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PubMed1997

Evaluation issues and strategies for community-based organizations developing women's HIV prevention programs.

This article discusses issues and strategies for program evaluation particularly useful for community-based organizations (CBOs) involved in the development and implementation of HIV preventing programs for women. The approach the authors present is an extension of a traditional public health paradigm suggested for use in the development and evaluation of violence prevention programs. This study incorporates Becker's Health Belief Model, which provides a framework for viewing the influence of various psychosocial variables on health-related behavior, into this development and evaluation paradigm. Factors influencing the successful development and evaluation of HIV prevention programs for women are reviewed and discussed. The purpose of this article is to provide some guidance to CBOs to strengthen their evaluation strategies and to encourage their use of evaluation during all phases of program development and implementation.

Community Networks↗
PubMed1997

Sexual Assertiveness Scale (SAS) for women: development and validation.

Four studies were conducted to develop and validate the Sexual Assertiveness Scale (SAS), a measure of sexual assertiveness in women that consists of factors measuring initiation, refusal, and pregnancy-sexually transmitted disease prevention assertiveness. A total of 1,613 women from both university and community populations were studied. Confirmatory factor analyses demonstrated that the 3 factors remained stable across samples of university and community women. A structural model was tested in 2 samples, indicating that sexual experience, anticipated negative partner response, and self-efficacy are consistent predictors of sexual assertiveness. Sexual assertiveness was found to be somewhat related to relationship satisfaction, power, and length. The community sample was retested after 6 months and 1 year to establish test-retest reliability. The SAS provides a reliable instrument for assessing and understanding women's sexual assertiveness.

Adult↗
PubMed1977

Negative smears in women developing invasive cervical cancer.

Fifty-six cervical smears originally classified as Pap. I, from women in whom cervical cancer of stage I to IV was detected within 4 to 5 years after the cytological check, were re-examined in order to estimate the screening error and sampling failure. At the review, 35 smears were classified as Pap. II to V. The incidence of changed classification of the smears obtained from population screening was 70% and that of the smears taken at private specialists or at hospitals was about 50%. The influence of sampling failure on the evaluation of the smears classified as Pap. II should be considered. On 14 slides, correctly interpreted as negative, there were no columnar cells present, a fact that may indicate inefficient sampling of cells from the squamo-columnar junction.

Adenocarcinoma↗
PubMed1991

[Serology against Toxoplasma gondii in pregnant women. Development of prevalence rates in the course of 4 years].

Sera from 1,221 pregnant women were screened for antibodies against Toxoplasma gondii. The prevalence rate of antibodies was 38.9%. We have observed specific IgM antibodies 15 pregnant women (1.2%). The prevalence rate was not increased significantly with the age and number of pregnancies. The seropositivity was reduced significantly in the 4th year studied. The high rate of seronegativity observed in the pregnant women represent a high risk of Toxoplasma infestation.

Antibodies, Protozoan↗
PubMed1981

Do women develop alcoholic liver disease more readily than men?

The sudden increase in alcoholic liver disease among women in the past 10 years has caused much speculation that they may be more susceptible to the hepatotoxic effects of alcohol than men. Women tend to present with more severe liver disease, particularly alcoholic hepatitis, and do so after a shorter period of excessive drinking and at a lower daily alcohol intake. Differences in body size and composition are partly responsible for the greater susceptibility of women, but differences in immune reactivity between the sexes may also play a part. Greater emphasis must be placed on designing abstinence programmes specifically for female patients, on earlier detection of liver disease, and on educating women about hazardous drinking levels.

Alcohol Drinking↗
PubMed1993

Cervical smear histories of Maori women developing invasive cervical cancer.

AIMS: To locate problems with the implementation of cervical screening for Maori women by investigating the histories of women with invasive cervical cancer, and determining why their disease had not been detected by screening and treated at an intraepithelial stage. METHODS: In a national study, the screening histories of 46 Maori women with invasive cervical cancer were ascertained by interview and from hospital, general practitioner and cytology laboratory records. RESULTS: Possible reasons for failure of cervical screening were never having had a smear (54%), infrequent smear tests (22%) and previous abnormal smears without appropriate follow-up (4%). Only six women (13%) had one or more normal smears in the three years before diagnosis. CONCLUSIONS: The main factor underlying the onset of invasive cancer was an absence of cervical screening or infrequent smear tests. Although no slide review was done, false negative reporting could have been a factor in only a small number of cases. Ways need to be found to encourage Maori women to be screened and to recall women regularly.

Adult↗
PubMed1993

[Gyneco-obstetric aspects in women developing postpartum depression].

The relationship between different variables was studied related to pregnancy, labor, puerperium, newborn and breast-feeding with the development of a depressive disorders during pregnancy, in a sample of 125 pregnant women. No relationship it's found with the presence of disease during the gestation period, except urinary tract infection. The same happens with other variable of labor, puerperium and newborn, Nevertheless, the major stress situations (urgent cesarean section, use of anesthesia during labor, diseases of the newborn, etc.) systematically present a higher incidence of depression. It is observer a relationship between the development of a depressive disorders and a decrease of the natural lactation period.

Adolescent↗
PubMed1997

Assessing sexual dimensions in Hispanic women. Development of an instrument.

The purpose of this study was to examine the psychometric properties of a culturally sensitive sexual functioning instrument, the Sexual Dimensions Instrument for Hispanic Women (SDIHW). Using a vignette, the respondent indicated her level of agreement with 26 items that were developed by Hispanic and Anglo nurses/researchers and validated by a panel of clinical and instrument experts. It was translated into Spanish and back-translated; the reading level was at the sixth to seventh grade. The convenience sample consisted of 179 Hispanic women being treated for gynecologic cancer as outpatients. The typical respondent was 35-50 years of age, married, minimally acculturated, religious, and surviving for 1-3 years; she had three or more children, had less than a high-school education, and had little sexual activity in the past month. A three-factor scale with 22 items was determined to have conceptual clarity and moderate reliability (0.63-0.77). Factors included role (eight items), personal sexual satisfaction (eight items), and relationship (six items). The instrument was completed in Spanish by 60% of the respondents. Total and subscale scores were generally not influenced by demographic characteristics. The psychometric properties of the SDIHW indicate future research value. Moderate internal consistency, reliability, content, and construct validity were demonstrated. Achieving a better understanding of the Hispanic woman's perception of herself as a sexual being will aid the clinician in the development of culturally sensitive interventions.

Adult↗
PubMedDate not supplied

Consumer assessment of the quality of interpersonal processes of prenatal care among ethnically diverse low-income women: development of a new measure.

PURPOSE: Consumer assessments of interpersonal processes of care during prenatal care provide important information about how well clinicians satisfy the perceived needs of the women they serve, but few measures are available that tap the various components of these processes. The purpose of this study is to develop a multidimensional measure of prenatal interpersonal processes of care (PIPC) that demonstrates reliability and validity in ethnically diverse women in Medicaid managed care plans. METHODS: A telephone survey of African American, Latino (U.S. and foreign born) and Caucasian pregnant women in four Medicaid managed care plans in California was conducted in English and Spanish in 2001. Factor analytic methods were used to test the PIPC measures. A psychometric evaluation, including reliability, variability, and construct validity, was conducted with the final scales for the total sample and for each racial/ethnic group. RESULTS: Three dimensions, Communication, Patient-Centered Decision Making, and Interpersonal Style, with seven scales were supported with 30 items. The scales for each dimension exhibit acceptable reliability for the total sample (Internal Consistency Reliability ranged from 0.66 to 0.85) and for all racial/ethnic groups. All scales had significant associations with satisfaction with prenatal care and explained considerable variation in satisfaction (19-43%). The scale qualities and validity associations held for all scales and ethnic groups except some scales for U.S.-born Latinas. CONCLUSIONS: The multidimensional PIPC measure for assessing what actually happens between providers and low-income pregnant women of diverse ethnic groups demonstrates acceptable reliability and construct validity.

Adult↗
PubMed1992

Do women develop alcoholic brain damage more readily than men?

Chronic alcoholism is related to brain damage (i.e., volume changes) in both men and women. There is an open question whether the brains of women are more vulnerable than those of men to alcohol toxicity. The present follow-up study focuses on a direct comparison of sex-related differences in alcoholic brain shrinkage and its reversibility. In a prospective design, a random sample of 65 alcoholics of both sexes (51 males and 14 females) was studied. Computerized tomography brain scans before and after a 6-week inpatient treatment program with controlled abstinence revealed a significant re-expansion of the brain as assessed by linear measurements. By controlling for moderating variables such as age, mean daily alcohol consumption, liver dysfunction, etc. the degree of brain shrinkage was found to be similar in men and women despite significantly shorter ethanol expositions in the women. These findings corroborate the hypotheses of other investigators about basic biological differences between the two sexes as to the effects of alcohol. The hypothesis of an enhanced vulnerability of women to acute and chronic complications of alcoholism is supported.

Adult↗
PubMed2003

Infertility drugs and the risk of breast cancer: findings from the National Institute of Child Health and Human Development Women's Contraceptive and Reproductive Experiences Study.

OBJECTIVE: To determine the association between infertility drug use and invasive breast cancer in a population-based case-control study. DESIGN: Multicenter case-control study. SETTING: Women aged 35 to 64 years in metropolitan Atlanta, Detroit, Los Angeles, Philadelphia, and Seattle. PATIENT(S): The 4,575 case patients had histologically confirmed primary invasive breast cancer. The 4,682 control subjects were women without breast cancer identified in the same geographic locations using randomized-digit dialing. INTERVENTION(S): A standardized questionnaire focusing on reproductive health and family history as well as use of oral contraceptives and other hormones and infertility drugs was administered to all subjects. Data on the type of breast cancer were also obtained. MAIN OUTCOME MEASURE(S): Odds ratios examining the association between use of various infertility drugs and invasive breast cancer. RESULT(S): Overall, a history of infertility drug use was not associated with the risk of developing breast cancer. Compared with women who never used any fertility medication, however, women using human menopausal gonadotropin (hMG) for > or = 6 months or for at least six cycles had a relative risk of breast cancer ranging between 2.7 to 3.8. CONCLUSION(S): Long-term use of certain infertility drugs could adversely affect risk of breast cancer. Additional confirmatory studies are needed.

Adult↗
PubMed2006

An investigation of the relationship between anxiety and depression and urge incontinence in women: development of a psychological model.

OBJECTIVES: The study investigated the association between anxiety and depression and urge incontinence and the direction of causal pathways between these variables. DESIGN: A prospective longitudinal postal survey. METHOD: A random sample of women aged 40 years or more, registered with a general practitioner in Leicestershire or Rutland, was mailed a postal questionnaire. The questionnaire included questions on general health, urinary symptoms and the Hospital Anxiety and Depression Scale (HADS). In total, 12,568 women responded to the baseline postal survey (65.3% response rate) and 9,596 to the first annual follow-up (79.8% response rate). The prevalence and one-year incident rates of these symptoms were compared and contrasted, whilst controlling for confounding variables. RESULTS: A significant proportion of women with urge incontinence reported symptoms of anxiety (56.6%) and depression (37.6%). Anxiety and depression were associated with a number of urinary symptoms and were not exclusive to urge incontinence. Incident cases of anxiety and depression were predicted by the presence of urge incontinence at baseline. Incident cases of urge incontinence were predicted by anxiety at baseline, but not depression. Anxiety, urge incontinence and frequency appeared to interact and exacerbate each other. CONCLUSIONS: The findings demonstrated the relevance of emotional factors in the development and maintenance of urge incontinence. Currently, assessment and treatment protocols for urge incontinence concentrate on physical symptoms and toilet behaviours. A more integrated psychological model of urge incontinence is proposed.

Adult↗
PubMed2000

Reproductive features in women developing ovarian granulosa cell tumour at a fertile age.

Ovarian granulosa cell tumour (GCT) is a rare malignancy, which has been linked to both infertility and infertility treatment with ovulation inducers. The reproductive features were analysed of 146 women with GCT diagnosed between 1956 and 1996. During the study period no changes were found in the mean age (53 years), menopausal status (59% postmenopausal), parity (32% nulliparous) or tumour size or stage at diagnosis. The clinical features in women with GCT at fertile age were compared with GCT diagnosed later in life and to population-based data. Nulliparity (50%) and history of infertility (22%) were more frequent if the tumour occurred at fertile age (n = 50). Of the 12 infertile cases, seven had anovulatory infertility (58%); 11 occurred during the era of ovulation inducers, but only five had used these drugs (clomiphene citrate in five patients, gonadotrophins in two, and tamoxifen in one patient) and no patient had undergone in-vitro fertilization. Endometrial hyperplasia was associated with GCT at all ages, while endometrial cancer was found solely after the age of 45 years. In conclusion, GCT at fertile age is associated with nulliparity and with a clinical presentation of anovulatory infertility, while GCT later in life is associated with a more normal average fertility pattern and with occurrence of endometrial cancer.

Adolescent↗
PubMed2005

Cerebral edema on MRI in severe preeclamptic women developing eclampsia.

OBJECTIVE: The aim of this study is to identify suitable applications for cerebral MR (magnetic resonance) scanning in cases of severe preeclampsia and eclampsia through comparison of clinical course and easily accessible parameters. METHODS: From January 2001 to December 2003, cerebral MR scans were performed on 43 women with severe preeclampsia; of those 41 were enrolled in data analyses. Twenty clinical parameters, including age, body mass index, blood pressure, liver and renal function, and coagulation status, were compared for each patient. Data were analyzed using the SPSS program on a VAX main frame. RESULTS: Among 41 severe preeclamptic women, abnormal MR images were observed in 11 cases including six with systemic seizures. Predictive accuracy of eclampsia with abnormal cerebral MR imaging was 84.9% (P=0.00001), while only 14.3% of severe preeclampsia cases had been diagnosed radiologically. Statistical analysis suggests diastolic BP and serum AST as predictive parameters for abnormal MR images with 82.9% predictive accuracy (P=0.0007). CONCLUSIONS: Cerebral edema can be observed in preeclamptic patients developing eclampsia. Rapid delivery is indicated when diastolic BP and AST are elevated. MR scanning is useful when delivery is delayed due to fetal immaturityin cases of severe preeclampsia.

Acute Disease↗
PubMed2001

[Sexual satisfaction of women--development and results of a questionnaire].

In sexology the existing questionnaires do not sufficiently consider the experiencing of sexuality and the extent of sexual satisfaction. That is why a questionnaire was developed which includes, besides the frequency and duration of sexual activities, the satisfaction with frequency and duration of these activities and the desired sexual behaviour. A first study with this questionnaire was carried out on 112 women with heterosexual behaviour, aged 20 to 48 years. The frequent desire with regard to coital orgasm as one result of our investigation confirms the centering of orgasm in other studies. But half of the women do not describe orgasm as the favoured feeling during sexual intercourse. For 37% of the women the emotional and physical closeness to the partner is explicitly more important than experiencing an orgasm. According to the comparison of extreme groups sexual satisfaction particularly correlates with self-determination realized in partnership and with satisfaction of communicational desires and need for tenderness within the partnership.

Adult↗
PubMed1996

The utility of IgA antibody to human immunodeficiency virus type 1 in early diagnosis of vertically transmitted infection. National Institute of Allergy and Infectious Diseases and National Institute of Child Health and Human Development Women and Infants Transmission Study Group.

OBJECTIVE: To determine the sensitivity and specificity of anti-human immunodeficiency virus (HIV) IgA in identifying infected infants at or before 6 months of age among the offspring of HIV-infected mothers. DESIGN: Prospective comparison of anti-HIV IgA measurement performed in 2 different laboratories by 2 different methods with the criterion standard of blood culture. SETTING: Five centers in the United States and Puerto Rico. PATIENTS: Population-based sample of 156 infants of HIV-infected mothers in the Women and Infants Transmission Study. MAIN OUTCOME MEASURES: Results of anti-HIV IgA test in relation to the infection status of the infants as measured by blood culture. RESULTS: Six-month plasma or serum samples were first tested in the 2 laboratories. The sensitivity and specificity of anti-HIV IgA in detecting infected infants at this age by laboratories 1 and 2 were 69% and 63% and 100% and 99%, respectively. A look-back study of samples obtained at birth, 1, 2, and 4 months was then performed on all infected children and a matched set of uninfected children. The performance of the test at birth was unsatisfactory in both laboratories (sensitivity 44% and 33%, specificity 43% and 60%), whether peripheral or cord blood was examined. At 1, 2, and 4 months, the sensitivity of the test was lower than at 6 months, but specificity was high. A modest correlation of absent anti-HIV IgA antibody and low percentage of CD4 cells in peripheral blood was seen at 6 months of age. CONCLUSIONS: The anti-HIV IgA test has moderate sensitivity and high specificity for the diagnosis of HIV infection at 6 months of age in the offspring of infected mothers.

Female↗