Women's health (London, England)最新文献

{"title":"The development and evaluation of educational resources for young women with neurofibromatosis type 1 undergoing breast cancer surveillance.","authors":"Caitlin Forwood, Emma Hartley, Jane Fleming, Ashley Crook, Diana Nawara, Mathilda Wilding, Lavvina Thiyagarajan, Katrina Moore, Yobelli Jimenez, Rebecca B Saunderson, Nicola Poplawski, Yemima Berman","doi":"10.1177/17455057251337118","DOIUrl":"10.1177/17455057251337118","url":null,"abstract":"<p><strong>Background: </strong>Women with neurofibromatosis type 1 (NF1) have an increased risk of breast cancer and poorer 5-year survival. Current breast surveillance patient information resources may be inappropriate for this cohort due to increased cognitive deficits and cancer worry.</p><p><strong>Objectives: </strong>This study aimed to develop and evaluate NF1-specific patient-centric educational resources about breast cancer surveillance.</p><p><strong>Design: </strong>A pilot, prospective longitudinal cohort study was conducted through a Sydney tertiary hospital (Royal North Shore Hospital) adult NF1 clinic and an established breast cancer risk management clinic.</p><p><strong>Methods: </strong>A brochure was developed with input from stakeholders and women with NF1 participating in breast surveillance. The content was adapted to create a webpage and animation evaluated through clinician and patient surveys. Final iterations of the resources were based on stakeholder feedback.</p><p><strong>Results: </strong>Nine semi-structured interviews were conducted with women with NF1 after breast surveillance. All considered the brochure acceptable and valuable and supported sharing the resource. Fifty-seven patient and clinician surveys were also completed, with the webpage and animation highly rated regarding acceptability, usefulness, and relevance.</p><p><strong>Conclusions: </strong>Information in three media has been developed specifically for women with NF1, considering breast surveillance to increase understanding, provide reassurance, and as a memory aid to support clinician consultation.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251337118"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D3 supplementation enhances the effect of aerobic water-based training on physical fitness indices in obese and overweight menopausal women: A randomized controlled trial.","authors":"Foroozandeh Zaravar, Golamhossein Tamaddon, Mohammadamin Safari, Leila Zaravar, Maryam Koushkie Jahromi","doi":"10.1177/17455057251361255","DOIUrl":"10.1177/17455057251361255","url":null,"abstract":"<p><strong>Background: </strong>Obesity is associated with decreased physical performance, especially in older individuals. Some studies have examined the impact of exercise on obesity outcomes as part of a palliative care program.</p><p><strong>Objective: </strong>This parallel-group randomized controlled trial investigated the effects of water-based aerobic exercise training and vitamin D3 supplementation on body mass index (BMI) and physical performance in postmenopausal women who were overweight or obese and had insufficient or deficient levels of serum vitamin D.</p><p><strong>Design: </strong>This was an experimental study.</p><p><strong>Methods: </strong>Forty women were randomly assigned to one of four groups: Water-based training + vitamin D (WTD), water-based training (WT), vitamin D (D), and control. The training program (aerobic-based exercise) and vitamin D3 supplementation were conducted for 8 weeks, three times a week. Measurements were taken before and after the intervention.</p><p><strong>Results: </strong>The WTD group showed significant improvement in BMI, handgrip strength, and gait speed compared to all other groups (<i>p</i> > 0.05), and significant enhancements in right and left leg static balance and gait speed compared to the D and control groups (<i>p</i> < 0.05). The WT group demonstrated improvements in handgrip strength compared to the control group and enhancements in right and left leg static balance and gait speed compared to the D and control groups (<i>p</i> < 0.05). Vitamin D3 supplementation improved handgrip strength compared to the control group (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Water-based training with or without vitamin D3 supplementation significantly improved physical fitness indices, with combination showing the most pronounced effects. Vitamin D3 supplementation alone did not have a significant impact on most physical fitness measures.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251361255"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menopausal hormone therapy shows superior efficacy to complementary and alternative medicine in treating symptomatic hand osteoarthritis in Japanese women during perimenopause.","authors":"Hiromi Sasaki, Mika Sakihama, Noriko Karakida, Takasuke Miyazaki, Hiroaki Kobayashi, Noboru Taniguchi","doi":"10.1177/17455057251359384","DOIUrl":"10.1177/17455057251359384","url":null,"abstract":"<p><strong>Background: </strong>Symptomatic hand osteoarthritis frequently affects perimenopausal women and is believed to be associated with estrogen deficiency. However, effective medical therapies for symptomatic relief remain limited.</p><p><strong>Objective: </strong>To compare the effectiveness of menopausal hormone therapy and complementary and alternative medicine in treating symptomatic hand osteoarthritis in perimenopausal women.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Data sources and methods: </strong>We retrospectively reviewed the medical records of 73 perimenopausal Japanese women treated for symptomatic hand osteoarthritis at Kagoshima University Hospital between 2019 and 2022. Fifty-four patients received menopausal hormone therapy, and 19 received complementary and alternative medicine (Kampo formula and/or S-equol supplementation). No patients received additional orthopedic treatments for hand osteoarthritis, such as analgesics, splinting, rehabilitation, or injections. The outcomes included the disability of the arm, shoulder, and hand score and visual analog scale score for hand pain, which were assessed at baseline and 3 months. Two-factor repeated-measures analysis of variance was used to assess condition-by-time interactions, and effect sizes were calculated. For outcomes with significant interactions, post hoc Mann-Whitney <i>U</i> tests were used to compare between-group changes.</p><p><strong>Results: </strong>Significant condition-by-time interactions were found for the disability of the arm, shoulder, and hand score (<i>F</i> = 12.85, p = 0.0007, partial η² = 0.17) and visual analog scale score (<i>F</i> = 7.39, p = 0.008, partial η² = 0.02), indicating that treatment effects differed between groups over time. Post hoc analyses revealed that the menopausal hormone therapy group showed significantly greater improvements than the complementary and alternative medicine group in both the disability of the arm, shoulder, and hand (10.85 versus -1.75 points, p = 0.003) and visual analog scale scores (27.9 versus 9.17 mm, p = 0.02). The mean improvement in disability of the arm, shoulder, and hand scores in the menopausal hormone therapy group exceeded the minimal clinically important differences, supporting both statistical and clinical significance.</p><p><strong>Conclusions: </strong>Compared with complementary and alternative medicine, menopausal hormone therapy showed superior efficacy in improving hand pain and dysfunction associated with symptomatic hand osteoarthritis in perimenopausal Japanese women.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251359384"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Schistosomiasis and ruptured ectopic pregnancy: A case report.","authors":"Juleca Manuela Sobrejale Ucama, Lee Smith, José Pires, Pita Tomás, Ivo Jone, Rogerio Ucama, Damiano Pizzol, Angelica Stellato, Giuseppe Maggioni","doi":"10.1177/17455057251387469","DOIUrl":"10.1177/17455057251387469","url":null,"abstract":"<p><p>Schistosomiasis is a parasitic disease mainly prevalent in tropical and subtropical areas, especially in poor settings without adequate sanitation and access to clean water. It is caused by trematode parasites living within the veins of their human host, where they mate and produce fertilized eggs. The eggs are either shed into the environment through feces or urine, or are retained in host tissues where they induce inflammation and then die. The genital form is caused by <i>Schistosoma haematobium</i> and affects both the urinary and genital tracts in up to 75% of infected individuals, both male and female. Female genital schistosomiasis is a challenging and potentially lethal condition and may affect the whole genital tract leading to a wide range of urinary, sexual, and reproductive health problems. The main reasons leading women to health services are infertility and genital nonspecific symptoms including vaginal discharge, pruritus, pelvic pain, dyspareunia, and haematuria. Other severe complications caused by schistosomiasis include increased risk of HIV and HPV infection, genital ulcers, miscarriage, and ectopic pregnancy. We report in the present case study a 23-year-old female with schistosomiasis and ruptured ectopic tubal pregnancy successfully managed in a low-income setting.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251387469"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12536102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative analysis of patient and key informant interviews to inform integration of HIV pre-exposure prophylaxis services into gynecology care in Alabama.","authors":"Madeline C Pratt, Hannah Goymer, Kaylee Burgan, Lynn T Matthews, Bernadette Johnson, Desiree Phillips, Mirjam-Colette Kempf, Michael J Mugavero, Audra Williams, Latesha E Elopre","doi":"10.1177/17455057251331714","DOIUrl":"10.1177/17455057251331714","url":null,"abstract":"<p><strong>Background: </strong>HIV pre-exposure prophylaxis (PrEP) use is low among Southern, Black cis-gender women (CGW). Gynecology clinics are well-positioned to integrate PrEP services as a component of sexual and reproductive healthcare for CGW.</p><p><strong>Objectives: </strong>Identify key determinants to PrEP implementation into routine gynecologic care.</p><p><strong>Design: </strong>Qualitative, in-depth interviews (IDIs).</p><p><strong>Methods: </strong>We conducted IDIs with key informants (i.e., physicians, nurses, medical assistants) and focus group discussions (FGDs) with patients accessing care in a gynecology clinic serving under- and uninsured women in Alabama. IDIs explored individual-, setting-, and process-level factors that may impact PrEP care implementation in a clinic serving approximately 3000 women yearly, 64% of whom are Black women.</p><p><strong>Results: </strong>Ten key informants participated in individual IDIs (median age 33.5, range 24-58 years, 80% female); 20 women participated in either 1 of 4 FGDs (<i>n</i> = 8) or an individual IDI (<i>n</i> = 12); median age 32, range 19-44. The following themes emerged: (1) patient- and provider-level stigmas related to sexuality, sexually transmitted infections (STIs), and HIV limit discussions about sexual health and HIV prevention. (2) Providers report limited knowledge about prescribing and monitoring PrEP, which is reflected in patient's observations that providers do not routinely initiate discussions about HIV prevention or PrEP. (3) Providers utilize a more risk-based approach to PrEP counseling; patients expect non-targeted, comprehensive sexual health information. (4) Structural and social barriers will be challenges to implementing PrEP in routine gynecological care. (5) Patients and providers support a clinic-wide approach to integration of PrEP into gynecology clinics.</p><p><strong>Conclusion: </strong>Discussions around sexual health and STIs are limited in routine gynecologic care, but patients expect comprehensive counseling from knowledgeable providers. Additional provider training may increase comfort discussing and providing PrEP. These findings will inform development of implementation strategies to integrate PrEP care into gynecologic services.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251331714"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidimensional analysis of stigma among female sex workers in Northern Uganda: Principal component and factor analyses.","authors":"Amir Kabunga, Felix Bongomin, Vella Ayugi, Eustes Kigongo","doi":"10.1177/17455057251341729","DOIUrl":"10.1177/17455057251341729","url":null,"abstract":"<p><strong>Background: </strong>Female sex workers (FSWs) face significant stigma, which hinders their access to healthcare, social support, and fundamental human rights. Stigma is often compounded by criminalization, violence, and discriminatory attitudes, particularly in low-income regions like Northern Uganda.</p><p><strong>Objectives: </strong>This study aims to analyze the underlying dimensions of stigma among FSWs in Gulu City, Northern Uganda, to provide insights for targeted interventions.</p><p><strong>Design: </strong>A community-based cross-sectional study was conducted from February to March 2023 in Gulu City, Northern Uganda.</p><p><strong>Methods: </strong>A total of 314 FSWs aged 18-49 years participated in the study, yielding a response rate of 83.9%. Participants were recruited using consecutive sampling from hotspots such as bars, brothels, streets, and community health centers. Data were collected through face-to-face interviews using a pre-tested semi-structured questionnaire. Descriptive statistics summarized sociodemographic and economic characteristics. Principal component analysis (PCA) with varimax rotation was applied to identify the primary components of stigma. Factor retention was guided by eigenvalues >1.0, scree plot analysis, and factor loadings ⩾0.35. Reliability was assessed using Cronbach's alpha. Multivariate analysis examined the association between stigma and demographic variables.</p><p><strong>Results: </strong>The mean age of participants was 28.8 years (standard deviation = 6.4), with most having completed primary education (46.2%). A majority resided in urban areas (93.3%), and 70.7% reported experiencing violence from clients. PCA identified three key dimensions of stigma: social stigma, healthcare-related stigma, and self-stigma. Social stigma encompassed community rejection and discrimination, while healthcare-related stigma involved negative attitudes and experiences within health settings. Self-stigma reflected internalized shame and reduced self-worth among participants. The cumulative variance explained by the three components was 67.2%, with strong internal reliability (Cronbach's alpha = 0.88). Factors significantly associated with stigma included age, education level, and experience of violence (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>The multidimensional nature of stigma among FSWs in Gulu City highlights the urgent need for holistic interventions. Addressing community stigma, improving healthcare provider attitudes, and offering psychosocial support to reduce self-stigma are critical for improving health outcomes and quality of life. The use of PCA provided a robust framework to uncover key stigma dimensions and guiding tailored interventions.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251341729"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salivary BDNF to predict at-risk status of eating disorders in young nutritionist Jordanian females: Results from a preliminary multistage study.","authors":"Aseel AlSaleh, Hebah Abdalla Ali, Amani Ali Almasri, Razan Mahmoud Omoush, Adam Tawfiq Amawi, Mohammed Ahmed Alkharisi, Seithikurippu R Pandi-Perumal, Khaled Trabelsi, Hadeel Ghazzawi, Haitham Jahrami","doi":"10.1177/17455057251376885","DOIUrl":"10.1177/17455057251376885","url":null,"abstract":"<p><strong>Background: </strong>Brain-derived neurotrophic factor (BDNF) is associated with the development of different psychiatric conditions, including eating disorders (EDs).</p><p><strong>Objectives: </strong>To investigate the salivary BDNF's ability to act as a potential biomarker for detecting the risk of developing EDs among young females.</p><p><strong>Design and methods: </strong>A cross-sectional study was carried out in Amman, Jordan, with a total of 216 nutrition students completing the Eating Attitudes Test-26 (EAT-26) to assess the risk of developing EDs, the Cohens' Perceived Stress Scale-10 (PSS-10) to measure stress levels, and the International Physical Activity Questionnaire-Short Form (IPAQ-SF) to assess physical activity levels. Dietary intake was analyzed using a semiquantitative food frequency questionnaire. A nested sample of 34 females from both extreme EDs was selected and tested for salivary BDNF levels.</p><p><strong>Results: </strong>The nested sample of 34 female nutrition students 22.00 (2.75) years old with body mass index (BMI) of 23.60 (3.35) kg/m² were divided into two groups; 18 students were at lower risk, while 16 were at higher risk of developing EDs. The salivary BDNF levels did not differ significantly between the low-risk and high-risk groups (391.03 (128.17), 339.15 (102.52), and <i>p</i> = 0.347, respectively). BMI, PSS-10 score, and total metabolic equivalent (MET) were significantly different between the two groups. No associations were found between salivary BDNF levels and BMI, PSS-10 score, MET, or different food groups. The odds ratio for the risk of BDNF-related EDs was 1.07 (95% CI, 1.03-1.10) in the higher-risk group versus the lower-risk group.</p><p><strong>Conclusion: </strong>BDNF is not a robust biomarker of risk for EDs. The changes in salivary BDNF levels could reflect individual ED eating patterns rather than indicating a direct causative role in the disorder's development. According to our results, psychiatric consultation for ED detection remains the gold standard for diagnosis and treatment.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251376885"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep patterns of Canadian women across the life course: A systematic review.","authors":"Siobhan E Woods, Patricia Nistor, Kelly K Anderson, Saverio Stranges","doi":"10.1177/17455057251367141","DOIUrl":"10.1177/17455057251367141","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of poor sleep is increasing. Women and men have different sleep needs, and uniquely female life transitions, such as the perinatal period and menopause, are associated with further differences in sleep patterns. In Canada, sleep disparities across socioeconomic groups are profound, but sleep research rarely differentiates between women and men.</p><p><strong>Objectives: </strong>To examine the current evidence on the sleep quality and quantity of Canadian women using a life course perspective, drawing comparisons to men's sleep where possible, and to identify correlates associated with poor sleep to help determine avenues for improving women's sleep health.</p><p><strong>Design: </strong>Systematic review.</p><p><strong>Methods: </strong>A literature search was conducted in August 2024 to identify observational studies examining the relationship between sleep and potential correlates. Community-based studies set in Canada with exclusively female participants, or those in which results were stratified by sex, were included. Risk of bias was assessed using tools developed by the CLARITY group at McMaster University. Outcomes were summarized narratively.</p><p><strong>Results: </strong>Fifty-five studies (including 25,952,718 total participants) were included. Among children and adolescents, short sleep was associated with poorer biopsychosocial health, particularly among girls. Sleep was affected by the menstrual cycle, and sleep difficulties were more prevalent among adult women than men. The perinatal period was fraught with sleep disturbances that influenced key aspects of motherhood. Sleep dissatisfaction was prevalent among perimenopausal and older women.</p><p><strong>Conclusion: </strong>Canadian women have different sleep patterns than men, and their sleep is negatively affected in uniquely female life transitions. Poor sleep is influenced by, and impacts, women's health and behaviors. Characterizing these differences is an important step toward improving sleep health, and thus overall well-being, for women. Future research would benefit from further exploration of the role of social determinants of health and sleep.</p><p><strong>Registration: </strong>PROSPERO CRD42024582007.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251367141"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144982122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unlocking breast cancer in Brazilian public health system: Using tissue microarray for accurate immunohistochemical evaluation with limitations in subtyping.","authors":"Rubia Denise Ruppenthal, Emily Ferreira Salles Pilar, Jordan Boeira Dos Santos, Rafael Correa Coelho, Carina Machado Costamilan Henriques, Diego de Mendonça Uchôa, Marcia Silveira Graudenz","doi":"10.1177/17455057241304654","DOIUrl":"10.1177/17455057241304654","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer (BC) is a significant burden on healthcare systems, especially in low- and middle-income countries where access to diagnosis and treatment is challenging.</p><p><strong>Objectives: </strong>The purpose of this study was to assess the diagnostic accuracy and cost using tissue microarray (TMA) instead of traditional immunohistochemical (IHC) evaluation for estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2 (HER2), and the proliferation marker Ki-67 and BC subtyping within the Brazilian public health system.</p><p><strong>Design: </strong>This is a retrospective cohort study comparing TMA slides with traditional whole-slide evaluation for IHC markers in 242 BC cases.</p><p><strong>Methods: </strong>We used formalin-fixed tissue blocks for TMA assembly. Clinical data and IHC scores for ER, PR, HER2, and Ki-67 were obtained from pathology reports. Cohen's kappa (<i>k</i>) was used to assess TMA performance.</p><p><strong>Results: </strong>BC samples were distributed in 10 TMAs and 968 cores were scored (242 BC cases × 4 markers). In 97% of these, TMA reached high quality to adequate IHC scoring with minimal technical issues. Inter-examiner agreement was almost perfect for all markers (ranging from 0.85 for HER2 to 0.91 for ER, <i>p</i> < 0.001). The intratumoral heterogeneity ranged from almost perfect agreement for ER and HER2 to moderate to substantial for PR and Ki-67. TMA offers substantial time and cost savings, with an approximately 11-fold reduction compared to traditional methods. The concordance between TMA and original reports was almost perfect, with 93% overall agreement (<i>k</i> = 0.81, <i>p</i> < 0.001). However, TMA performance varied between markers, with intratumoral heterogeneity significantly impacting discordant results, particularly for Ki-67 and HER2. This ultimately affected the accuracy of BC subtyping. TMA performed well in identifying luminal A and triple-negative cases, but misclassification was common for luminal B and HER2-positive cases.</p><p><strong>Conclusion: </strong>TMA offers accurate and lower-cost results in the individualized IHC assessment of BC markers. However, we do not recommend the use of TMA in the subtyping of BC, where analysis of the whole section remains necessary for more accurate results. We advocate more studies using the TMA approach in the Brazilian public health system to advance women's health care.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057241304654"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Person-centered maternity care and satisfaction with post-abortion care: A facility-based cross-sectional survey in Northern Uganda.","authors":"Samson Udho, Emmanuel Ekung, Deborah Andrinar Namutebi, Josephine Aryek-Kwe, Abraham Rubaihayo, Marvin Musinguzi, Eustes Kigongo, Annaloice Penduka, Yvonne Delphine Nsaba Uwera, Bosco Opio, Jasper Ogwal-Okeng","doi":"10.1177/17455057251318897","DOIUrl":"10.1177/17455057251318897","url":null,"abstract":"<p><strong>Background: </strong>The experience of post-abortion care (PAC) is crucial to the quality of PAC services. However, there is limited literature on women's experience with PAC, particularly the aspects of person-centered maternity care (PCMC) and satisfaction with PAC services.</p><p><strong>Objective: </strong>To examine the relationship between PCMC and satisfaction with PAC services.</p><p><strong>Design: </strong>A facility-based analytical cross-sectional study.</p><p><strong>Methods: </strong>A survey was conducted among 370 women aged 15-49 who sought PAC services at public health facilities in Lira city, Northern Uganda. Data were collected using a validated questionnaire. Data analysis included descriptive statistics, the Spearman correlation test, and multiple linear regression.</p><p><strong>Results: </strong>The mean age of study participants was 26.1 (±6.3) years. The overall PCMC median score was 21.5 (interquartile range (IQR): 11) out of 36. The median scores for the sub-scales were as follows: 6 (IQR: 6-6) for dignity and respect out of 9; 9 (IQR: 5-13) for communication and autonomy out of 18; and 8 (IQR: 6-9) for supportive care out of 9. Satisfaction with PAC services' score ranged from 6 to 42, and the median satisfaction score was 30 (IQR range: 28-32). Bivariate analysis revealed a weak but significant correlation between the overall PCMC scale and satisfaction with PAC services (<i>r</i> = 0.21, <i>p</i> < 0.001). Sub-scales of dignity and respect and communication and autonomy also had a weak but significant correlation with satisfaction with PAC services (<i>r</i> = 0.16, <i>p</i> = 0.002, and <i>r</i> = 0.21, <i>p</i> < 0.001 respectively). In a linear regression model, communication and autonomy score was significantly associated with higher satisfaction with PAC score (<i>β</i> = 0.10; 95% confidence interval (CI): 0.01, 0.19; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>PCMC, particularly the aspects of communication between clients and providers and the promotion of clients' autonomy, is associated with higher satisfaction with PAC services. Efforts to increase clients' satisfaction with PAC should focus on strengthening communication between clients and providers and promoting clients' autonomy during care.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251318897"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}