Database : MEDLINE
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[PMID]: 29524900
[Au] Autor:Krantzberg G; Hartley P
[Ad] Address:McMaster University, Canada. Electronic address: krantz@mcmaster.ca.
[Ti] Title:Feasible policy development and implementation for the destruction of endocrine disruptors in wastewater.
[So] Source:Sci Total Environ;631-632:246-251, 2018 Mar 07.
[Is] ISSN:1879-1026
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:Endocrine disruptors when introduced to waterways have many adverse health effects on wildlife and humans. These health effects vary from neurological, immune, carcinogenic and reproductive disorders. Currently, there are few wastewater treatment facilities that are purposefully treating endocrine disruptors as part of the normal wastewater treatment process. Current literature has shown that endocrine disruptors can be treated using conventional methods. These conventional methods are centered around the denitrification process, which is rarely adopted in Canada. This paper investigates the current wastewater effluent regulations and guidelines in Canada, Ontario and the European Union. The research identifies a policy strategy that would include denitrification in the wastewater treatment process to help eliminate endocrine disruptors and acutely toxic nitrogen based compounds. Our emphasis here is on action possible in the Province of Ontario Canada, give the context of the Great Lakes basin and the potential for early action to stimulate other jurisdictions to follow. Our recommendations while aimed at one jurisdiction, have broad application globally.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

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[PMID]: 29524822
[Au] Autor:Noszczynska M; Piotrowska-Seget Z
[Ad] Address:Department of Microbiology, University of Silesia, Jagiellonska 28, 40-032 Katowice, Poland. Electronic address: magdalena.noszczynska@us.edu.pl.
[Ti] Title:Bisphenols: Application, occurrence, safety, and biodegradation mediated by bacterial communities in wastewater treatment plants and rivers.
[So] Source:Chemosphere;201:214-223, 2018 Feb 28.
[Is] ISSN:1879-1298
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Numerous data indicate that most of bisphenols (BPs) are endocrine disrupters and exhibit cytotoxicity, neurotoxicity, genotoxicity and reproductive toxicity against vertebrates. Nevertheless, they are widely applied in material production what result in their ubiquitous occurrence in ecosystems. While BPA is the most frequently detected in environment, BPAF, BPF and BPS are also often found. Ecosystem particularly exposed to BPs pollution is industrial and municipal wastewater being a common source of BPA in river waters. Different techniques to remove BPs from these ecosystems have been applied, among which biodegradation seems to be the most effective. In this review the current state of knowledge in the field of BPs application, distribution in the environment, effects on animal and human health, and biodegradation mediated by bacterial populations in wastewater treatment plants and rivers is presented.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

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[PMID]: 29524609
[Au] Autor:Yuk JS; Shin JY; Moon HS; Lee JH
[Ad] Address:Department of Obstetrics and Gynecology, Gyeongsang National University Changwon Hospital, School of Medicine, Gyeongsang National University, Changwon, Gyeongnam, Republic of Korea.
[Ti] Title:The incidence of unexpected uterine malignancy in women undergoing hysteroscopic myomectomy or polypectomy: A national population-based study.
[So] Source:Eur J Obstet Gynecol Reprod Biol;224:12-16, 2018 Mar 03.
[Is] ISSN:1872-7654
[Cp] Country of publication:Ireland
[La] Language:eng
[Ab] Abstract:OBJECTIVE: The objective of this study was to investigate the incidence of unexpected uterine malignancy (UUM) diagnosed after hysteroscopic surgery for presumed submucosal leiomyomas or endometrial polyps. STUDY DESIGN: From the Korean national health insurance database between January 1, 2009 and December 31, 2015, we analyzed inpatient sample data that were extracted by a stratified random sampling (gender and age) method. We extracted women with or without UUM that was diagnosed after hysteroscopic surgery using diagnosis codes and procedure codes. RESULTS: A total of 11,866 women who underwent hysteroscopic surgery were extracted from 4,476,495 women. The mean age of the patients who underwent hysteroscopic surgery was 37.8 ±â€¯0.1 years. A hysteroscopic myomectomy or polypectomy was performed in 3498 and 8368 women, respectively. The incidence of UUM diagnosed after hysteroscopic myomectomy or polypectomy was 0.86% and 1.11%, respectively. The logistic regression analysis showed that the risk of UUM increased with age (Odds Ratio (OR), 1.61; 95% Confidence Interval (CI), 1.47-1.77; P < 0.001) and did not indicate hysteroscopic myomectomy or polypectomy (OR, 1.21; 95% CI, 0.93-1.55; P = 0.151). CONCLUSIONS: The incidence of UUM diagnosed after hysteroscopic myomectomy (0.86%) or polypectomy (1.11%) was higher than that of UUM diagnosed after hysterectomy (0.19%) or myomectomy (0.12%) for presumed benign leiomyoma. The incidence of UUM increased over the age of 50.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

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[PMID]: 29510718
[Au] Autor:Schmidt NC; Fargnoli V; Epiney M; Irion O
[Ad] Address:Department of Obstetrics and Gynecology, University Hospitals of Geneva, Geneva, Switzerland. nicole.schmidt@hcuge.ch.
[Ti] Title:Barriers to reproductive health care for migrant women in Geneva: a qualitative study.
[So] Source:Reprod Health;15(1):43, 2018 Mar 06.
[Is] ISSN:1742-4755
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Migrant mothers in developed countries often experience more complicated pregnancy outcomes and less fewer women access preventive gynecology services. To enlighten health care providers to potential barriers, the objective of this paper is to explore barriers to reproductive health services in Geneva described by migrant women from a qualitative perspective. METHODS: In this qualitative study, thirteen focus groups (FG) involving 78 women aged 18 to 66 years were conducted in seven languages. All the FG discussions were audio-recorded and later transcribed. The data was classified, after which the main themes and sub-themes were manually extracted and analyzed. RESULTS: Barriers were classified either into structural or personal barriers aiming to describe factors influencing the accessibility of reproductive health services vs. those influencing client satisfaction. The five main themes that emerged were financial accessibility, language barriers, real or perceived discrimination, lack of information and embarrassment. CONCLUSION: Structural improvements which might meet the needs of the emergent extremely diverse population are the (1) provision of informative material that is easy to understand and available in multiple languages, (2) provision of sensitive cultural training including competence skill for all health professionals, (3) provision of specifically trained nurses or social assistance to guide migrants through the health system and (4) inclusion of monitoring and evaluation programs for the prevention of personal and systemic discrimination.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Process
[do] DOI:10.1186/s12978-018-0478-7

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[PMID]: 29510682
[Au] Autor:Ewerling F; Victora CG; Raj A; Coll CVN; Hellwig F; Barros AJD
[Ad] Address:International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil. fewerling@equidade.org.
[Ti] Title:Demand for family planning satisfied with modern methods among sexually active women in low- and middle-income countries: who is lagging behind?
[So] Source:Reprod Health;15(1):42, 2018 Mar 06.
[Is] ISSN:1742-4755
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Family planning is key for reducing unintended pregnancies and their health consequences and is also associated with improvements in economic outcomes. Our objective was to identify groups of sexually active women with extremely low demand for family planning satisfied with modern methods (mDFPS) in low- and middle-income countries, at national and subnational levels to inform the improvement and expansion of programmatic efforts to narrow the gaps in mDFPS coverage. METHODS: Analyses were based on Demographic and Health Survey and Multiple Indicator Cluster Survey data. The most recent surveys carried out since 2000 in 77 countries were included in the analysis. We estimated mDFPS among women aged 15-49 years. Subgroups with low coverage (mDFPS below 20%) were identified according to marital status, wealth, age, education, literacy, area of residence (urban or rural), geographic region and religion. RESULTS: Overall, only 52.9% of the women with a demand for family planning were using a modern contraceptive method, but coverage varied greatly. West & Central Africa showed the lowest coverage (32.9% mean mDFPS), whereas South Asia and Latin America & the Caribbean had the highest coverage (approximately 70% mean mDFPS). Some countries showed high reliance on traditional contraceptive methods, markedly those from Central and Eastern Europe, and the Commonwealth of Independent States (CEE & CIS). Albania, Azerbaijan, Benin, Chad and Congo Democratic Republic presented low mDFPS coverage (< 20%). The other countries had mDFPS above 20% at country-level, yet in many of these countries mDFPS coverage was low among women in the poorest wealth quintiles, in the youngest age groups, with little education and living in rural areas. Coverage according to marital status varied greatly: in Asia & Pacific and Latin America & the Caribbean mDFPS was higher among married women; the opposite was found in West & Central Africa and CEE & CIS countries. CONCLUSIONS: Almost half of the women in need were not using an effective family planning method. Subgroups requiring special attention include women who are poor, uneducated/illiterate, young, and living in rural areas. Efforts to increase mDFPS must address not only the supply side but also tackle the need to change social norms that might inhibit uptake of contraception.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Process
[do] DOI:10.1186/s12978-018-0483-x

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[PMID]: 29510675
[Au] Autor:Abekah-Nkrumah G
[Ad] Address:Department of Public Administration and Health Services Management, University of Ghana Business School, P. O. Box 78, Legon, Accra, Ghana. gabekah-nkrumah@ug.edu.gh.
[Ti] Title:Spatial variation in the use of reproductive health services over time: a decomposition analysis.
[So] Source:BMC Pregnancy Childbirth;18(1):63, 2018 03 06.
[Is] ISSN:1471-2393
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: The paper argues that several Sub-Saharan African countries have recorded marked improvements in the use of reproductive health services. However, the literature has hardly highlighted such progress and the factors responsible for them. The current study uses Ghana as a case to examine progress in the consumption of reproductive health services over the last two decades and the factors responsible for such progress. METHODS: The study uses two rounds (1998 and 2014) of Demographic and Health Survey data from Ghana. Standard frequencies, a logit model and decomposition of the coefficients of the logit model (i.e. Oaxaca-type decomposition) was employed to examine changes in the use of reproductive health services (4+ antenatal visits and skilled attendance at birth) at national and sub-national levels (i.e the four ecological zones of Ghana) between 1998 and 2014 as well as factors explaining observed spatial changes between the two periods. RESULTS: Descriptive results suggest that the highest level of improvement occurred in resource-poor zones (i.e. northern belt followed by the southern belt) compared to the middle belt and Greater Accra, where access to resources and infrastructure is relatively better. Results from Oaxaca-type decomposition also suggest that women and partner's education, household wealth and availability and accessibility to health facilities are the key factors explaining spatial variation in reproductive health service consumption over the two periods. Most importantly, the marginal efficiency of investment in women and partner's education and access to health services were highest in the two resource poor zones. CONCLUSION: There is the need to target resource poor settings with existing or new pro-poor reproductive health interventions. Specifically, the northern and southern zones where the key drivers of education and availability of health facilities are the lowest, will be key to further improvements in the consumption of reproductive health services in Ghana.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Process
[do] DOI:10.1186/s12884-018-1695-3

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[PMID]: 29506559
[Au] Autor:Dynes MM; Twentyman E; Kelly L; Maro G; Msuya AA; Dominico S; Chaote P; Rusibamayila R; Serbanescu F
[Ad] Address:Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, Georgia. mdynes@cdc.gov.
[Ti] Title:Patient and provider determinants for receipt of three dimensions of respectful maternity care in Kigoma Region, Tanzania-April-July, 2016.
[So] Source:Reprod Health;15(1):41, 2018 Mar 05.
[Is] ISSN:1742-4755
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Lack of respectful maternity care (RMC) is increasingly recognized as a human rights issue and a key deterrent to women seeking facility-based deliveries. Ensuring facility-based RMC is essential for improving maternal and neonatal health, especially in sub-Saharan African countries where mortality and non-skilled delivery care remain high. Few studies have attempted to quantitatively identify patient and delivery factors associated with RMC, and none has modeled the influence of provider characteristics on RMC. This study aims to help fill these gaps through collection and analysis of interviews linked between clients and providers, allowing for description of both patient and provider characteristics and their association with receipt of RMC. METHODS: We conducted cross-sectional surveys across 61 facilities in Kigoma Region, Tanzania, from April to July 2016. Measures of RMC were developed using 21-items in a Principal Components Analysis (PCA). We conducted multilevel, mixed effects generalized linear regression analyses on matched data from 249 providers and 935 post-delivery clients. The outcomes of interest included three dimensions of RMC-Friendliness/Comfort/Attention; Information/Consent; and Non-abuse/Kindness-developed from the first three components of PCA. Significance level was set at p < 0.05. RESULTS: Significant client-level determinants for perceived Friendliness/Comfort/Attention RMC included age (30-39 versus 15-19 years: Coefficient [Coef] 0.63; 40-49 versus 15-19 years: Coef 0.79) and self-reported complications (reported complications versus did not: Coef - 0.41). Significant provider-level determinants included perception of fair pay (Perceives fair pay versus unfair pay: Coef 0.46), cadre (Nurses/midwives versus Clinicians: Coef - 0.46), and number of deliveries in the last month (11-20 versus < 11 deliveries: Coef - 0.35). Significant client-level determinants for Information/Consent RMC included labor companionship (Companion versus none: Coef 0.37) and religiosity (Attends services at least weekly versus less often: Coef - 0.31). Significant provider-level determinants included perception of fair pay (Perceives fair pay versus unfair: Coef 0.37), weekly work hours (Coef 0.01), and age (30-39 versus 20-29 years: Coef - 0.34; 40-49 versus 20-29 years: Coef - 0.58). Significant provider-level determinants for Non-abuse/Kindness RMC included the predictors of age (age 50+ versus 20-29 years: Coef 0.34) and access to electronic mentoring (Access to two mentoring types versus none: Coef 0.37). CONCLUSIONS: These findings illustrate the value of including both client and provider information in the analysis of RMC. Strategies that address provider-level determinants of RMC (such as equitable pay, work environment, access to mentoring platforms) may improve RMC and subsequently address uptake of facility delivery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Process
[do] DOI:10.1186/s12978-018-0486-7

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[PMID]: 29506542
[Au] Autor:Turner KL; Pearson E; George A; Andersen KL
[Ad] Address:Global Citizen, LLC Consulting, 732 Ninth St., No. 521, Durham, 27705, NC, USA.
[Ti] Title:Values clarification workshops to improve abortion knowledge, attitudes and intentions: a pre-post assessment in 12 countries.
[So] Source:Reprod Health;15(1):40, 2018 Mar 05.
[Is] ISSN:1742-4755
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Women's access to abortion care is often denied or hampered due to a range of barriers, many of which are rooted in abortion stigma. Abortion values clarification and attitude transformation (VCAT) workshops are conducted with abortion providers, trainers, and policymakers and other stakeholders to mitigate the effects of abortion stigma and increase provision of and access to abortion care. This study assesses changes in knowledge, attitudes, and behavioral intentions of VCAT workshop participants. METHODS: Pre- and post-workshop surveys from 43 VCAT workshops conducted in 12 countries in Asia, Africa, and Latin America between 2006 and 2011 were analyzed to assess changes in three domains: knowledge, attitudes and behavioral intentions related to abortion care. A score was created for each domain (range: 0-100), and paired t-tests or Wilcoxon matched-pairs signed-ranks tests were used to test for significant differences between the pre- and post-workshop scores overall and by region and participant type (providers, trainers, and policymakers/other stakeholders). We also assessed changes in pre- and post-workshop scores for participants with the lowest knowledge and negative attitudes on the pre-workshop survey. RESULTS: Overall, the mean knowledge score increased significantly from 49.0 to 67.1 (p < 0.001) out of a total possible score of 100. Attitudes and behavioral intentions showed more modest, but still statistically significant improvements between the pre- and post-workshop surveys. The mean attitudes score increased from 78.2 to 80.9 (p < 0.001), and the mean behavioral intentions score rose from 82.2 to 85.4 (p = 0.03). Among participants with negative attitudes pre-workshop, most shifted to positive attitudes on the post-workshop survey, ranging from 35.2% who switched to supporting unrestricted access to second-trimester abortion to 90.9% who switched to feeling comfortable working to increase access to contraceptive services in their country. Participants who began the workshop with the lowest level of knowledge experienced the greatest increase in mean knowledge score from 20.0 to 55.0 between pre- and post-workshop surveys (p < 0.001). CONCLUSIONS: VCAT workshop participants demonstrated improvements in knowledge, attitudes, and behavioral intentions related to abortion care. Participants who entered the workshops with the lowest levels of knowledge and negative attitudes had the greatest gains in these domains.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Process
[do] DOI:10.1186/s12978-018-0480-0

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[PMID]: 29506538
[Au] Autor:Uusküla A; Raag M; Vorobjov S; Jarlais DD
[Ad] Address:Department of Family medicine and Public Health, University of Tartu, Ravila 19, 50411, Tartu, Estonia. anneli.uuskula@ut.ee.
[Ti] Title:Another frontier for harm reduction: contraceptive needs of females who inject drugs in Estonia, a cross-sectional study.
[So] Source:Harm Reduct J;15(1):10, 2018 Mar 05.
[Is] ISSN:1477-7517
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Despite increasing contraceptive availability, unintended pregnancy remains a global problem. Developing strategies to reverse this trend and increasing occurrence of withdrawal syndrome among newborn children of females currently injecting drugs warrants special attention. The knowledge base on the uptake of effective contraception among females who inject drugs (FWID) is scant. We aimed to examine the prevalence of and factors associated with the use of non-condom contraceptives among sexually active FWID with the focus on effective contraception. METHODS: In a series of cross-sectional studies (2007-2013), 265 current FWID were recruited through respondent-driven sampling (RDS), interviewed, and tested for HIV. RDS weights were used to estimate the prevalence of effective contraception (hormonal contraception, intrauterine device, sterilization) use in the last 6 months. RESULTS: Of the sexually active women with main partners (n = 196) 4.8% (95% CI 2.3-9.7) were using effective contraception, 52.7% (95% CI 42.5-62.7) less-effective or no contraception. 42.5% (95% CI 32.7-52.9) relied on condoms for contraception. The odds for using effective contraception were higher among women with > 10 years of education (OR 7.29, 95% CI 1.4-38.8). None of the women lacking health insurance (n = 84) were using effective contraception. CONCLUSIONS: The very low coverage with effective contraception highlights the need to improve contraceptive services for FWID. Reproductive health service including contraception should be considered essential components of harm reduction and of comprehensive prevention and care for HIV among persons who use drugs.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Data-Review
[do] DOI:10.1186/s12954-018-0215-0

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[PMID]: 29506534
[Au] Autor:Ali M; Farron M; Ouedraogo L; Mahaini RK; Miller K; Kabra R
[Ad] Address:Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland. alimoa@who.int.
[Ti] Title:Research gaps and emerging priorities in sexual and reproductive health in Africa and the eastern Mediterranean regions.
[So] Source:Reprod Health;15(1):39, 2018 Mar 05.
[Is] ISSN:1742-4755
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: In-country research capacity is key to creating improvements in local implementation of health programs and can help prioritize health issues in a landscape of limited funding. Research prioritization has shown to be particularly useful to help answer strategic and programmatic issues in health care, including sexual and reproductive health (SRH). The purpose of this paper is to present the results of a priority setting exercise that brought together researchers and program managers from the WHO Africa and Eastern Mediterranean regions to identify key SRH issues. METHODS: In June 2015, researchers and program managers from the WHO Africa and Eastern Mediterranean regions met for a three-day meeting to discuss strategies to strengthen research capacity in the regions. A prioritization exercise was carried out to identify key priority areas for research in SRH. The process included five criteria: answerability, effectiveness, deliverability and acceptability, potential impact of the intervention/program to improve reproductive, maternal and newborn health substantially, and equity. RESULTS: The six main priorities identified include: creation and investment in multipurpose prevention technologies, addressing adolescent violence and early pregnancy (especially in the context of early marriage), improved maternal and newborn emergency care, increased evaluation and improvement of adolescent health interventions including contraception, further focus on family planning uptake and barriers, and improving care for mothers and children during childbirth. CONCLUSION: The setting of priorities is the first step in a dynamic process to identify where research funding should be focused to maximize health benefits. The key elements identified in this exercise provides guidance for decision makers to focus action on identified research priorities and goals. Prioritization and identifying/acting on research gaps can have great impact across multiple sectors in the regions for improved reproductive, maternal and children health.
[Pt] Publication type:LETTER
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Process
[do] DOI:10.1186/s12978-018-0484-9


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