2024

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16 pages, 824 KiB

Open AccessSystematic Review

The Elephant in the Room: A Systematic Review of the Application and Effects of Psychological Treatments for Pregnant Women with Dual Pathology (Mental Health and Substance-Related Disorders)

by Irene Caro-Cañizares, Nayara López Carpintero and Rodrigo Carmona-Camacho

Int. J. Environ. Res. Public Health 2024, 21(4), 392; https://doi.org/10.3390/ijerph21040392 - 23 Mar 2024

Viewed by 1091

Abstract

Purpose: Maternal mental health and substance use, referred to as dual pathology, represent significant concerns associated with adverse pregnancy and birth outcomes, a prevalence higher than commonly anticipated. Nonetheless, a notable dearth exists ofevidence-based treatment protocols tailored for pregnant women with dual pathology. [...] Read more.

Purpose: Maternal mental health and substance use, referred to as dual pathology, represent significant concerns associated with adverse pregnancy and birth outcomes, a prevalence higher than commonly anticipated. Nonetheless, a notable dearth exists ofevidence-based treatment protocols tailored for pregnant women with dual pathology. Methods: A systematic review, adhering to the PRISMA methodology, was conducted. Results: Out of the 57 identified papers deemed potentially relevant, only 2were ultimately included. Given the limited number of studies assessing the efficacy of psychological interventions utilizing randomized controlled trials (RCTs) for both mental health and substance misuse, and considering the diverse objectives and measures employed, definitive conclusions regarding the effectiveness of psychological interventions in this domain prove challenging. Conclusions: Maternal mental health appears to be the proverbial “elephant in the room”. The development of specialized and integrated interventions stands as an imperative to effectively address this pressing issue. As elucidated in the present review, these interventions ought to be grounded in empirical evidence. Furthermore, it is essential that such interventions undergo rigorous evaluation through RCTs to ascertain their efficacy levels. Ultimately, the provision of these interventions by psychology/psychiatric professionals, both within clinical practice and the RCTs themselves, is recommended to facilitate the generalizability of the results to specialized settings. Full article

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2022

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10 pages, 329 KiB

Open AccessArticle

Celebrities and Breast Cancer: A Multidimensional Quali-Quantitative Analysis of News Stories Shared on Social Media

by Priscila Biancovilli, Lilla Makszin, Faten Amer and Alexandra Csongor

Int. J. Environ. Res. Public Health 2022, 19(15), 9676; https://doi.org/10.3390/ijerph19159676 - 05 Aug 2022

Cited by 2 | Viewed by 2131

Abstract

In 2020, breast cancer was the most frequent type of cancer in 158 countries. To advise the population about risk factors and the importance of preventive measures, celebrities can be of great help, acting as spokespersons for reliable scientific information. The goal of [...] Read more.

In 2020, breast cancer was the most frequent type of cancer in 158 countries. To advise the population about risk factors and the importance of preventive measures, celebrities can be of great help, acting as spokespersons for reliable scientific information. The goal of this study is to analyse the content of news stories about breast cancer shared on different social media, examining how stories with celebrity presence are constructed. We performed a quali-quantitative multidimensional analysis of news stories in English that addressed breast cancer on the following social media platforms: Facebook, Pinterest, Twitter and Reddit. We compared news stories with and without the presence of celebrities. Our sample consists of 1594 news stories that had at least 1000 total shares across all analysed social media; 262 news stories mention a celebrity (16.44%), while 1332 stories do not (83.56%). Nevertheless, the ones that feature celebrities are, as a rule, more shared. The percentage of stories with celebrities addressing breast cancer prevention is quite low (1.9%). The same can be said for mentions of scientific papers/specialist quotes (3.4%). This research may help outline some possible paths that healthcare organizations and communication professionals can take to improve breast cancer content available online. Full article

2021

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11 pages, 668 KiB

Open AccessArticle

How Do Serum Zonulin Levels Change in Gestational Diabetes Mellitus, Pregnancy Cholestasis, and the Coexistence of Both Diseases?

by Huri Güvey, Samettin Çelik, Canan Soyer Çalışkan, Zehra Yılmaz, Merve Yılmaz, Özlem Erten and Andrea Tinelli

Int. J. Environ. Res. Public Health 2021, 18(23), 12555; https://doi.org/10.3390/ijerph182312555 - 29 Nov 2021

Cited by 5 | Viewed by 2285

Abstract

We investigated the question of how serum zonulin levels change in intrahepatic cholestasis of pregnancy (ICP) and gestational diabetes mellitus (GDM) and, in the case of the coexistence of ICP and GDM, evaluated the eventual increase in zonulin plasmatic levels. Participants were enrolled [...] Read more.

We investigated the question of how serum zonulin levels change in intrahepatic cholestasis of pregnancy (ICP) and gestational diabetes mellitus (GDM) and, in the case of the coexistence of ICP and GDM, evaluated the eventual increase in zonulin plasmatic levels. Participants were enrolled for the study between 25 February 2021 and 20 August 2021. The prospective case-control study included: group 1 of 95 pregnant women diagnosed with ICP; group 2 of 110 pregnant women diagnosed with GDM; group 3 of 16 women diagnosed with both GDM and ICP; group 4 of 136 healthy pregnant women as the control group. The groups were compared in terms of age, body mass index (BMI), gravidity, parity, gestational week of delivery, plasma zonulin levels, delivery type, birth weight, first- and fifth-minute APGAR scores, newborn intensive care unit (NICU) admission, and meconium staining of amniotic fluid parameters. The results suggested that the plasma zonulin levels of ICP (group 1), GDM (group 2), and GDM with ICP (group 3) patients were higher than those of the healthy pregnant women of group 4 (p < 0.001). Among the patient groups, the highest median plasma zonulin levels were found in group 3 (110.33 ng/mL). Zonulin levels were also associated with the severity of ICP and adverse pregnancy outcomes. High serum zonulin levels were related to GDM, ICP, and adverse perinatal outcomes. The coexistence of GDM and ICP led to higher serum zonulin concentrations. Full article

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11 pages, 913 KiB

Open AccessArticle

Gender and Observed Complexity in Palliative Home Care: A Prospective Multicentre Study Using the HexCom Model

by Xavier Busquet-Duran, Eduard Moreno-Gabriel, Eva Maria Jiménez-Zafra, Magda Tura-Poma, Olga Bosch-DelaRosa, Anna Moragas-Roca, Susana Martin-Moreno, Emilio Martínez-Losada, Silvia Crespo-Ramírez, Lola Lestón-Lado, Núria Salamero-Tura, Joana Llobera-Estrany, Ariadna Salvago-Leiracha, Ana Isabel López-García, Josep María Manresa-Domínguez, Teresa Morandi-Garde, Eda Sara Persentili-Viure and Pere Torán-Monserrat

Int. J. Environ. Res. Public Health 2021, 18(23), 12307; https://doi.org/10.3390/ijerph182312307 - 23 Nov 2021

Cited by 2 | Viewed by 2045

Abstract

This study analyses gender differences in the complexity observed in palliative home care through a multicentre longitudinal observational study of patients with advanced disease treated by palliative home care teams in Catalonia (Spain). We used the HexCom model, which includes six dimensions and [...] Read more.

This study analyses gender differences in the complexity observed in palliative home care through a multicentre longitudinal observational study of patients with advanced disease treated by palliative home care teams in Catalonia (Spain). We used the HexCom model, which includes six dimensions and measures three levels of complexity: high (non-modifiable situation), medium (difficult) and low. Results: N = 1677 people, 44% women. In contrast with men, in women, cancer was less prevalent (64.4% vs. 73.9%) (p < 0.001), cognitive impairment was more prevalent (34.1% vs. 26.6%; p = 0.001) and professional caregivers were much more common (40.3% vs. 24.3%; p < 0.001). Women over 80 showed less complexity in the following subareas: symptom management (41.7% vs. 51,1%; p = 0.011), emotional distress (24.5% vs. 32.8%; p = 0.015), spiritual distress (16.4% vs. 26.4%; p = 0.001), socio-familial distress (62.7% vs. 70.1%; p = 0.036) and location of death (36.0% vs. 49.6%; p < 0.000). Men were more complex in the subareas of “practice” OR = 1.544 (1.25–1.90 p = 0.000) and “transcendence” OR = 1.52 (1.16–1.98 p = 0.002). Observed complexity is related to male gender in people over 80 years of age. Women over the age of 80 are remarkably different from their male counterparts, showing less complexity regarding care for their physical, psycho-emotional, spiritual and socio-familial needs. Full article

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16 pages, 515 KiB

Open AccessArticle

Relationship between Physical Activity and Physical and Mental Health Status in Pregnant Women: A Prospective Cohort Study of the Japan Environment and Children’s Study

by Yasuyuki Yamada, Takeshi Ebara, Taro Matsuki, Hirohisa Kano, Hazuki Tamada, Sayaka Kato, Hirotaka Sato, Mayumi Sugiura-Ogasawara, Shinji Saitoh, Michihiro Kamijima and on behalf of the Japan Environment and Children’s Study (JECS) Group

Int. J. Environ. Res. Public Health 2021, 18(21), 11373; https://doi.org/10.3390/ijerph182111373 - 29 Oct 2021

Cited by 2 | Viewed by 2378

Abstract

To discuss appropriate physical activity (PA) levels during pregnancy, this prospective cohort study examined the relationships between PA levels before and during pregnancy and physical and mental health status. Fixed data for 104,102 pregnant women were used from the Japan Environment and Children’s [...] Read more.

To discuss appropriate physical activity (PA) levels during pregnancy, this prospective cohort study examined the relationships between PA levels before and during pregnancy and physical and mental health status. Fixed data for 104,102 pregnant women were used from the Japan Environment and Children’s Study, of which data for 82,919 women were analyzed after excluding women with multiple birth and pregnancy complications. PA levels were measured using the International Physical Activity Questionnaire-Short Form. The 8-Item Short Form Health Survey was used to measure outcomes. Logistic regression with multiple imputations showed that moderate PA for over 720 min/wk and vigorous PA before pregnancy were associated with poorer mental health in the first trimester (adjusted odds ratio (AOR): 1.087–1.376. Walking in the second and third trimesters was associated with better physical and mental health (AOR: 0.855–0.932). Moderate PA over 1080 min/wk and vigorous PA in the second and third trimesters were associated with poorer mental health (AOR: 1.223–1.873). Increases over 4135.4 MET–min/wk and decreases in PA levels were associated with poorer mental and physical health (AOR: 1.070–1.333). Namely, pregnant women receiving health benefits prefer continuous walking in addition to avoiding vigorous PA and excessive changes in PA levels during pregnancy. Full article

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17 pages, 1606 KiB

Open AccessReview

Health Impact and Risk Factors Affecting South and Southeast Asian Women Following Natural Disasters: A Systematic Review

by Syadani Riyad Fatema, Leah East, Md Shahidul Islam and Kim Usher

Int. J. Environ. Res. Public Health 2021, 18(21), 11068; https://doi.org/10.3390/ijerph182111068 - 21 Oct 2021

Cited by 11 | Viewed by 3689

Abstract

(1) Background: Following natural disasters, women have a higher prevalence of adverse physical and mental health outcomes. Given that the South and Southeast Asia regions are highly disaster prone, a review was undertaken to identify the potential health impact and key risk factors [...] Read more.

(1) Background: Following natural disasters, women have a higher prevalence of adverse physical and mental health outcomes. Given that the South and Southeast Asia regions are highly disaster prone, a review was undertaken to identify the potential health impact and key risk factors affecting women after disasters in the countries located in South and Southeast Asia regions. (2) Methods: A systematic literature search of four databases yielded 16 studies meeting the inclusion criteria. The review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidance, between July 2008 and March 2021. (3) Results: The majority of studies reported women’s negative/poor mental health, identifying a significant association of socio-demographics, during disaster exposure, post-disaster, and pre-existing risk factors. The six most-cited influences on women’s mental health found in the reviewed literature were being female, adult age group, having no formal education, poverty or low economic status, poor physical health/physical injuries, and death of family members. Women’s health during the post-disaster period was generally reported as poor among all the countries of the South and Southeast Asia regions. (4) Conclusions: Appropriate social support and the availability of free healthcare access for women are warranted in disaster-affected areas. This review offers a valuable contribution to the knowledge of women’s health complications/challenges and associated risk factors related to disasters, essential for the development of strategies to help reduce this burden in the future. Further research is required on natural disasters to identify ways to reduce women’s health impacts after natural disasters, especially in the context of low-income and lower-middle-income countries. Full article

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15 pages, 358 KiB

Open AccessArticle

Socio-Demographic and General Health Factors Associated with Quality of Life in Long-Term Breast Cancer Survivors from Southwestern Poland

by Małgorzata Socha and Krzysztof A. Sobiech

Int. J. Environ. Res. Public Health 2021, 18(17), 9321; https://doi.org/10.3390/ijerph18179321 - 03 Sep 2021

Cited by 6 | Viewed by 1943

Abstract

Background: Identification of factors associated with quality of life (QOL) in breast cancer survivors can contribute to better functioning in this group of patients. The study aimed to assess the association between QOL and anthropometric, sociodemographic, and medical characteristics in postmastectomy women [...] Read more.

Background: Identification of factors associated with quality of life (QOL) in breast cancer survivors can contribute to better functioning in this group of patients. The study aimed to assess the association between QOL and anthropometric, sociodemographic, and medical characteristics in postmastectomy women from southwestern Poland, 9.4 (±6.5) years after completed treatment. Materials and methods: QOL was estimated with the SF-36v2 questionnaire in 250 survivors aged 62.8 (±8.0) years with previously histologically confirmed invasive breast cancer. Results: Women in this study rated their overall QOL with an average of 60.7 (±17.9), Mental Component Summary of 62.8 (±19.8), and Physical Component Summary of 57.5 (±18.8) points. The use of multivariate regression analysis revealed that depression, chronic diseases, abdominal obesity, and pregnancy history have a statistically significant negative effect on the QOL of women after mastectomy, whereas participation in regular physical activity, living with a partner, the education level ≥ 12 years, and living in the city were associated with a higher QOL assessment. There were no significant relationships between QOL and the age, time since surgery, type of treatment, smoking, and occupational status of the patients. Conclusions: Health education, greater social support, specialist care in the treatment of comorbidities, and propagation of a physically active lifestyle can improve the physical and mental functioning of breast cancer survivors long after diagnosis and treatment. Full article

14 pages, 974 KiB

Open AccessReview

COVID-19′s Impact on American Women’s Food Insecurity Foreshadows Vulnerabilities to Climate Change

by Maryruth Belsey-Priebe, Deborah Lyons and Jonathan J. Buonocore

Int. J. Environ. Res. Public Health 2021, 18(13), 6867; https://doi.org/10.3390/ijerph18136867 - 26 Jun 2021

Cited by 9 | Viewed by 4171

Abstract

The COVID-19 pandemic is wreaking havoc on human lives and the global economy, laying bare existing inequities, and galvanizing large numbers to call for change. Women are feeling the effects of this crisis more than others. This paper explores the pre-COVID relationships and [...] Read more.

The COVID-19 pandemic is wreaking havoc on human lives and the global economy, laying bare existing inequities, and galvanizing large numbers to call for change. Women are feeling the effects of this crisis more than others. This paper explores the pre-COVID relationships and amplified negative feedback loops between American women’s economic insecurity, lack of safety, and food insecurity. We then examine how COVID-19 is interacting with these intersecting risks and demonstrate how climate change will likely similarly intensify these feedback loops. The COVID-19 pandemic may be revealing vulnerabilities that societies will face in the wake of an increasingly warming world. It is also an opportunity to build resilience, inclusiveness, and equity into our future, and can help inform how to include gender equity in both COVID-19 and climate recovery policies. Finally, we identify possible strategies to build resilience, specifically highlighting that gendered economic empowerment may create a buffer against environmental health hazards and discuss how these strategies could be integrated into a women-centered Green New Deal. Full article

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10 pages, 343 KiB

Open AccessArticle

Economic Crisis: A Factor for the Delayed Diagnosis of Breast Cancer

by Iasmina Petrovici, Mihaela Ionica and Octavian C. Neagoe

Int. J. Environ. Res. Public Health 2021, 18(8), 3998; https://doi.org/10.3390/ijerph18083998 - 10 Apr 2021

Cited by 8 | Viewed by 2383

Abstract

Considering the constant increase in breast cancer patients, identifying factors that influence the moment of diagnosis is essential for optimizing therapeutic management and associated cost. The purpose of the study is to evaluate the impact of the economic crisis on the moment of [...] Read more.

Considering the constant increase in breast cancer patients, identifying factors that influence the moment of diagnosis is essential for optimizing therapeutic management and associated cost. The purpose of the study is to evaluate the impact of the economic crisis on the moment of a breast cancer diagnosis. This retrospective observational study analyzed a cohort of 4929 patients diagnosed with breast cancer over the course of 19 years in the Western region of Romania. The time interval was divided based on the onset of the economic crisis into 3 periods: pre-crisis (2001–2006), crisis (2007–2012), and post-crisis (2013–2019). The disease stage at the moment of diagnosis was considered either early (stages 0, I, II) or advanced (stages III, IV). Although recording a similar mean number of patients diagnosed per year during the pre- and crisis periods, a significantly higher percentage of patients were diagnosed with late-stage breast cancer during the economic crisis period compared to the previous interval (46.9% vs. 56.3%, p < 0.01). This difference was further accentuated when accounting for environmental setting, with 65.2% of patients from a rural setting being diagnosed with advanced disease during the crisis interval. An overall improvement of 12% in early-stage breast cancer diagnosis was recorded in the post-crisis period (55.7%, p < 0.001). The findings of this study support periods of economic instability as potential factors for a delay in breast cancer diagnosis and highlight the need for the development of specific strategies aimed at reducing cancer healthcare and associated financial burden in times of economic crisis. Full article

13 pages, 6521 KiB

Open AccessArticle

A Decision Tree Model for Breast Reconstruction of Women with Breast Cancer: A Mixed Method Approach

by Eun Young Park, Myungsun Yi, Hye Sook Kim and Haejin Kim

Int. J. Environ. Res. Public Health 2021, 18(7), 3579; https://doi.org/10.3390/ijerph18073579 - 30 Mar 2021

Cited by 11 | Viewed by 3143

Abstract

The number of breast reconstructions following mastectomy has increased significantly during the last decades, but women are experiencing a number of conflicts with breast reconstruction decisions. The aim of this study was to develop a decision tree model of breast reconstruction and to [...] Read more.

The number of breast reconstructions following mastectomy has increased significantly during the last decades, but women are experiencing a number of conflicts with breast reconstruction decisions. The aim of this study was to develop a decision tree model of breast reconstruction and to examine its predictability. Mixed method design using ethnographic decision tree modeling was used. In the qualitative stage, data were collected using individual and focus group interviews and analyzed to construct a decision tree model. In the quantitative stage, the questionnaire was developed questions based on the criteria identified in the qualitative stage. A total of 61 women with breast cancer participated in 2017. Five major criteria: recovery of body image; impact on recurrence; recommendations from others; financial resources; and confirmation by physicians. The model also included nine predictive pathways. It turns out that the model predicted 90% of decisions concerning whether or not to have breast reconstruction. The findings indicate that the five criteria play a key role in decision-making about whether or not to have breast reconstruction. Thus, more comprehensive issues, including these five criteria, need to be integrated into an intervention for women with breast cancer to make their best decision on breast reconstruction. Full article

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2020

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7 pages, 260 KiB

Open AccessEditorial

Potential Risks and Factors of Women’s Health Promotion

by Claudio Costantino, Alessandra Casuccio and Vincenzo Restivo

Int. J. Environ. Res. Public Health 2020, 17(24), 9555; https://doi.org/10.3390/ijerph17249555 - 21 Dec 2020

Viewed by 1697

Abstract

In addition to diseases shared by both sexes, there are a number of illnesses and injuries that are primarily associated with women [...] Full article

11 pages, 312 KiB

Open AccessArticle

Human Papilloma Virus Infection and Vaccination: Pre-Post Intervention Analysis on Knowledge, Attitudes and Willingness to Vaccinate Among Preadolescents Attending Secondary Schools of Palermo, Sicily

by Claudio Costantino, Emanuele Amodio, Francesco Vitale, Cecilia Trucchi, Carmelo Massimo Maida, Stefania Enza Bono, Francesca Caracci, Claudia Emilia Sannasardo, Francesco Scarpitta, Carlotta Vella, Gianmarco Ventura, Giancarlo Icardi, Alessandra Casuccio and Vincenzo Restivo

Int. J. Environ. Res. Public Health 2020, 17(15), 5362; https://doi.org/10.3390/ijerph17155362 - 25 Jul 2020

Cited by 12 | Viewed by 2591

Abstract

In recent years, vaccination coverage rates against Human Papilloma Virus (HPV) in Europe have shown a decreasing trend and remain below the required standard. The present study aims to assess knowledge and attitudes regarding HPV infection and vaccination among a representative sample of [...] Read more.

In recent years, vaccination coverage rates against Human Papilloma Virus (HPV) in Europe have shown a decreasing trend and remain below the required standard. The present study aims to assess knowledge and attitudes regarding HPV infection and vaccination among a representative sample of preadolescents of Palermo, Italy. A survey was carried out throughout two questionnaires, before and after carrying out an educational intervention scheduled during school hours. A total of 1702 students attending first-grade secondary schools of the province of Palermo were enrolled (response rate 68.9%). Students attending third classes (adj OR = 1.18; CI 95% 1.03–1.36), being of higher socioeconomic status (adj OR = 1.35; CI 95% 1.05–1.73), who had previously received information about sexually transmitted diseases (STDs) at home (adj OR = 1.62; CI 95% 1.27–2.07) or at school (adj OR = 2.15; CI 95% 1.70–2.71) and who had ever heard in the past about HPV (adj OR = 1.80; CI 95% 1.42–2.29) showed a significantly higher baseline level of knowledge regarding HPV. Willingness to receive HPV vaccination, in a 10-point Likert scale, significantly increased between the pre- (8.51; SD ± 1.79) and post- (9.01 SD ± 1.52) intervention questionnaires (p < 0.001). A total of 188 out of 272 (69.1%) preadolescents attending five out eighteen schools involved in the project, who had not previously received the HPV vaccine, were vaccinated. During past years, education campaigns on HPV were mainly dedicated to adult women, excluding teenagers and omitting young males. It should therefore be of primary importance that school-based education and vaccination programmes be standardized. Full article

16 pages, 343 KiB

Open AccessArticle

Influence of Environmental Tobacco Smoke and Air Pollution on Fetal Growth: A Prospective Study

by Meiman Maggie Chen, Chun-Hui Chiu, Chi-Pin Yuan, Yen-Chi Liao and Su-Er Guo

Int. J. Environ. Res. Public Health 2020, 17(15), 5319; https://doi.org/10.3390/ijerph17155319 - 23 Jul 2020

Cited by 9 | Viewed by 2682

Abstract

Exposure to air pollution during pregnancy leads to adverse pregnancy outcomes. Few studies have evaluated the influences of air quality, including environmental tobacco smoke (ETS) and particulate matter (PM), on fetal development, which this study examined. This longitudinal correlation study used multiple linear [...] Read more.

Exposure to air pollution during pregnancy leads to adverse pregnancy outcomes. Few studies have evaluated the influences of air quality, including environmental tobacco smoke (ETS) and particulate matter (PM), on fetal development, which this study examined. This longitudinal correlation study used multiple linear regression data analysis of PM_2.5/PM₁₀, self-reported ETS exposure, urinary cotinine level, maternal characteristics, and birth parameters (gestational week, body weight, body length, head, and chest circumferences) with the effect of air quality on fetal growth. The study included 74 pregnant women (mean age 31.9 ± 4.2 years, body mass index 23.6 ± 3.8 kg/m², average gestational duration 38.5 ± 0.8 weeks). ETS exposure decreased birth length by ≥1 cm, and potentially is an independent risk factor for fetal growth restriction, and pregnant women should avoid indoor and outdoor ETS. However, neither PM_2.5/PM₁₀ nor ETS was associated with low birth weight or small for gestational age. This study adds to the evidence base that ETS exposure of nonsmoking pregnant women affects the fetal birth length. Family members should refrain from smoking near expectant mothers, although smoking in the vicinity of their residential surroundings potentially exposes mothers and their fetuses to ETS. Public pollution and childbirth education classes should include details of indoor ETS. Full article

12 pages, 324 KiB

Open AccessArticle

Italian Health Care Workers’ Knowledge, Attitudes, and Practices Regarding Human Papillomavirus Infection and Prevention

by Cecilia Trucchi, Vincenzo Restivo, Daniela Amicizia, Francesca Fortunato, Alessia Manca, Domenico Martinelli, Alfredo Montecucco, Maria Francesca Piazza, Rosa Prato, Valentino Tisa, Filippo Ansaldi and Giancarlo Icardi

Int. J. Environ. Res. Public Health 2020, 17(15), 5278; https://doi.org/10.3390/ijerph17155278 - 22 Jul 2020

Cited by 20 | Viewed by 2594

Abstract

Objective: To assess healthcare workers’ knowledge and attitudes about human papillomavirus (HPV) infection, related diseases, and prevention. Methods: A cross-sectional multicenter survey about HPV and its prevention, targeted to healthcare workers involved in HPV vaccine counseling, was performed from May 2017 to December [...] Read more.

Objective: To assess healthcare workers’ knowledge and attitudes about human papillomavirus (HPV) infection, related diseases, and prevention. Methods: A cross-sectional multicenter survey about HPV and its prevention, targeted to healthcare workers involved in HPV vaccine counseling, was performed from May 2017 to December 2018. Results: The overall median knowledge and attitude scores were 69.2% (25–75, p = 61.5–84.6) and 5 (25–75, p = 4–5), respectively. Both knowledge and attitudes statistically significantly differ between physicians and healthcare professions. The median propensity score before and after the educational intervention was stable and high, at 10 (25–75, p = 9–10). The predictors of statistically significantly high knowledge scores are to be a physician, general practitioner, or pediatrician, attending courses/congresses, and consulting technical product characteristics and scientific literature to obtain information about the HPV vaccine. Being a physician and consulting scientific literature to obtain information about the HPV vaccine were found also as predictors of statistically significantly different attitude scores among study participants. Conclusions: Although healthcare workers showed overall positive attitudes towards the relevance of HPV burden and prevention tools, demonstrated knowledge was largely suboptimal, particularly that shown by healthcare professions. Obtained results allow highlighting knowledge gaps, and thus improving counselling to HPV vaccine targets. Full article

19 pages, 1713 KiB

Open AccessArticle

Psychological Climacteric Symptoms and Attitudes toward Menopause among Emirati Women

by Amira Mohammed Ali, Afaf Hassan Ahmed and Linda Smail

Int. J. Environ. Res. Public Health 2020, 17(14), 5028; https://doi.org/10.3390/ijerph17145028 - 13 Jul 2020

Cited by 54 | Viewed by 9803

Abstract

Menopause is an inevitable developmental event that women encounter at an age of 42–54 years. The drop of estrogen levels that accompanies cessation of menstruation is associated with multiple vasomotor, physical, neuropsychological, and sexual symptoms, which may hamper quality of life. This study [...] Read more.

Menopause is an inevitable developmental event that women encounter at an age of 42–54 years. The drop of estrogen levels that accompanies cessation of menstruation is associated with multiple vasomotor, physical, neuropsychological, and sexual symptoms, which may hamper quality of life. This study aimed to examine the severity of psychological symptoms and their correlates among peri- and postmenopausal Emirati women (N = 60, mean age = 54.88 ± 6 years). Participants were interviewed using the Menopause-Specific Quality of Life (MENQOL) and attitudes toward menopause scale (ATMS). In four path analysis models, vasomotor symptoms, weight gain, and fatigue had significant direct effects on symptoms of anxiety, depression (only weight gain and fatigue), and psychological distress. Fatigue significantly mediated the effects of vasomotor symptoms and weight gain on symptoms of anxiety, depression (only vasomotor symptoms), psychological distress, and memory problems. These models explained 47.6%, 44.5%, 56.6%, and 29.1% of the variances in anxiety, depression, psychological distress, and memory problems, respectively. Participants with more severe menopausal symptoms expressed more negative attitudes toward menopause though regression analysis revealed that only vasomotor symptoms could significantly contribute to ATMS scores. In conclusion, psychological distress is widespread among menopausal women, and it is associated with vasomotor symptoms, fatigue, and change of body composition (obesity). Psychological symptoms, along with vasomotor symptoms, express a key link to negative attitudes toward menopause. Therefore, interventional strategies that target psychological distress may promote coping with midlife transition and improve mental health among menopausal women. Full article

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12 pages, 565 KiB

Open AccessArticle

Intention to Pay for HPV Vaccination among Women of Childbearing Age in Vietnam

by Xuan Thi Thanh Le, Phuong Thi Ngoc Nguyen, Toan Thi Thanh Do, Thang Huu Nguyen, Huong Thi Le, Cuong Tat Nguyen, Giang Hai Ha, Chi Linh Hoang, Bach Xuan Tran, Carl A. Latkin, Roger C.M. Ho and Cyrus S.H. Ho

Int. J. Environ. Res. Public Health 2020, 17(9), 3144; https://doi.org/10.3390/ijerph17093144 - 30 Apr 2020

Cited by 9 | Viewed by 3688

Abstract

The intention to pay for human papillomavirus (HPV) vaccination among women of childbearing age in Vietnam, where cervical cancer remains a significant public health concern, has been mostly lacking. To examine this issue, we conducted a cross-sectional study of 807 pregnant women in [...] Read more.

The intention to pay for human papillomavirus (HPV) vaccination among women of childbearing age in Vietnam, where cervical cancer remains a significant public health concern, has been mostly lacking. To examine this issue, we conducted a cross-sectional study of 807 pregnant women in an urban and a rural district (Dong Da and Ba Vi) of Hanoi, Vietnam. The vast percentage of our respondents expressed a firm intention to vaccinate, especially women in rural areas (over 90.0%). However, on being informed of the current price of the HPV vaccine, their intention to vaccinate dropped to about one-fifth of overall respondents, i.e., only 4.4% of women in rural areas. It was also observed that the initial intention to get the HPV vaccination among women in the rural district was about ten times higher than that of women living in the metropolitan district. Those participants who had greater knowledge of cervical cancer and HPV vaccinations also had a significantly higher intention to vaccinate. Our findings underscore the need to develop a well-designed vaccination program in Vietnam and other countries in a similar situation to increase the adoption of HPV vaccination. Full article

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16 pages, 649 KiB

Open AccessArticle

Socioeconomic Status and Physical Activity among Mothers of Young Children in an Asian City: The Mediating Role of Household Activities and Domestic Help

by Alison Carver, Muhammad Akram, Anthony Barnett, Robin Mellecker and Ester Cerin

Int. J. Environ. Res. Public Health 2020, 17(7), 2498; https://doi.org/10.3390/ijerph17072498 - 06 Apr 2020

Cited by 7 | Viewed by 3043

Abstract

Mothers of preschoolers (3 to 5 years old) risk being physically inactive. This study aimed to examine associations between socioeconomic status (education, employment, income) and moderate to vigorous physical activity (MVPA) among mothers of preschoolers in Hong Kong. Family functioning (e.g., having a [...] Read more.

Mothers of preschoolers (3 to 5 years old) risk being physically inactive. This study aimed to examine associations between socioeconomic status (education, employment, income) and moderate to vigorous physical activity (MVPA) among mothers of preschoolers in Hong Kong. Family functioning (e.g., having a domestic helper, division of household chores and child-related activities) was explored as a potential mediator of associations between socioeconomic indicators and the mother’s self-reported MVPA. Using zero-inflated negative binomial modelling confounder-adjusted associations between socioeconomic indicators and MVPA (total effects) were estimated. Mediation analyses (joint-significance test) were also performed. Using generalized linear mixed models, intermediate pathways were identified. No significant total effects of any socioeconomic indicator on the mother’s MVPA were found. However, mediation analyses identified a complex network of inconsistent mediators partly explaining their associations via eight pathways. Also, whilst non-residents/extended family playing with the child(ren) was not associated with any socioeconomic indicator, this was negatively associated with the mother’s MVPA. A further pathway was mediated by the mother playing with her child(ren). Extended family playing with the child(ren) was inversely associated with the mother doing so. Associations between socioeconomic indicators and MVPA among preschoolers’ mothers are complex and inconsistent, requiring further investigation in diverse contexts. Encouraging active play with their preschoolers may increase mothers’ physical activity levels. Full article

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17 pages, 1106 KiB

Open AccessArticle

How to Educate Pregnant Women about Endocrine Disruptors?

by Steeve Rouillon, Houria El Ouazzani, Jean-Benoit Hardouin, Line Enjalbert, Sylvie Rabouan, Virginie Migeot and Marion Albouy-Llaty

Int. J. Environ. Res. Public Health 2020, 17(6), 2156; https://doi.org/10.3390/ijerph17062156 - 24 Mar 2020

Cited by 11 | Viewed by 3516

Abstract

Background: Despite mediatization, only half of pregnant women are informed about endocrine disruptors (EDs). We wished to inquire about appropriate environmental health education procedures during pregnancy: Who, when, and how? Methods: The question stems from a comprehensive population health intervention research project. It [...] Read more.

Background: Despite mediatization, only half of pregnant women are informed about endocrine disruptors (EDs). We wished to inquire about appropriate environmental health education procedures during pregnancy: Who, when, and how? Methods: The question stems from a comprehensive population health intervention research project. It includes qualitative studies aimed at constructing an educational program in environmental health and an accompanying assessment tool. The validation of a customized questionnaire (PREVED^© for Pregnancy Prevention Endocrine Disruptors) about the knowledge, attitudes, and practices (KAP) of pregnant women regarding exposure to EDs was carried out in a quantitative study. Results: Health education by a prenatal professional with communication skills should take place as early as possible, during the preconception period or early pregnancy, as part of individual consultation or group workshops. In order to customize the discourse and to develop women’s empowerment, concomitant presentation of the risks by the products used in each room and of previous solutions is recommended. Conclusion: Appropriate health education procedures on EDs should be done at every contact but taking the KAP of pregnant women into account first. We propose all educational actions should be accompanied by questioning of the KAP of pregnant women; for example, with questions from the PREVED^© questionnaire. Full article

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14 pages, 978 KiB

Open AccessArticle

Women’s Well-Being and Rural Development in Depopulated Spain

by Veronica Cobano-Delgado and Vicente Llorent-Bedmar

Int. J. Environ. Res. Public Health 2020, 17(6), 1966; https://doi.org/10.3390/ijerph17061966 - 17 Mar 2020

Cited by 12 | Viewed by 2818

Abstract

The threat of depopulation in the rural areas making up what has become to be known as “empty Spain” is currently an extremely urgent national issue. Women are a fundamental pillar of rural sustainability, but the lack of decent living conditions has led [...] Read more.

The threat of depopulation in the rural areas making up what has become to be known as “empty Spain” is currently an extremely urgent national issue. Women are a fundamental pillar of rural sustainability, but the lack of decent living conditions has led to their mass exodus to the country’s cities. We analysed the factors undermining their health and well-being, thus leading to their dissatisfaction and their subsequent desire to abandon the countryside for a better life. A mixed methodology was employed, combining qualitative and quantitative data collection techniques. For data collection, an ad hoc questionnaire was developed before being administered to members of the Rural Development Groups of the Celtiberian Highlands, while some of their number were also interviewed. Rural women experience personal dilemmas that prompt them to migrate. These include choosing between living in the place where they were born, close to their families and neighbours, and a decent productive job, the availability of basic services and a broader range of leisure opportunities, among other aspects. It is essential to acknowledge the socio-economic importance of women’s work, to identify invisible burdens and their risks and to adopt measures that facilitate the reconciliation of work and family life. Full article

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14 pages, 740 KiB

Open AccessReview

Inflammatory Markers in Dysmenorrhea and Therapeutic Options

by Zofia Barcikowska, Elżbieta Rajkowska-Labon, Magdalena Emilia Grzybowska, Rita Hansdorfer-Korzon and Katarzyna Zorena

Int. J. Environ. Res. Public Health 2020, 17(4), 1191; https://doi.org/10.3390/ijerph17041191 - 13 Feb 2020

Cited by 100 | Viewed by 19402

Abstract

Dysmenorrhea often significantly reduces the quality of women’s life and is still an important public health problem. Despite numerous studies, the pathomechanism of dysmenorrhea is not fully understood. Previous research indicates the complexity of biochemical reactions between the endocrine, vascular, and immune systems. [...] Read more.

Dysmenorrhea often significantly reduces the quality of women’s life and is still an important public health problem. Despite numerous studies, the pathomechanism of dysmenorrhea is not fully understood. Previous research indicates the complexity of biochemical reactions between the endocrine, vascular, and immune systems. Prostaglandins play a major role in the pathomechanism of dysmenorrhea. In contrast, cytokines and other proinflammatory factors in primary dysmenorrhea are less studied. In addition to the applied pharmacotherapy, more and more studies proving the effectiveness of non-pharmacological methods appear. Therefore, the present work contains a review of the latest research concerning factors involved in dysmenorrhea, as well as therapeutic options. In the literature search, authors used online databases, PubMed, and clinitrials.gov and browsed through individual gynecology, physiotherapy journals and books. Full article

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11 pages, 493 KiB

Open AccessArticle

Postpartum Physical Activity and Weight Retention within One Year: A Prospective Cohort Study in Vietnam

by Anh Vo Van Ha, Yun Zhao, Colin W. Binns, Ngoc Minh Pham, Phung Thi Hoang Nguyen, Cong Luat Nguyen, Tan Khac Chu and Andy H. Lee

Int. J. Environ. Res. Public Health 2020, 17(3), 1105; https://doi.org/10.3390/ijerph17031105 - 10 Feb 2020

Cited by 15 | Viewed by 3767

Abstract

After delivery, mothers are encouraged to increase physical activity (PA) gradually to regulate body weight; however, data on PA in relation to postpartum weight retention remains scarce, particularly among Asian women. In a cohort of 1617 Vietnamese mothers, we investigated the prospective association [...] Read more.

After delivery, mothers are encouraged to increase physical activity (PA) gradually to regulate body weight; however, data on PA in relation to postpartum weight retention remains scarce, particularly among Asian women. In a cohort of 1617 Vietnamese mothers, we investigated the prospective association between habitual PA exposures at 3-month postpartum and weight retention at 6-month and 12-month postpartum. Detailed information on PA intensity and domains was collected from participants using a validated instrument specifically for Vietnamese women. Linear regression analyses and a general linear model for the repeated weight retention measures were used to ascertain the apparent relationships. On average, the participants reported 3.6 (SD 3.9) and 2.6 (SD 3.8) kg weight loss at 6- and 12-month postpartum, respectively. Total and light-intensity PA were inversely associated with the postpartum weight retention (p for trend <0.05). Our findings highlight the importance of resuming PA in the early postpartum period as an appropriate weight management strategy. Full article

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9 pages, 339 KiB

Open AccessArticle

Work Hours and Difficulty in Leaving Work on Time in Relation to Work-to-Family Conflict and Burnout Among Female Workers in Taiwan

by Shu-Ling Huang, Ren-Hau Li, Shu-Yi Fang and Feng-Cheng Tang

Int. J. Environ. Res. Public Health 2020, 17(2), 605; https://doi.org/10.3390/ijerph17020605 - 17 Jan 2020

Cited by 18 | Viewed by 3271

Abstract

The present study explores the relations between work hours and the difficulty in leaving work on time to both work-to-family conflict (WFC) and burnout among female workers in Taiwan. A cross-sectional research design and questionnaire were employed to obtain the research data. In [...] Read more.

The present study explores the relations between work hours and the difficulty in leaving work on time to both work-to-family conflict (WFC) and burnout among female workers in Taiwan. A cross-sectional research design and questionnaire were employed to obtain the research data. In total, 738 full-time female workers took part in the study. The results of regression analyses showed that when age, marital status, economic status, occupation, parental status, and housework responsibilities were controlled, more work hours were positively associated with WFC and burnout. When the difficulty in leaving work on time was also considered in the analysis, long working hours were still significantly associated with burnout; however, the significant relation with WFC disappeared. It is surmised that if female employees work overtime voluntarily, the perception of WFC diminishes; nevertheless, the adverse effect of long working hours on health remains unabated. This study concludes that female employees who work overtime on a voluntary basis are at risk of health problems, which should be a focus of concern. Full article

18 pages, 713 KiB

Open AccessArticle

Study on the Utilization of Inpatient Services for Middle-Aged and Elderly Rural Females in Less Developed Regions of China

by Xiaotong Wen, Lanyue Cui, Fang Yuan, Xiaojun Liu, Mufeng Ouyang, Yuxiao Sun, Yuchen Liu, Yong Liu, Huiqiang Yu, Huilie Zheng, Yuanan Lu and Zhaokang Yuan

Int. J. Environ. Res. Public Health 2020, 17(2), 514; https://doi.org/10.3390/ijerph17020514 - 14 Jan 2020

Cited by 8 | Viewed by 2652

Abstract

The aim of this study is to understand the utilization of inpatient services and its contributing factors among middle-aged and elderly females (MAEF) in less developed rural regions. Five surveys were conducted between 2006 and 2014 with rural residents of Jiangxi by stratified [...] Read more.

The aim of this study is to understand the utilization of inpatient services and its contributing factors among middle-aged and elderly females (MAEF) in less developed rural regions. Five surveys were conducted between 2006 and 2014 with rural residents of Jiangxi by stratified cluster random sampling. Participant females included only those who were aged 45 and above. Complex sampling logistics analysis was performed to analyze the effect of three factors on inpatient service. Complex sampling logistics regression analysis revealed that the probability of hospitalization for the divorced or widowed females was significantly lower than that of married ones (aOR = 0.177, p < 0.05). However, the probability of early discharge was significantly higher among divorced or widowed females than married ones (aOR = 3.237, p < 0.05). In addition, females with chronic diseases were more likely to be hospitalized (aOR = 3.682, p < 0.05). Also, early discharge (aOR = 7.689, p < 0.05) occurred among the participants who should be hospitalized but were not hospitalized occurred (aOR = 3.258, p < 0.05). The continuous improvement of the new rural cooperative medical policy has promoted the utilization of inpatient services for the MAEF. Findings from this study emphasize the need to strengthen the prevention and treatment of chronic diseases among middle-aged and elderly women. Full article

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2019

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11 pages, 297 KiB

Open AccessArticle

Association of Night Eating with Depression and Depressive Symptoms in Korean Women

by Kyung Won Lee and Dayeon Shin

Int. J. Environ. Res. Public Health 2019, 16(23), 4831; https://doi.org/10.3390/ijerph16234831 - 01 Dec 2019

Cited by 12 | Viewed by 2863

Abstract

This study examined the associations of night eating with depression and depressive symptoms in Korean adults. The study used a nationally representative sample of 31,690 Korean adults (≥19 years old) from the Korea National Health and Nutrition Examination Survey from 2008 to 2013. [...] Read more.

This study examined the associations of night eating with depression and depressive symptoms in Korean adults. The study used a nationally representative sample of 31,690 Korean adults (≥19 years old) from the Korea National Health and Nutrition Examination Survey from 2008 to 2013. The participants were divided into two groups based on status of night eating: night eaters (consuming ≥25% of total daily energy intake between 21:00 and 06:00) and non-night eaters. Depression was defined based on diagnosis by a doctor, whereas depressive symptoms were defined as feelings of sadness or desperation for more than two weeks in the last one year. Multivariable logistic regression analyses were performed to examine the relationship between night eating and odds of depression and depressive symptoms after controlling for age, education, income, marital status, drinking, smoking, day of recalled intake, physical activity, body mass index, menopausal status (women only), total energy intake, and sleep duration. A total of 14.3% of Korean adults were night eaters. Night eaters were more likely to be men, young, less educated, single, drinkers, current smokers, and not employed (all ps < 0.05). In women, night eaters had higher odds of depression (adjusted odds ratio [AOR], 1.33; 95% confidence interval [CI], 1.02–1.75; p for trend = 0.0389) and depressive symptoms (AOR, 1.20; 95% CI, 1.01–1.41; p for trend = 0.0382) compared with non-night eaters. However, no associations of night eating with depression and depressive symptoms were found in men. Night eaters had higher odds of depression and depressive symptoms only in Korean women. Future studies are warranted to elucidate the underlying psychological and behavioral mechanisms that in turn may shed light on the factors influencing both night eating and odds of depression and depressive symptoms. Full article

11 pages, 302 KiB

Open AccessArticle

Domestic Violence During Pregnancy in Greece

by Evangelia Antoniou and Georgios Iatrakis

Int. J. Environ. Res. Public Health 2019, 16(21), 4222; https://doi.org/10.3390/ijerph16214222 - 31 Oct 2019

Cited by 12 | Viewed by 4948

Abstract

There are no data about the prevalence of domestic violence during pregnancy in Greece. The purpose of this study is to determine the prevalence and the associated factors of domestic violence in a representative population of pregnant women in Greece. Five hundred and [...] Read more.

There are no data about the prevalence of domestic violence during pregnancy in Greece. The purpose of this study is to determine the prevalence and the associated factors of domestic violence in a representative population of pregnant women in Greece. Five hundred and forty-six consecutive women, in outpatient clinics of two Public General Regional Hospitals in Athens, agreed to answer anonymously the Abuse Assessment Screen (AAS) questionnaire, translated into the Greek language. Five hundred and forty-six questionnaires were returned (100% response rate), revealing that the prevalence of domestic violence in pregnancy is 6%, with 3.4% of the sample having being abused since the beginning of pregnancy, mainly by their husband/partner. The factors associated with higher risk of abuse during pregnancy were nationality, socio-economic background, and educational level. Foreign women or women with a foreign partner, unemployed individuals, housewives, and university students faced a higher risk of being abused. A substantial age difference (≥10 years) in the couple, a history of abortions, and an undesired pregnancy also increased the risk of violence in pregnancy. These findings suggest that prenatal care is an important period for discussing abuse and, in the end, encouraging women to seek help. Full article

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17 pages, 3210 KiB

Open AccessArticle

A Bespoke Social Network for Deaf Women in Ecuador to Access Information on Sexual and Reproductive Health

by Yaroslava Robles-Bykbaev, Christian Oyola-Flores, Vladimir Espartaco Robles-Bykbaev, Martín López-Nores, Paola Ingavélez-Guerra, José Juan Pazos-Arias, Fernando Pesántez-Avilés and Manuel Ramos-Cabrer

Int. J. Environ. Res. Public Health 2019, 16(20), 3962; https://doi.org/10.3390/ijerph16203962 - 17 Oct 2019

Cited by 8 | Viewed by 3772

Abstract

Many deaf women face the lack of numerous resources related to their personal development. The unavailability of proper information on Sexual and Reproductive Health (SRH), in particular, causes problems of sexually transmitted infections, unwanted pregnancy in adolescence, sexual violence, complications during pregnancy, etc. [...] Read more.

Many deaf women face the lack of numerous resources related to their personal development. The unavailability of proper information on Sexual and Reproductive Health (SRH), in particular, causes problems of sexually transmitted infections, unwanted pregnancy in adolescence, sexual violence, complications during pregnancy, etc. In response to this, we have created a social network that delivers SRH content (verified and validated by experts) to women with different degrees of hearing loss. The site features a recommender system that selects the most relevant pieces of content to deliver to each woman, driven by her individual preferences, needs and levels of knowledge on the different subjects. We report experiments conducted in Cuenca, Ecuador, between 2017 and 2018 with 98 volunteers from low- and middle-income settings, aiming to evaluate the quality and appeal of the contents, the coherence of the methodology followed to create them, and the effectiveness of the content recommendations. The positive results encourage the frequent creation of new content and the refinement of the recommendation logic as the cohort of users expands over time. Full article

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15 pages, 398 KiB

Open AccessArticle

Living with Urinary Incontinence: Potential Risks of Women’s Health? A Qualitative Study on the Perspectives of Female Patients Seeking Care for the First Time in a Specialized Center

by María Zahara Pintos-Díaz, Cristina Alonso-Blanco, Paula Parás-Bravo, César Fernández-de-las-Peñas, María Paz-Zulueta, Víctor Fradejas-Sastre and Domingo Palacios-Ceña

Int. J. Environ. Res. Public Health 2019, 16(19), 3781; https://doi.org/10.3390/ijerph16193781 - 08 Oct 2019

Cited by 29 | Viewed by 5946

Abstract

Background: Urinary incontinence (UI) represents a complex problem which commonly affects women and influences their physical, mental, and social wellbeing. The objective of this study was to explore the experiences of a group of women with urinary incontinence. Methods: A qualitative exploratory study. [...] Read more.

Background: Urinary incontinence (UI) represents a complex problem which commonly affects women and influences their physical, mental, and social wellbeing. The objective of this study was to explore the experiences of a group of women with urinary incontinence. Methods: A qualitative exploratory study. Purposeful sampling was used. Recruited patients were females aged >18 years old with positive symptoms, signs of urinary incontinence, and attending a specialized urinary incontinence center for the first time. We collected data using interviews and participants’ personal letters. A thematic analysis was performed. Results: 18 women participated with a mean age of 47.32 years. Four themes emerged: (a) Experiencing uncontrolled urinary leakage, (b) Information based on beliefs and myths regarding UI, (c) Adapting to change and developing strategies, (d) The role of education. Women’s experiences were accompanied by feelings of stress and shame. A lack of information regarding UI was found, together with numerous misconceptions. Urinary incontinence triggers many changes in women. Some women may develop feelings of rejection towards their own body. Family involvement during these times is essential for education and promoting healthy sexual practices. Conclusions: This study highlights the importance of developing educational programs that focus on women’s information and education regarding triggering factors and coping strategies. Full article

11 pages, 349 KiB

Open AccessArticle

Association of the Individual and Context Inequalities on the Breastfeeding: A Study from the Sicily Region

by Achille Cernigliaro, Sara Palmeri, Alessandra Casuccio, Salvatore Scondotto, Vincenzo Restivo and In Primis Working Group

Int. J. Environ. Res. Public Health 2019, 16(19), 3514; https://doi.org/10.3390/ijerph16193514 - 20 Sep 2019

Cited by 14 | Viewed by 2360

Abstract

Despite the advantages of breastfeeding being widely recognized, the economic level can have an influence on breastfeeding rates, with rich women breastfeeding longer than poor in high-income countries. In Italy, socio-economic differences affect breastfeeding start and continuation among most deprived people, such as [...] Read more.

Despite the advantages of breastfeeding being widely recognized, the economic level can have an influence on breastfeeding rates, with rich women breastfeeding longer than poor in high-income countries. In Italy, socio-economic differences affect breastfeeding start and continuation among most deprived people, such as in Southern Italy. The objective of the study was to evaluate the prevalence of the initiation and continuation of exclusive breastfeeding and its association with the levels of socio-economic deprivation in Sicily. A prospective cohort study with a two-phase survey in three breastfeeding detection times was conducted. Overall, 1,055 mothers were recruited with a mean age of 31 years. Breastfeeding decreased from 86% during hospitalization to 69% at the first month and 42% at the sixth month, yet at the same time, exclusive breastfeeding increased from 34% to 38% during hospitalization to the first month and went down to 20.2% at the sixth month. The adjusted multivariate analysis showed no association with individual inequalities. On the other hand, the context inequalities had a significant association with the risk of not following exclusive breastfeeding in the deprived class (odds ratio (OR): 2.08, confidence interval (CI) 95% 1.01–4.27) and in the very deprived class (OR: 1.83, CI 95% 1.00–3.38) at the six-month survey. These results indicate that the context inequalities begin to emerge from the return home of the mother and the child. Full article

16 pages, 323 KiB

Open AccessArticle

Hospitalization Services Utilization Between Permanent and Migrant Females in Underdeveloped Rural Regions and Contributing Factors—A Five-Time Data Collection and Analysis

by Xiaotong Wen, Huilie Zheng, Zhenyi Feng, Winter Tucker, Yuanan Lu and Zhaokang Yuan

Int. J. Environ. Res. Public Health 2019, 16(18), 3419; https://doi.org/10.3390/ijerph16183419 - 14 Sep 2019

Cited by 4 | Viewed by 1994

Abstract

The proportion of migrating females has increased, and more often, old females are left in rural regions. Resources are needed to provide suitable hospitalization service to females in underdeveloped rural regions. Using multi-stage hierarchical cluster random sampling method, nine towns from three counties [...] Read more.

The proportion of migrating females has increased, and more often, old females are left in rural regions. Resources are needed to provide suitable hospitalization service to females in underdeveloped rural regions. Using multi-stage hierarchical cluster random sampling method, nine towns from three counties were enrolled in five-time points between 2006 and 2014 in this study. The research subjects of this study were females age 15 and up. Data regarding the utilization of inpatient services were collected and analyzed. Complex sampling logistic regression was conducted to analyze influencing factors. This study reveals that for both permanent females and migrant females, the older their age, the higher their hospitalization rate. The utilization of hospitalization service for permanent females was associated with the occurrence of chronic diseases (adjusted Odds Ratio (aOR) = 5.402). In addition, permanent females suffering from chronic diseases were more likely to avoid hospitalization despite their doctor’s advice (aOR = 34.657) or leave the hospital early against medical advice (AMA) (aOR = 10.009). Interventions to combat chronic diseases and adjust compensation schemes for permanent females need to be provided. Full article

12 pages, 471 KiB

Open AccessFeature PaperArticle

Determinants of Maternal Health-Related Quality of Life after Childbirth: The Generation R Study

by Guannan Bai, Ida J Korfage, Eva Mautner and Hein Raat

Int. J. Environ. Res. Public Health 2019, 16(18), 3231; https://doi.org/10.3390/ijerph16183231 - 04 Sep 2019

Cited by 14 | Viewed by 3493

Abstract

Having good health-related quality of life (HRQoL) is essential, particularly for women after childbirth. However, little is known about its determinants. We aimed to identify the determinants of HRQoL after childbirth in a large community sample in the Netherlands. We have included 4312 [...] Read more.

Having good health-related quality of life (HRQoL) is essential, particularly for women after childbirth. However, little is known about its determinants. We aimed to identify the determinants of HRQoL after childbirth in a large community sample in the Netherlands. We have included 4312 women in the present study. HRQOL was assessed by a 12-Item Short Form Survey (SF-12) at around two months after childbirth; Physical and Mental Component Summary scores were calculated. Information on 27 potential determinants of HRQoL was collected through questionnaires and medical records. Multivariate linear regression models were applied to assess significant determinants of physical and mental HRQoL. Our study showed that older maternal age, shorter time since childbirth, elective/emergency cesarean delivery, loss of energy, maternal psychopathology, and the hospital admission of the infant were significantly associated with worse physical HRQoL (p < 0.05); older maternal age, non-western background, low household income, loss of energy, and maternal psychopathology were significantly associated with worse mental HRQoL (p < 0.05). We identified multiple determinants of suboptimal physical and mental HRQoL after childbirth. In particular, maternal psychopathology after childbirth was profoundly associated with mental HRQoL. These women may need support. We therefore call for awareness among health care professionals. Full article

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12 pages, 323 KiB

Open AccessArticle

Body Changes and Decreased Sexual Drive after Dialysis: A Qualitative Study on the Experiences of Women at an Ambulatory Dialysis Unit in Spain

by Miriam Álvarez-Villarreal, Juan Francisco Velarde-García, Lourdes Chocarro-Gonzalez, Jorge Pérez-Corrales, Javier Gueita-Rodriguez and Domingo Palacios-Ceña

Int. J. Environ. Res. Public Health 2019, 16(17), 3086; https://doi.org/10.3390/ijerph16173086 - 25 Aug 2019

Cited by 14 | Viewed by 3844

Abstract

Chronic kidney disease (CKD) has considerable effects on the quality of life of patients, impairing everyday activities and leading to lifestyle changes, as well as affecting body image and intimate relationships. Our aim was to describe the experience of female patients with CKD [...] Read more.

Chronic kidney disease (CKD) has considerable effects on the quality of life of patients, impairing everyday activities and leading to lifestyle changes, as well as affecting body image and intimate relationships. Our aim was to describe the experience of female patients with CKD at an ambulatory dialysis unit regarding body changes and sexuality. A qualitative phenomenological study exploring how 18 female patients, treated at the dialysis unit of a Spanish hospital, perceived their sexuality and intimate relationships. Data were collected using in-depth interviews, researcher field notes, and patients’ personal letters. A thematic analysis was performed. Four main themes arose from the data describing the experience of how CKD impacts body changes and sexuality: (a) Accepting body changes, (b) The catheter, the fistula, and body image, (c) Experiencing a different sexuality, and (d) The catheter, the fistula, and sexuality. Patients experienced changes in their body, perceiving it as being bloated or deformed, together with overall decline. The catheter and/or the fistula triggered changes in the way the women dress in an attempt to hide port sites. Women experience sexuality changes, affecting sexual desire and satisfaction. The presence of catheters was found to be the most cumbersome during sexual acts. Full article

12 pages, 510 KiB

Open AccessArticle

Gender Discrimination in the Workplace: Effects on Pregnancy Planning and Childbirth among South Korean Women

by Ji-Hye Kim, Sarah Soyeon Oh, Suk Won Bae, Eun-Cheol Park and Sung-In Jang

Int. J. Environ. Res. Public Health 2019, 16(15), 2672; https://doi.org/10.3390/ijerph16152672 - 26 Jul 2019

Cited by 17 | Viewed by 9129

Abstract

Introduction: This study aims to investigate the association between gender discrimination in the workplace and pregnancy planning/childbirth experiences among working women in South Korea. Methods: We analyzed data from the Korean Longitudinal Survey of Women and Families (KLoWF) for the years [...] Read more.

Introduction: This study aims to investigate the association between gender discrimination in the workplace and pregnancy planning/childbirth experiences among working women in South Korea. Methods: We analyzed data from the Korean Longitudinal Survey of Women and Families (KLoWF) for the years 2007 to 2016. The study population consisted of 7996 working women, between the ages of 19 and 45. Gender discrimination was measured through the 6-item Workplace Gender Discrimination Scale, evaluating discrimination in terms of recruitment, promotions, pay, deployment, training and lay-offs. Multiple logistic regression analysis was employed to measure the association between gender discrimination and the pregnancy planning/childbirth experience. Results: Compared to individuals experiencing no discrimination in the workplace, those experiencing low [odds ratio (OR): 0.78, 95% confidence interval (95% CI) 0.61–0.99] or medium (OR: 0.69, 95% CI: 0.54–0.89) levels of discrimination had decreased odds of pregnancy planning. Likewise, individuals scoring low (OR: 0.70, 95% CI 0.54–0.92), medium (OR: 0.68, 95% CI: 0.51–0.92), or high (OR: 0.47, 95% CI: 0.27–0.80) levels of discrimination also had decreased odds of childbirth experience when compared to the no-experience group. When stratified by income, compared to individuals experiencing no discrimination in the workplace, those experiencing gender discrimination had decreased odds of pregnancy planning for low income (low OR: 0.64, 95% CI: 0.45–0.92; medium OR: 0.55, 95% CI: 0.52–0.97; high OR: 0.45, 95% CI: 0.24–0.87), medium income (medium OR: 0.53, 95% CI: 0.37–0.77; high OR: 0.29, 95% CI: 0.14–0.63), and high income groups (low OR: 0.64, 95% CI: 0.49–0.84; medium OR: 0.69, 95% CI: 0.52–0.92). Conclusions: The present study finds that gender discrimination in the workplace is associated with decreased odds of pregnancy planning/childbirth experience among working South Korean women. Furthermore, low and medium income groups were especially more likely to be affected by the level of gender discrimination in the workplace when planning pregnancy. Full article

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8 pages, 480 KiB

Open AccessArticle

Bone Mineral Density and Bone Turnover Markers in Postmenopausal Women Subjected to an Aqua Fitness Training Program

by Krystian Wochna, Alicja Nowak, Anna Huta-Osiecka, Katarzyna Sobczak, Zbigniew Kasprzak and Piotr Leszczyński

Int. J. Environ. Res. Public Health 2019, 16(14), 2505; https://doi.org/10.3390/ijerph16142505 - 13 Jul 2019

Cited by 19 | Viewed by 3926

Abstract

The purpose of this study was to analyze the influence of aqua fitness training in deep water on bone tissue. The study was performed with 18 postmenopausal women separated into two groups: training and control groups. Before and after the training program, the [...] Read more.

The purpose of this study was to analyze the influence of aqua fitness training in deep water on bone tissue. The study was performed with 18 postmenopausal women separated into two groups: training and control groups. Before and after the training program, the hip and spine areal bone mineral density were measured along with the biochemical parameters of serum concentration of osteocalcin (OC) and C-terminal telopeptide of type I collagen (CTX). The most significant effect was found in differences between the two groups of women in terms of femur strength index (p < 0.05) during the period of the training program. The study demonstrated that an aqua fitness training program caused favorable changes in femur strength index in postmenopausal women, and this kind of exercise could be a useful form of physical activity for postmenopausal women. Full article

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12 pages, 1092 KiB

Open AccessArticle

Pregnancy with Heart Disease: Maternal Outcomes and Risk Factors for Fetal Growth Restriction

by Thang Nguyen Manh, Nhon Bui Van, Huyen Le Thi, Long Vo Hoang, Hao Nguyen Si Anh, Huong Trinh Thi Thu, Thuc Nguyen Xuan, Nga Vu Thi, Le Bui Minh and Dinh-Toi Chu

Int. J. Environ. Res. Public Health 2019, 16(12), 2075; https://doi.org/10.3390/ijerph16122075 - 12 Jun 2019

Cited by 15 | Viewed by 4438

Abstract

Caring for children and mothers suffering from cardiac disease is highly challenging, with issues including late diagnosis as well as inadequate infrastructure and supply of drugs. We aimed to evaluate maternal outcomes among pregnant women suffering from heart disease with a live birth, [...] Read more.

Caring for children and mothers suffering from cardiac disease is highly challenging, with issues including late diagnosis as well as inadequate infrastructure and supply of drugs. We aimed to evaluate maternal outcomes among pregnant women suffering from heart disease with a live birth, and explored the risk factors for fetal growth restriction among these patients. A retrospective study was performed at the National Hospital of Obstetrics and Gynecology (Hanoi, Vietnam) over a 3-year period from 2014 to 2016. A total of 284 patients were enrolled in the study. Overall, most women were aged below 35 years and were diagnosed with heart disease before pregnancy. Of the women experiencing rheumatic heart disease, the prevalence of mitral valve regurgitation was the highest (40.14%), while the figure for aortic valve regurgitation was the lowest (4.23%). Of women with congenital heart defects, the most common defects were ventricular septal defect (VSD) and atrial septal defect (ASD) (19.37% and 16.55%, respectively), while 5.28% of mothers were diagnosed with tetralogy of Fallot and 1.76% with patent ductus arteriosus. Noted clinical presentations of the patients included palpitation (63.38%), breathlessness (23.59%), leg edema (8.45%), and chest pain (8.1%). The common complications in the study population included 16.90% of women having heart failure and 19.37% having arrhythmias. The incidence of fetal growth restriction was 9.15%. Hypertension (odds ratio (OR): 59.75, 95% confidence interval (CI): 9.1–392.17), the heart disease types (ASD (OR: 4.27, 95% CI: 1.19–15.29) and tetralogy of Fallot (OR: 6.82, 95% CI: 1.21–38.55)), and the complications (heart failure (OR: 10.34, 95% CI: 2.75–38.87) and pulmonary edema (OR: 107.16, 95% CI: 4.96–2313.93)) were observed as risk factors for intrauterine growth restriction. This study provides a cornerstone to promote further studies and to motivate people to apply evidence-based medical care for mothers with diagnosed cardiac disease in the antenatal and postnatal periods. Full article

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Potential Risks and Factors of Women's Health Promotion

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