Reductions in abortion-related mortality following policy reform: evidence from Romania, South Africa and Bangladesh

Unsafe abortion is a significant contributor to worldwide maternal mortality; however, abortion law and policy liberalization could lead to drops in unsafe abortion and related deaths. This review provides an analysis of changes in abortion mortality in three countries where significant policy reform and related service delivery occurred. Drawing on peer-reviewed literature, population data and grey literature on programs and policies, this paper demonstrates the policy and program changes that led to declines in abortion-related mortality in Romania, South Africa and Bangladesh. In all three countries, abortion policy liberalization was followed by implementation of safe abortion services and other reproductive health interventions. South Africa and Bangladesh trained mid-level providers to offer safe abortion and menstrual regulation services, respectively, Romania improved contraceptive policies and services, and Bangladesh made advances in emergency obstetric care and family planning. The findings point to the importance of multi-faceted and complementary reproductive health reforms in successful implementation of abortion policy reform

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Since Trajan and Decebalus: online media reporting of the 2010 GayFest in Bucharest

The current study uses critical discourse analysis to examine how a high-profile gay pride event in Romania, the annual Bucharest GayFest, is represented by online media outlets. Same-gender relationships were only decriminalised in Romania a decade ago, and research on Romanian sexualities is scarce. In order to examine the construction of homosexualities in Romania, we employed critical discourse analysis on 23 internet news reports of a gay pride event. Three major themes emerged: the GayFest as exotic, the GayFest as a political event and the link between sexuality and national identity. Both exoticising and politicising discourses contribute to the positioning of gay people outside the nation. Pro-gay voices complement this marginalising perspective by reproducing political discourse. Only one statement in the news reports could be read against minoritising discourses: an ironic banner construed the trope of founding fathers (Trajan and Decebalus, in the case of Romania) as a potentially homoerotic motif, and thus undermined the relationship between nationalism and homophobia. The implications of these findings are discussed; the link of nationalism to homophobia and the almost unquestioned marginalisation of gay people are especially scrutinised

Outreach programmes for health improvement of Traveller Communities: a synthesis of evidence

Background: The term ‘Traveller Communities’ refers to a complex population group encompassing Romani Gypsies, Irish Travellers, Welsh Travellers, Scottish Travellers, Roma, New Travellers, Travelling Showpeople, Circus People and Boat Dwellers. A lack of reliable demographic data combined with nomadic lifestyles leads to potential invisibility in health service planning and results in unmet needs.Outreach has been utilised as a key strategy to engage Traveller Communities in health improvement interventions. Aim: To synthesise the evidence on outreach programmes to improve the health of Traveller Communities. Design: Scoping, economic and realist reviews were employed with the following objectives: (1) to quantify and classify the evidence concerning Traveller Communities’ health; (2) to estimate the costs of different types of outreach and determine which might be considered cost-effective and (3) to develop explanations of how, for whom and in what circumstances outreach works best. Methods: Comprehensive searches of electronic databases and grey literature were undertaken using a broad search strategy to identify publications relevant to Traveller Communities and health. The following databases were searched: Web of Knowledge, MEDLINE, The British Library’s Electronic Table of Contents (Zetoc), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Applied Social Sciences Index and Abstracts (ASSIA), Social Services Abstracts, British Humanities Index, PsycArticles, Allied and Complementary Medicine Database (AMED), ProQuest Nursing and Allied Health Source, International Bibliography of the Social Sciences (IBSS) and Sociological Abstracts. Searches were conducted between August 2011 and November 2011. No restrictions on inclusion were imposed according to type of journal, publication date (up to the date of searching) or country of research or practice. Foreign-language publications were excluded. This formed a core literature base to be drawn on by the different arms of thereview. Expert hearings involving Traveller Community members and outreach workers were also undertaken to refine and validate emerging findings. Findings: Two hundred and seventy-eight articles were included in the scoping review, which highlighted the emergent nature of the evidence on outreach interventions for Traveller Communities. While much research describes the needs of Traveller Communities, as yet there has been little response to this in the form of discussion and evaluation of outreach and other interventions that might improve their health. From an economic perspective, the data available suggest that the cost of providing mobile services to travellers is high; improving accessibility of services and signposting Traveller Communities is cheaper and may be equally effective. The realist synthesis generated an explanatory framework of why outreach might lead to certain outcomes depending on the particular circumstances. The extent to which workers are trusted by the Community and whether or not the intervention focus is negotiated both have clear impacts on intervention success. Individuals engage differentially with outreach interventions, leading to participation, behaviour change or social capital improvement outcomes. Conclusions: Outreach workers need clarity about the purpose of their intervention, in terms of degrees of engagement (leading to the three outcome categories above). Where outreach aims to promote attendance at one-off events such as screening, the worker may not need to have long-established links with the Community. Changing behaviour or developing social capital, on the other hand, is a challenge that needs to build explicitly on long-established, trusting relationships. Any flexibility built into the intervention in terms of negotiating intervention topic can contribute significantly to the outcome. While true engagement with an issue must not be assumed from participation at an event, these events can be used as part of longer-term trust-building strategies. These synthesis approaches offer maximum translational potential for other marginalised groups. There is a need for more theoretically informed evaluations of engagement initiatives, in order to develop transferable lessons around how and for whom interventions work in different contexts. Further research is needed to test the explanatory potential of the framework in other socially excluded groups. Funding: The National Institute for Health Research Public Health Research programme

Joint EVS/WVS 2017-2021 Dataset (Joint EVS/WVS)

The European Values Study (EVS) and the World Values Survey (WVS) are two large-scale, cross-national and longitudinal survey research programmes. They include a large number of questions on moral, religious, social, political, occupational and family values which have been replicated since the early eighties. Both organizations agreed to cooperate in joint data collection from 2017. EVS has been responsible for planning and conducting surveys in European countries, using the EVS questionnaire and EVS methodological guidelines. WVSA has been responsible for planning and conducting surveys in countries in the world outside Europe, using the WVS questionnaire and WVS methodological guidelines. Both organisations developed their draft master questionnaires independently. The joint items define the Common Core of both questionnaires. The Joint EVS/WVS is constructed from the two EVS and WVS source datasets: - European Values Study 2017 Integrated Dataset (EVS 2017), ZA7500 Data file Version 4.0.0, doi:10.4232/1.13560 (https://doi.org/10.4232/1.13560). - European Values Study 2017: Ukraine (EVS 2017), ZA7539 Data file Version 1.0.0, doi:10.4232/1.13714 (https://doi.org/10.4232/1.13714). - World Values Survey: Round Seven–Country-Pooled Datafile. Version 2.0.0, doi: 10.14281/18241.13 (https://doi.org/10.14281/18241.13).The European Values Study (EVS) and the World Values Survey (WVS) are two large-scale, cross-national and longitudinal survey research programmes. They include a large number of questions on moral, religious, social, political, occupational and family values which have been replicated since the early eighties. Both organizations agreed to cooperate in joint data collection from 2017. EVS has been responsible for planning and conducting surveys in European countries, using the EVS questionnaire and EVS methodological guidelines. WVSA has been responsible for planning and conducting surveys in countries in the world outside Europe, using the WVS questionnaire and WVS methodological guidelines. Both organisations developed their draft master questionnaires independently. The joint items define the Common Core of both questionnaires. The Joint EVS/WVS is constructed from the two EVS and WVS source datasets: - European Values Study 2017 Integrated Dataset (EVS 2017), ZA7500 Data file Version 4.0.0, doi:10.4232/1.13560 (https://doi.org/10.4232/1.13560). - European Values Study 2017: Ukraine (EVS 2017), ZA7539 Data file Version 1.0.0, doi:10.4232/1.13714 (https://doi.org/10.4232/1.13714). - World Values Survey: Round Seven–Country-Pooled Datafile. Version 2.0.0, doi: 10.14281/18241.13 (https://doi.org/10.14281/18241.13)