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Women Ages (woman + age)
Selected AbstractsNormal Values of Balance Tests in Women Aged 20,80JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2004Rosemary C. Isles B Phty Objectives: To determine normal values for four commonly used clinical functional balance tests from community-dwelling women aged 20 to 80 and to identify any significant decline due to aging. Design: A cross-sectional study was undertaken to provide normative values for four clinical balance tests across 6 decade cohorts. Setting: The Betty Byrne-Henderson Center for Women and Aging, Royal Womens' Hospital, Brisbane, Australia. Participants: Four hundred fifty-six community-dwelling, independently ambulant women with no obvious neurological or musculoskeletal-related disability, aged 20 to 80, were randomly recruited from a large metropolitan region. Measurements: The clinical balance measures/tests were the Timed Up and Go test, step test, Functional Reach test, and lateral reach test. Multivariate analysis was used to test the effect for age, height, and activity level. Results: Normal data were produced for each test across each decade cohort. Gradual decline in balance performance was confirmed, with significant effect for age demonstrated. Conclusion: New normative data across the adult age decades are available for these clinical tests. Use of clinical balance tests could complement other balance tests and be used to screen women aged 40 to 60 whose performance is outside the normal values for age and to decrease later falls risk. [source] Resistance and Agility Training Reduce Fall Risk in Women Aged 75 to 85 with Low Bone Mass: A 6-Month Randomized, Controlled Trial,JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2004Teresa Liu-Ambrose PhD Objectives: To compare the effectiveness of group resistance and agility-training programs in reducing fall risk in community-dwelling older women with low bone mass. Design: A randomized, controlled, single-blind 25-week prospective study with assessments at baseline, midpoint, and trial completion. Setting: Community center. Participants: Community-dwelling women aged 75 to 85 with low bone mass. Intervention: Participants were randomly assigned to one of three groups: resistance training (n=32), agility training (n=34), and stretching (sham) exercises (n=32). The exercise classes for each study arm were held twice weekly. Measurements: The primary outcome measure was fall risk (derived from weighted scores from tests of postural sway, reaction time, strength, proprioception, and vision), as measured using a Physiological Profile Assessment (PPA). Secondary outcome measures were ankle dorsiflexion strength, foot reaction time, and Community Balance and Mobility Scale score. Results: Attendance at the exercise sessions for all three groups was excellent: resistance training (85.4%), agility training (87.3%), and stretching program (78.8%). At the end of the trial, PPA fall-risk scores were reduced by 57.3% and 47.5% in the resistance and agility-training groups, respectively, but by only 20.2% in the stretching group. In the resistance and agility groups, the reduction in fall risk was mediated primarily by improved postural stability, where sway was reduced by 30.6% and 29.2%, respectively. There were no significant differences between the groups for the secondary outcomes measures. Within the resistance-training group, reductions in sway were significantly associated with improved strength, as assessed using increased squat load used in the exercise sessions. Conclusion: These findings support the implementation of community-based resistance and agility-training programs to reduce fall risk in older women with low bone mass. Such programs may have particular public health benefits because it has been shown that this group is at increased risk of falling and sustaining fall-related fractures. [source] Sexual Healthcare Needs of Women Aged 65 and OlderJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2004Margaret R. H. Nusbaum DO Objectives: To compare prevalence and type of sexual concerns and interest in and experience with discussing these concerns with physicians for women younger than 65 and 65 and older. Design: Cross-sectional survey. Setting: Departments of Family Practice and Obstetrics and Gynecology at Madigan Army Medical Center, Tacoma, Washington. Participants: Of 1,480 women seeking routine gynecological care, 964 (65%) responded; 163 (17%) were aged 65 and older. Measurements: Self-reported sexual concerns and interest in and experience with discussing these concerns with their physicians. Results: Older women had a similar number of sexual concerns as younger women and were more likely to be concerned about their partner's sexual difficulties. Older women were less likely to have ever had the topic of sexual health raised during healthcare visits. Even though these women were more likely to report youthful-appearing physicians as hindering the topic of sexual health, the majority indicated that they would have discussed their concerns had the physician raised the topic and were interested in a follow-up appointment to do so. Conclusion: Although the types of sexual concerns vary in frequency, women aged 65 and older have a similar number of sexual concerns as younger women. Older women want physicians to inquire about their sexual health. This discussion should include inquiries about their partner's sexual functioning. To overcome age as a barrier to this discussion, younger physicians should be particularly attentive to initiating the topic of sexual health. [source] Volunteerism in a Community-Based Sample of Women Aged 50 to 80 Years,JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 9 2000Deborah J. Bowen This paper has 2 purposes: (a) to present the differences in demographic and health characteristics of older women volunteers and nonvolunteers in a community-based sample; (b) to identify the motivations of current and past volunteers, as contrasted with those who have never volunteered. A population-based survey was conducted with a sample of 1,104 women aged 50 to 80 years in the state of Washington. Nonvolunteers were less likely to be married and were slightly less likely to be White than were current or past volunteers. Demographic variables (e. g., age) and health status predicted level of reported motivation for volunteering. These data provide us with population-based estimates of volunteering and motivations for older women. [source] American Cancer Society Guidelines Still Advise Yearly Mammography for Women Aged 40 to 49 YearsCA: A CANCER JOURNAL FOR CLINICIANS, Issue 4 2007Article first published online: 31 DEC 200 No abstract is available for this article. [source] The cancer screening practices of adult survivors of childhood cancer,CANCER, Issue 3 2004A report from the Childhood Cancer Survivor Study Abstract BACKGROUND The current study characterized the self-reported cancer screening practices of adult survivors of childhood cancer. METHODS A cohort of 9434 long-term survivors of childhood cancer and a comparison group of 2667 siblings completed a 289-item survey that included items regarding cancer-screening practices. RESULTS Overall, 27.3% of female respondents reported performing breast self-examination (BSE) regularly, 78.2% reported undergoing a Papanicolaou smear within the previous 3 years, 62.4% underwent a clinical breast examination (CBE) within the last year, and 20.9% had gotten a mammogram at least once in their lifetime. Approximately 17.4% of male respondents reported performing regular testicular self-examination (TSE). Women age , 30 years who had been exposed to chest or mantle radiation therapy were more likely to report undergoing CBE (odds ratio [OR], 1.59; 95% confidence interval [95% CI], 1.32,1.92) and mammography (OR, 1.92; 95% CI, 1.47,2.56). Compared with the sibling comparison group, survivors demonstrated an increased likelihood of performing TSE (OR, 1.52; 95% CI, 1.22,1.85) or BSE (OR, 1.30; 95% CI, 1.10,1.52), of having undergone a CBE within the last year (OR, 1.18; 95% CI, 1.02,1.35), and of ever having undergone a mammogram (OR, 1.82; 95% CI, 1.52,2.17). CONCLUSIONS The results of the current study demonstrate that the cancer screening practices among survivors of childhood cancer are below optimal levels. Primary care physicians who include childhood cancer survivors among their patients could benefit these individuals by informing them about future cancer risks and recommending appropriate evidence-based screening. Cancer 2004. © 2003 American Cancer Society. [source] Increased mammography use and its impact on earlier breast cancer detection in Vermont, 1975,1999CANCER, Issue 8 2002Pamela M. Vacek Ph.D. Abstract BACKGROUND A trend toward earlier breast carcinoma detection in the United States has been attributed to screening mammography, although direct evidence linking this trend to the increased use of mammography in a general population is lacking. This study examined the effects of mammography on tumor size and axillary lymph node metastasis in Vermont over 25 years. METHODS Pathology and mammography data from 3499 Vermont women who were diagnosed with invasive breast carcinoma during 1975,1984, 1989,1990, and 1995,1999 were compared. Logistic regression analysis was used to estimate the effects of age, mammography use, and period on the odds of a tumor , 2 cm and the odds of negative lymph nodes. RESULTS The proportion of breast tumors that were detected by screening mammography increased from 2% during 1974,1984 to 36% during 1995,1999 (P < 0.001), and these tumors were more likely to measure , 2 cm than tumors that were detected by other methods. Among women age > 50 years, the odds ratio (OR) was 4.5, with a 95% confidence interval (95% CI) of 3.5,6.4. The effect was smaller in younger women (OR, 1.8; 95% CI, 1.1,3.0). Mammographic detection increased the odds of negative lymph nodes by a similar amount in both age groups, although women age > 50 years were more likely to have negative lymph nodes than younger women (OR, 1.3; 95% CI, 1.1,1.6). Tumor size and lymph node metastasis also were related to the number of mammograms and to the mammographic interval. CONCLUSIONS Most of the trend toward earlier detection in Vermont was due to mammography. Mammography had a lesser effect on tumor size among younger women, which may be related to less frequent screening, although its effect on lymph node metastasis was not age dependent. Women age < 50 years were more likely to have positive lymph nodes, independent of the method of detection or the frequency of mammography. Cancer 2002;94:2160,8. © 2002 American Cancer Society. DOI 10.1002/cncr.10459 [source] Visible changes of female facial skin surface topography in relation to age and attractiveness perceptionJOURNAL OF COSMETIC DERMATOLOGY, Issue 2 2010Nadine Samson Summary Objectives, Evolutionary psychology suggests that a woman's age and physical appearance are important mate choice criteria. Given that changes in female facial skin surface topography are important, prominent visible signs of aging, male perceptual sensitivity for variation in this trait may also affect preference and attractiveness judgment. Methods, Two experiments were conducted to investigate perception (Experiment 1) and noticeability (Experiment 2) of skin surface topography manipulations in facial images of six British women, aged 45,65 years. In Experiment 1 skin surface topography cues were completely removed on the cheeks, the "crow's feet" area adjacent to the eye, under the eyes, above the upper lip, and on the forehead while, in Experiment 2, it was removed gradually (20% increments) on the forehead and around the eyes. In both experiments, stimuli were presented to American and German participants (total N = 300, aged 15,55 years) in omnibus pair-wise combinations (within-face). With each pair, respondents were asked to select that face which they considered as younger looking (Experiments 1 and 2) and more attractive (Experiment 1). Results, Faces with skin surface topography cues removed were judged significantly younger and more attractive than their original (unmodified) counterparts, with modifications on the forehead and around the eyes showing the highest differences. In these areas, participants were able to detect at least a 20% visual change in skin surface topography. Conclusions, The results support the assertion that even small changes in skin surface topography affect the perceptions of a woman's facial age and attractiveness and may, thus, also influence men's mate preferences. [source] Being an outsider: nurses' statements about a vignette of an elderly resident with a schizophrenia diagnosis and dementia behaviourJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2004O. HELLZÉN rn phd In an exploratory study of nurses' approach to elderly people with a diagnosis of long-term schizophrenia, the aim was to investigate nurses' views of the care of an elderly fictitious person with long-term schizophrenia. All the nurses in one municipality in northern Sweden working at seven different units were investigated. A vignette, which was based on a case description in a previous study of an 84-year-old woman with severe dementia and problematic behaviour, was used after a minor alteration. In this study, the woman's age in the case description was changed from 84 to 68 years and the diagnosis was changed from severe dementia to long-term schizophrenia; otherwise, the description was the same as in the original case. The main finding was the nurses' inability to see the resident as anything other than what the ,label', the diagnosis, said. The nurses are interpreted as being caught in a dilemma of loyalty , on the one hand, the loyalty to the organization with its traditional goals and means and, on the other hand, the loyalty to the resident with her wishes in the forefront of their minds. [source] Does second-to-fourth digit length ratio (2D:4D) predict age at menarche in women?AMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 3 2010Samuli Helle Prenatal steroid levels, estimated as the ratio of second-to-fourth digit length (2D:4D), have been related to reproductive success in women, but direct associations between 2D:4D and physiological measures of fertility remain rare. A recent study reported that lower, masculinized right hand 2D:4D was correlated with delayed age at menarche in women. We addressed this question by investigating whether 2D:4D was associated with recalled age at menarche in 282 post-reproductive Finnish women, using Cox regression model that controlled for a woman's sibling composition, urban or rural residence and temporal trend in menarcheal age. We found no evidence that neither the 2D:4D of the right nor the left hand were related to a woman's age at menarche among these Finnish women. Am. J. Hum. Biol., 2010. © 2009 Wiley-Liss, Inc. [source] Reproductive development and parental investment during pregnancy: Moderating influence of mother's early environmentAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 2 2010David A. Coall The association between a woman's age at menarche and the birth weight of her children is highly variable across human populations. Life history theory proposes that a woman's early environment may moderate this association and thus account for some of the variation between populations. According to one life history theory model, for individuals who develop in a childhood environment of high local mortality rates (experienced subjectively as psychosocial stress), it can be adaptive to mature earlier, have more offspring during their reproductive lifetime, and reduce investment in each offspring. In an environment of low psychosocial stress, however, it may be adaptive to mature later, have fewer offspring, and invest more in each. In this study, birth weight and proportionate birth weight (neonate's birth weight as a percentage of its mother's prepregnancy weight) were used as measures of parental investment during pregnancy. In a sample of 580 first-time mothers, we tested the hypothesis that the psychosocial stress experienced as a child would moderate the association between age at menarche and investment during pregnancy. We found that earlier menarche in those women who experienced stressful life events before 15 years of age was associated with a lower birth weight and proportionate birth weight. Conversely, in those who reported no childhood stressors, earlier menarche was associated with increased birth weight and proportionate birth weight. Our data suggest that the moderating influence of the childhood psychosocial environment on the association between age at menarche and parental investment throughout gestation operates in a dose-dependent manner. Am. J. Hum. Biol., 2010. © 2009 Wiley-Liss, Inc. [source] The ecology and evolutionary endocrinology of reproduction in the human femaleAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue S49 2009Virginia J. Vitzthum Abstract Human reproductive ecology (HRE) is the study of the mechanisms that link variation in reproductive traits with variation in local habitats. Empirical and theoretical contributions from biological anthropology, physiology, and demography have established the foundation necessary for developing a comprehensive understanding, grounded in life history theory (LHT), of temporal, individual, and populational variation in women's reproductive functioning. LHT posits that natural selection leads to the evolution of mechanisms that tend to allocate resources to the competing demands of growth, reproduction, and survival such that fitness is locally maximized. (That is, among alternative allocation patterns exhibited in a population, those having the highest inclusive fitness will become more common over generational time.) Hence, strategic modulation of reproductive effort is potentially adaptive because investment in a new conception may risk one's own survival, future reproductive opportunities, and/or current offspring survival. The hypothalamic-pituitary-ovarian (HPO) axis is the principal neuroendocrine pathway by which the human female modulates reproductive functioning according to the changing conditions in her habitat. Adjustments of reproductive investment in a potential conception are manifested in temporal and individual variation in ovarian cycle length, ovulation, hormone levels, and the probability of conception. Understanding the extent and causes of adaptive and non-adaptive variation in ovarian functioning is fundamental to ascertaining the proximate and remote determinants of human reproductive patterns. In this review I consider what is known and what still needs to be learned of the ecology of women's reproductive biology, beginning with a discussion of the principal explanatory frameworks in HRE and the biometry of ovarian functioning. Turning next to empirical studies, it is evident that marked variation between cycles, women, and populations is the norm rather than an aberration. Other than woman's age, the determinants of these differences are not well characterized, although developmental conditions, dietary practices, genetic variation, and epigenetic mechanisms have all been hypothesized to play some role. It is also evident that the reproductive functioning of women born and living in arduous conditions is not analogous to that of athletes, dieters, or even the lower end of the "normal range" of HPO functioning in wealthier populations. Contrary to the presumption that humans have low fecundity and an inefficient reproductive system, both theory and present evidence suggest that we may actually have very high fecundity and a reproductive system that has evolved to be flexible, ruthlessly efficient and, most importantly, strategic. Yrbk Phys Anthropol 52:95,136, 2009. © 2009 Wiley-Liss, Inc. [source] Dietary patterns, the Alternate Healthy Eating Index and plasma sex hormone concentrations in postmenopausal womenINTERNATIONAL JOURNAL OF CANCER, Issue 4 2007Teresa T. Fung Abstract To evaluate the association between overall diet and sex hormones concentrations, we collected blood from 578 postmenopausal women ages 43 and 69 years in 1989 or 1990. Food intake was measured in 1990 via a food frequency questionnaire. We calculated the Alternate Healthy Eating Index (AHEI), and dietary patterns were identified by factor analysis. The cross-sectional association between diet and estrogens, sex hormone binding globulin (SHBG) were evaluated with linear regression and adjusted for energy and other potential confounders. We found a higher AHEI score was associated with lower concentrations of estradiol, free estradiol, and higher concentrations of SHBG. The prudent pattern, with higher intakes of fruits, vegetables, and whole grains, was not associated with any sex hormones. The Western pattern, which represents higher intakes of red and processed meats, refined grains, sweets and desserts, was associated with a higher level of estradiol and lower concentrations of SHBG. Further adjustment for BMI attenuated these results except for free estradiol (5th vs. 1st quintile = 0.09 vs. 0.11 pg/mL, p for trend = 0.03). In addition, the AHEI was inversely associated with estradiol among those with BMI > 25, and Western pattern with SHBG among those with BMI < 25. In conclusion, we observed inverse associations between the AHEI score and several estrogens, and it was positively associated with plasma levels of SHBG. In contrast, the Western pattern was positively associated with estrogen levels and inversely with SHBG. However, these associations appeared to be largely accounted for by BMI. © 2007 Wiley-Liss, Inc. [source] Hormone Replacement Therapy Dissociates Fat Mass and Bone Mass, and Tends to Reduce Weight Gain in Early Postmenopausal Women: A Randomized Controlled 5-Year Clinical Trial of the Danish Osteoporosis Prevention Study,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 2 2003LB Jensen MD Abstract The aim of this study was to study the influence of hormone replacement therapy (HRT) on weight changes, body composition, and bone mass in early postmenopausal women in a partly randomized comprehensive cohort study design. A total of 2016 women ages 45,58 years from 3 months to 2 years past last menstrual bleeding were included. One thousand were randomly assigned to HRT or no HRT in an open trial, whereas the others were allocated according to their preferences. All were followed for 5 years for body weight, bone mass, and body composition measurements. Body weight increased less over the 5 years in women randomized to HRT (1.94 ± 4.86 kg) than in women randomized to no HRT (2.57 ± 4.63, p = 0.046). A similar pattern was seen in the group receiving HRT or not by their own choice. The smaller weight gain in women on HRT was almost entirely caused by a lesser gain in fat. The main determinant of the weight gain was a decline in physical fitness. Women opting for HRT had a significantly lower body weight at inclusion than the other participants, but the results in the self-selected part of the study followed the pattern found in the randomized part. The change in fat mass was the strongest predictor of bone changes in untreated women, whereas the change in lean body mass was the strongest predictor when HRT was given. Body weight increases after the menopause. The gain in weight is related to a decrease in working capacity. HRT is associated with a smaller increase in fat mass after menopause. Fat gain protects against bone loss in untreated women but not in HRT-treated women. The data suggest that women's attitudes to HRT are more positive if they have low body weight, but there is no evidence that the conclusions in this study are skewed by selection bias. [source] Phosphatidylethanol and Alcohol Consumption in Reproductive Age WomenALCOHOLISM, Issue 3 2010Scott H. Stewart Background:, Fetal alcohol disorders are preventable, but self-reported alcohol consumption can be misleading and impede effective treatment. Biomarkers represent an alternative method for assessing alcohol use, and this study evaluated the relationship between blood phosphatidylethanol (PEth) and alcohol use in a sample of reproductive age women. Methods:, Alcohol use was estimated by validated self-report methods in 80 nonpregnant women ages 18 to 35. PEth was measured by a contracted laboratory using a liquid chromatography-tandem mass spectrometry assay. Regression methods appropriate for the distribution of PEth were used to define its relationship to alcohol consumption during the prior 2 weeks and explore the effects of drinking patterns on this association. Receiver operating characteristic analysis was used to estimate the sensitivity of PEth for various drinking levels at 95% specific cutoffs. Results:, PEth had a positive linear association with grams of alcohol consumed (p < 0.001), and was detectable in 93% of subjects consuming an average of 2 or more drinks per day. The relationship between total alcohol consumption and PEth may be stronger in women with recent heavy drinking days. The relationship between drinking and PEth varied considerably between individuals, and sensitivity for a certain amount of drinking was low at a highly specific cutoff concentration. Conclusions:, PEth is a highly sensitive indicator of moderate and heavy alcohol consumption in reproductive age women and may complement the use of self-report alcohol screens when additional objective markers of alcohol use are desirable. However, choosing a highly valid cutoff concentration for PEth to differentiate various levels of alcohol consumption may not be feasible. [source] Periodontitis and Gestational Diabetes Mellitus: Exploring the Link in NHANES IIIJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 3 2006Karen F. Novak DDS Abstract Objectives: The authors hypothesized that women with a history of gestational diabetes mellitus (GDM) during pregnancy would exhibit more severe periodontal disease than controls without a history of diabetes during pregnancy. Methods: Data from NHANES III provided information for 4,244 women ages 20,59. One hundred and thirteen had a history of GDM (GDM+), while 4,131 had no history of diabetes before or during their pregnancies (GDM-). Women were further classified by the presence or absence of diabetes mellitus (DM+ or OM-) at the time of their NHANES 111 examination. Periodontal disease (PO) was defined as one or more teeth with one or more sites with probing depth ,4mm, loss of affachment ,2mm, and bleeding on probing. Results: The PD prevalence among women who were GDM+DM- was 9.0% and 4.8% for those who were GDM-DM-. PD prevalence for women who were GDM+DM+ was 30.5% and 11.6% for GDM-DM+ subjects, respectively. A logistic regression model, controlling for age, calculus, smoking, and income estimated women who were GDM+DM+ were more likely to have periodontal disease than women who were GDM-DM- and women who were GDM-DM+. The GDM+DM- group also tended to be more likely to have PD than the GDM-DM- and GDM-DM+ groups. However, the odds ratios were not statistically significant. Conclusions: These results support the hypothesis that women with gestational diabetes mellitus (GDM) during pregnancy may be at greater risk for developing more severe periodontal disease than pregnant women without GDM. [source] Psychological distress and GI symptoms are related to severity of bloating in women with irritable bowel syndromeRESEARCH IN NURSING & HEALTH, Issue 2 2008Hyo Jung Park Abstract Bloating is a frequent complaint of women with irritable bowel syndrome (IBS). We compared retrospective and daily diary gastrointestinal and psychological distress symptoms in 183 women ages 18,48 in three IBS subgroups: Minimal-Bloating, Mild-Bloating, Moderate-Severe-Bloating. More women with moderate to severe levels of bloating reported a history of hard stools, straining to have a stool, a history of depressive disorders, and more severe daily symptoms of depression and anxiety as compared to women with minimal or mild bloating symptoms. Appraising the level of symptom severity and psychological distress is vital to the selection of appropriate treatment options. © 2008 Wiley Periodicals, Inc. Res Nurs Health 31:98,107, 2008 [source] Variations in sleep hygiene practices of women with and without insomnia,RESEARCH IN NURSING & HEALTH, Issue 4 2004Rita E. Cheek Abstract Sleep hygiene education is a basic component of behavioral treatment for chronic insomnia, yet the actual sleep hygiene practices of people with insomnia have not been well documented. In this descriptive secondary analysis, midlife women ages 41,55 years with either chronic insomnia (n,=,92) or good sleep (n,=,29) kept diaries of sleep perceptions and sleep hygiene practices during 6 nights of somnographic monitoring at home. In both groups few reported smoking cigarettes (<10%), most drank caffeine (>80%), and many averaged 30 min of exercise per day (,50%). Very few in either group (<10%) had regular (<30 min variation) bedtimes or getting-up times. Compared to women with good sleep, those with insomnia reported drinking less caffeine per day, being more abstinent from alcohol, and having smaller variations in day-to-day alcohol intake and bedtimes. Although some women with insomnia limit or refrain from caffeine and alcohol intake, many have not optimized behaviors believed to help prevent or modulate insomnia. © 2004 Wiley Periodicals, Inc. Res Nurs Health 27:225,236, 2004 [source] Enduring love: A grounded formal theory of women's experience of domestic violenceRESEARCH IN NURSING & HEALTH, Issue 4 2001Margaret H. Kearney Abstract Using a grounded formal theory approach, 13 qualitative research reports were analyzed with the goal of synthesizing a middle-range theory of women's responses to violent relationships. The combined sample numbered 282 ethnically and geographically diverse women ages 16,67. Within cultural contexts that normalized relationship violence while promoting idealized romance, these women dealt with the incongruity of violence in their relationships as a basic process of enduring love. In response to shifting definitions of their relationship situations, many women moved through four phases, which began with discounting early violence for the sake of their romantic commitment ("This is what I wanted"), progressed to immobilization and demoralization in the face of increasingly unpredictable violence that was endured by the careful monitoring of partner behavior and the stifling of self ("The more I do, the worse I am"), shifted to a perspective that redefined the situation as unacceptable ("I had enough"), and finally moved out of the relationship and toward a new life ("I was finding me"). Variations in the manifestation and duration of these phases were found to be linked to personal, sociopolitical, and cultural contexts. © 2001 John Wiley & Sons, Inc. Res Nurs Health 24:270,282, 2001 [source] Pubic Hair Removal among Women in the United States: Prevalence, Methods, and CharacteristicsTHE JOURNAL OF SEXUAL MEDICINE, Issue 10 2010Debra Herbenick PhD ABSTRACT Introduction., Although women's total removal of their pubic hair has been described as a "new norm," little is known about the pubic hair removal patterns of sexually active women in the United States. Aims., The purpose of this study was to assess pubic hair removal behavior among women in the United States and to examine the extent to which pubic hair removal methods are related to demographic, relational, and sexual characteristics, including female sexual function. Methods., A total of 2,451 women ages 18 to 68 years completed a cross-sectional Internet-based survey. Main Outcome Measures., Demographic items (e.g., age, education, sexual relationship status, sexual orientation), cunnilingus in the past 4 weeks, having looked closely at or examined their genitals in the past 4 weeks, extent and method of pubic hair removal over the past 4 weeks, the Female Genital Self-Image Scale (FGSIS) and the Female Sexual Function Index (FSFI). Results., Women reported a diverse range of pubic hair-grooming practices. Women's total removal of their pubic hair was associated with younger age, sexual orientation, sexual relationship status, having received cunnilingus in the past 4 weeks, and higher scores on the FGSIS and FSFI (with the exception of the orgasm subscale). Conclusion., Findings suggest that pubic hair styles are diverse and that it is more common than not for women to have at least some pubic hair on their genitals. In addition, total pubic hair removal was associated with younger age, being partnered (rather than single or married), having looked closely at one's own genitals in the previous month, cunnilingus in the past month, and more positive genital self-image and sexual function. Herbenick D, Schick V, Reece M, Sanders S, and Fortenberry JD. Pubic hair removal among women in the United States: Prevalence, methods and characteristics. J Sex Med 2010;7:3322,3330. [source] Recombinant human relaxin in the treatment of systemic sclerosis with diffuse cutaneous involvement: A randomized, double-blind, placebo-controlled trial,ARTHRITIS & RHEUMATISM, Issue 4 2009Dinesh Khanna Objective A phase II randomized controlled trial of recombinant human relaxin suggested that a dosage of 25 ,g/kg/day was safe and clinically effective in improving skin disease and reducing functional disability in scleroderma (systemic sclerosis; SSc). We undertook a large randomized, double-blind, placebo-controlled clinical trial to compare placebo with 10 ,g/kg/day and 25 ,g/kg/day recombinant human relaxin, given for 24 weeks in patients with stable, diffuse, moderate-to-severe SSc. Methods Men and women ages 18,70 years with diffuse cutaneous SSc (dcSSc) were administered recombinant human relaxin (10 ,g/kg/day or 25 ,g/kg/day) or placebo for 24 weeks as a continuous subcutaneous infusion. There was a followup safety visit at week 28. Results The primary outcome measure, the modified Rodnan skin thickness score, was similar among the 3 groups at baseline and at weeks 4, 12, and 24. Secondary outcomes such as functional disability were similar in all 3 groups, while the forced vital capacity decreased significantly in the relaxin groups. The discontinuation of both doses of relaxin at week 24 led to statistically significant declines in creatinine clearance and serious renal adverse events (defined as doubling of serum creatinine, renal crisis, or grade 3 or 4 essential hypertension) in 7 patients who had received relaxin therapy but in none who had received placebo. Conclusion Recombinant relaxin was not significantly better than placebo in improving the total skin score or pulmonary function or in reducing functional disability in patients with dcSSc. In addition, relaxin was associated with serious renal adverse events, the majority of which occurred after stopping the infusion. If relaxin is used therapeutically for any conditions other than scleroderma, close monitoring of blood pressure and renal function must be performed. [source] Meniscal tear in knees without surgery and the development of radiographic osteoarthritis among middle-aged and elderly persons: The multicenter osteoarthritis study,ARTHRITIS & RHEUMATISM, Issue 3 2009Martin Englund Objective Although partial meniscectomy is a risk factor for the development of knee osteoarthritis (OA), there is a lack of evidence that meniscal damage that is not treated with surgery would also lead to OA, suggesting that surgery itself may cause joint damage. Furthermore, meniscal damage is common. The aim of this study was to evaluate the association between meniscal damage in knees without surgery and the development of radiographic tibiofemoral OA. Methods We conducted a prospective case,control study nested within the observational Multicenter Osteoarthritis Study, which included a sample of men and women ages 50,79 years at high risk of knee OA who were recruited from the community. Patients who had no baseline radiographic knee OA but in whom tibiofemoral OA developed during the 30-month followup period were cases (n = 121). Control subjects (n = 294) were drawn randomly from the same source population as cases but had no knee OA after 30 months of followup. Individuals whose knees had previously undergone surgery were excluded. Meniscal damage was defined as the presence of any medial or lateral meniscal tearing, maceration, or destruction. Results Meniscal damage at baseline was more common in case knees than in control knees (54% versus 18%; P < 0.001). The model comparing any meniscal damage with no meniscal damage (adjusted for baseline age, sex, body mass index, physical activity, and mechanical knee alignment) yielded an odds ratio of 5.7 (95% confidence interval 3.4,9.4). Conclusion In knees without surgery, meniscal damage is a potent risk factor for the development of radiographic OA. These results highlight the need for better understanding, prevention, and treatment of meniscal damage. [source] Incidence and time course of bleeding after long-term amenorrhea after breast cancer treatmentCANCER, Issue 13 2010A prospective study Abstract BACKGROUND: The incidence of chemotherapy-induced amenorrhea (CIA) and the time to subsequent menstrual bleeding in premenopausal breast cancer patients treated with current standard chemotherapy regimens was examined. METHODS: Four hundred sixty-six women ages 20 to 45 years at the time of diagnosis of a stage I to III breast cancer were recruited between January 1998 and July 2002. Patients completed monthly bleeding calendars from the time of study recruitment. Updated medical history data were obtained at 6-month intervals. RESULTS: Most women received doxorubicin and cyclophosphamide (AC); doxorubicin, cyclophosphamide, and paclitaxel (ACT); or cyclophosphamide, methotrexate, and 5-fluorouracil (CMF). Approximately 41% of women experienced an initial 6 months of CIA, and an additional 29% had at least 1 year of CIA. Approximately half of the women with 6 months of CIA and 29% of those with 1 year of CIA resumed bleeding within the subsequent 3 years, usually in the year after their amenorrheic episode. Resumption of bleeding differed significantly by treatment regimen after 6 months of CIA (P = .002; 68% with AC, 57% with ACT, and 23% with CMF), but not after 1 year of CIA (P = .5). Of the 23% of women who experienced an initial 2-year period of CIA, 10% resumed bleeding within the ensuing 3 years after their amenorrheic episode, but none had regular menses. CONCLUSIONS: A considerable proportion of women treated with chemotherapy will experience periods of CIA, but many will resume bleeding. Newer treatment regimens such as ACT appear to have a higher resumption of bleeding compared with CMF. This finding may have implications for choice of anti-estrogen treatment and for future potential pregnancies/fertility. Cancer 2010. © 2010 American Cancer Society. [source] Incidence and mortality rates for colorectal cancer in Puerto Rico and among Hispanics, non-Hispanic whites, and non-Hispanic blacks in the United States, 1998-2002CANCER, Issue 13 2009Marievelisse Soto-Salgado MS Abstract BACKGROUND: Colorectal cancer (CRC) is the second most commonly diagnosed cancer in Puerto Rico (PR). In the United States, the incidence and mortality rates of CRC have great variation by sex and race/ethnicity. Age-standardized incidence and mortality rates of CRC in PR were assessed and compared with the rates among US Hispanics (USH), non-Hispanic whites (NHW), and non-Hispanic blacks (NHB) in the United States for the period from 1998 through 2002. Incidence and mortality trends and relative differences among racial/ethnic groups by sex and age were determined. METHODS: Age-standardized rates using the world standard population (ASR[World]) were based on cancer incidence and mortality data from the PR Central Cancer Registry and from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program using the direct method. The annual percentage changes (APC) and relative risks (RR) were calculated using Poisson regression models. RESULTS: During 1998 through 2002, the APC of CRC incidence and mortality increased for men in PR, whereas descending trends were observed for other racial/ethnic groups. Overall period rates indicated that, in both sexes, Puerto Ricans had CRC incidence and mortality rates similar to those for USH, but their rates were lower than those for NHW and NHB. However, Puerto Rican men and women ages 40 years to 59 years had the greatest risk of incidence and mortality compared with their USH counterparts. CONCLUSIONS: Areas of concern include the increasing trends of CRC in PR and the higher burden of the disease among young Puerto Ricans compared with the USH population. The authors concluded that further research should be performed to guide the design and implementation of CRC prevention and education programs in PR. Cancer 2009. © 2009 American Cancer Society. [source] Estimating personal costs incurred by a woman participating in mammography screening in the National Breast and Cervical Cancer Early Detection Program,,CANCER, Issue 3 2008Donatus U. Ekwueme PhD Abstract BACKGROUND. The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) covers the direct clinical costs of breast and cervical cancer screening and diagnostic follow-up for medically underserved, low-income women. Personal costs are not covered. In this report, the authors estimated personal costs per woman participating in NBCCEDP mammography screening by race/ethnicity and also estimated lifetime personal costs (ages 50-74 years). METHODS. A decision analysis model was constructed and parameterized by using empiric data from a retrospective cohort survey of mammography rescreening among women ages 50 years to 64 years who participated in the NBCCEDP. Data from 1870 women were collected from 1999 to 2000. The model simulated the flow of resources incurred by a woman participating in the NBCCEDP. The analysis was stratified by annual income into 2 scenarios: Scenario 1, <$10,000; and Scenario 2, from $10,000 to <$20,000. Sensitivity analyses were conducted to appraise uncertainty, and all costs were standardized to 2000 U.S. dollars. RESULTS. In Scenario 1, for all races/ethnicities, a woman incurred a 1-time cost of $17 and a discounted lifetime cost of $108 for 10 screens and $262 for 25 screens; in Scenario 2, these amounts were $31 and from $197 to $475, respectively. In both scenarios, a non-Hispanic white woman incurred the highest cost. The sensitivity analyses revealed that >70% of cost incurred was attributable to opportunity cost. CONCLUSIONS. Capturing and quantifying personal costs will help ascertain the total cost (ie, societal cost) of providing mammography screening to a medically underserved, low-income woman participating in a publicly funded cancer screening program and, thus, will help determine the true cost-effectiveness of such programs. Cancer 2008. Published 2008 by the American Cancer Society. [source] Racial differences in diagnosis, treatment, and clinical delays in a population-based study of patients with newly diagnosed breast carcinoma,,CANCER, Issue 8 2004Karin Gwyn M.D., M.P.H. Abstract BACKGROUND Few studies have addressed the issue of whether delays in the interval between medical consultation and the diagnosis and treatment of breast carcinoma are greater for African American women than for white women. The authors examined differences with respect to these delays and analyzed the factors that may have contributed to such differences among women ages 20,54 years who had invasive breast carcinoma diagnosed between 1990 and 1992 and who lived in Atlanta, Georgia. METHODS A total of 251 African American women and 580 white women were interviewed and had their medical records reviewed. The authors estimated racial differences in delay times and used polytomous logistic regression to determine the contributions of various factors (socioeconomic and other) to these differences. RESULTS Although most women in both groups were treated within 3 months of initial consultation, 22.4% of African American women and 14.3% of white women had clinical delays of > 3 months. Compared with white women, African American women were more likely to experience delays in diagnosis and treatment. Access to care (as represented by method of detection and insurance status) and poverty index partially accounted for these differences in delay time; however, racial differences in terms of delayed treatment and diagnosis remained even after adjustment for contributing factors. CONCLUSIONS The findings of the current study suggest that among women ages 20,54 years who have breast carcinoma, potentially clinically significant differences in terms of delayed diagnosis and treatment exist between African American women and white women. Improvements in access to care and in socioeconomic circumstances may address these differences to some degree, but additional research is needed to identify other contributing factors. Cancer 2004. Published 2004 American Cancer Society. [source] Anthropometric variables, physical activity, and incidence of ovarian cancerCANCER, Issue 7 2004The Iowa Women's Health Study Abstract BACKGROUND Reports on the relation between anthropometric variables (height, weight) and physical activity with ovarian cancer have been inconclusive. The objective of the current study was to extend investigation of potential associations in the Iowa Women's Health Study cohort. METHODS The relation between self-reported anthropometric variables and incident ovarian cancer was studied in a prospective cohort of women ages 55,69 years who were followed for 15 years. Two hundred twenty-three incident cases of epithelial ovarian cancer were identified by linkage to a cancer registry. RESULTS No association was found overall between ovarian cancer and height, but a positive association was observed for serous ovarian cancers (relative risk [RR], 1.86 for highest quartile vs. lowest quartile; 95% confidence interval [95% CI], 1.06,3.29). Although current body mass index (BMI) was not associated with ovarian cancer, a BMI , 30 kg/m2 at age 18 years appeared to be associated positively with ovarian cancer (multivariate-adjusted RR, 1.83 for BMI , 30 kg/m2 vs. BMI < 25 kg/m2; 95% CI, 0.90,3.72), and this association was stronger after exclusion of the first 2 years of follow-up (RR, 2.15; 95% CI, 1.05,4.40). In a multivariate analysis, waist-to-hip ratio was associated with ovarian cancer (RR, 1.59 for highest quartile vs. lowest quartile; 95% CI, 1.05,2.40), but a linear dose response was not found. An index that combined the frequency and intensity of leisure-time physical activity was associated positively with ovarian cancer incidence (multivariate-adjusted RR, 1.42 for high activity vs. low activity; 95% CI, 1.03,1.97). This association was particularly strong for frequency of vigorous physical activity (multivariate-adjusted RR, 2.38 for > 4 times per week vs. rarely/never; 95% CI, 1.29,4.38). CONCLUSIONS Anthropometric variables were not major risk factors for ovarian cancer in the cohort studied; however, high BMI in early adulthood and frequent and vigorous physical activity may increase the risk of ovarian cancer among postmenopausal women. Cancer 2004;100:1515,21. © 2004 American Cancer Society. [source] | |||||||||||||||||||||||||