Peripartum is the time of pregnancy and one year postpartum. The lack of peripartum education in entry-level occupational therapy programs creates a gap in knowledge for generalist occupational therapy practitioners treating clients in pregnancy and postpartum. This problem leads to insufficient treatment methods and an increase in occupational dysfunction during peripartum. This guide aims to provide access to evidence-based practice to ensure a straightforward search process for peripartum interventions, increasing appropriate treatment and reducing occupational dysfunction. The program is distributed through online and in-person marketing platforms and funded by volunteer resources and grants. This single group pre-test/post-test design will collect data from occupational therapists and peripartum people while following the guide to improve peripartum care, increase occupational therapist comfort, and create more positive outcomes for this population.

The United States is home to approximately 44.5 million immigrants and refugees, and these numbers continue to grow. To ensure a healthy immigrant and refugee population, it is important to address the unique health needs of these communities. Migrant women face many obstacles in obtaining women’s health services, including language and cultural barriers, difficulty finding childcare to attend medical appointments, and transportation difficulties. These factors are compounded by systemic difficulties in receiving health insurance coverage. Published literature describes women’s health in immigrant and refugee women living in the United States, but much of this literature either focuses on specific cultural or religious groups rather than looking at overall trends in women’s health care or does not differentiate between women’s and men’s health services in immigrant and refugee populations. Through reviewing published studies, the aim of this paper is to analyze general trends about the accessibility of women’s health services to immigrant and refugee women living in the United States. This paper will also look at specific examples of cultural and religious groups in the United States to examine the variation in women’s health preferences and issues among immigrant women of different backgrounds. Finally, this paper will explore potential ways to improve women’s health services available to immigrant and refugee women living in the United States.

Uterine cancer is the nation’s most common gynecologic malignancy but is understudied in the geographically and socioeconomically diverse state of Kentucky (KY). This study assessed the frequency, distribution, and survival of uterine corpus malignancies in KY, and specifically the differences between Appalachia (AP) and non-Appalachia (NAP). This study utilizes SEER and Kentucky Cancer Registries to study uterine corpus malignancy between January 1, 2000 and December 31, 2014. The analysis looks at incidence between diagnoses in AP and NAP. Evaluation criteria includes: tumor histology (Type I, Type II, sarcoma, and mixed uterine malignancy), age, race, smoking status, stage at diagnosis, insurance status, and county of residence at diagnosis.

Increased signaling of various hormones through their cognate G Protein-Coupled Receptors (GPCRs), including the angiotensin, endothelin, and vasopressin systems, are implicated in human preeclampsia (PreE) and animal models of the disorder. Cascade-specific termination of GPCR signaling following receptor activation is catalyzed by the Regulator of G protein Signaling (RGS) family members. Within the RGS B/R4 family, RGS5 and RGS2 are implicated in human PreE and gestational hypertensive disorders. Mutations within the RGS2 gene, a B/R4 RGS member, are associated with human hypertensive populations and increased risk of developing PreE and its sequelae. Given the role for the placenta in the pathogenesis of PreE, we hypothesized a role for RGS2 in the placenta during PreE. My studies showed RGS2 mRNA expression is reduced in placentas from pregnancies affected by PreE. Reduced fetal-placental Rgs2 induces gestational hypertension, proteinuria, and increased plasma ALT activity in wildtype dams. Placentas with reduced Rgs2 expression exhibit reduced vascularization, increased thickness of the labyrinth and spongiotrophoblast layers, and enrichment for pathways associated with human PreE. Analysis of human PreE placenta samples reveals an increase in the cAMP/CREB signaling pathway, yet we demonstrate loss of CREB occupancy at the RGS2 promoter. HTR8 cell cultures indicate HDAC activity may be required CREB transcription of specific gene sets. In silico analysis supports this concept and further implies it may be impaired in human PreE placentas. These findings demonstrate heterozygous loss of fetal-placental Rgs2 is sufficient to induce PreE phenotypes in wildtype dams during pregnancy. Additionally, they highlight the role of the placenta in maternal pathogenesis of PreE and support the concept that paternal genetics influence the risk of developing PreE.

Thesis (Ph. D.)--Ohio State University, 2006. / Available online via OhioLINK's ETD Center; full text release delayed at author's request until 2009 Jun 16

Economic globalization is characterized by increased liberalization, privatization and deregulation of national economies, principally imposed via the International Monetary Funds and World Banks structural adjustment programs and poverty reduction strategies. The rationale for these strategies includes reducing the inflation rate, generating income to service debt payments, and increasing growth to combat poverty. Nicaragua, the second poorest country in the Western Hemisphere, has been under structural adjustment and poverty reduction strategies since 1991. Forty-eight percent of the country is under the nationally defined poverty line. Under- and unemployment are a combined 60%. Migration is an oft-used survival strategy, with 7 out of 10 Nicaraguan migrants choosing to go to Costa Rica. The Nicaraguan Migration Network estimates a minimum 350,000 Nicaraguans in Costa Rica at any one time. Women bear a disproportional burden of the health inequalities that globalization- induced, employment-seeking migration causes. While there is already evidence showing that their health is negatively affected, there is no documentation in their own words of how they experience and understand these impacts. A qualitative study using interpretive description conducted 12 interviews and 2 participatory group activity sessions to explore how women understand their migration experiences and its health impacts. Results show structural and personal level causes and both beneficial and harmful effects. Explanations of causes include structural and cultural reasons. Migration affects women in particular ways due to gendered social and cultural roles within a polarized economic environment. It was difficult for participants to identify if the costs of migration were worth the benefits. A document analysis of structural adjustment agreements and poverty reduction strategy papers was also undertaken. Results show consistent limitations on the Nicaraguan governments social spending budget, increased privatization and liberalization requirements, and specific amounts for debt service payments. The countrys currency is regularly devalued and there are limits on tariff barriers. In conclusion, it is clear that women are absorbing the cost of SAPs and PRSs at the household level and that migration is negatively affecting their health.

The purpose of this dissertation is to examine how women seek health information on the Web in relation to information source characteristics, situational characteristics, and socio-demographic characteristics. The Web is conceptualized as three facets that reflect the three main modes of seeking health information on the Web: websites; Web-based bulletin boards and chatrooms; and Web-based listservs and newsgroups. The lack of analytical research on this gendered online activity prompted this study. The conceptual framework is based primarily on theoretical foundations from two academic disciplines: information science and health sciences. The independent variables in the conceptual framework are health information need, family caregiving, perceived Web self efficacy, perceptions of the quality and accessibility of the Web as a source of health information, and socio-demographic variables. The dependent variable is intensity (frequency) of seeking health information on the Web (FSHIW). Data was collected from 264 women from November 2000 until April 2001 using a Web survey questionnaire. The participants were predominantly well educated, English-speaking Canadians. A subset of 27 survey respondents completed at least one additional component of this multi-method study. Perception of the reliability of the Web as a source of health information was identified as the key variable influencing frequency of seeking health information on the Web (FSHIW). As well, perceived information source reliability was correlated with two information source characteristics, perceived information source relevance and cognitive access. Two situational variables, health information need and family caregiving, were weakly correlated with FSHIW. Three socio-demographic variables – racial identity, household income, and occupation – affected FSHIW. Qualitative interview data, Web use journals, and recordings of Web use sessions provided a contextualized understanding of the survey data. In particular, they highlighted the importance of situational and affective relevance. To-date, very few empirical research studies have been conducted on how women seek health information on the Web. This unique multi-method study contributes to a better understanding of women’s use of the Web as a source of health information for resolving personal health problems and caring for family members by identifying key variables that affect the frequency of this online behaviour and contextualizing these variables.

The purpose of this dissertation is to examine how women seek health information on the Web in relation to information source characteristics, situational characteristics, and socio-demographic characteristics. The Web is conceptualized as three facets that reflect the three main modes of seeking health information on the Web: websites; Web-based bulletin boards and chatrooms; and Web-based listservs and newsgroups. The lack of analytical research on this gendered online activity prompted this study. The conceptual framework is based primarily on theoretical foundations from two academic disciplines: information science and health sciences. The independent variables in the conceptual framework are health information need, family caregiving, perceived Web self efficacy, perceptions of the quality and accessibility of the Web as a source of health information, and socio-demographic variables. The dependent variable is intensity (frequency) of seeking health information on the Web (FSHIW). Data was collected from 264 women from November 2000 until April 2001 using a Web survey questionnaire. The participants were predominantly well educated, English-speaking Canadians. A subset of 27 survey respondents completed at least one additional component of this multi-method study. Perception of the reliability of the Web as a source of health information was identified as the key variable influencing frequency of seeking health information on the Web (FSHIW). As well, perceived information source reliability was correlated with two information source characteristics, perceived information source relevance and cognitive access. Two situational variables, health information need and family caregiving, were weakly correlated with FSHIW. Three socio-demographic variables – racial identity, household income, and occupation – affected FSHIW. Qualitative interview data, Web use journals, and recordings of Web use sessions provided a contextualized understanding of the survey data. In particular, they highlighted the importance of situational and affective relevance. To-date, very few empirical research studies have been conducted on how women seek health information on the Web. This unique multi-method study contributes to a better understanding of women’s use of the Web as a source of health information for resolving personal health problems and caring for family members by identifying key variables that affect the frequency of this online behaviour and contextualizing these variables.

Obesity is associated with higher death rates from breast and gynecological cancers. African American women(AAW) are more likely to be diagnosed with these cancers at later stages and have lower survival rates than Caucasian women. African American women are also disproportionately affected by obesity. Studies suggest that the healthcare experiences of obese women (primarily stigmatization), may contribute to their decisions to utilize healthcare services. However, these studies have largely comprised Caucasian women; there remains a paucity of studies addressing this issue in AAW. The purpose of this study was to explore the healthcare experiences of obese AAW and their utilization of preventive healthcare services. Interpretive phenomenology, based on the work of Maxx van Manen, was used to describe and interpret the healthcare experiences of 15 obese AAW living in communities in Georgia. The women ranged in age from 23 to 62, with body mass index ranging from 35-55. The majority of the sample (83%) had adequate health insurance. This was a well educated sample with 87% having college degrees or some college education. Individual, audio-taped interviews were used to collect data. Data were analyzed using interpretive phenomenological methods, with analysis and collection occurring concurrently. Data were analyzed as a whole then line by line to identify themes across transcripts. Two patterns and five themes were identified. Patterns were: They're not listening and Good or bad, it's my decision. Themes were: Attributing all problems to weight; They say lose weight but give us no tools; Stigmatization; Cancel my appointment please: I won't be back, and Empowerment. The women recalled a pleothra of negative encounters with providers that they termed "demeaning" and "nastiness for no reason." Many women reacted by delaying or avoiding healthcare, some not returning for preventive health screens for many years. The significant association between obesity and mortality from cervical and breast cancers necessitates timely preventive screens by obese women. The results of this study can help to inform practice, education, and research. Recommendations for all three areas were deleneated in the study.

Economic globalization is characterized by increased liberalization, privatization and deregulation of national economies, principally imposed via the International Monetary Funds and World Banks structural adjustment programs and poverty reduction strategies. The rationale for these strategies includes reducing the inflation rate, generating income to service debt payments, and increasing growth to combat poverty. Nicaragua, the second poorest country in the Western Hemisphere, has been under structural adjustment and poverty reduction strategies since 1991. Forty-eight percent of the country is under the nationally defined poverty line. Under- and unemployment are a combined 60%. Migration is an oft-used survival strategy, with 7 out of 10 Nicaraguan migrants choosing to go to Costa Rica. The Nicaraguan Migration Network estimates a minimum 350,000 Nicaraguans in Costa Rica at any one time. Women bear a disproportional burden of the health inequalities that globalization- induced, employment-seeking migration causes. While there is already evidence showing that their health is negatively affected, there is no documentation in their own words of how they experience and understand these impacts. A qualitative study using interpretive description conducted 12 interviews and 2 participatory group activity sessions to explore how women understand their migration experiences and its health impacts. Results show structural and personal level causes and both beneficial and harmful effects. Explanations of causes include structural and cultural reasons. Migration affects women in particular ways due to gendered social and cultural roles within a polarized economic environment. It was difficult for participants to identify if the costs of migration were worth the benefits. A document analysis of structural adjustment agreements and poverty reduction strategy papers was also undertaken. Results show consistent limitations on the Nicaraguan governments social spending budget, increased privatization and liberalization requirements, and specific amounts for debt service payments. The countrys currency is regularly devalued and there are limits on tariff barriers. In conclusion, it is clear that women are absorbing the cost of SAPs and PRSs at the household level and that migration is negatively affecting their health.