Sandra Haider

Objectives: To assess self-reported knowledge, training and clinical practices related to female genital mutilation/cutting (FGM/C) among healthcare professionals in Austria and to identify profession-specific gaps relevant to prevention and care. Design: Cross-sectional online survey. Setting: Nationwide survey conducted in Austria between September 2023 and February 2024. Participants: A convenience sample of 537 healthcare professionals, including midwives (29%, n=157), gynaecologists (21%, n=113), general practitioners (18%, n=95), paediatricians (13%, n=72), and other (19%, n=100). Participants were recruited via professional associations. Main outcome measures: Self-reported knowledge of FGM/C (including WHO typology, Austrian legislation and International Classification of Diseases (ICD)-10 codes), exposure to FGM/C training during professional education, clinical experience with patients from FGM/C-practising countries and comfort discussing FGM/C in clinical practice. Associations between professional group and outcome measures were analysed using logistic regression. Results: Knowledge gaps were particularly pronounced as 63% of respondents were unfamiliar with legislation and 85% lacked knowledge of relevant ICD-10 codes. Compared with general practitioners, gynaecologists reported higher knowledge of legislation (adjusted OR (aOR)=4.75; 95% CI 2.47 to 9.14), traditional and cultural aspects (aOR=2.65; 95% CI 1.39 to 5.05) and ICD-10 codes (aOR=4.52; 95% CI 1.87 to 10.97). Only 34% (n=182) reported receiving any FGM/C training during professional education. Demand for additional training was high, particularly regarding legal frameworks (88%, n=474) and WHO typology (74%, n=397). Paediatricians were significantly less likely to feel comfortable initiating discussions about FGM/C (aOR=0.17; 95% CI 0.08 to 0.36) compared with general practitioners, whereas gynaecologists reported the highest comfort levels (aOR=1.44; 95% CI 0.64 to 3.28). Conclusions: Substantial, profession-specific gaps in knowledge and training on FGM/C exist among healthcare professionals in Austria. Despite increasing availability of specialised services, insufficient integration of FGM/C into professional education may hinder effective prevention, identification and care. Targeted and systematic training, particularly for paediatricians and general practitioners, alongside national clinical guidelines may strengthen healthcare responses to FGM/C in Austria.

Background and Objectives: Functional decline and sarcopenia are major aging-related concerns. While protein intake is known to influence muscle health, its longitudinal impact on strength and physical function across age and gender remains underexplored. We assessed whether low protein intake correlate with future onset of low handgrip strength (HGS) and physical impairments in older adults using SHARE data. Methods: We analyzed 38,073 adults aged ≥50 years from 27 European countries using SHARE Waves 8 (2019/20) and 9 (2021/22). A protein intake index was derived from the frequency of consuming dairy, legumes/eggs, and meat/fish/poultry. Low intake was defined as the lowest decile. Logistic regression models, adjusted for age, gender, country, and baseline health, examined associations with low HGS and ten physical difficulties, stratified by age (50–65 vs. ≥66 years) and gender. Results: Low protein intake is associated with higher odds of low HGS in men (OR = 1.39 for 50–65; OR = 1.35 for ≥66) and older women (OR = 1.21). It was also associated with higher odds of mobility-related limitations, including walking 100 m (ORs = 1.25–1.53), stooping/kneeling (ORs = 1.20–1.19 in women), and reaching overhead (ORs = 1.19–1.33). Strength-related tasks, such as pushing/pulling large objects were more affected in men (ORs = 1.44 and 1.21). Notably, women aged 50–65 had over twice the odds of toileting difficulty (OR = 2.27) and significantly higher odds of difficulty shopping (OR = 1.65). These patterns highlight gender- and age-specific vulnerabilities. Conclusions: Low protein intake is associated with modest but consistent increases in the risk of reduced muscle strength and functional difficulties in older adults. Tailored nutritional strategies may mitigate age- and gender-specific risks to physical independence.

Aims: This cross‐sectional study examined associations between self‐reported taste perception changes and appetite‐related outcomes in individuals with obesity treated with glucagon‐like peptide‐1 receptor agonist (GLP‐1 RAS) or dual glucose‐dependent insulinotropic polypeptide (GIP)/GLP‐1 RAS in real‐world conditions. Materials and Methods: Four hundred and eleven adults on Wegovy® ( n = 217), Ozempic® ( n = 148) and Mounjaro® ( n = 46) completed an online survey assessing sociodemographic, anthropometric and sensory changes and appetite‐related outcomes. Multivariable logistic regression was used to assess associations between taste changes and satiety, appetite and craving. Results: Participants (69.6% female; median age 39 [interquartile range, IQR 33–47]) had baseline body mass index ( BMI) of 35.6 (Wegovy®), 34.7 (Ozempic®) and 36.2 kg/m ² (Mounjaro®). Adjusted models for baseline BMI , treatment duration, dose, age and sex showed significant reductions in BMI of 17.6% (95% CI : 15.7–19.5) for Wegovy®, 17.4% (15.0–19.8) for Ozempic® and 15.5% (8.8–22.2) for Mounjaro®. Reduced appetite was reported by 58.4% of participants (Wegovy®: 54.4%, Ozempic®: 62.1%, Mounjaro®: 56.5%) and increased satiety by 63.5% (Wegovy®: 66.8%, Ozempic®: 58.8%, Mounjaro®: 63.1%). Additionally, 21.3% reported increased sweet taste perception and 22.6% reported increased salty taste perception. Independent of the type of therapy, increased sweet taste perception was significantly associated with increased satiety (adjusted odds ratios [ AOR] = 2.02; 95% CI : 1.15–4.57), decreased appetite ( AOR = 1.67; 95% CI : 1.04–3.25) and decreased craving ( AOR = 1.85; 95% CI : 1.05–3.29). Increased salty taste perception was associated with increased satiety ( AOR = 2.17; 95% CI : 1.16–5.17; all p < 0.05). Conclusions: Self‐reported changes in taste perception during GLP‐1 or dual GIP/GLP‐1 RAS therapy were associated with favourable appetite‐related outcomes, suggesting a potential mechanism contributing to treatment response.

Women with polycystic ovary syndrome (PCOS) exhibit sustained elevation in circulating androgens during pregnancy, an independent risk factor linked to pregnancy complications and adverse outcomes in offspring. Yet, further studies are required to understand the effects of elevated androgens on cell type‐specific placental dysfunction and fetal development. Therefore, a PCOS‐like mouse model induced by continuous androgen exposure is examined. The PCOS‐mice exhibited impaired placental and embryonic development, resulting in mid‐gestation lethality. Co‐treatment with the androgen receptor blocker, flutamide, prevents these phenotypes including germ cell specification. Comprehensive profiling of the placenta by whole‐genome bisulfite and RNA sequencing shows a reduced proportion of trophoblast precursors, possibly due to the downregulation of Cdx2 expression. Reduced expression of Gcm1 , Synb , and Prl3b1 is associated with reduced syncytiotrophoblasts and sinusoidal trophoblast giant cells, impairs placental labyrinth formation. Importantly, human trophoblast organoids exposed to androgens exhibit analogous changes, showing impaired trophoblast differentiation as a key feature in PCOS‐related pregnancy complications. These findings provide new insights into the potential cellular targets for future treatments.

Background: Therapeutic climbing (TC) has emerged as a prospective rehabilitation approach for individuals with multiple sclerosis (MS). The existing literature primarily focuses on the physical and psychological benefits of TC across diverse populations but is limited concerning its application and efficacy for patients with MS. Objectives: This study aimed to delineate the experiences, subjective effects, and perceptions of both individuals with MS and therapists regarding TC, highlighting the potential benefits and challenges of this therapeutic approach. Methods: Using a qualitative design, semi-structured interviews were conducted with patients living with MS (N = 5) and therapists (N = 7) involved in TC sessions at a rehabilitation facility. The interviews were recorded, transcribed verbatim, and subjected to thematic qualitative text analysis. Results: Our analysis resulted in the identification of five main categories: (1) motivational factors, (2) training conditions, (3) training content, (4) observed effects, and (5) safety protocol. Our findings primarily centred around the motivational aspects of TC. Participants consistently reported experiencing feelings of accomplishment, success, enjoyment, and increased self-confidence. Furthermore, TC was often perceived as a comprehensive intervention, addressing endurance, strength, flexibility, neuromotor functions, cognition, and mental health while having a low-risk profile. However, due to the demanding nature of TC, careful fatigue management is crucial. This entails personalised intensity adjustments during sessions and coordinating TC with other physically demanding therapies when implementing TC within a rehabilitation environment. Conclusions: TC shows promise within MS rehabilitation and can be considered safe under certain framework conditions. This research sheds light on its potential benefits, facilitators, and barriers and provides insights for practical integration into rehabilitation programs.

This article explores the factors influencing the choice of general practitioners (GPs) and their role in the health care of vegans in Austria. The number of people identifying as vegan is on the rise, and GPs are increasingly confronted with vegan patients. A qualitative method was chosen for this study, and 14 semi-structured interviews with vegans were conducted between April 2022 and July 2022. Participants were recruited primarily through vegan social media groups. In their experiences with health care, vegans felt treated unequally or sometimes incorrectly. The experiences described highlight that participants felt that most GPs were biased against their veganism. Information exchange among vegans primarily takes place online and through publications of vegan associations, while GPs play a minor role in information provision. As the number of vegans grows, an appreciative way of communicating between GPs and vegan patients ought to be promoted. Voluntary interdisciplinary nutritional training, collaboration of the medical field with support organizations, provision of evidence-based information, and collaboration with dietitians and nutritionists could enrich the care of patients with a vegan diet.

Background: Therapeutic climbing (TC) has emerged as a prospective rehabilitation approach for individuals with Multiple Sclerosis (MS). Existing literature primarily focuses on the physical and psychological benefits of TC across diverse populations but is limited concerning its application and efficacy for patients with MS. Objectives: This study aimed to delineate the experiences, effects, and perceptions of both individuals with MS and therapists regarding TC, highlighting the potential benefits and challenges of this therapeutic approach. Methods: Using a qualitative design, structured interviews were conducted with patients living with MS (N=5) and therapists (N=7) involved in TC sessions at a rehabilitation facility. The interviews were recorded, transcribed verbatim, and subjected to thematic qualitative text analysis. Results: Our analysis resulted in the identification of five main categories: (1) motivational factors, (2) training conditions, (3) training content, (4) observed effects, and (5) safety protocols. Findings primarily centred around the motivational aspects of TC. Participants consistently reported experiencing feelings of accomplishment, success, enjoyment, and increased self-confidence. Furthermore, TC was often perceived as a comprehensive intervention, addressing endurance, strength, flexibility, neuromotor functions, cognition, and mental health while having a low-risk profile. However, due to the demanding nature of TC, careful fatigue management is crucial. This entails personalized intensity adjustments during sessions and coordinating TC with other physically demanding therapies when implementing TC within a rehabilitation environment. Conclusions: TC shows promise within MS rehabilitation and can be considered safe under certain framework conditions. This research sheds light on its potential benefits, facilitators and barriers and provides insights for practical integration into rehabilitation programmes.

A balanced diet and sufficient physical activity (PA) are known to have positive health effects. The relationship between a vegan diet and PA levels is understudied. This cross-sectional online survey aimed to analyze whether different vegan dietary patterns differ in PA. In total, 516 vegan participants were included (June to August 2022). Different dietary patterns were compiled through principal component analysis, while group differences were calculated using independent tests, or chi-squared tests as well as logistic regression analyses. The population had an average age of 28.0 (SD: 7.7) years and had been living vegan for 2.6 (95% CI: 2.5–3.0) years. Two dietary patterns, the “convenience” and the “health-conscious” group, were identified. People with a convenience dietary pattern had significantly higher odds of sitting more (OR 1.10, 95% CI 1.04–1.18) and not achieving aerobic PA (OR 1.81, 95% CI 1.18–2.79) or strength training recommendations (OR 1.81, 95% CI 1.26–2.61) than people with a health-conscious dietary pattern. This study suggests the heterogeneity of vegan diets and that dietary patterns must be differentiated, as they also differ in the level of PA. Additional studies involving complete dietary assessment with a focus on ultraprocessed foods, blood metabolite analysis, and objective PA assessment are required.