Context or composition? Spatial Bayesian analysis of sexual violence against adolescent girls and young women in Namibia.

To examine associations between mental health, substance use, and pre-exposure prophylaxis (PrEP) persistence among South African adolescent girls and young women (AGYW). A longitudinal analysis of a decentralized PrEP implementation program. We analyzed data from FastPrEP, a youth-focused program delivering PrEP with peer-navigator support through community-based mobile clinics and public clinics near Cape Town. Female participants aged 15-29 years who received a one-month supply of daily oral PrEP at program enrollment were included. Moderate to severe depression/anxiety symptoms (PHQ-4 ≥6) and hazardous alcohol use (AUDIT-C ≥3) were assessed at enrollment. Log-binomial regression was used to estimate overall and age-stratified adjusted prevalence ratios (aPRs) for associations with short-term PrEP persistence at the one-month follow-up visit. From April 2022 to April 2024, 6,271 AGYW were enrolled in FastPrEP and dispensed daily oral PrEP (median age 21 years); 75% enrolled at mobile clinics. At enrollment, 8% reported moderate to severe depression/anxiety symptoms and 50% hazardous drinking. Only 10% returned and received PrEP within a 28-day window of their one-month follow-up visit. Moderate-severe depression/anxiety symptoms were associated with greater PrEP persistence (aPR = 1.37, 95% confidence interval [95% CI] 1.04-1.79), as was hazardous drinking (aPR = 1.46, 95% CI 1.23-1.75). Associations were strongest among AGYW aged 15-19 years (depression/anxiety: aPR = 1.71, 95% CI 1.11-2.65; hazardous drinking: aPR=1.60, 95% CI 1.16-2.19). Contrary to expectations, mental health and substance use challenges were associated with greater short-term PrEP persistence, particularly among younger AGYW. These findings suggest that youth-centered, peer-supported delivery models may help sustain engagement among higher-risk AGYW.

Sex-related mortality differences in septic shock: A propensity score-matched study.

How do community contexts shape relationship dynamics? A case study of young people living in informal settlements in eThekwini municipality, South Africa.

Moderately age-disparate relationships dominate phylogenetically linked pairs involving young women with HIV in KwaZulu-Natal, South Africa.

Tampon test measurement properties in women with provoked vestibulodynia: baseline data from a pragmatic randomized clinical trial.

Ten young women with grade 2 lipodystrophy were studied. All subjects participated in a series of anti-cellulite massage treatments using Chinese cupping. Eleven treatments were performed over a 3-week period. Before and after the series of treatments, selected skin characteristics were measured, and the degree of lipodystrophy was determined. Massage was performed only on the right lower limb (study limb) (it has always been the dominant limb), while the left lower limb was the control limb. The study showed a significant increase in skin hydration (F = 19.44; p = 0.00), elasticity (F = 9.08; p = 0.00) and smoothness (F = 34.01; p = 0.00), as well as a reduction in transepidermal water loss (F = 11.01; p = 0.00) in the study and control groups. In addition, a statistically significant reduction in lower limb circumference was observed in the study group (F = 3.29; p = 0.04; F = 1.75; p = 0.18; F = 3.07; p = 0.04), indicating a positive effect of anti-cellulite massage on skin parameters and circumference reduction in young women with lipodystrophy. The anti-cellulite massage using the Chinese cupping has a positive effect on skin hydration, smoothness and firmness, as well as on reducing transepidermal water loss. It also has a beneficial effect on reducing the circumference in the treatment area. Ethics approval and consent to participate: The study was conducted in accordance with the Declaration of Helsinki, and approved by the Bioethical Committee of the District Medical Chamber in Krakow: 64/KBL/OIL/2024 of 04/07/2024. Informed consent was obtained from all subjects involved in the study.

ObjectiveFew studies have simultaneously addressed self-management of cardiovascular disease and mental health in Black women at cardiovascular risk. This 24-week pilot prospective crossover randomized-controlled trial tested TEAM-Red, a 5-session, biweekly, nurse and peer-educator remotely delivered group self-management intervention for young Black women, compared to an enhanced waitlist control (eWL) group.MethodsThe TEAM-Red intervention, adapted from an evidence-based program and culturally tailored based on stakeholder input, enrolled 50 depressed Black women ages 18-49 with at least one risk factor for hypertension. Participants were randomized to TEAM-Red (n = 25) or eWL (n = 24) and assessed at screening, baseline, 12 weeks, and 24 weeks. Those in eWL crossed over to receive TEAM-Red at 12 weeks and all participants were followed to 24 weeks. The primary goal was acceptability and feasibility. The primary outcome was change in depression severity from baseline to 12 weeks assessed by the 9-item Patient Health Questionnaire (PHQ-9). Secondary outcomes were perceived stress, mental health quality of life, diet quality, energy expended, social support, hypertension knowledge, and alcohol use.ResultsAmong women depressed at baseline (N = 31), TEAM-Red participants had 17.1 times higher odds of depression remission at week 12 (OR = 17.14, 95% CI: 1.78, 164.97; P = .014). At 12 weeks, TEAM-Red participants also showed significantly lower PHQ-9 scores (P = .042), improved diet quality (P = .025), higher mental health quality of life (P = .032), and reduced perceived stress (P = .038) compared to those in the eWL. Treatment satisfaction and engagement in the intervention group was high (89% found it useful), with 22% attrition.ConclusionsThe TEAM-Red intervention demonstrated significant clinical benefits with a 17-fold higher odds of depression remission and meaningful improvements in mental health quality of life, diet quality, and perceived stress compared to controls. Despite limitations including small sample size and short follow-up period, this culturally tailored intervention showed promise for reducing cardiovascular risk and improving mental health outcomes in young Black women at risk for hypertension. These results need replication in a larger sample as part of a fully powered trial.

Iron-deficiency anemia is the most common micronutrient deficiency and a leading cause of disability-adjusted life years among adolescent girls and young women (AGYW) globally. Although multiple micronutrient supplementation (MMS) provides a broader range of micronutrients than iron-folic acid supplementation (IFAS) prior to conception, the acceptability of MMS and home-based supplementation strategies remains underexplored. We assessed the acceptability of MMS, IFAS, and a contextualized nutrition curriculum delivered via school clubs in a two-arm cluster-randomized trial across three rural secondary schools in Monapo District, Mozambique. Fourteen teachers (clusters) were randomized to deliver either weekly school-based IFAS or daily home-based MMS. A total of 492 AGYW aged 13-20 years were enrolled (240 IFAS; 252 MMS); both arms received the same nutrition curriculum. Participants in both arms reported increased energy, improved appetite, and relief from menstrual symptoms. IFAS was significantly more acceptable than MMS for smell, and some participants perceived the once-weekly IFAS regimen as less burdensome than daily MMS. Some AGYW also reported that male peers perceived MMS as birth control, or assumed the girls were pregnant, due to the image of a pregnant woman on the pill bottle. Ratings of the nutrition curriculum and teachers' facilitation were positive in both arms. Participants generally preferred the regimen they were assigned, and family support facilitated adherence. These findings suggest home-based supplementation may be a feasible and acceptable strategy for reaching in-school and out-of-school AGYW in Mozambique. Including boys in future interventions and redesigning the MMS label could help reduce misconceptions and enhance acceptability.

ADHD is a neurodevelopmental disorder linked to impulsivity and self-regulation difficulties. While the association between ADHD and nicotine dependence is well-established, less is known about the association with smokeless tobacco use, such as snuff. Given the adverse health effects of nicotine during pregnancy, this study examines whether women diagnosed with ADHD are more likely to use snuff prior to and early in pregnancy, and whether they persist in use between these periods. This study also explores the associations between ADHD and snuff use in the presence of common psychiatric disorders: depression, anxiety and substance use disorders (SUDs). Using Swedish population-based registers, we identified women who gave birth between 2000 and 2020. ADHD was defined based on clinical diagnoses and/or ADHD medication prescriptions. Snuff use was self-reported during a prenatal care visit. Logistic regression models estimated odds ratios (ORs) with 95% confidence intervals (CIs) for snuff use prior to and early in pregnancy among women with ADHD, adjusting for sociodemographic factors. We also stratified the analyses by depression, anxiety, and/or SUDs to assess potential differences in associations. Women diagnosed with ADHD were more likely to use snuff prior to pregnancy (adjOR = 1.89, 95% CI: 1.83-1.95), early in pregnancy (adjOR = 2.43, 95% CI: 2.32-2.55), as well as be persistent snuff users (adjOR = 2.39, 95% CI: 2.27-2.52) compared to women without ADHD. Stratification by common psychiatric disorders revealed that the associations between ADHD and snuff use prior to and early in pregnancy were strongest among women diagnosed with ADHD without depression, anxiety, and/or SUDs. ADHD is an important risk factor for snuff use prior to and early in pregnancy, underscoring the need for targeted interventions to prevent nicotine use in young women with ADHD as part of integrated care. Retrospectively registered.

Immunogenicity of 2 versus 3 dose HPV vaccination by HIV infection status in Eswatini.

In young-onset stroke with inflammatory features, consider systemic causes alongside vascular imaging. This case links cervical internal carotid artery dissection with coexisting sarcoidosis and antiphospholipid syndrome, highlighting the value of targeted work-up and appropriate long-term anticoagulation.

ObjectiveTo describe a case of probable autoimmune encephalitis initially misdiagnosed as a primary psychiatric disorder.MethodReview and description of probable autoimmune encephalitis presenting with catatonia in a young woman 6 months post-partum.ResultsA young woman was initially admitted to an outside hospital and was diagnosed with a primary psychiatric condition. She was referred for psychiatric inpatient care, but was denied admission due to labile hypertension. After admission to the medical service (and ICU), she responded to a lorazepam challenge, and made a complete recovery after several weeks of combined treatment with IV methylprednisolone, IV immunoglobulin (IVIG), and rituximab, and was discharged with a diagnosis of autoimmune encephalitis.ConclusionAutoimmune encephalitis should be suspected in patients presenting with labile vital signs, family history of autoimmunity, and new psychosis without a prior history of psychiatric problems. Other important diagnostic considerations include neuroleptic malignant syndrome, substance-induced psychosis, or catatonia secondary to post-infectious immune-mediated encephalitis. While a first psychotic break should always be considered, the presence of autonomic instability, catatonia, seizures, or dyskinesias in a young woman postpartum should prompt a thorough medical and neurological work-up.

Single-session consultation (SSC) interventions are a promising approach for increasing access to timely evidence-based mental health care. This manuscript describes the early implementation, including feasibility and acceptability, of an SSC intervention delivered in a community-based gender-responsive mental health program at an academic medical center in the United States. Six clients completed a 45-60-minute SSC intervention that identified individualized goals, action steps, internal and external supports, and coping strategies. Pre- and post-session measures assessed psychological symptoms, hopelessness, agency, and satisfaction with care. Illustrative case studies are presented for two transition-aged youth. In both cases, the young women collaboratively completed the SSC and their post-session feedback indicated that they found the intervention helpful and aligned with their goals. Clinicians found the service easy to be trained in, viable to implement, and effective. Initial/preliminary results suggest the SSC intervention is feasible and acceptable for use in a free, community-based outpatient clinic serving young women and gender expansive youth. Findings highlighted increases in hopefulness mirroring findings from previous SSC studies. Implementation challenges included lower-than-expected uptake, including difficulty re-engaging youth who did not attend their SSC appointment. Lessons learned included the importance of flexible delivery, structured action planning, and intentional engagement strategies for successful implementation.

Between stigma and solidarity: Experiences of sexual and reproductive health among young women in the Republic of Ireland.

Three-year virological outcomes among adolescent girls and young women living with human immunodeficiency virus enrolled in vertical transmission prevention services during pregnancy and postpartum in Tanzania: A prospective cohort study.

Postural control during quiet standing: impact of stance variation, sex, and body composition.

Glaucoma is a progressive, irreversible optic neuropathy that leads to the loss of retinal ganglion cells, vision loss, and blindness. Elevated intraocular pressure (IOP) is the only modifiable risk factor, and topical hypotensive eye drops remain the mainstay of treatment, reducing disease progression by up to 60%. However, patient adherence to therapy remains a significant challenge since this disease is usually asymptomatic in its early stages. Patient preferences and individual characteristics play a key role in adherence. This study aimed to obtain further knowledge about patient preferences regarding glaucoma treatment to better understand factors influencing adherence. A cross-sectional, multicenter survey was conducted in Spain between March and December 2024 among patients with glaucoma receiving topical treatment for more than 6 months. A questionnaire was designed to collect patients' information about their beliefs, preferences, and adherence-related factors. Of 200 participants, 169 valid responses were analyzed. Most patients were aged 51-74years, 60.2% were women, and 71.2% had been on treatment for more than 12months. Although 93.5% recognized the importance of preservatives, only 36.0% reported having received information about them from their ophthalmologist. Preferences between multidose bottles (MDBs, 42.2%) and single-dose units (SDUs, 37.0%) were similar, although younger women (18-30years) showed a preference for SDUs (p < 0.05). Perceived ease of handling was strongly influenced by prior experience. Most patients considered SDUs as more hygienic, whereas MDBs were perceived as more environmentally friendly; nearly 79% valued ecological impact. Self-reported adherence to therapy was moderate, with 57.6% of participants denying missed doses. Nonadherent patients were more likely to favor reminder systems (74.5%, p = 0.029). Treatment efficacy was ranked as the most important factor, followed by side effects, ease of use, cost, and environmental impact. This study highlights substantial variability in patient preferences and underscores the importance of personalized, patient-centered glaucoma care. Enhanced education on preservatives, improved communication, and sustainable packaging could improve adherence and satisfaction. Larger multicenter studies are needed to confirm these findings and inform long-term adherence strategies.

Dieting is common among young adult women, yet it may be associated with problematic psychological outcomes. The current study aimed to profile styles of eating among undergraduate women (n = 478, average age = 19.3, 50.8% Hispanic/Latina/x), and to explore the extent to which dieting attitudes were associated with psychological well-being. A latent profile analysis of self-reported intuitive eating, binge eating, and dietary restraint measures indicated a four-profile model provided a reasonable fit to the data. These profiles differed significantly in BMI, and psychological measures of well-being, body appreciation, impulsivity, and self-efficacy. Profiles characterized by greater endorsement of restraint were associated with depressed mood and binge eating. These results suggest an intuitive approach to eating is related to greater well-being amongst an ethnically diverse sample of college women, and that individuals who restrict their eating differ from those who do not across various psychological constructs, regardless of whether they explicitly identify as "dieters."

Defining BMI cutoff points for detecting excess body fat in young adults.