Search results for: women’s sexual empowerment (WSE)

Authors: Jaishree Ellis

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The United States Centers for Disease Control tells us that many women with disabilities will not receive regular health screenings, including Pap Smears and mammograms. This article was comprised and written to recognize the barriers to care, gaps in existing healthcare implementation, and viable methodologies for the provision of comprehensive and robust gynecologic care for women with disabilities. According to the World Health Organization, 15% of the world's population, or approximately 1 billion people, have disabilities, most of whom are identified as women. Women with disabilities are described as being multi-disabled, as in some places, they suffer exclusion because of their disabilities as well as their gender. The paucity of information regarding how to create a healthcare system that is inclusive of every woman, regardless of her type of disability (physical, mental, intellectual or medical), has made it challenging to establish an environment that makes it possible for individuals to access care in an equitable, respectful and comprehensive way. A review of the current literature, institutional websites within the United States and American resource guides was implemented to determine where comprehensive models of care for women with disabilities exist, as well as the modalities that are being employed to meet their healthcare needs. The many barriers to care that women with disabilities face were also extracted from various sources within the literature to provide an exhaustive list that can be tackled, one by one. Of the 637 Hospital Systems in the United States, only 7 provide website documentation of health care services that address the unique needs of women with disabilities. The presumption is that if institutions have not marketed such interventions to the community, then it is likely that they do not have a robust suite of services with which to make gynecologic care available to patients with disabilities. Through this review, 7 main barriers to comprehensive gynecologic care were identified, with more than 20 sub-categories existing within those. As with many other areas of community life, inclusion remains lacking in the delivery of healthcare for women with disabilities. There are at least 7 barriers that must be overcome in order to provide equity in the medical office, the exam room, the hospital and the operating room. While few institutions have prioritized this, those few have provided blueprints that can easily be adopted by others. However, as the general population lives longer and ages, the incidence of disabilities increases, as do the healthcare disparities surrounding them. Further compounded by this is a lack of formal education for medical providers in the United States.

Keywords: health equity, inclusion, healthcare disparities, education

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Authors: Pankaj Prashar, Bimlesh Kumar, Ankita Sood, Anamika Gautam

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Pharmacovigilance (PV) is a rapidly growing discipline in pharmaceutical industries as an integral part of clinical research and drug development over the past few decades. PV carries a breadth of scope from drug manufacturing to its regulation with safer utilization. The fundamental steps of PV not only includes data collection and verification, coding of drugs with adverse drug reactions, causality assessment and timely reporting to the authorities but also monitoring drug manufacturing, safety issues, product quality and conduction of due diligence. Standardization of adverse event information, collaboration of multiple departments in different companies, preparation of documents in accordance to both governmental as well as non-governmental organizations (FDA, EMA, GVP, ICH) are the advancements in discipline of PV. De-harmonization, lack of predictive drug safety models, improper funding by government, non-reporting, and non-acceptability of ADRs by developing countries and reports directly from patients to the monitoring centres respectively are the major road backs of PV. Mandatory pharmacovigilance reporting, frequent inspections, funding by government, educating and training medical students, pharmacists and nurses in this segment can bring about empowerment in PV. This area needs to be addressed with a sense of urgency for the safe utilization of pharmaceuticals.

Keywords: pharmacovigilance, regulatory, adverse event, drug safety

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Authors: Khaled Igbaria

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While Ba'albakī ceased writing or publishing since 1964, it is considerable and significant to investigate Ba'albakī's influence on others. This paper examines her influence on three Lebanese women writers: Emily Nasrallah, Muná Jabbūr, and Hanan al-Shaykh. However, the aim is not simply to examine the influence of the writer on these three authors, but rather to note similarities and differences in the challenges they faced and the agendas they followed in their fiction writing. For each of these writers, this article will describe elements of their literature, and then sketch out the influence which Ba'albakī has had on them. This paper relies on material from Sidawi because it includes interviews with the female writers discussed that are relevant to the current discussion. Sidawi asked them about Ba'albakī and her influence on them, the challenges they faced, and how they coped with them. This paper points out their comments using their own words. To be clear, examining these writers' notes and works is beyond the scope of this paper. To sum up, there are significant parallels between the life and work of Ba'albakī, and other Lebanese women writers such as Nasrallah, Jabbūr and al-Shaykh. Like Ba'albakī, Nasrallah and al-Shaykh also suffered in their struggle against their families. Nasrallah and al-Shaykh, like Ba'albakī, suffered because their society did not trust in their abilities and creativity. Ba'albakī opted for isolation because of her conflict with patriarchal society including the Lebanese women’s groups, while Nasrallah's isolation was because she preferred individualism and autonomy, and Jabbūr, as could be speculated, was not able to cope with the suffering caused by her role as a woman writer within Lebanese society. Whereas Ba'albakī isolated herself from the Lebanese women’s groups, focusing instead on her feminist writing and joining the Shi'r group, Al-Shaykh and the Lebanese women’s groups are able to cooperate in harmony. Furthermore, while Nasrallah and Al-Shaykh continued to publish fiction, Ba'albakī stopped publishing fiction in 1964. All of the above confirms not only that it is worthy to investigate deeply and academically both the biography and the works of Ba'albakī, but also that she deserves to include her throughout the top great Arab female writers, at the time, like Al-Shaykh and Nawal El Saadawi.

Keywords: feminist writing, Hanan Al-Shaykh, Laylá Ba'albakī, Lebanese women writers, Muná Jabbūr

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Authors: Zhen Li

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In contemporary China, the rise of consumer culture and feminism has facilitated the ‘She-Economy’, where Chinese women’s consumption power has been boosted along with the thriving Chinese economy. Domestic reality TV shows such as Sisters Who Make Waves (hereafter SWMW) target female audiences by bringing women's issues such as age, appearance, and balance between family and career to the discussion. Against this backdrop, this study adopted multimodal content analysis to investigate how SWMW failed to live up to the feminist goals the show had claimed and how serious women’s issues were consumed and capitalized by the consumer media culture from consumer culture and feminist perspectives. The findings reveal that while the female-themed work claims to uncover the charm that age brings to women over their thirties, it merely mentions female anxiety and uses feminism in disguise to achieve commercial success without in-depth thinking and discussion of what real-life issues women in China are tackling. They further show that the mass media-promoted modern femininity combined with consumerism deepens anxiety over aging among female audiences. The study sheds light on understanding the new development of Chinese femininity and the impact of consumer culture on feminist consciousness in contemporary China.

Keywords: consumer culture, feminism, multimodal content analysis, she-economy

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Authors: Hamza Ikhlaq, Stephen Franks

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Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age. The aetiology behind PCOS is poorly understood but influencing ethnic, environmental, and genetic factors have been recognised. However, literature examining the impact of ethnicity is scarce. We hypothesised Body Mass Index (BMI) and ethnicity influence the clinical, metabolic, and biochemical presentations of PCOS, with an interaction between these factors. Methods: A database of 1081 women with PCOS and a control group of 72 women were analysed. BMIs were grouped using the World Health Organisation classification into normal weight, overweight and obese groups. Ethnicities were classified into European, South Asian, and Afro-Caribbean groups. Biochemical and clinical presentations were compared amongst these groups, and statistical analyses were performed to assess significance. Results: This study revealed ethnicity significantly influences biochemical and clinical presentations of PCOS. A greater proportion of South Asian women are impacted by menstrual cycle disturbances and hirsutism than European and Afro-Caribbean women. South Asian and Afro-Caribbean women show greater measures of insulin resistance and weight gain when compared to their European peers. Women with increased BMI are shown to have an increased prevalence of PCOS phenotypes alongside increased levels of insulin resistance and testosterone. Furthermore, significantly different relationships between the waist-hip ratio and measures of insulin and glucose control for Afro-Caribbean women were identified compared to other ethnic groups. Conclusions: The findings of this study show ethnicity significantly influence the phenotypic and biochemical presentations of PCOS, with an interaction between body habitus and ethnicity found. Furthermore, we provide further data on the influences of BMI on the manifestations of PCOS. Therefore, we highlight the need to consider these factors when reviewing diagnostic criteria and delivering clinical care for these groups.

Keywords: PCOS, ethnicity, BMI, clinical

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Authors: Monika Szpringer, Aneta Pawlinska

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Adverse childhood experiences are linked to various types of health and adapt problems at different stages of life. They include various types of abuse, neglect, and dysfunctional environment. They have an unfavorable impact on the development of a child and his future functioning in society. Adolescents who were exposed to bad treatment may suffer from health problems during adulthood, like chronic diseases, psychological disorders, drug addiction, and suicide attempts. Objective: The aim of the project is to assess the relationship between adverse childhood experiences and the sense of efficacy and coping with emotions among teenagers aged 16-18 taking drugs. Material And Methods: The research was carried out in the period from March to December 2018 in Mazowieckie, Świętokrzyskie, Łódzkie, and Lubelskie Voivodship. The group consisted of 600 people aged 16-18 (M=16,58; SD=0, 78), men (63,2%) aged 16-18 (M=16,60;SD= 0,78) and women (35,5%) aged 16-18 (M16,55;SD=0,79). Participants included residents from Youth Educational Centers and Youth Sociotherapy Centers. Each participant filled in Author's Questionnaire, Adverse Childhood Questionnaire, then Courtland Emotional Control Scale-CECS and Generalized Self Efficacy Scale-GSES. Results and conclusions: The most common adverse experiences, according to teenagers, were family abuse, divorce/separation/parent's death, overuse of alcohol or drugs by an inmate, and emotional neglect. Adolescents who suffered from five to twelve adverse experiences had a higher level of depression's control. Adverse childhood experiences have an importance for the level of anger and depression's control among teenagers taking drugs. The greatest importance of the level of anger's control has emotional neglect. A higher level of emotional neglect is linked to a lower ability to control anger. The greatest importance of the level of depression's control has physical abuse and emotional neglect. The higher physical abuse during childhood, and the higher frequency of emotional neglect, the bigger the depression's control. The sense of efficacy in the group of people who suffered from one to four adverse experiences is close to the sense of efficacy that suffered people from five to twelve adverse experiences. The most important factor lowering the sense of one's efficacy was the intensification of sexual abuse. It was confirmed that the intensification and frequency of adverse childhood experiences were higher among women than men. Women also characterized lower anger control and greater depression's control. The authors’ own analyses confirmed the relationship between adverse childhood experiences and the sense of efficacy and coping with emotions among teenagers aged 16-18 taking drugs.

Keywords: adolescences, adverse childhood experiences, coping with emotions, drugs

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Authors: E. Rommes, Els Toonen, Rahil Roodsaz, Suborna Camellia, Farhana Alam, Saad Khan, Jhalok Ranjon Talukder, Tanveer Hassan, Syeda Farjana Ahmed, Sabina Faiz Rashid

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In Bangladesh, a country in which adults (both parents and teachers) find it particularly hard to speak with youth about sexuality, adolescents seem to struggle with various insecurities about their sexual feelings, thoughts, behavior and physical characteristics. On the basis of a large number of interviews and focus groups with rural and urban Bangla adolescent girls and boys of lower and middle class as part of the large-scale three-year project ‘Breaking the Shame’, we have identified ten sexual themes or ‘myths’ that youth struggle with most. These encompass amongst others beliefs and insecurities on masturbation, discharge, same-sex behavior and feelings, the effects of watching porn and gender norms. We argue that the Internet is a particularly suitable medium to ‘debunk’ those myths, as youth can consult it anonymously and privately and so avoid social shame. Moreover, amongst the myths, we have identified two kinds which may need different debunking techniques. One kind of myth concerns scientifically uncontested, generally biological related information, such as the effects of having sex with a pregnant woman, questions on the effects of a penile or vaginal discharge or questions on the effects of masturbation. The second kind of myths concerns more diverse information sources and deals with e.g. religious or culturally specific norms, such as on the meaning and existence of homosexuality or gender appropriate norms of behavior in Bangladesh. For addressing both kinds of myths, expert information including a wealth of references to information resources needs to be provided, which the Internet is very suitable for. For the second kind of myths, adolescents also need to learn how to deal with sometimes conflicting norms and information sources, and they need to develop and reflect on their own opinions as part of their identity formation. On the basis of a literature review, we thus distinguish general information needs from identity formation needs, which includes the need to be able to relate information and opinions to one’s own opinions and situation. Hence, we argue that youth not only need abstract expert information to be able to debunk sexual myths, but also the option to discuss this information with other adolescents and compare their own situation and opinions with other peers, who in that way serve as ‘warm experts’ for each other. In this paper, we will describe the outcomes of our qualitative study above. In addition, we will present our findings of an intervention by presenting youth with general, uncontested information on the Internet with additional peer discussion options to compare the debunking effects on different kinds of myths.

Keywords: peer discussion, intervention, sexual myths, shame

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Authors: Maria de Nazaré Moraes Soares, Silvia Maria Dias Pedro Rebouças, José Carlos Lázaro

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The Solidarity Economy (SE) acts in the re-articulation of the economic field to the other spheres of social action. The significant participation of women in SE resulted in the formation of a national network of self-managed enterprises in Brazil: The Solidarity and Feminist Economy Network (SFEN). The objective of the research is to identify factors of gender justice and feminist self-management practices that adhere to the reality of women in SE enterprises. The conceptual apparatus related to feminist studies in this research covers Nancy Fraser approaches on gender justice, and Patricia Yancey Martin approaches on feminist management practices, and authors of postcolonial feminism such as Mohanty and Maria Lugones, who lead the discussion to peripheral contexts, a necessary perspective when observing the women’s movement in SE. The research has a quantitative nature in the phases of data collection and analysis. The data collection was performed through two data sources: the database mapped in Brazil in 2010-2013 by the National Information System in Solidary Economy and 150 questionnaires with women from 16 enterprises in SFEN, in a state of Brazilian northeast. The data were analyzed using the multivariate statistical technique of Factor Analysis. The results show that the factors that define gender justice and feminist self-management practices in SE are interrelated in several levels, proving statistically the intersectional condition of the issue of women. The evidence from the quantitative analysis allowed us to understand the dimensions of gender justice and feminist management practices intersectionality; in this sense, the non-distribution of domestic work interferes in non-representation of women in public spaces, especially in peripheral contexts. The study contributes with important reflections to the studies of this area and can be complemented in the future with a qualitative research that approaches the perspective of women in the context of the SE self-management paradigm.

Keywords: feminist management practices, gender justice, self-management, solidarity economy

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Authors: Laura Ulitzky, Dougbeh-Chris Nyan, Manuel M. Lafer, Erica Silberstein, Nicoleta Cehan, Deborah R. Taylor

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Hepatitis C virus (HCV)-associated hepatocellular carcinoma, fibrosis and cirrhosis are more frequent in men and postmenopausal women than in premenopausal women and women receiving hormone replacement therapy, suggesting that β-estradiol (estrogen) plays an innate role in preventing viral infection and liver disease. Estrogen classically acts through nuclear estrogen receptors or, alternatively, through the membrane-bound G-protein-coupled estrogen receptor (GPR30 or GPER). We observed a marked decrease in detectable virus when HCV-infected human hepatoma cells were treated with estrogen. The effect was mimicked by both Tamoxifen (Tam) and G1, a GPR30-specific agonist, and was reversed by the GPR30-specific antagonist, G15. Through GPR30, estrogen-mediated the down-regulation of occludin; a tight junction protein and HCV receptor, by promoting activation of matrix metalloproteinases (MMPs). Activated MMP-9 was secreted in response to estrogen, cleaving occludin in the extracellular Domain D, the motif required for HCV entry and spread. This pathway gives new insight into a novel innate immune pathway and the disparate host-virus responses to HCV demonstrated by the two sexes. Moreover, these data suggest that hormone replacement therapy may have beneficial antiviral properties for HCV-infected postmenopausal women and show promise for new antiviral treatments for both men and women.

Keywords: HCV, estrogen, occludin, MMPs

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Authors: Tsediso Makoelle

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South Africa like in other parts of the world has acknowledged the prevalence of the phenomenon of homosexuality in the society. Due to the number of homosexuality cases in the South African society, questions have been asked about the impact of homosexuality in schools and how teachers and learners deal with homosexuality within the context of an emerging inclusive education system. This qualitative study analysis the experiences of teachers and learners in selected secondary schools in relation to prevalence of transgender in schools. Interviews were conducted with principals, teachers and focus group of learners in schools were cases homosexuality have been reported. Data was analysed using an inductive analysis framework. Among the findings was that homosexuality is still viewed as a taboo in Black-African dominated school communities and that the need to create all-embracing and inclusive environment was evident. The study suggests a needs to open communications in communities about homosexuality in order to develop an all-inclusive environment for all learners regardless of their sexual orientation.

Keywords: homosexuality, inclusive education, sexual orientation, transgender

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Authors: Oli Sophie Meredith, Jacquelyn Osborne, Sarah Verdon, Jane Frawley

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PROJECT OVERVIEW AND BACKGROUND: Over one million Australians are affected by ADHD at an economic and social cost of over $20 billion per annum. Despite health outcomes being significantly worse compared with men, women have historically been overlooked in ADHD diagnosis and treatment. While research suggests physical activity and other non-prescription options can help with ADHD symptoms, the frontline response to ADHD remains expensive stimulant medications that can have adverse side effects. By interviewing women with ADHD, this research will examine women’s self-directed approaches to managing symptoms, including alternatives to prescription medications. It will investigate barriers and affordances to potentially helpful approaches and identify any concerning strategies pursued in lieu of diagnosis. SIGNIFICANCE AND INNOVATION: Despite the economic and societal impact of ADHD on women, research investigating how women manage their symptoms is scant. This project is significant because although women’s ADHD symptoms are markedly different to those of men, mainstream treatment has been based on the experiences of men. Further, it is thought that in developing nuanced coping strategies, women may have masked their symptoms. Thus, this project will highlight strategies which women deem effective in ‘thriving’ rather than just ‘hiding’. By investigating the health service use, self-care and physical activity of women with ADHD, this research aligns with a priority research areas as identified by the November 2023 senate ADHD inquiry report. APPROACH AND METHODS: Semi-structured interviews will be conducted with up to 20 women with ADHD. Interviews will be conducted in person and online to capture experience across rural and metropolitan Australia. Participants will be recruited in partnership with the peak representative body, ADHD Australia. The research will use an intersectional framework, and data will be analysed thematically. This project is led by an interdisciplinary and cross-institutional team of women with ADHD. Reflexive interviewing skills will be employed to help interviewees feel more comfortable disclosing their experiences, especially where they share common ground ENGAGEMENT, IMPACT AND BENEFIT: This research will benefit women with ADHD by increasing knowledge of strategies and alternative treatments to prescription medications, reducing the social and economic burden of ADHD on Australia and on individuals. It will also benefit women by identifying risks involved with some self-directed approaches in lieu of medical advice. The project has an accessible impact plan to directly benefit end-users, which includes the development of a podcast and a PDF resource translating findings. The resources will reach a wide audience through ADHD Australia’s extensive national networks. We will collaborate with Charles Sturt’s Accessibility and Inclusion Division of Safety, Security and Well-being to create a targeted resource for students with ADHD.

Keywords: ADHD, women's health, self-directed strategies, health service use, physical activity, public health

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Authors: Y. Suchitra Devi, L. Hemchandra Singh

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Background: Because of its geographical location, Manipur lies in the conventional goiter endemic belt. During the post salt iodization period, endemic goiter was prevalent in the valley districts of Manipur without iodine deficiency. Objectives: The present study aim at the prevalence of goiter among school children (6-12 years) and women of reproductive age group (above 20 years) of Andro Assembly Constituency, Imphal- East, Manipur, India. Method: A total of 3992 individuals were clinically examined for thyroid enlargement. Hormones like TSH, FT₄, FT₃, and Anti-TPO, Anti-Tg were tested, UIC, USCN, testing of iodine in water and salt. Result: Total goiter prevalence was found to be 13.98%, median urinary iodine level was 166.0 µg/l, mean urinary thiocyanate concentration was 0.726 ± 0.408, mean water iodine concentration was 3.843 ± 2.291, and all the salt samples were above 15ppm. 6 out of 41 children and 93 out of 176 women were auto antibody positive. 41 children and 176 women were tested for TSH, FT₄, and FT₃, which shows disturbance in hormone level. Conclusion: The present study showed that the region is mildly goiter endemic without biochemical iodine deficiency.

Keywords: goiter, TSH, FT₄, FT₃, anti-TPO, anti-Tg, UIC, USCN, school children and women of reproductive age

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Authors: Annika Agarwal, Sara Baumann

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The urbanization of Mumbai has loosened restrictions placed on Indian women while menstruating, like not praying or entering the kitchen, but it has also introduced sanitary issues. On one hand, residents use community toilets that lack water, electricity, doors, or disposal, making menstruation a communal issue. On the other hand, menstrual taboos perpetuate a culture of a dirty and clandestine menstrual experience. This dichotomy makes India the ideal location for public health research given the complexities of purity and pollution concepts in the Hindu tradition. This study asks: What are the attitudes, practices, and sources of knowledge production around menstrual disposal among men and women of different age groups in Dharavi? Using collaborative filmmaking (CF), researchers cocreated films on menstrual disposal with 20-30 women from 3 slum sites: Dharavi, Kandivali, and Kalwa. Results demonstrate 1) fear and availability issues around sustainable product use, 2) the prominence of certain myths and traditions, 3) lack of disposal facilities and clean toilets, and 4) a lack of discussion around periods with males. These factors jeopardize the health and safety for menstruating women.

Keywords: menstruation, sustainability, sanitation, public health, global health

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Authors: Ivan Orozco

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Introduction: Forced contraception constitutes part of an effort to control the life and reproductive capacity of women through public health institutions. This phenomenon has affected many Mexican women historically and still persists nowadays. The notion of reproductive governmentality refers to the mechanisms through which different historical configurations of social actors (state institutions, churches, donor agents, NGOs, etc.) use legislative controls, economic incentives, moral mandates, direct coercion, and ethical incitements, to produce, monitor and control reproductive behaviors and practices. This research focuses on the use of these mechanisms by the Mexican State to control women's contraceptive practices in a public hospital. Method: An Institutional Ethnography was carried out, with the objective of knowing women's experiences from their own perspective, as they occur in their daily lives, but at the same time, discovering the structural elements that shape the discourses that promote women's contraception, even against their will. The fieldwork consisted in an observation of the dynamics between different participants within a public hospital and the conduction of interviews with the medical and nursing staff in charge of family planning services, as well as women attending the family planning office. Results: Public health institutions in Mexico are state tools to control and regulate reproduction. There are several strategies that are used for this purpose, for example, health personnel provide insufficient or misleading information to ensure that women agree to use contraceptives; health institutions provide economic incentives to the members of the health staff who reach certain goals in terms of contraceptive placement; young women are forced to go to the family planning service, regardless of the reason they went to the clinic; health campaigns are carried out, consisting of the application of contraceptives outside the health facilities, directly in the communities of people who visit the hospital less frequently. All these mechanisms seek for women to use contraceptives, from the women’s perspective; however, the reception of these discourses is ambiguous. While, for some women, the strategies become coercive mechanisms to use contraceptives against their will, for others, they represent an opportunity to take control over their reproductive lives. Conclusion: Since 1974, the Mexican government has implemented campaigns for the promotion of family planning methods as a means to control population growth. Although it is established in several legislations that the counselling must be carried out with a gender and human rights perspective, always respecting the autonomy of people, these research testify that health personnel uses different strategies to force some women to use contraceptive methods, thereby violating their reproductive rights.

Keywords: feminist research, forced contraception, institutional ethnography, reproductive. governmentality

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Authors: Vladyslav Povoroznyuk, Oksana Ivanyk, Nataliia Dzerovych

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In the diagnostics of osteoporosis, the gold standard is considered to be bone mineral density; however, X-ray densitometry is not an accurate indicator of osteoporotic fracture risk under all circumstances. In this regard, the search for new methods that could determine the indicators not only of the mineral density, but of the bone tissue quality, is a logical step for diagnostic optimization. One of these methods is the evaluation of trabecular bone quality. The aim of this study was to examine the quality and mineral density of spine bone tissue, femoral neck, and body composition of women depending on the duration of the postmenopausal period, to determine the correlation of body fat with indicators of bone mineral density and quality. The study examined 179 women in premenopausal and postmenopausal periods. The patients were divided into the following groups: Women in the premenopausal period and women in the postmenopausal period at various stages (early, middle, late postmenopause). A general examination and study of the above parameters were conducted with General Electric X-ray densitometer. The results show that bone quality and mineral density probably deteriorate with advancing of postmenopausal period. Total fat and lean mass ratio is not likely to change with age. In the middle and late postmenopausal periods, the bone tissue mineral density of the spine and femoral neck increases along with total fat mass.

Keywords: osteoporosis, bone tissue mineral density, bone quality, fat mass, lean mass, postmenopausal osteoporosis

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Authors: Jamal Alkoteesh, Mohammed Zeki, Mouza Alnaqbi

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Objective: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. Design: Retrospective study. In this study, most women opted for UFE as a fertility treatment after failure of myomectomy or in vitro fertilization, or because hysterectomy was the only suggested option. Background. Myomectomy is the standard approach in patients with fibroids desiring a future pregnancy. However, myomectomy may be difficult in cases of numerous interstitial and/or submucous fibroids.In these cases, UFE has the advantage of embolizing all fibroids in one procedure. This procedure is an accepted nonsurgical treatment for symptomatic uterine fibroids. Study Methods: A retrospective study of 210 patients treated with UFE for symptomatic uterine fibroids between 2011-2016 was performed. UFE was performed using ((PVA; Embozen, Beadblock) (500-900 µm in diameter). Pregnancies were identified using screening questionnaires and the study database. Of the 210 patients who received UFE treatment, 35 women younger than the age of 40 wanted to conceive and had been unable. All women in our study were advised to wait six months or more after UFE before attempting to become pregnant, of which the reported time range before attempting to conceive was seven to 33 months (average 20 months). RESULTS: In a retrospective chart review of patients younger than the age of 40 (35 patients,18 patients reported 23 pregnancies, of which five were miscarriages. Two more pregnancies were complicated by premature labor. Of the 23 pregnancies, 16 were normal full-term pregnancies, 15 women had conceived once, and four had become pregnant twice. The remaining patients did not conceive. In the study, there was no reported intrauterine growth retardation in the prenatal period, fetal distress during labor, or problems related to uterine integrity. Two patients reported minor problems during pregnancy that were borderline oligohydramnios and low-lying placenta. In the cohort of women who did conceive, overall, 16 out of 18 births proceeded normally without any complications (86%). Eight women delivered by cesarean section, and 10 women had normal vaginal delivery. In this study of 210 women, UFE had a fertility rate of 47%. Our group of 23 pregnancies was small, but did confirm successful pregnancy after UFE. The 45.7% pregnancy rate in women below the age of 40 years old who completed a term pregnancy compares favorably with women who underwent myomectomy via other method. Of the women in the cohort who did conceive, subsequent birth proceeded normally (86%). Conclusion: Pregnancy after UFE is well-documented. The risks of infertility following embolization, premature menopause, and hysterectomy are small, as is the radiation exposure during embolization. Fertility rates appear similar to patients undergoing myomectomy.UFE should not be contraindicated in patients who want to conceive and they should be able to choose between surgical options and UFE.

Keywords: fibroid, pregnancy, therapeutic embolization, uterine artery

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Authors: Josephine Eghonghon Ahiante, Barry Hanyane

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To give effect to the constitutional rights of gender equality, the South African government instituted various legislative policy frameworks and legislations to equalise the public service. Nonetheless, gender inequality in senior management positions remains a rift in government institutions, particularly the local sphere of government. The methodology for gathering and analysing data for this study was based on both primary and secondary data sources, namely literature review, qualitative and quantitative data collection and analysis, triangulation, and inductive and deductive thematic analysis. The study found that misogynist tendencies which are manifest in organisational culture suffocate the good intentions of government in ensuring social justices, leadership diversity, and women equality. It also demonstrates that traditional gender role expectation still informs the ground in which senior management positions are allocated, men perceive women as non-leadership fit and discriminate against them during recruitment, selection, and promotion into high positions. The analyses from the study portray that, while government legislation and framework has been instrumental in the leadership acceleration of women, much more has to be done to deconstruct internalised leadership stereotypes on women's gender roles and leadership requirements. The study recommends that gender bias training intervention is needed to teach public employees on management excellence.

Keywords: gender, leadership, misogyny, orgnisational cultural, patriachy

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Authors: Jummai Aliyu Mohammed

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The Sapir-Whorfian hypothesis postulates that the structure of a language determines the way in which species of that language view the world. It also states that the culture of a people finds reflection in their language. Consequently language becomes a vehicle of thought; a channel through which negative stereotypes of women is created and also one through which such images are dispelled. Women are generally portrayed as weaker vessels and inferior to men; a position which draws a counter reaction from women through their writings. In their writings, they attempt to reinvent womanhood and liberate the woman from the hitherto negative light they were portrayed. This position best describes the term feminism which argues that women be given equal rights in all spheres of life as men. This paper attempts to evaluate Ba’s ‘So Long a Letter’ and Alkali’s ‘The Stillborn’ with the view to identify the relationship between language and feminism. In evaluating this relationship, the paper concludes that there are several factors responsible for the variation in the speech pattern of male and female. All of these factors favour the male gender and further condemns the woman to oppression. Although the writers come from two different cultural backgrounds, the works amplify feminism and captured them as apostles of feminism.

Keywords: feminism, language, politics, Sapir-Whorfian hypothesis

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Authors: Fouzia Mannan, Deepa Joshi

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Millions of Bangladeshis move from low-income agrarian villages to the country’s urban landscape with the hope to gain from the rapidly-growing middle-income urban, industrial future. However, the economic gains are mostly offset by new forms of extreme depravity, indignity, and inequality. Nonetheless, many scholars report unique gendered gains through migration - the rupture of traditional, entrenched inequalities by gender, providing women not only reliable incomes but also the opportunity to re-negotiate gendered roles, responsibilities and identities. In this study, we present the reflections of ten long-term urban migrant women in Dhaka city: of their gains, their losses as well as their aspirations for the future. Our findings show the incredibly high costs of a migration that is induced by desperate rural poverty. Further, we find that patriarchy persists - within the often 'kutcha' walls of urban low-income homes to the nature of so-called economic opportunities - in the constant intertwining of capitalism, globalization, and patriarchy. Caught in between, women have little choice but to cope with these new vulnerabilities by relying on the very norms and boundaries established by patriarchy and by recreating patriarchy to celebrate the (if) gains from displacement and migration.

Keywords: gender, internal migration, patriarchy, urbanization

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Authors: Thirumila Muthukamaru

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The objective of a Health Risk Assessment (HRA) is to achieve a quality evaluation of risk assessments in a timely manner where adequate controls can be in place to protect workers health, especially during turnarounds where the exposure to health hazards is expected to rise during the performance of the many activities that take place, exposing workers to health risk. HRA development requires a competent team comprising experienced subject matter experts in the field, such as Industrial hygienists, Occupational Health Doctors, Turnaround Coordinators, Operation / Maintenance personnel, etc. The conventional way of conducting HRA is not only tedious and time-consuming but also less appreciated when it is not interpreted correctly, which may contribute to inadequate operationalization of it. Simplification can be the essence of timely intervention in managing health risks. This paper is intended as a sharing of the approach taken to simplify the methodology of developing the HRA report and operationalizing it. The approach includes developing a Generic HRA for turnaround activities to be used as a reference document and the empowerment of identified personnel through upskilling sessions to take up the role of facilitating HRA sessions. This empowerment is one of the key approaches towards the successful translation of the HRA into specific turnaround Job Hazard Analysis (JHA) that embed it in the Permit to Work (PTW) process. The approach used here increases awareness and compliance on HRA for turnaround activities through better interpretation and operationalization of the HRA report, adding value to the risk assessment for turnaround activities.

Keywords: industrial hygiene, health risk assessment, HRA, risk assessment

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Authors: Seyed Ali Kimiaei, Reza Pishghadam, Fatemeh Hajizadeh, Marjan Entezari

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The aim of this study was to investigate the effectiveness of the Minnesota Spouses Communication Skills Program on reducing emotional harassment and adjusting the marital expectations of married women. The research method was quasi-experimental with pretest-posttest design with waiting list group and follow-up period. The statistical population of the study consisted of married women referring to counseling and psychology centers in Mashhad, from which 30 people were selected as a sample by examining the entry criteria and questionnaire scores, and randomly divided into two experimental groups (15 people) and the waiting list group (15 people) were replaced. The experimental group was given 8 sessions of communication skills program of spouses. The emotional harassment and marital expectations questionnaire was used to collect data. The results showed a significant difference between the experimental group and the waiting list group, so that the communication skills training of the spouses reduced emotional harassment and adjusted marital expectations, and these effects continued in the follow-up period. Therefore, we can conclude that teaching the husband's communication skills program in the Minnesota method reduces emotional harassment and modifies women's marital expectations.

Keywords: spouses communication skills program, emotional harassment, marital expectations, women

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Authors: Majeda Hammoud

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Background: Anemia during pregnancy increases the risk of delivery by cesarean section, low birth weight, preterm birth, perinatal mortality, stillbirth, and maternal mortality. In this study, we aimed to assess the prevalence of anemia in pregnant women and its associated factors in the Kuwait birth cohort study. Methods: The Kuwait birth cohort (N=1108) was a prospective cohort study in which pregnant women were recruited in the third trimester. Data were collected through personal interviews with mothers who attend antenatal care visits, including data on socio-economic status and lifestyle factors. Blood samples were taken after the recruitment to measure multiple laboratory indicators. Clinical data were extracted from the medical records by a clinician including data on comorbidities. Anemia was defined as having Hemoglobin (Hb) <110 g/L with further classification as mild (100-109 g/L), moderate (70-99 g/L), or severe (<70 g/L). Predictors of anemia were classified as underlying or direct factors, and logistic regression was used to investigate their association with anemia. Results: The mean Hb level in the study group was 115.21 g/L (95%CI: 114.56- 115.87 g/L), with significant differences between age groups (p=0.034). The prevalence of anemia was 28.16% (95%CI: 25.53-30.91%), with no significant difference by age group (p=0.164). Of all 1108 pregnant women, 8.75% had moderate anemia, and 19.40% had mild anemia, but no pregnant women had severe anemia. In multivariable analysis, getting pregnant while using contraception, adjusted odds ratio (AOR) 1.73(95%CI:1.01-2.96); p=0.046 and current use of supplements, AOR 0.50 (95%CI: 0.26-0.95); p=0.035 were significantly associated with anemia (underlying factors). From the direct factors group, only iron and ferritin levels were significantly associated with anemia (P<0.001). Conclusion: Although the severe form of anemia is low among pregnant women in Kuwait, mild and moderate anemia remains a significant health problem despite free access to antenatal care.

Keywords: anemia, pregnancy, hemoglobin, ferritin

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Authors: Theresia F. Mrema, Innocent Semali

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Food insecurity to pregnant women seriously impedes efforts to reduce maternal mortality in resource poor countries. This study was carried out to assess determinants food insecurity among pregnant women in urban areas. A cross sectional study design was used to collect data for the period of two weeks. A structured questionnaire with both closed and open ended questions was used to interview a total of 225 randomly selected pregnant women who attend the three randomly selected antenatal care clinics in Temeke Municipal council. The food insecurity was measured using a modified version of the USDA’s core food security module which consists of 15questions. Logistic regression analysis was used to obtain strength of association between dependent and independent variables. Among 225 pregnant women attending antenatal care (ANC) interviewed 55.1% were food insecure. Food insecurity declined with increasing household wealth, it was also significantly low among those with less than three children compared with having more. Low level of food insecurity was associated with having Secondary education (Adjusted OR=0.24; 95%CI, 0.12–0.48), College Education (OR=0.156; 95%CI, 0.05-0.46), paid employment (OR=0.322; 95%CI, 0.11-0.96) and high income (OR=0.031; 95%CI, 0.01–0.07). Also, having head of the household with secondary education (OR=0.51; 95%CI, 0.07-0.32) college education (OR=0.04; 95%CI, 0.01-0.13) and paid employment (OR=0.225; 95%CI, 0.12-0.42). Food insecurity is a significant problem among pregnant women in Temeke Municipal which might significantly affect health of the pregnant woman and foetus due to higher maternal malnutrition which increases risk of miscarriage, maternal and infant mortality, and poor pregnancy outcomes. The study suggests a multi-sectoral approach in order to address this problem.

Keywords: food security, nutrition, pregnant women, urban settings

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Authors: Danielle A. Walker, Kyle L. Johnson, Patrick J. Fox, Jacen S. Moore

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The HIV Continuum of Care has become a universal model to provide context for the process of HIV testing, linkage to care, treatment, and viral suppression. HIV testing is the first step in moving toward community viral suppression. Countries with a lower socioeconomic status experience the lowest rates of testing and access to care. The Democratic Republic of the Congo is located in the heart of sub-Saharan Africa, where testing and access to care are low and women experience higher HIV prevalence compared to men. In the Democratic Republic of the Congo there is only a 21.6% HIV testing rate among women. Because a critical gap exists between a woman’s risk of contracting HIV and the decision to be tested, this study was conducted to obtain a better understanding of the relationship between factors that could influence HIV testing among women. The datasets analyzed were from the 2013-14 Democratic Republic of the Congo Demographic and Health Survey Program. The data was subset for women with an age range of 18-49 years. All missing cases were removed and one variable was recoded. The total sample size analyzed was 14,982 women. The results showed that there did not seem to be a difference in HIV testing by mean age. Out of 11 religious categories (Catholic, Protestant, Armee de salut, Kimbanguiste, Other Christians, Muslim, Bundu dia kongo, Vuvamu, Animist, no religion, and other), those who identified as Other Christians had the highest testing rate of 25.9% and those identified as Vuvamu had a 0% testing rate (p<0.001). There was a significant difference in testing by religion. Only 0.7% of women surveyed identified as having no religious affiliation. This suggests partnerships with key community and religious leaders could be a tool to increase testing. Over 60% of women who had never been tested for HIV did not know where to be tested. This highlights the need to educate communities on where testing facilities can be located. Almost 80% of women who believed HIV could be transmitted by supernatural means and/or witchcraft had never been tested before (p=0.08). Cultural beliefs could influence risk perception and testing decisions. Consequently, misconceptions need to be considered when implementing HIV testing and prevention programs. Location by province, years of education, and wealth index were also analyzed to control for socioeconomic status. Kinshasa had the highest testing rate of 54.2% of women living there, and both Equateur and Kasai-Occidental had less than a 10% testing rate (p<0.001). As the education level increased up to 12 years, testing increased (p<0.001). Women within the highest quintile of the wealth index had a 56.1% testing rate, and women within the lowest quintile had a 6.5% testing rate (p<0.001). This study concludes that further research is needed to identify culturally competent methods to increase HIV education programs, build partnerships with key community leaders, and improve knowledge on access to care.

Keywords: Democratic Republic of the Congo, cultural beliefs, education, HIV testing

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Authors: Amanda Maitland

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This preliminary study has examined ways in which social media may help cause stalker murder by individuals with personality disorders and a strong sense of sexual propriety. A public display on social media by the intended victim was felt to be a trigger that instigated interpersonal violence. To identify behavioural paradigms, case studies of intimate partner murders were explored using news media sources and documentaries. In all of the case studies, social media interaction and social media postings occurred shortly before the murder. The evidence suggested a preponderance of correlations between the social media postings, stalking behaviours, personality disorders, and the murder of an intimate partner. In addition to this, a profile for of Facebook/social media murder was gleaned from the paradigms of behavior found in the case studies. The evidence showed a complex relationship between severe violence, stalking, borderline personality, and intimate partner violence was identified through the study. The struggle clients have in dealing with the: public, ambiguous and unrelenting nature of social media postings was also observed. The murderers anguish and rage appeared to be further intensified by attitudes of sexual propriety and entitlement. These attitudes were evident in all the case studies. The study concluded with further research on how the public can protect themselves from entering situations where social media postings might trigger a violent response. Further to this, psychological approaches were identified that might support client’s with personality disorders to cope with perceived provocative and distressing data on the internet. Thus, the findings of this study will be of interest to: therapists, psychologists, nurses, criminologists and social workers.

Keywords: social media, borderline personality, murder, cyberstalking, intimate partner violence, sexual propriety, Facebook

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Authors: Elhem Zaatir, Taher Hamza

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Several governments seek to implement gender parity on boards, but the results of doing so are not clear and could harm corporations and economies. The present paper aims to investigate the relationship between women’s presence on boards and firms’ performance in the context of the French listed firms during the quota period. A dynamic panel generalized method of moment estimation is applied to control the endogenous effect of board structure and reverse the causality impact of the financial performance. Our results show that the impact of gender diversity manifests in conflicting directions, positively affecting accounting performance and negatively influencing market performance. These results suggest that female directors create economic value, but the market discounts their impact. Apparently, they are subject to a biased evaluation by the market, which undervalues their presence on boards. Added to that, our results confirm a twofold nature of female representation in the French market. The effect of female directorship on firm performance varies with the affiliation of the directors. In other words, the positive impact of gender diversity on return on assets primarily originates from the positive effect of non-family-affiliated women directors on market performance rather than on the effect of family-affiliated women directors on ROA. Finally, according to our results, women’s demographic attributes namely the level of education and multiple directorships strongly and positively impact firm performance as measured by return on assets (ROA). Obviously, women directors seem to be appointed to the business case rather than as token directors.

Keywords: corporate governance, board of directors, women, gender diversity, demographic attributes, firm performance

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Authors: Renee Moten

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Introduction: Knee pain becomes chronic because the therapy used focuses only on the symptoms of knee pain and not the causes of knee pain. Preventing knee injuries is not in the toolbox of the traditional practitioner. This research was done to show that we must reduce the inflammation (holistically), reduce the swelling and regain flexibility before considering any type of exercise. This method of performing the correct exercise stops the bowing of the knee, corrects the walking gait, and starts to relieve knee, hip, back, and shoulder pain. Method: The holistic method that is used to heal knees is called the Knee Pain Recipe. It’s a six step system that only uses alternative medicine methods to reduce, relieve and restore knee joint mobility. The system is low cost, with no hospital bills, no physical therapy, and no painkillers that can cause damage to the kidneys and liver. This method has been tested on 200 women with knee, back, hip, and shoulder pain. Results: All 200 women reduce their knee pain by 50%, some by as much as 90%. Learning about ankle and foot flexibility, along with understanding the kinetic chain, helps improve the walking gait, which takes the pressure off the knee, hip and back. The knee pain recipe also has helped to reduce the need for a cortisone injection, stem cell procedures, to take painkillers, and surgeries. What has also been noted in the research was that if the women's knees were too far gone, the Knee Pain Recipe helped prepare the women for knee replacement surgery. Conclusion: It is believed that the Knee Pain Recipe, when performed by men and women from around the world, will give them a holistic alternative to drugs, injections, and surgeries.

Keywords: knee, surgery, healing, holistic

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Authors: Husham Bayazed

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Purpose of presentation: Pregnancy represents the most important period for the conservation of the species. The immune system is one of the most important systems protecting the mother against the environment and preventing damage to the fetus. This presentation aims to review and discuss the role of the immune system during pregnancy, the evolutionary inflammatory process through pregnancy, infectious and environmental exposure influences on the mother and the fetus, and the impacts of sexual dimorphism of the placenta on offspring susceptibility to different disorders. Recent Findings: In 1960, Peter Medawar (Nobel Prize Winner) proposed that the fetus, a semi-allograft, is similar to a tissue graft that escapes rejection through a mechanism involving systemic immune suppression (Graft –Host response). However, recent researchers and studies have documented that implantation means inflammation, and the inflammatory process is considered a breach of tolerance in pregnancy with immune induction, which is necessary for the protection of the mother and the fetus against infections and environmental triggers. This inflammatory process should be maintained during different pregnancy phases till parturition, and any block at any phase will be associated with pregnancy complications, including pregnancy failure or loss, miscarriage, and preterm birth subsequently. Maternal immune activation following any trigger can have a positive effect on the fetus. The old concept of the placenta being asexual is inaccurate, and being with sexual dimorphism with clear differences in susceptibility to different factors that stimulate maternal immunity. Summary: The presence of different immune cells ((i.e., T cells, B cells, NK cells, etc.) at the implantation site is considered proof of a strong maternal immune response to the fetus. Therefore, human pregnancy is considered a unique immunological paradigm requiring maternal immune modulation rather than suppression. So Medawar's postulation of maternal systemic immunosuppression is wrong. Maternal immune system activation triggered by infections, stress, diet, and pollution can have a positive effect on the fetus, with the development of fetal-trained immunity necessary for survival. The sexual dimorphism of the placenta seems to have an impact on the differences in sex susceptible to the environment maternal risk stimuli. This link to why the incidence of autism is increasing more among boys than girls.

Keywords: pregnancy, maternal immunity, implantation and inflammation, placenta sexual dimorphism

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Authors: Zafar Ali

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The aim of this research is to highlight problems that are faced by women at the hands of men. Males in Pakistani society have power and use this power for the exploitation of women. Further, the purpose of the study is to make societies like Pakistan and especially the young generation, aware and enable them to resist such issues, and the role of discourse in this regard is to minimize its political and social repercussions. The study finds out different discursive techniques and manipulative language used in the short story to construct gender identity. The study also investigates socio-economic roles in the construction of gender identity. This study has been completed with the help of Critical Discourse Analysis (CDA) principles. CDA principles have been applied to the text of the selected short story Saleema from Daniyal Mueenuddin’s collection In Other Rooms, Other Wonders. Related passages, structures, expressions, and text are analyzed from the point of view of CDA, especially Norman Fairclough’s CDA approach. It was found from the analysis that women have no identity of their own in patriarchal societies like Pakistan. Further, it was found women are mistreated, and they have a very limited and defined role in Pakistan. They cannot go beyond the limit defined to them by men.

Keywords: gender issues, resourceful groups, CDA, exploitation

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Authors: Misha Teimouri

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Our world has been transformed by the use of the internet and the constant flow of information. While this transmission has its benefits, it has also added significant challenges to family relations, primarily in the field of parenting and children's digital lives. Screens, speed, and connectedness are the words that characterize the lives of today's digital generation; it's as if the entire world is in their pockets at all times. Parents attempt to regulate and control their children's internet use in the hopes of maximizing the advantages and minimizing the disadvantages of their children's internet use; however, given that children spend more time online, particularly ever since the pandemic, children's cyber-aggression has become an issue for them. Children may externalize their behavior online, bully others, send anger/hatred/resist messages, share violent and bloody content, and engage in sexting. These types of online aggression make parenting more difficult, especially for digital immigrant parents compared to digital native parents. In response to these challenges, this study investigated the level of cyber aggression among children, as well as the effects of digi-parenting (active, monitoring, restrictive, and warm and supportive) on children's cyber-aggression (sexual, verbal, visual) as victims or aggressors. The study also determined whether there were any differences in parenting styles between digital natives (DN) and digital immigrants. In accordance with the study, boys and older children are more likely to engage in cyber aggression as aggressors, whereas girls and younger children are more likely to engage as victims. Warmth and supportive digiparenting have a greater impact on children's cyber-aggression (sexual, verbal, and visual) as victims or aggressors. This study also found that, when compared to DI parents, DN parents are more successful at digi-parenting and reducing their children's exposure to cyber-aggression.

Keywords: digi-parenting, cyber-aggression, digital natives, digital immigrants, children's cyber-aggression (sexual, verbal, visual)

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