Women's Health Commons^™

Provincial Disparities In Adolescent Fertility In Indonesia: An Ecological Analysis Of Child Marriage, Median Age At First Marriage, And Family Development Index, Andi Nisa Fathimiyah Afidah, Milla Herdayati

Kesmas

Adolescent fertility remains a public health concern in Indonesia, with substantial variations across provinces. However, the evidence explaining provincial disparities using population-level indicators remains limited. This study aimed to examine provincial disparities in adolescent fertility and assess the association of child marriage, median age at first marriage among women, and the Family Development Index called iBangga with adolescent fertility across Indonesia. This ecological, cross-sectional study used aggregated data from 34 Indonesian provinces. Descriptive statistics, spatial visualization, Pearson’s correlation, and multiple linear regression analyses were performed. The mean adolescent fertility rate was 25.0 births per 1,000 female adolescents aged 15–19 years, …

Environmental Perspective For System Dynamics Modeling Of Stunting Mitigation To Achieve The Sustainable Development Goals In West Sumatra, Indonesia, Elsa Yuniarti, Nabila Azzahra, Yulhendri Yulhendri, Heldi Heldi, Mery Delvina, Saskia Putri Azeli

Kesmas

This study developed a system dynamics model to simulate stunting reduction in West Sumatra Province, Indonesia, by integrating infant and toddler health, maternal health, and environmental determinants. Secondary data from 2020–2024 on low birth weight, immunization, malnutrition, exclusive breastfeeding, maternal chronic energy deficiency, iron and folic acid supplement distribution, sanitation, and safe drinking water access were compiled from West Sumatra Provincial Health Office and Statistics Indonesia, and validated through consultation with five stakeholder institutions. Causal Loop Diagrams mapped feedback relationships among determinants and were translated into Stock Flow Diagrams using Powersim Studio 10. The model was validated through structural verification, …

Healthcare Access And The Persistent Racial Disparities In Low Birth Weight, Zaheda A. Hussain, Yadanar Moe

DePaul Discoveries

Low birth weight (LBW), defined as less than 2,500 grams, is an influential factor contributing to infant mortality in the United States, with significant racial disparities between Black and White mothers. This study analyzed data from 3,054 Black and White mothers collected from the 2018 National Health Interview Survey to explore the association between access to medical care and LBW within different racial groups. The prevalence of LBW was 8.0%. Overall, mothers without a usual place of medical care had, on average, an 18% higher risk of LBW than those with a usual place (OR = 1.18, 95% CI: 0.80–1.74). …

Determinants Of Behavioral Intention To Change Sexual And Reproductive Health Practices Among Adolescents: A Hierarchical Multiple Linear Regression Analysis, Md Mizanur Rahman, Gerraint Gillan Ahi, Rafazila Ramli, Rasitasam Safii, Jacey Lynn Minoi, Stephanie Chua Hui Li, Ahmad Sofian Bin Shminan, Lee Jun Choi

Kesmas

Conventional and web-based sexual and reproductive health (SRH) interventions are increasingly used with adolescents, yet their comparative effectiveness and underlying mechanisms remain unclear. This study compared the two formats and examined the Theory of Planned Behavior (TPB) constructs as predictors of changes in intention to adopt health-protective SRH practices (including contraceptive use, service utilization, and parent–child communication) among Malaysian adolescents. A randomized controlled trial allocated adolescents to conventional or web-based SRH education. Intention-to-change behavior towards sexual and reproductive health scores was assessed at baseline, 1 month, and 3 months; change scores were modeled using hierarchical linear regression, including intervention type, …

Long Work Hours, Suboptimal Diabetes Management, And Differences By Sex And Race/Ethnicity, Nhanes (2011-2018), Tailisha Gonzalez, Margrethe Horlyck-Romanovsky, Terry T.-K. Huang, Sandra E. Echeverria

Publications and Research

In the United States (US), occupational segregation by sex and race/ethnicity can contribute to health disparities. Although work schedule characteristics have been previously linked to elevated cardiovascular risk, little is known about the effects on chronic disease management in women and minoritized workers. We examined the association between work hours and diabetes management among US workers, testing for differences by sex and race/ethnicity. We utilized 2011–2018 National Health and Nutrition Examination Survey (NHANES) data on working adults (age ≥20 years) with diagnosed diabetes (n = 1041). Suboptimal diabetes management was defined as HbA1c ≥7%. Work hours were categorized per WHO …

Connectivity, Classroom, And Contagion: An Ecological Analysis Of Testing Availability, Sex Education, And Sti Rates In The Upper Midwest, Macey M. Boerhave

Honors Thesis

Rural and frontier communities in the Upper Midwest face unique challenges that shape how young people access sexual health information and testing. While sexually transmitted infection (STI) rates continue to rise nationally, less is known about how sexual health education, digital access, and geographic distance influence these trends at a county level. This study examines the relationship between broadband internet access rates, poverty rates, proximity to free or low-cost STI testing sites, and county-level STI rates among individuals aged 15-24 in selected counties across South Dakota, North Dakota, Minnesota, Iowa, and Nebraska. Using an ecological, cross-sectional design, county-level STI surveillance …

Prevalence And Determinant Factors Of Depression Among Pregnant Women In Poned Health Center In Tangerang City Area, Dian Geumala Hayati, Sudijanto Kamso, Popy Yuniar, Yuli Puspita Devi

Jurnal Epidemiologi Kesehatan Indonesia

According to World Health Organization (WHO), approximately 10% of pregnant women experience mental disorders, with depression being particularly prevalent. In developing countries, this rate is was even higher, reaching 19.8% after childbirth and 15.6% during pregnancy. Various studies conducted in Indonesia show that the prevalence of depression among pregnant women ranges widely, from 21.4% to 26.2%.This study aimed to determine the prevalence and risk factors associated with depression during pregnancy in pregnant women at the PONED Community Health Center in Tangerang City Area. A facility-based cross-sectional study was conducted with 105 pregnant women attending antenatal check-ups at the 17 PONED …

The Role Of Gynecologic Oncologists In Improving Survival Outcomes Of Epithelial Ovarian Cancer: A Retrospective Cohort Study, Widyorini Lh Hanafy, Bambang Dwipoyono, Asri C. Adisasmita, Yosephine E. Regina, Airine S. Lians, Oktaviani P. Rahayu, Jane G. Auwelia

Kesmas

Epithelial ovarian cancer (EOC) is a leading cause of gynecological cancer mortality and is often diagnosed at an advanced stage, resulting in poor survival outcomes. Access to specialized gynecological oncology services has been associated with improved prognosis; however, data on its impact in Indonesia remain limited. This study aimed to evaluate the association between gynecologic oncologist (GO) services and disease-free survival (DFS) in patients with EOC. This retrospective cohort study included 76 patients with EOC who were treated at a national cancer hospital in Jakarta between 2015 and 2018. Patient data were obtained from medical records and followed for three …

Short-Term Survival And Prognostic Factors In Cervical Cancer Patients Requiring Hemodialysis: A Retrospective Cohort Study, Muhammad Trihatmowijoyo Bundjali, Maruhum Bonar Hasiholan Marbun, Wulyo Rajabto, Ikhwan Rinaldi, Hamzah Shatri, Dwi Lestari Partiningrum, Dadang Makmun, Pringgodigdo Nugroho, Sukamto Koesnoe, Pradana Soewondo

Kesmas

Cervical cancer is a common gynecological malignancy, particularly in developing countries, where it coexists with renal impairment in over one-third of patients. This disease typically presents acutely and progresses rapidly. Consequently, kidney replacement therapy, including hemodialysis (HD), is commonly required. To assess survival rates and associated factors, this retrospective cohort study analyzed the medical records of 252 cervical cancer patients who began HD across a three-month follow-up period. Kaplan–Meier analysis indicated a median short-term survival duration of 71.5 days (range: 7–90), with 1-, 2-, and 3-month survival rates of 56%, 51%, and 49%, respectively. Multivariate Cox regression identified post-HD systolic …

Associations Between Oral Hormonal Contraceptive Use, Digestive And Other Health Symptoms In Young Women, Silviana E. Buzatu

Honors Undergraduate Theses

Oral hormonal contraceptives (OHCs) are widely used among reproductive-age women; however, their gastrointestinal (GI) side effects remain understudied. The present study examined associations between OHC use, GI, physical, and psychological symptom burden in a large sample of undergraduate women. Participants (N = 669) aged 18 to 25 years were recruited from UCF’s SONA system and classified into three groups based on self-reported contraceptive status: no birth control, combined estrogen–progestin OHC, and progestin-only OHC. Participants completed GI questionnaires, as well as physical and mental health symptoms ones.

Multivariate analyses indicated that overall GI symptom profiles did not differ significantly by birth …

Association Between Neighborhood Social Determinants Of Health And Stillbirth, Tetsuya Kawakita, Misa Hayasaka, Ann M. Harper, John Brush, George Saade

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE:

To examine the association between neighborhood-level social determinants of health and stillbirth.

METHODS:

We performed a retrospective cohort study of deliveries that occurred at a gestational age of at least 20 weeks within a five-hospital system (2012-2022). Electronic health record data mapped to the Observational Medical Outcomes Partnership Common Data Model were geocoded using addresses at the time of delivery and linked to neighborhood health indices, which included the Area Deprivation Index (ADI), Maternal Vulnerability Index (MVI), and Social Vulnerability Index (SVI) at the Census tract level. Stillbirths were adjudicated by medical record review. Modified Poisson regression generated relative …

Examining The Association Of Maternal Oral Health Experiences With Adverse Birth Outcomes: Findings From Virginia's Prams Survey, May Salama, Abdullah Al-Taiar, Denise C. Mckinney, Li-Wu Chen, Anwar T. Merchant

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Preterm birth (PTB) and low birth weight (LBW) are significant public health challenges globally, contributing to neonatal morbidity, mortality, and long-term complications. Maternal oral health has been increasingly recognized as a potential contributor to PTB and LBW, yet there is inconclusive evidence about the effectiveness of dental cleaning in preventing PTB and LBW. This study examined the association between dental cleaning during pregnancy and the prevalence of PTB and LBW using data from the Virginia Pregnancy Risk Assessment Monitoring System (PRAMS).

Methods

We analyzed data from Virginia PRAMS Phases 7 and 8, spanning a 10-year period from 2012 to …

Age-Specific Distribution Of Cervical Precancer And Cancer Among Women Living With Hiv Across Seven Countries: A Systematic Review And An Individual Patient Data Meta-Analysis, Shona Dalal, Karin Sundström, Ronaldo Silva, Katayoun Taghavi, Helen Cejtin, Michael Chung, Sharon Greene, Smita Joshi, Helen Kelly, Elkanah Orang'o

Obstetrics and Gynaecology, East Africa

Background Women living with HIV have an elevated risk for cervical cancer, present earlier, and have more recurrent human papillomavirus (HPV) infections compared with women without HIV. To update WHO recommendations on screening and treatment to prevent cervical cancer, we aimed to identify whether women living with HIV should be screened for cervical cancer at a specific age, the optimal screening interval following a negative cervical screen, and the screening interval following treatment.

Methods We conducted a systematic literature review on cervical cancer and HIV by searching MEDLINE, Embase, CENTRAL, the Cochrane Library, and clinical trial registries covering Jan 1, …

Factors Associated With Cervical Cancer Screening Among Women Attending Maternal Child Health Clinics In Kenya, Loise Nthambi, Marleen Temmerman, William Macharia, Joshua Nyagol, Sophia Mogere, Jillian Neary, Edward Nyabs, Janet Itindi, Agnes Langat, Evelyn Wangari

Centre of Excellence in Women and Child Health

Background Cervical cancer is the second leading malignancy in incidence among women in sub-Saharan Africa. Early detection through screening and treatment of pre-cancerous cervical lesions is paramount in preventing cervical cancer. We sought to examine factors associated with ever being screened for cervical cancer among women attending infant immunization clinics in Kenya.

Methods We conducted secondary data analysis from a cross-sectional survey that enrolled mother-infant pairs attending 55 infant immunization clinics in Kenya between 2018 and 2019. Clinics were selected from high and medium/low HIV-burden counties using probability-proportionate-to-size sampling. The primary outcome was self-reported cervical cancer screening. To align with …

Unnoticed Early Pregnancy During Myomectomy With Favorable Outcome: Case Report, Ronak Mulji, Lusajo Mwagobele, Farhat Seif, Zainab Fidaali, Munawar Kaguta

Obstetrics and Gynaecology, East Africa

Introduction

Uterine fibroids are a common cause of infertility, and myomectomy remains a key surgical intervention to improve reproductive outcomes. However, the occurrence of an undetected pregnancy during myomectomy is rare and poses significant clinical risks.

Case Presentation

We report a 34-year-old woman, nulliparous with a history of secondary infertility and three first-trimester miscarriages. She had multiple fibroids and was managed for polycystic ovarian syndrome and hyperprolactinemia. Scheduled for abdominal myomectomy, the surgery proceeded uneventfully, with six fibroids removed and no breach of the endometrial cavity. Five weeks postoperatively, she presented with symptoms suggestive of early pregnancy. Ultrasound confirmed a …

Cervical Hpv 18 Detection Is Associated With High-Grade Cervical Dysplasia In Kenyan And Ugandan Women Living With Hiv, Miriam Nakalembe, Collins Mpamani, Jane Namugga, Carolyn Nakisige, Grace Banturaki, Phillip Tonui, Peter Itsura, Elkanah Orang'o, Kapten Muthoka, Anthony Ngeresa

Obstetrics and Gynaecology, East Africa

Objectives Cervical cancer, caused by “high-risk” (HR) HPV, is the most common malignancy and the leading cause of cancer deaths among women living in Kenya and Uganda. Women living with HIV (WLWH) are at a high risk for HR-HPV infection. This longitudinal, observational cohort analysis was conducted to identify factors that are important among WLWH in prediction of cervical intraepithelial neoplasia grades 2 or 3 (CIN2/3).

Methods Data of this analysis was based on a study of HPV natural history and cervical cancer among Kenyan and Ugandan WLWH. Demographic, behavioral and biological data were collected; HR-HPV DNA testing of cervical …

Associations Between Social Drivers Of Health And Breast Cancer Stage At Diagnosis Among U.S. Black Women, Mollie Barnard, Bo Qin, Marc Emerson, Etienne Holder, Matthew Dunn, Shromona Sarkar, Nuo Xu, Yutong Li, Christine Ambrosone, Elisa Bandera, Julie Palmer, Melissa Troester, Terry Hyslop

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

U.S. Black women have disproportionately high breast cancer mortality, partly due to later-stage diagnoses. We examined how social drivers of health (SDOH) relate to stage at diagnosis by analyzing data from 4,995 breast cancer survivors in the Black Women's Health Study, Carolina Breast Cancer Study, and Women's Circle of Health Studies. SDOH were self-reported and stage was ascertained from medical records. We used polytomous logistic regression to estimate odds ratios (ORs) for diagnosis at stages III/IV or II versus stage I (referent), adjusting for age, insurance status, and income. Meta-analyzed results indicated that underutilization of screening mammography (OR = 3.21, …

Breast Cancer Survival Rates And Determinants In Ethiopia: A Systematic Review And Meta-Analysis Of Longitudinal Studies, Abenezer M. Tafese, Meseker T. Fentie, Beminate L. Seifu, Angwach A. Asnake, Bikiltu D. Dirbaba, Abdisa G. Jara, Elsabeth Tizazu Asare, Brandon George

College of Population Health Faculty Papers

BACKGROUND: Breast cancer is the most common cancer and the leading cause of cancer mortality among women in Ethiopia, accounting for 32% of new cancer cases and 17.6% of cancer deaths. Despite its growing burden, comprehensive data on survival rates and contributing factors remain limited. This systematic review and meta-analysis aimed to synthesize existing data on breast cancer survival in Ethiopia and identify key determinants influencing outcomes.

METHODS: A comprehensive systematic search was conducted in PubMed, Web of Science, Scopus, Embase, and CINAHL to identify studies on breast cancer survival in Ethiopia published between January 2014 and August 2024. Eligible …

A Cancer Education Needs Assessment: Informing Middle-Aged Female Patients About The Relationships Between Obesity And Women’S Health Concerns In The Reproductive System, Breast, And Endometrial Health, Batul Mirza

MUSC Theses and Dissertations

Obesity significantly impacts women’s health, particularly among middle-aged women, by increasing the risk of hormone-sensitive cancers such as breast, endometrial, and reproductive system cancers. This study examines the educational needs of this demographic group regarding obesity-related cancer risks and explores effective intervention strategies. Obesity-induced mechanisms – hormonal imbalances, chronic inflammation, and insulin resistance – drive cancer susceptibility, emphasizing the need for targeted health education. The study employs a qualitative design, which includes interviews with subject matter experts (SMEs) and surveys of middle-aged women. The goal is to assess awareness, perceived barriers, and preferred learning methods. Findings suggest that with many …

Common Sources, Perceived Communication Efficacy And Sufficiency Of Cervical Cancer Information, Education And Communication Materials For Women With Hiv/Aids In Rural Kenya, Scholastic Musakali Adeli, Elkanah Orang'o, Violet Naanyu, Ann Mwangi, Peter Itsura, Barry Rosen, Patrick Loehrer

Obstetrics and Gynaecology, East Africa

Introduction: Cervical cancer is the greatest cause of cancer-related death among women in Sub-Saharan Africa, with particularly high incidence and mortality rates in rural regions. In Kenya, Women with HIV/AIDS (WLHA) are at a greater risk of developing cervical cancer though screening rate remains low. Information, education and communication (IEC) materials play a crucial role in raising awareness, promoting screening, and supporting early detection and treatment; however, little is known about the accessibility, content, and perceived effectiveness of these materials from the perspective of WLHA.

Methods: The objective of this study was to determine the common sources, perceived communication efficacy …

Intersectoral Interventions: Integration For Impact On Preterm Birth, Etienne V. Langlois, Maria El Bizri, Kelly Thompson, Amy Reid, Merette Khalil, Giulia Gasparri, Joy E. Lawn, Teesta Dey, Judith Robb-Mccord, Marleen Temmerman

Centre of Excellence in Women and Child Health

Progress: The last two decades have seen a growing focus on intersectoral interventions to improve maternal and newborn health and well-being outcomes, as refected in eforts to achieve the Millennium Development Goals (MDGs) and advance the Sustainable Development Goals (SDGs). Preterm births are linked to cross-sectoral determi‑ nants that afect health outcomes and human capital across the life-course, necessitating an intersectoral approach that addresses these multifaceted challenges.

Programmatic priorities: Recognizing that social, biological and economic determinants signifcantly infuence health outcomes, it is critical that robust health systems are reinforced by a comprehensive intersectoral approach. Evidence suggests that the factors infuencing …

Geographic Inequalities, And Social-Demographic Determinants Of Reproductive, Maternal And Child Health At Sub-National Levels In Kenya, Janette Karimi, Anitah Cherono, Victor Alegana, Martin Mutua, Hellen Kiarie, Rose Muthee, Marleen Temmerman, Peter Gichangi

Centre of Excellence in Women and Child Health

Background; Global initiatives have emphasized tracking indicators to monitor progress, particularly in countries with the highest maternal and child mortality. Routine data can be used to monitor indicators for improved target setting at national and subnational levels. Our objective was to assess the geographic inequalities in estimates of reproductive, maternal and child health indicators from routine data at the subnational level in Kenya.

Methods; Monthly data from 47 counties clustered in 8 regions, from January 2018 to December 2021 were assembled from the District Health Information Software version 2 (DHIS2) in Kenya. This included women of reproductive age receiving family …

Socioeconomic Disparities In Breast Cancer Survival: Examining Potential Mediator Role Of Oncotype Dx(Odx) Test And Stage At Diagnosis Among Hr+/Her2- Breast Cancer Women, Pratibha Shrestha, Qingzhao Yu, Edward S. Peters, Edward Trapido, Mei Chin Hsieh, Tekeda Ferguson, Quyen D. Chu, Xiao Cheng Wu

School of Public Health Faculty Publications

Background: Women with a lower socioeconomic status (SES) have an increased risk of dying from breast cancer (BC) than those with a higher SES. The association of SES with BC survival may be partially mediated by factors such as Oncotype DX (ODX) testing and stage at diagnosis. This study aims to examine SES disparities in survival among HR+/HER2- BC women and to quantify the mediating effects of the ODX test and stage. Methods: We used data from the Louisiana Tumor Registry to identify women aged 20–90 years diagnosed with stage I–II in 2011–2014 and stage I–III in 2015–2017 HR+/HER2- BC …

Racial Disparity And Environmental Influences On Perinatal Health In Jefferson County, Kentucky., Felicia A Pugh

Electronic Theses and Dissertations

Background: Severe maternal morbidity (SMM) risk has tripled over the past 30 years. Adverse infant birth outcomes in the U.S. have also increased with substantial Black-White disparities. Objectives: This work compares the frequency of adverse maternal and infant birth outcomes by maternal race (Black vs White) and examines associations between maternal ambient heavy metal exposures and birth outcomes in Jefferson County, Kentucky, 2017-2022. Methods: Jefferson County inpatient hospital delivery and birth certificate records of self-identified Black or White birthing parents were used. Incidence of SMM, stillbirth, preterm birth (PTB), and small for gestational age (SGA) with 95% confidence intervals (CI) …

A Comprehensive Literature Review Of Barriers To Hormone Therapy Utilization: Strategies For Improving Menopause Management In Women Aged 40-60, Suhan Lee

Capstone Experience: Master of Public Health

Menopause is a natural transition marked by the cessation of ovarian activity, often accompanied by vasomotor symptoms (VMS), genitourinary syndrome of menopause (GSM), and psychological changes that significantly impact women’s quality of life. Hormone therapy (HT) has been the primary treatment for managing menopausal symptoms, particularly VMS, providing substantial relief when initiated within 10 years of menopause. Despite its effectiveness, HT usage has declined dramatically over the past two decades primarily due to barriers such as stigma, safety, misinformation, provider hesitancy, financial barriers, and cultural beliefs. This comprehensive literature review explores key factors influencing HT decision-making, including the media’s role …

Association Of Plant-Based Dietary Patterns With Female Reproductive Cancer Incidence And Mortality: A Systematic Review, Esther L. Farley, Scott Moore, Gary A. Giovino, Darryl Somayaji

Campus Research Month

Healthy plant-based eating, a health-related behavior that nurses may promote, has been associated with a decrease in multiple types of cancer. However, the association of a healthy plant-based dietary pattern with decreased female reproductive cancers has not yet been established.

This review of the literature followed PRISMA guidelines to search for the relationship between a healthy plant-based dietary pattern and incidence of and mortality from a breast or gynecological cancer diagnosis. Databases searched for this review included PubMed, EMBASE, CINAHL, and Web of Science.

We identified 27 publications that met the qualifications for inclusion. Twelve studies covered mortality from breast, …

Mothers’ Characteristics And Children's Diarrhea Between 2010-2020 In Rwanda, Amans Ntakarutimana Dr., Patrick A. Tschida Dr.

Journal of Social, Behavioral, and Health Sciences

Mothers’ characteristics influence children’s health and development. We conducted a cross-sectional study to assess the influence of mothers’ education level, employment status, and exposure to domestic violence on diarrhea among children under 5 years old using secondary data from 2010, 2015, and 2020 Rwanda Demographic Health Surveys. We used stratified descriptive statistics, pairwise comparisons, and logistic regression designs to assess (a) the prevalence of mothers per education level, employment status, and exposure to domestic violence; (b) their variation over time; and (c) their influence on diarrhea among children under 5 years old between 2010 and 2020 in Rwanda. According to …

From Crisis To Action: Investigation, Research, And Response In The Rio Grande Valley Following The Anencephaly Cluster Of 1990-1991, Jonathan Hebert, Miguel Lopez, Padmanabhan Rengasamy

MEDI 9331 Scholarly Activities Clinical Years

The 1990-1991 birth defect cluster of anencephaly in the Rio Grande Valley has had lasting effects on Texas public health and birth defect prevention nationwide. The purpose of this study is to clearly illuminate public health efforts to investigate, identify, and combat the rise of anencephaly and other neural tube defects (NTDs) in the Rio Grande Valley and other border counties following the 1990-1991 cluster, as well as to report the findings of each branch of environmental, infectious, and genetic investigation into the possible causes of the disaster. Information was gathered via a literature review and from other sources including …

Risk Factors And Public Health Interventions Associated With Adolescent Pregnancy Prevention Among Females Aged 10–19 Years In Kenya: A Scoping Review Protocol, Kimbley Asaso Omwodo, Abdu Mohiddin, Danielle Denwood, Augustine N. Gitonga

Centre of Excellence in Women and Child Health

Background ; Adolescent pregnancy is associated with multifaceted challenges that impact countries’ health, education and economic stability. Despite ongoing interventions, in developing countries such as Kenya, adolescent pregnancy rates continue to be high. There is a need for more synthesised evidence on regional-specific risk factors to support tailored prevention strategies.

Objective; This scoping review aims to explore what is known about the risk factors and intervention strategies focused on adolescent pregnancy prevention in Kenya.

Methods and analysis; Using the Arksey and O’Malley framework combined with a three-step search strategy as recommended by the Joanna Briggs Institute, relevant articles will be …

Atypical Presentation Of Non-Small Cell Lung Carcinoma With Metastasis To Breast Tissue, Tylar P. Seckman, Diane Krutzler-Berry, Mohamed Ashal, Waqas Mahmud, Krista L. Denning, Logan M. Lawrence

Marshall Journal of Medicine

Malignant neoplasms of the lung commonly metastasize to lymph nodes, bone, brain, and liver via hematogenous and lymphatic routes. Much less commonly, metastasis occurs in the breast. Secondary metastatic disease of the breast is very rare, with a reported incidence ranging from 0.4-1.3%­­—with primary lung cancer being one of the most anomalous sources. This case details non-small cell lung cancer metastasis to the breast with proven primary contralateral lung origination. This atypical finding prompts medical professionals to consider these malignant cells' immunologic, histologic, and pathologic makeup to understand further and treat the neoplasm.