搜索结果：Obstetrical & gynecological survey

In Afghanistan, little is known about menstrual hygiene management (MHM) and the social isolation women experience during menstruation. Drawing on the nationally representative 2022-23 Afghanistan Multiple Indicator Cluster Survey (MICS), we quantified the prevalence of appropriate MHM and menstrual-related social exclusion and examined their sociodemographic drivers. We conducted a cross-sectional analysis of 40,330 women aged 15-49 years who responded to questions on MHM, corresponding to those who had menstruated in the past year preceding the survey. "Appropriate MHM" was defined as the use of a sanitary pad, tampon, or clean cloth, plus access to a private space for changing or washing. "Social exclusion" captured any missed social activities, work, or schooling due to menstruation. Survey-weighted logistic regression models estimated adjusted odds ratios (AORs) for both outcomes, including interaction and stratified analyses by place of residence. Overall, 86.0% of women met criteria for appropriate MHM, yet 30.2% reported menstrual-related social exclusion. Provincial estimates of appropriate MHM varied widely (49.4% in Jawzjan to 98.5% in Khost), and social exclusion ranged from 2.7% (Ghor) to 79.0% (Faryab). After adjustment, women in rural areas (AOR: 1.91, 95%CI: 1.53-2.37), those with internet access (AOR: 1.50; 1.19-1.90), and those from the richest wealth quintile (AOR: 1.66; 1.22-2.26) had significantly higher odds of appropriate MHM. Never-married women had lower odds of appropriate MHM (AOR 0.86; 0.75-0.97). The odds of social exclusion were lower in women aged 18-24 (AOR: 0.87; 0.78-0.96), 25-34 (AOR: 0.79; 0.70-0.89), and 35-49 (AOR: 0.86; 0.76-0.98). However, mobile-phone ownership was associated with higher odds of social exclusion (AOR: 1.20; 1.08-1.33). A significant interaction by residence (p&#x2009;<&#x2009;0.001) indicated that lack of adequate MHM was associated with higher odds of social exclusion among urban women (AOR: 1.46; 1.07-2.00), whereas in rural areas it was associated with lower odds (AOR: 0.68; 0.56-0.82). Although the majority of Afghan women report appropriate MHM, nearly one-third still experience social exclusion during menstruation. Policy efforts should prioritize low-tech, community-based approaches to address menstrual health challenges, particularly among unmarried and economically disadvantaged women, while considering digital platforms as complementary tools for subgroups with existing access.

Women's perceptions of long-term outcomes of assisted reproductive technology (ART) remain underexplored in the United Kingdom. National database studies investigating these outcomes may provide clearer information. This survey investigates women's perceptions of: long-term ART outcomes, information provision on these outcomes, and such national database studies. Over an 8-month period, women who had undergone ART, were considering ART, or had conceived naturally completed an anonymous, cross-sectional survey distributed via social media. Descriptive and inductive, semantic thematic analyses were performed. Of 562 respondents, most were aged 25-40 (72.4%) and underwent private ART (37.9%). Most reported no concerns about maternal health (51.8%), child health (66.9%) and child education (82.5%). Reported concerns focused on maternal reproductive, cancer and endocrine outcomes, and child reproductive, neurodevelopmental, developmental and learning outcomes. Information on long-term outcomes was frequently not provided by fertility clinics (up to 91.9%). While up to 68.3% considered national database studies useful for investigating offspring outcomes, some raised data confidentiality concerns. Dissemination via healthcare professionals sensitively pre-treatment was preferred. Overall, most women reported no concerns about and received no information on long-term ART outcomes in maternal health, child health and child education. Improving clinician-led information provision may address knowledge gaps and support research dissemination.

Hypertensive disorders of pregnancy represent a major cause of maternal and fetal morbidity and mortality. Despite primary aldosteronism (PA) being the most common cause of secondary hypertension, there is limited data on pregnancy complications in patients with PA. We conducted an international survey across 5 Hypertension Centers in Europe to gather data on maternal and neonatal complications in women diagnosed with PA from 2000 to 2022. We included 102 women aged 18 to 45 years at PA diagnosis who were pregnant either after or <1-year before the diagnosis of PA. The first eligible pregnancy for each patient was included. Overall, 56% of pregnancies were complicated, with the most frequent complications being maternal preeclampsia (36%), preterm birth (30%), low birth weight (30%), and neonatal intensive care admission (22%). Hypokalemia occurred in 31% of pregnancies. Pregnancies occurring before PA diagnosis presented a poorer blood pressure control and were associated with higher rates of overall, maternal, and fetal/neonatal complications compared with pregnancies in patients with an established PA diagnosis. Independent predictors of complications included uncontrolled blood pressure values during pregnancy (odds ratio [OR], 7.05), undiagnosed PA (OR, 4.37), North/Black African ethnicity (OR, 3.69), a higher body mass index (OR, 1.09), and treatment with a higher number of antihypertensive drugs at PA diagnosis (OR, 2.18). PA is associated with a high rate of pregnancy-related complications, predominantly preeclampsia. Undiagnosed PA during gestation significantly increases the risk of adverse outcomes. Early identification and optimized hypertension control in women with PA are critical to improve maternal and fetal outcomes.

Mayer-Rokitansky-K&#xfc;ster-Hauser (MRKH) syndrome is characterised by congenital underdevelopment of the uterus and vagina. While absence of menstruation might be expected to reduce pelvic pain, the prevalence and nature of pain syndromes in MRKH are not well established. To determine the prevalence and severity of self-reported chronic pelvic pain (CPP) and generalised persistent pain (GPP) in a large Australian sample of women with MRKH, and to compare findings with general population estimates. A cross-sectional online survey was conducted in collaboration with MRKH Australia. Validated questionnaires were used to assess CPP and GPP, somatic symptom burden, and depressive symptoms. Data on age, self-reported uterine remnant status, and prior diagnosis of fibromyalgia were also collected. Among 142 participants (median age 32, range 18-71), 34.0% reported no pelvic pain in the preceding three months, while 38.3% reported moderate to severe CPP. Overall, 3.5% reported a diagnosis of fibromyalgia, comparable to global female prevalence, and 55.2% reported depressive symptoms. Younger participants described a higher burden of somatic symptoms. Pelvic pain was strongly associated with increased likelihood of GPP. Women with MRKH experience moderate to severe CPP and GPP symptoms at rates comparable to those reported in the general female population. This study was designed to estimate the prevalence and severity of pelvic and generalised persistent pain, rather than to determine specific pain aetiologies. Early recognition of pain symptoms and integration of holistic, patient-centred care addressing both somatic and psychosocial contributors are recommended.

BackgroundAdolescent girls in rural fishing communities in Uganda engage in early sexual activity, putting them at risk of unintended pregnancies and sexually transmitted infections. Moreover, the fishing communities in Uganda are among the populations with low educational attainment, a factor linked to low contraceptive usage. This makes fishing communities in Uganda among the subpopulations with the greatest need for sexual and reproductive healthcare. However, the modern contraceptive practices of adolescent girls in the rural fishing communities of northern Uganda are unclear.ObjectivesWe aimed to identify modern contraceptive utilisation and its determinants among adolescent girls in the fishing communities of rural northern Uganda.DesignThis was a descriptive cross-sectional study.MethodThe study involved adolescent girls aged 15-19 from four fishing communities in rural northern Uganda. Data were collected through face-to-face interviews via structured questions. Data analysis involved descriptive statistics and modified Poisson regression at a 95% confidence interval via STATA 17. Both crude and adjusted prevalence ratios were reported.ResultsOut of the 577 adolescent girls, 55.3% were aged 17-19 and 50.1% reported current sexual activity. The proportion of sexually active adolescent girls who had ever used a modern contraceptive was 47%. The prevalence of modern contraceptive method utilization was 94% higher among adolescent girls who were currently employed compared to those who were not, and 98% higher among adolescent girls who had at least one child compared to those who did not have any.ConclusionsThe level of modern contraceptive utilisation was at 47% among sexually active adolescent girls. Their contraceptive use was shaped by their lived reproductive experiences and economic engagement. We recommend strengthening adolescent-friendly services and expanding opportunities for their economic participation. BackgroundAdolescent girls in rural fishing communities in Uganda engage in early sexual activity, putting them at risk of unintended pregnancies and sexually transmitted infections. Moreover, the fishing communities in Uganda are among the populations with low educational attainment, a factor linked to low contraceptive usage. This makes fishing communities in Uganda among the subpopulations with the greatest need for sexual and reproductive healthcare. However, the modern contraceptive practices of adolescent girls in the rural fishing communities of northern Uganda are unclear. The study aimed to identify the use of modern family planning and the reasons for use among adolescent girls in the fishing communities of rural northern Uganda.MethodThis study conducted face-to-face interviews with 577 adolescent girls aged 15--19 from four fishing communities in rural northern Uganda. The adolescent girls were assessed if they were using or not using any of the modern family planning methods and were also asked some of the reasons why they used or did not use family planning methods. The information given by the teenage girls was analysed, and the results were presented.ResultsA total of 577 adolescent girls were interviewed from 12 villages and 633 households. Half of the interviewed girls (50.1%) were sexually active. The proportion of sexually active adolescent girls who had ever used a modern family planning method was 47%. The adolescent girls who were working or had been pregnant before were more likely to use modern family planning compared to those who were not employed, and those who had not been previously pregnant.ConclusionsThere was a low level of modern family planning use among sexually active adolescent girls in the fishing communities of rural northern Uganda. Girls who were having jobs and those who had been pregnant were the ones commonly using family planning methods. We recommend making family planning services more friendly to the adolescent girls and providing them with job opportunities.

Pregnant patients were surveyed to determine marijuana use, their interest in additional education of the risks marijuana use in pregnancy, and if they had been educated by their providers about these. Fisher's exact tests were used to determine significant differences in both demographics and survey answers on provider education between those who used and did not use marijuana during pregnancy. 409 patients were surveyed with 367 completing the survey. 87 participants (23.7%) of those surveyed endorsed marijuana use in their current pregnancy. Significant differences between those who used marijuana and those who did not were seen in race/ethnicity (17.1% among White people versus 38.9% among those of other race/ethnicity; p&#x2009;=&#x2009;0.017), age (with 33.3% of 18-24 year olds reporting the highest use vs. 0.0% of &#x2265;&#x2009;40 year olds reporting the lowest use; p&#x2009;=&#x2009;0.014) and education level (with those who had not completed high school reporting the highest rates of use, p&#x2009;=&#x2009;0.001). 15.3% of all respondents received counseling on the risks of marijuana use during pregnancy. Among those who used marijuana, 25.3% received the counseling, compared to 12.1% of those who did not use (p&#x2009;=&#x2009;0.003). 41.4% of those who used marijuana expressed an interest in additional information on this topic, significantly higher than those who did not use (p&#x2009;<&#x2009;0.001). A gap exists in the area, as only 25%of pregnant patients who used marijuana reported receiving counseling, compared to the 41% who stated a desire for additional information. This emphasizes the need for both accessible resources on how marijuana affects both the pregnant mother and infant, as well as education for providers on this gap in care.

Sensory behaviors are common, clinically relevant features of many neurodevelopmental disorders, including autism. However, existing assessments lack granularity in evaluating hypersensitivity and hyposensitivity, particularly in relation to stimulus intensity. We address this gap with our Sensory Response Questionnaire Phenotyper (SRQP), a parent-questionnaire that comprehensively assesses sensory behaviors across five sensory modalities. The purpose of this study was to validate the SRQP against established tools and assess its efficacy in identifying nuanced sensory processing patterns in children with autism. A convenience sample of 317 participants (57 with autism, 260 typically developing) aged 3-17 years were enrolled in a cross-sectional study. The SRQP's psychometric properties were analyzed using classical test theory and item response theory. Statistical tests were used to evaluate sensory processing patterns from SRQP results. Data from 271 participants (69% female, 83% white, 84% Hispanic) were included. The SRQP demonstrated strong psychometric properties. A receiver operating characteristic (ROC) curve analysis identified 37 as the cut-off value that most accurately distinguishes between typical and atypical responses on the SRQP (sensitivity 0.75, specificity 0.79, AUC 0.87). Total but not modality-specific hyper vs hyposensitivity scores were moderately correlated (&#x3c1; = .5). Responses to high-intensity stimuli were not correlated with responses to low-intensity stimuli for auditory, visual, taste, or tactile hyposensitivity (&#x3c1; < .4). The SRQP is a new validated parent questionnaire that assesses sensory behaviors' multi-dimensional properties. Stimulus intensity is an important parameter of sensory behaviors that future models should account for.

Clinical trial participants rarely represent the real-world treatment population, potentially due to costs associated with participation. Monetary reimbursement for trial-related costs could address financial barriers to trial recruitment and retention. This mixed methods, pilot, feasibility study provided financial reimbursement to women with breast cancer participating in a clinical trial. Patients were reimbursed $1,000/month during their first four months of trial participation, surveyed biweekly to assess changes in financial toxicity, then interviewed to explore the effects of receiving reimbursement on trial-related costs and recruitment and retention. Mixed-effect modeling and thematic analysis were completed. Feasibility was defined as 80% retention of patients on the reimbursement study, with those retained completing 75% of surveys. Of 39 consented patients, 33 patients completed the pilot study (85% retention, 100% survey completion). Patients were a median 52&#x2009;years old (IQR 44 to 59), 48% Black, 67% privately insured, and 42% found it difficult to live on their current income. Patient financial toxicity modestly decreased. Patients (n&#x2009;=&#x2009;32) reported using the reimbursement to pay for trial visit-related food, transportation, caregiver expenses, and out-of-pocket medical costs. Patients felt receiving reimbursement affected trial retention more so than recruitment, stating "I would have enrolled regardless&#x2026;[but knowing] it wasn't going to place a financial strain on us because of these reimbursements&#x2026;It made it easier for me to feel good about continuing." Reimbursement for clinical trial-related costs is feasible, suggests decreases in financial toxicity, and is a promising approach to improve trial retention outcomes in women with breast cancer. NCT05871125.

Cervical cancer is a significant health concern worldwide, and early detection through screening and vaccination can significantly reduce its burden. This study investigated the factors influencing cervical cancer screening and HPV vaccination among doctors in Punjab, India. A cross-sectional study was conducted using an online survey among 616 female doctors in Punjab, India. The survey assessed doctors' knowledge, attitudes, and practices regarding cervical cancer screening and HPV vaccination, as well as their Barriers and influences. The data were analysed using the chi-square test, multivariable binary logistic regression, and the Kruskal-Wallis Test. The study found varying levels of knowledge among different cadres of doctors, with gynaecologists exhibiting higher comprehensive knowledge scores than non-clinician doctors. Attitudes towards cervical cancer screening and HPV vaccination differed significantly among the surveyed doctors, with non-clinician doctors showing more positive attitudes compared to gynaecologists. Doctors' professional cadre, age, marital status, practising area, length of practice, and parity were significantly associated with getting screened for cervical cancer. HPV vaccination was associated with doctors' professional cadre, religion, current practice area, and sexual activity status. The study highlights the importance of targeted interventions and awareness campaigns tailored to different healthcare provider groups, particularly gynaecologists and older doctors, to improve cervical cancer screening and HPV vaccination rates. The study also emphasises the need for tailored educational programs to enhance awareness among all medical professionals, especially non-clinician doctors, to bridge knowledge gaps.

Effective integration of perinatal mental health care into primary care settings faces several challenges. This exploratory cross-sectional study aims to survey nurses to understand their experience and skills in identifying perinatal depression. A total of 101 nurses in the Departments of Obstetrics/Gynecology and Neonatology of a General Hospital in Urban Bangalore were administered a survey to obtain information on their practice, experience, and skills and their perceived role in screening for perinatal mental health problems. Two focus group discussions were also conducted to elaborate on the findings of this survey. Nearly one-third of the respondents (32.7%) indicated that they often came across women who appeared to need a mental health assessment, while 27.8% reported that they had directed these women to psychological services. In addition, over half of the nursing staff (58.4%) stated that they were familiar with tools used to screen for perinatal depression. The nurses were receptive to receiving education on mental health and considered it feasible and within their scope of work to identify perinatal depression. Gaps in knowledge about perinatal depression, lack of time, and stigma were identified as barriers to screening, and accessibility to patients and ease of communication due to proximity were identified as facilitators for screening in the focus group discussion. The nurses demonstrated awareness about perinatal depression and had high interest in undergoing further training and were confident of incorporating screening for depression along with routine perinatal care.

Providing high-quality family planning services is one of the cornerstones&#xa0;for improving maternal and child health outcomes, and the intrauterine contraceptive device (IUD) is among the most cost-effective contraceptive methods available. Despite this, IUD use among&#xa0;women in Meghalaya remains very low.&#xa0;There is a strong need to understand the gaps in our system and monitor the delivery of services in order to optimize the existing services and ensure that the right impact is achieved in the community.&#xa0;To address this gap, a multiphase implementation research project, which included a Formative phase, Co-Implementation phase, and Iteration and Dissemination phases, was undertaken to increase IUD uptake.&#xa0;The formative phase of the study aimed to assess knowledge, attitudes, and practices (KAP) related to IUD use and to identify key barriers to its uptake. This research study has been planned to facilitate the coming together of all stakeholders across the broad spectrum of health systems to ensure maximizing the beneficial impact of using the IUCD as a spacing device.&#xa0;The&#xa0;Formative phase utilized a mixed-methods design combining&#xa0;a quantitative method via a cross-sectional KAP survey (n = 1,064), along&#xa0;with the qualitative methods (49 in-depth interviews and&#xa0;three focus group discussions).&#xa0;A KAP survey assessed KAP; qualitative interviews and focus group discussions (FGDs; guided by the WHO Health Systems Framework) explored barriers and facilitators to IUD uptake.&#xa0;East Khasi Hills and Ri Bhoi districts were chosen, covering urban, semiurban, and rural settings across Subcenters, Primary Health Centers, Community Health Centers, and a tertiary hospital. A KAP survey assessed KAP; qualitative interviews and FGDs explored barriers and facilitators to IUD uptake. Awareness of contraception was high (1,015 (95.4%) and 959 (90.1%) specifically for IUDs), but only 141 (13.3%) had ever used an IUD. Common barriers included fear of side effects, myths/misconceptions, spousal/family disapproval, and inadequate counseling. IUD use was more frequent among women with more than two children and an older youngest child. Despite widespread awareness, IUD uptake remains low due to persistent sociocultural barriers and health system gaps. Targeted counseling, strengthened provider training, and male engagement are essential to overcome these barriers and improve IUD uptake. Bridging this divide requires context-specific strategies that strengthen provider competence, foster community trust, and engage both men and families in open dialogue.

In the management of gestational diabetes mellitus (GDM), the usual medical treatment requires frequent visits for glucose monitoring and insulin dose adjustment, and this imposes significant physical, psychological, and economic burdens on pregnant women. As mobile health platforms become increasingly integrated into diabetes care, telemedicine may help alleviate these burdens; however, evidence evaluating its effectiveness as a replacement for routine in-person GDM care remains limited. This study aims to evaluate the impact of telemedicine on the quality of life and costs for patients with GDM requiring insulin therapy. This single-center, 2-arm, randomized, open-label, parallel-group study included patients with GDM who started insulin injection therapy. Participants were randomized to either the telemedicine or standard face-to-face care groups for 10 (SD 2) weeks. The telemedicine intervention used a smartphone-linked platform that enabled the automatic transfer of glucose data from connected glucose meters and facilitated real-time video consultations. Primary end points included costs and patient satisfaction. Costs were assessed using claims data, transportation calculations, and wage-based productivity losses, while patient satisfaction was evaluated through changes in the Problem Areas in Diabetes Survey and Diabetes Therapy-Related Quality of Life questionnaire scores. Secondary outcomes included glycemic control and perinatal outcomes. In total, 38 participants were included, with 18 assigned to the telemedicine group and 20 to the standard care group. Total costs (32,712, 95% CI 15,412-50,013 vs 59,202, 95% CI 42,603-75,800 Japanese yen; $284, 95% CI 134-435 vs $515, 95% CI 370-659, purchasing power parity [PPP]-adjusted; P=.01), direct non-health care costs (922, 95% CI -240 to 2084 vs 2561, 95% CI 1447-3676 yen; $8, 95% CI -2 to 18 vs $22, 95% CI 13 to 32 PPP-adjusted; P=.02), and indirect costs (8981, 95% CI -7119 to 25,082 vs 32,832, 95% CI 17,384-48,279 yen; $78, 95% CI -62 to 218 vs $285, 95% CI 151-420 PPP-adjusted; P=.01) reduced significantly in the telemedicine group compared with the standard care group. The improvements in the Problem Areas in Diabetes Survey (-7.6, 95% CI -13.7 to -1.4; P=.02) and Diabetes Therapy-Related Quality of Life domain 1 (10.5, 95% CI 0.9-20.1; P=.03) scores from the baseline were significantly greater in the telemedicine group than that in the standard care group. Nonetheless, glycemic control and frequency of perinatal complications were comparable between the 2 groups. Consultation time was similar across groups, suggesting no added workload for clinicians. In this randomized trial, mobile health-enabled telemedicine safely replaced routine in-person visits for patients with GDM requiring insulin therapy. Telemedicine significantly reduced psychological and economic burdens without compromising glycemic or perinatal outcomes, demonstrating its value as a patient-centered and cost-efficient model of care. These findings support the broader implementation of mobile-based telemedicine approaches in GDM management.

Objective Determine the efficacy, feasibility, and attitudes surrounding lecture-based and hands-on ergonomic training in junior obstetrics and gynecology residents. Methods A mixed-methods prospective pre-post study evaluating the efficacy of a new didactic lecture and one-on-one hands-on ergonomics workshop for junior residents. Paired sample t-test was used to compare pre- and post- survey scores. Posture was evaluated using the Rapid Upper Limb Assessment (RULA) tool. Results Of the nine participating residents, the average age was 27.33 years, 8/9 (88.9%) identified as cis-female, and 8/9 (88.9%) were in post-graduate year one. Zero (0%) and 4/9 (44.4%) reported exposure to any formal or informal ergonomics education in residency thus far, respectively. When comparing pre-and post-intervention survey data, residents identified improved knowledge of surgical ergonomics, increased awareness of available guidelines, improved perception of the importance of ergonomics training in residency, and stronger belief that time should be allocated to surgical ergonomics training in residency (p<0.001, p=0.020, p=0.034, and p=0.011, respectively).&#xa0; On average, RULA scores improved following intervention (4.00&#xb1;0.71 vs 3.56&#xb1;0.53, p=0.052), including 1 point improvement for the majority of participants (n=5/9, 55.6%), no change for three residents (33.3%), and only one subject with worsening posture (11.1%), these results were not statistically significant. Conclusions Lecture-based and hands-on ergonomic training was a feasible and acceptable strategy to improve posture, improve awareness and knowledge of surgical ergonomics, and change attitudes regarding the importance of surgical ergonomics education during residency. Future studies should expand ergonomics education to all residency years and review whether this formal curriculum confers long-lasting change in a learner's ergonomics.

Sex toy use is a common yet complex component of female sexuality, often serving dual roles as an enhancement tool or a functional necessity. Grounded in a biopsychosocial framework, this study examined the associations between sex toy usage patterns, sexual functioning, and sexual risk behaviors in young adult women. An online cross-sectional survey was conducted among 199 female university students using the Female Sexual Function Index (FSFI), the Sexual Risk Survey (SRS), and a study-specific questionnaire on erotic accessory usage. Over 50% of women reported using sex toys during masturbation, and 30% integrated them into partnered activity. Multivariate regression analysis revealed that while the 'perceived necessity of a sex toy for orgasm' was a significant independent negative predictor for specific FSFI domains- arousal, lubrication and orgasm -it did not independently predict the total FSFI score. Furthermore, frequent toy use during masturbation emerged as an independent positive predictor of FSFI arousal domain. Higher frequency of sex toy use across both solo and partnered contexts was independently associated with an increased propensity for sexually risky behaviors across all SRS domains. Incorporating erotic accessories serves as a positive intimacy-enhancing strategy in stable relationships, while subjective reliance on these devices represents a functional adaptation to reach physiological thresholds rather than a marker of global sexual impairment. The correlation between frequent usage and elevated sexual risk scores underscores the need for stigma-sensitive sexual health education focused on safe exploration and hygiene.

Fast food is a highly prevalent choice of diet for Female university students because of its convenience and Affordability. Whichever the reason, good nutrition is vital for the best health and well-being. The issue is that, although the adequate intake of nutrients is crucial to health, relying too much on fast foods can lead to poor health consequences. The eating behavior of university women is usually influenced by social influences, time constraints, and financial limitations. This study investigated factors correlating with fast-food consumption and their relation to identity formation among 385 female university students in Egypt. A mixed-methods approach was used involving both survey and focus group techniques. These methods involved A survey that included participants' sociodemographic, eating habits, fast food knowledge, and attitudes about consumption; control perception related behaviors; subjective norms; and intentions. showed moderate awareness regarding risk factors associated with fast food (mean&#x2009;=&#x2009;5.37&#x2009;&#xb1;&#x2009;1.74), though 67.8% considered fast food to be tasty. That awareness of health risks does not necessarily diminish its appeal. Attitudes toward fast food are moderately favorable (mean&#x2009;=&#x2009;92.63&#x2009;&#xb1;&#x2009;15.06), though 57% believe fast food causes obesity. There was a significant relationship between perceived behavioral control (mean&#x2009;=&#x2009;58.39&#x2009;&#xb1;&#x2009;9.47), which was influenced by craving and lack of time (p&#x2009;<&#x2009;0.01). The subjective norms indicated that 74.3% considered family members' approval important (p&#x2009;<&#x2009;0.05). The result showed that intentions to reduce fast food behavior are moderately favorable (mean&#x2009;=&#x2009;30.22&#x2009;&#xb1;&#x2009;3.52). The result showed that obese subjects scored high values for all constructs compared to nonobese subjects (p&#x2009;<&#x2009;0.01). Family income was found to positively correlate with values for all constructs (p&#x2009;<&#x2009;0.05), though there was no significant association between parental education (p&#x2009;>&#x2009;0.05). High values positively associated with attitude (r&#x2009;=&#x2009;0.826), attitude (r&#x2009;=&#x2009;0.331), perceived behavioral control (r&#x2009;=&#x2009;0.202), and subjective norms (r&#x2009;=&#x2009;0.253), which indicated association between attitude and intention (p&#x2009;<&#x2009;0.001), attitude and intention (p&#x2009;<&#x2009;0.01), perceived behavioral control (p&#x2009;<&#x2009;0.05), subjective norms (p&#x2009;<&#x2009;0.01), respectively. From these results, it appears that interventions based on attitude, perceived behavioral control, or social influences-focusing on self-efficacy-enhancing or socially influenced eating behavior-may prove to be more effective in encouraging healthier eating behaviors in female university-age students. Our study was registered retrospectively with Clinicaltrials.gov under the identifier NCT06783959 on 29 January 2025.

This study aimed to examine reproductive health and the experience of adolescents and young adult females with sickle cell disease (SCD). We investigated reproductive health experiences of adolescents and young adults aged 13-21 with SCD, examining menstruation's impact, sexual activity patterns, contraceptive use, and counseling received at Children's National Hospital. A cross-sectional quality improvement project surveyed seventy-five females with SCD (ages 13-21) presenting to routine hematology visits from April - December 2024. We administered a 20-question survey that included sexual activity, pubertal, menstrual, and contraceptive history. The median age of thelarche and menarche was 12 years; 12% of participants reported heavy periods or bleeding for >7 days. Seventy-five percent used hydroxyurea therapy. Twenty-three participants (31%) were sexually active, with 100% using contraception; 34.78% hormonal and 65.2% non-hormonal types. Only 25% received contraceptive counseling, significantly associated with older age (p=0.01). Participants >18 years old reported significantly more pain crises related to menses (46.15%) than those 13-18 years (8.33%), p<0.001; no significant difference in catamenial pain crises between those on hormonal vs. non-hormonal contraception 57.1% vs. 33.33% respectively (p=0.38). This study revealed significant age-related patterns in menstruation-associated pain crises and contraceptive counseling among SCD adolescents and young adults. Despite high contraceptive use among sexually active participants, overall contraceptive counseling rates remain low. The high prevalence of disease-modifying therapies such as hydroxyurea may influence pubertal timing compared to historical data, suggesting evolving reproductive health patterns in contemporary SCD management.

BackgroundOver 20 million people in the U.S. are behind on cervical cancer screenings (CCS). Sexual minority populations are 50% less likely to engage in routine screening, putting them at higher risk for cervical dysplasia and cancer due to undetected precancer and delayed diagnosis. Their barriers to speculum exams include access to care, sexual trauma, and provider bias. At-home HPV self-collection (SC) offers a clinically accurate, preferred alternative screening method.ObjectiveTo assess clinical agreement, usability, and screening experiences and preferences for an FDA-authorized at-home vaginal SC device among participants who identify as lesbian, gay, bisexual, pansexual, queer, or other non-heterosexual identities (LGBQ+).MethodsSELF-CERV was a prospective, multi-site method-comparison study conducted across 16 U.S. sites. Participants completed SC in a simulated at-home setting and underwent clinician collection with a speculum and cervical brush; paired specimens were tested for primary HPV using the Roche cobas. Surveys assessed barriers to screening, prior screening experiences, usability, and preferences. 609 participants were enrolled; 599 had paired samples, including 74 LGBQ+ participants.ResultsCompared with heterosexual participants, LGBQ+ participants more frequently delayed or avoided screening, had lower preventive care engagement, and described worse prior speculum-based screening experiences, including higher pain, discomfort, and aversion. Clinical agreement between self- and clinician-collected specimens was comparable, with no unanticipated safety concerns. The SC device was rated as easy to use and acceptable across groups; LGBQ+ participants reported greater comfort and empowerment and a stronger preference for at-home self-collection. Qualitative comments emphasized privacy and reduced distress, including trauma- and dysphoria-related concerns.ConclusionAt-home SC is a clinically valid, usable, and strongly preferred CCS option, particularly among LGBQ+ populations who experience disproportionate barriers to speculum-based CCS. Broader adoption of FDA-authorized at-home SC paired with telehealth will enable future impact assessment to reduce persistent disparities in CCS for LGBQ+ populations. Cervical cancer can often be prevented through regular screening, but many people in the United States are behind on recommended tests. People who identify as lesbian, gay, bisexual, queer, or another sexual minority are less likely to get screened. Common reasons include discomfort or pain during clinic exams, past trauma, difficulty accessing care, and negative experiences with healthcare providers. This study looked at whether an at-home screening option could help reduce these barriers. Participants used the Teal Wand, a device that allows people to collect their own vaginal sample at home and mail it to a laboratory for HPV testing. The results were compared with samples collected by a healthcare provider during a clinic visit. The study included 609 participants, including 74 people who identified as a sexual minority. The at-home test was just as accurate as samples collected by a clinician. People who identified as a sexual minority were more likely to report pain and discomfort during past clinic exams and were more likely to have delayed or avoided screening in the past. When using the at-home option, sexual minority participants reported feeling more comfortable, more in control, and more empowered than during clinic-based screening. Most found the device easy to use and preferred at-home testing over a traditional exam. Many also said they would be more likely to stay up to date with screening if an at-home option were available. These findings show that at-home cervical cancer screening is a safe, effective, and more comfortable option, especially for people who face barriers to clinic-based care. Expanding access to at-home screening, along with telehealth support, may help reduce long-standing gaps in cervical cancer prevention and improve health outcomes for underserved sexual minority communities.

Antenatal care (ANC) is essential for improving maternal and fetal health outcomes, yet utilization remains suboptimal in Cameroon. This study explored pregnant women's perspectives on determinants of ANC utilization and perceived quality of care in the Buea and Limbe Health Districts, conceptualizing satisfaction both as an outcome of service quality and a contextual influence on continued utilization. An explanatory sequential mixed-methods design was employed, comprising a cross-sectional survey of 410 pregnant women attending public, private, and faith-based health facilities, followed by 20 in-depth interviews. Quantitative data were analyzed using descriptive statistics and multivariable logistic regression, while qualitative data were thematically analyzed and integrated through side-by- side comparison. Only 45.6% of participants achieved the World Health Organization-recommended minimum of eight ANC contacts. Adequate utilization was significantly associated with receiving care in public facilities, formal employment, lower parity, and timing of ANC initiation. The association between second-trimester initiation and adequate utilization reflects cumulative attendance patterns rather than optimal timing and should therefore be interpreted cautiously. Key barriers to ANC use included financial constraints, long waiting times, negative provider attitudes, and delayed disclosure of pregnancy. Although overall satisfaction with ANC services was relatively high, dissatisfaction persisted regarding waiting times, indirect costs, and the quality of health education. Qualitative findings highlighted the importance of respectful, nonjudgmental provider behavior, partner support, privacy during consultations, and clear communication in shaping women's engagement with ANC services. Improving ANC utilization and quality in Cameroon requires woman-centered, multisectoral strategies that address financial barriers, promote respectful maternity care, and strengthen community-based health education to encourage early initiation and sustained engagement.

Caring for a child with a chronic condition places enduring emotional, relational, and practical demands on families. A deeper understanding of how families adapt, and how nursing care supports this process, is essential to strengthen family-centered pediatric nursing practice. This study explored parents' perceptions of their family's adaptation to a child's chronic condition and examined how they viewed the role of nurses in this process across diverse European healthcare contexts. This qualitative sub-study was part of a multinational comparative project. Data comprised responses to three open-ended survey questions from parents of children (0-18&#xa0;years) living with chronic conditions. Thematic analysis was conducted following Braun and Clarke's six-phase framework. Two overarching themes were identified. Meaning-Making in the Context of Family Vulnerability and Growth described families' experiences of psychological and relational burden, unmet support needs, and gradual adaptive growth. Relational Care and Strengthening Family Agency captured how trust in professional competence, nurses' empathetic presence, and tailored guidance empowered families to manage care at home. Parents reported ongoing strain and uncertainty but also described resilience and a sense of shared purpose when supported by relational and continuous nursing care. Family adaptation to a child's chronic condition is a dynamic relational process shaped by both vulnerability and opportunities for growth. Nurses play a pivotal role in fostering trust, strengthening family agency, and alleviating emotional and practical burdens. Healthcare systems should prioritize continuity, relational depth, and accessible psychosocial and educational resources for families.