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There is growing recognition of the importance of menstruation in achieving health, education, and gender equality for all. New policies in high income countries (HICs) have responded to anecdotal evidence that many struggle to meet their menstrual health needs. Qualitative research has explored lived experiences of menstruating in HICs and can contribute to designing intervention approaches. To inform the growing policy attention to support people who menstruate, here we review and synthesise the existing research. Primary, qualitative studies capturing experiences of menstruation in HICs were eligible for inclusion. Systematic database and hand searching identified 11485 records. Following screening and quality appraisal using the EPPI-Centre checklist, 104 studies (120 publications) detailing the menstrual experiences of over 3800 individuals across sixteen countries were included. We used the integrated model of menstrual experiences developed from studies in low- and middle-income countries (LMICs) as a starting framework and deductively and inductively identified antecedents contributing to menstrual experiences; menstrual experiences themselves and impacts of menstrual experiences. Included studies described consistent themes and relationships that fit well with the LMIC integrated model, with modifications to themes and model pathways identified through our analysis. The socio-cultural context heavily shaped menstrual experiences, manifesting in strict behavioural expectations to conceal menstruation and limiting the provision of menstrual materials. Resource limitations contributed to negative experiences, where dissatisfaction with menstrual practices and management environments were expressed along with feelings of disgust if participants felt they failed to manage their menstruation in a discrete, hygienic way. Physical menstrual factors such as pain were commonly associated with negative experiences, with mixed experiences of healthcare reported. Across studies participants described negative impacts of their menstrual experience including increased mental burden and detrimental impacts on participation and personal relationships. Positive experiences were more rarely reported, although relationships between cis-women were sometimes strengthened by shared experiences of menstrual bleeding. Included studies reflected a broad range of disciplines and epistemologies. Many aimed to understand the constructed meanings of menstruation, but few were explicitly designed to inform policy or practice. Few studies focused on socioeconomically disadvantaged groups relevant to new policy efforts. We developed an integrated model of menstrual experience in HICs which can be used to inform research, policy and practice decisions by emphasising the pathways through which positive and negative menstrual experiences manifest.

[This corrects the article DOI: 10.1371/journal.pone.0260472.].

Disposal and washing facilities and services for menstrual materials are often designed based upon technical specifications rather than an in-depth understanding of what drives peoples' choices of practices. This systematic review identified and summarised the main behavioural drivers pertaining to the choice of disposal and washing practices of menstrual materials through the thematic content analysis and study appraisal of 82 publications (80 studies) on menstrual health and hygiene published since 1999, reporting the outcomes of primary research across 26 countries. Disposal and washing behaviours are primarily driven by the physical state of sanitation facilities; however, this is intrinsically linked to taboos surrounding and knowledge of menstruation. Using reasons given for disposal and washing practices by menstruators or those who know them well, or inferred by authors of the reviewed studies, we identify the key considerations needed to design facilities and services which best suit the desired behaviours of both planners and those who menstruate. The term menstruators is used throughout to encompass all those mentioned in the studies reviewed (girls and women); although no studies explicitly stated including non-binary or transgender participants, this review uses inclusive language that represents the spectrum of genders that may experience menstruation. The review protocol is registered on PROSPERO: 42019140029.

Makeup is commonly attributed with increasing attractiveness in female faces, but this effect has not been investigated in male faces. We therefore sought to examine whether the positive effect of makeup on attractiveness can be extended to male faces. Twenty men were photographed facing forward, under constant camera and lighting conditions, with neutral expressions, and closed mouths. Each man was photographed twice: once without any cosmetics applied and another time with subtle cosmetics applied by a professional makeup artist. Two hundred participants then rated those 40 images on attractiveness. The male faces were rated as higher in attractiveness when presented wearing makeup, compared to when presented not wearing makeup. This was true for both male and female raters, and whether analyzing the data using a by-participant or a by-face analysis. These results provide the first empirical evidence that makeup increases attractiveness in male faces. Following work on female faces, future research should examine the effect of makeup on several other traits in male faces. The market for male cosmetics products is growing and evolving and this study serves as an initial step in understanding the effect of makeup on the perceptions of male faces.

Makeup is commonly attributed with increasing attractiveness in female faces, but this effect has not been investigated in male faces. We therefore sought to examine whether the positive effect of makeup on attractiveness can be extended to male faces. Twenty men were photographed facing forward, under constant camera and lighting conditions, with neutral expressions, and closed mouths. Each man was photographed twice: once without any cosmetics applied and another time with subtle cosmetics applied by a professional makeup artist. Two hundred participants then rated those 40 images on attractiveness. The male faces were rated as higher in attractiveness when presented wearing makeup, compared to when presented not wearing makeup. This was true for both male and female raters, and whether analyzing the data using a by-participant or a by-face analysis. These results provide the first empirical evidence that makeup increases attractiveness in male faces. Following work on female faces, future research should examine the effect of makeup on several other traits in male faces. The market for male cosmetics products is growing and evolving and this study serves as an initial step in understanding the effect of makeup on the perceptions of male faces.

ObjectiveThe COVID-19 pandemic has set unprecedented demand on the healthcare workforce around the world. The UK has been one of the most affected countries in Europe. The aim of this study was to explore the perceptions and experiences of healthcare workers (HCWs) in relation to COVID-19 and care delivery models implemented to deal with the pandemic in the UK.MethodsThe study was designed as a rapid appraisal combining: (1) a review of UK healthcare policies (n=35 policies), (2) mass media and social media analysis of front-line staff experiences and perceptions (n=101 newspaper articles, n=1 46 000 posts) and (3) in-depth (telephone) interviews with front-line staff (n=30 interviews). The findings from all streams were analysed using framework analysis.ResultsLimited personal protective equipment (PPE) and lack of routine testing created anxiety and distress and had a tangible impact on the workforce. When PPE was available, incorrect size and overheating complicated routine work. Lack of training for redeployed staff and the failure to consider the skills of redeployed staff for new areas were identified as problems. Positive aspects of daily work reported by HCWs included solidarity between colleagues, the establishment of well-being support structures and feeling valued by society.ConclusionOur study highlighted the importance of taking into consideration the experiences and concerns of front-line staff during a pandemic. Staff working in the UK during the COVID-19 pandemic advocated clear and consistent guidelines, streamlined testing of HCWs, administration of PPE and acknowledgement of the effects of PPE on routine practice.

Teachers frequently use humour, but it is unclear how this affects the academic experiences and psychosocial development of students. There is sparsity in the literature regarding the impact of teachers’ humour on adolescent students. Teachers and the use of humour in the classroom have the potential to foster healthy development of social and academic skills during this key formative stage of maturation, but equally may be detrimental. This scoping review aimed to determine how and why teachers used humour in the classrooms of students aged 11-18, and the effect humour may have on students’ educational experiences. The Joanna Briggs methodological framework and PRISMA extension for Scoping Reviews checklist were used. The narrative synthesis generated six themes from 43 empirical papers. Many studies have considered humour as a single construct, reporting improved classroom management and students’ learning processes. However, other reports have suggested that humour use could lead to a loss of class control and for important information to be lost. Studies considering specific humour styles have identified affiliative humour as increasing engagement in deeper thinking. However, aggressive and course-related humour have reported mixed effects on educational experiences. This review identifies the humour styles and sub-styles reported in the sparse literature. It also highlights the lack of a comprehensive humour styles measure that adequately captures humour use and perceptions in teachers of adolescents and, importantly, how teachers’ humour is perceived by this population. Such a tool is vital to enable understanding of how teaching humour styles may directly affect adolescents’ educational experiences.

Opinion statement Targeted treatment strategies are available for human epidermal growth factor receptor 2 (HER2)–positive (amplified and/or overexpressed) metastatic colorectal cancer (mCRC), and HER2 testing is indicated in patients with mCRC. At present, standard of care first-line treatment for those with HER2-positive mCRC remains chemotherapy in combination with epidermal growth factor receptor (EGFR) inhibitors or bevacizumab, depending on RAS / BRAF mutational status and tumor sidedness. HER2-targeted agents should be considered for those with RAS/BRAF wild-type disease in subsequent-line treatment and in first-line treatment for patients not appropriate for intensive therapy. While the choice of anti-HER2 therapy is empiric given lack of head-to-head comparisons, the combination of trastuzumab plus tucatinib has received FDA accelerated approval for use in this setting and is generally the authors’ preference. Trastuzumab plus lapatinib, trastuzumab plus pertuzumab, and trastuzumab deruxtecan (T-DXd) also have evidence of efficacy in this setting. As T-DXd has demonstrated activity following treatment with other HER2-targeted regimens and carries an increased risk of high-grade toxicities, the authors favor reserving it for use after progression on prior anti-HER2 therapy. HER2-targeted therapies that inhibit signal transduction appear to have limited activity in those with RAS mutations, including trastuzumab-containing regimens. However, the antibody drug conjugate T-DXd has some data showing efficacy in this setting, and the authors would consider T-DXd in subsequent-line therapy for HER2-positive, RAS- mutated mCRC. Several areas of uncertainty remain regarding how to best utilize HER2-targeted therapies in mCRC. These include the optimal sequence of anti-HER2 therapies with chemotherapy and anti-EGFR therapies, the optimal combination partners for anti-HER2 therapies, and the incorporation of predictive biomarkers to guide use of anti-HER2 therapies. Results of ongoing studies may thus alter the treatment paradigm above in the coming years.