Sinai Hospital

Early parenthood is shaped by evolving parental behaviors, attitudes, beliefs, and well-being embedded within biopsychosocial contexts. In this nationwide longitudinal study, we used latent growth curve modeling to examine how biopsychosocial vulnerability is associated with trajectories of parental experiences among new mothers and fathers during the first 2 years postpartum. Coresiding mothers (N = 2,994) and fathers (N = 2,787) across Canada self-reported various biopsychosocial vulnerabilities (e.g., lower couple relationship quality, lower perceived social support) at a single time point, with most factors collected at 3 weeks postpartum and others at 3 months postpartum. Parents further reported on parental outcomes (e.g., involvement, distress, overreactivity) starting at 3 months postpartum for up to five time points across the first 2 years postpartum. Results showed that vulnerability factors had the strongest and most frequent associations with initial status in parental outcomes, with lower relationship quality and lower perceived social support having the largest effect sizes. These patterns were similar for both mothers and fathers. In contrast, the number and strength of associations with change in parental outcomes over time was smaller. While lower relationship quality and perceived social support were linked to improvements in some parental outcomes over time, high childhood adversity, immigrant background, lower household income, and lower education were associated with less favorable changes in outcomes. These patterns varied between mothers and fathers. Overall, the findings underscore the contribution of biopsychosocial vulnerability in the functioning and well-being of first-time parents, with shared and unique risks for mothers and fathers. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Gynecologic health has traditionally been approached through a reproductive-centered lens; however, growing international evidence demonstrates that gynecologic conditions, hormonal transitions, and interventions exert significant systemic and long-term clinical effects across the female lifespan. This narrative review synthesizes high-impact literature addressing gynecologic health beyond reproductive function, with particular emphasis on metabolic, cardiovascular, endocrine, immune-inflammatory, genitourinary, and oncologic outcomes. Chronic conditions such as polycystic ovary syndrome and endometriosis are examined as early and midlife determinants of long-term systemic risk, while menopause is analyzed as a critical biological transition influencing cardiometabolic health. The review also explores the long-term implications of gynecologic surgery, hormonal contraception, and menopausal hormone therapy, highlighting the complexity and context-dependence of associated risks and benefits. By adopting a life-course and systems-based perspective, this article underscores the importance of integrating gynecologic history into comprehensive risk assessment, preventive strategies, and medical education. The findings support a reframing of gynecology as a foundational component of women’s overall health, with relevance across diverse healthcare settings, including Mexico, Colombia, and Ecuador.

Malpractice litigation remains a source of professional and financial risk in aesthetic surgery. Prior Westlaw/LexisNexis studies typically focus on single procedures. We assessed aesthetic surgery malpractice across five common procedures and compared verdicts and indemnity between body and facial domains. Retrospective review of Westlaw Edge for U.S. malpractice cases adjudicated 1982-2022 involving abdominoplasty, breast augmentation, breast reduction, blepharoplasty, and facelift. Variables included procedure, allegations, injuries, verdict, and payout. Outcomes were categorized as defense versus non-defense (plaintiff verdict or settlement). Awards are reported in unadjusted U.S. dollars. χ2 and Mann-Whitney U tests compared verdict distributions and indemnity. 534 lawsuits met inclusion (408 body; 126 facial). Non-defense outcomes were 33.6% in body vs 38.1% in facial cases (χ2 = 1.74, p = 0.19). Among paid cases, median (IQR) award was $155,000 ($52,000-$586,371) for body and $337,500 ($118,750-$650,000) for face (Mann-Whitney U, p = 0.04). By procedure, non-defense proportions were 46.9% facelift, 39.5% breast augmentation, 32.5% blepharoplasty, 32.0% breast reduction, and 23.3% abdominoplasty. Lack of informed consent was associated with higher odds of a non-defense outcome on unadjusted comparison (p = 0.03). Major injury/death was associated with larger awards (median~$780,000 vs $210,000; p < 0.01). Over four decades, defense verdicts predominated, yet facial procedures carried greater indemnity than body procedures among paid cases. Findings support expectation forward informed consent, reliable postoperative communication, and risk stratification for combination body procedures as practical targets to reduce medicolegal exposure while improving patient understanding. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .