The purpose of this study was to determine the effects of aerobic exercise on carotid to femoral pulse wave velocity (cf-PWV), cell adhesion molecules (intracellular adhesion molecules (ICAM-1), vascular cell adhesion molecules (VCAM-1), and endothelial selectin (E-selectin), and oxidized-LDL in elderly women aged 70–85 years, and to identify the effect of and correlation with vascular stiffness. Forty participants were recruited and divided into three groups; vascular stiffness (VSG, n=14), obesity (OG, n=14), and normal (NG, n=12). All groups were given a 16-week intervention of aerobic exercise, and the data collected before and after exercise were analyzed using SPSS Ver. 23.0. Two-way repeated-measures ANOVA was used to evaluate between-group and time-dependent interaction effects. One-way ANOVA was used to evaluate between-group variations. In addition, the significance was tested using a post-hoc test (Scheffe). The within-group variations by time before and after exercise were examined using a paired t-test, and correlation analysis was performed using Pearson correlation coefficients. Simple regression analysis was performed for variables showing significant differences. The results indicated interaction effects for cf-PWV (p<.001), VCAM-1 (p<.01), E-selectin (p<.05) and oxidized LDL (p<.001). The rate of change of cf-PWV was positively correlated with that of VCAM-1 (r=.352, p<.05) and that of oxidized-LDL (r=.325, p<.05) with statistical significance. To determine the effect of the rate of change of cf-PWV on the rate of change of VCAM-1, the variables were tested, and the coefficient of determination in the regression analysis was .124, indicating that 12.4% of the tested variables fit the standard regression line. The variables for the effect of the rate of change of cf-PWV on the rate of change of oxidized LDL were also tested, and the coefficient of determination in the regression analysis was .106, indicating that 10.6% of the tested variables fit the standard regression line. Thus, the 16-week regular and consistent aerobic exercise program had significant effects on the cf-PWV, ICAM-1, VCAM-1, E-selectin, and oxidized-LDL in elderly Korean women with vascular stiffness, suggesting improvements in vascular stiffness, based on which the intervention is predicted to contribute to the prevention of vascular dysfunction by lowering the risk of cardiovascular disease due to atherosclerosis, as well as having a positive effect in the prevention of impairment of vascular endothelial cells.

This qualitative research study explores the experiences of three Emirati women who have achieved significant success in their higher education institutes in the (UAE). The study aims to understand how childhood and adolescent experiences shape the leadership development of these women, both positively and negatively. The study also includes interviews with family members and close colleagues of the participants to gain additional perspectives. The findings the importance of family support, role models, and mentors in shaping the leadership development of women in the UAE. The study also sheds light on the challenges and barriers that women face in leadership positions, including gender bias and discrimination. Overall, the study contributes to a deeper understanding of the experiences of Emirati women in leadership positions and provides insights into how to support their leadership development.

Globally, the impact of COVID-19 on mental health has been significant. Pregnant women are known to be a vulnerable population in relation to mental health. In Australia, there was an unprecedented demand during the pandemic for mental health services, including services for pregnant women. Maternal mental health has unique and enduring features that can significantly shape a child’s overall development and poor maternal mental health can have considerable social and economic costs. This cross-sectional study evaluated antenatal depression and COVID-19 related distress in a sample of two hundred and sixty-nine pregnant women residing in Australia aged between 20 and 43 (M = 31.79, SD = 4.58), as part of a larger study. Social media advertising was used to recruit participants between September 2020 and November 2021. Prevalence rates for antenatal depression were found to be higher in this study (16.4%) compared with previous Australian prevalence rates (7%). COVID-19 distress in relation to having a baby during a COVID-19 outbreak significantly predicted antenatal depression, B = 1.46, p &lt; .001. Results from this study suggest that mothers and families may have increased mental health vulnerabilities as a consequence of the pandemic for some time yet.

The issue of being pro-gender is still a controversial topic to be debated in Indonesian society. However, in the 21st Century, many women have been able to break through barriers and participate in the public sphere. It is a form of self-existence as proposed by Simone de Beauvoir on existentialist feminism. Based on these problems, this study aims to find out and answer questions about how Indonesian women exist in the public sphere in the 21st Century and find out how Indonesian women exist in the public sphere through Simone de Beauvoir's existentialist feminism paradigm. The research method used is descriptive-qualitative through a literature review of 23 journal articles, websites, and data reports with a range of 2019-2021. This study found that based on Simone de Beauvoir's feminist paradigm, Indonesian women in the 21st Century are no longer a figure other than complete. Furthermore, the data collected by the researcher shows that several gender indicators have shown that Indonesian women have been able to occupy public spaces in various aspects. Based on these results, it is hoped that it can provide information about Simone de Beauvoir's existentialist feminism thought and its relevance to the existence of Indonesian women in the public sphere in the 21st Century. However, this research has limitations, those are only about women in Indonesia, and the paradigm of feminism is limited to Simone de Beauvoir's existentialist feminism.

Around one billion people live in informal settlements, globally, including over half of Nairobi, Kenya’s three million residents. The purpose of this study was to explore women’s fear of victimization within Mathare, an informal settlement in Nairobi, Kenya and how fear of victimization influences behavior. Fifty-five in-depth interviews were conducted with women in 2016. A modified grounded theory approach guided data collection and analysis. Findings suggest fear of victimization is a serious concern in informal settlements. Women have found ways to adopt their behaviors that allow them to continue to function and protect their children despite fearing victimization, but at a potential cost to their health and well-being. Thus, there is a critical need for more research focused on social, economic, structural, community, infrastructure, technological, and individual strategies to prevent violence, enhance residents’ sense of safety, and, subsequently, minimize women’s fear of victimization in informal settlements.

Background: Reproductive coercion and abuse (RCA) is a hidden form of violence against women. It includes behaviours intended to control or dictate a woman’s reproductive autonomy, for the purpose of either preventing or promoting pregnancy. Main text: In this commentary, we argue that there is a lack of conceptual clarity around RCA that is a barrier to developing a robust evidence base. Furthermore, we suggest that there is a poor understanding of the way that RCA intersects with other types of violence (intimate partner violence; sexual violence) and – as a result – inconsistent definition and measurement in research and practice. To address this, we propose a new way of understanding RCA that centres perpetrator intent and the presence of fear and control. Recommendations for future research are also discussed. Conclusion: We suggest that IPV and SV are the mechanisms through which RCA is perpetrated. In other words, RCA cannot exist without some other form of co-occurring violence in a relationship. This has important implications for research, policy and practice including for screening and identification of women in reproductive healthcare settings.

Considering the increasing number of women entering the accounting profession; it is timely to explore inequalities that still exist; and consider what policy processes continue to forge inequalities between men and women. Through a SLR of accounting and management journals during the period 1994-2017 we assess the different dynamics that have shaped inequalities between men and women, presenting both employee and employer perspectives of professional enhancement. The study is framed around conceptualizations of gendered organizations and highlights how cultural and social practices impact men and women differently. Our study finds there are still arrays of organization practices that have profound gendered effects. Our study shows that there are commonalities in research which include HR practices of recruitment, selection, and advancement; perceptions of women's visibility and invisibility at work; motherhood and childcare responsibilities; and discourses of the glass ceiling that constitute barriers to women's progression. Most importantly we reveal that constraints nowadays are similar to those identified in the 90s. We explored these gendered constructions and suggest relevant HR strategies that can aid women's advancement.

High maternal mortality in the developing countries, particularly in Nigeria, poses serious challenge to achieving the maternal mortality target of the Sustainable Development Goals (SDGs) in the countries. Hence, there is need for multifaceted approach to curtailing the scourge. Women being the victims of maternal mortality, this study finds the effect of their household decision making power in reducing maternal mortality. The study used data from the 2013 Nigeria Health and Demographic Survey (NDHS) and logistic regression model to explore the relationship between women household decision making power and maternal mortality in Nigeria. The finding shows that women who decide and participate in household decision on own health, major purchases and visit to family and relatives were 35% (OR = 0.65, 95% CI: 0.52, 0.83), 27% (OR = 0.73, 95% CI: 0.57, 0.92), and 37% (OR = 0.63, 95% CI: 0.50, 0.80) less likely to experience maternal mortality, respectively, compared to those whose husbands alone decide. Women household decision making power is therefore instrumental to reducing maternal mortality. It is thus important for policy makers, particularly in Nigeria, to pay more attention to social and cultural factors that surround women household decision making ability for speedy reduction in maternal deaths.

Abstract: Background: Exposure to ETS (Environmental Tobacco Smoke) is one of the most toxic environmental exposures. Objective: To investigate the impact of ETS on physiological, biochemical, psychological indicators, on the urine antioxidant capacity (AC) and oxidative damage to lipids in a pilot sample of healthy pregnant women. Methods: The exposure to ETS was investigated by a validated questionnaire, urine cotinine and the marker of oxidative damage to lipids - 8-isoprostane concentrations using an ELISA kit. Urine AC was determined by the spectrophotometric TEAC method. From the sample of pregnant women (n=319, average age 30.84 ± 5.09 years) in 80 the levels of cotinine and oxidative stress markers were analyzed. Results: From our sample, 5 % individuals (7.4 % objectified by cotinine) were current smokers and 25 % reported passive smoking in the household (18.8 % objectified by cotinine). The Kappa was 0.78 for smokers and 0.22 for ETS exposed non-smokers. Smokers as well as non-smokers had significantly higher (p<0.05) urine AC than ETS exposed non-smokers. Non-smokers had significantly lower levels of 8-isoprostane than smokers (p<0.01) and ETS-exposed non-smokers (p<0.05). Correlations between urine levels of cotinine and AC were positive in ETS exposed non-smokers. Conclusion: The harmful effect of active and passive smoking on oxidative stress parameters has been indicated.

The creation of the National Muslims Women’s Advisory Group (NMWAG) in 2008 by Britain’s New Labour Government was part of a strategy which sought to engage different levels of Muslim communities beneath an overarching focus on reducing ‘Islamic extremism’. To do so however, Government acknowledged that it would need to support Muslim women to overcome some of the constraints it believed were placed on Muslim women in contemporary Britain. Deeming theology and religious interpretation to be one of those constraints, Government saw the need to empower Muslim women to ‘influence and challenge’ religious and theological discourses as a priority. This article therefore offers a case study on a project that was commissioned by Government that sought to empower Muslim women to ‘influence and challenge’ theological interpretations in collaboration with the NMWAG. Having gained unprecedented access to the NMWAG, its activities and engagement with Government, this article presents previously unpublished findings from that project to focus on two key themes: Muslim women, their identity and position; and theology, leadership and the participation of women. Having explored these in detail, this article concludes by critically reflecting on the way in which Government engaged and interacted with Muslim women, the role and relative success of the NMWAG and, most importantly, the extent to which the NMWAG was able to ‘influence and challenge’ interpretations of Islamic theology.

Abstract: Understanding the reliability and sensitivity of jump testing is essential to determine the neuromuscular progress of athletes and make informed decisions. This study aimed to assess the reliability and sensitivity of countermovement jump (CMJ) and drop jump (DJ) tests metrics in female volleyball players. Sixteen semi-professional female volleyball players participated in the study. Intrasession and intersession reliability of CMJ and DJ metrics were evaluated using a randomized cross-over design. Dual force platform was used to collect data, and several dependent variables were calculated using forward dynamics. Intraclass correlation coefficients (ICC), coefficients of variation (CV) and minimum difference (MD) were calculated. The third attempt presented the highest values for both test, and changes in jump strategy in DJ. CMJ is consistent across sessions, while DJ also shows intersession differences (p<0.05) in 11 out of 15 variables. Most CMJ variables exhibit excellent reliability while DJ variables have lower reliability and higher variability. Concentric and eccentric impulses for DJ showed excellent reliability. Most CMJ variables showed excellent reliability and variability, DJ had lower reliability, higher variability, and lower sensitivity. These findings provide valuable information when assessing athletes' performance and highlight the reliability, sensitivity, and variability in jump performance for CMJ and DJ tests.

Chronic Fatigue Syndrome (CFS) can be triggered by different factors and create a complex health situation. In the last decades incidence has been increasing. This situation is a clear example of how humans, viruses, and the environment are all connected. In the 90s cases related to CFS, com-plaints about a feeling of chronic fatigue, inability for everyday tasks, dull pain, cephalalgia, de-pression, anxiety, poor concentration. Clinical tests for EBV, HHV, CMV, IgG, IgM, T4 and T8 subsets were tested, along with hormones and hemogram tests. Most of the cases were women. The timeline of the medical history showed also myomas, breast lumps, premenstrual syndrome previously to CFS development. The nature of these conditions promoted the idea of a possible common link among them and CFS. Some cases also suffered from allergies, food intolerances, candidiasis, intestinal impairment, thyroid implications, endometriosis. As an initial working hypothesis, The Liver Link (TLL) was proposed in order to understand those different conditions affecting body, mind and emotional wellbeing. Considering liver implication can make a differ-ence in treatment and recovery. Low grade inflammatory conditions are related to Th2 predom-inance and liver functions. Functional disharmonies are very important because they usually still do not appear in any conventional tests. In 2002, TLL was presented as a framework to explain the concomitance of CFS and other conditions and the relationship with some viruses such as EBV, HHV, CMV, as a lecture in a congress at the University of Westminster (London). When SARS-CoV-2 outbroke, TLL helped to warn about the post-covid syndrome more likely to occur in specific individuals.

Climate change is one of the widely acknowledged challenges faced by international communities in the 21^st century. It poses challenges to fundamental elements of our understanding of appropriate goals for socioeconomic policies, such as the connection of prosperity, growth, equity and sustainable development. Human activities-induced climatic changes have been widely perceived as threatening criteria for the long-term resilience of societies and communities throughout the world. The United Nations Intergovernmental Panel on Climate Change (UNIPCC) reported that greenhouse gas (GHG) emissions due to human activities, such as the burning of fossil fuels for energy generation, is changing the climate of Earth. Despite contributing less towards the causes, poor citizens of developing countries bear a lot of its impacts. In particular, women and girls face a major impact and finally, they migrate due to the social gender division and scarcity of food. Studies on gender and climate change-induced migration are scarce. This study provides an overview of the induced impact of climate change on the livelihood, health and migration of women and girls. The aim of this study would significantly advance our understanding of the current inter-linkages between migration, displacement patterns and climate change impacts.

This study examines the prospective association of egg consumption with multiple domains of cognitive function in older, community-dwelling men and women followed 16.3 years. Participants were 617 men and 898 women from the Rancho Bernardo Cohort aged 60 and older who were surveyed about egg intake/week in 1972-74, and attended a 1988-91 research visit when cognitive function was assessed with 12 tests. Analyses showed that egg intake ranged from 0-24/week (means: men=4.23.2, women=3.52.7, p<0.0001). In men, covariate-adjusted regressions showed egg intake was associated with better performance on Buschke total (p=0.04), long-term (p=0.02) and short-term (p=0.05) recall. No significant associations were observed in women (p’s>0.05). Analyses in those <60y at in 1972-74 showed egg intake was positively associated with scores on Heaton copying(p<.04) and the Mini-Mental Status Exam(MMSE;p<.02) in men, and category fluency(p<0.05) in women. Egg intake was not significantly associated with odds of poor performance on MMSE, Trails B, or category fluency in either sex. These reassuring findings suggest there are no long-term detrimental effects of egg consumption on multiple cognitive function domains, and for men, there may be beneficial effects for verbal episodic memory. Egg consumption in middle-age may also be related to better cognitive performance later in life.

(1) Background : Low dietary intake of calcium, vitamin D, vitamin C and magnesium has been associated with increased risk of osteoposrosis. The purpose was to evaluate changes in biomarkers of bone metabolism, and cardiometabolic health in postmenopausal women, with high risk of osteoporosis, followed by a nutritional intervention program. (2) Method: It was a prospective randomized controlled trial. A sample of 115 apparently healthy postmenopausal women(45 -75 years of age) randomized into four groups: (I) nutritional intervention group(n=40) received daily 1000mg vitamin C, 500mg vitamin D3, 500mg calcium(Ca) and 300mg magnesium (Mg); (II) control group(n=42) received daily 500mg vitamin D3, 500mg Ca and 300mg Mg; (III) nutritional intervention group (n=18) received daily 150mg bisphosphonates, 500mg vitamin D3, 500mg Ca and 300mg Mg; and (IV) nutritional intervention group (n=15) received daily about 364 mg polyphenols via an innovative functional food (50g olive paste enriched with mountain tea extract) along with 500mg vitamin D3, 500mg Ca and 300mg Mg. Groups I -III received supplementation for a year whereas group IV for 5 months. Changes in calciregulatory hormone parathormone (PTH) were evaluated at the beginning of the study as well as at 5 and 12 months intervals. Blood levels of vitamin D, vitamin C, Ca, Mg and the lipid profile were assessed at the beginning and at the end of the study. Anthropometric indices (weight, body fat(Kg), Body Mass Index(BMI) and bone mineral density(BMD) were evaluated at the beginning and at the end of the study. Statistical analysis was performed with IBM-SPSS Statistics-21. The level of statistical significance was set at p<0.05. (3) Results: 25(OH)D3 levels were improved, in groups II, III and IV (+3,71% and +1.45% and +5.62% respectively). PTH levels were increased at the end of the intervention period, for groups I and IV. Significant positive changes recorded, in total BMD, in all four study groups. Significant beneficial changes for total cholesterol was observed in group IV (-2.07%, P<0.05) and positive changes in group I for HDL biomarker (+61.62%, P<0.05) (4) Conclusions:. Additional larger-scale clinical trials and intervention studies are considered essential, in order to fully investigate and elucidate associations between dietary components and biochemical indices of bone metabolism.

To date, the impact of COVID-19 vaccination on formerly menstruating women remains unknown. For this reason, a retrospective observational cross-sectional study was conducted (N= 548) using an online survey. General characteristics, medical history, and adverse events following COVID-19 vaccination were recorded. In comparison with the first dose, significantly higher percentages of respondents experienced menstrual-related disturbances (dose 1: 38.5% vs. dose 2: 44.8%; McNemar=9.15; mid P-value=0.002), as well as the simultaneous occurrence of two or more of these symptoms (dose 1: 11.2% vs. dose 2: 15.3%; McNemar=13.53; mid P-value=0.044) after receiving the second one. Among them, those related with the length and flow stand out, being of long-term nature in about 17-20% of cases. Interindividual factors influencing this unexpected event after receiving the dose 1 may include weight (AOR 1.02, CI 95% 1.01–1.03, P&lt;.001), perimenopause (AOR 2.28, CI 95% 1.37–3.77, P=.001), pre-existing diagnoses of non-autoimmune rheumatic/articular conditions (AOR 0.31, CI 95% 0.10–1.00, P=0.05), hormonal contraceptive use (AOR 0.25, CI 95% 0.07-0.82, P=0.02), suffering from other vaccine side effects − such as arm pain (AOR 0.61, CI 95% 0.39–0.95, P=0.03), headache (AOR 0.53, CI 95% 0.35 – 0.80, P=.003), swollen glands (AOR 0.29, CI 95% 0.15 – 0.60, P=.001) and nauseas (AOR 0.35, CI 95% 0.14 – 0.86, P=0.02) – and the number of previous pregnancies (AOR 2.70, CI 95% 1.54 – 4.76, P=.001). Formerly menstruating women may experience long-term menstrual-related disturbances following COVID-19 vaccination.

Nonalcoholic fatty liver disease (NAFLD) is a prevalent condition among postmenopausal women that can lead to severe liver dysfunction and increased mortality. In recent years, research has focused on identifying potential lifestyle dietary interventions that may prevent or treat NAFLD in this population. Due to the complex and multifactorial nature of NAFLD in postmenopausal women, the disease can present as different subtypes, with varying levels of clinical presentation, and variable treatment responses. By recognizing the significant heterogeneity of NAFLD in postmenopausal women, it may be possible to identify specific subsets of individuals who may benefit from targeted nutritional interventions. In this review, we sought to examine the current evidence supporting the role of three specific nutritional factors - choline, soy isoflavones, and probiotics – as potential nutritional adjuvants in the prevention and treatment of NAFLD in postmenopausal women. There is promising evidence supporting the potential benefits of these nutritional factors for NAFLD prevention and treatment, particularly in postmenopausal women, and further research is warranted to confirm their effectiveness in alleviating hepatic steatosis in this population.

This study aimed to examine the trends in the prevalence of overweight and obesity and to determine the associated socioeconomic and household environmental factors among women in Nepal. Using nationally representative data from the 1996, 2001, 2006, 2011 and 2016 cross-sectional Nepal Demographic and Health Surveys (NDHSs) (n = 33,507), the prevalence of overweight–obesity (body mass index (BMI) ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) among women aged 15–49 years were examined. From the latest NDHS 2016, non-pregnant women with recorded anthropometric measurements (n = 6165) were included in the final analyses. Multivariate logistic regression models were used to determine the socioeconomic and household environmental factors associated with BMI ≥ 25 and BMI ≥ 30. Between 1996 and 2016, the prevalence of overweight–obesity increased from 1.8% to 19.7%, while the prevalence of obesity increased from 0.2% to 4.1%. Age, marital status, wealth index, province of residence, cooking fuel, refrigerator, and bicycle were significantly associated with having both overweight–obesity and obesity. Similarly, educational status, religion, type of toilet facility, television, and mobile phone were significantly associated with having overweight–obesity. Given the alarming increase in the prevalence of overweight and obesity among Nepalese women, there is an urgent need of interventions addressing these critical socioeconomic and household environmental factors.

Oxidative stress negatively affects folliculogenesis and embryo development. However, a reliable and biologically accurate indicator of oxidative stress does not yet exist. On these bases, the aim of this study was to assess -and compare- blood and follicular fluid (FF) redox status in 45 infertile subjects (and 45 age-matched controls) undergoing in vitro fertilization (IVF) and to establish its connection with the outcome of IVF. Blood and FF were obtained at the time of egg retrieval and immediately analyzed. Firstly, ROS production in blood leukocytes and in granulosa cells was assessed. Oxidative stress markers in blood and in granulosa cells resulted significantly (p<0.001) increased in infertile patients compared to controls. Then, a redox index was obtained in plasma and in FF of patients and controls. The main findings emerging from our study in infertile women are: i) blood oxidative stress reflects FF oxidative stress as demonstrated by the significant correlation between blood redox markers and FF redox markers; ii) a significant correlation between oxidative stress parameters and the considered IVF outcomes is present. We suggest the strict monitoring of the redox parameters for the improvement of assisted reproductive techniques success rate and infertility management.

Violence against women or gender-based violence (GBV) is a major public health issue facing women and girls in different settings and is reported to have worsened globally during the COVID-19 pandemic. Despite the impact of the COVID-19 pandemic on increased violence against women in general, which has been reported in many settings globally, there is a paucity of evidence of its impact on violence against highly vulnerable women living with HIV or tuberculosis (TB). Using a qualitative design, this study aimed to explore the views and experiences of women living with HIV (n=19) or TB (n=23) in Timor Leste regarding the GBV they faced during the COVID-19 pandemic. They were recruited using the snowballing sampling technique. Data were collected using one-on-one in-depth interviews and focus group discussions. The five steps of qualitative data analysis suggested in Ritchie and Spencer’s analysis framework were employed to guide the analysis of the findings. Findings indicated that women in this study experienced intensified physical, verbal, sexual and psychological violence by their partners, spouses, in-laws, and parents or other family members during the COVID-19 pandemic. Several prominent risk factors that worsened violence against women during the pandemic were (i) HIV or TB-positive status, (ii) traditional gender roles or responsibilities and expectations, (iii) economic and financial difficulties reflected in the loss of jobs and incomes due to the pandemic, and (iv) individual factors such as jealousy and increased alcohol drinking developed during the lockdowns. The findings underscore the urgent need for multifaceted interventions to address GBV, which should encompass challenging traditional gender norms, addressing economic inequalities, and targeting individual-level risk factors. The findings also indicate the need for the development of robust monitoring and evaluation systems to assess the effectiveness of policies and interventions addressing GBV where the results can inform future improvement. The findings also indicate the need to include GBV in the protocol or guidelines for HIV and TB management. Future large-scale quantitative studies to capture the magnitude and specific drivers of GBV against women living with HIV and TB during the pandemic are recommended.

Mucinous breast carcinoma is a rare subtype of mammary neoplasm encountered in medical practice. It represents approximately 1-6% of all breast cancers and is more common in postmenopausal women. There are two subtypes of mucinous breast carcinoma: pure and mixed. We report the case of a 73-year-old Caucasian woman diagnosed with mucinous pancreatic cystadenoma in 2007. She underwent a surgical procedure involving pancreatectomy of the body and tail, along with multiple known cardiovascular and metabolic comorbidities. In November 2019, during a clinical-biological evaluation for associated diseases, a mucinous carcinoma of the right breast was accidentally detected and later confirmed through further investigations. For treatment, a surgical procedure was performed involving lower right quadrantectomy with right axillary lymph node dissection. The postoperative clinical course was favorable. In conclusion, we present the case of a patient diagnosed with mixed mucinous breast carcinoma, without axillary lymph node invasion. Postmenopausal women with diabetes, overweight, and obesity have an increased susceptibility to breast cancer, with our patient having all these risk factors. To date, no study has demonstrated the genetic or radiation implication in the occurrence of mucinous carcinomas, nor the possible development of mucinous carcinomas in series in the same patient. Current data are insufficient to provide recommendations for the screening of malignant mucinous tumors in subjects with significant cardiometabolic risk factors.

This study investigated the effects of flamenco dance on mood and subjective well-being in older women. In a broader context, the question was raised about how participation in dance activities could influence the emotional well-being of this demographic group. Thirty-four older women, aged between 62 and 79 years, with a mean age of 70.11 years (SD = 5.13), voluntarily participated in the study after providing informed consent. All of them were enrolled in a 12-week flamenco dance workshop conducted by the Autoestima Flamenca Association, with one two-hour session per week. Mood measurements (sadness, anxiety, anger, and joy) were taken biweekly before and after each session, and subjective well-being assessments were conducted before and after the intervention. The results revealed significant improvements in the overall mood of the participants, as well as an increase in their subjective well-being. These improvements were observed at both the individual and group levels. In conclusion, participation in flamenco dance demonstrated a positive impact on the mood and subjective well-being of older women. These findings support the idea that physical and artistic activities, such as flamenco dance, can play an important role in promoting emotional well-being in this age group.

Introduction. Self-sampling has the potential to increase cervical cancer screening (CCS) among women living with HIV (WLWH) in low and middle-income countries (LMICs). However, our understanding of how HPV self-collection studies have been conducted in WLWH is limited. The purpose of this scoping review was to examine the extent to which the HPV self-sampling has been applied among WLWH in LMICs. Method: We conducted multiple searches in several databases for articles published between 2000 and January 2022. With the combination of keywords relating to HPV self-sampling, LMICs, and WLWH, we retrieved over 9,000 articles. We used pre-defined inclusion and exclusion criteria to select relevant studies for this review. Once a study met the inclusion criteria, we created a table to extract each study’s characteristics and classified them under common themes. We used a qualitative descriptive approach to summarize the scoping results. Results: A total of 12 articles were included in the final review. Overall, 3,178 women were enrolled in those studies and 2,105 (66%) of them were WLWH. The self-sampling participation rate was 92.6%. The findings of our study show that 43% of the WLWH in 8 of the studies reviewed tested positive for high-risk HPV (hr-HPV) genotypes, indicating 4 out of 10 WLWH in the studies are at risk of cervical cancer. The prevalence of the hr-HPV in WLWH was 18% higher than that of HIV-negative women. Most women in the study found the self-sampling experience acceptable, easy to use, convenient, and comfortable. Self-sampling performance in detecting hr HPV genotypes is comparable to clinician-performed sampling. However, limited access (i.e., affordability, availability, transportation), limited knowledge about self-screening, doubts about the credibility of self-sampling results, and stigma remain barriers to wide acceptance and implementation of self-sampling. In conclusion, the findings of this review highlight that (a) cervical cancer is a threat to every sexually active woman but for WLWH the threat increases, (b) self-sampling laboratory performance is similar to clinician performed sampling, (c) self-sampling is associated with an increase in cervical cancer screening uptake and (d) WLWH reported a positive experience with self-sampling. However, personal, environmental, and structural barriers challenge the application of self-sampling in LMICs, and these need to be addressed. Keywords: keyword 1; keyword 2; keyword 3 (List three to ten pertinent keywords specific to the article yet reasonably common within the subject discipline.)

Cardiovascular diseases (CVD) are rising rapidly among the postmenopausal woman but they are less likely to identify their risk by an appropriate risk assessment tool. This review evaluates available literature on cardiovascular risk assessment among postmenopausal women to provide a concise view of risk factors and disease burden among them, present risk assessment systems including their drawbacks, emergence of new risk factors and their role in risk prediction, and finally use of hormone replacement therapy during menopause. Results demonstrate that menopause is a transition point for developing CVD not due to physiological changes only but psychosocial factors like depression and marital stress are also responsible. Both conventional and emerging risk factors burden are high among postmenopausal women. Though data regarding CVD risk assessment among postmenopausal population is lacking but existing evidences claimed underestimation or overestimation of risk among women. Moreover application of different tools on same population has revealed significant variation in result. In this regard, recalibration of conventional tools with local data and new risk factors has showed improvement of risk prediction. Hormone replacement therapy during early menopause has reported beneficial to prevent CVD but in secondary prevention it has no role. All of these findings demand further studies on cardiovascular risk assessment, especially in developing countries where women after menopause are not in consideration of health strategy makers.

Preconception lifestyle modification and reducing several known risk factors may have an influence on the future pregnancy outcome. The aim of the study was to analyse health behaviour and personal values, as well as to assess the relationship of these factors in women without children, in pregnant ones and in women who had already delivered babies. The questionnaire survey included Health Behaviour Inventory (HBI), Personal Value List (PVL) and the sociodemographic data and was conducted in 538 women. These women were divided into 3 groups: women who recently delivered (n = 235), pregnant women (n = 121) and childless women (n = 182). Pregnant women demonstrated a significantly higher level of declared health behaviours and also they rated higher subscales values "positive mental attitude" and "health practices" in comparison to women who recently delivered and to childless women. In all tested groups the highest rated personal value was "a successful family life", while the most appreciated symbol of happiness was "love and friendship". Our results suggest that the system of values and the perception of happiness symbols may influence women's health behaviours. Positioning “health” in the hierarchy of personal values as the most important one may facilitate introduction of healthy behaviours. This in turn could reduce several adverse pregnancy outcomes that are potentially modifiable with changing preconception health attitudes. Our results also identify several unanswered questions and highlights areas where new research is needed.

A 24 week-controlled trial was conducted in menopausal women (mean age:61.5) to assess serum 25-hydroyvitaminD (s25OHD) evolution in relation to three interdependent determinants: doses of supplemented (Suppl.) vitamin D₃ (VitD₃); baseline status; seasonality. Participants were randomized into 3 groups (Gr): Gr.Suppl.0, time-controls maintaining dietary habits; Gr.Suppl.5 and Gr.Suppl.10 consuming one and two 125 g servings of VitD₃-fortified yogurts with 5 and 10 µg daily doses, respectively. The 16 intervention-weeks lasted from early-January to mid-August, the 8 follow-up-weeks from late-August to mid-October. Before enrollment, subjects were randomized into two s25OHD strata: “Low stratum (LoStr)“: 25-50 nmol/L; “High stratum (HiStr)“: >50-75 nmol/L. All enrolled participants remained compliant until study end: Gr.Suppl.0 (n=45), Gr.Suppl.5 (n=44) Gr.Suppl.10 (n=44). Over the 16 intervention and 8 follow-up weeks, s25OHD increased in both supplemented groups, more in Gr.Suppl.10 than Gr.Suppl.5. The constant rate of s25OHD per supplemental VitD₃ microgram was greater in LoStr than HiStr. s25OHD increase was greater with late (mid-March) than early (mid-January) inclusion. In conclusion, this randomized trial demonstrates: -a dose-dependent s25OHD improvement related to fortified yogurt consumption; -an inversely baseline-dependent increase in s25OHD; -a seasonal effect that highlights the importance of vitamin D₃ supplementation during winter, even at 5µg/d, in healthy menopausal women.

The measurement of discrimination in employment is a key variable in understanding dynamics in the nature of and change in ‘race relations’. Measuring such discrimination using ‘situation’ and ‘correspondence’ tests was influenced by John Rex’s sociological analyses, begun in in England in the 1960s, and replicated in Europe and America in later decades. This literature is reviewed, and the methodologies of testing for employment discrimination are discussed. Recent work in Britain and The Netherlands is considered in detail in the light of changing social structures, and the rise of Islamophobia. Manchester, apparently the city manifesting the most discrimination in Britain, is considered for a special case study, with a focus on one individual, a Muslim woman seeking intermediate level accountancy employment. Her vita was matched with that of a manifestly indigenous, white Briton. Submitted vitas (to 1,043 potential employers) indicated significant discrimination against the Muslim woman candidate. Results are discussed within the context of Manchester’s micro-sociology, and Muslim women’s employment progress in broader contexts, drawing on our work in Jordan and Palestine. We conclude with the critical realist comment that the “hidden racism” of employment discrimination shows that capitalist societies continue to be institutionally racist, and the failure to reward legitimate aspirations of minorities pushes ethnic minorities into a permanent precariat, with implications for social justice and social control, which denies minority efforts to “integrate” in society’s employment systems.

The present study is an attempt to investigate the factors behind spinsterhood, the sort of perception popular mindset hold on spinsters and the consequences of being a spinster. It starts with a theoretical part as a background to the topic. Then, it moves to the practical part where the study depends a field work for testing the constructed hypothesis. The field work is conducted through distributing quiet a big number of representative questionnaires. Briefly, the findings proved that the majority of respondents, 51/° believe that the society considers spinsters as those who had never been proposed to. Moreover, 52/° of respondents believes that spinsters are old women who had never been married. Both may imply a negative connotation set by society and culture for unmarried women. As to the factors behind spinsterhood, the findings proved that the majority of the respondents, 75/° refer spinsterhood to the fact that women prioritize their education and careers on marriage. For the consequences of spinsterhood, the major result demonstrates that 53/° of respondents believe that spinsters’ isolation and embarrassment is one major impact of spinsterhood.

Women of color (WoC) in the health professions encounter challenges in advancement to higher positions, disparities in wages, discrimination, lack of expectation to achieve leadership positions, and absence of extensive support networks. Articles in the literature have addressed race and/or gender in the context of professional development. However, applying an intersectionality lens or framework to better understand the contextual issues of professional development for WoC remains to be addressed. Thus, this scoping review aimed to (i) identify health professions literature that addresses disparities affecting WoC, and (ii) describe strategies and approaches to support WoC in the health professions. Methods: Literature searches were conducted in multiple databases. Three independent reviewers reviewed and screened articles for inclusion. Results: 31 articles were included - medicine(17), nursing(1), pharmacy(7), other(4), and multiple health professions(2). Key findings included underrepresentation of women and minority groups, inequities in professional advancement and leadership positions for WoC, and greater dissatisfaction and attrition among minority and women professionals. Conclusion: WoC face unique and distinct challenges and barriers in their professional careers resulting from the intersectionality of not only race and gender, but also lived experiences and opportunities. Strategies to improve diversity and representation should include an intersectionality framework or lens and be critically evaluated.

Men with non-small cell lung cancer (NSCLC) have a more favorable response to immune-checkpoint inhibitor (ICI) monotherapy, while women especially benefit from ICI-chemotherapy (CHT) combinations. To elucidate such sex differences in clinical practice, we retrospectively analyzed two cohorts treated with either ICI monotherapy (n=228) or ICI-CHT combination treatment (n=80) for advanced NSCLC. Kaplan-Meier analyses were used to calculate progression-free (PFS) and overall survival (OS), influencing variables were evaluated using Cox-regression analyses. No significant sex differences for PFS/OS could be detected in either cohort. Men receiving ICI monotherapy had a statistically significant independent impact on PFS by Eastern Cooperative Oncology Group performance status (ECOG) ≥2 (hazard ratio (HR) 1.90, 95% confidence interval (CI): 1.10-3.29, p=0.021), higher C-reactive protein (CRP; HR 1.06, 95%CI: 1.00-1.11, p=0.037) and negative programmed death-ligand 1 (PD-L1) status (HR 2.04, 95%CI: 1.32-3.15, p=0.001), and on OS by CRP (HR 1.09, 95%CI: 1.03-1.14, p=0.002). In men on ICI-CHT combinations, multivariate analyses (MVA) revealed squamous histology (HR 4.00, 95%CI: 1.41-11.2, p=0.009) significant for PFS; ECOG≥2 (HR 5.58, 95%CI: 1.88-16.5, p=0.002) and CRP (HR 1.19, 95%CI: 1.06-1.32, p=0.002) for OS. Among women undergoing ICI monotherapy, no variable proved significant for PFS, ECOG≥2 had a significant interaction with OS (HR 1.90, 95%CI 1.04-3.46, p=0.037). Women treated with ICI-CHT had significant MVA findings for CRP with both PFS (HR 1.09, 95%CI: 1.02-1.16, p=0.007) and OS (HR 1.11, 95%CI: 1.03-1.19, p=0.004). Although men and women responded similarly to both ICI mono- and ICI-CHT treatment, predictors of response differed by sex.

(1) Background: The aim of this work was to systematically review existing studies on whether hysteroscopy improves the reproductive outcomes of women with infertility even in the absence of intrauterine pathologies when compared to women who did not receive a hysteroscopy. (2) Methods: We established the Participant-Intervention-Comparison-Outcome strategy and used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to conduct a systematic review of 11 studies which were retrieved from 3 electronic databases: Ovid-Medline, Ovid-Embase, and the Cochrane Library. Two independent investigators extracted the data from the included studies and used the Cochrane risk-of-bias tool to assess their quality. (3) Results: The primary outcome measures were the clinical pregnancy rates (CPRs) and live birth rates (LBRs) in the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles. Hysteroscopy in infertile women without intrauterine pathologies showed higher CPRs and LBRs than those in the same population who did not receive hysteroscopy in cases of recurrent implantation failure and IVF (odds ratio: 1.79 and 1.46, 95% confidence interval: 1.46-2.30 and 1.08-1.97 for CPR and LBR, respectively); however, the degree of significance was not as high for LBR. (4) Conclusions: Hysteroscopy before IVF/ICSI in infertile women without intrauterine pathologies may potentially be effective in improving the CPRs and LBRs in patients with RIF. Robust and high-quality randomized trials are warranted to confirm this finding.

Despite several attempts by governments and non-governmental organizations to eliminate female genital mutilation or cutting, it is puzzling that this traditional procedure is widely practiced today in many parts of sub-Saharan Africa (SSA). Scholarly arguments on the influence of female genital mutilation on sexual behavior up until now remain inconclusive. The current study sought to examine the association between female genital mutilation and early sexual initiation among girls and young women (AGYW) in SSA. Data from Demographic and Health Surveys (DHS) of 12 SSA countries were combined. A total of 30,089 AGYW (15-24 years) who had ever had sex and had complete information on all the variables of interest were considered. The outcome variable for the study was early sexual initiation. The study employed multilevel logistic regression for the data analysis, with reported odds ratio and associated 95% confidence intervals (CIs). The overall prevalence of female genital mutilation among AGYW was 49.9%, with the highest and lowest prevalence in Guinea (95.8%) and Togo (3.3%) respectively. The prevalence of early sexual initiation was 42.4%, with the highest and lowest prevalence in Niger (59.9%) and Burkina Faso (30.6%) respectively. AGYW who had not experienced female genital mutilation were less likely to have early sexual initiation [OR= 0.74, CI= 0.70-0.78], compared to those who had experienced female genital mutilation, after controlling for significant covariates. The likelihood of early sexual initiation was high among AGYW aged 15-19 [OR=2.38, CI=2.26-2.51] but low among AGYW with secondary education [AOR=0.58, CI=0.54-0.63], those who had never married [OR=0.68, CI=0.60-0.78], those in households with richest wealth quintile [OR=0.64, CI=0.57-0.72], those who were exposed to mass media [OR=0.88, CI=0.83-0.93], and those working [OR=0.91, CI=0.87-0.96]. Not undergoing female genital mutilation in the midst of socio-economic factors (e.g., education level, household wealth) could limit AGYW from early sexual debut. These findings underscore the need for effective campaign and programs (e.g., educational programs, entrepreneurial training, micro-finance schemes) against the practice of female genital mutilation. Policy interventions (e.g., “schooling for the girl-child” initiatives) that might delay early sexual initiation among adolescent girls and young women in the midst of identified socio-economic factors should be developed.

Gestational diabetes mellitus (GDM) pathophysiology comprises clinical and genetic factors. In fact, GDM has been associated with several single nucleotide polymorphisms (SNPs). This study aimed to build a prediction model of GDM combining clinical and genetic risk factors. A total of 1588 pregnant women from the San Carlos Cohort participated in the present study, 1069 (67.3%) Caucasian (CAU) and 519 (32.7%) Latin American (LAT), 255 (16.1%) with GDM. The incidence of GDM was similar in both groups (16.1% CAU and 16.0% LAT). Genotyping was performed by IPLEX Mass ARRAY PCR selecting 110 SNPs based on literature references. The SNPs showing the strongest likelihood of GDM development were the rs10830963, rs7651090 and rs1371614 in CAU and rs1387153 and the rs9368222 in LAT. Clinical variables including age, pre-pregnancy body mass index and fasting plasma glucose (FPG) at 12 gestational weeks predicted the risk of GDM (AUC 0.648, 95%CI 0.601-0.695 in CAU; AUC 0.688, 95%CI 0.628-9.748 in LAT) and adding the SNPs modestly improved prediction (AUC 0.722, 95%CI 0.680-0.764 in CAU; AUC 0.769, 95%CI 0.711-0.826 in LAT). In conclusion, adding genetic variants enhanced the prediction model of GDM risk in CAU and LAT pregnant women. An RCT is underway to demonstrate its usefulness

In Japan, where the working population is declining, there is a growing expectation that the potential working population will play an active role, and in this context, administrative measures such as the promotion of women's activities have been implemented. However, there is no end to the number of women who leave the workforce after life events such as childbirth or child rearing.　For example, in Fukuoka Prefecture (population 5.1 million) alone, where we are based, it is estimated that there are 43,300 potential female workers. Many of these women have have been employed in the past, but have left the workforce due to childbirth, family care, or other reasons, and still wish to work. However, although this group has potential employment needs, they have not yet engaged in specific job-hunting activities, and thus are on the periphery of the labor market, without access to the current active labor market. There are many promising potential employees there, and support for their career redevelopment and participation in the labor market is required. On the other hand, few studies have been conducted in Japanese prefectures to systematically estimate social value, i.e., to determine the scope of impact on society and the stakeholders. This is an obstacle to the formulation of policies for women's advancement and the establishment of related social projects. This paper is aware of this problem and, based on the support for women seeking to re-enter society (career redevelopment) that the authors are implementing, selects seven prefectures in Kyushu, which is also a wide economic zone, as a support area and estimates the social value to companies and families in these areas by using SROI. As a result, it was derived that if 3,586 individuals were reemployed, the SROI ratio (1:X) X would be 76.1 in the first year of reintegration assistance activities and X would be 313.3 in the fourth year.

BACKGROUND&AIMS: Hepatitis B virus (HBV) infection remains a major public health problem. The interaction between HBV and the host inflammatory response is an important factor contributing to liver damage and disease development. We compared the correlation between the subclinical index and PBMCs concentration in two groups of pregnant women (HBsAg positive), which are different in HBV DNA concentration in Vietnam. METHODS: The Hierarchical cluster analysis (HCA) was run with 20 different clustering methods on data collected from 80 Vietnamese pregnant women and their babies (60/80 cord blood). RESULTS: In the high viral load group (HBV DNA ≥ 5x10^7 copies/ml), a strong correlation between CBMCs with serum maternal Haemoglobin concentration and maternal platelet and maternal ALT. Their R values are: -0.88, 0.82, and 0.84 with p=8.97E-03, 2.41E-02 and 1.75E-01, respectively. CONCLUSIONS: We found a significant correlation shift of subclinical index between the two groups, which may be important in diagnosing pregnant women with chronic hepatitis B virus infection.

Anemia and thyroid disorders are global health issues that affect all ages but are more apparent in women. In this case, some serological components responsible for IDA and TSH disorders in women have been found actively regulated through a complex steroidal-calcitriol mediated pathway. This research has been investigated the correlation between Calcitriol and the serological components responsible for IDA and TSH disorders in childbearing and non-child-bearing women of different health conditions. Experimental sampling from 452 women suffering from both IDA and TSH disorders were taken, aged between 0 and 70 years. Serological parameters, such as iron, total iron-binding capacity and ferritin, were assessed for IDA profiling, whereas thyroid-stimulating hormone and free thyroxin were for TSH profiling based on the individual’s serum calcitriol status. The resulted serological data were interpreted using sophisticated computer programming language and algorithms for quantitative biochemical analysis. The study resulted in a significant correlation between FT4 and Calcitriol (P<0.0001) for all age groups. TSH also showed strong interactions with the fluctuation of calcitriol level (P<0.0001), except for the children aged below 10 years (P<0.063). The iron, TIBC, TSH, and FT4 showed phenomenal regulation with the steroidal-calcitriol concentration for congenital patients. Unlike the others, ferritin has a substantial connection with Calcitriol (P<0.0064) fluctuation in the serum. To ratify, the concentrations of TSH, FT4, iron, TIBC, and ferritin were found to be significantly interconnected in terms of serum calcitriol level in women suffering from IDA and TSH disorders simultaneously. To understand the accuracy and efficacy of the Calcitriol in IDA and TSH disorders, some other inflammatory markers and parathyroid hormone analysis are need in future studies, besides a large number of samples.

Back pain is a common symptom that affects all age groups across the globe, when left untreated may eventually lead to disability. A convenient sample selection method was used in this study due to the global Covid-19 pandemic lockdown which was effective in Turkey during the investigation period. Thus, virtual data collection and health education including some health risks were employed. A total population of two hundred adult women was involved in the study but one hundred and twenty-one responses were collected. Findings show that, for socio-demographic characteristics, the pain was found highest in women between the ages of 41-50 and obese/overweight individuals. Although, there was no significant difference recorded in the marital status category. Moreover, statistical mean differences were detected between the scales for ODI (4.18) and BPFS (6.09). Also, p<0.05, paired sample t-test was 0.001 ODI and 0.001 BPFS after the training exercise. This suggests that exercise training is inversely correlated with pain severity which implies that training has a significant influence on pain intensity. Thus, it could be concluded that there is a relationship between the training exercise and ODI/BPFS.

Background: Animal-assisted therapy has positive effects on cognitive function, depression, performance ability, and social functioning in elderly patients. The aim of this study was to evaluate the effects of rearing pet insects on the cognitive function of healthy elderly participants, with fMRI (functional magnetic resonance imaging) being used for this purpose. Methods: Community-dwelling elderly women (≥60 years) with normal cognitive function were enrolled during April 2015. They were randomized at a 1:1 ratio into two groups: insect-rearing and control (n=16) groups, with the insect-rearing group being further classified into two groups for analysis according to the subjects’ scores in the Wisconsin Card Sorting Test, WCST) at the first fMRI: insect-rearing group I with a relatively high score (n=13), and insect-rearing group II with a relatively low score (n=6). All subjects were educated on a healthy lifestyle for better cognitive function at every visit, and the insect-rearing groups received and reared crickets as pet insects. The fMRI was performed at baseline and after 8 weeks using the WCST as a stimulus. The WCST consisted of two variations, a high level baseline (HLB) and semi-WCST version. Results: There were no significant differences in the baseline characteristics among the three groups. There was a significant difference accuracy of the HLB–semi-WCST (p<0.05) in insect-rearing group II after 8 weeks from the baseline test. In the fMRI analysis involving the WCST reaction test, increased activation was observed in the right dorsal lateral prefrontal cortex and parietal cortex in insect-rearing group II when the semi-WCST, rather than the HLB, was performed. There were no significant differences in the other groups. Conclusion: The rearing of pet insects as an animal-assisted therapy is cost-effective, easy, and occupies little space. In this study, it showed positive effects on executive functions and performance improvement in elderly women. Further larger studies on the effects of pet insects on cognitive function are warranted.

In Italy HPV vaccination was implemented for girls since 2007 but its coverage was lower than recommended level. Sicily is one of the Italian administrative regions with lower vaccination coverage, ranging in the birth cohorts 1996–1999 from 59% to 62%. Aim of the study was to investigate factors associated with refusal of anti-HPV vaccination among young adult women of Palermo, Italy. A cross-sectional study was conducted through the administration of a telephone questionnaire, consisting of 23 items on HPV infection and vaccination knowledge based on Health Belief Model framework. The eligible population were young women with at least a previous vaccination among all included in Sicilian Vaccination schedule, without starting or completing anti-HPV vaccination schedule. Overall, 141 young women were enrolled, of them 84.4% were unvaccinated and 15.6% had at least one dose of HPV vaccine. In multivariate analysis, factors associated with the failure to perform the HPV vaccination were degree as school level (OR = 10.2, p = 0.041), lower participation at school seminar on HPV (OR = 0.2, p = 0.047) and lower perception of anti-HPV vaccine benefits (OR = 0.4, p = 0.048). Public health educational program focusing and tailored on benefits perception of anti-HPV vaccine and HPV disease severity, especially if carried out at school, can improve HPV vaccination uptake.

AbstractBackground: Maternal health service (MHS) use is a key strategy to reduce maternal mortality. However, the existing evidence is scarce to design efficient intervention strategies in Ethiopia. Thus, we aimed to explore community members and health care providers' perceptions of MHS, and barriers, and facilitators of MHS use in southern Ethiopia. Methods: A phenomenological qualitative study was conducted from November 14-30, 2022, in the northern zone of the Sidama region. Sixteen in-depth interviews, nine focus group discussions, and 15 key informant interviews were done with 112 study participants. A maximum variance sampling method was used to select study participants. Data coding and analysis were done using MAXQAD 2020 software and presented in narratives. Results: Communities have positive perceptions and good practices of skilled antenatal care (ANC) and health facility delivery (HFD), but lack awareness of postnatal care (PNC) services and schedules. Some have experienced negative interactions with health care providers, health facilities, and ambulance drivers. The main identified barriers to ANC use were lack of awareness of ANC benefits, distance from a health facility, costs associated with ANC use, long waiting time, lack of access to road, and women being busy with different household chores. Distance from health facility, costs associated with HFD use, unpredicted labour, lack of an ANC visit, lack of a birth preparedness plan, and non-dignified care were the main barriers to HFD. The major identified barriers to PNC use were home delivery, lack of awareness of PNC service and schedule, and socio-cultural beliefs. The main identified facilitators of MHS use were previous experience and fear of obstetric complications, health extension workers and women’s development teams, and pregnant women's forum.Conclusions: Rural women still encounter several challenges when using MHS, even though communities have positive perceptions and good practices of skilled MHS. Bad experiences mothers faced in health facilities, challenges associated with the costs of MHS use, poor awareness of service, and unpredictable labour continued to be basic barriers to MHS use. Intervention approaches should consider inter-sectoral collaboration to address barriers at the community and health facility levels. The programs must emphasize the transportation arrangements during unpredictable labour, the needs of poor mothers, and women who have poor awareness of MHS at the community level.

Sex dimorphism starts during early embryogenesis and is further manifested in response to hormones during puberty. As this leads to physical divergence that is measurably different between sexes, males enjoy physical performance advantages over females within competitive sport. While this advantage is the underlying basis of the segregation into male and female sporting categories, these sex-based categories do not account for transgender persons who experience incongruence between their biological sex and their experienced gender identity. Accordingly, the International Olympic Committee determined criteria by which a transgender woman may be eligible to compete in the female category, requiring total serum testosterone levels to be suppressed below 10 nmol/L for at least 12 months prior to and during competition. Whether this regulation removes the male performance advantage has not been collectively scrutinized. Here, we aim to review how differences in biological characteristics between biological males and females affect sporting performance and assess whether evidence exists to support the assumption that testosterone suppression in transgender women removes the male performance advantage. In this review, we report that the performance gap between males and females amounts to 10-50% depending on sport. The performance gap is more pronounced in sporting activities relying on muscle mass and strength, particularly in the upper body. Longitudinal studies examining the effects of testosterone suppression on muscle mass and strength in transgender women consistently show very modest changes, where the loss of lean body mass, muscle area and strength typically amounts to approximately 5% after 1 year of treatment. Thus, current evidence shows that the biological advantage enjoyed by transgender women is only minimally reduced when testosterone is suppressed. Sports organizations may therefore be compelled to reassess current policies regarding participation of transgender women in the female category of sport.

The decline in assisted reproductive technology (ART) success among older women, attributed to decreased oocyte quantity and quality, poses a significant challenge. Currently, no consensus ex-ists on the optimal ovarian stimulation protocol for older women undergoing IVF. This retrospec-tive registered cohort study aimed to compare cumulative live birth rates (CLBR), time to live birth (TTLB), and cost-effectiveness in women over 35 years using gonadotropin-releasing hor-mone agonist (GnRHa) or clomiphene-primed ovarian stimulation (CPOS). We performed pro-pensity score matching (PSM) on 2,871 IVF cycles in women over 35 who received either GnRHa or CPOS protocols, resulting in 375 cycles in each group to compare treatment outcomes. Addition-ally, a decision tree model was utilized to assess the cost-effectiveness of the two protocols. Fol-lowing PSM, both groups showed similar baseline characteristics. The CPOS protocol exhibited a higher cycle cancellation rate (13.07% vs 8.00%, p=0.032), yet maintained comparable fertilization and embryo quality. While CLBRs per initial cycle (41.07% vs. 45.33%, p=0.269) and delivery out-comes were similar between the groups after a 24-month follow-up, TTLB was longer in the CPOS group. Notably, the average cost per live birth in the CPOS group was 21.27% less than that in the GnRHa group (￥32,301.42 vs ￥39,174.22). In conclusion, for women over 35 undergoing IVF, the CPOS protocol demonstrated similar CLBR to GnRHa but with lower costs, suggesting its potential as a viable and cost-efficient ovarian stimulation option.

The 2022-2023 Mpox multi-country outbreak, identified in over 110 WHO Member States, revealed a predominant impact on cisgender men, particularly those engaging in sex with men, while less frequently affecting women. This disparity prompted a focused investigation into the gender-specific characteristics of Mpox infections, particularly among women, to address a notable knowledge gap. This review systematically gathers and analyzes scientific literature and case reports concerning Mpox infections in women, covering a broad geographical spectrum including regions such as Buenos Aires, Brazil, Northern California, Colombia, Nigeria, Europe, Vietnam, Spain, Switzerland, and the United States. The analysis delves into various aspects of Mpox in women, including clinical features, epidemiology, psychological impacts, preparedness strategies, and case studies, with particular attention to pregnant women and those with underlying health conditions. Empirical data from multiple studies underscore the unique epidemiological and clinical patterns of Mpox in women. In the United States, a small percentage of Mpox cases were reported among cisgender women, with a notable portion involving non-Hispanic Black or African American, non-Hispanic White, and Hispanic or Latino ethnicities. The primary transmission route was identified as sexual or close intimate contact, with the virus predominantly manifesting on the legs, arms, and genital areas. Further, a study in Spain highlighted significant disparities in diagnosis delays, transmission modes, and clinical manifestations between genders, indicating a different risk profile and disease progression in women. Additionally, a case from Vietnam linked to a new Mpox sublineage in women emphasizes the role of women in the transmission dynamics and the importance of genomic monitoring. This review emphasizes the necessity for inclusive surveillance and research to fully understand Mpox dynamics across diverse population groups, including women. Highlighting gender and sexual orientation in public health responses is crucial for an effective approach to managing the spread and impact of the disease. The findings advocate for a gender-diverse assessment in health services and further research to explore the nuances of Mpox transmission, behavior, and progression among different groups, thereby enhancing the global response to Mpox and similar public health challenges.

Africa was the only continent not to achieve the 2015 Millennium Development Goal of 50% poverty reduction. This paper asks whether Africa will fare better in meeting Sustainable Development Goals (SDGs) addressing poverty and hunger by 2030. To answer this question we examine literature, including our field research published over the last thirteen years. We find that ‘sustainable development’ is a failed concept immersed in the contemporary global economic system that favors growth over ecosystem stability and patriarchal systems of governance that undervalue women’s capacity for sustainability in their care-work as food providers. We examine barriers to women’s farming (climate change, gender bias, limited access to land, technology, finance) and provide examples of women’s innovative strategies for overcoming these barriers in their care practices toward family and community well-being and ecosystem health. We conclude that sustainability is only possible through transformation of thinking away from approaches that value profit over people and ecosystems and toward gender-based approaches for achieving the goals laid out in the SDGs through holistic, integrative systems of ecosystem fit.

Diagnosis and treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in women remain insufficient. Fluctuations of reproductive hormones during the premenstrual period, postpartum period and (peri)menopause are neglected, even though they impact ADHD symptoms and as-sociated mood disorders [1]. Therefore, we created a female-specific treatment group for women with ADHD and premenstrual worsening of ADHD and/or mood symptoms. We describe the group programme and underlying rationale, offering a qualitative analysis of the participants’ evaluation. The 7 two-weekly sessions foreground the menstrual cycle and address several ADHD-specific topics in relation to this cyclical pattern: emotional regulation; impulsivity; setting boundaries, and triggers. Concurrently, women track their menstrual cycle and (fluctuating) ADHD and mood symptoms with an adjusted premenstrual calendar. In total, 18 women (25-47yrs) participated in three consecutive groups. We analysed the evaluation of the last group. Participants experienced the group as a safe and welcoming space. Recognition was valued by all. The topics discussed were deemed valuable and the structure suited them well. Completing the premenstrual calendar augmented awareness and recognition of individual cyclical symptoms. Discussing ADHD throughout the lifespan increased self-understanding. Participants took their menstrual cycle more seriously, prioritising self-acceptance and self-care in the luteal phase of the cycle. Exploring a cyclical approach in a group setting seems to be a positive addition to treatment for female ADHD.

AbstractIntroduction: Increasing knowledge of obstetric danger signs (ODS) and encouraging birth preparedness and complication readiness (BPCR) practices are strategies to increase skilled maternal health service utilization in low-income countries. One of the methods to increase mothers' knowledge about ODS and promote BPCR practice is through health education intervention (HEI). However, the effect of context-specific community-based health education led by women's groups on these outcomes has not been comprehensively studied, and the existing evidence is inconclusive. Thus, we aimed to evaluate the effect of a context-specific community-based HEI led by women's groups on mothers' knowledge regarding ODS and BPCR practices in southern Ethiopia.Methods: An open-label, two-arm parallel group cluster-randomized controlled trial was conducted from January to August 2023 on pregnant women from 24 clusters (kebeles) (12 interventions and 12 controls) in the northern zone of the Sidama region. The Open Data Kit smartphone application was utilized to collect data. The intention-to-treat analysis was used to compare outcomes between groups. We fitted multi-level mixed-effects modified Poisson regression with robust standard error to account for between and within cluster effects. Results: One thousand and seventy pregnant women (540 in the intervention and 530 in the control clusters) responded to this study, making the overall response rate 95.02%. Excessive vaginal bleeding (94.3% in the interventional group vs. 88.7% in the control group) was the commonest ODS mentioned during childbirth. Overall, 68.7% of women in the intervention group and 36.2% of mothers in the control group had good knowledge of ODS (P-value < 0.001). Saving money and materials (97.1% in the interventional group vs. 92.7% in the control group) was the most frequently practiced BPCR plan. Overall, 64.3% of women in the intervention group and 38.9% of mothers in the control group practiced BPCR (P-value < 0.001). HEI significantly increased overall knowledge of ODS (adjusted risk ratio [ARR]: 1.71; 99% CI: 1.14-2.57) and improved overall BPCR practice (ARR: 1.55; 99% CI: 1.02-2.39). Conclusions: A community-based HEI led by women's groups improved mothers' knowledge regarding ODS and BPCR practices in a rural setting in southern Ethiopia. Interventions designed to increase women's knowledge of ODS and improve BPCR practice must implement context-specific, community-based HEI that aligns with World Health Organization recommendations. Trial registration: NCT05865873

This work is the result of a two-year research leave (French CNRS delegation) with field research in France, India and England, based on a total of 36 interviews in the three countries. The aim of this publication is to discuss how the laws of different countries deal with gender and what representations the laws reveal about gender roles in the societies they regulate through discourses. For example, France, England and India have laws that are more or less specific about gender roles in society: the language used to express the laws also fulfils gender roles while affecting people’s everyday lives. The whole issue of gender and rights is about the presumed and desired equality of rights for women and men, and the way in which this corresponds to the reality of women’s and men’s lives. Indeed, laws are necessary to regulate human relations in society. For example, anti-discrimination laws exist to protect and regulate these relationships in a common space, to regulate and combat abuse. The emphasis on gender – including gender roles – and LGBTQ+ people shows that this phenomenon is understood and experienced differently in global practice. Our examples in this publication focus on France and India.

This research paper aimed to explore the impact of childhood and adolescent experiences on the leadership development of Emirati women in the United Arab Emirates (UAE). Using a qualitative research methodology, the study utilized in-depth narrative semi-structured interviews, document analysis, and diary writing to understand the complex issue of leadership development. Findings indicate that childhood and adolescent experiences, including family upbringing, education, culture, and societal expectations, have significant impacts on the leadership development of Emirati women. Specifically, family upbringing and cultural values shape Emirati women's leadership aspirations and behaviors, while education and societal expectations provide opportunities and barriers for women's leadership development. The implications of these findings for policymakers and practitioners seeking to promote women's leadership development in the UAE are discussed.