Background: Despite increased recognition of the need for sexual and reproductive health and rights in humanitarian settings, evidence focusing on mainstreaming reproductive health services such as maternal, neonatal ...Background: Despite increased recognition of the need for sexual and reproductive health and rights in humanitarian settings, evidence focusing on mainstreaming reproductive health services such as maternal, neonatal mortality, human immunodeficiency virus transmission and unsafe abortion still remains inadequate. The ability to understand the magnitude of the needs and highlight existing gaps is supported by improved data which is critical to informing effective policies, programming and funding decisions. The purpose of this report is to present the results of a research prioritization exercise on sexual and reproductive health and rights services in humanitarian settings for the WHO Africa region for the next three years. Methods: We adapted the Child Health and Nutrition Research Initiative method in three phases. Experts from the region participated in an online survey to identify key areas for research in sexual and reproductive health and rights. To identify potential areas for research, the experts ensured answerability, effectiveness, deliverability, equity and potential impact of the questions. The research areas they identified were reviewed by World Health Organization technical team from headquarters. In a meeting of 67 participants, the questions were subjected to further review and analysis. Using a modified for scoring criteria, the questions were scored and ranked to provide the top ten priority questions to address sexual and reproductive health and rights services in humanitarian settings. Results: A list of 21 priority research questions on sexual and reproductive health and rights services in humanitarian settings were scored and ranked. Top ten priorities research questions were identified. Those that scored highly by scoring 30 points out of the possible maximum of 30 include: “determining the prevalence and associated factors of unwanted pregnancies and abortions performed in emergency and humanitarian settings”, “evidence on gender-based violence in humanitarian situations and its associated factors” and “defining an optimal model for coordinating sexual and reproductive health and rights interventions and responses in crisis situations”. Conclusions: Top ten research priorities in sexual and reproductive health and rights services in humanitarian settings were identified. The priority research areas have the potential to identify the best areas for programming of services in humanitarian settings. It is our hope that the identified research areas will be prioritized to support programming of services in humanitarian settings based on scientific evidence.展开更多
Background: The use of mobile phones continues to rise rapidly in the provision of health related services. Many countries have adopted the use of mobiles to provide sexual and reproductive health and rights and espec...Background: The use of mobile phones continues to rise rapidly in the provision of health related services. Many countries have adopted the use of mobiles to provide sexual and reproductive health and rights and especially among the adolescents where specific messages are tailored for various audiences with specific messages. The purpose of this paper is to present the results of a research priority setting exercise on mHealth and innovative strategies. Methods: We adapted Child Health and Nutrition Research Initiative methodology to identify and set research priorities on mHealth and innovative strategies that respond to sexual and reproductive health and rights services. General potential research questions were gathered online from multiple stakeholders in the region and sent for consolidation consolidated to technical experts in World Health Organization headquarters. The second phase involved a meeting with experts to review and thematically analyze the questions list of 33 questions producing a list of 22 research questions. The questions were scored against a six point criteria and ranked accordingly. Ten top priority research questions were identified. Results: Lists of 33 priority research questions for mHealth and innovative strategies were proposed for discussions by 67 stakeholders. The questions were reviewed, scored and ranked in a technical meeting by experts. The highest ranking questions at 87% include evaluation of mHealth for data management and sexual and reproductive health and rights decision making, assessment of innovative local financing techniques to support community based sexual reproductive health and rights and evaluation of the role of mobile technologies in referral and counter referral. Conclusions: Information and communication technology is developing drastically and has a great potential in improving health especially in sexual and reproductive health and rights service delivery. This potential must be demonstrated with more relevant and quality research on mHealth and innovative strategies priorities identified.展开更多
Background: Many policy makers deliberating on comprehensive sexual and reproductive health and rights services need reliable evidence to make choices that benefit women, adolescents, children and the wider society. W...Background: Many policy makers deliberating on comprehensive sexual and reproductive health and rights services need reliable evidence to make choices that benefit women, adolescents, children and the wider society. While universal health coverage discourse provides an opportunity to expand access through evidence based interventions, many gaps exist. Research prioritization has proved to be very helpful in identifying relevant areas especially in constrained resource settings. The purpose of this paper is to present the results of the World Health Organization Africa Region research prioritization for sexual and reproductive health and rights. These priorities hope to guide the region for the next three years. Methods: We used the Child Health and Nutrition Research Initiative approach to identify priority questions among many potential areas for research prioritization on sexual and reproductive health and rights. The implementation process was organized in three phases. The first phase involved sending out an online survey to various experts with experience in sexual and reproductive health rights. These questions were received by a technical team from World Health Organization headquarters for review. 634 questions were identified for potential research and grouped into 12 themes. The second phase involved experts who reviewed the questions. The team merged questions with duplications, removed the questions that were out of scope and finally refined the wordings. In the final phase, experts worked in groups to score and rank top ten priority questions for each of the 12 thematic areas. Results: A list of 120 priority questions for sexual and reproductive health and rights were prioritized by 67 participants drawn from 16 organizations. Most of the priority research questions (45%) focused on the theme of gender-based violence, 35% prioritized services in sexual and reproductive health and rights in humanitarian settings while 15% prioritized preventing unsafe abortion. 5% of the participants prioritized cervical cancer prevalence, prevention and treatment as a thematic area out of the questions in the top 20 research priority questions. Conclusions: Key priority research questions in sexual and reproductive health and rights were identified around five themes. The priority list will be of significance to World Health Organization regional Office for Africa and her stakeholders for the next three years.展开更多
This paper is to reflect on 25 wonderful years of my collaboration with the Chinese scientists and policy makers on social science and operations research in sexual reproductive health. Past and ongoing collaboration ...This paper is to reflect on 25 wonderful years of my collaboration with the Chinese scientists and policy makers on social science and operations research in sexual reproductive health. Past and ongoing collaboration is reviewed, followed by a discussion on the record of achievements and ideas for future directions and research priorities. The paper represents my views based on an exceptionally rich personal and professional experience working with numerous Chinese scientists on a range of research topics.展开更多
Objective To analyze the status of parent-child communication on sexual matters and its relationship to the sexual behaviors of adolescents. Methods The data were obtained from a study which was conducted in Changchun...Objective To analyze the status of parent-child communication on sexual matters and its relationship to the sexual behaviors of adolescents. Methods The data were obtained from a study which was conducted in Changchun city of China in 2001, Unmarried adolescents aged 15-19 years old（322 males and 360females） were selected for this analysis. Results Ten percent of adolescents reported having experience of sexual intercourse （16% of male and 5% of female）. The percentages of adolescents communicating with peers, mothers and fathers were 35%, 30% and 17%, respectively, Males were more likely to talk about sexual issues with peer, while females were more likely to talk with mothers. Significant difference was also noted between the ratio of communication on sexual matters and having a girl/boyfriend with peers and with parents, There was a statistically significant relationship between sexual experience and communication with fathers among male adolescents＇, Despite the fact that parents are the most closest care providers, adolescents obtained most of the sex information from ＂reading materials＂ and from ＂teachers＂, but not from their parents. There was an age difference in the main source of obtaining sexual information. Younger adolescents obtained sexual information mainly from teachers while older adolescents mainly from reading materials. Conclusion In addition to schools and reading materials, parents should serve as an important source of information on sexual education as well.展开更多
Background: There is an increasing emphasis on conducting research to identify gender based violence issues to enable development of appropriate programs and interventions. However, these efforts are mixed in quality ...Background: There is an increasing emphasis on conducting research to identify gender based violence issues to enable development of appropriate programs and interventions. However, these efforts are mixed in quality and often raise ethical questions. The increased pressure on policy makers to move to a more evidence-based approach in addressing gender based issues creates the need for this research prioritization activity. Inadequate evaluative evidence in this area poses a challenge in the planning for responsive interventions especially in resource limited settings. The purpose of this paper is to present gender based violence research priority areas for the WHO Africa Region. Methods: We utilized a modified version of the Child Health and Nutrition Research Initiative approach to reach consensus on research priorities on the thematic area of gender based violence. In three phases, we first conducted an online survey with sexual and reproductive health and rights experts in academia, ministries of health, non-governmental organizations and other health actors with a wide range of experiences. These questions were consolidated by three experts from World Health Organization headquarters into themes. Secondly, experts were invited in a meeting in Cape Town South Africa to analyze and generate relevant areas of research based on the themes. Finally, a smaller group of experts prioritized research areas based on agreed criteria. Results: A list of 10 priority research questions for addressing gender based violence were scored and ranked. Four priority research questions scored 30 points out of the possible 30 points and were thus ranked as the highest priority. These included questions that “engage young adolescents in behavioral interventions to influence gender roles”, “determinants of gender based violence analysis”, “both long and short term complications of gender based violence on survivors” and “assessment of men’s involvement in addressing gender-based violence against women”. The second most highly ranked question was on the assessment of the extent and strategies to prevent gender-based violence in the context of humanitarian crises. Conclusions: Priority research questions for addressing gender based violence were identified. This exercise provides a three year investment case for research with high potential of effectively identifying interventions with high impact on addressing gender based violence.展开更多
Background: Unsafe abortion is a commonly neglected sexual and reproductive health and rights issue despite the serious health problems it causes to women and girls in their reproductive ages. It is classified as a ma...Background: Unsafe abortion is a commonly neglected sexual and reproductive health and rights issue despite the serious health problems it causes to women and girls in their reproductive ages. It is classified as a main cause of maternal mortality and morbidity. This paper has considered questions that have the greatest potential to successfully reduce unsafe abortions in the resource poor settings. Methods: We adapted the Child Health and Nutrition Research Initiative (CHNRI) to identify and prioritize many competing sexual and reproductive health and rights research ideas that impact the health of the populations. The implementation was done in three phases which included generation and collection of research ideas from various experts virtually in August 2019 consolidation of the potential questions through thematic analysis conducted in September 2019. Finally, scoring and ranking of the research questions was done in a workshop of experts. Results: Out of a list of 45 priority research questions, two questions were ranked the highest scoring 28 out of the possible 30. The research priorities include: “The effectiveness of interventions (e.g. counseling or incentives or home visits) to increase post abortion uptake and continuance”, “Reducing repeat abortion on improving maternal health outcomes” and “Evaluation of community-based awareness programs to reduce unwanted pregnancies and encourage women to seek help early”. Conclusions: Ten key research priorities in preventing unsafe abortion were identified. The priority list covers areas of focus that could effectively impact preventing unsafe abortions while also acting as a knowledge base for researchers, policy makers and other interested stakeholders who would want to invest in this area.展开更多
Background: Cervical cancer has been ranked among the leading causes of deaths among women in Africa. Despite this, priority setting mechanisms used in planning for programmes and interventions that respond to sexual ...Background: Cervical cancer has been ranked among the leading causes of deaths among women in Africa. Despite this, priority setting mechanisms used in planning for programmes and interventions that respond to sexual and reproductive health and rights services particularly in cervical cancer prevalence, prevention and treatment have not adequately taken into account research based evidence to respond appropriately. Methods: We adapted the Child Health and Nutrition Research Initiative method. A wide range of stakeholders identified potential research areas in an online survey. A technical working group comprising of 67 participants reviewed the questions for modification and removal of out scope questions. Finally, scoring and ranking was done to provide the top ten priorities questions. Results: “Cost-benefit analysis of systematic human papillomavirus vaccination compared to the current cost of cervical cancer in public health care systems” scored 27. This was followed by two research questions ranked at 24 points: “assessment of women’s and girls’ knowledge on the importance of early cervical cancer screening,” and “human papilloma virus vaccination and contributions of new technologies to the supply and storage of vaccines, including human papillomavirus vaccine”. Conclusion: The study identified 10 priority research questions that can guide the agenda for cervical cancer prevalence, prevention and treatment in the WHO Africa region. The identified priorities will be of use to policy makers, researchers and programmers and other stakeholders who can invest in areas that greatly affect cervical cancer prevalence, prevention and treatment.展开更多
Objective To assess the effectiveness, side effects, and acceptability of copper uterine cavity - shaped intrauterine devices （UCD） with and without indomethacin. Methods We used electronic search and hand search to...Objective To assess the effectiveness, side effects, and acceptability of copper uterine cavity - shaped intrauterine devices （UCD） with and without indomethacin. Methods We used electronic search and hand search to identify relevant literatures. Included papers were systematically reviewed according to previous established guidelines. Results A total of 39 related papers were identified. Of them, 9papers were included in this review： 4 associated with medicated or non-medicated UCD200 （containing copper 200 mm^2） and 5 associated with medicated or non-medicated UCD300 （containing copper 300 mm^2）. The contraceptive effectiveness, cumulative one-year and two-year continuation rates＇ were similar between medicated UCD200, non-medicated UCD200 and TCu220C. The effectiveness of non-medicated UCD300 was similar to that of TCu220C and TCu200. The effectiveness of medicated UCD300 was similar to that of MLCu375 and TCu220C but lower than that of TCu38OA. The cumulative one-year, three-year and five-year continuation rates were similar between medicated, non-medicated UCD300 and TCu380A or MLCu375. The problem of bleeding was less common among medicated UCD users than among non-medicated devices. Conclusions Uterine cavity-shaped devices should continue to be used in the National Family Planning Proramme. However, priority should be given to the 300 mm^2 copper containing device. A large multicenter randomized comparative trial of UCD300 and TCu380A is needed.展开更多
Objective: The purpose of this trial was to determine whether calcium supplementation of pregnant women with low calcium intake reduces preeclampsia and preterm delivery. Study design: Randomized placebo- controlled, ...Objective: The purpose of this trial was to determine whether calcium supplementation of pregnant women with low calcium intake reduces preeclampsia and preterm delivery. Study design: Randomized placebo- controlled, double- blinded trial in nulliparous normotensive women from populations with dietary calcium < 600 mg/d. Women who were recruited before gestational week 20 received supplements (1.5 g calcium/d or placebo) through-out pregnancy. Primary outcomes were preeclampsia and preterm delivery; secondary outcomes focused on severe morbidity and maternal and neonatal mortality rates. Results: The groups comprised 8325 women who were assigned randomly. Both groups had similar gestational ages, demographic characteristics, and blood pressure levels at entry. Compliance were both 85% and follow- up losses (calcium, 3.4% ; placebo, 3.7% ). Calcium supplementation was associated with a non- statistically significant small reduction in preeclampsia (4.1% vs 4.5% ) that was evident by 35 weeks of gestation (1.2% vs 2.8% ; P = .04). Eclampsia (risk ratio, 0.68: 95% CI, 0.48- 0.97) and severe gestational hypertension (risk ratio, 0.71; 95% CI, 0.61- 0.82) were significantly lower in the calcium group. Overall, there was a reduction in the severe preeclamptic complications index (risk ratio, 0.76; 95% CI, 0.66- 0.89; life- table analysis, log rank test; P = .04). The severe maternal morbidity and mortality index was also reduced in the supplementation group (risk ratio, 0.80; 95% CI, 0.70- 0.91). Preterm delivery (the neonatal primary outcome) and early preterm delivery tended to be reduced among women who were ≤ 20 years of age (risk ratio, 0.82; 95% CI, 0.67- 1.01; risk ratio, 0.64; 95% CI, 0.42- 0.98, respectively). The neonatal mortality rate was lower (risk ratio, 0.70; 95% CI, 0.56- 0.88) in the calcium group. Conclusion: A 1.5 g calcium/day supplement did not prevent preeclampsia but did reduce its severity, maternal morbidity, and neonatal mortality, albeit these were secondary outcomes.展开更多
Background: Adipose-derived stem cells (ASCs) are considered ideal candidates for both research and cellular therapydue to ease of access, large yield, feasibility, and efficacy in preclinical and clinical studies. Un...Background: Adipose-derived stem cells (ASCs) are considered ideal candidates for both research and cellular therapydue to ease of access, large yield, feasibility, and efficacy in preclinical and clinical studies. Unlike the subcutaneousabdominal fat depot, breast ASCs features are still not well recognized, limiting their possible therapeutic use. ASCswere found to exert immunomodulatory and antioxidative activities for maintaining homeostasis and functionality ofdiseased/damaged tissues. This study aims to investigate the immunomodulatory and antioxidative potentials of breastversus abdominal isolated ASCs to find out which anatomical site provides ASCs with better immunoregulatory andoxidative stress resistance capabilities.Methods: ASCs were isolated from abdominal and breast tissues. Gene expression analysis was conducted for a panelof immunomodulatory and antioxidative genes, as well as adipokines and proliferation genes. Flow cytometric analysisof a group of immunomodulatory surface proteins was also performed. Finally, the significantly expressed genes haveundergone protein-protein interaction and functional enrichment in silico analyses.Results: Our results revealed similar morphological and phenotypic characteristics for both breast and abdominalASCs. However, a significant elevation in the expression of two potent immunosuppressive genes, IL-10 and IDO aswell as the expression of the multifaceted immunomodulatory adipokine, visfatin, was detected in breast versusabdominal ASCs. Moreover, a significant overexpression of the antioxidative genes, GPX1, SIRT5, and STAT3 and theproliferation marker, Ki67, was also observed in breast ASCs relative to abdominal ones. In silico analysis showed thatboth of the differentially upregulated immunomodulatory and antioxidative mediators integratively involved inmultiple biological processes and pathways indicating their functional association.Conclusion: Breast ASCs possess superior immunomodulatory and antioxidative capabilities over abdominal ASCs. Ourfindings shed light on the possible therapeutic applications of breast ASCs in immune-related and oxidative stressassociateddiseases.展开更多
Introduction:Mongolia's health ministry prioritizes control of Sexually Transmitted Infections,including syphilis screening and treatment in antenatal care(ANC).Methods:Adult syphilis prevalence trends were fitted...Introduction:Mongolia's health ministry prioritizes control of Sexually Transmitted Infections,including syphilis screening and treatment in antenatal care(ANC).Methods:Adult syphilis prevalence trends were fitted using the Spectrum-STI estimation tool,using data from ANC surveys and routine screening over 1997e2016.Estimates were combined with programmatic data to estimate numbers of treated and untreated pregnant women with syphilis and associated incidence congenital syphilis(CS)and CS-attributable adverse birth outcomes(ABO),which we compared with CS case reports.Results:Syphilis prevalence in pregnant women was estimated at 1.7%in 2000 and 3.0%in 2016.We estimated 652 CS cases,of which 410 ABO,in 2016.Far larger,annually increasing numbers of CS cases and ABO were estimated to have been prevented:1654 cases,of which 789 ABO in 2016thanks to increasing coverages of ANC(99%in 2016),ANC-based screening(97%in 2016)and treatment of women diagnosed(81%in 2016).The 42 CS cases reported nationally over 2016(liveborn infants only)represented 27%of liveborn infants with clinical CS,but only 7%of estimated CS cases among women found syphilis-infected in ANC,and 6%of all estimated CS cases including those born to women with undiagnosed syphilis.Discussion/Conclusion:Mongolia's ANC-based syphilis screening program is reducing CS,but maternal prevalence remains high.To eliminate CS(target:<50 cases per 100,000 live births),Mongolia should strengthen ANC services,limiting losses during referral for treatment,and under-diagnosis of CS including still-births and neonatal deaths,and expand syphilis screening and prevention programs.展开更多
文摘Background: Despite increased recognition of the need for sexual and reproductive health and rights in humanitarian settings, evidence focusing on mainstreaming reproductive health services such as maternal, neonatal mortality, human immunodeficiency virus transmission and unsafe abortion still remains inadequate. The ability to understand the magnitude of the needs and highlight existing gaps is supported by improved data which is critical to informing effective policies, programming and funding decisions. The purpose of this report is to present the results of a research prioritization exercise on sexual and reproductive health and rights services in humanitarian settings for the WHO Africa region for the next three years. Methods: We adapted the Child Health and Nutrition Research Initiative method in three phases. Experts from the region participated in an online survey to identify key areas for research in sexual and reproductive health and rights. To identify potential areas for research, the experts ensured answerability, effectiveness, deliverability, equity and potential impact of the questions. The research areas they identified were reviewed by World Health Organization technical team from headquarters. In a meeting of 67 participants, the questions were subjected to further review and analysis. Using a modified for scoring criteria, the questions were scored and ranked to provide the top ten priority questions to address sexual and reproductive health and rights services in humanitarian settings. Results: A list of 21 priority research questions on sexual and reproductive health and rights services in humanitarian settings were scored and ranked. Top ten priorities research questions were identified. Those that scored highly by scoring 30 points out of the possible maximum of 30 include: “determining the prevalence and associated factors of unwanted pregnancies and abortions performed in emergency and humanitarian settings”, “evidence on gender-based violence in humanitarian situations and its associated factors” and “defining an optimal model for coordinating sexual and reproductive health and rights interventions and responses in crisis situations”. Conclusions: Top ten research priorities in sexual and reproductive health and rights services in humanitarian settings were identified. The priority research areas have the potential to identify the best areas for programming of services in humanitarian settings. It is our hope that the identified research areas will be prioritized to support programming of services in humanitarian settings based on scientific evidence.
文摘Background: The use of mobile phones continues to rise rapidly in the provision of health related services. Many countries have adopted the use of mobiles to provide sexual and reproductive health and rights and especially among the adolescents where specific messages are tailored for various audiences with specific messages. The purpose of this paper is to present the results of a research priority setting exercise on mHealth and innovative strategies. Methods: We adapted Child Health and Nutrition Research Initiative methodology to identify and set research priorities on mHealth and innovative strategies that respond to sexual and reproductive health and rights services. General potential research questions were gathered online from multiple stakeholders in the region and sent for consolidation consolidated to technical experts in World Health Organization headquarters. The second phase involved a meeting with experts to review and thematically analyze the questions list of 33 questions producing a list of 22 research questions. The questions were scored against a six point criteria and ranked accordingly. Ten top priority research questions were identified. Results: Lists of 33 priority research questions for mHealth and innovative strategies were proposed for discussions by 67 stakeholders. The questions were reviewed, scored and ranked in a technical meeting by experts. The highest ranking questions at 87% include evaluation of mHealth for data management and sexual and reproductive health and rights decision making, assessment of innovative local financing techniques to support community based sexual reproductive health and rights and evaluation of the role of mobile technologies in referral and counter referral. Conclusions: Information and communication technology is developing drastically and has a great potential in improving health especially in sexual and reproductive health and rights service delivery. This potential must be demonstrated with more relevant and quality research on mHealth and innovative strategies priorities identified.
文摘Background: Many policy makers deliberating on comprehensive sexual and reproductive health and rights services need reliable evidence to make choices that benefit women, adolescents, children and the wider society. While universal health coverage discourse provides an opportunity to expand access through evidence based interventions, many gaps exist. Research prioritization has proved to be very helpful in identifying relevant areas especially in constrained resource settings. The purpose of this paper is to present the results of the World Health Organization Africa Region research prioritization for sexual and reproductive health and rights. These priorities hope to guide the region for the next three years. Methods: We used the Child Health and Nutrition Research Initiative approach to identify priority questions among many potential areas for research prioritization on sexual and reproductive health and rights. The implementation process was organized in three phases. The first phase involved sending out an online survey to various experts with experience in sexual and reproductive health rights. These questions were received by a technical team from World Health Organization headquarters for review. 634 questions were identified for potential research and grouped into 12 themes. The second phase involved experts who reviewed the questions. The team merged questions with duplications, removed the questions that were out of scope and finally refined the wordings. In the final phase, experts worked in groups to score and rank top ten priority questions for each of the 12 thematic areas. Results: A list of 120 priority questions for sexual and reproductive health and rights were prioritized by 67 participants drawn from 16 organizations. Most of the priority research questions (45%) focused on the theme of gender-based violence, 35% prioritized services in sexual and reproductive health and rights in humanitarian settings while 15% prioritized preventing unsafe abortion. 5% of the participants prioritized cervical cancer prevalence, prevention and treatment as a thematic area out of the questions in the top 20 research priority questions. Conclusions: Key priority research questions in sexual and reproductive health and rights were identified around five themes. The priority list will be of significance to World Health Organization regional Office for Africa and her stakeholders for the next three years.
文摘This paper is to reflect on 25 wonderful years of my collaboration with the Chinese scientists and policy makers on social science and operations research in sexual reproductive health. Past and ongoing collaboration is reviewed, followed by a discussion on the record of achievements and ideas for future directions and research priorities. The paper represents my views based on an exceptionally rich personal and professional experience working with numerous Chinese scientists on a range of research topics.
文摘Objective To analyze the status of parent-child communication on sexual matters and its relationship to the sexual behaviors of adolescents. Methods The data were obtained from a study which was conducted in Changchun city of China in 2001, Unmarried adolescents aged 15-19 years old（322 males and 360females） were selected for this analysis. Results Ten percent of adolescents reported having experience of sexual intercourse （16% of male and 5% of female）. The percentages of adolescents communicating with peers, mothers and fathers were 35%, 30% and 17%, respectively, Males were more likely to talk about sexual issues with peer, while females were more likely to talk with mothers. Significant difference was also noted between the ratio of communication on sexual matters and having a girl/boyfriend with peers and with parents, There was a statistically significant relationship between sexual experience and communication with fathers among male adolescents＇, Despite the fact that parents are the most closest care providers, adolescents obtained most of the sex information from ＂reading materials＂ and from ＂teachers＂, but not from their parents. There was an age difference in the main source of obtaining sexual information. Younger adolescents obtained sexual information mainly from teachers while older adolescents mainly from reading materials. Conclusion In addition to schools and reading materials, parents should serve as an important source of information on sexual education as well.
文摘Background: There is an increasing emphasis on conducting research to identify gender based violence issues to enable development of appropriate programs and interventions. However, these efforts are mixed in quality and often raise ethical questions. The increased pressure on policy makers to move to a more evidence-based approach in addressing gender based issues creates the need for this research prioritization activity. Inadequate evaluative evidence in this area poses a challenge in the planning for responsive interventions especially in resource limited settings. The purpose of this paper is to present gender based violence research priority areas for the WHO Africa Region. Methods: We utilized a modified version of the Child Health and Nutrition Research Initiative approach to reach consensus on research priorities on the thematic area of gender based violence. In three phases, we first conducted an online survey with sexual and reproductive health and rights experts in academia, ministries of health, non-governmental organizations and other health actors with a wide range of experiences. These questions were consolidated by three experts from World Health Organization headquarters into themes. Secondly, experts were invited in a meeting in Cape Town South Africa to analyze and generate relevant areas of research based on the themes. Finally, a smaller group of experts prioritized research areas based on agreed criteria. Results: A list of 10 priority research questions for addressing gender based violence were scored and ranked. Four priority research questions scored 30 points out of the possible 30 points and were thus ranked as the highest priority. These included questions that “engage young adolescents in behavioral interventions to influence gender roles”, “determinants of gender based violence analysis”, “both long and short term complications of gender based violence on survivors” and “assessment of men’s involvement in addressing gender-based violence against women”. The second most highly ranked question was on the assessment of the extent and strategies to prevent gender-based violence in the context of humanitarian crises. Conclusions: Priority research questions for addressing gender based violence were identified. This exercise provides a three year investment case for research with high potential of effectively identifying interventions with high impact on addressing gender based violence.
文摘Background: Unsafe abortion is a commonly neglected sexual and reproductive health and rights issue despite the serious health problems it causes to women and girls in their reproductive ages. It is classified as a main cause of maternal mortality and morbidity. This paper has considered questions that have the greatest potential to successfully reduce unsafe abortions in the resource poor settings. Methods: We adapted the Child Health and Nutrition Research Initiative (CHNRI) to identify and prioritize many competing sexual and reproductive health and rights research ideas that impact the health of the populations. The implementation was done in three phases which included generation and collection of research ideas from various experts virtually in August 2019 consolidation of the potential questions through thematic analysis conducted in September 2019. Finally, scoring and ranking of the research questions was done in a workshop of experts. Results: Out of a list of 45 priority research questions, two questions were ranked the highest scoring 28 out of the possible 30. The research priorities include: “The effectiveness of interventions (e.g. counseling or incentives or home visits) to increase post abortion uptake and continuance”, “Reducing repeat abortion on improving maternal health outcomes” and “Evaluation of community-based awareness programs to reduce unwanted pregnancies and encourage women to seek help early”. Conclusions: Ten key research priorities in preventing unsafe abortion were identified. The priority list covers areas of focus that could effectively impact preventing unsafe abortions while also acting as a knowledge base for researchers, policy makers and other interested stakeholders who would want to invest in this area.
文摘Background: Cervical cancer has been ranked among the leading causes of deaths among women in Africa. Despite this, priority setting mechanisms used in planning for programmes and interventions that respond to sexual and reproductive health and rights services particularly in cervical cancer prevalence, prevention and treatment have not adequately taken into account research based evidence to respond appropriately. Methods: We adapted the Child Health and Nutrition Research Initiative method. A wide range of stakeholders identified potential research areas in an online survey. A technical working group comprising of 67 participants reviewed the questions for modification and removal of out scope questions. Finally, scoring and ranking was done to provide the top ten priorities questions. Results: “Cost-benefit analysis of systematic human papillomavirus vaccination compared to the current cost of cervical cancer in public health care systems” scored 27. This was followed by two research questions ranked at 24 points: “assessment of women’s and girls’ knowledge on the importance of early cervical cancer screening,” and “human papilloma virus vaccination and contributions of new technologies to the supply and storage of vaccines, including human papillomavirus vaccine”. Conclusion: The study identified 10 priority research questions that can guide the agenda for cervical cancer prevalence, prevention and treatment in the WHO Africa region. The identified priorities will be of use to policy makers, researchers and programmers and other stakeholders who can invest in areas that greatly affect cervical cancer prevalence, prevention and treatment.
文摘Objective To assess the effectiveness, side effects, and acceptability of copper uterine cavity - shaped intrauterine devices （UCD） with and without indomethacin. Methods We used electronic search and hand search to identify relevant literatures. Included papers were systematically reviewed according to previous established guidelines. Results A total of 39 related papers were identified. Of them, 9papers were included in this review： 4 associated with medicated or non-medicated UCD200 （containing copper 200 mm^2） and 5 associated with medicated or non-medicated UCD300 （containing copper 300 mm^2）. The contraceptive effectiveness, cumulative one-year and two-year continuation rates＇ were similar between medicated UCD200, non-medicated UCD200 and TCu220C. The effectiveness of non-medicated UCD300 was similar to that of TCu220C and TCu200. The effectiveness of medicated UCD300 was similar to that of MLCu375 and TCu220C but lower than that of TCu38OA. The cumulative one-year, three-year and five-year continuation rates were similar between medicated, non-medicated UCD300 and TCu380A or MLCu375. The problem of bleeding was less common among medicated UCD users than among non-medicated devices. Conclusions Uterine cavity-shaped devices should continue to be used in the National Family Planning Proramme. However, priority should be given to the 300 mm^2 copper containing device. A large multicenter randomized comparative trial of UCD300 and TCu380A is needed.
文摘Objective: The purpose of this trial was to determine whether calcium supplementation of pregnant women with low calcium intake reduces preeclampsia and preterm delivery. Study design: Randomized placebo- controlled, double- blinded trial in nulliparous normotensive women from populations with dietary calcium < 600 mg/d. Women who were recruited before gestational week 20 received supplements (1.5 g calcium/d or placebo) through-out pregnancy. Primary outcomes were preeclampsia and preterm delivery; secondary outcomes focused on severe morbidity and maternal and neonatal mortality rates. Results: The groups comprised 8325 women who were assigned randomly. Both groups had similar gestational ages, demographic characteristics, and blood pressure levels at entry. Compliance were both 85% and follow- up losses (calcium, 3.4% ; placebo, 3.7% ). Calcium supplementation was associated with a non- statistically significant small reduction in preeclampsia (4.1% vs 4.5% ) that was evident by 35 weeks of gestation (1.2% vs 2.8% ; P = .04). Eclampsia (risk ratio, 0.68: 95% CI, 0.48- 0.97) and severe gestational hypertension (risk ratio, 0.71; 95% CI, 0.61- 0.82) were significantly lower in the calcium group. Overall, there was a reduction in the severe preeclamptic complications index (risk ratio, 0.76; 95% CI, 0.66- 0.89; life- table analysis, log rank test; P = .04). The severe maternal morbidity and mortality index was also reduced in the supplementation group (risk ratio, 0.80; 95% CI, 0.70- 0.91). Preterm delivery (the neonatal primary outcome) and early preterm delivery tended to be reduced among women who were ≤ 20 years of age (risk ratio, 0.82; 95% CI, 0.67- 1.01; risk ratio, 0.64; 95% CI, 0.42- 0.98, respectively). The neonatal mortality rate was lower (risk ratio, 0.70; 95% CI, 0.56- 0.88) in the calcium group. Conclusion: A 1.5 g calcium/day supplement did not prevent preeclampsia but did reduce its severity, maternal morbidity, and neonatal mortality, albeit these were secondary outcomes.
基金This work was funded by the National Research Centre,Cairo,Egypt(grant no.11010122)the Academy of Scientific Research and Technology in Egypt“Jesor initiative”(grant no.1057).
文摘Background: Adipose-derived stem cells (ASCs) are considered ideal candidates for both research and cellular therapydue to ease of access, large yield, feasibility, and efficacy in preclinical and clinical studies. Unlike the subcutaneousabdominal fat depot, breast ASCs features are still not well recognized, limiting their possible therapeutic use. ASCswere found to exert immunomodulatory and antioxidative activities for maintaining homeostasis and functionality ofdiseased/damaged tissues. This study aims to investigate the immunomodulatory and antioxidative potentials of breastversus abdominal isolated ASCs to find out which anatomical site provides ASCs with better immunoregulatory andoxidative stress resistance capabilities.Methods: ASCs were isolated from abdominal and breast tissues. Gene expression analysis was conducted for a panelof immunomodulatory and antioxidative genes, as well as adipokines and proliferation genes. Flow cytometric analysisof a group of immunomodulatory surface proteins was also performed. Finally, the significantly expressed genes haveundergone protein-protein interaction and functional enrichment in silico analyses.Results: Our results revealed similar morphological and phenotypic characteristics for both breast and abdominalASCs. However, a significant elevation in the expression of two potent immunosuppressive genes, IL-10 and IDO aswell as the expression of the multifaceted immunomodulatory adipokine, visfatin, was detected in breast versusabdominal ASCs. Moreover, a significant overexpression of the antioxidative genes, GPX1, SIRT5, and STAT3 and theproliferation marker, Ki67, was also observed in breast ASCs relative to abdominal ones. In silico analysis showed thatboth of the differentially upregulated immunomodulatory and antioxidative mediators integratively involved inmultiple biological processes and pathways indicating their functional association.Conclusion: Breast ASCs possess superior immunomodulatory and antioxidative capabilities over abdominal ASCs. Ourfindings shed light on the possible therapeutic applications of breast ASCs in immune-related and oxidative stressassociateddiseases.
基金funded by the World Health Organization,Department of Reproductive Health and Research
文摘Introduction:Mongolia's health ministry prioritizes control of Sexually Transmitted Infections,including syphilis screening and treatment in antenatal care(ANC).Methods:Adult syphilis prevalence trends were fitted using the Spectrum-STI estimation tool,using data from ANC surveys and routine screening over 1997e2016.Estimates were combined with programmatic data to estimate numbers of treated and untreated pregnant women with syphilis and associated incidence congenital syphilis(CS)and CS-attributable adverse birth outcomes(ABO),which we compared with CS case reports.Results:Syphilis prevalence in pregnant women was estimated at 1.7%in 2000 and 3.0%in 2016.We estimated 652 CS cases,of which 410 ABO,in 2016.Far larger,annually increasing numbers of CS cases and ABO were estimated to have been prevented:1654 cases,of which 789 ABO in 2016thanks to increasing coverages of ANC(99%in 2016),ANC-based screening(97%in 2016)and treatment of women diagnosed(81%in 2016).The 42 CS cases reported nationally over 2016(liveborn infants only)represented 27%of liveborn infants with clinical CS,but only 7%of estimated CS cases among women found syphilis-infected in ANC,and 6%of all estimated CS cases including those born to women with undiagnosed syphilis.Discussion/Conclusion:Mongolia's ANC-based syphilis screening program is reducing CS,but maternal prevalence remains high.To eliminate CS(target:<50 cases per 100,000 live births),Mongolia should strengthen ANC services,limiting losses during referral for treatment,and under-diagnosis of CS including still-births and neonatal deaths,and expand syphilis screening and prevention programs.
