Search

Introduction: Poor communication is a leading root cause of preventable maternal mortality in the United States. Communication challenges are compounded with the presence of biases, including racism. Hospital administrators and clinicians are often aware that communication is a problem, but understanding where to intervene can be difficult to determine. While clinical leadership routinely reviews incident reports and acts on them to improve care, we hypothesized that reviewing incident reports in a systematic way might reveal thematic patterns, providing targeted opportunities to improve communication in direct interaction with patients and within the healthcare team itself. Methods: We abstracted incident reports from the Women's Health service and linked them with patient charts to join patient's race/ethnicity, birth outcome, and presence of maternal morbidity and mortality to the incident report. We conducted a qualitative content analysis of incident reports using an inductive and deductive approach to categorizing communication challenges. We then described the intersection of different types of communication challenges with patient race/ethnicity and morbidity outcomes. Results: The use of incident reports to conduct research on communication was new for the health system. Conversations with health system‐level stakeholders were important to determine the best way to manage data. We developed a thematic codebook based on prior research in healthcare communication. We found that we needed to add codes that were equity focused, as this was missing from the existing codebook. We also found that clinical and contextual expertise was necessary for conducting the analysis—requiring more resources to conduct coding than initially estimated. We shared our findings back with leadership iteratively during the work. Conclusions: Incident reports represent a promising source of health system data for rapid improvement to transform organizational practice around communication. There are barriers to conducting this work in a rapid manner, however, that require further iteration and innovation. [ABSTRACT FROM AUTHOR]

Introduction: To accelerate healthcare transformation and advance health equity, scientists in learning health systems (LHSs) require ready access to integrated, comprehensive data that includes information on social determinants of health (SDOH). Methods: We describe how an integrated delivery and finance system leveraged its learning ecosystem to advance health equity through (a) a cross‐sector initiative to integrate healthcare and human services data for better meeting clients' holistic needs and (b) a system‐level initiative to collect and use patient‐reported SDOH data for connecting patients to needed resources. Results: Through these initiatives, we strengthened our health system's capacity to meet diverse patient needs, address health disparities, and improve health outcomes. By sharing and integrating healthcare and human services data, we identified 281 000 Shared Services Clients and enhanced care management for 100 adult Medicaid/Special Needs Plan members. Over a 1‐year period, we screened 9173 (37%) patients across UPMC's Women's Health Services Line and connected over 700 individuals to social services and supports. Conclusions: Opportunities exist for LHSs to improve, expand, and sustain their innovative data practices. As learnings continue to emerge, LHSs will be well positioned to accelerate healthcare transformation and advance health equity. [ABSTRACT FROM AUTHOR]

Objective: We aim to investigate the prevalence of low vitamin D levels in pregnant women receiving medical care at a tertiary hospital by analyzing the seasonal variations in these levels. Methods: This study was conducted at the Obstetrics and Gynecology outpatient facility of a tertiary medical institution between February 2020 and February 2024. The demographic data, including maternal age, parity, gestational age, smoking status, vitamin D level, and seasonal information, were duly captured from the first antenatal medical examination records. Results: After the exclusion of individuals who did not meet the predetermined criteria, a total of 1101 pregnant women were selected to partake in the study. Among the pregnant women, a large proportion (866, 79%) had serum 25(OH)D concentrations lower than 20 ng/mL, with an additional 132 out of 866 (15.2%) having levels below 5 ng/mL. The overall sample group showed a mean vitamin level of 13.71±9.18, while the subset of participants with a vitamin D deficiency had a recorded value of 9.85±4.62. During the fall and summer seasons, a considerable 82% and 72.8% respectively exhibited a significant prevalence of hypovitaminosis D. The trend curve for the seasonal vitamin D levels of the vitamin D-deficient group shows a relatively flat pattern, with an R²=0.0097 score. Conclusion: The findings from our investigation corroborate the implementation of prenatal multivitamins enriched with vitamin D as a preventive measure against musculoskeletal and non-musculoskeletal conditions for maternal and neonatal health. [ABSTRACT FROM AUTHOR]

This article examines the issue of maternal health disparities in the US, specifically focusing on racial disparities in maternal mortality rates. It highlights the high rates of maternal mortality in the US compared to other developed countries, with Black women experiencing the highest rates. The article identifies implicit bias in healthcare as a contributing factor, with stereotypes and prejudices affecting the quality of care received by Black women. It also compares maternity care in the US and the UK, emphasizing the overmedicalization of childbirth in the US and the midwife-driven approach in the UK. The importance of access to healthcare and primary prevention is emphasized, as well as addressing social determinants of health. The article discusses the benefits of community support and doula care in improving maternal health outcomes, and efforts to increase access to doula care through Medicaid coverage and private insurance. It also highlights the need for comprehensive programs that address mental health disparities and the role of state governments and financial incentives in driving change. [Extracted from the article]

Background and Objectives: The virtual community plays a crucial role in increasing health literacy. A successful and empowered woman demands an adequate level of health literacy. Knowing the determinants affecting e-health literacy in the virtual community was hoped to optimize efforts to increase ehealth literacy. This research is aimed to assess the determinants that affect e-health literacy in virtual communities for empowering women. Materials and Methods: A study with a cross-sectional approach was used to assess the determinants of e-health literacy. A total of 117 samples were taken using the total sampling technique. Data was collected using demographic variables checklist, social support, community participation, ehealth literacy, and information process paradigms questionnaire. Data was analyzed for path analysis using Stata 13 software. Results: The path analysis showed that social support and community participation in women had a significant positive direct effect (p<0.05) on health literacy. The community participation, information processing paradigm, ethnicity, number of social media owned, age, education, distance from home to healthcare facilities, and number of healthcare places significantly indirectly affect health literacy (p <0.05). Conclusion: To empower woman's health literacy in online communities, we should pay attention to increase social support, community participation, processing information paradigm, ethnicity, number of social media owned, age, education, distance from home to healthcare facilities, and number of healthcare places. [ABSTRACT FROM AUTHOR]

Introduction: Although access to sexual and reproductive health services is a human right, violations of the rights of women with disabilities in this aspect are frequent. However, there are no studies regarding gynaecological and obstetric violence that this population subgroup may face. This qualitative study is aimed at identifying and analysing the experiences of women with disabilities with regard to gynaecological and obstetric violence in Chile. Methods: From a feminist phenomenological paradigm of research, data were collected from March 2017 to December 2018. Women with disabilities (n = 18) were interviewed regarding their experiences. Data were analysed through thematic analysis. Results: The experiences of women with disabilities regarding gynaecological and obstetric violence fall under three central categories: (a) health inequity in communication, (b) objectification of girls' and women's bodies through practices, such as forced sterilisation, and (c) intimidation and discrimination related to maternity. Conclusions: Gynaecological and obstetric violence of women with disabilities is a present form of gender-based violence in Chile. Such instances occur systematically and persistently and lead to the dehumanisation of healthcare, an increase in health inequities, and the creation of particularly complex scenarios experienced by women with disabilities regarding access to sexual and reproductive healthcare. Policy Implications: It is necessary to promote research on gynaecological and obstetric violence faced by women with disabilities, take action against this form of gender-based violence, and improve access to sexual and reproductive services for this population. Specific recommendations aimed at the elimination of gynaecological and obstetric violence are given. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Midwifery & Health Sciences is the property of Ataturk University Coordinatorship of Scientific Journals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Portuguese Journal of Mental Health Nursing / Revista Portuguesa de Enfermagem de Saúde Mental is the property of Portuguese Society of Mental Health Nursing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Globally, non-communicable diseases (NCDs) are increasingly the primary cause of mortality and morbidity among women. Like many developing countries, Bangladesh also faces a growing burden of NCDs. The "Multisectoral Action Plan for Prevention and Control of Non-communicable Diseases, 2018–2025" signifies Bangladesh's commitment to comprehensively combating the rising burden of NCDs. This study investigates the perceptions of those involved in developing the action plan and if/how a gender lens was incorporated into its implementation. Methods: In-depth interviews were conducted with 25 key individuals involved in a high-level committee to develop and implement Bangladesh's multisectoral action plan to address the burden of NCDs. Data were collected between July and November 2021, and thematic analysis was conducted. Results: The findings revealed that interviewees believed the multisectoral action plan adopted a population-wide approach without considering gender-specific needs. This study presents the explanations for this inattention under five themes: (1) A population-level approach to NCD prevention; (2) Understanding women's health beyond reproductive health; (3) Absence of gender-specific programs; (4) Lack of consideration of gender constraints on physical activity; and (5) Lack of collaborative efforts to address NCDs beyond the health ministry. Conclusion: In conclusion, governments in countries like Bangladesh can develop more effective strategies to reduce the disease burden of NCDs among women by recognizing and addressing the gendered nature of preventive health. This can be achieved by promoting gender-responsive research, programs, and policy initiatives that consider women's specific health concerns, ultimately leading to better health outcomes for all. [ABSTRACT FROM AUTHOR]

Introduction: Despite increasing global commitment to meeting the family planning needs of adolescent girls and young women (AGYW), there is limited research on how they prioritize contraceptive method and service delivery characteristics. In this qualitative study, we examine the specific elements that drive the contraceptive choices of Kenyan AGYW, and apply our findings to the development of attributes and levels for a discrete choice experiment (DCE). Methods: Our four-stage approach included data collection, data reduction, removing inappropriate attributes, and optimizing wording. Between June-October 2021, we conducted in-depth interviews with 30 sexuallyactive 15--24 year-old AGYW in Kisumu county, Kenya who were nonpregnant and desired to delay pregnancy. Interviews focused on priorities for contraceptive attributes, how AGYW make trade-offs between among these attributes, and the influences of preferences on contraceptive choice. Translated transcripts were qualitatively coded and analyzed with a constant comparative approach to identify key concepts. We developed and iteratively revised a list of attributes and levels, and pre-tested draft DCE choice tasks using cognitive interviews with an additional 15 AGYW to optimize comprehension and relevance. Results: In-depth interview participants' median age was 18, 70% were current students, and 93% had a primary sexual partner. AGYW named a variety of priorities and preferences related to choosing and accessing contraceptive methods, which we distilled into six key themes: side effects; effectiveness; user control; privacy; source of services; and cost. Bleeding pattern was top of mind for participants; amenorrhea was generally considered an intolerable side effect. Many participants felt more strongly about privacy than effectiveness, though some prioritized duration of use and minimizing chance of pregnancy above other contraceptive characteristics. Most AGYW preferred a clinic setting for access, as they desired contraceptive counseling from a provider, but pharmacies were considered preferable for reasons of privacy. We selected, refined, and pre-tested 7 DCE attributes, each with 2--4 levels. Conclusions: Identifying AGYW preferences for contraceptive method and service delivery characteristics is essential to developing innovative strategies to meet their unique SRH needs. DCE methods may provide valuable quantitative perspectives to guide and tailor contraceptive counseling and service delivery interventions for AGYW who want to use contraception. [ABSTRACT FROM AUTHOR]

Background: Women's role as patients is associated with power relationships embedded in society. Although trust in the health care system is a general prerequisite for positive health outcomes, practices regarding women's agency in healthcare systems in Southeastern Europe reinforce women's passivity. Most of the current psychological measures of trust have been constructed and validated in "WEIRD" (samples that are drawn from populations that are White, Educated, Industrialized, Rich, and Democratic) countries, thus having a limited application in other social contexts. Objectives: We aimed to construct an instrument for assessing women's trust in healthcare systems to describe the structure of trust: Women's Trust and Confidence in the Healthcare System scale. Design: Two independent samples (N1 = 329; N2 = 333) of adult women in Serbia voluntarily completed an online questionnaire. The questionnaire comprised 20 trust-related items which were selected from an extensive collection of women's experiences in the healthcare system and evaluated by experts on a 5-point Likert-type scale. Methods: We used exploratory factor analysis of the Women's Trust and Confidence in the Healthcare System scale to analyze the structure of trust in the first sample data set and validated it with the second sample using confirmatory factor analysis. We tested concurrent validity by exploring how women's trust in the healthcare system predicts health-related behaviors (multigroup structural equation modeling). All analyses were conducted using R statistical software. Results: The Women's Trust and Confidence in the Healthcare System scale (Cronbach's alpha = 0.86) indicated a three-factor structure of trust in the healthcare system: trust in healthcare professionals, distrust in the public healthcare system, and confidence in healthcare system. This was validated using an independent sample. Interpersonal trust positively predicted women's desirable health behaviors, while trust in the system had a negative impact. Conclusion: The Women's Trust and Confidence in the Healthcare System scale captures women's trust in a paternalistic healthcare system, is reliable, and has a stable three-factor structure. The study's findings reveal the relationship between women's trust and health-related behavior: in paternalistic environments, trust reinforces women's passivity. [ABSTRACT FROM AUTHOR]

Purpose: Polycystic ovary syndrome (PCOS) management has hardly been standardized until recent years. Despite the existence of a detailed, evidence-based guideline published by the European Society of Human Reproduction and Embryology (ESHRE), it remains unclear to what extent healthcare providers adhere to this guideline. Our aim is to evaluate the gynaecological medical care provided in women with PCOS, particularly in terms of mental health, from the patients' perspective. Methods: For this cross-sectional online cohort study in women with PCOS, we designed a standardized, non-validated questionnaire covering aesthetic aspects, metabolism, menstrual cycle, reproduction, mental health, and prevention of chronic non-communicable diseases. Results: Among 1879 participants, various mental health aspects were reported: body image (n = 1879), eating patterns/habits (n = 1878), and emotional well-being (n = 1874). Although nearly all women (99.7%) reported complaints on at least one session of mental health, consultation rates were low (body image 9.7%, eating patterns/habits 16.6%, emotional well-being 4.4%). Mean satisfaction with counselling on the different domains varied from moderate to fairly satisfying, with scores of 56.0 points (SD 31.7), 53.5 points (SD 32.0), and 63.7 points (SD 30.2), respectively. More complaints were associated with lower satisfaction. The overall satisfaction with the management provided by the healthcare practitioner (HCP) was low, averaging 36.5 points (SD 29.7). Consequently, most women wished for more counselling (58.9%). Conclusion: Women affected by PCOS are not properly managed according to ESHRE guideline in regard to mental health issues. Overall consultation rates and corresponding satisfaction with management were poor, highlighting the need for significant improvements in healthcare provision. [ABSTRACT FROM AUTHOR]

Introduction and objectives: Ninety percent of maternal deaths are attributed to postpartum hemorrhage, with 50% being preventable. Annually, University of Mississippi Medical Center staff have more than 20,000 obstetrical encounters and deliver thousands of infants, with ∼75% being high-risk. The mother/baby unit, 3 Wiser, experienced two postpartum hemorrhages in August 2022. Post-event debriefings revealed opportunities for improvement. This project aimed to promote evidence-based practices regarding the prevention and management of postpartum hemorrhage in 3 Wiser. Methods: The project was guided by the JBI Model of Evidence-Based Healthcare and used the JBI Practical Application of Clinical Evidence System together with the Getting Research into Practice audit and feedback strategy. Four evidence-based practices were selected as audit criteria. After baseline audits were conducted, strategies to improve compliance with evidence-based practices were implemented. Finally, a follow-up audit was conducted, and the results of both audits were compared. Results: The baseline audits revealed 84% average compliance with the four evidence-based practices. Strategies to improve compliance included a simulation for nursing staff with a review of postpartum hemorrhage policies and skills. The post-implementation audit revealed 98% average compliance with the four evidence-based practices, a 14% increase from the baseline audit. Conclusions: This evidence implementation project utilized a clinical audit process, which led to improvements in practice related to the prevention and management of postpartum hemorrhage in the inpatient postpartum unit. [ABSTRACT FROM AUTHOR]

This document highlights the importance of discussing menstrual health in primary care, particularly in addressing the stigma and lack of conversation surrounding this topic. It emphasizes the role of family medicine clinicians in addressing menstrual health concerns and provides guidance on common concerns to discuss with patients. The document acknowledges the variation in menstrual health across individuals and regions, with a focus on high-income countries. It emphasizes the need for open and informed conversations to reduce stigma and improve patient experiences, while also calling for further research and culturally sensitive approaches to menstrual health. [Extracted from the article]

Hypoactive sexual desire dysfunction (HSDD) is prevalent among women. This retrospective cohort study aimed to verify the results of the strategies used by Gynecologists and Obstetricians (Ob-gyn) residents in the management of female HSDD. For this, we conducted a data collection of patient medical records of women with HSDD from the Human Sexuality Studies outpatient clinic of the Human Reproduction Center, Department of Gynecology and Obstetrics of FMRP-USP, from 2005 to 2019. Among the 437 women included, 361 (82.6%) answered the question concerning the effect of the protocol to which they were submitted, whereas 234 (64.8%) reported improvements in sexual desire. The univariate model showed that patients without chronic pelvic pain were 19.0% less likely to report improvements in HSDD than those with chronic pelvic pain (p = 0.03). Patients without depression and without orgasmic dysfunction were, respectively 32% and 23% more likely to show improvements in their HSDD than those who had depression or orgasmic dysfunction (respectively p = 0.001, p = 0.008). However, the multivariate model did not identify any associations. The assistance regarding HSDD by the Ob-gyn resident in training to deal with female sexual complaints may be effective in improving sexual complaints. [ABSTRACT FROM AUTHOR]

Background Heterogeneity in ageing rates drives the need for research into lifestyle secrets of successful agers. Biological age, predicted by epigenetic clocks, has been shown to be a more reliable measure of ageing than chronological age. Dietary habits are known to affect the ageing process. However, much remains to be learnt about specific dietary habits that may directly affect the biological process of ageing. Objective To identify food groups that are directly related to biological ageing, using Copula Graphical Models. Methods We performed a preregistered analysis of 3,990 postmenopausal women from the Women's Health Initiative, based in North America. Biological age acceleration was calculated by the epigenetic clock PhenoAge using whole-blood DNA methylation. Copula Graphical Modelling, a powerful data-driven exploratory tool, was used to examine relations between food groups and biological ageing whilst adjusting for an extensive amount of confounders. Two food group–age acceleration networks were established: one based on the MyPyramid food grouping system and another based on item-level food group data. Results Intake of eggs, organ meat, sausages, cheese, legumes, starchy vegetables, added sugar and lunch meat was associated with biological age acceleration, whereas intake of peaches/nectarines/plums, poultry, nuts, discretionary oil and solid fat was associated with decelerated ageing. Conclusion We identified several associations between specific food groups and biological ageing. These findings pave the way for subsequent studies to ascertain causality and magnitude of these relationships, thereby improving the understanding of biological mechanisms underlying the interplay between food groups and biological ageing. [ABSTRACT FROM AUTHOR]

This study aims to understand the meanings related to sexual health and the delineations that define the experience of accessing health services for lesbian women in Manaus, Brazil. This study followed a qualitative approach, counting on the participation of ten women who self-reported themselves as lesbians. Semi-structured interviews were carried out and their analyses occurred through three thematic axes. The first addressed the representations concerning prevention and sexual practices, highlighting the notion of fidelity in the relationship as a "protective factor". Difficulties in the use of condoms in relationships between two women were reported. The second discussed heteronormativity and its effects on self-care, reporting the participants' difficulties in being understood and welcomed by health services. The third addressed the search for one's own knowledge as a care tactic, highlighting the importance of information and autonomy for health promotion and prevention of Sexually Transmitted Infections (STIs). It can therefore be concluded that there is a need for public policies aimed at promoting the sexual health of lesbian women and the recognition of their specificities by health services. [ABSTRACT FROM AUTHOR]

Background & Objective: The etiology of endometriosis is unknown and many hormonal, inflammatory, genetic and environmental factors are effective in the formation of endometriosis. The present study investigated the epidemiology of endometriosis in patients referred to ShohadayeTajrish Hospital in six years. Materials & Methods: This descriptive study performed on endometriosis Iranian women who referred to ShohadayeTajrish Hospital between 2016 and 2022. The sample size of this study was determined using the census method, and 711 patients. For analysis, SPSS version 22 was used, and results were reported as mean ± SD. Results: Finally, 711 patients enrolled in this study and the average age of patients was 34.69± 7.53 years and the mean age of onset of disease was 29.97±4.61 years. More than 55% of patients had a healthy weight and normal body mass index. 17.72 percent of patients had a history of infertility in their life's. Conclusion: Endometriosis patients' life in many aspects, including their job, lifestyle, education, marital status and health care is affected. [ABSTRACT FROM AUTHOR]

Objective: Sexual and reproductive health (SRH) is a priority public health emergency response for women during humanitarian crisis situations as they face the risk of being neglected in health care systems of the country of arrival. This study aimed to investigate Syrian women's utilization of SRH services through Minimum Initial Service Package (MISP) approach, who received services from Women Health Counseling Units (WHCU) established as part of a collaborative Project in Türkiye. Methods: Questionnaires were administered face-to-face by Arabic-speaking female interviewers to 413 Syrian women who previously received services from the WHCU. Descriptive statistics were used and Pearson chi-square as well as Exact chi-square tests were conducted to analyse bivariate differences between categorical variables. Results: Child marriages were common among more than half (59%) of the participants. Majority of deliveries took place in the public hospitals (95%) and as attended by a doctor (93%). The percentage of participants using modern contraceptive methods was found to be 39.7% who were more frequently from younger age groups. However, the withdrawal method was relatively more prevalent among older participants. Conclusion: Despite the data being gathered from a limited population of Syrian women in Türkiye, the study offers descriptive, evidence-based insights on improving women's access to high-quality SRH services in line with the MISP approach during humanitarian crisis situations. [ABSTRACT FROM AUTHOR]

Background: The last decade saw the emergence of a new significant migration corridor due to the mass migration of Venezuelans to neighboring countries in South America. Since 2018, Brazil became the third host country of Venezuelan displaced populations. Little is known about how migratory processes affect needs, access to social programs, and public health services of migrant women. The goal of this study is to shed light on the socio-economic profile, living conditions, and use of health services of Venezuelan migrant women in two main reception cities in Brazil. Methods: A survey was conducted using respondent-driven sampling (RDS) in the cities of Boa Vista (Roraima), and Manaus (Amazonas). The study included 2012 Venezuelan migrant women aged between 15 and 49 years old who migrated from Venezuela to Brazil between 2018 and 2021. Relative prevalence was calculated, and the χ2 test was used to analyse the homogeneity of proportions. All analyses considered the complex sampling. Results: The main reasons for migrating relate to difficulties obtaining food (54%) and accessing health services (37.8%) in their country of origin. They were young and mixed race (65.7%) and had high school education (69.9%). In Manaus, 3.7% of the interviewees declared that they had no family income in the last month, while in Boa Vista, it was higher (66.2%) (p-value < 0.001). Almost one-third of them sought health care in the last 15 days, and 95% of them received care. The residents of Boa Vista arrived more recently and family income and access to paid work improved with time of residence in Brazil. Conclusions: Given the increasing flow of Venezuelan migrants crossing to Brazil, a reception system was established for the provision of food, shelter, access to health services, and income transfer programs to migrants. This was the case despite high unemployment and poverty levels and income inequality, particularly in the city of Boa Vista. However, the majority had legal migrant status and had access to the public and universal healthcare system in Brazil (SUS). The use of the SUS was similar in both cities, acting as a buffer for the differences in opportunities offered. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: Urinary incontinence (UI) is prevalent among older women, but conservative treatment rates remain low due to limited accessibility, despite evidence supporting pelvic floor muscle training (PFMT) efficacy. Group-based approaches, including online options, could offer cost-effective alternatives. Recent evidence supports the feasibility of online group-based PFMT for treating UI in older women. This pilot study now evaluated the clinical effects of this program on the number of leakage episodes per day, additional UI-specific outcomes, and other symptoms and indicators. Methods: Community-dwelling women aged 65 and over, with stress or mixed UI, were recruited. Eligibility was assessed through in-person evaluations conducted by pelvic floor physiotherapists, who instructed participants on pelvic floor muscle contraction using digital palpation. Participants engaged in a 12-week group-based PFMT program with weekly 1-h sessions. Data were collected at three time points: recruitment (PRE1), before the first session (PRE2), and after the program (POST). Participants recorded UI symptoms using 7-day bladder diaries and standardized questionnaires on UI symptoms, quality of life (QoL), UI self-efficacy, and perceived costs. After the program (POST), participants provided feedback on their impression of improvement and satisfaction. Results: Participants reported a significant reduction in their number of leakage episodes per day. Standardized questionnaire scores also supported the positive effects of the program on UI symptoms and QoL, self-efficacy in avoiding leakage and performing PFMT exercises, and monthly costs for continence products. Older women expressed high satisfaction with symptom improvement and the program. Conclusions: Online group-based PFMT improved UI symptoms, QoL, UI self-efficacy, and perceived UI costs among older women. Pragmatic randomized controlled trials are necessary for further validation. [ABSTRACT FROM AUTHOR]

Copyright of Saúde e Sociedade is the property of Universidade de Sao Paulo, Faculdade de Saude Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Non-invasive ventilation (NIV), namely continuous positive airway pressure (CPAP) and bi-level positive airway pressure (BiPAP), delivers mechanical ventilation without endotracheal intubation. Short-term NIV (planned for <21 days during initiation) can be used for the management of acute respiratory distress (ARD) among paediatric palliative patients with "Do Not Resuscitate or Intubate" (DNI) as the ceiling of care. This study aimed to describe the usage of short-term NIV among paediatric palliative patients in a woman and child hospital with a paediatric palliative subspecialty. Materials and Methods: A retrospective and observational study was conducted on all paediatric palliative patients who received short-term NIV in Tunku Azizah Hospital Kuala Lumpur, Malaysia, from March 2020 to May 2022. Results: During the study period, short-term NIV was offered on 23 occasions for 20 different children. Indications for short-term NIV include 16 (69.6%) occasions of potentially reversible ARD (NIV Category 1) and 7 (30.4%) occasions of comfort care at the end of life (NIV Category 2). The main cause of ARD was pneumonia (90.3%) due to either aspiration or infection. The modality of NIV used was BiPAP only (14 occasions, 60.9%), CPAP only (three occasions, 13%) and both BiPAP and CPAP (six occasions, 26.1%). The median duration of NIV usage was four days (minimum one day and maximum 15 days). NIV was initiated as an escalation from nasal prong, Ventimask or high-flow mask oxygen on 22 occasions and as weaning down post-extubation on one occasion. For the 22 occasions of escalating therapy, there was significant improvement at six hours compared to pre-NIV in the median heart rate (136 to 121, P=0.002), respiratory rate (40 to 31, P=0.002) and oxygen saturation (96% to 99%, P=0.025). All 17 documented parental impressions of the child's condition post six hours of NIV were that the child had improved. Adverse events during short-term NIV include five episodes (21.7%) of stomach distension, four episodes (17.4%) of skin sores on the face and one episode (4.3%) of excessive drooling. Three patients passed away while on NIV in the hospital. For the other 20 (87%) occasions, patients were able to wean off NIV. Post-weaning off NIV, three patients passed away during the same admission. On 17 occasions, patients were discharged home after weaning off NIV. Conclusion: Usage of short-term NIV in paediatric palliative care, where children have an advanced directive in place indicating DNI, as seen in our study, can be a valuable modality of management for distressing symptoms, in addition to the pharmacological management of breathlessness. This is shown through our study to be of benefit in potentially reversible ARD as well as comfort care at the end of life. Further rigorous studies will need to be conducted for a clearer understanding of short-term NIV that would enable the formulation of guidelines to improve the quality of life and death in children [ABSTRACT FROM AUTHOR]

ABSTRACT OBJECTIVE To assess maternal mortality (MM) in Brazilian Black, Pardo, and White women. METHODS We evaluated the maternal mortality rate (MMR) using data from the Brazilian Ministry of Health public databases from 2017 to 2022. We compared MMR among Black, Pardo, and White women according to the region of the country, age, and cause. For statistical analysis, the Q2 test prevalence ratio (PR) and confidence interval (CI) were calculated. RESULTS From 2017 to 2022, the general MMR was 68.0/100,000 live births (LB). The MMR was almost twice as high among Black women compared to White (125.81 vs 64.15, PR = 1.96, 95%CI:1.84–2.08) and Pardo women (125.8 vs 64.0, PR = 1.96, 95%CI: 1.85–2.09). MMR was higher among Black women in all geographical regions, and the Southeast region reached the highest difference among Black and White women (115.5 versus 60.8, PR = 2.48, 95%CI: 2.03–3.03). During the covid-19 pandemic, MMR increased in all groups of women (Black 144.1, Pardo 74.8 and White 80.5/100.000 LB), and the differences between Black and White (PR = 1.79, 95%CI: 1.64–1.95) and Black and Pardo (PR = 1.92, 95%CI: 1.77–2.09) remained. MMR was significantly higher among Black women than among White or Pardo women in all age ranges and for all causes. CONCLUSION Black women presented higher MMR in all years, in all geographic regions, age groups, and causes. In Brazil, Black skin color is a key MM determinant. Reducing MM requires reducing racial disparities.

Ensuring patient safety is a crucial aspect of healthcare including TM/CAM, particularly in the field of women's health. Healthcare providers must prioritize the safety of women during pregnancy and childbirth to prevent any harm or potential risks. This research used a traditional review, increasing the amount of literature that has been read and analyzed by the researcher. Normative-juridical principles in a prescriptive analytical manner with a statutory regulatory approach and the thinking method is deductive. General patient safety principles can be used in TM/CAM services by implementing the International Classification of Patient Safety (ICPS). Women are at risk due to their genital, hormonal, and pregnancy characteristics and may be affected by disease conditions acquired before or during pregnancy, and complications from physiological events at the end of pregnancy. Regulations on traditional health services and women's health care in Law No. 17 of 2023 and other regulations. This arrangement must guarantee safety, quality, and affordability. Patient safety is specifically regulated by Regulation of the Minister of Health of the Republic of Indonesia Number 11 of 2017 concerning Patient Safety. TM/CAM health services have developed in society and have to assess quality and safety standards, registration and accreditation have been established and TM/CAM health service practitioners, both those with formal and non-formal education, are required to have a competency certificate and Registration Certificate (STR). And Licenses (SIP) and Traditional Healers Registered Certificate (STPT). [ABSTRACT FROM AUTHOR]

Primary mental healthcare nurses are an essential workforce that provide necessary inpatient psychiatric treatment. Continuity of care has become a significant aspect of the provision of mental health services. However, caring for South African healthcare users comes with challenges, including difficulties accompanying the provision of care for acutely ill patients with complex mental health problems. Therefore, this study explored the perceptions and experiences of primary mental healthcare nurses concerning the continuity of care required in post-inpatient psychiatric treatment for mental health users from low-income communities in the Western Cape. Through undertaking a study using a qualitative exploratory design and purposive sampling technique, and in which nine primary mental healthcare nurses from two psychiatric hospitals in the Western Cape were interviewed, the researchers were able to obtain a deeper understanding of the participants' experiences. Four themes were identified during the reflexive thematic analysis namely: the roles and responsibilities of primary mental healthcare nurses, the lack of support within the current continuity-of-care system, barriers to continuity of care for women patients, and suggested improvements for quality of mental healthcare. It was evident that both women patients and primary mental healthcare nurses experienced various forms of marginalisation, discrimination, and gendered oppression. This intersectionality accentuates systemic issues within the current public healthcare system and highlights the stigmatisation of mental illness, especially among women. Overall, primary mental healthcare nurses have a plethora of roles and responsibilities within the primary healthcare sector, which hinder their ability to provide mental health services to women patients. Their reports highlight the needs of a specific patient population that first need to translate into changes that will assist in improving their roles as primary mental healthcare nurses. Their shared experiences of a lack of support from South Africa's healthcare system were the focal points of this study. [ABSTRACT FROM AUTHOR]

We aimed to investigate 12-week-Zumba training effects on physical and psychological parameters, and quality of life (QoL) in postmenopausal women. Forty-two postmenopausal women were randomly allocated to a control group or a Zumba group (ZG). Postural balance, lower limb strength, mood level, and QoL were assessed before and after the 12-week-Zumba training. The ZG showed significantly better balance performances under all conditions such as on firm and foam surfaces with opened and closed eyes as well as improvements in limb strength, mood and QoL compared to their baselines. Thereby, 12-week-Zumba training was effective in improving postural balance, limb strength, mood and, QoL in postmenopausal women. [ABSTRACT FROM AUTHOR]

Legislations for persons with disabilities emerged in the 1990s in India, providing them with rights and entitlements. Aligned with the UNCRPD, the Rights of Persons with Disabilities Act (2016) supports improved programmes and services. There are no exclusive policies for those with intellectual and developmental disabilities. Different government departments and non‐government organisations provide services including centrally sponsored programmes to persons with disabilities and enable them to exercise their rights. For example, rehabilitation and provision of aids and appliances lie with the Ministry of Social Justice and Empowerment, right to education is with the Ministry of Education, and, early intervention and health services and related supports are with the Ministry of Health. In India, non‐government organisations also play a vital role in health care services. In this paper, we discuss the existing health care systems including medical services in India for persons with disabilities with a specific focus on persons with intellectual and developmental disabilities. The discussion include how the system was evolved and what is in place today, the coverage, strengths, and limitations in the system. We have tried to provide a comprehensive description of existing policies, and practices of health care as well as the cultural influences with regard to health care for people with intellectual and developmental disabilities in India. [ABSTRACT FROM AUTHOR]

The high prevalence and costs of urinary incontinence and related pelvic floor disorders in adults highlights the need for competent nurses and advanced practice nurses who can provide high-quality continence and pelvic health care. However, challenges exist in recognizing this as a nursing specialty, preparing new and experienced nurses with specialty knowledge and skills, increasing the number and diversity of the workforce, and promoting individual achievement and professional recognition as a continence and pelvic health nursing specialist. This White Paper provides recommendations based on evidence and expert opinion to support the Society of Urologic Nurses and Associate's efforts in advancing the roles of registered nurses and advanced practice registered nurses in the expanded specialty area of continence and pelvic health nursing. [ABSTRACT FROM AUTHOR]

Objective: Shelters are an important part of a full response to survivors, as stated in many international conventions, such as the 1995 Beijing Declaration and Platform for Action (BDPfA). This study aims to provide a comprehensive perspective on the establishment of shelters for women survivors of violence. Materials and methods: This narrative review was conducted based on the Scale for the Assessment of Narrative Review Articles (SANRA). The MEDLINE, SCOPUS, Web of Science, Embase, Ovid, and EBSCO databases in English and Magiran and Scientific Information Database (SID) in Persian were searched for related documents. Also, WHO, the Joint United Nations Programme on HIV and AIDS (UNAIDS), the Centers for Disease Control and Prevention (CDC), and the United Nations Population Fund's (UNFPA) guidelines and instructions for shelter services for women and girls who have been subjected were searched up to July 31, 2023. A qualitative synthesis was carried out on the 28 eligible articles and instructions out of the 420 retrieved documents. Results: "A "shelter" describes emergency and temporary "safe accommodation for women and children who have been subjected to or are at risk of (typically male) domestic abuse. Types of shelters include emergency shelters or safe homes, second-stage or transitional housing facilities, third-stage housing, and alternative accommodation during (and occasionally after) the period of residence. The shelter delivers a wide range of services, including health services, socio-economic services, and legal services. These principles consisted of a comprehensive perspective, quality of service, organization, funding, and the right issues. Conclusion: Women who are survivors need holistic, interdisciplinary, and specialist care that focuses on safety and needs. The adoption of regulations with robust enforcement guarantees and the facilitation of approvals for the construction of non-governmental shelters and safe houses should be on the agenda setting. [ABSTRACT FROM AUTHOR]

Quilombolas are ethnic-racial groups, of black ancestry, and had their territories consolidated in Brazil in regions with difficult access and far from large centers. The objective of this study is to know the therapeutic itinerary (IT) adopted by quilombola women in traditional communities located in the North of the state of Minas Gerais. This is a qualitative study with the theoretical model using the Arthur Kleinman health care system. The study scenario was 23 quilombola communities in northern Minas Gerais. Forty quilombola women aged between 25 and 89 years were interviewed. Data analysis was performed following the IT. Units of analysis emerged that were grouped into three categories: quilombola women and the meaning of health and care; the professional care system in quilombola communities; and route of care in situations experienced by women. The therapeutic itinerary of the communities is mainly related to the actions of popular medicine. It was also possible to observe that there are weaknesses in relation to health care due to factors such as difficulty of access to institutionalized services. [ABSTRACT FROM AUTHOR]

Human immunodeficiency virus (HIV) viral load (VL) monitoring was likely interrupted during the Coronavirus disease 2019 (COVID-19) pandemic. We used routine data on repeat VL testing among 667 prevention of vertical HIV transmission (PVT) clients in Ehlanzeni district, to determine compliance to VL testing recommendations and associated factors during different time periods: pre-COVID-19, transition, and COVID-19. Descriptive and multivariable Poisson regression analyses were conducted, with and without including revised PVT-guidelines rolled out in January-2020. Among 405 women with ≥ 2 VL tests, the overall median age was 30 years (interquartile range: 26–35 years). Compliance to recommended VL testing guidelines ranged between 81.5% (172/211) and 92.3% (191/207) at different time periods. Across all three periods and when revised PVT-guidelines were used, being compliant was significantly reduced among those with earliest VL = 50–999 copies/ml (incidence rate ratio (IRR) = 0.71 [95% confidence interval (CI) 0.61–0.82], p value < 0.001) and VL ≥ 1000 copies/ml (IRR = 0.18 [95% CI 0.09–0.36], p value < 0.001). When guideline revisions were excluded, compliance was only significantly reduced among those with VL ≥ 1000 copies/ml (IRR = 0.14 [95% CI 0.06–0.32], p value < 0.001) and increased during the COVID-19 period versus pre-COVID-19 (IRR = 1.10 [95% CI 1.05–1.15], p value < 0.001). Similar significant associations between compliance and VL level were observed when the COVID-19 period was analyzed separately. Significantly increased compliance to VL testing among the 25–34 years age-group versus younger women was also observed across all periods. These results highlight the importance of strengthening strategies such as short message service reminders and educational messaging, reaching all age-groups, to fast-track implementation targets for VL monitoring. [ABSTRACT FROM AUTHOR]

Objective: To explore perceptions of women in the Chittoor district regarding the PAP smear as a cervical cancer screening test. Materials and methods: A cross sectional study was conducted among 2141 in OPD patients of obstetrics and gynecology department, healthcare workers working in institute of AIMSR and Government hospital, Chittoor district, Andhra Pradesh in study duration of six months. All categorical data were presented as numbers and percentages. Results: Among the total study population (2141), 59.8% had not known about cervical cancer screening test. 22.5% of the study population is familiar about pap smear through health care workers. 68.6% of the population did not know about the importance of pap smears. Among the total population astonishingly 94.2% are interested in knowing about PAP smear which is a cervical cancer screening test. Conclusions: Our research indicates that the populace of the Chittoor district has an unacceptable level of knowledge and attitude about PAP smears. The importance of screening tests in detecting cervical cancer early, when it is still curable, must thus be properly communicated. [ABSTRACT FROM AUTHOR]

According to the World Health Organization, cardiovascular disease (CVD) is the leading cause of death among women worldwide, yet its magnitude is often underestimated. Biological and gender differences affect health, diagnosis, and healthcare in numerous ways. The lack of sex and gender awareness in health research and healthcare is an ongoing issue that affects not only research but also treatment and outcomes. The importance of recognizing the impacts of both sex and gender on health and of knowing the differences between the two in healthcare is beginning to gain ground. There is more appreciation of the roles that biological differences (sex) and sociocultural power structures (gender) have, and both sex and gender affect health behavior, the development of diseases, their diagnosis, management, and the long-term effects of an illness. An important issue is the knowledge and awareness of women about vascular diseases. The risk of cardiovascular events is drastically underestimated by women themselves, as well as by those around them. The purpose of this review is to draw attention to improving the medical care and treatment of women with vascular diseases. [ABSTRACT FROM AUTHOR]

Purpose: According to the 4th and 5th rounds of National Family Health Survey (NFHS), there is high prevalence of hysterectomies in the three states of Andhra Pradesh Telangana and Bihar. The three said states have more than double the number of hysterectomies taking place than the national average. Our purpose is to analyse whether these rates are increasing, decreasing or have stabilized and their reasons thereof. Such an analyses will help the policy makers in recommending good clinical practices within their states. Material and methods: We used data from NFHS-4 (2015-16) and NFHS-5 (2019-2021) rounds. We calculated the differences in predicted probabilities for various factors, performed a Fairlie Decomposition analyses to quantify the positive and negative contributors in the prevalence of hysterectomy across the three states over two time points, and assessed the association of various socio-demographic characteristics to hysterectomy through a multilevel logistic regression model. Results and conclusion: The results show that out of a total of 80,976 eligible respondents from the states under study, 5826 respondents self-reported that they had a hysterectomy done. It was found that older age, living in rural areas, belonging to other backward classes and higher wealth quintile, and higher parity positively contributed to the increased prevalence of hysterectomies in the three states. Higher educational attainment and previous use of family planning methods acted as protective factors. Characteristics at the household level had the highest intra-class correlation value in the prevalence of hysterectomy among women, followed by the Primary Sampling Unit and District levels, indicating high clustering in the prevalence of hysterectomy at the household level in all three states. Heavy menstrual bleeding/pain was the leading cause of hysterectomies in all three states, followed by fibroids/cysts in Andhra Pradesh and Telangana and Uterine disorder/ prolapse in Bihar. Over 80% of hysterectomies took place in the private hospitals. Recommendations: The study recommends better, more efficient and accountable hysterectomy surveillance to ensure more sustainable woman's reproductive health services in India. Government should adopt and implement standard regulatory guidelines to prevent provider-driven avoidable hysterectomies. Moreover, we recommend informing primary care professionals about the long-term health effects of hysterectomy and promoting alternate therapies for treating uterine fibroids and heavy bleeding. [ABSTRACT FROM AUTHOR]

In Australia, 20% of pregnancies occur within the first year after birth and most are unintended. Both unintended pregnancies and short interpregnancy intervals (<12–18 months) can have adverse effects on maternal, infant, and child health. Access to postpartum contraception reduces the risk of unintended pregnancies and short interpregnancy intervals, and supports women in pregnancy planning and birth spacing. In this forum article, we describe how postpartum contraception is currently provided in Australia and highlight opportunities for improving access in the primary care setting. Unintended pregnancy in the first year after birth is common. Unintended pregnancies and short interpregnancy intervals can have adverse effects on maternal, infant and child health. Contraception can support pregnancy planning. Opportunities to increase access to postpartum contraception in primary care include antenatal counselling, contraception provision during routine postnatal home visits, contraception provision during other postnatal appointments (e.g. well-baby checks), and pharmacist-led contraception provision. Improving access to postpartum contraception can support women in pregnancy planning and improve health outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Pelvic mesh was first used for stress urinary incontinence in 1998 following which its usage rapidly expanded to include treatment of pelvic organ prolapse. Numerous complications relating to mesh insertion soon became apparent, culminating in the Independent Medicines and Medical Devices Safety: First Do No Harm Report published by Baroness Cumberlege in 2020. Following this report, the UCLH London Complex Mesh Centre funded by NHS England, was one of a small number of specialist centres set up for mesh-injured women. The Pelvic Pain service of the Pain Management Centre at UCLH provides a service for patients attending the London Complex Mesh Centre. The aim of our study was to distinguish the differing needs of mesh-injured women from those with chronic pelvic pain by comparing patient-reported outcome measures between these two cohorts. Methods: Distribution of data was calculated using the D'Agostino–Pearson normality test. Mann–Whitney tests were used to ascertain statistical difference between the two cohorts. Ethnicity was compared between groups using Fisher's exact test. Quantile regression models were used to assess whether differences in medians between groups remained after adjustment for age and ethnicity. Statistical significance was set at p <.05. Results: Patients with mesh were significantly older than those with chronic pelvic pain and were more likely to be of white ethnicity. After adjustment for age and ethnicity, analysis revealed that bladder interference, sex interference and DAPOS A were significantly higher amongst mesh-injured women, whereas GP and hospital admissions were significantly lower. Discussion: Our data shows the importance of mesh-injured women having access to pain management services with pathways of care integrated within women's and mental health services. It is essential that these programmes include support to discuss ways of returning to sexual relationships and have models to address anxiety such as graded exposure and psychological input. [ABSTRACT FROM AUTHOR]

The article focuses on the impact of the Dobbs v. Jackson Women's Health Organization Supreme Court decision on abortion rights and the concept of "fetal personhood," highlighting the risks it poses to pregnant people's autonomy in healthcare decisions. It discusses the need for healthcare workers, including those outside obstetrics and midwifery, to safeguard reproductive autonomy and promote positive arguments defending autonomy and bodily integrity.

Introduction: Surgical menopause is the cessation of menstruation resulting from the surgical removal of the uterus and bilateral ovaries, which leads to a sudden decrease in oestrogen levels and its subsequent effects. Urogenital symptoms are chronic and progressive, but only a few women seek medical care for these symptoms, which are often overlooked during routine follow-ups. Aim: To investigate the onset and progression of various urogenital symptoms after surgical menopause. Materials and Methods: A prospective cohort study was conducted in the Department of Obstetrics and Gynaecology at Government Medical College, Thrissur, Kerala, India from January 2020 to December 2020. A total of 110 women who underwent Total Abdominal Hysterectomy (TAH) and Bilateral Salpingo-Oophorectomy (BSO) for benign conditions were included in the study. The women were asked about the onset of urogenital symptoms at six weeks and 12 weeks after surgery. They were required to indicate whether they experienced four urogenital symptoms (vaginal dryness, frequent urination, urinary incontinence, and reduced sexual desire) using a menopause rating scale. The severity of symptoms was categorised as none (0), mild (1), moderate (2), severe (3), or very severe (4). The progression of symptom severity from three months to six months of follow-up was analysed using Chi-square tests. Results: Urogenital symptoms that developed after surgery included vaginal dryness, dyspareunia, bladder symptoms, and reduced sexual desire. At least one of these symptoms developed in 95 (86.4%) women by 12 weeks. Vaginal dryness was reported by 40 subjects (36.4%) at six weeks, with 36 (32.7%) reporting mild symptoms, 4 (3.6%) reporting moderate symptoms, and none reporting severe or very severe symptoms. At 12 weeks, vaginal dryness was reported by 61 subjects (55.5%), with 21 (19.1%) reporting mild symptoms, 18 (16.4%) reporting moderate symptoms, 20 (18.2%) reporting severe symptoms, and 2 (1.8%) reporting very severe symptoms (p-value<0.05). Other symptoms showed a similar pattern of progression. Conclusion: Urogenital symptoms can start as early as six weeks after surgery and can worsen in severity if left untreated. [ABSTRACT FROM AUTHOR]

Contrary to its critics, Dobbs v. Jackson Women’s Health Organization is not illegitimate or lawless. It is a highly consequential but fundamentally ordinary example of the inextricable connections between morality and constitutional law. If abortion is akin to murder, Dobbs could not—and should not—have come out any other way. If abortion is essential to personal autonomy and equal citizenship, the case was wrongly decided and should be reversed at the earliest opportunity. The appropriate response to decisions like Dobbs is to criticize the moral judgments underlying them. Depending on the circumstances, institutional responses, such as court packing and jurisdiction stripping, might also be justified. But conflating moral disagreement with lawlessness is both unpersuasive and a distraction from the core issue. It is also a form of crying wolf that risks backfiring when the charge of lawlessness is actually justified. [ABSTRACT FROM AUTHOR]

The article provides an overview of the state of health services in Ireland in 2023, highlighting challenges such as long waiting lists and overspending on the health budget. It discusses the impact of the Covid-19 pandemic and the progress and challenges in implementing healthcare reforms. The document also covers various developments and initiatives in the Irish healthcare system, including advancements in women's health services, infrastructure projects, and efforts to address workforce challenges. It mentions updates to medical ethics guidelines and provides references for further research. [Extracted from the article]

Introduction: The Veterans Health Administration (VA) Office of Rural Health (ORH) and Office of Women's Health Services (OWH) in FY21 launched a three-year Enterprise-Wide Initiative (EWI) to expand access to preventive care for rural, women Veterans. Through this program, women's health care coordinators (WHCC) were funded to coordinate mammography, cervical cancer screening and maternity care for women Veterans at selected VA facilities. We conducted a mixed-methods evaluation using the RE-AIM framework to assess the program implementation. Materials and methods: We collected quantitative data from the 14 program facilities on reach (i.e., Veterans served by the program), effectiveness (e.g., cancer screening compliance, communication), adoption, and maintenance of women's health care coordinators (WHCC) in FY2022. Implementation of the program was examined through semi-structured interviews with the facility WHCC funding initiator (e.g., the point of contact at facility who initiated the request for WHCC funding), WHCCs, and providers. Results: Reach. The number of women Veterans and rural women Veterans served by the WHCC program grew (by 50% and 117% respectively). The program demonstrated effectiveness as screening rates increased for cervical and breast cancer screening (+0.9% and +.01%, respectively). Also, maternity care coordination phone encounters with Veterans grew 36%. Adoption: All facilities implemented care coordinators by quarter two of FY22. Implementation. Qualitative findings revealed facilitators and barriers to successful program implementation and care coordination. Maintenance: The EWI facilitated the recruitment and retention of WHCCs at respective VA facilities over time. Implications: In rural areas, WHCCs can play a critical role in increasing Reach and effectiveness. The EWI demonstrated to be a successful care coordination model that can be feasibly Adopted, Implemented, and Maintained at rural VA facilities. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to describe the experiences of healthcare professionals providing women’s health services to asylum seeking women at hospitals. Methods: A qualitative design was used in this study. The data were collected from thirty-four healthcare professionals providing women’s healthcare services to asylum seeking women through semi-structured, face-to-face, individual in-depth interviews. The data were evaluated using Colaizzi’s seven-step analysis method in the NVivo12 package program. Results: Three themes were identified (1) challenges, (2) reflections, and (3) needs. Healthcare professionals evaluated the process of providing women’s healthcare services to asylum seeking women from a positive and negative point of view. They stated that they should be supported personally, professionally, and as a health team in improving this experience. Conclusion: This study narrows the gap in the literature and expands the scope of existing knowledge concerning the healthcare professionals experience about asylum seeking women health care. [ABSTRACT FROM AUTHOR]

The study aimed to identify the prevalence of symptoms, changes in exercise levels, and exercise advice received during the menopausal transition in a large multi-country sample. Using total population sampling, 2.5 percent of female Strava app users (n = 970) from 7 countries completed an online survey between 14 February 2019 and 11 March 2019. The survey discussed menopause status (perimenopausal or postmenopausal), menopausal symptoms, changes to exercise behaviors, and advice received concerning exercise during menopause. Frequencies, chi-square statistics, and linear regressions were used to analyze data. The most commonly reported menopausal symptoms were sexual (18–83 percent) and cognitive/psychological (77–78 percent). 41 percent of women reported no change in exercise behavior since menopause began (46 percent increased and 11 percent decreased behaviors). The majority (88 percent) of women did not receive advice regarding exercise during menopause. Women who received advice were more likely to report an increase in their exercise than those not receiving advice (60 percent vs 46 percent; X2 (df 2, n = 927) = 7.1, p =.03). Exercise behaviors increased the longer it had been since the menopausal onset (X2 (df 8, n = 937) = 77.42, p <.001). The results suggested high menopausal symptom prevalence in active women and a general lack of exercise advice. More women reported higher symptom prevalence and an increase in exercise participation, the longer it had been since menopause onset. Future research should determine whether these increased exercise behaviors are being used as a coping mechanism. [ABSTRACT FROM AUTHOR]

Aims Female genital tuberculosis is an infrequent form of tuberculosis that is often underestimated due to its low prevalence in developed countries, difficult and delayed diagnosis, and misleading clinical presentation. This systematic review aimed to describe the epidemiology, clinical presentation, diagnosis, and treatment of female genital tuberculosis during 2000-2021. Information & Methods The current study is a systematic review that was conducted through exploration of English keywords like “female genital tuberculosis”, “vulva tuberculosis”, “tuberculosis”, and “genital system” as well as, Persian keywords. Furthermore, a similar search methodology was employed in various international databases, including PubMed, Scopus, and Web of Sciences, as well as in certain Iranian databases, like Irandoc and Magiran, between 2000 and 2021. Findings Most patients (37.5%) were from India. Upper genital tuberculosis was more common among women of reproductive age, and the most involved upper genital organs were the endometrium and fallopian tubes. In contrast, vulvar tuberculosis was more prevalent in postmenopausal women, and the vulva was the most common site involved in lower genital tuberculosis. Weight loss (31.25%) and vaginal discharge (31.25%) were the most common symptoms reported by the study participants. The main histologic finding in female genital TB was the presence of epithelioid cell granulomas (81.25%). 29 (90.6%) patients received the standard antibiotic therapy (combination of rifampicin, isoniazid, ethambutol, and pyrazinamide), all of whom responded positively. Conclusion Most patients experience prolonged vulva ulcers and inadvertently receive various antibiotics. The typical lesions are epithelioid cell granulomas, which may be accompanied by Langerhans giant cells. [ABSTRACT FROM AUTHOR]

This paper aims to explore the impact of the COVID-19 pandemic on the health and mental health of necessary entrepreneurs in Brasilian favelas, the social problems they experienced and implications for public health social work. The study used structured in-person interviews within selected Favela's, with a sample size of 721 entrepreneurs, aged between 16–70 years. All participants both worked and were resident in 15 out of the 27 Brasilian federal states. The bespoke questions explored socio-demographic questions, sought information on their entrepreneurship, health and administered the Warwick-Edinburgh Mental Wellbeing Scale for Health. The results highlighted that many entrepreneurs have engaged in this form of enterprise due to economic necessity, with 64% of women and 43.6% of men identifying increased levels of anxiety through the pandemic, with the presence of children in the family being statistically significant (p ≤ 0.05 chi-square test) for anxiety. Of the 9.8% sample respondents have accessed the health care service and for women with children, the impact of the pandemic accentuated existing problems of childcare and patriarchy. We conclude by highlighting the importance of universal and accessible health and mental health support and care, their ongoing accessibility, along with the importance of social work during crisis. [ABSTRACT FROM AUTHOR]