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Open accessJournal ArticleDOI: 10.3390/IJERPH18052555

Sex Education in the Spotlight: What Is Working? Systematic Review.

04 Mar 2021-International Journal of Environmental Research and Public Health (MDPI AG)-Vol. 18, Iss: 5, pp 2555
Abstract: Adolescence, a period of physical, social, cognitive and emotional development, represents a target population for sexual health promotion and education when it comes to achieving the 2030 Agenda goals for sustainable and equitable societies. The aim of this study is to provide an overview of what is known about the dissemination and effectiveness of sex education programs and thereby to inform better public policy making in this area. Methodology: We carried out a systematic review based on international scientific literature, in which only peer-reviewed papers were included. To identify reviews, we carried out an electronic search of the Cochrane Database Reviews, ERIC, Web of Science, PubMed, Medline, Scopus and PsycINFO. This paper provides a narrative review of reviews of the literature from 2015 to 2020. Results: 20 reviews met the inclusion criteria (10 in school settings, 9 using digital platforms and 1 blended learning program): they focused mainly on reducing risk behaviors (e.g., VIH/STIs and unwanted pregnancies), whilst obviating themes such as desire and pleasure, which were not included in outcome evaluations. The reviews with the lowest risk of bias are those carried out in school settings and are the ones that most question the effectiveness of sex education programs. Whilst the reviews of digital platforms and blended learning show greater effectiveness in terms of promoting sexual and reproductive health in adolescents (ASRH), they nevertheless also include greater risks of bias. Conclusion: A more rigorous assessment of the effectiveness of sexual education programs is necessary, especially regarding the opportunities offered by new technologies, which may lead to more cost-effective interventions than with in-person programs. Moreover, blended learning programs offer a promising way forward, as they combine the best of face-to-face and digital interventions, and may provide an excellent tool in the new context of the COVID-19 pandemic.

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Topics: Blended learning (56%), Reproductive health (55%), PsycINFO (51%)
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Open accessJournal ArticleDOI: 10.1097/MD.0000000000026709
30 Jul 2021-Medicine
Abstract: BACKGROUND: The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread wildly across the world. In March of 2020, almost all kindergarten through 12th grade (K-12) schools were closed in the United States in an urgent attempt to curb the pandemic in the absence of effective therapeutics or vaccination. Thirteen months since then, schools remain partially closed. Accumulated evidence suggests that children and adolescents are not the primary facilitators of transmission, limiting the restrictive effects of school closures on disease transmission. The negative effects of school closures on K-12 students need to be systematically reviewed. METHODS: Following the guideline of Preferred Reporting Items for Systematic Reviews and Meta-analyzes, a comprehensive literature search from PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science regarding school closures and its impact on K-12 students was conducted. The primary outcomes included the impact of school closures on the mitigation of the pandemic and the resulting public health concerns of K-12 students. RESULTS: Prolonged school closures possessed negative effects on K-12 students' physical, mental, and social well-being and reduced the number of health and social workers, hindering the reopening of the country. CONCLUSIONS: School closures were over-weighted against the mitigation of coronavirus disease 2019 (COVID-19) transmission. A safe reopening of all K-12 schools in the United States should be of top priority.

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Topics: Public health (51%)

Journal ArticleDOI: 10.1016/J.JOGN.2021.06.002
Abstract: An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of how fetal monitoring may lead to overuse of birth-related interventions, commentaries on reviews focused on bedsharing, and women's lifetime estrogen exposure and risk of cardiovascular mortality.

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Topics: Evidence-based practice (51%)

Open accessJournal ArticleDOI: 10.3390/IJERPH18189760
Abstract: Family talks about sex can protect against teens' risky sexual behavior, but most research has focused on the role of mothers. The current study included cross-sectional survey data from 728 adolescents in the 11th and 12th grades (Mage = 17.00, SD = 0.90) in the United States. Structural equation modeling (SEM) was used to assess associations between teens' direct and indirect talk, defined as less straightforward ways to communicate one's sexual values, with fathers about sex, and teens' sexual behaviors. There were no significant direct associations between father-teen talk about sex and teens' sexual behavior. However, teen gender moderated associations between indirect father-teen communication and teens' sexual behavior. The results suggest the need to assess indirect talk about sex in studies of family sexuality communication and to further investigate the role of teens' identities in determining the influence of father-teen talk about sex on teens' sexual behavior.

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Topics: Human sexuality (59%), Reproductive health (55%)

Journal ArticleDOI: 10.1016/J.DISAMONTH.2021.101287
11 Sep 2021-Dm Disease-a-month
Abstract: Pelvic inflammatory disease (PID) is an infection of the female upper genital tract that is typically polymicrobial with classic core involvement of Neisseria gonorrhoeae and/or Chlamydia trachomatis, though other endogenous flora from the vagino-cervical areas can be involved as well. It is often a sexually transmitted disease but other etiologic routes are also noted. A variety of risk factors have been identified including adolescence, young adulthood, adolescent cervical ectropion, multiple sexual partners, immature immune system, history of previous PID, risky contraceptive practices and others. An early diagnosis and prompt treatment are necessary to reduce risks of PID complications such as chronic pelvic pain, ectopic pregnancy and infertility. Current management principles of PID are also reviewed. It is important for clinicians to screen sexually active females for common sexually transmitted infections such as Chlamydia trachomatis and provide safer sex education to their adolescent and young adult patients. Clinicians should provide comprehensive management to persons with PID and utilize established guidelines such as those from the US Centers for Disease Control and Prevention (CDC).

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Topics: Sexually transmitted disease (64%), Pelvic inflammatory disease (63%), Chlamydia trachomatis (56.99%) ... show more

Open accessJournal ArticleDOI: 10.3390/HEALTHCARE9111594
20 Nov 2021-Healthcare
Abstract: The tendency towards the radicalization of abortion law is observed in numerous countries, including Poland. The aim of the present paper was to determine the main factors influencing the number of abortions performed worldwide and to indicate the main directions which should be followed to improve the patients’ well-being. The authors conducted their search in the PubMed of the National Library of Medicine and Google Scholar. Databases were extensively searched for all original and review articles/book chapters in English until June 2021. The main problems associated with the contemporary policy of birth regulation include no possibility of undergoing a termination because of the conscience clause invoked by the medical personnel, restrictive abortion law and lack of sexual education. Minimal changes that should be considered are: improved sex education and the availability of contraception, free access to abortion-inducing drugs with adequate information provided by qualified medical personnel in countries with a conscience clause invoked by the personnel, and the development of an international network which would facilitate undergoing a pregnancy termination abroad to provide women with access to legal abortion assisted by professional medical personnel.

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Topics: Abortion law (67%), Abortion (60%)

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90 results found


Journal ArticleDOI: 10.1111/J.1471-6402.1997.TB00108.X
Abstract: This article offers objectification theory as a framework for understanding the experiential consequences of being female in a culture that sexually objectifies the female body. Objectification the...

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Topics: Objectification (71%), Self-objectification (66%), Sexual objectification (65%) ... show more

3,468 Citations


Open accessJournal ArticleDOI: 10.1186/1471-2288-7-10
Abstract: Our objective was to develop an instrument to assess the methodological quality of systematic reviews, building upon previous tools, empirical evidence and expert consensus. A 37-item assessment tool was formed by combining 1) the enhanced Overview Quality Assessment Questionnaire (OQAQ), 2) a checklist created by Sacks, and 3) three additional items recently judged to be of methodological importance. This tool was applied to 99 paper-based and 52 electronic systematic reviews. Exploratory factor analysis was used to identify underlying components. The results were considered by methodological experts using a nominal group technique aimed at item reduction and design of an assessment tool with face and content validity. The factor analysis identified 11 components. From each component, one item was selected by the nominal group. The resulting instrument was judged to have face and content validity. A measurement tool for the 'assessment of multiple systematic reviews' (AMSTAR) was developed. The tool consists of 11 items and has good face and content validity for measuring the methodological quality of systematic reviews. Additional studies are needed with a focus on the reproducibility and construct validity of AMSTAR, before strong recommendations can be made on its use.

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Topics: Construct validity (55%), Content validity (54%), Systematic review (53%)

3,196 Citations


Open accessJournal ArticleDOI: 10.1136/BMJ.J4008
Beverley Shea1, Beverley Shea2, Barnaby C Reeves3, George A. Wells2  +10 moreInstitutions (5)
21 Sep 2017-BMJ
Abstract: The number of published systematic reviews of studies of healthcare interventions has increased rapidly and these are used extensively for clinical and policy decisions. Systematic reviews are subject to a range of biases and increasingly include non-randomised studies of interventions. It is important that users can distinguish high quality reviews. Many instruments have been designed to evaluate different aspects of reviews, but there are few comprehensive critical appraisal instruments. AMSTAR was developed to evaluate systematic reviews of randomised trials. In this paper, we report on the updating of AMSTAR and its adaptation to enable more detailed assessment of systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. With moves to base more decisions on real world observational evidence we believe that AMSTAR 2 will assist decision makers in the identification of high quality systematic reviews, including those based on non-randomised studies of healthcare interventions.

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2,093 Citations


Journal ArticleDOI: 10.17763/HAER.58.1.U0468K1V2N2N8242
Abstract: Michelle Fine argues that the anti-sex rhetoric surrounding sex education and school-based health clinics does little to enhance the development of sexual responsibility and subjectivity in adolescents. Despite substantial evidence on the success of both school-based health clinics and access to sexuality information, the majority of public schools do not sanction or provide such information. As a result, female students, particularly low-income ones, suffer most from the inadequacies of present sex education policies. Current practices and language lead to increased experiences of victimization, teenage pregnancy, and increased dropout rates, and consequently, ". . . combine to exacerbate the vulnerability of young women whom schools, and the critics of sex education and school-based health clinics, claim to protect." The author combines a thorough review of the literature with her research in public schools to make a compelling argument for "sexuality education" that fosters not only the full developmen...

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Topics: Human sexuality (57.99%), Teenage pregnancy (55%), Curriculum (51%)

1,215 Citations


Open accessJournal ArticleDOI: 10.1186/1472-6947-7-16
Connie Schardt1, Martha B. Adams1, Thomas Owens1, Sheri A. Keitz  +1 moreInstitutions (2)
Abstract: Supporting 21st century health care and the practice of evidence-based medicine (EBM) requires ubiquitous access to clinical information and to knowledge-based resources to answer clinical questions. Many questions go unanswered, however, due to lack of skills in formulating questions, crafting effective search strategies, and accessing databases to identify best levels of evidence. This randomized trial was designed as a pilot study to measure the relevancy of search results using three different interfaces for the PubMed search system. Two of the search interfaces utilized a specific framework called PICO, which was designed to focus clinical questions and to prompt for publication type or type of question asked. The third interface was the standard PubMed interface readily available on the Web. Study subjects were recruited from interns and residents on an inpatient general medicine rotation at an academic medical center in the US. Thirty-one subjects were randomized to one of the three interfaces, given 3 clinical questions, and asked to search PubMed for a set of relevant articles that would provide an answer for each question. The success of the search results was determined by a precision score, which compared the number of relevant or gold standard articles retrieved in a result set to the total number of articles retrieved in that set. Participants using the PICO templates (Protocol A or Protocol B) had higher precision scores for each question than the participants who used Protocol C, the standard PubMed Web interface. (Question 1: A = 35%, B = 28%, C = 20%; Question 2: A = 5%, B = 6%, C = 4%; Question 3: A = 1%, B = 0%, C = 0%) 95% confidence intervals were calculated for the precision for each question using a lower boundary of zero. However, the 95% confidence limits were overlapping, suggesting no statistical difference between the groups. Due to the small number of searches for each arm, this pilot study could not demonstrate a statistically significant difference between the search protocols. However there was a trend towards higher precision that needs to be investigated in a larger study to determine if PICO can improve the relevancy of search results.

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1,102 Citations