Journal of women's health
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Background: Hysterectomies can be performed with a minimally invasive surgical (MIS) approach or a laparotomic (abdominal) approach. The objective of this study was to assess any racial differences in the likelihood of having a planned MIS hysterectomy. Materials and Methods: A prospective cohort study of women undergoing hysterectomy at Henry Ford Health System was conducted where laparotomic and MIS approaches are available to all patients. ⋯ The associations were not confounded by the baseline survey data from standardized questionnaires on depression, financial distress, and satisfaction with their decision. Conclusions: Black women were not less likely than White women to have planned an MIS hysterectomy after controlling for important confounding variables. These results emphasize the importance of considering all important confounders when examining racial differences.
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Journal of women's health · Jan 2022
Postabortion Medicaid Enrollment and the Affordable Care Act Medicaid Expansion in Oregon.
Background: The Affordable Care Act Medicaid expansion had the potential to increase continuity of insurance coverage and remove barriers to accessing health services following an abortion in states where Medicaid pays for abortion. We examined the association of Medicaid expansion with postabortion Medicaid enrollment and described postabortion preventive reproductive services among Medicaid-enrolled women in Oregon. Methods: We used Medicaid claims and enrollment data to identify abortions to women ages 20-44 in 2009-2017 (N = 30,786), classified into a treatment group-those likely to be affected by Medicaid expansion-and a comparison group. ⋯ Results: Medicaid expansion was associated with enrollment increases of 2.0 and 4.7 months and with declines in any enrollment lapse of 54 and 48 percentage-points over 6 and 12 months postabortion, respectively (p < 0.001). Many who remained enrolled through postabortion received preventive care including contraceptive services (41%) and screening for sexually transmitted infections (23%). Conclusions: Medicaid expansion may increase continuity of insurance coverage for those receiving abortions, and in turn promote access to preventive services that can improve subsequent reproductive health outcomes.
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Journal of women's health · Jan 2022
Systemic and Ocular Comorbidities of Black, Hispanic, and White Women with Cataracts.
Background: Cataracts are one of the leading causes of blindness in the world and disproportionately affect the elderly people and women. Sex- and race-related differences in cataract formation are not well understood. Furthermore, race and socioeconomic factors can play a role in developing systemic diseases. ⋯ Results: There are differences among races for frequency of smoking, hemoglobin A1c, hypertension, and diabetes mellitus in female patients with cataracts and differences among races and insurance types for preoperative BCVA for patients who underwent cataract surgery (p < 0.001 for all). Conclusions: Female minority and non-minority patients with cataracts have a high frequency of systemic and ocular comorbidities at our county hospital. Patients with no insurance and white and Hispanic patients had worse preoperative BCVA.
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Journal of women's health · Jan 2022
Need for Awareness and Training in Women's Gastrointestinal Health: A Call to Action.
Women's gastrointestinal (GI) health is a topic that is not well understood nor taught in most training programs. In this article, we highlight the importance of proper training in women's GI health among gastroenterologists and fellows, and identify some common conditions to provide the best possible treatment for their female patients.
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Journal of women's health · Jan 2022
Impact of Stress on Menstrual Cyclicity During the Covid-19 Pandemic: A Survey Study.
Background: The coronavirus disease 2019 (COVID-19) pandemic has introduced acute and persistent psychosocial stressors for many individuals, with emerging gender differences that suggest women may be at greater risk for poorer mental health outcomes. This may have unintended consequences for women's overall health and well-being, including disruptions to reproductive function as elevated stress is often associated with menstrual cycle irregularities. The objective of this study was to determine if and how the COVID-19 pandemic and its related stressors have impacted women's menstrual cyclicity. ⋯ These included changes in menstrual cycle length (50%), the duration of menses (34%), and changes in premenstrual symptoms (50%). Respondents with high perceived stress scale (PSS) scores during Covid were more likely to experience a longer duration of menses (p < 0.001) and heavier bleeding during menses (p = 0.028) compared with those with moderate Covid PSS scores. Conclusions: By uncovering a trend in increased menstrual cycle irregularities during the early months of the COVID-19 pandemic, this study contributes to our understanding of the implications that the pandemic may have on women's reproductive health.