Comparison of Skin Biomechanics and Skin Color in Puerto Rican and Non-Puerto Rican Women

Objective: Skin biomechanics are physical properties that protect the body from injury. Little is known about differences in skin biomechanics in racial/ethnic groups and the role of skin color in these differences. The purpose of this study was to determine the relationship between skin biomechanics (viscoelasticity, hydration) and skin color, when controlling for demographic and health-related variables in a sample of Puerto Rican and non-Puerto Rican women. Methods: We performed a secondary analysis of data from 545 women in a longitudinal, observational study of skin injury in Puerto Rico and the United States. Data included measures of skin viscoelasticity, skin hydration, skin color, demographic, and health-related variables. Skin color was measured by spectrophotometry (L* - lightness/darkness, a*- redness/greenness, b* - yellowness/blueness). The sample was 12.5% Puerto Rican, 27.3% non-Puerto Rican Latina, 28.8% Black, 28.6% White, and 2.8% Other. Results: Regression analyses showed that: 1) higher levels of skin viscoelasticity were associated with lower age, higher BMI, and identifying as non-Puerto Rican Latina as compared to Puerto Rican; (all p \u3c .001); and 2) higher levels of hydration were associated with lower L* values, higher health status, lower BMI, and identifying as non-Puerto Rican Latina, White, or Other as compared to Puerto Rican (all p \u3c .05). Conclusion: When adjusting for skin color, Puerto Rican women had lower viscoelasticity and hydration as compared to other groups. Puerto Rican women may be at long-term risk for skin alterations, including pressure injury, as they age or become chronically ill

The health of women and girls determines the health and well-being of our modern world: A White Paper From the International Council on Women's Health Issues

The International Council on Women's Health Issues (ICOWHI) is an international nonprofit association dedicated to the goal of promoting health, health care, and well-being of women and girls throughout the world through participation, empowerment, advocacy, education, and research. We are a multidisciplinary network of women's health providers, planners, and advocates from all over the globe. We constitute an international professional and lay network of those committed to improving women and girl's health and quality of life. This document provides a description of our organization mission, vision, and commitment to improving the health and well-being of women and girls globally

Symptom Phenotypes in Pulmonary Arterial Hypertension: The PAH “Symptome”

Women with pulmonary arterial hypertension (PAH) experience multiple symptoms, including dyspnea, fatigue, and sleep disturbance, that impair their health‐related quality of life (HRQOL). However, we know little about phenotypic subgroups of patients with PAH with similar, concurrent, multiple symptoms. The objectives of this study were to define the “symptome” by symptom cluster phenotypes and compare characteristics such as biomarkers, cardiac structure and function (echocardiography), functional capacity (6‐min walk distance), and HRQOL between the groups. This cross‐sectional study included 60 women with PAH. Subjects completed an assessment battery: Pulmonary Arterial Hypertension Symptom Scale, Pittsburgh Sleep Quality Index, Multidimensional Dyspnea Profile, Patient‐Reported Outcomes Measurement Information System (PROMIS®) Physical Function, PROMIS® Sleep‐Related Impairment, and the emPHasis‐10. Subjects also underwent transthoracic echocardiography, phlebotomy, 6‐min walk distance, and actigraphy. The three symptoms of dyspnea, fatigue, and sleep disturbance were used to define the symptom clusters. Other PAH symptoms, plasma and serum biomarkers, cardiac structure and function (echocardiography), exercise capacity (6‐min walk distance), sleep (actigraphy), and HRQOL were compared across phenotypes. The mean age was 50 ± 18 years, 51% were non‐ Hispanic white, 32% were non‐Hispanic Black and 40% had idiopathic PAH. Cluster analysis identified Mild (n = 28, 47%), Moderate (n = 20, 33%), and Severe Symptom Cluster Phenotypes (n = 12, 20%). There were no differences for age, race, or PAH etiology between the phenotypes. WHO functional class (p \u3c 0.001), norepinephrine levels (p = 0.029), right atrial pressure (p = 0.001), physical function (p \u3c 0.001), sleep onset latency (p = 0.040), and HRQOL (p \u3c 0.001) all differed significantly across phenotypes. We identified three distinctive symptom cluster phenotypes (Mild, Moderate, and Severe) for women with PAH that also differed by PAH‐related symptoms, physical function, right atrial pressure, norepinephrine levels, and HRQOL. These phenotypes could suggest targeted interventions to improve symptoms and HRQOL in those most severely affected

Correspondence Between Perceived Pubertal Development and Hormone Levels in 9-10 Year-Olds From the Adolescent Brain Cognitive Development Study.

Aim: To examine individual variability between perceived physical features and hormones of pubertal maturation in 9-10-year-old children as a function of sociodemographic characteristics. Methods: Cross-sectional metrics of puberty were utilized from the baseline assessment of the Adolescent Brain Cognitive Development (ABCD) Study—a multi-site sample of 9–10 year-olds (n = 11,875)—and included perceived physical features via the pubertal development scale (PDS) and child salivary hormone levels (dehydroepiandrosterone and testosterone in all, and estradiol in females). Multi-level models examined the relationships among sociodemographic measures, physical features, and hormone levels. A group factor analysis (GFA) was implemented to extract latent variables of pubertal maturation that integrated both measures of perceived physical features and hormone levels. Results: PDS summary scores indicated more males (70%) than females (31%) were prepubertal. Perceived physical features and hormone levels were significantly associated with child\u27s weight status and income, such that more mature scores were observed among children that were overweight/obese or from households with low-income. Results from the GFA identified two latent factors that described individual differences in pubertal maturation among both females and males, with factor 1 driven by higher hormone levels, and factor 2 driven by perceived physical maturation. The correspondence between latent factor 1 scores (hormones) and latent factor 2 scores (perceived physical maturation) revealed synchronous and asynchronous relationships between hormones and concomitant physical features in this large young adolescent sample. Conclusions: Sociodemographic measures were associated with both objective hormone and self-report physical measures of pubertal maturation in a large, diverse sample of 9-10 year-olds. The latent variables of pubertal maturation described a complex interplay between perceived physical changes and hormone levels that hallmark sexual maturation, which future studies can examine in relation to trajectories of brain maturation, risk/resilience to substance use, and other mental health outcomes

Injuries in Older Women who are Sexually Assaulted

Sexual assault is considered a silent, violent epidemic against women of all ages. We have prospectively investigated genital and non-genital injuries in women examined by our Sexual Assault Nurse Examiner (SANE) Program since 1998. Our hypothesis was that age is significantly and positively related to the number of genital and non-genital injuries in women following sexual assault. We studied 132 women over 39 years of age (mean age=50.58; SD 13.71; range 40-94) during the study period. Methods: We maintain a Sexual Assault Registry with documentation of injury on all individuals examined by the SANEs (N=1010). Following stratification by age (\u3e39 years), we found 132 women in our sample with registry data. Vaginal penetration occurred in 75% of the assaults, anal penetration in 21%, and oral penetration in 24%. Women 40-49 (n=92) had a mean of 0.87 genital injuries. Women over 49 (n=40) had a mean of 2.28 genital injuries. Correlation between age and number of genital injuries was r = 0.296 (p \u3c 0.001) and between age and non-genital injuries was -0.90 (ns). Black women (n=65) had significantly fewer genital injuries than White women (n=63) [t(116)=1.98, p=0.05)]. The labia minora was the most frequently injured genital location followed by the vagina and posterior fourchette. In our sample of women older than 39 years, older women who were sexually assaulted had higher rates of injury than younger women. Further work is needed to determine the reasons for the higher injury rates among older women and for ethnic and racial differences. Learning Objectives: Discuss the type and location of genital injuries caused by sexual assault Analyze the relationship between age and injury caused by sexual assault Assess the role of race in genital injuries caused by sexual assaul

Injuries in Older Women who are Sexually Assaulted

Sexual assault is considered a silent, violent epidemic against women of all ages. We have prospectively investigated genital and non-genital injuries in women examined by our Sexual Assault Nurse Examiner (SANE) Program since 1998. Our hypothesis was that age is significantly and positively related to the number of genital and non-genital injuries in women following sexual assault. We studied 132 women over 39 years of age (mean age=50.58; SD 13.71; range 40-94) during the study period. Methods: We maintain a Sexual Assault Registry with documentation of injury on all individuals examined by the SANEs (N=1010). Following stratification by age (\u3e39 years), we found 132 women in our sample with registry data. Vaginal penetration occurred in 75% of the assaults, anal penetration in 21%, and oral penetration in 24%. Women 40-49 (n=92) had a mean of 0.87 genital injuries. Women over 49 (n=40) had a mean of 2.28 genital injuries. Correlation between age and number of genital injuries was r = 0.296 (p \u3c 0.001) and between age and non-genital injuries was -0.90 (ns). Black women (n=65) had significantly fewer genital injuries than White women (n=63) [t(116)=1.98, p=0.05)]. The labia minora was the most frequently injured genital location followed by the vagina and posterior fourchette. In our sample of women older than 39 years, older women who were sexually assaulted had higher rates of injury than younger women. Further work is needed to determine the reasons for the higher injury rates among older women and for ethnic and racial differences. Learning Objectives: Discuss the type and location of genital injuries caused by sexual assault Analyze the relationship between age and injury caused by sexual assault Assess the role of race in genital injuries caused by sexual assaul

Incidence and Location of Genital Injury After Sexual Assault

Of the estimated 6.8 million rapes and physical assaults that occur each year against U.S. women, 2.6 million will result in injury and 792,200 will require health care. The reported incidence of genital injury resulting from sexual assault ranges from 32% on direct visualization to 87% with colposcopy. Physiologic theory suggests that consensual sex is associated with lower rates of genital injury than that of non-consensual sex because of the lack of lubrication that occurs during non-consensual sex

Incidence and Location of Genital Injury After Sexual Assault

Of the estimated 6.8 million rapes and physical assaults that occur each year against U.S. women, 2.6 million will result in injury and 792,200 will require health care. The reported incidence of genital injury resulting from sexual assault ranges from 32% on direct visualization to 87% with colposcopy. Physiologic theory suggests that consensual sex is associated with lower rates of genital injury than that of non-consensual sex because of the lack of lubrication that occurs during non-consensual sex

Design of a randomized controlled clinical trial assessing dietary sodium restriction and hemodialysis-related symptom profiles

Aim: In hemodialysis patients, the need to have intercurrent sodium and water intake removed by ultrafiltration increases disease burden through the symptoms and signs that occur during hemodialysis (HD). This added burden may be mitigated by reduction of dietary sodium intake. The National Kidney Foundation (NKF) recommends 2400 mg of dietary sodium daily for patients on HD, and the American Heart Association (AHA) suggests 1500 mg, evidence is lacking, however, to support these recommendations in HD. Moreover, little is known about the relationship of specific levels of dietary sodium intake and the severity of symptoms and signs during ultrafiltration. Our goal will be to determine the effects of carefully-monitored levels of sodium-intake as set forth by the NKF and AHA on symptoms and signs in patients undergoing (HD). Methods: We designed a three-group (2400 mg, 1500 mg, unrestricted), double blinded randomized controlled trial with a sample of 42 HD participants to determine whether 1. Symptom profiles and interdialytic weight gains vary among three sodium intake groups; 2. The effect of HD-specific variables on the symptom profiles among the three groups and 3. Whether total body water extracellular volume and intracellular volume measured with bioimpedance varies across the three groups. We will also examine the feasibility of recruitment, enrollment, and retention of participants for the five-day inpatient stay. Conclusion: Curbing dietary sodium intake may lead to improvement in intradialytic symptom amelioration and potential for better long-term outcomes. Generating empirical support will be critical to ascertain, and espouse, the appropriate level of sodium intake for patients receiving HD