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Beyond Bikini ScienceJody Hewgill

Beyond Bikini Science (continued)

Planning for Safety

Family planning clinics offer a range of services to women—access to contraceptives, cervical cancer screenings and HIV testing, to name a few.

Michele Decker, ScD, MPH, assistant professor in PFRH, is exploring whether the clinics can also serve as effective entry points to educate women about physical and sexual abuse and link them with support services.

“Evidence increasingly shows that young women bear the brunt of partner violence, and violence is associated with unintended pregnancy as well as other aspects of poor sexual and reproductive health,” she says.

In a pilot study at four Northern California family planning clinics, Decker and colleagues found significant declines in reports of reproductive coercion at clinics that screened for abuse. Reproductive coercion by a partner includes preventing a woman from using contraception or sabotaging her birth control method.

The study used “enhanced” screenings that emphasize education about abuse and referral to services. Clinicians also distribute wallet-sized “safety” cards to all women, listing hotlines, shelters and other resources.

“It removes the burden on the patient to disclose violence in that moment,” says Decker, who is working on a larger study to advance the pilot findings.

Comparing Apples to Pears

When it comes to matters of the heart, cardiovascular disease is not created equal.

“Heart disease in men and women looks different, and we’re not sure why,” says Morgana Mongraw-Chaffin.

While pain is a common heart attack symptom in both sexes, for example, women are more likely to experience atypical symptoms, including abdominal stress, back pain or shortness of breath—sometimes in the absence of chest discomfort.

“The way women put on fat is subcutaneous, whereas men put on fat more viscerally,” reflected in the traditional apple and pear shapes in men and women, explains Mongraw-Chaffin, whose research focuses on possible connections between sex hormones and body fat composition in men and women.

“Why do they put on fat differently, and does that help explain some of the differences we’re seeing in cardiovascular disease later in life?”

Mongraw-Chaffin hopes that her work can contribute to the development of more precise body mass index classifications in both men and women and among different racial groups.

“If we can better understand differences in risks, we can better tailor research and population-level interventions to the people who need it most,” she says.

Holding Back Frailty

Geriatricians have long known what frailty looks like: hunched posture, halting movements, a slow gait and the loss of muscle mass.

However, instead of viewing frailty as separate symptoms, the Women’s Health and Aging Study (WHAS) team defined it as a syndrome and developed precise metrics (a frailty assessment) to identify it.

WHAS research, conducted at Hopkins from 1991 to 2011, has important implications in caring for a rapidly aging population—particularly for women who are disproportionately affected by frailty, says Karen Bandeen-Roche, PhD, Biostatistics chair. Frailty, for example, is associated with more severe responses to falls and other stressors.

Bandeen-Roche and WHAS colleagues Linda Fried, MD, MPH ’84, dean of Columbia University’s Mailman School of Public Health, and Jeremy Walston, MD, a professor of Medicine, hope to see the assessment adopted more widely as a diagnostic tool by clinicians.

Researchers now are exploring the biological determinants of frailty, which could lead to treatments to delay its onset. “The key idea is that it doesn’t result from a single insult to the body, but from widespread dysregulation in the system,” she says.

 

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Beyond Bikini Science

Beyond Bikini Science

A band of scientists is expanding the scope of women's health.

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