Background: The HPV vaccine is a primary prevention method available to reduce the burden of HPV-related cancers and genital warts. The vaccine is currently approved for catch-up vaccination among women 18 to 26 years of age. Despite this recommendation, the rate of vaccine uptake among this group is considerably low (~34% uptake). One demographic characteristic that is consistently reported as a risk factor for non-vaccination is relationship status, specifically married or monogamous relationships. While the epidemiological data confirm this association, there is a lack of understanding how this risk factor operates. By elucidating the mechanism for this risk factor, HPV vaccine uptake among this consistently unvaccinated group could be improved. Purpose: The purpose of this study was to understand how young adult women’s relationship status influence informational needs, motivations, and behavioral skills related to HPV vaccination. This objective was achieved through the following specific aims: (1) assess how relationship status affects primary reasons for non-vaccination among 18 to 26 year old women; and (2) understand how relationship status frames HPV vaccine decision-making among 18 to 26 year old women. Methods: To effectively achieve these specific aims, a concurrent mixed-methods study design was conducted. In Phase I, a secondary data analysis using the 2010 National Health Interview Survey was employed to determine if women in relationships are less likely to be interested in vaccination and identify the primary reasons (e.g., misinformation, motivations, behavioral skills) for non-vaccination among different relationship status categories. In Phase II, in-depth interviews were conducted with a sample (N=50) of 18 to 26 year old women at the University of South Florida, stratified by relationship status and vaccination status. A comparative thematic analysis was conducted to determine if there were differences in informational needs, motivations, behavioral skills, and HPV vaccine decision-making between the groups. Results: Using NHIS 2010 data, women who were living with a partner (PR 1.44 95%CI 1.07-1.87) and never married (PR 1.41 95%CI 1.12-1.73) were less likely to be interested in HPV vaccination compared women who were married. Moreover, primary reasons for non-vaccination differed significantly by relationship status group (p Conclusion: This study found that relationship status impacts HPV vaccine decision-making among young adult women. Specifically, it operates by modifying risk perceptions for HPV, which serve as barriers to vaccination. Young adult women have the knowledge and behavioral skills necessary to access and understand the importance of HPV vaccination; however, women were unable to accurately perceive their risk for HPV, resulting in impaired motivation for vaccination. A potential approach to address this issue is the use of health literacy. Future research should integrate health literacy techniques with healthcare providers serving this population to assist in the evaluation process for risk of HPV. This will facilitate shared decision-making and patient-provider communication surrounding the HPV vaccine. This can ultimately promote HPV vaccination among young adult women and reduce the morbidity and mortality of HPV-related diseases.

No / In this pilot study, we explored the difference in the use of occupational competence strategies for daily participation between more active and less active older Hispanic women. Twenty-nine women who were 70 and older and lived alone participated in this study. We used a mixed-methods design by which the principal investigator administered a tool to measure participation restrictions during the quantitative phase and conducted in-depth interviews with a subsample in the qualitative phase. More active women predominantly used transportation resources, emotional social support, and spirituality to support participation in life activities. Less active women used more practical social support, assistive technology, and environmental modifications. Personal facilitators seemed to directly modify these strategies. These results suggest that older women with different activity levels use distinct internal and external resources to maintain or enhance daily participation. Future studies should explore whether these resources remain consistent across gender, living status, and ethnicity. / This publication was supported by the National Institutes of Health (NIH), National Institute on Minority Health and Health Disparities (NIMHD), Clinical Research Education and Career Development (CRECD) grant R25RR017589, in collaboration with the Puerto Rico Clinical and Translational Research Consortium (PRCTRC) grant 8U54 MD 007587-03 and the National Center for Research Resources (NCRR) grant 8U54RR026139- 01A1.

Objectives: The purpose of this study was to examine what motivates physically active women to maintain their active lifestyle through exercise. Design: Cross sectional study. Methods: Physically active women (N=70) between the age of 19 and 84 were recruited at fitness centers and they completed the survey regarding their motives to maintain an active life style. The survey contained questions with several response options, and an open ended question where the women were asked to share their experiences and encouraging words for physically inactive women. The total number of distributed surveys was 90, of which 70 were complete. Results: The findings showed an association between a physically active life and good health. The majority of the participants claimed positive health benefits from training. The women who had a high exercise frequency also graded the exercise to be fun more often than women who were not training as frequently. The women also shared their own experiences of being active, and claimed that the physical, psychological and social benefits were great motivational factors to keep being active. Conclusions: The positive health benefits constituted the greatest motivation for maintaining a physically active life style.  The physically active women in this study showed that exercise has benefits; physical benefits such as pain relief or psychological benefits such as feeling good and happy, but also the social benefits of meeting new people.

There is accumulating evidence from many directions indicating that gender plays a critical role in drug abuse. Biological factors, including gonadal sex hormones, contribute in a significant although incompletely understood manner, to gender differences in drug abuse. Female sex hormones have been shown to affect central nervous system function and modulate the effects of drugs of abuse. For example, GABAA receptor function is positively modulated by progesterone. There is evidence from preclinical in vitro and in vivo studies as well as some clinical research suggesting that progesterone and its metabolites may enhance the behavioral effects of benzodiazepines, which also serve as positive modulators of GABAA receptors. The three studies presented here utilize within subject designs to assess the role of progesterone on the discriminative stimulus, subjective, performance and cardiovascular effects of triazolam, a short-acting benzodiazepine, in healthy, premenopausal women. The first study examined the effect of menstrual cycle phase on the discriminative stimulus effects of triazolam (0.00, 0.06, 0.12 and 0.25 mg/70 kg). The results of this study indicated that when progesterone levels peak (mid luteal phase), the discriminative stimulus effects of triazolam (0.12 mg/70 kg) are enhanced. The second study examined the separate and combined effects of a range of acute doses of oral micronized progesterone (0, 100 and 200 mg) and oral triazolam (0.00, 0.12 and 0.25 mg/70 kg) on the subjective, psychomotor and physiological effects of these medications, tested under conditions of low circulating sex hormones. The results of this study indicated that progesterone alone has some short-acting, sedative-like effects and enhances the subjective and performance effects of triazolam. The final study examined the effects of progesterone (0 and 100 mg) on the discriminative stimulus effects of triazolam (0.00, 0.06, 0.12 and 0.25 mg/70 kg), also under conditions of low circulating sex hormones. The results of this study indicated that the parent hormone progesterone does not appear to alter sensitivity to the discriminative stimulus effects of triazolam. Increases in sensitivity to triazolam in studies 1 and 2 may have been the result of neuroactive progesterone metabolites (e.g., allopregnanolone, TH-DOC), although future studies will be required to further examine this possibility. Taken together, these studies help clarify the manner in which the ovarian hormone progesterone and its metabolites modulate the behavioral effects of the benzodiazepines.

Continuing high maternal mortality ratios, especially in Africa, and high discrepancies between richer and poorer households in relation to access to maternal health care and maternal health status have focussed attention on the importance of reducing financial barriers to skilled care. This PhD compares the findings of two evaluations of national policies exempting women from user fees for deliveries, conducted in Ghana in 2005-6 and in Senegal in 2006-7. The detailed findings from each evaluation are presented as well as the broad lessons learnt from what are similar (but not identical) policies with similar goals, both of which were implemented in poorer regions initially but then scaled up, using national resources.  Both demonstrate the potential of fee exemption policies to increase utilisation.  The cost per additional associated delivery was $62 (average) in Ghana and $21 (normal delivery) and $457 (caesarean section) in Senegal. However, despite reducing direct costs for women (from $195 to $153 for caesareans and from $42 to $34 for normal deliveries in Ghana), in neither country were delivery fees costs reduced to zero.  This was linked to a number of important factors, including inadequate budgets (in Ghana) and failure to adequately reimburse lower level providers (in Senegal).  The study also highlights the need to address quality of care and geographical access issues alongside fee exemption. While there has been a lot of debate over the relative merits of different targeting approaches and design of policies to reduce financial barriers to health care (maternal and general), the Ghana and Senegal evaluations suggest the details of implementation and their interaction with contextual factors can be more significant than design of the policy per se.

This paper contributes to a growing body of literature on women with endometriosis, a gynecological condition in which tissue similar to the endometrium, or lining of the uterus which is shed during menses, grows elsewhere in the body. Despite a growing understanding of the disease in medical literature, it is still not well known by the general population or fully understood by the medical community. The paper incorporates a biomedical understanding with Emma Whelan’s idea of these women as an epistemological community, autoethnography, and narratives of sufferers in order to understand how women discuss, experience, and form communities around it. It draws upon individual interviews, a focus group, and readings of medical and social science literature and found that women of dissimilar socioeconomic backgrounds approached and discussed the disease distinctively from one another with three phases of coping with the illness: the discovery, quest, and revelation.

No description available.

Great disparities exist in women’s health outcomes in rural indigenous communities in Guatemala; indigenous women are less likely to utilize family planning and cervical cancer screening services. This pilot study assessed baseline women’s health knowledge and the effects of a comprehensive women’s health course on women’s health knowledge and behaviors. From February to November 2013, 61 participants in a seven-week language-appropriate women’s health curriculum were evaluated before and after the course using a 10-item knowledge assessment. Cervical cancer screening and contraceptive utilization rates were assessed by self-report before and after the course. Several women’s health knowledge deficits were noted: belief that contraception causes cancer, inability to name symptoms of STIs, lack of understanding of pap smears, and lack of familiarity with condoms. The average pre-test score was 54.6%; increasing to 83.7% on the post-test (p<0.0001). 79% had received a pap smear prior to the course; this increased to 92% at the post-test (p=0.013). 53% had utilized contraception prior to the course; at the time of the post-test the percentage was 54% (p=1). This study reveals important patterns in women’s health beliefs in rural Guatemala, and shows that a seven-week curriculum was effective in improving scores on a knowledge assessment.

Background: Urbanization is increasing around the world, and in India this trend has translated into an increase in the size of slum dwellings. Slum environments may have a negative effect on human health, in particular women’s health. The objective of the study is to determine factors associated with Indian women’s health in slum environments. Methods: The relationship between women’s health, measured by BMI, and demographic, behavioural, and socioeconomic factors was statistically modelled. A multiple linear regression was performed, using data from the India National Family Health Survey. Results: Increasing BMI is significantly and positively associated with: frequency of watching television, having diabetes, age, wealth index, and residency status in the areas of New Delhi, Andhra Pradesh or Tamil Nadu. Conclusion: While belonging to a scheduled tribe was not associated with changes in BMI, unadjusted rates suggest that tribal status may be worthy of deeper investigation. Among slum dwellers, there is a double-burden of under-nutrition and over-nutrition. Therefore a diverse set of interventions will be required to improve the health outcomes of these women.

Bakgrund: Fysioterapeuter verksamma inom kvinnors hälsa har god kunskap om rörelse- och stödjeapparaten med kompetens att bland annat bedöma bäckenbottenmuskulatur, stödja återgång till fysisk aktivitet och finnas som stöd- och rådgivare. Sveriges Kommuner och Regioner menar att tillgången till fysioterapeutisk kompetens inom kvinnors hälsa bör förbättras. Det saknas i dagsläget studier på svenska fysioterapeuters uppfattningar om sin roll i eftervården efter förlossning. Syfte och frågeställning: Syftet var att undersöka hur fysioterapeuter verksamma inom kvinnors hälsa och som träffar postgravida kvinnor i sitt arbete uppfattar sin roll i eftervården efter förlossning. Design och metod: Studien var av kvalitativ deskriptiv design och dess innehåll baserades på semistrukturerade intervjuer med fem legitimerade fysioterapeuter verksamma inom kvinnors hälsa. Datan analyserades med kvalitativ innehållsanalys. Resultat: Fyra kategorier och 14 underkategorier identifierades under databearbetningsprocessen. Kategorierna kom att heta Fysioterapeuten som stöd- och rådgivare i eftervården, Fysioterapeutens unika bäckenbottenkompetens, Framtidens eftervård samt Utmaningar för fysioterapeuten i eftervården. Inom dessa kategorier framkom beskrivningar om fysioterapeutens roll kring att stödja återgång till fysisk aktivitet, utmaningar kring att nå ut till patienterna samt önskemål om att erbjuda rutinuppföljning hos fysioterapeut. Konklusion: De intervjuade fysioterapeuterna uppfattade att sin roll i eftervården efter förlossning innefattar att vara emotionellt stöd, att vara stöd-och rådgivare och att de har en unik bäckenbottenkompetens med möjlighet att individualisera bäckenbottenträning. De upplevde att kvinnohälsa bortprioriteras, att det saknas kompetens inom området och att samarbetet med andra professioner var utmanande. Det framkom även att fysioterapeuterna önskar kunna erbjuda rutinuppföljningar efter förlossning. / Background: Physiotherapists active in women's health have good knowledge of the musculoskeletal system with the competence to, among other things, assess pelvic floor muscles, support return to physical activity and be available as support and counselors. Sweden's municipalities and regions believe that access to physiotherapeutic competence in women's health should be improved. There is currently a lack of studies on Swedish physiotherapists' perceptions of their role in aftercare after childbirth. Aim: The aim was to investigate how physiotherapists working with women's health and who meet post-pregnant women in their work perceives their role in aftercare after childbirth.Design and method: The study was of qualitative descriptive design and its content is based on semi-structured interviews with five licensed physiotherapists active in women's health. The data has been analyzed with qualitative content analysis. Results: Four categories and 14 subcategories were identified during the data processing process. The categories came to be called the Physiotherapist as a support and advisor in aftercare, the Physiotherapist's unique pelvic floor competence, Future aftercare and Challenges for the physiotherapist in aftercare. Within these categories, descriptions emerged about the physiotherapist's role in supporting return to physical activity, challenges in reaching out to patients and wishes to offer routine follow-up to a physiotherapist. Conclusion: The interviewed physiotherapists perceive that their role in aftercare after childbirth includes being emotional support, being a support and counselor and that they have a unique pelvic floor competence with the opportunity to individualize pelvic floor muscle training. They feel that women's health is de-prioritized, that there is a lack of competence in this subject and that they find collaboration with other professions challenging. It also emerged that the physiotherapists wish to be able to offer routine follow-ups after childbirth.