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1.
This study aimed to assess the effectiveness of a group-based educational training on the self-efficacy and self-acceptance of Iranian menopausal women using the PRECEDE–PROCEED model. This Randomized Controlled Trial (RCT) was conducted on 80 menopausal women in the age range of 47–55 years residing in the northeast of Iran. The participants were divided randomly into a test group (n = 40) and a control group (n = 40). We found that designing and implementation of a group-based educational training according to the PRECEDE–PROCEED model can significantly enhance the knowledge and performance of the test group with regard to self-efficacy and self-acceptance.  相似文献   

2.
ABSTRACT

Inactivity has been associated with decreased quality of life of older people, and many physical activity programs are encouraged. However, the heterogeneity of the different exercise programs available is well recognized. The objective was to compare three physical activity programs (strength training, aqua fitness, and aerobic exercise) to discern the differences in the benefits achieved by each of them in older women over a period of 6 months. For that, a double-blind randomized trial sorted 347 women over 50 years old into three groups of exercise programs; they completed three sessions of evaluation that included the measurement of weight and body mass index and used the Senior Fitness Test (SFT) and SF-12 questionnaire. A t-test for related samples compared the evolution of each group, and ANOVA statistic was used to compare the effect of the different exercise programs. The results showed that women should consider performing aerobic activity up to age 60. After that age, aerobic activity or strength training can provide greater benefits.  相似文献   

3.

Background

Castor oil is a substance used for labor induction in an inpatient setting. However, its efficacy as an agent for the induction of labor, for post-date pregnancies in an outpatient setup is unknown.

Objective

Efficacy of castor oil as an agent for the induction of labor, for post-date pregnancies in outpatient settings.

Methods

Eighty-one women with a low-risk post-date singleton pregnancy with a Bishop score  7, without effective uterine contractions were randomized to the intervention, 60 ml of castor oil, or the control, 60 ml of sun-flower oil. The primary outcome was proportion of women entering the active phase of labor 24, 36, 48 h after ingestion. Secondary outcomes included meconium stained amniotic fluid, abnormal fetal heart rate tracing, cesarean section rate, instrumental deliveries, birth weight, 5 min Apgar score, chorioamnionitis, hypertensive complications, retained placenta, and post-partum hemorrhage.

Findings

Intervention and control groups included 38 and 43 women, respectively. No differences in baseline characteristics, except for age were noted. The observed interaction between castor oil and parity was significant (pinteraction = 0.02). Multiparous women in the intervention group exhibited a significant beneficial effect on entering active labor within 24, 36 and 48 h after castor oil consumption compared with the placebo (Hazard Ratio = 2.93, p = 0.048; Hazard Ratio = 3.29, p = 0.026; Hazard Ratio = 2.78, p = 0.042 respectively). This effect was not noted among primiparous women. No differences in rate of obstetric complications or adverse neonatal outcomes were noted.

Conclusion

Castor oil is effective for labor induction, in post-date multiparous women in outpatient settings.  相似文献   

4.
A 3(n + l)-dimensional ordinary differential equation for HSV-2 includes l groups of men and n groups of women with different risks of infection. Global Lyapunov functions based on graph theory and on LaSalle invariance principle show that the model dynamics are completely determined by the basic reproduction number ?0. The disease-free equilibrium is globally asymptotically stable when ?0 ≤ 1; a unique endemic equilibrium is globally asymptotically stable in the interior of the feasible region when ?0 > 1.  相似文献   

5.

Problem

The process of industrialization and lifestyle changes have gradually exposed human ?societies to a larger number of environmental risk factors, which may cause hormonal ?abnormalities and congenital anomalies.

Background

The current study aimed to investigate the relationship ?between environmental factors and hormonal abnormalities among pregnant women in Yazd, ?Iran.

Methods

A hundred participants were randomly selected from among a group of pregnant women. According to the screening tests (AFP, free β-?HCG, uE3, PAPP-A, and inhibin-A) performed at the genome clinic in Yazd in 2016, the risk of Down Syndrome (DS) was sufficiently high in this group of pregnant women from which the participants were selected. A ?questionnaire was used to collect data on the degree of the participants’ exposure to pesticides ?at home, use of canned and fast foods, and consumption of greenhouse fruits. The collected data were ?analyzed by One-way ANOVA and Kruskal–Wallis Test.

Findings

The mean of Multiple of Median (MoM) for inhibin-A was significantly higher among pregnant ?women who often or always used pesticides at home (p = 0.047). The mean MoM ?for free β-HCG was significantly higher among pregnant women who often or always used canned ?foods (p = 0.024). Finally, the mean MoM for uE3 (1.85 ± 1.30) was significantly higher among ?pregnant women who never consumed greenhouse fruits (p = 0.003).

Conclusion

It can be concluded that it is possible to reduce environmental exposures affecting hormonal abnormalities among pregnant women by improving nutritional patterns, minimizing the use of pesticides at home, and reducing the intake of canned foods and greenhouse fruits.  相似文献   

6.
《Journal of homosexuality》2012,59(2):244-264
ABSTRACT

Sexual orientation has been linked to certain health conditions, and yet quantifying sexual orientation in longitudinal studies is challenging. This study examined different methods of accounting for sexual orientation in a cohort study of 300 homeless and unstably housed women followed every 6 months over 3 years. Altogether, 39.7% (= 119) could be considered sexual minority at one or more time points based on identity and/or behavior; 16.3% (= 49) reported shifts in sexual identity. Only 24.0% (= 72) were identified as sexual minority through a single measure of sexual identity, 27.0% (= 81) were identified with a single measure of identity and behavior, 33.0% (= 99) were identified through annual measures of identity and behavior, and 22.0%–22.3% (= 66–67) were identified through latent class analysis including all identity/behavior measures. This study found that sexual fluidity is common in unstably housed women, and many sexual minority women would be missed in longitudinal studies with different methods of accounting for sexual orientation.  相似文献   

7.

Problem

Gestational diabetes mellitus, defined as any carbohydrate intolerance first diagnosed during pregnancy, is associated with a variety of adverse outcomes, both for the mother and her child.

Aim

To investigate the impact of a structured exercise programme which consisted of aerobic and resistance exercises on the parameters of glycaemic control and other health-related outcomes in pregnant women diagnosed with gestational diabetes mellitus.

Methods

Thirty-eight pregnant women diagnosed with gestational diabetes mellitus were randomised to two groups. Experimental group was treated with standard antenatal care for gestational diabetes mellitus, and regular supervised exercise programme plus daily brisk walks of at least 30 min. Control group received only standard antenatal care for gestational diabetes mellitus. The exercise programme was started from the time of diagnosis of diabetes until birth. It was performed two times per week and sessions lasted 50–55 min.

Findings

The experimental group had lower postprandial glucose levels at the end of pregnancy (P < 0.001). There was no significant difference between groups in the level of fasting glucose at the end of pregnancy. Also, there were no significant differences in the rate of complications during pregnancy and birth, need for pharmacological therapy, maternal body mass and body fat percentage gains during pregnancy, and neonatal Apgar scores, body mass and ponderal index. Neonatal body mass index was higher in the experimental group (P = 0.035).

Conclusion

The structured exercise programme had a beneficial effect on postprandial glucose levels at the end of pregnancy.  相似文献   

8.
ABSTRACT

We assessed the relationship between the stages of the frailty syndrome and the development of limitations in the activities of daily living, hospitalization, and death among women aged ≥80 as compared to men over the course of 12 months. The Fried criteria and selected tests of comprehensive geriatric assessment were performed in 213 participants (phase 1). After 12 months, detailed feedback on the general health and functioning was collected (phase 2). Statistically significantly higher mortality (p < .05) was found among men as compared to women. The number of deaths in the frail group was higher among frail men than frail women (p < .007).  相似文献   

9.
BackgroundRecent trials demonstrated the safety and efficacy of sterile water injections to provide relief from labour back pain. While four injections is the most common approach variations in technique, such as employing two injections, are also used.AimTo determine if the analgesic effect of two sterile water injections is clinically equivalent to four.Methods238 women in labour with a Visual Analogue Scale pain score (VAS) of 70 millimetres (mm) (0 = no pain; 100 = worst pain imaginable) were randomised to two or four sterile water injections. The primary outcome was pain measured on a VAS at 30 min post treatment. A priori margin of equivalence was set at ±10 mm. Secondary outcomes included the likelihood of achieving an at least 30% and 50% reduction in pain, birth and neonatal outcomes.ResultsAt 30 min post-injection the difference in VAS scores between the techniques was ?5.97 (95% Confidence Interval [CI] ?13.18–1.22). As the lower end of the CI exceeds the margin of ?10 mm equivalence was not demonstrated. Both techniques achieved an at least 30% reduction in pain in over 75% of participants though duration of effect was longer in the four injection group. There was no difference in other birth related secondary outcomes.ConclusionFour injections provided a margin of benefit over two injections in level and duration of analgesia.DiscussionFour injections remains the technique of choice though two injections still provided significant pain relief and would be suitable where it was not possible or desirable to provide four.  相似文献   

10.
BackgroundWater birth involves the complete birth of the baby under warm water. There is a lack of consensus regarding the safety of water birth.AimThis study aimed to describe the maternal and neonatal outcomes associated with water birth among labouring women deemed at low risk for obstetric complications and compare these outcomes against women of similar risk who had a standard land birth.MethodA retrospective audit and comparison of women giving birth in water with a matched cohort who birthed on land at Bankstown hospital over a 10 year period (2000–2009).ResultsIn total 438 childbearing women were selected for this study (N = 219 in each arm). Primigravida women represented 42% of the study population. There was no significant difference in mean duration of both first and second stages of labour or postpartum blood loss between the two birth groups. There were no episiotomies performed in the water birth arm which was significantly different to the comparison group (N = 33, p < 0.001). There were more babies in the water birth group with an Apgar score of 7 or less at 1 min (compared to land births). However, at 5 min there was no difference in Apgar scores between the groups. Three of eight special care nursery admissions in the water birth group were related to feeding difficulties.ConclusionThis is the largest study on water birth in an Australian setting. Despite the limitations of a retrospective audit the findings make a contribution to the growing body of knowledge on water birth.  相似文献   

11.
ABSTRACT

Exercise in healthy female adults around the menopausal transition has been routinely examined in leisure activities alone, potentially discounting the physical activity (PA) that is accumulated in household and outdoor domains. The purpose of this study was to quantify PA in healthy middle-aged women and to examine the extent to which the Center for Disease Control (CDC) PA guidelines were met through leisure, household, and outdoor activities. Methods: 440 healthy women, 51–64 years old, BMI ≥18.5 or < 40 kg/m2, participated in the study using the Lifetime Physical Activity Questionnaire (LPAQ) to quantify PA. Results: 25.91% met the CDC PA guidelines if leisure time alone was examined. When multiple domains were included, 73.41% of the women met the PA guidelines. This percentage is much higher than the reported 20.6% of U.S. adults who met the guidelines in 2011. PA in women may be underrepresented in data limited to leisure time PA.  相似文献   

12.
《Journal of women & aging》2013,25(3-4):59-75
ABSTRACT

We sought to determine the performance and anthropometric correlates of physical self-concept and self-esteem and to observe whether long-term resistance training would alter these variables in postmenopausal women. Forty-four nonsmoking, community-dwelling, Caucasian women aged 50–75 years participated in the study. Half of the subjects participated in a 9-month regimen of weight-bearing exercises performed 3 times per week which emphasized lower body muscle strength and power development. At baseline, total body fat was negatively associated with physical self-concept and perception of physical appearance but not with self-esteem. Perception of physical appearance improved in both exercisers and controls after the 9-month trial but was most noticeable in exercisers who had low self-esteem at baseline. The only predictor of improvement in perception of physical appearance was a decrease in lower body fat mass. Minimal or nonsignificant change in psychological measures associated with the training may be due to high initial values.  相似文献   

13.
Resistance training (RT) improves overall health, but the psychological effects of RT in healthy old adults have not been tested. The aim of this study was to investigate a sample of 65–70-year-old healthy and physically active women to assess their sense of coherence, health-related quality of life, hope, and affect, before and after taking part in a 24-week RT intervention (N = 14), compared to controls (N = 18). Findings showed a significant increase in hope (p = 0.013) and a significant decrease in negative affect (p = 0.002). Starting RT after age 65 does not appear to negatively impact on women’s psychological health but seems to be associated with important psychological health benefits.  相似文献   

14.
In lower-income settings, women more often than men justify intimate partner violence (IPV). Yet, the role of measurement invariance across gender is unstudied. We developed the ATT-IPV scale to measure attitudes about physical violence against wives in 1,055 married men and women ages 18–50 in My Hao district, Vietnam. Across 10 items about transgressions of the wife, women more often than men agreed that a man had good reason to hit his wife (3 % to 92 %; 0 % to 67 %). In random split-half samples, one-factor exploratory factor analysis (EFA) (N 1 = 527) and confirmatory factor analysis (CFA) (N 2 = 528) models for nine items with sufficient variability had significant loadings (0.575–0.883; 0.502–0.897) and good fit (RMSEA = 0.068, 0.048; CFI = 0.951, 0.978, TLI = 0.935, 0.970). Three items had significant uniform differential item functioning (DIF) by gender, and adjustment for DIF revealed that measurement noninvariance was partially masking men’s lower propensity than women to justify IPV. A CFA model for the six items without DIF had excellent fit (RMSEA = 0.019, CFI = 0.994, TLI = 0.991) and an attitudinal gender gap similar to the DIF-adjusted nine-item model, suggesting that the six-item scale reliably measures attitudes about IPV across gender. Researchers should validate the scale in urban Vietnam and elsewhere and decompose DIF-adjusted gender attitudinal gaps.  相似文献   

15.
Menopause is an important life transition in women, and it is associated with significant physical and psychological changes. This study aimed at examining how the menopausal transition influences body image and satisfaction with sexual life. To this aim, body image dissatisfaction, sexual dissatisfaction, and self-esteem were compared in three groups of women with distinct menopausal status (premenopausal n = 142, perimenopausal n = 66, or postmenopausal n = 149), while controlling for depressive and anxiety symptoms and BMI. Using ANOVA between these three groups, we observed that dissatisfaction with body image was significantly higher in the perimenopausal sample compared with its premenopausal counterpart. In the postmenopausal sample, body image improved, as this group displayed body image scores close to the premenopausal level. In addition, sexual dissatisfaction was significantly increased in the perimenopausal and postmenopausal samples, which is compatible with the concept that higher body appreciation positively predicted sexual function. We conclude that body image dissatisfaction reaches a maximum during the perimenopausal phase, before returning to a level nearly identical between the premenopausal and the postmenopausal phases.  相似文献   

16.
This study examined biological sex differences in the development of mild cognitive impairment (MCI) and probable Alzheimer’s disease (AD) development as predicted by changes in the hippocampus or white matter hyperintensities. A secondary data analysis of the National Alzheimer’s Coordinating Center Uniform Data Set was conducted. We selected samples of participants with normal cognition at baseline who progressed to MCI (n = 483) and those who progressed to probable AD (n = 211) to determine if hippocampal volume or white matter hyperintensities (WMH) at baseline predicted progression to probable AD or MCI and whether the rate of progression differed between men and women. The survival analyses indicated that changes in hippocampal volumes affected the progression to probable AD (HR = 0.535, 95% CI [0.300–0.953]) only among women. White men had an increased rate of progression to AD (HR = 4.396, CI [1.012–19.08]; HR = 4.665, 95% CI [1.072–20.29]) compared to men in other race and ethnic groups. Among women, increases in hippocampal volume ratio led to decreased rates of progressing to MCI (HR = 0.386, 95% CI [0.166–0.901]). Increased WMH among men led to faster progression to MCI (HR = 1.048. 95% CI [1.011–1.086]). Women and men who were older at baseline were more likely to progress to MCI. In addition, results from longitudinal analyses showed that women with a higher CDR global score, older age at baseline, or more disinhibition symptoms experienced higher odds of MCI development. Changes in hippocampal volumes affect the progression to or odds of probable AD (and MCI) more so among women than men, while changes in WMH affected the progression to MCI only among men.  相似文献   

17.
ABSTRACT

Overactive bladder (OAB) is a common health problem in older women. The aim of the study was to investigate coffee consumption, health-related quality of life (HRQOL), and associated factors of OAB in older Korean women living in rural South Korea. A total of 248 women aged 65 years and older participated in this study. Chi-square tests, t-tests, and multivariable logistic regressions were performed. The means of coffee consumption between OAB and non-OAB groups were not significantly different. Women with OAB showed significantly lower HRQOL than women with stress urinary incontinence only. OAB was associated with high body mass index and poor health status.  相似文献   

18.
The objective of this study was to determine the various dimensions of social capital in Tehran and its association with socioeconomic variables. Two thousand, four hundred and eighty-four persons participated in the study through multi-stage stratified sampling in Tehran. The study questions were extracted from the World Bank integrated questionnaire. While respondents obtained over 50 % of the attainable scores in the ‘trust’, ‘cooperation’, ‘social cohesion’, and ‘political action’ dimensions, they obtained only 18.9 % of the attainable scores in the ‘networks’ dimension. The respondents in age groups older than 45 had higher trust scores than respondents in the 18–25 age group. Men had higher ‘network’ and ‘social cohesion’ scores than women (p ≤ 0.001). Respondents in the poorest wealth quintile had lower ‘networks’ and ‘social cohesion’ scores than the richest group and ‘political action’ scores higher than the richest group (p = 0.038). The lowest score in ‘Tehranians’ social capital was in the groups and networks dimension. Therefore designing effective interventions for such activities, particularly in women’s groups, is a priority.  相似文献   

19.
BackgroundThe practice of waterbirth is increasing worldwide and has been a feature of maternity services in the United Kingdom for over twenty years. The body of literature surrounding the practice focusses on maternal and neonatal outcomes comparing birth in and out of water.AimTo undertake a review of qualitative studies exploring women’s experiences of waterbirth. This understanding is pertinent when supporting women who birth in water.MethodsA literature search was conducted in databases British Nursing Index, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Maternity and Infant Care, Medline, Applied Social Sciences Index and Abstracts and Web of Science, using search terms waterbirth, labour/labor, childbirth, women, mothers, experience, perception and maternity care. Five primary research articles published between 2003 and 2018 which explored the views of women who had birthed in water were selected for inclusion. Using meta-ethnography, qualitative research studies were analysed and synthesised using the method of ‘reciprocal translational analysis’ identifying themes relating to women’s experiences of birthing in water.FindingsFour themes were identified: women’s knowledge of waterbirth; women’s perception of physiological birth; water, autonomy and control; and waterbirth: easing the transition.Discussion and conclusionDespite the paucity of qualitative studies exploring women’s experiences of waterbirth, meta-synthesis of those that do exist suggested women identify positively with the choice. The experience of birthing in water appears to enhance a woman’s sense of autonomy and control during childbirth suggesting waterbirth can be an empowering experience for women who choose it.  相似文献   

20.

Background

Asking women about experiences of domestic violence in the perinatal period is accepted best practice. However, midwives and nurses may be reluctant to engage with, or effectively respond to disclosures of domestic violence due a lack of knowledge and skills.

Aim

To evaluate the impact of training on knowledge and preparedness of midwives and nurses to conduct routine enquiry about domestic violence with women during the perinatal period.

Method

A pre-post intervention design was used. Midwives and nurses (n = 154) attended a full day workshop. Of these, 149 completed pre-post workshop measures of knowledge and preparedness. Additional questions at post-training explored participants’ perceptions of organisational barriers to routine enquiry, as well as anticipated impact of training on their practice. Training occurred between July 2015 and October 2016.

Findings

Using the Wilcoxon signed-rank test, all post intervention scores were significantly higher than pre intervention scores. Knowledge scores increased from a pre-training mean of 21.5–25.6 (Z = ?9.56, p < 0.001) and level of preparedness increased from 40.8 to 53.2 (Z = ?10.12, p < 0.001). Most participants (93%) reported improved preparedness to undertake routine enquiry after training. Only a quarter (24.9%) felt their workplace allowed adequate time to respond to disclosures of DV.

Conclusions

Brief training can improve knowledge, preparedness, and confidence of midwives and nurses to conduct routine enquiry and support women during the perinatal period. Training can assist midwives and nurses to recognise signs of DV, ask women about what would be helpful to them, and address perceived organisational barriers to routine enquiry. Practice guidelines and clear referral pathways following DV disclosure need to be implemented to support gains made through training.  相似文献   

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