BackgroundFor decades, the rates of sexually transmitted infections (STIs), such as gonorrhoea, chlamydia and syphilis, have increased in Greenland, especially within the young age groups (15–29 years). From 2006 to 2013, the number of abortions has been consistent with approximately 800–900 abortions per year in Greenland, which is nearly as high as the total number of births during the same period. Previous studies in Greenland have reported that knowledge about sexual health is important, both as prevention and as facilitator to stop the increasing rates of STIs. A peer-to-peer education programme about sexual health requires adaption to cultural values and acceptance among the population and government in order to be sustainable.ObjectiveFormative evaluation of a voluntary project (SexInuk), in relation to peer-to-peer education with focus on sexual health. Two workshops were conducted in Nuuk, Greenland, to recruit Greenlandic students. DesignQualitative design with focus group interviews (FGIs) to collect qualitative feedback on feasibility and implementation of the project. Supplemented with a brief questionnaire regarding personal information (gender, age, education) and questions about the educational elements in the SexInuk project. Eight Greenlandic students, who had completed one or two workshops, were enrolled.ResultsThe FGIs showed an overall consensus regarding the need for improving sexual health education in Greenland. The participants requested more voluntary educators, to secure sustainability. The articulation of taboo topics in the Greenlandic society appeared very important. The participants suggested more awareness by promoting the project.ConclusionCultural values and language directions were important elements in the FGIs. To our knowledge, voluntary work regarding peer-to-peer education and sexual health has not been structurally evaluated in Greenland before. To achieve sustainability, the project needs educators and financial support. Further research is needed to investigate how peer-to-peer education can improve sexual and reproductive health in Greenland.

Background: Prostate cancer is a frequently diagnosed cancer and made up 6% of male cancer deaths globally in 2008. Its incidence varies more than 25-fold worldwide, which is primarily attributed to the implementation of the prostate-specific antigen (PSA) test in developed countries. To reduce harm of overdiagnosis, most international guidelines recommend surveillance programmes. However, this approach can entail negative psychosocial consequences from being under surveillance for an (over)diagnosed prostate cancer. Aim: To explore men's feelings and experiences in a surveillance programme. Design and setting: Qualitative study with Danish men diagnosed with asymptomatic prostate cancer Gleason score 6, who are in a surveillance programme Methods: 12 semi-structured, individual interviews were conducted and analysed with systematic text condensation and selected theories. Results: Most informants reported that they were astonished at the time of diagnosis. They were aware of the small likelihood of dying from cancer, but in some cases, the uncertainty created ambivalence between knowing and not knowing. The men expressed their risk awareness in different ways: a realization that life does not last forever, uncertainty towards the future, a feeling of powerlessness, and a need for control. Conclusions: The men in this study had substantial psychosocial consequences from being labelled with a cancer diagnosis. Bearing these men's high risk of overdiagnosis in mind, it is important to discuss whether the harms of this diagnosis outweigh the benefits. The psychosocial consequences of being in a prostate cancer surveillance programme should be explored further. KEY POINTS Current awareness: The number of men living with an asymptomatic prostate cancer has increased the last 20 years after the implementation of the PSA test. Main Statements: Men living with an asymptomatic, low-risk prostate cancer experience negative psychocosial consequences GPs should consider the possible negative psychosocial consequences in their decision-making of measuring the PSA level ARTICLE HISTORY

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medicine and physical education journals, and written 2 responses to letters from those entrenched in poor methodologies. Despite our polite, transparent, scientifically-based pleas for 'constructive, collaborative debate' we have encountered editorial bias, e.g. turned down without review; turned down despite positive reviews; appealed editorial decisions and been prevented from responding to letters commenting Conclusions Others have attempted to diminish our contributions by employing in letters a tone of thinly disguised hostility or accusing us of evangelistic fervour whilst failing to justify their own methods. Yes, we are challenging; shifting an entire research culture, which has its roots in university teaching, is not easyscientific rigour in aspects of our discipline plays second fiddle to practical, convenient, traditional and feasible. Although this is happening on the periphery of mainstream medical research, children's health matters and as the population becomes increasingly sedentary and overweight we urgently need to develop scientifically rigorous methods to measure and interpret CRF in health and disease. Already a generation of researchers and policy makers has been misinformed and misled by flawed data. Those of us facing these challenges need to work together to develop strategies for shifting research culture back towards defensible science.