Ny forskning om jente- og kvinnehelse

Malignant transformation of endometriosis is rare and most commonly involves the ovary; transformation from paraurethral endometriosis is exceedingly rare. A 73-year-old postmenopausal woman with prior ovarian endometrioma presented with dysuria and voiding difficulty. Positron emission tomography-computed tomography revealed a paraurethral mass at the bladder neck, whereas cystoscopy and urine cytology were normal. Transvaginal biopsy demonstrated adenocarcinoma; however, immunohistochemistry did not identify the primary site. After radical cystectomy with urethrectomy and partial vaginectomy, histopathology showed endometrioid carcinoma arising from paraurethral endometriosis with lymph node metastasis. Comprehensive genomic profiling identified alterations consistent with endometrioid/Müllerian-type carcinoma and compatible with endometriosis-associated carcinogenesis. Despite chemotherapy and immune checkpoint inhibitors, the patient died approximately 16 months after diagnosis. Paraurethral endometrioid carcinoma is exceptionally rare. Accurate diagnosis relies on careful correlation of imaging with histopathology, while comprehensive genomic profiling provides corroborative molecular evidence.

The prevalence of steatotic liver disease (SLD) is increasing globally. Endometriosis, affecting up to 10% of women, is a major cause of infertility. While associations between endometriosis and metabolic syndrome have been reported, its relationship with SLD remains unclear. Our study aimed to evaluate the association between endometriosis severity and SLD. We retrospectively analyzed women who underwent surgery for endometriosis with documented revised American Society for Reproductive Medicine scores at a tertiary hospital (January 1, 2009, to February 28, 2025) and had undergone abdominal computed tomography (CT) within 6 months as part of the clinical evaluation for endometriosis. Hepatic steatosis was assessed on abdominal CT using the liver-to-spleen Hounsfield unit (LS) ratio with predefined cutoff values, where lower values indicate greater hepatic fat accumulation, and SLD and severe SLD were defined as LS <1.0 and <0.8, respectively. The hepatic steatosis index (HSI) was used for sensitivity analysis. Among 455 patients, 232 had severe endometriosis (SE, stage 4) and 223 had non-severe endometriosis (NSE). Baseline characteristics were similar between groups, except for higher estradiol levels in the SE group (P < 0.001). The prevalence of SLD was significantly lower in SE (48.3%) compared to NSE (62.3%) (P = 0.002), and severe SLD was less common in SE (8.2% vs 16.1%, P = 0.009). Patients with SLD exhibited lower estradiol levels than those without, suggesting a potential protective effect of estradiol on hepatic steatosis. Multivariate analysis confirmed that SE was independently associated with a reduced risk of SLD, irrespective of age, body mass index, and metabolic comorbidities. SE was associated with a lower prevalence of SLD, potentially mediated by higher estradiol levels.

Women are disproportionately diagnosed with symptom-based conditions, notably post-COVID condition (PCC). In Sweden, as of February 2022, 2.3% of PCR-verified female COVID-19 cases versus 1.6% of male cases had a PCC diagnosis. Post-viral fatigue syndrome (PVFS) and exhaustion disorder (ED), a common and relevant diagnosis in Sweden, share substantial symptom overlap with PCC. To quantify the association between pre-pandemic, symptom-based primary-care visits and subsequent PCC, PVFS, and ED among adult women, adjusting for risk factors for severe COVID-19. We conducted a registry-based prospective cohort study of 208,050 women from the Swedish Medical Birth Register, linked to primary-care data and national sociodemographic registers. The exposure was the frequency of visits for predefined symptom-based conditions during 2015-2019. Adjusted odds ratios (ORs) for diagnoses in 2020-2024 were estimated using logistic regression controlling for BMI, education, age, and region of birth. Across 2,431,182 primary-care physician visits, 19% were symptom-based. Women with >8 such visits had higher odds of all three outcomes: PCC (OR 5.45, 95% CI 4.43-6.71), PVFS (OR 7.71, 95% CI 5.97-9.96), and ED (OR 5.32, 95% CI 4.84-5.85). Pre-pandemic BMI and education were not associated with PCC or PVFS but showed some association with ED. Still, 17% of women with PCC had no recorded symptom-based visits before the pandemic. Pre-pandemic symptom-based primary-care visits were strongly associated with higher risk of PCC, PVFS, and ED in a dose-dependent way, but modest discrimination underscores heterogeneous individual risk. Patterns suggest other influences alongside biological susceptibility.

Female sexual dysfunction (FSD) is a common and often overlooked complication of type 2 diabetes, adversely affecting quality of life and marital satisfaction. It involves vascular, neurological, hormonal, and psychological mechanisms. Vitamin D deficiency, prevalent among individuals with type 2 diabetes, is associated with metabolic disturbances, endothelial dysfunction, and may contribute to impaired sexual function. Although some studies in healthy women with low vitamin D levels suggest benefit, evidence on its effect in women with type 2 diabetes is limited. This randomized, double-blind, placebo-controlled clinical trial investigates whether weekly vitamin D supplementation improves sexual function in reproductive-age women with type 2 diabetes. One hundred eligible participants will be randomly allocated (1:1) to receive either vitamin D (50,000 IU) or placebo weekly for 12 weeks. The primary outcome is change in total Female Sexual Function Index (FSFI) score from baseline to week 13. Secondary analyses will explore relationships with glycemic control (HbA1c and fasting blood sugar), body mass index (BMI), and demographic factors. Women with severe stress, anxiety, or depression, as assessed by the Depression, Anxiety and Stress Scale (DASS-21), will be excluded. Compliance will be monitored via weekly follow-up, and analyses will follow the intention-to-treat principle using appropriate statistical tests at a significance level of 0.05. This trial will provide evidence on the effectiveness of vitamin D supplementation in improving sexual function among women with type 2 diabetes, potentially offering a safe and cost-effective approach to enhance metabolic and sexual health. Iranian Registry of Clinical Trials, IRCT20150624022896N3 (registered 2024-02-27).

Retrospective research has reported a high prevalence of breast injuries in women's rugby union (RU); however, most injuries are not reported to medical staff. This study compared the incidence and severity of breast injuries collected both prospectively and retrospectively over a comparable match exposure period. Prospective surveillance was conducted by clinicians (n = 14) using an online injury surveillance system across 140 RU players. Retrospective surveillance was conducted using an anonymous online survey completed by 370 RU players. Injury incidence was calculated per 1000 hours of match exposure. Severity was assessed using breast pain, bruising and swelling, ability to continue play, perceived effect on performance, and long-term breast changes. Three breast injuries were prospectively recorded over 1204 hours of competition (2.5 injuries/1000 hours). In contrast, 144 breast injuries were reported retrospectively over 5055 hours of competition (28.5 injuries/1000 hours). The retrospective injury rate was significantly higher than the prospective rate (IRR = 11.4, 95% CI: 3.15-41.73; p < 0.002). Ninety-six percent (n = 139) of retrospectively reported injuries had not been disclosed to medical staff. Injury severity was similar between surveillance methods, with bruising commonly reported, all players continuing to participate despite injury, and over half perceiving a negative effect on performance. Long-term breast changes were reported by 6% (n = 8) of players. The substantially lower incidence recorded prospectively suggests that breast injuries are underreported in women's RU. Improved reporting and surveillance strategies are required to better capture breast injuries and support female athlete health and performance.

Drug treatment for overactive bladder (OAB) is changing, with an increasing share of β3-adrenoceptor agonists relative to anticholinergics, but it is not known how far this change has progressed in older people, who are most vulnerable to the risks of anticholinergics. We examined the use of these drugs in Japan by age and sex, and analyzed changes in anticholinergic burden using a large database. We analyzed outpatient prescriptions of two β3-adrenoceptor agonists and six anticholinergics from FY2017 to FY2024, using the sex- and age-stratified tables of the NDB Open Data of Japan. Dispensed tablets were converted into patient-days, and the β3-adrenoceptor agonist share was calculated. Anticholinergic burden was measured as ACB-weighted prescription volume (patient-days multiplied by the anticholinergic cognitive burden score). Because FY2021-FY2022 was a period of nationwide generic supply disruption, FY2018 and FY2024 were used as endpoints when estimating change over time. The β3-adrenoceptor agonist share rose from 36.2% to 64.9%, but anticholinergic use fell only slightly (3.10 × 10 8 to 2.94 × 10 8 tablets; -5.0%). In FY2024, the β3-adrenoceptor agonist share was higher in men than in women in every age group, and the difference widened with age (+1.2 percentage points at 50-54 years and +14.2 at ≥ 90 years). ACB-weighted prescription volume was higher in women than in men, and the female-to-male ratio rose with age (1.1 at 65-74 years, 1.6 at 75-84 years, and 2.8 at ≥ 85 years). Between FY2018 and FY2024, prescription volume fell by about 20% at 65-74 and 75-84 years, but the fall was smallest in women aged ≥ 85 years (-11.3%). The β3-adrenoceptor agonist share for OAB has continued to increase in Japan, but this change appears slower in older women, in whom anticholinergic exposure remains high.

Disasters can have important consequences for health, yet much evidence is cross-sectional and cannot account for time-invariant individual heterogeneity. To examine the association between reported disaster exposure and women's mental health, psychological distress, and general health using longitudinal Australian data. Data from women aged ≥ 15 years participating in Waves 9-22 of the Household, Income and Labour Dynamics in Australia Survey were analysed. Individual and survey-wave fixed-effects models examined within-person associations between disaster exposure and mental health (MHI-5), psychological distress (Kessler-10), and SF-36 General Health. Sensitivity analyses considered long-term illness and single exposure. Dynamic associations were examined using the Callaway-Sant'Anna multiple-period difference-in-differences estimator with formal pre-trend tests. Reported disaster exposure was associated with modest declines in mental health (β = -0.86, 95% CI - 1.51 to -0.20) and general health (β = -0.83, 95% CI - 1.44 to -0.22). Psychological distress was higher but not statistically significant in the primary model (β = 0.33, 95% CI - 0.04 to 0.70). Sensitivity analyses generally supported the mental and general health findings. Event-study analyses showed no consistent evidence of persistent post-exposure deterioration; however, the MHI-5 joint pre-trend test indicated differential pre-exposure patterns, limiting causal interpretation. Reported disaster exposure was associated with modest within-person declines in women's mental and general health, while evidence for psychological distress was less conclusive. The findings support consideration of women's health in disaster preparedness and recovery planning. Main findings : Reported disaster exposure was associated with modest declines in women’s mental and general health, while evidence for increased psychological distress was less conclusive. Added knowledge : This longitudinal study provides evidence of within-individual health changes associated with reported disaster exposure while accounting for time-invariant individual characteristics. Global health impact for policy and action : The findings support consideration of women’s mental and general health in disaster preparedness and recovery planning.

Ethnoracially minoritized LGBTQ+ young people demonstrate greater suicide risk than their non-Hispanic White peers, yet limited research exists examining state equality protective factors that can reduce risk, especially among lesbian and bisexual women/nonbinary individuals assigned female at birth (LBWNBI). Guided by a strengths-based approach and integrated theoretical model, we used an observed variable path analysis to examine moderating effects of state racial and LGBTQ+ equality, and interactions between these factors and individual- and interpersonal/community-level protective factors, on prospective associations between intersectional minority stressors and entrapment, and entrapment and suicidal ideation. The analytic sample included 486 ethnoracially minoritized LBWNBI in the National Queer Women's Mental Health Cohort longitudinal study (M age = 22; 40% Hispanic/Latine, 38% Black/African American, 18% Asian; 51% bisexual) who completed baseline (T1), 3-month (T2), and 6-month (T3) surveys. Intersectional minority stressors at T1 led to greater suicidal ideation at T3 via entrapment at T2. Conjoined state racial and LGBTQ+ equality moderated the relationship between T1 intersectional minority stressors and T2 entrapment to reduce T3 suicidal ideation. This effect was also moderated by individual protective factors, proving especially important for LBWNBI living in states with low equality. Suicide prevention efforts with this population should involve multi-faceted, multi-sectoral policies and interventions that effect transformative change to redress historical and contemporary structural-level oppressions, injustices, and inequities.

Perimenopause, the hormonal transition preceding menopause, typically begins in the late 30s to mid-40s and lasts an average of seven years. Its neurobiological effects, including disruptions to serotonin synthesis, dopamine signaling, γ-aminobutyric acid receptor activity, and hypothalamic-pituitary-adrenal axis reactivity, produce a symptom profile nearly identical to primary psychiatric disorders. Women presenting with new or worsening anxiety, depression, insomnia, or cognitive changes during midlife are routinely diagnosed with psychiatric conditions before a hormonal etiology is considered, a pattern with measurable consequences for patients. Perimenopause does not require abnormal laboratory values or menstrual irregularity for a diagnosis to be made. Nurses across various settings encounter perimenopausal women daily. Nurses in any role can recognize the pattern and advocate for hormonal evaluation. Advanced practice RNs, including psychiatric NPs, can integrate perimenopause into the psychiatric intake, conduct structured hormonal assessments, and initiate or coordinate evidence-based treatment. This article aims to equip nurses with the tools to recognize perimenopause, challenge five pervasive clinical misconceptions, conduct a hormonally informed assessment, and support appropriate management in any practice setting.

The menstrual cycle is associated with variation in psychological and sensory processing and can exert substantial influence on mental health. One process which may be impacted by hormonal fluctuations during the menstrual cycle is interoception - the process by which the nervous system senses, integrates, and models the internal state of the body. However, limited work has examined if and how interoception may change across the menstrual cycle and if these changes are associated with mental health outcomes. Additionally, outstanding questions surrounding the reliability and concordance of interoception measures over time hinder progress in understanding these associations. To address these limitations, the CHIRP study aims to provide an illustrative example in two participants of how measures of interoception may vary across the course of the menstrual cycle using a dense sampling approach that spans multiple organ systems and dimensions of interoception (e.g., self-report and task-based measures), focusing on associations between fluctuations in interoception and mood. The repeated measures will be analyzed using Generative Additive Models (GAMs) to assess fluctuations across the cycle. Ultimately, this project aims to provide insight into how reproductive hormones may shape interoceptive processing and generate hypotheses for future investigations of menstrual-cycle-related mental health risk.

Pregnancy and childbirth are significant life events that can affect women's mental health and maternal functioning. Psychological flexibility, defined as the ability to adapt to changing situations and maintain balance under stress, plays a crucial role in this process. This study aimed to examine the effects of psychological flexibility and pregnancy stress on the perception of traumatic birth and breastfeeding success among primiparous pregnant women in the latent phase. This cross-sectional study was carried out between January 2021 and June 2022 at a training and research hospital in eastern Türkiye. The study sample consisted of 310 primiparous pregnant women, selected through simple random sampling among eligible participants admitted in the latent phase of labor. Data were collected using the Personal Information Form, Psychological Flexibility Scale, Pregnancy Stress Rating Scale, Traumatic Birth Perception Scale, and LATCH Breastfeeding Assessment Tool. Data were analyzed using descriptive statistics, Pearson correlation analysis, and path analysis based on structural equation modeling (SEM). The study found a significant negative correlation between psychological flexibility and traumatic birth perception (r = -.183, p < .001) and was positively correlated with breastfeeding success (r = .208, p < .001). Pregnancy stress was positively correlated with the perception of traumatic birth (r = .472, p < .001) and negatively correlated with breastfeeding success (r = -.263, p < .001). Path analysis demonstrated that psychological flexibility had a significant negative effect on traumatic birth perception (β = -.159, p = .001) and a significant positive effect on breastfeeding success (β = .214, p < .001). Pregnancy stress had a significant positive effect on traumatic birth perception (β = .468, p < .001) and a significant negative effect on breastfeeding success (β = -.257, p < .001). Increased psychological flexibility was associated with a lower perception of traumatic birth and higher breastfeeding success. Conversely, higher pregnancy stress was linked to higher traumatic birth perception and lower breastfeeding success. These findings highlight the importance of integrating psychological flexibility-based interventions into prenatal education and midwifery care to promote maternal mental health and breastfeeding outcomes. In addition, future studies could explore intervention programs designed to enhance psychological flexibility among pregnant women to prevent traumatic birth experiences and improve postpartum adaptation.

Parental son preference has been recognized as a potential risk factor for the mental health of female adults in later life; however, the underlying mechanisms involved in this association have not been extensively explored. This study aims to investigate the mediating effects of parental affection and discipline, as well as the moderating effects of social engagement. A nationally representative sample of 6,458 female respondents (mean age = 60.01 years, SD = 9.06) was drawn from the China Health and Retirement Longitudinal Study. This study adopted a cross-sectional analytic design based on retrospective reports of childhood experiences from the 2014 wave and mental health outcomes measured in the 2018 wave. Data analysis revealed that parental son preference was positively associated with depressive symptoms in later life ( b = 0.132, p = 0.030). Bootstrap analyses indicated significant indirect effects through lower parental affection ( b = 0.050, 95% CI [0.026, 0.076]) and stricter parental discipline ( b = 0.020, 95% CI [0.010, 0.032]). Social engagement significantly moderated the association between parental son preference and later-life depressive symptoms (interaction b = -0.168, p = 0.006). These findings enhance our understanding of how parental son preference during childhood may be associated with women's mental health in later life and have implications for the development of gender-sensitive policies and interventions.

Menstrual cycle tracking is a much-discussed component of the ' female athlete' research theme; however, more translational work is needed to meet practitioners' desire for further guidance on the implementation of tracking in applied settings. The purpose of this paper is to present a preliminary conceptual model to inform practitioners' decision-making around menstrual cycle tracking and assist researchers in identifying and framing future research directions. The proposed model-Conducting and Navigating menstrual cycle Education, Communication and Tracking (ConNECT)-proposes that communication and education strategies may be utilised to affect social, organisational and individual level change, ultimately supporting the implementation of menstrual cycle tracking by increasing its uptake and impact. This model was developed based on the findings from a series of studies conducted by the authors, which considered the existing literature on tracking and the perspectives of athletes and practitioners. Therefore, the ConNECT model offers an ecologically sound starting point for sport scientists, coaches and other members of an athlete's support team to base their practice on.

According to an emerging paradigm in the field of sports science and medicine, women athletes can optimize performance and minimize injury by syncing their training to their menstrual cycles. This paradigm links specific cycle phases to performance, perceived exertion, and injury risk. Some researchers, training staff, and coaches have started to apply the paradigm, embracing digital surveillance and prediction of menstrual cycle phase as a strategy to track and optimize athlete performance, promote health, and understand and minimize injury risk. Many see digital menstrual cycle tracking as empowering to female athletes at all levels, from the elite to the recreational. In this article, we identify five often implicit assumptions underpinning the menstrual cycle tracking model of female athlete health and performance. We find the evidence for these assumptions to be unconvincing, warranting skepticism about their efficacy and caution about implementing digital cycle tracking in sport.

The aim of the study was to evaluate the historical trends of sex differences in athletic performance and participation among male and female wheelchair marathon athletes. This retrospective, observational study utilized secondary, publicly available data of the Boston, Chicago, and New York City marathons within the wheelchair division from 1984 to 2023. Athletic performance and participation were evaluated across all marathon events and over time using univariate analysis of variance and Pearson correlations. Sex differences in athletic performance were observed with males outperforming females in all marathon events over time ( P < 0.001). The sex difference among first place finishers was 20% and increased to 33% for tenth place finishers. Although sex differences decreased over time ( P < 0.001), large sex differences in performance remain. Female athlete participation in wheelchair marathon events significantly increased over time ( P < 0.001) and the ratio of male athletes to female athletes in these events significantly decreased over time ( P < 0.001). Overall participation and male athlete participation also generally increased over time. Significant sex differences were observed in wheelchair marathon performance and participation. These findings highlight the importance of sex as a key biological variable related to human health and performance, especially among wheelchair athletes.

We aimed to report the prevalence of acetabular morphologies in professional female footballers and explore the association between these morphologies and sport exposure during the period of skeletal maturation. 100 professional female footballers (200 hips) were included. Athletes with a history of systemic disease were excluded. Questionnaires obtained information on previous sport frequencies and age of menarche. Participants reported the minimum hours of sport played weekly during three age categories/stages of growth: cartilaginous hypertrophy (8-10 years), skeletal growth (11-12 years), and closure of growth plates (13-16 years). Participants underwent a pelvic radiograph. The Wiberg-center edge angle classified hips with normal coverage, borderline dysplasia, dysplasia or pincer morphology. Logistic regression models explored the association between prevalence of acetabular morphologies and minimum of sport hours played weekly in different age groups. Interactions with age of menarche were explored. From 200 hips, 32% were classified as having borderline dysplasia, 9% had dysplasia, 1% had pincer morphology, and 58% had normal coverage. Athletes with a later age of menarche had higher odds of dysplasia with increasing sport exposure between 8-10 (OR [95%CI] = 1.23 [1.05-1.44]). p = 0.011) and 11-12 years (OR [95%CI] = 1.21 [1.06-1.38], p = 0.006) compared to those with an earlier age of menarche. Skeletal maturation might be an important period for the development of acetabular morphology in female footballers. Exposure to high‑load sport activity during skeletal maturation and age of menarche may contribute to the development of hip dysplasia in these athletes.

Targeted evidence is needed to inform health promotion initiatives amongst growing Myanmar diaspora communities in Australia and globally. This study aimed to report on health information priorities and recommendations identified by women of refugee background from Myanmar settled in Western Australia and their female community leaders. Guided by participatory action research principles, four community listening sessions were conducted with 39 women of refugee background from Myanmar and community leaders in February and March 2024. Women were from Karen and Chin cultural groups living in metropolitan and regional communities. Data underwent content analysis informed by an unstructured analysis matrix. Five categories and 27 subcategories were identified: 1) changing contexts, 2) motivations, 3) information priorities, 4) information sources, and 5) structural barriers for action. Categories contextualise women's health information experiences and priorities, before offering a set of topics for which women needed information. Identified gaps in available information resources and structural barriers have implications for health and settlement policies. Health literacy is framed as a collective, relational, and structurally constrained process for women of refugee background from Myanmar. To support women to build their health knowledge, comprehensive health promotion initiatives and targeted improvements to structural barriers are needed.

Internal migration and urbanisation are important determinants of health in Latin America, particularly among Indigenous populations. To evaluate associations of migration and health, we conducted a cross-sectional study of 185 Indigenous women in a rural Andean community ( n = 92) and a low-income urban Lima community ( n = 93). Migration status was defined by birthplace versus self-reported current residence. Anthropometry, blood pressure (BP), sociodemographic and migration-related data were collected. Regression models tested associations of migration with body mass index (BMI) and systolic/diastolic BP, adjusting for confounders. Exploratory interaction models assessed modification by community. Additional analyses examined migration timing, distance, duration and frequency. Migration was associated with a 4%-5% increase in systolic and 6% increase in diastolic BP; BMI was not significant. Community modified these effects: migrant and non-migrant urban women had significantly higher systolic BP compared to rural non-migrants, and urban migrant women had significantly higher diastolic BP compared to rural non-migrants. Migration timing, duration and distance were not linked to BP or BMI. Multiple migrations predicted higher diastolic BP. In conclusion, migration was associated with increased BP, with effects differing by rural versus urban setting. Findings underscore the need to study how mobility and community context influence Indigenous women's health.

Artificial intelligence (AI) tools such as ChatGPT are rapidly being adopted in medical education, yet evidence regarding their impact on learners' history-taking (anamnesis) skills remains limited. This gap is particularly relevant in women's health education, where high-quality anamnesis is essential for addressing sensitive, context-dependent concerns and for ensuring the safety of two interrelated patients: mother and fetus. This study comprised two phases. First, semi-structured virtual interviews were administered to students and faculty to assess their familiarity with ChatGPT and access to digital technologies. Second, an in-person classroom intervention was implemented within the Women's Health discipline, integrating ChatGPT into history-taking instruction. Students' anamnesis performance was evaluated before and after ChatGPT-assisted learning. Additionally, a novel instructional activity was introduced in which ChatGPT generated cases classified as plausible, intermediate, or physiologically impossible, serving as prompts for guided discussion focused on diagnostic pitfalls, critical appraisal, and clinical reasoning. In the virtual phase, faculty ( n = 62) and students ( n = 115) completed the questionnaires. The classroom intervention involved 40 medical students participating as part of routine Women's Health teaching activities, with faculty oversight to ensure pedagogical alignment and responsible AI use. A pronounced discrepancy emerged between students' familiarity with ChatGPT (99.1%) and lower levels of familiarity among faculty. Anamnesis performance improved significantly after ChatGPT-assisted learning ( p < 0.0001). Students reported increased confidence and perceived enhancement of history-taking quality, and all participants viewed ChatGPT as a valuable educational resource. The AI-generated cases effectively stimulated discussion and reinforced clinical reasoning processes. Findings contributed to the development of a practical guideline for the responsible integration of ChatGPT into Women's Health education. ChatGPT can enhance anamnesis and promote critical reasoning through structured interaction with AI-generated cases. However, its effective and responsible use depends on targeted faculty development to ensure alignment with pedagogical goals, appropriate oversight, and consistent integration into curriculum.

Breast cancer is the most common type of cancer among Saudi women. Despite this prominence, the lack of data on the association between intimate partner violence (IPV) and breast cancer among Saudi women has presented significant obstacles for both academics and practitioners. This study sought to determine the prevalence, consequences, and types of IPV-including physical, emotional, and verbal abuse as well as controlling behavior-among Saudi breast cancer patients and survivors (BCPS). A cross-sectional study was conducted in Saudi Arabia (SA) among 146 BCPS. The frequency of IPV among BCPS varied by IPV type. The most prevalent forms of IPV were verbal and emotional (26%). All BCPS who were exposed to emotional and verbal IPV had at least one emotional issue. IPV was found to be significantly associated with both participants and their partners being unemployed and having a lower level of education. IPV can adversely impact the health and well-being of BCPS as well as that of their children and families. Therefore, future research and practice must prioritize enhancing IPV awareness among patients with cancer and their families due to its profound effect on the health and well-being of those affected.

Adequate nutrition plays a vital role in maintaining women's health and ensuring the healthy growth and development of infants and children. However, during emergencies and displacement, multiple factors can disrupt adequate maternal and child nutrition. The aim of this study was to explore the available literature reporting the prevalence and associated risk factors of undernutrition among displaced pregnant and lactating women. This review follows the PRISMA guidelines for Scoping Reviews. An electronic search was conducted in the PubMed, Web of Science, and Google Scholar databases. The Emergency Nutrition Network and ReliefWeb websites were also explored for grey literature. The prevalence of wasting among pregnant and lactating women varied widely, reaching 77% in Tigray internally displaced person (IDP) camps. The underweight prevalence ranged from 9.3% in a Nigerian IDP camp to 26.7% in a refugee camp in Bangladesh. Anemia was common, affecting up to 44.7% of pregnant Syrian refugees in Jordan. Maternal age, family size, childbirth interval, family income, and lack of education were the main factors associated with undernutrition among displaced pregnant and lactating women. Acknowledging the burden of undernutrition and identifying the most frequent risk factors, should inform the development of relevant nutrition interventions in different displacement settings.

This study aimed to examine how mutuality is experienced, constructed and negotiated within caring relationships among nurses, women and relatives in women's health nursing. The study followed a theory-research-theory strategy, within which Charmaz's constructivist grounded theory methodology guided the empirical stage. In the initial theoretical stage, the Human Caring Theory was used as a sensitizing theoretical lens. During the empirical stage, the study employed Charmaz's constructivist grounded theory methodology and included 14 nurses, 18 women and 18 relatives recruited from obstetric and gynaecological settings. Data were collected through observations and individual interviews and analysed through initial coding, focused coding, constant comparison, memo-writing and theoretical integration. In the final stage, only after the categories and their relationships had been developed from the data were they integrated into a context-sensitive substantive theory, subsequently named 'Constructing Mutuality in Caring Relationships'. Two core categories, six categories and 13 subcategories were identified in the constructivist grounded theory data analysis. Under the core category of 'nature of mutuality', categories included 'establishing and sustaining the caring connection', 'conditions shaping relational engagement', 'forms of mutuality' and 'perceived mutual healing and transformation'. Under the core category of 'unrealized caring experience' categories of 'relational disconnection' and 'consequences of relational challenges' were identified. The Constructing Mutuality in Caring Relationships theory was developed from data generated using constructivist grounded theory, resulting in a context-sensitive substantive theory. The findings suggest that mutuality in women's health nursing is a context-dependent relational process shaped by humanistic understanding, compassionate engagement and what participants described metaphorically as relational energy among nurses, women and relatives. Participants described two forms of mutuality-unconditional and partial-and indicated that the process could be initiated, sustained, constrained or remain unrealized. Unrealized caring experiences were perceived to be associated with relational disconnection and difficulties in communication, participation in care and well-being. Further research is needed to refine the Constructing Mutuality in Caring Relationships substantive theory and examine its transferability and practical usefulness across diverse women's health settings. There is no patient or public contribution.

Many female-specific health services in Canada are delivered by obstetrician-gynecologists and family physicians. However, little is known about how patterns of care delivery, physician workforce supply, and patient characteristics have changed over time, limiting evidence-informed workforce and health system planning. To examine long-term trends in outpatient women's health service delivery, physician workforce supply, and patient characteristics in Alberta and identify implications for workforce planning, access, and health system reform. This population-based cohort study used linked administrative health data from Alberta between 1994 and 2020 to analyze outpatient visits for female-specific health services to obstetrician-gynecologists or family medicine physicians. We estimated temporal trends in visit rates by health complaint, physician characteristics, and patient reproductive life stage (reproductive, perimenopausal, or postmenopausal), and comorbidities. Over a 26-year period, >2 million females accessed care from 416 obstetrician-gynecologists and 7658 family medicine physicians. While the number of obstetrician-gynecologists and family medicine physicians per 1000 females increased (from 0.11 to 0.15 and 2.21 to 2.57, respectively), the average number of visits per physician per 1000 females declined (from 291 to 250 and 834 to 625, respectively). The nature and volume of visits varied by life stage. Physician and patient demographics shifted with more women physicians, patients with multimorbidity, and a U-shaped relationship between neighbourhood income and specialist utilization. Findings suggest that physician supply alone may provide an incomplete picture of the resources required to meet women's health care needs. Future workforce planning efforts may benefit from considering changes in patient complexity, patterns of care delivery across physician types, and potential inequities in access to specialty services.

Nearly half of India's urban population lives in informal settlements, facing substandard living conditions due to overcrowding, poor infrastructure, and limited access to basic amenities. These conditions critically affect the psychosocial well-being of mothers, yet limited research exists on how the built environment impacts maternal psychosocial health in urban poor settings in India. To explore the influence of housing conditions and neighborhood environments on maternal psychosocial health among mothers of children under five residing in urban slums and in-situ slum rehabilitation colonies in Bhopal, India. A qualitative study using a phenomenological approach was conducted through focus group discussions and in-depth interviews with mothers from both slum and in-situ slum rehabilitation settings. Thematic analysis was employed to identify emerging patterns and interpretive themes reflecting shared and lived experiences. Women residing in slum areas were particularly vulnerable due to overcrowded and poorly constructed dwellings. Inadequate infrastructure and environmental stressors contributed to persistent fears of accidents and safety risks. In both slum and BSUP rehabilitation contexts, social isolation and limited community cohesion heightened fears of crime, adversely affecting psychosocial health. Uncertainty surrounding potential relocation, combined with caregiving-related health concerns, further intensified emotional stress and psychosocial burden. The findings highlight the need to improve housing quality, ensure reliable access to essential amenities, and strengthen community support systems. Developing comprehensive, context-sensitive strategies that enhance resilience and psychosocial well-being is essential for promoting inclusive and sustainable urban development among vulnerable populations. Main findings : Poor housing conditions, neighbourhood infrastructure, environmental hazards, and weak social cohesion contribute to maternal psychosocial distress among women living in urban slums and slum rehabilitation colonies in Bhopal, India. Added knowledge : This qualitative study demonstrates that maternal psychosocial well-being is influenced not only by housing quality but also by neighbourhood environments and social relationships, highlighting that relocation to improved housing alone may not reduce psychosocial distress. Global health impact for policy and action : The findings support integrated urban policies that improve housing quality, neighbourhood infrastructure, sanitation, environmental conditions, and community support to promote maternal psychosocial well-being among vulnerable urban populations.

The goal in selecting these recent articles was to help identify literature that may change the clinical practice of women's health for practitioners in the primary care setting. Articles were identified by reviewing the high-impact medical and women's health journals, national guidelines, ACP JournalWise, and NEJM Clinician.

Screening mammography contributes to reduced breast cancer mortality and is an essential preventive service. In the Department of Veterans Affairs (VA), women are the fastest-growing group enrolling in health care, yet factors that influence their screening use remain understudied. Our aim was to characterize screening mammography use among women veterans in VA primary care. We conducted a retrospective cohort study using VA administrative data, including 374,132 women veterans aged 42-74 who were eligible for breast cancer screening and using VA primary care. The study period was July 1, 2022, to September 30, 2024. Multivariable logistic regression models estimated associations between veteran characteristics and biennial screening mammography completion. The screening mammography completion rate was 70%. Completion was associated with a recent women's health visit (odds ratio [OR] = 1.75; 95% confidence interval [CI]: 1.72, 1.78), any service-connected disability (OR = 1.58; 95% CI: 1.55, 1.61), and Black race (OR = 1.40; 95% CI: 1.38, 1.42). Lower completion was associated with substance-related disorder (OR = 0.67; 95% CI: 0.64, 0.69), alcohol-related disorder (OR = 0.87; 95% CI: 0.84, 0.90), and Pacific region residence (OR = 0.76; 95% CI: 0.74, 0.78). Women aged 54-62 had the highest screening odds; those aged 42-53 had the lowest across predictors. Efforts to optimize screening should target regional barriers, developing interventions for specific groups, and increasing the availability of specialized women's health training for VA.

Breast cancer following metastatic dissemination is associated with high mortality rates, severely threatening women's health. As principal mediators of intercellular communication within the tumor microenvironment, secretory autophagosomes (SAPs) propel breast cancer progression and metastasis by modulating the establishment of the pre-metastatic niche, thereby positioning them as highly promising biomarkers for breast cancer. However, the paucity of accurate and simplified quantitative tools has impeded the direct detection of circulating SAPs. This study presents a sensing platform that couples nanozyme cascade catalysis with a covalent organic frameworks (COFs)-derived nanohydrogel (CGNH) for precisely assessing trace-level SAPs. The AuNBP@PtPd-MoS 2 nanozyme, via its stereoconfiguration and trimetallic synergy, recapitulates the dual enzyme-mimicking activities of GOx/CAT. Hence, it enables self-sustained interfacial charge transfer. As a signal probe, it efficiently accelerates self-cascade catalysis and electrochemical mass transfer. Additionally, CGNH creates an ideal interface for SAPs enrichment and cascade catalysis, featuring a hierarchical pore structure, a hybrid conductive network, and suitable biocompatibility. With self-assembled antifouling peptide nanoparticles (APNP) as a shielding barrier, the platform reliably detects SAPs in intricate biological matrices verified using cellular, murine and clinical specimens. Compared with conventional biomarkers, SAPs produce more informative readouts on disease progression. This electrochemical platform differentiates between benign and malignant breast diseases and healthy controls with high diagnostic accuracy (AUC = 0.962), especially for gray-zone differentiation and metastasis forecasting. This study offers new avenues for SAPs-based liquid biopsy to identify signs of breast cancer metastasis and is expected to become a reliable non-invasive tool for personalized breast cancer management.

Hormonal intrauterine device (IUD) is an effective contraceptive method with high user satisfaction rates. To guide the introduction of hormonal IUD into the public sector in Tanzania, an operational research study was conducted to assess client acceptability of hormonal IUDs. To explore clients' perspectives on contraceptives and experiences with hormonal IUDs. This observational mixed-methods study (2023-2024) used focus group discussions with current or future contraceptive users ( N = 58, baseline), plus facility register reviews, a structured quantitative survey ( N = 100, endline) and semi-structured in-depth qualitative interviews ( N = 18 at midline 2, N = 15 at endline) with hormonal IUD clients. Register and survey data were analysed for descriptive statistics. Qualitative data was analysed thematically and triangulated with quantitative data. In total, 1,198 clients chose hormonal IUD during the eight-month study. At baseline, women had limited knowledge and several concerns about IUDs and emphasised the importance of good contraceptive counselling. Client satisfaction with hormonal IUD at six months post-insertion was high (93% were strongly or somewhat satisfied). Most (92%, 83% and 100%) clients were strongly satisfied with the counselling, follow-up care and removal services received, respectively. Hormonal IUD clients found the characteristic of localised release of hormones possibly offering a better side-effect profile than other hormonal methods appealing. Hormonal IUD clients showed high satisfaction with the method and care received throughout the study. The authors recommend introduction of hormonal IUD into the public sector in Tanzania, with investments in community awareness, male engagement, and strengthening the quality of contraceptive counselling and side effects management. Main findings: Hormonal intrauterine devices were highly acceptable to women accessing family planning services at primary health care level in Tanzania Added knowledge: While other studies have found high acceptability of hormonal intrauterine device across several settings, this was the first such study conducted in Tanzania. It strengthens the evidence base that hormonal intrauterine devices are acceptable to clients across different contexts and adds new insight into features of hormonal intrauterine devices that women in Tanzania found appealing or concerning, which can help tailor counselling materials and provider training materials. Global health impact for policy and action: This study contributes to the global literature supporting high acceptability of hormonal intrauterine devices among women across a range of contexts and provides insights on how to align comprehensive counselling on contraceptive options with women’s needs.

Women's empowerment is critical for achieving gender equality and sustainable development in low-and-middle-income countries (LMICs). Capacity-building interventions, such as vocational training, microfinance, and digital literacy programmes, are frequently employed to foster empowerment. However, wide variation exists in how empowerment is defined, theorised, and measured, limiting comparability across studies. This scoping review mapped the conceptual foundations, theoretical frameworks, and measurement approaches used in capacity-building interventions for women entrepreneurs in LMICs. The review followed Arksey and O'Malley's framework and was reported in line with PRISMA-ScR guidelines. Searches were conducted in PubMed, Scopus, Web of Science, and JSTOR, complemented by grey literature from major development agencies (2010-2024). Eligible studies focused on capacity-building interventions targeting women entrepreneurs in LMICs. Two reviewers independently screened and extracted data, which were synthesised thematically. Of 11,109 records identified, 25 met inclusion criteria. Most studies were cross-sectional, conducted in sub-Saharan Africa (48%) and South Asia (32%). While 76% defined empowerment, 60% did not employ any explicit theoretical or conceptual framework. Among those that did, frameworks, such as Kabeer's, Longwe's, and Malhotra et al.'s were used inconsistently. Economic empowerment was the most frequently assessed domain, often measured through income or business performance, while social, political, and psychological dimensions were seldom examined. Indicators were heterogeneous and largely self-reported. Conceptual ambiguity and inconsistent measurement hinder progress in women's empowerment research in LMICs. Future studies should adopt theoretically grounded, multidimensional, and context-sensitive frameworks to capture empowerment as a dynamic process beyond economic gains. Main findings: Capacity-building interventions for women’s empowerment in low-and-middle income countries use highly heterogeneous and often atheoretical definitions and indicators, with a dominant focus on economic outcomes and limited attention to social, political, psychological, or process-based dimensions of empowerment. Added knowledge: This review systematically maps how women’s empowerment is conceptualised, theorised, and measured across capacity-building interventions in low-and-middle income countries, demonstrating a persistent disconnect between empowerment theory and evaluation practice and highlighting gaps in multidimensional and longitudinal measurement. Global health impact for policy and action: Policymakers, funders, and implementers should move beyond income-only metrics and adopt theoretically grounded, multidimensional, and context-sensitive empowerment frameworks to design, monitor, and scale equitable capacity-building programmes aligned with Sustainability Development Goal 5.