Distribution Of Women Research Articles

Initiation and continued use of oral pre-exposure prophylaxis among pregnant and postpartum women in South Africa (PrEP-PP): a demonstration cohort study

When used effectively, oral pre-exposure prophylaxis (PrEP; tenofovir disoproxil fumarate and emtricitabine) prevents maternal HIV acquisition and reduces the risk of vertical transmission. Our study aimed to better understand PrEP initiation, continued use, and adherence in pregnant and postpartum women. The PrEP in Pregnancy and Postpartum (PrEP-PP) study is a demonstration cohort study that enrolled pregnant women aged 16 years and older without HIV attending their first antenatal care visit in Cape Town, South Africa, between Aug 29, 2019, and Oct 10, 2021. Eligible, consenting women were followed up quarterly up to 12 months postpartum with regular HIV testing and offer of PrEP with ongoing adherence counselling. The primary outcome was distribution of women across the PrEP cascade (ie, initiation and continuation up to 12 months postpartum) with crude and adjusted hazard ratios (HRs). We also report on HIV incidence by pregnancy and postpartum status. Overall, 1195 pregnant women were recruited and followed up (median age 26 years, IQR 23-31; median gestational age 21 weeks, IQR 15-31); 1009 (84·4%) started PrEP at enrolment. Among women who initiated PrEP at enrolment, 668 (67·5%) of 990 continued PrEP at the 1-month follow-up, 485 (49·9%) of 972 continued at 3 months, 392 (39·4%) of 994 at 6 months, and 275 (27·4%) of 1005 at 12 months. Of 186 women who did not accept PrEP at enrolment, 70 (37·6%) of 186 subsequently initiated PrEP. Overall, 200 (18·6%) of 1076 women continued PrEP at 12 months postpartum. Of 186 women who did not initiate PrEP at baseline, 70 (37·6%) subsequently initiated PrEP during the study. Factors associated with PrEP discontinuation up to 12 months postpartum included being married or cohabiting (adjusted HR 1·32, 95% CI 1·16-1·50), condomless sex since last visit (1·43, 1·23-1·65), reporting intimate partner violence (2·03, 1·59-2·59), or depression in the past 12 months (1·53, 1·14-2·05). Overall, 16 women seroconverted over 1673·8 woman-years (HIV incidence rate 0·96 per 100 woman-years, 95% CI 0·49-1·42); 14 discontinued PrEP use and two never initiated PrEP. HIV incidence was 0·28 per 100 woman-years during pregnancy (95% CI 0·22-0·33), and the incidence rate ratio was 1·77 per 100 woman-years (0·53-5·90) 0-6 months postpartum and 2·19 per 100 woman-years (0·61-7·83) 6-12 months postpartum compared with pregnant women. There is an urgent need for the integration of PrEP into antenatal and postnatal care and interventions that address barriers to continued use, including targeted counselling during pregnancy and postpartum to reduce PrEP discontinuation. National Institute of Mental Health and Fogarty International, US National Institutes of Health. For the French translation of the abstract see Supplementary Materials section.

The effect of body mass index on bone density by age distribution in women.

Osteoporosis significantly affects public health, especially among postmenopausal women, by reducing bone mass and increasing the risk of fractures. While the influence of body mass index (BMI) on Bone Mineral Density (BMD) is acknowledged, the specific age range in which BMI most significantly affects bone density remains unclear. This study aims to explore the relationship between BMI and BMD in different age groups to identify potential age-specific risk factors for osteoporosis. In a retrospective cohort study at the University of Health Sciences Turkey, X Hospital, DXA scans of 240 postmenopausal women aged 40 to 80 were analyzed between February 2018 and February 2020. The study used statistical analyses, including ANCOVA and Pearson correlation, to investigate the effects of BMI on BMD, adjusting for age and other variables. Analysis revealed a complex interaction between BMI and BMD. Controlling for BMI showed a statistically significant difference in measurements of lumbar T, neck T, and trochanter T between age groups (P < .05). Specifically, bone density in the 40 to 49 age range was found to be lower when adjusted for BMI, suggesting that the protective effect of higher BMI is less pronounced in younger postmenopausal ages but decreases less negatively in older groups. The impact of BMI on trochanter T measurements was markedly different, increasing in the 40 to 49 age group, while decreasing in others. BMI, along with body weight and age, are important determinants of BMD, but not the sole factors influencing bone loss. The study highlights the need for a personalized approach to osteoporosis risk, considering a broader spectrum of genetic, hormonal and lifestyle factors. It recommends further evaluation of other risk factors in larger cohorts and emphasizes the importance of future longitudinal research to elucidate the dynamic relationship between BMI and BMD over time.

Государственное регулирование занятости женщин и профессиональная сегрегация в российской сфере труда – 100 лет истории. Часть 2. 1945-1991 годы

This paper, based on a general analysis of political documents and legislative acts, examines the changes in the regulation of employment conditions and regimes for women, as well as the dynamics of gender industry segregation. The first part of the article was dedicated to the initial Soviet period and the period of the Great Patriotic War (1917-1945). The second part covers the entire post-war Soviet period (1945-1991), during which there remained a commitment to the idea of maximizing women's participation in the economy. However, perceptions of the conditions for achieving gender equality in employment changed when the country faced the threat of critically low birth rates. As this demographic problem was directly linked to the high total workload of women, a system of benefits and preferences exclusively addressed to working women began to be developed, aiming to create "the most favourable conditions for combining professional and family duties." The implementation of an ever-expanding system of benefits did not lead to the equalization of opportunities for men and women in the labour sphere but contributed to the expansion of labour discrimination by gender and the formation of stereotypical views about jobs most "suitable for men" and "most suitable for women." The article analyzes the dynamics of differences in the sectoral employment structure of women and men based on historical and contemporary statistics, demonstrating that in the Russian Soviet society, committed to traditional gender role divisions, and without pressure on women in their choice of workplace, there was an increase in gender professional segregation due to the concentration of women in non-production sectors and men in material production sectors. The empirical basis for this study relies on data from the Central Statistical Office of the Russian Soviet Federative Socialist Republic (RSFSR) and Rosstat. The statistical analysis of gender segregation dynamics in this study employed the Duncan index, which quantitatively assesses and compares differences between the distributions of women and men across sectors and types of economic activity.

Urban public transport system accessibility for different groups of residents: Case of Bratislava city

The main goal of the article is to characterize the functioning of the Urban Public Transport System (UPTS) in the capital city of the Slovak Republic (Bratislava) during different time periods (morning rush, evening, night, average working day, and weekend − Sunday) and express its accessibility for various groups of city residents (low-income households, unemployed individuals, seniors (age 60+), children (age 0–14), women (for comparison, men as well). To achieve this goal, we combined datasets of UPTS in Bratislava with the pedestrian communication network and identified an effective service area for which we subsequently determined the sizes of the respective population groups of residents. Finally, we verified the functionality of the entire UPTS model by measuring the accessibility of the selected destination, Ružinov Hospital. Our results could be summarized as follows: The functioning of UPTS is very similar during the morning rush, evening, average working day (Monday to Friday), and weekend − Sunday. During these time periods, approximately the same main lines operate, and there is a higher utilization of the same transfer points. The difference lies mainly in the frequency of departures of specific lines. During the night, the system operates based on different lines compared to the daytime, with transfers possible only at one central point/corridor. This fact also affects the usability and accessibility of UPTS, reflected in the accessibility of Ružinov Hospital, which is very limited during the night-time period. However, the accessibility of the hospital by UPTS is higher for the unemployed residents, low-income individuals, and children than the overall residents average, which is also reflected in the distribution of women. A negative aspect is that UPTS is less accessible for seniors. It must be said that this fact varies significantly in the heterogeneous spatial layout of the city. This was confirmed in our measurement of the accessibility to Ružinov Hospital, where seniors have roughly the same level of accessibility as the overall residents average.

Demographic pathways and intergenerational effects of changes in women's education: Evidence from China

Using data from the 2011 baseline China Health and Retirement Longitudinal Study, this study employs a simulation model developed by Mare and Maralani to investigate the intergenerational effects of changes in the distribution of women's education on the educational distribution of their offspring's generation in China. Different from the conventional retrospective studies of intergenerational mobility that have focused on associations between parents’ and children's socioeconomic attainment, the prospective approach adopted in this study examines the relative importance of both the demographic pathways, namely assortative mating and fertility differentials, and the social mobility pathway to the intergenerational transmission processes in a changing socioeconomic and policy context of China. First, I found a positive intergenerational effect across all three cohorts of women born between 1925 and 1965: an increase in women's education led to an improvement in their daughters’ educational attainment. Second, the two demographic pathways, marriage and fertility, and intergenerational transmission jointly affected the educational attainment of the next generation in a complex way. While assortative mating strengthened the intergenerational effects, educational differentials in fertility dampened the intergenerational effects, since improvement in women's education increased their chances of marrying better-educated husbands but reduced their fertility levels. Third, the intergenerational effects and the respective effects of two demographic pathways became smaller across cohorts, which could be attributed jointly to educational expansion at the national level and changing family planning policies experienced by different cohorts of women and their offspring. Fourth, rural/urban comparison further demonstrated the existing educational inequality in contemporary China.

Assessing the pattern of key factors on women's empowerment in Bangladesh: Evidence from Bangladesh Demographic and Health Survey, 2007 to 2017-18.

With half a female population, empowering women can be a key factor in our country's global advancement. Focusing on household decision-making and attitudes toward wife beating, our study addresses the dearth of research exploring how different socio-economic and demographic factors associated with women's empowerment evolve over the past decade in Bangladesh (from BDHS 2007 to BDHS 2017-18). Data from four waves of Bangladesh Demographic and Health Survey (BDHS, 2007 to BDHS, 2017-18) were used in this study. We put forth two domains-household decision-making and attitudes toward domestic violence-to assess women's empowerment. Principal component analysis (PCA) was employed to create women's empowerment index. To assess the unadjusted association between the selected covariates and women's empowerment, Pearson Chi-square test and ANOVA F test have been used, while adjusted association has been analyzed through proportional odds model (POM). In BDHS 2017-18, women from urban areas experienced 'high' empowerment than women in rural areas (56.08% vs. 45.69%). A notable change has been observed in the distribution of women's empowerment index by education over the survey years. Findings also showed that in all the survey years, division, place of residence, education level, number of living children, media exposure, wealth index, working status, and relationship with household head have been found to have significant association with women's empowerment index. For instance, women who completed secondary education in 2007, 2011, 2014, and 2017-18, respectively have 14.4%, 31.8%, 24.6%, and 39.6% higher odds of having empowerment compared to those who were uneducated. Further, age at first marriage, spousal age gap, NGO membership etc. emerged as a contributing factor in specific survey years. Our study affirmed that, over a ten-year period, women were more likely to protest against physical violence and to participate in various decision-making regarding their personal and social life. Empowerment is notably higher among women in urban residents, those with secondary education, 1-2 children, media exposure, and employment. Policy recommendations should emphasize targeted measures to raise awareness and empower uneducated, unemployed, economically disadvantaged, and physically oppressed women.

Consanguineous Marriages and the Perception of Wife-Beating Justification in Pakistan: An Application of Fairlie Decomposition Analysis.

Pakistan has a significant occurrence of both consanguineous marriages and intimate partner violence (IPV), which may be interlinked. The practice of consanguineous marriages could potentially influence women to rationalize and accept instances of IPV. Such attitudes perpetuate a culture of violence against women, creating difficulties for victims to reject or escape from it. Pakistan has high prevalence rate of consanguineous marriages and IPV. However, no research has been done to explain the difference in acceptance of IPV between women in consanguineous and non-consanguineous marriages. This study used Pakistan Demographic and Health Survey data and applied association tests, logistic regression, and the Fairlie decomposition analysis. The Fairlie decomposition helps us identify the relative contribution of different socioeconomic factors in the inequalities in IPV between the two types of marriages. Five dimensions of wife-beating justification are used as outcome variables. Age, education, and empowerment of women, husband education, woman witness parental violence, region, place of residence, and household wealth status are used as independent variables. The logistic regression results indicated that women in consanguineous marriages of younger age and who witnessed parental violence are more likely to justify wife-beating than those who belong to wealthy households and enjoy more empowerment. Compared to the Punjab province, women residing in Sindh and Baluchistan are less likely and in the Khyber Pakhtunkhwa province are more likely to justify wife-beating. The Fairlie decomposition analysis shows that household wealth status, woman education, and empowerment are the main contributors in explaining the gap between the wife-beating justification of the two groups. The IPV gap can be reduced up to 77% if the distribution of women in different wealth quantiles of the consanguineous marriage group is identical to the non-consanguineous marriage group. Furthermore, woman education level is the second highest contributor. Consanguineous marriages are a prevalent cultural practice in Pakistan and are associated with several negative health and social outcomes. Addressing this issue requires a sustained and comprehensive effort by the government, civil society, and international partners, with a particular focus on women from poor households with less education.

Association between the digit ratio (2D:4D), handgrip strength, wrist ratio, and body fat distribution in women with different carpal tunnel syndrome severity

BackgroundTo evaluate the relationship of the second to fourth digit ratio (2D:4D), a biomarker of prenatal sex hormone exposure, with wrist ratio (WR), wrist-palm ratio (WPR), body mass index (BMI), waist-hip ratio (WHR), and handgrip strength (HGS) in different carpal tunnel syndrome (CTS) severity. MethodThis study involved 90 female participants (aged 18 to 83) with CTS. According to CTS severity, the participants were divided into four groups: normal, mild, moderate, and severe. All parameters of hand anthropometry and body fat distribution were measured, and the mean 2D:4D, WR, WPR, HGS, BMI, and WHR values were compared based on CTS severity. Data were collected with a visual analog scale (VAS) for pain and a Likert (LS) scale for numbness severity. ResultsThe mean age, 2D:4D, WD, WW, WR, WPR, BMI, and HGS values showed a significant differences between CTS severity groups. We found that lower 2D:4D and higher WPR and BMI were associated with increased risk of CTS (AUC = 0.728) after removing the effect of age. Bilateral hands were affected in 38.9 % (70/180) of participants. Regression analysis showed that lower HGS can be used as independent variable for predicting the females having bilateral affected hands. The LS score was considerably higher in the severe and moderate groups. Also, the VAS score was significantly higher in the severe group. ConclusionThe findings of the study demonstrated an association between 2D:4D, WPR, and BMI among women, emphasizing the effect of intrauterine sex hormone exposure on late life CTS severity.

Screening accuracy of PAP and VIA in terms of Colposcopy guided cervical biopsy: A comparative study

Introduction: Approximately 80% of cervical cancer occurs in developing countries of which India contributes about 20-30% of the global burden. WHO considers cervical cancer as a preventable disease because it can be diagnosed in its precancerous phase. Cytology and VIA for screening and colposcopy for directed biopsy jointly may achieve accuracy of approximately 90% to 99%.Methods: An observational cross sectional comparative study was performed to find accuracy of screening protocols of exfoliative cervical cell cytology and visual inspection under acetic acid in terms of the diagnostic test of Colposcopy guided biopsy on 300 symptomatic women of age 18-60 years over the period of one year.Result: Both PAP and VIA positivity increased with age, increasing parity, gynaecological symptoms. PAP and VIA positive results co related with Colposcopy directed biopsy histopatholgy reports in a statistically significant proportion.Discussion: VIA can screen out a large number of women suspected to have cervical cancer in an easy method done in OPD in naked eye and does not require any meticulous microscopic examination with a high degree of sensitivity and high false positivity but on the other hand PAP was less sensitive but more specific test when both combined with Colposcopy guided biopsy.Conclusion: The associations between distribution of women who were Pap +ve and histology +ve as well as VIA and histo +ve were statistically significant.

Transcriptional Control of Subcutaneous Adipose Tissue by the Transcription Factor CTCF Modulates Heterogeneity in Fat Distribution in Women.

Determining the mechanism driving body fat distribution will provide insights into obesity-related health risks. We used functional genomics tools to profile the epigenomic landscape to help infer the differential transcriptional potential of apple- and pear-shaped women's subcutaneous adipose-derived stem cells (ADSCs). We found that CCCTC-binding factor (CTCF) expression and its chromatin binding were increased in ADSCs from pear donors compared to those from apple donors. Interestingly, the pear enriched CTCF binding sites were located predominantly at the active transcription start sites (TSSs) of genes with active histone marks and YY1 motifs and were also associated with pear enriched RNAPII binding. In contrast, apple enriched CTCF binding sites were mainly found at intergenic regions and when identified at TSS, they were enriched with the bivalent chromatin signatures. Altogether, we provide evidence that CTCF plays an important role in differential regulation of subcutaneous ADSCs gene expression and may influence the development of apple vs. pear body shape.

Sectors on the Czech Labour Market

Abstract This paper deals with the situation on the Czech labour market from the point of view of the sectors, namely Agriculture and Mining Sector, Manufacturing Industry, Energy, Construction Sector, Service Sector Requiring Mostly Personal Contact, Service Sector Rather without Personal Contact and Service Sector Usually Provided by the Public Sector. Wages and salaries together constitute the investigated variable. The main aim is not only to capture the wage and salary level in individual sectors, but an equally important objective is the construction of models of the entire distribution of wages and salaries in individual sectors. Special attention is paid to employees of individual sectors, separated into men and women, whose remuneration for work is at the level of the minimum wage. An important aim is to determine the most frequent occupations of the CZ-ISCO classification in individual distinguished sectors, while this classification codes are considered for the first three digits. Important attention is paid to the representation of foreign nationals in the position of employees in individual sectors, separated into men and women. Three-parametric lognormal curves are used in the construction of wage and salary distribution models. The amount of the minimum gross monthly wage valid on January 1 of the previous year represented the beginning of the curves, the other two parameters were estimated using the maximum likelihood method. Accuracy of lognormal curves is evaluated using Akaike and Bayes information criterion. The results show that the highest levels of wages and salaries are mainly achieved by men in the Service Sector Rather without Personal Contact. In all five monitored sectors, the level of wages and salaries of women is lower than the level of wages and salaries of men. The overall distribution of women’s wages and salaries is more skewed, with higher skewness, but with lower level and variability compared to the overall distribution of men’s wages and salaries.

Frequency of Dyslipidemias and Cardiovascular Risk Determination in Patients with Systemic Arterial Hypertension

Objective: to determine the frequency of dyslipidemia and cardiovascular risk (CVR) in patients with systemic arterial hypertension (SAH) in a family medicine unit. Methods: analytical cross-sectional study conducted at the Family Medicine Unit No. 26 of the Mexican Institute of Social Security (IMSS) in Acapulco, Mexico, which included 150 patients with a confirmed diagnosis of systemic arterial hypertension in the electronic clinical record, obtained by non-probabilistic sampling by convenience, from November 2020 to May 2021. It was applied a questionnaire to obtain sociodemographic information, somatometry, laboratory tests, and the cardiovascular risk was assessed with the Globorisk estimation table. Descriptive statistics, bivariate and multivariate analysis were performed with the obtained data. Results: the frequency of dyslipidemia was 56.7% (n= 85), with a greater distribution in women 67% (n= 57), female to male ratio 2:1, 22.7% (n= 34) had mixed hyperlipidemia. 48% (72/150) presented moderate cardiovascular risk. Being a man and having a glomerular filtration rate &lt;60 ml/min/1.27m2sc increased the possibility of presenting high cardiovascular risk. Conclusion: moderate cardiovascular risk was observed in almost half of the patients. Being male and having a gfr &lt;60 ml/min/1.27m2sc increased the risk of presenting high cvr.

Государственное регулирование занятости женщин и профессиональная сегрегация в российской сфере труда – 100 лет истории

This article investigates the dynamics of gender occupational segregation, a crucial parameter that reflects the position of men and women in the workforce and significantly influences gender disparities in pay and working conditions. Over the course of our country's history, efforts have been made to reduce such segregation, highlighting the importance of collecting information to assess the effectiveness of these initiatives. The study provides a comprehensive analysis of political documents and legislative acts from both the Soviet and post-Soviet eras, aimed at promoting equal rights and, in the past three decades, equal opportunities for women and men in the labor market, which have a significant impact on gender segregation in employment. It explores the transformation of perceptions regarding the strategies, methods, and conditions necessary to achieve gender equality. In the early Soviet period, the focus was on the ideological dogmatization of maximizing women's involvement in a wide range of professions and industries. This was accompanied by labor legislation restrictions on female employment in hazardous and demanding conditions (to safeguard health) and measures to protect women during childbirth and child-rearing. During the developed socialist period, an entire system of benefits and preferences was developed to create the most favorable conditions for working women to balance their professional and family responsibilities. This included expanding the list of prohibited professions and occupations for women. In the post-Soviet era, efforts shifted toward prohibiting gender discrimination in the workplace. Labor legislation was transformed to ensure that rights, benefits, and preferences related to child-rearing and care were assigned to both mothers and fathers with family responsibilities. Rights, benefits, and preferences related to childbirth and breastfeeding assigned solely to mothers. Restrictions on female employment in hazardous and strenuous conditions have been reduced, and in some cases, these restrictions have been seen as discriminatory. Additionally, the article analyzes the dynamics of gender differences in the occupational structure of employment for women and men, drawing on historical and contemporary statistics. It reveals that despite changes in the regulation of women's work, their distribution across sectors has consistently differed significantly from that of men. However, a period from the late 1920s to the post-war years stands out as a period of substantial reduction in gender occupational segregation. Subsequently, there was a gradual increase in the level of segregation, which continued with minor fluctuations in subsequent years. The empirical basis for this study relies on data from the Central Statistical Office of the Russian Soviet Federative Socialist Republic (RSFSR) and Rosstat. The statistical analysis of gender segregation dynamics in this study employed the Duncan index, which quantitatively assesses and compares differences between the distributions of women and men across sectors and types of economic activity.

Race and Gender Shift among Academic Glaucoma Specialists in the Last 5 Decades.

To evaluate the demographic composition of academic glaucoma specialists currently practicing in the United States. Retrospective and observational study. Academic glaucoma specialists identified from ophthalmology residency programs listed on the Doximity database. The American Board of Ophthalmology (ABO) membership directory, Doximity database, publicly available data, and direct communications were used to identify academic glaucoma specialists and their demographics. Information collected included-name, gender, race/ethnicity, geographic location, board certification date, academic affiliation, and academic rank. Ophthalmic age was defined as the number of years since ophthalmology board certification. Underrepresented minority (URM) groups were defined as Hispanics, Black or African Americans, Latinos, American Indians, or Alaskan Natives as defined by San Francisco match. In addition, the temporal, geographic, and academic rank distributions among females and URMs were explored. Women and URMs representations among academic glaucoma specialists across academic ranks, geographic regions, as well as ophthalmic age. There were 457 active academic glaucoma specialists identified from 110 institutions in 38 states. Among them, 185 (40.5%) were women and 42 (9.2%) were URM. The proportion of women glaucoma specialists in academia had increased significantly with a rate of 1.049 in odds ratio (OR) per year (p < 0.001). However, there were no significant changes in the proportion of URMs over time. The earliest year of certification was 1,964 for males and 1,974 for females. When controlled for ophthalmic age, there were no significant differences in the distribution of women or URMs between the different academic ranks (p = 0.572 and p = 0.762, respectively). Among assistant professors, women had a significantly higher ophthalmic age compared to men (p < 0.001), but there was no significant difference in ophthalmic age in both the associate and full professor groups. There were no significant differences in the geographic distribution of gender (p = 0.516) and URM across United States regions (p = 0.238). The proportion of women among academic glaucoma specialists has significantly increased over the past 5 decades; however, the proportion of URMs has been stagnant in the same period. Enhancing URM representation among academic glaucoma specialists deserves to be a future priority. Afzali K, Fujimoto DK, Mohammadi SO, et al. Race and Gender Shift among Academic Glaucoma Specialists in the Last 5 Decades. J Curr Glaucoma Pract 2023;17(2):98-103.

Distribution of Women's Functions as Family Heads from a Normative and Gender Perspective

Pemahaman umum tentang konsep qiwama, menempatkan peran kepala keluarga berada pada laki-laki, sedangkan perempuan berperan pada ranah domestik. Dalam UU no. 1 Tahun 1974 dan KHI dinyatakan bahwa laki-laki adalah kepala keluarga, dan perempuan adalah ibu rumah tangga. Namun, realita sosialnya, banyak perempuan yang secara praktiknya bertanggung jawab sebagai kepala keluarga, misalnya janda sebab suaminya meninggal atau cerai, perempuan korban poligami, dan perempuan pencari nafkah utama. Penelitian ini merupakan penelitian pustaka (library research), dengan menggunakan pendekatan gender. Hasil dari penelitian ini menunjukkan bahwa berdasarkan teori Mubadalah, keluarga dikepalai oleh laki-laki bukanlah hal mutlak, melainkan dapat disesuaikan dengan keadaan dan kemampuan. Sehingga perempuan yang berperan sebagai kepala keluarga tidaklah menyalahi hukum agama maupun perundang-undangan IndonesiaKata kunci: Perempuan, Kepala Keluarga, Gender.

Facilitated Central Pain Mechanisms Across the Menstrual Cycle in Dysmenorrhea and Enlarged Pain Distribution in Women With Longer Pain History

Dysmenorrhea (DYS), or recurrent menstrual pain, is a highly prevalent pain condition among otherwise healthy women. However, the progression of DYS over time and the influence of the menstrual cycle phases need to be better understood. While the location and distribution of pain have been used to assess pain mechanisms in other conditions, they are unexplored in DYS. Thirty otherwise healthy women with severe DYS and 30 healthy control women were recruited into 3 subgroups (n = 10) according to the length of their menstrual history (<5, 5–15, or>15 years since menarche). The intensity and distribution of menstrual pain were recorded. Pressure pain thresholds at abdominal, hip, and arm sites, pressure-induced pain distribution, temporal summation of pain, and pain intensity after pressure cessation over the gluteus medius were assessed at 3 menstrual cycle phases. Compared with the healthy control women, those with DYS showed lower pressure pain thresholds in every site and menstrual cycle phase (P < .05), enlarged pressure-induced pain areas during menstruations (P < .01), and increased temporal summation and pain intensity after pressure cessation in the overall menstrual cycle (P < .05). Additionally, these manifestations were enhanced during the menstrual and premenstrual phases compared to ovulation in women with DYS (P < .01). Women with long-term DYS demonstrated enlarged pressure-induced pain distribution, enlarged menstrual pain areas, and more days with severe menstrual pain compared to the short-term DYS subgroup (P < .01). Pressure-induced and menstrual pain distributions were strongly correlated (P < .001). These findings suggest that severe DYS is a progressive condition underscored by facilitated central pain mechanisms associated with pain recurrence and exacerbation. PerspectiveEnlarged pressure-induced pain areas occur in DYS, associated with the length of the condition and the distribution of menstrual pain. Generalized hyperalgesia is present throughout the entire menstrual cycle and intensifies during premenstrual and menstrual phases.

Incidence and survival in patients with urachal carcinoma: Cancer registry analysis between 2008 and 2019.

480 Background: Urachal carcinoma (UrC) is a rare and poorly studied cancer without evidence-based treatment strategies. Due to the low prevalence of this cancer, only sparse data on its incidence and survival are available. Therefore, we analyzed the incidence and survival rates of patients with UrC in North Rhine-Westphalia (NRW), a state of the Federal Republic of Germany. Methods: UrC (ICD-O-3: C67.7) diagnosed between 2008 and 2019 were identified via the NRW Cancer Registry (population 18 million) and classified according to Mayo-staging and T-category. Mayo stage was based on the TNM classification. We calculated age-standardized incidence rates using the European standard and Kaplan-Meier overall survival (OS). Age was stated as mean and standard deviation (SD). Results: A total of 121 UrC patients were described, of which men were more frequently affected at 57%. The distribution for women was 43%. The mean age was 61.1 (SD: 15.5) years for men and 58.8 (SD: 15.3) years for women. The overall age-standardized incidence rate was 0.43 per 1.000.000 person-years, which was 0.5 for men and 0.37 for women. 85.1% had adenocarcinomas, 6.6% urothelial carcinoma, 4.1% unspecified cancer, 2.5% epithelial carcinomas, 0.8% squamous cell carcinomas or others, respectively. The 5-year OS rate were 60.4% (CI-95%: 48.9%; 74.7%) for men and 41.7% (CI-95%: 28.8%; 60.2%) for women. According to TNM classification, 33% of the patients presented with T1-2, 29.8% with T3-4, while for the Mayo staging a distribution of 17.4% for stage I-II and 13.2% for stage III-IV was shown. Data regarding T-category and Mayo-satging were available in 63.6% (44 patients) and 30.6% (84 patients), respectively. The 5-year OS was 73.3% (CI-95%: 59.3%; 90.6%) in T1-2, 37.2% (CI-95%: 23.6%; 58.6%) in T3-4. and 69.3% (CI-95%: 47.6%; 100%) and 25.6% (CI-95%: 9.89%; 66.49%) in Mayo stage I-II and III-IV, respectively. Conclusions: UrC is a rare cancer and OS rate in NRW were comparable to historical data. The prognosis was stage-dependent and identified poor outcome in patients with advanced disease. Our data underscored the role of proper staging and diagnosis for future clinical studies that investigate optimal treatment strategies.

Gender differences in first authorship of randomized controlled trials from India

BackgroundIt has been established that identity of the trial leadership plays a role in the conduct of the trial. An estimation of the gender composition of RCT leadership in India has not been undertaken. We performed this study to quantify the gender composition of first authors of RCTs published from India for the years 2011 to 2020. MethodsPubMed database was searched using the keyword “randomized controlled trial”. We included studies that were classified as a RCT, had a first author affiliation that belonged to India and were published online between 1st January 2011 to 31st December 2020. The gender of the first authors was determined using Gender-API and manually. ResultsOut of the total 4136 RCTs included in our study, the gender of 4056 (98%) first authors were identified. Of the 4056 first authors, 1198 (30%) were women and 2858 (70%) were men. The mean (SD) percentage of yearly distribution of women and men as first authors was 29.53(2.23) and 70.46(2.23), respectively. We did not find any significant change in gender distribution of first authors over the course of ten years [P = 0.78]. ConclusionThe persistence of gender disparity in the leadership of RCTs from India demands greater efforts towards inclusion of women as leaders of clinical trials.

The Dynamic of the Fertility Age Model in the Two Regions of Russia

Introduction. The increase of the age of mothers at the birth of children is observed in the modern period. The speed of this process in different regions of Russia and the world is different. The aim of this research is to estimate the average age of mothers and the number of children born by one woman in Tyumen and Petropavlovsk-Kamchatsky in 2017–2018. Materials and Methods. The archival documents from medical institutions about 676 women who registered for pregnancy have been analyzed. For temporary comparison for the period from 1985 to 2003, we use the data presented in a previously published monograph. The standard methods of statistics, spatial and temporal analysis are used, which have made it possible to identify the dynamics of the age model of fertility. Results. The authors have determine that the distribution of women by age at the birth of children is the same in two Russian cities. A group of women aged 26 to 33 years is represented with 55% frequency. The average age of women in labor from two cities is the same. In Tyumen is 30.1 ± 0.63, in Petropavlovsk-Kamchatsky is 29.5 ± 0.38. The article provides evidence that in the previous period, the proportion of women in labor aged 18 to 25 years was 60%. In both cities, the distribution of women by the number of births is the same, 83% gave birth twice. 14% of children were born in third births. In the previous time interval, 65% of children were born in first birth. During this period it has been defined that the average number of births in the city of Tyumen is less than in the rural areas of the south of the Tyumen region, and less than among the indigenous women in the north of the region (Khanty and Mansi). Discussion and Conclusion. In the studied period, the dynamic of increase of the age of women in labor is obvious. One of the reasons for this trend is the increase count of mothers giving birth again. The financial support from the state makes possible to implement the two-child and large family model in Russia. But it should be aware of the increased risk of biological problems in the group of older women. It is advisable to discuss the negative consequences of delayed motherhood, for example, through the education system. The material of the article is useful, first of all, for future parents.

Legal Pluralism in the Context of the Distribution of Women's Inheritance

This paper is a legal pluralism research on the partition of women's inheritance. It investigates the reality that not all existing and applicable legal laws are being followed. Furthermore, the distribution of women's inheritance is regulated in the Compilation of Islamic Law regarding the share of an heir. There is also a judicial institution that resolves disputes with material law and is accessible to the community. However, it is not always used as a downstream dispute resolution that involves inheritance. The emergence of customary law amongst other diverse sources cannot be ignored as having its place within society, which is frequently used to address normatively controlled legal issues. The results of this study showed the settlement of inheritance is not always handled by trial or litigation, particularly for indigenous peoples in Padangsidimpuan City. Hence, to minimize conflict, it is better to decide inheritance issues by consensus amongst families, with regulations that are ambiguous but geared toward the common interest. This paper is expected to be a study among legal practitioners and academics, even though law has restricted the inheritance share of each heir, and society strives to avoid litigation and settle disputes amicably. Therefore, his study can be pursued by examining whether other indigenous groups handle inheritance disputes in the same manner.