As a result of the recent findings of the Women's Health Initiative (WHI), many women who have been on hormone replacement therapies (HRT) have begun to renegotiate their understandings and strategies of this stage of their lives. The WHI findings suggested that the risks of HRT outweighed the benefits for healthy menopausal women. This study examined women's emerging sensemaking regarding HRT and menopause in light of the WHI findings. Seven women in the Tampa Bay area, who were in various stages of menopause, participated in three focus group sessions and two one-on-one interviews to discuss their lives in menopause. Based upon the women's conversations, I constructed individual stories about each of the women. I included my voice in each step of the process, both participating in the focus group and interview discussions and inserting my voice in the women's stories as an interview and focus group participant. I analyzed the stories to determine categories in the w omen's emerging sensemaking. A theme of change emerged in terms of loss, decay, and decline. The women talked about change while discussing personal issues such as children, their bodies, aging, health concerns, and sex. Throughout their discussions, the women spoke about the contradictions and dilemmas they faced as they tried to sort through the conflicting and sometimes contradictory information they have been receiving about the effects of menopause and HRT on their bodies. Emily Martin's medical metaphors, Michel Foucault's ideas on discourse, and Watzlawick, Weakland, and Fisch's theory of change helped me understand the women's sensemaking. Many of the women framed their sensemaking within the biomedical model of health care, using what Martin called the body-as-machine metaphor, thereby making a first-order change, even though they changed from one HRT formula to another, from "synthetic" to "natural" HRT, or stopped taking HRT entirely. One woman appeared to make a secon d-order change. Overall, the women felt they had little to guide them as they determined how to take care of themselves in the menopausal stage of their lives.

<p>Up to two million women worldwide have obstetric fistula, a maternal morbidity prevalent in developing countries that causes uncontrollable leaking of urine and/or feces and a persistent bad odor. There is both theoretical and empirical evidence for psychopathology in patients presenting for fistula surgery, albeit with methodological limitations. The current studies sought to improve on past limitations of study design. Study A compared psychological symptoms and social support between fistula patients and a comparison group recruited from gynecology outpatient clinics. Measures included previously validated psychometric questionnaires, administered orally by data collectors. Results showed that compared to gynecology outpatients, fistula patients had significantly higher levels of depression, traumatic stress, somatic symptoms and avoidant coping, and had lower social support. Study B investigated changes in psychological symptoms, stigma and social support between the time of admission for fistula repair and 3 months after discharge from the hospital. At follow-up, fistula patients reported significant improvements in all study outcome variables. Exploratory analysis revealed that the extent of leaking was associated with depression and PTSD. These results indicate the potential benefit of mental health interventions for this population. Additionally, future research may clarify the relationship between residual leaking after fistula surgery, and its effect on post-surgery mental health outcomes.</p> / Dissertation

Healthy Women, Healthy Families is a survey collection and story sharing project spearheaded by NARAL Pro Choice Texas. The reproductive justice based project asks survey respondents to rate how urgently their community needs a variety of health care services. While all Texas women are invited to participate, special attention was paid to targeting low income and minority women. In this report, I analyze the survey data and make both policy and internal recommendations for NPCT. Overall the survey results show that while all of the services in question are needed by women in Texas, there are differences in the strength of this need based on race and income. General health care services were most valued by all demographics, but NARAL’s priority services were valued most by upper class white women, while low income and minority women were more likely to support services aimed at specific populations (non-English speakers, women in prison, undocumented immigrants, those without transportation, etc.). Based on these survey results, I recommend that NARAL conduct follow up surveys as a way of illuminating some still unanswered questions. In addition, I recommend that NARAL reach out to coalition partners who advocate for the most needed services, expand outreach into low income and minority communities, and use outreach and messaging to try and frame NARAL’s services in a larger, more general health care context. / text

Within the last ten years HIV rates in Central Asia have more than quadrupled amongst the general population. Labor migrants from the region who are working in Russia are considered at high risk of HIV infection due to risky sexual practices. Similar behavior has been documented among labor migrants in sub Saharan Africa. By reviewing medical data and literature written by international health professionals in both regions, I analyze the chain of sexual contact of labor migrants within female partners that contribute to the spread of HIV from Russia to the general population within Central Asia. I use Tajikistan as a case study. The findings of this study recommend that existing behavior modification strategies need to recognize existing gender structures when addressing at risk populations. They must also emphasize collaboration with community religious leaders and civil society organizations to promote effective and appropriate HIV/AIDS education efforts in order to curb the growing prevalence rates among male labor migrants in Central Asia. / text

Women living in rural Kenya rely on wood for cooking and are exposed to elevated amounts of wood smoke. The objective of this thesis was to assess the health and quality of life benefits of installing biogas digesters on rural Kenyan dairy farms. Thirty-one farms with biogas digesters and 31 farms without digesters (referent group) were assessed for wood utilization practices, basic respiratory and self-reported health, and exposure to volatile organic compounds (VOCs). Women with biogas digesters spent less time and money acquiring wood, and less time exposed to wood smoke (p<0.01). Multivariable linear regression showed associations between daily wood consumption and having a biogas digester, family size, and number of cows. Individual VOCs were lower in cookhouses on biogas farms (p<0.001) and women with biogas digesters reported fewer respiratory symptoms. Biogas digesters are one technology that can reduce reliance on wood fuel and reduce exposures to harmful wood smoke.

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Two research methods, a correlational survey and a case study method were used to explore the impact of health focused and economic focused women's organizations on community development and health. Through the study the following questions were answered: (i) Is there a difference in the health and development indicators of the households of Elim Care Group Project members, Akanani members and members of the community who do not belong to any of the organizations? (ii) What contribution have these organizations made to individuals' and/or communities' way of life? (iii) What aspects of these organizations' structure and/or function strengthen or weaken the organization? For the correlational survey, quantitative data were collected from three categories of thirty households each that belonged to Care Group members, Akanani members and community members who did not belong to any organization. The analysis of the data showed that both the health focused and economic focused organizations kept their focus even though their functioning tended to overlap. The health focused group had a greater impact on health indicators e.g. number of diarrhoea episodes, respiratory tract infection episodes, nutritional state, while the economic focused group had greater impact on development indicators e.g. housing, income and education. The improvement in the development indicators did not influence the health indicators directly. The qualitative data collected for the case study provided an indepth information about the case studied. The health focused organization demonstrated stability in its management. This was composed of health personnel under the employment of the Department of Health Managing the Care Group was a paid job for them. The organization was established and supported by the community and therefore expressed the community's concerns. The economic focused organization provided opportunities for the rural people to establish money making enterprises. Some of the problems shown in this study in this regard relate to poor managerial and business skills that resulted in the production of products that were not readily marketable in the locality. This caused a lot of anxiety amongst members as earnings were irregular. The differences in the structure and functioning of the groups were analysed. These influenced the effectiveness and continued viability of the organizations. / Thesis (Ph.D.)-University of Natal, Durban, 1996.

Objective: To compare psychological work and life stress indicators among female hospital employees in both shift work (SW) and non-shift work (NSW) positions, and determine associations with demographic and vocational factors, and indicators of cardiovascular risk (CVR). Methods: Female employees from one Southeastern Ontario acute care hospital (n=212) provided fasting blood samples, demographic and work related data, and completed a physical assessment and questionnaires. Work stress was measured with the Job Content Questionnaire and Effort-Reward Balance Index (ERI). Life stress was assessed with the Derogatis Stress Profile. Metabolic Syndrome (MS) was determined based on Interim Societies Joint Guidelines. Results: SW in comparison to NSW employees reported higher mean scores in: global ERI (.70 (SD .4) vs. .58 (SD.29) p<.05), psychological job demands (21.2 (SD 4.8) vs. 19.2 (5.7) p<.01), physical job demands (13.8 (SD 2.6) vs. 10.2 (SD 3.8), skill discretion (36.5 (SD 4.4) vs. 34.7 (SD 5.4) p<.01), lower decision authority (31.6 (SD 5.8) vs. 33.5 (SD 6.5) p<.05), and lower total life stress scores (39.2 (SD 7.3) vs. 42.1 (SD 9.4) p<.05). There were no significant differences between SW and NSW group for MS or CVR factors. MS was present among 17% of all employees, 18.5% of SW, and 15.5% of NSW. In logistic regression analysis MS occurrence was associated with chronic SW exposure of 6 or more years (AOR 5.41 (95% CI, 1.84 – 15.87), decisional authority (AOR 1.09 (95% CI, 1.00 – 1.18), skill discretion (AOR 1.13 (95% CI, 1.01 – 1.26), and depression (AOR 1.26 (95% CI 1.08 – 1.46). Conclusions: Women working in SW positions experience more psychological and physical work stress, and effort-reward imbalance. The interplay between effort and reward aspects of the work environment may significantly contribute to psychological work stress and persist with increasing age among female hospital employees regardless of SW status. Among female hospital employees SW status and psychological stress measures do not appear to have an immediate effect upon CVR, as measured by the MS, but may contribute to its development with prolonged exposure. / Thesis (Master, Nursing) -- Queen's University, 2014-04-27 21:22:11.951

The state of global health and wellbeing is threatened by the pervasive and dangerous decision to engage in unprotected sex. Only male or female condoms can prevent the spread of both sexually transmitted infections and unintended pregnancies. Despite this, condoms remain dangerously underused because of the perception that they diminish sexual pleasure. The pleasure gap in the design and promotion of condoms cripples sexual health outcomes. Acknowledging and harnessing the power of pleasure in sexual-decision making is key to increasing condom use.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2002. / Härtill 4 uppsatser.