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Midlife, beginning at 40 years and extending to 65 years, a range that encompasses the late reproductive to late menopausal stages, is a unique time in women's lives, when hormonal and physical changes are often accompanied by psychological and social evolution. Access to sexual health and sexual well-being (SHSW) services, which include the prevention and management of sexually transmitted infections, contraception and the support of sexual function, pleasure and safety, is important for the health of midlife women, their relationships and community cohesion. The objective was to use the socio-ecological model to synthesise the barriers and enablers to SHSW services for midlife women in high-income countries. A systematic review of the enablers and barriers to women (including trans-gender and non-binary people) aged 40–65 years accessing SHSW services in high-income countries was undertaken. Four databases (PubMed, PsycINFO, Web of Science and Google Scholar) were searched for peer-reviewed publications. Findings were thematically extracted and reported in a narrative synthesis. Eighty-one studies were included; a minority specifically set out to study SHSW care for midlife women. The key barriers that emerged were the intersecting disadvantage of under-served groups, poor knowledge, about SHSW, and SHSW services, among women and their healthcare professionals (HCPs), and the over-arching effect of stigma, social connections and psychological factors on access to care. Enablers included intergenerational learning, interdisciplinary and one-stop women-only services, integration of SHSW into other services, peer support programmes, representation of minoritised midlife women working in SHSW, local and free facilities and financial incentives to access services for under-served groups. Efforts are needed to enhance education about SHSW and related services among midlife women and their healthcare providers. This increased education should be leveraged to improve research, public health messaging, interventions, policy development and access to comprehensive services, especially for midlife women from underserved groups. Plain language summary: Sexual health and sexual wellbeing services for midlife women in high income countries Midlife, beginning at 40 years and extending to 65 years, a range that encompasses the late reproductive to late menopausal stages, is a unique time in women's lives. Access to Sexual Health and Sexual Wellbeing (SHSW) services, which include the prevention and management of sexually transmitted infections, contraception and the support of sexual function, pleasure and safety, is important for the health of midlife women, their relationships and community cohesion. The objective of this systematic review was to use the socio-ecological model to synthesise the barriers and enablers to SHSW services for midlife women in high income countries. Eighty-one studies were included; a minority specifically set out to study SHSW care for midlife women. The key barriers that emerged were the intersecting disadvantage of under-served groups, poor knowledge, about SHSW, and SHSW services, among women and their HealthCare Professionals (HCPs), and the over-arching effect of stigma, social connections, and psychological factors on access to care. Enablers included intergenerational learning, interdisciplinary and one-stop women-only services, integration of SHSW into other services, peer support programmes, representation of minoritised midlife women working in SHSW, local and free facilities, and financial incentives for under-served groups to access services. The appetite for education about SHSW and SHSW services among midlife women and their HCPs should be capitalised upon, and utilised to improve research, public health messaging, interventions and access to holistic services, particularly for midlife women from under-served groups. [ABSTRACT FROM AUTHOR]

The article author focuses on the ways to make a journal look international. A journal editor based overseas, an editorial board spanning multiple countries and continents or a slate of ad hoc reviewers from around the world can help in upgrading its image to international level. However, it is equally clear that the geographic dispersion of the people associated with a journal does not add up to an international look. The author provides a few tips to reviewers and editors, for making a journal become international. The author elaborates that if the reader is different--psychologically, geographically--from an article writer, the reader may be unable to appreciate the value of the research. The author would like all writers to fully immerse themselves in the target journal's conversation before they submit their paper for review. Structure of the paper based on recent publications should be modeled. Each journal has its own unique format, but each journal also has a unique style that is often invisible to the casual reader. Like for example, in Europe and Australia the spelling and sentence structure of written English differ from American English.

Delayering and the flattening of organizational hierarchies was a widespread trend through the 1990s. Peters (1992) in the USA promoted flattening as an organizational strategy and Keuning and Opheij (1994) promoted the prescriptions in Europe. Despite these strategies and apparent structural changes, the number and ratio of managers appears to have grown. This paradox of managerial downsizing has not been adequately probed in the literature. The predominant explanation, that there has been a `myth of managerial downsizing', is associated with Gordon (1996). However, this debate has been shaped by the US experience and data. There is a need to reassess the dynamics of the 1990s in relation to other economies. This article focuses on a semi-peripheral economy, that of Australia. A study of the population of firms over time is necessary in order to resolve the issues. The article utilizes a comprehensive range of data, including several national surveys and a longitudinal database of all larger private-sector firms in Australia during the 1990s. The results indicate that the `myth of managerial downsizing' must be rejected. There were dramatic effects on managers through the course of the 1990s in larger Australian firms. The dynamics of the process are analysed, tracking 4,153 firms across the decade and the paradox explained. The theoretical implications are discussed. [ABSTRACT FROM AUTHOR]

Objectives To compare attendance and prevalence of abdominal aortic aneurysm (AAA) in population based randomised trials of sonographic screening in the United Kingdom, Western Australia, and Denmark. Methods 65 290 men were randomised to screening in the four trials, and data were collected and analysed from 46 397 aortic scans for men aged between 64 and 83 years who attended one of four community screening programmes. Comparisons were made for age standardised populations (65–74 years). Results Age standardised attendance varied between 74% and 81%, and was highest in the United Kingdom and lowest in Western Australia. Age standardised prevalence of AAAs of 3.0 cm or more varied significantly between 4.5% and 7.7%, and was highest in the United Kingdom and lowest in Denmark. Conclusions Participation in the four programmes compares favourably with other reported screening studies. The possibility that variations may reflect the different recruitment methods used is discussed. The prevalence of AAA in central Denmark would appear to be significantly different from that in southern England and Western Australia. [ABSTRACT FROM AUTHOR]