bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring the views of undocumented migrant women on access to maternity services in the UK
Authors: Hargreaves S , Nellums L B , Powis J , Jones L , Miller A , Rustage K , Russell N , Friedland J 
Published: October 2020

Abstract

Background
Migrant women face inequalities in access to health-care services and are known to experience poorer maternal and child outcomes than women born in the UK. The development of more restrictive health policies in the UK and Europe, including being denied or charged for healthcare at maternity services, may be exacerbating these outcomes, particularly among undocumented migrant women without permission to reside. We investigated undocumented migrant women's experiences of accessing maternity services in the UK and their impact on health outcomes.

Methods
We did semi-structured in-depth qualitative interviews with a purposive sample of migrant women (born outside the UK) who were aged 18 and over, and had experiences of pregnancy in the UK whilst undocumented. Participants were recruited through the Doctors of the World UK clinic. Interviews were transcribed and analysed using thematic analysis.

Results
We did interviews with 20 undocumented women (age range 31-40 years; mainly from Africa and Asia). Among participants, of whom 13 were pregnant at the time of interview, 10 (50%) first accessed antenatal care late (after the national target of 13 weeks). Women described an ongoing cycle of precariousness, defined by their legal status, social isolation, and poor economic status. Women reported receiving bills of up to £11,500 for maternity services (range £3,072 to £11.500). The impact of their experiences meant that they were deterred from seeking timely health care and were reluctant to present to health services, with women reporting fear and loss of trust in the health system.

Conclusions
These women's narratives illustrated the potential deterrent and detrimental impact of increasingly restrictive health policies on women's access to care and their health. UK and European health policies must be equitable, non-discriminatory, and better align with our commitments to promote universal health coverage among all individual residing in the region.

Key messages
Increasingly restrictive health policies may have a deterrent and detrimental impact on migrant women’s access to health care. Undocumented migrant women in the UK reported fear and loss of trust in the health system.
Adolescent childbearing in a Brazilian border municipality: the new mother’s profile
Authors: Nampo F K , Fernandes C M , Souza S 
Published: October 2020

Abstract

Background
Adolescent childbearing is considered a public health problem, due to the often associated social impacts. Understanding the phenomenon is necessary to support intervention proposals aimed at reducing its incidence.

Methods
In this cross-sectional study we investigated all adolescent mothers living in Foz do Iguassu that gave birth in the 2013-2017 period. Data from a governmental database were used and descriptive analysis was performed.

Results
Between 2013 and 2017, 3,207 adolescent mothers gave birth to a live child, of which 135 aged 10 to 14 years and 3,072 aged 15 to 19 years. 51.3% of the mothers were white, and 22.1% had previous pregnancy experience. 68.4% had a vaginal delivery, and 80.6% had full-term pregnancies. Among the women aged 10 to 14 years, 57.8% started prenatal care in the first trimester and 47.4% had 7 or more prenatal consultations. Among women aged between 15 and 19 years, 73.7% started prenatal care in the first trimester and 53.4% had 7 or more prenatal consultations. Additionally, at least 49% of the adolescents were delayed in school.

Conclusions
In Foz do Iguassu, adolescent mothers are predominantly white. At least half are delayed in school, and more than 1 in 5 already had previous pregnancy experience. Parturients between 15 and 19 years old start prenatal earlier and attend more prenatal consultations than parturients aged 10 to 14 years. Prematurity is more frequent among adolescents.

Key messages
Adolescents receive poor prenatal care, especially the younger ones. Adolescent pregnancy is not a synonym to unintended pregnancy, and its relationship should be further investigated.
Sickness absence in relation to first childbirth by occupational group: a Swedish cohort study
Authors: Laszlo K , Björkenstam C , Orellana C , Lidwall U , Lindfors P , Voss M , Svedberg P , Alexanderson K 
Published: October 2020

Abstract

Background
Childbirth has been suggested to increase sickness absence (SA) and disability pension (DP). This may vary by occupation; however, knowledge in this field remains limited. We explored SA and DP in the years before and after childbirth among women in four occupational groups and among those without any occupation.

Methods
We conducted a register-based study of nulliparous women aged 18-39 years, living in Sweden on December 31, 2004 (n = 492,504). Women were categorized into five skill-level based occupational groups and three childbirth groups; no childbirths within three years (B0), first childbirth in 2005 with no childbirth within three years (B1), and first childbirth in 2005 with at least one more birth within three years (B1+). We compared crude and standardized annual mean SA (in spells&gt;14 days) and DP net days in the three years before and three years after first childbirth date.

Results
Women in the highest skill level occupations and managers had generally lower mean SA/DP days e.g., B0: 11.3, B1: 11.6, B1+: 6.8 during the third year after first childbirth than the lowest skill level occupations group; B0: 28.1, B1: 22.8, B1+: 15.2 days. In B1 and B1+, absolute differences in mean SA/DP, particularly in SA, among occupational groups were highest during the year before childbirth. DP was most common in B0, regardless of group and year.

Conclusions
We found that women's mean SA/DP days before and after first childbirth were higher with decreasing skill-level of the occupational group, with these differences being most pronounced in the year before childbirth. DP was most common among women not giving birth, regardless of occupational group.

Key messages
Women’s mean SA/DP days before and after first childbirth increased with decreasing skill-level of the occupational group and these differences were most pronounced in the year before childbirth.
Physical activity during pregnancy in Italy: prevalence, intensity and associated factors
Authors: Fioretti E , Palandri L , Fantuzzi G , Facchinetti F , Righi E 
Published: October 2020

Abstract

Background
Recently the Italian Ministry of Health, following WHO and ACOG example, recommend that healthy pregnant women practice at least 150 minutes per week of moderate intensity activity (3-6 METs). The study aimed to evaluate if women meet guidelines and to identify potential target groups for public health intervention.

Methods
From November 2015 to November 2017, 390 women completed, just after delivery at an Italian hospital, a questionnaire about sports and exercise before and during pregnancy. Physical activity (PA) was classified according to intensity in Metabolic Equivalent Task (MET). Women were considered sufficiently active when reaching the recommended PA levels.

Results
52% of women practiced any sport at anytime during pregnancy, with a higher prevalence in the II trimester (45%), while only 30% of women kept exercising throughout all trimesters. When including time and sport intensity, only 4,6%, 6,4% and 4,6% of women reached the recommended PA levels in the I, II and III trimester. Sufficiently active women practiced mainly swimming and walking, two highly recommend sports in pregnancy. Factors favour PA practice were Italian nationality, higher educational level, work, BMI, attending birthing classes and being active before pregnancy. However, even without contraindications, 26% of women active before pregnancy stopped exercising in pregnancy and only 15% achieved recommended PA levels. 58% of sedentary women before pregnancy, kept being sedentary in pregnancy.

Conclusions
Although half of women practiced sport during pregnancy, only a few were sufficiently regular and active. As pregnancy is an ideal time to adopt or to reinforce a healthy lifestyle, public health interventions should be strengthen considering also specific target groups.

Key messages
Effective public health policies should be identified and implemented to favour an active lifestyle during pregnancy. Specific target groups less prone to meet PA guidelines should also be addressed.
Involvement of perinatal health professionals to reduce the exposure of pregnant women to chemicals
Authors: Sauvant-Rochat M , Bernard L , Pelissier M , Marie C , Lémery D , Vendittelli F 
Published: October 2020

Abstract

Background
During pregnancy, reducing exposure to chemicals is obvious to many pregnant women (PW), and also perinatal health professionals (PHP), but few of them are aware that these substances are present in everyday products (cleaning products, DIY products, gardening products, personal health care products, cosmetics, food plastic wrappers etc.).

AIM
This study aimed to estimate the perception of risks related to chemicals by PW, and also to describe the advice provided by PHP to PW.

Methods
A cross-sectional survey was performed among French PW. Interviewers, using a standardized questionnaire, collected data anonymously. Data focused on socio-demographic and occupational characteristics, perception of environmental risks, identification of chemicals by PW, and preventive advices performed by PHP. Statistical analysis (univariate analysis - logistic regression) were done with Modalisa® 8.0 software (Kynos, Paris).

Results
300 PW (29.5 +/- 5 years old) were included. They report a relatively high level of sensitivity to environmental issues (SE Score = 6.3 ± 1.7, on a Likert 0-10 scale). When asked about the level of risk associated with 15 environmental risks, pregnant women placed exposure to chemicals in only twelfth position. Two thirds of PW were interested by the composition of everyday products, and looked at the ingredients mentioned on the labels, but most of them declared that the information present on the labels were not comprehensible. An interest for organic products was noted. These behaviors were related to the age, socio-occupational status, perception of environmental risks. For most of PW, the main sources of information on chemicals were the Internet and medias. Only 5% PW identified PHP as potential interlocutors on this topic.

Conclusions
For most PW, everyday products were not identified as health risk products. To date, it is important to strengthen the information provided to PW by PHP on the risks linked o chemicals during pregnancy.

Key messages
Exposures to chemicals present in everyday products (DIY, cleaning products, cosmetics, food plastic wrappers etc.) are not well identified by pregnant women and by perinatal health professionals. Exposure to chemicals must be reduced during pregnancy and health promotion messages must integrate this advice to promote healthy behaviors.
Breast self-examination: knowledge and practices among women in Sousse, Tunisia
Authors: Bannour I , Bannour B , Frigui R , Bannour R , Khairi H 
Published: October 2020

Abstract

Backgrounds and aims
Breast cancer is a major public health problem. In Tunisia, breast cancer is the first leading cause of cancer-related deaths. Different organizations and professionals advise women to learn how to perform breast self-examination (BSE) so that they can detect the slightest change as soon as it intervenes.

Objective
This study aims to determine the prevalence of women performing breast self-examination and to evaluate their practices.

Materials and Methods
A cross-sectional descriptive study was performed about women's knowledge, attitude and practice of breast cancer screening and breast self-examination. The study was conducted in the Reproductive Health Center of Sousse spread over a period of 2 months (February, March 2018). Self administered questionnaires were distributed to women.

Results
The mean age of the participants was 34 years with extremes ranging from 18 to 64 years. 47% of women surveyed have already performed breast self examination at least once during the last year. 14% of participants practiced breast cancer screening less than once a year. The first source of learning for breast cancer screening was health professionals in 27% of cases. The score of the practice of women surveyed was average; mostly, women have intermediate results for the technique of self-examination breast. No woman had a score of 15/15.

Conclusions
A better education of the practice of self-examination is essential in order to improve the screening program for breast cancer. The role of the gynecologist, general practitioner or midwife is therefore essential in education and training.

Key messages
A better education of the practice of self-examination is essential in order to improve the screening program for breast cancer. The role of the gynecologist, general practitioner or midwife is therefore essential in education and training.
The risk and protective factors for risky sexual behaviors among school-aged adolescents in Indonesia
Authors: Setio K , Pardosi J , Beek K , Razee H 
Published: October 2020

Abstract

Background
Indonesia's 65 million young people aged 10-24 comprise 28% of its total population. Studies revealed that adolescents who engage in early sexual activity are prone to sexually transmitted diseases, unwanted pregnancy, and unsafe abortion. This study examined the prevalence and associated factors of risky sexual behaviors among Indonesian secondary school adolescents using the 2015 Indonesia Global School-based Student Health Survey (GSHS).

Methods
A total of 11,142 students filled the self-administered questionnaire. Risky sexual behaviors measured included 1) ever had sexual intercourse, 2) multiple partners, 3) condom use. The determinant factors were sociodemographic characteristics, mental health-related factors, interpersonal variables, socioeconomic, and parental understanding. A multivariate logistic regression model was used to estimate the adjusted odds ratio and 95% CI.

Results
The prevalence of ever had sex was 5.3%; 1.2% of students had sexual intercourse with multiple partners; The prevalence of condom use was 34%. Results from the multivariate logistic regression indicated that ever-had sex had the strongest association with suicide ideation (aOR= 4.636; 95% CI = 4.542-4.732) and significantly lower among respondents who have a parental understanding (aOR = 0.318; 95% CI = 0.310-0.326). Having sex with multiple partners had the highest correlation with smoking behavior (aOR= 9.967; 95% CI = 9.816-10.12), significantly lower among respondents who have a parental understanding (aOR=0.644; 95% CI = 0.632-0.656). Having parental understanding had the strongest correlation with condom use (aOR= 6.597; 95% CI = 6.291-6.918), while loneliness had the lowest relation. (aOR= 0.706; 95% CI = 0.669-0.745).

Conclusions
Adolescent sexual reproductive health programs should employ a holistic approach involving mental health promotion and tobacco control programs. It is also essential to engage parents in any adolescent sexual reproductive health program.

Key messages
Risky sexual behaviors have a strong correlation with mental health. It is essential to engage parents in any adolescent sexual reproductive health program.
Flubromazolam-Derived Designer Benzodiazepines: Toxicokinetics and Analytical Toxicology of Clobromazolam and Bromazolam
Authors: Wagmann Lea , Manier Sascha K , Felske Christina , Gampfer Tanja M , Richter Matthias J , Eckstein Niels , Meyer Markus R 
Published: October 2020

Abstract
Flubromazolam is widely known as highly potent designer benzodiazepine (DBZD). Recently, the two flubromazolam-derived new psychoactive substances (NPS) clobromazolam and bromazolam appeared on the drugs of abuse market. Since no information concerning their toxicokinetics in humans is available, the aims of the current study were to elucidate their metabolic profile and to identify the isozymes involved in their phase I and phase II metabolism. In vitro incubations with pooled human liver S9 fraction were performed and analyzed by liquid chromatography coupled to orbitrap-based high-resolution tandem mass spectrometry (LC–HRMS-MS). Biosamples after the ingestion of bromazolam allowed the identification of metabolites in human plasma and urine as well as the determination of bromazolam plasma concentrations by LC–HRMS-MS using the standard addition method. In total, eight clobromazolam metabolites were identified in vitro as well as eight bromazolam metabolites in vitro and in vivo. Predominant metabolic steps were hydroxylation, glucuronidation and combinations thereof. Alpha-hydroxy bromazolam glucuronide and bromazolam N-glucuronide are recommended as screening targets in urine. Bromazolam and its alpha-hydroxy metabolite are recommended if conjugate cleavage is part of the sample preparation procedure. The bromazolam plasma concentrations were determined to be 6 and 29 μg/L, respectively. Several cytochrome P450 (CYP) and uridine 5'-diphospho-glucuronosyltransferase (UGT) isozymes were shown to catalyze their metabolic transformations. CYP3A4 was involved in the formation of all phase I metabolites of both NPS, while UGT1A4 and UGT2B10 catalyzed their N-glucuronidation. Several UGT isoforms catalyzed the glucuronidation of the hydroxy metabolites. In conclusion, the determined bromazolam plasma concentrations in the low micrograms per liter range underlined the need for sensitive analytical methods and the importance of suitable urine screening procedures including DBZD metabolites as targets. Such an analytical strategy should be also applicable for clobromazolam.
Efficiency—What Else?
Authors: Mistelis Loukas 
Published: October 2020

Abstract
This chapter focuses on the value of efficiency in international arbitration. It also briefly discusses the tension between party autonomy and the desire of various authors to attribute to arbitration systemic qualities and features of private ordering. While efficiency did not feature as a typical feature of international arbitration some twenty odd years ago, serious concerns were expressed about the cost and length of proceedings. Paradoxically, at the same time, arbitration was seen as a method of dispute resolution which saves money and time for the users. However, in the last ten years, or perhaps a bit longer, there has been a marked awareness and indeed demand for a higher level of efficiency in the arbitral process. The chapter looks at the origins of the quest for efficiency in international arbitration and its establishment as a value of international arbitration, before exploring the role of arbitrators and arbitral institutions in ensuring efficiency.
Artificial Intelligence in International Arbitration
Authors: Gicquello Myriam 
Published: October 2020

Abstract
This chapter assesses the introduction of artificial intelligence in international arbitration. The contention is that it would not only reinstate confidence in the arbitral system—from the perspective of the parties and the general public—and participate in the development of the rule of law, but also engage with broader systemic considerations in enhancing its legitimacy, fairness, and efficiency. Yet, before addressing the why, what, and how of this proposition, a definition of artificial intelligence is warranted. It should be noted at the outset that this concept has a variety of meanings. Despite the lack of consensus on its meaning, the chapter will thus treat artificial intelligence as encompassing both semi-autonomous and autonomous computer systems dedicated to assisting or replacing human beings in decision-making tasks. It presents the conclusions of two extensive research programs respectively dealing with the performance of statistical models and naturalistic decision-making. From that behavioural analysis, the introduction of artificial intelligence in international arbitration be discussed against the general considerations of international adjudication and the specific goals pertaining to international arbitration.
Empirical Findings on International Arbitration
Authors: Drahozal Christopher R. 
Published: October 2020

Abstract
This chapter surveys the existing empirical literature on international arbitration. It focuses on quantitative rather than qualitative empirical studies, and covers studies both of international commercial arbitration and international investment arbitration. The chapter first describes empirical research on the use of arbitration to resolve transnational disputes—in particular, the extent to which parties use arbitration clauses in international contracts, why they do so, and the frequency of international commercial and investment arbitration proceedings. Empirical studies have also examined an array of topics about the procedures in international arbitration. The empirical evidence typically comes from surveys or observational studies of commercial and investment arbitration proceedings. The chapter then considers empirical insights on selected topics such as the cost and length of arbitration proceedings, the size of arbitral tribunals, interim measures, multi-party disputes, challenges to arbitrators, the role of tribunal secretaries, and the use of mediation. It also looks at empirical studies on the applicable law in international commercial arbitration; the demographics of international arbitrators; and compliance with and enforcement of international arbitration awards.
The Creation of Investor–State Arbitration
Authors: St. John Taylor 
Published: October 2020

Abstract
This chapter explores the creation of investor–state arbitration. There is no shortage of antecedents for investor–state arbitration. So why is it perceived as ‘dramatically different’ from what had gone before? In the second half of the twentieth century, consent to investor–state arbitration was provided prospectively (before disputes arose) and pursuant to generalized jurisdiction (for any treaty breach); this is profoundly different from previous practices. Two institutional developments were crucial for creating prospective, generalized consent. First, the ICSID Convention emerged. Second, provisions providing consent to investor–state arbitration were added to investment treaties. The chapter then focuses on these two developments. It reconstructs the choices that officials faced, their constraints, and the reasons why they made the choice for investor–state arbitration against other alternatives. To do so, it uses primary documents from five archives: the American, British, German, and Swiss national archives as well as the World Bank archives.
Safeguarding Intangible Cultural Heritage
Authors: Blake Janet 
Published: October 2020

Abstract
This chapter assesses the drafting of the 2003 Convention on Intangible Cultural Heritage (ICH), the result of three decades of consideration within UNESCO. For many UNESCO Member States—especially in the African, Asia-Pacific, and Latin American regions—ICH constitutes a major part of their cultural heritage. The contribution that it can make to social and economic development in such societies was an important factor in the desire to strengthen international safeguarding of this heritage. UNESCO’s 2003 Convention was developed within two main international law and policy contexts: human-centred and sustainable development and the growing importance accorded to cultural rights. The 2003 Convention makes clear the role of cultural heritage in preserving cultural diversity; ensuring truly sustainable development models; protecting human rights and the cultural identities of individuals, social groups, and communities; and protecting the right of communities to be themselves socially and economically sustainable through their heritage.