Purpose As more young female patients with cancer survive their primary disease, concerns about reproductive health related to primary therapy gain relevance. Cancer therapy can often affect reproductive organs, leading to impaired pubertal development, hormonal regulation, fertility, and sexual function, affecting quality of life. Methods The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancer (COG-LTFU Guidelines) are evidence-based recommendations for screening and management of late effects of therapeutic exposures. The guidelines are updated every 2 years by a multidisciplinary panel based on current literature review and expert consensus. Results This review summarizes the current task force recommendations for the assessment and management of female reproductive complications after treatment for childhood, adolescent, and young adult cancers. Experimental pretreatment as well as post-treatment fertility preservation strategies, including barriers and ethical considerations, which are not included in the COG-LTFU Guidelines, are also discussed. Conclusion Ongoing research will continue to inform COG-LTFU Guideline recommendations for follow-up care of female survivors of childhood cancer to improve their health and quality of life.

Objective The incidence of anal cancer is higher in women than men in the general population and has been increasing for several decades. Similar to cervical cancer, most anal cancers are associated with human papillomavirus (HPV) and it is believed that anal cancers are preceded by anal high-grade squamous intraepithelial lesions (HSIL). Our goal was to summarize the literature on anal cancer, HSIL and HPV infection in women, and provide screening recommendations in women. Methods A group of experts convened by the ASCCP and the International Anal Neoplasia Society reviewed the literature on anal HPV infection, anal SIL and anal cancer in women. Results Anal HPV infection is common in women but is relatively transient in most. The risk of anal HSIL and cancer varies considerably by risk group, with HIV-infected women and those with a history of lower genital tract neoplasia (LGTN) at highest risk compared with the general population. Conclusions While there are no data yet to demonstrate that identification and treatment of anal HSIL leads to reduced risk of anal cancer, women in groups at the highest risk should be queried for anal cancer symptoms and have digital anorectal examinations to detect anal cancers. HIV-infected women and women with LGTN, may be considered for screening with anal cytology with triage to treatment if HSIL is diagnosed. Healthy women with no known risk factors or anal cancer symptoms do not need to be routinely screened for anal cancer or anal HSIL.

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Vulvovaginal pain problems are major health concerns in women of childbearing age.Controlled studies have shown that vulvovaginal pain can adversely affect women and their partners' general psychological well-being, relationship adjustment and overall quality of life. These women have significantly lower levels of sexual desire, arousal, and satisfaction, as well as a lower intercourse frequency than normal controls. They also report more anxiety and depression, in addition to more distress about their body image and genital self-image. Empirical studies indicate that specific psychological and relationship factors may increase vulvovaginal pain intensity and its psychosexual sequelae. Randomized clinical trials have shown that psychosexual interventions, namely cognitive-behavioral therapy (CBT), are efficacious in reducing vulvovaginal pain and improving associated psychosexual outcomes. Women reporting significant psychological, sexual and/or relationship distress should be referred for psychosexual treatment. A multimodal approach to care integrating psychosexual and medical management is thought to be optimal.Keywords: vulvovaginal pain, vulvodynia, provoked vestibulodynia, psychological adjustment, sexual function, cognitive-behavioral therapy 3 Vulvovaginal pain problems are major health concerns in women of all ages. As conditions which are often misdiagnosed, mismanaged, trivialized or ignored, they entail a great personal cost to patients and a significant financial cost to society [1]. A case in point is vulvodynia: a population-based study suggests that the lifetime cumulative incidence of vulvodynia is 16% [2, 3] and its incidence is thought to be increasing in young women [4,5]. In fact, many women suffering from vulvovaginal pain are under the age of 30, with community estimates showing that one in five women aged 18-29 report chronic dyspareunia [6]. In addition to disrupting all aspects of sexual function, controlled studies have shown that vulvovaginal pain can adversely affect women and their partners' general psychological well-being, relationship adjustment and overall quality of life [7, 8]. Because of their deleterious impact on sexuality and romantic relationships, vulvovaginal pain problems may indeed carry a heavier psychosocial burden in comparison to other pain problems common in women, with many patients reporting feelings of shame, inadequacy and low self-esteem [9]. Further, up to 45% of women with vulvodynia report a comorbid-pain condition, and having a comorbidity is associated with increased feelings of isolation and invalidation [10]. In terms of helpseeking behaviors, epidemiological results indicate that only 60% of women who report chronic vulvovaginal pain seek treatment, and 40% of these never receive a formal diagnosis [5]. A recent study involving a community sample showed that women saw an average of five physicians before diagnosis [10]. The quality of health care received by this patient population is thus less than optimal. It has been suggested that a multi...

Background The impact of the COVID-19 pandemic on Advanced Practice Registered Nurse (APRN) practice is not well known. Purpose This study aimed to describe state practice barriers and explore the effects of the COVID-19 pandemic on APRN practice. Methods A descriptive study design used a 20-item web-based survey open from June 1 through September 23, 2020. Findings A total of 7,467 APRNs responded from all 50 states, including nurse practitioners (n = 6,478, 86.8%), certified registered nurse anesthetists (n = 592, 7.9%), certified nurse-midwives (n = 278, 3.7%), and clinical nurse specialists (n = 242, 3.2%). A number of barriers to practice prior to the pandemic were identified. Most respondents (n=6334, 84.8%) identified that practice barriers limited the ability of APRNs to provide care during the pandemic. Discussion Barriers to APRN practice continue to restrict aspects of patient care and patient access to care, even in states with FPA, during the COVID-19 pandemic and with state executive orders waiving practice restrictions. The study findings can be used to advocate for policy changes to support APRN practice authority.