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Woman's Experience (woman + experience)
Selected AbstractsLooking for an Obstetrical Caregiver in the United States: One Woman's ExperienceBIRTH, Issue 2 2000Alison Barrows Ronn No abstract is available for this article. [source] Photoperiod at conception predicts C677T-MTHFR genotype: A novel gene-environment interactionAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 4 2010Mark Lucock Data is presented, which suggest that the day length a woman experiences during the periconceptional period predicts the C677T-MTHFR genotype of her child. Logistic regression analysis involving 375 neonates born in the same geographical location within a three year period demonstrated that photoperiod (minutes) at conception predicts both genotype (P = 0.0139) and mutant allele carriage (P = 0.0161); the trend clearly showing that the 677T-MTHFR allele frequency increases as photoperiod increases. We propose a number of explanations, including a hypothesis in which a long photoperiod around conception decreases maternal systemic folate because of UVA induced dermal oxidative degradation of 5-methyl-H4folate, leading to a lower cellular 5,10-methylene-H4folate status. In this scenario, 5,10-methylene-H4folate would be more efficiently used for dTMP and DNA synthesis by 677T-MTHFR embryos than wildtype embryos giving the 677T-MTHFR embryos increased viability, and hence increasing mutant T-allele frequency. Alternate hypotheses include: increased seasonal availability of folate rich foods that genetically buffer any negative effect of 677T-MTHFR in embryos; seasonal oxidative stress lowering embryo-toxic homocysteine; an undefined hormonal effect of photoperiod on the neuroendocrine axis, which mediates genotype/embryo selection. The effect of photoperiod on genotype seems clear, but the speculative molecular mechanism underpinning the effect needs careful examination. Am. J. Hum. Biol., 2010. © 2010 Wiley-Liss, Inc. [source] Eliciting individual preferences for health care: a case study of perinatal careHEALTH EXPECTATIONS, Issue 1 2010Marjon Van Der Pol PhD Abstract Objective, To demonstrate how a discrete choice experiment (DCE) can be used to elicit individuals' preferences for health care and how these preferences can be incorporated into a cost,benefit analysis. Methods, A DCE which elicited preferences for three perinatal services: specialist nurse appointments; home visits from a trained lay visitor; and home-help. Cost was included to obtain a monetary measure of the value that individuals place on the services. In total, 292 women who had previously participated in a randomized trial of alternative forms of pre-natal care were interviewed. Results, The most preferred service configuration consisted of three nurse appointments and two home visits before birth and 4 h of home-help per week for the first 4 weeks after birth. On average, women are willing to pay $371 for this package. A package that excluded home-help was valued at $122 whilst provision of three nurse appointments only was valued at $97. The predicted uptake of the services ranged from 37% to 93% depending on the woman's experience with the service, whether or not it was her first child and her level of education. Conclusion, The willingness to pay values were much higher than the costs for nurse appointments, suggesting this service produces a net social benefit. The willingness to pay for the package including both the nurse appointments and home visits only just exceeded the costs of the package, suggesting there is a relatively high chance that this package produces a net social loss. [source] Information needs of women with non-invasive breast cancerJOURNAL OF CLINICAL NURSING, Issue 5 2000Marina Brown BN ,,The purpose of this inquiry was to gain a better understanding of the experience of women who have had surgery for non-invasive breast cancer. In particular, issues surrounding information were explored. ,,Six women who had undergone surgery for a non-invasive breast cancer (ductal carcinoma in situ or DCIS) participated in the research and an interpretive approach was used to guide the research process. ,,In-depth interviews took place in the women's homes and the interviews were transcribed verbatim. ,,Through a process of familiarization with the tapes and transcripts, clusters of significant statements were assembled into individual stories of each woman's experience. ,,The findings highlight the individual nature of the experience of information, with the women wanting information that is tailored to their personal needs. ,,Nurses can provide care that is more responsive to the information needs of each woman by being aware of the diverse ways in which women experience information. ,,This small study contributes to the limited understanding of the experience of having surgery for ductal carcinoma in situ and the information needs of these women. [source] Feeling in Control During Labor: Concepts, Correlates, and ConsequencesBIRTH, Issue 4 2003AFBPsS, CPsychol, Josephine M. Green BA(Hons) Since not all studies conceptualize "control" in the same way or distinguish between "external" and "internal" control, the purpose of this study is to advance understanding of how these senses of control relate to each other. Methods:, Questionnaires were sent to women 1 month before birth to assess their preferences and expectations and at 6 weeks after birth to discover their experiences and assess psychological outcomes. Data are presented from 1146 women. Three control outcomes were considered: feeling in control of what staff do to you, feeling in control of your own behavior, and feeling in control during contractions. Results:, Women were less likely to report being in control of staff (39.5%) than in control of their own behavior (61.0%). Approximately one-fifth of the sample felt in control in all three ways, and another one-fifth did not feel in control in any of them. Parity was strongly associated with feeling in control, with multiparas feeling more in control than primiparas in all cases. In logistic regression analyses, feeling in control of staff was found to relate primarily to being able to get comfortable, feeling treated with respect and as an individual, and perceiving staff as considerate. Feeling in control of one's behavior and during contractions were primarily related to aspects of pain and pain relief, but also to antenatal expectations of control. Worry about labor pain was also an important antenatal predictor for primiparas. All three control outcomes contributed independently to satisfaction, with control of staff being the most significant; relationships with emotional well-being were also demonstrated. Conclusions:, All three types of control were important to women and contributed to psychological outcomes. Internal and external control were predicted by different groups of variables. Caregivers have the potential to make a significant difference to a woman's experience of childbirth. The ways in which women are helped to deal with pain will affect internal control; the extent to which they feel that they are actually cared about, rather than care being something that is done to them, will affect external control. Both contribute to satisfaction and emotional well-being. (BIRTH 30:4 December 2003) [source] Evaluation of a Prediction Model for Long-Term Fracture Risk,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 4 2005L Joseph Melton III MD Abstract The NOF cost-effectiveness model, based on clinical risk factors and femoral neck aBMD, predicted overall fracture risk in a cohort of postmenopausal women followed for up to 22 years. Introduction: To assess the ability of a statistical model to predict long-term fracture risk for a population of postmenopausal women, we compared observed fractures to those predicted by the National Osteoporosis Foundation's (NOF) cost-effectiveness model. Materials and Methods: In this population-based study, 393 postmenopausal Rochester, MN, women had baseline measurements of femoral neck areal BMD (aBMD) and assessment of the clinical risk factors (personal fracture history, family history of osteoporotic fracture, low body weight, and smoking status) that were included in the NOF model. They were then followed prospectively for up to 22 years. Fractures were ascertained by periodic interview and review of community medical records. Standardized incidence ratios (SIRs) compared observed fractures to predicted numbers. Results: During 4782 person-years of follow-up, 212 women experienced 503 fractures, two-thirds of which were caused by moderate trauma. When undiagnosed (incidentally noted) vertebral and rib fractures were excluded, there was general concordance between observed and predicted fractures of the hip (SIR, 0.78; 95% CI, 0.56-1.01), distal forearm (SIR, 1.22; 95% CI, 0.86-1.68), spine (SIR, 0.76; 95% CI, 0.50-1.11), and all other sites combined (SIR, 1.18; 95% CI, 0.97-1.42). Fracture prediction by the NOF model was about as good after 10 years as it was earlier during follow-up. Conclusions: This study validates the ability of a statistical model based on femoral neck aBMD and common clinical risk factors to predict the actual occurrence of fractures in a cohort of postmenopausal white women. [source] Hereditary angioedema and pregnancyAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2009Niranthari CHINNIAH Background:, Hereditary angioedema (HAE) is an autosomal dominant disease caused by a quantitative or functional defect in C1-esterase inhibitor (C1-INH). Patients with this deficiency present with episodes of angioedema which can be life-threatening. Studies examining HAE and pregnancy are scarce with little known about the interrelationship between the two. Objective:, To examine the effect, and evaluate the clinical manifestations of HAE in pregnancy using retrospective interviews of affected women. Methods:, Women with HAE who have undergone one of more pregnancies were identified throughout Australia using the national Australasian Society of Clinical Immunology and Allergy immunodeficiency database. Following informed consent, identified women were interviewed regarding their HAE status during pregnancy and the perinatal period using a questionnaire. Results:, Seven women with a total of 16 pregnancies were identified. During the first trimester of pregnancy, more than ten attacks of angioedema were experienced in six of 16 pregnancies. During the second trimester only in three of 16 pregnancies did women experience greater than ten attacks. During the post-partum period, four of seven women experienced increased frequency and severity of attacks as compared to the pre-pregnancy state. For two of four patients, this impacted on their breast-feeding routine. Conclusion:, Our study showed that women with HAE have greatly reduced or absent attacks in the last two trimesters of pregnancy, although, during the post-partum period, the majority of women experienced increased frequency and severity of attacks. [source] | ||||||||||