Computer-assisted Self-interview Research Articles

Estimation of Utility Weights for Prostate-related Health States in Korea.

ObjectivesVery limited previous research has investigated the utility weights of prostate-related diseases in the general population in Korea. The purpose of this study was to calculate the utility of prostate-related health states in the Korean general public using the standard gamble (SG) method.MethodsSeven health states for hypothetical prostate cancers, 1 for benign prostate hyperplasia, and 1 for erectile dysfunction were developed based on patient education material and previous publications. In total, 460 responses from the Korean general population were used to analyze the utility of prostate-related health states. Computer-assisted personal interviews were conducted, and utility values were measured using a visual analogue scale (VAS) and SG. Mean utility values were calculated for each prostate-related health state.ResultsThe mean utility values of prostate cancer derived from SG ranged from 0.281 (metastatic castration-refractory prostate cancer) to 0.779 (localized prostate cancer requiring prostatectomy). The utility value of benign prostate hyperplasia was 0.871, and that of erectile dysfunction was 0.812. The utility values obtained using the SG method in all conditions were higher than the values obtained by VAS. There were no significant demographic variables affecting utility values in multivariate analysis.ConclusionsOur findings might be useful for economic evaluation and utility calculation of screening and interventions for prostate-related conditions in the general population.

Impact of risk-based sexually transmitted infection screening inthe emergency department.

Sexually transmitted infections (STIs), including chlamydia, gonorrhea, and human immunodeficiency virus (HIV) pose a significant health burden in adolescents. Many adolescents receiving care in the emergency department (ED) are in need of testing, regardless of their chief complaint. Our objective was to determine whether an electronic, risk-based STI screening program in our ED was associated with an increase in STI testing among at-risk adolescents. We conducted a retrospective cohort analysis of patient outcomes in our pediatric ED after integrating an Audio-enhanced Computer-Assisted Self-Interview (ACASI) as standard of care. It obtained a focused sexual history and generated STI testing recommendations. Patient answers and testing recommendations were integrated in real-time into the electronic health record. Patients who tested positive received treatment according to our standard-of-care practices. All patients 15-21 years of age were asked to complete this on an opt-out basis, regardless of the reason for their ED visit. Exclusions included those unable to independently use a tablet, severe illness, sexual assault, or non-English speaking. Our primary outcome was to describe STI-testing recommendations and test results among ACASI participants. We also compared STI testing between ACASI participants and those who were eligible but did not use it. In the first 13 months, 28.9% (1788/6194) of eligible adolescents completed the ACASI and 44.2% (321/790) accepted recommended STI testing. The mean age of participants was 16.6±1.3 years, with 65.4% (1169) being female. Gonorrhea/chlamydia testing was significantly higher among participants vs. non-participants (20.1% [359/1788] vs 4.8% [212/4406]; p<0.0001). The proportion of positive STI tests was similar between the two groups: 24.8% (89/359) vs. 24.5% (52/212; p=0.94) were positive for chlamydia and/or gonorrhea, while 0.6% (2/354) participants vs. 0% non-participants (p>0.99) were positive for HIV. Among participants whose chief complaints were unlikely to be related to STIs but accepted recommended testing, 20.9% (37/177) were positive for gonorrhea or chlamydia. Our program facilitated STI testing in the ED and identified many adolescents with STIs, even when their ED complaint was for unrelated reasons. More rigorous implementation is needed to determine the impact of deployment of ACASI to all eligible adolescents and addressing barriers to accepting STI testing recommendations.

Association Between Hypertension Management Education and Multiple Healthy Behaviors: A Cross-Sectional Study.

This study aimed to evaluate the association between hypertension management education and the adoption of multiple healthy behaviors. Cross-sectional study. Data from the 2019 Community Health Survey in Korea. Of the 213,900 participants in the 2019 database, 89,773 (42.0%) were hypertensive and 124,127 (58.0%) were normotensive. Secondary data analysis included a 1:1 computer-assisted personal interview. "Multiple healthy behaviors" included not smoking, not drinking excessively, and walking briskly. "Hypertension management education" referred to information on hypertension management that participants received from clinics, hospitals, and public health centers, outside consultation with a doctor. The association between hypertension management education and the adoption of multiple healthy behaviors was evaluated using multiple logistic regression. In total, 89,773 (42.0%) participants were hypertensive. Among 61,589 patients with diagnosed hypertension, only 7,719 (12.5%) received hypertension management education. Participants who received such education were more likely to adopt multiple healthy behaviors (odds ratio [OR] = 1.27, 95% confidence interval [CI]: 1.21-1.34) than their counterparts (OR = 0.91, 95% CI: 0.89-0.93). Participants with undiagnosed hypertension were least likely to adopt multiple healthy behaviors (OR = 0.89, 95% CI: 0.86-0.92). No causal relationships were ascertained because of the cross-sectional study design. Education can improve the adoption of multiple healthy lifestyles among hypertensive patients. Patients should be encouraged to participate in hypertension management education.

The use of composite time trade-off and discrete choice experiment methods for the valuation of the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS): a think-aloud study

PurposeTo identify patterns and problems in completing composite time trade-off (C-TTO) and discrete choice experiment (DCE) exercises for the valuation of the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) to inform the optimisation of a valuation protocol.MethodsFourteen cognitive interviews were conducted in the UK using concurrent and retrospective think-aloud and probing techniques. Each participant completed 8 C-TTO tasks and 8 DCE tasks within a computer-assisted personal interview setting. Verbal information was transcribed verbatim. Axial coding and thematic analysis were used to organise the qualitative data and identify patterns and problems with the completion of tasks.ResultsWhile participants found the tasks generally manageable, five broad themes emerged to explain and optimise the response to the tasks. (1) Format and structure: attention to the design of practice examples, instructions, and layout were needed. (2) Items and levels: underlying relationships were discovered across different combinations of levels of SWEMWBS items. (3) Decision heuristics: participants engaged in diverse strategies to assist trade-off decisions. (4) Valuation feasibility: certain states were difficult to imagine, compare and quantify. (5) Valuation outcome: the data quality was affected by participants’ discriminatory ability across states and their time trade-off decisions.ConclusionThe interviews contributed insights regarding the robustness of the proposed methods. The application of C-TTO and DCE valuation techniques was practical and suitable for capturing individual attitudes towards different mental well-being scenarios. A modified protocol informed by the results is being tested in a larger sample across the UK.

Assessment of Knowledge and Attitudes Toward Organ Donation Among School Teachers: First National Survey Study

The most important factors affecting organ donation are socioeconomic, educational, and cultural factors. The aim of this study was to evaluate the attitudes, knowledge levels, and behaviors of school teachers toward organ donation METHODS: This study surveyed 2400 school teachers working in official public schools. Turkey was divided into 26 regions based on the similarity of social, economic, and geographic factors identified by the Turkish Statistical Institute. Teachers were distributed equally in the city center and towns based on population. The survey procedures were carried out using computer-assisted personal interviewing. Among teachers, 89.6% had a bachelor's degree and 8.5% had a master's degree. In addition, 32.5% worked in primary schools, 33.1% worked in secondary schools, and 34.4% worked in high schools. Furthermore, 0.7% had donated an organ; 66.5% were not considering organ donation in the future, of whom 9.0% indicated religion as the reason for not donating an organ, and 34.8% did not indicate any reason. In addition, 96.6% considered organ donation to be proper behavior for humanity and 68% believed that organ donation is appropriate in religious terms. This study showed that school teachers have inadequate knowledge and attitudes toward organ donation. Encouraging children and adolescents to make a well-informed decision about organ donation and to register this choice will depend largely on preparing school teachers with adequate knowledge and motivation toward creating generations with a positive attitude toward organ donation.

Non-sampling errors in questionnaire surveys: findings from a National Fertility Survey

Non-sampling errors can generally be divided into three types: sampling frame errors, non-response errors and measurement errors. Missing target units in the sampling frame, improper handling of non-responses, and misreporting or underreporting of key variables in the questionnaire can all cause deviations in a survey’s results. The widespread application of Computer-Assisted Personal Interviewing (CAPI) systems and the inclusion of administrative records from government sources in surveys has strengthened the ability to control non-sampling errors. Taking a national fertility sampling survey as an example, this study summarizes the sources of various non-sampling errors and explains how to harness big data resources such as administrative records to control non-sampling errors throughout the survey. The study analyzes the impact of three types of non-sampling errors on the results of the fertility survey and examines the strategies used to address the problems caused by these non-sampling errors. The findings indicate that non-sampling errors were the main source of total error in the survey, and that the errors found came mainly from sampling frame errors; non-response errors and measurement errors were controlled and had little impact on the survey results.

Psychosocial risk factors of erectile dysfunction among heterosexual men living with HIV

ABSTRACT The risk of erectile dysfunction (ED) is significantly higher in men living with HIV (MLWH). Despite the adverse effects of ED on quality of life for MLWH, there is a lack of research on the psychosocial factors that may influence ED, especially among heterosexual MLWH. According to a recent systematic review, findings on the psychosocial risk factors of ED in past studies have been largely conflicting or inconclusive. To bridge this gap, we analyzed psychosocial and other correlates of ED among a sample of 317 primarily Black and Latino heterosexual adult MLWH in New York City. Data collection involved quantitative surveys administered using a combination of computer-assisted personal interview and audio computer-assisted self-interview techniques. After adjusting for age and general health, the relative risk of ED among heterosexual men living with HIV was associated with higher HIV-related stigma, anxiety, depression, and negative HIV-coping; greater social support was associated with a lower risk of ED. In addition, the data were consistent with the potential effects of childhood emotional, physical, and sexual abuse and structural discrimination on the risk of ED. Overall, our research findings help provide a better understanding of the psychosocial factors associated with ED among heterosexual MLWH.

Discrepant abortion reporting by interview methodology among men from the United States National Survey of Family Growth (2015-2017)

Objective: To examine discrepancies in men's abortion reporting when queried via face-to-face interview versus audio computer-assisted self-interviewing (ACASI) in the National Survey of Family Growth (NSFG). Study Design: The NSFG collects nationally representative data on family life, sexual behavior, and reproductive health in the United States. The questionnaire is administered to participants via face-to-face interview (FTF), with selected items also asked of the same participant via ACASI for direct comparison. As the 2015-2017 NSFG queried individuals’ abortion history via both methods, we examined discrepant reporting among respondents. We additionally explored sociodemographic and reproductive characteristics associated with discrepant abortion reporting in a multivariable logistic regression model. Results: Of 4540 male respondents ages 15-49, 45.3% reported a pregnancy. Via FTF, 12.3% reported an abortion, compared to 19.9% via ACASI (p < 0.01). With respect to discrepancies in the number of reported abortions, 8.5% of respondents reported more abortions via ACASI versus FTF. Multivariable logistic regression modeling noted independently greater odds of abortion reporting in ACASI among non-Hispanic Black men (aOR 2.31, 95% CI 1.19-4.45), men living below the Federal Poverty Level (less than 100% FPL: aOR 3.65, 95% CI 1.93-6.89; 100-400% FPL: aOR 2.04, 95% CI 1.20-3.45), and those desiring more children in the future (aOR 1.91, 95% CI 1.20-3.04). Conclusion: Men were more likely to disclose their abortions in ACASI compared to FTF interview. Disproportionate, discrepant abortion reporting among low-income, minority men who report desiring more children in the future warrants further research. Implications: Surveys utilizing ACASI as an adjunct to FTF interviews may more accurately capture men's abortion experience.

Development of an EQ-5D Value Set for India Using an Extended Design (DEVINE) Study: The Indian 5-Level Version EQ-5D Value Set

ObjectivesThis study aimed to develop the Indian 5-level version EQ-5D (EQ-5D-5L) value set, which is a key input in health technology assessment for resource allocation in healthcare. MethodsA cross-sectional survey using the EuroQol Group’s Valuation Technology was undertaken in a representative sample of 3548 adult respondents, selected from 5 different states of India using a multistage stratified random sampling technique. The participants were interviewed using a computer-assisted personal interviewing technique. This study adopted a novel extended EuroQol Group’s Valuation Technology design that included 18 blocks of 10 composite time trade-off (c-TTO) tasks, comprising 150 unique health states, and 36 blocks of 7 discrete choice experiment (DCE) tasks, comprising 252 DCE pairs. Different models were explored for their predictive performance. Hybrid modeling approach using both c-TTO and DCE data was used to estimate the value set. ResultsA total of 2409 interviews were included in the analysis. The hybrid heteroscedastic model with censoring at −1 combining c-TTO and DCE data yielded the most consistent results and was used for the generation of the value set. The predicted values for all 3125 health states ranged from −0.923 to 1. The preference values were most affected by the pain/discomfort dimension. ConclusionsThis is the largest EQ-5D-5L valuation study conducted so far in the world. The Indian EQ-5D-5L value set will promote the effective conduct of health technology assessment studies in India, thereby generating credible evidence for efficient resource use in healthcare.

Impact of Alcoholism and Other Factors on Violence against Women in the State of Bihar, India - Data from NFHS (National Family Health Survey -5-2019-21)

National Family Health Survey-5 data which was conducted at household level in all 38 districts of the state of Bihar from 9 July, 2019 to 2 February, 2020 revealed that there is failure of complete alcohol ban in Bihar. Violence against women under the influence of alcoholism is still going on under influence of liquor consumption. Alcohol is a risk factor for partner violence across a range of settings for all types of violence where alcohol plays as a key situational factor, escalating the probability of violence by plummeting inhibitions, clouding judgment and deteriorating ability to interpret cues. Psychiatric morbidities such as paranoid schizophrenia, bipolar disorder, delusional and antisocial personality disorder formulate the man more likely to commit sexual crimes. In the light of the above mentioned background this study based on data of NFHS-5 is aimed to analyses the status of liquor consumption relation with violence against women in the state of Bihar and Gender role attitudes, experience of physical and sexual violence, experience of violence during pregnancy, forms of spousal violence, injuries to women due to spousal violence and help seeking against violence by the women of the state of Bihar in India. The total sample size of NFHS-5 was 35,834 households, 42,483 women of age group 15-49 (including 6,350 women interviewed in PSUs in the state module), and 4,897 men of age group 15-54 for the state of Bihar. Household questionnaire regarding Gender role attitudes, Experience of physical and sexual violence, Experience of violence during pregnancy, Forms of spousal violence, Injuries to women due to spousal violence, Help seeking against violence in the household three years preceding the survey were asked from respondents and the information was gathered and utilized to construct information in 19 languages using CAPI (Computer Assisted Personal Interviewing). In residents of Bihar eligible women and men were women ages 15-49 and men ages 15-54 who lived in the household the night before the household interview (including both usual residents and visitors). See table-1- This table is based on the unweight sample. 84.4% of women whose husbands often get drunk have experienced emotional, physical, or sexual violence, compared to those who gets drunk sometimes (61.4%), drinks/never gets drunk (45.4%) and minimum 36.4% of those whose husbands do not drink -see table-8 and figure-4. The survey data analysis revealed that the drinking pattern plays a crucial role in the extent of violence against women in the state. The more the men consume liquor, the more is the domestic abuse. Nearly, 56.6% of women are afraid of their husband most of the time that have experienced spousal violence.

Innovations in the Implementation of Polio Surveillance Enhancement Plan in Oyo State, Nigeria: Key Benefits, Lessons Learned, Challenges and Opportunities

Background: Nigeria attained the milestone of being certified wild poliovirus free in the year 2020. However, a drop in the key performance indicators of polio surveillance system was across various Local Government Areas (LGAs) in Oyo State. This drop highlighted the need for an innovative way of enhancing polio surveillance in Oyo State. Methods: This study was conducted in four phases and each phase utilized a cross-sectional study design and purposive sampling technique to select eligible LGAs and participants. LGAs that met at least two of the set-out criteria (had not reported at least a case of Acute Flaccid Paralysis (AFP) 12 months preceding the survey, with decline in AFP case detection rate, had not met AFP key indicators, are densely populated, and has an international border) were selected. A concurrent mixed method of data collection was utilized, and quantitative data were collected with a semi-structured questionnaire administered using Computer Assisted Personal Interviews (CAPI) during community active case search, health facility retroactive case search (HFRACS). Qualitative data collection was done through Focus Group Discussion (FGD). Surveillance intensification activities were conducted over eight weeks period. Data were analyzed using Microsoft Excel Software; summarization was done using frequencies and percentages while presentation was done using charts and spot maps. Results: A total of 1277, 49, 259 and 632 settlements, households and health facilities respectively were visited across 24 (73%) LGAs in Oyo State. Of the 150 suspected AFP cases identified, 45 (30%) were rejected cases, 33 (22%) were missed cases and 72 (48%) were true AFP cases. Non-Polio AFP Rate (NP-AFP rate) increased from 2.7 to 6.9 (P < 0.0001) after the surveillance intensification, also, the Non-Polio Enterovirus (NPENT) isolation was increased by 40% (16% to 23%). At the end of the intensification activities, all LGAs in Oyo State had met the WHO recommended Non-Polio Acute Flaccid Paralysis (NP-AFP) rate of ≥3/100,000 population. Conclusions: Innovative strategies implemented in AFP surveillance across Oyo State have resulted in improvement in AFP surveillance performance indicators in the State. There is therefore the need for dynamic and innovative ways of conducting AFP surveillance to prevent poliomyelitis epidemics and to ensure maintenance of Nigeria polio free certification status.

What can be Impact of Civil Authorities’ Faulty Mortality Registration on COVID-19 Mortality Count in the State of Bihar, India- Evidence from NFHS (National Family Health Survey -5)

Several local / global / national / international agencies have been estimating the impact of COVID-19 pandemic on mortality count in different regions. On 30 January 2020 the World Health Organization (WHO) declared COVID-19 a Public Health Emergency of International Concern (PHEIC). Death toll was only 171 on 30-01-2020 and by 31 -12- 2020, this figure increased to 1 813 188. The estimates of global deaths attributable to the COVID-19 pandemic in 2020 as published by WHO is at least 3 million, which is 1.2 million more than officially reported. Objective of this research study is to find out number of deaths in the household in the three years preceding the survey registered with the civil authorities’ with another objective of this research study is to estimate the excess mortality due to COVID-19 in a simple way to be understood by most of the readers. The total sample size was 35,834 households, 42,483 women of age 15-49 (including 6,350 women interviewed in PSUs in the state module), and 4,897 men of age 15-54 for the state of Bihar. This sample size was based on the size needed to produce reliable indicator estimates for each district. Household questionnaire regarding number of deaths in the household in the three years preceding the survey were collected and utilized to produce information in 19 languages using CAPI (Computer Assisted Personal Interviewing). This cross sectional survey study revealed that only 37.1 percent of deaths of households members due to any cause were registered with the civil authorities in the three years preceding the survey, of which 28 percent of deaths are at age 0-4, 45 percent of deaths occurred at age 25-34, and 41 percent of deaths occurred at age 35 and above (see table-1 and 2 for more details).

The association between sleep and depressive symptoms in US adults: data from the NHANES (2007-2014).

To assess the association of sleep factors (sleep duration, trouble sleeping, sleep disorder) and combined sleep behaviours with the risk of clinically relevant depression (CRD). A total of 17 859 participants (8806 males and 9053 females) aged 20-79 years from the National Health and Nutrition Examination Survey (NHANES) 2007-2014 waves were included. Sleep duration, trouble sleeping and sleep disorder were asked in the home by trained interviewers using the Computer-Assisted Personal Interviewing (CAPI) system. The combined sleep behaviours were referred to as 'sleep patterns (healthy, intermediate and poor)', with a 'healthy sleep pattern' defined as sleeping 7-9 h per night with no self-reported trouble sleeping or sleep disorders. And intermediate and poor sleep patterns indicated 1 and 2-3 sleep problems, respectively. Weighted logistic regression was performed to evaluate the association of sleep factors and sleep patterns with the risk of depressive symptoms. The total prevalence of CRD was 9.5% among the 17 859 participants analysed, with females having almost twice as frequency than males. Compared to normal sleep duration (7-9 h), both short and long sleep duration were linked with a higher risk of CRD (short sleep: OR: 1.66, 95% CI: 1.39-1.98; long sleep: OR: 2.75, 95% CI: 1.93-3.92). The self-reported sleep complaints, whether trouble sleeping or sleep disorder, were significantly related with CRD (trouble sleeping: OR: 3.04, 95% CI: 2.59-3.56; sleep disorder: OR: 1.83, 95% CI: 1.44-2.34). Furthermore, the correlations appeared to be higher for individuals with poor sleep pattern (OR: 5.98, 95% CI: 4.91-7.29). In this national representative survey, it was shown that there was a dose-response relationship between sleep patterns and CRD.

Sexual mixing patterns among male&#x2013;female partnerships in Melbourne, Australia.

Individuals who have both opposite- and same-sex partners have the potential to pass sexually transmitted infections (STIs) between high- and low-risk populations. Our aim was to examine assortative sexual mixing in terms of same-sex activity among male-female partnerships. This was a retrospective repeated cross-sectional study of male-female partnerships attending the Melbourne Sexual Health Centre (MSHC) from 2015 to 2019. Sex of sexual partners was collected via computer-assisted self-interview. We calculated the proportion of partnerships where at least one individual reported same-sex partners in the previous 12months and the degree of assortativity by bisexuality. A total of 2112 male-female partnerships (i.e. 4224 individuals) were included, with a median age of 27 years (IQR 23-31). Overall, 89.3% (1885/2112) of male-female partnerships did not report any other same-sex partners; however, in 9.5% (201/2112) of partnerships, same-sex partners were reported by one individual and in 1.2% (26/2112) of partnerships, both individuals reported same-sex partners. Bisexuality appeared to be slightly assortative in male-female partnerships (r =0.163, 95% CI: 0.150-0.176; P <0.001). One in 10 individuals in male-female partnerships had at least one same-sex partner within the previous 12months. Individuals were minorly selective by bisexuality, suggesting the patterns of bisexual mixing in male-female partners are more variable and this may have a significant impact on STI transmission in heterosexual populations.

Stigma, Social Support, and Substance Use in Diverse Men Who Have Sex With Men and Transgender Women Living with HIV in the US Southeast.

Human immunodeficiency virus (HIV) rates in the southeast United States are high and substance use is common among people living with HIV (PLWH). This study used baseline data from the weCare intervention study to examine factors associated with the use of alcohol, tobacco, and marijuana among racially and ethnically diverse young gay, bisexual, and other men who have sex with men (GBMSM) and transgender women in the southeast who were newly diagnosed as having HIV, not linked to care, out of care, and/or not virally suppressed. Self-reported data were collected from 196 GBMSM and transgender women living with HIV via Audio Computer-Assisted Self-Interview at enrollment. Measures assessed demographics; stigma; social support; basic and clinical service needs; HIV disclosure; social media use; and recent use of alcohol, tobacco, and marijuana. Logistic regression identified correlates of past 30-day substance use. In multivariable analysis, increased age and needing basic support services were associated with past 30-day tobacco, cigarette, electronic cigarette, and/or hookah use. Increased HIV-related stigma and needing basic support services were associated with past 30-day marijuana use. Being White and needing clinical support services were associated with infrequent or no past 30-day marijuana use. HIV-related stigma and needing basic support services were associated with substance use among GBMSM and transgender women living with HIV in the southeastern United States. Routine screening for basic needs could identify GBMSM and transgender women living with HIV at risk for substance use and offer insight into intervention leverage points.

Prevalence and determinants of self‐reported anxiety and stress among women with abortion‐related complications admitted to health facilities in Eastern and Southern Africa: A cross‐sectional survey

To estimate the prevalence of women who were admitted to health facilities with abortion-related complications who reported feeling anxious/stressed during their stay, and to identify sociodemographic, facility, and abortion-related characteristics associated with self-reported experience of anxiety/stress. We used data from four countries in Eastern and Southern Africa (Kenya, Malawi, Mozambique, and Uganda) collected from 2017-2018 as part of the World Health Organization (WHO) Multi-Country Survey on Abortion-related morbidity (MCS-A). Information was extracted from women's medical records and their participation in audio computer-assisted self-interviews (ACASI). Based on a question in the ACASI, "Did you encounter any anxiety or stress during your hospital stay?", the percentage of women who self-reported feeling anxious/stressed during their facility stay was calculated. Generalized estimating equations were used to identify the determinants of anxiety/stress following a hierarchical approach whereby potential determinants were grouped from most distal to most proximal and analyzed accordingly. There were 1254 women with abortion-related complications included in the analysis, of which 56.5% self-reported that they felt anxious/stressed during their facility stay. We found evidence that lower socioeconomic status, lower levels of education, no previous childbirth, no previous abortion, higher gestational age at abortion, and use of unsafe methods of abortion were independent determinants of self-reporting anxiety/stress. Action should be taken to reduce experience of anxiety/stress among women attending facilities for postabortion complications, including reducing the number of women experiencing abortion-related complications by improving access to safe abortion. This issue warrants further study using more comprehensive and validated tools to understand the levels and drivers of anxiety/stress self-reported by women attending facilities with abortion-related complications.

Analysis of the 2012 Canadian Community Health Survey-Mental Health demonstrates employment insecurity to be associated with mental illness.

A growing number of people depend on flexible employment, characterized by outsider employment and lower levels of job security. This study investigated whether there was a synergistic effect of employment status and job insecurity on mental disorders.This study used data from the 2012 Canadian Community Health Survey-Mental Health (CCHS) of 13,722 Canada's labor force population aged 20 to 70. Data were collected from January to December, 2012, using computer-assisted personal interviewing. As combining employment status with perceived job insecurity, we formed five job categories: secure full-time, full-time insecure, part-time secure, part-time insecure employment, and unemployment.Results showed that, regardless of employment status (full-time vs part-time), insecure employment was significantly associated with high risk of mental disorders. Furthermore, the odds ratios for insecure employment were similar to those for unemployment. Male workers who are full-time, but with insecure jobs, were more likely to experience mental disorders than female workers.This study's findings imply that while perceived job insecurity may be a critical factor for developing mental health problems among workers, providing effective health care services can mitigate an excessive health risk for the most vulnerable employment, especially for insecure part-time employment and unemployment.

Reproductive intentions among HIV-negative gay and bisexual men initiating pre-exposure prophylaxis in the Sustainable Health Center Implementation pre-exposure prophylaxis pilot study, 2014-2016.

We assessed reproductive intentions and associated characteristics among men enrolled in the Sustainable Health Center Implementation pre-exposure prophylaxis (PrEP) Pilot (SHIPP) Study. We analyzed baseline data from 1275 men who self-identified as gay or bisexual and participated in the SHIPP study. SHIPP was a cohort study of PrEP implementation in five community health centers in Chicago, Jackson, Philadelphia, and Washington, D.C. conducted from 2014 to 2016. Participants completed audio computer-assisted self-interviews querying intentions to have a child in the future. We estimated the association between participants' reproductive intentions and their characteristics using Poisson regression models. Approximately 47% of participants indicated their intentions to have a child. Black/non-Hispanic (aPR = 1.40; 95% CI: 1.10-1.78) and other/non-Hispanic participants (aPR = 1.40; 95% CI: 1.01-1.93) were more likely to report intentions to have a child than white/non-Hispanic participants. Participants were less likely to report intentions to have children as age increased (18-29years, reference group; 30-39years, aPR = 0.80, 95% CI: 0.64-0.99; 40-49years, aPR = 0.49, 95% CI: 0.33-0.72; 50+ years, aPR = 0.07, 95% CI: 0.02-0.21). Clinicians offering PrEP to black and other/non-Hispanic gay and bisexual men should assess their reproductive intentions as family-planning counseling may be an opportunity to introduce PrEP to HIV-negative gay and bisexual men.

The Readiness to Cooperate Within the Triple Helix Model in Poland

Theoretical background: The present article focuses on the assessment of the readiness of representatives of science, business and local administration in Poland to establish mutual cooperation in the areas of leadership, management style, competences and technologies. Subject literature refers to the cooperation of these three spheres as the triple helix. The literature, however, still lacks an assessment of readiness to cooperate from the perspective of science, business and administration. This article belongs to the area of institutional economics. Purpose of the article: The main purpose of this article was to present the functioning of cooperation between representatives of science, business and administration in Lublin and Warsaw. The methodological purpose was to develop the proprietary methodology of readiness to function according to the Triple Helix Readiness concept as a tool for assessing the level of readiness of the scientific, business and administration environment for mutual cooperation in Polish cities. The empirical purpose was to evaluate Polish cities in terms of their preparation for cooperation, as well as to formulate recommendations for the science, business and administration environment focused on increasing the effectiveness of mutual cooperation. Research methods: Qualitative and quantitative research methods were selected. Among the qualitative methods, a diagnostic survey was used. The Computer-Assisted Self Interviewing (CASI) online survey technique was also used, which is in line with the quantitative methodology of market and opinion research. The tool used to conduct the research was an Internet questionnaire addressed to stakeholders. For the present article we adopted the assumption that the adaptation of the modified Net Readiness methodology will enable us to assess the level of readiness of the science, business and administration environments in Poland to establish mutual cooperation. The author modified the original Net Readiness methodology for the purposes of conducting the research. Main findings: The adopted research hypothesis: cooperation between science, business and administration is determined by various factors. Diversifiation of the level of cooperation depends on the management style, leadership, level of competence and technology advancement used. The results of our research indicate that the readiness to cooperate with external entities depends on many factors. From the perspective of enterprises, these include the level of advancement of information systems, modern tools supporting knowledge management, their research and development activities, registered and transferred patents, trademarks and training expenditure. On the other hand, universities pay attention to the possibility of commercializing their solutions and later marketing them. Still other factors determine the readiness to undertake such cooperation on the part of cities and towns. The main added value of this article is that it adds to the scientific output an assessment of the readiness of the scientific, business and administration communities to cooperate under the triple helix model and recommendations focusing on increasing the effectiveness of their mutual cooperation.

Adolescents' satisfaction with care for abortion-related complications in 11 Sub-Saharan African countries: A cross-sectional facility-based study.

To assess satisfaction with care for abortion-related complications experienced among adolescents compared to older women. A secondary analysis of the WHO Multi-Country Survey on Abortion-related Morbidity and Mortality-a cross-sectional study conducted in health facilities in 11 Sub-Saharan African countries. Women with abortion-related complications who participated in an audio computer-assisted self-interview were included. Two composite measures of overall satisfaction were created based on five questions: (1) study participants who were either satisfied or very satisfied across all five questions; and (2) study participants who reported being very satisfied only across all five questions. Multivariable general estimating equation analyses were conducted to assess whether there was any evidence that age (adolescents 12-19years and older women 20+) was associated with each composite measure of satisfaction, controlling for key confounders. The study sample consisted of 2817 women (15% adolescents). Over 75% of participants reported being satisfied or very satisfied for four out of five questions. Overall, 52.9% of study participants reported being satisfied/very satisfied across all five questions and 22.4% reported being consistently very satisfied. Multivariable analyses showed no evidence of an association between age group and being either satisfied or very satisfied (OR 1.07; 95% CI, 0.82-1.41, P=0.60), but showed strong evidence that adolescents were 50% more likely to be consistently very satisfied with their overall care than older women (OR 1.49; 95% CI, 1.13-1.96, P=0.005). Both adolescents and older women reported high levels of satisfaction with care when looking at different components of care individually, but the results of the composite measure for satisfaction showed that many study participants reported being less than satisfied with at least one element of their care. Further studies to explore the expectations, needs, and values of women's satisfaction with care for abortion-related complications are needed.