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Hope is a common phenomenon in human life. The process of infertile women being treated with assisted reproductive technology is difficult. The concept of hope can be applied in the nursing practice to help patients have a positive treatment experience, reduce feelings of despair, and find significance in difficult treatments. This study used phenomenological approach to understand the essential structure of the hope experiences of infertile women after successful artificial reproduction. A total of 10 infertile women who were successfully pregnant for more than 8 weeks and less than 24 weeks participated in this study. The essence of the hope experiences of infertile women after successful artificial reproduction was the process of "becoming a mother" which included four themes: (1) try hard to get pregnant; (2) outline a blueprint for the future of motherhood; (3) protect the fetus; and (4) integrate the fetus into the family. This study enabled medical teams to play the role of caregivers, intervened in hope care, and strengthened evidence‐based practice to improve the quality of care by focusing on feelings of hope. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion It is extremely important for healthcare professionals to protect patients' privacy during diagnosis and treatment processes related to gynecology and obstetrics and to warn them in case patients' privacy is violated. This study was aimed at determining attitudes of female patients having obstetrics examination towards privacy and raising their awareness of privacy.This cross‐sectional‐descriptive study was conducted with 410 patients who presented to the gynecology and obstetrics outpatient clinic of a university hospital. The survey form consisted of two forms: The descriptive characteristics questionnaire and the body privacy scale for gynecology and obstetrics (BPSGO). Frequency tables, descriptive statistics, Mann–Whitney U‐test, Kruskal–Wallis H‐test, and Bonferroni correction were used in the analysis of the data.The mean age of the participants was 36.75 ± 11.18 years. Of these, 38.0% were in the age group of ≥40 years, 84.0% were married, 66.8% presented to the gynecology clinic, and 58.3% had negative emotions before they had gynecologic examination. Ethics and privacy subscale scores of the single participants were significantly higher than were those of the married participants.It was determined that privacy was affected by cultural characteristics, belief systems and personal values, and that most of the participants were likely to experience negative emotions. It is important to raise health professionals' awareness of privacy by drawing their attention to the value of privacy which is among ethical values in their education and to support the better functioning of legal regulations on this issue. [ABSTRACT FROM AUTHOR]

ABSTRACT Although body image is one of the essential concepts that should be addressed in comprehensive care, the question of how body image affects women with schizophrenia remains unanswered. This study aimed to explore the body image experiences of women living with schizophrenia. This study employed a qualitative approach and participants were recruited from a community mental health center in Türkiye. Semi‐structured interviews were conducted with 18 women with schizophrenia. Data were analysed via content analysis. The data were categorised into five themes: (i) body image evaluation, (ii) factors affecting body image, (iii) effects of body image distortion, (iv) coping with body image challenges and (v) protective factors. Schizophrenia affects body functionality, appearance and the self. Women living with schizophrenia experience feelings of shame, sadness, worthlessness and anger related to their body appearance. Body image distortion leads to social distancing and treatment compliance problems. Mental health nurses should support patients to express their feelings and thoughts about the body and recognise their beliefs about ideal body image. Patients should be supported with psychoeducational interventions in the management of symptoms associated with body image disturbance such as weight gain, galactorrhea, sedation and hypersalivation. [ABSTRACT FROM AUTHOR]

Objective: To identify factors influencing women's perceptions of traumatic childbirth (TCP) and to determine the relationship between TCP, desire to avoid pregnancy, and sexual quality of life. Methods: A descriptive and correlational research study was designed. Data were collected from 225 women aged between 18 and 45 years old. A Demographic Information Form, the Desire to Avoid Pregnancy Scale (DAP), the Sexual Quality of Life Questionnaire‐Female (SQLQ‐F), and the Perception of Traumatic Childbirth Scale (PTCS) were used for data collection. Results: Women who were not employed, had given birth previously, and did not plan their last pregnancy tended to have higher levels of TCP. Conversely, women who did not experience health problems in their last pregnancy and recalled their last childbirth as very comfortable and happy tended to have lower levels of TCP. A very weak, statistically significant, positive correlation was found between the mean DAP and PTCS scores (r = 0.168, P < 0.05). A very weak, statistically significant, negative correlation was found between the mean SQLQ‐F and PTCS sores (r = −0.138, P < 0.05). A 1‐unit increase in TCP was associated with a 0.005‐unit increase in the desire to avoid pregnancy and a 0.094‐unit decrease in sexual quality of life. Conclusion: TCP in women is associated with an increase in the desire to avoid pregnancy and a decrease in sexual quality of life. It is recommended to identify women with high levels of TCP, determine factors contributing to this perception, and plan appropriate nursing interventions accordingly. Synopsis: The perception of traumatic birth in women increases the desire to avoid pregnancy and reduces the quality of sexual life. [ABSTRACT FROM AUTHOR]

Introduction: Female sexual dysfunction is very common, but its determinants remain under‐investigated. Vasculogenic impairments are suggested to be related to female sexual dysfunction, but previous literature regarding the association is scarce. This study aims to study the association between arterial health and female sexual function in women in their 60s. Material and methods: The sample for this cross‐sectional study comprised 117 women (aged 60–64 years) who participated in the Finnish Retirement and Aging study. Arterial health was measured according to the participants' pulse wave velocity, ankle–brachial index, blood pressure, and pulse pressure. Sexual function was measured using the Female Sexual Function Index, which resulted in a total score and six sub‐scores. Associations were examined using multivariable regression analyses, which were adjusted for age, relationship happiness, systemic menopausal hormone therapy and/or local estrogen, smoking, alcohol risk use, body mass index, and depressive symptoms. Results: Higher diastolic blood pressure was associated with a higher total Female Sexual Function Index score (β = 0.24, 95% confidence interval [CI] 0.07–0.41) and with higher desire (β = 0.02, 95% CI 0.01–0.04), arousal (β = 0.04, 95% CI 0.01–0.08), lubrication (β = 0.04, 95% CI 0.002–0.08), satisfaction (β = 0.03, 95% CI 0.003–0.05), and pain (β = 0.06, 95% CI 0.02–0.10) sub‐scores. Also, higher ankle–brachial index was associated with higher satisfaction sub‐score (β = 2.10, 95% CI 0.44–3.73) and lower pulse pressure was associated with higher orgasm sub‐score (β = 0.03, 95% CI 0.0002–0.06). Other associations between ankle–brachial index and Female Sexual Function Index scores were statistically insignificant, but considering the magnitude the findings may imply clinical significance. Systolic blood pressure and pulse wave velocity were not associated with sexual function. Conclusions: This study suggested a plausible association between higher diastolic blood pressure and female sexual function, but considering clinical significance our findings suggest an association between higher ankle–brachial index and good sexual function in women in their 60s. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the effect of transurethral resection of the prostate (TURP) surgery on quality of sexual life in patients' spouses. A pre/post‐operative test, quasi‐experimental design with no control group was employed. The research was conducted in the urology clinics of two hospitals in the west of Turkey between 30 June and 30 September 2022. It was completed with 172 patient spouses recruited using non‐probability sampling. The study data were collected using an individual information form and the Sexual Quality of Life‐Female questionnaire. The preoperative test applied prior to surgery was administered by the face‐to‐face interview method, while the postoperative test was completed by telephone interviews 8 weeks after the initial data collection. The mean age of the individuals undergoing TURP surgery in this study was 62.69 ± 7.98 years (min 40, max 77), and the mean age of the spouses was 57.91 ± 7.46 (min 39, max 73). Sexual Quality of Life‐Female scores after surgery were significantly higher than the pre‐surgical values (p < 0.001). A significant difference in sex life quality was determined in terms of age, education, employment status, presence of chronic disease, number of children, and 'love marriages' (p < 0.05). The sexual life quality of the spouses of patients exposed to TURP surgery increased significantly 8 weeks after the procedure. The quality of sex life was higher among individuals with higher education levels, working individuals, and those who 'married for love', but decreased in line with age and number of children. [ABSTRACT FROM AUTHOR]

Background: Monte Carlo (MC) simulations or measurements in anthropomorphic phantoms are recommended for estimating fetal dose in pregnant patients in radiotherapy. Among the many existing phantoms, there is no commercially available physical phantom representing the entire pregnant woman. Purpose: In this study, the development of a low‐cost, physical pregnant female phantom was demonstrated using commercially available materials. This phantom is based on the previously published computational phantom. Methods: Three tissue substitution materials (soft tissue, lung and bone tissue substitution) were developed. To verify Tena's substitution tissue materials, their radiation properties were assessed and compared to ICRP and ICRU materials using MC simulations in MV radiotherapy beams. Validation of the physical phantom was performed by comparing fetal doses obtained by measurements in the phantom with fetal doses obtained by MC simulations in computational phantom, during an MV photon breast radiotherapy treatment. Results: Materials used for building Tena phantom are matched to ICRU materials using physical density, radiation absorption properties and effective atomic number. MC simulations showed that percentage depth doses of Tena and ICRU material comply within 5% for soft and lung tissue, up to 25 cm depth. In the bone tissue, the discrepancy is higher, but again within 5% up to the depth of 5 cm. When the phantom was used for fetal dose measurements in MV photon breast radiotherapy, measured fetal doses complied with fetal doses calculated using MC simulation within 15%. Conclusions: Physical anthropomorphic phantom of pregnant patient can be manufactured using commercial materials and with low expenses. The files needed for 3D printing are now freely available. This enables further studies and comparison of numerical and physical experiments in diagnostic radiology or radiotherapy. [ABSTRACT FROM AUTHOR]

Objective: Hyperemesis gravidarum (HG) is a severe form of excessive vomiting during pregnancy. The connection between psychiatric morbidity and HG has been debated, but only a few studies have focused on eating disorders (EDs). The objective of this study was to evaluate the association between HG and both pre‐pregnancy and new post‐pregnancy EDs. Methods: A register‐based controlled study. HG diagnoses were retrieved from healthcare registers between 2005 and 2017. Women with HG in their first pregnancy resulting in delivery were chosen as cases (n = 4265; the HG group) and women with no HG as controls (n = 302,663; the non‐HG group). The associations between EDs and HG were analyzed by binary logistic regression, adjusted with age, body mass index, smoking, socioeconomic status, and pre‐pregnancy psychiatric diagnoses. Results: In the HG group, 1.6% and in the non‐HG group, 0.2% had a pre‐pregnancy ED. Women with ED were more likely to have HG in their first pregnancy compared with women with no history of EDs (adjusted odds ratio [AOR] 9.4, 95% CI 6.52–13.66, p <.0001). Moreover, 0.4% of the women in the HG group and 0.1% of the women in the non‐HG group had a new ED diagnosis after pregnancy, and thus the women in the HG group were more likely to have an ED diagnosis after pregnancy (AOR I 3.5, 95% CI 1.71–7.15, p <.001, AOR II 2.7, 95% CI 1.30–5.69, p =.008). Discussion: We found a bidirectional association between ED and HG, suggesting a shared etiology or risk factors between these disorders. This finding emphasizes the importance of collaboration across various specialties when treating these patients. Public Significance: Our findings suggest a bidirectional association between HG and EDs before and after pregnancy. This finding provides essential information for healthcare professionals working with pregnant women. As both of these disorders are known to have far‐reaching effects on the lives of both the mother and her offspring, our results help clinicians to target special attention and interventions to the patients suffering from these disorders. [ABSTRACT FROM AUTHOR]

The aim of this article is to show how Spanish painting of the nineteenth century helped to construct the narrative of a female religiosity based on sentiment, which was specific to women. This narrative was not free from misogyny because women's piety was often diluted, converted into something superficial. It was brimming with exaggerated sentimentalism, the product of superstition and lacking in careful reflection, without an intellectual religious discourse – which women, by their nature, could never reach. Women's involvement in religion and catholic movements was not as insubstantial, sentimental or naïve as it has been presented or made out to be; but this reality was not reflected in painting. [ABSTRACT FROM AUTHOR]

Introduction: The pathogenesis and risk factors for hyperemesis gravidarum, excessive nausea and vomiting of pregnancy, are not adequately recognized. In our previous study, we found that women with a personal history of nausea in different situations and a family history of nausea and vomiting of pregnancy (NVP) were more likely to have severe NVP. The present study focuses on these themes in association with hyperemesis gravidarum in a hospital setting. Material and methods: Women with hyperemesis gravidarum (n = 102) were recruited from among patients hospitalized due to hyperemesis gravidarum in Turku University Hospital, Finland. Our control group (Non‐NVP group, n = 138) consisted of pregnant women with no NVP. Personal history of nausea in different situations was inquired about in relation to "motion sickness", "seasickness", "migraine", "other kind of headache", "after anesthesia", "during the use of contraception", and "other kinds of nausea". Relatives with NVP were divided into first‐degree (mother and sisters) and second‐degree (more distant) relatives. Results: In univariate analysis, a personal history of motion sickness, seasickness, nausea related to migraine, nausea with other headache and nausea in other situations were associated with hyperemesis gravidarum. After adjusting for age, parity, pre‐pregnancy body mass index, marital status, and smoking, motion sickness (adjusted odds ratio [aOR] 5.24, 95% confidence interval [CI] 2.67–10.31, p < 0.0001), seasickness (aOR 4.82, 95% CI 2.32–10.03, p < 0.0001), nausea related to migraine (aOR 3.00, 95% CI 1.58–5.70, p < 0.001), and nausea in other situations (aOR 2.65, 95% CI 1.13–6.20, p = 0.025) remained significant. In multivariable analysis with all history of nausea variables, motion sickness (OR 2.76, 95% CI 1.29–5.89, p = 0.009) and nausea related to migraine (OR 3.10, 95% CI 1.40–6.86, p = 0.005) were associated with hyperemesis gravidarum. Having any affected relative (OR 3.51, 95%CI 1.84–6.73, p = 0.0002), especially a first‐degree relative (OR 3.06, 95% CI 1.62–5.79, p = 0.0006), was also associated with hyperemesis gravidarum. Adjustment did not change the results. Conclusions: Women with a personal history of nausea or a family history of NVP are more likely to suffer from hyperemesis gravidarum. These results are beneficial to better identify and help women at risk for hyperemesis gravidarum. [ABSTRACT FROM AUTHOR]

Males are diagnosed with autism much more frequently than females, and most research study samples reflect this male predominance. The result is that autistic females are understudied. There is a critical need to increase our understanding of autistic females, both biologically and clinically. The only way to do this is to recruit sex‐balanced cohorts in studies so that similarities and differences between males and females can be evaluated in all autism research studies. The purpose of this commentary is to (1) provide historical context about how females came to be under‐represented in all research, not just in the field of autism and (2) learn from other areas of health and medicine about the potentially dire consequences of not studying both sexes, and (3) draw attention to the need to recruit sex‐balanced cohorts in autism research, particularly in neuroimaging studies. Lay Summary: Most of what we know about autism comes from studies of males. Because there are so many more males diagnosed with autism than females, most research studies do not include enough autistic females to evaluate how autistic females may be different from autistic males. The purpose of this commentary is to provide some historical background from other areas of health and medicine on how leaving females out of research studies can sometimes lead to harmful outcomes. The hope is that the field of autism will not repeat these mistakes and that more studies will recognize the need to make every effort to include equal numbers of autistic females in research. [ABSTRACT FROM AUTHOR]

Background: Fibromyalgia is a complex pain‐focused syndrome. Previous studies showed that Cannabis is efficacious in promoting sleep, deepening and lengthening the sleep cycle, and good pain relief (compared with the SSRIs and SNRIs). Purpose: This study aimed to use the World Health Organization Quality of Life Bref questionnaire (WhoQoL‐bref) to characterize the impact of Cannabis Treatment initiation on the quality of life in women suffering from treatment‐resistant fibromyalgia. Methods: A prospective cohort study involving 30 women aged 18–70 years old diagnosed with fibromyalgia, exhausted pharmacological fibromyalgia treatment, and started Cannabis treatment. Pregnant women were excluded. WhoQoL‐bref was filled before Cannabis treatment initiation and 1 month following treatment. Results: Women's average age was 46 years (±5), with a poor general quality of life (1.47 ± 0.63), poor general health (1.47 ± 0.78), pain and discomfort, and dependence on medication (3.77 ± 1.3 and 3.07 ± 1.74, respectively) prior to Cannabis intervention. Cannabis treatment for 30 days showed a marked improvement in general quality of life (1.97 scores, p < 0.01), general health (1.83, p < 0.01), physical health (1.5, p < 0.01), and psychological domain (1.3, p < 0.01). Financial resources and home environment were not influenced by cannabis treatment (p = 0.07, p = 0.31, respectively). Conclusion: Results suggest a potentially significant role of Cannabis in treatment‐resistant Fibromyalgia women. Early Cannabis treatment may result in a beneficial short‐term effect on the quality of life through its influence on pain, sleep, and physical and psychological domains. Further studies are still indicated to understand this potential and its long‐term beneficial impact. [ABSTRACT FROM AUTHOR]

This study was conducted to determine the effects of urinary symptoms and incontinence on quality of life in postmenopausal women. The sample of the cross‐sectional study consisted of 327 women aged 50–65 who visited primary healthcare centers between 16 April and 30 July 2018. The data were collected using a personal information form, the Urinary Symptom Profile Questionnaire (USP) and the Incontinence Quality of Life Scale (I‐QOL). The mean age of the women participating in the study was 57.89 ± 5.05. It was found that 50.5% of the women had a history of incontinence. While the total mean USP score of all women participating in the study was 4.94 ± 4.81, it was 7.98 ± 4.85 for the women with a history of incontinence. The mean total I‐QOL score was 87.09 ± 16.04 in all women and 76.95 ± 16.93 in the women with a history of incontinence. The women with a history of incontinence were found to have a strong negative correlation between their total USP and total I‐QOL scores. In this study, it was found that the quality of life of women with urinary incontinence, especially their psychosocial health, was found to be significantly affected. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to perform a validity and reliability study of the Turkish version of the Aging Anxiety Scale for Middle‐Aged Women. Design and Methods: This methodological study was conducted with 262 women aged between 40 and 59 years. Findings: While language, content and construct validity analyses were performed at the validity phase of the scale, internal consistency and stability over time analyses were performed at the reliability stage. Factor analyses were performed for the construct validity, and it was determined that the items of the scale were classified under four factors; this was consistent with the original form. The Cronbach's α reliability was 0.962 for the overall scale and ranged between 0.836 and 0.949 for the four subdimensions. Practice Implications: The study determined that the Turkish adaptation of the scale is a valid and reliable measuring instrument. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effect of perceived social support of menopausal women on their menopausal complaints. Design and Methods: This descriptive and correlational study was conducted with 505 women. The data were obtained using personal information form, menopause rating scale, and multidimensional scale of perceived social support. Frequency, percentage, t test, analysis of variance Skewness and Kurtosis (±1) and correlation were used in the analysis of the data. Findings: In the study, it was found that there was a positive and significant relationship between menopausal symptoms and social support, and menopausal symptoms decreased as social support increased. Practice Implications: Nurses should provide consultancy for women to increase their social support systems to decrease their menopausal complaints. [ABSTRACT FROM AUTHOR]

Background: Fast recovery after cesarean section is vital since the mother not only has to take care of herself but also the newborn. Recovery scores are useful tools to measure and compare recovery; however, standardized questionnaires may miss in-depth patient experiences. What is important to women in the postoperative period after cesarean section can vary in different populations, making it crucial to understand the specific needs of one's own population. This study aims to explore what matters most to Danish mothers during the early phase of recovery following elective cesarean section., Methods: Qualitative design: Adult, Danish-speaking women undergoing elective cesarean section under spinal anesthesia were included in three Danish hospitals. Semi-structured interviews focusing on women's experiences of recovery, pain, and mobilization both in hospital and after discharge were conducted for 4-7 days following their cesarean section. Baseline characteristics and maternal outcomes were collected from patient files. The interviews were recorded, transcribed verbatim, and analyzed using manifest content analysis., Results: In total, 25 women were interviewed a median of 6 days post cesarean section (IQR 5-8). Three themes emerged: "Experience of being a cesarean section patient," "I'm doing good - and better than expected," and "Challenges when going home." The cesarean section itself was described as a disturbing experience. The initial days post-cesarean section were described as very painful, but hereafter, many patients expressed surprise at their rapid recovery. None used opioids after discharge. Post-discharge, having a partner's support, especially with other children to care for, was helpful, and moving from lying to sitting position and getting out of bed were noted as particularly painful. Many women requested more information and specific rehabilitation programs., Conclusions: In this qualitative study of Danish women 4-7 days after elective cesarean sections, the women described the initial days as very painful but felt that they recovered rather quickly thereafter. The study indicated a need for enhanced communication, especially regarding the experience of surgery, pain after cesarean section, and physical rehabilitation plans., Editorial Comment: In this qualitative, explorative study, participants were interviewed by telephone 4-7 days following their elective cesarean section. The focus was the women's experience of recovery, pain, and mobilization, both in hospital and when going home. The findings identified a need for more information about the perioperative course, as most participants were surprised and unprepared both for the pain from other areas than the scar and for the surgery experience being unpleasant, and many requested physical rehabilitation plans., (© 2025 The Author(s). Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.)

Background: Clinical characteristics of women with different obstructive sleep apnoea (OSA) severity and adherence to continuous positive airway pressure (CPAP) therapy have not been previously explored. Aims: To assess OSA prevalence, predictors, clinical and polysomnographic (PSG) characteristics and adherence to CPAP therapy among adult Australian women in a retrospective study. Methods: All female patients who underwent a diagnostic PSG between 2014 and 2015 were included. CPAP adherence was assessed during the study period between 2018 and 2019 using multiple regression models. Results: Among a total of 591 women included in this study (Aboriginal, n = 86), OSA was diagnosed in 458/591 (78%) patients; mild, moderate and severe OSA was present in 44%, 27% and 29% respectively. Older age, higher BMI and hypertension predicted the presence and severity of OSA. The Epworth Sleepiness Scale (ESS) score was not significantly different with (8 (5, 12)) or without (10 (5, 13)) OSA. PSG showed the rapid eye movement (REM) sleep‐associated apnoea−hypopnea index (AHI) was higher with all severity of OSA. Adherence to CPAP therapy was noted in 171 (57%) patients; 47% mild, 57% moderate and 63% with severe OSA respectively. Three multiple regression models (clinical, PSG parameters, OSA severity, combined (clinical and PSG)) showed the combined model had the strongest predictive value and demonstrated that higher ESS and more severe oxygen desaturation were associated with CPAP adherence irrespective of OSA severity. Conclusions: Older age, higher BMI and the presence of hypertension predicted the presence of OSA. The REM sleep‐related AHI was higher. Adherence to CPAP was associated with symptomatic OSA and severe oxygen desaturation. [ABSTRACT FROM AUTHOR]

Objective: This study aims to determine the effectiveness of the digital storytelling (DS) method in increasing human papilloma virus (HPV) awareness., Study Design: The study was conducted in the gynecology and obstetrics outpatient clinic of a state hospital between April and December 2023. The universe of the study consisted of women who applied to the outpatient clinic between these dates and volunteered. A total of 80 women who met the inclusion criteria were included in the study (n = 40 for each group). Data for the study were gathered using Personal Introduction Form and Human Papilloma Virus Knowledge Scale. Repeated measures ANOVA method was used to determine the difference between the pre-training, post-first training and post-second training measurement scores according to the intervention and control groups. For significant ANOVA results, measurements with differences were compared pairwise using Bonferroni correction. All statistical analyses were examined at the p < 0.05 significance level., Results: Socio-demographic characteristics and HPV awareness levels of women in the intervention and control groups were similar before training (p > 0.05). After the activity conducted with the digital story method in the intervention group, the HPV awareness levels of women in this group increased significantly (p < 0.05). Considering the development in each group, an increase in posttest scores is observed in both groups. However, when the increase amounts in each group in the intervention and control groups were examined, it was determined that all awareness levels increased more in the intervention group. In the intergroup comparison, it was determined that the mean measurements of general HPV knowledge, general HPV vaccine knowledge, and knowledge of the current HPV vaccination program of women in the intervention group at the first and second follow-ups after the training were higher than those in the control group., Conclusion: The DS method was effective in raising HPV awareness given to the intervention group. Health professionals and researchers can benefit from DS in providing health education and consultancy services such as HPV awareness., (© 2024 The Author(s). Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.)

Hormonal contraceptives have been used in perimenopausal women to manage a variety of symptoms and prevent unintended pregnancy. However, it is unclear what contraceptive regimen is best for these women. To evaluate hormonal contraceptive methods in women experiencing perimenopause using two prespecified outcomes: perimenopausal symptom management and long‐term effects. A literature search of PubMed and EMBASE databases was performed (January 1990 to October 2021) using search terms "perimenopause" and "contraception." Relevant full‐text articles in English were included. Fifteen clinical articles were reviewed: Fourteen were internationally based, and one study was conducted in the United States. Nine articles evaluated symptom resolution, and six of these nine reported statistically significant changes in favor of treating perimenopausal women with hormonal contraceptives compared with no treatment. Seven studies evaluated long‐term outcomes including bone loss and metabolic parameters, and six of these seven showed statistically significant improvements with hormonal contraceptives. Based on limited data and a lack of comparative studies, the use of a levonorgestrel intrauterine device with supplemental low‐dose menopausal estrogen has positive results for the management of disruptive perimenopausal symptoms and long‐term outcomes. Hormonal contraception in perimenopausal women improves symptom management and long‐term outcomes if patients do not have contraindications. When selecting a contraceptive for women in perimenopause, clinicians and pharmacists need to address specific patient risk factors, symptom profiles, long‐term risks and benefits, and patient preferences. [ABSTRACT FROM AUTHOR]

Objective: To assess the participation of women in publications of dental journals with a high impact factor. Methods: Articles published in 2016, 2011, and 2006 in 10 dental journals chosen for their highest impact factors in each dental fields were included in this research. Articles‐related variables collected included the country of origin of each author, the type of study, and gender of the researchers. Gender was examined through PubMed, Scopus, ResearchGate, and respective affiliated institutions. Furthermore, a website designed to discover the gender of names was used when the previous alternatives were not conclusive. Forward stepwise Poisson regression models were used for data analysis. Results: A total of 3365 studies were included in the first authorship analysis and 3398 in analysis related to last authorship. The prevalence of women as first authors was 37.2% (confidence interval (CI) 95% 34.5–37.5) and as last authors was 22.6% (CI 95% 21.3–23.9). Having a woman as the last author increased the presence of women in the first author position in scientific dental articles by 16% (prevalence ratio = 1.16, CI 95% [1.04–1.29]). The year of publication, journal, and region of the author were associated with an increase in the prevalence of women as last authors. From 2006 to 2016, the prevalence of women as last authors increased by 61%. Despite these trends, women were still underrepresented in science in the evaluated period. Conclusions: There are meaningful gender inequalities in publications of scientific dental papers. Encouraging women to lead research groups can reduce the inequities observed in the present study. [ABSTRACT FROM AUTHOR]

Introduction: Approximately every fourth labor is induced. In Finland, when labor is induced, it is commonly carried out with a catheter in the inpatient (IP) setting. However, in uncomplicated, full-term pregnancies, induction of labor (IOL) in the outpatient (OP) setting is also possible. Nevertheless, there is only a limited amount of information about the experiences of IOL in OP setting. Our study compared the experiences of catheter IOL in OP and IP settings.Material and Methods: We performed a prospective randomized study, including 113 women with uncomplicated full-term pregnancies with planned IOL. After catheter insertion, women were randomized into OP or IP settings: after dropouts, there were 53 women in the OP group and 54 in the IP. The experiences of IOL were evaluated with three sets of visual analog scale (VAS) questionnaires: the general experience questionnaire (eight questions), the concurrent induction experience questionnaire (1, 5, 9, 13 hours; nine questions) and the postpartum experience questionnaire (14 questions).Results: Both groups had low VAS scores, indicating good experiences of IOL. Women in the OP group were less satisfied (mean VAS difference Δ = 7.8, P = .015) and more anxious (Δ = 4.8, P = .008) than were women in the IP group. In the course of the IOL, all women became less satisfied (Δ = 8.4, P = .001), had more contraction pain (Δ = 8.9, P = .020) and had a higher frequency of contractions (Δ = 9.9, P = .004) but they were more relaxed and experienced less fear (Δ = 6.9, P = .036, Δ = 5.3, P = .001, respectively). There was no interaction between group and time. According to the postpartum experience questionnaire, both groups had a similar good general experience of IOL (P = .736) but the OP group had more fear (Δ = 9.5, P = .009) and was more anxious (Δ = 9.0, P = .007). Most of the women would choose catheter IOL in a subsequent pregnancy (OP 82.6%, IP 87.0%).Conclusions: The women in the OP setting were less satisfied and more anxious than were the women in the IP setting. However, the differences were marginal and the general experience after IOL was good. IOL in an OP setting is thus a viable option in low-risk full-term pregnancies. Therefore, when using catheter IOL, both setting options should be available. [ABSTRACT FROM AUTHOR]

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Female sexual hormones have known hypnogenic effects and the use of hormonal replacement therapy in postmenopausal women leads to improvement in sleep quality. However, the effects of hormonal contraceptives in women of reproductive age are still scarcely understood. This study sought to evaluate the impact of hormonal contraceptive use on subjective self‐reports of sleep through a web‐based cross‐sectional survey. A total of 2,055 women between 18 and 40 years old participated by answering an online questionnaire evaluating hormonal contraceptive use, sleep‐related characteristics and related features. Sleep assessment tools comprised the Epworth Sleepiness Scale (ESS) and the Insomnia Severity Index (ISI). Statistical comparisons were performed between hormonal contraceptive users and those who reported no current use. Analyses were repeated to compare users of combined contraceptives with users of progestagens only, as well as to compare users of different generations of contraceptives. Among the total sample, 1,286 participants met the inclusion criteria (918 of them were currently taking a hormonal contraceptive). Contraceptive users reported more frequent sleep complaints and had higher scores on ESS and ISI, which means increased excessive daytime sleepiness and more insomnia symptoms. Women using progestagen‐only therapies reported lower total sleep duration compared with combined therapy. Users of third‐generation contraceptives showed lower total sleep time and higher ISI score when compared with non‐users. In conclusion, contraceptive users have more insomnia symptoms and increased excessive daytime sleepiness when compared with women who do not use any hormonal contraceptive method, and progestagen‐only therapy was associated with lower sleep duration. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to define the relationship of experiencing premenstrual syndrome (PMS) and dysmenorrhea with the personality structure of women. Design and Methods: The sample of this descriptive relation-seeker-type study comprised 353 women. Data were collected using the PMS Scale, Quick Big Five Personality Test, and The Questionnaire Form between 1 April and 31 August 2019 in a city in the Mediterranean region in Turkey. Findings: There was a weak negative-biased correlation between PMS and extraversion, a very weak negative-biased correlation between PMS and conscientiousness, a moderate negative-biased correlation between PMS and neuroticism, and a very weak positive-biased significant correlation between PMS and openness (P < .05). Practice Implications: These data suggest that women who are introverted, have weak self-confidence, tend to have negative feelings such as anxiety, depression, and anger, and have weak coping skills are at risk for experiencing PMS. [ABSTRACT FROM AUTHOR]

Purpose: This study determined the anxiety and hopelessness levels of women during in vitro fertilization‐embryo transfer. Design and Methods: This cross‐sectional and descriptive study was conducted with 50 infertile women. The Personal Information Form, State‐Trait Anxiety Inventory, and Beck Hopelessness Scale (BHS) were used to collect data. Findings: A statistically significant difference between the BHS total score before oocyte pick‐up and after embryo transfer was found (P <.05). However, no statistically significant relationship was found between state anxiety in the same process (P >.05). Practice Implications: This study showed that women had high levels of hopelessness and as a woman's state anxiety level increased, her level of hope decreased. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to compare the allodynia score in headache attacks related and not related to menstruation in women diagnosed with menstrually related migraine without aura. Background: Allodynia is an important symptom in migraine and has been associated with migraine chronification. No study has yet compared prospectively allodynia in menstrual vs non‐menstrual attacks within the same cohort of patients. Methods: This is a prospective cohort study, where participants had the 12‐item Allodynia Symptom Checklist (ASC‐12) assessed after 1, 2, 4, and 24 hours from the onset of migraine attacks in 2 different conditions, with menstrual migraine attack (MM+) and with non‐menstrual migraine attack (MM−). Results: A total of 600 women with headache complaints were screened from March 2013 to July 2014 in a headache outpatient or headache tertiary clinic. From these, 55 participants were recruited, and 32 completed the study. Participants' mean age was 27 years, BMI was 22.1, menarche age 12 years, migraine history was 11.5 years, and most women were young (ranged from 17 to 44 years of age), were in higher school (13/32 = 41%), single (20/32 = 63%), and used contraceptives (22/32 = 69%). Multiple pairwise comparisons of ANCOVA's test showed significant higher ASC‐12 scores in MM+ group compared to MM− group at 2 hours [mean, 95% CI of difference: 2.3 (0.31, 4.7), P =.049)]. For the ASC‐12 categorical scores (absent, mild, moderate, and severe) MM+ yielded higher scores than MM− at 1 hour (z = −3.08, P =.021) and 4 hours (z = −2.97, P =.03). Conclusion: This study demonstrated that in the patents from tertiary headache center assessed, menstrual‐related migraine attacks augment allodynia scores in the beginning of attacks compared to non‐menstrual migraine attacks. [ABSTRACT FROM AUTHOR]

Background: Few studies have explored ethical and legal issues in contraceptive counselling among women with intellectual disability (ID). This study aimed to gain a deeper understanding of these issues during midwifery contraceptive counselling. Method: The present authors interviewed 19 midwives in five focus groups in Sweden 2016 – 2017 and analysed data with content analysis. Results: The participants expressed that women with intellectual disability have equal right to relationships and sexual expressions, but feared exposure to sexual exploitation/abuse. They experienced ethical dilemmas related to principles of fairness and autonomy, but strived to provide assistance in spite of the women's cognitive impairment, presence of supporting persons and uncertainty of optimal counselling. Organizational support was insufficient. Conclusions: The midwives experienced ambivalence, uncertainty and ethical dilemmas in their counselling. They were, however, aware of legal aspects and strived for the women's best interest, right to self‐determination and autonomous choices. The participants wanted better professional teamwork and support. [ABSTRACT FROM AUTHOR]

The impact of dehydroepiandrosterone (DHEA) administration has been widely studied for anti‐doping purposes in men, whereas only a few studies have been performed in women. In the present study, the impact of DHEA on the steroid profile parameters and their carbon isotopic ratios was explored. Eleven healthy young women and 10 healthy young men received two treatments: One with 100 mg/day of DHEA for 28 days and one with a placebo according to a double‐blind crossover protocol. Urine and saliva (only in females) samples were collected before and for 72 hours after each short‐term treatment. In all female subjects, concentrations of the urinary parameters of the steroid profile were highly impacted by short‐term DHEA administration including epitestosterone (E). Gas chromatography–combustion–isotope ratio mass spectrometry (GC–C–IRMS) analysis was performed and positive results were observed for E in the four female subjects where E concentration was adequate for such analysis, whereas men results remained negative for E. Last, the ability of the Anti‐Doping Administration and Management System (ADAMS) software used for the athlete biological passport to identify such doping was assessed. Of the 11 passports generated for female subjects, 10 were automatically classified as an atypical passport finding (ATPF). For the remaining passport with normal status in one woman, the variability of the concentrations prevented the ADAMS software from adjusting individual limits. The most impacted markers in women were T/E and 5αAdiol/E, with a detection window of 36 hours for 5αAdiol/E. In addition, good correlations were observed for DHEA and T concentrations in urine and saliva in females. The impact of short‐term DHEA treatment was studied in female volunteers and compared to male observations. Both APB and GC‐C‐IRMS results were able to detect such administration with however a surprising positive result found for the carbon isotopic ratio of epitestosterone in women only. Over the 11 passports generated for female subjects, 10 were automatically classified as atypical passport finding. The most impacted markers in women were T/E and 5αAdiol/E ratios with a detection window of 36 hours for 5αAdiol/E. [ABSTRACT FROM AUTHOR]

Objective: To explore women's experiences of obstetric violence related to childbirth in Ecuador.Methods: The present cross-sectional descriptive study combined qualitative and quantitative elements of women's childbirth experience in Quito, Ecuador, between July 1, 2016, and July 1, 2017. Women who delivered in public health units providing different levels of care completed a survey of 32 questions, divided into six dimensions of obstetric violence.Results: Overall, 388 women completed the survey, of whom 259 (66.8%) delivered vaginally and 129 (33.2%) delivered by cesarean. Among 120 women who delivered for the first time, 62 (51.7%) had an episiotomy. At the second stage of labor, uterine fundus pressure (Kristeller maneuver) was performed for 49 (19.4%) of 252 women. Overall, 196 (50.5%) women reported that they were not allowed to engage in early attachment, and 135 (34.8%) reported that they did not receive support for the initiation of breastfeeding.Conclusion: Various forms of obstetric violence are occurring in the public health services of Quito, despite World Health Organization recognition of the need for perinatal care at the highest level. Programs designed to prevent and diminish obstetric violence are urgently required. [ABSTRACT FROM AUTHOR]

Objective: The challenging and stressful nature of emergency medicine place the practitioners of this young branch of medicine at risk of burnout. In Iran, the number of women choosing the specialty of emergency medicine has been increasing in recent years. No studies have focused on burnout among female emergency medicine physicians. We conducted this study to evaluate the level of burnout in female emergency medicine physicians in Iran. Methods: In this cross-sectional study, all Iranian female emergency medicine physicians with more than 2 years of work experience as specialists, received a questionnaire containing 22-item Maslach Burnout Inventory scales and 7-item Cassidy social support scale, as well as questions about workload and career satisfaction. Results: In total, 77 questionnaires were analysed (response rate: 75%; median age: 36 years, median for work experience = 3 years). A total of 34% of participants were academic faculties. The level of burnout in three subscales of emotional exhaustion, depersonalisation and perceived low personal accomplishment was moderate to high in 84.5, 48.1 and 80.5% of participants respectively. A total of 94.8% of female emergency medicine physicians perceived their workload to be moderate to high and only 1.3% of them had high job satisfaction. Conclusions: Alarming high rate of burnout and job dissatisfaction among female emergency medicine physicians in our study requires careful attention. Further investigations are suggested to identify the contributory factors to burnout and the probability of some gender disparities in this field. [ABSTRACT FROM AUTHOR]

The aim was to compare the epidemiology of injuries between elite male and female football players from the same club. Injuries and individual exposure time in a male team and a female team, both playing in the Spanish first division, were prospectively recorded by the club's medical staff for five seasons (2010‐2015) following the FIFA consensus statement. Total, training, and match exposure hours per player‐season were 20% higher for men compared to women (P<.01). Total, training, and match injury incidence were 30%‐40% higher in men (P≤.04) mainly due to a 4.82 (95% confidence interval [CI] 2.30‐10.08) times higher incidence of contusions, as there were no differences in the incidence of muscle and joint/ligament injuries (P≥.44). The total number of absence days was 21% larger in women owing to a 5.36 (95% CI 1.11‐25.79) times higher incidence of severe knee and ankle ligament injuries. Hamstring strains and pubalgia cases were 1.93 (95% CI 1.16‐3.20) and 11.10 (95% CI 1.48‐83.44) times more frequent in men, respectively; whereas quadriceps strains, anterior cruciate ligament ruptures, and ankle syndesmosis injuries were 2.25 (95% CI 1.22‐4.17), 4.59 (95% CI 0.93‐22.76), and 5.36 (95% CI 1.11‐25.79) times more common in women, respectively. In conclusion, prevention strategies should be tailored to the needs of male and female football players, with men more predisposed to hamstring strains and hip/groin injuries, and women to quadriceps strains and severe knee and ankle ligament injuries. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess a possible correlation between zolpidem use and acute pyelonephritis (APN) in women in Taiwan. Therefore, we performed a case-control study involving the Taiwan's National Health Insurance Research Database between 2000 and 2011. This study included 3151 female participants aged 20 to 84 years who experienced the first bout of APN (case group) and 6015 randomly selected female participants without APN (control group). Zolpidem use was defined as 'current,' 'early,' or 'late,' if the last remaining 1 tablet for zolpidem was detected within 7 days, between 8 and 14 days, or ≥15 days before the date of APN diagnosis, respectively. The multivariable unconditional logistic regression model was used to calculate the odds ratios (ORs) with 95% confidence intervals (CIs) to assess the correlation between zolpidem use and APN. After adjusting for confounders, the multivariable analysis yielded an adjusted APN OR of 2.2 for participants with current zolpidem use (95%CI 1.7-2.8) compared with participants who never used zolpidem. The adjusted ORs gradually decreased to 1.4 for participants with early zolpidem use (95%CI 0.8-2.5) and 1.1 for participants with late zolpidem use (95%CI 0.9-1.2), but without statistical significance. Only patients with current zolpidem use had a significantly increased relative risk of APN. Additional large confirmatory studies are needed to illustrate a causal relationship. Meanwhile, physicians and pharmacists should be more cautious about the risk of APN when prescribing and dispensing zolpidem in women. [ABSTRACT FROM AUTHOR]

Introduction: Sleep disturbances are common during pregnancy, yet underdiagnosed and under-investigated. We evaluated sleep quality during pregnancy and assessed associated factors, especially depressive and anxiety symptoms.Material and Methods: A total of 78 healthy pregnant women from the FinnBrain Birth Cohort Study were studied twice prospectively during pregnancy (in mid-pregnancy and late pregnancy). Sleep quality was evaluated by the Basic Nordic Sleep Questionnaire, depressive symptoms by the Edinburgh Postnatal Depression Scale, and anxiety symptoms by the State-Trait Anxiety Inventory.Results: Poor general sleep quality, difficulty falling asleep, the number of nocturnal awakenings per night, and too-early morning awakenings increased in late pregnancy compared with mid-pregnancy (all p-values < 0.020). The total insomnia score (p < 0.001) and sleep latency increased (p = 0.005), but sleep duration and preferred sleep duration did not change. Women tended to snore more often in late pregnancy, but apneas remained rare. Almost one-fourth of the women reported both morning and daytime sleepiness, but the frequencies did not increase during the follow up. In late pregnancy, depressive and anxiety symptoms were cross-sectionally related to sleep disturbances, but depressive or anxiety symptoms in mid-pregnancy were not associated with sleep disturbances in late pregnancy.Conclusions: We found deterioration in sleep quality across pregnancy. However, no increase in negative daytime consequences was found, presumably indicating a compensatory capacity against sleep impairment. Additionally, depressive and anxiety symptoms and sleep disturbances were only cross-sectionally associated. Our study calls for further research on the factors that influence sleep disturbances during pregnancy. [ABSTRACT FROM AUTHOR]

In this study, we examined social relations in women exposed to earthquake trauma in Eastern Anatolia, Turkey. We examined women's perceptions regarding the changes in their social relations within their neighbourhood, within their marriage and with their children; analysed the factors that were associated with these relations; and tested the hypothesis that an improvement in social relations will protect women's mental health from the negative impact of earthquake trauma. Participants consisted of a random selection of 1253 women, who were interviewed regarding their psychosocial needs and mental health status 1 year after earthquake. They reported trauma‐related changes in their social relations; their mental health was evaluated using the Post Traumatic Stress Diagnostic Scale and Brief Symptom Inventory. Our study demonstrated severe earthquake trauma was associated with deteriorated social relations, especially neighbourhood and marital relations. Deteriorated marital and child relations were associated with increased levels of psychiatric distress; deteriorated neighbourhood relations were associated with intrusive posttraumatic stress symptoms. Improved neighbourhood relations, but not family relations, were able to protect women's mental health from the negative impact of trauma. The results are discussed regarding their relevance to gender effects and the provision of relation‐specific and symptom‐specific disaster relief. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The present study aimed to identify urine metabolites in women exposed to high cadmium (Cd) levels. Twenty-one women exposed to environmental Cd and 12 age-matched controls were categorized as high exposure (urine Cd ≥ 15 μg/g creatinine; n = 9) or low exposure (15 μg/g creatinine > urine Cd > 5 μg/g creatinine; n = 12). Low-molecular weight metabolites in urine were analyzed by gas chromatography and mass spectrometry after derivatization. An orthogonal partial least-squares discriminant analysis model was constructed, and metabolites from the dimensional model were selected according to the variable importance in projection (>1). Metabolites differing significantly in abundance between different exposure groups were identified by searching mass spectral databases, and related pathways were analyzed using the Kyoto Encyclopedia of Genes and Genomes. Approximately 110 significantly different metabolites were detected with variable importance in projection > 1, and 48 of them were found to differ markedly in abundance among the 3 groups. Twenty-seven matched with known metabolites, including 22 significantly increased and 5 markedly decreased in the high-exposure group ( p < 0.01). Kyoto Encyclopedia of Genes and Genomes results indicated that carbohydrate, amino acid, bone, and intestinal flora metabolism and the tricarboxylic acid cycle were affected by Cd exposure. The present study identified metabolites that differed in abundance in response to Cd exposure. Further studies may connect these biomarkers to early damage caused by Cd. Environ Toxicol Chem 2016;35:1268-1275. © 2015 SETAC [ABSTRACT FROM AUTHOR]

Purpose: To investigate if duplex ultrasonography findings change according to the menstrual cycle phases in women with early symptoms of lower extremity chronic venous disease.Methods: Thirty women (60 extremities) aged 18-50 years with regular menstrual cycles who presented with complaints of telangiectasia and/or trunk varices with accompanying leg pain were evaluated prospectively by duplex ultrasonography at three different times of a single menstrual cycle. Previous DVT or menstrual irregularities were exclusion criteria. All exams were performed by the same radiologist, under the same conditions. Reflux was provoked in the deep veins, great saphenous vein (GSV), and small saphenous vein (SSV) using the Valsalva maneuver. Reflux times in each vein and average diameters of the GSV and SSV were recorded.Results: Reflux times showed no significant differences in any of the vein segments and the diameters of GSV and SSV were similar in the different menstrual phases (p > 0.05). Reflux was not predominant at any specific phase, and its presence was independent of menstrual phase.Conclusions: Reflux was not specific to a particular phase of menstrual cycle in women with early symptoms of chronic venous disease. [ABSTRACT FROM AUTHOR]

Bladder outlet obstruction ( BOO) should be considered when a woman complains of voiding difficulty, abdominal straining to void, or refractory storage symptoms. Diagnosis of female BOO is not straightforward and usually requires invasive (video)urodyanmic study. A diagnostic algorithm is recommended for making optimal diagnosis. Female BOO can be classified as having anatomical and functional origins, and each contains several sub-classifications. Literatures published between 1988 and 2013 were reviewed and summarized for the diagnosis and therapy in each subtype of female BOO. [ABSTRACT FROM AUTHOR]

Background Chrysotile had been used in asbestos textile workshops in Southeast China but a clear relation to mesothelioma is lacking. Methods All patients diagnosed with mesothelioma from 2003 to 2010 at Yuyao People's Hospital were re-evaluated by multiple expert pathologists with immunohistochemistry and asbestos exposure data were collected. Results Of 43 patients with a mesothelioma diagnosis, 19 peritoneal and nine pleural cases were finally diagnosed as mesothelioma. All were females, and the mean age of the patients with peritoneal or pleural mesothelioma was 52.4 and 58.2 years, respectively. All these cases had a history of domestic or occupational exposure to chrysotile. Two-thirds of the patients were from two adjoining towns with multiple small asbestos textile workshops. Contamination of tremolite was estimated to be less than 0.3%. Conclusions This is a report of mesothelioma in women exposed to chrysotile asbestos at home and at work, with an over-representation of peritoneal mesothelioma. Am. J. Ind. Med. 58:1040-1049, 2015. © 2015 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Objective/Background Obesity is related to migraine. Maladaptive pain coping strategies (eg, pain catastrophizing) may provide insight into this relationship. In women with migraine and obesity, we cross-sectionally assessed: (1) prevalence of clinical catastrophizing; (2) characteristics of those with and without clinical catastrophizing; and (3) associations of catastrophizing with headache features. Methods Obese women migraineurs seeking weight loss treatment (n = 105) recorded daily migraine activity for 1 month via smartphone and completed the Pain Catastrophizing Scale ( PCS). Clinical catastrophizing was defined as total PCS score ≥30. The six-item Headache Impact Test ( HIT-6), 12-item Allodynia Symptom Checklist ( ASC-12), Headache Management Self- Efficacy Scale ( HMSE), and assessments for depression ( Centers for Epidemiologic Studies Depression Scale) and anxiety (seven-item Generalized Anxiety Disorder Scale) were also administered. Using PCS scores and body mass index ( BMI) as predictors in linear regression, we modeled a series of headache features (ie, headache days, HIT-6, etc) as outcomes. Results One quarter (25.7%; 95% confidence interval [ CI] = 17.2-34.1%) of participants met criteria for clinical catastrophizing: they had higher BMI (37.9 ± 7.5 vs 34.4 ± 5.7 kg/m2, P = .035); longer migraine attack duration (160.8 ± 145.0 vs 97.5 ± 75.2 hours/month, P = .038); higher HIT-6 scores (68.7 ± 4.6 vs 64.5 ± 3.9, P < .001); more allodynia (7.0 ± 4.1 vs 4.5 ± 3.5, P < .003), depression (25.4 ± 12.4 vs 13.3 ± 9.2, P < .001), and anxiety (11.0 ± 5.2 vs 5.6 ± 4.1, P < .001); and lower self-efficacy (80.1 ± 25.6 vs 104.7 ± 18.9, P < .001) compared with participants without clinical catastrophizing. The odds of chronic migraine were nearly fourfold greater in those with (n = 8/29.6%) vs without (n = 8/10.3%) clinical catastrophizing (odds ratio = 3.68; 95% CI = 1.22-11.10, P = .021). In all participants, higher PCS scores were related to more migraine days (β = 0.331, P = .001), longer attack duration (β = 0.390, P < .001), higher HIT-6 scores (β = 0.425, P < .001), and lower HMSE scores (β = −0.437, P < .001). Higher BMI, but not higher PCS scores, was related to more frequent attacks (β = −0.203, P = .044). Conclusions One quarter of participants with migraine and obesity reported clinical catastrophizing. These individuals had more frequent attacks/chronicity, longer attack duration, higher pain sensitivity, greater headache impact, and lower headache management self-efficacy. In all participants, PCS scores were related to several migraine characteristics, above and beyond the effects of obesity. Prospective studies are needed to determine sequence and mechanisms of relationships between catastrophizing, obesity, and migraine. [ABSTRACT FROM AUTHOR]

Aim: We examined qualitative data from a larger study of benzodiazepine-using women older than 65 years, living in the United States, for subjective experiences of loneliness and social isolation. Method: Data from semistructured interviews with seven participants discussed aspects of social isolation or loneliness. Following a phenomenological design, data were coded and analysed for experiences. Results: Three themes emerged: 'Dislike being alone'; 'Loneliness and isolation'; and 'Social isolation causes negative feelings'. Conclusion: Social isolation and loneliness are negative aspects of the lived experience for older benzodiazepine-using women and the loss of companions and transportation is important to this experience. Being isolated can cause depression, fear and insecurity. Future research should consider the role psychotropic medications have in coping with social isolation and loneliness among older adults. Clinicians should be aware of social isolation and loneliness in late life and discuss non-pharmacologic treatment options with their ageing patients. [ABSTRACT FROM AUTHOR]

Objective We aimed to investigate which factors make a mentor mother support programme for abused women successful. Method We used semi-structured interviews with abused women and focus group discussions with the mentor mothers to evaluate their experiences and needs within a mentor support programme (MeMo SA). Fourteen abused women were interviewed 6 months after the support programme ended. Mentor mothers participated in two focus group discussions. Results Abused women emphasised that nonjudgmental listening, equivalence, involvement and bonding are important factors for successful support. Mentor mothers described that empathy, availability, persistence and advocacy fitted the needs of women best to empower them and help them to cope with their violent situation at home. A safe place to meet each other was also an important factor. Conclusion A good relationship, tailored support provided by home visiting, advocacy and safety are required to effectively help abused women. MeMo SA, a home-visiting support programme, is a promising valuable new support programme in primary care for abused women. [ABSTRACT FROM AUTHOR]

Objective We aimed to gain insight into the process of help seeking of abused women visiting their family physician ( FP). Setting Family practice in Rotterdam, the Netherlands. Method We used a qualitative method with interviews in a sample of 14 abused women, identified in an earlier cross-sectional survey with the Composite Abuse Scale ( CAS) and the Beck Depression Inventory ( BDI). This qualitative method with semi-structured interviews was used to obtain information on the process of seeking help. Results Unawareness of the impact of abuse on themselves and their children, unfamiliarity and negative experiences with professionals and fear for their partner hampers abused women to seek professional help. Our study reveals that abused women need informal support by family and friends to ask for professional support. Current health care does not fit into the needs of abused women during the abuse they want more practical support, after the abuse they need also psychological help. In our study, FPs and mothers pay less attention to the impact of witnessing violence on children. Conclusion When women are unaware of the negative consequences of IPV, the physical and mental well-being of themselves and their children they do not ask for professional support. Abused women view informal support is important in the changing process. FPs should be trained to pay more attention to informal support and be alert to children's well-being. [ABSTRACT FROM AUTHOR]

Background Breast cancer is the most commonly diagnosed invasive cancer in New Zealand women and modifiable lifestyle risk factors may contribute to this. Aim To estimate population attributable risks for modifiable lifestyle factors and breast cancer in New Zealand. Methods Estimates of the magnitude of the impact of modifiable lifestyle risk factors for breast cancer (relative risks and odds ratios obtained from published epidemiological studies) and the prevalence of exposure in New Zealand were used to calculate the population attributable risk percent ( PAR%) for each risk factor. The PAR% show the relative importance of these considered risk factors and give an indication of the potential impact of reducing the prevalence of these lifestyle risk factors on the incidence of breast cancer in New Zealand. Results Six modifiable lifestyle factors were identified for breast cancer. These were obesity, lack of physical activity, high alcohol intake, oral contraceptive use, hormone replacement therapy ( HRT) and delayed first birth. The PAR% for these risk factors ranged from 1% for delayed first birth to 10% for obesity (16% for Maori women and 17% for Pacific women). Conclusions The most important primary preventive strategies to reduce the risk of breast cancer in New Zealand are lifestyle changes to reduce obesity, promoting regular physical activity (which may in turn reduce the prevalence of obesity), reducing HRT use and avoiding high alcohol intake. Strategies that encourage regular physical activity and reduce obesity could also have other benefits, such as reduced risks of cardiovascular disease and diabetes. [ABSTRACT FROM AUTHOR]

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow-up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow-up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission. [ABSTRACT FROM AUTHOR]

Women with severe premenstrual syndrome report sleep-related complaints in the late-luteal phase, but few studies have characterized sleep disturbances prospectively. This study evaluated sleep quality subjectively and objectively using polysomnographic and quantitative electroencephalographic measures in women with severe premenstrual syndrome. Eighteen women with severe premenstrual syndrome (30.5 ± 7.6 years) and 18 women with minimal symptoms (controls, 29.2 ± 7.3 years) had polysomnographic recordings on one night in each of the follicular and late-luteal phases of the menstrual cycle. Women with premenstrual syndrome reported poorer subjective sleep quality when symptomatic in the late-luteal phase compared with the follicular phase ( P < 0.05). However, there were no corresponding changes in objective sleep quality. Women with premenstrual syndrome had more slow-wave sleep and slow-wave activity than controls at both menstrual phases ( P < 0.05). They also had higher trait-anxiety, depression, fatigue and perceived stress levels than controls at both phases ( P < 0.05) and mood worsened in the late-luteal phase. Both groups showed similar menstrual-phase effects on sleep, with increased spindle frequency activity and shorter rapid eye movement sleep episodes in the late-luteal phase. In women with premenstrual syndrome, a poorer subjective sleep quality correlated with higher anxiety ( r = −0.64, P = 0.005) and more perceived nighttime awakenings ( r = −0.50, P = 0.03). Our findings show that women with premenstrual syndrome perceive their sleep quality to be poorer in the absence of polysomnographically defined poor sleep. Anxiety has a strong impact on sleep quality ratings, suggesting that better control of mood symptoms in women with severe premenstrual syndrome may lead to better subjective sleep quality. [ABSTRACT FROM AUTHOR]

Background: Numerous factors influence career decisions for internal medicine trainees and Fellows. There is a perception that a greater emphasis is placed on work-family balance by younger physicians. Aims: To determine the characteristics of the modern internal medicine workforce and ascertain whether job flexibility is important to career decision-making. We hypothesised that factors which reflect flexibility would be highly influential in decision-making, especially for women and those with young children. Methods: A questionnaire was mailed to 250 New Zealand internal medicine trainees and Fellows. It focused on factors, including job flexibility, interest and collegial support, and included demographic details which were primarily aimed at ascertaining family responsibilities. Results: Response rate was 54%. The majority of female physicians are the main person responsible for their children (62%), and the majority of their partners work full-time (80%). This contrasts with male physicians, of whom only 4% are the main person responsible for their children. Flexibility was found to be more influential in women, those with young children, trainees and those working in outpatient-based subspecialties. However, contrary to our original hypothesis, flexibility was not reported to be highly influential in any group, with career choice being most influenced by interest and enjoyment, intellectual challenge and variety within the job. Conclusion: It is hoped that results will inform employers and those involved with training to enable them to better cater for the needs of the workforce and also encourage trainees to consider future family commitments when making career decisions. [ABSTRACT FROM AUTHOR]

Background: Osteoporosis is a major healthcare issue with over 50% of postmenopausal women suffering an osteoporosis-related fracture. Vertebral fractures, the commonest, are often asymptomatic, unrecognised and untreated. Aims: In a high risk population we aimed to screen for vertebral fractures with a lateral chest X-ray then to intervene to highlight risk and improve fracture prevention. Methods: In this prospective interventional study, 104 postmenopausal women, presenting to hospital for unrelated conditions, were recruited. A baseline lateral chest X-ray and fracture risk questionnaire was completed with a follow-up questionnaire at 12 months. Where fractures were detected the study team intervened through correspondence, including evidence-based guidelines recommending investigations and management to patients and general practitioners. Results: Ninety-six women had a lateral chest X-ray with 53 (55%) having vertebral fractures. Sixty-five women completed baseline questionnaires and 64/65 had a calculated 5-year fracture risk greater than 10%. At 12 months, 21% were commenced or continued on bisphosphonates with 17% adhering to therapy while eight had sustained a subsequent symptomatic fracture and eight women had died. Conclusions: Fifty-five per cent of women over 65 years, presenting to hospital with unrelated medical conditions, had a previous minimal trauma vertebral fracture on lateral chest X-ray. Potentially, a lateral chest X-ray may provide a simple effective screening tool for osteoporotic fracture in this high-risk population. Despite notification and recommendations to both patients and general practitioners, treatment uptake was poor, highlighting the need for further research into risk perception and behaviour change in both practitioners and patients. [ABSTRACT FROM AUTHOR]

Occurrence of gestational trophoblastic neoplasia (GTN) and adnexal torsion is rare in postmenopause. We report a 58-year-old postmenopausal woman with adnexal torsion caused by hydatidiform mole. The patient was admitted to our clinic complaining of acute abdominal pain, nausea and vomiting lasting one day. Ultrasonography showed an enlarged uterus including hypo/hyperechogenous cystic areas in the endometrial cavity and bilateral adnexal masses. β-HCG level was investigated and determined as 157.000 IU/l, because of the suspicion of GTN in ultrasonography. Doppler sonography revealed enlarged left adnexa with absence of vascular flow. The patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. β-HCG decreased to normal ranges in the fourth postoperative week. The resected uterus contained an endometrial, cystic, grapelike tumor. The ovaries were enlarged bilaterally with necrotic appearance. Histopathology revealed complete hydatidiform mole and theca lutein cysts. To our knowledge, the present case is the first hydatidiform mole associated with bilateral adnexal torsion caused by theca lutein cysts in postmenopausal period. [ABSTRACT FROM AUTHOR]

( Headache 2011;51:208-219) Intimate partner violence (IPV) among women is a global public health problem. The association between childhood maltreatment and migraine is well established, but not the association between IPV and migraine. The aim of this cross-sectional study was to evaluate the relationship between type and severity of IPV and migraine in a large cohort of Peruvian women. Women who delivered singleton infants (n = 2066) at the Instituto Nacional Materno Perinatal, Lima, Peru were interviewed during their postpartum hospital stay. Participants were queried about their lifetime experiences with headaches and migraine, and with physical and sexual violence. The International Classification of Headache Disorders (ICHD-2) diagnostic criteria were used to classify participants according to their migraine status. Questions on physical and sexual violence were adapted from the protocol of Demographic Health Survey Questionnaires and Modules: Domestic Violence Module and the World Health Organization (WHO) Multi-Country Study on Violence against Women. Depressive symptoms were assessed using a modified version of the Patient Health Questionnaire-9. Logistic regression was used to estimate multivariate adjusted odds ratios (aOR) and 95% confidence intervals (CI). Compared with women without a history of violence, women with experiences of lifetime physical or sexual violence (aOR = 1.44, 95% CI 1.19-1.75), physical violence only (aOR = 1.36, 95% CI 1.10-1.68), sexual violence only (aOR = 1.76, 95% CI 0.97-3.21), and both physical and sexual violence (aOR = 1.61, 95% CI 1.12-2.31) had increased odds of any migraine after adjusting for maternal age, parity, and access to basic foods. There was no gradient of increased odds of any migraine with severity of physical violence. The relationship between IPV and any migraine was strongest among women with moderate to severe levels of depressive symptoms. The odds of any migraine was increased 2.25-fold (95% CI 1.75-2.28) among abused women who also had moderate to severe levels of depressive symptomology compared with women who were not abused and had none or mild levels of depressive symptomology. Associations from sensitivity analyze that segregated women according to probable migraine (ICHD-2 category 1.6.1) and migraine (ICHD-2 category 1.1) diagnoses were of similar magnitudes as those reported here for women with any migraine diagnoses. IPV, particularly sexual violence, appears to be a risk factor for migraine. Our findings suggest the potential importance of considering a history of violence among migraineurs. [ABSTRACT FROM AUTHOR]