bluuebunny/crossref_metadata_2025_split huggingface dataset:
The use of E-sexual health as a way of lowering help-seeking barriers for sexual dysfunctions
Authors: Van Der Heijde C M , Bunte I , Hilverda F , Vonk P 
Published: November 2019

Abstract

Background
The prevalence of sexual dysfunctions is not negligible and experiencing a sexual problem is often accompanied by psychosocial effects, increasing the risk of comorbidities such as depression, greater levels of anxiety and lower self-esteem. Less than half of the individuals who experience sexual problems seek professional help, partially because of stigma and ignorance. Therefore a solution is required. E-sexual health has potential to help individuals with sexual dysfunctions, but little is known about its’ use.

Methods
We examined the predictors of E-sexual health usage using the Technology Acceptance Model (TAM). Perceived usefulness, ease of use, attitude, and intention to use E-sexual health were explored as potential predictors in a cross-sectional survey (N = 426). 413 of them were female, 180 male, aged from 18 to 72 years (M = 24.5, sd = 7.8). Structural equation modeling (SEM) was used to test the model.

Results
The results showed that TAM can effectively predict whether patients adopt E-sexual health. The model demonstrated a good fit (χ2 = 1197.73, df = 500, χ2/df = 2.40 TLI = .913, CFI = .927, IFI = .927, RMSEA = .048). Notwithstanding, it appeared that the current use and implementation of E-sexual health is much lower compared to several other E-health services.

Conclusions
It should be taken into account by healthcare providers that people are hesitant to disclose sexual problems. Further research is necessary to find out how to increase awareness of the relevance of treating sexual problems and how to increase knowledge about the possibilities of E-sexual health and its’ usefulness.

Key messages
E-sexual health has the potential to reach more patients with sexual dysfunctions. Increasing awareness for the relevance of treating sexual dysfunctions, and the potential of E-sexual health can lower the barriers for help-seeking behavior.
Primary care providers’ beliefs and practices on colorectal cancer screening in Kuwait
Authors: Tolma E L , Aljunid S M , Amrizal M N , Longenecker J , Al-Basmy A , Annaka M , Al-Wotayan R 
Published: November 2019

Abstract

Background
Colorectal cancer (CRC) is a major public health issue in the Arab region. In Kuwait, CRC is the second most frequent cancer, with an age-standardized (world) incidence rate of 13.2 cases/100,000 in 2018. Despite the national efforts to promote CRC screening the current participation rate is very low (5 to 17%). Primary Care Providers (PCPs) are considered as the gatekeepers of cancer screening globally. This is one of the first studies in Kuwait that examined the current beliefs/practices of PCPs on CRC screening.

Methods
This cross-sectional study was conducted at governmental primary care centers in Kuwait from 2015-2017. Of 564 PCPs invited to participate from all centers, 255 completed the self-administered questionnaires. The 14-page survey contained 75 questions on PCPs’ beliefs and practices of CRC screening. Data were analyzed by using descriptive statistics.

Results
The study sample consisted primarily of females (52.0%) and non-Kuwaiti (79%) physicians, with mean age =43.3 (SD: 11.2) years. Most respondents (92%) believed that colonoscopy is the most effective screening tool. The majority (78%) reported that they recommend CRC screening to their patients, with colonoscopy as the most frequent modality (87%) followed by the Faecal Occult Blood Test (FOBT) (52%). Around 40% of the respondents stated that they did not have time to discuss CRC screening with their patients. The majority (72%) believed that their patients did not complete their CRC screening tests. Health system related barriers included difficulties in obtaining test results from the gastroenterologist (61.4%), ordering follow-up test after a positive screening test (50.6%) and shortage of trained staff to conduct the screening test (44.2%).

Conclusions
A majority of PCPs in Kuwait recommend CRC screening to their patients, but not all patients follow through their recommendation. More research is needed to find out how to further enhance patient uptake of CRC screening.

Key messages
Colonoscopy is the most frequent screening CRC modality used in Kuwait. Health system related factors can be important future intervention targets to promote CRC screening.
High-throughput profiling of health-associated political, economic, commercial and social factors
Authors: Sandoval J L , de Ridder D , Stringhini S , Guessous I 
Published: November 2019

Abstract

Background
Political, economic, commercial and social factors have considerable impact in shaping health outcomes. Yet, most research is hypothesis-driven and, probably, not fully exploring the available data. We aimed at adapting gene expression profiling methods to perform unsupervised high-throughput profiling analysis of large databases of country indicators associated with life expectancy at birth.

Methods
We analysed 464 World Bank development indicators for 217 countries using a Limma software R package. We established the differentially represented indicators (DRIs) between countries in the first and third terciles of life expectancy at birth. The analysis was stratified according to high (HIC), middle- (MIC) or low-income (LIC) status. Indicator profiles by development category were compared to determine overlaps and group-specific DRIs. Confounder-adjusted multivariable linear regression models were used to validate chosen DRIs.

Results
We identified 99 DRIs for HICs, 7 for MICs and 190 for LICs. One DRI was common to all categories - “particulate emission damage (% of GNI)” (adjusted p.value=7.3E-5). This DRI was negatively associated with life expectancy despite adjustment for GDP per capita (GDP), human capital index (HCI) and development classification (Beta=-2.7, p &lt; 0.001). We also analysed the 7 identified gender-related DRIs. Only female murder rate (per 100 000 females) was negatively associated with life expectancy, independently of GDP, HCI, GINI index, education parity indexes, overall and male murder rates (Beta=-2.1, p = 0.001). This association was found in HICs (p = 0.001) and MICs (p = 0.03), but not in LICs (p = 0.4).

Conclusions
Bioinformatics methods could help to analyse large country level datasets, allowing the profiling of DRIs and identify potential new determinants of health or health-associated indicators.

Key messages
Using bioinformatics tools can be useful in uncovering health-associated indicators for global health. Particulate emission damage or female murder rate could represent potential important determinants of health or health-associated indicators.
A practical guide to make the case for sustainable investment in well-being and health
Authors: Stielke A , Ashton K , Dyakova M , Bellis M 
Published: November 2019

Abstract

Growing health, inequity, economic and environmental challenges threaten the well-being of present and future generations. Current investment policies and practices are unsustainable and result in high human, social, economic and environmental costs. Countries require the tools to build the case for investment in areas of greatest need by applying evidence-informed practice.
A practical guide with tools and resources was developed on how to develop an evidence-informed product to make the case for investment in well-being and health equity.
Stakeholder interviews with national and international experts in health policy, equity, economics and social sciences were conducted to inform the outline of the guide and identify enablers for creating evidence-informed products. An evidence review gathered tools and resources on how to translate and communicate public health evidence into policy and practice. An international cross-sector expert consultation assured relevance and transferability of the guide across countries, contexts and policies.
The guide aims to prevent disinvestment in health and increase investment in prevention as well as mainstream cross-sector investment to target the wider determinants of well-being and health equity. It outlines how to synthesise, translate and communicate public health and health economic evidence into policy and practice and proposes a step-by-step approach following four key phases (i) project scoping and planning, (ii) evidence gathering, synthesis and design, (iii) dissemination and communication, (iv) monitoring and evaluation.
The guide presents information to develop an evidence-informed product to make the case for sustainable investment in an innovative and informative way for use by a range of stakeholders. It accounts for policies and contexts and is communicated in a way that is accessible for decision-makers, easy to use and available as hard copy and interactive version.

Key messages
Investing in well-being and health equity drives and enables sustainable development. Making the case for investment in health equity requires a well-planned, evidence-informed approach.
Stress perceived by pregnant and decision-making factors of maternal caesarean section request
Authors: Riquet S , Coste C , Monguillon M , Zakarian C 
Published: November 2019

Abstract

Background
Pregnancy is a time of psychological vulnerability which can generate intense stress. This represents a maternal and child public health problem. Prenatal stress has harmful impacts on the foetus, the newborn and can cause an increased maternal request for caesareans sections, with nonmedical grounds. The perceived level of prenatal stress factors was assessed in women, as well as mothers’ incentives and decision-making factors for a caesarean section on maternal request.

Methods
A descriptive study on 203 pregnant women, then a comparative study between primiparas (n = 72) and multiparas (n = 131) were carried out with the Antenatal perceived stress inventory. Incentives and decision-making factors for a caesarean on the mother’s demand were studied by in-depth interviews with primiparas mothers (n = 16) who had made this choice.

Results
The perception of stress level during pregnancy is higher at the first quarter regarding the foetus’ health, medical and obstetric risks and reverses with the perception of projections linked to giving birth at the last quarter. Primiparas are significantly (p &lt; 0.001) more stressed. All the elements of the three assessed factors are very significantly (p &lt; 0.001) correlated for the whole population. Among them, 75% choose a caesarean section on maternal request during the first quarter. This choice is confirmed at the end of the second quarter or during the third one for 50% of them, with a one-month time to think for 58.3% of them. The main incentives are tokophobia (66.7%) and preserving the baby’s health (50%).

Conclusions
Pregnancy causes important stress, which is pronounced in primiparas. In France, these results speak in favour of screening tokophobia and an earlier start of birth and parenthood preparation classes in order to handle stress from the first quarter of pregnancy, when medical and prenatal exams are initiated. Birth preparation should be taken on at the last quarter.

Key messages
Investigate stress perceived and identification incentives and decision-making factors of maternal caesarean section request it’s a solution to building bridge for solidarity with tokophobic women. The relation enter stress perceived by pregnant women and decision-making factors of maternal caesarean section request, represents a maternal and child public health problem.
Induced abortions in Estonia, 1992-2017: registry-based study
Authors: Veerus P 
Published: November 2019

Abstract

Background
In Estonia, termination of pregnancy is allowed until 12 gestational weeks on request or for medical reasons, and until 22 gestational weeks only for women under 15 or over 45 years of age and for severe medical illness of the mother or the fetus. Information about all induced abortions is collected in the central digital Abortion Registry since 1996. The source document for collection of data is the Abortion Card which is filled in for every abortion that has taken place in a health care institution by all health care institutions (incl. private doctors) who do abortions or provide medical care to women who have had an abortion. The choice of contraceptive devices is large and their price is affordable. Sexual education is included in school curriculum. Councelling about contraception is free for all citizens until 25 years of age. Termination of pregnancy is free only for medical reasons, in other cases there is a small fee.

Methods
Data for the analysis was obtained from the Estonian Abortion Registry.

Results
The total number of induced abortions in Estonia decreased from 25803 in 1992 to 4017 in 2017. The abortion rate per 1000 women aged 15-49 declined from 69.6 in 1992 to 14.0 in 2017. The abortion rate among women under 20 has declined from 43 in 1996 to 10.8 in 2017. The abortion rate has always been the highest in the age group from 20 to 24 years. Abortion rates in 2017 varied in different counties from 7.4 to 17.3. In 1996, 97.8 % of preganancies were terminated surgically, in 2017, only 22.3%.

Conclusions
Although induced abortion is legal and not restricted in Estonia, the abortion rate has fallen rapidly due to sexual education at school, free youth councelling services and easily available contraceptive devices. Abortion Registry database is a valuable source of information for evaluating and planning public health interventions. Regional differences in abortion rates deserve further interventions.

Key messages
Abortion rates in Estonia have fallen rapidly due to sexual education, free councelling and available contraceptive devices. The Estonian Abortion Registry is a valuable source of information for public health interventions.
School Health Programme in Sri Lanka: Assessment using WHO’s ‘4S’ Framework
Authors: Wickramasinghe N , Lokubalasooriya A , Vithana C , Hemachandra N 
Published: November 2019

Abstract

Background
Sri Lanka has one of the oldest school health programmes (SHP) in the region, which was started in 1918, and at present caters for 70% of adolescents in the country. This study assessed the implementation status of the Sri Lankan SHP.

Methods
This review was conducted by a panel of experts adopting a participatory approach. Policies and supporting documents were collected from the relevant sectors of the Ministry of Health and Ministry of Education using electronic and manual search and by visiting institutions/resource persons. The WHO’s ’4S’ Framework; consisting of strategic information (S1), supportive evidence-informed policies (S2), strengthening services for adolescents (S3) and strengthening collaboration with other sectors (S4); was used as the guiding framework to analyse the strengths and weaknesses of the SHP.

Results
Having a comprehensive national health information system was the main strength on S1, gaps in timeliness, completeness and accuracy of the data, and the lack of evidence on perceived health needs of school children were the main weaknesses. On S2, Sri Lanka has a strong unifying policy platform supportive of the SHP, but the timeliest need is to finalise the School Health Policy. More than 90% island-wide coverage of school medical inspection was the main strength on S3, while focusing more on physical health and less emphasis on promoting mental health in the existing service package and gaps in the referral/follow-up were the weaknesses. On S4, school staff focusing more on achieving academic-related outcomes and focusing less on health-related activities, undue media and industry influence hindering the promotion of healthy behaviours in school settings were the main challenges.

Conclusions
Despite several emerging challenges, the SHP in Sri Lanka is one of the best school health programmes in the region with more than 90% island-wide coverage of health services.

Key messages
The SHP in Sri Lanka, which is one of the oldest and the best school health programmes in the region, caters for 70% of adolescents in the country. Assessment of Sri Lankan SHP according to the WHO’s ‘4S’ Framework revealed multiple strengths such as comprehensive national health information system and high island-wide coverage.
eDelphi survey to shape the content of a digital resource to enhance parental health literacy
Authors: Kolokotroni O , Hadjigeorgiou E , Gourounti C , Christodoulides V , Sarantaki A , Nicolaou C , Lykeridou K , Karanikola M , Kouta C , Middleton N 
Published: November 2019

Abstract

Background
Information-seeking on the internet is very prevalent, in contrast to low attendance of antenatal classes. In addition to varying quality, few digital resources are developed using participatory research approaches.

Methods
Antenatal learning needs were explored in a modified Delphi survey among the professional community and parents-to-be/new parents. A list of 174 topics was developed using the Nominal Group Technique among antenatal educators and representatives of local professional associations. In an online survey, the relative importance of each was rated on a 5-point scale by the wider professional community and general public. Topics rated by ≥ 80% as at least “very important” or by ≥ 50% as “essential” by either group were shortlisted and re-rated by delegates of the annual Midwifery conference.

Analysis
193 health professionals (77.7% midwives) and 275 mothers-to-be/new mothers (56.4% attendance of antenatal classes) participated in the online survey. Based on pre-set criteria, 95 topics (54.6%) were identified, 55 (31.6%) nominated by both groups. Among 18 themes, those with the highest number of nominated topics were: Breastfeeding, Prematurity, Giving birth, Caring for Baby and Mental health & well-being. There was good agreement between the two groups (r = 0.88) and in the top 20 single topics, thirteen were common. Priorities were largely unchanged in the last round, but a number of new topics emerged, including pre-eclampsia and domestic abuse. On a 1-10 scale, health literary of expectant parent was rated at M = 5.7 (SD 1.5) by professionals.

Conclusions
In a “changing landscape” of antenatal education, new technologies provide opportunities for broader reach. This formative research study explored the perceived learning needs and local priorities in order to shape the content of Baby Buddy, a public health digital intervention to enhance the health literacy of new parents and support the educational role of health professionals.

Key messages
Local needs and priorities for a digital parenthood platform were identified using a Delphi method. Participatory formative research can maximize the potential though co-creation and co-ownership.
The effect of Women’s decision-making autonomy on family Planning acces in Senegal in 2017
Authors: Sougou N M , Bassoum O , Leye M M M M , Tal-Dia A 
Published: November 2019

Abstract

Background
The impact of access to decision-making on women’s health in the choice of fertility control has been highlighted by research. The aim of this study was to analyze the impact of access to decision-making for women’s health on access to family planning in Senegal in 2017.

Methods
The analyses of this study had been done on the Individual Records file of Senegal’s Demographic Health Survey 2017. This data covered 8865 women aged 15 to 49 years. The propensity scores matching method had been done. The variable access to the decision was considered as the variable of interest. Matching was done using variables that were not modified by the effect of the treatment. These were religion and socio-economic level. The outcome variables were modern contraceptive use, the existence of unmet needs and the type of modern contraceptive method used. Significance was at 5%. The condition of common support had been respected. The analysis was done with the STATA.15 software.

Results
Six percent (6.26%) of women could decide about their health on their own. Access to decision-making increased significantly with the woman’s age (p &lt; 0.05). Fifteen percent (15.24%) women used a modern contraceptive method. Women using a contraceptive method were more numerous in the group with access to decision-making (29.43%) with a significant difference with the other group of 8% (p &lt; 0.05). After matching, there was no significant difference between women in terms of modern contraceptive use and the existence of unmet needs. There was a significant difference in the type of contraceptive method used between the two groups of women. These differences were 23.17% for Intra Uterine Device, 52.98% for injections, 08.9% for implants and 10.79% for condoms.

Conclusions
Access to decision-making for health would facilitate women’s access to long-acting contraceptive methods. These findings show the importance of implementing gender transformative interventions in improving access to family planning.

Key messages
Access to decision-making for health would allow better access to modern contraceptive methods, especially those with a long duration of action. Better consideration of gender disparity reduction could improve access to family planning in Senegal.
“Shared learning in action” - model of early prevention program on drug abuse in primary schools
Authors: Grujičić A , Mladenović Janković S , Matijević D , Kovačević N , Stefanović N 
Published: November 2019

Abstract

Issue/Problem
In Serbia, 12,8% of younger adults and 16,5% of sixteen years old adolescents have tried some of the illegal drugs. “Creative workshop with schoolchildren on prevention of drug abuse” program was developed as a part of National strategy against drug abuse, aiming to improve capacities of teachers and children in primary schools.

Description of the practice
Program based on educational approach “Shared learning in action” changes traditional school roles, transforming teachers into facilitators, allowing full expression of children’s ideas, thus enhancing development of their emotional intelligence. Children’s research about drugs mobilizes an extensive list of supporters in gathering relevant information: health workers, police, psychologists, teachers, parents and media. This information is then shaped into a variety of products with strong public health messages: songs, posters, comics, brochures, short plays and videos.

Results
Since 2010, around 450 teachers and nearly 7000 children in 115 Belgrade primary schools were included. Children’s knowledge about drugs has an upturn of over 50%, concurrently with improvement of their teamwork skills, self-confidence, research and creative potentials. Both teachers’ and children’s evaluation grades show a high level of satisfaction with the program.

Lessons
This program is an example of cooperation between educational and health sector, followed by a well implemented monitoring system and quality improvement. Its universal and flexible approach made it a part of official curricula in several schools. It was acknowledged as good practice by the Institute for improvement of education in 2012 and The City of Belgrade in 2018. Since 2014, the program has its Facebook page “Tvoje znanje menja sve”.

Key messages
High grade of children autonomy, supported by teachers and community, makes the learning process amusing and effective. Program achievements demonstrate its potential for systemic implementation to a wide range of public health topics.