BACKGROUND Epidemiologic studies suggest that declining estrogen level in menopause may play an important role in the pathogenesis of dementia and contribute to increased risk of cognitive impairment in women. Most previous studies have been conducted in Western population to investigate the relations of the length of reproductive periods and use of HRT with risk of cognitive function and dementia, but the findings are inconclusive. Relevant evidence among Asian populations is limited. OBJECTIVES To evaluate the association between reproductive and hormonal factors, and risk of cognitive impairment in Chinese women with natural menopause. STUDY DESIGN The Singapore Chinese Health Study is a population-based study that recruited participants aged 45-74 years between 1993 and 1998, and the current study included 8,222 women from this cohort who had natural menopause, complete data on reproductive factors and hormonal therapies at baseline (1993-1998), follow-up 1 (1999-2004) and follow-up 2 interviews (2006-201women with short-term use (≤ 5 years) of oral contraceptives had 26% lower odds of having cognitive impairment (OR 0.74; 95% CI 0.63, 0.87), while the association was not statistically significant for those used for more than 5 years (OR 0.87; 95% CI 0.68, 1.13). Women who used HRT had a 39% lower odd of getting cognitive impairment compared to non-users (OR 0.61; 95% CI 0.46, 0.80). CONCLUSIONS Our data suggested that shorter reproductive years and higher parity were associated with higher risk of cognitive impairment in late life, while use of oral contraceptives and hormone replacement therapy were associated with decreased risk. As the population ages, understanding how these factors affect late-life cognitive function in women may help health professionals develop preventive measures targeting lifetime estrogen exposure from endogenous or exogenous sources. Poor sleep is frequently reported by women during the menopausal transition period. Difficulties with sleep can affect women’s physical and emotional health as well as their overall quality of life. Investigators have found that there is a correlation between a woman’s menopausal history and poor sleep; however, there are differences within each menopausal stage. In this short review, we examine a recent secondary analysis study of quality of sleep and risk factors for poor sleep among women ages 45 to 54 years. After declining for many years, rates of syphilis in the United States are increasing. In this article, I explore possible reasons why women, and specifically pregnant women, are not getting tested properly. Lack of prenatal care, poor access to prenatal care, and improper prenatal care all have contributed to cases of congenital syphilis. Clinicians working in women’s health care can address this issue by taking accurate sexual histories, remaining open to sexual fluidity among their patients, being knowledgeable about the appropriate guidelines for testing for syphilis, and routinely offering screening to any woman at risk. Syphilis is a treatable and preventable sexually transmitted infection, and nurses, advanced practice nurses, and midwives can significantly contribute to reversing the current trend. Gemcitabine order OBJECTIVE To explore the knowledge, attitudes, and perceptions of exclusive breastfeeding among professional caregivers in a suburban community hospital who typically provide, or influence, the care of parturient women. DESIGN Cross-sectional quantitative study. SETTING Acute care community hospital in suburban New Jersey with 3,500 births per year. PARTICIPANTS Obstetricians, midwives, neonatologists, pediatricians, and registered nurses. INTERVENTIONS/MEASUREMENTS We designed a survey using two instruments-the Iowa Infant Feeding Attitudes Scale and the Breastfeeding Attitudes Scale-to explore concepts of breastfeeding knowledge, attitudes, and perceptions. Data were analyzed by using descriptive and inferential statistics with SPSS (Version 19). Independent sample t tests, Pearson’s correlation coefficient, and Pearson’s chi-square test (×2) were used to assess differences between the groups. RESULTS When the physician scores were separated out by specialty, statistically significant differences in mean scores were found (p = .002). Pediatricians had lower scores on attitude toward breastfeeding. In contrast, mean scores for perceptions and knowledge of breastfeeding were positive for physicians and nurses, regardless of area of specialization, with no statistically significant differences found. CONCLUSION Although pediatricians’ attitudes, perceptions, and knowledge of breastfeeding cannot be deemed the sole cause for our organization’s low rates of sustained exclusive breastfeeding in the postpartum period, this study provided an avenue for exploration that we did not immediately consider as we dissected our performance metrics related to exclusive breastfeeding. We encourage teams at other organizations to replicate and build on this work to explore influences surrounding low rates of exclusive breastfeeding. BACKGROUND Image-guided bronchoscopy techniques have emerged as a means of improving pulmonary nodule biopsy yield. However, comparisons of diagnostic efficacy of electromagnetic navigation bronchoscopy (ENB) and virtual bronchoscopic navigation (VBN) have not reached a consensus. This meta-analysis evaluates the overall diagnostic yield and accuracy of ENB and VBN for pulmonary nodules. METHODS A systematic search was conducted to identify relevant articles. Meta-analysis was used to summarize the sensitivities, specificities, and area under the curve for ENB and VBN. RESULTS A total of 32 studies (1,981 patients with pulmonary nodules) were included in this analysis. The pooled sensitivity, specificity, and area under the curve with 95% confidence intervals of ENB were 0.80 (0.73-0.85), 0.81 (0.71-0.88), and 0.87 (0.84-0.90), respectively. For VBN, the corresponding values were 0.80 (0.76-0.83), 0.65 (0.56-0.73), and 0.81 (0.78-0.85), respectively. Comparison of the two techniques revealed that ENB had higher specificity and area under the curve, but no difference in sensitivity. CONCLUSIONS Both ENB and VBN are valuable tools in the diagnosis of lung nodules. ENB achieved a higher specificity than VBN in the diagnose of lung nodules, while ENB performed better than VBN for pulmonary nodules. The reason for these results is due to the real-time positioning function of ENB.