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Feature Papers in Women's Health

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Women's Health".

Deadline for manuscript submissions: closed (10 April 2021) | Viewed by 67727

Special Issue Editors

Prof. Dr. Colin W. Binns

E-Mail Website
Guest Editor
School of Public Health, Curtin University, Perth 6845, Australia
Interests: public health nutrition; development of dietary guidelines; breastfeeding policy
Special Issues, Collections and Topics in MDPI journals
Dr. Mi Kyung Lee

E-Mail Website
Guest Editor
School of Health Sciences, Murdoch University, Perth 6150, Australia
Interests: nutrition; public health
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue will publish a series of high-quality articles on key topics in Women’s Health.

The papers will be directed towards health professionals, women’s health experts, public health workers, social scientists, policy makers, and others concerned with issues related to the health and care delivery to women. While welcoming papers on all aspects of women’s health, we aim to include papers on epidemiology, including the social determinants of health, and prevention. This Special Issue aims to discuss new knowledge or new cutting-edge developments in women’s health research as well as evaluations of programs that work and innovative ideas in the field. We will welcome papers that address issues of women’s health in achieving the Sustainable Development Goals and in addressing climate change.

Papers could be either research papers with a detailed summary of their own work done so far or papers highlighting the state-of-the-art developments in one of the areas of Women’s Health.

Prof. Dr. Colin W. Binns
Dr. Mi Kyung Lee
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Women’s health and mental health
  • Epidemiology, risk factors, prevention in women’s health
  • Communication of women’s health issues
  • Women’s health in the mass media
  • Social and behaviour change to improve health
  • Health literacy of women in lower income countries
  • Family as a key factor in women’s health
  • Equity in health risk factor alleviation and health care access, Socio-economic status
  • Health after birth (but not health during pregnancy)

Published Papers (17 papers)

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Editorial

Jump to: Research, Review, Other

3 pages, 259 KiB  
Editorial
The Broad Spectrum and Continuing Needs of Women’s Health
by Colin Binns, Mi Kyung Lee and Lyn Wren
Int. J. Environ. Res. Public Health 2022, 19(3), 1446; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19031446 - 27 Jan 2022
Cited by 1 | Viewed by 1840
Abstract
The Women’s Health section of the IJERPH has published almost 700 papers in the past three years, reflecting its importance in public health [...] Full article
(This article belongs to the Special Issue Feature Papers in Women's Health)

Research

Jump to: Editorial, Review, Other

10 pages, 487 KiB  
Article
Consequences of Early Separation of Maternal-Newborn Dyad in Neonates Born to SARS-CoV-2 Positive Mothers: An Observational Study
by Maria Giulia Conti, Fabio Natale, Ilaria Stolfi, Roberto Pedicino, Giovanni Boscarino, Camilla Ajassa, Viviana Cardilli, Giovanni Luca Ciambra, Laura Guadalupi, Paola Favata, Paola Repole, Francesca De Luca, Giulia Zacco, Roberto Brunelli and Gianluca Terrin
Int. J. Environ. Res. Public Health 2021, 18(11), 5899; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115899 - 31 May 2021
Cited by 16 | Viewed by 3062
Abstract
As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection continues its spread all over the world, data on perinatal management of the maternal-infant dyad are urgent. We performed an observational study to describe the effects of the early separation of the maternal-infant [...] Read more.
As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection continues its spread all over the world, data on perinatal management of the maternal-infant dyad are urgent. We performed an observational study to describe the effects of the early separation of the maternal-infant dyad, in case of maternal SARS-CoV-2 infection. We reported the medical records for 37 neonates born to 37 SARS-CoV-2 positive mothers in a setting of separation of the dyad after birth. Data on neonatal infection, clinical condition, and breastfeeding rate were recorded until the first month of life. No maternal deaths were recorded; 37.8% of women had at least one pregnancy-related complication. We reported a high adherence to recommended safety measures after discharged with 84.8% of the mothers using at least one personal protective device and 51.5% using all the protective devices. We reported one case of vertical transmission and no cases of horizontal transmission. However, the separation of the dyad had a negative impact on breastfeeding because only 23.5% of the newborns received exclusively human milk during the first month of life. Despite early separation of the dyad protecting the newborns from possible horizontal transmission of SARS-CoV-2, it negatively affects breastfeeding during the first months of life. Full article
(This article belongs to the Special Issue Feature Papers in Women's Health)
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10 pages, 474 KiB  
Article
Clinical Factors Associated with Asymptomatic Women Having Inconclusive Screening Mammography Results: Experiences from a Single Medical Center in Taiwan
by Chun-Li Wang, Pi-Shan Hsu, Chia-Yen Lin and Shun-Fa Yang
Int. J. Environ. Res. Public Health 2021, 18(10), 5410; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18105410 - 19 May 2021
Viewed by 1912
Abstract
Screening mammography is used worldwide for the early detection of breast cancer in women experiencing no symptoms. The Breast Imaging Reporting and Database System (BI-RADS) is used to report mammographic findings. However, little is known about the clinical characteristics of Asian women with [...] Read more.
Screening mammography is used worldwide for the early detection of breast cancer in women experiencing no symptoms. The Breast Imaging Reporting and Database System (BI-RADS) is used to report mammographic findings. However, little is known about the clinical characteristics of Asian women with BI-RADS category 0, and we aimed to explore such characteristics in the context of Taiwan. This retrospective cross-sectional study was conducted using data from a single tertiary medical center. We examined the association of blood test data and estrogen exposure–related medical histories with BI-RADS reports from screening mammography of 4280 women between 1 January 2010 and 31 July 2019. The data of 4280 participants were evaluated, and they were categorized into BI-RADS category 0 (n = 413; 9.6%) and 1–5 (n = 3867; 90.4%) subgroups. In a multivariate analysis, breast surgery history and premenopausal status had a positive relationship with a category 0 status, with respective risk increases of 64% and 34% (p = 0.010 and 0.013). Hormone contraceptive use for ≥5 years was a negative independent predictor of having a category 0 status. In conclusion, breast surgery history and premenopausal status significantly increased the likelihood of individuals having incomplete mammographic findings, even when they were older than 45 years. Identifying related factors before screening mammography is helpful for clinical physicians to arrange more proper and alternative examination and obtain a definite diagnosis. Full article
(This article belongs to the Special Issue Feature Papers in Women's Health)
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14 pages, 327 KiB  
Article
The Impact of Neglected Tropical Diseases (NTDs) on Women’s Health and Wellbeing in Sub-Saharan Africa (SSA): A Case Study of Kenya
by Elizabeth A. Ochola, Susan J. Elliott and Diana M. S. Karanja
Int. J. Environ. Res. Public Health 2021, 18(4), 2180; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18042180 - 23 Feb 2021
Cited by 11 | Viewed by 4273
Abstract
Neglected Tropical Diseases (NTDs) trap individuals in a cycle of poverty through their devastating effects on health, wellbeing and social–economic capabilities that extend to other axes of inequity such as gender and/or ethnicity. Despite NTDs being regarded as equity tracers, little attention has [...] Read more.
Neglected Tropical Diseases (NTDs) trap individuals in a cycle of poverty through their devastating effects on health, wellbeing and social–economic capabilities that extend to other axes of inequity such as gender and/or ethnicity. Despite NTDs being regarded as equity tracers, little attention has been paid toward gender dynamics and relationships for gender-equitable access to NTD programs in sub-Saharan Africa (SSA). This paper examines the impact of NTDs on women’s health and wellbeing in SSA using Kenya as a case study. This research is part of a larger research program designed to examine the impact of NTDs on the health and wellbeing of populations in Kenya. Thematic analysis of key informants’ interviews (n = 21) and focus groups (n = 5) reveals first that NTDs disproportionately affect women and girls due to their assigned gender roles and responsibilities. Second, women face financial and time constraints when accessing health care due to diminished economic power and autonomy. Third, women suffer more from the related social consequences of NTDs (that is, stigma, discrimination and/or abandonment), which affects their health-seeking behavior. As such, we strongly suggest a gender lens when addressing NTD specific exposure, socio-economic inequities, and other gender dynamics that may hinder the successful delivery of NTD programs at the local and national levels. Full article
(This article belongs to the Special Issue Feature Papers in Women's Health)
11 pages, 643 KiB  
Article
Efficacy of Denosumab Therapy Following Treatment with Bisphosphonates in Women with Osteoporosis: A Cohort Study
by Chiara Marocco, Giovanna Zimatore, Edoardo Mocini, Rachele Fornari, Giovanni Iolascon, Maria Chiara Gallotta, Viviana Maria Bimonte, Carlo Baldari, Andrea Lenzi and Silvia Migliaccio
Int. J. Environ. Res. Public Health 2021, 18(4), 1728; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18041728 - 10 Feb 2021
Cited by 3 | Viewed by 2653
Abstract
Denosumab is a human monoclonal antibody that neutralizes RANKL, a cytokine able to interact with the RANK receptor on preosteoclasts and osteoclasts, decreasing their recruitment and differentiation, leading to a decreased bone resorption. The aim of this observational real-life study was to analyze [...] Read more.
Denosumab is a human monoclonal antibody that neutralizes RANKL, a cytokine able to interact with the RANK receptor on preosteoclasts and osteoclasts, decreasing their recruitment and differentiation, leading to a decreased bone resorption. The aim of this observational real-life study was to analyze adherence to denosumab therapy and assess its efficacy in increasing bone mineral density (BMD) and modulating biochemical skeletal markers following previous treatments with bisphosphonates in a group of post-menopausal women with osteoporosis. Women were recruited in the specialized center from March 2012 to September 2019. Biochemical markers were recorded at baseline and every six months prior to subsequent drug injection. Dual X-ray absorptiometry was requested at baseline and after 18/24 months. Comparing BMD at baseline and after denosumab therapy in naive patients and in those previously treated with bisphosphonates, a positive therapeutic effect was observed in both groups. The results of our real-life study demonstrate, as expected, that BMD values significantly increased upon denosumab treatment. Interestingly, denosumab showed an increased efficacy in patients previously treated with bisphosphonates. Moreover, biochemical markers data indicate that osteoporotic patients, without other concomitant unstable health conditions, could be evaluated once a year, decreasing the number of specialistic center access. Full article
(This article belongs to the Special Issue Feature Papers in Women's Health)
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12 pages, 902 KiB  
Article
Add-On Effect of Postural Instructions to Abdominopelvic Exercise on Urinary Symptoms and Quality of Life in Climacteric Women with Stress Urinary Incontinence. A Pilot Randomized Controlled Trial
by Laura Fuentes-Aparicio, Mercè Balasch-Bernat and Laura López-Bueno
Int. J. Environ. Res. Public Health 2021, 18(3), 928; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18030928 - 21 Jan 2021
Cited by 5 | Viewed by 2785
Abstract
The aim of this study was to investigate the add-on effect of postural instructions to an abdominopelvic exercise program on incontinence urinary symptoms (UI symptoms) and quality of life (QoL) in climacteric women with stress urinary incontinence (SUI). A randomized controlled trial was [...] Read more.
The aim of this study was to investigate the add-on effect of postural instructions to an abdominopelvic exercise program on incontinence urinary symptoms (UI symptoms) and quality of life (QoL) in climacteric women with stress urinary incontinence (SUI). A randomized controlled trial was performed with a total of 40 climacteric women with SUI aged between 46 and 75 years old. Participants were randomly assigned to two groups: a group performing an abdominopelvic exercise program (AEP) (n = 20) and a group performing abdominopelvic exercise with the addition of postural instructions (AEPPI) (n = 20). Primary outcome measures were UI symptoms, UI impact and QoL related to UI (UI-QoL), measured by 48 h Pad Test and International Consultation on Incontinence Questionnaire Short Form (ICIQ-UI-SF), which were assessed at baseline, post-intervention and 3 months follow-up. Secondary outcome was patient’s satisfaction measured by the 100-point Visual Analogic Scale (VAS) only after the intervention. Between-groups differences were observed in terms of UI-QoL immediately after intervention. Within-groups differences were observed between baseline to 3 months follow-up and between post-intervention to 3 months follow-up in AEPPI group (p < 0.05) for UI-QoL and UI impact. UI symptoms were improved in both groups between baseline to 3-months follow-up (p < 0.05). Patient’s satisfaction was higher in the AEPPI group (p < 0.05). The addition of postural instructions to an abdominopelvic exercise program improves UI impact to QoL and patients’ satisfaction in women with SUI. Full article
(This article belongs to the Special Issue Feature Papers in Women's Health)
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15 pages, 552 KiB  
Article
Evaluating Health Literacy among Adolescent and Young Adult Pregnant Women from a Low-Income Area of Northeast Brazil
by Allen Suzane França, Catherine M. Pirkle, Tetine Sentell, Maria P. Velez, Marlos R. Domingues, Diego G. Bassani and Saionara M. A. Câmara
Int. J. Environ. Res. Public Health 2020, 17(23), 8806; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17238806 - 27 Nov 2020
Cited by 7 | Viewed by 3027
Abstract
Adequate health literacy is important for strong health outcomes during pregnancy, particularly among mothers with high risk of adverse outcomes related to pregnancy and childbirth. Understanding the health literacy of young pregnant women in low-income settings could support strategies to reduce adverse outcomes [...] Read more.
Adequate health literacy is important for strong health outcomes during pregnancy, particularly among mothers with high risk of adverse outcomes related to pregnancy and childbirth. Understanding the health literacy of young pregnant women in low-income settings could support strategies to reduce adverse outcomes in this population. This exploratory study assessed the health literacy of young pregnant adolescents and young adults from a rural area in Northeast Brazil and associated factors such as socioeconomic conditions, adequacy of prenatal care, and social support from family and friends. In this cross-sectional study, 41 pregnant adolescents (13–18 years) and 45 pregnant adults (23–28 years) from the Rio Grande do Norte state, Brazil, were assessed regarding health literacy through the Short Assessment of Health Literacy for Portuguese-Speaking Adults (SAHLPA, score from 0–18, inadequate if <15). Income sufficiency, self-perceived school performance, compliance with recommendations for adequate prenatal care, and social support were also assessed. A linear regression analysis was conducted to evaluate the variables associated with the SAHLPA score. Ninety-five percent of the adolescents and 53.3% of the adults (p < 0.001) presented inadequate health literacy. Adolescent age (β − 3.5, p < 0.001), poorer self-perceived school performance (β − 2.8, p < 0.001), and insufficient income for basic needs (β − 2.8, p = 0.014) were associated with worse SAHLPA scores. Adolescent mothers have higher rates of inadequate health literacy in this population. Policies are needed to improve access to health information for young populations from rural low-income areas. Full article
(This article belongs to the Special Issue Feature Papers in Women's Health)
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12 pages, 1940 KiB  
Article
Association between Anemia and Stroke in Females: A Nationwide, Population-Based Cohort Study in Taiwan
by Yuan Sui, Chien-Tai Hong, Li-Nien Chien, Hung-Yi Liu, Hung-Yi Chiou and Yi-Chen Hsieh
Int. J. Environ. Res. Public Health 2020, 17(20), 7440; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17207440 - 13 Oct 2020
Cited by 2 | Viewed by 2331
Abstract
Optimal stroke prevention strategies for women should take into account specific sex-related stroke risk factors. Anemia is a common medical condition in females, particularly in women of reproductive age. This study investigated whether anemia is an independent risk factor for stroke in females [...] Read more.
Optimal stroke prevention strategies for women should take into account specific sex-related stroke risk factors. Anemia is a common medical condition in females, particularly in women of reproductive age. This study investigated whether anemia is an independent risk factor for stroke in females in a population-based cohort study. We investigated newly diagnosed anemic female patients with no history of central nervous system disease, psychiatric disorders, traumatic brain injury, major operations or hemorrhagic diseases identified from the Taiwan National Health Insurance Research Database. Non-anemic matched controls (1:1) were selected based on a propensity score estimated using a logistic regression model that included demographic characteristics and comorbidities. A competing risk analysis was applied to estimate the stroke risk in anemic patients compared to that of their matched controls. In our study, the adjusted sub-distribution hazard ratios (aSHRs) of overall, hemorrhagic and ischemic stroke in anemic female patients aged <50 years were 1.35 (95% confidence interval (CI): 1.19–1.52, p < 0.001), 1.31 (95% CI, 1.09-1.56, p < 0.003), and 1.35 (95% CI, 1.15–1.58, p < 0.001), respectively, compared to non-anemic female controls. However, a positive association between anemia and stroke was not found for those aged ≥50 years. Similar results were observed when the follow-up age was limited to 50 years to reduce the potential effects of menopause on stroke. In conclusion, the present population-based cohort study found that anemia is a potential risk factor for overall, hemorrhagic and ischemic stroke in females of reproductive age. Full article
(This article belongs to the Special Issue Feature Papers in Women's Health)
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11 pages, 430 KiB  
Article
Incidence and Determinants of Caesarean Section in Shiraz, Iran
by Mahnaz Zarshenas, Yun Zhao, Colin W. Binns and Jane A. Scott
Int. J. Environ. Res. Public Health 2020, 17(16), 5632; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17165632 - 05 Aug 2020
Cited by 4 | Viewed by 2348
Abstract
The rate of Caesarean section (CS) without medical indication has increased markedly worldwide in the past decades. This study reports the incidence of CS and identifies the determinants of elective and emergency CS as separate pregnancy outcomes in a cohort of Iranian women. [...] Read more.
The rate of Caesarean section (CS) without medical indication has increased markedly worldwide in the past decades. This study reports the incidence of CS and identifies the determinants of elective and emergency CS as separate pregnancy outcomes in a cohort of Iranian women. Mothers (n = 700) of healthy, full-term infants were recruited from five maternity hospitals in Shiraz. The association between maternal socio-demographic and biomedical factors with mode of delivery was explored using multivariable, multinomial logistic regression. Most mothers underwent either an elective (35.4%) or emergency (34.7%) CS. After adjustment, women were more likely to deliver by elective CS than vaginally if they were older (≥30 year) compared to younger mothers (<25 year) (Relative Risk Ratio (RRR) 2.22; 95% Confidence Interval (CI) 1.28, 3.84), and had given birth at a private hospital (RRR 3.64; 95% CI 1.79, 7.38). Compared to those educated to primary or lower secondary level, university educated women were more likely to have undergone an elective (RRR 2.65; 95% CI 1.54, 4.58) or an emergency CS (RRR 3.92; 95% CI 2.27, 6.78) than a vaginal delivery. Similarly, overweight or obese women were more likely than healthy weight women to have undergone an elective (RRR 1.91; 95% CI 1.27, 2.87) or an emergency CS (RRR 2.02; 95% CI 1.35, 3.02) than a vaginal delivery. Specialist education of obstetricians and midwives along with financial incentives paid to private hospitals to encourage natural delivery may help in the reduction of unnecessary CS in Iran. In addition, to increase their childbirth knowledge and self-efficacy, pregnant women need to have the opportunity to attend purposefully designed antenatal childbirth preparation classes where they receive evidence-based information on natural childbirth and alternative methods of pain control, as well as the risks and indications for CS. Full article
(This article belongs to the Special Issue Feature Papers in Women's Health)
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17 pages, 583 KiB  
Article
Improving Breastfeeding by Empowering Mothers in Vietnam: A Randomised Controlled Trial of a Mobile App
by Thi Thuy Duong Doan, Colin Binns, Ngoc Minh Pham, Yun Zhao, Thi Phuong Hoa Dinh, Thi Thu Ha Bui, Trung Chuyen Tran, Xuan Hoai Nguyen, Roslyn Giglia, Fenglian Xu and Andy Lee
Int. J. Environ. Res. Public Health 2020, 17(15), 5552; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17155552 - 31 Jul 2020
Cited by 19 | Viewed by 7359
Abstract
Breastfeeding provides benefits to the infant and mother; however, the rates of breastfeeding, particularly exclusive breastfeeding, remain below optimal levels in many Asian countries. The aim of this study is to review the benefits of breastfeeding to mothers and infants and current rates [...] Read more.
Breastfeeding provides benefits to the infant and mother; however, the rates of breastfeeding, particularly exclusive breastfeeding, remain below optimal levels in many Asian countries. The aim of this study is to review the benefits of breastfeeding to mothers and infants and current rates of breastfeeding in Vietnam, and to evaluate the effectiveness of a mobile application on exclusive breastfeeding among mothers in Vietnam. A two-arm, parallel triple-blinded randomised controlled trial will be conducted among 1000 mothers in Hanoi City, Vietnam, during 2020–2021. Eligible participants are pregnant women who will seek antenatal care from health facilities at 24–36 weeks of gestation and plan to deliver at two participating hospitals, own a smartphone, and carry a singleton foetus. Permuted-block randomisation method stratified by maternal age, education and parity will be used to ensure an equal number of participants in each group. A smartphone app will be developed to deliver breastfeeding and non-breastfeeding information to the intervention and control group, respectively. Data will be collected at baseline, before hospital discharge, and at 1, 4, and 6 months postpartum. This study envisages demonstrating whether a smartphone-based intervention can be effective at improving breastfeeding in Vietnam. Trials registration: ACTRN12619000531112. Full article
(This article belongs to the Special Issue Feature Papers in Women's Health)
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15 pages, 2220 KiB  
Article
Hyperhomocysteinemia is Associated with Inflammation, Bone Resorption, Vitamin B12 and Folate Deficiency and MTHFR C677T Polymorphism in Postmenopausal Women with Decreased Bone Mineral Density
by Massimo De Martinis, Maria Maddalena Sirufo, Cristina Nocelli, Lara Fontanella and Lia Ginaldi
Int. J. Environ. Res. Public Health 2020, 17(12), 4260; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17124260 - 15 Jun 2020
Cited by 40 | Viewed by 4473
Abstract
Osteoporosis is an age-related bone disease, affecting mainly postmenopausal women, characterized by decreased bone mineral density (BMD) and consequent risk of fractures. Homocysteine (Hcy), a sulfur-aminoacid whose serum level is regulated by methylenetrahydrofolate reductase (MTHFR) activity and vitamin B12 and folate as cofactors, [...] Read more.
Osteoporosis is an age-related bone disease, affecting mainly postmenopausal women, characterized by decreased bone mineral density (BMD) and consequent risk of fractures. Homocysteine (Hcy), a sulfur-aminoacid whose serum level is regulated by methylenetrahydrofolate reductase (MTHFR) activity and vitamin B12 and folate as cofactors, is a risk factor for inflammatory diseases. Literature data concerning the link between Hcy and osteoporosis are still debated. The aim of our study was to assess the relationship among Hcy and BMD, inflammation, vitamin status and bone turnover in postmenopausal osteoporosis. In 252 postmenopausal women, BMD was measured by dual-energy X-ray absorptiometry (DXA). In addition to serum Hcy, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and bone turnover markers (bone alkaline phosphatase-BAP, osteocalcin-OC, C-terminal telopeptide of type I collagen (CTX), vitamin deficiencies and MTHFR-C677T polymorphism were evaluated. Hcy, inflammation, bone resorption markers and prevalence of C677T polymorphism were higher, whereas vitamin D, B12, folate, and bone formation markers were lower in women with decreased BMD compared to those with normal BMD. Our results suggest a significant association between Hcy, BMD and inflammation in postmenopausal osteoporosis. The regulation of Hcy overproduction and the modulation of the inflammatory substrate could represent additional therapeutic approaches for osteoporosis prevention. Full article
(This article belongs to the Special Issue Feature Papers in Women's Health)
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21 pages, 3512 KiB  
Article
Transcriptomic Response of Breast Cancer Cells MDA-MB-231 to Docosahexaenoic Acid: Downregulation of Lipid and Cholesterol Metabolism Genes and Upregulation of Genes of the Pro-Apoptotic ER-Stress Pathway
by Benoît Chénais, Marine Cornec, Solenne Dumont, Justine Marchand and Vincent Blanckaert
Int. J. Environ. Res. Public Health 2020, 17(10), 3746; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17103746 - 25 May 2020
Cited by 16 | Viewed by 3975
Abstract
Despite considerable efforts in prevention and therapy, breast cancer remains a major public health concern worldwide. Numerous studies using breast cancer cell lines have shown the antiproliferative and pro-apoptotic effects of docosahexaenoic acid (DHA). Some studies have also demonstrated the inhibitory effect of [...] Read more.
Despite considerable efforts in prevention and therapy, breast cancer remains a major public health concern worldwide. Numerous studies using breast cancer cell lines have shown the antiproliferative and pro-apoptotic effects of docosahexaenoic acid (DHA). Some studies have also demonstrated the inhibitory effect of DHA on the migration and invasion of breast cancer cells, making DHA a potential anti-metastatic agent. Thus, DHA has shown its potential as a chemotherapeutic adjuvant. However, the molecular mechanisms triggering DHA effects remain unclear, and the aim of this study was to provide a transcriptomic basis for further cellular and molecular investigations. Therefore, MDA-MB-231 cells were treated with 100 µM DHA for 12 h or 24 h before RNA-seq analysis. The results show the great impact of DHA-treatment on the transcriptome, especially after 24 h of treatment. The impact of DHA is particularly visible in genes involved in the cholesterol biosynthesis pathway that is strongly downregulated, and the endoplasmic reticulum (ER)-stress response that is, conversely, upregulated. This ER-stress and unfolded protein response could explain the pro-apoptotic effect of DHA. The expression of genes related to migration and invasion (especially SERPINE1, PLAT, and MMP11) is also impacted by DHA. In conclusion, this transcriptomic analysis supports the antiproliferative, pro-apoptotic and anti-invasive effects of DHA, and provides new avenues for understanding its molecular mechanisms. Full article
(This article belongs to the Special Issue Feature Papers in Women's Health)
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Graphical abstract

Review

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18 pages, 1480 KiB  
Review
Female Fertility and Environmental Pollution
by Rita Canipari, Lucia De Santis and Sandra Cecconi
Int. J. Environ. Res. Public Health 2020, 17(23), 8802; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17238802 - 26 Nov 2020
Cited by 51 | Viewed by 8325
Abstract
A realistic picture of our world shows that it is heavily polluted everywhere. Coastal regions and oceans are polluted by farm fertilizer, manure runoff, sewage and industrial discharges, and large isles of waste plastic are floating around, impacting sea life. Terrestrial ecosystems are [...] Read more.
A realistic picture of our world shows that it is heavily polluted everywhere. Coastal regions and oceans are polluted by farm fertilizer, manure runoff, sewage and industrial discharges, and large isles of waste plastic are floating around, impacting sea life. Terrestrial ecosystems are contaminated by heavy metals and organic chemicals that can be taken up by and accumulate in crop plants, and water tables are heavily contaminated by untreated industrial discharges. As deadly particulates can drift far, poor air quality has become a significant global problem and one that is not exclusive to major industrialized cities. The consequences are a dramatic impairment of our ecosystem and biodiversity and increases in degenerative or man-made diseases. In this respect, it has been demonstrated that environmental pollution impairs fertility in all mammalian species. The worst consequences are observed for females since the number of germ cells present in the ovary is fixed during fetal life, and the cells are not renewable. This means that any pollutant affecting hormonal homeostasis and/or the reproductive apparatus inevitably harms reproductive performance. This decline will have important social and economic consequences that can no longer be overlooked. Full article
(This article belongs to the Special Issue Feature Papers in Women's Health)
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14 pages, 1191 KiB  
Review
Increasing HPV Vaccination Uptake among Adolescents: A Systematic Review
by Anna Acampora, Adriano Grossi, Andrea Barbara, Vittoria Colamesta, Francesco Andrea Causio, Giovanna Elisa Calabrò, Stefania Boccia and Chiara de Waure
Int. J. Environ. Res. Public Health 2020, 17(21), 7997; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17217997 - 30 Oct 2020
Cited by 29 | Viewed by 4340
Abstract
Human Papillomavirus (HPV) vaccination is a well-known fundamental strategy in the prevention of cervical cancer, as it is always caused by HPV infection. In fact, primary prevention of the infection corresponds to primary prevention of HPV-related cancers and other diseases. Since an effective [...] Read more.
Human Papillomavirus (HPV) vaccination is a well-known fundamental strategy in the prevention of cervical cancer, as it is always caused by HPV infection. In fact, primary prevention of the infection corresponds to primary prevention of HPV-related cancers and other diseases. Since an effective prevention at the population level is the final goal, it is mandatory for healthcare systems to achieve a high HPV vaccination coverage among the adolescents to reduce the circulation of the virus and the burden of HPV-related diseases. This research identified, through a systematic literature review, 38 papers on strategies adopted to increase HPV vaccination coverage among adolescents. The evaluated strategies targeted adolescents/parents and/or healthcare providers and could be grouped in three main types: (1) reminder-based, (2) education, information, and communication activities, and (3) multicomponent strategies. Several types of strategy, such as those relied only on reminders and integrating different interventions, showed a positive impact on vaccination coverage. Nonetheless, the heterogeneity of the interventions suggests the importance to adapt such strategies to the specific national/local contexts to maximize vaccination coverage. Full article
(This article belongs to the Special Issue Feature Papers in Women's Health)
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13 pages, 376 KiB  
Review
Women with Schizophrenia over the Life Span: Health Promotion, Treatment and Outcomes
by Alexandre González-Rodríguez, Armand Guàrdia, Aida Álvarez Pedrero, Maria Betriu, Jesús Cobo, Sidharta Acebillo, José Antonio Monreal, Mary V. Seeman, Diego Palao and Javier Labad
Int. J. Environ. Res. Public Health 2020, 17(15), 5594; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17155594 - 03 Aug 2020
Cited by 25 | Viewed by 4421
Abstract
Women with schizophrenia show sex-specific health needs that differ according to stage of life. The aim of this narrative review is to resolve important questions concerning the treatment of women with schizophrenia at different periods of their life—paying special attention to reproductive and [...] Read more.
Women with schizophrenia show sex-specific health needs that differ according to stage of life. The aim of this narrative review is to resolve important questions concerning the treatment of women with schizophrenia at different periods of their life—paying special attention to reproductive and post-reproductive stages. Review results suggest that menstrual cycle-dependent treatments may be a useful option for many women and that recommendations re contraceptive options need always to be part of care provision. The pregnancy and the postpartum periods—while constituting vulnerable time periods for the mother—require special attention to antipsychotic effects on the fetus and neonate. Menopause and aging are further vulnerable times, with extra challenges posed by associated health risks. Pregnancy complications, neurodevelopmental difficulties of offspring, cancer risk and cognitive defects are indirect results of the interplay of hormones and antipsychotic treatment of women over the course of the lifespan. The literature recommends that health promotion strategies need to be directed at lifestyle modifications, prevention of medical comorbidities and increased psychosocial support. Careful monitoring of pharmacological treatment has been shown to be critical during periods of hormonal transition. Not only does treatment of women with schizophrenia often need to be different than that of their male peers, but it also needs to vary over the course of life. Full article
(This article belongs to the Special Issue Feature Papers in Women's Health)
11 pages, 351 KiB  
Review
Addressing Delusions in Women and Men with Delusional Disorder: Key Points for Clinical Management
by Alexandre González-Rodríguez and Mary V. Seeman
Int. J. Environ. Res. Public Health 2020, 17(12), 4583; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17124583 - 25 Jun 2020
Cited by 11 | Viewed by 6981
Abstract
Delusional disorders (DD) are difficult conditions for health professionals to treat successfully. They are also difficult for family members to bear. The aim of this narrative review is to select from the clinical literature the psychosocial interventions that appear to work best for [...] Read more.
Delusional disorders (DD) are difficult conditions for health professionals to treat successfully. They are also difficult for family members to bear. The aim of this narrative review is to select from the clinical literature the psychosocial interventions that appear to work best for these conditions and to see whether similar strategies can be modeled or taught to family members so that tensions at home are reduced. Because the content of men’s and women’s delusions sometimes differ, it has been suggested that optimal interventions for the two sexes may also differ. This review explores three areas: (a) specific treatments for men and women; (b) recommended psychological approaches by health professionals, especially in early encounters with patients with DD; and (c) recommended psychoeducation for families. Findings are that there is no evidence for differentiated psychosocial treatment for men and women with delusional disorder. What is recommended in the literature is to empathically elicit the details of the content of delusions, to address the accompanying emotions rather than the logic of the presented argument, to teach self-soothing techniques, and to monitor behavior with respect to its safety. These recommendations have only been validated in individual patients and families. More rigorous clinical trials need to be conducted. Full article
(This article belongs to the Special Issue Feature Papers in Women's Health)

Other

9 pages, 371 KiB  
Project Report
Levels of Polychlorinated Dibenzo-p-Dioxins/Furans (PCDD/Fs) and Dioxin-Like Polychlorinated Biphenyls (DL-PCBs) in Human Breast Milk in Chile: A Pilot Study
by Claudia Foerster, Liliana Zúñiga-Venegas, Pedro Enríquez, Jacqueline Rojas, Claudia Zamora, Ximena Muñoz, Floria Pancetti, María Teresa Muñoz-Quezada, Boris Lucero, Chiara Saracini, Claudio Salas and Sandra Cortés
Int. J. Environ. Res. Public Health 2021, 18(9), 4825; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18094825 - 30 Apr 2021
Cited by 9 | Viewed by 2478
Abstract
Persistent organic pollutants (POPs) are organic compounds that resist biochemical degradation, moving long distances across the atmosphere before deposition occurs. Our goal was to provide up-to-date data on the levels of polychlorinated dibenzo-p-dioxins/furans (PCDD/Fs) and dioxin-like polychlorinated biphenyls (DL-PCBs) in breast [...] Read more.
Persistent organic pollutants (POPs) are organic compounds that resist biochemical degradation, moving long distances across the atmosphere before deposition occurs. Our goal was to provide up-to-date data on the levels of polychlorinated dibenzo-p-dioxins/furans (PCDD/Fs) and dioxin-like polychlorinated biphenyls (DL-PCBs) in breast milk from Chilean women and to estimate the exposure of infants due to breast milk consumption. In Chile, we conducted a cross-sectional study based on methodologies proposed by the WHO, with a sample of 30 women recruited from three defined areas: 10 from the Arica Region (urban; Arica and Parinacota Region), 10 from Coltauco (rural; O’Higgins Region), and 10 from Molina (40% rural; Maule Region). High-resolution gas chromatography coupled with high-resolution mass spectrometry (HRGC/HRMS) was performed on pooled samples from each area. We calculated equivalent toxic concentrations (WHO-TEQ) based on the current WHO Toxic Equivalency Factors (TEF). The minimum and maximum values of ∑ PCDDs/Fs + DL-PCBs-TEQ were 4.317 pg TEQ/g fat in Coltauco and 6.31 pg TEQ/g fat in Arica. Molina had a total TEQ of 5.50 pg TEQ/g fat. The contribution of PCDD/Fs was approximately five-fold higher than that of DL-PCBs. The Estimated Daily Intake (EDI) of ∑ PCDDs/Fs + DL-PCBs based on the three pooled samples ranged between 6.71 and 26.28 pg TEQ/kg body weight (bw)/day, with a mean intake of 16.11 (±6.71) pg TEQ/kg bw/day in breastfed children from 0 to 24 months old. These levels were lower than those reported in international studies. Despite the fact that the observed levels were low compared to those in most industrialized countries, the detection of a variety of POPs in breast milk from Chilean women indicates the need for follow-up studies to determine whether such exposures during childhood could represent a health risk in adulthood. Full article
(This article belongs to the Special Issue Feature Papers in Women's Health)
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