Despite benefits of screening mammography, many South Asian (SA) immigrant women in Canada remain under screened. We aimed to elicit their experiences and beliefs about barriers to mammography and possible solutions. SA immigrant women aged 50 years or over were eligible if they never had a mammogram or had one more than 3 years ago. We employed the participatory mixed-method approach of Concept Mapping. Sixty women participated with a mean age of 58 years. Participants brainstormed 150 items which were consolidated into 67 items. After sorting and rating, cluster analysis revealed eight clusters of barriers on knowledge, fear, language and transportation, access to mammogram center, access to doctor, beliefs and practices, self-care, and family dependence. Participants discussed possible solutions, and emphasized out-reach models to address knowledge gaps and issues of language and transportation. One example was a community-based shuttle bus to screening centres, hosted by trained co-ethnic workers. The results are discussed to enhance the socio-cultural sensitivity of breast screening programs.
There has been little research on etiology and treatment correlation. These results indicate a strong correlation between a longer limb and unilateral plantar fasciitis pain.
Background
Findings about the effect of prophylactic antibiotics in preventing genital tract infection (GTI) associated with surgical procedures used for incomplete abortions are conflicting. Some reported a decrease in infection associated with the use of antibiotic prophylaxis, whereas others found no significant reduction in GTI.
Objective
To synthesise systematically the evidence on the effect of prophylactic antibiotics compared with placebo in women undergoing surgical procedures for incomplete abortion.
Search strategy
In February 2020, PubMed, Embase and Cochrane Central for Register of Controlled Trials were searched for relevant published randomised controlled trials.
Selection criteria
Randomised controlled trials reporting GTI following surgical procedures for incomplete abortion and comparing antibiotic prophylaxis with placebo.
Data collection and analysis
Meta‐analysis using inverse variance heterogeneity model included subgroup and sensitivity analyses determined a priori were conducted. The quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE).
Main results
A total of 16 178 women who participated in 24 eligible randomised controlled trials published between 1975 and 2019 were included. Pooled estimates showed the risk of GTI following surgical procedures after incomplete abortion was significantly lower among those who had prophylactic antibiotics (relative risk [RR] = 0.72; 95% CI 0.58–0.90; I2 = 49%). There was no significant effect of antibiotics in women in low‐ and middle‐income countries (three studies, 3579 participants, RR = 0.90; 95% CI 0.50–1.62; I2 = 63%), but it was clinically and statistically significant among women high‐income countries (21 studies, 12 599 participants, RR = 0.67; 95% CI 0.53–0.84; I2 = 44%), with a strong level of evidence as assessed by GRADE.
Conclusion
This study provides evidence that antibiotic prophylaxis is beneficial in reducing post‐abortion GTI among women undergoing surgical procedures for incomplete abortion. More studies are needed from low‐ and middle‐income countries.
Tweetable abstract
Prophylactic antibiotics after incomplete abortion are effective in reducing GTI. More studies are needed from low‐ and middle‐income countries.
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