Journal of women's health
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Journal of women's health · Mar 2023
Observational StudyChildhood Sexual Abuse and Pelvic Floor Dysfunction in Midlife Women in the Study of Women's Health Across the Nation.
Objectives: Research has shown a link between childhood sexual abuse (CSA) and lower urinary tract and sexual disorders in clinical settings. We examined whether CSA was associated with two specific aspects of high tone, elevated resting tension pelvic floor dysfunction (PFD) in community-dwelling women. Materials and Methods: Data were from 2068 participants (25.5% Black, 9.6% Chinese, 10.8% Japanese, 5.0% Hispanic, and 49.1% Non-Hispanic White) in the Study of Women's Health Across the Nation (SWAN), a multirace/multiethnic longitudinal observational study of women's midlife health. ⋯ The final adjusted model that included sociodemographic variables and physical and behavioral risk factors was significant for pain with sexual activity (OR = 1.48 [95% CI = 1.08-2.02]), but not for urgency urinary incontinence (OR = 1.38 [95% CI = 0.96-1.98]). Conclusions: In midlife women, pain with sex, but not urgency urinary incontinence, was associated with a history of CSA. A multidisciplinary diagnostic and therapeutic approach to PFD is key, inclusive of CSA screening.
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Journal of women's health · Mar 2023
Surveillance Systems for Monitoring Vaccination Coverage with Vaccines Recommended for Pregnant Women, United States.
Pregnant women* and their infants are at increased risk for serious influenza, pertussis, and COVID-19-related complications, including preterm birth, low-birth weight, and maternal and fetal death. The advisory committee on immunization practices recommends pregnant women receive tetanus-toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine during pregnancy, and influenza and COVID-19 vaccines before or during pregnancy. Vaccination coverage estimates and factors associated with maternal vaccination are measured by various surveillance systems. ⋯ Each surveillance system differs in the population of pregnant women, time period, geographic area for which estimates can be obtained, how vaccination status is determined, and data collected regarding vaccine-related knowledge, attitudes, behaviors, and barriers. Thus, multiple systems are useful for a more complete understanding of maternal vaccination. Ongoing surveillance from the various systems to obtain vaccination coverage and information regarding disparities and barriers related to vaccination are needed to guide program and policy improvements.
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Journal of women's health · Mar 2023
Use of Sexual and Reproductive Health Services Among Women Living in Rural and Urban Oregon: Impact of the Affordable Care Act Medicaid Expansion.
Objectives: We compared the use of sexual and reproductive health (SRH) services for Medicaid-enrolled women of reproductive age (WRA) living in Oregon by urban/rural status and examined the effect of the Affordable Care Act (ACA) Medicaid expansion on the use of SRH services for these women. Methods: We linked Oregon Medicaid enrollment files and claims for the years 2008-2016 to identify 392,111 WRA. Outcome measures included receipt of five key SRH services. ⋯ Following the implementation of ACA Medicaid expansion, the average number of all five SRH services increased for all women. With the exception of contraceptive services, the average number of SRH services examined increased more for urban women than for women living in small rural towns. Conclusions: Although Medicaid expansion contributed to increased use of SRH services for all WRA, the policy was unsuccessful in reducing disparities in access to SRH services for WRA living in rural areas compared with urban areas.
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Journal of women's health · Mar 2023
Lifetime Smoking History and Prevalence of Osteoporosis and Low Bone Density in U.S. Adults, National Health and Nutrition Examination Survey 2005-2010.
Background: Osteoporosis is common among older adults. Women are more likely to have osteoporosis than men. The prevalence varies with race/ethnicity, with the highest prevalence observed among non-Hispanic, Asian women. ⋯ Among men, null associations of smoking history, osteoporosis, and low bone density were observed, except for a positive association of ≥30 pack-years and low bone density among non-Hispanic Black men. Conclusion: Osteoporosis was twice as prevalent among women who smoked ≥30 pack-years than among women who never smoked, regardless of race/ethnicity. Smoking history and osteoporosis were not associated among men.
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Journal of women's health · Mar 2023
American College of Radiology Paid Family/Medical Leave Policy: A Call to Action for the House of Medicine.
The American College of Radiology (ACR) passed a historic paid family/medical leave (PFML) resolution at its April 2022 meeting, resolving that "diagnostic radiology, interventional radiology, radiation oncology, medical physics, and nuclear medicine practices, departments and training programs strive to provide 12 weeks of paid family/medical leave in a 12-month period for its attending physicians, medical physicists, and members in training as needed." The purpose of this article is to share this policy beyond radiology so that it may serve as a call to action for other medical specialties. Such a PFML policy (1) supports physician well-being, which in turn supports patient care; (2) is widely needed across American medical specialties; and (3) should not take nearly a decade to achieve, as it did in radiology, especially given increasing physician burnout and the ongoing COVID-19 pandemic. Supported by information on the step-by-step approach used to achieve radiology-specific leave policies and considering current and normative policies at the national level, this article concludes by reviewing specific strategies that could be applied toward achieving a 12-week PFML policy for all medical specialties.