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Biomedical subjects

P K Mansfield

Publications and source records attributed to P K Mansfield.

18 recordsLinked to original sources
PubMed2006

Ovulation detection methods for urinary hormones: precision, daily and intermittent sampling and a combined hierarchical method.

BACKGROUND: We evaluate the performance of ovulation detection methods and present new approaches, including evaluation of methods for precision, combining multiple markers into a hierarchical system and using ovulation markers in intermittent sampling designs. METHODS: With serum LH peak day as the 'gold standard' of ovulation, we estimated accuracy and precision of ovulation day algorithms using 30 ovulatory menstrual cycles with daily urinary and serum hormones and transvaginal ultrasound. Sensitivity and specificity for estimating the presence of ovulation were tested using visually assessed ovulatory (30) and anovulatory (22) cycles. RESULTS: Sensitivity and specificity ranged from 70 to 100% for estimating presence of ovulation with twice-per-cycle, weekly, twice weekly, every-other-day and daily specimens. A combined hierarchical method estimated ovulation day using daily specimens within +/-2 days of the gold standard in 93% of cases. Accuracy of estimating ovulation day within +/-2 days using intermittent sampling ranged from 40% (weekly sampling) to 97% (every-other-day). CONCLUSIONS: A combined hierarchical algorithm using precise and accurate markers allows maximal use of available data for efficient and objective identification of ovulation using daily specimens. In intermittent sampling designs, the presence and the timing of ovulation can be estimated with good sensitivity, specificity and accuracy.

Adult↗
PubMed2000

Midlife women's attributions for their sexual response changes.

This study focused on the sexual response changes of 280 mostly White, married, highly educated midlife women and on the attributions they made for these changes. In a U.S. sample of women participating in the Midlife Women's Health Survey (MWHS), women whose sexual response had changed in the past year (40%) reported more decrements than increases in sexual response. When asked how they accounted for these changes, women referred most often to the physical and emotional changes of menopause and to life circumstances, and less often to their relationships with their partners. The attributions showed a distinct pattern: Most of the decrements were explained by physical events related to menopause, whereas most of the increases were explained by life circumstances. These findings are discussed in terms of a need for studying women's sexuality from a biopsychosocial perspective.

Adult↗
PubMed2000

What perimenopausal women think about using hormones during menopause.

The purpose of this study was to improve our understanding of women's thoughts about taking hormones during menopause. Analysis of the responses of 61 perimenopausal women resulted in the identification of four categories of factors influencing women's opinions about taking hormones: perceptions of need, perceptions of risk, beliefs and values, and knowledge and information. Women used multiple cognitive processes in forming opinions about taking hormones, and the presence of conflicting factors contributed to their uncertainty. Women's references to interactions with their doctors indicated they preferred to take one of three roles in the decision making process: accepting advice, deciding together, or taking control. These findings indicate that women's decisions about hormone use take place in an arena broader and more complex than heretofore acknowledged in some studies.

Adult↗
PubMed1998

Chinese midlife women's perceptions and attitudes about menopause.

OBJECTIVE: The purpose of this research was to discover and describe the meaning of and attitudes toward menopause in midlife Chinese women in Taiwan. How these women learned about menopause was also explored. DESIGN: Questionnaires were distributed to a convenience sample of 208 Chinese women aged 35 to 55 living in Taiwan; 168 responded. Qualitative data were analyzed using content analysis. Percentage and chi-square were used to examine the quantitative data. RESULTS: The findings revealed that 154 (91.7%) women perceived menopause as a natural phenomenon. No statistically significant differences in attitude toward menopause were found between women grouped by different menopausal levels, by use or not use of hormones, or by religious preference. Some women described menopause as, "no longer young, getting old." Others described menopause as, "wisdom and maturation," "a symbol of achievement," and "a time to start enjoying life." Sixty-eight (40.5%) of the sample indicated they obtained menopausal information from friends and printed materials such as books, newspapers, and magazines. CONCLUSIONS: Study findings indicate that Chinese women in Taiwan perceive menopause in a positive and holistic way. Culturally sensitized Western practitioners can utilize this study's findings to more appropriately individualize care for Chinese midlife women.

Adult↗
PubMed1995

A comparison of substance use rates among female nurses, clerical workers and blue-collar workers.

The issue of impairment of practising professional nurses by alcohol and other drugs has become a critical concern since the 1980s. The literature abounds with conjectures about the large numbers of nurses who are impaired, often without valid data to support the claims that the problem in nursing is greater than it is in the general population. This study reflects an effort to compare the reported substance use of employed female nurses with that of two other groups of working females. Survey data from 920 nurses, 405 clerical workers and 200 females employed in non-traditional trades jobs in two large eastern states in the US revealed that there was little evidence of 'abuse' of any of 15 substances; nurses did not report higher rates of substance use than the other two groups; and most reported substance use occurred in the younger age groups, reflecting the national trend. The need for continuing research efforts and confirmation of valid data, and primary prevention efforts with young female workers, including at-risk student nurses, is made evident.

Adult↗
PubMed1989

Toward a better understanding of the "advanced maternal age" factor.

Women over the age of 30-35 are presumed to encounter more adverse pregnancy outcomes because of their reduced reproductive efficiency. In the vast majority of studies of advanced maternal age and pregnancy outcome, however, researchers have failed to control for important contextual differences surrounding the pregnancy and childbirth experiences of younger and older women. These contextual differences can account for a considerable portion of the differential results mistakenly ascribed to reproductive age. In this article are reviewed research findings that identify three such hidden factors: older women's increasing likelihood of chronic diseases that adversely affect pregnancy outcome; the altered medical management of middle-aged women's pregnancies and labors, with resultant iatrogenically caused complications; and demographic characteristics suggesting that midlife pregnancy in the past has been associated with poverty or subfertility and today is associated with healthy middle-class postponers.

Adult↗
PubMed1989

The Job Context Index: a guide for improving the 'fit' between nurses and their work environment.

Stress and burnout have reached crisis levels among hospital nurses. The authors of this paper address this problem with the development of a scale to improve the 'fit' between a nurse and his/her work environment, thereby potentially increasing satisfaction, and reducing stress and burnout. Approximately 1000 hospital nurses, randomly selected from a large eastern state, described their work in each of 10 clinical areas; their reports enabled the construction of the Job Context Index, which rank orders the 10 settings on three dimensions, including general work pressure/uncertainty, routinization of tasks, and co-worker interdependence. Nurses, as well as educators and administrators, may find their index a useful tool for matching nurses' temperaments and workstyles with the characteristics of the clinical areas in which they might be working.

Burnout, Professional↗
PubMed1989

Occupational stress among nurses in hospital settings.

1. This study provides empirical evidence for the repeated statements by hospital nurses that their work situation is overwhelmingly stressful. 2. Stress seems to arise from the overall complexity of nurses' work rather than specific tasks required of nurses. 3. Stressors are uniform across clinical areas, especially with regard to perceived work pressure. 4. Among the most frequently cited stressors for nurses in nearly every hospital setting were "keeping track of many things"; "It is hard to predict what will happen each day"; and "Simple mistakes could have dire consequences."

Adult↗
PubMed1986

Re-evaluating the medical risks of late childbearing.

A critical review of the scientific literature linking advanced maternal age to eight adverse pregnancy outcomes commonly believed to increase with advancing age revealed little support for the pessimistic medical view that late childbearing is necessarily riskier. Most studies (61% of the 104 studies reviewed) were seriously flawed methodologically, primarily by confounding age with other factors; many reached conclusions without statistical verification (29% of the studies reviewed). Results concerning the advantages or disadvantages of late childbearing were inconsistent as well. Evidence from the sound research studies strongly suggests that many of the adverse outcomes found by some researchers to increase at an older maternal age may be reflecting the particular circumstances surrounding late childbearing (altered medical management, pre-existing diseases, subfertility, unplanned pregnancy, high parity birth) rather than a biological condition of aging. Further research must move away from looking at maternal age as an isolated variable because of the temptation to impute causality to the factor when other associated factors are not controlled. A better understanding of the reproductive aging process is urgently needed.

Cesarean Section↗
PubMed1986

Stress and later-life childbearing: important implications for nursing.

Scientific literature which links advanced maternal age to pregnancy outcome was critically appraised. Little evidence was found to support the pessimistic advice offered to older expectant mothers. Evidence is accumulating which suggests that emotional stress has a deleterious effect on obstetrical outcome, although the manner in which the deleterious effects are produced remains unclear.

Adult↗
PubMedDate not supplied

Woman-centered information on menopause for health care providers: findings from the Midlife Women's Health Survey.

Despite their growing numbers, midlife women continue to feel marginalized by a health care system that is unresponsive to their needs for current information about the perimenopausal experience and for egalitarian, woman-centered care. In this article, the authors call upon physicians, health educators, nurses, counselors, and other health providers to meet the consumer needs of this ever-growing clientele. To this end, they provide data-based information derived from the responses of more than 400 middle-aged women from across the United States to annual Midlife Women's Health Surveys from 1990 to 1993. The authors focus on enhancing the sensitivity of health care providers toward their midlife clients by offering data describing the normal menopausal transition and the feelings and concerns of this group.

Adult↗
PubMedDate not supplied

Women and their husbands: mood and arousal fluctuations across the menstrual cycle and days of the week.

This study examined the relationship between biological (menstrual cycle) and social-contextual (day of the week) factors and psychological and physical events among nine women and their spouses. Employing P-technique factor analysis to identify consistent patterns in single-subject data over 90 days of reporting, two factors emerged: Negative Mood and Arousal. When these factors were compared over five phases of each woman's menstrual cycle, the only significant finding was that men's Arousal scores were significantly greater during their wives' menses phase compared to their follicular phase. Negative Moods decreased on weekends for both males and females, and females also showed a decline in Arousal on the weekend. The finding that our social factor (day of the week) accounted for more variability in subjects' reports than did our biological factor (the menstrual cycle) emphasizes the importance of considering biological events in the context of social structures and belief systems.

Adult↗
PubMedDate not supplied

The menopausal transition: guidelines for researchers.

We believe that the menopausal transition can be eased for women if they have information about normal changes they can anticipate. Until now, research on the subject of menopause has been fragmented and flawed, in large part because an "oppositional approach" to the study of menopause has pitted biology against culture and has slowed progress toward a more fruitful interactive approach. Failure to agree on basic definitions has contributed further to fragmentation. Future research efforts must employ healthy, non-clinical samples and prospective designs that will avoid recall problems. Women must be at the center of this research, as respondents whose experiences and interpretations of these experiences become the focus of study. It is the normalcy of menopause that remains undocumented (Voda & George, 1986). When research has identified a range of experiences common to the menopausal transition for healthy women, it will be possible for aging women and their health care providers to make accurate assessments of their individual patterns of change. It is anticipated that studies will document a wider range of changes as normal than is currently accepted, perhaps reducing the number of interventions occurring when pathology is identified incorrectly. Studies with a bi-directional focus will make possible an understanding of the mutual influences of biology and culture on premenopausal women's changing experiences. Knowledge of which symptoms are inevitable conditions of hormonal shifts and which are not will remove the burden of ignorance from women and empower them to better cope with this life stage.

Female↗