Vulvodynia, including generalized vulvodynia and vestibulodynia, affects at least 8% to 16% of people with a vulva and may have a negative impact on one's quality of life, psychological health, ...interpersonal relationships, and individual behaviors.
The aim of this scoping review is to synthesize and analyze the emerging literature of vulvodynia research while determining what psychosocial barriers exist for people with vulvodynia.
A rigorous literature search was completed in 6 databases: PubMed, CINAHL, Embase, Web of Science, APA PsycInfo, and Academic Search Premier. Key terms and subject headings, including Medical Subject Headings, were used to systematically search these databases. Two reviewers were utilized to assess the reference list and reduce bias.
A total of 671 articles were discovered during the search, which was narrowed down to 73 that included at least 1 psychosocial barrier that patients experience in the United States and Canada.
The findings of the literature search revealed the various psychosocial barriers that patients commonly face: pain, anxiety, depression, catastrophization, fear, lack of self-efficacy, low desire and arousal, negative body image, stigma, distress, posttraumatic stress disorder, child maltreatment and abuse, mistrust, invalidation and isolation, low levels of self-compassion, negative partner support, low relationship satisfaction, lack of physical affection, emotional regulation, and avoidance and lack of approach goals. In addition to psychosocial barriers, structural determinants and environmental barriers-such as delayed diagnosis, low health literacy, cost, transportation, and racial disparities-adversely affected individuals with vulvodynia.
This review should serve as a guide for researchers, medical providers, and program developers to understand all the barriers that patients may face.
This review comprehensively highlights existing psychological barriers while promoting structural and environmental barriers that people with vulvodynia face. More research and greater emphasis on the underlying physical conditions that contribute to vulvodynia are needed to effectively educate providers and patients on vulvar pain conditions.
This scoping review highlights the numerous barriers faced by patients with vulvodynia and serves to improve education for patients and providers to achieve earlier diagnoses and better patient outcomes.
We investigated whether Peace4Tarpon's trauma‐responsive community capacity activities led to greater collaboration among community partners. We conducted longitudinal social network analysis (SNA) ...among organizations within Peace4Tarpon's network in 2016 and 2018 to capture cooperation around adverse childhood experiences‐related topics. We examined network structure, cohesion, organizational collaboration, and associations between centrality and organizational practices. Peace4Tarpon's network included diverse sectors, with a group of organizations forming the network core and collaborating over time. The network displayed a small increase in cohesion, more cross‐sector collaboration, and less heterophily over time. We found a significant difference between the mean betweenness centralities of organizations who assessed resilience and those who did not in the 2018 average union network. This is one of the first studies using SNA to investigate a trauma‐informed community network. Findings from this type of analysis may assist community organizations in strengthening outreach and strategically engaging organizations within a trauma‐informed network.
Objective We sought to investigate whether maternal smoking during pregnancy affects telomere length of the fetus. Study Design Pregnant women were recruited on hospital admission at delivery. A ...self-report questionnaire and salivary cotinine test were used to confirm tobacco exposure. Neonatal umbilical cord blood samples were collected, and genomic DNA was isolated from cord blood leukocytes and was analyzed for fetal telomere length based on quantitative polymerase chain reaction. A ratio of relative telomere length was determined by telomere repeat copy number and single copy gene copy number (T/S ratio) and used to compare the telomere length of active, passive, and nonsmokers. Bootstrap and analysis of variance statistical methods were used to evaluate the relationship between prenatal smoking status and fetal telomere length. Results Of the 86 women who were included in this study, approximately 69.8% of the participants were covered by Medicaid, and 55.8% of the participants were black or Hispanic. The overall mean T/S ratio was 0.8608 ± 1.0442. We noted an inverse relationship between smoking and fetal telomere length in a dose-response pattern (T/S ratio of nonsmokers that was more than passive smokers that was more than active smokers). Telomere length was significantly different for each pairwise comparison, and the greatest difference was between active and nonsmokers. Conclusion Our results provide the first evidence to demonstrate a positive association between shortened fetal telomere length and smoking during pregnancy. Our findings suggest the possibility of early intrauterine programming for accelerated aging that is the result of tobacco exposure.
Several communities are implementing trauma‐informed, community‐level approaches focused on addressing/preventing adverse childhood experiences (ACEs), yet most community resilience definitions from ...published articles are based on acute traumas. This scoping review aims to determine how community resilience is defined and operationalized within the context of chronic/complex traumas. Methods: We performed a rigorous, comprehensive literature search using multiple databases. Results: The 38 included articles addressed multiple types of chronic traumas, including historical trauma, poverty, minority stress, mass incarceration, and ACEs. A variety of definitions of community resilience were cited, several of which stressed the ability to thrive despite risk factors and the safety and wellbeing of residents. Few articles operationalized community resilience within the context of ACEs, suggesting significant gaps in the literature. Conclusion: This review can serve as an important building block to develop expanded definitions of community resilience for chronic traumas and assist communities in promoting community‐wide responses to ACEs.
Purpose
Studies have reported a surge in the prevalence of obesity among various demographic groups including pregnant women in the U.S. Given the association between maternal obesity and risk of ...fetal macrosomia, we hypothesized that the incidence of fetal macrosomia will be on the rise in the U.S. We examined trends in fetal macrosomia and macrosomia phenotypes in the U.S. among singleton live births within the gestational age of 28–42 weeks inclusive.
Methods
This was a retrospective cohort study covering the period 1971–2017 using U.S. Natality Data files. We applied Joinpoint regression models to derive the average annual percentage change in the outcome. We measured incidence and trends of fetal macrosomia which was defined as birth weight ≥ 4000 g. We further subdivided macrosomia into its phenotypes as previously recommended: Grade 1 (4000–4499 g), Grade 2 (4500–4999 g) and Grade 3 (≥ 5000 g).
Results
A total of 147,331,305 singleton births over the entire study period of 47 years were analyzed. From a baseline incidence of 8.84%, the rate of fetal macrosomia declined to 8.07% by the end of the study representing a drop of 8.70% in relative terms. The greatest drop was among infants with Grade 3 macrosomia, the most severe and lethal phenotype. The most impactful factors were maternal age and gestational weight gain.
Conclusion
This study is the largest population-based study conducted regarding fetal macrosomia. The rate of fetal macrosomia declined over the previous 5 decades with the most substantial drop observed in the phenotype with the worst prognosis.
Structural factors in the United States, such as criminalization, contribute to disproportionate rates of violence against sex workers and subsequent risk of adverse health outcomes. There is a clear ...need for systemic interventions and risk reduction strategies to reduce violence in this population. To inform next steps in prevention, this scoping review provides an overview of the literature on violence prevention efforts targeting sex workers in the United States, mapped out according to the social-ecological model (SEM). A comprehensive search of peer-reviewed literature across five databases with no limit on publication date yielded 2,372 documents. Studies were eligible for inclusion if they focused on the U.S. population of sex workers and had a clearly defined aim or purpose of exploring, describing, or evaluating sex work violence prevention interventions or risk reduction strategies. Twelve studies met all eligibility criteria and were selected. Only two of the studies evaluated sexual violence prevention interventions, while the remaining 10 explored strategies sex workers use to minimize the risk of violence. Most research focused on female sex workers, violence from paying clients, and prevention at the individual level of the SEM. Our findings suggest a need for additional violence prevention interventions tailored for diverse groups of sex workers and cognizant of the overlapping forms of violence they face. This scoping review contributes to the limited body of research on the prevention of violence against sex workers in the United States by providing future directions for research and program development that span across the SEM.
Children living in disadvantaged communities experience higher rates of adverse childhood experiences (ACEs) which can lead to poor health outcomes. Mindfulness has been shown to help individuals who ...are exposed to cumulative stress build resilience and psychological well‐being. This pilot study aimed to determine teachers' perceptions of a 6‐week school‐based, teacher‐led mindfulness program in a Gainesville, Florida pre‐ and early elementary low‐income school. The program was conducted as part of a trauma‐responsive, resilient community initiative. Teachers were trained on a set of mindfulness skills and were asked to lead practices for 10–15 min per day, 3 or more times per week for 6 weeks. Teachers completed qualitative interviews to determine their perceptions of the program. A total of eight teachers participated, with 124 students receiving the program. Teachers reported high impressions of the program and that students were calmer and more relaxed as a result of the program. Training teachers to deliver mindfulness practices as part of their normal classroom activities is realistic, easily adaptable, and can lead to adoption of a community‐wide mindfulness framework. Diffusing mindfulness programs more broadly as part of a preventive, trauma‐responsive community has the potential to lessen the effects of ACEs.
Objectives
To evaluate the association between macrosomia and stillbirth over the previous four decades and to determine the consistency of the relationship.
Methods
This was a population‐based ...retrospective cohort study using United States Natality and Fetal Death Data from 1982 to 2017 and restricted to the gestational age range of 37‐41 weeks inclusive. Macrosomia was defined as birthweight ≥4000 g and subdivided into its grades as previously recommended: grade 1 (4000‐4499 g), grade 2 (4500‐4999 g), and grade 3 (≥5000 g). We calculated temporal trends of stillbirth among fetuses with macrosomia over the years using joinpoint regression. We generated odds ratios from adjusted binomial logistic regression models to examine the association between macrosomia and risk of stillbirth stratified by grades using normal‐weight infants (2500‐3999 g) as referent.
Results
Within the fetal macrosomia group, the rate of stillbirth declined from 2.04/1000 in 1982 to 1.05/1000 by the end of the study period (2017), representing a drop of about 48.5%. For the normal‐weight fetuses, stillbirth rate declined from 1.95/1000 to 0.83/1000, equivalent to a decline of 57.4%. Macrosomia was significantly associated with elevated risk for stillbirth: grade 2 (OR = 1.27; 95% CI = 1.22‐1.32) and grade 3 (OR = 5.97; 95% CI = 5.69‐6.22).
Conclusions
Fetal macrosomia is a significant risk factor for fetal demise with the worst intrauterine survival observed among those classified as grade 3. Fetal macrosomia is a heterogeneous rather than a homogeneous entity in terms of risk profiles, and this needs to be considered in future policy guidelines.
This randomized clinical trial examines the effect of folic acid supplementation in pregnant women who smoke tobacco on infant birth weight, infant status as small for gestational age, and fetal ...growth restriction.
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