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Abstract Background Despite surgical and pharmacological interventions, endometriosis can recur. Reliable information regarding risk of recurrence following a first diagnosis is scant. The aim of this study was to examine clinical and survey data in the setting of disease recurrence to identify predictors of risk of endometriosis recurrence. Methods This observational study reviewed data from 794 patients having surgery for pelvic pain or endometriosis. Patients were stratified into two analytic groups based on self-reported or surgically confirmed recurrent endometriosis. Statistical analyses included univariate, followed by multivariate logistic regression to identify risk factors of recurrence, with least absolute shrinkage and selection operator (Lasso) regularisation. Risk-calibrated Supersparse Linear Integer Models (RiskSLIM) and survival analyses (with Lasso) were undertaken to identify predictive features of recurrence. Results Several significant features were repeatedly identified in association with recurrence, including adhesions, high rASRM score, deep disease, bowel lesions, adenomyosis, emergency room attendance for pelvic pain, younger age at menarche, higher gravidity, high blood pressure and older age. In the surgically confirmed group, with a score of 5, the RiskSLIM method was able to predict the risk of recurrence (compared to a single diagnosis) at 95.3% and included adenomyosis and adhesions in the model. Survival analysis further highlighted bowel lesions, adhesions and adenomyosis. Conclusions Following an initial diagnosis of endometriosis, clinical decision-making regarding disease management should take into consideration the presence of bowel lesions, adhesions and adenomyosis, which increase the risk of endometriosis recurrence.

This paper examines the complexities of the help-seeking process of minoritized women (primarily asylum-seekers and immigrants) experiencing domestic violence in Northern Ireland. The term ‘minoritized’ is used here to emphasize that “minority” status is not a static or innate trait of certain groups but instead is the outcome of a process of being positioned as a minority. The paper addresses the intersections of ethnicity, nationality, class and gender and shows how state policies in relation to immigration and social security reinforce inequalities in gendered power relations. Despite attempts to improve the social security and immigration systems, the findings from a Northern Ireland study show how recent policy changes have not addressed the systemic institutional racism and institutionalised patriarchy in these agencies. Where avenues for action are undermined by such practices, the policies raise concerns about the safety and protection of minoritized women living in abusive relationships. We argue that the UK is failing to meet its human rights responsibilities to provide adequate support and assistance to minoritized women in abusive relationships and conclude that delivering state accountability alongside a human rights framework based on security, autonomy, liberty and equality is what is needed. Este artículo analiza las complejidades del proceso de búsqueda de ayuda en Irlanda del Norte para mujeres pertenecientes a minorías (principalmente solicitantes de asilo e inmigrantes) que sufren violencia doméstica. El término 'minoritarizadas' se utiliza aquí para hacer hincapié en que la situación de "minoría" no es un rasgo estático o innato de ciertos grupos, sino que es el resultado de un proceso de ser posicionado como una minoría. El artículo aborda las intersecciones de origen étnico, nacionalidad, clase y género y muestra cómo las políticas estatales en relación a la inmigración y la seguridad social refuerzan las desigualdades en las relaciones de poder desde una perspectiva de género. A pesar de los intentos de mejorar los sistemas de seguridad social e inmigración, los resultados de un estudio de Irlanda del Norte demuestran que los cambios políticos recientes no han abordado el racismo institucional sistémico y el patriarcado institucionalizado en estos organismos. Estas prácticas debilitan las vías de acción emprendidas, sin embargo, las políticas generan interés sobre la seguridad y protección de mujeres pertenecientes a minorías que sufren abusos en sus relaciones. Se sostiene que el Reino Unido no está cumpliendo su responsabilidad de defender los derechos humanos para proporcionar apoyo y asistencia adecuada a estas mujeres que sufren relaciones abusivas y se llega a la conclusión de que es necesario ofrecer una responsabilidad estatal dentro del marco de los derechos humanos, basado en la seguridad, autonomía, libertad e igualdad. DOWNLOAD THIS PAPER FROM SSRN: http://ssrn.com/abstract=2700201