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2022 ◽  
Vol 24 (1) ◽  
Sarah Pirikahu ◽  
Helen Lund ◽  
Gemma Cadby ◽  
Elizabeth Wylie ◽  
Jennifer Stone

Abstract Background High participation in mammographic screening is essential for its effectiveness to detect breast cancers early and thereby, improve breast cancer outcomes. Breast density is a strong predictor of breast cancer risk and significantly reduces the sensitivity of mammography to detect the disease. There are increasing mandates for routine breast density notification within mammographic screening programs. It is unknown if breast density notification impacts the likelihood of women returning to screening when next due (i.e. rescreening rates). This study investigates the association between breast density notification and rescreening rates using individual-level data from BreastScreen Western Australia (WA), a population-based mammographic screening program. Methods We examined 981,705 screening events from 311,656 women aged 40+ who attended BreastScreen WA between 2008 and 2017. Mixed effect logistic regression was used to investigate the association between rescreening and breast density notification status. Results Results were stratified by age (younger, targeted, older) and screening round (first, second, third+). Targeted women screening for the first time were more likely to return to screening if notified as having dense breasts (Percentunadjusted notified vs. not-notified: 57.8% vs. 56.1%; Padjusted = 0.016). Younger women were less likely to rescreen if notified, regardless of screening round (all P < 0.001). There was no association between notification and rescreening in older women (all P > 0.72). Conclusions Breast density notification does not deter women in the targeted age range from rescreening but could potentially deter younger women from rescreening. These results suggest that all breast density notification messaging should include information regarding the importance of regular mammographic screening to manage breast cancer risk, particularly for younger women. These results will directly inform BreastScreen programs in Australia as well as other population-based screening providers outside Australia who notify women about breast density or are considering implementing breast density notification.

2022 ◽  
Vol 21 (1) ◽  
Laila Rahman ◽  
Janice Du Mont ◽  
Patricia O’Campo ◽  
Gillian Einstein

Abstract Background Physical intimate partner violence (IPV) risk looms large for younger women in Bangladesh. We are, however, yet to know the association between their intersectional social locations and IPV across communities. Drawing on intersectionality theory’s tenet that interacting systems of power, oppressions, and privileges work together, we hypothesized that (1) younger, lower educated or poor women’s physical IPV experiences will be exacerbated in disadvantaged communities; and conversely, (2) younger, higher educated or nonpoor women’s physical IPV experiences will be ameliorated in advantaged communities. Methods We applied intercategorical intersectionality analyses using multilevel logistic regression models in 15,421 currently married women across 911 communities from a national, cross-sectional survey in 2015. To test the hypotheses, women’s probabilities of currently experiencing physical IPV among intersectional social groups were compared. These comparisons were made, at first, within each type of disadvantaged (e.g., younger or poor) and advantaged (e.g., older or nonpoor) communities; and then, between different types of communities. Results While our specific hypotheses were not supported, we found significant within community differences, suggesting that younger, lower educated or poor women were bearing the brunt of IPV in almost every community (probabilities ranged from 34.0–37.1%). Younger, poor compared to older, nonpoor women had significantly higher IPV probabilities (the minimum difference = 12.7, 95% CI, 2.8, 22.6) in all communities. Similar trend was observed between younger, lower educated compared to older, higher educated women in all except communities that were poor. Interestingly, younger women’s advantage of higher education and material resources compared to their lower educated or poor counterparts was observed only in advantaged communities. However, these within community differences did not vary between disadvantaged and advantaged communities (difference-in-differences ranged from − 0.9%, (95% CI, − 8.5, 6.7) to − 8.6%, (95% CI, − 17.6, 0.5). Conclusions Using intersectionality theory made visible the IPV precarity of younger, lower educated or poor women across communities. Future research might examine the structures and processes that put them at these precarious locations to ameliorate their socio-economic-educational inequalities and reduce IPV in all communities. For testing hypotheses using intersectionality theory, this study might advance scholarship on physical IPV in Bangladesh and quantitative intersectionality globally.

2022 ◽  
Vol 9 ◽  
Joseph Ollier ◽  
Marcia Nißen ◽  
Florian von Wangenheim

Background: Conversational agents (CAs) are a novel approach to delivering digital health interventions. In human interactions, terms of address often change depending on the context or relationship between interlocutors. In many languages, this encompasses T/V distinction—formal and informal forms of the second-person pronoun “You”—that conveys different levels of familiarity. Yet, few research articles have examined whether CAs' use of T/V distinction across language contexts affects users' evaluations of digital health applications.Methods: In an online experiment (N = 284), we manipulated a public health CA prototype to use either informal or formal T/V distinction forms in French (“tu” vs. “vous”) and German (“du” vs. “Sie”) language settings. A MANCOVA and post-hoc tests were performed to examine the effects of the independent variables (i.e., T/V distinction and Language) and the moderating role of users' demographic profile (i.e., Age and Gender) on eleven user evaluation variables. These were related to four themes: (i) Sociability, (ii) CA-User Collaboration, (iii) Service Evaluation, and (iv) Behavioral Intentions.Results: Results showed a four-way interaction between T/V Distinction, Language, Age, and Gender, influencing user evaluations across all outcome themes. For French speakers, when the informal “T form” (“Tu”) was used, higher user evaluation scores were generated for younger women and older men (e.g., the CA felt more humanlike or individuals were more likely to recommend the CA), whereas when the formal “V form” (“Vous”) was used, higher user evaluation scores were generated for younger men and older women. For German speakers, when the informal T form (“Du”) was used, younger users' evaluations were comparable regardless of Gender, however, as individuals' Age increased, the use of “Du” resulted in lower user evaluation scores, with this effect more pronounced in men. When using the formal V form (“Sie”), user evaluation scores were relatively stable, regardless of Gender, and only increasing slightly with Age.Conclusions: Results highlight how user CA evaluations vary based on the T/V distinction used and language setting, however, that even within a culturally homogenous language group, evaluations vary based on user demographics, thus highlighting the importance of personalizing CA language.

Heena Mir ◽  
Neha Mahajan

Background: The pregnancy complications associated with women over 35 years of age are becoming more frequent. Late or too late remains the thread bearing discussion these days. Multiple studies have reported that women with 35 years of age or beyond are more vulnerable to develop obstetric complications. The present study has been conducted to reckon the strength of the association between maternal age and obstetric issues pertaining to women.Methods: This prospective study considered 217 single consecutive pregnancies which were divided into two groups based on age of patients. Group A consists of 163 pregnant women aged < 35 years and group B consists of 54 pregnant patients aged ≥35 years. The study was conducted at government medical college, Lala-Ded, and hospital Srinagar.Results: In spite of the underlying mechanisms, rigorous statistical analysis revealed the negative impact of extreme maternal ages on pregnancy. We found a significant difference between group A and group B with respect to early pregnancy loss, C-section, antepartum, intrapartum and postpartum complications (p<0.001).Conclusions: Evidently, it was demonstrated that women aging 35 years or above are more vulnerable to develop multiple intrapartum and postpartum complications than younger women in group B.

Cancers ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 167
Linda J. Rogers

Vulvar cancer is a rare gynaecological malignancy, accounting for 2–5% of cancers of the female genital tract. Squamous cell carcinoma is the most frequently occurring subtype and, historically, has been a disease of older post-menopausal women, occurring with a background of lichen sclerosus and other epithelial conditions of the vulvar skin that may be associated with well-differentiated vulvar intra-epithelial neoplasia (dVIN). An increase in human papillomavirus (HPV) infections worldwide has led to an increase in vulvar squamous carcinomas in younger women, resulting from HPV-associated high-grade vulvar squamous intra-epithelial lesions (vHSIL). Surgical resection is the gold standard for the treatment of vulvar cancer. However, as approximately 30% of patients present with locally advanced disease, which is either irresectable or will require radical surgical resection, possibly with a stoma, there has been a need to investigate alternative forms of treatment such as chemoradiation and targeted therapies, which may minimise the psychosexual morbidity of radical surgery. This review aims to provide an update on management strategies for women with advanced vulvar cancer. It is hoped that investigation of the molecular biologies of the two different pathways to vulvar squamous cell carcinoma (HPV-associated and non-HPV-associated) will lead to the development of targeted therapeutic agents.

Reports ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 1
Ornella Morsilli ◽  
Raffaella Guerriero ◽  
Luigi Palmieri ◽  
Cinzia Lo Noce ◽  
Tanja Zeller ◽  

Vitamin D is known as an antirachitic factor, although it also plays a critical role in several nonskeletal diseases. In our study, we evaluated vitamin D status and sex, age and seasonal association in a general population cohort living in central Italy. Data from 1174 men and 2274 women aged 20–81 were analyzed, and stored serum samples were assayed for 25-hydroxyvitamin D (25(OH)D). Vitamin D was low in both sexes with values significantly lower in women than in men; furthermore, its deficiency was highly correlated with age. The younger men had just sufficient 25(OH)D levels (32.3 ng/mL ± 13.2), which decreased with increasing age. The younger women showed insufficient 25(OH)D levels (24.8 ng/mL ± 11.9) that, as with men, further decreased with increasing age. This study demonstrated that hypovitaminosis D may be a very frequent condition also in a rural central Italian area with remarkable solar irradiation throughout the year. Our data clearly indicated an evident seasonal trend: at the end of the winter, serum 25(OH)D levels of the examined cohort were below the official sufficient value for both adult sexes. Sufficient levels were just reached in summer for men and only at the end of summer for young women.

Vaccines ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 26
Jessica Carter ◽  
Shannon Rutherford ◽  
Erika Borkoles

Vaccine uptake in younger Australian women living in rural and regional communities is poorly understood. This research explored factors affecting their decision making in the context of social determinants of health. A mixed methods design applying an explanatory sequential approach commenced with an online questionnaire followed by in-depth interviews with a sample of the same participants. The majority (56%) of participants indicated a positive intention to be vaccinated against COVID-19, but a substantially high proportion (44%) were uncertain or had no intention to be vaccinated. Significant factors affecting vaccine uptake included inadequate and sometimes misleading information leading to poor perceptions of vaccine safety. The personal benefits of vaccination—such as reduced social restrictions and increased mobility—were perceived more positively than health benefits. Additionally, access issues created a structural barrier affecting uptake among those with positive or uncertain vaccination intentions. Understanding factors affecting vaccine uptake allows for more targeted, equitable and effective vaccination campaigns, essential given the importance of widespread COVID-19 vaccination coverage for public health. The population insights emerging from the study hold lessons and relevance for rural and female populations globally.

2021 ◽  
Nida Gizem Yılmaz ◽  
Danielle R. M. Timmermans ◽  
Johanneke Portielje ◽  
Julia C. M. Van Weert ◽  
Olga C. Damman

Vaccines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1505
Toshihiro Okubo ◽  
Atsushi Inoue ◽  
Kozue Sekijima

Vaccination has been critical to reducing infections and deaths during the coronavirus disease 2019 (COVID-19) pandemic. While previous studies have investigated attitudes toward taking a vaccine, studies on the determinants of COVID-19 vaccination behavior are scant. We examine what characteristics, including socioeconomic and non-economic factors, are associated with vaccination behavior for COVID-19 in Japan. We use a large nationwide online survey with approximately 10,000 participants. As of September 2021, 85% of the respondents said that they had received or would receive a COVID-19 vaccine. Employing logistic regression analysis on vaccination behavior, we found that vaccination rates are higher among those who are older, married, educated, and/or work in a large company. On the other hand, vaccination rates tend to be lower among the self-employed, younger women, and those with poor mental health. Income did not significantly correlate with vaccination. Medical workers were found to have a relatively high rate of vaccination. Although attitude towards risk and time preference were not crucial factors for vaccination, fear of infection, infection prevention behavior, and agreement with government policies on behavioral restrictions in crisis situations positively correlated with vaccination.

2021 ◽  
Dilu Feng ◽  
Sitian Wei ◽  
Jun Chen ◽  
Zhicheng Yu ◽  
Hongbo Wang ◽  

Abstract Background: Data regarding human papillomavirus (HPV) prevalence and genotype distribution are limited in Shannan City, Tibet Tibetan Autonomous Region, China. The purpose of this study is to provide reliable data for guiding women in Shannan City in cervical cancer screening and HPV vaccine innoculation. Methods: HPV testing was performed on women aged 16 to 109 years (mean age 44.03 ± 9.25 years) from Shannan City in 2019 and 2020, which was implemented technically by gynecological examination, vaginal discharge smear microscopy, cytology, and HPV detection. The overall prevalence, age-specific prevalence, and genotype distribution were analyzed. Results: A total of 48,126 women received HPV testing, of which 3,929 were detected human papillomavirus. The HPV-positive rate was 8.16% (3,929/48,126), and the highest prevalence was in the ≤ 25-year-old age group (12.68%). After the age of 25, the prevalence rate decreased rapidly, and then slowly increased from 7.49% in the 46-55 age group to 9.82% in the ≥ 66 age group, showing a “U-shaped” pattern. The positive prevalence of HPV 16 or 18-only was 1.43%, that of other HPV genotypes except HPV 16 or 18 was 6.39%, and mixed HPV infections including HPV 16 or 18 was 0.34%. Conclusions: The HPV infection rate in Shannan city is rather low, and the age-specific prevalence of HPV infection presents a “U” curve, suggesting the importance of screening among younger women and the necessity of detection among older women.

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