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Topical Collection "Potential Risks and Factors of Women's Health Promotion"

Editors

Prof. Dr. Alessandra Casuccio
E-Mail Website
Collection Editor
Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties “G. D’Alessandro” – Hygiene section, University of Palermo, 90133 Palermo, Italy
Interests: public health; preventive medicine; communicable disease prevention; health promotion; palliative care epidemiology; health determinants
Special Issues and Collections in MDPI journals
Dr. Vincenzo Restivo
E-Mail Website
Collection Editor
Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties “G. D’Alessandro” – Hygiene section, University of Palermo, 90133 Palermo, Italy
Interests: non-communicable disease; vaccine safety; screening; epidemiology; HPV; MPRV, gynecological cancer; health belief model
Special Issues and Collections in MDPI journals
Dr. Claudio Costantino
E-Mail Website
Collection Editor
Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties “G. D’Alessandro” – Hygiene section, University of Palermo, Palermo, Italy
Interests: vaccination strategies; health communication; counselling; smoking habit; nutrition; food hygiene; influenza
Special Issues and Collections in MDPI journals

Topical Collection Information

Dear Colleagues,

In addition to diseases shared by both sexes, there are a number of illnesses and injuries that are primarily associated with women. These health problems are less likely to be detected and treated because of the narrow framework used in considering health care for women that results from the lack of awareness of both the recipients and providers regarding the extent of women's health care needs and their requirements for comprehensive care. Worldwide, women are either not aware of such health care needs; they are aware but tend to ignore these needs because of their demanding role responsibilities, workload, and other caregiving activities; or they have been prevented from seeking health care and from maintaining their health by limited resources and structural constraints. Among the preventive strategies adopted to counteract cervical cancer the only available instrument are vaccination and screening, and only a little percentage of socially deprived women adhere to these preventive practices. Furthermore, the exclusive breastfeeding is a major topic to give short and long time benefit on the health of children and several attitude by healthcare workers and mothers can have a particular role on breastfeeding attitude. Innovative surgical technique and drugs can have a higher impact to reduce women burden of disease. Only a little core of women are familiar with results of such intervention and their adoption among women with different deprivation level can have a great impact on women’s health. Communication strategies should be also a therapeutic instruments for hard to reach women and their effectiveness should be evaluated.

This Special Issue seeks research papers on various aspects of women’s health such as breastfeeding, HPV and gynecologic diseases. Especially we encourage the submission of interdisciplinary work and multi-country collaborative research. We welcome original research papers using different study designs as well as systematic reviews and meta-analysis.

Prof. Alessandra Casuccio
Dr. Vincenzo Restivo
Dr. Claudio Costantino
Collection Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the collection website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Women health
  • Health Promotion
  • HPV
  • Breastfeeding
  • Screening
  • Reproductive health
  • Social economic deprivation
  • Gynecology and Obstetrics

Published Papers (29 papers)

2021

Jump to: 2020, 2019

Review
Health Impact and Risk Factors Affecting South and Southeast Asian Women Following Natural Disasters: A Systematic Review
by , , and
Int. J. Environ. Res. Public Health 2021, 18(21), 11068; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111068 (registering DOI) - 21 Oct 2021
Abstract
(1) Background: Following natural disasters, women have a higher prevalence of adverse physical and mental health outcomes. Given that the South and Southeast Asia regions are highly disaster prone, a review was undertaken to identify the potential health impact and key risk factors [...] Read more.
(1) Background: Following natural disasters, women have a higher prevalence of adverse physical and mental health outcomes. Given that the South and Southeast Asia regions are highly disaster prone, a review was undertaken to identify the potential health impact and key risk factors affecting women after disasters in the countries located in South and Southeast Asia regions. (2) Methods: A systematic literature search of four databases yielded 16 studies meeting the inclusion criteria. The review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidance, between July 2008 and March 2021. (3) Results: The majority of studies reported women’s negative/poor mental health, identifying a significant association of socio-demographics, during disaster exposure, post-disaster, and pre-existing risk factors. The six most-cited influences on women’s mental health found in the reviewed literature were being female, adult age group, having no formal education, poverty or low economic status, poor physical health/physical injuries, and death of family members. Women’s health during the post-disaster period was generally reported as poor among all the countries of the South and Southeast Asia regions. (4) Conclusion: Appropriate social support and the availability of free healthcare access for women are warranted in disaster-affected areas. This review offers a valuable contribution to the knowledge of women’s health complications/challenges and associated risk factors related to disasters, essential for the development of strategies to help reduce this burden in the future. Further research is required on natural disasters to identify ways to reduce women’s health impacts after natural disasters, especially in the context of low-income and lower-middle-income countries. Full article
Article
Socio-Demographic and General Health Factors Associated with Quality of Life in Long-Term Breast Cancer Survivors from Southwestern Poland
Int. J. Environ. Res. Public Health 2021, 18(17), 9321; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18179321 - 03 Sep 2021
Viewed by 472
Abstract
Background: Identification of factors associated with quality of life (QOL) in breast cancer survivors can contribute to better functioning in this group of patients. The study aimed to assess the association between QOL and anthropometric, sociodemographic, and medical characteristics in postmastectomy women [...] Read more.
Background: Identification of factors associated with quality of life (QOL) in breast cancer survivors can contribute to better functioning in this group of patients. The study aimed to assess the association between QOL and anthropometric, sociodemographic, and medical characteristics in postmastectomy women from southwestern Poland, 9.4 (±6.5) years after completed treatment. Materials and methods: QOL was estimated with the SF-36v2 questionnaire in 250 survivors aged 62.8 (±8.0) years with previously histologically confirmed invasive breast cancer. Results: Women in this study rated their overall QOL with an average of 60.7 (±17.9), Mental Component Summary of 62.8 (±19.8), and Physical Component Summary of 57.5 (±18.8) points. The use of multivariate regression analysis revealed that depression, chronic diseases, abdominal obesity, and pregnancy history have a statistically significant negative effect on the QOL of women after mastectomy, whereas participation in regular physical activity, living with a partner, the education level ≥ 12 years, and living in the city were associated with a higher QOL assessment. There were no significant relationships between QOL and the age, time since surgery, type of treatment, smoking, and occupational status of the patients. Conclusions: Health education, greater social support, specialist care in the treatment of comorbidities, and propagation of a physically active lifestyle can improve the physical and mental functioning of breast cancer survivors long after diagnosis and treatment. Full article
Review
COVID-19′s Impact on American Women’s Food Insecurity Foreshadows Vulnerabilities to Climate Change
Int. J. Environ. Res. Public Health 2021, 18(13), 6867; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18136867 - 26 Jun 2021
Viewed by 902
Abstract
The COVID-19 pandemic is wreaking havoc on human lives and the global economy, laying bare existing inequities, and galvanizing large numbers to call for change. Women are feeling the effects of this crisis more than others. This paper explores the pre-COVID relationships and [...] Read more.
The COVID-19 pandemic is wreaking havoc on human lives and the global economy, laying bare existing inequities, and galvanizing large numbers to call for change. Women are feeling the effects of this crisis more than others. This paper explores the pre-COVID relationships and amplified negative feedback loops between American women’s economic insecurity, lack of safety, and food insecurity. We then examine how COVID-19 is interacting with these intersecting risks and demonstrate how climate change will likely similarly intensify these feedback loops. The COVID-19 pandemic may be revealing vulnerabilities that societies will face in the wake of an increasingly warming world. It is also an opportunity to build resilience, inclusiveness, and equity into our future, and can help inform how to include gender equity in both COVID-19 and climate recovery policies. Finally, we identify possible strategies to build resilience, specifically highlighting that gendered economic empowerment may create a buffer against environmental health hazards and discuss how these strategies could be integrated into a women-centered Green New Deal. Full article
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Article
Economic Crisis: A Factor for the Delayed Diagnosis of Breast Cancer
Int. J. Environ. Res. Public Health 2021, 18(8), 3998; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18083998 - 10 Apr 2021
Viewed by 705
Abstract
Considering the constant increase in breast cancer patients, identifying factors that influence the moment of diagnosis is essential for optimizing therapeutic management and associated cost. The purpose of the study is to evaluate the impact of the economic crisis on the moment of [...] Read more.
Considering the constant increase in breast cancer patients, identifying factors that influence the moment of diagnosis is essential for optimizing therapeutic management and associated cost. The purpose of the study is to evaluate the impact of the economic crisis on the moment of a breast cancer diagnosis. This retrospective observational study analyzed a cohort of 4929 patients diagnosed with breast cancer over the course of 19 years in the Western region of Romania. The time interval was divided based on the onset of the economic crisis into 3 periods: pre-crisis (2001–2006), crisis (2007–2012), and post-crisis (2013–2019). The disease stage at the moment of diagnosis was considered either early (stages 0, I, II) or advanced (stages III, IV). Although recording a similar mean number of patients diagnosed per year during the pre- and crisis periods, a significantly higher percentage of patients were diagnosed with late-stage breast cancer during the economic crisis period compared to the previous interval (46.9% vs. 56.3%, p < 0.01). This difference was further accentuated when accounting for environmental setting, with 65.2% of patients from a rural setting being diagnosed with advanced disease during the crisis interval. An overall improvement of 12% in early-stage breast cancer diagnosis was recorded in the post-crisis period (55.7%, p < 0.001). The findings of this study support periods of economic instability as potential factors for a delay in breast cancer diagnosis and highlight the need for the development of specific strategies aimed at reducing cancer healthcare and associated financial burden in times of economic crisis. Full article
Article
A Decision Tree Model for Breast Reconstruction of Women with Breast Cancer: A Mixed Method Approach
Int. J. Environ. Res. Public Health 2021, 18(7), 3579; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073579 - 30 Mar 2021
Viewed by 712
Abstract
The number of breast reconstructions following mastectomy has increased significantly during the last decades, but women are experiencing a number of conflicts with breast reconstruction decisions. The aim of this study was to develop a decision tree model of breast reconstruction and to [...] Read more.
The number of breast reconstructions following mastectomy has increased significantly during the last decades, but women are experiencing a number of conflicts with breast reconstruction decisions. The aim of this study was to develop a decision tree model of breast reconstruction and to examine its predictability. Mixed method design using ethnographic decision tree modeling was used. In the qualitative stage, data were collected using individual and focus group interviews and analyzed to construct a decision tree model. In the quantitative stage, the questionnaire was developed questions based on the criteria identified in the qualitative stage. A total of 61 women with breast cancer participated in 2017. Five major criteria: recovery of body image; impact on recurrence; recommendations from others; financial resources; and confirmation by physicians. The model also included nine predictive pathways. It turns out that the model predicted 90% of decisions concerning whether or not to have breast reconstruction. The findings indicate that the five criteria play a key role in decision-making about whether or not to have breast reconstruction. Thus, more comprehensive issues, including these five criteria, need to be integrated into an intervention for women with breast cancer to make their best decision on breast reconstruction. Full article
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2020

Jump to: 2021, 2019

Editorial
Potential Risks and Factors of Women’s Health Promotion
Int. J. Environ. Res. Public Health 2020, 17(24), 9555; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17249555 - 21 Dec 2020
Viewed by 564
Abstract
In addition to diseases shared by both sexes, there are a number of illnesses and injuries that are primarily associated with women [...] Full article
Article
Human Papilloma Virus Infection and Vaccination: Pre-Post Intervention Analysis on Knowledge, Attitudes and Willingness to Vaccinate Among Preadolescents Attending Secondary Schools of Palermo, Sicily
Int. J. Environ. Res. Public Health 2020, 17(15), 5362; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17155362 - 25 Jul 2020
Cited by 6 | Viewed by 933
Abstract
In recent years, vaccination coverage rates against Human Papilloma Virus (HPV) in Europe have shown a decreasing trend and remain below the required standard. The present study aims to assess knowledge and attitudes regarding HPV infection and vaccination among a representative sample of [...] Read more.
In recent years, vaccination coverage rates against Human Papilloma Virus (HPV) in Europe have shown a decreasing trend and remain below the required standard. The present study aims to assess knowledge and attitudes regarding HPV infection and vaccination among a representative sample of preadolescents of Palermo, Italy. A survey was carried out throughout two questionnaires, before and after carrying out an educational intervention scheduled during school hours. A total of 1702 students attending first-grade secondary schools of the province of Palermo were enrolled (response rate 68.9%). Students attending third classes (adj OR = 1.18; CI 95% 1.03–1.36), being of higher socioeconomic status (adj OR = 1.35; CI 95% 1.05–1.73), who had previously received information about sexually transmitted diseases (STDs) at home (adj OR = 1.62; CI 95% 1.27–2.07) or at school (adj OR = 2.15; CI 95% 1.70–2.71) and who had ever heard in the past about HPV (adj OR = 1.80; CI 95% 1.42–2.29) showed a significantly higher baseline level of knowledge regarding HPV. Willingness to receive HPV vaccination, in a 10-point Likert scale, significantly increased between the pre- (8.51; SD ± 1.79) and post- (9.01 SD ± 1.52) intervention questionnaires (p < 0.001). A total of 188 out of 272 (69.1%) preadolescents attending five out eighteen schools involved in the project, who had not previously received the HPV vaccine, were vaccinated. During past years, education campaigns on HPV were mainly dedicated to adult women, excluding teenagers and omitting young males. It should therefore be of primary importance that school-based education and vaccination programmes be standardized. Full article
Article
Influence of Environmental Tobacco Smoke and Air Pollution on Fetal Growth: A Prospective Study
Int. J. Environ. Res. Public Health 2020, 17(15), 5319; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17155319 - 23 Jul 2020
Cited by 2 | Viewed by 999
Abstract
Exposure to air pollution during pregnancy leads to adverse pregnancy outcomes. Few studies have evaluated the influences of air quality, including environmental tobacco smoke (ETS) and particulate matter (PM), on fetal development, which this study examined. This longitudinal correlation study used multiple linear [...] Read more.
Exposure to air pollution during pregnancy leads to adverse pregnancy outcomes. Few studies have evaluated the influences of air quality, including environmental tobacco smoke (ETS) and particulate matter (PM), on fetal development, which this study examined. This longitudinal correlation study used multiple linear regression data analysis of PM2.5/PM10, self-reported ETS exposure, urinary cotinine level, maternal characteristics, and birth parameters (gestational week, body weight, body length, head, and chest circumferences) with the effect of air quality on fetal growth. The study included 74 pregnant women (mean age 31.9 ± 4.2 years, body mass index 23.6 ± 3.8 kg/m2, average gestational duration 38.5 ± 0.8 weeks). ETS exposure decreased birth length by ≥1 cm, and potentially is an independent risk factor for fetal growth restriction, and pregnant women should avoid indoor and outdoor ETS. However, neither PM2.5/PM10 nor ETS was associated with low birth weight or small for gestational age. This study adds to the evidence base that ETS exposure of nonsmoking pregnant women affects the fetal birth length. Family members should refrain from smoking near expectant mothers, although smoking in the vicinity of their residential surroundings potentially exposes mothers and their fetuses to ETS. Public pollution and childbirth education classes should include details of indoor ETS. Full article
Article
Italian Health Care Workers’ Knowledge, Attitudes, and Practices Regarding Human Papillomavirus Infection and Prevention
Int. J. Environ. Res. Public Health 2020, 17(15), 5278; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17155278 - 22 Jul 2020
Cited by 3 | Viewed by 858
Abstract
Objective: To assess healthcare workers’ knowledge and attitudes about human papillomavirus (HPV) infection, related diseases, and prevention. Methods: A cross-sectional multicenter survey about HPV and its prevention, targeted to healthcare workers involved in HPV vaccine counseling, was performed from May 2017 to December [...] Read more.
Objective: To assess healthcare workers’ knowledge and attitudes about human papillomavirus (HPV) infection, related diseases, and prevention. Methods: A cross-sectional multicenter survey about HPV and its prevention, targeted to healthcare workers involved in HPV vaccine counseling, was performed from May 2017 to December 2018. Results: The overall median knowledge and attitude scores were 69.2% (25–75, p = 61.5–84.6) and 5 (25–75, p = 4–5), respectively. Both knowledge and attitudes statistically significantly differ between physicians and healthcare professions. The median propensity score before and after the educational intervention was stable and high, at 10 (25–75, p = 9–10). The predictors of statistically significantly high knowledge scores are to be a physician, general practitioner, or pediatrician, attending courses/congresses, and consulting technical product characteristics and scientific literature to obtain information about the HPV vaccine. Being a physician and consulting scientific literature to obtain information about the HPV vaccine were found also as predictors of statistically significantly different attitude scores among study participants. Conclusions: Although healthcare workers showed overall positive attitudes towards the relevance of HPV burden and prevention tools, demonstrated knowledge was largely suboptimal, particularly that shown by healthcare professions. Obtained results allow highlighting knowledge gaps, and thus improving counselling to HPV vaccine targets. Full article
Article
Psychological Climacteric Symptoms and Attitudes toward Menopause among Emirati Women
Int. J. Environ. Res. Public Health 2020, 17(14), 5028; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17145028 - 13 Jul 2020
Cited by 19 | Viewed by 1563
Abstract
Menopause is an inevitable developmental event that women encounter at an age of 42–54 years. The drop of estrogen levels that accompanies cessation of menstruation is associated with multiple vasomotor, physical, neuropsychological, and sexual symptoms, which may hamper quality of life. This study [...] Read more.
Menopause is an inevitable developmental event that women encounter at an age of 42–54 years. The drop of estrogen levels that accompanies cessation of menstruation is associated with multiple vasomotor, physical, neuropsychological, and sexual symptoms, which may hamper quality of life. This study aimed to examine the severity of psychological symptoms and their correlates among peri- and postmenopausal Emirati women (N = 60, mean age = 54.88 ± 6 years). Participants were interviewed using the Menopause-Specific Quality of Life (MENQOL) and attitudes toward menopause scale (ATMS). In four path analysis models, vasomotor symptoms, weight gain, and fatigue had significant direct effects on symptoms of anxiety, depression (only weight gain and fatigue), and psychological distress. Fatigue significantly mediated the effects of vasomotor symptoms and weight gain on symptoms of anxiety, depression (only vasomotor symptoms), psychological distress, and memory problems. These models explained 47.6%, 44.5%, 56.6%, and 29.1% of the variances in anxiety, depression, psychological distress, and memory problems, respectively. Participants with more severe menopausal symptoms expressed more negative attitudes toward menopause though regression analysis revealed that only vasomotor symptoms could significantly contribute to ATMS scores. In conclusion, psychological distress is widespread among menopausal women, and it is associated with vasomotor symptoms, fatigue, and change of body composition (obesity). Psychological symptoms, along with vasomotor symptoms, express a key link to negative attitudes toward menopause. Therefore, interventional strategies that target psychological distress may promote coping with midlife transition and improve mental health among menopausal women. Full article
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Article
Intention to Pay for HPV Vaccination among Women of Childbearing Age in Vietnam
Int. J. Environ. Res. Public Health 2020, 17(9), 3144; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17093144 - 30 Apr 2020
Cited by 3 | Viewed by 1220
Abstract
The intention to pay for human papillomavirus (HPV) vaccination among women of childbearing age in Vietnam, where cervical cancer remains a significant public health concern, has been mostly lacking. To examine this issue, we conducted a cross-sectional study of 807 pregnant women in [...] Read more.
The intention to pay for human papillomavirus (HPV) vaccination among women of childbearing age in Vietnam, where cervical cancer remains a significant public health concern, has been mostly lacking. To examine this issue, we conducted a cross-sectional study of 807 pregnant women in an urban and a rural district (Dong Da and Ba Vi) of Hanoi, Vietnam. The vast percentage of our respondents expressed a firm intention to vaccinate, especially women in rural areas (over 90.0%). However, on being informed of the current price of the HPV vaccine, their intention to vaccinate dropped to about one-fifth of overall respondents, i.e., only 4.4% of women in rural areas. It was also observed that the initial intention to get the HPV vaccination among women in the rural district was about ten times higher than that of women living in the metropolitan district. Those participants who had greater knowledge of cervical cancer and HPV vaccinations also had a significantly higher intention to vaccinate. Our findings underscore the need to develop a well-designed vaccination program in Vietnam and other countries in a similar situation to increase the adoption of HPV vaccination. Full article
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Article
Socioeconomic Status and Physical Activity among Mothers of Young Children in an Asian City: The Mediating Role of Household Activities and Domestic Help
Int. J. Environ. Res. Public Health 2020, 17(7), 2498; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17072498 - 06 Apr 2020
Cited by 2 | Viewed by 1009
Abstract
Mothers of preschoolers (3 to 5 years old) risk being physically inactive. This study aimed to examine associations between socioeconomic status (education, employment, income) and moderate to vigorous physical activity (MVPA) among mothers of preschoolers in Hong Kong. Family functioning (e.g., having a [...] Read more.
Mothers of preschoolers (3 to 5 years old) risk being physically inactive. This study aimed to examine associations between socioeconomic status (education, employment, income) and moderate to vigorous physical activity (MVPA) among mothers of preschoolers in Hong Kong. Family functioning (e.g., having a domestic helper, division of household chores and child-related activities) was explored as a potential mediator of associations between socioeconomic indicators and the mother’s self-reported MVPA. Using zero-inflated negative binomial modelling confounder-adjusted associations between socioeconomic indicators and MVPA (total effects) were estimated. Mediation analyses (joint-significance test) were also performed. Using generalized linear mixed models, intermediate pathways were identified. No significant total effects of any socioeconomic indicator on the mother’s MVPA were found. However, mediation analyses identified a complex network of inconsistent mediators partly explaining their associations via eight pathways. Also, whilst non-residents/extended family playing with the child(ren) was not associated with any socioeconomic indicator, this was negatively associated with the mother’s MVPA. A further pathway was mediated by the mother playing with her child(ren). Extended family playing with the child(ren) was inversely associated with the mother doing so. Associations between socioeconomic indicators and MVPA among preschoolers’ mothers are complex and inconsistent, requiring further investigation in diverse contexts. Encouraging active play with their preschoolers may increase mothers’ physical activity levels. Full article
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Article
How to Educate Pregnant Women about Endocrine Disruptors?
Int. J. Environ. Res. Public Health 2020, 17(6), 2156; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17062156 - 24 Mar 2020
Cited by 4 | Viewed by 1203
Abstract
Background: Despite mediatization, only half of pregnant women are informed about endocrine disruptors (EDs). We wished to inquire about appropriate environmental health education procedures during pregnancy: Who, when, and how? Methods: The question stems from a comprehensive population health intervention research project. It [...] Read more.
Background: Despite mediatization, only half of pregnant women are informed about endocrine disruptors (EDs). We wished to inquire about appropriate environmental health education procedures during pregnancy: Who, when, and how? Methods: The question stems from a comprehensive population health intervention research project. It includes qualitative studies aimed at constructing an educational program in environmental health and an accompanying assessment tool. The validation of a customized questionnaire (PREVED© for Pregnancy Prevention Endocrine Disruptors) about the knowledge, attitudes, and practices (KAP) of pregnant women regarding exposure to EDs was carried out in a quantitative study. Results: Health education by a prenatal professional with communication skills should take place as early as possible, during the preconception period or early pregnancy, as part of individual consultation or group workshops. In order to customize the discourse and to develop women’s empowerment, concomitant presentation of the risks by the products used in each room and of previous solutions is recommended. Conclusion: Appropriate health education procedures on EDs should be done at every contact but taking the KAP of pregnant women into account first. We propose all educational actions should be accompanied by questioning of the KAP of pregnant women; for example, with questions from the PREVED© questionnaire. Full article
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Article
Women’s Well-Being and Rural Development in Depopulated Spain
Int. J. Environ. Res. Public Health 2020, 17(6), 1966; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17061966 - 17 Mar 2020
Cited by 4 | Viewed by 877
Abstract
The threat of depopulation in the rural areas making up what has become to be known as “empty Spain” is currently an extremely urgent national issue. Women are a fundamental pillar of rural sustainability, but the lack of decent living conditions has led [...] Read more.
The threat of depopulation in the rural areas making up what has become to be known as “empty Spain” is currently an extremely urgent national issue. Women are a fundamental pillar of rural sustainability, but the lack of decent living conditions has led to their mass exodus to the country’s cities. We analysed the factors undermining their health and well-being, thus leading to their dissatisfaction and their subsequent desire to abandon the countryside for a better life. A mixed methodology was employed, combining qualitative and quantitative data collection techniques. For data collection, an ad hoc questionnaire was developed before being administered to members of the Rural Development Groups of the Celtiberian Highlands, while some of their number were also interviewed. Rural women experience personal dilemmas that prompt them to migrate. These include choosing between living in the place where they were born, close to their families and neighbours, and a decent productive job, the availability of basic services and a broader range of leisure opportunities, among other aspects. It is essential to acknowledge the socio-economic importance of women’s work, to identify invisible burdens and their risks and to adopt measures that facilitate the reconciliation of work and family life. Full article
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Review
Inflammatory Markers in Dysmenorrhea and Therapeutic Options
Int. J. Environ. Res. Public Health 2020, 17(4), 1191; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17041191 - 13 Feb 2020
Cited by 21 | Viewed by 3232
Abstract
Dysmenorrhea often significantly reduces the quality of women’s life and is still an important public health problem. Despite numerous studies, the pathomechanism of dysmenorrhea is not fully understood. Previous research indicates the complexity of biochemical reactions between the endocrine, vascular, and immune systems. [...] Read more.
Dysmenorrhea often significantly reduces the quality of women’s life and is still an important public health problem. Despite numerous studies, the pathomechanism of dysmenorrhea is not fully understood. Previous research indicates the complexity of biochemical reactions between the endocrine, vascular, and immune systems. Prostaglandins play a major role in the pathomechanism of dysmenorrhea. In contrast, cytokines and other proinflammatory factors in primary dysmenorrhea are less studied. In addition to the applied pharmacotherapy, more and more studies proving the effectiveness of non-pharmacological methods appear. Therefore, the present work contains a review of the latest research concerning factors involved in dysmenorrhea, as well as therapeutic options. In the literature search, authors used online databases, PubMed, and clinitrials.gov and browsed through individual gynecology, physiotherapy journals and books. Full article
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Article
Postpartum Physical Activity and Weight Retention within One Year: A Prospective Cohort Study in Vietnam
Int. J. Environ. Res. Public Health 2020, 17(3), 1105; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17031105 - 10 Feb 2020
Cited by 4 | Viewed by 1280
Abstract
After delivery, mothers are encouraged to increase physical activity (PA) gradually to regulate body weight; however, data on PA in relation to postpartum weight retention remains scarce, particularly among Asian women. In a cohort of 1617 Vietnamese mothers, we investigated the prospective association [...] Read more.
After delivery, mothers are encouraged to increase physical activity (PA) gradually to regulate body weight; however, data on PA in relation to postpartum weight retention remains scarce, particularly among Asian women. In a cohort of 1617 Vietnamese mothers, we investigated the prospective association between habitual PA exposures at 3-month postpartum and weight retention at 6-month and 12-month postpartum. Detailed information on PA intensity and domains was collected from participants using a validated instrument specifically for Vietnamese women. Linear regression analyses and a general linear model for the repeated weight retention measures were used to ascertain the apparent relationships. On average, the participants reported 3.6 (SD 3.9) and 2.6 (SD 3.8) kg weight loss at 6- and 12-month postpartum, respectively. Total and light-intensity PA were inversely associated with the postpartum weight retention (p for trend <0.05). Our findings highlight the importance of resuming PA in the early postpartum period as an appropriate weight management strategy. Full article
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Article
Work Hours and Difficulty in Leaving Work on Time in Relation to Work-to-Family Conflict and Burnout Among Female Workers in Taiwan
Int. J. Environ. Res. Public Health 2020, 17(2), 605; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17020605 - 17 Jan 2020
Cited by 6 | Viewed by 1310
Abstract
The present study explores the relations between work hours and the difficulty in leaving work on time to both work-to-family conflict (WFC) and burnout among female workers in Taiwan. A cross-sectional research design and questionnaire were employed to obtain the research data. In [...] Read more.
The present study explores the relations between work hours and the difficulty in leaving work on time to both work-to-family conflict (WFC) and burnout among female workers in Taiwan. A cross-sectional research design and questionnaire were employed to obtain the research data. In total, 738 full-time female workers took part in the study. The results of regression analyses showed that when age, marital status, economic status, occupation, parental status, and housework responsibilities were controlled, more work hours were positively associated with WFC and burnout. When the difficulty in leaving work on time was also considered in the analysis, long working hours were still significantly associated with burnout; however, the significant relation with WFC disappeared. It is surmised that if female employees work overtime voluntarily, the perception of WFC diminishes; nevertheless, the adverse effect of long working hours on health remains unabated. This study concludes that female employees who work overtime on a voluntary basis are at risk of health problems, which should be a focus of concern. Full article
Article
Study on the Utilization of Inpatient Services for Middle-Aged and Elderly Rural Females in Less Developed Regions of China
Int. J. Environ. Res. Public Health 2020, 17(2), 514; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17020514 - 14 Jan 2020
Cited by 4 | Viewed by 1071
Abstract
The aim of this study is to understand the utilization of inpatient services and its contributing factors among middle-aged and elderly females (MAEF) in less developed rural regions. Five surveys were conducted between 2006 and 2014 with rural residents of Jiangxi by stratified [...] Read more.
The aim of this study is to understand the utilization of inpatient services and its contributing factors among middle-aged and elderly females (MAEF) in less developed rural regions. Five surveys were conducted between 2006 and 2014 with rural residents of Jiangxi by stratified cluster random sampling. Participant females included only those who were aged 45 and above. Complex sampling logistics analysis was performed to analyze the effect of three factors on inpatient service. Complex sampling logistics regression analysis revealed that the probability of hospitalization for the divorced or widowed females was significantly lower than that of married ones (aOR = 0.177, p < 0.05). However, the probability of early discharge was significantly higher among divorced or widowed females than married ones (aOR = 3.237, p < 0.05). In addition, females with chronic diseases were more likely to be hospitalized (aOR = 3.682, p < 0.05). Also, early discharge (aOR = 7.689, p < 0.05) occurred among the participants who should be hospitalized but were not hospitalized occurred (aOR = 3.258, p < 0.05). The continuous improvement of the new rural cooperative medical policy has promoted the utilization of inpatient services for the MAEF. Findings from this study emphasize the need to strengthen the prevention and treatment of chronic diseases among middle-aged and elderly women. Full article
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2019

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Article
Association of Night Eating with Depression and Depressive Symptoms in Korean Women
Int. J. Environ. Res. Public Health 2019, 16(23), 4831; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16234831 - 01 Dec 2019
Cited by 4 | Viewed by 1111
Abstract
This study examined the associations of night eating with depression and depressive symptoms in Korean adults. The study used a nationally representative sample of 31,690 Korean adults (≥19 years old) from the Korea National Health and Nutrition Examination Survey from 2008 to 2013. [...] Read more.
This study examined the associations of night eating with depression and depressive symptoms in Korean adults. The study used a nationally representative sample of 31,690 Korean adults (≥19 years old) from the Korea National Health and Nutrition Examination Survey from 2008 to 2013. The participants were divided into two groups based on status of night eating: night eaters (consuming ≥25% of total daily energy intake between 21:00 and 06:00) and non-night eaters. Depression was defined based on diagnosis by a doctor, whereas depressive symptoms were defined as feelings of sadness or desperation for more than two weeks in the last one year. Multivariable logistic regression analyses were performed to examine the relationship between night eating and odds of depression and depressive symptoms after controlling for age, education, income, marital status, drinking, smoking, day of recalled intake, physical activity, body mass index, menopausal status (women only), total energy intake, and sleep duration. A total of 14.3% of Korean adults were night eaters. Night eaters were more likely to be men, young, less educated, single, drinkers, current smokers, and not employed (all ps < 0.05). In women, night eaters had higher odds of depression (adjusted odds ratio [AOR], 1.33; 95% confidence interval [CI], 1.02–1.75; p for trend = 0.0389) and depressive symptoms (AOR, 1.20; 95% CI, 1.01–1.41; p for trend = 0.0382) compared with non-night eaters. However, no associations of night eating with depression and depressive symptoms were found in men. Night eaters had higher odds of depression and depressive symptoms only in Korean women. Future studies are warranted to elucidate the underlying psychological and behavioral mechanisms that in turn may shed light on the factors influencing both night eating and odds of depression and depressive symptoms. Full article
Article
Domestic Violence During Pregnancy in Greece
Int. J. Environ. Res. Public Health 2019, 16(21), 4222; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16214222 - 31 Oct 2019
Cited by 5 | Viewed by 1490
Abstract
There are no data about the prevalence of domestic violence during pregnancy in Greece. The purpose of this study is to determine the prevalence and the associated factors of domestic violence in a representative population of pregnant women in Greece. Five hundred and [...] Read more.
There are no data about the prevalence of domestic violence during pregnancy in Greece. The purpose of this study is to determine the prevalence and the associated factors of domestic violence in a representative population of pregnant women in Greece. Five hundred and forty-six consecutive women, in outpatient clinics of two Public General Regional Hospitals in Athens, agreed to answer anonymously the Abuse Assessment Screen (AAS) questionnaire, translated into the Greek language. Five hundred and forty-six questionnaires were returned (100% response rate), revealing that the prevalence of domestic violence in pregnancy is 6%, with 3.4% of the sample having being abused since the beginning of pregnancy, mainly by their husband/partner. The factors associated with higher risk of abuse during pregnancy were nationality, socio-economic background, and educational level. Foreign women or women with a foreign partner, unemployed individuals, housewives, and university students faced a higher risk of being abused. A substantial age difference (≥10 years) in the couple, a history of abortions, and an undesired pregnancy also increased the risk of violence in pregnancy. These findings suggest that prenatal care is an important period for discussing abuse and, in the end, encouraging women to seek help. Full article
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Article
A Bespoke Social Network for Deaf Women in Ecuador to Access Information on Sexual and Reproductive Health
Int. J. Environ. Res. Public Health 2019, 16(20), 3962; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16203962 - 17 Oct 2019
Cited by 2 | Viewed by 1201
Abstract
Many deaf women face the lack of numerous resources related to their personal development. The unavailability of proper information on Sexual and Reproductive Health (SRH), in particular, causes problems of sexually transmitted infections, unwanted pregnancy in adolescence, sexual violence, complications during pregnancy, etc. [...] Read more.
Many deaf women face the lack of numerous resources related to their personal development. The unavailability of proper information on Sexual and Reproductive Health (SRH), in particular, causes problems of sexually transmitted infections, unwanted pregnancy in adolescence, sexual violence, complications during pregnancy, etc. In response to this, we have created a social network that delivers SRH content (verified and validated by experts) to women with different degrees of hearing loss. The site features a recommender system that selects the most relevant pieces of content to deliver to each woman, driven by her individual preferences, needs and levels of knowledge on the different subjects. We report experiments conducted in Cuenca, Ecuador, between 2017 and 2018 with 98 volunteers from low- and middle-income settings, aiming to evaluate the quality and appeal of the contents, the coherence of the methodology followed to create them, and the effectiveness of the content recommendations. The positive results encourage the frequent creation of new content and the refinement of the recommendation logic as the cohort of users expands over time. Full article
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Article
Living with Urinary Incontinence: Potential Risks of Women’s Health? A Qualitative Study on the Perspectives of Female Patients Seeking Care for the First Time in a Specialized Center
Int. J. Environ. Res. Public Health 2019, 16(19), 3781; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16193781 - 08 Oct 2019
Cited by 8 | Viewed by 1988
Abstract
Background: Urinary incontinence (UI) represents a complex problem which commonly affects women and influences their physical, mental, and social wellbeing. The objective of this study was to explore the experiences of a group of women with urinary incontinence. Methods: A qualitative exploratory study. [...] Read more.
Background: Urinary incontinence (UI) represents a complex problem which commonly affects women and influences their physical, mental, and social wellbeing. The objective of this study was to explore the experiences of a group of women with urinary incontinence. Methods: A qualitative exploratory study. Purposeful sampling was used. Recruited patients were females aged >18 years old with positive symptoms, signs of urinary incontinence, and attending a specialized urinary incontinence center for the first time. We collected data using interviews and participants’ personal letters. A thematic analysis was performed. Results: 18 women participated with a mean age of 47.32 years. Four themes emerged: (a) Experiencing uncontrolled urinary leakage, (b) Information based on beliefs and myths regarding UI, (c) Adapting to change and developing strategies, (d) The role of education. Women’s experiences were accompanied by feelings of stress and shame. A lack of information regarding UI was found, together with numerous misconceptions. Urinary incontinence triggers many changes in women. Some women may develop feelings of rejection towards their own body. Family involvement during these times is essential for education and promoting healthy sexual practices. Conclusions: This study highlights the importance of developing educational programs that focus on women’s information and education regarding triggering factors and coping strategies. Full article
Article
Association of the Individual and Context Inequalities on the Breastfeeding: A Study from the Sicily Region
Int. J. Environ. Res. Public Health 2019, 16(19), 3514; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16193514 - 20 Sep 2019
Cited by 5 | Viewed by 1030
Abstract
Despite the advantages of breastfeeding being widely recognized, the economic level can have an influence on breastfeeding rates, with rich women breastfeeding longer than poor in high-income countries. In Italy, socio-economic differences affect breastfeeding start and continuation among most deprived people, such as [...] Read more.
Despite the advantages of breastfeeding being widely recognized, the economic level can have an influence on breastfeeding rates, with rich women breastfeeding longer than poor in high-income countries. In Italy, socio-economic differences affect breastfeeding start and continuation among most deprived people, such as in Southern Italy. The objective of the study was to evaluate the prevalence of the initiation and continuation of exclusive breastfeeding and its association with the levels of socio-economic deprivation in Sicily. A prospective cohort study with a two-phase survey in three breastfeeding detection times was conducted. Overall, 1,055 mothers were recruited with a mean age of 31 years. Breastfeeding decreased from 86% during hospitalization to 69% at the first month and 42% at the sixth month, yet at the same time, exclusive breastfeeding increased from 34% to 38% during hospitalization to the first month and went down to 20.2% at the sixth month. The adjusted multivariate analysis showed no association with individual inequalities. On the other hand, the context inequalities had a significant association with the risk of not following exclusive breastfeeding in the deprived class (odds ratio (OR): 2.08, confidence interval (CI) 95% 1.01–4.27) and in the very deprived class (OR: 1.83, CI 95% 1.00–3.38) at the six-month survey. These results indicate that the context inequalities begin to emerge from the return home of the mother and the child. Full article
Article
Hospitalization Services Utilization Between Permanent and Migrant Females in Underdeveloped Rural Regions and Contributing Factors—A Five-Time Data Collection and Analysis
Int. J. Environ. Res. Public Health 2019, 16(18), 3419; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16183419 - 14 Sep 2019
Cited by 2 | Viewed by 883
Abstract
The proportion of migrating females has increased, and more often, old females are left in rural regions. Resources are needed to provide suitable hospitalization service to females in underdeveloped rural regions. Using multi-stage hierarchical cluster random sampling method, nine towns from three counties [...] Read more.
The proportion of migrating females has increased, and more often, old females are left in rural regions. Resources are needed to provide suitable hospitalization service to females in underdeveloped rural regions. Using multi-stage hierarchical cluster random sampling method, nine towns from three counties were enrolled in five-time points between 2006 and 2014 in this study. The research subjects of this study were females age 15 and up. Data regarding the utilization of inpatient services were collected and analyzed. Complex sampling logistic regression was conducted to analyze influencing factors. This study reveals that for both permanent females and migrant females, the older their age, the higher their hospitalization rate. The utilization of hospitalization service for permanent females was associated with the occurrence of chronic diseases (adjusted Odds Ratio (aOR) = 5.402). In addition, permanent females suffering from chronic diseases were more likely to avoid hospitalization despite their doctor’s advice (aOR = 34.657) or leave the hospital early against medical advice (AMA) (aOR = 10.009). Interventions to combat chronic diseases and adjust compensation schemes for permanent females need to be provided. Full article
Article
Determinants of Maternal Health-Related Quality of Life after Childbirth: The Generation R Study
Int. J. Environ. Res. Public Health 2019, 16(18), 3231; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16183231 - 04 Sep 2019
Cited by 5 | Viewed by 1335
Abstract
Having good health-related quality of life (HRQoL) is essential, particularly for women after childbirth. However, little is known about its determinants. We aimed to identify the determinants of HRQoL after childbirth in a large community sample in the Netherlands. We have included 4312 [...] Read more.
Having good health-related quality of life (HRQoL) is essential, particularly for women after childbirth. However, little is known about its determinants. We aimed to identify the determinants of HRQoL after childbirth in a large community sample in the Netherlands. We have included 4312 women in the present study. HRQOL was assessed by a 12-Item Short Form Survey (SF-12) at around two months after childbirth; Physical and Mental Component Summary scores were calculated. Information on 27 potential determinants of HRQoL was collected through questionnaires and medical records. Multivariate linear regression models were applied to assess significant determinants of physical and mental HRQoL. Our study showed that older maternal age, shorter time since childbirth, elective/emergency cesarean delivery, loss of energy, maternal psychopathology, and the hospital admission of the infant were significantly associated with worse physical HRQoL (p < 0.05); older maternal age, non-western background, low household income, loss of energy, and maternal psychopathology were significantly associated with worse mental HRQoL (p < 0.05). We identified multiple determinants of suboptimal physical and mental HRQoL after childbirth. In particular, maternal psychopathology after childbirth was profoundly associated with mental HRQoL. These women may need support. We therefore call for awareness among health care professionals. Full article
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Article
Body Changes and Decreased Sexual Drive after Dialysis: A Qualitative Study on the Experiences of Women at an Ambulatory Dialysis Unit in Spain
Int. J. Environ. Res. Public Health 2019, 16(17), 3086; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16173086 - 25 Aug 2019
Cited by 5 | Viewed by 1432
Abstract
Chronic kidney disease (CKD) has considerable effects on the quality of life of patients, impairing everyday activities and leading to lifestyle changes, as well as affecting body image and intimate relationships. Our aim was to describe the experience of female patients with CKD [...] Read more.
Chronic kidney disease (CKD) has considerable effects on the quality of life of patients, impairing everyday activities and leading to lifestyle changes, as well as affecting body image and intimate relationships. Our aim was to describe the experience of female patients with CKD at an ambulatory dialysis unit regarding body changes and sexuality. A qualitative phenomenological study exploring how 18 female patients, treated at the dialysis unit of a Spanish hospital, perceived their sexuality and intimate relationships. Data were collected using in-depth interviews, researcher field notes, and patients’ personal letters. A thematic analysis was performed. Four main themes arose from the data describing the experience of how CKD impacts body changes and sexuality: (a) Accepting body changes, (b) The catheter, the fistula, and body image, (c) Experiencing a different sexuality, and (d) The catheter, the fistula, and sexuality. Patients experienced changes in their body, perceiving it as being bloated or deformed, together with overall decline. The catheter and/or the fistula triggered changes in the way the women dress in an attempt to hide port sites. Women experience sexuality changes, affecting sexual desire and satisfaction. The presence of catheters was found to be the most cumbersome during sexual acts. Full article
Article
Gender Discrimination in the Workplace: Effects on Pregnancy Planning and Childbirth among South Korean Women
Int. J. Environ. Res. Public Health 2019, 16(15), 2672; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16152672 - 26 Jul 2019
Cited by 5 | Viewed by 2616
Abstract
Introduction: This study aims to investigate the association between gender discrimination in the workplace and pregnancy planning/childbirth experiences among working women in South Korea. Methods: We analyzed data from the Korean Longitudinal Survey of Women and Families (KLoWF) for the years [...] Read more.
Introduction: This study aims to investigate the association between gender discrimination in the workplace and pregnancy planning/childbirth experiences among working women in South Korea. Methods: We analyzed data from the Korean Longitudinal Survey of Women and Families (KLoWF) for the years 2007 to 2016. The study population consisted of 7996 working women, between the ages of 19 and 45. Gender discrimination was measured through the 6-item Workplace Gender Discrimination Scale, evaluating discrimination in terms of recruitment, promotions, pay, deployment, training and lay-offs. Multiple logistic regression analysis was employed to measure the association between gender discrimination and the pregnancy planning/childbirth experience. Results: Compared to individuals experiencing no discrimination in the workplace, those experiencing low [odds ratio (OR): 0.78, 95% confidence interval (95% CI) 0.61–0.99] or medium (OR: 0.69, 95% CI: 0.54–0.89) levels of discrimination had decreased odds of pregnancy planning. Likewise, individuals scoring low (OR: 0.70, 95% CI 0.54–0.92), medium (OR: 0.68, 95% CI: 0.51–0.92), or high (OR: 0.47, 95% CI: 0.27–0.80) levels of discrimination also had decreased odds of childbirth experience when compared to the no-experience group. When stratified by income, compared to individuals experiencing no discrimination in the workplace, those experiencing gender discrimination had decreased odds of pregnancy planning for low income (low OR: 0.64, 95% CI: 0.45–0.92; medium OR: 0.55, 95% CI: 0.52–0.97; high OR: 0.45, 95% CI: 0.24–0.87), medium income (medium OR: 0.53, 95% CI: 0.37–0.77; high OR: 0.29, 95% CI: 0.14–0.63), and high income groups (low OR: 0.64, 95% CI: 0.49–0.84; medium OR: 0.69, 95% CI: 0.52–0.92). Conclusions: The present study finds that gender discrimination in the workplace is associated with decreased odds of pregnancy planning/childbirth experience among working South Korean women. Furthermore, low and medium income groups were especially more likely to be affected by the level of gender discrimination in the workplace when planning pregnancy. Full article
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Article
Bone Mineral Density and Bone Turnover Markers in Postmenopausal Women Subjected to an Aqua Fitness Training Program
Int. J. Environ. Res. Public Health 2019, 16(14), 2505; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16142505 - 13 Jul 2019
Cited by 8 | Viewed by 1546
Abstract
The purpose of this study was to analyze the influence of aqua fitness training in deep water on bone tissue. The study was performed with 18 postmenopausal women separated into two groups: training and control groups. Before and after the training program, the [...] Read more.
The purpose of this study was to analyze the influence of aqua fitness training in deep water on bone tissue. The study was performed with 18 postmenopausal women separated into two groups: training and control groups. Before and after the training program, the hip and spine areal bone mineral density were measured along with the biochemical parameters of serum concentration of osteocalcin (OC) and C-terminal telopeptide of type I collagen (CTX). The most significant effect was found in differences between the two groups of women in terms of femur strength index (p < 0.05) during the period of the training program. The study demonstrated that an aqua fitness training program caused favorable changes in femur strength index in postmenopausal women, and this kind of exercise could be a useful form of physical activity for postmenopausal women. Full article
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Article
Pregnancy with Heart Disease: Maternal Outcomes and Risk Factors for Fetal Growth Restriction
Int. J. Environ. Res. Public Health 2019, 16(12), 2075; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16122075 - 12 Jun 2019
Cited by 4 | Viewed by 1961
Abstract
Caring for children and mothers suffering from cardiac disease is highly challenging, with issues including late diagnosis as well as inadequate infrastructure and supply of drugs. We aimed to evaluate maternal outcomes among pregnant women suffering from heart disease with a live birth, [...] Read more.
Caring for children and mothers suffering from cardiac disease is highly challenging, with issues including late diagnosis as well as inadequate infrastructure and supply of drugs. We aimed to evaluate maternal outcomes among pregnant women suffering from heart disease with a live birth, and explored the risk factors for fetal growth restriction among these patients. A retrospective study was performed at the National Hospital of Obstetrics and Gynecology (Hanoi, Vietnam) over a 3-year period from 2014 to 2016. A total of 284 patients were enrolled in the study. Overall, most women were aged below 35 years and were diagnosed with heart disease before pregnancy. Of the women experiencing rheumatic heart disease, the prevalence of mitral valve regurgitation was the highest (40.14%), while the figure for aortic valve regurgitation was the lowest (4.23%). Of women with congenital heart defects, the most common defects were ventricular septal defect (VSD) and atrial septal defect (ASD) (19.37% and 16.55%, respectively), while 5.28% of mothers were diagnosed with tetralogy of Fallot and 1.76% with patent ductus arteriosus. Noted clinical presentations of the patients included palpitation (63.38%), breathlessness (23.59%), leg edema (8.45%), and chest pain (8.1%). The common complications in the study population included 16.90% of women having heart failure and 19.37% having arrhythmias. The incidence of fetal growth restriction was 9.15%. Hypertension (odds ratio (OR): 59.75, 95% confidence interval (CI): 9.1–392.17), the heart disease types (ASD (OR: 4.27, 95% CI: 1.19–15.29) and tetralogy of Fallot (OR: 6.82, 95% CI: 1.21–38.55)), and the complications (heart failure (OR: 10.34, 95% CI: 2.75–38.87) and pulmonary edema (OR: 107.16, 95% CI: 4.96–2313.93)) were observed as risk factors for intrauterine growth restriction. This study provides a cornerstone to promote further studies and to motivate people to apply evidence-based medical care for mothers with diagnosed cardiac disease in the antenatal and postnatal periods. Full article
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Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

 

 

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