Post-pregnancy breast cancer often carries a poor prognosis, posing a major clinical challenge. The increasing trend of later-life pregnancies exacerbates this risk, highlighting the need for effective chemoprevention strategies. Current options, limited to selective estrogen receptor modulators, aromatase inhibitors, or surgical procedures, offer limited efficacy and considerable side effects. Here, we report that cabergoline, a dopaminergic agonist, reduces the risk of breast cancer post-pregnancy in a Brca1/P53-deficient mouse model, with implications for human breast cancer prevention. We show that a single dose of cabergoline administered post-pregnancy significantly delayed the onset and reduced the incidence of breast cancer in Brca1/P53-deficient mice. Histological analysis revealed a notable acceleration in post-lactational involution over the short term, characterized by increased apoptosis and altered gene expression related to ion transport. Over the long term, histological changes in the mammary gland included a reduction in the ductal component, decreased epithelial proliferation, and a lower presence of recombinant Brca1/P53 target cells, which are precursors of tumors. These changes serve as indicators of reduced breast cancer susceptibility. Additionally, RNA sequencing identified gene expression alterations associated with decreased proliferation and mammary gland branching. Our findings highlight a mechanism wherein cabergoline enhances the protective effect of pregnancy against breast cancer by potentiating postlactational involution. Notably, a retrospective cohort study in women demonstrated a markedly lower incidence of post-pregnancy breast cancer in those treated with cabergoline compared to a control group. Our work underscores the importance of enhancing postlactational involution as a strategy for breast cancer prevention, and identifies cabergoline as a promising, low-risk option in breast cancer chemoprevention. This strategy has the potential to revolutionize breast cancer prevention approaches, particularly for women at increased risk due to genetic factors or delayed childbirth, and has wider implications beyond hereditary breast cancer cases.

There is a paucity of research exploring how men and individuals who do not menstruate comprehend menstrual health and equity. The objective of this study was to explore the conceptualization and attitudes towards menstruation and the menstrual cycle among men and people who do not menstruate aged between 18 and 55 in the Barcelona area. Furthermore, it examined their involvement in menstrual health and equity initiatives. This qualitative study employed a feminist critical perspective. Seventeen semi-structured photo-elicitation interviews were conducted. It was frequently observed that menstrual education was often inadequate and biomedical in nature. Participants often acquired knowledge about menstruation through interactions with menstruating sex-affective partners. Menstruation was generally perceived negatively, and menstrual taboo and stigma were apparent. Some participants expressed the view that men should raise awareness of a more positive stance on menstruation. The findings of this study highlight the need for structural menstrual policies and community programs where men and people who do not menstruate are involved.

OBJECTIVE: To analyze the sociostructural determinants associated with mental health problems during the lockdown period among populations residing in Brazil, Chile, Ecuador, Mexico, Peru, and Spain who lived with minors or dependents, approached from a gender perspective. METHODS: A cross-sectional study was conducted in six participating countries via an adapted, self-managed online survey. People living with minors and/or dependents were selected. Multivariate logistic regression models were estimated to assess the associations between sociostructural variables and mental health problems (anxiety (GAD-7) and/or depression (PHQ-9)). The analyses were stratified by sex and country. RESULTS: Out of a total of 39,006 people, 18,040 reported living with minors and/or dependents (73% women). In all countries, women reported worse mental health, with Spain having a lower prevalence. The risks of mental health problems in women in most countries are associated with poor housing conditions and performing care work. University education was associated with a protective factor. For men, risks were related to being younger, worsening working conditions and concerns about living together at home. CONCLUSIONS: Women in Latin America who lived with dependents had worse outcomes than those in Spain did. It is necessary to develop intersectoral and social determinants strategies to prevent, protect and support the mental health of those who live with dependents and minors.

Since menstrual health and menstrual inequity are determined by social power structures, this study proposes to analyse, from an intersectional perspective, the experiences of menstrual inequity of women and people who menstruate (PWM) (>= 18 years) under circumstances of socioeconomic vulnerability in an urban and rural setting in Catalonia (Spain), focusing on menstrual poverty, menstrual management and access to health care for menstrual health. An exploratory and interpretative qualitative study was conducted. Venue-based convenience sampling was carried out, recruiting women from a non-governmental organisation and a primary health care centre. Eighteen individual semi-structured interviews were conducted between October 2022 and February 2023. Data were analysed through reflexive thematic analysis. Analysis revealed that menstrual care was generally a distant preoccupation that revolved around circumstances of socioeconomic vulnerability, housing, and productive/reproductive work. Menstrual poverty, menstrual management and menstrual self-care challenges, barriers to accessing health care for menstrual health, and menstrual taboo, stigma and discrimination were commonplace and deepened by socioeconomic vulnerability. In this way, women’s menstrual experiences were rooted in intersecting axes of inequity, based on gender, race and class. Intersectional and critical participatory research, policy and practice are imperative to develop counter mechanisms that confront systems of privilege-oppression to modulate menstrual experience, health and equity.
Puisque la sant & eacute; menstruelle et l’in & eacute;galit & eacute; menstruelle sont d & eacute;termin & eacute;es par les structures de pouvoir social, cette & eacute;tude propose d’analyser, dans une perspective intersectionnelle, les exp & eacute;riences d’in & eacute;galit & eacute; menstruelle des femmes et des personnes menstru & eacute;es (>= 18 ans) dans des circonstances de vuln & eacute;rabilit & eacute; socio & eacute;conomique en milieu urbain et rural en Catalogne (Espagne), en se concentrant sur la pauvret & eacute; menstruelle, la gestion des menstruations et l’acc & egrave;s aux soins de sant & eacute; menstruelle. Une & eacute;tude qualitative exploratoire et interpr & eacute;tative a & eacute;t & eacute; r & eacute;alis & eacute;e. Un & eacute;chantillonnage de convenance fond & eacute; sur la situation g & eacute;ographique a & eacute;t & eacute; effectu & eacute;; il a permis de recruter des femmes d’une organisation non gouvernementale et d’un centre de soins de sant & eacute; primaires. Dix-huit entretiens individuels semi-structur & eacute;s ont & eacute;t & eacute; men & eacute;s entre octobre 2022 et f & eacute;vrier 2023. Les donn & eacute;es ont & eacute;t & eacute; examin & eacute;es au moyen d’une analyse th & eacute;matique r & eacute;flexive. L’analyse a r & eacute;v & eacute;l & eacute; que les soins menstruels & eacute;taient g & eacute;n & eacute;ralement une pr & eacute;occupation lointaine qui tournait autour des circonstances de vuln & eacute;rabilit & eacute; socio & eacute;conomique, du logement et du travail productif/reproductif. Les difficult & eacute;s li & eacute;es & agrave; la pauvret & eacute; menstruelle, & agrave; la gestion des menstruations et & agrave; l’auto-prise en charge menstruelle, les obstacles & agrave; l’acc & egrave;s aux soins de sant & eacute; menstruelle, ainsi que les tabous, la stigmatisation et la discrimination en relation avec les menstruations & eacute;taient fr & eacute;quents et aggrav & eacute;s par la vuln & eacute;rabilit & eacute; socio & eacute;conomique. De cette mani & egrave;re, les exp & eacute;riences menstruelles des femmes & eacute;taient ancr & eacute;es dans des in & eacute;galit & eacute;s crois & eacute;es, fond & eacute;es sur le genre, la race et la classe sociale. Des recherches, des politiques et des pratiques participatives intersectionnelles et critiques sont imp & eacute;ratives pour mettre au point des m & eacute;canismes de lutte contre les syst & egrave;mes de privil & egrave;ge et d’oppression, afin de moduler l’exp & eacute;rience, la sant & eacute; et l’& eacute;galit & eacute; dans le domaine des menstruations.
Dado que la salud menstrual y la inequidad menstrual son determinadas por estructuras de poder social, este estudio propone analizar, desde una perspectiva interseccional, las experiencias de inequidad menstrual de mujeres y personas que menstr & uacute;an (PMM) (>= 18 a & ntilde;os) bajo circunstancias de vulnerabilidad socioecon & oacute;mica en un entorno urbano y rural de Catalu & ntilde;a (Espa & ntilde;a), con un enfoque en la pobreza menstrual, el manejo menstrual y el acceso a servicios de salud relacionados con la salud menstrual. Se realiz & oacute; un estudio cualitativo exploratorio e interpretativo. Se llev & oacute; a cabo un muestreo por conveniencia basado en sitios y se reclutaron mujeres de una organizaci & oacute;n no gubernamental y un centro de salud de atenci & oacute;n primaria. Entre octubre de 2022 y febrero de 2023, se realizaron 18 entrevistas semiestructuradas individuales. Se utiliz & oacute; el an & aacute;lisis tem & aacute;tico reflexivo para analizar los datos. El an & aacute;lisis revel & oacute; que la atenci & oacute;n menstrual era, por lo general, una preocupaci & oacute;n distante que giraba en torno a circunstancias de vulnerabilidad socioecon & oacute;mica, vivienda y trabajo productivo/reproductivo. Los retos de la pobreza menstrual, el manejo menstrual y el autocuidado menstrual, las barreras al acceso a servicios de salud relacionados con la salud menstrual, y el tab & uacute;, el estigma y la discriminaci & oacute;n menstrual, todos ellos eran comunes y agravados por la vulnerabilidad socioecon & oacute;mica. Por consiguiente, las experiencias menstruales de las mujeres estaban arraigadas en ejes interrelacionados de inequidad por motivo de g & eacute;nero, raza y clase. La invest

Introduction: Gestalt therapy (GT) and systemic pedagogy (SP) are useful tools to approach emotional difficulties and mental health problems among children and adolescents. The main objective of this study was to explore the perceptions on GT and SP techniques in paediatric mental health-related consultations in a primary healthcare (PHC) centre in Catalonia in 2018-2019, among families, healthcare, and education professionals.Methods: Qualitative study, combining semi-structured interviews with families (N = 42) and professionals (N = 15), conducted after a series paediatric PHC consultations including GT and SP techniques. Interviews lasted between 15 and 90 min and were conducted at the PHC centre where GT/SP consultations took place, and at professionals’ workplaces. Socio-demographics, reasons for consultation, and quantitative ratings on the perceived effectiveness of GT/SP consultations were also collected to combine these data with the qualitative interviews. Qualitative data were analyzed descriptively using thematic analysis. Quantitative data were analyzed by calculating frequencies (percentages) for categorical variables, and means, medians, and ranges for continuous variables.Results: Narratives from families and healthcare professionals indicate that GT/SP consultations might have been effective in improving children and adolescents’ symptomatology and emotional health. Improved well-being within the family context was another main finding, based on families’ perceptions and experiences. Besides, GT/SP were considered acceptable for approaching emotional and mental health in PHC services, although barriers for implementation were identified.Conclusions: This study presents data on the potential usefulness of GT/SP to design and implement services that promote emotional and mental health among children and adolescents in PHC. Also, for the development of health policies and future research in this area.

AIM(S): To observe and compare the environmental impacts of different types of infant feeding, considering the use of formula, infant feeding accessories, potentially increased maternal dietary intake during breastfeeding (BF) and food consumption habits. DESIGN: An observational cross-sectional multicentre study conducted in the Barcelona Metropolitan Area of the Catalan Institute of Health. METHODS: Data were collected from 419 postpartum women on infant feeding type (formula milk and accessories), maternal dietary intake (24-h register) and food consumption habits from November 2022 to April 2023. The environmental impacts (climate change (CC), water consumption and water scarcity) of the infant feeding types and maternal diet were calculated using the IPCC, ReCiPE and AWARE indicators, respectively. The differences in impacts were calculated by Kruskal-Wallis test. RESULTS: Significant differences for the three environmental impacts were observed. The CC impact of formula milk and feeding accessories was 0.01 kg CO(2)eq for exclusive BF, 1.55 kg CO(2)eq for mixed feeding and 4.98 kg CO(2)eq for formula feeding. While BF mothers consumed an extra 238 kcal, no significant differences were found related to maternal diet across feeding types. CONCLUSION: Exclusive BF was the most sustainable type of infant feeding, considering formula and infant feeding accessories. In our study, the difference between the impacts of BF and non-BF mothers’ diet was insignificant. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Offer informative and educational support for midwives and other healthcare professionals on BF and a healthy, sustainable diet to transfer this knowledge to the general public. IMPACT: Raise the general public’s awareness about BF and a healthy, sustainable diet. To reduce environmental impacts through behavioural changes. REPORTING METHOD: STROBE. PATIENT OR PUBLIC CONTRIBUTION: Patients of the Catalan Health Service reviewed the content of the data collection tools. TRIAL REGISTRATION: (for the whole GREEN MOTHER project): NCT05729581 (https://clinicaltrials.gov).

Background: The debate on the safety and outcomes of home versus hospital births highlights the need for evidence-based evaluations of these birthing settings, particularly in Catalonia where both options are available. Aim: To compare sociodemographic characteristics and maternal and neonatal outcomes between low-risk women opting for home versus hospital births in Catalonia, Spain. Methods: This observational cross-sectional study analysed 3,463 low-risk births between 2016 and 2018, including 2,713 hospital and 750 home births. Researchers collected sociodemographic data, birthing processes, and outcomes, using statistical analysis to explore differences between the settings. Findings: Notable differences emerged: Women choosing home births typically had higher education levels and were predominantly Spanish. They were 3.43 times more likely to have a spontaneous birth and significantly less likely to undergo instrumental births than those in hospitals. Home births were associated with higher utilization of non-pharmacological analgesia and a more pronounced tendency to iniciate breastfeeding within the first hour post birth and stronger inclination towards breastfeeding. Hospital births, conversely, showed higher use of the lithotomy position and epidural analgesia. There were no significant differences in neonatal outcomes between the two groups. Conclusions and implication for practice: Home births managed by midwives offered better obstetric and neonatal outcomes for low-risk women than hospital births. These results suggest home birth as a safe, viable option that promotes natural birthing processes and reduces medical interventions. The study supports the integration of midwife-led home birth into public health policies, affirming its benefits for maternal and neonatal health.

ObjectiveTo assess the prevalence of anxiety and depression and their associated risk factors throughout the pregnancy and postpartum process using a new screening for the early detection of mental health problems.DesignA prospective cross-sectional descriptive multicentred study. Participants were consecutively enrolled at >= 12 weeks’ gestation and followed at three different time points: at 12-14 weeks of pregnancy, at 29-30 weeks of pregnancy, and 4-6 weeks postpartum. All women completed a mental screening at week 12-14 of pregnancy consisting of two questions from the Generalised Anxiety Disorder Scale (GAD-2) and the two Whooley questions. If this screening was positive, the woman completed the Edinburgh Postnatal Depression Scale (EPDS).SettingSeven primary care centres coordinated by a Gynaecology and Obstetrics Department in the city of Terrassa (Barcelona) in northern Spain.ParticipantsPregnant women (N = 335, age 18-45 years), in their first trimester of pregnancy, and receiving prenatal care in the public health system between July 2018 and July 2020.FindingsThe most relevant factors associated with positive screening for antenatal depression or anxiety during pregnancy, that appear after the first trimester of pregnancy, are systematically repeated throughout the pregnancy, and are maintained in the postpartum period were: a history of previous depression, previous anxiety, abuse, and marital problems. In weeks 12-14 early risk factors for positive depression and anxiety screening and positive EPDS were: age, smoking, educational level, employment status, previous psychological/psychiatric history and treatment, suicide in the family environment, voluntary termination of pregnancy and current planned pregnancy, living with a partner and partner’s income. In weeks 29-30 risk factors were: being a skilled worker, a history of previous depression or anxiety, and marital problems. In weeks 4-6 postpartum, risk factors were: age, a history of previous depression or anxiety or psychological/psychiatric treatment, type of treatment, having been mistreated, and marital problems.ConclusionsEarly screening for anxiety and depression in pregnancy may enable the creation of more effective healthcare pathways, by acting long before mental health problems in pregnant women worsen or by preventing their onset. Assessment of anxiety and depression symptoms before and after childbirth and emotional support needs to be incorporated into routine practice.