What are important areas where better technology would support women's health? Findings from a priority setting partnership.

BACKGROUND: Women's health has historically lacked investment in research and development. Technologies that enhance women's health ('FemTech') could contribute to improving this. However, there has been little work to understand which priority unmet needs should be a focus for women's health technology development. The voices of clinicians and those who experience and utilise these technologies (including those used at home or encountered in clinical settings) are needed to ensure that device development aligns with need, without risking exacerbating or creating health inequities. METHOD: We undertook a priority setting partnership project exploring unmet needs in women's health and well-being where physical technologies or innovations could help. This comprised gathering feedback from: patients and clinicians using both qualitative surveys and discussions; collating and publishing these responses and asking for feedback; evidence checking unmet needs identified, and holding a partnership priority setting event to agree a top 10 and top 20 list of priorities. RESULTS: We generated a 'longlist' of 54 suggestions for areas where better kit, devices or equipment could support women's health. For three, we found evidence of existing technologies which mitigated against that need. We took the remaining 51 suggestions to a partnership priority setting meeting which brought together clinicians and service users. Through discussion as this group, we generated a list of the top 10 areas identified as priorities for technological development and improvement. These included better devices to manage examination, diagnosis and treatment of pelvic pain (including endometriosis), prolapse care, continence (treatment and prevention, related to pregnancy and beyond), menstruation, vaginal pain and vaginismus, point of care tests for common infections, and nipple care when breastfeeding. CONCLUSION: The top priorities suggest far-reaching areas of unmet need across women's life course and across multiple domains of health and well-being, and opportunities where innovation in the devices that people use themselves or encounter in health settings could potentially enhance health and healthcare experiences.

Social Risk of Pregnant Women at a Community Health Center: An Application of the PRAPARE Assessment Tool.

Community health centers (CHCs) screen patients for social determinants of health (SDoH). The study's purpose was to assess the relationship between demographic factors and unmet social needs (SDoH risk) among pregnant mothers. Patient data from 345 pregnant women between January 2019-December 2020 assessed SDoH risk, using the Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences (PRAPARE) tool. Chi-square analyses explored relationships between social needs and demographic factors, and a multivariate logistic regression examined associations between these variables controlling for covariates. Hispanic patients and those who preferred to speak Spanish had 2.35 and 5.39 times the odds, respectively as non-Hispanic Whites and English speakers of having moderate/high/urgent SDoH risks. Mothers who had not completed high school had increased odds (aOR = 7.38) of SDoH risk. By identifying indicators that increase social risk level, CHCs can connect patients to essential social services, improving the downstream health of mothers and children.

A Comparative Neuro-Histological Assessment of Gluteal Skin Thickness and Cutaneous Nociceptor Distribution in Horses and Humans.

The current project aims to build on knowledge of the nociceptive capability of equine skin to detect superficial acute pain, particularly in comparison to human skin. Post-mortem samples of gluteal skin were taken from men (n = 5) and women (n = 5), thoroughbreds and thoroughbred types (mares, n = 11; geldings, n = 9). Only sections that contained epidermis and dermis through to the hypodermis were analysed. Epidermal depth, dermal depth and epidermal nerve counts were conducted by a veterinary pathologist. The results revealed no significant difference between the epidermal nerve counts of humans and horses (t = 0.051, p = 0.960). There were no significant differences between epidermal thickness of humans (26.8 µm) and horses (31.6 µm) for reference (left side) samples (t = 0.117, p = 0.908). The human dermis was significantly thinner than the horse dermis (t = -2.946, p = 0.007). Epidermal samples were thicker on the right than on the left, but only significantly so for horses (t = 2.291, p = 0.023), not for humans (t = 0.694, p = 0.489). The thicker collagenous dermis of horse skin may afford some resilience versus external mechanical trauma, though as this is below the pain-detecting nerve endings, it is not considered protective from external cutaneous pain. The superficial pain-sensitive epidermal layer of horse skin is as richly innervated and is of equivalent thickness as human skin, demonstrating that humans and horses have the equivalent basic anatomic structures to detect cutaneous pain. This finding challenges assumptions about the physical capacity of horses to feel pain particularly in comparison to humans, and presents physical evidence to inform the discussion and debate regarding the ethics of whipping horses.