Psychoanalytic considerations of young women with endometriosis.

ObjectivesTo identify the determinants of institutional delivery among young married women in Nepal.DesignNepal Demographic and Health Survey (NDHS) data sets 2011 were analysed. Bivariate and multivariate logistic regression analyses were...

Review question/objective What are the psychosocial experiences of women with breast cancer across the lifespan, including similarities and differences in the psychosocial experiences of younger, middle-aged and older women with breast cancer? Inclusion criteria Types of participants This review will consider studies that include women with a breast cancer diagnosis of any type or stage, with the exception of a cancer recurrence. Women with a recurrence will be excluded since the experience of recurrence has been shown, through research, to be dissimilar to the experience of the first diagnosis and treatment of the disease. The experience of women in all treatment modalities will be included (i.e. lumpectomy, mastectomy of all types with or without breast reconstruction, chemotherapy, radiation therapy and hormone therapy). This review will consider studies that include age as a primary area of interest in the study design. That is, the study will focus on: 1) younger women or older women, or 2) a psychosocial issue and compare it across the lifespan from younger to older. The definition of “younger” and “older” will not be described by the reviewers prior to the review because no consensus has been reached in the literature about defining “young” and “old” in cancer. However, this will be observed in the studies and reported on in the analysis. Therefore, studies that identify the participants as “young” and/or “old”, and provide a range of ages of the participants, will be included. Studies will be excluded if they do not define their population(s) by age or if they combine younger and older populations together. Phenomenon of interest The phenomenon of interest is women’s psychosocial experience of breast cancer, including the social, psychological, emotional, spiritual and quality-of-life aspects of cancer. Context This review will include women from all geographical regions. It will also include all cancer care contexts (e.g. acute care hospital, ambulatory care setting, home care, primary health care).

Many scientific studies have shown the superiority of the Harvold method when performing linear measurements for both the upper and lower jaw. The purpose of the work is to construct and analyze the regression models of teleroentgenographic indices used in the method of E.P. Harvold young men and women with normal occlusion close to orthognathic bite and harmonic face. The analysis of lateral teleroentgenograms of 38 young men (aged from 17 to 21) and 55 young women (aged from 16 to 20 years) with normal occlusion close to orthognathic bite and harmonic face, obtained using the Veraviewepocs 3D device, Morita (Japan), was performed according to the techniques of R.M. Ricketts, C.J. Burstone, E.P. Harvold. In the course of the study, all the indicators of the above methods, were divided into three groups: 1 – metric characteristics of the skull, which usually do not change during surgical and orthodontic treatment; 2 – indicators of the tooth-jaw system that allow people with already formed bone skeleton to change the width, length, angles and position of the bones of the upper and lower jaws; 3 – indicators that characterize the position of each individual tooth relative to each other, to the bony cranial structures and face profile. In the licensed package “Statistica 6.0”, regression models were constructed for the following parameters included in the second group, depending on the parameters of the first group: ANS-Сond (maxillary length in the Harvold method described as TM-ANS), Pog-Cond (mandibular length in the E.P. Harvold method is indicated as TM-PGN), Max-Mand – (difference in jaw lengths); as well as the index included in the third group, depending on the indicators of the first and second groups – Ap1uAp1l-DOP (angle Ap1uAp1l-DOP). In the young men, all three possible reliable models of teleroentgenographic parameters were constructed using the E.P. Harvold method, which were included in the second group, depending on the indicators of the first group (R2 = from 0.616 to 0.940), and in young women only the length of the upper and lower jaws (R2=0.857 and 0.792). In both young men and women, all models of the second group of models built according to the indicators of the first group included the distance P-PTV. Up to two models for young men and one model for young women included the distance Pt-N. Also, one model for young men and women included the angle of the cranial tilt (POr-NBa). Only young women have models for the front length of the skull base (N-CC). As for young men and women, we also built a reliable model of the third group indicator, depending on the indicators of the first and second groups (the angle Ap1uAp1l-DOP) (respectively, R2=0.626 and R2=0.584). And in young men and women, the size of the distance A-B is included to the constructed regression equations. In addition, in young men, the regression equation includes the value of the distance P-PTV; while in young women - the angles of the ANS-Xi-PM, MeGo-NPog and N-CF-A, as well as the difference in jaw lengths Max-Mand.

Genetic counseling and testing for hereditary cancer risk in young adult women: Facilitating autonomy and informed decision making is key

Body Image and Televised Images of Thinness and Attractiveness: A Controlled Laboratory Investigation

In the USA, an estimated one-in-two adolescent African American women have a sexually transmissible infection (STI). 1 In addition, African American women have the second highest rates of HIV infection of any race/ethnic and gender group, and 13-29-year-old women have the highest proportion of new HIV infections compared with all other age groups. 2 These findings represent a 'syndemic' for young African American women, where the STI and HIV epidemics are 'interacting synergistically to contribute to excess burden of disease'. 3or young African American women, the disproportionately high STI prevalence along with behavioural, biological and social circumstances signals the potential for the HIV epidemic to become more entrenched by creating an effective and efficient pathway for sexual transmission of HIV.First, due to higher STI prevalence rates within African American sexual networks, young African American women are at increased risk for STIs and HIV. 4 Second, the presence of certain STIs can increase the likelihood of HIV transmission by two-to fivefold. 5,6Third, adolescent women often have older male sexual partners, 7 which can set up a link from a higher HIV prevalence network of older men to a relatively low prevalence network of adolescent women. 8Fourth, the increased biological efficiency of HIV transmission from male to female in heterosexual intercourse 9 and the increased physiological susceptibility to HIV infection of young women because their cervical cells are more easily traumatised compared with older women 10 further intensify these high-to-low-prevalence transmission dynamics.When these factors are embedded in a larger context of high HIV prevalence, a move from a concentrated to a generalised HIV epidemic becomes possible.As seen in Washington D.C., high rates of incident HIV cases among women coincided with heterosexual sex as the primary transmission mode. 11e need to heed the early warning signs of this 'canary in the coal mine'.The STI rates among young African American women represent a window into where the HIV epidemic may be moving.We have an opportunity to intervene early in the epidemic trajectory; however, it is important that we develop, implement, and fund new and existing prevention for young African American women and their sexual partners that is proactive, integrated and comprehensive.

This paper describes a study which explored the lives of young Ugandan women through their voices, and related the findings to HIV prevention paradigms. The research was conducted in the context of the continuing vulnerability of young Ugandan women to HIV; reflected in disproportionately high prevalence compared to young men. The participants of the study were 15 young women aged 15–19 years, from Busoga Region in Eastern Uganda. Given the focus on young women's voices within norms of gender inequality, a narrative methodology was used as a safe space for participants to speak about their lives, expanding on research experiences with young people. The methods used included drawing; written stories and drama; aspirational writing and diary keeping. Forty-eight narratives, in image and word form, represented everyday experiences in young women's lives, as well as difficult experiences of inequality and resistance. Young women portrayed considerable social barriers to empowerment, and a challenging environment of poverty and educational limitations. Young women's representations were analysed using a gender empowerment and positive sexuality framework. The resulting analysis was then critically applied to HIV prevention paradigms. Evidence from the study showed that prevailing HIV prevention paradigms reinforce the difficulties faced by young women in their sexual lives. This research adds to calls for alternative and wider approaches to HIV prevention, underpinned by gender empowerment. Alternative approaches need to build young African women's voices in the spaces of homes, schools and communities. It is vital, however, that such efforts are embedded in more radical change leading to social environments receptive to the needs of young women.

The relationship between young adulthood, women and psychosis was the focus for this systematic review. Age and gender are factors that can influence responses to illness. Research indicates that there are differences in how young men and women are affected biologically and psychosocially, including the presentation of a constellation of symptoms, response to anti-psychotic medications and how they assess their life circumstances. Yet in literature that examines experiences of young people with psychosis, the specific needs of young women are usually not presented separately. To better understand and address young adult women's healthcare and social service needs, a synthesis of evidence addressing the relationship between young adulthood, women and psychosis is needed. The aim of this systematic review was to synthesize the best available evidence on the experiences of young adult women (aged 18-35 years) living with a psychotic illness in the community. Specifically, the review question was:What are the experiences of young adult women living with a psychotic illness? Participants were young women between 18 and 35 years of age who were living with a psychotic illness in the community. The phenomenon of interest was the experiences of living with a psychotic illness of women aged 18-35 years in the community. Experiences were defined broadly as and inclusive of perceptions and experiences with health and social systems. The context for this review was the community setting. The current review included studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research, feminist research and the qualitative component of mixed methods studies. A three-step search strategy was used to locate both published and unpublished studies. The search was limited to studies published from 1995 to the search date of May 13, 2015. Two reviewers independently appraised the nine included studies using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) assessment tool. Data were extracted from included papers using the standardized data extraction tool from JBI-QARI. Two reviewers independently reviewed the extracted findings to identify potential categories to pool similar findings. A third member of the team met with the reviewers to collaboratively review these derived categories to create a meta-synthesis that reflected a comprehensive set of synthesized findings. Based on the thematic findings from nine qualitative studies, two synthesized findings were identified: (1) the complexity of living with psychosis and finding health, and (2) the presence of harming and healing relationships in young women's lives. The included studies explored a range of experiences relevant for women within the broader phenomenon of experiences of living with a psychotic illness, including experiences within healthcare and social systems. The systematic exploration of the literature resulted in identification of nine studies of moderate-to-high methodological quality that met the inclusion criteria. The ConQual evaluation of the level of evidence resulted in synthesized finding 1 (the complexity of living with psychosis and finding health) rated as moderate and synthesized finding 2 (the presence of harming and healing relationships in young women's lives) rated as low. Practitioners can use these findings to guide practice. Further research exploring other experiences relevant for this population is needed.

The increasing incidence of cancer in younger women: What preventative strategy is best? (397)

SummaryThe aim of this study was to determine if bone-specific physical activity questionnaire (BPAQ) scores were positively related to bone health in healthy young and middle-aged premenopausal women. The total BPAQ was a stronger predictor of bone strength and bone mineral density of hip in young women as compared to middle-aged premenopausal women.PurposeThe purpose of this study was to determine whether the BPAQ scores were predictive indices of volumetric BMD (vBMD), bone strength, and bone geometry in young and middle-aged premenopausal women.MethodsHealthy young (n = 60) and middle-aged premenopausal women (n = 54) between the ages of 18 and 50 years were recruited for this study. Areal bone mineral density (aBMD) of lumbar spine and dual proximal femur (FN; femoral neck) was measured using DXA. We assessed vBMD of the tibia 4%, 38%, and 66% by peripheral quantitative computed tomography (pQCT). The BPAQ was used to obtain a comprehensive account of lifetime physical activity related to bone health.ResultsPearson’s correlation tests showed positive correlations between total BPAQ and aBMD of the right FN (r = 0.313, p = 0.015) and the left FN (r = 0.307, p = 0.017) in young women while not found in middle-aged premenopausal women (p > 0.05). A positive relationship was only observed between total BPAQ and tibia 38% vBMD in middle-aged premenopausal women (r = 0.283, p = 0.038). All bone geometry variables were associated with total BPAQ (r = 0.280–0.422, p = 0.03–0.001) in young women. The Strength-Strain Index of tibia 38% (r = 0.350, p = 0.006) and 66% (r = 0.406, p = 0.001) was associated with total BPAQ in young women. In both young and middle-aged premenopausal women, when age, bone-free lean body mass (BFLBM), and total BPAQ were included in a stepwise multiple linear regression analysis, BFLBM was a significant predictor of all aBMD variables, accounting for 7–25.7% (p = 0.043–0.001).ConclusionsThe total BPAQ score-derived physical activity was more predictive of positive bone characteristics in young women than in middle-aged premenopausal women.

Introduction: Breast cancer (BC) in women < 40 years old accounts for ~5% of BC diagnosed in the U.S. However, young women have more aggressive tumors and worse outcomes, including higher rates of recurrence and lower disease-free and overall survival, compared to older women. To better understand mechanisms for these disparities, an integrated proteogenomic study of tumors from young (< 40) and older (≥ 60) women was performed through the Applied Proteogenomics OrganizationaL Learning and Outcomes (APOLLO) program. Methods: 34 pairs of retrospectively collected, untreated primary breast tumors from young and older women, matched by immunohistochemistry (IHC) subtype and race, were selected from the Clinical Breast Care Project. Median patient follow-up was 7 years. Tumor cells were enriched by laser microdissection and analyzed using RNA sequencing, whole genome sequencing, global proteomics, phosphoproteomics, and reverse phase protein array (RPPA). Molecular and clinical data from tumors from young and old patients in the TCGA-BC and METABRIC studies, matched by IHC subtype and race, were used to corroborate findings from our cohort. Results are presented comparing young women and their tumors to their older counterparts. Results: Young women have worse clinical outcome measured by progression-free interval. Despite matching for IHC subtypes, tumors from young women are enriched for intrinsic basal-like subtype, BRCA1/2 germline mutations, and had fewer invasive lobular BCs. Differentially enriched molecules and pathways: A number of significantly differentially expressed genes (DEGs) and proteins were detected, which were able to separate luminal subtypes of BC by patient age. IRS1 and IRS2 were enriched at both transcript and protein levels; IRS1 has been reported to promote tamoxifen resistance. We observed limited overlap of DEGs between the APOLLO, TCGA, and METABRIC datasets. In contrast, 14 of the 28 significantly upregulated Cancer Hallmark pathways were also enriched in TCGA-BC and METABRIC datasets; suggesting targeting pathways, vs genes, may be more effective for therapeutic intervention. Integrated pathway/network analysis: Integrated pathway analysis of RNA and protein levels identified 5 Hallmark pathways upregulated in younger women, including ER response and proliferative pathways, and 6 downregulated immune-response pathways; 10 of the 11 were supported by the public datasets. Immune scores were also lower. Kinase substrate enrichment analysis identified 4 kinases with increased activity in tumors from young women. ESR1/ER: We identified for the first time a significant reduction of ER protein expression while confirming previously reported lower ESR1 gene expression and copy number variations. Surprisingly, integrated pathway analysis identified elevation of early and late estrogen responses in young women. ER activation, indicated by phosphorylated ER (pS118) normalized to total ER protein, was elevated in LumA tumors from young women. Conclusions: This first-ever integrated proteogenomic study shows that BC in young women is enriched for more aggressive molecular subtypes and for genes that promote tamoxifen resistance, exhibits lower immune pathways and immune scores, and shows enhanced ER responses despite lower gene and protein expression of ER. These findings may contribute to the understanding of the molecular mechanisms underlying worse outcomes of BC in young women, and offer new insight to therapeutic strategies. Disclaimer: The contents of this publication are the sole responsibility of the authors and do not necessarily reflect the views, opinions or policies of USUHS, HJF, the DoD or the Departments of the Army, Navy or Air Force. Mention of trade names, commercial products, or organizations does not imply endorsement by the U.S. Government. Citation Format: Praveen Kumar Raj Kumar, Jianfang Liu, Anthony Soltis, Nicholas Bateman, Qingrong Chen, Lori Sturtz, Brenda Deyarmin, Mariaelena Pierobon, Tamara Abulez, Anupama Praveen-Kumar, Xijun Zhang, Trinh Nguyen, Chunhua Yan, Ying Hu, Kate Guion, Jeffrey Hooke, Albert Kovatich, Leigh Fantacone-Campbell, Brad Mostoller, Leonid Kvecher, Stella Somiari, Patricia Steeg, Sheila Rajagopal, Kathleen Darcy, Jerry Lee, Clifton Dalgard, Thomas Conrads, Emanuel Petricoin, Daoud Meerzaman, Matthew Wilkerson, APOLLO Research Network, Xiaoying Lin, Craig Shriver, Stanley Lipkowitz, Hai Hu. Proteogenomic characterization of primary invasive breast tumors from young women compared to matched tumors from older women [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-13-10.

BackgroundThis study investigated the quality and quantity of eggs and embryos as well as the clinical pregnancy outcome in young infertile women with diminished ovarian reserve (DOR) after in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI).Material/MethodsWe retrospectively reviewed records of 4285 infertile women and divided them into 3 groups according to age and ovarian reserve: young women with normal ovarian reserve (n=1695), young women with DOR (n=1121), and older women with DOR (n=1469).ResultsIn young women with DOR, the proportion of high-quality embryos was significantly higher than in older women with DOR and lower than in young women with normal ovarian reserve (P<0.01). The proportions of ovulation cancellation, ovulation without egg acquisition, and ovulation without available embryos in young women with DOR were significantly higher than in young women with normal ovarian reserve. The rates of biochemical pregnancy, clinical pregnancy, and embryo implantation in young women with DOR were significantly higher than in older women with DOR, and lower than in young women with normal ovarian reserve. The miscarriage rate was 19.17% in young women with DOR, significantly lower than in older women with DOR (33.90%), and higher than in young women with normal ovarian reserve.ConclusionsYoung women with DOR have ovarian hypo-response and low numbers of acquired eggs and embryos, but the possibilities of high-quality embryo and good clinical pregnancy are higher once eggs are acquired. The indications to IVF/ICSI can be widened and active treatments should be administered for these women.

The prevalence of mental health and well-being issues among young women is increasing. Pregnancy is a time when new mental health challenges may arise, or existing conditions can be exacerbated. This project presents preparatory work on how nature-based interventions may help to support the mental health and well-being of young pregnant women (aged 16-24 years) in a future study. This project was formed of three main phases conducted from March to August 2022: (1) mapping nature activities available across the East Midlands region and two focus groups with providers of nature activities (n = 6); (2) public participation and involvement work to inform future research. This included four focus groups with young women (n = 11), leading to the formation of a new young women's panel (Research Influencers Group). Networking and stakeholder engagement to support future research. The mapping survey identified 68 nature-based organisations/projects operating in the region, many of whom expressed interest in being involved in future research. The young women's focus groups confirmed the importance of the topic and generated a wealth of information to support the intervention design. A Research Influencer Group of five young women was established from the focus group participants. The Research Influencer Group chose the nature-based intervention and had input into all aspects of the study design. This group will continue into future projects. Focus groups with providers of nature activities have further advanced the study design. The project team have developed relationships with relevant stakeholders and networks that will inform the future trial. This preparatory co-design work suggested that a nature-based intervention may be acceptable to young women, and providers of such interventions felt it was feasible to offer these activities to young pregnant women. This preparatory work has led to an outline research plan which has been co-produced with public contributors and stakeholders throughout. This preparatory work is limited by small focus group samples, and the possibility that not all providers were reached through the snowballing approach to the mapping survey. Future research is needed to test the nature-based intervention; this would be in the form of a feasibility randomised controlled trial of nature-based interventions to promote the mental health and well-being of young pregnant women. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR135167.

O86 - “I deserve to be in the loop”: A Mixed Methods Study of Young Women’s Experiences of Pregnancy Care in NSW

Background: HIV pre-exposure prophylaxis (PrEP) is highly effective and could reduce the persistent high HIV incidence among young South African women. Demand creation is needed to increase PrEP uptake of this novel prevention technology. Theoretically-grounded formative research (FR) could identify factors to include in a demand creation campaign to motivate young South African women to seek PrEP. Methods: Thirty-four household visits with young women (aged 16–32) were conducted in a township near Cape Town using Behavior Centered Design (BCD), investigating behavior contexts, the social and family environments and psychological processes, using qualitative and interactive tools, such as forced choice dilemmas, ranking games, daily script elicitation and network- and community drawings. Results: The FR generated findings concerning a wide variety of topic areas and identified a range of opportunities as well as challenges for the successful implementation of PrEP promotion in this population. Potential challenges were young women underestimating the consequences of acquiring HIV; taking medicine to prevent a disease (which was an unfamiliar concept) and young women having few responsibilities, making health care seeking and daily pill-taking with PrEP challenging. Potential opportunities that could be leveraged for PrEP demand creation were young women’s desire for trust and emotional closeness in relationships and the limited existing roles for young women, which could provide room for creating new aspirational roles that would motivate young women to take PrEP. Conclusion: A theory-based and context-specific approach to FR led to a broad understanding of the lives and influences on young South African women and generated a comprehensive set of opportunities for intervention.