Journal of women's health
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Journal of women's health · Mar 2021
Removing Unnecessary Medical Barriers to Contraception: Celebrating a Decade of the U.S. Medical Eligibility Criteria for Contraceptive Use.
In 2010, the Centers for Disease Control and Prevention (CDC) released the U. S. ⋯ Over the past decade, CDC has updated recommendations based on new evidence, collaborated with national partners to disseminate and implement the guidelines, and conducted provider surveys to assess changes in attitudes and practices around contraception safety and provision. CDC remains committed to supporting evidence-based guidelines for safe use of contraception, as the basis for improving access to contraception and high-quality family planning services, reducing unintended pregnancy, and improving reproductive health in the United States.
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Journal of women's health · Mar 2021
Willingness to Use Cannabis for Gynecological Conditions: A National Survey.
Objective: Expanded legal access to cannabis in the United States has led to its increased use for treating medical conditions. We assessed the use of and attitudes toward cannabis for treating gynecological conditions. Materials and Methods: We utilized Amazon.com Inc.'s Mechanic Turk platform to administer a survey to U. S. women 18 years and older about cannabis use for recreational and medicinal purposes and willingness to use cannabis to treat 17 gynecological conditions. ⋯ Women willing to use cannabis for gynecological conditions were most interested in using cannabis for treating gynecological pain (61.2% of never users vs. 90.0% of ever users; p < 0.001) compared with procedural pain (38.2% vs. 79.0%, respectively; p < 0.001) or other conditions (38.0% vs. 79.8%, respectively; p < 0.001). In multivariate analysis, willingness to use cannabis for a gynecological condition was associated only with a history of ever using cannabis and views that cannabis should be legal in some capacity and not by age, race, or education. Conclusions: The majority of women would consider using cannabis to treat gynecological conditions. Overall, respondents who had a history of cannabis use were more likely to report willingness to use cannabis for all gynecological conditions, but a large proportion of those who reported never using cannabis were also willing to use it.
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Journal of women's health · Mar 2021
Evidence of Gender Differences in the Diagnosis and Management of Coronavirus Disease 2019 Patients: An Analysis of Electronic Health Records Using Natural Language Processing and Machine Learning.
Background: The impact of sex and gender in the incidence and severity of coronavirus disease 2019 (COVID-19) remains controversial. Here, we aim to describe the characteristics of COVID-19 patients at disease onset, with special focus on the diagnosis and management of female patients with COVID-19. Methods: We explored the unstructured free text in the electronic health records (EHRs) within the SESCAM Healthcare Network (Castilla La-Mancha, Spain). The study sample comprised the entire population with available EHRs (1,446,452 patients) from January 1st to May 1st, 2020. ⋯ Imaging by chest X-ray or blood tests were performed less frequently in females (65.5% vs. 78.3% and 49.5% vs. 63.7%, respectively), all p < 0.001. Regarding hospital resource use, females showed less frequency of hospitalization (44.3% vs. 62.0%) and intensive care unit admission (2.8% vs. 6.3%) than males, all p < 0.001. Conclusion: Our results indicate important sex-dependent differences in the diagnosis, clinical manifestation, and treatment of patients with COVID-19. These results warrant further research to identify and close the gender gap in the ongoing pandemic.
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Journal of women's health · Mar 2021
Randomized Controlled TrialEvaluation of a Discussion Guide to Promote Patient Understanding of Menopause and Informed Treatment Decision-Making.
Background: Patient-provider communication surrounding menopause symptoms and treatment is often limited. We developed and evaluated a health literacy-appropriate discussion guide to support patient education. Materials and Methods: A cross-sectional randomized study was conducted among 100 English-speaking women, aged 45-60 years, in Chicago, IL, and Durham, NC. Participants were randomly assigned to review either the discussion guide or a standard education material (n = 50 per arm) and to complete an open book knowledge questionnaire; they then rated the appearance and quality of both materials. ⋯ M = 18.1, SD = 2.6; p < 0.001); 82.0% of those exposed to the discussion guide correctly answered ≥85% of knowledge items compared with only 48.0% of those reviewing the standard material (p < 0.001). In multivariable analyses, participants receiving the discussion guide displayed significantly greater knowledge in comparison with those receiving the standard material regardless of whether knowledge was examined as a score (∝ = 1.9, 95% confidence interval [CI]: 0.9-2.9, p < 0.001) or 85% threshold (odds ratio: 5.7, 95% CI: 2.0-16.2, p < 0.001). More than two-thirds of women (68%) preferred the discussion guide; it was rated highly in terms of appearance and content. Conclusions: The discussion guide improved understanding of menopause symptoms and treatment options in comparison with a current standard and was well received by a diverse audience.
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Journal of women's health · Mar 2021
Adverse Childhood Experiences and Early and Continued Breastfeeding: Findings from an Integrated Health Care Delivery System.
Purpose: To examine whether adverse childhood experiences (ACEs) are associated with breastfeeding behaviors. Methods: Women in three Kaiser Permanente Northern California medical centers were screened for ACEs during standard prenatal care (N = 926). Multivariable binary and multinomial logistic regression was used to test whether ACEs (count and type) were associated with early breastfeeding at the 2-week newborn pediatric visit and continued breastfeeding at the 2-month pediatric visit, adjusting for covariates. ⋯ Individual ACEs were not related to breastfeeding outcomes, with the exception that living with someone who went to jail or prison was associated with lower odds of continued breastfeeding 2 months postpartum. Conclusions: ACE count was associated with greater early breastfeeding, but not continued breastfeeding, among women screened for ACEs as part of standard prenatal care. Results reiterate the need to educate and assist all women to meet their breastfeeding goals, regardless of ACE score.