ObjectivesWe systemically reviewed the literature to assess how long-term testosterone suppressing gender-affirming hormone therapy influenced lean body mass (LBM), muscular area, muscular strength and haemoglobin (Hgb)/haematocrit (HCT).DesignSystematic review.Data sourcesFour databases (BioMed Central, PubMed, Scopus and Web of Science) were searched in April 2020 for papers from 1999 to 2020.Eligibility criteria for selecting studiesEligible studies were those that measured at least one of the variables of interest, included transwomen and were written in English.ResultsTwenty-four studies were identified and reviewed. Transwomen experienced significant decreases in all parameters measured, with different time courses noted. After 4 months of hormone therapy, transwomen have Hgb/HCT levels equivalent to those of cisgender women. After 12 months of hormone therapy, significant decreases in measures of strength, LBM and muscle area are observed. The effects of longer duration therapy (36 months) in eliciting further decrements in these measures are unclear due to paucity of data. Notwithstanding, values for strength, LBM and muscle area in transwomen remain above those of cisgender women, even after 36 months of hormone therapy.ConclusionIn transwomen, hormone therapy rapidly reduces Hgb to levels seen in cisgender women. In contrast, hormone therapy decreases strength, LBM and muscle area, yet values remain above that observed in cisgender women, even after 36 months. These findings suggest that strength may be well preserved in transwomen during the first 3 years of hormone therapy.

More longitudinal research is required to fully determine the impact of cancer and its treatment on work ability, occupational health services can help such employees make a full recovery and maintain employment by regularly assessing work ability and working hours so that work adjustment and support can be appropriately tailored.

Introduction A shift in focus towards risk stratification and survivorship in early stage endometrial cancer (EC) has led to the replacement of hospital follow‐up (HFU) with patient‐initiated follow‐up (PIFU) schemes. Methods A mixed methods study was undertaken prospectively to investigate utility and patient satisfaction with a newly introduced PIFU scheme. Results Two hundred and twenty‐eight women were enrolled onto PIFU in the first 18 months, median age 65 years (range 42–90 years). Twenty‐four (10.5%) women were non‐British White ethnicity. Forty‐five women contacted the Clinical Nurse Specialist (CNS) at least once (19.7%), the primary reason being vaginal bleeding/discharge (42%). Contact was greater in first six months on the scheme compared to the second 6 months, and women who made contact were significantly younger than those who did not (57 years vs. 65 years, p < 0.001). Conclusions PIFU appears to be well received by the majority of women. Although many of the CNS contacts were due to physical symptoms, a number were for psychological support or reassurance. Younger women had greater CNS contact indicating that they may benefit from a greater level support. Patient feedback of the PIFU scheme was positive, with many women reporting that it enabled them to have more control over their own health.

2Recent interest in analytical pluralism -the application of more than one qualitative 3 analytical method to a single data set -has demonstrated its potential to produce multiple, 4 complex and varied understandings of phenomena. However tensions remain regarding the 5 commensurability of findings produced from diverse theoretical frameworks, the practical 6 application of multiple methods of analysis and the capacity of pluralism to contribute to 7 knowledge in psychology. This study addresses these issues, through a critical interpretation 8 of existing qualitative studies that utilised analytical pluralism. Using a meta-study design, 9we examined the use of theory, application of methods and production of findings in studies 10 that had adopted qualitative analytical pluralism. Following comprehensive database 11 searches, 10 articles were included in the analysis. Epistemological and ontological 12 considerations, the influence of decisions made in the practical application of pluralism and 13 approaches to interpreting findings produced from multiple analyses are discussed, and 14 implications for future research are considered. 15 16

A note on versions:The version presented here may differ from the published version or, version of record, if you wish to cite this item you are advised to consult the publisher's version. Please see the 'permanent WRAP url' above for details on accessing the published version and note that access may require a subscription. Results: Track and field coaches reported using physical, social and performance indicators 7 to identify disordered eating in their athletes. Coaches also monitored their athletes' eating 8 attitudes and behaviors. Weight loss (both observed and objectively monitored) was 9 considered to be a key indicator of disordered eating. Coaches placed a high level of 10 importance on weight for performance, and an "ideal" female athlete body. Previous 11 experiences of detecting disordered eating and a close relationship with the athlete facilitated 12 the identification of disordered eating. Athlete secrecy and masking behaviors, difficulties in 13 communication and coaches' stereotypical beliefs were found to complicate the identification 14 process. 15Conclusions: This study highlights the need for additional information, advice and guidance 16 for track and field coaches to improve their knowledge and confidence in identifying 17 disordered eating among their athletes. 18