bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of the family on health inequalities in children – A systematic scoping review
Authors: Wachtler B , Hoffmann S , Blume M , Rattay P , Herr R , Deindl C , Sundmacher L , Richter M , Spallek J , Lampert T 
Published: October 2020

Abstract

Background
Health inequalities in school-aged children and adolescents were repeatedly reported across Europe but less is known about the contextual and compositional factors of families that might influence and reproduce those health inequalities. In this systematic scoping review we aim to provide a comprehensive overview of the available international literature on the mediating and moderating influence of the family on health inequalities in children and adolescents in Europe and North America.

Methods
This review follows the PRISMA guidelines for scoping reviews. After defining the research question a search strategy was developed in cooperation with a scientific librarian and the study protocol was registered. A search of three databases (Pubmed, Scopus, PsycINFO) was conducted to identify relevant literature in English or German published between the year 2000 and 2019. A qualitative data charting process was used to extract the relevant data.

Results
In total 11.838 records were identified through the multi database search (Pubmed n = 6370, PsycINFO n = 3505, Scopus n = 1963). After elimination of duplicates and records from excluded countries, 8862 abstracts were screened by two researchers independently. Different cluster of evidence of family influences on health inequalities were identified: Parental behaviors and children's obesity, parents' smoking and drinking habits and adolescents' risk behaviors, parenting style and children's common mental disorders, parental resources and children's quality of life.

Conclusions
There are different aspects of family's contextual and compositional characteristics on health inequalities identifiable in the international literature. These characteristics might be new targets for family-focused health promotion strategies.

Key messages
A systematic scoping review found different family aspects that influence health inequalities in children and adolescents. The identified family traits are promising targets for family-focused health promotion strategies to reduce health inequalities.
Maternal mortality in Brazil among adolescents between 2007 and 2017
Authors: Saldanha R C O , Abe G M , Abe A H M , Mariano M E O , Pierson I D S , Santana B F 
Published: October 2020

Abstract

Introduction
One of the Sustainable Development Goals is to reduce the amount of maternal deaths. This study is essential in Brazil.

Methods
Epidemiological descriptive study regarding maternal deaths between 10 to 19 years old, according to race, age group, marital status, year of occurrence, schooling status, and ICD-10 category, during 2007 to 2017 in Brazil. Data was obtained from DATASUS.

Results
In the period, there were 2,767 maternal deaths between 10 to 19 years old; 152(5,5%) of them between 42 days to one year postpartum. Regarding age, 2,582(93%) were between 15 to 19 years old, 185(6,6%) between 10 to 14 years old. Regarding race, 1,565(56,5%) were brown, 761(27,5%) were white, 236(8,5%) were black, 69(2,5%) were indigenous. Regarding marital status, 2,060(74,4%) were single, 240(8,7%) were married. Regarding the cause of death, 542(19,5%) were due to maternal diseases with labor and puerperium complications, 348(12,5%) due to eclampsia, 209(7,5%) due to puerperal infection, 152(5,5%) due to other causes of late maternal death, 150(5,4%) due to gestational hypertension, 115(4%) due to urinary tract infection. Regarding schooling status 1,062(38,3%) had 4 to 7 school years 809(29%) had 8 to 11 years, 207(7%) had 1 to 3 years, 44(1,6%) had no schooling. The total amount of maternal deaths and late maternal deaths, respectively, according to the year, were: 220 and 12(2007), 247 and 12(2008), 267 and 7(2009), 273 and 6(2010), 242 and 12(2011), 225 and 17(2012), 241 and 17(2013), 239 and 20(2014), 235 and 19(2015), 214 and 17(2016), and 212 and 13(2017).

Conclusions
The limited 0,03% reduction in the amount of maternal deaths in this age group between 2007 to 2017is worrisome. The deaths among mostly single girls with some schooling level reveals that the country needs to review its sexual education policies, and to enforce guidance regarding family planning, as well as enable the female youth to recognize and denounce sexual aggressions.

Key messages
Know the characteristics of adolescents who suffers with the risk of maternal death in Brazil, in order to create ways of reducing these risks. Alert to Brazilian government to take part in the awareness process and start investing in improving the specialized public health service and access to information for these women.
Effects of integrated interventions on growth and development of young children: A meta-analysis
Authors: Dulal S , Prost A , Saville N , Karki S , Merom D 
Published: October 2020

Abstract

Background
We did a systematic review to understand: (a) the effects of integrated versus usual care on the developmental outcomes and nutritional status of children under five years; and (b) which intervention characteristics are associated with positive effects.

Methods
We searched eight electronic databases for studies published between January 2013 and September 2019. Eligible studies were Randomised Controlled Trials (RCTs) and non-randomised controlled studies of integrated nutrition and stimulation interventions with child growth and developmental outcomes. We extracted data on intervention characteristics including delivery strategies, behaviour change techniques, intervention intensity and delivery personnel. We meta-analysed data for Length-for-age/Height-for-age Z scores (LAZ/HAZ) and cognitive, motor and language development scores, and conducted subgroup analyses by main intervention characteristics.

Results
Twenty-two unique RCTs met the inclusion criteria, of which 16 were included in the meta-analysis. Compared to the usual care, pooled Effect Sizes (ES) showed small to medium benefits of integrated interventions on cognitive (n = 15, ES 0.64; 95% CI: 0.39, 0.88) and language development scores (n = 10, ES 0.47, 95% CI: 0.21, 0.73) but heterogeneity was high (I2&gt;75%). We found no significant effects of interventions on motor development scores (n = 12, ES 0.31, 95% CI: -0.02, 0.64) or LAZ/HAZ scores (n = 8, ES -0.03, 95% CI: -0.11, 0.03). The effects of interventions on developmental outcomes did not differ by intervention characteristics, and heterogeneity remained high in sub-group analyses.

Conclusions
Integrated nutrition and stimulation interventions had significant effects on cognitive and language development, but no detectable effect on motor development or linear growth. Our ability to identify intervention characteristics linked to positive effects can be improved by standardising the reporting of implementation processes.

Key messages
More high-quality trials with longer follow-up duration are needed to examine the role of integrated nutrition and stimulation interventions on growth and developmental outcomes. Future research should map the characteristics of integrated nutrition and stimulation interventions following standardised guidelines to understand their influence on the outcomes reported.
Accessible diagnostics along the care trajectory of children with a developmental disorder
Authors: Cloet E , Kimpe E , Van Ransbeeck T , Leys M 
Published: October 2020

Abstract

Background
20% of all children suffer a neurodevelopmental disorder (NDD) worldwide. Each child with a (suspected) NDD should have access to a specialised multidisciplinary diagnostic setting to pass a qualitative and adequate diagnostic trajectory. In Flanders, Belgium, 6 types of public organisations offer multidisciplinary diagnostics of NDD for children. However the objective of timely diagnostics for the population is not realized.

Methods
Literature review, document- and website analysis, surveys and focus groups were done. Results of the surveys have been analysed by SPSS, focus groups have been thematically analysed by a process of data- and researchers triangulation. Results were discussed and validated by experts in focus groups.

Results
The response on the survey was 155. 67 surveys were included for analysis. 71 professionals participated in a focus group. As a result of an historical dispersed development, the field of organisations offering diagnostics of NDD in Flanders is heterogeneous. Diagnostics are provided in each region, but not in every region the same competences, knowledge, expertise and capacity are available. Overall it lacks sufficient capacity. The accessibility, nature of the diagnostics, target groups, composition of the diagnostic teams and working processes differ between organisations and are not coordinated. There is no shared interorganisational opinion on the concept and content of diagnostics. An important hampering factor for interorganisational collaboration is the lack of trust in the quality of diagnostics by other organisations. Many ruptures in the overall trajectory hamper continuity of care for NDD.

Conclusions
Besides creating more diagnostic capacity according to a geographical planning, interorganisational collaboration will tackle the accessibility problem. A coordinated common framework grounded in the logics of cooperation and collaboration of a heterogeneous mix of organisations providing diagnostics, is needed.

Key messages
Development of collaborative networks of different types of services offering diagnostics will improve the accessibility of early and timely multidisciplinary diagnostics for children with NDD. A shared interorganisational opinion on the concept and content of diagnostics aiming to improve interorganisational trust in the quality of diagnostics, must be developed.
Prevalence and pattern of risky sexual behavior among undergraduates in Benin City, Nigeria
Authors: Omuemu V O , Ogboghodo E O , Okungbowa N H , Omonhiaokpa O V 
Published: October 2020

Abstract

Background
Risky Sexual Behaviours (RSB) describe sexual activities that increase the probability of experiencing negative consequences in the physical, psychological and social wellbeing of individuals. Research has documented an association between risky sexual behaviour and Sexually Transmitted Infections (STIs), including Human Immunodeficiency Virus (HIV). The objective of this study was to assess the prevalence and pattern of RSB among undergraduates in Benin City, Nigeria.

Methods
A descriptive cross-sectional study was carried out among undergraduate students in Benin City, Nigeria. The University of Benin is one of Nigeria's first generation federal universities with about 75,000 students. A minimum sample size of 689 was calculated using the appropriate formulae for a descriptive study. Respondents were selected using a multistage sampling technique. Data was collected using a pre-tested structured self-administered questionnaire adapted from the illustrative questionnaire for interviews-surveys with young people. Data analysis was carried out using IBM SPSS version 22.0 software. A p-value &lt;0.05 was considered statistically significant.

Results
A total of 690 undergraduates with a mean age (SD) of 20.42 ± 2.7 years and a male: female ratio of 1:1.3 participated in this study. Two hundred and eight respondents (30.1%) were sexually active. Of these, 47 (24.0%) respondents admitted to have multiple sexual partners, 36 (23.5%) cross-generational sex, 29 (14.8%) troilism, 29 (14.8%) transactional sex, 22 (11.2%) homosexualism, and non-vaginal sex, 22 (11.2%). Overall, 196 (38.5%) of the respondents engaged in RSBs. Age group (p &lt; 0.001), sex (p &lt; 0.001), and residing off-campus (p = 0.047) were significantly associated with RSBs.

Conclusions
RSB in the studied population was high and having multiple sexual partners was the most reported type of RSB. Health interventions targeted at this age group are important for current and future sexual health.

Key messages
The prevalence of risky sexual behaviour is high among young persons. Health interventions targeted at this age group are important for current and future sexual health of young persons.
Perceptions of men aged 24-60 from three different socioeconomic level on child marriage, Ankara
Authors: Ors Reyhanioglu S , Arslan U E , Ozcebe H 
Published: October 2020

Abstract

Background
It is estimated that one in every five women has married before 18 year of age in Turkey. In majority of studies on child marriages the data have been collected from women. Number of studies conducted with men are limited and mostly qualitative. This study aims to determine some attitudes and perceptions of 24-60 age group men on child marriages in three neighborhoods with different socioeconomic status in Ankara.

Methods
A descriptive epidemiological study was conducted in three neighborhoods with low, middle and high socioeconomic status. The data was collected through a self-administrated questionnaire from 500 men aged 24-60 in each neighborhood through household visits. Ethics Commission permission was granted.

Results
The median age of first marriage increased both among men and their wives as the socioeconomic status improved (p &lt; 0.001 and p &lt; 0.001, respectively). From low socioeconomic status to high (respectively, 3.2%, 1.3%, 0.2%), men agreed women could marry before the age of 18 (p = 0.001). Men with low (69.2%) and medium (74.2%) socioeconomic status believed “marriage” was the most important experience in women's lives. Men with low socioeconomic status found marriage of their daughters and sons under 18 more acceptable compared to the men with high socioeconomic status (p &lt; 0.001, p &lt; 0.001, respectively). 14.0% of men whose wife was below 18 at the time of marrige, agreed women could marry before the age of 18, compared to 0.8% whose wife was 18 year old or older at the time of marriage (p &lt; 0.001).

Conclusions
This is the first quantitative study in Turkey conducted to understand the perceptions and attitudes of men on child marriages. These findings confirm that socioeconomic status is an important determinant of child marriages, there are disparities in gender perspective among different socioeconomic levels and child marriage is carried over between generations.

Key messages
Traditional gender roles for women and men in the family have a continuing trend in all socioeconomic levels, but more significant in the low and middle socioeconomic level neighborhoods. Specific male groups including fathers need to be targeted in interventions to prevent child marriages. Specific male groups need to be targeted in interventions to prevent child marriages.
Being bullied and associated factors among middle school students in the region of Monastir, Tunisia
Authors: Ben Fredj M , Dhouib W , Bennasrallah C , Kacem M , Zemni I , Abroug H , Trimech F , Belguith Sriha A 
Published: October 2020

Abstract

Introduction
The phenomenon of bullying among adolescents is a worldwide issue. The trend of this behavior is increasing in developed countries as well as in developing countries, with the creation of new forms such as cyberbullying. This study aimed to determine the prevalence of being bullied and to analyze the association between being bullied and some individual and familial factors.

Methods
This is a cross-sectional study conducted in two middle schools belonging to the region of Monastir in Tunisia in December 2017 and January 2018. The Global School-based Student Health Survey (GSHS) was administered for students. All present students from the two recruited schools were included.

Results
A total of 802 students were enrolled in the study. Just under half of the study group (44.0%) reported having been bullied in the past month with 95% CI [40.66%-47.57%]. The predominant type of bullying was being made fun of with sexual jokes, comments or gestures (9.1%), followed by being kicked, pushed, shoved or locked indoors (3.6%). In multivariate analysis, physical fight was an independent associated factor with being bullied (OR [CI]95%: 2.04[1,77-3,25]), p = 0.001. Lonely students had nearly 3.38 higher risk of undergoing bullying (OR [CI]95%: 3.38 [2.05-5.57]), p = 0.001). In addition, being worried was also an independent factor associated with being bullied (OR [CI]95%: 2,23 [1,45-3,43]), p = 0.001.

Conclusions
Our results support an association between existing mental health problems and bullying. Additional studies are needed to understand the factors associated with school bullying and to

Key messages
In this study, the prevalence of bullying was relatively high. Program education in schools should focus on life skills education in order to develop the self-confidence and the self-esteem of students.
The family of a child with chronic illness and its social relationships
Authors: Souza M H N , Santos T J , Vasconcellos R N , Costa M M , Lira A S , Conceição N V M , Sodré V R D , Cavalcante D F B 
Published: October 2020

Abstract

Introduction
The family life of a child with chronic illness is marked by several determinants and demands for care. Within that context, the greater the support received, the greater the resources available to face vulnerability, and to respond positively to guidance and care.

Objectives
describing the social network of families of children with chronic illness, and understanding the meaning of the relationship of the family caregiver with the members of his/her social network.

Methods
Qualitative research with nineteen relatives of children with chronic diseases at a rehabilitation center in the city of Rio de Janeiro, Brazil. The theoretical framework of Sanicola's social network was used. Data were collected in November 2019 by semi-structured interviews and analyzed using the content analysis technique. The research was approved by the Ethics and Research Committee of the participating institutions. The social network map showed the presence of few members and mothers as the main caregivers. The main problems among children were: autism, Down syndrome, cognitive disorders and cerebral palsy. Among the most involved people with the caregivers, friends, sisters and grandparents stood out as the ones who offered material, financial and emotional support. Rehabilitation unit support (secondary level) and dissatisfaction with the primary health unit were mentioned.

Conclusions
The social network of children with chronic illness is a small family network marked by social vulnerability and the female gender as responsible for care. It is noteworthy that the weakness in the relationship with health professionals at primary care level can compromise care continuity. Therefore, it is recommended to professionals to know the social network of the clientele served, as well as interacting and strengthening this network in order to provide more effective actions for health protection, rehabilitation and supported self-care strategies.

Key messages
Chronic childhood disease is a major public health problem. Being aware of social network favors the implementation of more actions toward health protection, rehabilitation and supported self-care strategies.
A women’s right with limitations - global and European perspective on abortion decriminalization
Authors: Pires M , Vital Brito D 
Published: October 2020

Abstract

Background
The decriminalization of abortion is a controversial subject whose policies widely vary across the world. In some countries it is available upon request, at least up to the 24-week limit, while in others it is totally prohibited. This practice also raises ethical issues, since some defend access to abortion as a human right, while others condemn it, highlighting the embryo's right to life. This study aims to compare abortion decriminalization laws and the maximum gestational age limit for induced abortion in each country of the six WHO member states.

Methods
Data on abortion decriminalization laws and the maximum gestational age limit for induced abortion were collected from the Global Abortion Policies Database on the WHO website. Descriptive analysis of data considered absolute and relative frequencies. Comparison between regions considered the number of countries, including a deeper analysis for European context.

Results
Approximately 30% of reviewed countries have specific laws for abortion decriminalization, while in 48% it is still a prohibited practice. Among the 48 European countries, 29 have decriminalized abortion laws, a practice that is only considered in 5 of the 54 African countries. Considering abortion by women's request, accepted practices are valid between 8 and 24 weeks gestation, depending on each country. However, 12 weeks of gestation is the most frequent limit for abortion, and it is the threshold of increased bleeding risk for pregnant women.

Conclusions
No legal abortion practices are performed after fetal viability period, usually up to 24 weeks of gestation. There are relevant differences between six regions. While most high-income countries have decriminalized abortion, this practice is still prohibited in most South American and African countries, raising multiple public health issues. Cultural, sociological and healthcare context is expected to have a strong influence in decriminalization of abortion.

Key messages
Abortion is considered a human right but there are many countries that do not allow it, particularly in Africa and South America. Most European countries have abortion decriminalization laws.
Navigating contrasting liminalities: Women’s experience of childbearing while undocumented in Sweden
Authors: Opperdoes M , Greenbrook J T V , Danielsson L , Elden H , Ascher H 
Published: October 2020

Abstract

Background
Pregnant women living as undocumented migrants navigate multiple and layered liminalities, exacerbating their vulnerability, and accenting ambiguity and uncertainty in their lives. Whilst previous research has addressed these women's interactions with healthcare institutions, the present study's aim was to explore their experiences of daily life during pregnancy and early motherhood, when living undocumented in Sweden.

Methods
A qualitative phenomenological study was conducted, where 13 women from 10 countries were interviewed; all undocumented, with a forced migration background. The anthropological theory of liminality was applied in furthering interpretations.

Results
The central theme of navigating the contrasting liminalities of celebrating pregnancy and early motherhood while immersed in the acute uncertainties of undocumentedness emerged, including two categories: (1) Embodying systemic injustice, with the subcategories living in the shadows of society to maintain personal safety, fearing the inability to satisfy basic needs in motherhood, and experience of dissonance when suspended in existence; (2) coping strategies for tackling daily life, with the subcategories: the importance of social relationships in satisfying needs and rights, striving for normality in the present, and dreaming of belonging to the fabric of the host society.

Conclusions
Pregnancy and early motherhood both exacerbated and countered the burden of undocumentedness. Daily life constituted a paradox, where undocumentedness resulted in being consumed by harsh living circumstances; driving fears of common spaces and services and uncertainty and unpredictability in meeting basic needs. Simultaneously, the universal and inherently human experiences of joy and longing that pregnancy can foster still emerged in little moments allowing it. Dreams of belonging were, however, thwarted by exclusion, being continuously and forcibly confined to inhabiting the liminal space on society's threshold.

Key messages
Pregnancy and early motherhood both acutely exacerbate and counter the burden of undocumentedness, rendering navigating daily life heavily paradoxical. Undocumentedness results in being consumed by harsh living circumstances; simultaneously, the universal and inherently human experiences of joy and longing that pregnancy can foster still emerge.