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1.
BMC Pregnancy Childbirth ; 15: 180, 2015 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-26285816

RESUMO

BACKGROUND: The United Kingdom (UK) caesarean section (CS) rate is largely determined by reluctance to augment trial of labour and vaginal birth. Choice between repeat CS and attempting vaginal birth after CS (VBAC) in the next pregnancy is challenging, with neither offering clear safety advantages. Women may access online information during the decision-making process. Such information is known to vary in its support for either mode of birth when assessed quantitatively. Therefore, we sought to explore qualitatively, the content and presentation of web-based health care information on birth after caesarean section (CS) in order to identify the dominant messages being conveyed. METHODS: The search engine Google™ was used to conduct an internet search using terms relating to birth after CS. The ten most frequently returned websites meeting relevant purposive sampling criteria were analysed. Sampling criteria were based upon funding source, authorship and intended audience. Images and written textual content together with presence of links to additional media or external web content were analysed using descriptive and thematic analyses respectively. RESULTS: Ten websites were analysed: five funded by Government bodies or professional membership; one via charitable donations, and four funded commercially. All sites compared the advantages and disadvantages of both repeat CS and VBAC. Commercially funded websites favoured a question and answer format alongside images, 'pop-ups', social media forum links and hyperlinks to third-party sites. The relationship between the parent sites and those being linked to may not be readily apparent to users, risking perception of endorsement of either VBAC or repeat CS whether intended or otherwise. Websites affiliated with Government or health services presented referenced clinical information in a factual manner with podcasts of real life experiences. Many imply greater support for VBAC than repeat CS although this was predominantly conveyed through subtle use of words rather than overt messages, with the exception of the latter being apparent in one site. CONCLUSIONS: Websites providing information on birth after CS appear to vary in nature of content according to their funding source. The most user-friendly, balanced and informative websites appear to be those funded by government agencies.


Assuntos
Recesariana , Informação de Saúde ao Consumidor , Internet , Nascimento Vaginal Após Cesárea , Tomada de Decisões , Feminino , Humanos , Gravidez , Pesquisa Qualitativa , Reino Unido
2.
J Med Internet Res ; 15(8): e166, 2013 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-23968998

RESUMO

The transformative power of the Internet on all aspects of daily life, including health care, has been widely recognized both in the scientific literature and in public discourse. Viewed through the various lenses of diverse academic disciplines, these transformations reveal opportunities realized, the promise of future advances, and even potential problems created by the penetration of the World Wide Web for both individuals and for society at large. Discussions about the clinical and health research implications of the widespread adoption of information technologies, including the Internet, have been subsumed under the disciplinary label of Medicine 2.0. More recently, however, multi-disciplinary research has emerged that is focused on the achievement and promise of the Web itself, as it relates to healthcare issues. In this paper, we explore and interrogate the contributions of the burgeoning field of Web Science in relation to health maintenance, health care, and health policy. From this, we introduce Health Web Science as a subdiscipline of Web Science, distinct from but overlapping with Medicine 2.0. This paper builds on the presentations and subsequent interdisciplinary dialogue that developed among Web-oriented investigators present at the 2012 Medicine 2.0 Conference in Boston, Massachusetts.


Assuntos
Atenção à Saúde , Internet , Armazenamento e Recuperação da Informação
3.
J Med Internet Res ; 14(6): e176, 2012 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-23232765

RESUMO

BACKGROUND: Most consider Twitter as a tool purely for social networking. However, it has been used extensively as a tool for online discussion at nonmedical and medical conferences, and the academic benefits of this tool have been reported. Most anesthetists still have yet to adopt this new educational tool. There is only one previously published report of the use of Twitter by anesthetists at an anesthetic conference. This paper extends that work. OBJECTIVE: We report the uptake and growth in the use of Twitter, a microblogging tool, at an anesthetic conference and review the potential use of Twitter as an educational tool for anesthetists. METHODS: A unique Twitter hashtag (#WSM12) was created and promoted by the organizers of the Winter Scientific Meeting held by The Association of Anaesthetists of Great Britain and Ireland (AAGBI) in London in January 2012. Twitter activity was compared with Twitter activity previously reported for the AAGBI Annual Conference (September 2011 in Edinburgh). All tweets posted were categorized according to the person making the tweet and the purpose for which they were being used. The categories were determined from a literature review. RESULTS: A total of 227 tweets were posted under the #WSM12 hashtag representing a 530% increase over the previously reported anesthetic conference. Sixteen people joined the Twitter stream by using this hashtag (300% increase). Excellent agreement (κ = 0.924) was seen in the classification of tweets across the 11 categories. Delegates primarily tweeted to create and disseminate notes and learning points (55%), describe which session was attended, undertake discussions, encourage speakers, and for social reasons. In addition, the conference organizers, trade exhibitors, speakers, and anesthetists who did not attend the conference all contributed to the Twitter stream. The combined total number of followers of those who actively tweeted represented a potential audience of 3603 people. CONCLUSIONS: This report demonstrates an increase in uptake and growth in the use of Twitter at an anesthetic conference and the review illustrates the opportunities and benefits for medical education in the future.


Assuntos
Anestesiologia , Educação , Internet , Recursos Humanos
4.
J Br Menopause Soc ; 11(3): 103-8, 2005 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16157001

RESUMO

The Internet was born in 1969; it was originally developed so that computers could share information on research and development in the scientific and military fields. The original Internet consisted of four university computers networked in the United States. Email became available two years later. The infant Internet initially required complex computing knowledge to be used. However, this was all to change with the development of the World Wide Web in the early 1990s, which made the Internet much more widely accessible. The Internet has since grown at a phenomenal rate and has evolved into a global communications tool. It is by nature anarchic, in that it is an unrestricted broadcast medium. Although this lack of censorship is a strength, it is also a weakness. The quality of information available on the Web is variable and discernment is required. With the growth of e-health, medicine and its allied specialties are faced with the challenges of providing their services in a novel way while maintaining the first principle of medicine, primum non nocere (first, do no harm). This provision of e-health care is in its infancy and this review explores issues arising from the use of the Internet as a medium for organizing menopausal health care in the third millennium.


Assuntos
Fogachos/prevenção & controle , Internet , Consulta Remota/tendências , Feminino , Previsões , Humanos , Menopausa , Consulta Remota/métodos , Estados Unidos
5.
JMIR Res Protoc ; 4(3): e85, 2015 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-26177562

RESUMO

BACKGROUND: Online health information seeking is an activity that needs to be explored in Scotland. While there are a growing number of studies that adopt a qualitative approach to this issue and attempt to understand the behaviors associated with online health information seeking, previous studies focusing on quantifying the prevalence and pattern of online health seeking in the United Kingdom have been based on Internet users in general. OBJECTIVE: This exploratory study sought to describe the prevalence of online health information seeking in a rural area of Scotland based on primary data from a patient population. METHODS: A survey design was employed utilizing self-completed questionnaires, based on the Pew Internet and American Life Project; questionnaires were distributed among adult patients in 10 primary care centers in a rural community in Scotland. RESULTS: A convenience sample of 571 (0.10% of the total population in Grampian, N=581,198) patients completed the questionnaire. A total of 68.4% (379/554) of patients had previously used the Internet to acquire health information. A total of 25.4% (136/536) of patients consulted the Internet for health information regarding their current appointment on the day surveyed; 34.6% (47/136) of these patients were influenced to attend their appointment as a result of that online health information. A total of 43.2% (207/479) of patients stated the health information helped improve their health and 67.1% (290/432) indicated that they had learned something new. A total of 34.0% (146/430) of patients talked to a health professional about the information they had found and 90.0% (376/418) reported that the information was useful. In total, 70.4% (145/206) of patients were concerned about obtaining health information online from reliable sources. A total of 67.1% (139/207) of patients were concerned that a health site may sell their personal information, yet only 6.7% (36/535) checked the privacy policy of the site visited. However, 27.9% (55/197) of patients were not concerned about their employer finding out what health sites they visited, whereas 37.5% (78/208) were concerned that others would find out. CONCLUSIONS: The results suggest that online health information-seeking behavior influences offline health-related behavior among the population surveyed. Patient attitudes to online health information seeking were focused on issues relating to trust, reliability, privacy, and confidentiality. This study provides support for the growing phenomenon of an empowered, computer-literate, health information consumer, and the impact of this phenomenon must be considered in the context of the patient-health professional dynamic. The unpredictable nature of human thought and action in relation to this field of study requires an ongoing program of ethnographic research, both physical and virtual, within a Health Web Science framework. This study has provided a baseline of the prevalence of online health information seeking in the Grampian region of Scotland.

6.
Saudi J Anaesth ; 8(Suppl 1): S8-S14, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25538529

RESUMO

BACKGROUND: Preoperative preparation (assessment) of patients reduces cancellations on the day of surgery. A Center for Reviews and Dissemination review (2007) concluded "the evidence was weak and it was uncertain that preassessment reduced cancellations." The aim of this study was to observe the impact of a preoperative preparation clinic on cancellations of operating room cases on the day of surgery, and in particular on those causes of cancellation on the day of surgery which were expected to be affected by preoperative preparation. MATERIALS AND METHODS: Observational study conducted in a 194 bed District General Hospital in the United Kingdom from April 1, 2006 to March 31, 2011. 42,082 operating room cases were scheduled for operation during this period. Surgical sessions which did not require anesthetic input were excluded. Contemporaneous data were collected and analyzed on a monthly basis, and also grouped by year over a 5-year period. The cancellations on the day of surgery were divided into two groups: Those considered to be affected by preoperative preparation and those which were not. Comparisons were made between these two groups and between individual reasons for cancellation. RESULTS: A total of 28,928 cases met the inclusion criteria. The clinic introduction reduced cancellations considered to be affected by preoperative preparation from 462 to 177 (78% and 42% total cancellations, respectively) (P < 0.001). There was a decrease in cancellations due to patients who did not arrive (P < 0.001) and medical reasons (P < 0.001), but an increase in the number of cancellations by the patients themselves (P = 0.002). Cancellations due to lack of beds and "other" reasons both increased (P < 0.001) across the study period. CONCLUSIONS: This study suggests that the introduction of preoperative preparation clinics for patients reduces cancellations on the day of surgery.

7.
Menopause Int ; 18(3): 110-5, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22761351

RESUMO

OBJECTIVE: This paper describes the investigation, categorization/characterization and viewing of pelvic floor muscle exercises (PFME) on YouTube from the perspective of the 'wisdom of the crowd'. The aim of the research was to increase awareness of the type of clips that individuals are likely to come across when searching YouTube and to describe trends and popularity. This awareness will be useful for the design of continence promotion services, especially for hard-to-reach individuals. STUDY DESIGN: Web-based videos relating to PFE were identified by searching YouTube using the snowball technique. Main outcome measures Number of views; the approach taken (health, fitness, sexual and pregnancy); product promotion; and the use of music, visual cues and elements designed to encourage exercise. The number of views of each video was recorded at three points over a seven-month period. RESULTS: Twenty-two videos were identified. Overall these videos had been viewed over 430,000 times during the study period. One video was viewed over 100,000 times and overall the median increase in views was 59.4%. CONCLUSIONS: YouTube is increasingly used to access information about pelvic floor exercises. Different approaches are used to communicate PFME information but there are no formal structures for quality control. Further research is required to identify which elements of the video clips are effective in communicating information and in motivating exercise and to establish appropriate protocols. Kitemarking is recommended in order that women obtain correct advice.


Assuntos
Terapia por Exercício , Diafragma da Pelve/fisiologia , Incontinência Urinária/terapia , Gravação em Vídeo , Adulto , Informação de Saúde ao Consumidor , Feminino , Humanos , Internet/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Autocuidado , Gravação em Vídeo/classificação , Gravação em Vídeo/estatística & dados numéricos , Webcasts como Assunto
8.
Menopause Int ; 18(3): 106-9, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22761350

RESUMO

BACKGROUND AND METHODOLOGY: Sociodemographic trends mean increasing numbers of new relationships in later life. These trends may not only have health consequences for women and health services but also impact on the targeting of sexual health messages. This study aimed to examine attitudes and knowledge surrounding contraception, sexual health and unwanted pregnancy among those accessing the website www.menopausematters.co.uk. A voluntary online survey was completed. RESULTS: Survey was completed by 550 respondents. Three hundred and sixty-six women, 94% of whom self-classified as pre- or perimenopausal, had been sexually active with a male partner in the previous four weeks. Commonest contraceptive methods used by perimenopausal and postmenopausal women were condoms, combined oral contraceptive pill (COCP) and male sterilization. Up to 42% of women surveyed were unhappy with their contraception. A total of 27% premenopausal, 32% perimenopausal women and 40% postmenopausal used no contraception. One-third of women were unhappy about this and 19 unplanned pregnancies had occurred. The majority of women were informed regarding COCP use over 35 years, hormone replacement therapy, emergency contraception and ceasing contraception. The majority of women were unaware that more terminations of pregnancy are performed in women over 40 than any other age group per total pregnancies.Almost a third of women were unaware that chlamydia incidence is increasing in older women. Most would use condoms in new relationship. DISCUSSION AND CONCLUSIONS: Women accessing www.menopausematters.co.uk are well informed about contraception and sexual health. The majority of those accessing the site are sexually active, but many use no contraception, or are unhappy with their chosen method, leaving them vulnerable to unwanted pregnancy or sexually transmitted infection.


Assuntos
Comportamento Contraceptivo , Conhecimentos, Atitudes e Prática em Saúde , Comportamento Sexual/psicologia , Aborto Induzido/estatística & dados numéricos , Fatores Etários , Distribuição de Qui-Quadrado , Infecções por Chlamydia/epidemiologia , Preservativos/estatística & dados numéricos , Anticoncepcionais Orais Combinados , Coleta de Dados , Feminino , Humanos , Internet , Perimenopausa/psicologia , Pós-Menopausa/psicologia , Gravidez , Gravidez não Desejada , Pré-Menopausa/psicologia , Reino Unido
9.
Menopause Int ; 17(1): 14-5, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21427419

RESUMO

Previous surveys on www.menopausematters.co.uk and published in this journal show that women are reluctant to seek help for reduced libido, vaginal atrophy and dyspareunia despite adverse effects on health and wellbeing. Additionally, health professionals frequently fail to explore these areas during consultations despite proven treatments being available. Women suffering urinary incontinence (UI) show similar trends in their reticence to seek help and in their health professionals addressing their issues. These issues must be addressed through patient empowerment and direct questioning from health professionals. Well maintained, publically accessible toilets are also an important provision to achieving a holistic approach to UI.


Assuntos
Internet , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Qualidade de Vida/psicologia , Banheiros/estatística & dados numéricos , Incontinência Urinária/prevenção & controle , Incontinência Urinária/psicologia , Adaptação Psicológica , Atitude Frente a Saúde , Feminino , Humanos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Relações Médico-Paciente , Inquéritos e Questionários , Reino Unido/epidemiologia , Incontinência Urinária/epidemiologia , Saúde da Mulher
10.
Menopause Int ; 17(3): 82-7, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21903711

RESUMO

OBJECTIVE: To survey women who stopped hormone replacement therapy (HRT) after 2002, including those who later restarted. STUDY DESIGN: A questionnaire on the UK-based menopause website www.menopausematters.co.uk evaluating how women are influenced by HRT advice. Main outcome measures Answers to questions regarding stopping/restarting HRT in response to the advice in the early 2000s and advice given today. RESULTS: A total of 1100 responses were obtained. Of those who made the decision to stop HRT themselves, 56.4% (n = 425/754) said that they were influenced by the media. In those who would potentially most benefit from HRT, 72.8% (n = 220/302) stopped without medical advice. Overall, women aged under 50 years were significantly more likely to stop HRT themselves than women over 50 (P < 0.001). In women in whom symptoms returned, 37.5% (n = 362/966) said these affected their ability to work, 45.1% (n = 436) had problems with decision-making, 53.6% (n = 518) admitted to relationships being negatively affected and 29.2% (n = 286) said that symptoms affected their social relationships. Overall 46.5% of women (n = 485/1044) would not have stopped HRT given the current understanding of risk. Compared with women over 50, significantly more women under the age of 50 said that they would not have previously stopped their HRT based on their current understanding of risk (P < 0.001). CONCLUSIONS: The negative impact of published research and its reporting from the early 2000s are being mitigated by current press coverage. Media reports appear to influence the younger woman more than the older woman. Health professionals and media must learn the lessons from the past.


Assuntos
Terapia de Reposição Hormonal/psicologia , Menopausa , Adulto , Feminino , Pesquisas sobre Atenção à Saúde , Comunicação em Saúde , Humanos , Pessoa de Meia-Idade , Risco , Inquéritos e Questionários
11.
Menopause Int ; 16(2): 51-5, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20729493

RESUMO

OBJECTIVE: To evaluate an online digital story aimed to empower women suffering from urogenital atrophy to seek health professional advice. STUDY DESIGN: A questionnaire evaluating a digital story on the UK-based menopause website www.menopausematters.co.uk. Main outcome measure Answers to questions on empowerment. RESULTS: A total of 539 responses were obtained over the 62 weeks that the questionnaire was online. In women who had not previously sought help for urogenital atrophy, 145 were too embarrassed and 105 did not want to bother the health professional. Having watched the video, 73% (n = 105/143) of women who had been too embarrassed to discuss their symptoms with their doctor would now do so and 87% (n = 89/102) of women who had not wanted to bother their doctor would also make an appointment. Ninety-six percent (n = 138/144) of women would be willing to try treatment. Over two-thirds of women favoured webcast information to written information; however, postmenopausal women were less likely than peri- or premenopausal to favour this method of presenting health information. CONCLUSION: Using digital stories for health promotion is a new area for research. Our data provide preliminary evidence that women can feel more empowered to seek help for urogenital atrophy using digital storytelling.


Assuntos
Aceitação pelo Paciente de Cuidados de Saúde , Poder Psicológico , Sistema Urogenital/patologia , Webcasts como Assunto , Atrofia , Feminino , Promoção da Saúde , Humanos , Internet , Menopausa/psicologia , Inquéritos e Questionários
12.
Menopause Int ; 16(2): 68-73, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20729498

RESUMO

Vaginismus is generally described as an involuntary contraction of the vaginal musculature, which usually results in the failure of penetration. Despite a lack of consensus as to the exact definition, prevalence rates vary between 4.2% and 42%. It is commonly diagnosed at both gynaecological and psychosexual clinics. The majority of studies and treatment options concentrate on the premenopausal age group. It is accepted that even within this age group, the diagnosis is often incorrect as symptoms can be confused with dyspareunia and other sexual pain disorders. There is no literature discussing vaginismus in the postmenopausal patient, despite evidence that an active sex life is important to the majority of women, irrespective of age. It is known that the majority of women do not report difficulties in their sex life and it may be that the older patient is more embarrassed at disclosing any such difficulties. This review aims to highlight the possible causes of vaginismus in this older age group and to aid the clinician in asking the appropriate questions, performing the appropriate examination and suggesting possible treatment options.


Assuntos
Clínicos Gerais , Perimenopausa/fisiologia , Pós-Menopausa/fisiologia , Vaginismo/diagnóstico , Vaginismo/etiologia , Dispareunia/diagnóstico , Terapia de Reposição de Estrogênios , Feminino , Humanos , Guias de Prática Clínica como Assunto , Comportamento Sexual/fisiologia , Comportamento Sexual/psicologia , Vagina/fisiologia , Vaginismo/classificação , Vaginismo/epidemiologia
13.
Menopause Int ; 15(1): 8-12, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19237616

RESUMO

OBJECTIVE: The objective of this study is to use the internet to survey the effect of menopause on women's experience of libido. STUDY DESIGN: A questionnaire incorporating the Brief Profile of Female Sexual Function (B-PFSF) on a UK menopause website. Main outcome measure Questions on reduced libido, distress, level of help sought and treatment. RESULTS: Eighty-four percent of women (n = 2112/2527) felt that an active sex life was important. One thousand and fifty-one perimenopausal and 560 postmenopausal women reported reduced libido causing distress with 23% and 35% discussing this with health professionals. Eighteen percent perimenopausal and 30% postmenopausal women had tried non-testosterone hormone replacement therapy with 34% and 37%, respectively, finding it helpful. Testosterone was deemed useful in some perimenopausal (n = 6/17) and postmenopausal (n = 23/50) women. Twenty-seven percent premenopausal, 38% perimenopausal and 56% postmenopausal women reported vaginal dryness with 78% peri- and 87% postmenopausal women believing it a factor causing reduced libido. Twenty-two percent premenopausal, 28% perimenopausal and 46% postmenopausal women had discussed this with health professionals and 17%, 36% and 55%, respectively, were on treatment. Women in all reproductive epochs completed the B-PFSF (a validated tool for postmenopausal women only). CONCLUSIONS: An active sex life was deemed to be important but many women were not seeking help for menopause-related reduced libido causing distress. For many, vaginal changes contributed to their symptoms. In those seeking advice, treatment was commonly not prescribed. Health professionals must ask appropriate direct questions to all women, especially as part of menopausal assessment. A need for the B-PFSF to be validated in non-postmenopausal women was also indicated.


Assuntos
Inquéritos Epidemiológicos , Internet , Libido/fisiologia , Menopausa/fisiologia , Terapia de Reposição de Estrogênios , Feminino , Humanos , Menopausa/psicologia , Aceitação pelo Paciente de Cuidados de Saúde , Satisfação do Paciente , Doenças Vaginais/complicações
14.
Menopause Int ; 13(2): 79-83, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17540139

RESUMO

OBJECTIVE: To survey women's views on hormone replacement therapy (HRT), alternative therapies and sexual health using the Internet. Study design and main outcome measures. Three questionnaires were offered on a UK, patient-tailored, independent, clinician-led dedicated menopause website. They covered HRT, alternative therapies and sexual health. The anonymous responses of the users of the website were analysed. RESULTS: There were 1026, 1072 and 1002 responses for the HRT, alternative therapies and sexual health questionnaires, respectively. On the first, 75% of respondents were in favour of HRT; 36% felt media reports of the risks of HRT had been exaggerated and 73% of women did not know enough about HRT to make informed choices. In relation to alternative therapies, 85% of respondents felt they did not know enough to make informed choices, 71% received no advice before starting an alternative therapy and 69% were unaware of possible interactions. Ninety-five per cent would try alternative therapies before HRT in the belief that they were more natural and 68% were prepared to pay more than pound10 a month for such therapies. On the questionnaire on sexual health, 88% of respondents indicated that they believed an active sex life was important. Fifty-three per cent recorded that they experienced dyspareunia, but 51% of women hid their symptoms and 31% made excuses to avoid intercourse; 54% felt their confidence had been adversely affected. Only 20% had discussed their symptoms with health professionals and only 12% were using prescribed treatment. CONCLUSIONS: Online questionnaires are a useful means to obtain data. Our surveys raised several issues, including the observations that the majority of women said they did not know enough about HRT and alternative therapies to make informed choices. There appeared to be many women with vaginal symptoms who had not spoken with a health professional and therefore were untreated.


Assuntos
Terapia de Reposição de Estrogênios/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Internet , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Fitoterapia/estatística & dados numéricos , Adulto , Dispareunia/prevenção & controle , Feminino , Humanos , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/prevenção & controle , Educação de Pacientes como Assunto/estatística & dados numéricos , Extratos Vegetais/uso terapêutico , Plantas Medicinais , Vigilância da População , Inquéritos e Questionários , Reino Unido/epidemiologia , Saúde da Mulher
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