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Kwinana N, Masilela C, Adeniyi OV. Healthcare workers' perceptions of sexual violence during the COVID-19 pandemic in the Eastern Cape. Afr J Prim Health Care Fam Med 2023; 15:e1-e6. [PMID: 37916716 PMCID: PMC10546217 DOI: 10.4102/phcfm.v15i1.4087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND The South African government implemented lockdown restrictions in order to prevent the spread of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). AIM This study explored the effects of the coronavirus disease 2019 (COVID-19) pandemic on sexual violence in the Eastern Cape province through the lens of healthcare workers' (HCWs) experiences. SETTING A Thuthuzela care centre in the Eastern Cape province, South Africa. METHODS This qualitative study brings together the findings from thematic analysis of semi-structured interviews conducted among 11 purposively selected HCWs in May 2022. RESULTS Overall, three themes emerged from the study: the effects of COVID-19 on sexual violence, profile of the survivors and recommendations for combating sexual violence in the region. Most respondents believed that the COVID-19 pandemic caused a surge in the incidence of sexual violence, although all acknowledged that movement restrictions affected reporting. The participants treated mostly black women and children's survivors, who experienced physical injuries simultaneously. The respondents' narratives revealed that educational campaigns targeting boys and men could reduce sexual violence in the region. In addition, it was recommended that stricter laws and harsher penalties would serve as deterrents for perpetrators of sexual violence in the country. CONCLUSION The COVID-19 lockdown restrictions exposed the vulnerabilities of black women and children to sexual violence in the study setting. Educational programmes aimed at re-orientating boys and men in both rural and urban communities should be implemented.Contributions: This study provides an insight into the perceived effect of the COVID-19 pandemic on sexual violence in the Amathole district and South Africa.
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Affiliation(s)
- Nolundi Kwinana
- Department of Public Health, Faculty of Health Sciences, University of Fort Hare, East London.
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Arslan HS, Nursal AF, Inanir A, Karakus N, Yigit S. Influence of ESR1 Variants on Clinical Characteristics and Fibromyalgia Syndrome in Turkish Women. Endocr Metab Immune Disord Drug Targets 2021; 21:1326-1332. [PMID: 32914729 DOI: 10.2174/1871530320666200910110915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/21/2020] [Accepted: 07/29/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Fibromyalgia syndrome (FMS) is characterized by widespread musculoskeletal pain. It is more common in women than in men, and sex hormones may play a role in this predominance. Therefore, this research investigated the clinical findings among Turkish females and whether Estrogen-α (ESR1) gene variants are associated with FMS. METHODS A total of 219 individuals were enrolled in this study. ESR1 variants (PvuII/XbaI) were genotyped using PCR-RFLP methods. The results of the analyses were evaluated for statistical significance. RESULTS There was a significant association between the ESR1 PvuII and FMS risk among Turkish women. The ESR1 PvuII CC genotype and C allele were higher in the patients than those in the controls (p=0.021, p=0.007, respectively). A more statistically significant association was observed between the patients and the controls in terms of TT genotype vs. TC+CC genotypes (p=0.022). Also, there was a statistically significant association between the patients and the controls in terms of TT+TC genotype vs. CC genotypes (p =0.028). There was no significant association between patients and the control group concerning the genotype distribution and allele frequencies of ESR1 XbaI (p>0.05). Headache was seen more frequently in the XbaI GA genotype (p=0.025), while XbaI AA genotype was associated with dysmenorrhea in patients with FMS (p=0.041). CONCLUSION Our results indicate that ESR1 PvuII/XbaI variants are possibly effective in the development of FMS and some clinical features.
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Affiliation(s)
- Habibe S Arslan
- Department of Medical Biology and Genetics, Akdeniz University, Faculty of Medicine, Antalya, Turkey
| | - Ayse F Nursal
- Department of Medical Genetics, Hitit University, Facultyof Medicine, Corum, Turkey
| | - Ahmet Inanir
- Department of Physical Medicineand Rehabilitation, Special Academic Pain Center, Samsun, Turkey
| | - Nevin Karakus
- Department of Medical Biology,Gaziosmanpasa University, Faculty of Medicine, Tokat, Turkey
| | - Serbulent Yigit
- Department of Medical Biology,Gaziosmanpasa University, Faculty of Medicine, Tokat, Turkey
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3
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Boulkrane MS, Fedotova J, Kolodyaznaya V, Micale V, Drago F, van den Tol AJM, Baranenko D. Vitamin D and Depression in Women: A Mini-review. Curr Neuropharmacol 2020; 18:288-300. [PMID: 31701847 PMCID: PMC7327938 DOI: 10.2174/1570159x17666191108111120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 08/01/2019] [Accepted: 10/31/2019] [Indexed: 12/16/2022] Open
Abstract
Affective-related disorders, including depression, are constantly rising, complicating people’s personal lifestyle increasing disqualification and hospital care. Because of the high intensity of urbanization, our lifestyle and food have altered dramatically in the last twenty years. These food modifications have been associated with scores of depression and other affective-related disorders in urbanized countries with high economic levels. Nutrients imbalance is considered as one of the critical causes enabling the pathophysiological mechanisms for the development of psychiatric disorders. The application of additional nutritional interventions for treatment of mood deteriorations can be beneficial for both the prophylaxis and therapy of affective-related disorders. This paper will review recent research on the relation of Vitamin D levels and the epidemiology of depression in women. In this paper, we will provide an overview of the results of a variety of different studies taking into account research which both suggests and refutes an association. Based on these findings we will propose important directions for future research in relation to this topic.
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Affiliation(s)
- Mohamed Said Boulkrane
- International Research Centre "Biotechnologies of the Third Millennium", ITMO University, 9 Lomonosova Str. St. Petersburg 191002, Russian Federation
| | - Julia Fedotova
- International Research Centre "Biotechnologies of the Third Millennium", ITMO University, 9 Lomonosova Str. St. Petersburg 191002, Russian Federation.,Laboratory of Neuroendocrinology, I.P. Pavlov Institute of Physiology RASci., 6 Emb. Makarova, St. Petersburg 199034, Russian Federation
| | - Valentina Kolodyaznaya
- International Research Centre "Biotechnologies of the Third Millennium", ITMO University, 9 Lomonosova Str. St. Petersburg 191002, Russian Federation
| | - Vincenzo Micale
- Department of Biomedical and Biotechnological Sciences, Biological Tower, School of Medicine, University of Catania, Via S. Sofia 97, Catania 95123, Italy
| | - Filippo Drago
- Department of Biomedical and Biotechnological Sciences, Biological Tower, School of Medicine, University of Catania, Via S. Sofia 97, Catania 95123, Italy
| | | | - Denis Baranenko
- International Research Centre "Biotechnologies of the Third Millennium", ITMO University, 9 Lomonosova Str. St. Petersburg 191002, Russian Federation
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Hodel EM, Marzolini C, Waitt C, Rakhmanina N. Pharmacokinetics, Placental and Breast Milk Transfer of Antiretroviral Drugs in Pregnant and Lactating Women Living with HIV. Curr Pharm Des 2020; 25:556-576. [PMID: 30894103 DOI: 10.2174/1381612825666190320162507] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 03/18/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Remarkable progress has been achieved in the identification of HIV infection in pregnant women and in the prevention of vertical HIV transmission through maternal antiretroviral treatment (ART) and neonatal antiretroviral drug (ARV) prophylaxis in the last two decades. Millions of women globally are receiving combination ART throughout pregnancy and breastfeeding, periods associated with significant biological and physiological changes affecting the pharmacokinetics (PK) and pharmacodynamics (PD) of ARVs. The objective of this review was to summarize currently available knowledge on the PK of ARVs during pregnancy and transport of maternal ARVs through the placenta and into the breast milk. We also summarized main safety considerations for in utero and breast milk ARVs exposures in infants. METHODS We conducted a review of the pharmacological profiles of ARVs in pregnancy and during breastfeeding obtained from published clinical studies. Selected maternal PK studies used a relatively rich sampling approach at each ante- and postnatal sampling time point. For placental and breast milk transport of ARVs, we selected the studies that provided ratios of maternal to the cord (M:C) plasma and breast milk to maternal plasma (M:P) concentrations, respectively. RESULTS We provide an overview of the physiological changes during pregnancy and their effect on the PK parameters of ARVs by drug class in pregnancy, which were gathered from 45 published studies. The PK changes during pregnancy affect the dosing of several protease inhibitors during pregnancy and limit the use of several ARVs, including three single tablet regimens with integrase inhibitors or protease inhibitors co-formulated with cobicistat due to suboptimal exposures. We further analysed the currently available data on the mechanism of the transport of ARVs from maternal plasma across the placenta and into the breast milk and summarized the effect of pregnancy on placental and of breastfeeding on mammal gland drug transporters, as well as physicochemical properties, C:M and M:P ratios of individual ARVs by drug class. Finally, we discussed the major safety issues of fetal and infant exposure to maternal ARVs. CONCLUSIONS Available pharmacological data provide evidence that physiological changes during pregnancy affect maternal, and consequently, fetal ARV exposure. Limited available data suggest that the expression of drug transporters may vary throughout pregnancy and breastfeeding thereby possibly impacting the amount of ARV crossing the placenta and secreted into the breast milk. The drug transporter's role in the fetal/child exposure to maternal ARVs needs to be better understood. Our analysis underscores the need for more pharmacological studies with innovative study design, sparse PK sampling, improved study data reporting and PK modelling in pregnant and breastfeeding women living with HIV to optimize their treatment choices and maternal and child health outcomes.
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Affiliation(s)
- E M Hodel
- Department of Molecular and Clinical Pharmacology, University of Liverpool, Molecular & Clinical Pharmacology, Liverpool, United Kingdom.,Liverpool School of Tropical Medicine, Liverpool, United Kingdom.,Division of Paediatric Pharmacology & Pharmacometrics, University of Basel Children's Hospital, Basel, Switzerland
| | - C Marzolini
- Department of Molecular and Clinical Pharmacology, University of Liverpool, Molecular & Clinical Pharmacology, Liverpool, United Kingdom.,Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - C Waitt
- Department of Molecular and Clinical Pharmacology, University of Liverpool, Molecular & Clinical Pharmacology, Liverpool, United Kingdom.,Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda.,Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - N Rakhmanina
- Department of Pediatrics, The George Washington University, School of Medicine & Health Sciences, Washington, DC, United States.,Division of Infectious Diseases, Children's National Medical Center, Washington, DC, United States.,Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, United States
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Sharami SH, Gholipour M, Milani F, Kazemnejad E, Heirati SFD, Ranjbar ZA. The Association between Dyslipidemia and Preterm Birth: A Prospective Cohort Study in The North of Iran. Endocr Metab Immune Disord Drug Targets 2019; 20:227-233. [PMID: 31142254 DOI: 10.2174/1871530319666190529090517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/25/2019] [Accepted: 04/30/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Dyslipidemia is recognized as an important factor in the incidence of Preterm Birth (PTB). The early diagnosis of factors affecting PTB is important in the reduction of maternalneonatal complications; therefore, we aimed to evaluate the association between dyslipidemia and PTB in women from the Guilan province of Iran. METHODS The current investigation was a prospective cohort study on 378 pregnant women in Rasht city (Guilan province), during 2018-2019. Samples were randomly selected among pregnant women who referred to Al-Zahra hospital. Association of the lipid profiles: Total Cholesterol (TC), High- Density Lipoprotein (HDLC), Low-Density Lipoprotein (LDLC), and Triglycerides (TG) with PTB was assessed using the Chi-square, Fisher tests and logistic regression analysis. RESULTS Our findings showed that of the evaluated lipid profiles, TG and TC had the highest predictive power with AUC =0.833 (95٪, CI: 0.736-0.930) and 0.772 (95%, CI: 0.676-0.867), respectively; also, their sensitivity and specificity were 83.3%, 70.2% and 83.3%, 66.1%, respectively. Moreover, abnormal LDL concentrations increase the risk of PTB by two folds (P < 0.05). CONCLUSION It seems that by controlling the lipid profiles of pregnant women, the risk of PTB could be reduced.
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Affiliation(s)
- Seyedeh H Sharami
- Department of Obstetrics & Gynecology, Reproductive Health Research Center, Azzhra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mahboobeh Gholipour
- Department of Cardiology, Cardiovascular Diseases Research Center, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Forozan Milani
- Department of Obstetrics & Gynecology, Reproductive Health Research Center, Azzhra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Ehsan Kazemnejad
- Department of Biostatictis, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Seyedeh F D Heirati
- Department of Obstetrics & Gynecology, Reproductive Health Research Center, Azzhra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra A Ranjbar
- Department of Endocrinology and Metabolism, Reproductive Health Research center, Guilan University of Medical Sciences, Rasht, Iran
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Sales JM, Steiner RJ, Brown JL, Swartzendruber A, Patel AS, Sheth AN. PrEP Eligibility and Interest Among Clinic- and Community-Recruited Young Black Women in Atlanta, Georgia, USA. Curr HIV Res 2018. [PMID: 30062969 DOI: 10.2174/1570162×16666180731143756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
BACKGROUND Atlanta has been identified as an HIV "hot spot" for Black women and ranks 5th in the US with new infections. Yet little is known about PrEP eligibility or interest among young Black women in Atlanta. METHODS A convenience sample of 1,261 Black women (ages 14-24 years) were recruited from two settings: community venues and sexual health clinics. They provided self-reported sexual behavior data and specimens for laboratory testing for chlamydia (CT) and gonorrhea (GC) infections. For each woman, the number of key self-reported behavioral HIV risk factors was calculated (0-6 factors for the clinic sample, 0-3 factors for the community sample). A single item assessed PrEP interest in the community sample only. RESULTS Bacterial STI positivity, an indicator for PrEP eligibility, was 20.5% (17.1% CT, 6.3% GC) and 20.9% (18.8% CT, 5.2% GC) for the clinic and community samples, respectively. Of the 144 STI positive women from the clinic sample, 20.1% reported no behavioral risk indicators and 47.2% reported > 2 behavioral indicators. Of the 117 STI positive women from the community sample, 21.4% reported no behavioral risk indicators. 60.7% of the community sample reported they would be likely or very likely to use PrEP if available. CONCLUSION Young Black women in Atlanta, whether sampled from community or sexual health settings, are at substantial risk for HIV infection and meet several PrEP eligibility criteria. Scaling up PrEP among women in Atlanta could have significant implications for HIV in this high burden region.
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Affiliation(s)
- J M Sales
- Rollins School of Public Health, Emory University, Atlanta, GA, 30322, United States
| | - R J Steiner
- Rollins School of Public Health, Emory University, Atlanta, GA, 30322, United States
| | - J L Brown
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, United States
| | - A Swartzendruber
- College of Public Health, University of Georgia, Athens, Georgia, United States
| | - A S Patel
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, United States
| | - A N Sheth
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, United States
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7
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Sales J, Steiner R, Brown J, Swartzendruber A, Patel A, Sheth A. PrEP Eligibility and Interest Among Clinic- and Community-Recruited Young Black Women in Atlanta, Georgia, USA. Curr HIV Res 2018; 16:250-255. [PMID: 30062969 PMCID: PMC6352727 DOI: 10.2174/1570162x16666180731143756] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 05/24/2018] [Accepted: 05/24/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Atlanta has been identified as an HIV "hot spot" for Black women and ranks 5th in the US with new infections. Yet little is known about PrEP eligibility or interest among young Black women in Atlanta. METHODS A convenience sample of 1,261 Black women (ages 14-24 years) were recruited from two settings: community venues and sexual health clinics. They provided self-reported sexual behavior data and specimens for laboratory testing for chlamydia (CT) and gonorrhea (GC) infections. For each woman, the number of key self-reported behavioral HIV risk factors was calculated (0-6 factors for the clinic sample, 0-3 factors for the community sample). A single item assessed PrEP interest in the community sample only. RESULTS Bacterial STI positivity, an indicator for PrEP eligibility, was 20.5% (17.1% CT, 6.3% GC) and 20.9% (18.8% CT, 5.2% GC) for the clinic and community samples, respectively. Of the 144 STI positive women from the clinic sample, 20.1% reported no behavioral risk indicators and 47.2% reported > 2 behavioral indicators. Of the 117 STI positive women from the community sample, 21.4% reported no behavioral risk indicators. 60.7% of the community sample reported they would be likely or very likely to use PrEP if available. CONCLUSION Young Black women in Atlanta, whether sampled from community or sexual health settings, are at substantial risk for HIV infection and meet several PrEP eligibility criteria. Scaling up PrEP among women in Atlanta could have significant implications for HIV in this high burden region.
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Affiliation(s)
- J.M. Sales
- Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - R.J. Steiner
- Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - J.L. Brown
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - A. Swartzendruber
- College of Public Health, University of Georgia, Athens, Georgia, USA
| | - A.S. Patel
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - A.N. Sheth
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
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8
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Ludema C, Cole SR, Eron JJ, Holmes GM, Anastos K, Cocohoba J, Cohen MH, Cooper HL, Golub ET, Kassaye S, Konkle-Parker D, Metsch L, Milam J, Wilson TE, Adimora AA. Health Insurance Type and Control of Hypertension Among US Women Living With and Without HIV Infection in the Women's Interagency HIV Study. Am J Hypertens 2017; 30:594-601. [PMID: 28407044 DOI: 10.1093/ajh/hpx015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 01/18/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Health care access is an important determinant of health. We assessed the effect of health insurance status and type on blood pressure control among US women living with (WLWH) and without HIV. METHODS We used longitudinal cohort data from the Women's Interagency HIV Study (WIHS). WIHS participants were included at their first study visit since 2001 with incident uncontrolled blood pressure (BP) (i.e., BP ≥140/90 and at which BP at the prior visit was controlled (i.e., <135/85). We assessed time to regained BP control using inverse Kaplan-Meier curves and Cox proportional hazard models. Confounding and selection bias were accounted for using inverse probability-of-exposure-and-censoring weights. RESULTS Most of the 1,130 WLWH and 422 HIV-uninfected WIHS participants who had an elevated systolic or diastolic measurement were insured via Medicaid, were African-American, and had a yearly income ≤$12,000. Among participants living with HIV, comparing the uninsured to those with Medicaid yielded an 18-month BP control risk difference of 0.16 (95% CI: 0.10, 0.23). This translates into a number-needed-to-treat (or insure) of 6; to reduce the caseload of WLWH with uncontrolled BP by one case, five individuals without insurance would need to be insured via Medicaid. Blood pressure control was similar among WLWH with private insurance and Medicaid. There were no differences observed by health insurance status on 18-month risk of BP control among the HIV-uninfected participants. CONCLUSIONS These results underscore the importance of health insurance for hypertension control-especially for people living with HIV.
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Affiliation(s)
- Christina Ludema
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, Indiana, USA
| | - Stephen R. Cole
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Joseph J. Eron
- Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - G. Mark Holmes
- Department of Health Policy and Management, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Kathryn Anastos
- Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, New York, New York, USA
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, New York, New York, USA
| | - Jennifer Cocohoba
- Department of Clinical Pharmacy, School of Pharmacy, University of California San Francisco, San Francisco, California, USA
| | - Marge H. Cohen
- Department of Medicine, Cook County Health and Hospital System, Chicago, Illinois, USA
- Department of Medicine, Rush University, Chicago, Illinois, USA
| | - Hannah L.F. Cooper
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Elizabeth T. Golub
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Seble Kassaye
- Division of Infectious Diseases and Travel Medicine, Department of Medicine, Georgetown University, Washington, District of Columbia, USA
| | - Deborah Konkle-Parker
- Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Lisa Metsch
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Joel Milam
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Tracey E. Wilson
- Department of Community Health Sciences, School of Public Health, State University of New York (SUNY) Downstate Medical Center, Brooklyn, New York, USA
| | - Adaora A. Adimora
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
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9
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Coogan PF, White LF, Yu J, Brook RD, Burnett RT, Marshall JD, Bethea TN, Rosenberg L, Jerrett M. Long-Term Exposure to NO2 and Ozone and Hypertension Incidence in the Black Women's Health Study. Am J Hypertens 2017; 30:367-372. [PMID: 28096146 PMCID: PMC5861564 DOI: 10.1093/ajh/hpw168] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 11/08/2016] [Accepted: 12/12/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Evidence shows that exposure to air pollutants can increase blood pressure in the short and long term. Some studies show higher levels of hypertension prevalence in areas of high pollution. Few data exist on the association of air pollution with hypertension incidence. The purpose of the present study was to prospectively assess the associations of the traffic-related nitrogen dioxide (NO2) and of ozone with the incidence of hypertension in the Black Women's Health Study (BWHS), a large cohort study of African American women. METHODS We used Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CI) for hypertension associated with exposure to NO2 and ozone among 33,771 BWHS participants. NO2 and ozone levels at participant residential locations were estimated with validated models. RESULTS From 1995 to 2011, 9,570 incident cases of hypertension occurred in a total of 348,154 person-years (median follow-up time, 11 years). The multivariable HRs per interquartile range of NO2 (9.7 ppb) and ozone (6.7 ppb) were 0.92 (95% CI = 0.86, 0.98) and 1.09 (95% CI = 1.00, 1.18). CONCLUSIONS In this large cohort of African American women, higher ozone levels were associated with an increase in hypertension incidence. Higher NO2 levels were not associated with greater hypertension incidence; indeed, incidence was lower at higher NO2 levels.
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Affiliation(s)
| | - Laura F White
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Jeffrey Yu
- Slone Epidemiology Center at Boston University, Boston, MA, USA
| | - Robert D Brook
- Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Richard T Burnett
- Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ontario, Canada
| | - Julian D Marshall
- Civil and Environmental Engineering, University of Washington, Seattle, WA, USA
| | - Traci N Bethea
- Slone Epidemiology Center at Boston University, Boston, MA, USA
| | - Lynn Rosenberg
- Slone Epidemiology Center at Boston University, Boston, MA, USA
| | - Michael Jerrett
- Department of Environmental Health Sciences and Center for Occupational and Environmental Health, Fielding School of Public Health, University of California, Los Angeles, USA
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10
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Gaisa M, Ita-Nagy F, Sigel K, Arens Y, Hennessy MA, Rodriguez-Caprio G, Mullen M, Aberg JA, Cespedes M. High Rates of Anal High-Grade Squamous Intraepithelial Lesions in HIV-Infected Women Who Do Not Meet Screening Guidelines. Clin Infect Dis 2016; 64:289-294. [PMID: 27965301 DOI: 10.1093/cid/ciw729] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 11/02/2016] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV)-infected women have a higher burden of anal high-grade squamous intraepithelial lesions (HSIL) and anal cancer (AC) compared with HIV-uninfected women. Guidelines for AC screening in this population are heterogeneous. Here we report outcomes and risk factors for anal HSIL following implementation of universal AC screening offered to all HIV-infected women. METHODS Data from women who underwent AC screening with anal cytology from April 2009 to July 2014 were analyzed. Routine clinical data included anal and cervical cytology, demographic/behavioral data, and high-resolution anoscopy (HRA) results. We evaluated the association of cytology with HRA results, and predictors of HSIL pathology, and compared rates of HSIL pathology among women meeting screening guidelines to those who did not. RESULTS Seven hundred forty-five HIV-infected women were screened with anal cytology. Thirty-nine percent had abnormal anal cytology on initial screen and 15% on secondary screen; 208 women underwent HRA following abnormal anal cytology. HSIL was found in 26% and 18% of anal biopsies following initial and secondary screening, respectively. One woman had AC. Cigarette smoking more than doubled HSIL risk. Among women who underwent AC screening despite not meeting existing guideline criteria, 21% and 10%, respectively, were found to have HSIL on biopsy. Neither meeting criteria for screening nor history of receptive anal sex was significantly associated with HSIL. CONCLUSIONS Anal HSIL is common in HIV-infected women. Substantial numbers of HSIL would have been missed by strictly adhering to existing AC screening guidelines. These results support routine screening of all HIV-infected women regardless of human papillomavirus history or sexual practices.
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Affiliation(s)
| | | | - Keith Sigel
- Divisions of Infectious Diseases and.,General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York
| | - Yotam Arens
- General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York
| | - Mary Ann Hennessy
- Adult Comprehensive Services, Jacobi Medical Center, Bronx, New York
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Allison MA, Aragaki AK, Ray RM, Margolis KL, Beresford SAA, Kuller L, Jo O'Sullivan M, Wassertheil-Smoller S, Van Horn L. A Randomized Trial of a Low-Fat Diet Intervention on Blood Pressure and Hypertension: Tertiary Analysis of the WHI Dietary Modification Trial. Am J Hypertens 2016; 29:959-68. [PMID: 26708006 DOI: 10.1093/ajh/hpv196] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 12/05/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This post hoc analysis determined if the Women's Health Initiative (WHI) Diet Modification intervention (DM-I) resulted in a significantly different rate of incident hypertension (HTN), as well as longitudinal changes in blood pressure. METHODS Participants were 48,835 postmenopausal women aged 50-79 years who were randomly assigned to either the intervention or comparison group. HTN was defined as self-report of treated HTN collected semiannually or blood pressure ≥140/90mm Hg at one of the annual follow-up clinic visits. RESULTS After a mean follow-up of 8.3 years, and among those who did not have HTN at baseline (n = 31,146), there were 16,174 (51.9%) HTN cases and those assigned to the intervention group had a 4% lower overall risk of developing incident HTN (hazard ratio (HR): 0.96, 95% confidence interval (CI): 0.93-0.99). Although the risk of HTN was lower in the DM-I group in the first few years, the HR became greater than 1 after year 5 (P-trend < 0.01). Similarly, randomization to the DM-I arm resulted in a small but significantly lower average systolic blood pressure (SBP) at 1 year of follow-up (-0.66mm Hg, 0.44-0.89) that increased over the following 8 years (0.16mm Hg/year, 0.11-0.21), such that any early benefit was eliminated by year 5 and a minimal deleterious effect emerged by year 7. CONCLUSION Randomization to an intensive behavioral dietary modification program aimed at a lower total fat intake is not associated with sustained reductions in blood pressure or risk of HTN in postmenopausal women. CLINICAL TRIAL REGISTRATION url http://www.clinicaltrials.gov, unique identifier nct00000611.
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Affiliation(s)
- Matthew A Allison
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA;
| | - Aaron K Aragaki
- Department of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Roberta M Ray
- Department of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Karen L Margolis
- HealthPartners Institute for Education and Research, Minneapolis, Minnesota, USA
| | | | - Lewis Kuller
- Department of Epidemiology, Pittsburgh University, Pittsburgh, Pennsylvania, USA
| | - Mary Jo O'Sullivan
- Department of Obstetrics and Gynecology, University of Miami, Miami, Florida, USA
| | | | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois, USA
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12
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Talley AE, Grimaldo G, Wilsnack SC, Hughes TL, Kristjanson AF. Childhood Victimization, Internalizing Symptoms, and Substance Use Among Women Who Identify as Mostly Heterosexual. LGBT Health 2016; 3:266-74. [PMID: 27269733 DOI: 10.1089/lgbt.2015.0073] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
PURPOSE The current article examines substance use behavior and associated factors that contribute to risk of substance misuse, such as history of childhood victimization and reports of internalizing symptoms among women from various sexual identity subgroups. METHODS We recruited a convenience sample of 332 community and university student women (M age = 20.88). Approximately 61.1% of the sample (n = 203) identified as exclusively heterosexual (or "straight"; EH) at the time of the survey, whereas 21.4% (n = 71) identified as primarily heterosexual (or "mostly heterosexual"), 6.6% (n = 22) as bisexual (or "equally gay/lesbian and heterosexual"), 3.0% (n = 10) as primarily gay/lesbian (or "mostly gay/lesbian") and 7.8% (n = 26) as exclusively gay/lesbian. RESULTS Mostly heterosexual women were more likely than EH women to report childhood physical abuse and lifetime tobacco and marijuana use. Mostly heterosexual women also had higher levels of past-year alcohol use disorder symptomology, recent tobacco and marijuana use, and depressive symptoms. Mostly heterosexual women were more likely than bisexual women to have ever tried marijuana, although, among lifetime users, bisexual women reported more frequent recent use. CONCLUSION Mostly heterosexual women reported levels of pathological alcohol use, lifetime rates of tobacco and marijuana use, and recent depressive symptoms that were higher than EH women and relatively similar to lesbian and mostly lesbian women. Bisexual women reported heavier current use of marijuana and were more likely than mostly heterosexual women to report childhood sexual abuse. Implications for mental health services for clients who identify as non-EH are discussed.
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Affiliation(s)
- Amelia E Talley
- 1 Department of Psychological Sciences, Texas Tech University , Lubbock, Texas
| | - Gabriella Grimaldo
- 1 Department of Psychological Sciences, Texas Tech University , Lubbock, Texas
| | - Sharon C Wilsnack
- 2 Department of Psychiatry and Behavioral Science, University of North Dakota , Grand Forks, North Dakota
| | - Tonda L Hughes
- 3 Department of Health Systems Science, University of Illinois at Chicago , Chicago, Illinois
| | - Arlinda F Kristjanson
- 2 Department of Psychiatry and Behavioral Science, University of North Dakota , Grand Forks, North Dakota
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Abstract
BACKGROUND Reproductive coercion impacts many women of reproductive age. OBJECTIVES We sought to explore how reproductive coercion, including pregnancy coercion and birth control sabotage, impacts women in a primary care population. METHODS We administered a survey to women accessing care at a family medicine clinic in the Bronx, NY. Reproductive coercion was defined as a positive response to at least one of five questions adapted from previous studies. We assessed the association of reproductive and demographic characteristics with a lifetime history of reproductive coercion. RESULTS At least one form of reproductive coercion was reported by 24% of the 97 respondents. Current lack of personal safety and a history of transactional sex for money or a place to stay were significantly associated with having experienced reproductive coercion (all P ≤ 0.02). CONCLUSIONS Reproductive coercion was common among women of reproductive age at this urban family medicine clinic in an underserved community, and was associated with other forms of control and violence. Clinicians are advised to discuss birth control sabotage and pregnancy coercion with their patients.
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Affiliation(s)
- Sharon J Phillips
- Department of Family and Social Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY and
| | - Ariana H Bennett
- Department of Family and Social Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY and
| | - Michele R Hacker
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Marji Gold
- Department of Family and Social Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY and
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Lokhmatkina NV, Agnew-Davies R, Costelloe C, Kuznetsova OY, Nikolskaya IM, Feder GS. Intimate partner violence and ways of coping with stress: cross-sectional survey of female patients in Russian general practice. Fam Pract 2015; 32:141-6. [PMID: 25556197 DOI: 10.1093/fampra/cmu086] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Despite World Health Organization guidelines on health service responses to intimate partner violence (IPV) against women general practitioners (GPs) often overlook the problem. Training on IPV addresses GPs' barriers to asking women patients about abuse and responding appropriately. One of the barriers is stereotype of women as passive victims. Little is known about coping behaviour of women patients with a history of IPV. OBJECTIVES The objectives are (i) to compare problem- and emotion-focused coping used by patients who have experienced IPV with those who have not; (ii) to examine whether greater coping resources (health, education, employment and income) would be associated with more problem-focused coping. METHODS The Russian Ways of Coping Questionnaire was administered to every fifth woman who participated in a cross-sectional survey on IPV prevalence in 24 St Petersburg general practices. Linear regression was used (n = 159) to test associations between life-time IPV, coping resources and ways of coping. RESULTS Mean problem-focused coping scores were 0.2-4.7 units higher in those patients who have experienced IPV compared with those who have not [95% confidence interval (CI): -4.2, 11.9; P = 0.16-0.92], while mean emotion-focused coping scores were 2.5-4.2 units higher (95% CI: -3.0, 11.0; P = 0.12-0.57). After adjustment for coping resources there was no evidence for an association between IPV and problem-focused coping. CONCLUSIONS Patients who have experienced IPV use as much problem-focused and emotion-focused coping, as those patients who have not experienced IPV. These findings should be incorporated into training on IPV to address GPs' stereotypes towards patients who have experienced IPV.
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Affiliation(s)
- Natalia V Lokhmatkina
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK,
| | - Roxane Agnew-Davies
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Ceire Costelloe
- Centre for Primary Care and Public Health, Queen Mary University of London, London, UK
| | - Olga Yu Kuznetsova
- Department of Family Medicine, North-Western State Medical University named after I.I. Mechnikov, St Petersburg, Russian Federation and
| | - Irina M Nikolskaya
- Department of Paediatric Psychiatry, Psychotherapy and Medical Psychology, North-Western State Medical University named after I.I. Mechnikov, St Petersburg, Russian Federation
| | - Gene S Feder
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
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15
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Loutfy MR, V LK, Mohammed S, Wu W, Muchenje M, Masinde K, Salam K, Soje L, Gregorovich S, Tharao W. Recruitment of HIV-Positive Women in Research: Discussing Barriers, Facilitators, and Research Personnel's Knowledge. Open AIDS J 2014; 8:58-65. [PMID: 25624955 PMCID: PMC4302460 DOI: 10.2174/1874613601408010058] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Revised: 11/03/2014] [Accepted: 11/03/2014] [Indexed: 11/22/2022] Open
Abstract
Background : Women have historically been under-represented in HIV research, partly due to ineffective recruitment strategies. Objective : To improve the existing understanding of recruitment for HIV-positive women based on a province-wide cross-sectional study. Methods : A survey was emailed to all site coordinators who recruited participants in a study involving 490 HIV-positive women living in Ontario, Canada. The survey consisted of questions regarding the important recruitment barriers and successes. Quantitative data were then contextualized within extensive knowledge from research personnel and team members. Results : Completed surveys were received from (89%) site coordinators (34/38) and 98% (31/34) were women. The highest ranked recruitment barriers identified were: sensitivity of the research topic (59%), time/availability constraints (59%), language barriers (53%), HIV disclosure/stigma issues (47%), lack of trust of research personnel (41%), fear of research (41%) and inaccessibility to child care and transportation (41%). The respondents felt that the most important personal attributes for recruitment were research personnel who were respectful (97%), skilled (91%), flexible (88%) and empathetic (88%) and had good communication skills (88%). The most successful recruitment strategies identified were: developing a strong rapport (88%) that was facilitated by an empathetic relationship (100%), acknowledging the sensitive nature of the research topic (94%), providing cash financial compensation (88%), and developing recruitment strategies unique to women (88%). Conclusion : There are differences in the approaches needed for the recruitment of HIV-positive women in research. For successful recruitment of HIV-positive women, a strong rapport between the research personnel and study participants is important. This rapport is facilitated by having study personnel who are respectful, trustworthy, empathetic, and flexible. Population-specific recruitment strategies are important to ensure adequate recruitment of minority groups in research with greater gender consideration for women requiring specific attention.
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Affiliation(s)
- Mona R Loutfy
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada ; Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Logan Kennedy V
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Saira Mohammed
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Wei Wu
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Marvelous Muchenje
- Women's Health in Women's Hands Community Health Centre, Toronto, Ontario, Canada
| | - Khatundi Masinde
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Khaled Salam
- AIDS Committee of Ottawa, Ottawa, Ontario, Canada
| | - Lena Soje
- Black Coalition for AIDS Prevention, Toronto, Ontario, Canada
| | | | - Wangari Tharao
- Women's Health in Women's Hands Community Health Centre, Toronto, Ontario, Canada
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Karlsson MK, Magnusson H, von Schewelov T, Cöster M, Karlsson C, Rosengren BE. Patients with Osteoarthritis in all Three Knee Compartments and Patients with Medial Knee Osteoarthritis Have a Phenotype with High Bone Mass and High Fat Mass but Proportionally Low Lean Mass. Open Orthop J 2014; 8:390-6. [PMID: 25408779 PMCID: PMC4235065 DOI: 10.2174/1874325001408010390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 09/17/2014] [Accepted: 09/21/2014] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND PURPOSE Cross-sectional studies have shown that patients with primary hip osteoarthritis (OA) have higher bone mineral density (BMD), higher BMI, lower lean body mass, and higher fat content. But it is unknown if this phenotype is found also in patients with knee OA and if it precedes OA or manifests as a result of the disease. PATIENTS AND METHODS We included 21 women and 18 men (mean age, 71 years; range, 48-85 years) with primary OA in all three knee compartments, 17 women and 56 men (mean age, 55 years; range, 34-74 years) with primary medial knee OA and 122 women and 121 men without OA as controls. We measured total body BMD (g/cm(2)), fat and lean mass (%) by dual energy X-ray absorptiometry and also registered height and weight to calculate BMI (kg/m(2)). Z-scores were calculated for each individual. Data are presented as means with 95% confidence intervals within brackets. RESULTS Individuals with primary OA in all three knee compartments had the following Z-scores: total body BMD 0.4 (0.0, 0.9); BMI 1.2 (0.7, 1.6); proportion of lean mass -0.6 (-1.1, -0.1); proportion of fat mass 0.4 (0.0, 1.8). Individuals with medial knee OA had the following Z-scores: total body BMD 0.4 (0.3, 0.6); BMI 1.1 (0.8, 1.4); proportion of lean mass -0.8 (-1.3, -0.9); proportion of fat mass 0.9 (0.7, 1.1). INTERPRETATIONS A phenotype with higher BMD, higher BMI, higher fat mass, and proportionally lower lean body mass is evident in individuals with primary OA in all three knee compartments and in patients with only medial knee OA.
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Affiliation(s)
- Magnus K Karlsson
- Department of Orthopedics, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - Håkan Magnusson
- Department of Orthopedics, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - Thord von Schewelov
- Department of Orthopedics, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - Maria Cöster
- Department of Orthopedics, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - Caroline Karlsson
- Department of Orthopedics, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - Björn E Rosengren
- Department of Orthopedics, Skåne University Hospital, SE-205 02 Malmö, Sweden
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17
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Abstract
BACKGROUND It is recommended that older people report their falls to their general practitioner (GP), to identify falls risk factors. However, many older people do not report falling to their GP. Little is known about the reasons why older people do and do not seek help about falling. OBJECTIVE To explore why older women do or do not seek GP help after a fall. METHODS A qualitative study, using semi-structured interviews with 11 community-dwelling women aged ≥ 65 years, living in Adelaide, Australia, who had fallen in the last 12 months. Interviews focused on women's experience of falling and seeking GP help. Interviews were analysed using constant comparison. RESULTS Four women sought GP help when they believed their fall-related injury was serious enough. Family and a bystander persuaded three women to attend for a fall-related injury. The four women who did not seek help believed their fall or fall-related injury was not serious enough to seek help and justified this by using internal rationales (they monitored and managed the outcome of falling, they wanted to be associated with a positive image and attitude, and they recognized and interpreted the cause and control of falling) and external rationales (they did not want to waste GPs' time for trivial reasons and they believed they did not have timely access to their GP). CONCLUSIONS Given the reasons why some older women do not seek help for falling, GPs should routinely ask older women for their 12-month fall history.
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18
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Engqvist I, Nilsson K. The Recovery Process of Postpartum Psychosis from Both the Woman's and Next of Kin's Perspective - An Interview Study in Sweden. Open Nurs J 2014; 8:8-16. [PMID: 24660040 PMCID: PMC3960751 DOI: 10.2174/1874434601408010008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Revised: 01/11/2014] [Accepted: 01/13/2014] [Indexed: 01/27/2023] Open
Abstract
Objectives: The most serious type of psychiatric disorder in connection with childbirth is postpartum
psychosis. With this disorder occasionally follows emotional rejection of the infant which has serious long term effect on
mother and child. The aim of this study was to explore the experiences of the recovery process of postpartum psychosis
from the women, from the partners of the women, and their next of kin. Methods: Interviews were conducted with seven women, who had previously suffered postpartum psychosis, and six of
their next of kin. The interviews were transcribed verbatim and analysed using content analysis. Results: Two categories emerged: the recovery process and the circumstances of the support provided. The women and
their next of kin spoke about the turning point in the illness, their own personal as well as their social recovery, the
importance of support not only from relatives and friends, but also from professionals, and the use of medication.
However, the key to recovery was an internal decision by the women themselves. Conclusion: Conclusion is that the recovery from this severe mental disorder requires hard work and the key to their
recovery was the decision made by the women. This disorder causes a mental darkness to descend, but at the start of the
recovery a dim light shines in the dark tunnel. The nursing staff must be made aware that good sleep is important for the
psychiatric treatment and that recovery may take a long time. The nurse needs to provide hope and encouragement, as
well as help the woman to recognise the strength that exists within her. To reduce the risk of a recurrence of the disorder,
the staff needs to offer follow up visits.
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Affiliation(s)
- I Engqvist
- School of Life Science, University of Skövde, Sweden ; Skaraborg Hospitals, Falköping, Sweden
| | - K Nilsson
- Institute of Health and Caring Sciences, The Sahlgrenska Academy, University of Gothenburg, Sweden
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19
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Abstract
BACKGROUND Longitudinal associations between depressive symptoms and blood pressure have been inconsistent. Most studies have examined incident hypertension as an outcome, and few have examined effect modification. METHODS This study examined moderating influences of sex and age on coincident trajectories of depressive symptoms and blood pressure among 2,087 participants from the Baltimore Longitudinal Study of Aging (aged 19-97 years; 53% men; 74% white). Participants underwent clinical blood pressure measurement and completed the Center for Epidemiological Studies-Depression (CES-D) scale on up to 14 occasions (mean = 3.8; SD = 2.6) over up to 29 years (mean = 7.8; SD = 6.4). CES-D was log-transformed (CES-D(log)) for analyses. RESULTS Mixed-effects regression revealed that prospective relations of CES-D(log) to diastolic blood pressure differed by age in women (b = 0.095; P = 0.001) but not men; greater CES-D(log) attenuated the expected age-related decline in diastolic blood pressure. Across all testing sessions, greater CES-D(log) was associated significantly with higher average systolic blood pressure for women (b = 2.238; P = 0.006) but not men. Age-stratified analyses showed that greater CES-D(log) was associated significantly with higher average systolic (b = 3.348; P = 0.02) and diastolic (b = 1.730; P < 0.03) blood pressure for older adults (≥58.8 years at first visit). In the younger age cohort, sex moderated the relation of CES-D(log) to systolic blood pressure (b = -3.563; P = 0.007); greater CES-D(log) in women, but lesser CES-D(log) in men, was associated with higher systolic blood pressure. CONCLUSIONS Results demonstrate sex and age differences in the relation between depressive symptoms and blood pressure. Findings suggest the potential importance of preventing, detecting, and lowering depressive symptoms to prevent hypertension among women and older adults.
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Affiliation(s)
- Mauli T Shah
- Department of Psychology, University of Maryland-Baltimore County, Baltimore, Maryland
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20
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Baraković D, Avdibegović E, Sinanović O. Depression, anxiety and somatization in women with war missing family members. Mater Sociomed 2013; 25:199-202. [PMID: 24167436 PMCID: PMC3804435 DOI: 10.5455/msm.2013.25.199-202] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2013] [Accepted: 08/05/2013] [Indexed: 12/04/2022] Open
Abstract
Introduction: During the war circumstances, women and children are exposed to multiple traumatic experiences, one of which is an violent disappearance of a family member. Goal: The aim of this research was to establish the presence of symptoms of depression, anxiety and somatization in women in Bosnia and Herzegovina who have sought their war missing family members for 15 to 18 years. Subjects and Methods: The research was based on a sample of 120 women with war missing family member and 40 women without a war missing family member as a control group. For assessment of depression, anxiety and symptoms of somatization the self-rating Beck Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HAM-A), Somatic Symptoms Index (SSI) questionnaire and a general questionnaire on the sociodemographic data and data on war missing family members were used. Results: A significantly higher intensity of symptoms of depression (p<0.001), anxiety (p<0.001) and somatization (p = 0.013) was present in women with, in comparison to women without a missing family member. In comparison of the kinship with the missing family members, statistically significantly higher intensity of symptoms of depression, anxiety and somatization was in women with a missing child (p<0.001) in comparison to other missing family members. Conclusion: A prolonged period of seeking, waiting and uncertainty of what happened in the war with the missing family member presents for those women a prolonged suffering manifested through depression, anxiety and symptoms of somatization.
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Affiliation(s)
- Devla Baraković
- General Hospital, Neuropsychiatric Department, Brčko District, Bosnia and Herzegovina
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Malek AM, Chang CCH, Clark DB, Cook RL. Delay in Seeking Care for Sexually Transmitted Diseases in Young Men and Women Attending a Public STD Clinic. Open AIDS J 2013; 7:7-13. [PMID: 24078858 PMCID: PMC3785038 DOI: 10.2174/1874613620130614002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 05/28/2013] [Accepted: 05/31/2013] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Delay in seeking care for sexually transmitted diseases (STDs) has adverse consequences for both the individual and population. We sought to identify factors associated with delay in seeking care for STDs. METHODS Subjects included 300 young men and women (aged 15-24) attending an urban STD clinic for a new STD-related problem due to symptoms or referral for an STD screening. Subjects completed a structured interview that evaluated STD history, attitudes and beliefs about STDs, depression, substance use, and other factors possibly associated with delay. Delay was defined as waiting > 7 days to seek and obtain care for STDs. RESULTS Nearly one-third of participants delayed seeking care for > 7 days. Significant predictors for delay included self-referral for symptoms as the reason for visit (OR 5.3, 95% CI: 2.58 - 10.98), and the beliefs "my partner would blame me if I had an STD" (OR 2.44, 95% CI: 1.30 - 4.60) and "it's hard to find time to get checked for STDs" (OR 3.62, 95% CI: 1.95 - 6.69), after adjusting for age, race, sex, and other factors. Agreeing with the statement "would use a STD test at home if one were available" was associated with a decrease in delay (OR 0.24, 95% CI: 0.09 - 0.60). CONCLUSIONS Many young persons delay seeking care for STDs for a number of reasons. Strategies to improve STD care-seeking include encouragement of symptomatic persons to seek medical care more rapidly, reduction of social stigmas, and improved access to testing options.
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Affiliation(s)
- Angela M Malek
- Department of Neurosciences, Medical University of South Carolina, Charleston, SC, USA
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Ezechieli M, Berger S, Siebert CH, Miltner O. Injury rates of the German Women's American Football National Team from 2009 to 2011. Orthop Rev (Pavia) 2012; 4:e28. [PMID: 23066496 PMCID: PMC3470034 DOI: 10.4081/or.2012.e28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 05/22/2012] [Indexed: 12/02/2022] Open
Abstract
American football is one of the leading causes of athletic-related injuries. Injury rates in female elite players are mostly unknown. We hypothesized that the injury rates of female was comparable to those in men's football during practice, as well as games. From 2009 to 2011, injury data were collected from the German female national team during training camps, World Championship 2010 and International friendly matches. The injury was categorized by location on the body and recorded as fracture/dislocation, strain, concussion, contusion or other injury. Injury rates were determined based on the exposure of an athlete to a game or practice event. The injury rate was calculated as the ratio of injuries per 1000 athlete exposures (AE). The rate of injury was significantly higher during games (58.8/1000 AE) than practices [16.3/1000 AE, (P<0.01)]. Furthermore, the injury rate in the tryouts was significantly higher (24.05/1000 AE) compared to other training sessions with the national team (11.24/1000 AE). Our findings show that the injury rates in female elite American football players can be compared to those described for male players. Higher injury rates during matches than in training should also be underlined.
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Affiliation(s)
- Marco Ezechieli
- Department of Orthopaedic Surgery, Hanover Medical School, Hannover
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Mattioli AV, Pennella S, Demaria F, Farinetti A. Atrial Remodeling in Pregnant Hypertensive Women: Comparison between Chronic and Gestational Hypertension. Open Cardiovasc Med J 2012; 6:9-14. [PMID: 22431946 PMCID: PMC3293156 DOI: 10.2174/1874192401206010009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Revised: 01/09/2012] [Accepted: 01/15/2012] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Left atrial (LA) enlargement is a common finding in hypertensive patients (pts), however little information is available on LA changes during pregnancy. The present study evaluated LA size and function in pregnant women with hypertension. METHODS Patients population included 30 women with chronic hypertension and 30 patients with gestational hypertension. A control group of 16 normotensive pregnant women was selected. Serial echocardiography was performed at 12 and 24 week of gestation in chronic hypertension and at 24 week in gestational hypertension and after delivery. LA diameters and volumes were measured and compared. LA conduit volume, passive and active emptying volumes were calculated. Patients were divided in 2 groups according to max LAV Index > 32 ml/m(2) at 24 week of gestation. RESULTS Patients with chronic hypertension showed higher LA diameters (42 ± 2.0 vs. 36.5 ± 1.8; p<0.001) and LA volumes (maximal volume 45.5 ± 4.0 vs. 38.1 ± 7.3; p<0.001) compared with patients with gestational hypertension. The median value of max LAVI was 32 + 6.2 ml/m(2) in chronic and 26 + 5 ml/m(2) in gestational hypertension (p<0.01). During follow-up patients with max LAVI > 32 ml/m(2) had more clinical complications evaluated as increase of therapy, fluid retention that need diuretic and hospitalization. CONCLUSION Patients with chronic hypertension showed a more marked increased of LA volumes compared to gestational hypertension due to a remodeling of atrial shape as effect of chronic overload. Patients with more dilated LA volumes developed a greater number of clinical complications suggesting that a dilated LA could be a parameter of hemodynamic instability.
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Affiliation(s)
- Anna Vittoria Mattioli
- Department of Biomedical Science, University of Modena and Reggio Emilia, Modena, Italy
- Istituto Nazionale di Ricerche Cardiovascolari, Bologna, Italy
| | - Sonia Pennella
- Department of Biomedical Science, University of Modena and Reggio Emilia, Modena, Italy
- Istituto Nazionale di Ricerche Cardiovascolari, Bologna, Italy
| | - Fabrizio Demaria
- Neonatal Intensive Care Unit, Ospedale Maggiore Bologna, Bologna, Italy
| | - Alberto Farinetti
- Department of Surgery, University of Modena and Reggio Emilia, Modena, Italy
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Abstract
Angina in the absence of obstructive coronary artery disease, sometimes referred to as cardiac syndrome X (CSX), is a debilitating condition that disproportionately affects women. More than 50% of women evaluated for angina have non-obstructive disease by cardiac catheterization, although the total numbers of women affected by CSX are unknown. Varying clinical definitions and the lack of large scale epidemiologic studies focusing on this illness have resulted in limited knowledge about its risk factors, although there appears to be an association with black race, estrogen deficiency, and insulin resistance. Contrary to prior beliefs about the benign nature of this entity, these women suffer considerable morbidity with costly economic implications that approach the lifetime costs of healthcare utilization for those with obstructive coronary disease. Two prevailing hypotheses have emerged to explain CSX: the ischemic hypothesis detailing abnormal coronary microvascular function and the non-ischemic hypothesis describing altered pain perception and myocardial hypersensitivity. Treatment strategies have focused on both of these pathways with the main goal of improving symptoms. Beta blockers provide the most convincing evidence for benefit, with other antianginals having secondary roles. Other promising pharmacologic therapies include xanthine derivatives, estrogen replacement therapy, ACE inhibitors, and statin medications, among other emerging treatment options. Neurostimulation and lifestyle factors including exercise can also be beneficial in reducing symptoms. However, managing patients with CSX can be frustrating for both patients and physicians, as there is a lack of data regarding an optimal treatment algorithm including few large-scale randomized controlled trials to clarify effective therapies.
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Affiliation(s)
- Kamakki Banks
- From the Donald W. Reynolds Cardiovascular Clinical Research Center, the University of Texas Southwestern Medical Center, Dallas TX
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Høyer BB, Toft GV, Debess J, Ramlau-Hansen CH. A nurse-led telephone session and quality of life after radiotherapy among women with breast cancer: a randomized trial. Open Nurs J 2011; 5:31-7. [PMID: 21660182 PMCID: PMC3109608 DOI: 10.2174/1874434601105010031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 02/18/2011] [Accepted: 02/21/2011] [Indexed: 11/29/2022] Open
Abstract
The purpose of this study was to investigate whether a nurse-led telephone session with patients suffering from breast cancer approximately ten days after final radiotherapy treatment affected their quality of life two to four weeks after radiotherapy. The study was conducted at the Radiotherapy ward at Vejle Hospital, Denmark between January and May 2010. The study population consisted of 100 patients, who were randomized with a 1:1 ratio to have either ordinary supportive conversations (control group), or ordinary supportive conversations and a supplementary nurse-led telephone session (intervention group). The quality of life was assessed using the questionnaires EORTC QLQ-C30 and EORTC QLQ-BR23. For statistical comparison of quality of life and for adjustment for covariates, multiple linear regression analysis was conducted. The mean [95 % CI] quality of life was 72.0 [66.4-77.6] in the control group and 69.9 [64.3-75.2] in the intervention group. Adjustment for covariates did not change the estimates. No statistically significant differences were found in the groups in either of the analyses. The nurse-led telephone session had no positive effect on the quality of life of patients with breast cancer two to four weeks after their final radiotherapy.
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Affiliation(s)
- Birgit Bjerre Høyer
- Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark.
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26
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Amaro H, Dai J, Arévalo S, Acevedo A, Matsumoto A, Nieves R, Prado G. Effects of integrated trauma treatment on outcomes in a racially/ethnically diverse sample of women in urban community-based substance abuse treatment. J Urban Health 2007; 84:508-22. [PMID: 17356904 PMCID: PMC2219564 DOI: 10.1007/s11524-007-9160-z] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study presents findings from a quasiexperimental, nonequivalent, group-design study with repeated measures that explored the effects of integrated trauma-informed services on the severity of substance abuse, mental health, posttraumatic stress disorder (PTSD) symptomatology among women with histories of trauma in urban, community-based substance abuse treatment. The study also explored if the model of integrated services was equally beneficial for women of various racial/ethnic groups. Participants in the study were 342 women receiving substance abuse treatment in intervention and comparison sites. Results indicated that at 6 and 12 month follow-ups, those in the trauma-informed intervention group, in contrast to the comparison group, had significantly better outcomes in drug abstinence rates in the past 30 days as well as in mental health and PTSD symptomatology. Results also showed that, overall, integrated services were beneficial for women across the different racial/ethnic groups in substance abuse treatment, although some differences appear to exist across racial/ethnic groups in improving addiction severity and mental health and PTSD symptomatology.
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Affiliation(s)
- Hortensia Amaro
- Institute on Urban Health Research, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA.
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Riley ED, Weiser SD, Sorensen JL, Dilworth S, Cohen J, Neilands TB. Housing patterns and correlates of homelessness differ by gender among individuals using San Francisco free food programs. J Urban Health 2007; 84:415-22. [PMID: 17265132 PMCID: PMC2231829 DOI: 10.1007/s11524-006-9153-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Homeless individuals experience high rates of morbidity and mortality, yet many homeless studies include small percentages of female participants. We therefore sought to determine correlates of homelessness separately for men and women in a sample of individuals visiting free food programs. Between August 2003 and April 2004, 324 individuals were recruited from San Francisco free food programs and interviewed regarding housing, sociodemographics, health, drug use, sex trade, and incarceration. Over one-half of women and almost three-fourths of men reported homelessness in the prior year. Among women, white race, younger age, not living with minor children, engaging in sex trade and recent incarceration were strongly associated with homelessness; however, only incarceration maintained the strong association in adjusted analysis (OR = 7.16, CI = 3.83-13.4). Among men, heavy alcohol use, drug use, years spent living in San Francisco and monthly income were strongly associated with homelessness; however, only years living in San Francisco (OR = 0.28, CI = 0.19-0.42) and monthly income maintained strong association in adjusted analysis (OR = 0.27, CI = 0.13-0.57). Housing patterns and the strongest correlates of homelessness among individuals visiting free food programs differ by sex. These results suggest the need to characterize homelessness and develop effective homeless interventions separately for men and women.
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Affiliation(s)
- Elise D Riley
- San Francisco General Hospital, Epidemiology and Prevention Interventions Center, University of California, San Francisco, CA 94110, USA.
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