Browsing by Subject "women"
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Item ASSESSING REPRODUCTIVE INTERCONCEPTION CARE BEHAVIORS, BARRIERS, AND FACILITATORS AMONG WOMEN RECENTLY PREGNANT AND HOMELESS(2022-08) Galvin, Annalynn M.; Thompson, Erika; Lewis, Melissa; Walters, Scott T.Interconception care, care provided to mothers between pregnancies, reduces short birth interval risks such as prematurity and low birthweight. Women experiencing homelessness have higher rates of unintended pregnancy and may experience stronger benefits from reproductive interconception care through either unintended pregnancy reductions or healthy pregnancy promotion via family planning. It is critical to build on limited research on interconception care within this population to potentially reduce poverty and cyclical, intergenerational homelessness. By utilizing a sequential explanatory mixed-methods design, this proposed study aimed to first determine prevalence ratios of interconception behaviors such as attendance of maternal postpartum visits, birth spacing and family planning counseling, and postpartum contraception outcomes of women experiencing homelessness, then identify the most salient interconception barriers and facilitators related to interconception information (e.g., knowledge), motivation (e.g., personal attitudes), and behavioral skills (e.g., perceived self-efficacy) among postpartum women who experienced homelessness during pregnancy. Using the 2016-2019 Pregnancy Risk Assessment and Monitoring System, the prevalence of interconception care behaviors among women experiencing homelessness and the associations between housing status and interconception care behaviors were estimated. The sample (n=100,706) was primarily non-Hispanic White (59.4%), married (61.9%) women with private insurance (59.4%) and less than a 4-year degree (63.0%). Approximately 2.4% of participants experienced housing instability in the 12 months before their child was born. Perinatal housing instability was significantly associated with lower odds of attending a postpartum maternal visit (aOR=0.45, 95% CI 0.37, 0.56) and (aOR=1.30, 95% CI 1.07, 1.57) when compared to women who did not experience homelessness in the last 12 months from the time of the interview. Findings from aim 1 determined specific interconception care behavior deficits to further explore via one-hour semi-structured interviews with 12 women experiencing homelessness while pregnant who had given birth within the last four years. Eligible women were recruited through local agency partnerships using purposive sampling. Interviews were audio-recorded, coded to consensus, and analyzed for themes. Information-related themes included knowledge and misconceptions about perinatal processes (e.g., pregnancy, labor and delivery, becoming pregnant, preventing pregnancy) as well as information-seeking themes. Motivation-related themes included attitudes about recent interconception care experiences, perinatal social influences, perceived susceptibility to future pregnancy, and attitudes regarding reasons for not engaging in postpartum pregnancy prevention. Behavioral skill-related themes included objective ability to engage in perinatal behaviors during housing instability, as well as perceived self-efficacy related to barriers and facilitators to engaging in reproductive interconception pregnancies as well as ease of pregnancy. Macro-related themes included housing effects on perinatal period, how perinatal experiences affected seeking stable housing, and how the interconnected nature of housing and other macro-level factors influenced reproductive interconception care. These findings establish a baseline understanding of interconception behaviors and the associated barriers and facilitators related to interconception care information, motivation, and behavioral skills among women experiencing homelessness. Findings may potentially strengthen current interconception practices and augment reductions in unintended pregnancy, short birth intervals, or adverse birth outcomes in future pregnancies, thus improving pregnancy outcomes and improving the health of women before, during, and after pregnancy.Item Barriers to Women's Cardiovascular Risk Knowledge: A Tarrant County Study(2004-05-01) Liewer, Linda J.; Kristine LykensLiewer, Linda J., Barriers to Women’s Cardiovascular Risk Knowledge: A Tarrant County Study. Master of Public Health (Health Management and Policy), May 2004, 71 pp., 19 tables, 6 illustrations, 36 references, 17 titles. Women’s death rate from cardiovascular disease is greater than the death rate from all cancers. Awareness and knowledge of a disease are key to dealing with it, yet many women are still unaware of their CVD risk. The purpose of this study is to identify the barriers to knowledge about cardiovascular disease risk in women in Tarrant County. Interviews with administrative personnel in 10 community organizations confirmed the lack of awareness of CVD. Barriers included: women in caregiver roles advocate effectively for their family members, but less effectively for themselves; physician communication with women regarding CVD is often suboptimal; women fear breast cancer far more than CVD; a program deficiency exists in Tarrant County; lack of a visible woman champion and heart disease is still seen as a man’s disease.Item Cardiorespiratory Fitness, Body Mass Index and All-Cause Mortality in Women, ACLS 1970-1994(1999-12-01) Braun, LeeAnn; Sally Blakley; Antonio A. ReneBraun, LeeAnn, Cardiorespiratory Fitness, Body Mass Index and All-Cause Mortality in Women, Aerobics Center Longitudinal Study, 1970-1994. Master of Public Health (Epidemiology), December, 1999, 44 p.p., 9 tables, references, 24 titles. Cardiorespiratory fitness and body mass index are related to morbidity and mortality (Manson, 1996). There is a preponderance of evidence supporting this relation in men (Gibbons, 1983; Blair, 1989, 1995, 1996; Lee, I, 1993; Barlow, 1995; Kampert, 1996; Dorn, 1997; Lee, C, 1999). The evaluation of the stated risk factors have been virtually unexplored in a cohort of women. The aim of this study is to evaluate whether higher levels of cardiorespiratory fitness attenuate the risk of all-cause mortality in overweight and obese women. In this prospective study, the study population consisted of 7572 women ages 20-89 years, who had a medical examination and achieved at least 85% of their age-adjusted maximal heart rate during a maximal treadmill test were followed for 69,979 woman-years. After adjustment for age, exam year, health status and smoking status, unfit women had a higher risk for all-cause mortality across BMI categories [RR 1.70 95% CI (1.18, 2.43)]. The benefits of cardiorespiratory fitness significantly decrease the risk of all-cause mortality in women as the concurrent consideration of cardiorespiratory fitness.Item Comparison of Dietary Micronutrient Intakes by Body Weight Status among Mexican-American and Non-Hispanic Black Women Aged 19-39 Years: An Analysis of NHANES 2003-2014(MDPI, 2019-11-20) Liu, Jialiang; Zhu, Xiangzhu; Fulda, Kimberly G.; Chen, Shande; Tao, Meng-HuaThe objective of the current study was to examine micronutrient intake from foods in women of childbearing age and to better understand potential nutritional problems varied by body weight status in minority women. A sample of women aged 19-39 years from the National Health and Nutrition Examination Surveys (NHANES) 2003-2014 was analyzed. Dietary intakes of 13 micronutrients were estimated using the National Cancer Institute method. Mexican-American and non-Hispanic Black women were categorized into normal/under-weight, overweight, or obese groups according to their body mass index (BMI). Mexican-American and non-Hispanic Black women had lower dietary intakes for vitamins A, B2, B6, B12, and D, folate, calcium, and magnesium than non-Hispanic Whites. Among Mexican-Americans, obese women had the lowest dietary intake of vitamins A, B2, C and D. Obese non-Hispanic Black women had significantly lower dietary intakes of iron and zinc than their normal/under-weight counterparts. Comparable percentages (>30%) of Mexican-American and non-Hispanic Black women had dietary intake less than the Estimated Average Requirements (EARs) for several key nutrients including vitamin A, C and D, folate, calcium and magnesium, and the percentages varied by body weight status. These results indicate micronutrient inadequacies persist among and within racial/ethnic and body weight groups.Item Differences in the Rates of Cardiovasular Surgical Procedures in Men and Women with Coronary Heart Disease in the State of Texas(2003-02-01) Moreland, Matthew C.; Muriel Marshall; Doug A. MainsMoreland, Mathew, Differences in the rates of cardiovascular surgical procedures between men and women with coronary heart disease in the state of Texas. University of North Texas Health Science Center, School of Public Health, February 2003, 19pp., 3 tables, references, 23 titles. Data for the Texas Health Care Information Council was analyzed to identify the difference in the rates of invasive cardiovascular procedures performed on men and women among 411 Texas hospitals with the diagnosis of coronary heart disease in 1999. In all, 150,361 cases were compared for differences between gender, race, age and type of invasive cardiovascular procedure using chi-square test. Frequencies were tabulated for age, race and gender. Invasive cardiac procedures were differentiated by type: coronary angiography and coronary revascularization. Between the ages of 45 and 79 women were more likely to have angiography performed than men in the same age group. However, young (30-44) and elderly (80+) men were more likely to receive angiographic procedures when presenting with the same symptoms as women. Also, men of all ages and races were more likely to receive revascularization procedures (PTCA, CABG) than women when presenting with coronary heart disease symptomology. Additionally, men between the ages of 35 and 49 received twice the number of revascularization procedures than women. These findings identified patterns of treatment with defined differences between gender which may be attributed to external factors versus a true gender bias.Item Do physical activity levels differ by number of children at home in women aged 25-44 in the general population?(Sage Publications, 2019-09-09) Abell, Laura P.; Tanase, Kelly A.; Gilmore, Madison L.; Winnicki, Anna E.; Holmes, Victor L.; Hartos, Jessica L.OBJECTIVES: While physical activity is important for health, many women do not meet recommended levels, particularly mothers. The purpose of this study was to assess whether physical activity levels differ by number of children at home in women aged 25-44 in the general US population. METHODS: This cross-sectional analysis used 2017 Behavioral Risk Factor Surveillance System data for females aged 25-44 (N = 6266) from California, Colorado, New York, Texas, and Utah. Ordered logistic regression analysis assessed the relationship between physical activity levels and number of children at home while controlling for state and demographic, socioeconomic, and health-related factors. RESULTS: About half of participants reported "inactive" or "insufficiently active" physical activity levels and about two-thirds reported having one or more children at home. The results of adjusted analysis indicated that physical activity level was significantly related to having one child (adjusted odds ratio = 0.75, 95% confidence interval = 0.63, 0.89), two children (adjusted odds ratio = 0.79; 95% confidence interval = 0.67, 0.93), and three or more children (adjusted odds ratio = 0.80, 95% confidence interval = 0.67, 0.94) at home. CONCLUSION: Overall, physical activity levels were significantly related to presence of children at home for women aged 25-44, but increasing number of children at home did not impact effect size. For women aged 25-44 in a primary care setting, a moderate prevalence of inactive or insufficiently active physical activity may be expected. Providers should address physical activity with all patients in this target population during well-visits, but particularly for women with children at home; educate patients about the health benefits of regular physical activity; and provide resources that will help them integrate physical activity into their daily lifestyles.Item Moderation effects of serotype on dengue severity across pregnancy status in Mexico(BioMed Central Ltd., 2023-03-11) Annan, Esther; Nguyen, Uyen-Sa D. T.; Trevino, Jesus; Wan Yaacob, Wan F.; Mangla, Sherry; Pathak, Ashok K.; Nandy, Rajesh; Haque, UbydulBACKGROUND: Pregnancy increases a woman's risk of severe dengue. To the best of our knowledge, the moderation effect of the dengue serotype among pregnant women has not been studied in Mexico. This study explores how pregnancy interacted with the dengue serotype from 2012 to 2020 in Mexico. METHOD: Information from 2469 notifying health units in Mexican municipalities was used for this cross-sectional analysis. Multiple logistic regression with interaction effects was chosen as the final model and sensitivity analysis was done to assess potential exposure misclassification of pregnancy status. RESULTS: Pregnant women were found to have higher odds of severe dengue [1.50 (95% CI 1.41, 1.59)]. The odds of dengue severity varied for pregnant women with DENV-1 [1.45, (95% CI 1.21, 1.74)], DENV-2 [1.33, (95% CI 1.18, 1.53)] and DENV-4 [3.78, (95% CI 1.14, 12.59)]. While the odds of severe dengue were generally higher for pregnant women compared with non-pregnant women with DENV-1 and DENV-2, the odds of disease severity were much higher for those infected with the DENV-4 serotype. CONCLUSION: The effect of pregnancy on severe dengue is moderated by the dengue serotype. Future studies on genetic diversification may potentially elucidate this serotype-specific effect among pregnant women in Mexico.Item Racial and Ethnic Differences in Cardiovascular Disease Risk Factors in U.S. Older Women: Findings from the Behavioral Risk Factor Surveillance Survey(2006-08-01) Kurian, Anita K.; Sejong Bae; Karan Singh; Kristine LykensKurian, Anita K., Racial and Ethnic Differences in Cardiovasular Disease Risk Factors in U.S. Older Women: Findings from the Behavioral Risk Factor Surveillance Survey, 2003 & 2004. Doctor of Public Health (Clinical Research), August 2006, 118 pp., 55 tables, 14 illustrations, references, 69 titles. Objectives- The study sought to determine if there were any significant racial and ethnic differences in six modifiable cardiovascular disease risk factors in women aged 65 years and older. It also examined the dynamic relationships of race/ethnicity, socioeconomic status and cardiovascular risk factors. Methods- Data were extracted from the merged 2003 & 2004 Behavioral Risk Factors Surveillance Survey (BRFSS). Prevalence estimates and 95% of each of the six cardiovascular disease risk factors considered (Hypertension, Diabetes, Obesities, Hypercholesterolemia, Smoking, and No leisure-time physical activity) were calculated by race/ethnicity. Multinomial (for indicator outcomes) and multiple logistic regression analyses (for binary outcomes) were performed. Path analysis was performed to assess the complex pathways by which race/ethnicity and socioeconomic status (SES) were associated with cardiovascular disease risk factors. Results- Of the 77,492 survey respondents included in the sample, there were 68,251 whites, 4,912 blacks, 3,656 Hispanics and 673 AIANs. The odds of the cardiovascular risk factors were higher in race/ethnicity minority women (non-Hispanic black, Hispanic, American Indian Alaskan Native) compared to white women aged 65 years and older. Socioeconomic status was found to be a moderator rather than a mediator of the relationship between race/ethnicity and cardiovascular disease risk factors. The re-specified model with the behavioral risk factors (smoking and no leisure-time physical activity) as mediators was deemed a good fit to the data. Age, race/ethnicity, SES, smoking and leisure-time physical activity were found to have significant direct, indirect and total effects on cardiovascular disease risk factors. Conclusions- There is a need to find better ways to measure race/ethnicity, and future research should consider the impact of more fundamental determinants of CVD risk factors. Area-based measures, such as neighborhood conditions, should also be given consideration for influencing these risk factors. Identification of potential mediating and moderating factors in these pathways (for example, sense of personal control or social support) will help clinicians and public health professionals to develop culturally sensitive intervention or prevention programs specifically targeted toward risk burdens in each of these populations.Item Stress and Social Support as Risk Factors for the Occurrence of Neural Tube Defect-Affected Pregnancies in Women Living Along the Texas-Mexico Border(1999-06-01) Herron, Kathryn M.; Antonio Rene; John Licciardone; Gilbert RamirezHerron, Kathryn M., Stress and Social Support as Risk Factors for the Occurrence of Neural Tube Defect-Affected Pregnancies in Women Living Along the Texas-Mexico Border. Master of Public Health, June, 1999, 59 pp., 8 tables, 1 figure, references, 78 titles. Data were derived from the case-control study of the Texas Department of Health’s Neural Tube Defect Project, involving women living along the Texas-Mexico border, June 1995 to October 1998. Social support and stress information was obtained from a questionnaire, and a residual stress scale was created to determine an aggregate measure for each subject. Interviews were conducted with 261 women, with 1.2 controls to each case. Having high residual stress was found to be a significant risk factor for NTDs. Other significant risk factors included periconceptional injury, residential mobility, having no relatives to talk about private matters, and discontent with relationships.Item The Effects of Cardiorespiratory Fitness and Body Mass Index on the Development of Osteoarthritis in Women(2001-05-01) Hathwar, Supriya; Sally Blakley; Steven Blair; Antonio ReneHathwar, Supriya, The Effect of Cardiorespiratory Fitness and Body Mass Index on the Development of Osteoarthritis in Women, (ACLS 1970-1999). Master of Public Health (Epidemiology), May, 35 pp., 6 tables, references, 48 titles. Osteoarthritis (OA) of the hip and knee is one of the most important causes of pain and disability affecting nearly 21 million people in the United States. Obesity is one of the primary causes of secondary osteoarthritis especially of the hip and knee. (Felson, 1992). The aim of this prospective cohort study is to determine whether higher levels of CRF reduce the risk of development of OA in women across different body mass index (BMI) levels. The study population consisted of 3847 women, ages 20-87, examined at the Cooper Clinic, Dallas, Texas between 1970 and 1999. There were 379 cases of physician-diagnosed OA during 31,657 woman-years of follow-up. After adjustment for age, exam year and health status, obesity and overweight were found to be significant predictors of OA in women. At all levels of CRF, the odds of developing OA increase as weight increases. In the overweight category, the odds of developing OA are 80% higher among the low-fit women [OR=1.8,95% CI (1.1-3.1)], and 60% higher among the moderately fit women [OR=1.6,95%CI (1.0-2.3)] compared to high fit, normal weight women. In the obese category, the low-fit and the high fit women had the same odds of developing OA (OR=2.6), while moderately fit women had lower odds of developing OA (OR=1.7). These data suggest that CRF is not a consistent predictor for development of OA in women.Item Urbanicity and Mammography Utilization: How Living in an Urban or Rural Area Affects Mammography Screening Utilization Among Women in the United States(2008-05-01) Ylitalo, Kelly R.; Kathryn Cardarelli; Fang Fang Zhang; Nuha LackanYlitalo, Kelly R., Urbanicity and Mammography Utilization: How Living in an Urban or Rural Area Affects Mammography Screening Utilization among Women in the United States. Master of Public Health (Epidemiology), May 2008, 67 pp., 7 tables, 1 figure, references. Mammography is a widely used screening tool that can help prevent breast cancer mortality, yet utilization is not consistent. We utilized the 2006 Behavioral Risk Factor Surveillance System data to evaluate differences in mammography screening practices by urbanicity (urban vs. rural residence). Chi-square analyses, logistic regression, and propensity score matching were utilized to determine the association between urbanicity and mammography compared to women who lived in rural areas, even after controlling for individual variables. Geographic access to health care as represented by individual urban or rural residence may contribute to mammography screening practices in the United States.Item Women & Stress: Investigating the Female Stress Syndrome(2006-05-01) Oden, Melissa Standord; Sue LurieOden, Melissa Stanford, Women & Stress: Investigating the Female Stress Syndrome. Master of Public Health (Community Health), May 2006, 47 pp., bibliography. Research indicates that women experience long-term effects of stress that appear to be not only different from, but possibly more harmful than the long-term effects of stress in men. This situation creates the possibility of more chronic illness for women as well as the possibility for higher mortality rates. The purpose of this project is to investigate the effects of stress on professional women in Tarrant County based on meanings and interpretations women give to the stress they experience. It will also provide additional information about the effects of Female Stress Syndrome to contribute to the research literature on this topic.Item δ-2 Opioid receptor plasticity and GM-1(2005-05-01) Davis, Shavsa; Caffrey, James; Mallet, Robert T.; Singh, Meharvanδ-2 Opioid receptor plasticity and GM-1. Shavsha Davis, Masters of Science (Biomedical Sciences), May 2005, 56 pp, 3 tables, 10 figures. The native cardiac enkephalin, methionine-enkephalin-arginine-phenylalanine (MEAP) altered vagally induced bradycardia when introduced into the sinoatrial (SA) node by microdialysis. The responses to MEAP were bimodal in character with lower doses enhancing bradycardia while higher doses suppressed bradycardia. The opposing vagotonic and vagolytic effects were mediated respectively by δ-1 and δ-2-subtypes of the same δ-opioid receptor. The opposing responses were blocked by sub-type specific antagonists. When the mixed agonist, MEAP was evaluated after treatment with the monosialosyl ganglioside, GM-1, the δ-1-mediated vagotonic response was enhanced and the δ-2 mediated vagolytic response independent of a coincident increase in competing the δ-1-mediated vagotonic activity. The selective δ-2-agonist deltorphin was introduced into the SA node by microdialysis to evaluate initial δ-2-vagolytic responses. The right vagus nerve was stimulated and the expected decline in heart rate was significantly attenuated by deltorphin. GM-1 was then perfused into the nodal interstitium for one hour without a significant change in vagal transmission. Following GM-1, deltorphin was reintroduced and a clear attenuation of the deltorphin’s vagolytic response was observed. Similar results were obtained in time controls when GM-1 was omitted. In both cases the δ-1 selective antagonist 7-benzylidenaltrexone (BNTX) failed to restore the vagolytic response when added afterward. However when added to the time controls early in the protocol, BNTX completely prevented the loss in the vagolytic response. When both the intial deltorphin and GM-1 were omitted the vagolytic response was significantly improved. In summary, the initial study with the mixed agonist, MEAP suggested that GM-1 reduced the δ-2-vagolytic response. This was confirmed when the relatively selective δ-2-agonist, deltorphin, was substituted for MEAP. Subsequent protocols suggested that deltorphin and GM-1 produced qualitatively similar losses in the vagolytic response that were not restored by subsequent δ-1-receptor blockade. Thus, the attenuation of the δ-2 response was not due to the addition of completing δ-1-mediated vagotonic activity. The elimination of the deltorphin mediated attrition of the δ-2 response by the BNTX indicated that the declining response was mediated by δ-1-receptors. Thus GM-1, deltorphin, and time all interact to modify subsequent δ-2-mediated vagolytic responses. The specific contribution of deltorphin in this process was mediated by the activation of δ-1-receptors. Whether deltorphin has intrinsic δ-1 activity or causes the release of an endogenous δ-1 agonist is unclear. The specific mechanism by which the δ-1 and δ-2 opioid receptors interact likewise remains to be determined.