bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding non-compliance with surgical antibiotic prophylaxis prescribing guidance, in Nigeria
Authors: Wood C , Kostkova P , Olufemi O , Soriano D , Ogunsola F , Lefevre-Lewis C , Kpokiri E , Shallcross L 
Published: November 2019

Abstract

Background
Antimicrobial Resistance is a prominent worldwide threat that is increasing in low-to-middle income countries. Good antibiotic stewardship (AMS) improves compliance with evidence-based antimicrobial prescribing guidelines but just 4% of LMICs have national AMS initiatives in place and only 15% have national policies. As high as 20-50% of surgical antibiotic prophylaxis prescription in Nigeria is thought to be non-compliant. Behaviour change theories can structure our understanding of why poor compliance occurs and can facilitate development of effective interventions to improve it.

Methods
The Theoretical Domains Framework (TDF; Michie et al. 2009) was used to develop an online survey and interview schedule for focus group discussions. Audio recordings were transcribed and analysed by two researchers using thematic analysis, TDF and the COM-B model of behaviour change (Michie et al. 2010).

Results
60 surgeons (59% male; 43% surgical consultant; 5-10 yrs experience) from Lagos University Teaching Hospital, Lagos University College of Medicine and Niger Delta University Teaching Hospital completed the survey. A sub-group of 14 surgeons (79% male; 86% surgical consultant; 10-15 yrs experience) participated in three focus groups. Whilst compliance with guidance was generally considered desirable, surgeons reported translating guidance to Nigerian practice and context was often difficult, time-consuming and restricted by not having access to recommended antibiotics.

Conclusions
Behaviour change theory can be used to further our understanding of key barriers and facilitators to non-compliance with surgical antibiotic prophylaxis prescribing guidance, amongst surgeons in Nigeria. This presentation will conclude with discussion of how findings from this project are being used to develop a cost-effective, scalable, decision-support smartphone app for prescribing behaviour change.

Key messages
Behaviour change theory can be used effectively to further understanding of barriers and facilitators to Nigerian surgeons’ non-compliance with surgical antibiotic prophylaxis prescribing guidance. We must form a comprehensive understanding of factors (social & environmental) driving non-compliant attitudes and behaviours, before creating interventions to change prescribing behaviour.
Identifying latent needs in elderly digital literacy: the PROADAS study
Authors: Prodromou M , Lavranos G 
Published: November 2019

Abstract

Background
According to the Digital Agenda for Europe (2014 - 2020) enhancing digital literacy, skills and inclusion is one of the main priorities. All European elderly people must become e-seniors as soon as possible. On the hand, active ageing means that senior citizens activate themselves in order to be as independent as possible. As a result, triggering these new digital tools and ICT skills can assist the elderly to be a more integrated part of our society. The Erasmus+ Proadas project promotion of Active Digital Ageing Skills aims at tackling the gap between ageing population and digital literacy and strengthening and reinforcing the stakeholders, experts and practitioners, by identifying the needs of elderly people and their carers regarding technology.

Methods
The study was conducted in January 2019 in all six countries participating in the Proadas project. 35 carers and their assigned seniors were selected via convenience sampling by a minimum of three best practices- centres of excellence per country. A twelve-question close format questionnaire was developed, using a Delphi approach and completed by all participants. All data was analysed using SPPS 20.

Results
A total of 188 responders from all six countries agreed to participate response rate 89.5% of which 51.5% women. Age varied significantly between 20-75 years. Regarding existing ICT skills participants in all countries were familiar with basic use of computer and internet but very few used advance services. There was unanimous agreement that learning is facilitatedwith the help of family or friends. A combination of traditional and digital learning format was deemed most appropriate. The main obstacles involved lack of trainers, motivation and suitable educators.

Conclusions
There is latent need for the integration of ICT in elderly care. The development of suitable learning material and the involvement of motivated carers are key strategies for the successful implementation of such a reform.

Key messages
ICT is insufficiently used for elderly health education. Digital health can be beneficial for the elderly and their carers.
Maternal health care for refugee women in Germany: A qualitative approach on the interaction level
Authors: Kasper A 
Published: November 2019

Abstract

Background
In the recent past, the number of forcibly displaced people increased worldwide. About 1/3 of the persons seeking asylum in Germany are female. The majority of all refugee women who are coming to Germany are currently of childbearing age. Refugee women are considered a highly vulnerable refugee subgroup, as they frequently experience physical strains and psychological burdens while fleeing their home countries and being pregnant at the same time. Moreover, pregnancy and the following period require specialized care and support in order to allow a transition to maternity without complications. The aim of this project is to analyze maternal health care services for refugee women on the level of interaction with maternal health care professionals in Germany.

Methods
Maternal health care professionals in outpatient and clinical settings with experiences of caring for refugee women were recruited. Semi-structured interviews were conducted. The interviews are currently analyzed following the standards of qualitative thematic analysis.

Results
Maternal health care professionals experience challenges in executing particular maternal health care actions, such as taking the medical history where there is no communication possible or performing examinations where there is no or little privacy (e.g. in camps). In addition there are changes in tasks, which are no subject to originally maternal health care, such as organizing translation and transportation. Furthermore they face a shortage of resources (e.g. translators, time), which constrains them to find solutions on an individual level.

Conclusions
Maternal health care professionals provide maternal health care to refugee women under special circumstances (e.g. communication barriers, discontinuity of care). As there are limited resources (e.g. translators, time) they develop solutions and strategies on an individual level.

Key messages
Challenges and opportunities are disclosed by examining maternal health care professionals’ actions. Maternal health care improves through understanding maternal health care professionals’ strategies.
One-year activity of a “Casa de Espera” (Maternity Waiting Home) in the south of Angola
Authors: Fattorini M , Raguzzoni G , Cuccaro C , Nante N , Messina G , Ndilimondjo J M N , Ndapandula W , Tuitileni G , Caresia C , Putoto G 
Published: November 2019

Abstract

Background
Maternity Waiting Homes (MWHs) are structures usually located close to health facilities able to provide emergency obstetric care. Women can decide to be hosted in MWHs and when labour begins they move to the health facility for the delivery. Although the effectiveness of MWHs is debated, literature shows increasing findings about their importance. Aim of the study is to describe a one-year activity of a MWH located in Angola.

Methods
Since 2000, Italian Non-Governmental Organization (NGO) Doctors with Africa CUAMM supports the activities of the hospital of Chiulo in the district of Ombadja (Cunene province). Among the implemented projects, the NGO supports the local MWH (in Portuguese, “casa de espera”), providing dedicated staff and food for all the women hosted in the MWH. The MWH team routinely performs antenatal care visits and brief talks regarding maternal health. In case of pregnancy complications, the staff promptly refers women to the nearby hospital. The MHW team is also involved in routine data collection.

Results
In 2018, 703 women were admitted in the MWH. Three-hundred and forty-two (48.6%) were between 18 and 24 years of age. Four-hundred and eighty-two (68.6%) were invited to join the MWH by personnel of local health facilities, while 160 (22.8%) by family members and 61 (8.7%) by community health workers/traditional birth attendants. Age less than 18, previous abortion and/or caesarean were the most assessed factors for high risk pregnancy. In 2018, 1364 deliveries were performed in the hospital, and 593 (43.5%) concerned women hosted in the MWH.

Conclusions
To achieve the 2030 Sustainable Development Goals targets regarding maternal and neonatal mortality, the implementation of MHWs could represent an effective tool, especially in countries such as Angola where these indicators show a weak annual reduction. Regarding Chiulo’s MWH, an improvement of data collection could lead to a better comprehension of the efficacy of the facility.

Key messages
In the SDGs era, countries with a high burden of maternal and neonatal mortality should implement various and integrated approaches to achieve significant reductions of these indicators. Although the effectiveness of maternity waiting homes is still debated, increasing findings suggest that they could represent an effective tool to contain mother and child mortality.
Abortion among French students: result of a 15 years follow-up in a French university
Authors: Gerbaud L , Bourdet C , Chabanas B , Perrève A 
Published: November 2019

Abstract

Issue
The level of abortion in France is judged high, and since 2002 a policy is developed among students to lower it in this particular population

Methods
Since 2003, every 2 years we made an anonymous survey on abortion frequency, reasons and care in our university, which has between 12.000 and 12.000 she-students. We work on data from abortion centres of our area.

Results
Abortion rates are stable (5,3-8,5%0), half of the French rate for women (12,0-15,1%0).The risk is significantly lower for French students (6,3%0) compared to students from China (relative risk - RR 1,7, with a significant fall since 2011 - after a specific information campaign on contraception in France), North Africa (RR 2,0 stable) and Sub-Saharan Africa (RR 7,6 stable). ¼ had no contraception, ½ used condoms and 1/3 used oral contraception. 7,2% took emergency contraception. Medical abortion count for 1/3, but ¾ of the surgical techniques could have been replaced by medical drugs. After abortion, condoms are no more used and only 1% of the she-students decided not to take contraception. The main change is the fall down of the use of oral contraception after abortion (from 77% to 43%) replaced by intra-uterine device (IUD- from 1,7% to 22,5%) and contraceptive implant (CI- from 6,4% to 19,6%). Complete qualitative and quantitative results for 2018 will be also presented.

Lessons
General information on contraception did not change abortion rates, except for Chinese students. But, the increase use of hidden contraception (IUD and CI) after abortion encourage us to insist to the use of these hidden devices for the she-students belonging to social groups where contraception is discredited as a way to promote “bad habits”.

Key messages
Since 2003, abortion rates are stable among french students, and concerned mainly foreign students. The greater use ’hidden’ devices of contraception may improve this situation.
Cancer education support project: Spread of cancer education in Japan based on web search
Authors: Katayama K K , Sakaguchi M S , Ishikawa D I 
Published: November 2019

Abstract

Background
Since 2019, cancer education has been introduced in health classes from junior high school students in Japan. This research contributes to how “cancer education,” which is a newly launched cancer countermeasure plan, penetrates the general public.

Methods
In August 2018, the authors prepared an operation manual for classifying Web search results. A researcher majoring in informatics performed the operations outlined below. For the list (top 100 results of a Google search) of the Web search results using “cancer education” as the keyword, the link destinations starting from the top result were viewed in order using the browser.The name of the organization, the format of information media, summary of website information, and actions in case of a broken link were documented by the researcher.

Results
“Ministry of Education, Culture, Sports, Science and Technology Elementary and Secondary Education Bureau” occurred the most frequently at the rate of four times when the source word was “cancer education.” When this rate of occurrence was tabulated by the organization, the order was as follows: average companies (21.7%), prefectural (17.4), medical facility (12.0), and educational committee (9.8). In the format of information media, page link was the most common, followed by news articles and PDF files. The business type of the average companies were classified as follows: internet operations (30%), new website management companies (20), mail-order companies (15), and pharmaceutical companies (10).

Conclusions
Although public facilities and hospitals were more commonly involved in promoting cancer education, the holding of educational seminars by insurance companies and the creation and publication of cancer educational videos by pharmaceutical companies gradually trigger the interest of private companies in cancer education. The possibility of contribution to future development was demonstrated. This work was supported by 14th Hakuho Research Grant.

Key messages
In Japan, cancer education was introduced to school education from 2019. Private companies are expected to entry into cancer education in the future.
Health related behaviours of secondary students living in dormitory in Hungary
Authors: Skerlecz P , Gulyás B , Nedeczky L , Takács J , Rákosy Z s 
Published: November 2019

Abstract

Background
Previous studies have shown that unhealthy eating habits and lack of exercise are still widespread among high school students. Hungary and many other countries have attempted to introduce campaigns and health education programs among adolescents to promote healthier lifestyle, but the effectiveness of these programs is unclear. Our aim was to investigate the consistency between knowledge and behavior in adolescents.

Methods
A self-administered questionnaire survey was conducted in 9 secondary schools’ student dormitories, involving 163 students. Descriptive statistics were estimated and chi2- test was used to compare the prevalence between groups.

Results
Of the participants 69.3% reported their health status good, girls and those students who studied in vocational school frequently considered their own health bad (p = 0.002). Almost all of them highlighted the importance of regular physical activity, but 27.7% had low physical activity. Daily consumption of fruit and vegetables seems to be characteristic just half of the students, the structure of their daily snacks consists more in sugar-sweetened snacks (21.7%) and energy dense beverages (22.8%). Students with higher level of health-consciousness rated better their own health status and took exercise more frequently, but the higher level of health-consciousness had not positive effect on the healthy food consumption (p = 0.143).

Conclusions
Our findings suggest lack of exercise and unhealthy eating habits were still widespread among high school students. The results of the study showed that adolescents have sufficient knowledge about healthy lifestyle, however, it has little impact on their health-related behaviour.

Key messages
The most important characteristic of an effective health promotion programme is its ability to change behaviour. Health promotion programmes should continue in schools, especially focus on behaviour changing interventions to effectively influence the health of the students.
Teenage mothers: a long-term view on their well-being
Authors: van Tintelen A M G , Bolt S H , Jansen D E M C 
Published: November 2019

Abstract

Background
This study aims to address the lack of information about teenage mothers in different stages of their lives by exploring how they are doing in the long term and the social support they receive.

Methods
From December 2018 to February 2019 teenage mothers in the Netherlands were recruited by Fiom (an expert centre for unintended pregnancy), via social media and a website for teenage mothers (n = 248). Using an online survey, data were obtained to assess various outcomes, such as well-being, education, work, income, housing and social support. Respondents were divided into three groups: 0-3 years after teenage childbearing (short-term), 4-12 years (medium-term), &gt;12 years (long-term). Results were analysed using univariate and bivariate descriptions in SPSS.

Results
Almost 80% of the respondents reported that they were doing well and were satisfied with their life. 63.3% had a job, and 17.0% was enrolled in education. Short-term mothers worked fewer hours per week compared to long-term mothers (p &lt; 0.001). 85.1% of the respondents reported that they received benefits, short-term mothers receiving more benefits than long-term mothers (p &lt; 0.001). The majority (78.2%) was satisfied with their living conditions; short-term mothers were less satisfied than long-term mothers (p = 0.031). 36.3% of the respondents smoked cigarettes. Most support was given by family (83.1%), mainly from female relatives. About 24% of the respondents received formal support.

Conclusions
This study shows that teenage mothers, on average, were doing well and were satisfied with their life, in both the short and long term. Regarding income and housing, short-term mothers were in a less favourable position. These results suggest that as the years pass, teenage mothers overcome difficulties. Since the association between well-being and social support on the long term is unknown, we advise investigating the effect of social support on the outcomes of teenage childbearing.

Key messages
Both in the short-term and the long-term, most teenage mothers were doing well and satisfied with life. Regarding housing and income, short-term mothers function less well compared to long-term mothers.
Caesarean Delivery Rates in Birth Centres: confrontation using Robson Classification
Authors: Bocci G , Nante N , Napolitani M , Scinicariello I , Kundisova L , Messina G , Alaimo L 
Published: November 2019

Abstract

Background
A caesarean section (CS) is a life-saving procedure, reducing perinatal mortality and morbidity, over last decades CS rates are increasing. In 2015 the Robson classification (RC) was introduced by WHO as a global standard for assessing, monitoring and comparing CS rates within healthcare facilities and between them. The aim of this cross-sectional study was to identify the most numerous groups according to RC.

Methods
All women, who delivered by CS from January 2015 to June 2017 in two hospitals in the province of Siena (Italy): I level Birth Centre of Grosseto (GR) and II level Birth Centre of Siena (SI) were included. Age, type of hospital and group based on RC were extracted from Medical Register. The RC divides women into 10 groups based on 5 basic obstetric characteristics (parity, number of foetuses, previous CS, onset of labour, gestational age, foetus presentation). The percentages of the group’s contribution to the overall CS rate were calculated and confronted for two birth centres. All analysis was performed with Stata.

Results
A total of 2115 women was analysed, 50.5% from SI. Average age was 34.3±5.7; significantly higher for SI (34.7±5.6vs33.9±5.8). Most contributing groups were group V: multiparous, singleton, cephalic, term, with previous CS (24.2%), group II: nulliparous, singleton, cephalic, term, induced labour or CS (24%), group I: nulliparous, singleton, cephalic, term, spontaneous labour (11.45%), group VIII: multiple pregnancy (10.7%) and group X: singleton, cephalic, pre-term (10.4%).
Differences for type of birth centre were observed for groups I, II, V and VIII: I and VIII were more numerous in SI, II and V in GR (chi2; p &lt; 0.05).

Conclusions
The most numerous groups were I, II e V, concordant with literature. Reduction of CS rates in group V could be obtained through lowering of primary CS rates and by promotion of Vaginal Birth After CS. Healthcare professionals could help to reduce labour-related anxiety and elective CS rates.

Key messages
The most contributing groups to overall caesarean section rates were groups I, II e V, as reported in literature. Reduction of CS rates could be obtained through lowering rates of primary CS, but also by promotion of Vaginal Birth After CS.
Adolescent health literacy in 3 European cities and its association with smoking and smoking beliefs
Authors: Lindfors P , Kinnunen J M , Paakkari L , Rimpelä A , Richter M , Kuipers M A G , Kunst A E 
Published: November 2019

Abstract

Background
Beliefs about smoking have been found to be associated with smoking behaviour. Similarly, health literacy (HL) as a competence to make health-related decisions has been identified as an independent factor to explain differences in smoking. However, little is known about adolescents’ HL in different countries, and how HL is associated with health behaviour and health-related beliefs. The aim of this study is to describe the levels of HL in three European cities, and how HL is associated with smoking and beliefs about smoking consequences.

Methods
In 2016 as part of SILNE-R study, 5,088 adolescents aged 14 to 16 years answered a school survey in Amersfoort (NL), Hanover (GE) and Tampere (FI). Health Literacy for School-aged Children (HLSAC) covering five components (theoretical knowledge, practical knowledge, critical thinking, self-awareness and citizenship) was used. Questions on smoking and five statements on beliefs about smoking consequences were asked. The analyses were conducted with multinomial logistic regression, and with generalised linear mixed models.

Results
HL was the highest in Tampere (Finland), then in Amersfoort (the Netherlands), and the lowest in Hanover (Germany). HL was not associated with smoking, but it was positively associated with beliefs about smoking consequences, overall and when stratified by city.

Conclusions
Health literacy level was the highest in Tampere (FI), which may be due to Health Education as a curriculum-based school subject. In other cities, the education on health is not offered so systematically. Highly health literate students also know more about smoking consequences, but it does not affect their smoking behaviour. Systematic and compulsory health education in schools can be recommended in order to enhance adolescents HL.

Key messages
Adolescents’ high health literacy was associated with more accurate believes on smoking consequences. Health literacy was not associated with smoking behavior.