bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of health and cancer: investigating conceptions of children aged 6 to 11
Authors: Deyra M D , Gay C G , Pizon F P , Gerbaud L G 
Published: November 2019

Abstract

Context
Qualitative data on how children and adolescents view their health and its determinants are relatively few at the international level. This research is therefore part of a comprehensive and open-minded approach to better describe how elementary school children perceive the determinants of health and cancer.

Objectives
Our main objective is to map, from a multiphase qualitative protocol, the conceptions and systems of conceptions on the determinants of health and cancers perceived within a 6 to 11 age group.
The secondary objective is to analyze our ability to collect these healthy conceptions from children.

Methodology
Four different tools were used in four schools for 320 students: (1) “photo expression”, (2) “QC (Questions / Certainties)”, (3) “photo narration” and (4) “focus group”. This open and exploratory method, combining the use of photographs and focus groups, provided data on the experiences, stated practices and knowledge of each student. The mobilization of image mediation methods plays an essential ethical role by ensuring the distance between the theme and the child. The informative value of data from qualitative collection tools coupled with a mixed analysis methodology (qualitative and quantitative) allows us to collect dense and efficient data needed to understand the perception of determinants by elementary school students.

Conclusions
This study identifies promising methodological leads thanks to the complementarity of the different phases mobilized. It also provides us with elements of methodological understanding that can contribute to the development of prevention tools as part of the school health education journey.

Key messages
Map, from a multiphase qualitative protocol, the conceptions and systems of conceptions on the determinants of health and cancers perceived within a 6 to 11 age group. Analyze our ability to collect these healthy conceptions from children.
Antenatal care initiation in an ethnically dense socially disadvantaged maternal cohort
Authors: Puthussery S , Li L , Tseng P c , Puthusserry T 
Published: November 2019

Abstract

Background
Differential utilisation of antenatal care among ethnic minority mothers is a contributor to their increased risk of poor birth outcomes in developed countries. Links between ethnicity, area deprivation and the timing of antenatal care initiation remain poorly understood. This study investigated patterns of antenatal care initiation among an ethnically dense, socially disadvantaged maternal cohort.

Methods
We conducted a retrospective analysis of routinely collected anonymous data of live singleton births in a maternity unit serving an ethnically diverse population. We applied univariate regression models to examine the association between late antenatal care initiation and various predictor variables in particular ethnicity and area deprivation.

Results
Gestational week at antenatal initiation was available for 46, 089 births. One fifth (20.9%) of mothers initiated antenatal care after 12 weeks of gestation including 11.9% who had their first antenatal appointment at 13 -20 weeks (moderately late) and 8.9% who had it later than 20 weeks (extremely late). Among all the factors considered, late initiation was most strongly associated with non-White British ethnicity. Black African (34.2%) and Black Caribbean (29.0%) mothers were more than twice as likely to initiate antenatal care after 12 weeks of gestation compared to White British mothers [Odds ratio (OR)= 2.69 and 2.15 respectively). The odds did not increase with increasing area deprivation except for moderately late initiation in the most deprived and second most deprived areas [unadjusted OR = 1.54 and 1.24 respectively].

Conclusions
Non-White British ethnicity was the key predictor of late antenatal care initiation in our ethnically dense socially disadvantaged maternal cohort. Impact: Programs and policies should take in to account ethnic variations in antenatal care initiation while designing programs and policies to improve birth outcomes in ethnically dense socially disadvantaged areas.

Key messages
Non-White British ethnicity was the key predictor of late antenatal care initiation. Area deprivation per se appeared to have limited association with late antenatal care initiation.
Barriers and enablers for practicing kangaroo mother care (KMC) in rural Sindh, Pakistan
Authors: Shah M , Jamali Q , Aisha F , Shahid F 
Published: November 2019

Abstract

Background
More than 2.5 million newborns die each year, contributing to 47% of under 5 mortality worldwide. Globally, Every Newborn Action Plan has emphasized on Kangaroo Mother Care (KMC) as an essential component of neonatal health initiatives. An international joint policy statement and endorsement from health professional associations also recommended practicing KMC for newborn care.

Methods
We conducted a qualitative study with 12 in-depth interviews (IDIs) and 14 focus group discussion (FGD) sessions, in two health facilities of Sindh, Pakistan during October-December 2016, to understand the key barriers and enablers to a mother’s ability to practice KMC and the feasibility of implementing and improving these practices.

Results
Our study findings revealed that community stakeholders were generally aware of health issues especially related to maternal and neonatal health. Both the health care providers and managers were supportive of implementing KMC in their respective health facilities as well as for continuous use of KMC at household level. In order to initiate KMC at facility level, study respondents emphasized on strengthening of availability and quality of services as well as training of health providers as critical prerequisites. Also in order to continue practicing KMC at household level, engaging the community and establishing functional referral linkage between community and facilities were focused issues in facility and community level FGDs and IDIs. The study participants considered it feasible to initiate KMC practice at health facility and to continue practicing at home after returning from facility.

Conclusions
Ensuring facility readiness to initiate KMC, improving capacity of health providers, coupled with strengthened community mobilization, and targeting specific audiences may help policy makers and program planners to initiate KMC practice at health facility and keep KMC practice continued at household level.

Key messages
Introducing KMC at health facility followed by continuing practice at household level is feasible, even in a religiously conservative setting like Pakistan. Facility readiness, improved health workers’ capacity coupled with strengthened community mobilization targeting specific audiences could help scaling up this public health intervention in Pakistan.
Supporting child development to reduce child health inequalities in Belgium: a realist evaluation
Authors: Beauvarlet M , De Spiegelaere M 
Published: November 2019

Abstract

Background
Reducing social inequalities in child health is a major challenge in Belgium. In Brussels, 40% of children are born in a household below the poverty line. The most efficient way to reduce social inequalities in health is to address them on a structural level, via public policies that improve families’ income. But it is also proven that direct support of child development can reduce the risk of poverty in adulthood. Therefore, this study focuses on fields projects working directly with families living in poverty and aims to understand how, for whom and in which circumstances their actions can have effects on child’s development.

Methods
We conducted a realist evaluation of 30 field projects funded as part of the fight against child poverty and offering parenting support from prenatal period to the age of 6. Firstly, focus groups with the projects’ workers were conducted to identify the underlying mechanisms in their interventions and the contexts facilitating or hindering these mechanisms to achieve the desired effects. Secondly, these Context-Mechanisms-Outcomes (CMO) configurations are validated with project beneficiaries through semi-directed interviews, using picture telling.

Results
Despite the diversity of the actions carried out, common and transversal mechanisms are highlighted within 6 different CMOs that allow us to understand how and for whom those 30 projects work. Certain contexts - e.g. the characteristics of families, their feeling of freedom regarding the project, the density of projects network - can activate or hinder the mechanisms. We also note that workers tend to adjust their actions to support very vulnerable families for whom certain common mechanisms aren’t working.

Conclusions
This study, co-constructed through the collaboration of researchers and actors, could help workers to better understand and improve the mechanisms induced by their interventions, and stakeholders to recognise which projects are best suited to certain contexts.

Key messages
This realist evaluation enables to understand how for whom and in which circumstances field projects actions can have effects on child’s development and therefore take part in child poverty reduction. The realist approach used in this study, through the parallel evaluation of 30 different field projects, allows to refine hypothesis from one project to another, ensuring transferability of results.
Health and well-being of parents with 4-year-old children – a nationwide study in 2018 in Finland
Authors: Klemetti R , Vuorenmaa M , Ikonen R , Oksanen J , Lammi-Taskula J 
Published: November 2019

Abstract

Background
A nation-wide data collection on small children and their families’ health and well-being has been lacking in Finland. The aim of this study was to examine health and determinants of health among parents with a four-year-old child.

Methods
A nation-wide study for 4-year-old children (N = 8720) and their parents (N = 10 737) conducted in 2018. The families were recruited by public health nurses at child health clinics. Both parents had a possibility to answer a questionnaire considering questions on health, well-being and service use. General health of the parent was measured by one question (How do you find your general state of health?), depressive disorders by PHQ-2 and mental health by MHI-5. Data were analyzed by cross-tabulation. Results of logistic regression will be presented in the conference.

Results
Most participants were female (72%) and most families had two adults (93%). Mean age was 35 years and 58% were highly educated. Around 10% reported their health as average or poor, 19% had had depressive disorders within 12 months, and 6% had experienced mental distress. Single parents reported mental distress and depressive disorders significantly more often than the other parents. Average or poor health was reported significantly more often by female parents. Those with average or poor health or depressive disorders were significantly more likely to have one child, upper secondary education or less, or be outside of work. They felt themselves significantly more often lonely and unsatisfied with their life and family’s economic situation. They were also significantly more likely to report need of support for their own parenthood and partnership.

Conclusions
Health challenges among the parents were quite similar than those among the adults in same ages. However, detailed analysis is needed to find out the specific determinants affecting the parents and whole family’s life to be able to better support the families.

Key messages
Most parents with children aged 4-year-old were healthy and satisfied with their life. The parents having poor physical or mental health had also challenges in family life.
Sexual behaviour and attitudes among university students in Zagreb
Authors: Majer M , Puškarić Saić B , Musil V , Mužić R , Pjevač N , Jureša V 
Published: November 2019

Abstract

Background
Sexual behaviour of youth could have reproductive health outcomes with an impact on individual and general population health. The aim of this study was to determine sexual behaviour and attitudes among first year university students in city of Zagreb, Croatia.

Methods
Study included 298 first year students (61% of females) of Medical School University of Zagreb and 124 students (75% of females) of Catholic University of Zagreb in academic year 2017/2018. Data were collected by anonymous questionnaire School Health Survey, and analysed by descriptive statistics.

Results
Significantly higher proportion of Catholic University students have had sexual intercourse comparing to medical students of University of Zagreb (48% vs. 36%, P = 0.019). The age of first sexual intercourse for the most of students was from 16-18 years (73% of Catholic University students, and 79% of medical students). Contraception was always used among 54% of Catholic University students, and 67% of medical students, and never used among 11% and 4% of them respectively. Most of the students have gained information about human sexuality from the internet (26% of Catholic University students, and 30% of medical students), followed by friends (18%) and parents (11%) for Catholic University students, and television (25%) and friends (14%) for medical students. Most students expressed the attitude that sex education should be introduced in secondary schools (31% and 36%, respectively), followed by both, in primary and secondary schools (21%, and 30% respectively). Fourteen percent of Catholic University students and 7% of medical students thought that sex education should not be introduced to schools.

Conclusions
Results showed risky sexual behaviour of university students, especially Catholic University students, indicating the need of continuous education on reproductive health among youth.

Key messages
Results indicate the need of intervention and continuous education on reproductive health among university students in Zagreb, Croatia. Results showed insufficient use of contraception especially among Catholic University students indicating the need of education on reproductive health among medical and nonmedical students.
Maternal admissions to Intensive Care Units in France: trends in rates, causes and severity
Authors: Barry Y , Deneux-Tharaux C , Saucedo M , Goulet V , Guseva-Canu I , Chantry A A , Regnault N 
Published: November 2019

Abstract

Introduction
Maternal intensive care unit admission (ICU) is an indicator of severe maternal morbidity. This study aimed to estimate rates of maternal ICU admission during or following pregnancy in France, and to describe the characteristics of women admitted, the severity of their condition, associated diagnoses, regional disparities, and temporal trends between 2010 and 2014.

Methods
Women hospitalised in France in ICU during pregnancy or up to 42 days after pregnancy between 2010 and 2014 were identified using the national hospital discharge database (PMSI-MCO). The Simplified Acute Physiology Score (SAPS II) was used to estimate the severity. Trends in incidence rates were quantified using percentages of average annual variation based on a Poisson regression model.

Results
In total, 16,011 women were admitted to ICU, representing an overall rate of 3.97 ‰ deliveries. The average annual decrease in this rate between 2010 and 2014 was 1.7% (IC95%:-2, 00%; -1, 45%; p &lt; 0.0001) on average per year. The SAPS II score increased significantly from 18.4 in 2010 to 21.5 in 2014. Obstetrical hemorrhage (39.8%) and hypertensive complications during pregnancy (24.8%) were the most common reasons for admission. Within mainland France, we found notable disparities in maternal ICU admission rates between regions, from lowest in Pays-de-la-Loire region (2.69‰) to highest in Ile-de-France (5.05‰).

Conclusions
The rate of maternal ICU admission decreased from 2010 to 2014 in France, with a concomitant increase in case severity. Additional studies are needed to understand the territorial disparities identified in our study.

Key messages
The decreasing incidence of maternal ICU admission could be due to organisational changes with increased admission to intermediate care units. These changes have to be understood to accurately use maternal CU admission for maternal health surveillance.
A French network for prevention and reduction of reproductive risk in couples and pregnant women
Authors: Sunyach C , Perrin J , Bretelle F , Paris C , Garlantezec R , Belacel M , Pairon J-C , Sentilhes L , Delva F , Brochard P 
Published: November 2019

Abstract

Background
Since 2013, several international (ASRM, FIGO, ACOG) and French (ANSES) learned societies and the French National Health and Environment Plan (2015-2019) urged to take into account exposures to environmental reprotoxic substances during standard care of infertile couples and pregnant women. However perinatal health professionals hardly incorporate this recommendation into practice.

Objectives
To create a network of platforms to addressing the environmental aspects that can impact the pregnancy chances of infertile couples after ART and pregnancy outcomes.
We asked regional health authorities in France to provide funding for multidisciplinary hospital structures, in conjunction with clinical-biological reproductive health and gynecology-obstetric centers. Expertise, as well as information leaflets and risk detection tools have been shared.

Results
Platforms of counselling and prevention have been set up in the University Hospitals of Bordeaux, Marseille, Rennes, Créteil and Paris Fernand-Widal. Infertile couples and pregnant women, referred by reproductive physicians, benefit from personalized management of their domestic/professional reprotoxic exposures by addictology/tobacco, dietetics, occupational health and environmental pathology professionals. The network organizes an annual scientific day and a common database of exposure is being set up.

Conclusions
The PREVENIR (PREVENTION - ENVIRONMENT - Reproduction) network of platforms allows perinatal health professionals to refer their patients in order to optimize their chance of pregnancy through personalized and multidisciplinary care. The lifestyle changes initiated through this approach will also improve pregnancy outcomes and child health.

Key messages
A French network for the prevention and reduction of reproductive risk in infertile couples and pregnant women: the PREVENIR platforms (PREVENTION - ENVIRONMENT - Reproduction) is being established. Perinatal health professionals of multidisciplinary platforms engage into preventive actions to limit the exposure to environmental hazards during preconception and pregnancy.
First national results of the evaluation of the neonatal hearing loss screening programme in France
Authors: Doncarli A , Tillaut H , Goulet V 
Published: November 2019

Abstract

Background
The French newborn hearing screening programme set up in 2014 aims to identify affected children as early as possible to allow appropriate care. Our goal was to evaluate the implementation of this programme at the national level.

Methods
The programme consist in a screening using a test (T1) and a retest (T2) in the maternity hospital in all newborns. In some region, a delayed test (T3) is performed afterwards in children for whom it was not possible to confirm normal hearing. Children suspected of deafness subsequently enter the diagnosis phase. We defined evaluation indicators after stakeholders consultation. We developed a web application to collect aggregated data on live births. We estimated the rate of coverage, refusal, children suspected of hearing loss at the end of the screening phase and the prevalence of bilateral deafness.

Results
In 2015, one year after the initiation of the programme, the coverage rate was already very high (88%) and even more so in 2016 (96%). Parental acceptance was very good (refusal: 0.1%). By the end of 2016, 19 out 27 regions had added a T3. The rate of suspicion of bilateral hearing loss was decreased by using a T3 (1.4% vs 0.9%). Bilateral deafness rate, estimated after a 2-years follow up, was 1.3‰ although it was estimated only on 51.5% of suspected children for whom diagnosis data had been transmitted.

Conclusions
The objective of a 90% coverage set by the French ministry of health has been met after 2 years of operation of the program. T3 appears useful in relieving diagnostic structures from false positives. Our estimated prevalence of bilateral deafness could be more accurate if data collection was improved but is consistent with prevalence reported in North America.

Key messages
The universal newborn hearing screening program has been successfully set up in France in terms of coverage. Future work should focus on improving the collection of follow up data to better characterise diagnosed children.
Association between leisure-time physical activity and the risk of chronic diseases
Authors: Dedele A , Miskinyte A 
Published: November 2019

Abstract

Background
According to the World Health Organization, non-communicable diseases or chronic diseases, account for 71 percent of all deaths globally, affecting individuals of all age groups and countries. Epidemiological studies have shown an association between a lack of physical activity (PA) and the risk of raised blood pressure, increased body mass index and obesity that can lead to chronic diseases.

Methods
The aim of the study was to assess the relationship between leisure-time PA and the risk of chronic diseases among adult population. We conducted a cross-sectional study of 470 men and 641 women who participated in “The Impact of Sustainable Mobility, Physical Activity and Environmental Factors on Urban Population Health Study (ISMA)” in Lithuania. Leisure-time PA was self-reported and divided into three levels: low, moderate and high. Logistic regression was used to estimate adjusted odds ratios (ORs) of chronic diseases according to leisure-time PA.

Results
More than half (55%) of the study population engaged in a moderate intensity PA and 12% of participants engaged in a high intensity leisure-time PA. Men 1.6 times more often than women reported engaging in a high intensity PA in leisure time (p = 0.004). Adults who engaged in low intensity leisure-time PA had almost 3 times (OR = 2.91; 95% confidence interval (CI) 1.62-5.24) higher risk of chronic diseases, whereas those adults who reported moderate intensity leisure-time PA had an OR of 1.63 (95% CI 0.92-2.87) compared to individuals who engaged in a high-level PA.

Conclusions
Our findings suggest that high levels of leisure-time PA could reduce the risk of chronic diseases and this effect was significantly stronger in men.

Key messages
Global decline in PA is related to inaction during leisure time and sedentary behaviour at work and at home that has a major health impact worldwide. High levels of leisure-time PA are important factor for chronic disease prevention.