scholarly journals The Role of Hormones in Women’s Stroke Risk

2016 ◽  
Vol 27 (1) ◽  
pp. 3
Author(s):  
Dara M. Bier
Keyword(s):  
Stroke Risk ◽  
Hormone Replacement ◽  
Healthcare Providers ◽  
The United States ◽  
Health Issues ◽  
Mortality And Morbidity ◽  
Risks And Benefits ◽  
United States Today ◽  
Health Risks And Benefits

Although often overshadowed by breast cancer and other women’s health issues, stroke is a primary cause of mortality and morbidity among women in the United States today. This article explores three major populations of women: postmenopausal women who are taking hormone-replacement therapy, women ingesting estrogen-containing oralcontraceptive pills, and women who are currently pregnant. It compiles recent research and physiologic information that can aid in assessing these women’s risk for stroke. This review can help healthcare providers evaluate and manage these populations, and assess the health risks and benefits of certain estrogen-containing therapies.

Abstract TP197: Risk of Stroke in Women with use of Testosterone-Containing Hormone Replacement Therapy

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Haseeb A Rahman ◽  
Ahmed Malik ◽  
Aesha Rahman ◽  
Saqib Chaudhry ◽  
Malik M Adil ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Risk Factor ◽  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Stroke Risk ◽  
Hormone Replacement ◽  
Future Studies ◽  
Baseline Visit ◽  
Using Data

Background: There has been debate in the role of exogenous testosterone as a risk factor for stroke. Hormone replacement therapy (HRT) is considered a risk factor for stroke. The risk of ischemic stroke may increase when using testosterone-containing HRT. Methods: Using data from the observational component of the Women’s Health Initiative (WHI) [WHI Observational Study (OS)], we analyzed the 93,676 women aged 50-79 years, who participated in the OS over a period of 12±1 years. We compared the outcome of stroke in participants with reported use of a combination of testosterone and estrogen, estrogen alone, progesterone alone, and a combination of estrogen and progesterone, as recorded at the baseline visit. A logistic regression analysis was run to determine the odds of developing stroke. Results: Of the 93, 676 participants, 1772 used a combination of testosterone and estrogen (Estratest) HRT, 11,282 used progesterone alone, 10,808 used a combination of estrogen and progesterone, and 31,673 used estrogen alone. A smaller proportion of participants who developed an outcome of stroke had used Estratest as compared to estrogen alone or a combination of estrogen and progesterone (1.9% vs. 96.3% p=0.62). In the logistic regression, participants who had used Estratest were 1.2 times as likely to develop stroke as users of other hormone replacement therapy (OR 1.2 95%CI (0.96-1.6)), while women who had used progesterone only were 0.87 times less likely to develop stroke than users of other hormone replacement therapy (OR 0.874 95%CI (0.77-0.99)). After adjusting for confounders, the risk of developing stroke increased in users of Estratest (OR 1.25 95%CI (0.96-1.6) p=0.04), and decreased in users of progesterone only (OR 0.873 95%CI (0.77-0.99) p=0.038). Conclusion: Use of testosterone-containing HRT slightly increased the risk of stroke in women when compared to progesterone alone HRT, although this was not found to be significant. Stroke risk with Estratest may be considered to be similar to estrogen only and combination of estrogen plus progesterone HRT. Future studies are required to investigate these correlations.

scholarly journals Nothing in This World Is Indifferent to Us': The Primacy of Encounter and the Intersubjectivity of Nature

Lumen et Vita ◽  
2015 ◽  
Vol 6 (1) ◽  
Author(s):  
Anna Robertson
Keyword(s):  
Theological Anthropology ◽  
The United States ◽  
Natural World ◽  
Terry Tempest Williams ◽  
Human Relationships ◽  
United States Today ◽  
Wendell Berry ◽  
End Times ◽  
Ethical Response

“We’re moving from one plane of reality to another,” says Terry Tempest Williams in an interview with Yes! Magazine, “and what is required of us is spiritual.” Many people alive in the United States today have grown up bombarded by the seemingly futile refrain that if we don’t cut back on x (activity) in y (years), z (catastrophe) will ensue – with x becoming broader in scope, y becoming smaller in number, and z becoming more horrific with each passing year. Among the natural responses to such daunting and repetitive premonitions are anxiety and anguish: “Accept the anxiety, embrace the deeper anguish,” suggests Robert Jensen, “and then get apocalyptic.” Drawing upon Laudato si, liberation theology, and eco psychology, this paper argues for the importance of encounters (increasingly scarce) with the natural world, human and other-than-human, as a necessary spiritual practice grounding a commitment to ecojustice in times which are indeed end times of sorts. In a consideration of theological anthropology, I suggest, along with ecopsychologist Will Adams, that our subjectivity is indeed an intersubjectivity, arising out of our ethical response to not only the human other but also the other-than-human. We are by nature relational beings, and we must remember that this relation is not only relevant in human-human relationships. Liberation theologians have articulated the foundational nature of the encounter with poor – an experience which at once inspires awe, evokes mercy, and demands action – in grounding liberative praxis. Likewise, the encounter with nature, when its intersubjectivity is considered, grounds a praxis of ecojustice. Finally, understanding apocalypse in its etymological sense as “unveiling,” I argue for the role of the apocalyptic imagination, in making possible sustained exposure to such encounters, which entail both joy and despair. “Expect the end of the world,” writes Wendell Berry, “Be joyful though you have considered all the facts…Practice resurrection.”

scholarly journals Population dynamics modify urban residents’ exposure to extreme temperatures across the United States

2019 ◽  
Vol 5 (12) ◽  
pp. eaay3452 ◽  
Author(s):  
Jiachuan Yang ◽  
Leiqiu Hu ◽  
Chenghao Wang
Keyword(s):  
Population Dynamics ◽  
Climate Adaptation ◽  
Heat Waves ◽  
Global Climate ◽  
The United States ◽  
Urban Residents ◽  
Extreme Temperatures ◽  
Mortality And Morbidity ◽  
Spatiotemporal Population Dynamics

Exposure to extreme temperatures is one primary cause of weather-related human mortality and morbidity. Global climate change raises the concern of public health under future extreme events, yet spatiotemporal population dynamics have been long overlooked in health risk assessments. Here, we show that the diurnal intra-urban movement alters residents’ exposure to extreme temperatures during cold and heat waves. To do so, we incorporate weather simulations with commute-adjusted population profiles over 16 major U.S. metropolitan areas. Urban residents’ exposure to heat waves is intensified by 1.9° ± 0.7°C (mean ± SD among cities), and their exposure to cold waves is attenuated by 0.6° ± 0.8°C. The higher than expected exposure to heat waves significantly correlates with the spatial temperature variability and requires serious attention. The essential role of population dynamics should be emphasized in temperature-related climate adaptation strategies for effective and successful interventions.

scholarly journals Too Little, Too Late?

2018 ◽  
Vol 25 (2) ◽  
pp. 13-23
Author(s):  
Lilian Milanés ◽  
Joanna Mishtal
Keyword(s):  
Critical Role ◽  
Healthcare Providers ◽  
Young Men ◽  
The United States ◽  
Clinical Environment ◽  
Sexually Transmitted ◽  
Low Expectations ◽  
Research Findings ◽  
Reproductive Healthcare

AbstractScholarship and advocacy work regarding reproductive health have often focused on women’s experiences. Concerns about men’s sexual and reproductive healthcare (SRH) have historically been on the margins in this context. In the United States, young men are at the greatest risk for sexually transmitted infections (STIs), yet are the least likely to seek SRH. Based on research with 18 healthcare providers in a large public Florida university clinic, we examined providers’ perspectives about expanding men’s SRH provision and utilisation. Research findings demonstrate inconsistent provider strategies in treating men’s SRH needs and a clinical environment that has low expectations of men receiving preventive care, further perpetuating the placement of SRH responsibility upon women. This article contributes to applied and medical anthropology scholarship on health inequalities through its discussion of the challenges and barriers that contribute to poor SRH for young men and the critical role of providers in this context.

The Role of the Dental Professional in Diabetes Care

1999 ◽  
Vol 1 (2) ◽  
pp. 44-57 ◽  
Author(s):  
Frank Varon ◽  
Lynn Mack-Shipman
Keyword(s):  
Type 2 Diabetes ◽  
Management Strategies ◽  
The United States ◽  
Health Issues ◽  
Dental Patient ◽  
High Prevalence ◽  
Dental Professional

Abstract Diabetes mellitus, specifically type 2 diabetes, is one of the major public health issues facing the world in the 21st Century. This article summarizes the rapid changes in the management of diabetes and its impact on dental practice. The reader will find many “hyperlinks” to other diabetes information on the Internet throughout this article as these links provide greater detail. The incidence of type 1 diabetes has increased slowly, while that of type 2 diabetes has increased explosively. The worldwide incidence of type 2 is likely to double by the year 2010 due in large part to changing lifestyles, longer life expectancy, and rapid growth of ethnic and racial populations that have high prevalence rates. There are 15.7 million people or 5.9% of the population in the United States who have diabetes. While an estimated 10.3 million have been diagnosed, it is unfortunate that 5.4 million people are not aware they have the disease. Diabetic dental patient management strategies are presented. Dental professionals are urged to remain current in their knowledge of this disease in order to provide proper care for their patients.

Biomedicalization and Media in Comparative Perspective: Audiences, Frames, and Actors in Norwegian, Spanish, U.K. and U.S. Health News

2020 ◽  
pp. 194016122096041
Author(s):  
Daniel C. Hallin ◽  
Tine Ustad Figenschou ◽  
Kjersti Thorbjørnsrud
Keyword(s):  
The United States ◽  
Health Issues ◽  
Cultural Impact ◽  
Health News ◽  
News Stories ◽  
Journalism Studies ◽  
Political Roles ◽  
Health Journalism ◽  
Institutional Relationships

This study examines health news in Norwegian, Spanish, British, and U.S. newspapers. It seeks to fill a gap in journalism studies in the examination of health news as a genre, particularly in a comparative context, and with a focus on broader social and political roles and meanings of health news, rather than effects on individual behavior. It is rooted in literatures that seek to understand health journalism in sociological terms, considering the role of health journalism in relation to institutional relationships between biomedicine, the market, and the state. It departs, in particular, from the theory of biomedicalization, which holds that the field of biomedicine, increasingly transformed into a complex, commercialized “techno-service complex,” has deep cultural impact, including the spreading of a conception of an individualized patient-consumer who will actively seek information to control risk and pursue wellness. In this article, we ask whether research on health news centered around this model, mostly carried out in the United States, is generalizable to European countries where the health system is organized primarily according to a public service model. The study considers three aspects of health news content: the implied audience of news stories, distinguishing in particular between those that address readers as patient-consumers and those that address them as citizens; the distinction among biomedical, lifestyle, and social frames for understanding health issues; and the range of actors reflected in health news as sources and as story originators.

What Do Women Want? Consent for the Use of Electronic Fetal Monitoring

2021 ◽  
Vol 11 (3) ◽  
pp. 145-153
Author(s):  
Sonya Dal Cin ◽  
Lisa Kane Low ◽  
Denise Lillvis ◽  
Megan Masten ◽  
Raymond De Vries
Keyword(s):  
United States ◽  
Healthcare Providers ◽  
Fetal Monitoring ◽  
Healthcare Setting ◽  
Professional Associations ◽  
The United States ◽  
Cesarean Birth ◽  
Electronic Fetal Monitoring ◽  
Risk Patients

BACKGROUNDGuidelines published by professional associations of midwives, obstetricians, and nurses in the United States recommend against using continuous cardiotocography (CTG) in low-risk patients. In the United States, CTG or electronic fetal/uterine monitoring (EFM) rather than auscultation with a fetoscope or Pinard horn is the norm. Interpretation of the fetal heart rate (FHR) and uterine activity (UA) tracings provided by continuous EFM may be associated with the decision for a cesarean birth. Typically, consent is not sought in the decision about type of monitoring. No studies were identified where women's attitudes about the need to consent to the type of fetal monitoring used during labor have been explored. Therefore, the purpose of this research was to examine women's attitudes about the use of EFM in a healthcare setting.METHODSWe asked a sample of women aged 18–50 years to respond to one of three monitoringscenarios. The scenarios were used to distinguish between attitudes about monitoring in general, monitoring the health of a mother in labor, and monitoring the health of the fetus during labor. Wemeasured their level of interest in being monitored and their opinions about whether healthcare providers should be required to obtain consent for the monitoring described in the scenario.RESULTSInterest in receiving monitoring (across all three scenarios) was moderate, with the highest level of interest in monitoring the fetus during labor and the least interest in monitoring a general health context. Across all scenarios, 82% of respondents believed that practitioners should obtain consent for monitoring, 14% were unsure, and 4% said there should not be a requirement for consent. While low (6%), the percentage responding that consent was not needed was highest in monitoring a fetus in labor.CONCLUSIONSWomen in our study expressed a strong preference for the opportunity to consent to the use of monitoring regardless of the healthcare scenario. There is findings suggest the need for further research exploring what women do and do not know about CTG and what their informed performance are a pressing need to rethink the role of a pressing need to rethink the role of shared decision-making and informed consent about the type of monitoring use during labor.

Our Shadow Immigration System

2020 ◽  
pp. 103-130
Author(s):  
Adam B. Cox ◽  
Cristina M. Rodríguez
Keyword(s):  
United States ◽  
Twentieth Century ◽  
Illegal Immigration ◽  
The United States ◽  
Executive Branch ◽  
Shadow System ◽  
Deferred Action ◽  
United States Today ◽  
System P

This chapter explains how legal and institutional developments in immigration enforcement coincided with the dramatic acceleration of illegal immigration during the final third of the twentieth century. Together, these legal and demographic phenomena gave rise to a massive shadow immigration system that today operates alongside the formal immigration regime. This shadow system has rendered Congress’s intricate, detailed code of immigration rules increasingly less central to defining the content and character of the immigrant population. Instead, the Executive’s enforcement judgments—decisions about whom to target from the pool of deportable immigrants—have taken center stage. Indeed, the rise of the shadow system has effectively delegated vast screening authority to the President and other executive branch officials—authority that has culminated in events as dramatic as President Barack Obama’s Deferred Action for Childhood Arrivals (DACA). The large number of unauthorized immigrants living in the United States today amplifies the role of enforcement discretion and further entrenches the shadow immigration system.

Abstract WP520: The Role of Neighborhood Deprivation in Stroke Risk in Two Countries: France and the United States

Stroke ◽  
2019 ◽  
Vol 50 (Suppl_1) ◽  
Author(s):  
Suzanne E Judd ◽  
George Howard ◽  
Virginia J Howard ◽  
Elsayed Z Soliman ◽  
Philippa J Clarke ◽  
...  
Keyword(s):  
United States ◽  
Stroke Risk ◽  
The United States ◽  
Neighborhood Deprivation

scholarly journals A Narrative Systematic Literature Review: A Focus on Qualitative Studies on HIV and Medication-Assisted Therapy in the United States

Pharmacy ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 67
Author(s):  
Alina Cernasev ◽  
Sunitha Kodidela ◽  
Michael P. Veve ◽  
Theodore Cory ◽  
Hilary Jasmin ◽  
...  
Keyword(s):  
United States ◽  
Literature Review ◽  
Healthcare Providers ◽  
The United States ◽  
Hiv And Aids ◽  
Opioid Use ◽  
Screening Process ◽  
Persons Living With Hiv ◽  
Opioid Medications

Over the last two decades, the United States (U.S.) has experienced an opioid crisis that has had a significant negative societal and economic impact. Due to the high utilization of opioids in Persons Living with HIV and AIDS (PLWHA), there is a need for a qualitative literature review that presents opioid-use related problems in this population. This study aims to present and identify a thematic overview of the qualitative manuscripts on PLWHA who take opioid medications in the U.S., with a focus on perceptions surrounding medication assisted therapy. The systematic literature search was performed in December 2019. Four databases were searched: PubMed/MEDLINE, Scopus, Web of Science, and Cumulative Index to Nursing & Allied Health Literature (CINAHL). A total of 5348 results were exported from databases into EndNote x9, and duplicates were removed for a total of 3039 unique abstracts to screen. The records were imported into Rayyan, an online platform designed to expedite the screening process. Three authors screened titles and abstracts and determined 19 articles that would be screened in full text. On 9 April 2020, it was determined that eight articles would be included for review. The analysis of the eight manuscripts that fit the inclusion and exclusion criteria revealed barriers and facilitators to medication assisted therapy (MAT) in PLWHA. This review communicates or describes the story of PLWHA who might have delayed access to HIV healthcare providers and the commencement of antiretroviral therapy. In the literature, several studies have focused on the role of physicians in prescribing and addressing the medication regimens but none of the studies examined the role of pharmacists in access to care in this population. Therefore, further research is needed for a better understanding of the social aspects of taking opioid medications in PLWHA and the role of pharmacists within the continuum of care.

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