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1.
  • Ellaithi, M, et al. (författare)
  • Female genital mutilation of a karyotypic male presenting as a female with delayed puberty
  • 2006
  • Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 6:6
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Female genital mutilation (FGM) is commonly practiced mainly in a belt reaching from East to West Africa north of the equator. The practice is known across socio-economic classes and among different ethnic, religious, and cultural groups. Few studies have been appropriately designed to measure the health effects of FGM. However, the outcome of FGM on intersex individuals has never been discussed before. CASE PRESENTATION: The patient first presented as a female with delayed puberty. Hormonal analysis revealed a normal serum prolactin level of 215 Micro/L, a low FSH of 0.5 Micro/L, and a low LH of 1.1 Micro/L. Type IV FGM (Pharaonic circumcision) had been performed during childhood. Chromosomal analysis showed a 46, XY karyotype and ultrasonography verified a soft tissue structure in the position of the prostate. CONCLUSION: FGM pose a threat to the diagnosis and management of children with abnormal genital development in the Sudan and similar societies.
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2.
  • Finnbogadottir, Hafrún, et al. (författare)
  • Prevalence of domestic violence during pregnancy and related risk factors : a cross-sectional study in southern Sweden
  • 2014
  • Ingår i: BMC Women's Health. - : BioMed Central. - 1472-6874. ; 14
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Domestic violence during pregnancy is a serious public health issue which threatens maternal and foetal health outcomes. The aim of the study was to explore prevalence of domestic violence among pregnant women in southern Sweden (Scania) and to explore associations with background factors, as symptoms of depression and sense of coherence.Methods: This study has a cross-sectional design and is the first part of a longitudinal, cohort study. Inclusion criteria were women ≥ 18 years, registered at antenatal care when pregnant and who understand and write Swedish or English. Questionnaires were collected prospectively at seventeen antenatal care receptions situated in the two cities and six smaller municipalities in Scania. Statistical analyses were done using descriptive statistics, chi-square tests, bivariate logistic regression and multiple regression with Odds ratios (OR) and 95% confidence intervals (95% CI).Results: Study sample included 1939 women. History of violence was reported by 39.5% (n =761) women. Significant differences were obtained between the groups with or without history of violence regarding being single/living apart, unemployment, financial distress, smoking/snuffing, unintended pregnancy as well as history of miscarriage/legalised abortion (p < 0.001). Experience of domestic violence during pregnancy regardless of type or level of abuse was 1.0% (n = 18); history of physical abuse by actual intimate partner was 2.2% (n = 42). History of violence was the strongest risk factor associated with domestic violence during pregnancy, where all women (n = 18) exposed reported history of violence (p < 0.001). Several symptoms of depression (adjusted for low socio-economic status, miscarriage/abortion, single/living apart, lack of sleep, unemployment, age and parity) were associated with a 7.0 fold risk of domestic violence during pregnancy (OR 7.0; 95% CI: 1.9-26.3).Conclusions: The reported prevalence of domestic violence during pregnancy in southwest Sweden is low. However, a considerable proportion of women reported history of living in a violent relationship. Both history of violence and the presence of several depressive symptoms detected in early pregnancy may indicate that the woman also is exposed to domestic violence during pregnancy. Increased attention to this vulnerable group of women is needed to improve maternal and child health.
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3.
  • Gustafsson, Rita, et al. (författare)
  • The Lactobacillus flora in vagina and rectum of fertile and postmenopausal healthy Swedish women
  • 2011
  • Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 11:Article. nr 11
  • Tidskriftsartikel (refereegranskat)abstract
    • Abstract Background: Lactobacillus species are the most often found inhabitants of vaginal ecosystem of fertile women. In postmenopausal women with low oestrogen levels, Lactobacillus flora is diminishing or absent. However, no studies have been performed to investigate the correlation between oestrogen levels and the lactobacilli in the gut. The aim of the present study was to investigate the relation in healthy women between vaginal and rectal microbial flora as well as possible variations with hormone levels. Methods: Vaginal and rectal smears were taken from 20 healthy fertile women, average 40 years (range 28-49 years), in two different phases of the menstrual cycle, and from 20 postmenopausal women, average 60 years (range 52-85 years). Serum sex hormone levels were analyzed. Bacteria from the smears isolated on Rogosa Agar were grouped by Randomly Amplified Polymorphic DNA and identified by multiplex PCR and partial 16S rRNA gene sequencing. Results: Lactobacillus crispatus was more often found in the vaginal flora of fertile women than in that of postmenopausal (p = 0.036). Fifteen of 20 fertile women had lactobacilli in their rectal smears compared to 10 postmenopausal women (p = 0.071). There was no correlation between the number of bacteria in vagina and rectum, or between the number of bacteria and hormonal levels. Neither could any association between the presence of rectal lactobacilli and hormonal levels be found. Conclusion: Lactobacillus crispatus was more prevalent in the vaginal flora of fertile women, whereas the Lactobacillus flora of rectum did not correlate to the vaginal flora nor to hormonal levels.
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4.
  • Hayati, Elli N., et al. (författare)
  • "We no longer live in the old days": a qualitative study on the role of masculinity and religion for men's views on violence within marriage in rural Java, Indonesia
  • 2014
  • Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 14
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Previous studies on domestic violence in Indonesia have focused primarily on women's experiences and little research has been undertaken to understand men's views on domestic violence or their involvement in the prevention of domestic violence. This study aimed to explore men's views on masculinity and the use of violence within marriage, in order to gain knowledge on how to involve men in prevention of domestic violence in rural Indonesia. Methods: Focus group discussions with six groups of local male community leaders in Purworejo were conducted. The discussions were transcribed and coded for the construction of a positional map on different masculinities and their relation to the level of acceptance of domestic violence. Results: Social and cultural changes have played a crucial role in transforming the relationship between men and women in Indonesian society. Three different positions of masculinity with certain beliefs on the gender order and acceptance of violence within marriage were identified: the traditionalist, the pragmatist, and the egalitarian. The traditionalist had the highest acceptance of violence as a tool to uphold the superior position of men within marriage, while the pragmatist viewed violence as undesirable but sometimes needed in order to correct the wife's behavior. The egalitarian did not see any reason for violence because they believed that men and women are equal and complementary to each other. Conclusions: Adaptation to social and cultural changes combined with lack of exposures to contextual and progressive religious teachings has led to the formation of three different positions of masculinity among the population in this study. Each position has certain beliefs regarding the gender order and the use of violence within marriage. Religion is an extremely important aspect that must be included in every type of intervention with this population.
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5.
  • Lagerlund, Magdalena, et al. (författare)
  • Psychosocial factors and attendance at a population-based mammography screening program in a cohort of Swedish women
  • 2014
  • Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 14
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: A better understanding of the factors that influence mammography screening attendance is needed to improve the effectiveness of these screening programs. The objective of the study was to examine whether psychosocial factors predicted attendance at a population-based invitational mammography screening program. Methods: Data on cohabitation, social network/support, sense of control, and stress were obtained from the Malmo Diet and Cancer Cohort Study and linked to the Malmo mammography register in Sweden. We analyzed 11,409 women (age 44 to 72) who were free of breast cancer at study entry (1992 to 1996). Mammography attendance was followed from cohort entry to December 31, 2009. Generalized Estimating Equations were used to account for repeated measures within subjects. Adjusted odds ratios (OR) and 95% confidence intervals (CI) are reported. Results: Among 69,746 screening opportunities there were 5,552 (8%) cases of non-attendance. Higher odds of non-attendance were found among women who lived alone (OR=1.47 (1.33-1.63)) or with children only (OR=1.52 (1.29-1.81)), had one childbirth (OR=1.12 (1.01-1.24)) or three or more childbirths (OR=1.34 (1.21-1.48)), had low social participation (OR=1.21 (1.10-1.31)), low sense of control (OR=1.12 (1.02-1.23)), and experienced greater stress (OR=1.24 (1.13-1.36)). Conclusions: Public health campaigns designed to optimize mammography screening attendance may benefit from giving more consideration of how to engage with women who are less socially involved.
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6.
  • Laisser, Rose M, 1956-, et al. (författare)
  • Community perceptions of intimate partner violence : a qualitative study from urban Tanzania
  • 2011
  • Ingår i: BMC Women's Health. - : BioMed Central. - 1472-6874. ; 11
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Intimate partner violence against women is a prevailing public health problem in Tanzania, where four of ten women have a lifetime exposure to physical or sexual violence by their male partners. To be able to suggest relevant and feasible community and health care based interventions, we explored community members' understanding and their responses to intimate partner violence.METHODS: A qualitative study using focus group discussions with 75 men and women was conducted in a community setting of urban Tanzania. We analysed data using a grounded theory approach and relate our findings to the ecological framework of intimate partner violence.RESULTS: The analysis resulted in one core category, "Moving from frustration to questioning traditional gender norms", that denoted a community in transition where the effects of intimate partner violence had started to fuel a wish for change. At the societal level, the category "Justified as part of male prestige" illustrates how masculinity prevails to justify violence. At the community level, the category "Viewed as discreditable and unfair" indicates community recognition of intimate partner violence as a human rights concern. At the relationship level, the category "Results in emotional entrapment" shows the shame and self-blame that is often the result of a violent relationship. At the individual level, the risk factors for intimate partner violence were primarily associated with male characteristics; the category "Fed up with passivity" emerged as an indication that community members also acknowledge their own responsibility for change in actions.CONCLUSIONS: Prevailing gender norms in Tanzania accept women's subordination and justify male violence towards women. At the individual level, an increasing openness makes it possible for women to report, ask for help, and become proactive in suggesting preventive measures. At the community level, there is an increased willingness to intervene but further consciousness-raising of the human rights perspective of violence, as well as actively engaging men. At the macro level, preventive efforts must be prioritized through re-enforcement of legal rights, and provision of adequate medical and social welfare services for both survivors and perpetrators.
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7.
  • Lenora, Janaka, et al. (författare)
  • Effects of multiparity and prolonged breast-feeding on maternal bone mineral density : a community-based cross-sectional study
  • 2009
  • Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 9, s. 1-6
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Studies conducted in Western countries have shown that bone loss associated with pregnancy and breast-feeding is recovered after weaning. However, it is not clear whether recovery takes place after repeated pregnancies followed by prolonged periods of breast-feeding; especially in developing countries where nutritional intake is comparatively low.This study was designed to examine the effects of multiparity and prolonged breast-feeding on maternal bone mineral density (BMD) in a community-based sample of 210 Sri Lankan women, aged between 46 and 98 years.Methods: BMD of the lumbar spine (L 2-L 4) and femoral neck were measured by dual-energy X-ray absorptiometry. Reproductive history was recorded by using a questionnaire. Women were, first, divided into groups according to parity (nulliparous, 1-2, 3-4, and 5 or more children), and BMDs in different groups were compared, initially unadjusted and then adjusted for age. Same subjects were subdivided, again, according to the total duration of breast-feeding (0, 1-48, 49-96, and 97 months or more) and similar analysis was carried out.Results: Women who had 5 or more children and women who had breast-fed for 97 months or more were older than the other women (p < 0.01) but no differences in height, weight or BMI were observed among the groups. Age adjusted BMD at lumbar spine and femoral neck BMDs of women grouped according to parity were not significantly different. Neither was there any difference between lumbar spine or femoral neck BMD in groups based on duration of breast-feeding.Conclusion: From this population-based study conducted in a developing country, we infer that history of multiparity or prolonged breast-feeding has no detrimental effects on maternal BMD in post-menopausal age.
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8.
  • Persson, Gerthi, et al. (författare)
  • Somali women's view of physical activity - a focus group study
  • 2014
  • Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 14
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Physical inactivity presents a major public health challenge and is estimated to cause six to ten percent of the major non-communicable diseases. Studies show that immigrants, especially women, have an increased risk of non-communicable diseases compared to ethnic Swedes. Somali immigrant women have increased rates of overweight and obesity, low fitness levels and low levels of cardiorespiratory fitness compared to non-immigrant women. These findings suggest that Somali women are at increased risk of developing lifestyle-related diseases. Few studies explore determinants of physical activity among Somali women. The aim of this study was to explore Somali women's views and experiences of physical activity after migration to Sweden. Methods: A qualitative focused ethnographic approach was used in this study. Four focus groups were conducted with twenty-six Somali women ranging from 17 to 67 years of age. Focus group discussions were recorded, transcribed verbatim and analysed using qualitative content analysis. Results: The analysis resulted in four main themes and ten categories: Life in Somalia and Life in Sweden, Understanding and enhancing health and Facilitators and barriers to physical activity. Great differences were seen between living in Somalia and in Sweden but also similarities such as finding time to manage housework, the family and the health of the woman. The extended family is non-existent in Sweden, making life more difficult. Health was considered a gift from God but living a healthy life was perceived as the responsibility of the individual. Misconceptions about enhancing health occurred depending on the woman's previous life experience and traditions. There was an awareness of the importance of physical activity among the participants but lack of knowledge of how to enhance activity on an individual basis. Enhancing factors to an active lifestyle were identified as being a safe and comfortable environment. Conclusions: Some barriers, such as climate, lack of motivation and time are universal barriers to an active lifestyle, but some factors, such as tradition and religion, are distinctive for Somali women. Since traditional Somali life never involves leisure-time physical activity, one cannot expect to compensate for the low daily activity level with leisure-time activity the Swedish way. Immigrant Somali women are a heterogeneous group with individual needs depending on age, education and background. Tailored interventions with respect to Somali traditions are necessary to achieve an actual increase in physical activity among migrant women of Somalian origin.
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9.
  • Roth, Bodil, et al. (författare)
  • Smoking- and alcohol habits in relation to the clinical picture of women with microscopic colitis compared to controls.
  • 2014
  • Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 14:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Microscopic colitis (MC) induces gastrointestinal symptoms, which are partly overlapping with irritable bowel syndrome (IBS), predominately in middle-aged and elderly women. The etiology is unknown, but association with smoking has been found. The aim of this study was to examine whether the increased risk for smokers to develop MC is a true association, or rather the result of confounding factors. Therefore, patients suffering from MC and population-based controls from the same geographic area were studied regarding smoking- and alcohol habits, and other simultaneous, lifestyle factors, concerning the clinical expression of the disease.
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10.
  • Shirazi, Leila, et al. (författare)
  • Determinants of serum levels of vitamin D: a study of life-style, menopausal status, dietary intake, serum calcium, and PTH
  • 2013
  • Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 13
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Low blood levels of vitamin D (25-hydroxy D3, 25OHD3) in women have been associated with an increased risk of several diseases. A large part of the population may have suboptimal 25OHD3 levels but high-risk groups are not well known. The aim of the present study was to identify determinants for serum levels of 25OHD3 in women, i.e. factors such as lifestyle, menopausal status, diet and selected biochemical variables. Methods: The study was based on women from the Malmo Diet and Cancer Study (MDCS), a prospective, population-based cohort study in Malmo, Sweden. In a previous case-control study on breast cancer, 25OHD3 concentrations had been measured in 727 women. In these, quartiles of serum 25OHD3 were compared with regard to age at baseline, BMI (Body Max Index), menopausal status, use of oral contraceptives or menopausal hormone therapy (MHT), life-style (e. g. smoking and alcohol consumption), socio-demographic factors, season, biochemical variables (i.e. calcium, PTH, albumin, creatinine, and phosphate), and dietary intake of vitamin D and calcium. In order to test differences in mean vitamin D concentrations between different categories of the studied factors, an ANOVA test was used followed by a t-test. The relation between different factors and 25OHD3 was further investigated using multiple linear regression analysis and a logistic regression analysis. Results: We found a positive association between serum levels of 25OHD3 and age, oral contraceptive use, moderate alcohol consumption, blood collection during summer/autumn, creatinine, phosphate, calcium, and a high intake of vitamin D. Low vitamin D levels were associated with obesity, being born outside Sweden and high PTH levels. Conclusions: The present population-based study found a positive association between serum levels of 25OHD3 and to several socio-demographic, life-style and biochemical factors. The study may have implications e. g. for dietary recommendations. However, the analysis is a cross-sectional and it is difficult to suggest Lifestyle changes as cause-effect relationships are difficult to assess.
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11.
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12.
  • Löf, Marie, et al. (författare)
  • Dietary fat intake and gestational weight gain in relation to estradiol and progesterone plasma levels during pregnancy : a longitudinal study in Swedish women.
  • 2009
  • Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 9:10
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Elevated pregnancy hormone levels, such as oestrogen and progesterone, may increase the risk of developing breast cancer both in mothers and offspring. However, the reasons for large inter-individual variations in estrogen and progesterone levels during pregnancy remain unknown. The objectives of this study were to investigate whether a) intakes of total dietary fat, types of fat (monounsaturated: MUFA, polyunsaturated: n-3 and n-6 PUFA, and saturated) and b) gestational weight gain are associated with estradiol and progesterone levels in plasma during pregnancy. METHODS: We measured body weight as well as estradiol and progesterone in plasma among 226 healthy pregnant Swedish women on gestation weeks 12, 25 and 33. At the same time points, dietary intake of total fat and types of fat (MUFA, PUFA, SFA, n-3 and n-6 PUFA) were estimated using 3-day food diaries. RESULTS: A large variation in estradiol and progesterone levels was evident.Nulliparous women had 37%, 12% and 30% higher mean estradiol levels on gestation weeks 12, 25 and 33 compared to parous women (P = 0.008). No associations were found between dietary intake of total fat or fat subtypes (including n-3 PUFA and n-6 PUFA) and plasma estradiol or progesterone levels. Gestational weight gain was associated with progesterone levels (P = 0.03) but the effect was very small (20% increase in progesterone levels between gestational weeks 12 and 33 per kg body weight/week). CONCLUSION: No associations among gestational weight gain, maternal dietary fat intake (total or subtypes including n-3 PUFA and n-6 PUFA) and plasma estradiol levels were found. However, pregnancy progesterone levels correlated with weight gain during pregnancy. Identification of other possible determinants of pregnancy estradiol and progesterone levels, important for the development of breast cancer in both mothers and offspring, are needed.
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13.
  • André, Malin, et al. (författare)
  • Personality in women and associations with mortality: a 40-year follow-up in the Population Study of Women in Gothenburg
  • 2014
  • Ingår i: BMC Women's Health. - : BioMed Central. - 1472-6874. ; 14:61
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The question of whether personality traits influence health has long been a focus for research and discussion. Therefore, this study was undertaken to examine possible associations between personality traits and mortality in women. Methods: A population-based sample of women aged 38, 46, 50 and 54 years at initial examination in 1968-69 was followed over the course of 40 years. At baseline, 589 women completed the Cesarec-Marke Personality Schedule (the Swedish version of the Edwards Personal Preference Schedule) and the Eysenck Personality Inventory. Associations between personality traits and mortality were tested using Cox proportional hazards models. Results: No linear associations between personality traits or factor indices and mortality were found. When comparing the lowest (Q1) and highest quartile (Q4) against the two middle quartiles (Q2 + Q3), the personality trait Succorance Q1 versus Q2 + Q3 showed hazard ratio (HR) = 1.37 (confidence interval (CI) = 1.08-1.74), and for the factor index Aggressive non-conformance, both the lowest and highest quartiles had a significantly higher risk of death compared to Q2 + Q3: for Q1 HR = 1.32 (CI = 1.03-1.68) and for Q4 HR = 1.36 (CI = 1.06-1.77). Neither Neuroticism nor Extraversion predicted total mortality. Conclusions: Personality traits did not influence long term mortality in this population sample of women followed for 40 years from mid- to late life. One explanation may be that personality in women becomes more circumscribed due to the social constraints generated by the role of women in society.
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17.
  • Hallberg, Pär, et al. (författare)
  • Acute pancreatitis following medical abortion : Case report
  • 2004
  • Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 4:1, s. 1-
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • BACKGROUND: Acute pancreatitis rarely complicates pregnancy. Although most pregnant women with acute pancreatitis have associated gallstones, less common causes such as drugs have been reported. CASE PRESENTATION: We report the case of a 34-year-old woman who underwent medical abortion with mifepristone and gemeprost and received codeine as pain-relief during the induction of abortion. She developed a severe acute necrotizing pancreatitis which required 14 days of intensive care. Other possible etiological factors, i.e. gallstone, alcohol intake and hyperlipidemia, were excluded. CONCLUSIONS: The reported case of acute pancreatitis was most likely drug-induced.
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18.
  • Hammarström, Anne, et al. (författare)
  • Experiences of barriers and facilitators to weight-loss in a diet intervention : a qualitative study of women in Northern Sweden
  • 2014
  • Ingår i: BMC Women's Health. - : BioMed Central. - 1472-6874. ; 14, s. 59-
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: There is a lack of research about the experiences of participating in weight-reducing interventions. The aim of this study was to explore barriers and facilitators to weight-loss experienced by participants in a diet intervention for middle-aged to older women in the general population in Northern Sweden.METHOD: In the intervention the women were randomised to eat either a Palaeolithic-type diet or a diet according to Nordic Nutrition recommendations for 24 months. A strategic selection was made of women from the two intervention groups as well as from the drop-outs in relation to social class, civil status and age. Thematic structured interviews were performed with twelve women and analysed with qualitative content analyses.RESULTS: The results showed that the women in the dietary intervention experienced two main barriers - struggling with self (related to difficulties in changing food habits, health problems, lack of self-control and insecurity) and struggling with implementing the diet (related to social relations and project-related difficulties) - and two main facilitators- striving for self-determination (related to having clear goals) and receiving support (from family/friends as well as from the project) - for weight-loss. There was a greater emphasis on barriers than on facilitators.CONCLUSION: It is important to also include drop-outs from diet interventions in order to fully understand barriers to weight-loss. A gender-relational approach can bring new insights into understanding experiences of barriers to weight-loss.
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19.
  • Harlid, Sophia, 1978-, et al. (författare)
  • Interactive effect of genetic susceptibility with height, body mass index, and hormone replacement therapy on the risk of breast cancer.
  • 2012
  • Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 12
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Breast cancer today has many established risk factors, both genetic and environmental, but these risk factors by themselves explain only part of the total cancer incidence. We have investigated potential interactions between certain known genetic and phenotypic risk factors, specifically nine single nucleotide polymorphisms (SNPs) and height, body mass index (BMI) and hormone replacement therapy (HRT).METHODS: We analyzed samples from three different study populations: two prospectively followed Swedish cohorts and one Icelandic case-control study. Totally 2884 invasive breast cancer cases and 4508 controls were analysed in the study. Genotypes were determined using Mass spectrometry-Maldi-TOF and phenotypic variables were derived from measurements and/or questionnaires. Odds Ratios and 95% confidence intervals were calculated using unconditional logistic regression with the inclusion of an interaction term in the logistic regression model.RESULTS: One SNP (rs851987 in ESR1) tended to interact with height, with an increasingly protective effect of the major allele in taller women (p = 0.007) and rs13281615 (on 8q24) tended to confer risk only in non users of HRT (p-for interaction = 0.03). There were no significant interactions after correction for multiple testing.CONCLUSIONS: We conclude that much larger sample sets would be necessary to demonstrate interactions between low-risk genetic polymorphisms and the phenotypic variables height, BMI and HRT on the risk for breast cancer. However the present hypothesis-generating study has identified tendencies that would be of interest to evaluate for gene-environment interactions in independent materials.
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20.
  • Hayati, Elli N, et al. (författare)
  • Behind the silence of harmony : risk factors for physical and sexual violence among women in rural Indonesia.
  • 2011
  • Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 11, s. 52-
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Indonesia has the fourth largest population in the world. Few studies have identified the risk factors of Indonesian women for domestic violence. Such research will be useful for the development of prevention programs aiming at reducing domestic violence. Our study examines associations between physical and sexual violence among rural Javanese Indonesian women and sociodemographic factors, husband's psychosocial and behavioral characteristics and attitudes toward violence and gender roles.METHODS: A cohort of pregnant women within the Demographic Surveillance Site (DSS) in Purworejo district, Central Java, Indonesia, was enrolled in a longitudinal study between 1996 and 1998. In the following year (1999), a cross-sectional domestic violence household survey was conducted with 765 consenting women from that cohort. Female field workers, trained using the WHO Multi-Country study instrument on domestic violence, conducted interviews. Crude and adjusted odds ratios at 95% CI were applied for analysis.RESULTS: Lifetime exposure to sexual and physical violence was 22% and 11%. Sexual violence was associated with husbands' demographic characteristics (less than 35 years and educated less than 9 years) and women's economic independence. Exposure to physical violence among a small group of women (2-6%) was strongly associated with husbands' personal characteristics; being unfaithful, using alcohol, fighting with other men and having witnessed domestic violence as a child. The attitudes and norms expressed by the women confirm that unequal gender relationships are more common among women living in the highlands and being married to poorly educated men. Slightly more than half of the women (59%) considered it justifiable to refuse coercive sex. This attitude was also more common among financially independent women (71%), who also had a higher risk of exposure to sexual violence.CONCLUSIONS: Women who did not support the right of women to refuse sex were more likely to experience physical violence, while those who justified hitting for some reasons were more likely to experience sexual violence. Our study suggests that Javanese women live in a high degree of gender-based subordination within marriage relationships, maintained and reinforced through physical and sexual violence. Our findings indicate that women's risk of physical and sexual violence is related to traditional gender norms.
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21.
  • Hayati, Elli Nur, et al. (författare)
  • We no longer live in the old days : a qualitative study on men's views on masculinity and violence within marriage in rural Java, Indonesia
  • 2014
  • Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 14:58
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Previous studies on domestic violence in Indonesia have focused primarily on women's experiences and little research has been undertaken to understand men's views on domestic violence or their involvement in the prevention of domestic violence. This study aimed to explore men's views on masculinity and the use of violence within marriage, in order to gain knowledge on how to involve men in prevention of domestic violence in rural Indonesia. Methods: Focus group discussions with six groups of local male community leaders in Purworejo were conducted. The discussions were transcribed and coded for the construction of a positional map on different masculinities and their relation to the level of acceptance of domestic violence. Results: Social and cultural changes have played a crucial role in transforming the relationship between men and women in Indonesian society. Three different positions of masculinity with certain beliefs on the gender order and acceptance of violence within marriage were identified: the traditionalist, the pragmatist, and the egalitarian. The traditionalist had the highest acceptance of violence as a tool to uphold the superior position of men within marriage, while the pragmatist viewed violence as undesirable but sometimes needed in order to correct the wife's behavior. The egalitarian did not see any reason for violence because they believed that men and women are equal and complementary to each other. Conclusions: Adaptation to social and cultural changes combined with lack of exposures to contextual and progressive religious teachings has led to the formation of three different positions of masculinity among the population in this study. Each position has certain beliefs regarding the gender order and the use of violence within marriage. Religion is an extremely important aspect that must be included in every type of intervention with this population.
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22.
  • Jordal, Malin, 1973-, et al. (författare)
  • Unmarried women's ways of facing single motherhood in Sri Lanka : a qualitative interview study
  • 2013
  • Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 13, s. 5-
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: In Sri Lanka, motherhood within marriage is highly valued. Sex out of wedlock is socially unacceptable and can create serious public health problems such as illegal abortions, suicide and infanticide, and single motherhood as a result of premarital sex is considered shameful. The way unmarried women facing single motherhood reflect on and make use of their agency in their social environments characterised by limited social and financial support has consequences for the health and well-being of both themselves and their children. The aim of this study was to explore and describe how unmarried women facing single motherhood in Sri Lanka handle their situation. Methods: This qualitative study comprised semi-structured interviews with 28 unmarried pregnant women or single mothers. The data were analysed by qualitative content analysis and the results related to the conceptual framework of social navigation. Results: The women facing single motherhood expressed awareness of having trespassed norms of sexuality through self-blame, victimhood and obedience, and by considering or attempting suicide. They demonstrated willingness to take responsibility for becoming pregnant before marriage by giving the child up for adoption, bringing up the child themselves, claiming a father for their child, refraining from marriage in the future, permanently leave their home environment, and taking up employment. Throughout the interviews, the women expressed fear of shame, and striving for familial and societal acceptance and financial survival. Conclusions: A social environment highly condemning of unmarried motherhood hindered these women from making strategic choices on how to handle their situation. However, to achieve acceptance and survival, the women tactically navigated norms of femininity, strong family dependence, a limited work market, and different sources of support. Limited access to resources restricted the women's sexual and reproductive health and rights, including their ability to make acceptable and healthy choices for themselves and their children.
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23.
  • Larsson, P-G, et al. (författare)
  • Predisposing factors for bacterial vaginosis, treatment efficacy and pregnancy outcome among term deliveries, results from a preterm delivery study
  • 2007
  • Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 7
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Bacterial vaginosis (BV) during pregnancy is associated with an increased risk of preterm delivery but little is known about factors that could predict BV. We have analyzed if it is possible to identify a category of pregnant women that should be screened for BV, and if BV would alter the pregnancy outcome at term, we have also studied the treatment efficacy of clindamycin. Methods: Prospective BV screening and treatment study of 9025 women in a geographically defined region in southeast Sweden. BV was defined as a modified Nugent score of 6 and above. Data was collected from the Swedish Medical Birth Register. Women allocated to treatment were supplied with vaginal clindamycin cream. The main outcome goals were to identify factors that could predict BV. Results: Vaginal smears were consistent with BV criteria in 9.3%. Logistic regression indicates a significant correlation between smoking and BV (p < 0.001) and a greater prevalence of BV in the lower age groups (p < 0.001). We found no correlation between BV and history of preterm deliveries, previous miscarriages, extra-uterine pregnancies, infertility problems or reported history of urinary tract infections-factors that earlier have been associated with BV. Treatment with clindamycin cream showed a cure rate of 77%. Less than 1% of women with a normal vaginal smear in early pregnancy will develop BV during the pregnancy. There was no association between BV and the obstetric outcome among women who delivered at term. Women with BV, both treated patients and nontreated, had the same obstetric outcome at term as women with normal vaginal flora. Conclusion: BV is more than twice as common among smokers, and there is a higher prevalence in the younger age group. However these two markers for BV do not suffice as a tool for screening, and considering the lack of other risk factors associated with BV, screening of all pregnant women might be a strategy to follow in a program intended to reduce the number of preterm births. © 2007 Larsson et al, licensee BioMed Central Ltd.
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24.
  • Mol, Femke, et al. (författare)
  • The ESEP study: salpingostomy versus salpingectomy for tubal ectopic pregnancy; the impact on future fertility: a randomised controlled trial.
  • 2008
  • Ingår i: BMC women's health. - London : Springer Science and Business Media LLC. - 1472-6874. ; 8
  • Tidskriftsartikel (refereegranskat)abstract
    • For most tubal ectopic pregnancies (EP) surgery is the treatment of first choice. Whether surgical treatment should be performed conservatively (salpingostomy) or radically (salpingectomy) in women wishing to preserve their reproductive capacity, is subject to debate. Salpingostomy preserves the tube, but bears the risks of both persistent trophoblast and repeat ipsilateral tubal EP. Salpingectomy, avoids these risks, but leaves only one tube for reproductive capacity. This study aims to reveal the trade-off between both surgical options: whether the potential advantage of salpingostomy, i.e. a better fertility prognosis as compared to salpingectomy, outweighs the potential disadvantages, i.e. persistent trophoblast and an increased risk for a repeat EP.
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25.
  • Morken, Nils-Halvdan, 1969, et al. (författare)
  • Reference population for international comparisons and time trend surveillance of preterm delivery proportions in three countries
  • 2008
  • Ingår i: BMC Womens Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 8
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: International comparison and time trend surveillance of preterm delivery rates is complex. New techniques that could facilitate interpretation of such rates are needed. METHODS: We studied all live births and stillbirths (>or= 28 weeks gestation) registered in the medical birth registers in Sweden, Denmark and Norway from 1995 through 2004. Gestational age was determined by best estimate. A reference population of pregnant women was designed using the following criteria: 1) maternal age 20-35, 2) primiparity, 3) spontaneously conceived pregnancy, 4) singleton pregnancy and 5) mother born in the respective country. National preterm delivery rate, preterm delivery rate in the reference population and rate of spontaneous preterm delivery in the reference population were calculated for each country. RESULTS: The total national preterm delivery rate (< 37 completed gestational weeks), increased in both Denmark (5.3% to 6.1%, p < 0.001) and Norway (6.0% to 6.4%, p = 0.006), but remained unchanged in Sweden, during 1995-2004. In Denmark, the preterm delivery rate in the reference population (5.3% to 6.3%, p < 0.001) and the spontaneous preterm delivery rate in the reference population (4.4% to 6.8%, p < 0.001) increased significantly. No similar increase was evident in Norway. In Sweden, rates in the reference population remained stable. CONCLUSION: Reference populations can facilitate overview and thereby explanations for changing preterm delivery rates. The model also permits comparisons over time. This model may in its simplicity prove to be a valuable supplement to assessments of national preterm delivery rates for public health surveillance.
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26.
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27.
  • Pakbaz, Mojgan, 1962-, et al. (författare)
  • 'A hidden disorder until the pieces fall into place' : a qualitative study of vaginal prolapse
  • 2010
  • Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 10:1, s. 18-
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Vaginal prolapse affects quality of life negatively and is associated with urinary, bowel, and sexual symptoms. Few qualitative studies have explored women's experiences of vaginal prolapse. The objective of the study was to elucidate the experiences of living with prolapse and its impact on daily life, prior to surgical intervention. METHODS: In-depth interviews were conducted with 14 women with vaginal prolapse, prior to surgical treatment. Recruitment of the informants was according to 'purposive sampling'. An interview guide was developed, including open-ended questions addressing different themes, which was processed and revised during the data collection and constituted part of a study-emergent design. Data were collected until 'saturation' was achieved, that is, when no significant new information was obtained by conducting further interviews. Interviews were audiotaped, transcribed verbatim, and analyzed according to manifest and latent content analysis. RESULTS: The theme defining the process of living with prolapse and women's experiences was labelled 'process of comprehension and action'. The findings constitute two categories: obstacles and facilitators to seeking health care. The category obstacles comprises six subcategories that define the factors restraining women from seeking health care: absence of information, blaming oneself, feeling ignored by the doctor, having a covert condition, adapting to successive impairment, and trivializing the symptoms and de-prioritizing own health. The category facilitators include five subcategories that define the factors promoting the seeking of health care: confirmation and support by others, difficulty in accepting an ageing body, feeling sexually unattractive, having an unnatural body, and reaching the point of action. CONCLUSION: The main theme identified was the 'process of comprehension and action'. This process consisted of factors functioning as either obstacles or facilitators to seeking health care. The main obstacles described by the participants were lack of information and confirmation. The main facilitators constituted feeling sexually unattractive and impaired physical ability due to prolapse. Information on prolapse should be easily accessible, to improve the possibility for women to gain knowledge about the condition and overcome obstacles to seeking health care. Health care professionals have a significant role in facilitating the process by confirming and informing women about available treatment.
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28.
  • Pakbaz, Mojgan, 1962-, et al. (författare)
  • Outcomes of vaginal hysterectomy for uterovaginal prolapse : a population-based, retrospective, cross-sectional study of patient perceptions of results including sexual activity, urinary symptoms, and provided care
  • 2009
  • Ingår i: BMC Women's Health. - London : BioMed Central Ltd. - 1472-6874. ; 9
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Vaginal hysterectomy is often used to correct uterovaginal prolapse, however, there is little information regarding outcomes after surgery in routine clinical practice. The objective of this study was to investigate complications, sexual activity, urinary symptoms, and satisfaction with health care after vaginal hysterectomy due to prolapse. Methods: We analyzed data from the Swedish National Register for Gynecological Surgery (SNRGS) from January 1997 to August 2005. Women participating in the SNRGS were asked to complete surveys at two and six months postoperatively. Of 941 women who underwent vaginal hysterectomy for uterovaginal prolapse, 791 responded to questionnaires at two months and 682 at six months. Complications during surgery and hospital stay were investigated. The two-month questionnaire investigated complications after discharge, and patients’ satisfaction with their health care. Sexual activity and urinary symptoms were reported and compared in preoperative and six-month postoperative questionnaires. Results: Almost 60 % of women reported normal activity of daily life (ADL) within one week of surgery, irrespective of their age. Severe complications occurred in 3 % and were mainly intra-abdominal bleeding and vaginal vault hematomas. Six months postoperative, sexual activity had increased for 20 % (p=0.006) of women and urinary urgency was reduced for 50 % (p=0.001); however, 14 % (n=76) of women developed urinary incontinence, 76% (n=58) of whom reported urinary stress incontinence. Patients were satisfied with the postoperative result in 93 % of cases and 94 % recommended the surgery. Conclusion: Vaginal hysterectomy is a patient-evaluated efficient treatment for uterovaginal prolapse with swift recovery and a low rate of complication. Sexual activity and symptoms of urinary urgency were improved. However, 14 % developed incontinence, mainly urinary stress incontinence (11 %). Therefore efforts to disclose latent stress incontinence should be undertaken preoperatively
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29.
  • Paul, Mandira, 1985-, et al. (författare)
  • Simplified follow-up after medical abortion using a low-sensitivity urinary pregnancy test and a pictorial instruction sheet in Rajasthan, India : study protocol and intervention adaptation of a randomised control trial
  • 2014
  • Ingår i: BMC Women's Health. - : BioMed Central. - 1472-6874. ; 14
  • Tidskriftsartikel (refereegranskat)abstract
    • The World Health Organisation suggests that simplification of the medical abortion regime will contribute to an increased acceptability of medical abortion, among women as well as providers. It is expected that a home-based follow-up after a medical abortion will increase the willingness to opt for medical abortion as well as decrease the workload and service costs in the clinic.Trial designThe study is a randomised, controlled, non-superiority trial .MethodsWomen screened to participate in the study are those with unwanted pregnancies and gestational ages equal to or less than nine weeks. Eligible women randomised to the home-based assessment group will use a low-sensitivity pregnancy test and a pictorial instruction sheet at home, while the women in the clinic follow-up group will return to the clinic for routine follow-up carried out by a doctor. The primary objective of the study is to evaluate the effectiveness of home-based assessment using a low-sensitivity pregnancy test and a pictorial instruction sheet 10-14 days after an early medical abortion. Providers or research assistants will not be blinded during outcome assessment. To ensure feasibility of the self-assessment intervention an adaption phase took place at the selected study sites before study initiation. This was to optimise and tailor-make the intervention and the study procedures and resulted in the development of the pictorial instruction sheet for how to use the low-sensitivity pregnancy test and the danger signs after a medical abortion. DiscussionIn this paper, we will describe the study protocol for a randomised control trial investigating the efficacy of simplified follow-up in terms of home-based assessment, 10-14 days after a medical abortion. Moreover, a description of the adaptation phase is included for a better understanding of the implementation of the intervention in a setting where literacy is low and the road-connections are poor. Trial registration: Clinicaltrials.gov NCT01827995. Registered 04 May 2013
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30.
  • Salazar, Mariano, et al. (författare)
  • Violence against women and unintended pregnancies in Nicaragua : a population-based multilevel study
  • 2014
  • Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 14, s. 26-
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Despite an increased use of contraceptive methods by women, unintended pregnancies represent one of the most evident violations of women's sexual and reproductive rights around the world. This study aims to measure the association between individual and community exposure to different forms of violence against women (physical/sexual violence by the partner, sexual abuse by any person, or controlling behavior by the partner) and unintended pregnancies.Methods: Data from the 2006/2007 Nicaraguan Demographic and Health Survey were used. For the current study, 5347 women who reported a live birth in the five years prior to the survey and who were married or cohabitating at the time of the data collection were selected. Women's exposure to controlling behaviors by their partners was measured using six questions from the WHO Multi-Country Study on Women's Health and Domestic Violence against Women. Area-level variables were constructed by aggregating the individual level exposures to violence into an exposure measurement of the municipality as a whole (n = 142); which is the basic political division in Nicaragua. Multilevel logistic regression was used to analyze the data.Results: In total, 37.1% of the pregnancies were reported as unintended. After adjusting for all variables included in the model, individual exposure to controlling behavior by a partner (AOR = 1.28, 95% CrI = 1.13-1.44), ever exposure to sexual abuse (AOR = 1.31, 95% CrI = 1.03-1.62), and ever exposure to physical/sexual intimate partner violence (AOR = 1.44, 95% CrI = 1.24-1.66) were significantly associated with unintended pregnancies. Women who lived in municipalities in the highest tertile of controlling behavior by a partner had 1.25 times higher odds of reporting an unintended pregnancy than women living in municipalities in the lowest tertile (AOR = 1.25, 95% CrI = 1.03-1.48).Conclusions: Nicaraguan women often experience unintended pregnancies, and the occurrence of unintended pregnancies is significantly associated with exposure to different forms of violence against women at both the individual and the municipality level. National policies aiming to facilitate women's ability to exercise their reproductive rights must include actions aimed at reducing women's exposures to violence against women.
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31.
  • Shrestha, Binjwala, et al. (författare)
  • Women's experiences and health care-seeking practices in relation to uterine prolapse in a hill district of Nepal
  • 2014
  • Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 14:20
  • Tidskriftsartikel (refereegranskat)abstract
    • Abstract Background Although uterine prolapse (UP) occurs commonly in Nepal, little is known about the physical health and care-seeking practices of women with UP. This study aimed to explore women’s experiences of UP and its effect on daily life, its perceived causes, and health care-seeking practices. Methods Using a convenience sampling method, we conducted 115 semi-structured and 16 in-depth interviews with UP-affected women during September–December 2012. All interviews occurred in outreach clinics in villages of the Dhading district. Results Study participants were 23–82 years of age. Twenty-four percent were literate, 47.2% had experienced a teenage pregnancy, and 29% had autonomy to make healthcare decisions. Most participants (>85%) described the major physical discomforts of UP as difficulty with walking, standing, working, sitting, and lifting. They also reported urinary incontinence (68%) bowel symptoms (42%), and difficulty with sexual activity (73.9%). Due to inability to perform household chores or fulfill their husband’s sexual desires, participants endured humiliation, harassment, and torture by their husbands and other family members, causing severe emotional stress. Following disclosure of UP, 24% of spouses remarried and 6% separated from the marital relationship. Women perceived the causes of UP as unsafe childbirth, heavy work during the postpartum period, and gender discrimination. Prior to visiting these camps some women (42%) hid UP for more than 10 years. Almost half (48%) of participants sought no health care; 42% ingested a herb and ate nutritious food. Perceived barriers to accessing health care included shame (48%) and feeling that care was unnecessary (12.5%). Multiple responses (29%) included shame, inability to share, male service provider, fear of stigma and discrimination, and perceiving UP as normal for childbearing women. Conclusions UP adversely affects women’s daily life and negatively influences their physical, mental, and social well-being. The results of our study are useful to generate information on UP symptoms and female health care seeking practices. Our findings can be helpful for effective development of UP awareness programs to increase service utilization at early stages of UP and thereby might contribute to both primary and secondary prevention of UP.
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32.
  • Sparud Lundin, Carina, 1964, et al. (författare)
  • Extraordinary exposed in early motherhood - a qualitative study exploring experiences of mothers with type 1 diabetes.
  • 2011
  • Ingår i: BMC women's health. - : Springer Science and Business Media LLC. - 1472-6874. ; 11:1
  • Tidskriftsartikel (refereegranskat)abstract
    • ABSTRACT: Background Women with type 1 diabetes face several challenges during pregnancy, childbirth and in relation to breastfeeding. It is therefore of utmost importance to consider their need for specific support, early postpartum as well as in daily life after discharge from maternity care. Few studies have investigated these aspects of healthcare. The aim of this study was to explore experiences after childbirth regarding breastfeeding, glycemic control, support and well-being in women with type 1 diabetes. Methods A hermeneutic reflective life world research approach was used in this qualitative study. Data was gathered through audio-recorded focus group discussions and individual interviews with 23 women with type 1 diabetes, 6-24 months after childbirth. After verbatim transcription, the text was analyzed in order to identify themes of meaning and a conclusive interpretation of the explored phenomenon. Results Experiences of extraordinary exposure challenged the women with type 1 diabetes in their transition to early motherhood. The exposure included a struggle with breastfeeding, although with a driving force to succeed. Everyday life was filled with uncertainty and unpredictability related to one's own unstable glycemic control and the women down-prioritized their own needs in favor of the child. A feeling of being disconnected from professional care further contributed to the experiences of extraordinary exposure. Conclusion In early motherhood women with type 1 diabetes have a great need for support in managing daily life postpartum, which requires contemporary approaches to overlap insufficient linkage between health care professionals in maternity and child health care, and diabetes care.
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33.
  • Taha, Hana, et al. (författare)
  • "Voices of Fear and Safety" Women's ambivalence towards breast cancer and breast health : a qualitative study from Jordan
  • 2012
  • Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 12, s. 21-
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Breast cancer is the leading cause of cancer mortality among Jordanian women. Breast malignancies are detected at late stages as a result of deferred breast health-seeking behaviour. The aim of this study was to explore Jordanian women's views and perceptions about breast cancer and breast health. Methods: We performed an explorative qualitative study with purposive sampling. Ten focus groups were conducted consisting of 64 women (aged 20 to 65 years) with no previous history and no symptoms of breast cancer from four governorates in Jordan. The transcribed data was analysed using latent content analysis. Results: Three themes were constructed from the group discussions: a) Ambivalence in prioritizing own health; b) Feeling fear of breast cancer; and c) Feeling safe from breast cancer. The first theme was seen in women's prioritizing children and family needs and in their experiencing family and social support towards seeking breast health care. The second theme was building on women's perception of breast cancer as an incurable disease associated with suffering and death, their fear of the risk of diminished femininity, husband's rejection and social stigmatization, adding to their apprehensions about breast health examinations. The third theme emerged from the women's perceiving themselves as not being in the risk zone for breast cancer and in their accepting breast cancer as a test from God. In contrast, women also experienced comfort in acquiring breast health knowledge that soothed their fears and motivated them to seek early detection examinations. Conclusions: Women's ambivalence in prioritizing their own health and feelings of fear and safety could be better addressed by designing breast health interventions that emphasize the good prognosis for breast cancer when detected early, involve breast cancer survivors in breast health awareness campaigns and catalyse family support to encourage women to seek breast health care.
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34.
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35.
  • Umubyeyi, Aline, et al. (författare)
  • Women are considerably more exposed to intimate partner violence than men in Rwanda: results from a population-based, cross-sectional study
  • 2014
  • Ingår i: Bmc Womens Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 14
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Intimate partner violence (IPV) against women is an important, yet often neglected public health issue. The existence of gender norms imbalance expressed by men's and women's attitudes in relation to power and decision-making in intimate relationships may influence the magnitude of IPV. The aim of this study was to investigate the prevalence and potential risk factors of physical, sexual and psychological IPV in young men and women in Rwanda. Methods: This population-based, cross-sectional study included a representative sample of men and women from the Southern Province of Rwanda. Face-to-face interviews were performed using the World Health Organization (WHO) questionnaire for violence exposure to estimate past year and earlier in life IPV occurrence. Risk factor patterns were analyzed by use of bi- and multivariate logistic regression. Results: Women were, to a considerably higher extent, exposed to physical, sexual and psychological IPV than men. Of the women, 18.8% (n = 78) reported physical abuse in the past year, compared to 4.3% (n = 18) of men. The corresponding figures for women and men for sexual abuse were 17.4% (n = 71) and 1.5% (n = 6), respectively, and for psychological abuse, the corresponding figures were 21.4% (n = 92) and 7.3% (n = 32). Findings illustrate that violence against women was recurrent, as the highest frequency (> 3 times) dominated in women for the various acts of all forms of violence. Identified risk factors for women's exposure to physical violence were being low educated, having poor social support, being poor and having many children. For men exposed to physical violence, no statistically significant risk factor was identified. Conclusions: In this setting, IPV exposure was more common in women than men in the Southern Province of Rwanda. Promotion of gender equality at the individual level is needed to make a positive difference in a relatively short term perspective. Men's lower reporting of IPV confirms women's subordinate position, but men's denial of incidents could also explain the gender role pattern.
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36.
  • Wallin Lundell, Inger, et al. (författare)
  • Posttraumatic stress among women after induced abortion : a Swedish multi-centre cohort study
  • 2013
  • Ingår i: BMC Women's Health. - : BioMed Central. - 1472-6874. ; 13, s. Article Number: 52-
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Induced abortion is a common medical intervention. Whether psychological sequelae might follow induced abortion has long been a subject of concern among researchers and little is known about the relationship between posttraumatic stress disorder (PTSD) and induced abortion. Thus, the aim of the study was to assess the prevalence of PTSD and posttraumatic stress symptoms (PTSS) before and at three and six months after induced abortion, and to describe the characteristics of the women who developed PTSD or PTSS after the abortion. Methods: This multi-centre cohort study included six departments of Obstetrics and Gynaecology in Sweden. The study included 1457 women who requested an induced abortion, among whom 742 women responded at the three-month follow-up and 641 women at the six-month follow-up. The Screen Questionnaire-Posttraumatic Stress Disorder (SQ-PTSD) was used for research diagnoses of PTSD and PTSS, and anxiety and depressive symptoms were evaluated by the Hospital Anxiety and Depression Scale (HADS). Measurements were made at the first visit and at three and six months after the abortion. The 95% confidence intervals for the prevalence of lifetime or ongoing PTSD and PTSS were calculated using the normal approximation. The chi-square test and the Student's t-test were used to compare data between groups. Results: The prevalence of ongoing PTSD and PTSS before the abortion was 4.3% and 23.5%, respectively, concomitant with high levels of anxiety and depression. At three months the corresponding rates were 2.0% and 4.6%, at six months 1.9% and 6.1%, respectively. Dropouts had higher rates of PTSD and PTSS. Fifty-one women developed PTSD or PTSS during the observation period. They were young, less well educated, needed counselling, and had high levels of anxiety and depressive symptoms. During the observation period 57 women had trauma experiences, among whom 11 developed PTSD or PTSS and reported a traumatic experience in relation to the abortion. Conclusion: Few women developed PTSD or PTSS after the abortion. The majority did so because of trauma experiences unrelated to the induced abortion. Concomitant symptoms of depression and anxiety call for clinical alertness and support.
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37.
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38.
  • Agosti, Madelaine Törnquist, et al. (författare)
  • "the importance of awareness, support and inner strength to balance everyday life" - A qualitative study about women's experiences of a workplace health promotion program in human service organizations in Sweden
  • 2019
  • Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 19:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: In many European countries, women have a higher sickness absence rate than men. Women also report higher levels of work-life conflict, which has a negative impact on women's self-perceived health. Interventions studies on work-life balance literature are scarce. This research adds knowledge about work-life balance by examining female employees' experiences of a newly developed intervention program, the BELE program (Balance in Everyday Life Empowerment program), aiming to enhance the work-life balance and wellbeing of female employees. Methods: All participants in the BELE program were included in the sample (n = 55) of the study. The methods used for gathering data were focus group interviews (n = 8) and semi-structured individual interviews (n = 8). A qualitative content analysis was used for the analyses. Results: The results showed that a majority of the participants experienced a process of change for enhancement of wellbeing and balance in their everyday life when taking part in the BELE program. In the analyses, three main themes emerged. Reflecting and strengthening inner resource, Trying to change everyday patterns and habits and Experiencing more balance and well-being. Conclusions: The results point out the importance of awareness and reflection on everyday life to promote work-life balance and wellbeing. The BELE program was described as a wakeup call to one's own life and as an enhancer of empowerment processes and equality in the homes. Moreover, the results showed the need for health education in the workplace focusing on both work and private life to enhance balance and wellbeing among female employees'. The findings indicate that it is important to work at individual and group levels in work-life balance interventions and not merely at the organizational level or in the workplace setting.
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39.
  • Amin, M. A., et al. (författare)
  • Status of female sexual dysfunction among postmenopausal women in Bangladesh
  • 2022
  • Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 22:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Women's sexual health and physical desire for sex are most important for their emotional and physical well-being. This study aimed to examine the status of sexual dysfunction among postmenopausal women in Bangladesh and assess the significant risk factors behind this. Methods: A cross-sectional study was conducted among 45–55 years in four public and private hospitals in Bangladesh from April 2021 to June 2021 using a multi-stage sampling technique to enroll the study participants. The female sexual function index (FSFI) scale measured the prevalence of FSD, and the relationship of independent risk factors were assessed using a multivariate logistic regression model. Results: The total score of FSFI among postmenopausal Bangladeshi women was 18.07 ± 8.51. Among 260 participants, the prevalence of FSD was 56.9%. Out of all the significant risk factors, increasing age, urban population group, multiparous, homemakers, duration of menopause, and postmenopausal women with no hormone therapy were significantly associated with FSD. In contrast, those with regular physical activity were protective of FSD. Conclusion: In conclusion, a significant proportion of postmenopausal Bangladeshi women are enduring sexual dysfunction. Proper hormonal therapy and non-hormonal therapies such as physical activity and pelvic floor muscle (Kegel) exercise with adequate counseling are helpful to cope in this distressing situation. 
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40.
  • Andersson, Mikaela, et al. (författare)
  • Healthcare providers’ experience of identifying and caring for women subjected to sex trafficking : a qualitative study
  • 2024
  • Ingår i: BMC Women's Health. - : BioMed Central (BMC). - 1472-6874. ; 24:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Men’s violence against women, including human trafficking for sexual exploitation, is a severe threat to global health. Healthcare providers are uniquely positioned to identify and care for women subjected to human trafficking for sexual exploitation. They are among the few professionals the women interact with while being exposed to human trafficking for sexual exploitation. This study aims to describe healthcare workers’ experience of identifying and caring for women subjected to human trafficking for sexual exploitation seeking women’s healthcare. Method: A qualitative design was chosen and nine qualitative interviews with healthcare providers were conducted and analyzed using the content analysis method. Results: Three main categories were revealed: (1) the importance of being attentive, (2) the importance of providing safety, and (3) the importance of collaborating, followed by a number of subcategories: behavioral and physical signs, limited time to interact, security measures, value of confidence building, organizational collaboration, essential external network, and information transmission. Conclusions: As the women subjected to sex trafficking have limited time in healthcare, it is important for healthcare providers to be attentive and act immediately if suspecting human trafficking for sexual exploitation. It may be the only possibility for the healthcare providers to care for these women and reach them. They must endeavor to provide the women with safety due to their vulnerable position at the hospital. However, these women may leave the healthcare setting unidentified and unaided, which highlights the importance of collaboration on multiple levels. © The Author(s) 2024.
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41.
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42.
  • Anyango, Cartrine, et al. (författare)
  • Women with disabilities’ experiences of intimate partner violence : a qualitative study from Sweden
  • 2023
  • Ingår i: BMC Women's Health. - : BioMed Central (BMC). - 1472-6874. ; 23:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Intimate Partner Violence (IPV) is a prevalent form of gender-based violence affecting one in three women globally. It is also a preventable cause of ill-health, disability, and death. Current research suggests that women with disabilities are at a significantly higher risk of experiencing violence throughout their lifetime. They are almost twice as likely to experience violence compared to men with disabilities or men and women without disabilities. Additionally, they experience higher rates of all types of violence. This increased vulnerability may be due to factors related to disability such as dependence on others for support, mistrust, and social and physical isolation. Although there is existing research on IPV against women in general, there is limited knowledge on IPV against women with disabilities. To address this gap in knowledge, this study aimed to explore women with disabilities’ perceptions and experiences of being victims/survivors of IPV in Sweden.Methods: This was a qualitative study conducted through in-depth interviews with eleven women with disabilities. The participants were aged eighteen years upwards. The collected data was analyzed using reflexive thematic analysis with a constructivist epistemological standpoint.Results: We developed four themes. Theme one: “multiple abuse by multiple abusers, over time,” describes the participants’ experiences of various types of violence from different perpetrators for prolonged periods. Theme two: “psychological abuse—harmful, but neglected and difficult to prove,” explains how women with disabilities’ perceive psychological abuse as harmful, but not given the same level of seriousness as physical violence. It also expresses the difficulties they encountered in providing tangible evidence to prove instances of psychological abuse. Theme three: “abuse does not end with separation,” highlights how abuse can continue beyond separation/divorce. Theme four: “surviving abusive relationships” describes the different and evolving ways the participants used to navigate their abusive relationships.Conclusions: Women with disabilities face all forms of abuse. They find it challenging to prove psychological abuse, and the system is inadequate in addressing its harm. The abuse also continues after separation or divorce. The support system should consider the needs of women with disabilities who experience violence, both during and after the abusive relationship. Service providers should be better equipped to detect and handle all types of IPV, especially psychological abuse.
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43.
  • Arias Fuentes, Fara Faith, et al. (författare)
  • Social inequalities in women exposed to obstetric and gyneco-obstetric violence in Ecuador : a cross-sectional study
  • 2022
  • Ingår i: BMC Women's Health. - : BioMed Central (BMC). - 1472-6874. ; 22:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Obstetric and gyneco-obstetric violence (OV, GOV) is a concerning public health problem, particularly in Latin America. This study aimed to determine the prevalence of OV and GOV and to assess its socio-geographical distribution in Ecuador.Methods: This cross-sectional study used data from a national survey conducted in 2019 (n = 17,211) among women aged 15 years and over. Independent variables included age, marital status, education, ethnicity, place of residence and region. The chosen outcomes were lifetime experience of OV and GOV. Frequency tables were calculated and crude and adjusted regression models estimating prevalence ratios and their 95% confidence intervals were computed.Results: Nearly one-third (32.8%) of the participants had experienced OV and two-fifths (41.86%) GOV at least once in their lifetime. Prevalence of OV were particularly common in women 26–35 and 46–55 years old, with primary or middle education and in urban regions. In comparison, GOV had a higher prevalence in women aged > 65 years and with no formal education. Both subtypes of violence were more common among women with current or earlier partners compared with the single ones. Also the two outcomes were more prevalent in the non-white population, OV among the populations of colour (POC), while GOV both, in the POC and Indigenous group. Additionally, women from the Highlands and Amazon reported higher OV and GOV than the Coastal group.Conclusion: Our study showed that OV and GOV are common in Ecuador and identified an unequal distribution of their prevalence across different socio-geographical groups. Further studies including more social factors and a continuous monitoring of OV and GOV are recommended. Current policies, laws to protect women and guidelines regarding the treatment of women, particularly in health care settings, need to be constantly advocated for and effectively implemented in the country.
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44.
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45.
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46.
  • Benebo, Faith Owunari, et al. (författare)
  • Intimate partner violence against women in Nigeria : a multilevel study investigating the effect of women's status and community norms
  • 2018
  • Ingår i: BMC Women's Health. - : BioMed Central. - 1472-6874. ; 18
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Intimate partner violence (IPV) against women has been recognised as a public health problem with far-reaching consequences for the physical, reproductive, and mental health of women. The ecological framework portrays intimate partner violence as a multifaceted phenomenon, demonstrating the interplay of factors at different levels: individual, community, and the larger society. The present study examined the effect of individual- and community-level factors on IPV in Nigeria, with a focus on women's status and community-level norms among men.METHODS: A cross-sectional study based on the latest Nigerian Demographic Health Survey (2013) was conducted involving 20,802 ever-partnered women aged 15-49 years. Several multilevel logistic regression models were calibrated to assess the association of individual- and community-level factors with IPV. Both measures of association (fixed effect) and measures of variations (random effect) were reported.RESULTS: Almost one in four women in Nigeria reported having ever experienced intimate partner violence. Having adjusted for other relevant covariates, higher women's status reduced the odds of IPV (OR = 0.47; 95% CI = 0.32-0.71). However, community norms among men that justified IPV against women modified the observed protective effect of higher women's status against IPV and reversed the odds (OR = 1.89; 95% CI = 1.26-2.83).CONCLUSIONS: Besides women's status, community norms towards IPV are an important factor for the occurrence of IPV. Thus, addressing intimate partner violence against women calls for community-wide approaches aimed at changing norms among men alongside improving women's status.
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47.
  • Berin, Emilia, et al. (författare)
  • Postmenopausal womens experiences of a resistance training intervention against vasomotor symptoms : a qualitative study
  • 2022
  • Ingår i: BMC Women's Health. - : BMC. - 1472-6874. ; 22:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Resistance training may be an effective intervention to improve menopausal symptoms and increase womens quality of life. However, most postmenopausal women do not perform regular resistance training. The purpose of this study was to explore postmenopausal womens experiences of participation in a resistance-training intervention to find barriers and motivators for the training. Methods: Fifteen postmenopausal women with low physical activity, who participated in a randomized controlled trial evaluating the effect of a resistance-training program on vasomotor symptoms and health-related outcomes, were consecutively recruited to this qualitative study. After completion of the 15-week resistance-training program, they took part in individual semi-structured interviews, followed by a telephone interview 1 year later. All interviews were transcribed verbatim and thematic analysis was used to analyse the data. Results: The analysis generated three themes that were involved at different time points. These were: "Trigger-Hopes of symptom relief", "An evolving motivation as a driving force for change" and "Finding new triggers". Accountability, and continuous professional and emotional support, were factors that fueled the womens motivation to perform regular resistance training during the study. Resistance training improved general well-being and most women experienced improvement in vasomotor symptoms. The womens motivation changed from being driven by a wish to improve bothersome symptoms, into a wish to achieve feelings of well-being and enjoyment. The change was seen regardless of effects of the intervention on vasomotor symptoms. Conclusion: This first qualitative evaluation of physical exercise as an intervention to treat vasomotor symptoms in postmenopausal women, found that the symptoms acted as a motivational trigger to initiate resistance training in low-active women. The motivation to exercise changed during the intervention from a wish to ameliorate symptoms into something the women did for enjoyment and well-being in general. This change in motivating factors may have contributed to a behavior change since all participants had increased their physical activity after 1 year regardless of effects on VMS.
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48.
  • Bladh, Marie, 1972-, et al. (författare)
  • Sense of coherence and health in women : a 25-year follow-up study
  • 2023
  • Ingår i: BMC Women's Health. - : BioMed Central (BMC). - 1472-6874. ; 23:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundHealth and Sense of Coherence (SOC) has been shown to be intertwined and argued to have a reciprocal relationship. The theory of SOC implies relatively stable scores during adulthood, however there are few longitudinal studies on the association between SOC and mental and somatic health. The main aim of the present study was to examine how SOC and self-rated health (SRH) are related during 25 years of follow-up.MethodsUsing paper questionnaires distributed by postal services, 415 mothers were followed from childbirth and 25 years prospectively. SOC was measured at three, 12 and 25 years after inclusion. Self-reports on health status were obtained at the 25-year follow-up. The association between SOC and self-reported health as well as the effect of sociodemographic factors and experience of stressful life events was assessed through regression models.ResultsSOC scores increased between three and 12 years after inclusion, and slightly decreased at the 25-year follow-up. Women of good health had a higher SOC-score at all three measurements compared to women of poor health. Multiple logistic regression showed that the likelihood of reporting good health increased with the number of times the women had reported SOC-scores above the 75th percentile. Moreover, women who had not been through a divorce were close to 60% more likely to report good health compared to women who had been through a divorce, whereas women not reporting stressful life events during the past two years were more than twice as likely to report good health. Symptoms below cut-off for postpartum depression and not having been through a divorce were associated with SOC scores above the 75th percentile.ConclusionThis 25-year follow-up study of a cohort of women reports good stability of SOC assessments in the vast majority of women. There was a stronger and more stable SOC in women with better health. The findings are in line with other studies on the predictive value of SOC and self-perceived health.
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49.
  • Boldis, Beata Vivien, 1993-, et al. (författare)
  • Comorbidities in women with polycystic ovary syndrome : a sibling study
  • 2024
  • Ingår i: BMC Women's Health. - 1472-6874. ; 24:1, s. 221-221
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Polycystic ovary syndrome (PCOS) has previously been associated with several comorbidities that may have shared genetic, epigenetic, developmental or environmental origins. PCOS may be influenced by prenatal androgen excess, poor intrauterine or childhood environmental factors, childhood obesity and learned health risk behaviors. We analyzed the association between PCOS and several relevant comorbidities while adjusting for early-life biological and socioeconomic conditions, also investigating the extent to which the association is affected by familial risk factors. METHODS: This total-population register-based cohort study included 333,999 full sisters, born between 1962 and 1980. PCOS and comorbidity diagnoses were measured at age 17-45 years through national hospital register data from 1997 to 2011, and complemented with information on the study subjects´ early-life and social characteristics. In the main analysis, sister fixed effects (FE) models were used to control for all time-invariant factors that are shared among sisters, thereby testing whether the association between PCOS and examined comorbidities is influenced by unobserved familial environmental, social or genetic factors. RESULTS: Three thousand five hundred seventy women in the Sister sample were diagnosed with PCOS, of whom 14% had obesity, 8% had depression, 7% had anxiety and 4% experienced sleeping, sexual and eating disorders (SSE). Having PCOS increased the odds of obesity nearly 6-fold (adjusted OR (aOR): 5.9 [95% CI:5.4-6.5]). This association was attenuated in models accounting for unobserved characteristics shared between full sisters, but remained considerable in size (Sister FE: aOR: 4.5 [95% CI: 3.6-5.6]). For depression (Sister FE: aOR: 1.4 [95% CI: 1.2-1.8]) and anxiety (Sister FE: aOR: 1.5 [95% CI: 1.2-1.8), there was a small decrease in the aORs when controlling for factors shared between sisters. Being diagnosed with SSE disorders yielded a 2.4 aOR (95% CI:2.0-2.6) when controlling for a comprehensive set of individual-level confounders, which only decreased slightly when controlling for factors at the family level such as shared genes or parenting style. Accounting for differences between sisters in observed early-life circumstances influenced the estimated associations marginally. CONCLUSION: Having been diagnosed with PCOS is associated with a markedly increased risk of obesity and sleeping, sexual and eating disorders, also after accounting for factors shared between sisters and early-life conditions.
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50.
  • Borneskog, Catrin, 1963-, et al. (författare)
  • Relationship satisfaction in lesbian and heterosexual couples before and after assisted reproduction : a longitudinal follow-up study
  • 2014
  • Ingår i: BMC Women's Health. - London, United Kingdom : Springer Science and Business Media LLC. - 1472-6874. ; 14
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: More and more lesbian couples are planning parenthood through donor insemination and IVF and the number of planned lesbian families is growing in Sweden and other western countries. Research has shown that lesbian couples report as much overall satisfaction in their relationships as do heterosexual couples. However, although parenthood is highly desired, many parents are unaware of the demands of parenthood and the strain on their relationship that the arrival of the baby might bring. The aim of this study was to compare lesbian and heterosexual couples? perceptions of relationship satisfaction at a three-year follow up after assisted reproduction. Methods: The present study is a part of the Swedish study on gamete donation, a prospective longitudinal cohort study. The present study constitutes a three-year follow up assessment of lesbian and heterosexual couples after assisted reproduction. Participants requesting assisted reproduction at all fertility clinics performing gamete donation in Sweden, were recruited consecutively during 2005? 2008. A total of 114 lesbian women (57 treated women and 57 partners) and 126 heterosexual women and men (63 women and 63 men) participated. Participants responded to the ENRICH inventory at two time points during 2005? 2011; at the commencement of treatment (time point 1) and about three years after treatment termination (time point 3). To evaluate the bivariate relationships between the groups (heterosexual and lesbian) and socio-demographic factors Pearsons Chi- square test was used. Kolmogorov-Smirnov test was used for testing of normality, Mann? Whitney U-test to examine differences in ENRICH between the groups and paired samples t-test to examine scores over time. Results: Lesbian couples reported higher relationship satisfaction than heterosexual couples, however the heterosexual couples satisfaction with relationship quality was not low. Both lesbian and heterosexual couples would be classified accordingly to ENRICH-typology as vitalized or harmonious couples. Conclusions: At a follow-up after assisted reproduction with donated sperm, lesbian couples reported stable relationships and a high satisfaction with their relationships, even when treatment was unsuccessful.
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