Influencia de la edad, la maternidad y el empleo en las barreras para la práctica de actividad física y deporte de las mujeres adultas en España (Influence of age, maternity and employment in barriers to practicing physical activity and sport for Spanish

Los objetivos del presente estudio fueron analizar la influencia de la edad y tipo de ocupación relacionada con el empleo y la crianza, en las barreras para la práctica de las mujeres adultas en España. La metodología de carácter cuantitativa, se ha apoyado en el uso de la encuesta mediante el empleo de un cuestionario basado en la teoría bio-ecológica de Bronfenbrenner, con ítems individuales, ocupación crianza-hogar, ocupación empleo-tiempo y oferta de actividad física y deporte, a una muestra representativa de 1.731 mujeres adultas españolas (entre 30 y 64 años). Los resultados evidenciaron efecto multivariado de la ocupación en las barreras ocupación-empleo y tiempo (“No soy capaz de generar tiempo para mí”, “empleo” y “horarios incompatibles”). Las mujeres adultas que concilian maternidad y empleo perciben en mayor grado estas tres barreras mencionadas. Además, se evidenció efecto multivariado de la edad y la ocupación, y de la interacción, en las barreras ocupación maternidad-hogar (“Tengo que cuidar de mi/s hijo/as” y “Tengo que ocuparme de las tareas del hogar”). Las madres adultas, empleadas o no, percibieron la maternidad en mayor grado como barrera. En las empleadas que no son madres, las tareas del hogar como barrera tuvieron mayor prevalencia en las mayores de cincuenta años. Estas evidencias deberían considerarse para diseñar innovaciones y adaptar intervenciones, en el ámbito de la actividad física y el deporte, para estos grupos específicos, de mujeres adultas. Abstract. The objectives of the present paper were to analyze the age and occupation type related to employment and maternity influencing Spanish adult women’s barriers to practice. A quantitative methodology based on the use of the survey was applied to a representative sample of 1,731 Spanish adult women (between 30 and 64 years old) who filled out a questionnaire based on the Bronfenbrenner´s bioecological theory with individual items, occupation maternity-household, occupation employment-time and physical activity and sport provision through a personal interview. The results showed a multivariate effect of the occupation on the occupation-employment and time barriers (“I can´t generate time for myself”, “employment” and “incompatible timetables”). The adult women who combine maternity and employment perceived the three barriers mentioned to a greater extent. Also, there was found a multivariate effect of age and occupation, and of the interaction, on the occupation maternity-household barriers (“I have to take care of my children” and “I have to do the housework”). The adult mothers, employed or unemployed, perceived maternity as a barrier to a greater degree. In employed women who are not mothers, household chores as a barrier showed a higher prevalence in those over fifty years old. These findings should be considered for designing innovations and tailoring interventions in the field of physical activity and sport to fit these targeted groups of adult women.

The Clinical Features and Predictive Factors of Nocturnal Enuresis in Adult Women

ObjectiveOur current knowledge on nocturnal enuresis (NE) in adults is scarce due to its uncommon nature. The present study was designed to investigate symptom characteristics and risk factors of NE in adult women to improve the current clinical understanding and management of this rare disease.MethodsOver a 3-year period, we enrolled 70 adult women who complained of bedwetting, with a frequency of at least once per week and a symptom duration of 3 months or longer. Patients were excluded if they had known pregnancy, current urinary tract infection, untreated malignancies, anatomical abnormalities, and irregular sleep cycle. The International Consultation on Incontinence Modular Questionnaire—female lower urinary tract symptoms and bladder diary were employed to appraise lower urinary tract symptoms and voiding behavior. Urodynamics was performed to assess the bladder function. A linear regression analysis was applied to determine potential risk factors for NE frequency.ResultsAmong the recruited subjects, comorbidities and lower urinary tract symptoms were frequently reported. On bladder diary, patients commonly presented with nocturnal polyuria (NP), reduced nocturnal voided volumes (RNVVs), or both. Urodynamics revealed multiple dysfunctions, namely, detrusor overactivity (DO), urodynamic stress incontinence (USI), reduced compliance, bladder outlet obstruction, detrusor underactivity (DU), and simultaneous DO and DU. Patients with more frequent NE (≥4/week) demonstrated markedly increased body mass index, more comorbid conditions, worse incontinence symptoms, NP or NP plus RNVVs, reduced compliance, and poorer voiding possibly owing to DU. Whereas, RNVVs alone and worse overactive bladder-related parameters were associated with milder NE. Multivariate analysis indicated that frequency/urgency quality of life, incontinence symptom, NP + RNVVs, poor flow, increased bladder sensation, USI, and simultaneous detrusor overactivity plus DU were independent risk factors for NE severity.ConclusionNE in adult women may have both urological and non-urological pathophysiology. Imbalanced circadian urine production, jeopardized continence mechanisms, overactive bladder, and DU-induced poor voiding are major factors that contribute to the pathogenesis of NE in adult women. Focused treatments on restoring these functions should be individually considered.

Management of menstrual hygiene, practices and perceptions among vulnerable Bharia women in Madhya Pradesh: A pilot survey

India has the highest proportion of adolescents and the highest adolescent pregnancy and childbirth rate in the tribal segment of the population. Very few studies have focused on the use of sanitary pad and quality of health care as menstrual hygiene practices. The data was collected among ‘Bharia’ women who identified as one of the particularly vulnerable tribal groups (PVTGs) in Madhya Pradesh. Towards comparing the use, source, and components of menstrual hygiene practices among adolescents and adult mothers, the sample included adolescent (10-19 years) and adult women 20-49 years of age. The relevant information was collected by trained female investigator with designed questionnaire from the respondents. Findings revealed that only 22.7% women are using sanitary pad during menstruation period in the studied tribe. It was seen the use of this absorbent (sanitary pad) for menstrual hygiene among the adolescents were found significantly higher (37.5%) than that of adult women (14.3%), whereas, the use of old cotton was found significantly higher (78.6%) among adult women. Awareness on menstrual hygiene about 50% adolescents and 64% adult women believed it is a curse of God. About 25% adolescents and 21.4% adult women believed menstruation is a natural process. The tribe has underprivileged menstrual hygiene practices owing to low awareness, illiteracy, and poverty. The special IEC education campaign with suitable strategy can be forced to optimum hygiene practices.

Association of PC Use and TV Viewing Hours with Women’s Recreational Physical Activity and Its Impact on Their Obesity Indices

Background: Television (TV) viewing and computer (PC) use have been associated with poor health outcomes. Aim: To investigate the association of TV viewing and PC use with recreational physical activity energy expenditure (RPAEE), obesity indices, physical activity levels (PAL) and body fat percentage (BF%) of adult women. Methods: Bodyweight (BW), height, waist (WC) and hip (HC) circumferences of 150 adult women were measured. Body mass index (BMI) and waist-to-hip ratio (WHR) were calculated. The BF% was measured by bioelectrical impedance analysis. The Athens Physical Activity Questionnaire was used to assess PAL, RPAE, TV viewing and PC hours. Results: The majority of women (53%) were overweight and obese, watched TV for >14 hr/wk (59%), and almost half (47%) of them used computers for >1 hr/day. Slightly more than half of them (54%) had a sedentary lifestyle and reported exercise participation for <2 hr/wk. No walking for leisure was reported by one-third of the subjects, while an alarming low percentage (0.7%) walked only 2.5 hr/wk. No participation in informal physical activity was reported by 69%. RPAEE was estimated at 982 ± 973 kcal/wk and negatively correlated to TV-watching hours (r = –0.31, p < 0.05), computer use (r = –0.3, p < 0.05), BMI (r = –0.44, p < 0.01), BW (r = –0.44, p < 0.01), WC (r = –0.41, p < 0.01), WHR (r = –0.31, p = 0.01). Moreover, RPAEE and BF% were negatively correlated (r = –0.44, p < 0.01). BF% was associated with long hours of PC use and TV watching (R2 = 0.11, F1.148 = 17.94, p = 0.00; R2 = 0.14, F1.148 = 5.4, p = 0.002). Conclusion: Screen use affecting obesity indices seemed to overrun recreational time for physical activity participation and dominate women’s lifestyle. Further research targeting behavioral change practices is recommended. Keywords: obesity, women, physical activity, recreational physical activity expenditure

Effect of Weight Self-Stigma and Self-Esteem on Aerobic Exercise Capacity in Adult Women with Different Body Compositions

Background: Overweight individuals face weight-related stigmatization, driving self-exclusion from exercise and physical activity. The extent to which weight self-stigma and self-esteem are associated with aerobic capacity remains unclear. Therefore, this study aimed to characterize the cardiopulmonary fitness, weight self-stigma, and self-esteem of overweight women and examine whether weight self-stigma and self-esteem predict cardiopulmonary aerobic capacity. Methods: A cross-sectional study was conducted with 66 women stratified into two groups: a normal weight (NW) group and an overweight (OW) group. The mean body mass indexes and ages of the NW and OW groups were 20.4 ± 0.36 kg/m2 and 29.5 ± 0.8 kg/m2, and 24 ± 7 years and 21 ± 3 years, respectively. Submaximal exercise testing using the modified Bruce treadmill protocol was conducted to measure the predicted oxygen uptake (VO2 peak) and energy expenditure. The Weight Self-Stigma Questionnaire and the Rosenberg Self-Esteem Scale were used. Results: Significantly lower mean of predicted VO2 peak and higher mean of energy expenditure were reported in the OW group compared with the NW group (25.8 ± 5.3 mL/kg/min vs. 28.7 ± 4.8 mL/kg/min, p = 0.001 and 9.7 ± 1.9 kcal/min vs. 7.5 ± 1.8 kcal, p = 0.03, respectively). There was a significant difference in weight self-stigma and self-esteem between the groups. Regression model analysis indicated that weight self-stigma and self-esteem explained 45% of the variance in the predicted VO2 peak. Conclusion: Strategies enhancing self-esteem and avoiding stigmatization should be embraced to promote fitness and engagement in physical activity among OW women.

A comparative study of adult and adolescent maternal care continuum following community-oriented interventions in Cambodia, Guatemala, Kenya, and Zambia

Background The coverage for reproductive care continuum is a growing concern for communities in low- income economies. Adolescents (15–19 years) are often at higher odds of maternal morbidity and mortality due to other underlying factors including biological immaturity, social, and economic differences. The aim of the study was to examine a) differences in care-seeking and continuum of care (4 antenatal care (ANC4+), skilled birth attendance (SBA) and postnatal care (PNC) within 24h) between adult (20–49 Years) and adolescents and b) the effect of multilevel community-oriented interventions on adolescent and adult reproductive care-seeking in Cambodia, Guatemala, Kenya, and Zambia using a quasi-experimental study design. Methods In each country, communities in two districts/sub-districts received timed community health worker (CHW) household health promotion and social accountability interventions with community scorecards. Two matched districts/sub-districts were selected for comparison and received routine healthcare services. Results Results from the final evaluation showed that there were no significant differences in the care continuum for adolescents and adults except for Kenya (26.1% vs 18.8%, p<0.05). SBA was significantly higher for adolescents compared to adult women for Guatemala (64% vs 55.5%, p<0.05). Adolescents in the intervention sites showed significantly higher ANC utilization for Kenya (95.3% vs 84.8%, p<0.01) and Zambia (87% vs 72.7%, p<0.05), ANC4 for Cambodia (83.7% vs 43.2%, p<0.001) and Kenya (65.9% vs 48.1%, p<0.05), SBA for Cambodia (100% vs 88.9%, p<0.05), early PNC for Cambodia (91.8% vs 72.8%, p<0.01) and Zambia (56.5% vs 16.9%, p<0.001) compared to the comparison sites. However, the findings from Guatemala illustrated significantly lower care continuum for intervention sites (aOR:0.34, 95% CI 0.28–0.42, p<0.001). The study provides some evidence on the potential of multilevel community-oriented interventions to improve adolescent healthcare seeking in rural contexts. The predictors of care continuum varied across countries, indicating the importance of contextual factors in designing interventions.

“We Were Loving Warriors!”: A Content Analysis of Black Women’s Resistance Within Psychological Science

Though findings are mixed, collective action engagement has been shown to be positively associated with greater academic success, social support, political efficacy, and well-being with racially marginalized individuals. Despite these findings, however, investigations of collective action engagement with Black American adult women within psychological science are scarce. Consistent with Black feminist thought, the construct of resistance may provide a necessary expansion to include all the ways that Black women actively work to transform their communities toward justice, beyond collective action. To ascertain the breadth and scope of psychological research related to Black women’s resistance (i.e., collective action engagement) to interpersonal discrimination and structural oppression, in this systematic review and content analysis we sought to identify participants’ and scholars’ definitions of resistance, as well as thematic dimensions and specific strategies of resistance. Additionally, we sought to determine the outcomes of resistance that have been assessed and the degree to which psychological health and well-being have been examined as an outcome of resistance within the literature. Findings from the analysis suggest the need for future examinations of the specific influence of Black American women’s collective action engagement and resistance to oppression on their well-being. Additionally, the findings of this review may have important implications for Black women’s well-being and as such, we discuss resistance work as a therapeutic intervention that can be encouraged by therapists, healers, community leaders, and educators.

Efficacy of conservative physiotherapeutic approaches in hormonal-related headaches: a scoping review protocol.

ABSTRACT Introduction. Headache is one of the most common and disabling conditions worldwide, as described by the World Health Organization report. The risk of suffering from headache has been described to increase from twofold to threefold in adult women compared to men, depending on the studies. These gender differences have been linked to environmental, genetic, epigenetic, and hormonal aspects. Sex hormones can enhance headaches mainly through sensitization of the trigemino-vascular system and modulation of the blood vessel factors, with significant clinical consequences. International guidelines suggest several pharmacological and non-pharmacological treatments in the management of headache disorders as acute or preventive therapies. Few studies have been conducted on the efficacy and effectiveness of therapies in managing hormonal-related headaches to date. Therefore, this scoping review (ScR) aims to summarize the evidence regarding the efficacy of conservative physiotherapeutic approaches on this topic in the domain of gender medicine, which studies sex influences on pathophysiology, clinical signs, prevention, and therapy of diseases. Methods and analysis. The ScR will be performed following the 6-stage methodology suggested by Arksey and O Malley and the extensions to the original framework recommended by the Joanna Briggs Institute. MEDLINE, Cochrane Central, Scopus, CINHAL, Embase and PEDro databases will be searched. Additional records will be identified through searching in grey literature and the reference lists of all relevant studies. No study design, publication type, language nor date restrictions will be applied. Two reviewers will independently screen all abstracts and full-text studies for inclusion. The research team will develop a data collection form to extract the studies characteristics. A tabular and accompanying narrative summary of the information will be provided. This protocol received input from all authors who have expertise in research methodology and specific knowledge in the field. Ethics and dissemination. This study does not require ethical approval as we will not collect personal data. It will summarize information from publicly available studies in line with the nature of the study s methodology. Regarding dissemination activities, the results of this review will be submitted for publication in a peer-reviewed journal, presented at relevant conferences in the field and disseminated through working groups, webinars and partners. KEYWORDS Headache, menstruation, hormones, physical therapy, exercise therapy.

Outcome reporting in randomized controlled trials (RCTs) on the pharmacological management of idiopathic overactive bladder (OAB) in women; a systematic review for the development of core outcome sets (COS)

Introduction and hypothesis Evidence on OAB management remains suboptimal and methodological limitations in randomized control trials (RCTs) affect their comparability. High quality meta-analyses are lacking. This study aimed to compare selection and reporting of outcomes and outcome measures across RCTs as well as evaluate methodological quality and outcome reporting quality as a first stage in the process of developing core outcome sets (COS). Methods RCTs were searched using Pubmed, EMBASE, Medline, Cochrane, ICTRP and Clinicaltrials.gov from inception to January 2020, in English language, on adult women. Pharmacological management, interventions, sample size, journal type and commercial funding were documented. Methodological and outcome reporting quality were evaluated using JADAD and MOMENT scores. Results Thirty-eight trials (18,316 women) were included. Sixty-nine outcomes were reported, using 62 outcome measures. The most commonly reported outcome domains were efficacy (86.8%), safety (73.7%) and QoL (60.5%). The most commonly reported outcomes in each domain were urgency urinary incontinence episodes (UUI) (52.6%), antimuscarinic side effects (76.3%) and change in validated questionnaire scores (36.8%). A statistically significant correlation was found between JADAD and MOMENT (Spearman’s rho = 0.548, p < 0.05) scores. This indicates that higher methodological quality is associated with higher outcome reporting quality. Conclusions Development of COS and core outcome measure sets will address variations and lead to higher quality evidence. We recommend the most commonly reported outcomes in each domain, as interim COS. For efficacy we recommend: UUI episodes, urgency and nocturia episodes; for safety: antimuscarinic adverse events, other adverse events and discontinuation rates; for QoL: OAB-q, PPBC and IIQ scores.

Association of Late Marriage and Low Childbirth with Cervical Cancer Screening among Korean Women: Results from a Nationwide Survey

This study aimed to identify the association of marriage and childbirth with the adherence to cervical cancer screening among young adult women. Data across four years (2017–2020) of the cross-sectional Korean National Cancer Screening Survey were used. For measuring the adherence to cervical cancer screening, we used the cervical cancer screening rate with recommendation, which was defined as the percentage of women in the population eligible for screening who have had a cervical cancer screening within the past two years. Multiple logistic regression analysis was conducted to identify the association between marriage and adherence to cervical cancer screening. Overall, 3925 women aged 20–39 years were analyzed. Of these, 39.1% were screened for cervical cancer (26.6% unmarried and 57.1% married women). The married women had significantly higher adherence to cervical cancer screening than unmarried women (adjusted odds ratio = 2.80, 95% CI: 2.99–3.44). Compared with unmarried women, adherence to cervical cancer screening was significantly more likely to increase (p for trend, <0.001) in married women with an increased number of births. Our study confirmed that marriage and childbirth influence adherence to cervical cancer screening, suggesting that unmarried women may be vulnerable to cervical cancer.