Journal of women's health
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Journal of women's health · Oct 2019
Chronic Medical Illness as a Risk Factor for Poor Mammography Screening Adherence.
Objective: The aim of this study was to determine the association between the presence of chronic medical disease and mammography screening adherence. Materials and Methods: We performed a retrospective study on women between the ages of 50 and 64 who received screening mammography in 2005 and had at least 8 years of follow-up. Demographic and clinical information was obtained from our centralized patient data registry. Women diagnosed with one or more of the following diseases for at least 3 months before their index mammogram were considered to have a chronic disease, including atrial fibrillation, congestive heart failure, Chronic Obstructive Pulmonary Disease (COPD), diabetes mellitus type II, heart disease, and/or peripheral vascular disease. ⋯ Within this group, the presence of congestive heart failure (-0.88; CI = -0.84 to -0.45; p ≤ 0.01), COPD (-0.39; CI = -0.57 to -0.21; p ≤ 0.01), or diabetes mellitus type II (-0.37; CI = -0.57 to -0.17; p ≤ 0.01) was individually associated with reduced screening compared with women without the respective disease. Compared with women without chronic medical disease, women with multiple chronic medical diseases (-0.62; CI = -0.93 to -0.30; p ≤ 0.01) were significantly (p ≤ 0.05) less likely to receive routine screening, while no significant difference was seen in women with only one chronic medical disease (-0.18; CI = -0.39 to -0.02; p ≤ 0.08). Conclusion: Despite experiencing longer life expectancies, women with specific chronic diseases may experience additional barriers to uptake of mammography screening, which is likely compounded by the comorbidity burden of being simultaneously treated for multiple chronic conditions. Increased health care interactions seen in this group may represent missed opportunities to improve screening adherence.
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Background: In the U. S. civilian population, sex differences have been identified in cardiovascular health; these differences have been used to inform care. Our objective is to determine if the same sex differences are present in Veterans who use the Department of Veterans Affairs (VA) Health Care System given the additional stressors associated with military service. Materials and Methods: Cardiovascular disease (CVD) risk factors and conditions among women and men Veterans using VA in fiscal year (FY) 2014 were identified through the presence of International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes in VA administrative records. ⋯ Compared with men, women in this cohort were younger and more ethnically diverse. Overall, women were less likely to have traditional CVD risk factors, but more likely to have a nontraditional CVD risk factor (depression) compared with men. Women had higher odds of chest pain/angina (adjusted odds ratio [AOR] 1.03, confidence interval [95% CI] 1.02-1.05), palpitations (AOR 2.04; 95% CI 1.98-2.10), and valvular disease (AOR 1.05; 95% CI 1.02-1.08), but lower odds of coronary artery disease (AOR 0.29; 95% CI 0.29-0.30), acute MI (AOR 0.46; 95% CI 0.43-0.49), and heart failure (AOR 0.55; 95% CI 0.53-0.56) compared with men, overall. Conclusions: In age-adjusted comparisons, sex differences in the prevalence of CVD risk factors and conditions among the VA Veteran patient population was similar in that seen in the civilian population with a few exceptions.
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Background: Mother-infant dyads are not meeting recommended breastfeeding goals. There is lack of consensus regarding any program's ability to increase breastfeeding duration to meet the recommended guidelines, and effective strategies are needed moving forward to help families meet those goals. Primary prevention utilizing consistent visits with lactation professionals with a group of new mothers may efficiently address this care gap. Methods: Mother-infant dyads attending a newborn care clinic for 6 weeks received feeding assessment and standard-of-care guidance from an Internationally Board-Certified Lactation Consultant (IBCLC). ⋯ Bottle use correlated with decreased odds of AB at 6 weeks PP; similarly, dyads seen only at day 14 PP had decreased odds of EDB. When looking at timing of the first involvement, dyads seen at 3 days had higher odds of EDB than dyads first seen at day 14 PP. Conclusions: This primary prevention strategy of early minimal intervention using an IBCLC increased the odds of EDB and AB at 6 weeks PP. These data support the conclusion that early feeding assessment the first 2 weeks PP with an IBCLC may increase breastfeeding at 6 weeks PP.
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Journal of women's health · Oct 2019
Personalized Care in the Prevention of Treatment-Related Cardiac Dysfunction in Female Cancer Survivors.
Background: The American Cancer Society projects the number of U. S. cancer survivors to exceed 20 million individuals by 2026. ⋯ Multidisciplinary approaches in prevention are reviewed. Conclusions: Female cancer survivors with CTRCD represent an entirely new population at high risk of morbidity and mortality. Increased awareness of the short- and long-term effects of anti-cancer treatments is necessary for the community health care provider for early detection and CTRCD risk reduction.