Women's empowerment has gained attention as critical for child nutrition during the first 1000 days of life. However, the ways in which various women's empowerment measures are applied and the evidence for how they are differentially related to child nutrition is unclear. In this systematic review, therefore, we 1) systematically parse the many ways in which women's empowerment has been quantitatively measured in the context of child nutrition through the use of a theoretically driven application of dimensions and domains of empowerment; 2) summarize evidence for each of the various pathways between women's empowerment and child nutrition, based on dimensions and domains of empowerment; and 3) offer suggestions for future research to better articulate the relationship between women's empowerment and child nutrition. A search of evidence yielded 62 quantitative studies that used 200 unique indicators of women's empowerment, tested in 1316 associations with various child nutrition outcomes. Despite the large number of unique indicators, indicators for time resource allocation and reproductive decisions and indicators for men's engagement in child care and nutrition, all pertinent to child nutrition, were missing. Overall, the findings indicated an inconclusive relationship between women's empowerment and child nutrition: 379 out of 461 (82% weighted) and 217 out of 258 (84% weighted) associations found with stunting and wasting outcomes, respectively, were not significant. The current lack of evidence is likely not due to the absence of an underlying relationship between women's empowerment and child nutrition, but rather limitations in study design. Future research should carefully select women's empowerment indicators in context-specific ways, aggregate them meaningfully, and use a longitudinal study design to conduct pathway and lifecycle analysis in appropriate populations to clarify the relationship between women's empowerment and child nutrition.

Study Need and Importance: Antibiotic-refractory recurrent urinary tract infections (UTIs) are challenging to manage. Prior studies have shown that, in selected patients, electrofulguration (EF) of cystitis may disrupt potential nidus of recurrent UTI. We report on long-term outcomes of EF in women with at least 5 years of follow-up. What We Found: From 2006 to 2012, 96 women met study criteria with median age 64. Median follow-up was 11 years (IQR: 10-13.5); 71 women had >10year follow-up. The clinical outcome distribution by years of follow-up is displayed in the Figure . Prior to EF, 74% used daily antibiotic suppression, 5% used postcoital prophylaxis, 14% used self-start therapy, and 7% were not on prophylaxis. At last post-EF visit, 72% of women were cured, 22% improved, and 6% failed. Antibiotic usage decreased post-EF (P < .05). Five percent were on continuous antibiotics at last follow-up as compared to 74% on continuous antibiotics pre-EF (McNemar P < .05). Nineteen percent of women underwent a repeat EF. Limitations: This study was conducted at a single, tertiary-care, academic center with mainly postmenopausal and Caucasian women and a potential referral bias to a Female Pelvic Medicine and Reconstructive Surgeryespecialized practice, so generalizability may be limited. Given the length of the study period, there are also potentially confounding variables that may affect patient's UTI rates, including new onset of medical comorbidities (eg, diabetes, neurodegenerative conditions) that developed independently, as well as socio-environmental factors that may be difficult to capture. Interpretation for Patient Care: In women with over 5 years of follow-up after EF for antibiotic-refractory recurrent UTIs, some were cured durably, whereas others sustained prolonged benefit with overall reduction in antibiotic usage. These long-term data can help guide management for women with challenging recalcitrant UTIs in whom chronic bladder inflammatory lesions observed on cystoscopy can be considered for fulguration. Figure. Distribution of clinical outcomes by years of follow-up.

must be noted, however, that patients were treated with 4-6 weeks of a low-dose antibiotic after the procedure. Additionally, nearly a third of the women were on topical estrogens, while a significant number needed to continue with agents providing symptomatic relief, such as phenazopyridine or D-mannose, amongst other methods, suggesting that while the cure rates were impressive, symptomatic relief lagged.Apart from the study's retrospective nature, the element of recall via telephone interviews and possible treatments sought elsewhere are other limitations the authors accept. Previously, the same group has presented results in more extensive forms of cystitis, 4 with results less impressive than in the present study. 3 Therefore, the exact role of electrofulguration needs to be defined further. Nevertheless, the authors' results suggest that the time for trials of electrofulguration for recurrent UTI has arrived.

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