Community Screening for High-Risk Human Papilloma Virus Infection using Self-Sampling and 'Point-Of-Care' Test.

OBJECTIVE: HR-HPV types 16 and 18 are responsible for pre-invasive and invasive lesions of the cervix, accounting for 70-80% of the total subtypes. The aim of this study was to investigate the prevalence of high-risk HPV subtypes 16 and 18 in self-collected vaginal samples using real-time micro-PCR and to study the acceptability of self-sampling. METHODS: Eligible women (30-65 years) were screened from a semi-urban area of Uttarakhand (India) using self-sampling. High-risk HPV genotypes (16/31 and 18/45) were tested using real-time micro-PCR technique with results available in one hour. The positive results were validated by standard RT-PCR for high-risk HPV 16, 18, separately and for 12 other high-risk genotypes, combined. Ease of the procedure, level of comfort, and recommendation to other women were studied and the acceptability of self-sampling was analyzed using the Likert scale. RESULT: Of 975 eligible women screened, 45 participants tested positive for HR-HPV (16/31,18/45) using real-time micro-PCR with a prevalence of 4.6%. Positive samples were further tested through routine RT-PCR and 60% were found to be HR-HPV 16 and 18 positive. For self-sampling, 96.72% (n=943) participants were 'very satisfied' and 94.15% (n=918) found self-sampling to be 'very comfortable' and 88.51% (n=863) stated that they will strongly recommend this test to other eligible women in the community. CONCLUSION: We conclude that HR-HPV testing with limited genotyping showed a prevalence of 4.6%, 60% of these were HPV 16/18 positive. Point of care testing was feasible in the community and self-sampling was acceptable.

Insights into estrogen impact in oral health & microbiome in COVID-19.

BACKGROUND: COVID-19 emerged in late 2019 and has occasioned more than 765 millions cumulative cases and 6.9 millions of deaths globally. Notably, around 70% of patients with severe COVID-19 are men. Therefore, it is to be presumed that women have a hormonal protector factor in inflammation and ACE2 expression. On the other hand, oral health status, and local microbiome can be key factors to respiratory viral infections control. Nevertheless, it has been poorly investigated. In our study 20 premenopausal, 18 postmenopausal and 22 men with COVID-19 were included. Oral health status, viral load, lingual ACE2 expression, as well as microbiome, estrogens and cytokines in saliva were analyzed. RESULTS: Our results showed a lower expression of ACE2 in tongue cells of postmenopausal compared with premenopausal (p = 0.05), and a strong negative correlation between saliva estrogen and viral load (r = -0.76; p = 0.001). Respect to IFN-γ (p = 0.05), IL-1ß, TNF-α, IL-18, and IL-23 levels were increased in postmenopausal. Oral microbiome signature of premenopausal was characterized by Prevotella melaninogenica (Log2 = 26.68; p = 1.34e-10), Haemophilus (Log2 = 23.99; p = 2.96e-9), and Alloprevotella (Log2 = 7.92; p = 0.0001). On the other hand, Leptotrichia (Log2 = -18.74; p = 0.001), Tanerella (Log2 = -17.08; p = 0.004), and Clostridiales (Log2 = -2.88; p = 0.04) represented the poor oral health group compared with the adequate group which was enriched with the commensal microorganism Neisseria perflava (Log2 = 26.70; p = 1.74e-7). Furthermore, the high viral load group was characterized by Prevotella nanceiensis (Log2 = 19.60; p = 6.06e-8), Prevotella melaninogenica (Log2 = 21.45; p = 9.59e-6), Alloprevotella (Log2 = 23.50; p = 2.70e-7) and bacteria from the red complex Porphyromonas endodentalis (Log2 = 21.97; p = 1.38e-7). CONCLUSIONS: Postmenopausal and men have a poor oral health status which could be related to a detrimental progression of COVID-19 also linked to a lower expression of ACE2, lower saliva estrogen levels and oral dysbiosis. Nevertheless, functional studies are required for a deeper knowledge.

Pelvic floor dysfunction: prevalence and associated factors.

BACKGROUND: Pelvic floor dysfunction in women encompasses a wide range of clinical disorders: urinary incontinence, pelvic organ prolapse, fecal incontinence, and pelvic-perineal region pain syndrome. A literature review did not identify any articles addressing the prevalence of all pelvic floor dysfunctions. OBJECTIVE: Determine the prevalence of the group of pelvic floor disorders and the factors associated with the development of these disorders in women. MATERIAL AND METHODS: This observational study was conducted with women during 2021 and 2022 in Spain. Sociodemographic and employment data, previous medical history and health status, lifestyle and habits, obstetric history, and health problems were collected through a self-developed questionnaire. The Pelvic Floor Distress Inventory (PFDI-20) was used to assess the presence and impact of pelvic floor disorders. Pearson's Chi-Square, Odds Ratio (OR) and adjusted Odds Ratio (aOR) with their respective 95% confidence intervals (CI) were calculated. RESULTS: One thousand four hundred forty-six women participated. Urinary incontinence occurred in 55.8% (807) of the women, fecal incontinence in 10.4% (150), symptomatic uterine prolapse in 14.0% (203), and 18.7% (271) reported pain in the pelvic area. The following were identified as factors that increase the probability of urinary incontinence: menopausal status. For fecal incontinence: having had instrumental births. Factors for pelvic organ prolapse: number of vaginal births, one, two or more. Factors for pelvic pain: the existence of fetal macrosomia. CONCLUSIONS: The prevalence of pelvic floor dysfunction in women is high. Various sociodemographic factors such as age, having a gastrointestinal disease, having had vaginal births, and instrumental vaginal births are associated with a greater probability of having pelvic floor dysfunction. Health personnel must take these factors into account to prevent the appearance of these dysfunctions.

Bebidas de soja y salud femenina. Revisión de la evidencia y opinión de expertos / Soy beverages and women’s health: evidence review and experts opinion

Las bebidas vegetales de soja constituyen una alternativa dentro de la dieta habitual. Sin embargo, existe la preocupación de potenciales efectosen la salud reproductiva de la mujer por mecanismos de disrupción endócrina.En esta revisión se evalúan documentos científicos en el área de la Ginecología y la Obstetricia bajo el tamiz de la medicina basada en la evidencia,respondiendo preguntas estructuradas. La metodología se apegó a las guías establecidas por la declaración PRISMA 2020.Los estudios evaluados descartan un riesgo incrementado de pubertad precoz o cáncer de mama; incluso se aprecia un efecto protector frentea dicha neoplasia. Se ha reportado el paso transplacentario de isoflavonas de soja y su presencia en la leche materna, sin que ello implique unarelación con complicaciones materno-fetales o malformaciones congénitas. La exposición a productos de soja no parece influir sobre el pesocorporal y la salud ósea de la mujer.Los estudios en adultos indican que la soja favorece un mínimo incremento de tirotropina (TSH) en personas con antecedente de hipotiroidismosubclínico.El impacto de los alimentos basados en soja sobre la microbiota intestinal parece ser favorable para su diversidad, particularmente al consumirproductos fermentados.Muchos de los estudios en humanos han sido realizados con suplementos de isoflavonas o con productos que contienen proteínas aisladas otexturizadas de soja. Por tanto, los resultados y las conclusiones deben interpretarse con cautela ya que no son totalmente extrapolables a lasbebidas comerciales de soja. (AU)

Soy drinks are an increasingly consumed option within the Western diet. However, there are concerns about potential endocrine disruptor effectsand possible impact on women’s reproductive health.This review evaluates scientific documents in gynecology and obstetrics under an evidence-based medicine approach. All methods adhered toPRISMA 2020 declaration guidelines.The evaluated studies do not support a positive association between soy intake and early puberty or breast cancer; instead, a protective effectagainst such neoplasm was observed. Transplacental passage of soy isoflavones and their presence in breast milk has been reported withoutany maternal-fetal complications nor congenital malformations.Exposure to soy-derived products appears to have a neutral effect on body weight and bone health. Studies performed in adults indicate that soymay promote a minimal increase in thyrotropin (TSH) in subjects with subclinical hypothyroidism. The impact of soy-based foods on gut microbiotaappears favorable, especially when consuming fermented products.Many of the human studies have been conducted with isoflavones supplements, isolated or textured soy proteins. Therefore, the results andconclusions should be interpreted cautiously, as these are not entirely applicable to commercial soy beverages. (AU)

Women's experiences of physical therapy treatment for vulvodynia.

INTRODUCTION: Vulvodynia is a common and complex pain syndrome with a negative impact on quality of life and sexual health. Physical therapy is still an underexplored treatment for vulvodynia. Women's experiences of their physical therapy treatment might shed light on meaningful aspects and essential keys to facilitate change. PURPOSE: To explore and describe women's experiences of physical therapy treatment for vulvodynia. METHODS: A qualitative interview study, using qualitative content analysis. Fourteen women with a median age of 28 years and a median pain duration of 6.5 years participated. Digital interviews were conducted using a semi-structured interview guide with open-ended questions. RESULTS: One theme, four categories and thirteen sub-categories were developed in the analysis. The theme, "Trying to become friends with your vulva," illuminate how the women approached and reconnected to their bodies in physical therapy. The treatment increased their awareness and provided explanations for their symptoms. Four categories described aspects of the theme: 1) untapped resources in a complex healthcare; 2) a matter of trust; 3) a guide to understanding your body; and 4) a new way forward but not the whole solution. CONCLUSION: Women with vulvodynia perceive physical therapy as a promising and yet unknown approach. Physical therapy treatment gives the opportunity to reconnect with the body and vulva in a new way, and to manage pain and muscle tension as part of a multidisciplinary treatment.

[Secular trends of age at menarche and age at menopause in women born since 1951 from a county of Shandong Province, China].

OBJECTIVE: To describe the secular trends of age at menarche and age at natural menopause of women from a county of Shandong Province. METHODS: Based on the data of the Premarital Medical Examination and the Cervical Cancer and Breast Cancer Screening of the county, the secular trends of age at menarche in women born in 1951 to 1998 and age at menopause in women born in 1951 to 1975 were studied. Joinpoint regression was used to identify potential inflection points regarding the trend of age at menarche. Average hazard ratios (AHR) of early menopause among women born in different generations were estimated by performing multivariate weighted Cox regression. RESULTS: The average age at menarche was (16.43±1.89) years for women born in 1951 and (13.99±1.22) years for women born in 1998. The average age at menarche was lower for urban women than that for rural women, and the higher the education level, the lower the average age at menarche. Joinpoint regression analysis identified three inflection points: 1959, 1973 and 1993. The average age at menarche decreased annually by 0.03 (P < 0.001), 0.08 (P < 0.001), and 0.03 (P < 0.001) years respectively for women born during 1951-1959, 1960-1973, and 1974-1993, while it remained stable for those born during 1994-1998 (P=0.968). As for age at menopause, compared with women born during 1951-1960, those born during 1961-1965, 1966-1970 and 1971-1975 showed a gradual decrease in the risk of early menopause and a tendency to delay the age at menopause. The stratified analysis presented that the risk of early menopause gradually decreased and the age of menopause showed a significant delay among those with education level of junior high school and below, but this trend was not obvious among those with education level of senior high school and above, where the risk of early menopause decreased and then increased among those with education level of college and above, and the corresponding AHRs were 0.90 (0.66-1.22), 1.07 (0.79-1.44) and 1.14 (0.79-1.66). CONCLUSION: The age at menarche for women born since 1951 gradually declined until 1994 and leveled off, with a decrease of nearly 2.5 years in these years. The age at menopause for women born between 1951 and 1975 was generally delayed over time, but the trend of first increase and then decrease was observed among those with relatively higher education levels. In the context of the increasing delay in age at marriage and childbearing and the decline of fertility, this study highlights the necessity of the assessment and monitoring of women' s basic reproductive health status, especially the risk of early menopause.

Sexual Quality of Life of Breast Cancer Survivors: A Cross-Sectional Study.

AIM: Sexual quality of life (SQL), one of the essential issues of sexual and reproductive health, negatively affects the overall quality of life. This study aimed to investigate the SQL of breast cancer survivors. METHODS: In this cross-sectional study, 410 breast cancer survivors were recruited in a two-stage sampling process. The quota sampling method was employed in the first stage, and convenience sampling was used in the second stage between December 2020 and September 2021. The data were collected using the sexual Quality of Life-Female, Female Sexual Function Index, Revised Religious Attitude. RESULTS: The mean age of the participants and the time since the disease diagnosis were 42.64 ± 6.02 years and 13.9 ± 4.80 months, respectively. The mean score of SQL was 66.65 ± 10.23 (95% Confidence Interval: 66.63-67.62). Multiple linear regression analysis showed that the SQL of breast cancer survivors was significantly correlated with their occupation (ß=0.12, P<0.008), education (ß=-0.23, P<0.001), their spouse's education (ß=0.16, P<0.001), belief in the sex initiation by the spouse (ß=0.23, P<0.001), fear of being hurt by sexual intercourse (ß=0.21 P < 0.001), receiving training about sexual relations (ß = 0.1, P < 0.049), lumpectomy (ß = 0.11, P < 0.001), sexual function (ß = 0.13 ß = 0.001), and religious attitude (ß = 0.27, P < 0.001). These factors explain 60% of the variance of the SQL score. CONCLUSION: Considering the various factors contributing to the SQL of breast cancer survivors can inform interventions targeted at improving the health status of these women.

Sex comparisons in the association of prediabetes and type 2 diabetes with cognitive function, depression, and quality of life: The Maastricht study.

AIMS: There are sex differences in the excess risk of diabetes-associated cardiovascular disease. However, it is not clear whether these sex differences exist with regard to other complications like mental health aspects. Therefore, we investigated sex differences in the association of prediabetes and type 2 diabetes (T2D) with cognitive function, depression, and quality of life (QoL). MATERIALS AND METHODS: In a population-based cross-sectional cohort study (n = 7639; age 40-75 years, 50% women, 25% T2D), we estimated sex-specific associations, and differences therein, of prediabetes and T2D (reference: normal glucose metabolism) with measures of cognitive function, depression, and physical and mental QoL. Sex differences were analysed using multiple regression models with interaction terms. RESULTS: In general, T2D, but not prediabetes, was associated with higher odds of cognitive impairment, major depressive disorder, and poorer QoL. The odds ratio (OR) of cognitive impairment associated with T2D was 1.29 (95% CI: 0.96-1.72) for women and 1.39 (1.10-1.75) for men. The OR of major depressive disorder associated with T2D was 1.19 (0.69-2.04) for women and 1.68 (1.02-2.75) for men. The mean difference of the physical QoL score (ranging from 0 to 100, with 100 indicating the best possible QoL) associated with T2D was -2.09 (-2.92 to -1.25) for women and -1.81 (-2.48 to -1.13) for men. The mean difference of the mental QoL score associated with T2D was -0.90 (-1.79 to -0.02) for women and -0.52 (-1.23 to 0.20) for men. There was no clear pattern of sex differences in the associations of either prediabetes or T2D with measures of cognitive function, depression, or QoL. CONCLUSIONS: In general, T2D was associated with worse cognitive function, depression, and poorer QoL. The strength of these associations was similar among women and men.

Secular trends of age at menarche and age at menopause in women born since 1951 from a county of Shandong Province, China / 北京大学学报(医学版)

OBJECTIVE@#To describe the secular trends of age at menarche and age at natural menopause of women from a county of Shandong Province.@*METHODS@#Based on the data of the Premarital Medical Examination and the Cervical Cancer and Breast Cancer Screening of the county, the secular trends of age at menarche in women born in 1951 to 1998 and age at menopause in women born in 1951 to 1975 were studied. Joinpoint regression was used to identify potential inflection points regarding the trend of age at menarche. Average hazard ratios (AHR) of early menopause among women born in different generations were estimated by performing multivariate weighted Cox regression.@*RESULTS@#The average age at menarche was (16.43±1.89) years for women born in 1951 and (13.99±1.22) years for women born in 1998. The average age at menarche was lower for urban women than that for rural women, and the higher the education level, the lower the average age at menarche. Joinpoint regression analysis identified three inflection points: 1959, 1973 and 1993. The average age at menarche decreased annually by 0.03 (P < 0.001), 0.08 (P < 0.001), and 0.03 (P < 0.001) years respectively for women born during 1951-1959, 1960-1973, and 1974-1993, while it remained stable for those born during 1994-1998 (P=0.968). As for age at menopause, compared with women born during 1951-1960, those born during 1961-1965, 1966-1970 and 1971-1975 showed a gradual decrease in the risk of early menopause and a tendency to delay the age at menopause. The stratified analysis presented that the risk of early menopause gradually decreased and the age of menopause showed a significant delay among those with education level of junior high school and below, but this trend was not obvious among those with education level of senior high school and above, where the risk of early menopause decreased and then increased among those with education level of college and above, and the corresponding AHRs were 0.90 (0.66-1.22), 1.07 (0.79-1.44) and 1.14 (0.79-1.66).@*CONCLUSION@#The age at menarche for women born since 1951 gradually declined until 1994 and leveled off, with a decrease of nearly 2.5 years in these years. The age at menopause for women born between 1951 and 1975 was generally delayed over time, but the trend of first increase and then decrease was observed among those with relatively higher education levels. In the context of the increasing delay in age at marriage and childbearing and the decline of fertility, this study highlights the necessity of the assessment and monitoring of women' s basic reproductive health status, especially the risk of early menopause.

Transtorno depressivo em mulheres no período pós-parto: análise segundo a raça/cor autorreferida / Trastorno depresivo en mujeres en el período posparto: análisis según raza/color autodeclarado / Depressive disorder among postpartum women: an analysis according to self-reported race/color

Resumo Objetivo Identificar a raça/cor autorreferida por mulheres com 60 dias de pós-parto; identificar a prevalência do indicativo de transtorno depressivo nessas mulheres e verificar a associação entre o indicativo de transtorno depressivo e o quesito raça/cor autorreferida. Métodos Estudo transversal desenvolvido em um município do interior paulista. Foram utilizados, para a coleta de dados, um instrumento com dados sociodemográficos e a Escala de Depressão Pós-Natal de Edimburgo. Os dados foram analisados utilizando-se o Statistical Package for Social Sciences, SPSS, versão 17.0. Resultados Participaram deste estudo 186 mulheres, 60,8% referiram ser da cor parda, 24,2% apresentaram indicativo de transtorno depressivo e, entre estas, 81,7% eram da raça negra. O indicativo de transtorno depressivo associou-se às variáveis: número de filhos (p=0,006), gestação planejada (p=0,04) e tipo de parto (p< 0,001). Conclusão Os resultados deste estudo contribuem para maior visibilidade da temática da saúde mental das mulheres, especificamente das mulheres negras, pois, mesmo que não tenha sido identificada associação significativa dentre aquelas que apresentaram indicativo de transtorno depressivo, a maioria era da raça negra.

Resumen Objetivo Identificar la raza/color autodeclarado por mujeres con 60 días de posparto, identificar la prevalencia de indicios de trastorno depresivo en esas mujeres y verificar la relación entre los indicios de trastorno depresivo y el ítem raza/color autodeclarado. Métodos Estudio transversal realizado en un municipio del interior paulista. Para la recopilación de datos, se utilizó un instrumento con datos sociodemográficos y la Escala de Depresión Posnatal de Edimburgo. Para analizar los datos se utilizó el Statistical Package for Social Sciences, SPSS, versión 17.0. Resultados Participaron en el estudio 186 mujeres, el 60,8 % declararon ser de color pardo, el 24,2 % presentó indicios de trastorno depresivo y, entre ellas, el 81,7 % era de raza negra. Los indicios de trastorno depresivo se relacionaron a las variables: número de hijos (p=0,006), embarazo planeado (p=0,04) y tipo de parto (p< 0,001). Conclusión Los resultados de este estudio contribuyen para una mayor visibilidad del tema de salud mental de las mujeres, específicamente de mujeres negras, ya que, aunque no se haya identificado una relación significativa entre las que presentaron indicios de trastorno depresivo, la mayoría era de raza negra.

Abstract Objective To identify the race/color self-reported by women 60 days postpartum; to identify the prevalence of signs of depressive disorder among these women and to verify the association between signs of depressive disorder and the self-reported race/color. Methods Cross-sectional study carried out in a noncapital city in the state of São Paulo. An instrument with sociodemographic data and the Edinburgh Postnatal Depression Scale were used for data collection. Data was analyzed using the Statistical Package for Social Sciences, SPSS, version 17.0. Results A total of 186 women participated in this study, 60.8% reported being brown, 24.2% had signs of depressive disorder and, among these, 81.7% were black. Signs of depressive disorder were associated with the variables: number of children (p=0.006), planned pregnancy (p=0.04) and type of delivery (p< 0.001). Conclusion The results of this study contribute to greater visibility of the issue of women's mental health, specifically of black women, because even though no significant association was identified among those who showed signs of depressive disorder, most were black.

Salud Mental Perinatal y Reproducción Asistida por Ovodonación: un análisis de la situación actual en España / Perinatal Mental Health and Assisted Reproduction by Oocyte donation: an analysis of the current situation in Spain

Introducción: El número de mujeres que recurren a la ovodonación para lograr la maternidad biológica es cada vez mayor. Esta técnica puede generar conflictos y problemas emocionales en las mujeres que reciben óvulos donados. Se analiza el contexto social, asistencial y legal de la ovodonación en España, así como el papel de la atención de sus dificultades emocionales específicas en Unidades especializadas en Salud Mental Perinatal.Metodología: revisión bibliográfica de la jurisprudencia española y literatura científica especializada en Salud Mental Perinatal.Desarrollo: España es un país líder mundial en número de ovodonaciones, debido a su flexible legislación en materia de reproducción humana, el anonimato legal de las donantes de óvulos y la compensación económica que se ofrece a las mismas. La mayor parte de estos procedimientos se realizan en la red privada, por lo que muchas mujeres no tienen acceso a las Unidades de Salud Mental Perinatal de los sistemas públicos de salud, a pesar de que, en el caso de la ovodonación, la derivación se debe realizar por protocolo. Las mujeres que se plantean la ovodonación presentan con frecuencia sintomatología ansiosa, depresiva y postraumática que debe ser tratada por profesionales especializados. Además, la consulta de Perinatal ofrece un lugar de trabajo terapéutico sobre las cuatro áreas fundamentales de conflicto que pueden sufrir estas mujeres: la maternidad y el duelo genético, el vínculo madre-bebé, la revelación de su origen a las hijas o hijos, y los conflictos éticos.Conclusiones: El retraso de la edad materna y la efectividad de la ovodonación están aumentando el número de mujeres que recurren a la misma. Su asistencia integral debe incluir la atención a las dificultades emocionales que puedan presentar en Unidades de Salud Mental Perinatal. (AU)

Introduction: The number of women who resort to oocyte donation to achieve biological motherhood is constantly increasing. This technique may cause certain conflicts and emotional problems in the women who receive donated oocytes. In this paper, we analyze not only Spain’s oocyte donation social context, but also the healthcare and legal contexts involved. In addition to this, we study the role had by their specific emotional difficulties cared for in specialized Perinatal Mental Health Units.Methodology: A bibliographic review of Spanish jurisprudence and scientific literature specialized in Perinatal Mental Health.Development: Spain is one of the world’s leaders in the number of oocyte donations, due to its flexible legislation on human reproduction, the legal anonymity of oocyte donors and the financial compensa-tions offered to them. These procedures are mostly performed in the private healthcare network, which means that most of the women do not have access to the public health systems’ Perinatal Mental Health Units. However, it must be stressed that in the case of assisted reproduction by oocyte donation, the referral to a perinatal Mental Health unit is required by medical protocol. Women who consider oocyte donation frequently present anxious, depressive and post-traumatic symptoms that must be treated by specialized professionals. In addition to this, the Perinatal Mental Health Units offer a place for therapeutic work on the four fundamental areas of conflict that these women may suffer: motherhood and genetic mourning, the mother-baby bonding process, the disclosure of their origin to their daughters or sons, as well as the ethical conflicts they face. Conclusions: The delay in maternal age and the effectiveness of oocyte donation are leading to an increase in the number of women who resort to it. Their comprehensive assistance must include the due care of the emotional difficulties they may present in Perinatal Mental Health Units. (AU)

Promoción de la actividad física en mujeres mayores. Un estudio cualitativo con perspectiva de género / Promoting physical activity in older women. A qualitative study with a gender perspective

Objetivos: Conocer las estrategias profesionales utilizadas para lapromoción y adherencia de la práctica de actividad física entre lasmujeres mayores. Metodología: Estudio cualitativo con enfoquesociocrítico feminista y perspectiva de género mediante 3 grupos focales y2 entrevistas en profundidad. Participaron 26 profesionales del ámbito deatención primaria y monitores de actividades físicas (el 54% enfermeras).Análisis interpretativo de contenido y uso del programa informáticoMAXQDA-18. Resultados: Surgieron 2 categorías y 7 subcategorías.Los/las profesionales definieron el vínculo que existe entre la actividadfísica y las mujeres mayores a partir de los estereotipos de géneroque perciben que se han ido construyendo histórica y culturalmentealrededor de ellas, centrados principalmente en el rol de cuidadoras y enla identidad social entre iguales. Utilizan estrategias para incentivar lapráctica de actividad física basadas en la comunicación, experimentación,personalización, fortalecimiento de redes comunitarias y suempoderamiento. Conclusiones: Las mujeres mayores actuales presentanun vínculo con la actividad física marcado por estereotipos de génerotradicionales más alejados de beneficios físicos, pero cercanos a interesessociales y de identidad. Los/las participantes se apoyan en las experienciasde estas mujeres para la toma de conciencia de su autocuidado a travésde la actividad física y de la socialización. Estos hallazgos, que relacionanla actividad física con los estereotipos femeninos de socialización entreiguales, así como la responsabilidad y cuidado de su propia salud, sonlos que pueden ayudar a los/las profesionales a conseguir la satisfacción yadherencia en las mujeres mayores con la práctica. (AU)

Objectives: To understand the professional strategies usedto promote and adherence to the physical activity practiceamong older women. Methodology: Qualitative study witha feminist socio-critical approach and gender perspectivethrough three focus groups and two in-depth interviews.Twenty-six primary care professionals and fitness instructorparticipated (54% nurses). Interpretative content analysis anduse of the MAXQDA-18 software. Results: Two categoriesand seven subcategories emerged. Professionals defined thelink between physical activity and older women based on thegender stereotypes they perceived to have been historicallyand culturally constructed focusing mainly on the role ofcaregivers and social identity among equals. They use strategiesto encourage physical activity practice based on communication,experimentation, personalisation, enhancing communitynetworks and their empowerment. Conclusions: Currentolder women present a link with physical activity markedby traditional gender stereotypes that are more distant fromphysical benefits but closer to social and identity interests.Participants draw on these women’s experiences of self-careawareness through physical activity and socialisation. Thesefindings, which link physical activity with female stereotypesof peer socialisation as well as responsibility and care for one’sown health, can help practitioners to achieve older women’ssatisfaction and adherence with the practice. (AU)

Significados de exposição ao HIV/AIDS atribuídos por mulheres que professam religiões afro-brasileiras / Meanings of exposure to HIV/AIDS attributed by women who profess Afro-Brazilian religions / Significados de exposición al VIH/SIDA atribuidos por mujeres que profesan religiones afrobrasileñas

Objetivo: conhecer os significados atribuídos por mulheres que professam religiões afro-brasileiras à exposição ao HIV/AIDS. Método: estudo interpretativo, qualitativo, com amostragem por meio da técnica de bola de neve, selecionando 21 mulheres que professam religiões afro-brasileiras, em sete grupos amostrais. Coleta deda dados realizada entre julho de 2019 e outubro de 2020, por meio de entrevistas semiestruturadas, em parque urbano público em São Paulo e, virtualmente. Dados analisados segundo o Interacionismo Simbólico e a Grounded Theory. Resultados: participaram mulheres entre 18 e 70 anos, a maioria casada, com pós-graduação completa, frequentando, pelo menos uma vez na semana, a instituição religiosa, há mais de 5 anos. As participantes significam exposição ao HIV/AIDS como falta de autocuidado, não ter cuidado com o corpo, morada de orixás, relacionando com prevenção, discernimento e respeito, cuja visão conservadora enfoca o outro. Conclusão: os significados atribuídos à exposição ao HIV/AIDS estão fortemente influenciados pelas crenças religiosas, salientando a exposição dos outros.

Objective: to discover the meanings attributed by women who profess Afro-Brazilian religions to exposure to HIV/AIDS. Method: in this interpretive, qualitative study, using the snowball technique, 21 women who profess Afro-Brazilian religions were selected in 7 sample groups. Data were collected from July 2019 to October 2020 by semi-structured interviews in a public urban park in São Paulo and virtually by Google Meet, and analyzed by Symbolic Interactionism and Grounded Theory, with ATLAS.ti9 software. Results: participants were 18 to 70 years old, most married, with complete postgraduate studies, and had attended the religious institution at least once a week for more than 5 years. The participants attributed meaning to exposure to HIV/AIDS as lack of self-care, lack of care for the body, the home of orixá deities, and related it to prevention, discernment and respect, in a conservative view focusing on others. Conclusion: the meanings attributed to exposure to HIV/AIDS were strongly influenced by religious beliefs and emphasized the exposure of others.

Objetivo: conocer los significados atribuidos por mujeres que profesan religiones afrobrasileñas a la exposición al VIH/SIDA. Método: estudio interpretativo, cualitativo, utilizando para la muestra el método de bola de nieve, seleccionando 21 mujeres que profesan religiones afrobrasileñas, en siete grupos de muestra. La recolección de datos tuvo lugar entre julio/2019 y octubre/2020, a través de entrevistas semiestructuradas, en un parque público urbano de São Paulo y también virtualmente. Los datos se analizaron según el Interaccionismo Simbólico y la Grounded Theory. Resultados: participaron mujeres con edades entre 18 y 70 años, la mayoría casada, con estudios de posgrado completo, asistiendo a la institución religiosa al menos una vez por semana desde hace más de 5 años. Las participantes entienden la exposición al VIH/SIDA como falta de autocuidado, descuido del cuerpo, hogar de los orixás, comparado a la prevención, al discernimiento y al respeto, cuya mirada conservadora se enfoca en el otro. Conclusión: los significados atribuidos a la exposición al VIH/SIDA están fuertemente influenciados por las creencias religiosas, destacando la exposición de los demás.

Perception and Practice of Cervical Cancer Screening Services and the Role of Social Workers in Facilitating Screening Uptake in Enugu State, Nigeria.

OBJECTIVE: We examined the perception and practice of cervical cancer screening among women in Enugu State, Nigeria. METHODS: We employed mixed methods and conveniently sampled women aged >15 years. The quantitative data were subjected to chi-square and regression analysis while the qualitative data were analyzed using thematic analysis. RESULTS: The study findings show that over 57% of the respondents have a positive perception of cervical cancer screening while over 80% revealed that they practice cervical cancer screening. Factors such as education, income, and residence are significant in predicting the practice of cervical cancer screening. CONCLUSION: Therefore, social work strategies to leverage these modifiable predictors in facilitating cervical screening uptake are recommended.

Nursing students' knowledge about obstetric violence / Conhecimento de acadêmicos de Enfermagem sobre a violência obstétrica

INTRODUCTION: Obstetric violence is a worldwide multifactorial phenomenon. It is characterized by the disrespectful treatment of women at health institutions, during the pregnancy-puerperal period. Identifying future health professionals´ knowledge on this theme can be useful to design teaching strategies that support professional training for the prevention and coping of obstetric violence. OBJECTIVE: To evaluate the knowledge of nursing undergraduate students on Obstetric Violence. METHODS: This is descriptive and exploratory research with a quantitative approach and a sample of 115 students from a public university. The data were collected by a structured questionnaire. The questions were analyzed by applying statistical tests and Poisson regression models with robust variance. RESULTS: About 99.1% of the students stated some approach to the theme, and 56.3% know someone who suffered obstetric violence. The university and social media were cited as the main sources of information. Only 10.5% were able to estimate how many women currently suffer from obstetric violence; 13% know the available legislation and 33.04% said they know how to make a report of violence. CONCLUSION: The findings indicate that students have superficial knowledge about the investigated topic, ignoring epidemiological aspects, as well as related legislation in Brazil and available instances for reporting. These results justify the teaching improvement about obstetric violence in the educational process of these future professionals, as a strategy to prevent and struggle with obstetric violence.

INTRODUÇÃO: A violência obstétrica é um fenômeno multifatorial mundial. É caracterizada pelo tratamento desrespeitoso no contexto das instituições de saúde, durante o ciclo gravídico-puerperal. Dessa forma, identificar o conhecimento dos futuros profissionais de saúde sobre esse tema é uma maneira de contribuir para o desenho de estratégias de ensino que favoreçam uma formação profissional consciente e comprometida com a prevenção e enfrentamento da violência obstétrica. OBJETIVO: Avaliar o nível de conhecimento de estudantes de enfermagem sobre Violência Obstétrica. MÉTODOS: Pesquisa descritiva e exploratória, com abordagem quantitativa, com amostra de 115 acadêmicos de uma universidade pública. Os dados foram coletados com aplicação de instrumento estruturado. As questões foram analisadas utilizando testes estatísticos e modelos de regressão de Poisson com variância robusta. RESULTADOS: Cerca de 99,1% dos estudantes tiveram contato com o tema e 56,3% conhecem alguém que sofreu violência obstétrica. A universidade e as redes sociais foram citadas como as principais fontes de informação. Apenas 10,5% foram capazes de estimar quantas mulheres atualmente sofrem violência obstétrica; 13% conhecem a legislação disponível e 33,04% disseram saber como fazer uma denúncia. CONCLUSÃO: Os achados indicam que os acadêmicos possuem conhecimento superficial sobre o tema investigado, ignorando os aspectos epidemiológicos, a legislação vigente no Brasil e os equipamentos disponíveis para a denúncia. Esses resultados justificam a qualificação do ensino sobre violência obstétrica no processo de formação desses futuros profissionais, como estratégia de prevenção e combate à violência obstétrica.

COCREA SASI. Cocreación para la promoción de la salud afectiva sexual desde una mirada intercultural / COCREA SASI. Co-creation for the promotion of Sexual and Emotional Health from an intercultural perspective

Objetivo: identificar realidades sobre la salud afectiva sexual y reproductiva (SASR) de mujeres inmigrantes en Barcelona, y sus propuestas de herramientas para promoverla a través de un proceso Investigación-Acción-Participativa (IAP). Método: estudio cualitativo, descriptivo-interpretativo. Basado en la IAP, según el modelo de Kemmis y McTaggart, y coordinado por un grupo motor (GIAP). Se realizaron grupos de discusión y entrevistas a inmigrantes y profesionales siguiendo un guion (conceptos sobre SASR, conocimientos y experiencias sobre métodos de anticoncepción y de prevención, acceso a recursos, y propuestas de herramientas). El análisis narrativo de contenido se realizó con ATLAS-Ti. Resultados: se constituyó un Grupo Motor (GIAP) con 13 miembros. Se realizaron 10 grupos de discusión y tres entrevistas, con 51 inmigrantes de múltiples orígenes y 10 profesionales. La SASR se relaciona con la cultura de origen según la edad, el género, el estado civil, la familia, la religión y la educación recibida. Faltan conocimientos respecto a la anticoncepción y la prevención de infecciones de transmisión sexual y los servicios de atención a la SASR. Se proponen herramientas interactivas que incluyen juegos, dinamizadas por profesionales con competencias culturales. La escuela emergió como un espacio importante para trabajar con esta herramienta. Conclusión: el proceso IAP ha permitido identificar realidades de las mujeres inmigrantes y propuestas concretas para promover la equidad en SASR.(AU)

Objective: to identify real facts about the sexual and reproductive emotional health (SRH) in immigrant women in Barcelona, and their proposals for tools of promotion through a Participatory Action-Research (PAR) process. Method: a qualitative, descriptive-interpretative study, based on PAR, according to the model by Kemmis and McTaggart, and coordinated by a motor group (PARG). The study involved discussion groups and interviews with immigrants and professionals, following a script (SRH concepts, knowledge and experience about contraception and prevention methods, access to resources, and proposals for tools). The narrative content analysis was conducted through ATLAS-Ti. Results: a Motor Group (PARG) was formed with 13 members; 10 discussion groups and three interviews were conducted, with 51 immigrants from multiple origins and 10 professionals. SRH was associated with their culture of origin according to age, gender, marital status, family, religion, and education received. There was lack of knowledge regarding contraception and prevention of sexually-transmitted infections, and about support services for SRH. Interactive tools were suggested, including games, activated by professionals with cultural skills. The school appeared as an important space to work with this tool. Conclusion: the PAR process allowed to identify the realities of immigrant women, as well as specific proposals to promote equity in SRH.(AU)

Validation of Identifying Cancer Diagnosis Based on Self-Reported Information in the Japan Nurses' Health Study.

BACKGROUND: The Japan Nurses' Health Study (JNHS) is a large-scale, nationwide prospective cohort study of female nurses. This study aimed to examine the validity of self-reported diagnosis of cancer among the JNHS cohort members (N=15,019). METHODS: For women who reported any diagnosis of five cancers (stomach, colorectal, liver, lung and thyroid) in the biennial follow-up surveys, an additional outcome survey, medical facility survey, and confirmation of death certificate (DC) were conducted. The JNHS Validation Study Committee (referred to as "the committee") made a final decision on the reported outcomes. To examine the validity of self-reported diagnosis of cancer, the positive predictive value (PPV) was calculated using the committee's decision as the gold standard. To examine the validity of the committee's decision based on self-reports and DCs, PPV was calculated using physician-reported information as the gold standard. RESULTS: The PPV of self-reported diagnosis in the biennial follow-up surveys was 77.8% for stomach, 66.2% for colorectal, 41.7% for liver, 60.2% for lung, and 64.6% for thyroid cancer. The corresponding PPVs in the additional outcome survey were 96.2%, 80.7%, 62.5%, 82.5%, and 96.9%, respectively. The PPV of the committee's decision was 100% for stomach, 87.5% for colorectal, 94.7% for lung, and 100% for thyroid cancer (data not available for liver cancer). The proportion of DC-only cases among committee-defined cases was below 10% for all cancers except liver cancer (28.6%). CONCLUSIONS: The validity of identifying cancer diagnosis based on self-reported information in the JNHS was favorable for stomach, colorectal, lung and thyroid cancer.

A enfermagem na assistência às mulheres em situação de perda fetal e aborto: revisão integrativa / Nursing care for women with fetal loss and abortion: integrative review / Cuidados de enfermería a mujeres en situación de pérdida fetal y aborto: revisión integradora

Objetivo: Analisar a inserção da enfermagem na assistência às mulheres em situação de perda fetal e aborto nos diferentes níveis de atenção à saúde. Método: Revisão integrativa da literatura publicada entre 2015 e 2020 por meio de busca nas bases de dados Pubmed, Medline, CINAHL, LILACS, BVS, Embase e Web of Science e com descritores estabelecidos pelos MeSH e DeCS. Resultados: Foram selecionados 13 artigos de origem nacional (15,3%) e internacional (84,7%) nos idiomas português e inglês. Os principais resultados reportam que o cuidado integral e humanizado em situações de perda fetal envolve as seguintes etapas: o acolhimento; as orientações; e o esclarecimento de possíveis dúvidas. Afirma-se que o impacto emocional decorrente da perda afeta a mãe, familiares e o profissional de enfermagem. Conclusão: A revisão evidencia que a prática assistencial da enfermagem em situações de perda fetal e aborto representa uma experiência complexa, contudo, gratificante por oportunizar um espaço de humanização do cuidado com ênfase no sofrimento psíquico da mulher e companheiro. Apontam-se como eixos fortalecedores da qualidade desta assistência a capacitação profissional, o desenvolvimento de estudos e diretrizes sobre a prática assistencial.(AU)

Objective: To analyze the insertion of nursing in the assistance to women in situations of fetal loss and abortion in the different levels of health care. Método: Integrative review of literature published between 2015 and 2020 by searching Pubmed, Medline, CINAHL, LILACS, BVS, Embase and Web of Science databases and with descriptors established by MeSH and DeCS. Resultados: Thirteen articles were selected from national (15.3%) and international (84.7%) origins in Portuguese and English. The main results reported that integral and humanized care in situations of fetal loss involves the following stages: welcoming, guidance, and clarification of possible doubts. It is stated that the emotional impact resulting from the loss affects the mother, family members and the nursing professional. Conclusion: The review shows that the practice of nursing care in situations of fetal loss and abortion represents a complex experience, however, rewarding for providing an opportunity for humanization of care with emphasis on the psychological suffering of the woman and her companion. Professional training, the development of studies and guidelines on care practice are pointed out as strengthening axes for the quality of this assistance. Descriptors: Fetal Death; Abortion; Women´s Health; Obstetric Nursing; Nursing Care.(AU)

Objetivo: Analizar la inserción de la enfermería en la asistencia a las mujeres en situación de pérdida fetal y aborto en los diferentes niveles de atención sanitaria. Método: Revisión integradora de la literatura publicada entre 2015 y 2020 mediante búsqueda en las bases de datos Pubmed, Medline, CINAHL, LILACS, BVS, Embase y Web of Science y con los descriptores establecidos por MeSH y DeCS. Resultados: Se seleccionaron 13 artículos de origen nacional (15,3%) e internacional (84,7%) en portugués e inglés. Los principales resultados indican que el cuidado integral y humanizado en las situaciones de pérdida fetal incluye las siguientes etapas: el acolchado, las orientaciones y la aclaración de las posibles dudas. Se afirma que el impacto emocional resultante de la pérdida afecta a la madre, a los familiares y a los profesionales de la enfermería. Conclusión: La revisión evidencia que la práctica asistencial de la enfermería en situaciones de perdición fetal y aborto representa una experiencia compleja, sin embargo, gratificante por oportunizar un espacio de humanización del cuidado con énfasis en el sufrimiento psíquico de la mujer y el acompañante. La formación profesional, el desarrollo de estudios y directrices sobre la práctica asistencial se señalan como ejes de refuerzo para la calidad de esta asistencia.(AU)

Sexual and reproductive health of incarcerated women in French Guiana: a qualitative approach.

PURPOSE: Incarcerated women are a vulnerable population in terms of sexual and reproductive health. In French Guiana, most incarcerated women come from unsafe environments and are incarcerated because of drug trafficking. Medical follow-up processes used in prison (medical assessment on arrival, and then two half-days per week upon request but without an obstetrician-gynecologist) does not allow for a thorough assessment of the impact of incarceration on women prisoners' health to take place. In the absence of data, the purpose of this study was to describe incarcerated women's experiences in relation to sexual and reproductive health. DESIGN/METHODOLOGY/APPROACH: Semi-structured interviews were conducted among French-speaking adult women who had been incarcerated for at least four months in a French Guianan prison. Menstruation, contraception, pregnancy, abortion, sexually transmitted infections and sexuality were described by means of interpretative phenomenological analysis. FINDINGS: A total of 14 women were interviewed. They suffered from menstrual cycle disorders, poor hygiene and menstrual insecurity. They appeared to have emotionally disinvested sexuality. However, intra-prison sexual activity existed for some (masturbation, conjugal prison visits, homosexual intercourse between fellow prisoners). Homosexual relations were a source of discrimination. Being pregnant while incarcerated was viewed negatively. A lack of knowledge about sexual and reproductive health and high-risk behaviors such as piercing and tattooing practices were widespread. ORIGINALITY/VALUE: Incarceration is a vulnerable time for women's sexual and reproductive health. Sexual activity exposes women to risks and discrimination that should be taken into account in a multidisciplinary approach adapted to the prison environment.