Early medical abortion regimens, especially those that include mifepristone, have the potential to reshape the landscape of abortion provision in the United States. Because medical abortion does not require surgical training, it may attract new providers of abortion services from a variety of specialties, including advanced practice clinicians. The diffusion of abortion services into myriad clinical and office-based settings may
In a comparative study of the acceptability of medical abortion and surgical abortion among women in developing countries, patients at clinics in China, Cuba and India were allowed to choose between a surgical procedure and a medical regimen of mifepristone and misoprostol. The most common reasons women cited for choosing medical abortion were their desire to avoid surgery and general
Beverly Winikoff; Irving Sivin; Kurus J. Coyaji; Evelio Cabezas; Xiao Bilian; Gu Sujuan; Du Ming-kun; Usha R. Krishna; Andrea Eschen; Charlotte Ellertson
Despite the Supreme Court decision in 1973, Roe v. Wade, making abortion legally available without impedi ment during the first two trimesters of pregnancy, neither the legal nor ethical problems of abortion have been solved. Congressional opposition to federal financial support of abor tion, as well as a wide disparity in availability of abortion, indicates the still unsettled state of
The conventional management of spontaneous abortion is surgical evacuation of the uterus to prevent complications which may arise from retained products of conception (POC). This procedure is not without complications and also demands operating theatre resources. The purpose of this study was to determine the efficacy of a medical approach to the management of spontaneous abortion using the prostaglandin analogue, gemeprost. From an initial 212 women presenting with spontaneous abortion, 4 groups were defined according to what they required in the way of initial management. A group of 20 women were excluded from conservative medical management at presentation because they were bleeding heavily and judged to be unsuitable. Sixty women initially required no further management other than determining that they had a complete abortion using transvaginal sonography (TVS). The 132 women were treated with the prostaglandin analogue, gemeprost. Sixty were judged to need no further management afterwards and were initially discharged. The remaining 72 women underwent evacuation of retained products of conception (ERPC) after the gemeprost treatment as medical evacuation of the uterus appeared to had been incomplete. In each of these 4 groups so defined, there was 1 case where an ERPC was required after the patients have been discharged because of complications attributable to retained POC. We therefore found that no ERPC was necessary in the management of 118 out of 212 (55.6%) women who presented with spontaneous abortion. This has important implications in patient management and economical use of hospital resources. PMID:7848234
Chung, T K; Cheung, L P; Lau, W C; Haines, C J; Chang, A M
Comparisons of the efficacy of different regimens of medical abortion are difficult because of the widely varying protocols (even for testing identical regimens), divergent definitions of success and failure, and lack of a standard method of analysis. In this article we review the current efficacy literature on medical abortion, highlighting some of the most important differences in the way that
James Trussell; Charlotte Ellertson
Medical abortion is not recognized as a high-risk factor for invasive pelvic infection. Here, we report two cases of group A Streptococcus (GAS; Streptococcus pyogenes) endometritis following medical abortions with a protocol of oral mifepristone and misoprostol. PMID:24829245
Gendron, Nicolas; Joubrel, Caroline; Nedellec, Sophie; Campagna, Jennifer; Agostini, Aubert; Doucet-Populaire, Florence; Casetta, Anne; Raymond, Josette; Poyart, Claire; Kernéis, Solen
Early medical abortion was introduced in Denmark in 1998. This article describes our experiences with the first 100 patients at Herlev University Hospital. The regimen was 600 mg mifepriston (RU486) given orally on day one. All women had an ultrasound examination before RU486 was given in order to ensure an intrauterine pregnancy and a gestationel age of eight weeks or less, and all had a quantitative P-hCG. On day three the patients received 1 mg gemeprost as vagitory as well as a paracetamol/-codein suppository. They were observed in the department for four hours, and were thereafter discharged no matter whether a complete abortion had occurred ot not. On day 14 a new P-hCG was taken. All women in whom the hCG value was not reduced to one half of the initial value or less underwent a new ultrasound examination. All women were given a questionnaire. The effectivity was 96%. Four of 100 women were evacuated: one due to severe vaginal bleeding four hours after application of gemeprost, two because of womiting soon after having taken RU486 and one due to incomplete abortion. Half of the women began to bleed before application of gemeprost, and 91% had bleeding for more than six days. One half had no side effects to mifepristone, the other half had mild nausea. Nine of ten patients were sufficiently relieved of pain without opioids, whereas 10% were insufficiently pain relieved. Eight of ten patients would choose the same method again, in case of a future need for an induced abortion. The reason for not preferring a medical abortion among the remaining 20% was primarily pain. Early medical abortion should be offered to all women referred for induced abortion with a gestational age of eight weeks or less. PMID:10485206
Lidegaard, O; Larsen, J F; Blaabjerg, J; Larsen, E
NASA and DOD studies of medical-planning and logistical problems are reviewed as applicable to providing emergency medical care at remote transoceanic abort landing (TAL) sites. Two options are analyzed including a modified surgical response team and a combination physician/medical technician team. The two concepts are examined in terms of cost-effectiveness, specific types of medical support such as blood procurement, and search-and-rescue requirements. It is found that the physician/technician team is more economically efficient, and the description of the concept permits the development of an effective TAL-site astronaut medical-support system. A balance is struck between the competing problems of cost and medical capability by planning for on-scene medical stabilization and air evacuation to DOD tertiary medical centers.
Mckenas, David K.; Jennings, Richard T.
Vacuum aspiration, dilatation and curettage, hysterotomy, and, in some cases, hysterectomy comprise surgical methods of abortion. Oral administration of RU-486, epostane, prostaglandins E and F2 and vaginal suppositories of prostaglandins E and F2 are medical abortion methods. The traditional or clandestine methods are usually performed by unqualified persons and pregnant women themselves. These methods tend to be inefficient and harmful. They include oral preparations of herbs and drugs (e.g., quinine and ergot), introduction of fluids (e.g., household disinfectants) into the vagina, introduction of foreign bodies (e.g., twigs, stems, hollow tubes, needles, wire) into the uterus. Hospital records, death certificates, and community-based surveys are common sources of data on abortion. Worldwide, 40-70/1000 women of childbearing age undergo an abortion. 20-33% of all pregnancies are terminated. Abortion is always legal when it is performed to save a pregnant woman's life. In most countries, it is legal to protect the woman's physical or mental health against serious danger. The risk of death from a legal abortion is rare. On the other hand, when an abortion is performed by an unqualified, unskilled abortionist and/or under unhygienic conditions (all of which are common in countries who have a law against abortion) the risk of death is much higher. In fact, abortion is one of the leading causes of maternal death in many countries (25% and 86% of maternal deaths in Bangladesh and Romania, respectively). Common complications of abortion are incomplete abortion, trauma to pelvic organs (e.g., uterine perforation), tetanus, and infertility. In some developing countries, the cost of treating abortion complications account for up to 50% of maternity hospital budgets. Ways to reduce mortality from unsafe abortion include promoting contraceptive use, legalizing abortion, allowing trained practitioners to perform abortions for health reasons, and improving clinical management of abortion complications. PMID:12345783
Second trimester abortion is associated with higher rates of complications compared to first trimester abortion. Dilatation and evacuation (D&E) and medical induction using misoprostol alone or a combination of mifepristone and misoprostol are the methods most commonly used for later abortion in developed countries, yet little research has directly compared them. We reviewed the literature on PubMed and identified only
Daniel Grossman; Kelly Blanchard; Paul Blumenthal
The right to health under the International Covenant on Economic, Social, and Cultural Rights, to which Canada is a signatory, entitles women to available, accessible, and acceptable abortion care. Abortion care in Canada currently fails this standard. Medication abortion (the use of drugs to terminate a pregnancy) could improve abortion care in Canada, but its potential remains unrealized. This is in part attributable to the unavailability of mifepristone, the safest and most effective pharmaceutical for medication abortion. Given that it could improve abortion care, we investigated why mifepristone remains unapproved in Canada, whether its unavailability is attributable to government inaction, and whether Canada is therefore failing to fulfill its obligations under the right to health.
Grenon, Amy; Harrison-Wilson, Leigh
Nigeria has restrictive abortion laws; unsafe abortion and its complications are major public health challenges. Access to reproductive health services in Nigeria, including medical abortion, is poor. We determined the socio-demographic characteristics, patterns of abortion practices, and experiences of medical abortions among abortion seekers in southeastern Nigeria. We carried out a descriptive, cross sectional survey of 100 consecutive medical abortion seekers in southeastern Nigeria. Subjects had a mean age of 23.5 + 4.4 years. Fifty-five percent of respondents were students. Sixty-four percent had a secondary educational level, 33% had a tertiary education level and 3% had a primary educational level. Fifty-eight percent of subjects were ages 18-20 years at coitarche; 25% had one or more previous deliveries and 49% had a previous termination of pregnancy. Forty-eight percent had used drugs for pregnancy terminations. Drugs used for termination included quinine combined with other drugs in 8%; gynaecosid alone in 6%, gynaecosid combined with other drugs in 6% menstrogen combined with other drugs in 6% and an unclassified drug in 14%. Thirty-three percent of subjects purchased their abortion drugs in a pharmacy. Three percent, 2%, and 0% of subjects had a knowledge of misoprostol, mifepristone and methotrexate, respectively. One percent of respondents had used misoprostol. We detected serious information gaps regarding abortion and poor access to reproductive health services. There is a need for policies and program to bridge this gap, and a need for revision of the present Nigerian abortion law. PMID:23082598
Adinma, Echendu Dolly; Adinma, Joseph Ifeanyi Brian-D; Iwuoha, Chima; Akiode, Akinsewa; Oji, Ejike; Okoh, Matthew
Background and methodologySouth Africa's Choice on Termination of Pregnancy Act of 1996 provides for safe termination of pregnancy (TOP) in designated facilities in the public and private health sectors. In 2001, mifepristone-misoprostol medical abortion was approved for TOP up to 56 days, but this method is not yet available in the public sector. Information on the operational requirements for integrating
Mary Kawonga; Kelly Blanchard; Diane Cooper; Lee Cullingworth; Teresa Harrison; Kim Dickson; Claire von Mollendorf; Beverly Winikoff
84 women (mean age: 29 years) with a history of spontaneous abortion (unexplained in 95% of cases) were compared with a control group (n = 72). Two subgroups, each of 31 women were selected, in which cases with recurrent spontaneous abortion were compared with uncomplicated pregnancies. Psychological disturbances, ineffective coping strategies and medical risk factors were significantly increased in the abortion group, but socioeconomic (occupational, financial) problems linked with higher social class level less importantly. In women with recurrent spontaneous abortions psychological problems and depressive coping modes were predominant, in uncomplicated pregnancies the risk factors were very low. The most frequent psychological disturbances in the abortion group were mourning reactions after pregnancy loss. It appears that psychological factors are less a cause than the consequence of the abortion event. Moreover, both the multifactorial hypothesis of early pregnancy wastage, and the importance of prenatal diagnosis in order to identify possible risk factors, especially in cases of habitual abortion, are stressed. PMID:2618054
In Latin America, where abortion is almost universally legally restricted, medical abortion, especially with misoprostol alone, is increasingly being used, often with the tablets obtained from a pharmacy. We carried out in-depth interviews with 49 women who had had a medical abortion under clinical supervision in rural and urban settings in Mexico, Colombia, Ecuador and Peru, who were recruited through
María Mercedes Lafaurie; Daniel Grossman; Erika Troncoso; Deborah L Billings; Susana Chávez
In Latin America, where abortion is almost universally legally restricted, medical abortion, especially with misoprostol alone, is increasingly being used, often with the tablets obtained from a pharmacy. We carried out in-depth interviews with 49 women who had had a medical abortion under clinical supervision in rural and urban settings in Mexico, Colombia, Ecuador and Peru, who were recruited through
Maria Mercedes Lafaurie; Daniel Grossman; Erika Troncoso; Deborah L Billings; Susana Chaveze
Surveys of first- and fourth-year Johns Hopkins University (Maryland) medical students found little change in attitudes about abortion over four years. Attitudes correlated most strongly with personal beliefs about when a fetus is considered human life and somewhat with student gender. Results are used in a medical ethics course to illuminate…
Dans, Peter E.
Boundary work refers to the strategies deployed by professionals in the arenas of the public, the law and the workplace to define and defend jurisdictional authority. Little attention has been directed to the role of documents in negotiating professional claims. While boundary work over induced abortion has been extensively documented, few studies have examined jurisdictional disputes over the treatment of abortion complications, or post-abortion care (PAC). This study explores how medical providers deploy medical records in boundary work over the treatment of complications of spontaneous and induced abortion in Senegal, where induced abortion is prohibited under any circumstance. Findings are based on an institutional ethnography of Senegal's national PAC program over a period of 13 months between 2010 and 2011. Data collection methods included in-depth interviews with 36 health care professionals, observation of PAC services at three hospitals, a review of abortion records at each hospital, and a case review of illegal abortions prosecuted by the state. Findings show that health providers produce a particular account of the type of abortion treated through a series of practices such as the patient interview and the clinical exam. Providers obscure induced abortion in medical documents in three ways: the use of terminology that does not differentiate between induced and spontaneous abortion in PAC registers, the omission of data on the type of abortion altogether in PAC registers, and reporting the total number but not the type of abortions treated in hospital data transmitted to state health authorities. The obscuration of suspected induced abortion in the record permits providers to circumvent police inquiry at the hospital. PAC has been implemented in approximately 50 countries worldwide. This study demonstrates the need for additional research on how medical professionals negotiate conflicting medical and legal obligations in the daily practice of treating abortion complications. PMID:24608117
An engineering analysis and computer code (AERSEP) for predicting Space Shuttle Orbiter - HO Tank longitudinal aerodynamic characteristics during abort separation has been developed. Computed results are applicable at Mach numbers above 2 for angle-of-att...
The author refers to a previous article in the November 1972 issue which contains inaccuracies with regard to the state of the New Zealand law concerning abortions. The abortion law is not Section 182 of the Crimes Act as stated but Sections 183-187 of the Crimes Act under which everyone commits a crime who unlawfully uses any means with intent to produce a miscarriage. It is no defense that the patient was in fact not pregnant. All induced or attempted miscarriages are unlawful except when the doctor acts only in good faith to preserve the woman's life or to save her from becoming a physical or mental wreck. The law makes no provision for abortion in cases of rape, fetal deformity, girls under 16, idiots, or women incapable of being mothers. Abortion is unlawful even for the most drastic nonmedical indications. The quality of life of the mother is not a criterion. Section 186 prohibits the supply or procuring of any drug or instrument intended for unlawfully procuring a miscarriage. By Section 187, it is no defense that the instrument, drug, or other device was in fact incapable of procuring a miscarriage. PMID:4512497
The purpose of the manual is to provide the medical assisting student a text which presents the common laboratory procedures in use today in physician's offices. The procedures for performing a complete urinalysis are outlined, along with those for carrying out various hematological tests. Information is also presented to help the student learn to…
Most women undergoing first-trimester abortion are healthy. However, abortion providers also encounter women with a wide variety of medical conditions, some of which are serious and complex. When such a condition exists, consultation with the woman's physician or a specialist can facilitate decision making regarding hospital referral and additional preparations that may be required. Medical conditions may determine the approach to abortion. Surgical abortion is preferred when mifepristone or methotrexate is contraindicated. Medication abortion may be preferred when lithotomy position is not possible or in patients with extreme obesity. Limited data suggest that women treated with anticoagulation therapy bleed more than other women during surgical abortion, although this additional bleeding may be clinically unimportant. The decision to temporarily discontinue anticoagulation therapy will depend on the agent used and the underlying risk of thrombosis. According to the American Heart Association, additional antibiotics are not recommended to prevent endocarditis in women with cardiac lesions during surgical abortion. We review specific recommendations for women with common medical conditions. In some women, highly effective postabortion contraception is essential to prevent pregnancy-related morbidity. The U.S. Medical Eligibility Criteria for Contraceptive Use, 2010, provides guidance for method selection for women with medical problems. PMID:23039921
Guiahi, M; Davis, A
Objective: To determine whether management of incomplete first-trimester abortion with vaginal misoprostol in an under-resourced setting is a viable treatment option. Methods: A total of 94 women were randomized to 600 ?g of misoprostol intravaginally or to surgical curettage. The women receiving misoprostol were administered a second dose if the abortion was incomplete; and if still not complete after a
S. Moodliar; J. S. Bagratee; J. Moodley
According to this study based on survey data, little overt discrimination exists in medical admissions policy on the basis of applicants' personal or professional attitudes toward abortion and sterilization. Mandated by Congress to investigate charges of ...
Mid-level clinicians are integral to provision of pregnancy-related care in many settings. Yet midwives and other non-physician clinicians are excluded from training and from providing medical abortion. A substantial body of evidence exists demonstrating that mid-level providers, including nurses and midwives specialized in pregnancy-related care for women, are either already competently involved in providing medical abortions or have the requisite
Jillian Yarnall; Yael Swica; Beverly Winikoff
An engineering analysis and computer code (AERSEP) for predicting Space Shuttle Orbiter - HO Tank longitudinal aerodynamic characteristics during abort separation has been developed. Computed results are applicable at Mach numbers above 2 for angle-of-attack between plus or minus 10 degrees. No practical restrictions on orbiter-tank relative positioning are indicated for tank-under-orbiter configurations. Input data requirements and computer running times are minimal facilitating program use for parametric studies, test planning, and trajectory analysis. In a majority of cases AERSEP Orbiter-Tank interference predictions are as accurate as state-of-the-art estimates for interference-free or isolated-vehicle configurations. AERSEP isolated-orbiter predictions also show excellent correlation with data.
This article presents results from a small, introductory clinical study offering a simplified regimen medical abortion to women in Turkey. A total of 208 women from five sites were recruited from July 2000 through March 2001. All eligible consenting women were given 200 mg oral mifepristone at the clinic followed by 400 microg oral misoprostol 2 days later either at home or at the clinic. The overall success rate of 84.1% is lower than in previous studies of this regimen, and a surprisingly high proportion of women (9.1%) were diagnosed with incomplete abortion. In spite of the higher than expected failure rate, women expressed a high degree of satisfaction. Several challenges were faced during this study, providing valuable insights about ways to introduce medical abortion into new settings with the best chances for success. PMID:15504380
Akin, Ayse; Blum, Jennifer; Ozalp, Sinan; Ondero?lu, Lütfü; Kirca, Uzeyir; Bilgili, Nihal; Koço?lu, Gonca; Philip, Neena; Winikoff, Beverly
Induced abortion and sexual sterilization are the most common contraceptive methods in the world today. There were an estimated 40 million abortions in 1979, notwithstanding the fact that Islamism, Catholicism, and Buddhism are strongly against the practice. Some international and powerful organizations, notably the IPPF, are trying to expand abortion and sterilization services in the third world, while in the countries of the socialist block abortion as a contraceptive measure is being slowly replaced by oral contraception. On the other hand, in North America, England, and in the Scandinavian countries abortion and sterilization are gradually replacing oral contraception as the most used method of fertility control. The number of abortions in France is now estimated to be 30-40/100 live births, a percentage that very probably underestimates the reality; in France the number of abortions is almost the same in rural and in urban areas. Modern and highly effective methods of contraception are still preferred to abortion and sterilization. It would seem important to warn women against the clinical dangers of repeated abortions, and against the psychological dangers of sterilization and against the banalization of both such radical procedures. The responsibility for such medical acts does not only belong to women or to couples and to physicians, but to politicians and to members of the legal professions. PMID:7455552
Soutoul, J H
This article presents results from a small, introductory clinical study offering a simplified regimen medical abortion to women in Turkey. A total of 208 women from five sites were recruited from July 2000 through March 2001. All eligible consenting women were given 200 mg oral mifepristone at the clinic followed by 400 ?g oral misoprostol 2 days later either at
Ayse Akin; Jennifer Blum; Sinan Özalp; Lütfü Öndero?lu; Üzeyir K?rca; Nihal Bilgili; Gonca Koço?lu; Neena Philip; Beverly Winikoff
The Medical and Dental Audit Procedure Manual was developed under a grant to the Albert Einstein College of Medicine. The medical audit procedures represent procedures in use for over twenty years, but with the advent of the neighborhood health center mov...
After its formation in 1910 as a self-governing dominion within the British empire, the Union of South Africa followed a combination of English and Roman-Dutch common laws on abortion that decreed the procedure permissible only when necessary to save a woman's life. The government continued doing so after South Africa withdrew from the Commonwealth and became a republic in 1961. In 1972 a sensational trial took place in the South African Supreme Court that for weeks placed clandestine abortion on the front pages of the country's newspapers. Two men, one an eminent doctor and the other a self-taught abortionist, were charged with conspiring to perform illegal abortions on twenty-six white teenagers and young unmarried women. The prosecution of Dr Derk Crichton and James Watts occurred while the National Party government was in the process of drafting abortion legislation and was perceived by legal experts as another test of the judiciary's stance on the common law on abortion. The trial was mainly intended to regulate the medical profession and ensure doctors ceased helping young white women evade their 'duty' to procreate within marriage. Ultimately, the event encapsulated a great deal about elites' attempt to buttress apartheid culture and is significant for, among other reasons, contributing to the production of South Africa's extremely restrictive Abortion and Sterilisation Act (1975). PMID:24775430
Klausen, Susanne M
After its formation in 1910 as a self-governing dominion within the British empire, the Union of South Africa followed a combination of English and Roman-Dutch common laws on abortion that decreed the procedure permissible only when necessary to save a woman’s life. The government continued doing so after South Africa withdrew from the Commonwealth and became a republic in 1961. In 1972 a sensational trial took place in the South African Supreme Court that for weeks placed clandestine abortion on the front pages of the country’s newspapers. Two men, one an eminent doctor and the other a self-taught abortionist, were charged with conspiring to perform illegal abortions on twenty-six white teenagers and young unmarried women. The prosecution of Dr Derk Crichton and James Watts occurred while the National Party government was in the process of drafting abortion legislation and was perceived by legal experts as another test of the judiciary’s stance on the common law on abortion. The trial was mainly intended to regulate the medical profession and ensure doctors ceased helping young white women evade their ‘duty’ to procreate within marriage. Ultimately, the event encapsulated a great deal about elites’ attempt to buttress apartheid culture and is significant for, among other reasons, contributing to the production of South Africa’s extremely restrictive Abortion and Sterilisation Act (1975).
Klausen, Susanne M.
A proposal is presented for a Community College of Philadelphia course, entitled "Medical Office Laboratory Procedures," which provides a laboratory introduction to microscopic and chemical analysis of blood and urine as performed in the physician's office. Following a standard cover form, a statement of the purpose of the course discusses course…
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Since the U.S. Supreme Court's 1992 Casey decision many states have enacted biased abortion counseling laws. These laws mandate that abortion providers furnish to women with unwanted pregnancies state-approved medical information about possible side effects from having an abortion that are false. The most egregious falsehoods are that abortion is linked to mental health problems (e.g., suicide, postabortion traumatic stress
Marshall H. Medoff
Background Identifying unsafe abortion among the major causes of maternal deaths and respecting the rights to health of women, in 2002, the Nepali parliament liberalized abortion up to 12 weeks of pregnancy on request. However, enhancing women’s awareness on and access to safe and legal abortion services, particularly in rural areas, remains a challenge in Nepal despite a decade of the initiation of safe abortion services. Methods Between January 2011 and December 2012, an operations research study was carried out using quasi-experimental design to determine the effectiveness of engaging female community health volunteers, auxiliary nurse midwives, and nurses to provide medical abortion services from outreach health facilities to increase the accessibility and acceptability of women to medical abortion. This paper describes key components of the operations research study, key research findings, and follow-up actions that contributed to create a conducive environment and evidence in scaling up medical abortion services in rural areas of Nepal. Results It was found that careful planning and implementation, continuous advocacy, and engagement of key stakeholders, including key government officials, from the planning stage of study is not only crucial for successful completion of the project but also instrumental for translating research results into action and policy change. While challenges remained at different levels, medical abortion services delivered by nurses and auxiliary nurse midwives working at rural outreach health facilities without oversight of physicians was perceived to be accessible, effective, and of good quality by the service providers and the women who received medical abortion services from these rural health facilities. Conclusions This research provided further evidence and a road-map for expanding medical abortion services to rural areas by mid-level service providers in minimum clinical settings without the oversight of physicians, thus reducing complications and deaths due to unsafe abortion.
This was a randomized double-blind placebo-controlled trial to determine the effect of oral contraceptive (OC) pills taken immediately after medical abortion on the duration of bleeding and complete abortion rate. Two hundred women in the first 49 days of pregnancy were given 200 mg mifepristone orally followed by 400 mg misoprostol vaginally 48 h later. One day later, they were
Oi Shan Tang; Pei Pei Gao; Linan Cheng; Sharon W. H. Lee; Pak Chung Ho
A new route of sublingual administration of misoprostol was used by 25 women with first trimester, non-viable intrauterine gestation and by 18 women requesting mid-trimester termination of pregnancy. Twenty-three women (92%, 95% CI 75, 98) with first trimester, non-viable gestation had complete abortion after sublingual misoprostol. All women (100%, 95% CI 82, 100) requesting second trimester abortion aborted, and the
O. S. Tang; P. C. Ho
BackgroundMigrant Asian women reportedly have low levels of contraceptive use and high rates of abortion in New Zealand. Chinese make up the largest proportion of migrant Asian in New Zealand. This study aimed to describe the contraceptive choices of Chinese women seeking abortion; to examine method choice in relation to demographic characteristics (including length of stay) and to determine whether
Sally B. Rose; Zhang Wei; Annette J. Cooper; Beverley A. Lawton
Between December 1978-May 1979, 1118 health workers in 63 hospitals and 732 nonhospital facilities were interviewed to identify case reports of maternal and abortion-related deaths in Bangladesh. Of 1933 pregnancy-related deaths identified, 498 (25.8%) were due to induced abortion. Findings of an earlier study of maternal mortality was used to estimate that about 21,600 pregnancy-related deaths occur each year in Bangladesh. An estimated 7.5% of all pregnancy-related deaths were identified in this survey. Health workers reported 1590 cases of complications from abortion, of which 498 (31.3%) ended in death. Village dais (traditional birth attendants) and traditional practitioners were the largest groups of operators (42.1% and 18.1% respectively). Menstrual regulation or dilatation and curettage (medically approved procedures) were used in only 9.1% of the cases. Nearly 1/2 of the complicated abortions were induced by inserting a foreign object, such as a stick or root (sometimes treated with an herb), into the uterus and leaving it until either abortion or complications occurred. The proportion of complicated abortions resulting in death was lowest for medically approved procedures (4.9%) and highest for vigorous physical activity (100%) and abdominal pressure (66.7%), although the last 2 accounted for only 2.3% of abortion procedures. Women who died after abortion had a longer duration of pregnancy than women who survived. An extrapolation from these results gives a figure of 780,000 abortions in Bangladesh in 1978 and 7800 deaths that year from abortion complications. In this study, the attitudes toward abortion on the part of 396 physicians working in rural health complexes and subdivision and district hospitals were surveyed. Most of those interviewed (98.9%), indicated their approval of induced abortion in 1 or more circumstances not approved by the abortion law of the country. PMID:12338521
Obiadullah, M; Khan, A R; Measham, A R; Rosenberg, M J; Jabeen, S; Rochat, R W; Chowdhury, A Y
This prospective study of 104 women investigated the dose-related efficacy of mifepristone combined with oral misoprostol in the management of first trimester miscarriage (missed abortion and blighted ovum). Forty-four women (group A) received 600 mg of oral mifepristone and 60 women (group B) received 200 mg of mifepristone, followed after 48 hours by oral misoprostol. Successful treatment was an empty uterus on scan and no bleeding after 10 days. This was achieved in 70.5% of group A and 66.7% of group B. Also studied were amount and time to cessation of bleeding, pain scores, analgesic requirements, adverse effects and infections. Of group A, 54.5% had heavy bleeding and bleeding stopped on average by 8 days. Median pain scores were 5.5 on a linear scale and 18% of women received intramuscular opiate analgesia. Adverse effects were nausea in 25% of women and diarrhoea in 16%. Of group B, 38.3% had heavy bleeding and bleeding stopped on average by 7 days. Median pain scores were 4.5 with 25% of women receiving intramuscular opiates. Nausea occurred in 7% of women and diarrhoea in 7%. We concluded that 200 mg of mifepristone and oral misoprostol is as effective and better tolerated than 600 mg mifepristone with oral misoprostol. Medical management of miscarriage is a valid option for those women seeking an alternative to traditional surgical management. PMID:14675986
Coughlin, L B; Roberts, D; Haddad, N G; Long, A
Partial-birth abortion bans patterned after the federal bill passed by both houses of Congress are constitutional. The clear legislative definition can be easily distinguished from other abortion procedures. Abortion precedents do not apply to such bans because the abortion right pertains to unborn human beings, not to those partially delivered. Such bans are also rationally-related to legitimate state interests. Even if abortion jurisprudence is deemed to apply in the partial-birth abortion context, a ban is still constitutional under Casey because a ban on partial-birth abortions does not impose an undue burden on the abortion right. PMID:9707939
Bopp, J; Cook, C R
Medical confidentiality is of individual and of general interest. Medical confidentiality is not absolute. European countries differ in their legislative approaches of consent for data-sharing and lawful breaches of medical confidentiality. An increase of interference by the legislator with medical confidentiality is noticeable. In The Netherlands for instance this takes the form of new mandatory duties to report resp. of legislation providing for a release of medical confidentiality in specific situations, often under the condition that reporting takes place on the basis of a professional code that includes elements imposed by the legislator (e.g. (suspicion of) child abuse, domestic violence). Legislative interference must not result in the patient loosing trust in healthcare. To avoid erosion of medical confidentiality, (comparative) effectiveness studies and privacy impact assessments are necessary (European and national level). Medical confidentiality should be a subject of permanent education of health personnel. PMID:25065032
Abbing, Henriette Roscam
This manual presents laboratory procedures for the differentiation and identification of disease agents from clinical materials. Included are procedures for the collection of specimens, preparation of culture media, pure culture methods, cultivation of the microorganisms in natural and simulated natural environments, and procedures in…
Department of the Army, Washington, DC.
A costing procedure for medical information systems is described. The procedure incorporates state-of-the-art costing methods in an easy to follow “cookbook” format. Application of the procedure consists of filling out a series of Mac-Tor EZ-Cost forms. The procedure and forms have been field tested by application to a cardiovascular database system. This article describes the major features of the costing procedure. The forms and other details are available upon request.
Torrance, Janice L.; Torrance, George W.; Covvey, H. Dominic
BACKGROUND: Misoprostol and expectant care have been shown to be acceptable alternatives to routine surgical evacuation for treatment of spontaneous abortion in the first trimester of pregnancy. The objective of this study was to analyse the cost of expectant care, misoprostol therapy and surgical evacuation. METHODS: A decision tree was designed to simulate the clinical outcome and health care resource
Joyce H. S. You; Tony K. H. Chung
Professor Walker (June 13, p. 1319) is right in saying that it is best to use both the weight of the fetus and its presumed gestational age as the criteria for the registration of a stillbirth, and that any fetus delivered before the end of the 22nd week, and weighing less than 500 g, can be assumed to have had no chance of survival and should therefore be regarded as an abortion and not as a stillbirth. The difficulty when using the dates alone, "fairly and honestly and properly assessed," in order to determine the legality of a procured abortion is that it is seldom easy to be be sure that they have been accurately reported, depending as they often do upon the word of the mother. Most of the distressing stories of aborted fetuses crying, or showing other signs of life, before 24 weeks probably mean that they were considerably older than was originally supposed. A medical practitioner responsible for procuring an abortion under the 1967 Act, who honestly believed that the child was incapable of surviving, and therefore not protected under the Infant Life (Preservation) Act 1929, would not be guilty of an offense if this belief turned out to have been mistaken, provided it had been formed in good faith after proper inquiries, and provided that everything possible had been done to save the child as soon as it was realized that it might have had a chance of survival. If the child had been viable, and had died as a in the belief that it was not, then it cannot be regarded as an abortion and thus be excluded from the perinatal mortality statistics. To make sure that this will not happen, the regulations would have to be amended to require that the notification sent to the (CMO) Chief Medical Officer should record not only the date of the last menstrual period (as to the present) but also the weight of the fetus at delivery. If this is under 500 g, it can be counted as an abortion, but if it is above the figure there ought to be an independent postmortem examination, with a report to the CMO as to whether, and, if so, why (e.g., because the lungs were not inflatable) the fetus was considered not to have been viable. Failing such positive evidence of inviability, any child over, say 500 g, which dies before or after a procured "abortion" ought to be recorded as a perinatal death. PMID:6113390
Goodhart, C B
Replies to the request by the Journal of Nursing on readers' positions against induced abortion indicate there is a definite personal position against induced abortion and the assistance in this procedure. Some writers expressed an emotional "no" against induced abortion. Many quoted arguments from the literature, such as a medical dictionary definition as "a premeditated criminally induced abortion." The largest group of writers quoted from the Bible, the tenor always being: "God made man, he made us with his hands; we have no right to make the decision." People with other philosophies also objected. Theosophical viewpoint considers reincarnation and the law of cause and effect (karma). This philosophy holds that induced abortion impedes the appearance of a reincarnated being. The fundamental question in the abortion problem is, "can the fetus be considered a human life?" The German anatomist Professor E. Bleckschmidt points out that from conception there is human life, hence the fertilized cell can only develop into a human being and is not merely a piece of tissue. Professional nursing interpretation is that nursing action directed towards killing of a human being (unborn child) is against the nature and the essence of the nursing profession. A different opinion states that a nurse cares for patients who have decided for the operation. The nurse doesn't judge but respects the individual's decision. Some proabortion viewpoints considered the endangering of the mother's life by the unborn child, and the case of rape. With the arguments against abortion the question arises how to help the woman with unwanted pregnancy. Psychological counseling is emphasized as well as responsible and careful assistance. Referral to the Society for Protection of the Unborn Child (VBOK) is considered as well as other agencies. Further reader comments on this subject are solicited. PMID:6913282
Analysis of abortion in Mexico from a juridical perspective requires recognition that Mexico as a national community participates in a double system of values. Politically it is defined as a liberal, democratic, and secular state, but culturally the Judeo-Christian ideology is dominant in all social strata. This duality complicates all juridical-penal decisions regarding abortion. Public opinion on abortion is influenced on the 1 hand by extremely conservative groups who condemn abortion as homicide, and on the other hand by groups who demand legislative reform in congruence with characteristics that define the state: an attitude of tolerance toward the different ideological-moral positions that coexist in the country. The discussion concerns the rights of women to voluntary maternity, protection of health, and to making their own decisions regarding their bodies vs. the rights of the fetus to life. The type of analysis is not objective, and conclusions depend on the ideology of the analyst. Other elements must be examined for an objective consideration of the social problem of abortion. For example, aspects related to maternal morbidity and mortality and the demographic, economic, and physical and mental health of the population would all seem to support the democratic juridical doctrine that sees the clandestine nature of abortion as the principal problem. It is also observed that the illegality of abortion does not guarantee its elimination. Desperate women will seek abortion under any circumstances. The illegality of abortion also impedes health and educational policies that would lower abortion mortality. There are various problems from a strictly juridical perspective. A correct definition of the term abortion is needed that would coincide with the medical definition. The discussion must be clearly centered on the protected juridical right and the definition of reproductive and health rights and rights to their own bodies of women. The experiences of other countries with decriminalization of abortion should also be assessed. Factors considered should include the true impunity of abortion, public health problems and socioeconomic problems generated by the state through criminalization of abortion, and the psychological and economic implications for women of the criminal status of abortion. Systems of decriminalization should be examined to decide which would be appropriate for Mexico. These systems include authorizing complete freedom of choice for the 1st trimester and permitting abortion only for specific indications. All penal codes in Mexico now use the system of abortion for specific indications. Few cases are accepted for legal pregnancy termination. PMID:12158044
Perez Duarte, A E
Presented are laboratory procedures of a serologic or immunologic nature for use in the diagnosis of a variety of infectious and noninfectious conditions. Included are tests for the detection of specific antibodies in the patient's serum, as well as immunologic tests for the detection of other products in the patient's serum and biological fluids.…
Department of the Army, Washington, DC.
12 Banks and Banking 9 2013-01-01 2013-01-01 false Special procedure...Medical records. 1102.104 Section 1102.104 Banks and Banking FEDERAL FINANCIAL INSTITUTIONS EXAMINATION COUNCIL APPRAISER REGULATION...
12 Banks and Banking 9 2012-01-01 2012-01-01 false Special procedure...Medical records. 1102.104 Section 1102.104 Banks and Banking FEDERAL FINANCIAL INSTITUTIONS EXAMINATION COUNCIL APPRAISER REGULATION...
This article gives an overview of what is known about second trimester abortions in India, including the reasons why women seek abortions in the second trimester, the influence of abortion law and policy, surgical and medical methods used, both safe and unsafe, availability of services, requirements for second trimester service delivery, and barriers women experience in accessing second trimester services.
Suchitra S Dalvie
A bio-medical flow sensor including a packageable unit of a bottle, tubing and hypodermic needle which can be pre-sterilized and is disposable. The tubing has spaced apart tubular metal segments. The temperature of the metal segments and fluid flow therein is sensed by thermistors and at a downstream location heat is input by a resistor to the metal segment by a control electronics. The fluids flow and the electrical power required for the resisto to maintain a constant temperature differential between the tubular metal segments is a measurable function of fluid flow through the tubing. The differential temperature measurement is made in a control electronics and also can be used to control a flow control valve or pump on the tubing to maintain a constant flow in the tubing and to shut off the tubing when air is present in the tubing.
Winkler, H. E. (inventor)
In recent times, certain well-publicised cases involving allegations of inadequate and dangerous medical practice have led to a number of reviews into, and consequent changes to, the New South Wales medical regulatory and disciplinary system. The overwhelming focus has been upon both whether the existing system provided sufficient protection for the public from dangerous or under-performing medical practitioners and what was needed to ensure such protection. While the focus upon public protection is unquestionable and laudable, this still leaves considerable scope for ensuring a medical practitioner is afforded procedural fairness during the course of investigative and disciplinary processes. It is questionable whether procedural fairness is being afforded where to do so does not compromise the protection of the public. It is argued that only limited changes are required to create a system which affords procedural fairness without compromising the integrity of the system. PMID:19205311
Bowen, Timothy; Saxton, Andrew
The 26,939 abortions reported for the year were an 18.2% increase from calendar year 1976. The distribution of the number of abortions by age, marital status and procedure used, was in line with past experience. The age group 15-24 years included 69.8% of...
L. M. Sipes
HIV-positive women have abortions at similar rates to their HIV-negative counterparts, yet little is known about clinical outcomes of abortion for HIV-positive women or the best practices for abortion provision. To fill that gap, we conducted a literature review of clinical outcomes of surgical and medication abortion among HIV-positive women. We identified three studies on clinical outcomes of surgical abortion among HIV-positive women; none showed significant differences in infectious complications by HIV status. A review of seven articles on similar gynecological procedures found no differences in complications by HIV status. No studies evaluated medication abortion among HIV-positive women. However, we did find that previously expressed concerns regarding blood loss and vomiting related to medication abortion for HIV-positive women are unwarranted based on our review of data showing that significant blood loss and vomiting are rare and short lived among women. We conclude that although there is limited research that addresses clinical outcomes of abortion for HIV-positive women, existing data suggest that medication and surgical abortion are safe and appropriate. Sexual and reproductive health and HIV integration efforts must include both options to prevent maternal mortality and morbidity and to ensure that HIV-positive women and women at risk of HIV can make informed reproductive decisions.
Blanchard, Kelly; Lince, Naomi
Health-workers in 795 health centres in Bangladesh were interviewed about complications arising from induced abortion in rural Bangladesh. 1590 cases of complications from abortion were reported. Dais (traditional birth attendants) and traditional practitioners were the larger groups of operators (42.1% and 18.1%, respectively). Menstrual regulation or dilatation and curettage (the medically approved procedures) were used 9.1% of the time. Nearly half the complicated abortions were induced by inserting a foreign object, such as a stick or root (sometimes treated with an herb), into the uterus and leaving it until either abortion or complications ensued. 498 abortion-related deaths were reported. The proportion of complicated abortions resulting in death was lowest for medically approved procedures (4.9%) and highest for vigorous physical activity (100%) and abdominal pressure (66.7%), although the last two together accounted for only 2.3% of abortion procedures. Women who died after abortion were more likely than were women who survived to be further along in their pregnancies. An extrapolation from these results gives a figure of 780000 abortions in Bangladesh in 1978 and 7800 deaths that year from abortion complications. Many of these deaths might have been prevented if a means of safe, affordable termination of unwanted pregnancy had been available. PMID:6109865
Measham, A R; Obaidullah, M; Rosenberg, M J; Rochat, R W; Khan, A R; Jabeen, S
Introduction Maintaining patient safety during transition from prehospital to emergency department (ED) care depends on effective handoff communication between providers. We sought to determine emergency physicians’ (EP) knowledge of the care provided by paramedics in terms of both procedures and medications, and whether the use of a verbal report improved physician accuracy. Methods We conducted a 2-phase observational survey of a convenience sample of EPs in an urban, academic ED. In this large ED paramedics have no direct contact with physicians for non-critical patients, giving their report instead to the triage nurse. In Phase 1, paramedics gave verbal report to the triage nurse only. In Phase 2, a research assistant (RA) stationed in triage listened to this report and then repeated it back verbatim to the EPs caring for the patient. The RA then queried the EPs 90 minutes later regarding their patients’ prehospital procedures and medications. We compared the accuracy of these 2 reporting methods. Results There were 163 surveys completed in Phase 1 and 116 in Phase 2. The oral report had no effect on EP awareness that the patient had been brought in by ambulance (86% in Phase 1 and 85% in Phase 2.) The oral report did improve EP awareness of prehospital procedures, from 16% in Phase 1 to 45% in Phase 2, OR=4.28 (2.5–7.5). EPs were able to correctly identify all oral medications in 18% of Phase 1 cases and 47% of Phase 2 cases, and all IV medications in 42% of Phase 1 cases and 50% of Phase 2 cases. The verbal report led to a mild improvement in physician awareness of oral medications given, OR=4.0 (1.09–14.5), and no improvement in physician awareness of IV medications given, OR=1.33 (0.15–11.35). Using a composite score of procedures plus oral plus IV medications, physicians had all three categories correct in 15% of Phase 1 and 39% of Phase 2 cases (p<0.0001). Conclusion EPs in our ED were unaware of many prehospital procedures and medications regardless of the method used to provide this information. The addition of a verbal hand-off report resulted in a modest improvement in overall accuracy.
Waldron, Rachel; Sixsmith, Diane M.
...procedures for medical/psychiatric/psychological records. 1701.13...procedures for medical/psychiatric/psychological records. Current...access to their medical, psychiatric...psychological testing records by...
This essay, addressed to medical personnel and counselors, presents a bioethical approach to adolescent abortion. Topics include an overview of abortion in the U.S., related medical issues, data pertinent to adolescent abortions, ethical theory, adolescent moral development, and moral aspects of treatment of adolescents. (Author/DB)
Spontaneous abortion, which is the loss of a pregnancy without outside intervention before 20 weeks' gestation, affects up to 20 percent of recognized pregnancies. Spontaneous abortion can be subdivided into threatened abortion, inevi- table abortion, incomplete abortion, missed abortion, septic abortion, complete abortion, and recurrent spontaneous abortion. Ultrasonography is helpful in the diagnosis of spontaneous abortion, but other testing may
CRAIG P. GRIEBEL; JOHN HALVORSEN; THOMAS B. GOLEMON
Unilateral medical futility policies, which allow health-care providers to limit or withdraw life-sustaining treatment over patient or surrogate objections, are increasingly designed around a procedural approach. Medical or ethics committees follow a prespecified process, the culmination of which is a justified decision about whether ongoing treatment should be withheld or withdrawn. These procedures have three stages. First, health-care providers must decide to refer patients for consideration of whether ongoing treatment is futile. Second, the committees involved must decide whether ongoing treatment is actually futile. Third, there is a clinical outcome that often is, but not always, patient death. We review the available data on procedure-based futility policies, arguing that there is limited information on their potential harms and how these harms are distributed. We consider the ethical implications of policy-making under informational uncertainty, invoking the precautionary principle--in the absence of clear data, if a policy has significant risk of significant harm, the burden of proof that it is not harmful falls on those recommending the policy--as the guiding moral standard for hospitals and professional organizations considering whether to adopt a procedural approach to medical futility. On the basis of this principle, we argue that any new futility guideline must include a significant commitment to collecting prospective data on its application. PMID:24189864
Rubin, Emily; Courtwright, Andrew
The legal issues involved with the application of the United States Supreme Court decisions in Roe v. Wade and Doe v. Bolton (1973) are reveiwed, particularly the question of whether an indigent pregnant woman now has the right to abortion on demand at public expense. The 2 decisions, based on the Fourteenth Amendment, established that a woman, in consultation with her physician, must be free to choose to terminate her pregnancy, at least in the first trimester. State laws are permitted only to regulate abortion procedures in the second trimester and may only regulate or proscribe abortion itself after the fetus becomes viable. The Court did not rule that indigents had a corollary right to the implementation of abortion, and thus free abortions do not appear to be constitutionally required. However, depending on the type of Medicaid coverage in which the individual state is participating, the medically indigent may receive Medicaid benefits for abortions, at least in the first trimester. Since Medicaid is voluntary for the state, it could drop out of the program entirely or the Congress could specifically exclude abortions from Medicaid coverage. Both actions appear unlikely, however, and abortions for medical reasons clearly seem to fall under Medicaid's purpose. Consequently, despite the Wade and Bolton decisions, the right to abortion is limited by the ability of indigents to pay for it. In the light of the serious complications of illegal abortion, it is concluded that legislators should insure the availability of legal abortions. Such a move would not in itself encourage abortions but would properly extend the right to abortion to all citizens. PMID:11661025
The Supreme Court in 1973 in Roe v. Wade established that decision of first trimester abortion is left to the physician, exercising his best medical judgment, in consultation with the patient. During this period the state may not regulate abortion determination since there is no compelling state interest; therefore a physician performing abortion will be precluded from civil or criminal liability. In second trimester abortion the state has a compelling interest in the health of the mother and may regulate the procedure to protect maternal health; although a previable fetus may be able to survive the abortion, Roe v. Danforth definitively places the woman's right to an abortion above the life of the fetus during the previable stage; therefore the state cannot seek to safeguard the life or health of the fetus during the abortion. Third trimester abortion implies a viable fetus; thus, a compelling state interest in the potential life arises and the state may regulate and proscribe abortion except when necessary for the life and health of the mother. The determination of when viability has been achieved is a matter of judgment resting with the physician who has the choice of techniques and operating procedures which may or may not be fatal to the unborn. It is a question of either termination of pregnancy or destruction of the fetus. In this last case the legal responsibility placed upon the physician is very serious, and involving a risk of civil and criminal liability. Uncertainties as to the boundaries of legal abortion and the threat of criminal liability can only result in a reluctance among physicians to perform second and third trimester abortions, which is against the fundamental right to abortion guaranteed by the Constitution. The Supreme Court will have to elaborate upon the scope of the abortion right, whether it encompasses fetal destruction or only termination of pregnancy, because it directly affects the extent and quality of maternal and fetal care that must be rendered by a physician. If only termination of pregnancy is included the Court must resolve whether the woman's health interests predominate, or whether the physician can be required to enhance fetal survival. Physicians have a right to know the full extent of legal ramifications and implications of legally induced abortion. PMID:11655468
Barber, Rosamond A
...Medical and Related Benefits Medical Treatment and Related Issues...these procedures for obtaining medical care? In cases involving emergencies or unusual circumstances...in this subpart. Directed Medical...
The purpose of this study was to determine foaling rates in mares presented for medical or surgical treatment of colic, and to examine risk factors associated with abortion following colic. A retrospective analysis of 153 medical records found that mares treated surgically for colic (P = 0.0007) were 3.5 times more likely to have a negative pregnancy outcome than were mares treated medically for colic. Anesthetic time (P = 0.01) and intra-operative hypotension (P = 0.03) were significantly associated with negative pregnancy outcome. Mares with an anesthetic time ? 3 h were 6 times more likely to abort. Signs of endotoxemia (P = 0.30), hypoxia (P = 0.89), flunixin meglumine administration (P = 0.13), mucous membrane color at the time of presentation (P = 0.82) and capillary refill time (P = 0.76) were not associated with pregnancy outcome. There was no difference in the foaling rate for mares that had received progestin supplementation versus those that had not (P = 0.42). In this study, the significant risk factors for abortion were surgically treated colic, long anesthetic time, and intraoperative hypotension.
Chenier, Tracey S.; Whitehead, Ashley E.
Objective: This study examines the relationship between body mass and the risk of spontaneous abortion in a large cohort of patients who received infertility treatment.Research Methods and Procedures: This is a retrospective study using data on pregnancies (n = 2349) achieved after treatment in a tertiary medical center from 1987 to 1999. One pregnancy per subject was included, and the
Jim X. Wang; Michael J. Davies; Robert J. Norman; Jim Wang
According to World Health Organization, abortion is defined as an induced termination of pregnancy by use of medications or surgical interventions after implantation of the embryo and before the fetus is able to survive outside the maternal organism (before 22nd week of pregnancy). More than 75 millions of women experience unwanted pregnancy every year. Contraception for that group was either unavailable or the information about contraceptives use possibility was not efficient. Lack of conversation about family planning with the partner, rapes and inefficiency of contraceptives (8 to 30 millions women a year) might be other reasons. More than two-third such pregnancies are terminated by abortions. The number of women in reproductive age (15-44) is 1.38 million. Most of them are sexually active but not willing to have progeny. The decision of abortion is taken every year by 35 per 100 females (26 millions of legal abortions each year, 20 millions of illegal). By 1986, 36 countries introduced liberal abortion law that gives permission for abortion only for social, medical and personal reasons. The main law regulating the permission of abortion in Poland is a resolution of Family planning, embryo protection and conditions for conducting pregnancy termination from 1993, modified in 1997. In 1999, 151 abortion procedures were performed and that number is decreasing gradually. The development of so called "abortion basement", where unsafe abortion is usually performed, is a consequence of restrictive policy about the abortion law. In the last few years the holistic and individual approach to the patient has started to play an important role. Unfortunately, in the case of sexual education and knowledge of conscious family planning, medical services, and medical doctors especially, play only the minimal role. It seems to be essential in gynecological and general medicine practice to give information about different methods of family planning and protection against sexual transmitted diseases as well as to control patient's health when using contraceptives. PMID:15884260
Skrzypulec, Violetta; Drosdzol, Agnieszka; Nowosielski, Krzysztof; Rozmus-Warcholi?ska, Wioletta; Walaszek, Aneta; Piela, Bogus?awa; Zdun, Dariusz
RU-486 or mifepristone is best known as an antiprogestin and an abortifacient, but it has broad medical applicability. The drug is also a potent blocker of corticosteroid receptors, and it has shown promise in the treatment of breast cancer, inoperable meningioma, and cushing's disease. Cushing's is a model for the symptomatology of aging which may involve enhanced response to corticosteroid. RU-486 has reversed the osteoporosis, thinning of skin, muscle atrophy, obesity, adult onset diabetes, depression, hypertension, and immunosuppression associated with this disease. RU-486 may be of value in aiding cervical dilation, lactation, and the treatment of endometriosis. In addition, breast, bowel, kidney tumors, hepatomas, endometrial cancer, and fibrosarcomas can show corticosteroid dependency, suggesting that RU-486 may have clinical value against inoperable tumors. In a preliminary 1987 phase I study, in estrogen-positive, chemotherapy-refractory breast cancer patients in Montpelier, France, Ru-486 produced objective tumor regression (6 of 22) that was prolonged (3 months) in 4 patients. Clinical relief of bone pain was observed in 7 of 23 patients with a decline in carcinoembryonic antigen (CEA) tumor makers in 8 patients. Growing in vitro data also show that RU-486 can directly inhibit breast cancer cell proliferation. RU-486 has application for HIV infection, based on data that there is a serum factor in AIDS patients that enhances corticosteroid lympholysis. IN addition, the immune restorative action of RU-486 suggests that it could counteract the immunosuppression seen in aging, in cancer, or in viral or stress-related disease, which has recently focused clinical attention on its potential in the treatment of senile dementia and depression. Scientific conferences and workshops are needed to alert scientists, physicians, and the public to the potential medical benefits of this drug. PMID:1501996
Manual vacuum aspiration (MVA) and medical abortion were introduced to replace dilation and curettage/evacuation for incomplete abortions, and postabortion contraception was provided in 5 selected public hospitals in Pakistan. In the largest hospital, an Ipas MVA training center since 2007, MVA use reached 21% in 2008. After the International Federation of Gynecology and Obstetrics (FIGO) and UNFPA provided MVA kits, MVA use increased dramatically to 70%-90% in 2010-2013. In 2 of the remaining 4 hospitals in which the Society of Obstetricians and Gynecologists of Pakistan trained doctors in May 2012 and January 2013, the target of having 50% of women managed by MVA and medical abortion (MA) was met; however, in the third hospital only 43% were treated with MVA and MA. In the fourth hospital, where misoprostol and electric vacuum aspiration use was 64% and 9%, respectively, before training, an MVA workshop introduced the technique. Postabortion contraception was provided to 9%-29% of women, far below the target of 60%. PMID:24743026
Zaidi, Shahida; Yasmin, Haleema; Hassan, Lubna; Khakwani, Mehnaz; Sami, Shehla; Abbas, Tazeen
Objective: To assess the attitude to, the knowledge and practice of contraception and medical abortion in women attending the family planning clinic at the mvj medical college , hosakote , Bangalore, India. Materials and Methods: Between 1st of August, 2011 and 31st of July, 2012 200 women attending family planning clinic of the mvj medical college, hosakote, Bangalore India of which 105 requested for medical termination of pregnancy (mtp), 95 for family planning advice, were interrogated on a structured questionnaire. The age of women ranged in between 20-45 years, 71 (35.5%) were illiterate, 30 (15%) had primary school education and 99 (49.5%) had diplomas from high school and above. Patients were grouped into low and high socio-economic status according to modified kuppuswamy socio-economic status scale: (i). upper class, (ii). Upper middle class, (iii). Middle class, (iv). Lower middle class, (v). lower class.consent of both husband and wife was taken. They were counseled about the various contraceptives available and allowed to choose whichever suited them best. Results: Among the 200 women 85 (42%) did not use contraception; 51 (25.5 %) were on the barrier method; 49 (18.31%) used intrauterine devices (iud); 12 (6%) used oral pills and and 3 (1.5%) used other methods. the request for mtp was on grounds of unplanned pregnancy in 55.25% cases or failure of contraception in 44.7%. there was no eugenic indication of the women, 3 (1.5%) had heard about emergency contraceptives, however none had used them; 20 (10%) had heard of medical abortion and 12 (6%) had previously undergone mtp with satisfaction. the various methods of contraception accepted by the women post abortion were ocps by 11 (10.47%), iuds by 54 (51.5%) and female sterilization by 26 (24.71%). in the other group, 23 (24.2%) had iuds removed and reinserted; 37.8% had iuds inserted; 26 (27.36%) women underwent sterilization operation; and 6 (6.31%) had iuds removed opting for pregnancy. statistical analysis was done using spss software (Chicago) with ?2 test taking p value of 0.05 as significant. Conclusion: There is lack of awareness of emergency contraception and medical abortion in the women community under study.
K.M., Umashankar; M.N., Dharmavijaya; Kumar D.E., Jayanta; K., Kala; Nagure, Abed Gulab; Ramadevi
As with the delivery of any medical service, abortion has definite public health effects that should be evaluated. The Center for Disease Control (CDC) has monitored the impact of abortion in three ways: (a) conducting epidemiologic surveillance of legally induced abortion beginning in 1969. (b) funding a multicenter study of abortion morbidity beginning in 1971, and (c) undertaking surveillance of abortion-related mortality beginning in 1972. These activities are intended to identify health problems related to abortion, to assess the magnitude of these problems, and to make recommendations directed at eliminating the problems. In addition to the Programmatic uses of abortion data, the CDC statistics have also provided a basis for both legislative and judicial decisions that have had national and local impact. The CDC and the National Center for Health Statistics are currently working collectively to strengthen the reporting of national abortion statistics so that the public health need for abortion statistics can be met.
Smith, J C; Cates, W
When New York State's abortion laws were liberalized in 1970, there was a sharp rise in the number of clinic patients who requested abortions. Because social workers at Mount Sinai Medical Center believed that abortion still is an emotional risk for many women, a study was conducted to determine which patients needed intensive counseling. (Author)
Young, Alma T.; And Others
Across four decades of political and social action, Nepal changed from a country strongly enforcing oppressive abortion restrictions, causing many poor women's long imprisonment and high rates of abortion-related maternal mortality, into a modern democracy with a liberal abortion law. The medical and public health communities supported women's rights activists in invoking legal principles of equality and non-discrimination as a basis for change. Legislative reform of the criminal ban in 2002 and the adoption of an Interim Constitution recognizing women's reproductive rights as fundamental rights in 2007 inspired the Supreme Court in 2009 to rule that denial of women's access to abortion services because of poverty violated their constitutional rights. The government must now provide services under criteria for access without charge, and services must be decentralized to promote equitable access. A strong legal foundation now exists for progress in social justice to broaden abortion access and reduce abortion stigma. PMID:24890742
...COMPENSATION ACT, AS AMENDED Medical and Related Benefits Emergency Medical Care Â§ 10.304 Are there any...to these procedures for obtaining medical care? In cases involving emergencies or unusual circumstances,...
We conducted a retrospective cohort study using randomly selected medical charts of women reporting a history of partner violence and women with no history of partner violence at the time of a family planning or abortion appointment (n = 6,564 per group). We analyzed lifetime history of partner violence for odds of lifetime history of abortion and miscarriage number, and birth control problems. To more closely match timing, we analyzed a subsample of 2,186 women reporting current violence versus not at the time of an abortion appointment for differences in gestational age, medical versus surgical method choice, and return for follow-up visit. After adjusting for years at risk and demographic characteristics, women with a past history of partner violence were not more likely to have ever had one abortion, but they were more likely to have had problems with birth control, repeat abortions, and miscarriages than women with no history of violence. Women with current partner violence were also more likely to be receiving an abortion at a later gestational age. We found no differences between the groups in return for abortion follow-up visit or choice of surgical versus medication abortion. Findings support screening for the influence of partner violence on reproductive health and related safety planning. PMID:24580133
Colarossi, Lisa; Dean, Gillian
Parity is a major determinant of success rate in medical abortion: a retrospective analysis of 3161 consecutive cases of early medical abortion treated with reduced doses of mifepristone and vaginal gemeprost
The antiprogesterone mifepristone in combination with a suitable prostaglandin provides an effective method for induction of abortion in early pregnancy up to 63 days of gestation. The combination of 600 mg mifepristone followed by 1 mg of gemeprost vaginal pessary 48 h later is one of the standard regimens in practice, which is registered in several countries in Europe. In
Julia Bartley; Stephen Tong; Dawn Everington; David T Baird
According to international press reports, a law that would have allowed Portuguese women abortions through the 10th week of pregnancy and into the 16th week if their physical or mental health was at risk has been rescinded after a referendum to determine the statute's future was voided because of low voter turnout. Passed in February, the law was a liberalization of Portugal's strict anti-abortion laws, which ban all abortions except for narrowly defined medical reasons or in the case of rape (and those are permitted only until the 12th week of pregnancy). Because the issue is such a controversial one, politicians had turned to a national referendum asking Portuguese voters to overturn or ratify the new law. The referendum was the first in the country since the end of its right-wing dictatorship in 1974, and 50% participation was required. Only 31.5% of the country's 8.5 million eligible voters went to the polls on June 28. Of those voting, 50.9% voted against the liberalized new legislation. Sunny weather and World Cup soccer matches were both pointed to as reasons for the low turnout. Officials estimate there are some 20,000 illegal abortions annually in Portugal. Abortion-rights activists in the mostly Roman-Catholic country say hospitals see roughly 10,000 women a year suffering from complications from illegal abortions, and that at least 800 women die each year from the procedure. In the next day's Diario de Noticias, a daily paper in Portugal, the entire front page was filled with a giant question mark. "What now, lawmakers?" the headline read. PMID:12293809
A group of 120 women with gestations from 64 to 84 days received 800 ?g of vaginal misoprostol every 24 h for a maximum of three doses without performing postexpulsion systematic preventive curettage. Outcome measures included successful abortion (complete abortion without requiring a surgical procedure), side effects, and mean time of expulsion and vaginal bleeding. Complete abortion occurred in 104
J. L Carbonell Esteve; L Varela; A Velazco; E Cabezas; R Tanda; C Sánchez
...agency practice and procedure concerning OSHA access to employee medical records. ...AGENCY PRACTICE AND PROCEDURE CONCERNING OSHA ACCESS TO EMPLOYEE MEDICAL RECORDS ...agency practice and procedure concerning OSHA access to employee medical records....
...agency practice and procedure concerning OSHA access to employee medical records. ...AGENCY PRACTICE AND PROCEDURE CONCERNING OSHA ACCESS TO EMPLOYEE MEDICAL RECORDS ...agency practice and procedure concerning OSHA access to employee medical records....
Over the last decade undergraduate training in clinical procedures has moved from 'learning on patients' towards simulation-based training. Simulation was intended to be an adjunct rather than a replacement for experiential learning and several initiatives have emerged to redress this balance. With these initiatives in mind, we evaluated the impact of our undergraduate skills training programme and considered the need to change our teaching and learning strategy in this area. Outcomes-based data was accrued from the performance-based assessment of 64 medical students in four key procedures. Attitudinal data was gleaned from 130 responses to an electronic questionnaire and student self-efficacy ratings taken immediately before assessment. Students performed best in venepuncture. Performance in the other skills revealed 1 in 3 did not reach competence in i.v. cannulation and more than 1 in 2 were below standard when measuring a BM stix and priming an i.v. giving set. The data on self-efficacy and competence was analysed and a Spearman's Rank Correlation coefficient of 0.36 calculated. Students in final year were poor self-assessors and unaware that their skills often fell below standard. These results suggest a need to increase students' self-awareness and promote ward-based learning. This article considers how these objectives might be achieved. PMID:17594585
Morton, Jeremy; Anderson, Lisa; Frame, Fiona; Moyes, Janette; Cameron, Helen
...facility. (1) An individual who desires medical or dental care in civilian medical treatment facilities at Federal expense...Bureau or his/her designee, except in an emergency. (2) When medical care is obtained without prior...
Background The demand for induced abortions in Uganda is high despite legal and moral proscriptions. Abortion seekers usually go to illegal, hidden clinics where procedures are performed in unhygienic environments by under-trained practitioners. These abortions, which are usually unsafe, lead to a high rate of severe complications and use of substantial, scarce healthcare resources. This study was performed to estimate the costs associated with induced abortions in Uganda. Methods A decision tree was developed to represent the consequences of induced abortion and estimate the costs of an average case. Data were obtained from a primary chart abstraction study, an on-going prospective study, and the published literature. Societal costs, direct medical costs, direct non-medical costs, indirect (productivity) costs, costs to patients, and costs to the government were estimated. Monte Carlo simulation was used to account for uncertainty. Results The average societal cost per induced abortion (95% credibility range) was $177 ($140-$223). This is equivalent to $64 million in annual national costs. Of this, the average direct medical cost was $65 ($49-86) and the average direct non-medical cost was $19 ($16-$23). The average indirect cost was $92 ($57-$139). Patients incurred $62 ($46-$83) on average while government incurred $14 ($10-$20) on average. Conclusion Induced abortions are associated with substantial costs in Uganda and patients incur the bulk of the healthcare costs. This reinforces the case made by other researchers--that efforts by the government to reduce unsafe abortions by increasing contraceptive coverage or providing safe, legal abortions are critical.
Positive and negative aspects of therapeutic abortion are discussed upon review of trends found in the 6201 abortions performed in San Francisco between 1968 and 1970 (since Abortion was legalized in California in 1967). On the positive side, legalized abortion appears to have reduced the septic abortion rate (68 per 1000 live births in 1967 to 22 per 1000 in 1969) indicating a decline in criminal abortion. Maternal mortality has also declined from 8 per 100,000 to just over 3 per 100,000 from 1967 to 1969. Patients requesting abortion have averaged in age from 20-24 (26% were less than 19) and approximately half have been nulliparous. 37% of teenagers had saline abortions. Negative aspects have included the increasing morbidity rate associated with saline abortion, a second-trimester method. Compared to abortions performed at 12 weeks' gestation or less (usually done by vacuum aspiration), saline abortions required 5.7% second admissions (only 1.2% of the early abortions required readmission) and necessitated transfusion 3 times as often (in 2.3% of the cases). Regardless of the procedure used, later abortion involved a greater risk of hermorrhage and infection (2.7% incidence at 5-6 weeks' gestation compared to 12.9% at 11-12 weeks). Morbidity accompanying saline abortion was similar at 15 and 20 weeks however. Fortunately a trend toward earlier abortion is indicated. (74% of abortions were by suction and 22% by saline in 1970). Hysterotomy plus tubal ligation and hysterectomy accounted for only 4% of abortions but were accompanied by hemorrhage rates of 31% and 27% respectively and had respective infection rates of 13% and 22%. Private patients received abortions 3 times more often than ward patients although ward patients were subjected to more traumatic procedures: hysterectomies for ward patients were 2.0% vs .9% for private patients; sterilization by tubal ligation following suction abortion was 3.5% vs 1.7%. Additionally, black women had later abortions more often than white patients (33% of the black women were seen after 14 weeks gestation compared to 20% of the white women). Obstructions to early abortion must be eliminated to avoid such discrepancies in opportunity. Psychiatric examinations are unnecessary and causes for administrative delays must be remedied. Cost still presents a barrier for some women. The long-term effects of abortion now suggested by data from countries such as Czechoslovakia indicate that abortion is best viewed as a back-up measure to contraception making increased sex education, counseling and contraceptive practice essential. PMID:5024298
Goldstein, P; Stewart, G
Background The study aimed to describe the overall and age-specific trends of induced abortions from 1996 to 2011 with an emphasis on socio-demographic characteristics and contraceptive use of women having had repeat abortions in Estonia. Methods Data were retrieved from the Estonian Medical Birth and Abortion Registry and Statistics Estonia. Total induced abortion numbers, rates, ratios and age-specific rates are presented for 1996–2011. The percentage change in the number of repeat abortions within selected socio-demographic subgroups, contraception use and distribution of induced abortions among Estonians and non-Estonians for the first, second, third, fourth and subsequent abortions were calculated for the periods 1996–2003 and 2004–2011. Results Observed trends over the 16-year study period indicated a considerable decline in induced abortions with a reduction in abortion rate of 57.1%, which was mainly attributed to younger cohorts. The percentage of women undergoing repeat abortions fell steadily from 63.8% during 1996–2003 to 58.0% during 2004–2011. The percentage of women undergoing repeat abortions significantly decreased over the 16 years within all selected socio-demographic subgroups except among women with low educational attainment and students. Within each time period, a greater percentage of non-Estonians than Estonians underwent repeat abortions and obtained third and subsequent abortions. Most women did not use any contraceptive method prior to their first or subsequent abortion. Conclusion A high percentage of women obtaining repeat abortions reflects a high historical abortion rate. If current trends continue, a rapid decline in repeat abortions may be predicted. To decrease the burden of sexual ill health, routine contraceptive counselling, as standard care in the abortion process, should be seriously addressed with an emphasis on those groups - non-Estonians, women with lower educational attainment, students and women with children - vulnerable with respect to repeat abortion.
Around 25% of abortions in South Africa are performed in the second trimester. This study aimed to better understand what doctors, nurses and hospital managers involved in second trimester abortion care thought about these services and how they could be improved. Nineteen in-depth interviews with abortion-related service providers and managers in the Western Cape Province, South Africa, were undertaken. Data were analysed using a thematic analysis approach. Participants expressed resistance to the dilation and evacuation (D&E) procedure, as this required more active provider involvement. Medical abortion was preferred as it required less provider involvement in the abortion process. A shortage of providers willing to perform D&E resulted in most public sector services being outsourced to private sector doctors. Respondents noted an increased demand for services and a concomitant lack of infrastructure, physical space and personnel to respond to these demands, sometimes resulting in fragmented or poor quality care. At medical induction sites, most thought introducing the combined mifepristone-misoprostol regimen would improve service capacity, although they were concerned about cost. Improving contraceptive services was also seen as a much-needed intervention to improve care and prevent abortion. Ongoing training, including values clarification, as well as emotional support and team-building for providers are needed to ensure sustainable, high-quality second trimester abortion services. PMID:22088440
Harries, J; Lince, N; Constant, D; Hargey, A; Grossman, D
The purpose of this article is to show that the current level of scientific evidence linking induced abortion with increased breast cancer risk is sufficient to support an ethical and legal duty to disclose fully the risk to women who are considering induced abortion. The article examines the relationship between this evidence and the elements of a medical malpractice claim alleging failure to obtain informed consent. The first part focuses on the elements of informed consent, which require the plaintiff to establish that the physician had a duty to disclose information, which he failed to disclose, that this failure to disclose was a legal cause of the plaintiff's decision to undergo the procedure, and the procedure was a legal cause of the plaintiff's injury. The second part compares two prevalent standards for determining which risks a physician has a duty to disclose. Part three reviews the scientific evidence of the abortion/breast cancer (ABC) link and explains why it survives both the Frye and the Daubert tests for admissibility of expert testimony. The fourth part assesses the materiality of the risk posed by the ABC link. Parts five and six discuss evidentiary issues and the possibility of punitive damage awards. PMID:10758700
A medical approach to management of spontaneous abortion using misoprostol. Extending misoprostol treatment to a maximum of 48 hours can further improve evacuation of retained products of conception in spontaneous abortion.
A prospective, observational study of 354 women admitted to a Hong Kong hospital with a confirmed diagnosis of spontaneous abortion confirmed the effectiveness of a non-surgical 48-hour regimen using transvaginal ultrasound and misoprostol administration. 101 women were excluded because they had an empty uterus on transvaginal scan and another 28 were considered unsuitable for conservative management. The 225 remaining women were treated with up to 1200 mcgs of misoprostol administered orally in 3 divided doses per day for up to 48 hours; a comparison group of 137 women underwent surgical evacuation of retained products of conception. Evacuation of the uterus occurred within 24 hours of misoprostol administration in 107 women and by 48 hours after misoprostol administration in 148 women. The cumulative success rate was 69.6%. There were 3 uterine curettages for persistent bleeding up to 14 days after discharge, 2 cases of pelvic infection, and 1 ectopic pregnancy. In the reference group, 4 women required a repeat evacuation and 5 had infection. The overall complication rate in up to 3 weeks of follow-up was 6.6% in the surgical reference group and 1.7% in the medical treatment group. PMID:9093140
Chung, T; Leung, P; Cheung, L P; Haines, C; Chang, A M
The radiation risks from a range of medical x-ray examinations (radiography, fluoroscopy, and computed tomography) were assessed as a function of the age and sex of the patient using risk models described in Publication 103 (ICRP, 2007) and UNSCEAR (2006, Annex A). Such estimates of risk based on typical organ doses were compared with those derived from effective doses using the International Commission on Radiological Protection's nominal risk coefficients. Methodologically similar but not identical dose and risk calculations were performed independently at the Institute of Radiation Hygiene (Russia) and the Health Protection Agency (UK), and led to similar conclusions. The radiogenic risk of stochastic health effects following various x-ray procedures varied significantly with the patient's age and sex, but to differing degrees depending on which body organs were irradiated. In general, the risks of radiation-induced stochastic health effects in children are estimated to be higher (by a factor of ? 4) than in adults, and risks in senior patients are lower by a factor of ? 10 relative to younger people. If risks are assessed on the basis of effective dose, they are underestimated for children of both sexes by a factor of ? 4. This approach overestimates risks by a factor of ? 3 for adults and about an order of magnitude for senior patients. The significant sex and age dependence of radiogenic risk for different cancer types is an important consideration for radiologists when planning x-ray examinations. Whereas effective dose was not intended to provide a measure of risk associated with such examinations, it may be sufficient to make simple adjustments to the nominal risk per unit effective dose to account for age and sex differences. PMID:23089012
Balonov, M I; Shrimpton, P C
The establishment of standard history-taking will be discussed and will include examples of such histories developed in the clinic. The development of a protocol for performing and recording physical examinations will also be described. Special tests, such as pulmonary function and sputum cytology, will then be discussed. The integration of medical data into a data base will also be discussed with examples taken from the program in Pittsburgh. Presentation of the problems of obtaining adequate early medical information leads to the conclusion that medical surveillance programs must be integrated with industrial hygiene surveillance. The use of exposure measures to make and implement preventive medical decisions is essential until medical science provides tests with enhanced sensitivity and specificity for use in early detection of workplace disease. PMID:3746501
Parkinson, D K; Grennan, M J
Habitual abortion is not a frequent reproductive problem, but it is associated with a high degree of anxiety and frustration. The causes are considered according to genetic, endocrine, uterine and immunologic factors, and a plan of investigation and management is suggested. The importance of psychological support is stressed.
Poland, B. J.
Background Since the legalization of abortion services in the United States, provision of abortions has remained a controversial issue of high political interest. Routine abortion training is not offered at all obstetrics and gynecology (Ob-Gyn) training programs, despite a specific training requirement by the Accreditation Council for Graduate Medical Education. Previous studies that described Ob-Gyn programs with routine abortion training either examined associations by using national surveys of program directors or described the experience of a single program. Objective We set out to identify enablers of and barriers to Ob-Gyn abortion training in the context of a New York City political initiative, in order to better understand how to improve abortion training at other sites. Methods We conducted in-depth qualitative interviews with 22 stakeholders from 7 New York City public hospitals and focus group interviews with 62 current residents at 6 sites. Results Enablers of abortion training included program location, high-capacity services, faculty commitment to abortion training, external programmatic support, and resident interest. Barriers to abortion training included lack of leadership continuity, leadership conflict, lack of second-trimester abortion services, difficulty obtaining mifepristone, optional rather than routine training, and antiabortion values of hospital personnel. Conclusions Supportive leadership, faculty commitment, and external programmatic support appear to be key elements for establishing routine abortion training at Ob-Gyn residency training programs.
Guiahi, Maryam; Lim, Sahnah; Westover, Corey; Gold, Marji; Westhoff, Carolyn L.
This article presents current estimates of the number, rate, and proportion of abortions for all countries which make such data available. 76% of the world's population lives in countries where induced abortion is legal at least for health reasons. Abortion is legal in almost all developed countries. Most developing countries have some laws against abortion, but it is permitted at least for health reasons in the countries of 67% of the developing world's population. The other 33%--over 1 billion persons--reside mainly in subSaharan Africa, Latin America, and the most orthodox Muslim countries. By the beginning of the 20th century, abortion had been made illegal in most of the world, with rules in Africa, Asia, and Latin America similar to those in Europe and North America. Abortion legislation began to change first in a few industrialized countries prior to World War II and in Japan in 1948. Socialist European countries made abortion legal in the first trimester in the 1950s, and most of the industrialized world followed suit in the 1960s and 1970s. The worldwide trend toward relaxed abortion restrictions continues today, with governments giving varying reasons for the changes. Nearly 33 million legal abortions are estimated to be performed annually in the world, with 14 million of them in China and 11 million in the USSR. The estimated total rises to 40-60 million when illegal abortions added. On a worldwide basis some 37-55 abortions are estimated to occur for each 1000 women aged 15-44 years. There are probably 24-32 abortions per 100 pregnancies. The USSR has the highest abortion rate among developed countries, 181/1000 women aged 15-44, followed by Rumania with 91/1000, many of them illegal. The large number of abortions in some countries is due to scarcity of modern contraception. Among developing countries, China apparently has the highest rate, 62/1000 women aged 15-44. Cuba's rate is 59/1000. It is very difficult to calculate abortion rates in countries where the procedure is illegal. On the basis of hospital reports and other fragmentary information, the true rate appears to be relatively high in Latin America and the Far East. The abortion rate for Latin America in the mid-1970s was estimated at 65/1000 fertile aged women, and rates were believed to be higher in urban areas. Sub-Saharan Africa, where women desire very large families, apparently had the lowest rates. Up to 68% of pregnancies in the USSR, 57% in Rumania, and 55% in Japan may end in abortion. The proportion in developing countries ranged from 8% in Vietnam to 43% in China. Women undergoing abortion in developed countries tend to be young, childless, and single, while those in developing countries tend to be older, high parity, and married. Abortion mortality is still high in countries where large numbers of illegal abortions are performed by unqualified personnel, as in many parts of Latin America. PMID:12269047
Henshaw, S K
...1403.6 Section 1403.6 Banks and Banking FARM CREDIT SYSTEM INSURANCE CORPORATION PRIVACY ACT REGULATIONS ...records. Medical records in the custody of the Farm Credit System Insurance Corporation which are not subject to...
This study investigated two methods to improve organization and presentation of computer-based medical procedures. A literature review suggested that the GOMS (goals, operators, methods, and selecton rules) model can assist in rigorous task analysis, which can then help generate initial design ideas for the human-computer interface. GOMS model are hierarchical in nature, so this study also investigated the effect of hierarchical, hypertext interfaces. We used a 2 x 2 between subjects design, including the following independent variables: procedure organization - GOMS model based vs. medical-textbook based; navigation type - hierarchical vs. linear (booklike). After naive subjects studies the online procedures, measures were taken of their memory for the content and the organization of the procedures. This design was repeated for two medical procedures. For one procedure, subjects who studied GOMS-based and hierarchical procedures remembered more about the procedures than other subjects. The results for the other procedure were less clear. However, data for both procedures showed a 'GOMSification effect'. That is, when asked to do a free recall of a procedure, subjects who had studies a textbook procedure often recalled key information in a location inconsistent with the procedure they actually studied, but consistent with the GOMS-based procedure.
Gugerty, Leo; Halgren, Shannon; Gosbee, John; Rudisill, Marianne
Seventy-two Israeli women who were about to have abortions were interviewed. These women experienced intense emotions of sadness, ambivalence, confusion, and fear. To help them deal with this crisis, the women expressed a need for a professional counselor who provides information such as where to go, how to get money for the abortion, and how the operation is performed. The women also wished that the professional counselor would support them emotionally throughout the pregnancy experience and the abortion procedure. PMID:1885339
Spontaneous abortion occurs in 15% to 20% of all human pregnancies. Since the late 1800s, the management of incomplete spontaneous abortion has focused on using curettage to empty the uterus as quickly as possible. This practice began to reduce blood loss and infection and has been unquestioned for 4 decades. In today’s medical climate, few spontaneous abortions are the resuslt
Susan Aucott Ballagh; Heather A. Harris; Kafui Demasio
Improving prognosis for many forms of childhood cancer has resulted in increased attention on the quality-of-life experience. Conditioned anxiety and pain associated with recurrent diagnostic and treatment procedures have been identified as major sources of distress in children with malignant disease. To evaluate the efficacy of various…
Katz, Ernest R.
The first comprehensive national survey on frequency and radiation dose imparted to the population from radiological procedures was carried out in Kenya and reported here. This survey involved assessment of frequency, typical patient radiation exposure, and collective effective dose from general radiography, fluoroscopy, interventional procedures (IPs), mammography, and computed tomography. About 300 x-ray facilities across the country were invited to participate in the survey, and a 31% response was recorded. The individual and collective radiation burdens of more than 62 types of pediatric and adult radiological examinations were quantified using effective and collective dose. The average effective dose for each radiological examination was assessed from the x-ray efficiency performance tests and patient data from over 30 representative radiological facilities. The results found indicated that over 3 million x-ray procedures were performed in 2011, resulting in an annual collective effective dose of 2,157 person-Sv and an annual effective dose per capita of 0.05 mSv. The most frequent examinations were general radiography (94%), computed tomography (3.3%), and fluoroscopy (2.5%). Although the contribution of computed tomography was small in terms of frequency, this procedure accounted for 36% of the effective dose per capita. General radiography was the most frequent type of examination with a contribution of 55% of the effective dose per capita. PMID:24162056
Korir, Geoffrey K; Wambani, Jeska S; Korir, Ian K; Tries, Mark; Kidali, Mike M
Knee infection is a relatively rare complication after arthroscopic knee surgery (Babcok et al., 2002), with reported incidences ranging from 0.1% to 3.4% (Babcok et al., 2002 and Bert et al., 2007). Although postoperative dental and surgical procedures were formerly considered a risk factor for infection in arthroplasty patients, the American Dental Association (ADA) and Academy of Orthopaedic Surgery (AAOS) no longer recommend prophylactic antibiotics for patients with prosthetic joints and do not make recommendations concerning patients who have recently undergone arthroscopic surgery (J. M. Bert and T. M. Bert, 2010). We report two patients who had an uncomplicated postoperative course until having a procedure and then developed a septic knee.
Swank, Kat; Dragoo, Jason L.
Unsafe abortion accounts for approximately 13% of maternal deaths worldwide-roughly 47,000 deaths per year. Most deaths from unsafe abortion occur in low-resource countries. Second-trimester abortion carries a higher risk of morbidity and mortality compared with first-trimester abortion and, although the former comprises the minority of abortion procedures worldwide, it is responsible for the majority of serious complications and death where unsafe abortion is prevalent. Therefore, improving access to safe second-trimester abortion must be a priority in low-income regions of the world if the majority of deaths from unsafe abortion are to be prevented. In the present paper, we consider a variety of barriers to second-trimester care, including healthcare provider training and abortion stigma, which may lead to neglect of unmet need for second-trimester services. PMID:21820115
Harris, Lisa H; Grossman, Daniel
In this paper, we discuss the complex relationship between health technology assessment (HTA) and the regulation of medical devices and procedures. The relationship is first examined through a concep- tual framework describing the itinerary from research to three levels of policy making: micro (standards of medical practice), meso (institutional rules), and macro (health policies). Four reports from the Quebec Health
Renaldo N. Battista; Jean-Marie Lance; Pascale Lehoux; Guy Regnier
AimsChild protection is currently a particular challenge to paediatricians. Local safeguarding procedures have been developed to guide practice by medical professionals, social care and police. They include guidance on the writing of child protection medical reports and inter-agency communication. Our aim was to improve the quality of care offered to children, by assessing our performance against the local guidelines and
B A Klepacka; R Brockelbank; L Hayman; S Banerjee
Fault or failure of software contained in medical devices will seriously endanger users and should be considered to reduce\\u000a risk. In software development process, the risk analysis and risk control are very important for software contained in medical\\u000a devices. In order to promote the quality of software contained in medical devices, a website is designed to provide the operating\\u000a procedure
Yeou-Jiunn Chen; A. T. Liu; P. J. Chen; Y. T. Chen; U. Z. Hsieh; K. S. Cheng
In the medical field triaxial accelerometers are used for the monitoring of movements. Unfortunately, the long-term use of accelerometers is limited by drift of the sensitivities and the offsets. Therefore, a calibration procedure is designed which allows in-use calibration of a triaxial accelerometer. This procedure uses the fact that the modulus of the acceleration vector measured with a triaxial accelerometer
J. C. Lötters; J. Schipper; P. H. Veltink; W. Olthuis; P. Bergveld
Several technological enhancements have been made to METI's commercial Emergency Care Simulator (ECS) with regard to how microgravity affects human physiology. The ECS uses both a software-only lung simulation, and an integrated mannequin lung that uses a physical lung bag for creating chest excursions, and a digital simulation of lung mechanics and gas exchange. METI s patient simulators incorporate models of human physiology that simulate lung and chest wall mechanics, as well as pulmonary gas exchange. Microgravity affects how O2 and CO2 are exchanged in the lungs. Procedures were also developed to take into affect the Glasgow Coma Scale for determining levels of consciousness by varying the ECS eye-blinking function to partially indicate the level of consciousness of the patient. In addition, the ECS was modified to provide various levels of pulses from weak and thready to hyper-dynamic to assist in assessing patient conditions from the femoral, carotid, brachial, and pedal pulse locations.
Parker, Nigel; O'Quinn, Veronica
Abortion stigma is widely acknowledged in many countries, but poorly theorised. Although media accounts often evoke abortion stigma as a universal social fact, we suggest that the social production of abortion stigma is profoundly local. Abortion stigma is neither natural nor ‘essential’ and relies upon power disparities and inequalities for its formation. In this paper, we identify social and political
Anuradha Kumar; Leila Hessini; Ellen M. H. Mitchell
Specific guidance functions and trajectory design of return to launch site (RTLS) and transoceanic abort landing (TAL) intact abort profiles, as well as the increasing emphasis on contingency aborts, are presented. Various systems failures including Space Shuttle main engine failures and detailed technical analyses, including the design of powered flight abort trajectories, are considered. The most critical of flight abort situations is the RTLS, while TAL is the preferred abort when uphill capability is no longer available. It is concluded that one principle must remain to ensure continuing success of Space Shuttle flights: namely that intact and contingency aborts necessitate development to ensure safe return of the vehicle, payload, and crew whenever possible.
Schmidgall, Richard A.
International Space Station (ISS) Mission Operations are managed by multiple flight control disciplines located at the lead Mission Control Center (MCC) at NASA-Johnson Space Center (JSC). ISS Medical Operations are supported by the complementary roles of Flight Surgeons (Surgeon) and Biomedical Engineer (BME) flight controllers. The Surgeon, a board certified physician, oversees all medical concerns of the crew and the BME provides operational and engineering support for Medical Operations Crew Health Care System. ISS Medical Operations is currently addressing the coordinated response to a crew call down for an emergent medical event, in particular when the BME is the only Medical Operations representative in MCC. In this case, the console procedure BME Response to Crew Call Down for an Emergency will be used. The procedure instructs the BME to contact a Surgeon as soon as possible, coordinate with other flight disciplines to establish a Private Medical Conference (PMC) for the crew and Surgeon, gather information from the crew if time permits, and provide Surgeon with pertinent console resources. It is paramount that this procedure is clearly written and easily navigated to assist the BME to respond consistently and efficiently. A total of five BME flight controllers participated in the study. Each BME participant sat in a simulated MCC environment at a console configured with resources specific to the BME MCC console and was presented with two scripted emergency call downs from an ISS crew member. Each participant used the procedure while interacting with analog MCC disciplines to respond to the crew call down. Audio and video recordings of the simulations were analyzed and each BME participant's actions were compared to the procedure. Structured debriefs were conducted at the conclusion of both simulations. The procedure was evaluated for its ability to elicit consistent responses from each BME participant. Trials were examined for deviations in procedure task completion and/or navigation, in particular the execution of the Surgeon call sequence. Debrief comments were used to analyze unclear procedural steps and to discern any discrepancies between the procedure and generally accepted BME actions. The sequence followed by BME participants differed considerably from the sequence intended by the procedure. Common deviations included the call sequence used to contact Surgeon, the content of BME and crew interaction and the gathering of pertinent console resources. Differing perceptions of task priority and imprecise language seem to have caused multiple deviations from the procedure s intended sequence. The study generated 40 recommendations for the procedure, of which 34 are being implemented. These recommendations address improving the clarity of the instructions, identifying training considerations, expediting Surgeon contact, improving cues for anticipated flight control team communication and identifying missing console tools.
Johnson-Troop; Pettys, Marianne; Hurst, Victor, IV; Smaka, Todd; Paul, Bonnie; Rosenquist, Kevin; Gast, Karin; Gillis, David; McCulley, Phyllis
eens who abort are up to 4 times more likely to commit suicide than adults who abort eens who abort are up to 4 times more likely to commit suicide than adults who abort eens who abort are up to 4 times more likely to commit suicide than adults who abort eens who abort are up to 4 times more
Introduction: The health record serves several purposes and must be retained to meet those purposes. These varied purposes influence how long health records must be kept, or their retention period. Aim: Present study aimed to recognize laws and procedures pertaining to retention of health records in selected countries and provide a proposed guideline for Iran. Methods: This was an applied and descriptive-comparative research on laws and procedures pertaining to retention of medical records in USA, United Kingdom, Australia and Iran that performed in 2011. The data were collected via library sources, websites, and consultation with specialists in and out of the country. The validity of the data was confirmed by experts. Finally, the recommendations were provided for medical record retention in Iran. Results: The study revealed that, there are complete and transparent record retention schedules in selected counties so that retention situation for adults, minors, emergency, outpatients and deaths records is clearly recommended. But in Iran, either there aren’t specific laws and procedures for medical record or they are unspecified. Conclusion: The lack of a complete, transparent and update medical record retention schedule in Iran, lead to confusion for hospitals. Some of hospitals maintain medical records more than of determined retention period and some of them destruct them before expiring of essential retention period. In order to optimize the situation of health records retention in Iran, it is necessary to review, correction and correction and completion of medical records retention schedule on the provided recommendations for kinds of medical record.
Tavakoli, Nahid; Saghaiannejad, Sakineh; Reza Habibi, Mohammad
During the period between 1977 and the first quarter of 1988, 35 countries liberalized their abortion laws and four countries limited grounds for the procedure. Most legislation has extended abortion eligibility through traditional indications such as danger to maternal health or fetal handicap, but a number of other indications have been created such as adolescence, advanced maternal age, family circumstances, and AIDS or HIV infection. A number of countries have redesigned their abortion laws as part of a comprehensive package to facilitate access to and delivery of contraception, voluntary sterilization, and abortion services. Abortion litigation has increased and stimulated the liberalization of abortion provisions and the support of women's autonomous choice within the law. In Canada, the entire criminal prohibition of abortion was held unconstitutional for violating women's integrity and security. In contrast, Latin American and other constitutional developments may limit legal abortion to instances of danger to women's lives.
Cook, R J; Dickens, B M
One of the most demanding tasks that must be performed by the Space Shuttle flight crew is the process of determining whether, when and where to abort the vehicle should engine or system failures occur during ascent or entry. Current Shuttle abort procedures involve paging through complicated paper checklists to decide on the type of abort and where to abort. Additional checklists then lead the crew through a series of actions to execute the desired abort. This process is even more difficult and time consuming in the absence of ground communications since the ground flight controllers have the analysis tools and information that is currently not available in the Shuttle cockpit. Crew workload specifically abort procedures will be greatly simplified with the implementation of the Space Shuttle Cockpit Avionics Upgrade (CAU) project. The intent of CAU is to maximize crew situational awareness and reduce flight workload thru enhanced controls and displays, and onboard abort assessment and determination capability. SAFM was developed to help satisfy the CAU objectives by providing the crew with dynamic information about the capability of the vehicle to perform a variety of abort options during ascent and entry. This paper- presents an overview of the SAFM application. As shown in Figure 1, SAFM processes the vehicle navigation state and other guidance information to provide the CAU displays with evaluations of abort options, as well as landing site recommendations. This is accomplished by three main SAFM components: the Sequencer Executive, the Powered Flight Function, and the Glided Flight Function, The Sequencer Executive dispatches the Powered and Glided Flight Functions to evaluate the vehicle's capability to execute the current mission (or current abort), as well as more than IS hypothetical abort options or scenarios. Scenarios are sequenced and evaluated throughout powered and glided flight. Abort scenarios evaluated include Abort to Orbit (ATO), Transatlantic Abort Landing (TAL), East Coast Abort Landing (ECAL) and Return to Launch Site (RTLS). Sequential and simultaneous engine failures are assessed and landing footprint information is provided during actual entry scenarios as well as hypothetical "loss of thrust now" scenarios during ascent.
Hu, Howard; Straube, Tim; Madsen, Jennifer; Ricard, Mike
We use unique data on abortions performed in New York State from 1971 to 1975 to demonstrate that women traveled hundreds of miles for a legal abortion before Roe. A 100-mile increase in distance for women who live approximately 183 miles from New York was associated with a decline in abortion rates of 12.2 percent whereas the same change for women who lived 830 miles from New York lowered abortion rates by 3.3 percent. The abortion rates of nonwhites were more sensitive to distance than those of whites. We found a positive and robust association between distance to the nearest abortion provider and teen birth rates but less consistent estimates for other ages. Our results suggest that even if some states lost all abortion providers due to legislative policies, the impact on population measures of birth and abortion rates would be small as most women would travel to states with abortion services. PMID:23811233
Joyce, Ted; Tan, Ruoding; Zhang, Yuxiu
A nationally representative survey was conducted among 3000 Catholics in Mexico during 2009 and 2010. Respondents were presented with a hypothetical situation about a young woman who decided to have an abortion and were asked their personal opinion of her. On the basis of a stigma index, it was found that the majority (61%) had stigmatizing attitudes about abortion; however, 81% believed that abortion should be legal in at least some circumstances. Respondents were significantly more likely to stigmatize abortion if they disagreed with the Mexico City law legalizing the procedure (odds ratio 1.66; 95% CI, 1.30-2.11) and believed that abortion should be prohibited in all cases (odds ratio 3.13; 95% CI, 2.28-4.30). Such stigma can lead women to seek unsafe abortions to avoid judgment by society. PMID:22920621
McMurtrie, Stephanie M; García, Sandra G; Wilson, Kate S; Diaz-Olavarrieta, Claudia; Fawcett, Gillian M
On December 1, 2005 in the Netherlands, a new procedure was introduced to assess international medical graduates (IMGs) with a diploma acquired outside the European Economic Area (EEA). This procedure includes (a) general tests on the active and passive use of Dutch medical language, English reading proficiency, basic IT skills and knowledge of the Dutch health care system, and (b) a specific set of tests of medical competence, including knowledge of basic sciences, clinical knowledge and clinical skills. IMGs who wish to get their diploma acknowledged and be registered as a physician are required to complete this assessment. With the introduction of this procedure, the Netherlands have joined a minority of countries inside and outside Europe with setting high standards for intake procedures. It is advocated that all European countries should devise such procedures, as a European Directive (2005/36/EC) on the recognition of professional qualifications prohibits the assessment of medical graduates with a diploma that is recognised in another EEA country. PMID:18512533
ten Cate, T J; Kooij, L R
Women who wish to terminate a pregnancy, and physicians willing to perform abortions, are subject to increasing harassment from groups which challenge the constitutional abortion right upheld by the Supreme Court in Roe v. Wade. Their vulnerability, in fact, parallels the vulnerability of the abortion right. This Article analyzes the inherent weakness and impending obsolescence of the trimester framework established in Roe. Present medical evidence of maternal health risks and fetal viability demonstrates that the trimester framework is inconsistent with current medical knowledge, and will likely be rendered obsolete by developments in medical technology. The Article suggests that adoption of an alternative constitutional basis for legal abortion is necessary to preserve the abortion right, and explores the utility of two arguments grounded in the equal protection doctrine. Finally, it discusses means of preserving legal abortion within the confines of the trimester framework established in Roe v. Wade. PMID:3068986
Mangel, C P
As part of the Space Human Factors Engineering Critical Questions Roadmap, a three year Technology Development Project (TDP) was funded by NASA Headquarters to examine emergency medical procedures on ISS. The overall aim of the emergency medical procedures project was to determine the human factors issues in the procedures, training, communications and equipment, and to recommend solutions that will improve the survival rate of crewmembers in the event of a medical emergency. Currently, each ISS crew remains on orbit for six month intervals. As there is not standing requirement for a physician crewmember, during such time, the maintenance of crew health is dependant on individual crewmembers. Further, in the event of an emergency, crew will need to provide prolonged maintenance care, as well as emergency treatment, to an injured crewmember while awaiting transport to Earth. In addition to the isolation of the crew, medical procedures must be carried out within the further limitations imposed by the physical environment of the space station. For example, in order to administer care on ISS without the benefit of gravity, the Crew Medical Officers (CMOs) must restrain the equipment required to perform the task, restrain the injured crewmember, and finally, restrain themselves. Both the physical environment and the physical space available further limit the technology that can be used onboard. Equipment must be compact, yet able to withstand high levels of radiation and function without gravity. The focus here is to highlight the human factors impacts from our three year project involving the procedures and equipment areas that have been investigated and provided valuable to ISS and provide groundwork for human factors requirements for medical applications for exploration missions.
Byrne, V. E.; Hudy, C.; Smith, D.; Whitmore, M.
In 1795 the Marquis de Sade published his La Philosophic dans le boudoir, in which he proposed the use of induced abortion for social reasons and as a means of population control. It is from this time that medical and social acceptance of abortion can be dated, although previously the subject had not been discussed in public in modern times. It is suggested that it was largely due to de Sade's writing that induced abortion received the impetus which resulted in its subsequent spread in western society. PMID:6990001
Farr, A D
Compared program efficacy in helping parents cope with children's painful medical procedures. Parents (n=72) of pediatric leukemia patients participated in either stress inoculation program or observed child participating in cognitive behavior therapy. Found parents in stress inoculation program reported lower anxiety scores and higher positive…
Jay, Susan M.; Elliott, Charles H.
Describes a methodology for collecting and extracting linguistic forms from documents authored by healthcare consumers. The forms were mapped to concepts and the resulting terms were analyzed. Although the case study uses examples from a "consumer medical vocabulary," procedures are applicable to investigating non-professional vocabularies in…
Tse, Tony; Soergel, Dagobert
The necessity to provide prophylactic antibiotic cover to avoid infective endocarditis for patients receiving dental treatment leads, on occasions, to confusion and is frequently the subject of questions at postgraduate meetings. There are several medical conditions which have in the past been considered to require prophylaxis which are no longer considered indications for such therapy. However, a definitive list of conditions necessitating antibiotic cover has been agreed (Table 1). There are several different schedules of prophylaxis which may be used in different circumstances. This paper seeks to identify the main features of infective endocarditis and current prophylactic schedules accepted in the United Kingdom. Figure 1 outlines, in the form of a flow-diagram, the decision making process involved in choosing the most appropriate schedule. This flow-diagram may act as a 'quick-reference' for use in the surgery. PMID:8207705
Priestland, C R
Medical devices are many and various, ranging from tongue spatulas to implantable or invasive devices and imaging machines; their lifetimes are short, between 18 months and 5 years, due to incessant incremental innovation; and they are operator-dependent: in general, the clinical user performs a fitting procedure (hip implant or pacemaker), a therapeutic procedure using a non-implantable invasive device (arrhythmic site ablation probe, angioplasty balloon, extension spondyloplasty system, etc.) or follow-up of an active implanted device (long-term follow-up of an implanted cardiac defibrillator or of a deep brain stimulator in Parkinson's patients). A round-table held during the XXVIII(th) Giens Workshops meeting focused on the methodology of scientific evaluation of medical devices and the associated procedures with a view to their pricing and financing by the French National Health Insurance system. The working hypothesis was that the available data-set was sufficient for and compatible with scientific evaluation with clinical benefit. Post-registration studies, although contributing to the continuity of assessment, were not dealt with. Moreover, the focus was restricted to devices used in health establishments, where the association between devices and technical medical procedures is optimally representative. An update of the multiple regulatory protocols governing medical devices and procedures is provided. Issues more specifically related to procedures as such, to non-implantable devices and to innovative devices are then dealt with, and the proposals and discussion points raised at the round-table for each of these three areas are presented. PMID:23981256
Gilard, Martine; Debroucker, Frederique; Dubray, Claude; Allioux, Yves; Aper, Eliane; Barat-Leonhardt, Valérie; Brami, Michèle; Carbonneil, Cédric; Chartier-Kastler, Emmanuel; Coqueblin, Claire; Fare, Sandrine; Giri, Isabelle; Goehrs, Jean-Marie; Levesque, Karine; Maugendre, Philippe; Parquin, François; Sales, Jean-Patrick; Szwarcensztein, Karine
Erde review three works that in his opinion have made important contributions to the abortion debate: Abortion Policy: An Evaluation of the Consequences For Maternal and Infant Health, by Jerome S. Legge, Jr. (Albany: State University of New York Press; 1985); Abortion and the Politics of Motherhood, by Kristen Luker (Berkeley: University of California Press; 1984); and Abortion: Moral and Legal Perspective, edited by J.L. Garfield and P. Hennessey (Amherst: University of Massachusetts Press; 1984). A later issue of the Journal of Medical Humanities and Bioethics will carry Erde's review of two additional scholarly books on abortion: Abortion: Understanding the Differences, edited by Sidney Callahan and Daniel Callahan (New York: Plenum Press; 1984), and Abortion and the Status of the Fetus, edited by William B. Bondeson, H.T. Engelhardt, Jr., S.F. Spicker, and D.H. Winship (Boston: D. Reidel; 1983). PMID:11655806
Erde, Edmund L
This article grew out of a keynote address prepared for the conference, "From Abortion to Contraception: Public Health Approaches to Reducing Unwanted Pregnancy and Abortion Through Improved Family Planning Services," held in Tbilisi, Georgia, USSR in October 1990. The article reviews the legal, religious, and medical situation of induced abortion in Europe in historical perspective, and considers access to abortion services, attitudes of health professionals, abortion incidence, morbidity and mortality, the new antiprogestins, the characteristics of abortion seekers, late abortions, postabortion psychological reactions, effects of denied abortion, and repeat abortion. Special attention is focused on the changes occurring in Romania, Albania, and the former Soviet Union, plus the effects of the new conservatism elsewhere in the formerly socialist countries of central and eastern Europe, particularly Poland. Abortion is a social reality that can no more be legislated out of existence than the controversy surrounding it can be stilled. No matter how effective family planning services and practices become, there will always be a need for access to safe abortion services. PMID:1557791
David, H P
This review traces the discussion of abortion in the US through 10 of the best books published on the subject in the past 25 years. The first book considered is Daniel Callahan's "Abortion: Law, Choice and Morality," which was published in 1970. Next is book of essays also published in 1970: "The Morality of Abortion: Legal and Historical Perspectives," which was edited by John T. Noonan, Jr., who became a prominent opponent to the Roe decision. It is noted that Roman Catholics would find the essay by Bernard Haring especially interesting since Haring supported the Church's position on abortion but called for acceptance of contraception. Third on the list is historian James C. Mohr's review of "Abortion in America: The Origins and Evolution of National Policy," which was printed five years after the Roe decision. Selection four is "Enemies of Choice: The Right-to-Life Movement and Its Threat to Abortion" by Andrew Merton. This 1981 publication singled out a concern about sexuality as the overriding motivator for anti-abortion groups. Two years later, Beverly Wildung Harrison published a ground-breaking, feminist, moral analysis of abortion entitled "Our Right to Choose: Toward a New Ethic of Abortion. This was followed by a more empirical and sociopolitical feminist analysis in Kristin Luker's 1984 "Abortion and the Politics of Motherhood." The seventh book is by another feminist, Rosalind Pollack Petchesky, whose work "Abortion and Women's Choice: The State, Sexuality, and Reproductive Freedom" was first published in 1984 and reprinted in 1990. The eighth important book was "Abortion and Catholicism: The American Debate," edited by Thomas A. Shannon and Patricia Beattie Jung. Rounding out the list are the 1992 work "Life Itself: Abortion in the American Mind" by Roger Rosenblatt and Ronald Dworkin's 1993 "Life's Dominion: An Argument About Abortion, Euthanasia, and Individual Freedom." PMID:12178914
Hisel, L M
Radiation protection standards for space activities differ substantially from those applied to terrestrial working situations. The levels of radiation and subsequent hazards to which space workers are exposed are quite unlike anything found on Earth. The new more highly refined system of risk management involves assessing the risk to each space worker from all sources of radiation (occupational and non-occupational) at the organ level. The risk coefficients were applied to previous space and medical exposures (diagnostic x ray and nuclear medicine procedures) in order to estimate the radiation-induced lifetime cancer incidence and mortality risk. At present, the risk from medical procedures when compared to space activities is 14 times higher for cancer incidence and 13 times higher for cancer mortality; however, this will change as the per capita dose during Space Station Freedom and interplanetary missions increases and more is known about the risks from exposure to high-LET radiation.
Peterson, Leif E.; Nachtwey, D. Stuart
This is an historical survey of the abortion practices in Australia in the early 20th century. The evidence presented in the article is gathered from reports and documents, articles in medical journals, and information obtained at interviews. The estimated figures for induced abortion are 1/8 live births in 1904, 1/5 live birth in 1937, and 1/4 live births in 1970. Drugs inducing abortion were easily available by the 1890s; they usually were euphemistically advertised to correct irregularities, that is, to bring on a late period, thus enabling vendors to escape prosecution by law. Many of the prescriptions were simple purgatives, such as oil of savin, croton oil, aloe, or they caused contractions of the blood vessels or of the uterus, as did ergot of rye. The contents of the abortion inducing drugs were rarely stated and often misrepresented. In many cases abortion was a secondary effect of the woman poisoning her body with large quantities of drugs; women were also instructed to take hot mustard baths, to jump off tables, and to conduct other physical violence against themselves. Many women tried mechnical methods when chemical methods failed; they included insertion into the uterus of knitting needles, crochet hooks, laminaria and sponge tents. Women who could find the money went to an abortionist; in the 1890s there were an estimated 100-300 abortionists in the city of Sydney. The methods employed went from the use of laminaria tents, to insertion of a catheter, or forcing of fluids into the uterus. Septic infection, peritonitis, blood poisoning, and also uterine perforation were common complications noted in women being admitted to hospitals following abortion. Retention of the placenta was another common complication. After 1904 more restrictive laws reduced the availability of abortifacient drugs and also of contraceptives such as condoms and pessaries; the cost of an illegal abortion skyrocketed to 25 pounds. The result was that more women attempted to procure an abortion by themselves, and that morbidity and mortality rates increased. As recently as 1960 women were procuring abortions by the same means as in the 1890s with the same results and complications; the only advantage being the fact that they could be properly treated once they reached the hospital after attempting the abortion. There are still many restrictions placed on the availability of abortion in Australia; some abortion services, such as those in South Wales, interpret the law very freely. A survey conducted by the Preterm Foundation in 1976 found that 7.6% of its clients had attempted abortion before presenting at the clinic. PMID:12263459
Medical professionals need to revaluate current ethical standards which permit the killing of a normal fetus but require the use of heroic efforts to save the life of a severely deformed or mentally handicapped child once that child is born. The ethical issues involved in both abortion and infanticide are similar. Direct objections to both of these practices refer to the person killed and indirect objections refer to the side effects experienced by the family and society. Direct objections are irrelevant in abortion since the fetus is not aware that it is being killed and are also irrelevant in infanticide until the child is old enough to become aware of death. Indirect objections to abortion include: 1) guilt experienced by the mother and the abortion provider; 2) decline in maternal feeling in the society as a whole; and 3) the use of medical personnel and facilitates to provide unnecessary services. Advantages associated with abortion are that it: 1) reduces the number of unwanted children; 2) reduces the number of abnormal children; and 3) provides a safe and inexpensive form of contraception. Indirect objects to to infanticide are similar to those noted for abortion. The advantage of infanticide is that it avoids the on-going distress of parents who must live with and support a severe handicapped child. PMID:657265
Humphries, S V
Investigated the validity of the Child—Adult Medical Procedure Interaction Scale- Revised (CAMPIS-R) using multiple concurrent objective and subjective measures of child distress, approach-avoidance behavior, fear, pain, child cooperation, and parents' perceived ability to help their preschool children during routine immuni- zations. Parents', staffs', and children's behaviors in the treatment room were videotaped and coded. Results indicate that the validity of
Ronald L. Blount; Lindsey L. Cohen; Natalie C. Frank; Pamela J. Bachanas; Adina J. Smith; M. Reena Manimala; Joseph T. Pate
The enactment of Law 2/2010 on Sexual and Reproductive Health and on Voluntary Interruption of Pregnancy represents a radical change in the regulation of abortion in Spain. The law moves from the medical indication model that has been in place since 1985 (which established certain cases in which abortion was legal) towards a time-limit model that, with some exceptions, allows free abortion during the first 14 weeks of pregnancy. Along with the hot debate that this fundamental change has caused, other features of the law have also arisen as a source of conflict, including the regulation of the informed consent of underage women for having an abortion and the rules regarding the conscientious objection by healthcare professionals. PMID:21970052
Requejo, María Teresa
The present paper, based on the results of international studies, is focused on the reconsideration of the psychological aspects of induced abortion. By presenting a narrow cross-section of the Hungarian demographic data, we would like to emphasise the necessity and the significance of a deeper understanding of the subject. Factors behind the decision-making, short- and long term outcomes of the intervention influencing primarily the mental health of women and partner-relationship aspects are discussed in details. While acknowledging the complexity of the subject deriving from the legal, ethical, moral, religious, medical, social and sociological concerns, our aim is to call attention to the psychological aspects of induced abortion and the importance of psychological care of women undergoing surgical operation. PMID:22232522
Sz Makó, Hajnalka; Veszprémi, Béla
After 5 years of use in more than 100,000 European women, RU 486, an antiprogestin medication used as a medical abortifacient, has recently come under scrutiny in the United States. This article discusses the current and potential uses of RU 486. Also addressed are the history, advantages, and disadvantages of medical abortion (including the acceptability of the method from a woman-centered perspective); new clinical trials; and ethical issues. PMID:7996306
Donaldson, K; Briggs, J; McMaster, D
The need to allow threads to abort an attempt to ac- quire a lock (sometimes called a timeout) is an interest- ing new requirement driven by state-of-the-art database applications with soft real-time constraints. This paper presents a new composite abortable lock (CAL), a com- bination of abortable queue-based (QL) and test-and- set based backoff (BL) lock mechanisms, which provides non-blocking
Virendra J. Marathe; Mark Moir; Nir Shavit
One barrier in the US to wider acceptance of mifepristone for abortion is the additional cost of the routine use of two sonograms, that is, for pregnancy dating and confirmation of a complete abortion. The purpose of this study is to document how the accuracy of medical abortion clinicians experienced with pelvic exams and dating pregnancies in assessing gestational age
Stephen L. Fielding; Eric A. Schaff; Na-yon Nam
Since 2004 German universities have been able to use a selection procedure to admit up to 60 percent of new students. In 2005, the Carl Gustav Carus Faculty of Medicine at Dresden introduced a new admission procedure. In order to take account of cognitive as well as non-cognitive competencies the Faculty used the following selection criteria based on the legal regulations for university-admissions: the grade point average of the school-leaving exam (SSC, Abitur), marks in relevant school subjects; profession and work experience; premedical education; and a structured interview. In order to evaluate the effects of the Faculty admission procedures applied in the years 2005, 2006 and 2007, the results on the First National Medical Examination (FNME) were compared between the candidates selected by the Faculty procedures (CSF-group) and the group of candidates admitted by the Central Office for the Allocation of Places in Higher Education (the ZVS group, comprising the subgroups: ZVS best, ZVS rest and ZVS total). The rates of participation in the FNME within the required minimum time of 2 years of medical studies were higher in the CSF group compared to the ZVS-total group. The FNME pass rates were lowest in the ZVS rest group and highest in the ZVS best group. The ZVS best group and the ZVS total group showed the best FMNE results, whereas the results of the CSF-group were equal or worse compared to the ZVS rest group. No correlation was found between the interview results and the FNME results. According to studies of the prognostic value of various selection instruments, the school leaving grade point average seems the best predictor of success on the FNME. In order to validate the non-cognitive selection instruments of the Faculty procedure, complementary instruments are needed to measure non-cognitive aspects that are not captured by the FNME-results.
Hansel, Mike; Klupp, S.; Graupner, Anke; Dieter, Peter; Koch, Thea
Background Locus of pain control (LPC) is characterized by the behavior of people coping with their health problems, as a result of their own actions (internal control) or external factors or other people (external control). This parameter can be associated with medication adherence, in addition to other psychosocial factors that may also influence this behavior. This study was performed to investigate the influence of the LPC on medication adherence in patients undergoing an orthopedic procedure. Subjects and methods We conducted a prospective cohort study on patients who attended an orthopedic clinic for arthroscopy treatment. The patients’ LPC and pain intensity data were obtained on the day of admission through the use of the LPC scale and the visual analog scale (VAS), respectively, both being validated tools. After arthroscopic surgery, the patients received drug prescriptions and were reassessed after 15 days regarding treatment adherence, using the Morisky test. A P-value <0.05 was considered statistically significant. Results We assessed 79 individuals from both the internal LPC group (n=35) and external LPC group (n=44) and found that there were no group differences in sex, affected limb, cause of injury, repetitive strain injury, duration of pain, or pain intensity. However, there was a higher proportion of patients in the external LPC group that adhered to the prescribed medication compared with the internal LPC group (P<0.01). Conclusion The results showed that among patients who underwent an orthopedic procedure, there was a higher adherence rate to prescribed medication in the external LPC group compared with the internal LPC group.
Porto, Thaisy Mendes; Machado, Daniele Caferatti; Martins, Rafael Olivio; Galato, Dayani; Piovezan, Anna Paula
This study analyzed how the case management process has functioned at Walter Reed Army Medical Center in terms of staffing, procedures, and organizational structure. The researcher conducted interviews with case managers from many areas; collected data fr...
K. S. Smith
The January 1973 Supreme Court decision concerning abortion did not settle the issue. In fact, the issue becomes increasingly more critical. Supporters of "freedom of choice" thought the victory was theirs when the decision was announced by the Court, but advocates of an anti-abortion position were incensed by the decision. After a few months of letter writing, the anti-abortion forces developed a more comprehensive, long-range strategy. Their objective is a constitutional amendment barring abortion. Supporters of "freedom of choice" do have several important elements in their favor. 1st, the majority of public opinion is on the side of freedom of choice. 2nd, the position being advocated is clearly non-discriminatory and non-coercive. Unlike the opposition, those who support freedom of choice are not trying to impose their beliefs on any other group of people and are actually trying to protect each and every individual's freedom of choice. This seasoned and reasonable view needs to be presented nationally in a seasoned and reasonable manner. More mail from both men and women needs to be directed toward each member of the House and Senate with special emphasis on the members of the House and Senate Judiciary committees. In addition to sending more mail, Zero Population Growth chapters and members could help by: 1) initiating "freedom of choice" letters to editors of local newspapers; 2) having persons representing the "freedom of choice" point of view appear on local television shows and before community groups; and 3) enlisting the help of the local medical and legal communities to lend their expertise to an intelligent discussion of the issue. PMID:12276913
Two physicians debate whether abortions should be available on request regardless of medical indications. The crux of the issue is whether the fetus should be considered body tissue over which the woman has complete control or whether society has an interest in the embryo and should protect it. (Author/BY)
Nathanson, Bernard; Lawrence, George
In a pilot study about medical, psychological and psychosocial factors in spontaneous and recurrent spontaneous abortions, coping strategies of 83 women were investigated and compared with a control group (n = 69). Two further subgroups were selected (31 women with recurrent spontaneous abortions and 30 without pregnancy complications). A modified form of a stress-investigation-scale (SVF from Janke et al.) was used. The results indicated that women with spontaneous abortions had increased depressive and lowered positive and cognitive coping modes. According to the hypothesis most psychological disturbances and depressive coping strategies were found in recurrent spontaneous abortions. In pregnancy depressive withdrawal, need of social support and information seeking was further increased, but emotional self-control lowered. A connection between psychological disturbances and negative coping strategies was shown. After pregnancy loss psychological support and building up positive and efficient coping strategies are therefore indicated. PMID:2678214
Modern thinking on abortion, reflected in recent legal developments around the world, has turned from concentration upon criminality in favor of female and family well-being. New laws enacted during the last decade are coming to focus upon conditions of health and social welfare of women and their existing families as indications for lawful termination of pregnancy. Regulations governing the delivery of services may be restrictive, however, so as to limit in practice access to means of safe, legal abortion made available in theory. Requirements may be imposed that only medical personnel with unduly high qualifications perform procedures, or that they be undertaken only in institutions meeting standards higher than similar health care requires. Approval procedures may be established involving second medical opinions or committees to monitor observance of the law, which may delay abortions and therefore increase their hazards. Parental and spousal consent requirements may exist in addition with the same effects, or to veto a pregnant female's request. Regulations may be employed more positively, however, to encourage contraceptive practice. A disappointment with legislative reform is that it may fail to improve circumstances if public resources are not applied to achieve the supply of services newly rendered legitimate, and illegal practice may persist.
Cook, R J; Dickens, B M
Non-tubecrulosis mycobacterium infections were increasingly reported either pulmonary or extrapulmonary in the past decades. In Taiwan, we noticed several reports about the soft tissue infections caused by rapid growing mycobacterium such as Mycobacterium abscessus, Mycobacterium chelonae, on newspaper, magazines, or the multimedia. Most of them occurred after a plastic surgery, and medical or non-medical procedures. Here, we reported two cases of these infections following medical procedures. We also discussed common features and the clinical course of the disease, the characteristics of the infected site, and the treatment strategy. The literatures were also reviewed, and the necessity of the treatment guidelines was discussed.
Lin, Shih-Sen; Lee, Chin-Cheng
Non-tubecrulosis mycobacterium infections were increasingly reported either pulmonary or extrapulmonary in the past decades. In Taiwan, we noticed several reports about the soft tissue infections caused by rapid growing mycobacterium such as Mycobacterium abscessus, Mycobacterium chelonae, on newspaper, magazines, or the multimedia. Most of them occurred after a plastic surgery, and medical or non-medical procedures. Here, we reported two cases of these infections following medical procedures. We also discussed common features and the clinical course of the disease, the characteristics of the infected site, and the treatment strategy. The literatures were also reviewed, and the necessity of the treatment guidelines was discussed. PMID:24882980
Lin, Shih-Sen; Lee, Chin-Cheng; Jang, Tsrang-Neng
The authors investigate the effect of abortion access on teen birthrates using county-level panel data. Past research suggested that prohibiting abortion led to higher teen birthrates. Perhaps surprisingly, the authors find that more recent restrictions in abortion access, including the closing of abortion clinics and restrictions on Medicaid funding, had the opposite effect. Small declines in access were related to
Thomas J Kane; Douglas Staiger
Background While induced abortion is considered to be illegal and socially unacceptable in Nigeria, it is still practiced by many women in the country. Poor family planning and unsafe abortion practices have daunting effects on maternal health. For instance, Nigeria is on the verge of not meeting the Millennium development goals on maternal health due to high maternal mortality ratio, estimated to be about 630 maternal deaths per 100,000 live births. Recent evidences have shown that a major factor in this trend is the high incidence of abortion in the country. The objective of this paper is, therefore, to investigate the factors determining the demand for abortion and post-abortion care in Ibadan city of Nigeria. Methods The study employed data from a hospital-based/exploratory survey carried out between March to September 2010. Closed ended questionnaires were administered to a sample of 384 women of reproductive age from three hospitals within the Ibadan metropolis in South West Nigeria. However, only 308 valid responses were received and analysed. A probit model was fitted to determine the socioeconomic factors that influence demand for abortion and post-abortion care. Results The results showed that 62% of respondents demanded for abortion while 52.3% of those that demanded for abortion received post-abortion care. The findings again showed that income was a significant determinant of abortion and post-abortion care demand. Women with higher income were more likely to demand abortion and post-abortion care. Married women were found to be less likely to demand for abortion and post-abortion care. Older women were significantly less likely to demand for abortion and post-abortion care. Mothers’ education was only statistically significant in determining abortion demand but not post-abortion care demand. Conclusion The findings suggest that while abortion is illegal in Nigeria, some women in the Ibadan city do abort unwanted pregnancies. The consequence of this in the absence of proper post-abortion care is daunting. There is the need for policymakers to intensify public education against indiscriminate abortion and to reduce unwanted pregnancies. In effect, there is need for effective alternative family planning methods. This is likely to reduce the demand for abortion. Further, with income found as a major constraint, post abortion services should be made accessible to both the rich and poor alike so as to prevent unnecessary maternal deaths as a result of abortion related complications.
Investigated the validity of the Child-Adult Medical Procedure Interaction Scale-Revised (CAMPIS-R) using multiple concurrent objective and subjective measures of child distress, approach-avoidance behavior, fear, pain, child cooperation, and parents' perceived ability to help their preschool children during routine immunizations. Parents', staffs', and children's behaviors in the treatment room were videotaped and coded. Results indicate that the validity of the CAMPIS-R codes of Child Coping and Distress, Parent Distress Promoting and Coping Promoting, and Staff Distress Promoting and Coping Promoting behavior were supported, with all significant correlations being in the predicted direction. An unanticipated finding was that the child, parent, and staff Neutral behaviors were inversely related to some measures of distress and positively related to some measures of coping. Interobserver reliability was high for each CAMPIS-R code. PMID:9019049
Blount, R L; Cohen, L L; Frank, N C; Bachanas, P J; Smith, A J; Manimala, M R; Pate, J T
This privately posted page offers extensive and highly credible information on legislation and jurisprudence relating to abortion in the US. The site offers thoroughly linked discussions of constitutional law, Roe v. Wade, Planned Parenthood v. Casey, state and federal abortion laws, including partial-birth abortion laws, and much more. The hypertext links are to primary documents including court decisions, texts of legislation, court briefs, and oral argument transcripts. There is also an index to primary documents for ease of access. We found the page to have no political agenda. As the author states, "this page is being constructed to help people, regardless of their political bent, understand the background and state of abortion law in America, and access related legal material--especially that which is less available and less well known."
Objective Abortion either medical or criminal has distinctive physical, social, and psychological side effects. Detecting types and frequent psychological side effects of abortion among post abortion care seeking women in Tehran was the main objective of the present study. Method 278 women of reproductive age (15-49) interviewed as study population. Response rate was 93/8. Data collected through a questionnaire with 2 parts meeting broad socio-economic characteristics of the respondents and health- related abortion consequences. Tehran hospitals were the site of study. Results The results revealed that at least one-third of the respondents have experienced psychological side effects. Depression, worrying about not being able to conceive again and abnormal eating behaviors were reported as dominant psychological consequences of abortion among the respondents. Decreased self-esteem, nightmare, guilt, and regret with 43.7%, 39.5%, 37.5%, and 33.3% prevalence rates have been placed in the lower status, respectively. Conclusion Psychological consequences of abortion have considerably been neglected. Several barriers made findings limited. Different types of psychological side effects, however, experienced by the study population require more intensive attention because of chronic characteristic of psychological disorders, and women's health impact on family and population health.
Except for in Mexico City, abortion is legally restricted throughout Mexico, and unsafe abortion is prevalent. We surveyed 1,516 women seeking abortions in San Diego, California. Of these, 87 women (5.7%) self-identified as Mexican residents. We performed in-depth interviews with 17 of these women about their experiences seeking abortions in California. The Mexican women interviewed were generally well-educated and lived near the U.S.-Mexican border; most sought care in the United States due to mistrust of services in Mexico, and the desire to access mifepristone, a drug registered in the United States for early medical abortion. Several reported difficulties obtaining health care in Mexico or reentering the United States when they had postabortion complications. Several areas for improvement were identified, including outreach to clinics in Mexico. PMID:23066967
Grossman, Daniel; Garcia, Sandra G; Kingston, Jessica; Schweikert, Suzanne
When children endure needle-related medical procedures (NRMPs), different emotions arise for the child and his/her parents. Despite the parents’ own feelings, they have a key role in supporting their child through these procedures. The aim of this study is to describe the meanings of supporting children during NRMPs from the perspective of the parents. Twenty-one parents participated in this study. A reflective lifeworld research (RLR) approach was used and phenomenological analysis was applied. The essential meaning of the phenomenon—supporting children during an NRMP—is characterized as “keeping the child under the protection of one’s wings,” sometimes very close and sometimes a little further out under the wingtips. The essential meaning is additionally described through its constituents: paying attention to the child’s way of expressing itself, striving to maintain control, facilitating the child’s understanding, focusing the child’s attention, seeking additional support, and rewarding the child. The conclusion is that parents’ ability to be supportive can be affected when seeing their child undergo an NRMP. To regain the role as the child’s protector and to be able to keep the child “under the protection of one’s wings,” parents need support from the staff.
Karlsson, Katarina; Englund, Ann-Charlotte Dalheim; Enskar, Karin; Rydstrom, Ingela
...for notification of or access to medical records. 5b.6 Section 5b.6...for notification of or access to medical records. (a) General. An individual...notification of or access to his medical records, including psychological...
The number of qualified applicants seeking admission to medical school has increased substantially in recent years, with the result that medical schools have become increasingly selective. In choosing among such applicants, medical school admissions perso...
M. J. Gaffney D. M. Schember
This paper characterizes the Mexican abortion laws using the case of a girl aged 14 years, Paulina Ramirez Jacinta, who was raped, became pregnant, and chose to terminate the unwanted pregnancy, yet was denied an abortion. This case clearly showed that Mexican abortion law, despite its legality, is highly restrictive in nature and, in a way, violated the human rights of Paulina. Even though it permits first-trimester abortion procedures for rape victims or women whose lives are endangered by the pregnancy, many pregnant women still resort to illegal abortion. To further aggravate the restrictive nature of the law, Baja California state Rep. Martin Dominguez Rocha made a proposal to eliminate the rape exception in the state's penal code. The case of Paulina will be handled by the lawyers at the Center for Reproductive Law and Policy in order to arrive at a settlement favorable to Paulina. PMID:12322531
...medical benefits packageâ does not include the following: (1) Abortions and abortion counseling. (2) In vitro fertilization. (3) Drugs, biologicals, and medical devices not approved by the Food and Drug Administration...
Children state that among their worst fears during hospitalization are those related to various nursing procedures and to injections and needles. Nurses thus have a responsibility to help children cope with needle-related medical procedures (NRMP) and the potentially negative effects of these. The aim of the study is to describe the lived experience of supporting children during NRMP, from the perspective of nurses. Fourteen nurses took part in the study, six of whom participated on two occasions thus resulting in 20 interviews. A reflective lifeworld research approach was used, and phenomenological analysis was applied. The result shows that supporting children during NRMP is characterized by a desire to meet the child in his/her own world and by an effort to reach the child's horizon of understanding regarding these actions, based on the given conditions. The essential meaning of the phenomenon is founded on the following constituents: developing relationships through conversation, being sensitive to embodied responses, balancing between tact and use of restraint, being the child's advocate, adjusting time, and maintaining belief. The discussion focuses on how nurses can support children through various types of conversation and by receiving help from the parents’ ability to be supportive, and on whether restraint can be supportive or not for children during NRMP. Our conclusion is that nurses have to see each individual child, meet him/her in their own world, and decide on supportive actions while at the same time balancing their responsibility for the completion of the NRMP. This work can be described as “balancing on a tightrope” in an unpredictable situation.
Karlsson, Katarina; Rydstrom, Ingela; Enskar, Karin; Englund, Ann-Charlotte Dalheim
Background Despite changes to the South African abortion legislation in 1996, barriers to women accessing abortions still exist. Second trimester abortions, an inherently more risky procedure, continue to be 20% of all abortions. Understanding the reasons why women delay seeking an abortion until the second trimester is important for informing interventions to reduce the proportion of second trimester abortions in South Africa. Methods Qualitative research methods were used to collect data. Twenty-seven in-depth interviews were conducted in 2006 with women seeking a second trimester abortion at one public sector tertiary hospital and two NGO health care facilities in the greater Cape Town area, South Africa. Data were analysed using a grounded theory approach. Results Almost all women described multiple and interrelated factors that influenced the timing of seeking an abortion. Reasons why women delayed seeking an abortion were complex and were linked to changes in personal circumstances often leading to indecision, delays in detecting a pregnancy and health service related barriers that hindered access to abortion services. Conclusion Understanding the complex reasons why women delay seeking an abortion until the second trimester can inform health care interventions aimed at reducing the proportion of second trimester abortions in South Africa.
Harries, Jane; Orner, Phyllis; Gabriel, Mosotho; Mitchell, Ellen
The purpose of NASA's Constellation project is to create the new generation of spacecraft for human flight to the International Space Station in low-earth orbit, the lunar surface, as well as for use in future deep-space exploration. One portion of the Constellation program was the development of the Orion crew exploration vehicle (CEV) to be used in spaceflight. The Orion spacecraft consists of a crew module, service module, space adapter and launch abort system. The crew module was designed to hold as many as six crew members. The Orion crew exploration vehicle is similar in design to the Apollo space capsules, although larger and more massive. The Flight Test Office is the responsible flight test organization for the launch abort system on the Orion crew exploration vehicle. The Flight Test Office originally proposed six tests that would demonstrate the use of the launch abort system. These flight tests were to be performed at the White Sands Missile Range in New Mexico and were similar in nature to the Apollo Little Joe II tests performed in the 1960s. The first flight test of the launch abort system was a pad abort (PA-1), that took place on 6 May 2010 at the White Sands Missile Range in New Mexico. Primary flight test objectives were to demonstrate the capability of the launch abort system to propel the crew module a safe distance away from a launch vehicle during a pad abort, to demonstrate the stability and control characteristics of the vehicle, and to determine the performance of the motors contained within the launch abort system. The focus of the PA-1 flight test was engineering development and data acquisition, not certification. In this presentation, a high level overview of the PA-1 vehicle is given, along with an overview of the Mobile Operations Facility and information on the White Sands tracking sites for radar & optics. Several lessons learned are presented, including detailed information on the lessons learned in the development of wind placards for flight. PA-1 flight data is shown, as well as a comparison of PA-1 flight data to nonlinear simulation Monte Carlo data.
Hayes, Peggy Sue
This paper documents some of the evolutionary steps in developing a rigorous Space Shuttle launch abort capability. The paper addresses the abort strategy during the design and development and how it evolved during Shuttle flight operations. The Space Shuttle Program made numerous adjustments in both the flight hardware and software as the knowledge of the actual flight environment grew. When failures occurred, corrections and improvements were made to avoid a reoccurrence and to provide added capability for crew survival. Finally some lessons learned are summarized for future human launch vehicle designers to consider.
Henderson, Edward M.; Nguyen, Tri X.
OBJECTIVE: The previously held dictum that elective abortion before 6 weeks' gestation carried greater risks than a later procedure was challenged by this protocol.STUDY DESIGN: This study evaluated a protocol for abortion before the customary 6 weeks' gestation. Patients willing to return to the clinic within 72 hours were given the option of elective abortion even when no gestational sac
Jerry Edwards; Sandra Ann Carson
Changes in homicide and arrest rates were compared among cohorts born before and after legalization of abortion and those who were unexposed to legalized abortion. It was found that legalized abortion improved the lives of many women as they could avoid unwanted births.
This poster paper outlines the operational and medical procedures for a shuttle mission that has a failure that precludes a safe return to Earth. Information about the assumptions, procedures and limiting consumables is included.
Adams, Adrien; Patlach, Bob; Duchense, Ted; Chandler, Mike; Stepaniak, Philip C.
A laboratory-based simulated surgical procedure was designed to characterize the medical laser-generated air contaminant (LGAC) particles generated during surgical procedures and to estimate exposures in theoretical rooms. Laser operational parameter settings were varied between levels to investigate the influence of parameter settings on LGAC generation. Two medical lasers, the carbon dioxide at a wavelength of 10,600 nanometers (CO2, lambda =10,600 nm) and the holmium yttrium aluminum garnet (Ho:YAG) laser at the wavelength of 2100 nanometers (Ho:YAG, lambda =2100 nm) were used, varying three operational parameters (beam diameter, pulse-repetition frequency [PRF], and power) between two levels and the resultant plume was collected using two real-time size selective particle counters in a laboratory emission chamber. Analysis of variance (ANOVA) was used to determine the influence of operational parameter settings on size-specific particle emission rate. Particles from a limited number of experiments were also collected on polycarbonate filters and imaged using a scanning electron microscope (SEM) in backscatter mode to study the particle characteristics and if mechanism of formation could be determined. Particles on each filter were counted and a determination on shape (irregular versus homogenous) and diameter was made. Size-specific particle emission rates were then used to demonstrate potential concentration range using a two-zone exposure model. Results indicate power and beam diameter were statistically significant influential parameters for both lasers and for all particle size ranges, but pulse repetition frequency was only a statistically significant influential parameter for the smallest particles generated. An increase in power and decrease in beam diameter led to an increase in particle emission for the Ho:YAG laser. For the CO2 laser, higher power led to a decrease in emission rates of small particles and an increase for large particles while a smaller beam diameter led to an increase of particle emissions for most size ranges (<10microm). Beam diameter was the most influential variable in the generation of laser-generated particles at all sizes, and the three operational parameters we tested had the most influence on the generation of the smallest particle size ranges. Particle size varied, with the Ho:YAG laser producing particles in the 1--10 microm range and the CO2 laser producing particles between 1 and 50 microm in diameter. Particle shape was variable, with fibers, foam, and conglomerate particles present in our samples. Modeled concentrations for the near-field ranged between 0.03 and 0.5 mg/m3 and between 0.01 and 0.4 mg/m3 in the far-field. Results indicate concentrations in the simulated scenarios were similar to those obtained from previously reported field assessments conducted in hospital operating rooms (ORs). The methods used in this study provide a foundation for future investigations to better estimate particle-size dependent emission rates for additional laser operational parameters in order to inform occupational exposure control strategies.
A study is performed to ascertain the validity of the use of inviscid and viscous simulation methods to predict the axial and normal forces during a launch abort scenario for manned space flight vehicles. The proximity drag character of the Apollo launch escape vehicle (LEV) was studied in detail in a wind tunnel during the Apollo program. Simulation results obtained
Shishir Pandya; Jeffrey Onufer; William Chan; Goetz Klopfer
This article examines the struggle over abortion law reform that preceded the enactment in 1975 of the first statutory law on abortion in South Africa. The ruling National Party government produced legislation intended to eliminate access to doctors willing to procure abortions in an attempt to prevent young, unmarried white women from engaging in premarital (hetero) sexual activity. It was also aimed at strictly regulating the medical profession’s actions with regards to abortion. The production of the abortion legislation was directly influenced by international struggles for accessible abortion and, more broadly, sexual liberation. The regime believed South Africa was being infiltrated by Western "immorality" and the abortion law was an attempt to buttress racist heteropatriarchal apartheid culture. Examining the abortion controversy highlights the global circulation of ideas about reproduction in the twentieth century and foregrounds a neglected dimension of the history of sexual regulation in apartheid South Africa: the disciplining and regulation of white female reproductive sexuality. PMID:20857591
Klausen, Susanne M
Only 17% of US hospitals (265 public and 926 private hospitals) perform abortions, and hospital-based abortions represent only a small fraction of the number of abortions performed each year. Despite this low level of involvement, US hospitals have become involved in difficult situations concerning law, ethics, and standards of practice. A case in point is Baltimore's Saint Agnes Hospital, where the accreditation of the hospital's residency training program in obstetrics and gynecology was withdrawn in 1986 by the Accreditation Council for Graduate Medical Education. This decision was based on the hospital's refusal, for religious reasons, to perform abortions, sterilizations, and artificial insemination. The hospital further was cited for not providing family planning education to medical students. Saint Agnes Hospital maintained that the Council's decision represented discrimination against Catholic hospitals; as evidence, it cited the fact that, while Catholic- affiliated residency programs comprised only 10% of such programs, they accounted for 83% of programs in which deficiencies or concerns were identified by the Accreditation Council. Some Catholic hospitals deal with this situation by allowing residents to rotate to other facilities if they want to be trained in abortion services--an option Saint Agnes rejected. The number of hospitals that offer residents training in abortion has declined by 22% since 1977; at present, 13% of all gynecology-obstetrics residents have no access to such training. PMID:2753484
Prophylactic antibiotics (PA) are effective to prevent post hysterosalpingography pelvic inflammatory disease (PID) and should be performed in these patients. No advantages are reported concerning PA in patients undergoing intra uterine device placement, hysteroscopy (diagnosis or operative hysteroscopy), medical abortion or uterine revision. Systematic PA with tetracyclins or imadazols is effective to prevent post abortion PID in patients undergoing surgical abortion and should be performed in these patients. PMID:23142354
Shojai, R; Ohannessian, A; Maruani, J; Agostini, A
This paper summarizes the barriers to abortion in the United States, including the determination of viability, cost and insurance coverage, waiting periods and parental consent laws, restrictions on medical abortion, provider unavailability, harassment, targeted regulation of abortion providers laws, refusal clauses, anti choice laws, and the fetal legal rights movement. Federally subsidized abstinence-only sex education, which has not been shown to decrease the rate of unintended pregnancy (and may increase it), has expanded and access to a full range of contraceptive options has been limited. The policies of the current and past administrations have strengthened barriers to abortion both at home and abroad. Preserving women's right to choose will require improved public and professional education, legislative and legal efforts, and advocacy by physicians and other health care professionals. PMID:16845763
The findings of a study conducted in the rural areas around Jajaigarh, Delhi to collect information about different indigenous preparations, practices and rituals which the rural population maintain have abortion-inducing effects are presented. The resource persons interviewed include indigenous midwives, private medical practitioners, old women of the villages, teachers and barbers. Also contacted were maternity and child health workers. The 9 abortion-inducing practices reported are described. Some of the techniques have been recorded and some have some scientific basis causing abortion. For example, the administration of quinine is known to cause abortion. No scientific evidence is available to substantiate the efficacy of some of the methods, yet the resource persons providing the information were absolutely confident regarding their favorite methods. The resource persons were known to practice their favorite methods successfully. PMID:6903341
Verghese, T; Bhandari, U; Bhandari, V
The analgesic efficacy of naproxen sodium was compared with that of a placebo or of no drug in 137 women undergoing 1st-trimester elective abortion. 46 women received a single 550 mg dose of naproxen sodium 1-2 hours prior to abortion, 46 women received a placebo, and 45 women received no drug. Abortions were performed by means of suction curettage after anesthesia was produced by paracervical block with 1% lidocaine solution, and study subjects were asked to assess their pain on a scale from 0-99 at the most painful moment during abortion and at 15 and 30 minutes after abortion. Pain scores reported by naproxen sodium patients were consistently lower than those reported by placebo and no drug patients, and the difference between average pain scores of naproxen sodium patients and placebo patients was statistically significant at each evalution. Pain scores of untreated patients were comparable to those of placebo patients. Multiparous and multigravid women reported lower pain scores than women who had never been pregnant before. There were no apparent side effects of naproxen sodium treatment. These findings indicate that naproxen sodim can provide effective analgesia for pain caused by uterine contractions during and after suction abortion. Its terapeutic effectiveness may be enhanced by administration 1-2 hours prior to he abortion procedure so that peak plasma concentrations are attained. PMID:6507524
Suprapto, K; Reed, S
One of the main objectives of pharmaceutical policies in developing countries is to ensure accessibility and affordability of good quality medicines for the population. The Essential Medicines and Generic Drugs Purchasing Central (French acronym, CAMEG-Togo) is a not-for-profit association established in 1998 to ensure procurement for public and not-for-profit private public health facilities within the framework of recovery of costs. Although attention has been focused mainly on medicines, medical devices account for a growing part of the pharmaceutical products purchased by central stores, hospitals and health programs. Recognizing this need in 2002, CAMEG-Togo in collaboration with the French cooperation agency decided to upgrade its competency in evaluating the quality of medical devices. For that purpose the information sheet used to preselect suppliers for international tenders and the technical specifications sheet for medical devices was revised and pharmacists responsible for processing these files were given specific training. European directive N 93/42/CEE of 14 June 1993 is currently used by CAMEG-Togo as the regulatory basis for preselection of medical device suppliers. Referencing based on American regulatory requirements is now under way to widen the scope of suppliers eligible for preselection. The purpose of this article is first to describe the main guidelines of the European directive used by medical device manufacturers to obtain EC certification and second to present the procedures used by the CAMEG-Togo to preselect medical device suppliers, with special focus on the technical specifications sheet. PMID:17286037
The field of abortion counseling originated in the abortion rights movement of the 1970s. During its evolution to the present day, it has faced significant challenges, primarily arising from the increasing politicization and stigmatization of abortion since legalization. Abortion counseling has been affected not only by the imposition of antiabortion statutes, but also by the changing needs of patients who have come of age in a very different era than when this occupation was first developed. One major innovation--head and heart counseling--departs in significant ways from previous conventions of the field and illustrates the complex and changing political meanings of abortion and therefore the challenges to abortion providers in the years following Roe v Wade. PMID:23153144
Objective: To ascertain if there is an association between endometriosis and spontaneous abortion. Design: Prospective cohort study. Setting: Medical School Hospital. Population: 174 infertile women laparoscopically diagnosed with endometriosis and 174 infertile women in which endometriosis was ruled out by laparoscopy, in the same period of time. Main outcome measure: Spontaneous abortion. Non-progressive gestational sac and\\/or histological study. Results: Per
Roberto Matorras; Fernando Rodr??guez; Gloria Gutierrez de Terán; Jose Ignacio Pijoan; Olga Ramón; Francisco Javier Rodr??guez-Escudero
Like many Communist or post-Communist nations, Russia has one of the highest abortion rates in the world. These rates have created a legacy of significant medical problems. Complications from abortion are the cause of more than one in four maternal deaths...
The clinical value of maternal serum alpha-fetoprotein (AFP) as a guide to the outcome of threatened abortion was assessed. After the thirteenth week of gestation, abortion occurred more frequently (10/12) in women with abnormal serum AFP levels than in those (2/12) whose AFP concentrations were within the normal range. Low levels were present in women with blighted ovum and high concentrations were associated with intrauterine fetal death. In legal first and second trimester abortions, the circulating maternal AFP levels in postabortion samples were often higher than before abortion, irrespective of whether abortion was performed instrumentally or induced with prostaglandins. Maternal serum AFP levels provide a new means for prediction of the outcome of threatened abortion. ImagesFIG. 1FIG. 2
Seppala, Markku; Ruoslahti, Erkki
I recently watched a fascinating documentary about the crusade of Dr Bertram Wainer in the 1960s to bring the practice of illegal abortion in Victoria to an end. It documented the profound horror of the backyard abortion that so often ended in infection, sterility or death, and served as a potent reminder of a practice to which we must never return. Of course that cant happen again, abortion is legal now, isnt it? In Victoria in 1969 a Supreme Court judge ruled that an abortion is not unlawful if a doctor believed that: the abortion is necessary to preserve the woman from serious danger to her life or physical or mental health (Menhennit ruling). In Australia today however, abortion law remains conditional, unclear and inconsistent and, except in the ACT, is still part of criminal statutes. PMID:16969440
Read, Christine Margaret
A simple classification of products of conception aborted in early pregnancy is described. This classification bears a closer relation to the aetiology of the abortions and the timing of the teratological insult in those conceptuses with morphological abnormalities than have previous classifications. It is hoped it may be of value in counselling patients who abort recurrently and also in the assessment of some environmental hazards purported to cause early pregnancy wastage and congenital malformations. Images
Rushton, D I
Objective First trimester abortion was decriminalized in Mexico City in 2007. We studied client views of family planning services provided during abortion care at public facilities and acceptance of postabortion contraception. Methods We surveyed 402 clients seeking first trimester abortion care in Mexico City. We used logistic regression to test whether postabortion contraception varied by abortion visit characteristics or client sociodemographics. Results Most participants (81.6%) reported being offered contraception at their visit and 89.5% selected a contraceptive method postabortion, with 58.9% selecting the IUD. Surgical abortion clients were more likely to report being offered contraception than medical abortion clients (p<.001), as were clients attended by a female physician (p<.05). Clients at the general hospital were less likely to report being offered contraception (p<.001). Conclusion Public sector facilities in Mexico City are providing a generally high level of postabortion family planning care and uptake of postabortion contraception is high.
Becker, Davida; Diaz-Olavarrieta, Claudia; Garcia, Sandra G.; Harper, Cynthia C.
A Muslim woman in her sixteenth week of pregnancy was informed that her ultrasound scan showed spina bifida, and laboratory results confirmed the diagnosis. The child would have various complications and, most probably, would need medical care for life. With the consent of her husband she decided to terminate the pregnancy. Her decision sparked controversy among Muslim clerics in her community, sparking debate between those who would allow abortion for medical reasons and those who oppose abortion for any reason. This paper will review the philosophical and theological arguments of the pro-life and pro-choice groups as well as the Islamic perspective concerning a woman's autonomy over her reproductive system, the sanctity of the fetus and the embryo, therapeutic abortion, and ensoulment. PMID:23573379
Khitamy, Badawy A B
Recent developments in the field of instructional media provide educators with enhanced technological capabilities to teach procedures involving psychomotor skills. A general model for using an interactive video instruction (IVI) program to teach a simple...
A. M. Devney
...individual, (2) To explain the meaning of the documents, and (3) To offer counseling designed to temper any adverse reaction, the Agency will forward such records to the designated physician. (c) Procedure if physician option not...
...individual, (2) To explain the meaning of the documents, and (3) To offer counseling designed to temper any adverse reaction, NACIC will forward such records to the designated physician. (c) Procedure if physician option not...
In Thailand abortion is against the law except in cases of risk to a woman's health or if the pregnancy is the result of rape or other sexual crimes. This paper presents an overview of the history of the abortion debate in Thailand based upon research conducted from 1997-2001 for an ethnographic and historical study. Information was taken from media reports from 1950 in the Thai and English language press, a review of parliamentary records and interviews with 10 key informants. The debate over legal reform started in 1973. A reform bill was passed in 1981 in the House of Representatives but defeated in the Senate, primarily due to the lobbying efforts of Chamlong Srimuang, the leader of a broad-based religious coalition, who has been central in the anti-reform movement since then. The current democratically elected government in Thailand offers the best hope yet for reform, though abortion remains a politically sensitive issue, sensationalized in the press to counter reform efforts. A new advocacy network has recently been formed, including a range of women's organisations, public health advocates, academics and journalists. Current proposals from governmental and medical profession bodies may make abortions available to some women, but most, who seek abortions due to socio-economic and family planning reasons, will continue to have to find abortions by whatever means they can. PMID:12369331
Family planning counseling and the provision of postabortion contraception should be an integrated part of abortion and postabortion care to help women avoid another unplanned pregnancy and a repeat abortion. Postabortion contraception is significantly more effective in preventing repeat unintended pregnancy and abortion when it is provided before women leave the healthcare facility where they received abortion care, and when the chosen method is a long-acting reversible contraceptive (LARC) method. This article provides evidence supporting these two critical aspects of postabortion contraception. It suggests that gynecologists and obstetricians have an ethical obligation to do everything necessary to ensure that postabortion contraception, with a focus on LARC methods, becomes an integral part of abortion and postabortion care, in line with the recommendations of the International Federation of Gynecology and Obstetrics and of several other organizations. PMID:24739476
Gemzell-Danielsson, Kristina; Kopp Kallner, Helena; Faúndes, Anibal
The author argues that, if women have the right of self-determination, it is immoral of society to withhold or limit women's access to abortion services in Nigeria. Morality must pertain to society as well as women. In Nigeria, the abortion argument tends to focus on the rights of the fetus or the third party's interest. The abortion issue must involve understanding the rationale that is used by abortion-seeking women. Denial of access to abortion services dehumanizes women and reduces growth in national development. Women carry the burden of responsibility associated with child bearing and rearing. Unwanted pregnancies impose severe psychological, physical, social, and medical dangers on women. Impaired psychological and physical illness creates pain and suffering and limits productivity. "Doing good" is not necessarily accomplished by either abortion or unwanted childbearing. Society both discourages the taking of a human life and supports the health of its citizens, many of whom are women. A child brought into this world who is not adequately taken care of will be a burden to society. When society pursues its own self-interest in preventing abortion as a choice for women, then society becomes immoral and selfish. A woman pursuing her own self-interest is not necessarily immoral. The decision becomes immoral if the woman acts against the wishes of the father. Morality is not necessarily the opposite of the promotion of one's self-interest. Women who seek to terminate a pregnancy for health reasons seek a virtuous option of enhancing the well-being of every individual in society. The right to life for the fetus is very different from the right to self-determination for the abortion-seeking woman. When the Yoruba define a wife as a servant to the husband, the Yoruba deny women personhood. Women know best what serves their self-interest and that of society. PMID:12292664
Background Bowel perforation though rarely reported is a serious complication of induced abortion, which is often performed illegally by persons without any medical training in developing countries. A sudden increase in the number of patients in our centre in recent years prompted the authors to analyze this problem. The study was conducted to describe our own experiences in the surgical management of these patients. Methods This was a retrospective study involving patients who were jointly managed by the surgical and gynecological teams at Bugando Medical Centre (BMC) for bowel perforation secondary to illegally induced abortion from January 2002 to December 2011. The statistical analysis was performed using SPSS version 17.0. Results A total of 68 patients (representing 4.2% of cases) were enrolled in the study. Their ages ranged from 14 to 45 years with a median age of 21 years. Majority of patients were, secondary school students/leavers (70.6%), unmarried (88.2%), nulliparous (80.9%), unemployed (82.4%) and most of them were dependent member of the family. Previous history of contraceptive use was reported in only 14.7% of cases. The majority of patients (79.4%) had procured the abortion in the 2nd trimester. Dilatation and curettage (82.4%) was the most common reported method used in procuring abortion. The interval from termination of pregnancy to presentation in hospital ranged from 1 to 14 days (median 6 days ). The ileum (51.5%) and sigmoid colon (22.1%) was the most common portions of the bowel affected. Resection and anastomosis with uterine repair was the most common (86.8%) surgical procedure performed. Complication and mortality rates were 47.1% and 10.3% respectively. According to multivariate logistic regression analysis, gestational age at termination of pregnancy, delayed presentation, delayed surgical treatment and presence of complications were significantly associated with mortality (P<0.001). The overall median length of hospital stay (LOS) was 18 days (1day to 128 days ). Patients who developed complications stayed longer in the hospital, and this was statistically significant (P=0.012). Conclusion Bowel perforation following illegally induced abortion is still rampant in our environment and constitutes significantly to high maternal morbidity and mortality. Early recognition of the diagnosis, aggressive resuscitation and early institution of surgical management is of paramount importance if morbidity and mortality associated with bowel perforation are to be avoided.
The manual is the result of several years' effort toward developing a methodology to depict program resources-funding. The guidelines were developed based on a 1975 feasibility study and tested in seven medical colleges. It is hoped that the guidelines will be useful in analyzing the fiscal mechanisms for funding of the individual resources…
Agro, Gerlandino; Rosenthal, Joseph
Evidence suggests that restricting abortion does not reduce its occurrence but increases health risk. A qualitative analysis was performed, reviewing the medical charts of 12 women who died from unsafe induced abortions in Mexico City; most deaths occurred before abortion was decriminalized. Women resorted to using unsafe techniques, without medical guidance or under incorrect recommendations by providers, ultimately resulting in the loss of their lives. Postabortion care in private and public health facilities was often inadequate. The cases illustrate the importance of liberalizing abortion laws and improving postabortion care to protect the life and health of women seeking to terminate pregnancy. PMID:22920627
van Dijk, Marieke G; Ahued Ortega, Armando; Contreras, Xipatl; García, Sandra G
A measure of sex guilt was administered to clients of a university problem pregnancy counseling service who were planning to have abortions and to a group of sexually active nonpregnant university coeds. Sex guilt was found to be significantly higher for the abortion patients than for the nonpregnant group. (Author)
An estimated 60 000–70 000 women die annually from complications of unsafe abortion and hundreds of thousands more suffer long-term consequences which include chronic pelvic pain and infertility. The reasons for the continuing high incidence of unwanted pregnancy leading to unsafe abortion include lack of access to, or misuse of and misinformation about, effective contraceptive methods, coerced sex which prohibits
Paul F. A. Van Look; Jane C. Cottingham
The objective of this document is to encourage the use of gonad shielding during x-ray procedures so that unnecessary radiation exposure of the reproductive organs of patients can be avoided. This in turn can lessen the likelihood of adverse genetic conse...
The main purpose of this study was to reach a deeper understanding of factors influencing the attitudes toward organ donation and other procedures with the dead body. From a survey of 400 inhabitants of Uppsala, a city in the middle of Sweden, concerning attitudes toward transplantation issues, 38 individuals with different attitudes toward donation of their own organs were selected
Efficient application of wound treatment procedures is vital in both emergency room and battle zone scenes. In order to train first responders for such situations, physical casualty simulation kits, which are composed of tens of individual items, are commonly used. Similar to any other training scenarios, computer simulations can be effective means for wound treatment training purposes. For immersive and high fidelity virtual reality applications, realistic 3D models are key components. However, creation of such models is a labor intensive process. In this paper, we propose a procedural wound geometry generation technique that parameterizes key simulation inputs to establish the variability of the training scenarios without the need of labor intensive remodeling of the 3D geometry. The procedural techniques described in this work are entirely handled by the graphics processing unit (GPU) to enable interactive real-time operation of the simulation and to relieve the CPU for other computational tasks. The visible human dataset is processed and used as a volumetric texture for the internal visualization of the wound geometry. To further enhance the fidelity of the simulation, we also employ a surface flow model for blood visualization. This model is realized as a dynamic texture that is composed of a height field and a normal map and animated at each simulation step on the GPU. The procedural wound geometry and the blood flow model are applied to a thigh model and the efficiency of the technique is demonstrated in a virtual surgery scene.
Aras, Rifat; Shen, Yuzhong; Li, Jiang
The body's stress response to surgery has been cited as a primary cause of post-operative morbidity and has prompted growth in minimally invasive surgical techniques. The future of such techniques lies in the use of in vivo procedures, but is currently limited by the availability of motors with a volume of less than 1 mm3. In response to this we
Brett Watson; James Friend; Leslie Yeo
Human reproductive cloning (HRC) has not yet resulted in any live births. There has been widespread condemnation of the practice in both the scientific world and the public sphere, and many countries explicitly outlaw the practice. Concerns about the procedure range from uncertainties about its physical safety to questions about the psychological well-being of clones. Yet, key aspects such as
Racial differences have recently been described in hospital practice, most notably with regard to cardiac procedure utilization. To evaluate the possible reasons behind these differences, we analyzed statistics generated from a surgical referral conference at a large, tertiary care Veterans Affairs hospital between the years 1988 and 1996. In this setting, there is no financial incentive for physicians to recommend
Steven P. Sedlis; Vincent J. Fisher; David Tice; Rick Esposito; Lori Madmon; Eric H. Steinberg
Concerns are frequently raised about the extent to which formal consent procedures actually lead to "informed" consent. As part of a study of consent to high-risk medical procedures, we analyzed in-depth interviews with 16 health care professionals working in bone-marrow transplantation in Sydney, Australia. We find that these professionals recognize and act on their responsibility to inform and educate patients and that they expect patients to reciprocate these efforts by demonstrably engaging in the education process. This expectation is largely implicit, however, and when it is not met, this can give rise to trouble that can have adverse consequences for patients, physicians, and relationships within the clinic. We revisit the concept of the sick role to formalize this new role expectation, and we argue that "informed" consent is a process that is usually incomplete, despite trappings and assumptions that help to create the illusion of completeness. PMID:23288440
Jordens, Christopher F C; Montgomery, Kathleen; Forsyth, Rowena
Objective: To compare the efficacy of surgical evacuation of the uterus with medical evacuation using misoprostol in cases of spontaneous abortion.Design: A prospective, randomized, controlled trial.Setting: A university teaching hospital.Patient(s): Six hundred thirty-five women who aborted spontaneously and who consented to pretreatment randomization.Intervention(s): Routine surgical evacuation or medical evacuation of the uterus using misoprostol.Main Outcome Measure(s): Immediate, short-term (2–3 weeks),
Tony Kwok Hung Chung; Dominic Tak Sing Lee; Lai Ping Cheung; Christopher John Haines; Allan Mang Zing Chang
Clinical results showed that besides organic, psychological and psychosocial factors are implicated in spontaneous and recurrent spontaneous abortions and that psychotherapy may help women to prevent abortion. Diagnostic and therapeutic criteria were discussed in order to improve relevant preventive and curative interventions. PMID:2815907
Abortion represents a particularly interesting subject for a social movements analysis of healthcare issues because of the involvement of both feminist pro-choice activists and a segment of the medical profession. Although both groups have long shared the same general goal of legal abortion, the alliance has over time been an uneasy one, and in many ways a contradictory one. This paper traces points of convergence as well as points of contention between the two groups, specifically: highlighting the tensions between the feminist view of abortion as a women-centred service, with a limited, 'technical' role for the physicians, and the abortion-providing physicians' logic of further medicalization/professional upgrading of abortion services as a response to the longstanding marginality and stigmatisation of abortion providers. Only by noting the evolving relationships between these two crucial sets of actors can one fully understand the contemporary abortion rights movement. We conclude by speculating about similar patterns in medical/lay relationships in other health social movements where 'dissident doctors' and lay activists are similarly seeking recognition for medical services that are controversial. PMID:15383041
Joffe, C E; Weitz, T A; Stacey, C L
Little is known about women's contraceptive use and sexual activity in the immediate post-abortion period although effective contraceptive use is paramount during this time because fertility returns almost immediately. This study sought to learn more about women's contraceptive use and sexual behaviors to inform abortion providers and help them serve their clients better, potentially leading to a decline in the rates of unintended pregnancy and repeat abortion. Abortion clients of an Atlanta, GA clinic were surveyed over the telephone 3-5 weeks post-abortion. Background information was collected from clinic medical charts. Simple and stratified frequencies and logistic regression were used to describe women's sexual activity and contraceptive use in the immediate post-abortion period and to determine if variables known at the time of the abortion could predict contraceptive use 3-5 weeks post-abortion. 54.2% (n = 39) of women had engaged in sexual intercourse in the immediate post-abortion period. Of these, 30.8% (n = 12) were not using a contraceptive method or were not using it effectively. Women who said they did not want or need information about birth control on their medical history form were less likely to be using contraception 3-5 weeks post abortion. Emphasizing the rapid return of fertility and risk of conception in pre-abortion counseling sessions could prevent future unintended pregnancies among abortion clients. Further research could explore the interaction between a willingness to talk about contraceptive methods at the time of abortion and method use post-abortion. PMID:20602161
Moslin, Trisha A; Rochat, Roger W
The medical laboratory is providing services to the patients and clinicians, is a costumer for providers as manufacturers and partner for tierce parties as well. Contracts have to be established with the clients to define agreements and to ensure that the laboratory is able to meet the requirements of the regulation and of the standards. Contracts with partners involved in the processes shall be formally established (collaborative contract). This article includes different types of contracts to establish and control within a contract review. PMID:23765018
Roubille, M; Maurellet-Evrard, S
To test the hypothesis that a standard library system could be designed for hospital departmental libraries, a system was developed and partially tested for four departmental libraries in the Washington University School of Medicine and Associated Hospitals. The system from determination of needs through design and evaluation, is described. The system was limited by specific constraints to control of the monograph collection. Products of control include catalog cards, accessions list, new book list, location list, fund list, missing book list, and discard book list. Sample data form and pages from a procedure manual are given, and conversion from a manual to an automated system is outlined. The question of standardization of library records and procedures is discussed, with indications of the way in which modular design, as utilized in this system, could contribute to greater flexibility in design of future systems. Reference is made to anticipating needs for organizing departmental libraries in developing regional medical library programs and to exploring the role of the departmental library in a medical library network.
Howard, Ellen; Kharibian, Gloria
To document the relative contribution of abortion-related deaths to overall maternal deaths in Mexico, official mortality data were analyzed according to International Classification of Diseases (ICD) codes. During 1990-2008, among 24 805 maternal deaths, 1786 (7.2%) were abortion related. Of these, 13.2% occurred in adolescents and 65% in uninsured women; 60% were probably associated with unsafely induced procedures. The study calculated the number of abortion-related deaths per 100,000 abortion-related hospitalizations, expressed as a modified abortion case-fatality rate. During 2000-2008, this rate was 48 at the national level, with wide variations among states: from 140 deaths in Guerrero to 8 in Baja California Sur per 100,000 abortion hospitalizations. Unsafe abortion continues to represent a significant proportion of all maternal deaths in Mexico. PMID:22920626
Schiavon, Raffaela; Troncoso, Erika; Polo, Gerardo
This paper reviews pertinent literature and identifies research needs relating to unsafe abortion in Nigeria. The paper is organised into three sections. In the first part of the article, a conceptual framework for developing a research agenda to prevent unsafe abortion among Nigerian women is articulated. This section argues for a systematic research agenda that would allow a fuller understanding of the determinants of all segments of the induced abortion cycle. In the second section of the article, we offer a detailed description of the available research data as well as gaps in knowledge on unsafe abortion in Nigeria. In the final part of the paper, recommendations are made on priority areas of research that are capable of stemming the high rate of morbidity and mortality from unsafe abortion among Nigerian women. In particular, the paper recommends high quality, multidisciplinary formative and intervention research to foster an understanding of the determinants of abortion among Nigerian women. Such research should be geared toward providing accurate information to policy makers in a logical manner so as to enable them to generate appropriate policies for preventing unsafe abortion. PMID:10214400
Background Medical knowledge encompasses both conceptual (facts or “what” information) and procedural knowledge (“how” and “why” information). Conceptual knowledge is known to be an essential prerequisite for clinical problem solving. Primarily, medical students learn from textbooks and often struggle with the process of applying their conceptual knowledge to clinical problems. Recent studies address the question of how to foster the acquisition of procedural knowledge and its application in medical education. However, little is known about the factors which predict performance in procedural knowledge tasks. Which additional factors of the learner predict performance in procedural knowledge? Methods Domain specific conceptual knowledge (facts) in clinical nephrology was provided to 80 medical students (3rd to 5th year) using electronic flashcards in a laboratory setting. Learner characteristics were obtained by questionnaires. Procedural knowledge in clinical nephrology was assessed by key feature problems (KFP) and problem solving tasks (PST) reflecting strategic and conditional knowledge, respectively. Results Results in procedural knowledge tests (KFP and PST) correlated significantly with each other. In univariate analysis, performance in procedural knowledge (sum of KFP+PST) was significantly correlated with the results in (1) the conceptual knowledge test (CKT), (2) the intended future career as hospital based doctor, (3) the duration of clinical clerkships, and (4) the results in the written German National Medical Examination Part I on preclinical subjects (NME-I). After multiple regression analysis only clinical clerkship experience and NME-I performance remained independent influencing factors. Conclusions Performance in procedural knowledge tests seems independent from the degree of domain specific conceptual knowledge above a certain level. Procedural knowledge may be fostered by clinical experience. More attention should be paid to the interplay of individual clinical clerkship experiences and structured teaching of procedural knowledge and its assessment in medical education curricula.
Objective: Because of concern over the higher rates of failed abortion, many clinicians defer surgical abortion until 7 menstrual weeks or later. We conducted this study to evaluate the efficacy and safety of early surgical abortions that are performed by numerous physicians in a community-based setting. Study Design: We prospectively gathered data on all eligible patients who had surgical abortions
Maureen E. Paul; Caroline M. Mitchell; Angela J. Rogers; Michelle C. Fox; Elyse G. Lackie
The article deals with the analysis of the results of radionuclide studies in 624 children with the nephrotic form of glomerulonephritis according to the effect of pathogenetic therapy in the immediate and late-term periods. The authors determined the values characterizing the renal hemodynamics and the functional and metabolic condition of the kidneys and allowing the probable outcome of the disease to be appraised. The severity of the functional disorders in the period of marked clinical manifestations of glomerulo-nephritis and the changes of the values during treatment allows the tactics of the therapeutic measures to be determined. The persistence of renal hemodynamic disorders in the follow-up of patients with a complete clinico-laboratory remission is shown, which dictates the necessity for increasing the time of medical rehabilitation in the nephrotic form of glomerulonephritis in children. PMID:2063511
Bagdasarova, I V; Moskalenko, N I; Ivanov, D D
Measurements of doses to hands, legs and eyes are reported for operators in four different hospitals performing vertebroplasty or kyphoplasty. The results confirm that occupational doses can be high for interventional spine procedures. Extremity and eye lens doses were measured with thermoluminescent dosimeters positioned on the ring fingers, wrists, legs and near the eyes of interventional radiologists and neurosurgeons, over a period of 15 months. Doses were generally larger on the left side for all positions monitored. The median dose to the left finger was 225 ?Sv per procedure, although a maximum of 7.3 mSv was found. The median dose to the right finger was 118 ?Sv, but with an even higher maximum of 7.7 mSv. A median left eye dose of 34 ?Sv (maximum 836 ?Sv) was found, while the legs received the lowest doses with a median of 13 ?Sv (maximum 332 ?Sv) to the left leg. Annual dose to the hand assessed by the cumulated doses almost reached the annual dose limit of 500 mSv, while annual dose to the eyes exceeded the eye lens dose limit of 20 mSv yr(-1). Different x-ray systems and radiation protection measures were tested, like the use of lead gloves and glasses, tweezers, cement delivery systems and a magnetic navigation system. These measurements showed that doses can be significantly reduced. The use of lead glasses is strongly recommended for protection of the eyes. PMID:23803582
Struelens, L; Schoonjans, W; Schils, F; De Smedt, K; Vanhavere, F
The new Penal Code in 2009 was an opportunity for Timor-Leste to allow some legal grounds for abortion, which was highly restricted under Indonesian rule. Public debate was contentious before ratification of the new code, which allowed abortion to save a woman's life and health. A month later, 13 amendments to the code were passed, highly restricting abortion again. This paper describes the socio-legal context of unsafe abortion in Timor-Leste, based on research in 2006-08 on national laws and policies and interviews with legal professionals, police, doctors and midwives, and community-based focus group discussions. Data on unsafe abortions in Timor-Leste are rarely recorded. A small number of cases of abortion and infanticide are reported but are rarely prosecuted, due to deficiencies in evidence and procedure. While there are voices supporting law reform, the Roman Catholic church heavily influences public policy and opinion. Professional views on when abortion should be legal varied, but in the community people believed that saving women's lives was paramount and came before the law. The revised Penal Code is insufficient to reduce unsafe abortion and maternal mortality. Change will be slow, but access to safe abortion and modern contraception are crucial to women's ability to participate fully as citizens in Timor-Leste. PMID:19962638
Belton, Suzanne; Whittaker, Andrea; Fonseca, Zulmira; Wells-Brown, Tanya; Pais, Patricia
Background: The impact of early mobilization on perioperative comorbidities and length of stay (LOS) has shown benefits in other medical/surgical subspecialties. However, few spinal series have specifically focused on the “pros” of early mobilization for spinal surgery, other than in acute spinal cord injury. Here we reviewed how early mobilization and other adjunctive measures reduced morbidity and LOS in both medical and/or surgical series, and focused on how their treatment strategies could be applied to spinal patients. Methods: We reviewed studies citing protocols for early mobilization of hospitalized patients (day of surgery, first postoperative day/other) in various subspecialties, and correlated these with patients’ perioperative morbidity and LOS. As anticipated, multiple comorbid factors (e.g. hypertension, high cholesterol, diabetes, hypothyroidism, obesity/elevated body mass index hypothyroidism, osteoporosis, chronic obstructive pulmonary disease, coronary artery disease and other factors) contribute to the risks and complications of immobilization for any medical/surgical patient, including those undergoing spinal procedures. Some studies additionally offered useful suggestions specific for spinal patients, including prehabilitation (e.g. rehabilitation that starts prior to surgery), preoperative and postoperative high protein supplements/drinks, better preoperative pain control, and early tracheostomy, while others cited more generalized recommendations. Results: In many studies, early mobilization protocols reduced the rate of complications/morbidity (e.g. respiratory decompensation/pneumonias, deep venous thrombosis/pulmonary embolism, urinary tract infections, sepsis or infection), along with the average LOS. Conclusions: A review of multiple medical/surgical protocols promoting early mobilization of hospitalized patients including those undergoing spinal surgery reduced morbidity and LOS.
Epstein, Nancy E.
Scientifically based prevention and patient management concepts in occupational dermatology have substantially improved during recent years. Currently the public statutory employers' liability insurance bodies fund a multi-step intervention approach designed to provide quick preventive help for all levels of severity of occupational dermatoses. An administrative guideline (hierarchical multi-step intervention procedure for occupational skin diseases--"Stufenverfahren Haut") insures professional support and optimal patient orientation by the statutory insurers' representatives. For secondary prevention, the so-called dermatologist's procedure ("Hautarztverfahren") was recently updated in order to provide more rapid dermatologic consultations which are covered for by the public statutory employers' liability insurance bodies. Additionally, combined outpatient dermatologic and health-educational intervention seminars ("secondary individual prevention"[SIP]) are offered to affected employees in a nationwide scheme. For those cases of occupational dermatoses in which these outpatient prevention measures are not successful, interdisciplinary inpatient rehabilitation measures have been developed ("tertiary individual prevention"[TIP]). TIP requires 3 weeks inpatient treatment including intensive health care instruction and psychological counseling, followed by outpatient treatment by the local dermatologist. In 2005, a German prospective cohort multicenter study ("Medical-Occupational Rehabilitation Procedure Skin--optimizing and quality assurance of inpatient-management"-"Medizinisch-Berufliches Rehabilitationsverfahren Haut--Optimierung und Qualitätssicherung des Heilverfahrens"[ROQ]) started which will further standardize TIP and evaluate scientific sustainability in depth (3-year dermatological follow-up of 1,000 patients). The study is being funded by the German Statutory Accident Insurance (Deutsche Gesetzliche Unfallversicherung [DGUV]). PMID:18759737
Skudlik, Christoph; Weisshaar, Elke; Scheidt, Reginald; Wulfhorst, Britta; Diepgen, Thomas Ludwig; Elsner, Peter; Schönfeld, Michael; John, Swen Malte
The incidence and character of the bacteremia associated with elective suction abortion was investigated in volunteer subjects aged 19 to 35 years who were to undergo first trimester abortion by suction curettage. One hundred and forty-four blood cultures were obtained from thirteen pregnant and four non-pregnant (control) subjects matched for age. Transient bacteremia occurred during or soon after suction abortion in 11 of 13 (84.7%) study subjects. Four of these patients were bacteremic after bimanual pelvic examination, just prior to initiation of the abortion procedure. Seven others developed bacteremia temporally related to cervical dilatation and suction abortion. The bacteremia was intermittent in some, persistent in others, existed as long as one hour after the procedure, and was transient in all patients. Microorganisms isolated from the blood were all normal genital tract flora and were predominantly anaerobes, although alpha hemolytic streptococci were also recovered. Mixed bacteremia occurred in six patients. In contrast, blood cultures from four non-pregnant women were sterile. This study indicates that the systemic circulation-uterine cavity barrier is significantly disrupted during abortion by suction curettage permitting endogenous genital tract microorganisms to gain access into the bloodstream. These observations also suggest that there may be some risk of developing endocarditis during suction abortion in patients with cardiac deformities, and lend some support to the current practice of giving antibiotic prophylaxis to abortion patients with cardiac lesions which predispose them to endocarditis.
Ritvo, Rachel; Monroe, Phyllis; Andriole, Vincent T.
Congenital anomalies contribute a significant proportion of infant morbidity and mortality, as well as fetal mortality. They are generally grouped into three major categories: structural/metabolic, congenital infections, and other conditions. The most prevalent conditions include congenital heart defects, orofacial clefts, Down syndrome, and neural tube defects. Several prenatal diagnostic procedures have been introduced, both cytogenetic (such as chorion biopsy, amniocentesis and funiculocentesis) and biophysical (ultrasound 2-D, 3-D and 4-D, ultrasonography with Doppler, etc.). Insufficient data are currently available from Saudi Arabia on the epidemiology of the lethal congenital abnormalities which should be a priority due to high rate of consanguineous marriages among first cousins and their association with congenital anomalies. In terms of consanguinity and birth defects, a significant positive association has been consistently demonstrated between consanguinity and morbidity, and congenital defects with a complex etiology appear to be both more prevalent in consanguineous families and have a greater likelihood of recurrence. A debate regarding aborting a malformed fetus still exists among the senior Islamic scholars in many of the Islamic countries. The progressive interpretations of Islam have resulted in laws allowing for early abortion on request in two countries; six others permit abortion on health grounds and three more also allow abortion in cases of rape or fetal impairment. In Saudi Arabia, efforts to legalize abortion in certain circumstances have been recently discussed among Senior Religious Scholars and specialized physicians to permit abortions in certain circumstances. In this mini-review we discuss the current debate regarding aborting a malformed fetus in Saudi Arabia with a focus on the Islamic perspective. PMID:24027674
Al-Alaiyan, Saleh; Alfaleh, Khalid M
The clinical value of maternal serum alpha-fetoprotein (AFP) as a guide to the outcome of threatened abortion was assessed. After the thirteenth week of gestation, abortion occurred more frequently (10\\/12) in women with abnormal serum AFP levels than in those (2\\/12) whose AFP concentrations were within the normal range. Low levels were present in women with blighted ovum and high
Markku Seppälä; Erkki Ruoslahti
Abortion is an important health issue for Australian women, yet there are large variations across Australia in abortion service provision and in state laws regulating abortion practice. We conducted a survey of tertiary students in Far North Queensland to ascertain their knowledge of local abortion services and of abortion law in Queensland. Important gaps were demonstrated in their knowledge of the law and of the availability of abortion services. PMID:22413818
Phillips, Tegan; Eltherington, Jessica; de Costa, Caroline; Woods, Cindy
In many cases the combined assessment of three-dimensional anatomical and functional images [single photon emission computed tomography (SPECT), positron emission tomography (PET), magnetic resonance imaging (MRI), and computed tomography (CT)] is necessary to determine the precise nature and extent of lesions. It is important, prior to performing the addition, subtraction, or any other combination of the images, that they be adequately aligned and registered either by experienced radiologists via visual inspection, mental reorientation and overlap of slices, or by an automated registration algorithm. To be useful clinically, the latter case requires validation. The human capacity to evaluate registration results visually is limited and time consuming. This paper describes an algorithmic procedure to provide proxy measures for human assessment that discriminate between badly misregistered pairs of brain images and those likely to be clinically useful. The new algorithm consists of four major steps: segmentation of brain and skin/air boundaries, contour extraction, computation of the principal axes, and computation of the registration quality measures from the contour volumes. The test data were MR and CT brain images. The results of the present study indicate that the use of a measure based on the combination of brain and skin contours and a principal axis function is a good first step to reduce the number of badly registered images reaching the clinician. PMID:14606678
Rodriguez-Carranza, Claudia E; Loew, Murray H
Background: Topical anesthetic cream (TAC) is not in use in pediatric practice in Sub-saharan regions. Knowledge of Caregivers' willingness-to-pay (WTP) for the cream is necessary for its deployment. Objective: To determine the WTP for TAC for minor pediatric painful procedures. Materials and Methods: The study was a questionnaire-based conducted in two tertiary health institutions in southeast Nigeria. WTP was elicited using the contingent valuation method. The respondents were caregivers to children that attended out-patient clinics and in-patient. Data analysis was by Statistical Package for the Social Sciences software (SPSS) and STATA11. Results: Majority (94%) of the respondents were willing to pay for TAC. The mean maximum WTP was US$8.31. Multivariate analysis showed no statistically significant association between many variables with WTP for TAC. Conclusions: Their average WTP was higher than the market price of topical anesthetic cream. Therefore, there is a good prospect for TAC if deployed in Nigeria. PMID:24909478
Ughasoro, M D; Udem, N D; Chukwudi, N K; Korie, F C; Uzochukwu, Bsc; Onwujekwe, E O
The capability of the HL-20 lifting-body spacecraft to perform an abort maneuver from the launch pad to a horizontal landing was studied. This study involved both piloted and batch simulation models of the vehicle. A point-mass model of the vehicle was used for trajectory optimization studies. The piloted simulation was performed in a fixed-base simulator. A candidate maneuver was developed and refined for the worst-case launch-pad-to-landing-site geometry using an iterative procedure of off-line maneuver analysis followed by piloted evaluations and heuristic improvements to the candidate maneuver. The resulting maneuver demonstrates the launch site abort capability of the HL-20 and dictates requirements for nominal abort motor performance. The sensitivity of the maneuver to variations in several design parameters was documented.
Jackson, E. Bruce; Rivers, Robert A.; Chowdhry, Rajiv S.; Ragsdale, W. A.; Geyer, David W.
The National Aeronautics and Space Administration created the Constellation program to develop the next generation of manned space vehicles and launch vehicles. The Orion abort system is initiated in the event of an unsafe condition during launch. The system has a controller gains schedule that can be tuned to reduce the attitude errors between the simulated Orion abort trajectories and the guidance trajectory. A program was created that uses the method of steepest descent to tune the pitch gains schedule by an automated procedure. The gains schedule optimization was applied to three potential abort scenarios; each scenario tested using the optimized gains schedule resulted in reduced attitude errors when compared to the Orion production gains schedule.
Stillwater, Ryan Allanque
Leiomyomas are such common tumors of the uterus that at least two-thirds of women will have at least one by the age of 50. Despite this high incidence, we know relatively little about their cause, growth and development, and contribution to the genesis of reproductive disorders. The prevalence of lesions puts women with associated butun related symptoms at risk for unnecessary and/or unsuccessful interventions,especially if they have not been carefully evaluated and counseled. Indeed, because the majority of leiomyomas do not cause symptoms, when a woman presents with AUB, infertility, pelvic pain, or vague abdominal complaints, it is possible if not likely that the cause of the problem exists elsewhere. The other overwhelming impression that can be gleaned is this: when leiomyomas are the cause of the symptoms,particularly in women desiring to preserve fertility, the tumors have already and frequently induced irreparable harm, a circumstance that cries out for a strategy of early detection and interventions designed to minimize morbidity.Fortunately, because of the efforts of a few, we are just beginning to understand the potential molecular mechanisms by which leiomyomas may contribute to reproductive tract symptoms such as AUB, infertility, and pregnancy loss, work that may contribute to the development of more specific medical therapeutic techniques and strategies. The use of increasingly precise and accessible imaging for diagnosis,combined with the application of customized intrauterine drug-releasing systems or minimally invasive and highly accurate targeted ablative technologies that minimize collateral damage, may provide women the opportunity to avoid the mutilating,painful, expensive, and frequently unsuccessful surgical interventions of today that are applied to end-stage disease.For the present, clinicians should evaluate any woman with reproductive tract symptoms and leiomyomas carefully and with skepticism, ensuring that they have done all that is necessary to determine if the lesion or lesions are related to the problem. If leiomyomas are the suspected or known cause, clinicians must also be prepared to offer or otherwise provide access to the complete spectrum of care that the patient deserves, regardless of the limitations of the clinician’s training, experience,or institutional environment. Such an approach will limit the number of unnecessary and ineffective interventions and, it is hoped, minimize morbidity while optimizing quality of life for affected women. PMID:22134018
Munro, Malcolm G
A structured literature review has been undertaken in order to examine the role of medical and surgical methods of induced abortion at different gestations. Up to 63 days of amenorrhoea, evidence from randomised trials suggests that medical abortion is an effective, safe, acceptable and economic alternative to the conventional surgical approach. The most cost-effective published regimen comprises mifepristone 200 mg
Gillian C Penney
One of the primary design drivers for NASA's Crew Exploration Vehicle (CEV) is to ensure crew safety. Aborts during the critical ascent flight phase require the design and operation of CEV systems to escape from the Crew Launch Vehicle and return the crew safely to the Earth. To accomplish this requirement of continuous abort coverage, CEV ascent abort modes are being designed and analyzed to accommodate the velocity, altitude, atmospheric, and vehicle configuration changes that occur during ascent. The analysis involves an evaluation of the feasibility and survivability of each abort mode and an assessment of the abort mode coverage. These studies and design trades are being conducted so that more informed decisions can be made regarding the vehicle abort requirements, design, and operation. This paper presents an overview of the CEV, driving requirements for abort scenarios, and an overview of current ascent abort modes. Example analysis results are then discussed. Finally, future areas for abort analysis are addressed.
Davidson, John B., Jr.; Madsen, Jennifer M.; Proud, Ryan W.; Merritt, Deborah S.; Sparks, Dean W., Jr.; Kenyon, Paul R.; Burt, Richard; McFarland, Mike
The sociodemographic characteristics of abortion seekers and the reasons they give for procuring termination were studied in 356 clients selected from two abortion clinics in the city of Colombo. Nearly 80% were Buddhists and about 10% were Christians. Almost all had some formal education but only 20% were employed outside the home. Over 95% were currently married and at the peak of their childbearing age. More than one-half were aged 30 years or over, while adolescents only constituted about 3%. Fourteen per cent were nulliparous and about two-thirds had one or two living children at the time of obtaining the abortion. A significantly high proportion also had a very young child. In total, the 356 women had had 1130 pregnancies, and the mean rate of abortion was 42 per 100 pregnancies. Over one-quarter had had more than one abortion and about 10% had had three or more. Almost all abortions were performed within the first trimester with a mean gestation period of 6 weeks. About one-third of the clients were using some method of contraception at the time they became pregnant. The most common reasons cited for the present abortion were 'pregnancy too soon after previous delivery', 'no more children desired' or 'curtailment of opportunity for foreign employment'. Unmarried women constitute a special group of abortion seekers who have different needs and behave differently from married women. Their needs are not currently being met by reproductive health programmes in Sri Lanka, and it is important that they should be given special attention in the future. An interesting finding is that a significant minority of the abortion seekers answered negatively to the question regarding providing medical facilities for abortions without difficulty. This underscores the ambivalence many people have to abortion. PMID:12117211
Ban, Deok Jin; Kim, Jinhyun; De Silva, W Indralal
The journal's reply to Mr. Fischer accurately pointed out that the journal had been misquoted but the addition of the word "human" to the journal's statement fails to alter the comments unless it is incorrectly maintained that the unborn child is not a biologically distinct entity or he or she is a member of another species. Consequently, Fischer's conclusions remain valid and unaddressed by the journal's response. The only exception that this writer would take to Fischer is his assertion that the pro-abortion-on-demand movement claims to have an internally consistent philosophy. In the final analysis, the crux of the matter is neither biological accuracy nor internal consistency. The basic question is whether 1 human being ever has the right to define and the inherent ability to discern the personhood of another human being. If the response is affirmative, then everyone, rather than the pregnant female only, should be permitted the right to determine whether another live human being is a "subperson" eligible for euthanasia. All individual human beings have an unalienable right to life and must be granted personhood until a scientific technique which can measure the abstract qualities of humanity is developed. PMID:637174
The purpose of this study is to describe the knowledge and attitudes regarding abortion of a sample of health professionals in Mexico. In particular, we aim to explore their association with the practice of abortion and the care of post-abortion complications, taking into consideration the present legal framework in Mexico. The data come from an anonymous and computerized survey applied to participants attending a national meeting of gynecology and obstetrics in Mexico in 2009 (n=418). The attitudes of health professionals in relation to abortion play a key role in promoting access to both medical and surgical abortion services. We did not find a statistical association between living in a largely restrictive federal entity and the practice of abortions, which may be explained by the lack of knowledge that these survey participants had about abortion laws in their federal entity. This lack of knowledge about abortion legislation can hinder a woman's access to these services even when the legal framework such access. PMID:23989628
García-Núñez, Nubia Naneri; Atienzo, Erika Elizabeth; Dayananda, Ila; Walker, Dilys
Unsafe abortion is one of the major medical and public health problems in developing countries including Ethiopia. However, there is a lack of up-to-date and reliable information on induced abortion distribution and its determinant factors in the country. This study was intended to assess induced abortion and associated factors in health facilities of Guraghe zone, Southern Ethiopia. Institution based cross-sectional study was conducted in eight health facilities in Guraghe zone. Client exit interview was conducted on 400 patients using a structured questionnaire. Bivariate and multivariate logistic regression analysis was performed to identify factors associated with induced abortion. Out of 400 women, 75.5% responded that the current pregnancy that ended in abortion is unwanted. However, only 12.3% of the respondents have admitted interference to the current pregnancy. Having more than four pregnancies (AOR?=?4.28, CI: (1.24–14.71)), age of 30–34 years (AOR?=?0.15, CI: (0.04–0.55)), primary education (AOR?=?0.26, CI: (0.13–0.88)), and wanted pregnancy (AOR?=?0.44, CI: (0.14–0.65)) were found to have association with induced abortion. The study revealed high level of induced abortion which is underpinned by high magnitude of unwanted pregnancy. There is requirement for widespread expansion of increased access to high quality family planning service and post-abortion care.
Hambisa, Mitiku Teshome; Semahegn, Agumasie
The high demand for abortion related services in Addis Ababa, Ethiopia indicates a reliance on abortion to control fertility and highlights an opportunity to increase access to contraceptives and improve post-abortion care. We analyzed the medical records of 1,200 women seeking abortion related services. Logistic regression was used to determine factors associated with use of modern or long-acting contraceptive post-abortion. Multivariate results illustrate that women aged 40-44, students, employed women, receipt of services in private clinics, number of children, and number of previous abortions were significantly associated with the odds of adopting any modern contraceptive post-abortion. The odds of choosing a long-active contraceptive method were significantly and positively associated with being age 25-29, attaining secondary or higher education, and number of children. Improved services and information along with reliable access to modern and long-acting contraceptives can reduce the need to use abortion to control fertility among women in Addis. PMID:22574492
Prata, Ndola; Bell, Suzanne; Holston, Martine; Gerdts, Caitlin; Melkamu, Yilma
Maternal age related and procedure-related fetal abortion rates were studied in 384 women aged 36 and over scheduled for transabdominal chorionic villus sampling (TA-CVS) at 12-14 weeks of gestation. The pre-TA-CVS abortion rate within 30 days of intake (at 6-10 weeks of gestation) rose from 1.9% at age 35-36 years to 10.9% at 40 years and older. Women entering in the 6th week of gestation had a greater probability of aborting before TA-CVS than women entering after day 48. 26 women aborted spontaneously before TA-CVS, the majority of abortions occurring at 10-12 weeks. TA-CVS was done in 346 women. 11 pregnancies were terminated because of genetic anomalies, and 8 women had spontaneous fetal loss. These findings justify delaying prenatal diagnosis in older pregnant women until 12 weeks of gestation. PMID:1973216
Cohen-Overbeek, T E; Hop, W C; den Ouden, M; Pijpers, L; Jahoda, M G; Wladimiroff, J W
Medicaid would help pay for abortion in fewer circumstances under the fiscal 1979 Department of Health, Education, and Welfare (HEW), appropriations bill approved May 4, 1978, by the House HEW Appropriations Subcommittee than it did in 1978. The new language would permit the funding only if the mother's life would be endangered if the pregnancy were carried to term. Current law permits abortion payments for this reason; if pregnancy results from rape or incest, or if the birth would cause the mother severe and long-lasting physical damage. Behind the scenes pressure probably will be applied to resolve the issue quickly this year since all House members are up for reelection and do not want to have such a sensitive issue intruding on their campaigns. 1 strategy being discussed is the inclusion of riders that would directly or indirectly provide federal funds for abortions in other appropriation measures such as funding for the Defense Department and federal employees health benefits. The House will have to contend with Senator Brooke (R-Massachusetts) ranking minority member on the Senate HEW Appropriations Subcommittee, who is determined to stand firm in favor of liberal abortion funding. With only minimal opposition for his Senate seat this year, Senate staffers say Brooke is not concerned with the possibility of abortion becoming a major campaign issue. It was Brooke who forced the House's hand last year and obtained a more relaxed abortion curb, much to the chagrin of the Carter Administration. The White House, with the President's popularity at a low ebb, would prefer not to be put in a position of taking sides publicly although it prefers the strict curbs. Carter is currently deciding which House members to assist during the campaign and such a no-win issue would only serve to complicate matters. He will have enough of a problem reconciling health spending increases without the added burden of abortion. PMID:12335662
We compared the published results of the 1994-1995 Population Council (PC) trial to those from the 1996-1997 Abortion Rights Mobilization (ARM) trial to determine whether 200 mg mifepristone with 800 micrograms vaginal misoprostol is more effective and has fewer side effects than 600 mg mifepristone with 400 micrograms oral misoprostol. The complete medical abortion rate was lower in the PC trial than the ARM trial: 92% compared with 97% up to 49 days LMP (p < 0.05) and 83% versus 96% from 50 to 56 days LMP (p < 0.05). Nausea and vomiting were reported more frequently in the PC trial. The overall acceptability of the procedure was lower in the PC trial (88%) than in the ARM trial (94%), (p < 0.05). Mifepristone can be reduced from 600 to 200 mg when followed by vaginal misoprostol without loss of efficacy. Vaginal misoprostol extends the efficacy to 56 days LMP and is associated with less nausea and vomiting. Home use of misoprostol is safe and acceptable to women and decreases the number of required visits from three to two in most cases. PMID:10846323
Schaff, E A; Fielding, S L
Recent studies conducted by the World Health Organization's Special Program of Research, Development, and Research Training in Human Reproduction reveal high rates of unwanted pregnancy and illegal abortion in selected developing countries. In a Colombian study, 30% of women undergoing illegal abortion could not explain why they became pregnant, 40% believed that a woman bears sole responsibility for contraception, and almost 50% did not know when the likelihood for conception was greatest. In a study of pharmacists and herb vendors in Mexico, only 35% of those in the former group and none of those in the latter group could describe the mechanism of action of modern contraceptives, despite the fact that they were frequently consulted about pregnancy prevention. 25% of abortion seekers in a Cuban study had used no contraceptive method and the abortion ratio was highest (2 for every live birth) among women under 20 years old. The majority of the unwanted pregnancies occurring to contraceptive users involves use of an IUD that is not appropriate for young, nulliparous women. Finally, a study conducted in Tanzania found that a third of illegal abortions involved women under 17 years of age. 90% of whom had no knowledge of a family planning method. PMID:12345694
Congressional legislation seeking to overturn US government restrictions on international family planning assistance face a possible presidential veto. Dating back to the Reagan years, the 1984 Mexico City Policy prohibits foreign nongovernmental organizations (NGO) receiving US money from performing or actively promoting abortion as a family planning method. Even if abortion is legal in that particular country, the agency involved may not even discuss abortion as one of the medical options of a pregnant woman. In line with the Mexico City Policy, the US has withdrawn funding from both the International Planned Parenthood Federation, the largest NGO in the population field, and the Family Planning International Assistance, the international division of the Planned Parenthood federation of America. One of the effects of the Mexico City Policy has been to make family planning more controversial, and to increase opposition to birth control. In addition to the Mexico City Policy, the Reagan years also saw the implementation of a policy that denies funding to the UNFPA, charged by the US of "co-managing" China's population program that engages in coercive abortion and involuntary sterilization. The UNFPA has denied such charges. So far, President George Bush -- previously a supporter of family planning programs -- has sided with opponents of abortion, and has threatened a veto threat may soon be tested, since Congress has drafted a foreign aid appropriations bill that has includes a measure saying that NGOs should be treated in the same manner as their governments, which are exempt from the Mexico City Policy so long as US funds are not used to support abortions. PMID:12178849
The U.S. Occupational Safety and Health Administration (OSHA) estimates that half a million health-care workers are exposed to laser surgical smoke each year. The purpose of this study was to establish a methodology to (1) estimate emission rates of laser-generated air contaminants (LGACs) using an emission chamber, and to (2) perform a screening study to differentiate the effects of three laser operational parameters. An emission chamber was designed, fabricated, and assessed for performance to estimate the emission rates of gases and particles associated with LGACs during a simulated surgical procedure. Two medical lasers (Holmium Yttrium Aluminum Garnet [Ho:YAG] and carbon dioxide [CO2]) were set to a range of plausible medical laser operational parameters in a simulated surgery to pyrolyze porcine skin generating plume in the emission chamber. Power, pulse repetition frequency (PRF), and beam diameter were evaluated to determine the effect of each operational parameter on emission rate using a fractional factorial design. The plume was sampled for particulate matter and seven gas phase combustion byproduct contaminants (benzene, ethylbenzene, toluene, formaldehyde, hydrogen cyanide, carbon dioxide, and carbon monoxide): the gas phase emission results are presented here. Most of the measured concentrations of gas phase contaminants were below their limit of detection (LOD), but detectable measurements enabled us to determine laser operation parameter influence on CO2 emissions. Confined to the experimental conditions of this screening study, results indicated that beam diameter was statistically significantly influential and power was marginally statistically significant to emission rates of CO2 when using the Ho:YAG laser but not with the carbon dioxide laser; PRF was not influential vis-a-vis emission rates of these gas phase contaminants. PMID:24498966
Lippert, Julia F; Lacey, Steven E; Lopez, Ramon; Franke, John; Conroy, Lorraine; Breskey, John; Esmen, Nurtan; Liu, Li
Examines a film entitled "Whose Choice?" which chronicles the struggle to protect and extend existing abortion rights through the campaigns set in motion by the James White Abortion (Amendment) Bill (1975). (MH)
... Tests and Procedures General Procedures Blood Tests Imaging Tests Nuclear Medicine Scans Anxiety Around Medical Procedures Treatment Options Treatment Side Effects Relapse Late Effects of Treatment Clinical Trials Glossary Tests and Procedures Many tests and procedures are done ...
Since 2008, the FIGO Initiative for the Prevention of Unsafe Abortion and its Consequences has contributed to ensuring the substitution of sharp curettage by manual vacuum aspiration (MVA) and medical abortion in selected hospitals in participating countries of South-Southeast Asia. This initiative facilitated the registration of misoprostol in Pakistan and Bangladesh, and the approval of mifepristone for "menstrual regulation" in Bangladesh. The Pakistan Nursing Council agreed to include MVA and medical abortion in the midwifery curriculum. The Bangladesh Government has approved the training of nurses and paramedics in the use of MVA to treat incomplete abortion in selected cases. The Sri Lanka College of Obstetricians and Gynaecologists, in collaboration with partners, has presented a draft petition to the relevant authorities appealing for them to liberalize the abortion law in cases of rape and incest or when lethal congenital abnormalities are present. Significantly, the initiative has introduced or strengthened the provision of postabortion contraception. PMID:24743025
Zaidi, Shahida; Begum, Ferdousi; Tank, Jaydeep; Chaudhury, Pushpa; Yasmin, Haleema; Dissanayake, Mangala
Background Efficacy and safety of various treatments using fractional laser or radiofrequency depend, to a large extent, on precise movement of equipment head across the patient’s skin. In addition, they both depend on uniform distribution of emitted pulses throughout the treated skin area. The pulses should be closely adjacent but they should not overlap. Pulse overlapping results in amplification of irradiation dose and carries the danger of unwanted effects. Methods Images obtained in infrared mode (Flir SC5200 thermovision camera equipped with photon detector) were entered into Matlab environment. Thermal changes in the skin were forced by CO2RE laser. Proposed image analysis and processing methods enable automatic recognition of CO2RE laser sites of action, making possible to assess the correctness of performed cosmetic procedures. Results 80 images were acquired and analyzed. Regions of interest (ROI) for the entire treatment field were determined automatically. In accordance with the proposed algorithm, laser-irradiated Li areas (ROI) were determined for the treatment area. On this basis, error values were calculated and expressed as percentage of area not covered by any irradiation dose (?o) and as percentage area which received double dose (?z). The respective values for the analyzed images were ?o=17.87±10.5% and ?z=1.97±1.5%, respectively. Conclusions The presented method of verifying the correctness of performing low-invasive esthetic medical (cosmetic) procedures has proved itself numerous times in practice. Advantages of the method include: automatic determination of coverage error values ?o and ?z, non-invasive, sterile and remote-controlled thermovisual mode of measurements, and possibility of assessing dynamics of patient’s skin temperature changes.
Objective: To (1) examine prescribing patterns of migraine-specific abortive medication among new users and non-users of migraine preventive therapy and (2) determine if treatment with a migraine preventive agent influences the utilization of migraine-spe...
J. W. Devine
In 58 consecutive pregnancies in insulin-dependent diabetic women, glycosylated haemoglobin levels were abnormally high in 78% at the time of booking for antenatal care. Spontaneous abortion was the outcome in 15 pregnancies, 10 occurring before the 15th week of gestation. Glycosylated haemoglobin levels were significantly higher in those women who aborted spontaneously than in women who delivered successfully (12.8 +/- 1.8% v. 11.2 +/- 2.3%, mean +/- s.d.). These results emphasise the inadequacy of diabetic control in the first trimester and lend further support to the importance of good control at this critical time in insulin-dependent diabetes.
Wright, A. D.; Nicholson, H. O.; Pollock, A.; Taylor, K. G.; Betts, S.
Introduction Unsafe and illegal abortions are the third leading cause of maternal death. It affects physical, emotional and social health of women and their families. Abortion is a multi-dimensional phenomenon with several social, legal, and religious implications. The views of policy-makers affect the approach to abortion in every society. Understanding the attitudes and knowledge of high-ranking decision makers towards abortion was the purpose of this study. Materials and Methods A qualitative research was implemented by carrying out individual interviews with 29 out of a selection of 80 presidents of medical sciences universities, senior executive managers in the legal system, forensic medicine and decision-makers in the health system and a number of top Muslim clerics, using a semi-structured questionnaire for data gathering. Content analysis revealed the results. Results There were considerable unwillingness and reluctance among the interviewees to participate in the study. The majority of participants fairly knew about the prevalence of illegal abortions and their complications. There was strong agreement on abortion when health of the mother or the fetus was at risk. Abortion for reproductive health reasons was supported by a minority of the respondents. The majority of them disagreed with abortion when pregnancy was the result of a rape, temporary marriage or out of wedlock affairs. Making decision for abortion by the pregnant mother, as a matter of her right, did not gain too much approval. Conclusion It seemed that physical health of the mother or the fetus was of more importance to the respondents than their mental or social health. The mother's hardship was not any indication for induced abortion in the viewpoints of the interviewed policy-makers. Strengthening family planning programs, making appropriate laws in lines with religious orders and advocacy programs targeting decision makers are determined as strategies for improving women's health rights.
Shamshiri-Milani, Hourieh; Pourreza, Abolghasem; Akbari, Feizollah
This report hypothesized that Indian university students approve of abortion, that religiosity neutralizes the influence of education in abortion attitudes, and that Indian students are more liberal in their attitudes on abortion than American Catholic students. To test these hypotheses, the author collected data from 150 students from two…
Bardis, Panos D.
Nearly 20% of the 208 million pregnancies that occur annually are aborted. More than half of these (21.6 million) are unsafe, resulting in 47,000 abortion-related deaths each year. Accurate reports on the prevalence of abortion, the conditions under which it occurs, and the experiences women have in obtaining abortions are essential to addressing unsafe abortion globally. It is difficult, however, to obtain accurate and reliable reports of attitudes and practices given that abortion is often controversial and stigmatized, even in settings where it is legal. To improve the understanding and measurement of abortion, specific considerations are needed throughout all stages of the planning, design, and implementation of research on abortion: Establishment of strong local partnerships, knowledge of local culture, integration of innovative methodologies, and approaches that may facilitate better reporting. This paper draws on the authors' collaborative research experiences conducting abortion-related studies using clinic- and community-based samples in five diverse settings (Poland, Zanzibar, Mexico City, the Philippines, and Bangladesh). The purpose of this paper is to share insights and lessons learned with new and established researchers to inform the development and implementation of abortion-related research. The paper discusses the unique challenges of conducting abortion-related research and key considerations for the design and implementation of abortion research, both to maximize data quality and to frame inferences from this research appropriately. PMID:21530843
Gipson, Jessica D; Becker, Davida; Mishtal, Joanna Z; Norris, Alison H
Spontaneous abortion is common in early pregnancy, whilst recurrent miscarriage is relatively rare. Empirical studies of psychological sequellae of spontaneous abortions are limited, but strongly suggest that a significant number of women who miscarry, experience grief and various degrees of clinically-significant depression and anxiety. Depression is more common amongst women with recurrent abortions. Contributory factors for the development of psychological
D. Bagchi; T. Friedman
The evidence from gynaecologists in Northern Ireland shows confusion in interpretation and practice of abortion law, with some women even being denied abortion after rape. Over two-thirds of gynaecologists supported a change in the law which would leave the abortion decision to the woman and her doctor, but less than half wanted the introduction of the British law. PMID:7929486
The readiness of the Data Acquisition and Control System (DACS) to provide monitoring and control of the Programmable Logic Controller (PLC) abort coils from the Master and RSS stations will be systematically tested during performance of this procedure. It should be noted that these are not physical abort coils but software coils controlled by the software`s ladder logic. The readiness
The readiness of the Data Acquisition and Control System (DACS) to provide monitoring and control of the Programmable Logic Controller (PLC) abort coils from the Master and RSS stations will be systematically tested during performance of this procedure. It should be noted that these are not physical abort coils but software coils controlled by the software`s ladder logic. The readiness
In 'After-birth abortion: why should the baby live?', Giubilini and Minerva argue that infanticide should be permitted for the same reasons as abortion. In particular, they argue that infanticide should be permitted even for reasons that do not primarily serve the interests (or would-be best interests) of the newborn. They claim that abortion is permissible for reasons that do not primarily serve the interests (or would-be interests) of the fetus because fetuses lack a right to life. They argue that newborns also lack a right to life, and they conclude that therefore, the same reasons that justify abortion can justify infanticide. This conclusion does not follow. The lack of a right to life is not decisive. Furthermore, the justificatory power of a given reason is a function of moral context. Generalisations about reasons across dissimilar moral contexts are invalid. However, a similar conclusion does follow-that fetus-killing and newborn-killing are morally identical in identical moral contexts-but this conclusion is trivial, since fetuses and newborns are never in identical moral contexts. PMID:23637451
Induced abortion is widely practiced in Indonesia by both married and unmarried women. This paper draws on ethnographic research, conducted between 1996 and 1998, which focused on reproductive health and sexuality among young single women on the island of Lombok in Eastern Indonesia. While abortion for married women is tacitly accepted, especially for women with two or more children, premarital pregnancy and abortion remain a highly stigmatised and isolating experience for single women. Government family planning services are not legally permitted to provide contraception to single women and their access to reproductive health care is very limited. Abortion providers were highly critical of unmarried women who sought abortions, despite their willingness to carry out the procedure. The quality of abortion services offered to single women was compromised by the stigma attached to premarital sex and pregnancy. Women who experienced unplanned premarital pregnancy faced personal and familial shame, compromised marriage prospects, abandonment by their partners, single motherhood, a stigmatised child, early cessation of education, and an interrupted income or career, all of which were not desirable options. Young women were only able to legitimately continue premarital pregnancy through marriage. In the absence of an offer of marriage, single women necessarily resorted to abortion to avoid compromising their futures. PMID:11468844
Bennett, L R
NASA goals are set on resumption of human activity on the Moon and extending manned missions to Mars. Abort options are key elements of any system designed to safeguard human lives and stated requirements stipulate the provision of an abort capability throughout the mission. The present investigation will focus on the formulation and analysis of possible abort modes during the Earth departure phase of manned Mars interplanetary transfers. Though of short duration, the departure phase encompasses a mission timeline where failures have frequently become manifest in historical manned spacecraft necessitating the inclusion of a departure phase abort capability. Investigated abort modes included aborts to atmospheric entry, and to Earth or Moon orbit. Considered interplanetary trajectory types included conjunction, opposition, and free-return trajectory classes. All abort modes were analyzed for aborts initiated at multiple points along each of these possible departure trajectories across all launch opportunities of the fifteen-year Earth-Mars inertial period. The consistently low departure velocities of the conjunction trajectories facilitated the greatest abort capability. An analysis of Mars transportation architectures was performed to determine the amount of available delta V inherent in each candidate architecture for executing departure aborts. Results indicate that a delta V of at least 4 km/s is required to achieve a continuous departure phase entry abort capability with abort flights less than three weeks duration for all transfer opportunity years. Less demanding transfer years have a corresponding increase in capability. The Earth orbit abort mode does not become widely achievable until more than 6 km/s delta V is provided; a capacity not manifest in any considered architecture. Optimization of the Moon abort mode resulted in slight departure date shifts to achieve improved lunar alignments. The Moon abort mode is only widely achievable for conjunction transfers during the optimum transfer years and delta V values greater than 4 km/s. A lesser delta V potential of 3 km/s is sufficient to enable entry aborts during the least demanding transfer opportunity years. Extensive abort capability is achievable for high delta V capable Mars architectures. Less propulsively capable architectures achieve moderate abort capability during favorable opportunity years.
Dissel, Adam F.
Mars trajectory design options were examined that would accommodate a premature termination of a nominal manned opposition class mission for opportunities between 2010 and 2025. A successful abort must provide a safe return to Earth in the shortest possible time consistent with mission constraints. In this study, aborts that provided a minimum increase in the initial vehicle mass in low Earth orbit (IMLEO) were identified by locating direct transfer nominal missions and nominal missions including an outbound or inbound Venus swing-by that minimized IMLEO. The ease with which these missions could be aborted while meeting propulsion and time constraints was investigated by examining free return (unpowered) and powered aborts. Further reductions in trip time were made to some aborts by the addition or removal of an inbound Venus swing-by. The results show that, although few free return aborts met the specified constraints, 85% of each nominal mission could be aborted as a powered abort without an increase in propellant. Also, in many cases, the addition or removal of a Venus swing-by increased the number of abort opportunities or decreased the total trip time during an abort.
Tartabini, P. V.; Striepe, S. A.; Powell, R. W.
Occupational factors in spontaneous abortions are reviewed and discussed in terms of difficult working conditions (physical and psychological strains) and exposition to noxious agents in women and men. The discussion was based upon clinical, epidemiological and biological studies. The results showed elevated abortion risks in different occupational groups. Risk factors for both partners were hard physical work, psychological and socio-economic stress, some chemicals, metals and pharmacological products. Animal studies demonstrated time- and dose-dependent effects on embryonic and fetal development as well as accumulation and potentiation of teratogenic agents. Chronic and multifactorial occupational effects seem to be very important and need further occupational effects seem to be very important and need further study. PMID:2194385
In April 2007, elective first-trimester abortion was legalized in Mexico City. As of June 2011, more than 60,000 women from Mexico City and other Mexican states have obtained legal abortions in the city's public hospitals and health centers, with private facilities providing additional abortion services. This study examines women's experiences of abortion services in one public and two private clinic settings in 2008. Twenty-five in-depth interviews were conducted: 15 with women who obtained abortions in a public health center and 10 who obtained the procedure at either of two private clinics. Participants were highly satisfied with services at both public and private sites, although some had to go to more than one site before receiving services. None expressed doubts about their decision to have an abortion, and they felt unanimously that they were treated with respect. Furthermore, participants were pleased with the counseling they received and most accepted a contraceptive method after the procedure. PMID:21972669
van Dijk, Marieke G; Arellano Mendoza, Luis Jorge; Arangure Peraza, Ana Gabriela; Toriz Prado, Aldo Alberto; Krumholz, Abigail; Yam, Eileen A
On June 28, 2000, the US Supreme Court issued a decision that rejects Nebraska's ban on "partial-birth abortions." The decision affirmed that this abortion ban, and others like it, are extreme, deceptive and unconstitutional violations of the landmark decision that guaranteed women the liberty to choose abortion 27 years ago. While proponents of the Nebraska statute had attempted to convince the Court that the law only covered a particular abortion procedure known as dilation and extraction (D&X), the majority of judges agreed that the statute was written so broadly, it would affect other abortion procedures as well. Pro-choice organizations are elated by the decision; however, there are still some causes for concern. It is stated that while the Court's decision is a victory for women's rights to choose abortion, it also demonstrates how fragile this right is, as shown in the 5-4 decision. Still, even with only a small margin, this court decision will have immediate effect on rendering all similar statutes unconstitutional. PMID:12322632
The purpose of this study was to evaluate the effectiveness of a high-probability (high-"p") request sequence as a means of increasing compliance with medical examination tasks. Participants were children who had been diagnosed with autism and who exhibited noncompliance during general medical examinations. The inclusion of the high-"p" request…
Riviere, Vinca; Becquet, Melissa; Peltret, Emilie; Facon, Bruno; Darcheville, Jean-Claude
During a period of one year (1988-1989), a questionnaire was distributed to women applying for legal abortion at Frederikssund Hospital in Denmark. Two hundred and ninety-one answered the questions on the reasons for their wanting an abortion (91%). 75% were younger than 20 years old, older than 34 years old, had already two children or did not cohabit with a man. Among the reasons given by the women, consideration for their employment or education was the most frequent. Housing conditions and financial circumstances were given as the second most frequent reason. There was some variation in the answers the women gave. The older women did not want more children, and the younger women did not feel that they were mature enough for motherhood. Women with children stated frequently that they wanted an abortion for the sake of the family. Only 19% stated lack of or unstable cohabitation with a man as the reason. In comparison with the findings of previous studies, more women stated that they could not afford a child at present. PMID:2399619
Vestermark, V; Petersen, F V; Asping, U I
This study aimed at determining the knowledge and perception of physicians in Nigeria on abortion related deaths, and also to find out if they will support the liberalization of abortion as a means of reducing deaths from unsafe abortion. Physicians' willingness to offer abortion services was also explored. A self-administered questionnaire was distributed to a convenience sample of physicians in Delta state of Nigeria. Physicians were equally divided on whether legal liberalization of abortion would significantly reduce maternal mortality in Nigeria. Only 13.4% of the doctors were willing to offer abortion services if legally liberalized. The majority of the doctors considered promoting abstinence from pre-marital sex and contraceptive use as best effective strategies for reducing abortion-related deaths. However, liberalization of abortion law in Nigeria was not considered a very effective strategy. PMID:20636247
Okonta, Patrick I; Ebeigbe, Peter N; Sunday-Adeoye, Ileogben
In Sri Lanka, women do not have access to legal abortion except under life-saving circumstances. Clandestine abortion services are, however, available and quite accessible. Although safe specialist services are available to women who can afford them, others access services under unsafe and exploitative conditions. At the time of this writing, a draft bill that will legalize abortion in instances of rape, incest, and fetal abnormalities awaits approval, amid opposition. In this article, I explore the current push for legal reform as a solution to unsafe abortion. Although a welcome effort, this amendment alone will be insufficient to address the public health consequences of unsafe abortion in Sri Lanka because most women seek abortions for other reasons. Much broader legal and policy reform will be required. PMID:23327236
The records of all women applying for permission to have an abortion performed after the 12th week of pregnancy during a one-year period in the County of Aarhus were continuously reviewed, and the women who had the abortion performed due to psychosocial reasons were interviewed with a questionnaire at the time of the abortion and again four months later. Of the 76 women who applied for permission for a late abortion the following were excluded from the study: 31 who had the abortion because a malformed child was suspected, six women who did not have the abortion although permission had been given, five women who did not receive permission, four who were under 18 years of age, one who had a miscarriage, 10 who were from another country of origin and did not understand Danish and finally four women who were allowed an abortion on a medical indication and who were either in hospital or in jail. Fifteen women were questioned concerning their age, length of pregnancy and psychological and social histories and were asked to fill out a depression scale. The data showed that none of them had planned their pregnancy and they had had no symptoms of pregnancy until the time at which they applied for the abortion. None of them regretted the abortion afterwards; half of the women were under psychological strain at the time of application, and a few of them had even more psychological symptoms four months after the abortion. Although they had many social problems, physical complications and psychological problems only a few of the women had seen a doctor in the four month period between the abortion and the follow-up. PMID:8759996
Meyer, L; Petersson, B H
Objective: To find the effective dose of intravaginal misoprostol to induce second trimester abortion. Methods: Intravaginal misoprostol in 200-?g, 400-?g and 600-?g doses were applied at 12-h intervals in 150 consecutive pregnancies. Results: The 48-h successful abortion rate was 70.6%, 82% and 96%, respectively, and these rates were unaffected by parity. The mean induction to abortion interval was 45.0±41.5, 33.4±34.9
Y Herabutya; P O-Prasertsawat
... have an understanding of medical terminology, anatomy and physiology, grammar, and word-processing software. Pay The median ... must become familiar with medical terminology, anatomy and physiology, diagnostic procedures, pharmacology, and treatment assessments. Their ability ...
In January 1988 the Supreme Court of Canada struck down the country's archaic abortion law on the ground that it imposed arbitrary delays and unfair disparities in access to abortion across the country. Since then, the conservative government of Canada has made a few attempts to introduce a new abortion policy, but it did not get passed in the parliament because the revised bills failed to protect women's right to 'life, liberty, and security of the person' within the meaning of the Canadian Charter. Canada has been without an abortion law for over four years and there has been a wide range of provincial policies and confusion in the country. Despite the legal vacuum, Canadian women are not frenziedly having abortions. However, the militancy of the anti-abortion groups has steadily intensified with continued assault on a woman's right to make reproductive choices. Since no law, short of banning abortions altogether, is going to satisfy abortion opponents, the abortion battle will rage on in Canada. PMID:8065237
Objective To characterize the backgrounds of women who have repeat abortions. Study Design In a cross-sectional study of 259 women (M=35.2±5.6 years), the relation between adverse experiences in childhood and risk of having 2+ abortions versus 0 or 1 abortion was examined. Self-reported adverse events occurring between ages 0-12 were summed. Results Independent of confounding factors, women who experienced more abuse, personal safety, and total adverse events in childhood were more likely to have 2+ versus 0 abortions (OR=2.56, 95% CI=1.15-5.71; OR=2.74, 95% CI=1.29-5.82; OR=1.59, 95% CI=1.21-2.09) and versus 1 abortion (OR=5.83, 95% CI=1.71-19.89; OR=2.23, 95% CI=1.03-4.81; OR=1.37, 95% CI=1.04-1.81). Women who experienced more family disruption events in childhood were more likely to have 2+ versus 0 abortions (OR=1.75, 95% CI=1.14-2.69) but not versus 1 abortion (OR=1.16, 95% CI=0.79-1.70). Conclusions Women who have repeat abortions are more likely to have experienced childhood adversity than those having 0 or 1 abortion.
BLEIL, Maria E.; ADLER, Nancy E.; PASCH, Lauri A.; STERNFELD, Barbara; REIJO-PERA, Renee A.; CEDARS, Marcelle I.
This study examines the experiences and opinions of health-care professionals after the legalization of abortion in Mexico City in 2007. Sixty-four semistructured interviews were conducted between 1 December 2007 and 16 July 2008 with staff affiliated with abortion programs in 12 hospitals and 1 health center, including obstetricians/gynecologists, nurses, social workers, key decisionmakers at the Ministry of Health, and others. Findings suggest that program implementation was difficult because of the lack of personnel, space, and resources; a great number of conscientious objectors; and the enormous influx of women seeking services, which resulted in a work overload for participating professionals. The professionals interviewed indicate that the program improved significantly over time. They generally agree that legal abortion should be offered, despite serious concerns about repeat abortions. They recommend improving family planning campaigns and post-procedure contraceptive use, and they encourage the opening of primary health-care facilities dedicated to providing abortion services. PMID:21972671
Contreras, Xipatl; van Dijk, Marieke G; Sanchez, Tahilin; Smith, Patricio Sanhueza
This report summarizes information received from collaborators in state health departments, hospitals, and other pertinent sources regarding abortions reported to the Center for Disease Control for the April-June quarter of 1971. Data in tabular and narrative form are given for abortion ratios by state, reported abortions by menstrual weeks of…
Center for Disease Control (DHEW/PHS), Atlanta, GA.
BACKGROUND: Prolonged vaginal bleeding is a common complaint after medical abortion. The effect of a 1 week course of daily oral misoprostol after medical abortion with mifepristone and misoprostol on the amount of post- abortal blood loss was studied. METHODS: A total of 150 women (gestation ?63 days) were randomized to three groups using computer-generated tables. They received 200 mg
Oi Shan Tang; Sharon W. H. Lee; Pak Chung Ho
The purpose of this study was to determine if a computerized commercial selective dissemination of information service could contribute to the services offered to the patrons of a specific medical library who were already participating in a manual selective dissemination of information service. The citations generated by the two services were contrasted on the basis of literature coverage, timeliness of retrieval, and relevancy of output. Eighty-four percent of the discrete citations retrieved were from 664 periodicals subscribed to by both services. Only 16 percent of the total of 1,387 discrete citations were produced by both services. The manual service was more timely; and, although it produced fewer citations, a higher percentage of these were relevant. Numerically, a total of 346 useful citations were recovered by the manual service and 379 from the commercial service. It appears, therefore, that a computerized commercial SDI service could contribute to the services offered to the medical scientists participating in a manual SDI service.
Miller, Jean K.
Medical methods of early abortion differ from surgical methods in that women themselves can potentially administer the regimens. As currently researched and offered, however, the main regimen used for medical abortion, mifepristone-misoprostol, is highly medicalized, involving several clinic visits and extensive physician involvement.We re-examined the role of clinical supervision in each step of the abortion process, using data collected during
Cynthia Harper; Charlotte Ellertson; Beverly Winikoff
An analysis of Oregon Vital Statistics data from 1965 to 1975 was conducted to assess the impact of Oregon's 1969 abortion legislation, which substantially increased the number of reported medically induced abortions. This increase was associated with a slight increase in the age-adjusted 1970 fertility rate and there was no decrease in births to women in the age groups obtaining proportionately the most abortions. A significant and persistent 11 per cent reduction in premature births to women over age 20 (p less than .001) and a 22 per cent reduction in spontaneous fetal deaths (p less than .05) were associated with liberalized abortion. Decreases in neonatal and postneonatal infant mortality were observed, but were indistinguishable from an ongoing trend toward improved infant health. A gradual 25 per cent decline in the age-adjusted fertility rate occurred between 1969 and 1975, but the increase in the number of reported abortions could account for only one-fourth of this decrease. A seven-fold increase in the use of family planning clinics between 1970 and 1973 and more liberalized laws regarding provision of family planning service appeared to account for a much higher proportion of the decreased fertility than did liberalized abortion.
Quick, J D
This article presents the history and grounds of the official position of the Roman Catholic Church that abortion under any circumstances, including abortion to save the life of the mother, should be prohibited. After an introduction that deplores the lack of mercy shown to killers of abortionists while Catholic priests threatened by pro-abortion forces are not offered protection, the article traces the historic development of the Catholic abortion policy and rebuts arguments that abortion was permitted in the early Christian Church. The next section explains Catholic views on the personhood of a conceptus and refutes the contentions of Joseph Donceel that early abortion should be permitted because of uncertainty about the nature of the conceptus and the possibility of delayed animation. The fourth section of the paper debates the points raised by Susan Teft Nicholson who maintains that the Catholic position regarding abortion rests on the Church's animosity towards sexual pleasure. The paper goes on to criticize Nicholson's claims that the Roman Catholic position on abortion is inconsistent with the Church's own understanding of the Principle of Double Effect because the Church fails to allow abortion in many cases where it would be permissible under the Principle. Section 6 describes the underlying motive of the Roman Catholic Church's abortion position as an attempt to protect the innocent fetus from deliberate death and to justify the Church's application of protection from deliberate killing to those who are innocent of aggressive action. This discussion is followed by a justification of the Church's prohibition of abortion in cases of aggression, such as the aggression ascribed to a fetus when a pregnancy imperials the life of a mother. It is concluded that the US will likely legalize suicide and mercy killing as it has the killing of innocent fetuses who are probably ensouled with personhood and are not formal aggressors. PMID:12348326
The J-2X is an expendable liquid hydrogen (LH2)/liquid oxygen (LOX) gas generator cycle rocket engine that is currently being designed as the primary upper stage propulsion element for the new NASA Ares vehicle family. The J-2X engine will contain abort logic that functions as an integral component of the Ares vehicle abort system. This system is responsible for detecting and responding to conditions indicative of impending Loss of Mission (LOM), Loss of Vehicle (LOV), and/or catastrophic Loss of Crew (LOC) failure events. As an earth orbit ascent phase engine, the J-2X is a high power density propulsion element with non-negligible risk of fast propagation rate failures that can quickly lead to LOM, LOV, and/or LOC events. Aggressive reliability requirements for manned Ares missions and the risk of fast propagating J-2X failures dictate the need for on-engine abort condition monitoring and autonomous response capability as well as traditional abort agents such as the vehicle computer, flight crew, and ground control not located on the engine. This paper describes the baseline J-2X abort subsystem concept of operations, as well as the development process for this subsystem. A strategy that leverages heritage system experience and responds to an evolving engine design as well as J-2X specific test data to support abort system development is described. The utilization of performance and failure simulation models to support abort system sensor selection, failure detectability and discrimination studies, decision threshold definition, and abort system performance verification and validation is outlined. The basis for abort false positive and false negative performance constraints is described. Development challenges associated with information shortfalls in the design cycle, abort condition coverage and response assessment, engine-vehicle interface definition, and abort system performance verification and validation are also discussed.
Santi, Louis M.; Butas, John P.; Aguilar, Robert B.; Sowers, Thomas S.
Background: Unsafe abortion accounts for a greater proportion of maternal deaths, yet it is often not adequately considered in discussions around reducing maternal mortality. Aim: The aim of this study is to determine the pattern of unsafe abortion and the extent to which unsafe abortion contributes to maternal morbidity and mortality in our setting as well as assess the impact of post-abortion care. Subjects and Methods: A descriptive study of patients who were admitted for complications following induced abortions between January 1, 2001 and December 31, 2008 at the Federal Medical Center, Abakaliki South East of Nigeria with data obtained from case records. Results: Out of the 1,562 gynecogical admissions, a total of 83 patients presented with the complications arising from induced abortion. The age group 20-24 years was mostly affected and adolescents constituted 32.5% (27/83). Nearly 15.7% (13/83) of these patients died while the remaining 84.3% (70/83) had various complications, which were mainly septicemia 59.0% (49/83), anemia 47.0% (39/83), peritonitis 41.0% (34/83), hemorrhages 34.9% (29/83) and uterine perforation 30.1% (25/83). During the study, there were 38 gynecological deaths and abortion related death accounted for 34.2% (13/38) of these gynecological deaths. 84.3% (70/83) of the patients had no documented evidence of counseling on family planning and 59.0% (49/83) were not aware of the different methods of contraception. Conclusion: Unsafe abortion remains one of the most neglected sexual and reproductive health problems in developing countries today despite its significant contribution to maternal mortality and morbidity. Solutions and remedies include prevention of unplanned and unwanted pregnancies by sex education and access to safe and sustainable family planning methods.
Ikeako, LC; Onoh, R; Ezegwui, HU; Ezeonu, PO
The abort analysis for the cycle 3 Operational Flight Profile (OFP) for the Space Transportation System 1 Flight (STS-1) is defined, superseding the abort analysis previously presented. Included are the flight description, abort analysis summary, flight design groundrules and constraints, initialization information, general abort description and results, abort solid rocket booster and external tank separation and disposal results, abort monitoring displays and discussion on both ground and onboard trajectory monitoring, abort initialization load summary for the onboard computer, list of the key abort powered flight dispersion analysis.
Background: Spontaneous abortion is the most common complication of pregnancy. Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used during pregnancy. Published data are inconsistent regarding the risk of spontaneous abortion following exposure to NSAIDs. Methods: We performed a historical cohort study involving all women who conceived between January 2003 and December 2009 and who were admitted for delivery or spontaneous abortion at Soroka Medical Center, Clalit Health Services, Israel. A computerized database of medication dispensation was linked with 2 computerized databases containing information on births and spontaneous abortions. We constructed time-varying Cox regression models and adjusted for maternal age, diabetes mellitus, hypothyroidism, obesity, hypercoagulation or inflammatory conditions, recurrent miscarriage, in vitro fertilization of the current pregnancy, intrauterine contraceptive device, ethnic background, tobacco use and year of admission. Results: The cohort included 65 457 women who conceived during the study period; of these, 58 949 (90.1%) were admitted for a birth and 6508 (9.9%) for spontaneous abortion. A total of 4495 (6.9%) pregnant women were exposed to NSAIDs during the study period. Exposure to NSAIDs was not an independent risk factor for spontaneous abortion (nonselective cyclooxygenase [COX] inhibitors: adjusted hazard ratio [HR] 1.10, 95% confidence interval [CI] 0.99–1.22; selective COX-2 inhibitors: adjusted HR 1.43, 95% CI 0.79–2.59). There was no increased risk for specific NSAID drugs, except for a significantly increased risk with exposure to indomethacin (adjusted HR 2.8, 95% CI 1.70–4.69). We found no dose–response effect. Interpretation: We found no increased risk of spontaneous abortion following exposure to NSAIDs. Further research is needed to assess the risk following exposure to selective COX-2 inhibitors.
Daniel, Sharon; Koren, Gideon; Lunenfeld, Eitan; Bilenko, Natalya; Ratzon, Ronit; Levy, Amalia
Describes authors' experiences of three abortions and her unresolved grief. Presents authors' writing at different times throughout her life. Contends grief therapy must be part of abortion counseling. Claims unresolved grief affects others, relationships, pregnancies, and self-concept. (Author/ABL)
PURPOSE: Spontaneous abortion (SAB), the most common adverse pregnancy outcome, affects ?15% of clinically recognized pregnancies. Except for advanced maternal age and smoking, there are not well-established risk factors for SAB. Animal models associate increased fetal resorption or abortion with exposure to the pesticide dichlorodiphenyl trichloroethane (DDT), but epidemiologic investigations of DDT and SAB are inconsistent. We undertook a pilot
Susan A Korrick; Changzhong Chen; Andrew I Damokosh; Jiatong Ni; Xue Liu; Sung-Il Cho; Larisa Altshul; Louise Ryan; Xiping Xu
This publication seeks to explain the many facets of adolescent abortion: teenagers' need for access to safe abortion; the need for confidentiality in order to ensure safety; the real intent and effect of parental involvement laws; and the roles of parents and the state in safeguarding the health of pregnant teenagers. The first section looks at…
Background Induced abortion is a common medical intervention. Whether psychological sequelae might follow induced abortion has long been a subject of concern among researchers and little is known about the relationship between posttraumatic stress disorder (PTSD) and induced abortion. Thus, the aim of the study was to assess the prevalence of PTSD and posttraumatic stress symptoms (PTSS) before and at three and six months after induced abortion, and to describe the characteristics of the women who developed PTSD or PTSS after the abortion. Methods This multi-centre cohort study included six departments of Obstetrics and Gynaecology in Sweden. The study included 1457 women who requested an induced abortion, among whom 742 women responded at the three-month follow-up and 641 women at the six-month follow-up. The Screen Questionnaire-Posttraumatic Stress Disorder (SQ-PTSD) was used for research diagnoses of PTSD and PTSS, and anxiety and depressive symptoms were evaluated by the Hospital Anxiety and Depression Scale (HADS). Measurements were made at the first visit and at three and six months after the abortion. The 95% confidence intervals for the prevalence of lifetime or ongoing PTSD and PTSS were calculated using the normal approximation. The chi-square test and the Student’s t-test were used to compare data between groups. Results The prevalence of ongoing PTSD and PTSS before the abortion was 4.3% and 23.5%, respectively, concomitant with high levels of anxiety and depression. At three months the corresponding rates were 2.0% and 4.6%, at six months 1.9% and 6.1%, respectively. Dropouts had higher rates of PTSD and PTSS. Fifty-one women developed PTSD or PTSS during the observation period. They were young, less well educated, needed counselling, and had high levels of anxiety and depressive symptoms. During the observation period 57 women had trauma experiences, among whom 11 developed PTSD or PTSS and reported a traumatic experience in relation to the abortion. Conclusion Few women developed PTSD or PTSS after the abortion. The majority did so because of trauma experiences unrelated to the induced abortion. Concomitant symptoms of depression and anxiety call for clinical alertness and support.
Early abortion traditionally referred to abortion within 12 weeks of gestational age, but it is necessary to divide it into 3 stages: ultra early abortion for the one within 5 weeks of gestational age; very early abortion for the one within 8 weeks; early abortion for the one between 8 and 12 weeks. Progress and development in them are of IVF-ET and GIFT necessitated redefining pregnancy and resulted in great number of terms related to early pregnancy and abortion, which are not standardized and sometimes confusing. In connection with IVF-ET research, the following 3 stages of early pregnancy are recognized by Japanese doctors. Biochemical pregnancy is when plasma level of beta HCG is above norm. Early clinical pregnancy is when the Gestational sac is detected by ultrasonography but the heat beat of fetus is not yet confirmed. Established clinical pregnancy is when the heart beat of the fetus is confirmed via ultrasonography. Early abortion is divided into 2 stages: subclinical abortion (menstrual abortion), which is menstrual like fetus wastage in biomedical pregnancy, and clinical abortion in which a blighted ovum is detected by ultrasonic examination. Classification above is simple and easy but it heavily relies on measurement methods, results of which often fluctuate and are subject to change. It seems desirable to classify early abortion according to gestational age (GS). GS may be detected as early as 4 weeks, is above 10 mm in the maximum diameter at 5 weeks, and is detected in all cases at 6 weeks. Human chorionic gonadotropin (HCG) test by 1000 IU/1 sees positive response in almost all cases at 6 weeks, while HCG by 200 IU/1 sees the same at 5 weeks. The heart beat of the fetus is believed to commence at 4 weeks but it is not detected by ultrasonography at the earliest till the end of 5 weeks and in all cases till 8 weeks. The classification of ultra early abortion, very early abortion and early abortion, is based on above findings. PMID:12158570
Takahama, K; Hoshiai, H; Yajima, A
Although abortion for health reasons is not considered a crime in Peru, the State does not allow its inclusion in public policy, thus violating women's right to terminate a pregnancy when it affects their health. When examining the article in the Criminal Code which decriminalizes this type of abortion, provisions are identified which protect women and set the conditions to offer this type of service. This document sets the debate about the arguments used by the Peruvian State for not approving a therapeutic abortion protocol which would regulate the provision and financing of therapeutic abortion in public services, and explains why this obligation should be complied with, based on the conceptual framework of "health exception" In addition, it presents two cases brought before the judicial court in which the Peruvian State was found guilty of violating the human rights of two adolescents to whom a therapeutic abortion was denied. PMID:24100828
The potential reproductive toxicity of mercury vapour was investigated by comparing the rate of spontaneous abortions among the wives of 152 workers occupationally exposed to mercury vapour with the rate among the wives of 374 controls in the same plant. The results indicate an increase in the rate of spontaneous abortions with an increasing concentration of mercury in the fathers' urine before pregnancy. At concentrations above 50 micrograms/l the risk of spontaneous abortion doubles (odds ratio (OR) = 2.26; 95% confidence interval (95% CI) = 0.99-5.23). Special care was taken to avoid bias in reporting abortions and known risk factors of spontaneous abortions do not seem to explain the results. Several biological mechanisms might account for them including, in particular, direct action of mercury on the paternal reproductive system and indirect toxicity to the mother or embryo through transport of mercury from the father. These indications could be of practical importance and should therefore be further documented.
Cordier, S; Deplan, F; Mandereau, L; Hemon, D
Aim: The aim of this study was to evaluate the efficacy and tolerance of a high dose of vaginal misoprostol for outpatient medical management of missed abortion. Methods: Three doses of 400 lg misoprostol were administered intravaginally every 4 h daily, for a maximum period of 3 days, to 108 women with uneventful first trimester pregnancy failure. Results: A total
Stavros Sifakis; Emmanuel Angelakis; Elpida Vardaki; Yvoni Fragouli; Eugenios Koumantakis
Background Despite the adoption of the Medical Termination of Pregnancy Act in 1972, access to safe abortion services remains limited in India. Awareness of the legality of abortion also remains low, leading many women to seek services outside the health system. Medical abortion (MA) is an option that has the potential to expand access to safe abortion services. A multi-pronged intervention covering a population of 161,000 in 253 villages in the Silli and Khunti blocks of Jharkhand was conducted between 2007 and 2009, seeking to improve medical abortion services and create awareness at the community level by providing information through community intermediaries and creating an enabling environment through a behavior change communication campaign. The study evaluates the changes in knowledge about abortion-related issues, changes in abortion care-seeking, and service utilization as a result of this intervention. Methods A baseline cross-sectional survey was conducted pre-intervention (n?=?1,253) followed by an endline survey (n?=?1,290) one year after the completion of the intervention phase. In addition, monitoring data from intervention facilities was collected monthly over the study period. Results Nearly 85% of respondents reported being exposed to safe abortion messaging as a result of the intervention. Awareness of the legality of abortion increased significantly from 19.7% to 57.6% for women, as did awareness of the specific conditions for which abortion is allowed. Results were similar for men. There was also a significant increase in the proportion of men and women who knew of a legal and safe provider and place from where abortion services could be obtained. Multivariate analysis showed positive associations between exposure to any component of the intervention and increased knowledge about legality and gestational age limits, however only interpersonal communication was associated with a significant increase in knowledge of where to obtain safe services (OR 4.8, SE 0.67). Utilization of safe abortion services, and in particular MA, increased at all intervention sites over the duration of the intervention with a shift towards women seeking care earlier in pregnancy. Conclusion The evaluation demonstrates the success of the intervention and its potential for replication in similar contexts within India.
Despite the ascent of Bill Clinton to Presidential power in the US and his early successful repeals of bans on abortion counseling at federally funded clinics, abortions in military hospitals, and fetal tissue research, the controversy and debate over a woman's right to abortion continues in the US. The Hyde Amendment, named after Representative Henry Hyde, Republican from Illinois, has been in effect since 1976 barring Medicaid from funding abortions except to save the life of the pregnant woman. Congress in 1993, however, eased the amendment to allow states to use Medicaid funds to pay for abortions for low-income women in the cases of rape or incest. Anti-abortion lawmakers were assured by the provision's sponsors that the Clinton Administration would not force states to comply. The Department of Health and Human Services (HHS) instead sent a letter to state Medicaid directors on December 28, 1993, ordering them to use Medicaid funds to pay for abortions for low-income women who were the victims of rape or incest. President Clinton subsequently complained that HHS had bypassed his office in issuing the directive, state Medicaid directors protested that the directive had been imposed without the usual notice and allowance of time for public comment, and states claimed that the order clashes with existing state laws which ban the public funding of abortions not required to save the life of the mother. Officials from Arkansas, Colorado, North Dakota, Pennsylvania, and Utah have stated that they may fight the directive, while the HHS will most likely not move to rescind or change its directive. The issue will probably be resolved in the courts. The authors note that this state/federal battle over Medicaid-funded abortions is only part of a larger war scheduled to take place in Congress over whether pregnancy-related services, including abortion, will be covered in the Administration's Health Security Act. PMID:10132602
Kent, C; Tokarski, C
In the Netherlands, the practice of life-termination by physicians is still subject to the penal code and yet, since the seventies\\u000a euthanasia and physician assisted death are continuing to occur more openly; this development is supported by public opinion,\\u000a the majority of doctors, and in jurisprudence. Requirements for prudent practice have been compiled in jurisprudence and by\\u000a the medical profession
Gerrit van der Wal; P. J. van der Maas
A fluorescence in situ hybridization (FISH) procedure was used to detect chromosome abnormalities in archival abortion material. Nuclei were isolated from 50-µm-thick tissue blocks from 18 selected and karyotyped abortions. Five probes for repetitive centromeric sequences of chromosomes 1, 16, 18, X and Y were used. For each chromosome, at least 200 nuclei were scored blindly, i.e. without knowledge of
Gesina van Lijnschoten; Jozefa Albrechts; Monique Vallinga; Anton H. N. Hopman; Jan W. Arends; Joseph P. M. Geraedts
In 1992 in Israel, a woman in whom a missed early abortion (blighted ovum) was diagnosed underwent a dilatation and curettage procedure during the seventh week of pregnancy. When it was determined that the pregnancy was not terminated, it was allowed to continue until week 24 when suspected severe intrauterine growth retardation (IUGR) led to induction of labor and delivery of a female fetus with severe asymmetric IUGR, no congenital abnormalities, and a normal skeleton. Four other cases of failed pregnancy interruption between 1991 and 1994 ended in the delivery of normal infants at weeks 37, 39, and 40, and fetal death complicated by the development of a hydatidiform mole. Most cases of failed induced abortion occur in early abortions, and most women will return for another procedure. In most cases of failed abortion, damage to the placenta will result in damage to the fetus. The most likely cause of IUGR in the case described above was vascular disruption of the placenta due to the curettage. These rare occurrences of failed induced abortion are associated with a high emotional, physical, and legal cost. PMID:7660320
Arnon, J; Ornoy, A
Can one consistently deny the permissibility of abortion while endorsing the killing of human embryos for the sake of stem cell research? The question is not trivial; for even if one accepts that abortion is prima facie wrong in all cases, there are significant differences with many of the embryos used for stem cell research from those involved in abortion--most prominently, many have been abandoned in vitro, and appear to have no reasonably likely meaningful future. On these grounds one might think to maintain a strong position against abortion but endorse killing human embryos for the sake of stem cell research and its promising benefits. I will argue, however, that these differences are not decisive. Thus, one who accepts a strong view against abortion is committed to the moral impermissibility of killing human embryos for the sake of stem cell research. I do not argue for the moral standing of either abortion or the killing of embryos for stem cell research; I only argue for the relation between the two. Thus the conclusion is relevant to those with a strong view in favor of the permissibility of killing embryos for the sake of research as much as for those who may strongly oppose abortion; neither can consider their position in isolation from the other. PMID:18398698
Jensen, David A
The HL-20 has been designed with the capability for rescue of the crew during all phases of powered ascent from on the launch pad until orbital injection. A launch-escape system, consisting of solid rocket motors located on the adapter between the HL-20 and the launch vehicle, provides the thrust that propels the HL-20 to a safe distance from a malfunctioning launch vehicle. After these launch-escape motors have burned out, the adapter is jettisoned and the HL-20 executes one of four abort modes. In three abort modes - return-to-launch-site, transatlantic-abort-landing, and abort-to-orbit - not only is the crew rescued, but the HL-20 is recovered intact. In the ocean-landing-by-parachute abort mode, which occurs in between the return-to-launch-site and the transatlantic-abort-landing modes, the crew is rescued, but the HL-20 would likely sustain damage from the ocean landing. This paper describes the launch-escape system and the four abort modes for an ascent on a Titan III launch vehicle.
Naftel, J. C.; Talay, T. A.
On November 26-28, 1992, the Latin American and Caribbean Women's Health Network convened a meeting in Uruguay entitled, "Abortion in Latin America: Perspectives and Strategies." The first session was devoted to discussion of a paper that argues that a feminist ethic must be developed to counteract the dominant patriarchal ethic, which fails to improve women's lives. The next session covered the World Bank's concerns about the economic consequences of illegal abortion. The third session included descriptions of the experiences of the coordinator of the Sao Paulo Municipal Women's Health Program and of the new Argentine National Women's Health Network. Debate and discussion were generated by the next speaker, who presented a legislative proposal for the decriminalization of abortion in Latin America and noted that restrictive policies, which have failed to reduce abortion rates, will be difficult to change. It was proposed that regional campaigns be launched to legalize abortion as a first step in achieving reproductive rights for women. After a review of abortion-related activities in the region during the past year, participants composed a five-year plan of action in the areas of research, data centralization, petition campaigns, and publication of a review of abortion legislation. Finally, it was proposed that a counselor training course in sexual and reproductive rights be developed. PMID:12179717
Abortion has been illegal in Ireland since 1861. This position was written into the national Constitution in 1963 and reconfirmed by referendum in 1983. Contraception is also illegal in the country. The pregnancy of a 14-year old adolescent due to an alleged rape, however, has caused many in Ireland to voice their support for abortion in limited circumstances. Approximately 5000 pregnant women go from Ireland to the United Kingdom annually for abortions. This 14-year old youth also planned to make the crossing, but was blocked from leaving by the Irish police and later by an injunction of the Attorney-General. The Irish Supreme Court upheld the injunction even though the young woman was reportedly contemplating suicide. A national outcry ensued with thousands of demonstrators marching in Dublin to demand the availability of information on abortion and that Irish women be allowed to travel whenever and wherever they desire. 66% of respondents to recent public opinion polls favor abortion in certain circumstances. Ultimately, the Irish Supreme Court reversed their stance to allow pregnant Irish women to travel internationally and gave suicidal Irish women the right to abortions. These decisions were made shortly within the time frame needed for the young lady in question to received a legal abortion in the United Kingdom. PMID:12222235
The availability of abortion provides insurance against unwanted pregnancies since abortion is the only birth control method which allows women to avoid an unwanted birth once they are pregnant. Restrictive state abortion policies, which increase the cost of obtaining an abortion, may increase women's incentive to alter their pregnancy avoidance…
Objectives Compulsory community treatment has been shown to reduce preventable deaths from physical disorders—these causes being up to 10 times more common than suicide in psychiatric patients. We investigated whether this was mediated by better access to specialized medical procedures. Method: All patients on compulsory community treatment for over 11 years were compared with matched control subjects using linked administrative health data from Western Australia (state population of about 2.24 million). Outcomes were access to revascularization and other specialized procedures at 1-, 2-, and 3-year follow-up. Logistic regression was used to adjust for demographics, prior health service use, diagnosis, and length of psychiatric history. Results: There were 2757 patients and 2687 control subjects (total n = 5444). Sixty-five per cent were males (n = 3522), and the average age was 36 years (SD 13.2). Most had schizophrenia or other nonaffective psychoses (74%), followed by affective disorders (26%). At 2-year follow-up, 2% (n = 53) of patients and 2.6% (n = 69) of control subjects had undergone a specialized intervention. Compulsory community treatment did not result in greater access to specialized procedures at all 3 time points even after adjusting for potential confounders. Conclusions: Greater access to specialized procedures does not explain the reduced mortality from preventable physical illness that had been reported in patients on community treatment orders. There must be other explanations for this finding, such as mental health staff facilitating access to chronic disease management in primary care. This warrants further research.
Kisely, Steve; Xiao, Jianguo; Lawrence, David; Jian, Le
Background About 46 million induced abortions occur in the world annually. The studies have reported 80000 cases of induced abortions in Iran annually. Objectives This qualitative study was conducted to identify the causes of unsafe abortion in Iran from the standpoint of three groups of experts, women with a history of abortion or unwanted pregnancy and service providers. Patients and Methods A total of 72 in-depth semi structured interviews were conducted in 2012 in Tehran and Shahroud. After coordination with 8 experts, sampling from them was done using the Snowballing method in their offices. Sampling from 28 married and 10 engaged women with a history of unwanted pregnancy or unsafe abortion and 12 providers was done in health care centers and a in number of gynecologists’ and midwives’ offices. Sampling from women with a history of unwanted pregnancy or unsafe abortion such as single women, HIV positive women and drug users, and women who had sexual intercourse for money was started by referring to the social rehabilitation center for women and continued using the snowballing method due to difficulties in accessing them. Participants were from different ethnic groups including Fars, Gilaks, Mazandarani, Arab, Azerbaijani, and Lor. Content analysis was performed on collected data. Results Based on the results of the interviews, participants have abortion for following reasons: 1. Wanted pregnancy (sub categories: fetal abnormalities, Concern about fetal health and lack of trust to prenatal diagnostic methods, Fetal sex, Lack of independent and free decision making regarding pregnancy in women, 2. Unwanted pregnancy (sub-categories: Socio-economic factors, Beliefs and feelings, Lack of information about family planning) 3. Predisposing factors (sub-categories: Lack of information on religious aspects of abortion, Easy access to easy abortion methods). Some people, despite having unwanted pregnancy due to social, economic, cultural and family grounds, continued their pregnancy and did not have an abortion for the following reasons: Religious beliefs, Beliefs (fear of punishment in the afterlife and believing in fate) , Attachment to the unborn baby, Influence of the other people’s opinions (physician, mother or spouse) Late diagnosis of pregnancy, Unsuccessful abortion attempts (Self-treatment, Unsuccessful medical abortion), Economic weakness and arbitrary treatment. Conclusions In the present study, women who continued their pregnancy despite being unwanted were also interviewed. Although they had the same social, economic, cultural, and family problems as women with a history of unsafe abortion and had easy access to abortion, analysis showed that the difference in religious beliefs between the two groups was the most important factor that led women to choose two different approaches. The authors believe that in-depth analysis of people’s beliefs and opinions in this regard and correction of false beliefs plays a crucial role in decreasing the rate of unsafe abortion.
Motaghi, Zahra; Keramat, Afsaneh; Shariati, Mohammad; Yunesian, Masud
Background and Objective: Miscarriage is a common complication of early pregnancy with medical and psychological consequences. Dilation and Curettage are considered as two standard caring ways for early pregnancy failure. Alternatively misoprostol has been used as a single agent for termination of early pregnancy. Aim of the present study was to compare the usefulness of serum ?-hCG measurement and ultrasound examination to predict complete abortion after medical induction. Methods: There were one hundred and thirty three patients experiencing missed abortion or blighted ovum. Ultrasound examination and serum ?-hCG test were performed before treatment and during follow-up in all these patients. Results: Treatment was successful without any need for surgical intervention in 92.4% of the cases. Both methods could verify the complete abortion among all the patients at the end of the study (4(th) week). Kappa agreement coefficient for the two methods of diagnosis was 0.327 (P < 0.5). Conclusion: Based on our results, ?- hCG is as effective as ultrasound in confirming a successful medically induced abortion in early pregnancy, but it should be used as supplements to clinical assessments. PMID:24550955
Behnamfar, Fariba; Mahdian, Mehrdad; Rahimi, Fereshteh; Samimi, Mansoureh
Aim: To determine whether induced abortion (IA) increases breast cancer (BC) risk. Materials and Methods: A population-based case-control study was performed from Dec, 2000 to November, 2004 in Shanghai, China, where IA could be verified through the family planning network and client medical records. Structured questionnaires were completed by 1,517 cases with primary invasive epithelial breast cancer and 1,573 controls frequency- matched to cases for age group. The information was supplemented and verified by the family planning records. Statistical analysis was conducted with SAS 9.0. Results: After adjusting for potential confounders, induced abortions were not found to be associated with breast cancer with OR=0.94 (95%CI= 0.79-1.11). Compared to parous women without induced abortion, parous women with 3 or more times induced abortion (OR=0.66, 95%CI=0.46 to 0.95) and women with 3 or more times induced abortion after the first live birth (OR=0.66, 95%CI =0.45 to 0.97) showed a lower risk of breast cancer, after adjustment for age, level of education, annual income per capita, age at menarche, menopause, parity times, spontaneous abortion, age at first live birth, breast-feeding, oral contraceptives, hormones drug, breast disease, BMI, drinking alcohol, drinking tea, taking vitamin/calcium tablet, physical activity, vocation, history of breast cancer, eating the bean. Conclusions: The results suggest that a history of induced abortions may not increase the risk of breast cancer. PMID:24870770
Wu, Jun-Qing; Li, Yu-Yan; Ren, Jing-Chao; Zhao, Rui; Zhou, Ying; Gao, Er-Sheng
Spontaneous abortion is a common gynaecological condition. It is a commonly held belief that medical morbidity associated with this condition is low and that routine treatment should be surgical evacuation of the uterus. This study was performed to study the short-term complications of spontaneous abortion and its management. Transvaginal sonography (TVS) was used to determine whether retained products of conception (POCs) were visible inside the uterus in women presenting with spontaneous abortion. If tissue was present, surgical evacuation of retained products of conception (ERPC) was performed. If the uterus was empty, the patients were managed expectantly. Four hundred and seventy women were treated with ERPC and 297 were managed expectantly. The complication rate was 3.0% in those managed expectantly compared with 5.8% for those treated by ERPC. Subjects with no POCs on TVS can therefore be managed expectantly without increasing the risk of morbidity associated with this condition. PMID:9521393
Chung, T K; Cheung, L P; Sahota, D S; Haines, C J; Chang, A M
The feasibility of a special kicker to produce a damped spiral beam at the beam dump for the beam abort system was determined. There appears to be no problem with realizing this concept at a reasonably low cost.
Martin, R. L.
Thirty children presenting to the dental clinic of a pediatric hospital who required brief but urgent dental care, and who could not be satisfactorily examined or treated, were administered one of three medications--ketamine (Ketalar), 3 mg/kg; midazolam (Versed), 0.4 mg/kg; or sufentanil (Sufenta), 1.5 or 1.0 micrograms/kg--intranasally in a randomized, double-blinded protocol. The patients were brought to the day surgery area following appropriate fasting and administered one of the medications diluted in a dose of 0.1 mL/kg normal saline while sitting in a nurse's arms. Cardiorespiratory monitors were applied when tolerated, and the child was placed on the operating room table. Each child was injected locally with up to one dental cartridge of 2% lidocaine with 1:100,000 epinephrine before dental extractions. A sedation score was recorded using a scale where 1 = hysterical/untreatable, 5 = ideal sedation, and 10 = obtunded and desaturated, requiring airway management assistance. Midazolam administration resulted in acceptable sedation (mean score: 4) with no desaturations below 90% as measured by pulse oximetry and a mean recovery room observation time of only 3 +/- 2 min (+/- SD). Ketamine also had a mean sedation score of 4 and a short recovery period (7 +/- 7 min); however, two children experienced brief desaturations. Sufentanil at 1.5 micrograms/kg was noted to produce much more heavily sedated children (mean score 7), with a high incidence of significant oximetry desaturation (80%) and prolonged recovery room duration (58 +/- 40 min). Use of 1.0 microgram/kg sufentanil resulted in no desaturations, less sedation (mean score 4), and a brief recovery time (7 +/- 13 min).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7645790
Abrams, R; Morrison, J E; Villasenor, A; Hencmann, D; Da Fonseca, M; Mueller, W
This viewgraph presentation is an overview of the Launch Abort System (LAS) for the Constellation Program. The purpose of the paper is to review the planned tests for the LAS. The program will evaluate the performance of the crew escape functions of the Launch Abort System (LAS) specifically: the ability of the LAS to separate from the crew module, to gather flight test data for future design and implementation and to reduce system development risks.
Williams-Hayes, Peggy; Bosworth, John T.
Objective: To compare the effect of vaginal misoprostol with that of placebo when used prior to dilatation and aspiration in women with a missed abortion. Method: Eighty-four pregnant women with a missed abortion were randomized to receive either vaginal misoprostol (200 ?g) or placebo the day before the planned dilatation and aspiration under inhalation anesthesia. Result: Thirty-five women (83.33%) in
Y. Herabutya; P. O-Prasertsawat
This is a retrospective study of 614 women undergoing first trimester medical termination of pregnancy (TOP) from 1 January to 31 December 2006, at Nottingham Contraception and Sexual Health service. All women were in the gestational age of 6-9 weeks. The results showed that three women had blood loss of more than 500 ml and had to be transfused. All patients requiring blood transfusion were over 8 weeks' gestation. A total of 84 (13.8%) patients returned as planned to the unit for follow-up scan because of uncertainty over completeness of abortion. All patients (1.13%) who needed surgical intervention were more than 8 weeks' gestation. A total of 27 patients (4.3%) required admission overnight, the main indication being lack of support at home. Early medical TOP was successful in over 98% of women and allowed them to avoid the risks of surgical instrumentation and anaesthesia. Early medical abortion is a safe and effective procedure and deserves to be more widely available and utilised. PMID:18569476
Singh, M; Porter, C; Griffiths, S
It is common to think of scientific research and the knowledge it generates as neutral and value free. Indeed, the scientific method is designed to produce "objective" data. However, there are always values built into science, as historians of science and technology have shown over and over. The relevant question is not how to rid science of values but, instead, to ask which values and whose values belong? Currently, antiabortion values consistently determine US research policy. Abortion research is declared illegitimate in covert and overt ways, at the level of individual researchers and research policy broadly. Most importantly, federal policy impedes conduct of both basic and clinical research in abortion. However, it is not just research in abortion that is deemed "illegitimate;" research in infertility and in vitro fertilization is as well. Federal funding of any reproductive health research agenda that would pose more than minimal risk to a fetus or embryo is banned. This leaves unanswered scientific questions about abortion, infertility, miscarriage and contraception among other areas. Since moral ground is occupied not just by abortion opponents but also by people who support abortion rights, there is at the very least a competing moral claim to consider changing federal research funding policy. Women and families deserve access to knowledge across the spectrum of reproductive health issues, whether they seek to end or start a pregnancy. Thus, research funding is an issue of reproductive justice. PMID:23815965
Harris, Lisa H
The capability of the HL-20 lifting body spacecraft to perform an abort maneuver from the launch pad to a horizontal landing was studied at NASA Langley Research Center. This study involved both piloted and batch simulation models of the vehicle. A point-mass model of the vehicle was used for trajectory optimization studies. The piloted simulation was performed in the Visual Motion Simulator in fixed-base mode. A candidate maneuver was developed and refined for the worst-case launch-pad-to-landing-site geometry using an iterative procedure of off-line maneuver analysis followed by piloted evaluations and heuristic improvements to the candidate maneuver. The resulting maneuver demonstrates the launch site abort capability of the HL-20 and dictates requirements for nominal abort motor performance. The sensitivity of the maneuver to variations in several design parameters was documented.
Jackson, E. B.; Rivers, Robert A.; Chowdhry, Rajiv S.; Ragsdale, W. A.; Geyer, David W.
This paper examines the exchange relationships between women undergoing abortion, the clinicians who procure fetal tissue and stem cell scientists in Britain, and argues that the fetal tissue economy is an important dimension of the gendered bioeconomy that underpins stem cell science. In so doing it suggests that the path from the abortion clinic to the stem cell laboratory differs from the route taken by pre-implantation embryos from the in vitro fertilisation clinic in important ways. It reports on a study which included 29 in-depth, semi-structured interviews with stem cell scientists, policymakers, clinicians, activists and sponsors of stem cell research. The paper explores the meanings attached to aborted fetuses and how women's relationship to fetal tissue is constructed in the interviews, the law and official guidance on the use and disposal of fetal tissue. This is linked to variability in consent procedures and procurement practices. PMID:18945530
The capability of the HL-20 lifting body to perform an abort maneuver from the launch pad to a horizontal landing was studied. The study involved both piloted and batch simulation models of the vehicle. A point-mass model of the vehicle was used for trajectory optimization studies. The piloted simulation was performed in the Langley Visual/Motion Simulator in the fixed-base mode. A candidate maneuver was developed and refined for the worst-case launch-pad-to-landing-site geometry with an iterative procedure of off-line maneuver analysis followed by piloted evaluations and heuristic improvements to the candidate maneuver. The resulting maneuver demonstrates the launch-site abort capability of the HL-20 and dictates requirements for nominal abort-motor performance. The sensitivity of the maneuver to variations in several design parameters was documented.
Jackson, E. Bruce; Rivers, Robert A.; Chowdhry, Rajiv S.; Ragsdale, W. A.; Geyer, David W.
Two-stage winged space access vehicles consisting of a carrier stage with airbreathing turbo/ram jet engines and a rocket propelled orbital stage which may significantly reduce space transport costs and have additional advantages offer a great potential for mission safety improvements. Formulating the nominal mission and abort scenarios caused by engine malfunctions as an optimal control problem allows full exploitation of safety capabilities. The shaping of the nominal mission has a significant impact on the prospective safety. For this purpose, most relevant mission aborts are considered together with the nominal mission, treating them as an optimization problem of branched trajectories where the branching point is not fixed. The applied procedure yields a safety improved nominal trajectory, showing the feasibility of the included mission aborts with minimum payload penalty. The other mission aborts can be separately treated, with the initial condition given by the state of the nominal trajectory at the time when a failure occurs. A mission abort plan is set up, covering all emergency scenarios. PMID:16480117
Mayrhofer, M; Wächter, M; Sachs, G
In this investigation the indirect fluorescent antibody technique was used to titrate antibodies in bovine sera to parainfluenza 3, infectious bovine rhinotracheitis virus and bovine viral diarrhea virus. These results were compared to those determined on the same samples by hemagglutination inhibition for parainfluenza 3 virus and serum neutralization for bovine virus diarrhea and infectious bovine rhinotracheitis virus. The results of the serological methods agreed closely. The indirect fluorescent antibody technique is a rapid and sensitive method for detecting antibodies and the procedure lends itself to use in diagnostic laboratories. In addition to the above viruses the presence or absence of antibodies to bovine coronavirus and bovine adenovirus 3 were determined by the indirect fluorescent antibody technique in thoracic fluids from 100 aborted fetuses and 50 nonaborted fetuses. Results on these samples were not compared to hemagglutination inhibition or serum neutralization as the condition of fluid samples from aborted fetuses renders interpretation of such tests unreliable. Antibodies to one or more viruses were detected in 30 of the 100 aborted fetuses and in seven of the 50 nonaborted fetuses. Antibodies to more than one agent were detected in eleven of the 100 aborted and in one of the 50 nonaborted fetuses. Reasons for this occurrence and application of the test in determination of causes of abortion are discussed. PMID:226243
Miller, R B; Wilkie, B N
In this investigation the indirect fluorescent antibody technique was used to titrate antibodies in bovine sera to parainfluenza 3, infectious bovine rhinotracheitis virus and bovine viral diarrhea virus. These results were compared to those determined on the same samples by hemagglutination inhibition for parainfluenza 3 virus and serum neutralization for bovine virus diarrhea and infectious bovine rhinotracheitis virus. The results of the serological methods agreed closely. The indirect fluorescent antibody technique is a rapid and sensitive method for detecting antibodies and the procedure lends itself to use in diagnostic laboratories. In addition to the above viruses the presence or absence of antibodies to bovine coronavirus and bovine adenovirus 3 were determined by the indirect fluorescent antibody technique in thoracic fluids from 100 aborted fetuses and 50 nonaborted fetuses. Results on these samples were not compared to hemagglutination inhibition or serum neutralization as the condition of fluid samples from aborted fetuses renders interpretation of such tests unreliable. Antibodies to one or more viruses were detected in 30 of the 100 aborted fetuses and in seven of the 50 nonaborted fetuses. Antibodies to more than one agent were detected in eleven of the 100 aborted and in one of the 50 nonaborted fetuses. Reasons for this occurrence and application of the test in determination of causes of abortion are discussed.
Miller, R B; Wilkie, B N
For a long time in human history, global population growth was checked by infant mortality, which ranged from 30-50% and did not start sinking until the beginning of the 1800s in the west. Child murder in the west was prohibited by law around the 1100-1200s, but it continued secretly. Among private people, induced abortion was allowed. In the holy scripts of Hinduism and Brahminism, abortion was prohibited. Hippocrates wrote that doctors should not give women abortifacient. The church father Augustinus stated that it was not within human power to discern when the soul entered the body, a circumstance that forbid abortion. A church meeting in 305 A.D. distanced itself from abortion, and this has been the stand of the Catholic Church ever since. In Sweden, exposing a child to the elements was practiced until the end of the 1200s, when it became prohibited. Protestants punished child murder by death. During 1759-78, 217 women were executed for child-killing. From the 1400s, church law punished abortion, and later, capital and punishment was meted out for it, but a distinction was made if the fetus was alive or stillborn. The law in 1734 punished abortion by the death of all concerned. The death penalty was abolished in 1864. In 1896, Anna Linholm reported to the policy in Uppsala that a midwife had been practicing clandestine abortions. Some of her patients were admitted to hospital for hemorrhaging. She was sentenced to hard labor. During 1851-1903, a total of 1408 abortions were reported to the health service. 90% of these became known because of death caused by obduction. Phosphorus was used for abortion in 1271 cases, arsenic in 62, and mechanical aids in 8 cases. About 1//2 of all female suicides at the end of the 1800s was performed by pregnant women who ate phosphorus. Almost all were unmarried, and 56% carried it out after the 5th month of pregnancy. In 1901, phosphorus was prohibited in Swedish homes. In 1875, free abortions became available. However, the ethical question about whether and when a fetus has a soul is more contemporary and relevant than ever. PMID:1618684
This paper considers whether state Medicaid abortion funding restrictions affect the likelihood of getting pregnant, having an abortion and bearing a child. We exploit a natural experiment afforded by Supreme Court decisions and employ more traditional multivariate models with alternative fixed effect specifications. An analysis of 12 years of state-level data indicate that restrictions are associated with a reduction in
Phillip B. Levine; Amy B. Trainor; David J. Zimmerman
The paper provides a short overview of key problems of medical ethics in the Russian and Soviet contexts--confidentiality, informed consent, human experimentation, abortion, euthanasia, organ and tissue transplantation, abuse of psychiatry. In Soviet ideology common interests were declared superior to private ones. Hence, medical confidentiality was viewed as a bourgeois survival. On the other hand, diagnosis was normally not disclosed to a patient in the case of an incurable disease (especially cancer). Due to the strong paternalistic traditions of Russian medicine the idea of informed consent is still disputed by many physicians. Abortions were first legalized in Soviet Russia in 1920. A brief history of this landmark event is provided. However, abortions were forbidden in 1936 and legalized again only in 1955. Active euthanasia was legalized in Soviet Russia in 1922 but for a short period. Federal law regulating human transplantation was adopted only in 1992 and based on the presumed consent model. Until then forensic autopsy and procurement of cadaver organs were viewed as equal procedures. In 1960s-1980s there was a practice of declaring political dissidents insane in their involuntary treatment. PMID:17044159
Lichterman, Boleslav L
Background In Curaçao is a high incidence of unintended pregnancies and induced abortions. Most of the induced abortions in Curaçao are on request of the woman and performed by general practitioners. In Curaçao, induced abortion is strictly prohibited, but since 1999 there has been a policy of connivance. We present data on the relevance of economic and socio-cultural factors for the high abortion-rates and the ineffective use of contraception. Methods Structured interviews to investigate knowledge and attitudes toward sexuality, contraception and abortion and reasons for ineffective use of contraceptives among women, visiting general practitioners. Results Of 158 women, 146 (92%) participated and 82% reported that their education on sexuality and about contraception was of good quality. However 'knowledge of reliable contraceptive methods' appeared to be - in almost 50% of the cases - false information, misjudgements or erroneous views on the chance of getting pregnant using coitus interruptus and about the reliability and health effects of oral contraceptive pills. Almost half of the interviewed women had incorrect or no knowledge about reliability of condom use and IUD. 42% of the respondents risked by their behavior an unplanned pregnancy. Most respondents considered abortion as an emergency procedure, not as contraception. Almost two third experienced emotional, physical or social problems after the abortion. Conclusions Respondents had a negative attitude toward reliable contraceptives due to socio-cultural determined ideas about health consequences and limited sexual education. Main economic factors were costs of contraceptive methods, because most health insurances in Curaçao do not cover contraceptives. To improve the effective use of reliable contraceptives, more adequate information should be given, targeting the wrong beliefs and false information. The government should encourage health insurance companies to reimburse contraceptives. Furthermore, improvement of counseling during the abortion procedure is important.
We study the collision avoidance between two aircraft flying in the same vertical plane: a host aircraft on a glide path and an intruder aircraft on a horizontal trajectory below that of the host aircraft and heading in the opposite direction. Assuming that the intruder aircraft is uncooperative, the host aircraft executes an optimal abort landing maneuver: it applies maximum thrust setting and maximum angle of attack lifting the flight path over the original path, thereby increasing the timewise minimum distance between the two aircraft and, in this way, avoiding the potential collision. In the presence of weak constraints on the aircraft and/or the environment, the angle of attack must be brought to the maximum value and kept there until the maximin point is reached. On the other hand, in the presence of strong constraints on the aircraft and the environment, desaturation of the angle of attack might have to take place before the maximin point is reached. This thesis includes four parts. In the first part, after an introduction and review of the available literature, we reformulate and solve the one-subarc Chebyshev maximin problem as a two-subarc Bolza-Pontryagin problem in which the avoidance and the recovery maneuvers are treated simultaneously. In the second part, we develop a guidance scheme (gamma guidance) capable of approximating the optimal trajectory in real time. In the third part, we present the algorithms employed to solve the one-subarc and two-subarc problems. In the fourth part, we decompose the two-subarc Bolza-Pontryagin problem into two one-subarc problems: the avoidance problem and the recovery problem, to be solved in sequence; remarkably, for problems where the ratio of total maneuver time to avoidance time is sufficiently large (?5), this simplified procedure predicts accurately the location of the maximin point as well as the maximin distance.
Abortion is a universal phenomenon, occurring throughout recorded history and at all levels of societal organization. Techniques are highly varied, as are the circumstances under which it is practised. The status of and attitudes towards abortion in Western civilization are variable and have, in most cases, been changing. As of 1982, 10% and 18% of the world's population respectively, lived in countries where abortion was totally prohibited or where it was permitted only to save the mother's life. In the USA, various national surveys indicate liberalization of public attitudes towards pregnancy termination between 1965 and the years immediately following the Roe v. Wade Supreme Court decision (1973) which legalized abortion. More recent polls demonstrate little attitudinal change since 1972-1973: between 80% and 90% of Americans approve of abortion in the case of poor health, a seriously defective fetus, or rape, and between 40% and 50% indicate approval for all other reasons as well. Only 10% of the American population would like to see abortion prohibited under all circumstances. Sociodemographic analyses indicate that individuals who disapprove of abortion differ from those who approve of its availability in that they are more likely to be Roman Catholic or fundamentalist Protestant; are, in general, more strongly committed to organized religion; are on the traditional/conservative end of the spectrum with regard to women's role in life, premarital sex, sex education and civil liberties; and tend to have achieved a relatively low educational level. 'Pro-life' and 'pro-choice' activists tend to be women who are completely different from one another in sociodemographic characteristics and in overall values, particularly as these relate to traditional versus modern female roles. PMID:3519038
Shain, R N
Article 14(2)(c) of the Protocol to the African Charter on the Rights of Women enjoins States Parties to take appropriate measures "to protect the reproductive rights of women by authorising medical abortion in cases of sexual assault, rape, incest, and where continued pregnancy endangers the mental and physical health of the mother or the life of the mother or the foetus." This paper considers the implications of Article 14 for access to safe, legal abortion. It is submitted that Article 14 has the potential to impact positively on regional abortion law, policy, and practice in 3 main areas. First, it takes forward the global consensus on combating abortion as a major public health danger. Second, it provides African countries with not just an incentive, but also an imperative for reforming abortion laws in a transparent manner. Third, if implemented in the context of a treaty that centers on the equality and non-discrimination of women, Article 14 has the potential to contribute toward transforming access to abortion from a crime and punishment model to a reproductive health model. PMID:20546748
Ngwena, Charles G
Access to abortion remains a controversial issue worldwide. In Ireland, both north and south, legal restrictions have resulted in thousands of women travelling to England and Wales and further afield to obtain abortions in the last decade alone, while others purchase the 'abortion pill' from Internet sources. This paper considers the socio-legal context in both jurisdictions, the data on those travelling to access abortion and the barriers to legal reform. It argues that moral conservatism in Ireland, north and south, has contributed to the restricted access to abortion, impacting on the experience of thousands of women, resulting in these individuals becoming 'abortion tourists'. PMID:24617662
Bloomer, Fiona; O'Dowd, Kellie
There will always be women who need abortions after 12 weeks of pregnancy, and their reasons are often compelling. Although second trimester abortions carry relatively more risks than first trimester abortions, abortion is still very safe throughout the second trimester if done in safe conditions. This paper is about law and policy on second trimester abortions, which are allowed on more restrictive grounds than first trimester abortions in most countries, if at all. It focuses on countries where most or at least some second trimester abortions are allowed, including in Europe, where many women are still forced to travel for second trimester abortions, and countries in the developing world, where most second trimester abortions remain unsafe. The need for second trimester abortion should be met in a safe, timely and sympathetic manner. Abortion should be legal at the woman's request up to 24 weeks and on therapeutic grounds after that, and no other barriers or hurdles should be imposed on women seeking second trimester abortion. In-depth, country-based research is needed, to bring out the facts on second trimester abortion, as evidence of why it should be treated as a legitimate form of women's health care and supported in public health policy. PMID:18772078
Although abortions are common, few researchers have explored the experiences of women related to abortions. The aim of this qualitative study was to analyse women's experiences of induced abortion from a feminist perspective. Five women aged 19-33 years were interviewed about 1 month after their abortion. The interviews were analysed using thematic content analysis from which the following themes were identified: experiences connected with the decision-making process, experiences connected with the abortion and experiences after the abortion. Childhood experiences of divided families, financial problems, being too young, and an insecure partnership influenced the women's decision to have an abortion. Ambivalence about abortion was strongly expressed throughout the process. Despite positive attitudes towards abortion in general, the women had negative attitudes towards their own abortion. They described receiving most support from their mothers and friends, in the decision-making process, and least from their partners. After the abortion the women gained a feeling of maturity and experience although their ambivalence persisted. One conclusion drawn from our study is that nurses and midwives need to be aware of women's complex experiences with abortions in order to support and empower women who seek an abortion. PMID:15147479
Aléx, Lena; Hammarström, Anne
The number of pregnancies and induced abortions among Japanese teenagers has recently increased. 2 of 5 pregnant single women whom social workers assist are teenagers. The teenagers fall into 2 groups: those under 18, who are in a sexually awakening period, or 18 and older, who are maturing. Those under 18, despite a strong tendency toward sexual activity, are predominantly insecure and run away from home to escape adversity and seek friendship among members of the opposite sex. After becoming pregnant, they go home only to embarrass their parents. Ultimately, they choose abortion or, because of their own inability, their babies are taken care of by their families or in foster homes. Those 18 or older, despite their knowledge of the relationship between sexual intercourse and pregnancy, typically did not take it seriously. Consequently, their reaction to their pregnancies tends toward shock and panic. Many try to keep their pregnancy from their parents. Though they do not want abortion, their circumstances may force them to it. Behind the increase of unexpected pregnancy and unwanted abortion in both age groups are several factors: the lack of sexual education suitable to their level of their physical maturity; a lack of responsibility by the male teenagers, who cannot relate their own actions to their partners' pregnancies; and the ignorance of pregnant teenagers, who cannot see that abortions may hurt them not only physically but mentally in the long run. PMID:3854863
BACKGROUND: The aim of this study was to assess the effectiveness of neuroendoscopy compared with non-neuroendoscopic procedures for treating patients with arachnoid membrane cysts in the lateral ventricles. METHODS: The medical records of 28 patients with arachnoid membrane cysts in the lateral ventricles who were treated with neuroendoscopy and 39 such patients treated with non-neuroendoscopic techniques using classic treatment procedures were reviewed. The neuroendoscopic approach combined craniotomy, corticectomy, lesion resection and cyst ventriculostomy or cyst cisternostomy to restore normal cerebrospinal fluid circulation. The non-neuroendoscopic techniques included craniotomy, corticectomy, and lesion resection performed under a microscope. Clinical outcomes of symptoms and cyst size change on imaging were compared between the two treatment groups during follow-up (range: 1--5 years). RESULTS: Patients in the neuroendoscopy group had significantly less blood loss (P < 0.001) and shorter operative time (P < 0.001), better marked improvement in symptoms (64.3% vs. 5.1%, respectively), and a higher total resection rate (92.9% vs. 66.7%; P = 0.011) compared with the patients in the non-neuroendoscopy group. In the neuroendoscopy group there was no cyst recurrence whereas in the non-neuroendoscopy group 8 (20.5%) patients had cyst recurrence. However, all patients in the neuroendoscopy group had postoperative transient fever and 8 (28.6%) patients had subdural fluid accumulation which was treated and subsequently resolved during follow-up. These symptoms did not occur in the non-neuroendoscopy group. CONCLUSION: We found that neuroendoscopic therapy for arachnoid cysts in the lateral ventricles was more efficacious than non-neuroendoscopic methods. Our results indicate that neuroendoscopy may produce better clinical outcomes than non-neuroendoscopic procedures in treating patients with arachnoid cysts in the lateral ventricles. PMID:23763938
Zhao, Peng; Wang, Xinsheng; Li, Chuzhong; Gui, Songbai; Zong, Xuyi; Zhang, Yazhuo
Introduction This analysis explores the association between elements of surgical efficiency in voluntary medical male circumcision (VMMC), quality of surgical technique, and the amount of time required to conduct VMMC procedures in actual field settings. Efficiency outcomes are defined in terms of the primary provider’s time with the client (PPTC) and total elapsed operating time (TEOT). Methods Two serial cross-sectional surveys of VMMC sites were conducted in Kenya, Republic of South Africa, Tanzania and Zimbabwe in 2011 and 2012. Trained clinicians observed quality of surgical technique and timed 9 steps in the VMMC procedure. Four elements of efficiency (task-shifting, task-sharing [of suturing], rotation among multiple surgical beds, and use of electrocautery) and quality of surgical technique were assessed as explanatory variables. Mann Whitney and Kruskal Wallis tests were used in the bivariate analysis and linear regression models for the multivariate analyses to test the relationship between these five explanatory variables and two outcomes: PPTC and TEOT. The VMMC procedure TEOT and PPTC averaged 23–25 minutes and 6–15 minutes, respectively, across the four countries and two years. The data showed time savings from task-sharing in suturing and use of electrocautery in South Africa and Zimbabwe (where task-shifting is not authorized). After adjusting for confounders, results demonstrated that having a secondary provider complete suturing and use of electrocautery reduced PPTC. Factors related to TEOT varied by country and year, but task-sharing of suturing and/or electrocautery were significant in two countries. Quality of surgical technique was not significantly related to PPTC or TEOT, except for South Africa in 2012 where higher quality was associated with lower TEOT. Conclusions SYMMACS data confirm the efficiency benefits of task-sharing of suturing and use of electrocautery for decreasing TEOT. Reduced TEOT and PPTC in high volume setting did not result in decreased quality of surgical care.
Rech, Dino; Bertrand, Jane T.; Thomas, Nicholas; Farrell, Margaret; Reed, Jason; Frade, Sasha; Samkange, Christopher; Obiero, Walter; Agot, Kawango; Mahler, Hally; Castor, Delivette; Njeuhmeli, Emmanuel
Prenatal diagnosis is increasingly common. Whereas amniocentesis is typically performed in the second trimester, chorionic villus sampling (CVS) is a first-trimester procedure, which makes an earlier, safer abortion possible. However, CVS carries a slightly higher risk of miscarriage and other complications. In choosing a procedure, couples (with the aid of genetic counseling) must weigh the risks of miscarriage against the odds and implications of an abnormal diagnosis. Interviews with women who decided on abortions after amniocentesis or CVS and meetings with genetic counselors indicate that both types of abortion are more traumatic than is commonly realized. Both dash dreams and hopes. Termination after amniocentesis also forces the mother to take an active part in the life and death of a nearly viable fetus. Yet, because abortions for fetal abnormality are statistically rare, there is little societal understanding and minimal support for those who experience them. This is true of health care workers as well as for the couple's primary support group. PMID:8138469
Kolker, A; Burke, B M
As for most of its Caribbean neighbours, Trinidad and Tobago's leading cause of maternal morbidity is unsafe abortion. Yet activism to introduce public policy and legislation that effectively address this aspect of women's reproductive rights and health has been met with public outcry. With almost hysterical opposition coming from certain religious quarters, there is the unsubstantiated impression that Trinidadians are overwhelmingly opposed to abortion law reform. A national survey was therefore carried out of people's knowledge and views on the current abortion law in Trinidad and Tobago. The survey found that although almost half of respondents had an unfavourable perception of abortion, more than half of them were in favour of broadening the legal grounds for accessing terminations. Incest, rape and danger to a woman's life were cited as the most significant circumstances under which abortions should be permitted. The vast majority of respondents agreed that voting on abortion law reform by members of the legislature should not be based on personal beliefs. The findings demonstrate that there is not the degree of opposition to abortion law reform that is widely assumed. On the other hand, given the wide variance of views and perceptions, we argue that public health concerns and human rights should always trump public opinion. PMID:17512381
Martin, Cedriann J; Hyacenth, Glennis; Suite, Lynette Seebaran
Approximately 9 months after a legal therapeutic abortion, 188 Canadian women were interviewed. One half were single and the rest were married, separated or divorced. They were matched closely for a number of demographic variables with control women who had not had abortions. Neurotic disturbance in several areas of personality functioning was assessed from questionnaire responses. Out of 27 psychological scales, differences between the abortion and control groups were found on only 3: in general, women who had had abortions were more rebellious than control women, abortion tended to be associated with somewhat greater depression in married women, and single women who had had abortions scored higher on the shallow-affect scale. However, all the personality scores were well within the normal range. Perceived social support was strongly associated with favourable psychological reactions after abortion. Use of contraceptives improved greatly after the abortion, when over 90% of women reported using contraceptives regularly.
Greenglass, E. R.
... to offer abortion services to women. • The Federal Freedom of Access to Clinic Entrances (FACE) Act was ... Brief, 2008. 15 Gostin LO. Abortion politics: Clinical freedom, trust in the Judiciary, and the autonomy of ...
The history of the past 16 years has borne out pro-life predictions that abortion would be the precursor of an even wider assault on helpless people. The unborn initially were the victim of choice because they were, in 1973, outside our customary line of moral vision. But as a dress rehearsal for a pattern of discretionary killing what was most significant about abortion was its explicit rejection of the Declaration of Independence's principle holding that our right to life is "inalienable." Abortion taught us that the lives of some are alienable and raised the question, why not the lives of others? Contrary to stereotype, the pro-life movement is a classic reform movement, inbued with a fierce belief in the inherent worth and equality of mankind. PMID:10294688
The United Nations Population Information Network (POPIN) has recently published a collection of data tables that outline the abortion policies for regions and nations around the world. The tables display the grounds on which abortion is legally permitted, as well as national and international data on abortion rates, total fertility rates (births per woman), maternal mortality ratio (per 100,000 live births), and the rate of contraceptive use by married women. The data are divided into six regional tables (Africa, Asia, Europe, Latin America and the Caribbean, Northern America, and Oceania). Each regional table is organized by geographic area (e.g., Eastern Asia, Southeastern Asia, South Central Asia, and Western Asia) to facilitate comparisons.
There is a fundamental inconsistency in Western society's treatment of non-human animals on the one hand, and of human foetuses on the other. While most Western countries allow the butchering of animals and their use in experimentation, this must occur under carefully controlled conditions that are intended to minimize their pain and suffering as much as possible. At the same time, most Western countries permit various abortion methods without similar concerns for the developing fetus. The only criteria for deciding which abortion method is used centre in the stage of the pregnancy, the size of the fetus, the health of the pregnant woman and the physician's preference. This is out of step with the underlying ethos of animal cruelty legislation, cannot be justified ethically and should be rectified by adjusting abortion methods to the capacity of the fetus to experience nociception and/or pain. PMID:23076345
Kluge, Eike-Henner W
The prophylactic use of Rh immune globulin has been a medical success, protecting women who could be at risk from exposure to the Rh(D) antigen. Thus, it is not surprising that Rh(D) immunoprophylaxis has been extended from women with term pregnancies to all women with miscarriages, abortions, and ectopic pregnancies. In this article we review the existing medical literature to assess the risks of fetomaternal hemorrhage and Rh isoimmunization after complications of a first-trimester pregnancy, induced abortion, or ectopic pregnancy. The evidence to support the use of Rh immune globulin in the first trimester is sparse, but there is theoretic evidence of its necessity. Despite weak evidence to support its use, there is little risk. PMID:12634631
Jabara, Sami; Barnhart, Kurt T
Over the past several years, Fermilab has been operating with a single turn proton abort system in both the superconducting Tevatron and the conventional Main Ring. The abort kicker power supply for this system discharges a lumped capacitance into the inductive magnet load, causing the beam to enter the abort channel. The characteristics of this current waveform are defined by the requirements of the machine operation. The standard fixed target running mode calls for 12 booster batches of beam which leaves a rotating gap in the beams of approx.1.8 ..mu..s. The current waveform is required to rise to 90% of I/sub max/ in this time to avoid beam loss from partially deflected beam. Aperture limitations in both the accelerator and the abort channel demand that the current in the magnets stays above this 90% I/sub max/ for the 21 ..mu..s needed to ensure all the beam has left the machine. The 25 mm displacement needed to cleanly enter the abort channel at 1 TeV corresponds to a maximum current in each of the 4 modules of approx.20 kA. Similar constraints are needed for the Main Ring and Tevatron antiproton abort systems. A unique feature of this design is the high voltage, high current diode assembly used to clip the recharge of the capacitor bank. This allows the current to decay slowly with the L/R time constant of the magnet and diode series combination. Special attention is given to the diode characteristics needed for this passive switching element. Operational experience and proposed upgrades are given for the two operational systems. 2 refs., 4 figs., 1 tab.
Krafczyk, G.; Dugan, G.; Harrison, M.; Koepke, K.; Tilles, E.
In countries where data on induced abortion are underreported or nonexistent—such as the Philippines and Bangladesh—indirect estimation techniques may be used to approximate the level of abortion. The collection of data about women hospitalized for abortion complications and the use of such indirect estimation techniques indicates that the abortion rate in the Philip- pines is within the range of 20-30
Susheela Singh; Josefina V. Cabigon; Altaf Hossain; Haidary Kamal; Aurora E. Perez
Kicker magnets typically represent the most important contributors to the transverse impedance budget of accelerators and storage rings. Methods of reducing the impedance value of the SNS extraction kicker presently under construction and, in view of a future performance upgrade, that of the RHIC abort kicker have been thoroughly studied at this laboratory. In this paper, the investigation of a potential improvement from using ferrite different from the BNL standard CMD5005 is reported. Permeability measurements of several ferrite types have been performed. Measurements on two kicker magnets using CMD5005 and C2050 suggest that the impedance of a magnet without external resistive damping, such as the RHIC abort kicker, would benefit.
Background and Objectives: We performed two retrospective chart surveys, the first of 200 con- secutive hospital emergency visits for spontaneous abortion and the second in 33 family physi- cians' offices examining 245 patients with spontaneous abortions. This study determined the rate of surgical management of spontaneous abortions within family practices and hospitals, as well as the rate of referrals and
Ellen Wiebe; Patricia Janssen
Objective: To determine the pregnancy outcome following a previous spontaneous abortion (miscarriage). Method: A prospective cohort study was done on 300 gravida-2 patients: 200 patients (case group) whose previous pregnancy was spontaneously aborted (early abortion), and 100 patients (control group) whose previous pregnancy went to term and a live fetus was delivered. All the patients were followed until delivery, and
M. Kashanian; A. R. Akbarian; H. Baradaran; S. H. Shabandoust
Utilizing data from Edmonton Area Surveys of 1977, 1984, and 1987, this paper examines the attitudes of Canadian men toward the contentious issue of abortion. Respondents were presented with various different circumstances for abortion and asked to indicate the conditions in which they feel women ought to or ought not to be allowed to obtain a legal abortion. Findings reveal
BACKGROUND: The mechanisms of abortion induced by bacterial infection are largely unknown. In the present study, we investigated abortion induced by Brucella abortus, a causative agent of brucellosis and facultative intracellular pathogen, in a mouse model. RESULTS: High rates of abortion were observed for bacterial infection on day 4.5 of gestation, but not for other days. Regardless of whether fetuses
Suk Kim; Dong Soo Lee; Kenta Watanabe; Hidefumi Furuoka; Hiroshi Suzuki; Masahisa Watarai
Objective: To use the molecular identification of Y chromosome material in products of conception cytogenetically diagnosed as “46,XX” to confirm the occurrence of inaccurate cytogenetic test results most likely attributable to maternal cell contamination.Design: Retrospective analysis.Setting: Academic medical center.Patient(s): Thirty-four archival tissues from cases of spontaneous abortion with a “46,XX” karyotype based on cytogenetic analysis.Intervention(s): Maternal and villus DNA were
Karen A Bell; Peter G Van Deerlin; Bassem R Haddad; Ronald F Feinberg
Bovine abortion is a limiting factor for dairy business, as it decreases milk production and the potential, number of herd replacements, increases feeding and medical treatment costs, increases the number of artificial inseminations to obtain a calf as well as culling rates of cows. An estimation of the economic impact of abortion in dairy farms in Chile is not available yet. The aim of this study was to estimate the economic consequences of bovine abortion syndrome (BAS) in dairy cows from Chile. A stochastic model was proposed to evaluate the cost of an abortion on a yearly basis to include variability in cost and income by dairy and by year. The marginal total net revenue (?TNR) for a typical, lactation was obtained by the calculating the difference between total revenues (retail milk and calf sales) and total expenses (production cost (cows, feeding, labor, health) plus administrative and, general costs) for lactation with and without abortion. Production data were obtained from a retrospective study of 127 dairy herds located in southern Chile between 2000 and 2006. Milk production from cows with and without abortion was estimated by a mixed model using milk test day data. Production cost and prices paid to farmers were obtained from service company records (TODOAGRO S.A.). Cost and income value was corrected for inflation and expressed in the values from 2006. In addition, a separate analysis for different parities (1, 2, 3 or more) was performed. Distributions for the stochastic variables were obtained by fitting distributions from our database using @Risk. The stochastic variables included in the analysis were all related to income, feeding, depreciation, health, Artificial Insemination and general costs like fuel, salaries, taxes, etc. There was a high probability (89.20%) of a negative ?TNR in lactations with abortion for overall, parities, with a mean loss of $ -143.32. Stratifying by parity, the predicted mean of the distribution for ?TNR in each parity (1, 2, 3 or more) was also negative and the probability of a negative ?TNR was 89.40%, 95.30% and 97.00%, respectively, but differs between them (p<0.05). For parity 1, mean ?TNR was $ -120.92, parity 2 $ -116.35 and for parities ?3 it was $ -132.26 and the mean was statistically different from the others (p<0.05). The age of culled cows was the input variable most correlated with TNR and dairy production was the second. However, the sale price of milk resulted in a low correlation with abortion cost. PMID:20800301
Gädicke, P; Vidal, R; Monti, G
The protozoa Neospora caninum is an important cause of bovine abortion world-wide. The objective of this survey was to determine the distribution pattern of infectious abortion in Southern Brazil with special reference to N. caninum infection. A total of 161 bovine aborted fetuses from 149 farms were analysed during a 1.5 year period. The cause of abortion was identified in 51.5% of cases. Overall, 23% (37/161) of the fetuses were considered to be infected with N. caninum. Bacterial infection accounted for 17.4% (28/161) of cases, fungal infection for 3.1% (5/161) of cases and viral aetiology for 1.8% (3/161). Six fetuses had concurrent infection with N. caninum and Leptospira spp. Data from 111 fetuses and the respective aborted cows were analysed to investigate the association between previous abortion and current N. caninum infection. The prevalence of N. caninum-infected fetuses from cows with and without a history of previous abortion was 44% (11/25) and 24.4% (21/86), respectively. Cows aborting a N. caninum-infected fetuses were 2.4 times more likely to have aborted previously than cows aborting for other reasons (95% CI of odds ratio=0.9-6.8, P=0.06). PMID:16772136
Corbellini, Luis G; Pescador, Caroline A; Frantz, Fernanda; Wunder, Elsio; Steffen, David; Smith, David R; Driemeier, David
The origins of the International Federation of Gynecology and Obstetrics (FIGO) Initiative for the Prevention of Unsafe Abortion and its Consequences began in 1969 when a young British medical student encountered a young woman in Canada with complications of unsafe abortion. Through evolving understanding of the context of women's lives, including the role of family planning and access to safe abortion globally in preventing the deaths and imprisonment of women, I was able to contribute to FIGO's advocacy through a collaborative initiative with country-led action plans based on a situational analysis. Forty-six member associations rapidly agreed to participate with results of situational analyses-an unprecedented result in FIGO's history. Professor Anibal Faúndes' role has been pivotal to the success of this initiative, including the establishment of a working group of regional coordinators and collaborating agencies to oversee the implementation of action plans involving in-country partners and the Ministry of Health. Deaths from unsafe abortion and its complications are preventable. PMID:24745693
On May 16, 1994, the French manufacturer of the abortifacient drug RU-486 donated its US patent rights to the Population Council, an international nonprofit research organization. The manufacturer, Roussel-Uclaf, took this step largely due to fears that US anti-abortion groups would follow through on threats to boycott other products from the corporation. Clinical trials involving 2000 women from 12 US sites will begin in Fall 1994 and application to the US Food and Drug Administration will follow. If the safety and efficacy of RU-486 are documented, as they have been in European clinical trials, the drug could be available to US women by 1996. The Clinton Administration has hailed this step as a means of providing US women with a nonsurgical alternative to abortion. Abortion opponents, on the other hand, have characterized RU-486 as a form of "baby poisoning" and express concerns that women injured by the drug will be ineligible for financial compensation given the Population Council's nonprofit status. Strict distribution and use conditions are expected. In Europe, RU-486 is dispensed in a physician's office or clinic. The woman returns 2 days later for a dose of prostaglandin and remains in the medical facility until the abortion is complete. PMID:12287701
For human spaceflight missions, a launch vehicle failure poses the challenge of returning the crew safely to earth through environments that are often much more stressful than the nominal mission. Manned spaceflight vehicles require continuous abort capability throughout the ascent trajectory to protect the crew in the event of a failure of the launch vehicle. To provide continuous abort coverage during the ascent trajectory, different types of Orion abort modes have been developed. If a launch vehicle failure occurs, the crew must be able to quickly and accurately determine the appropriate abort mode to execute. Early in the ascent, while the Launch Abort System (LAS) is attached, abort mode selection is trivial, and any failures will result in a LAS abort. For failures after LAS jettison, the Service Module (SM) effectors are employed to perform abort maneuvers. Several different SM abort mode options are available depending on the current vehicle location and energy state. During this region of flight the selection of the abort mode that maximizes the survivability of the crew becomes non-trivial. To provide the most accurate and timely information to the crew and the onboard abort decision logic, on-board algorithms have been developed to propagate the abort trajectories based on the current launch vehicle performance and to predict the current abort capability of the Orion vehicle. This paper will provide an overview of the algorithm architecture for determining abort achievability as well as the scalar integration scheme that makes the onboard computation possible. Extension of the algorithm to assessing abort coverage impacts from Orion design modifications and launch vehicle trajectory modifications is also presented.
Tedesco, Mark B.
The paper argues that the women's movement has failed to adequately take account of women with disabilities. By supporting women's right to abortions for handicapped fetuses, the movement denies disabled women an identity as equal human beings worthy of respect. (JDD)
Findings from empirical research differ greatly from the Supreme Court's assumptions about psychological factors in adolescent abortion. Psychologists should preserve adolescent clients' privacy in counseling about pregnancy-related decisions. Government should encourage counseling services for pregnant adolescents and research on psychological…
American Psychologist, 1987
Confined placental chorionic mosaicism is reported in 2% of viable pregnancies cytogenetically analyzed on chorionic villi samplings (CVS) at 9–12 weeks of gestation. In follow-up studies this mosaicism has been shown to be associated with increased frequency of second and third trimester pregnancy loss or intrauterine fetal growth retardation. We have studied 54 spontaneous abortions (SA) for the detection of
Dagmar K. Kalousek; Irene J. Barrette; Antia B. Gärtner
Data from a cytogenetic survey of spontaneous abortions were examined to determine the incidence and origin of mosaic trisomies in this population. The overall frequency of mosaicism among trisomies was approximately 5%, but the level of mosaicism varied significantly among trisomies, being much higher for the nonacrocentric than for the acrocentric trisomies. Evidence from chromosome heteromorphism analysis suggests that the
Terry Hassold; John A. Burns
Lymphoedema-distichiasis syndrome, a type of familial lymphoedema praecox, is a rare, primary lymphoedema of pubertal onset associated with distichiasis and other associations including congenital heart disease, ptosis, varicose veins, cleft palate, and spinal extradural cysts. We report a case of familial lymphoedema with associated distichiasis, atrial septal defect, varicose veins, and recurrent abortions in a 29-year-old female. PMID:23806988
Sardesai, Vidyadhar R; Mhatre, Madhulika A; Patil, Rohan M
The struggle within Roman Catholicism over contraception, and the struggle which is likely to arise over abortion, reflect a mixture of theological and social change. The challenge to papal authority inherent in the dissent from Pope Paul's encyclical on birth control is bound to have pro found ramifications in the church. At the same time, however, the fact of Catholic
OBJECTIVES: To assess the association between petrochemical exposure and spontaneous abortion, a retrospective epidemiological study in a large petrochemical complex in Beijing, China was conducted. METHODS: Plant employment records identified 3105 women who were married, were 20-44 years of age, and had never smoked. Of those, 3070 women (98.8%) reported at least one pregnancy. From this group, 2853 (93%) of
X. Xu; S. I. Cho; M. Sammel; L. You; S. Cui; Y. Huang; G. Ma; C. Padungtod; L. Pothier; T. Niu; D. Christiani; T. Smith; L. Ryan; L. Wang
Kicker magnets typically represent the most important contributors to the transverse impedance budget of accelerators and storage rings. Methods of reducing the impedance value of the SNS extraction kicker presently under construction and, in view of a future performance upgrade, that of the RHIC abort kicker have been thoroughly studied at this laboratory. In this paper, the investigation of a
H. HAHN; D. DAVINO
Recurrent spontaneous abortion (RSA) is defined as three or more consecutive pregnancy losses prior to the 20th week of gestation. The etiology of recurrent spontaneous abortion is often unclear and may be multifactorial, with much controversy regarding diagnosis and treatment. Reasonably accepted etiologic causes include, genetics, anatomical, endocrine, placental anomalies, hormonal problems, infection, smoking and alcohol consumption, exposure to environmental factors, psychological trauma and stressful life event, certain coagulation and immunoregulatory protein defects. Detection of an abnormality in any of these areas may result into specific therapeutic measures, with varying degrees of success. However, the majority of cases of RSA remains unexplained and is found to be associated with certain autoimmune (APA, ANA, ACA, ATA, AECA) and alloimmune (APCA, Ab2, MLR-Bf) antibodies that may play major role in the immunologic failure of pregnancy and may lead to abortion. Alteration in the expression of HLA-G molecules, T-helper-1 (Th-1) pattern of cytokines and natural killer (NK) cells activity may also induce abortion. Various forms of treatment like antithrombotic therapies such as aspirin and heparin, intravenous immunoglobulin (IVIg) therapy, immunotherapy with paternal lymphocytes and vitamin D3 therapy are effective mode of treatment for unexplained cause of fetal loss in women with RSA. PMID:15906053
Pandey, Manoj Kumar; Rani, Reena; Agrawal, Suraksha
To assess the relationship between hemostatic factors and spontaneous abortion, 134 pregnant women presenting to the emergency department were recruited and followed through 22 weeks' gestation. Cases were women experiencing a spontaneous abortion and controls were women who maintained their pregnancy. Fibrinogen, factor VII antigen, activated protein C-sensitivity ratio (APC-SR), protein S, and plasmin-antiplasmin (PAP) were measured. Cases had lower mean levels of fibrinogen and factor VII antigen compared with controls (3.1 g/L vs. 3.7 g/L and 89% of normal vs. 109% of normal, respectively). Regression analyses found that women with fibrinogen levels below 3.0 g/L had a five-fold increased risk of spontaneous abortion (OR = 5.1, 95% CI: 1.8-14.4) and women with factor VII antigen levels below 94% of normal had a threefold increased risk of spontaneous abortion normal (OR = 3.3, 95% CI: 1.2-8.5). Similar mean levels of APC-SR, protein S, and PAP were found in the two groups. PMID:11444363
Nelson, D B; Ness, R B; Grisso, J A; Cushman, M
Scott and Scherer recently pointed out that existing locking algorithms do not meet a need that arises in practical systems. Specifically, database systems and real time systems need mutual exclusion locks that support the abort capability, which makes it possible for a process that waits \\
Data were obtained from the 1975 National Fertility Study concerning the acceptability of abortion, based largely on reinterviews with respondents from the 1970 sample. Using these data, aggregate trends over time and patterns of change for individuals have been analyzed. (BB)
Jones, Elise F.; Westoff, Charles F.
? Helcococcus ovis as a potential novel cause of bovine abortion ? Mannheimia haemolytica pneumonia in lambs ? Glässer's disease in growing pigs ? Fibroma in an alpaca ? Pullorum disease in backyard flocks These are among matters discussed in the Animal Health and Veterinary Laboratories Agency's (AHVLA's) disease surveillance report for April 2014. PMID:25013196
A sample of 52 spontaneous blighted ovum abortions (BO) was examined cytogenetically and compared with a sample of abortions with echographic evidence of the embryo (AE). Abnormal karyotypes were 67% in the BO sample and 53% in the AE sample, a non significant difference. In the BO abortions trisomies were 74% of the abnormal karyotypes but 35% in the AE abortion, and the 45,X karyotype was absent among the BO but was found in 10 cases of AE. The prevalence of trisomies 16 and 22 in the BO abortions indicates that genes on these chromosome may be responsible for the early arrest of embryonic development. PMID:8215215
Minelli, E; Buchi, C; Granata, P; Meroni, E; Righi, R; Portentoso, P; Giudici, A; Ercoli, A; Sartor, M G; Rossi, A
The Crew Exploration Vehicle (CEV) is required to maintain continuous abort capability from lift off through destination arrival. This requirement is driven by the desire to provide the capability to safely return the crew to Earth after failure scenarios during the various phases of the mission. This paper addresses abort trajectory design considerations, concept of operations and guidance algorithm prototypes for the portion of the ascent trajectory following nominal jettison of the Launch Abort System (LAS) until safe orbit insertion. Factors such as abort system performance, crew load limits, natural environments, crew recovery, and vehicle element disposal were investigated to determine how to achieve continuous vehicle abort capability.
Tedesco, Mark B.; Evans, Bryan M.; Merritt, Deborah S.; Falck, Robert D.
The birth rate is a major concern in contemporary society today. Socialist countries having the material wherewithal and cultural wealth to maintain their populations have a genuine interest in population growth and maternity is therefore encouraged. The decision to have children lies with each individual family and does not involve society directly, except for the significant number of women who regulate their family size by having an abortion. In connection with the severity of such an intervention, a study of social and hygienic aspects of induced abortion was conducted in Odessa. The information was gathered anonymously among women who came to the gynecological department of a city hospital. 6.1% of the women were under age 20 and this figure may increase in the future. In the U.S. that figure already constitutes 1/3 of all abortions. 47.5% said they had had 3 previous abortions. 13.4% had no children, and 48.8% had 1 child. None of the women with no children thought of that as being the ideal. As reason for the abortion 31.7% gave irregular housing and living conditions, 12.2% unsatisfactory material well-being, 17.1% health reasons, 7.3% enough children already in the family, and 7.3% sickness of children and husband. In 24.4% of cases the husband was indifferent, and in 35.4% insisted on, and in 40.1% was against the woman having an abortion. 60% were thus probably poorly informed about the harmfulness of the operation. 39% of women did not use any contraception. Only 20% had received any information regarding contraceptives. Only 1/3 of obstetricians regularly instruct their patients about the use of contraceptives. Half of the nurses do not touch upon the subject due to lack of time and since instruction in birth control methods is not considered obligatory. Nevertheless it is important for women's health that during clinical examinations risk factors of abortion and the purposefulness of contraception are pointed out. PMID:3367727
Zakharchenko, E M; Popov, V E
The Large Hadron Collider (LHC) beam-dump system relies on extraction kickers that need 3 microseconds to rise to their nominal field. Since particles transiting the kickers during the rise will not be dumped properly, the proton population in this interval must always remain below quench and damage limits. A specific monitor to measure the particle population of this gap has been designed based on the detection of synchrotron radiation using a gated photomultiplier. Since the quench and damage limits change with the beam energy, the acceptable population in the abort gap and the settings of the monitor must adapt accordingly. This paper presents the design of the monitor, the calibration procedure and the detector performance with beam.
Lefevre, Thibaut; /CERN; Bart Pedersen, Stephane; /CERN; Boccardi, Andrea; /CERN; Bravin, Enrico; /CERN; Goldblatt, A.; /CERN; Jeff, Adam; /CERN; Roncarolo, Federico; /CERN; Fisher, Alan; /SLAC
This study examined the stigma of abortion and psychological implications of concealment among 442 women followed for 2 years from the day of their abortion. As predicted, women who felt stigmatized by abortion were more likely to feel a need to keep it a secret from family and friends. Secrecy was related positively to suppressing thoughts of the abortion and negatively to disclosing abortion-related emotions to others. Greater thought suppression was associated with experiencing more intrusive thoughts of the abortion. Both suppression and intrusive thoughts, in turn, were positively related to increases in psychological distress over time. Emotional disclosure moderated the association between intrusive thoughts and distress. Disclosure was associated with decreases in distress among women experiencing intrusive thoughts of their abortion, but was unrelated to distress among women not experiencing intrusive thoughts. PMID:10531670
Major, B; Gramzow, R H
Abortion remains a highly contentious moral issue, with the debate usually framed as a battle between the fetus's right to life and the woman's right to choose. Often overlooked in this debate is the impact of the concurrent legalization of abortion and the development of new prenatal screening tests on the birth prevalence of many inherited diseases. Most proponents of abortion support abortion for fetuses with severe congenital diseases, but there has unfortunately been, in our opinion, too little debate over the moral appropriateness of abortion for much less severe congenital conditions such as Down's syndrome, deafness, and dwarfism. Due to scientific advances, we are looking at a future in which prenatal diagnosis will be safer and more accurate, raising the specter, and the concomitant ethical concerns, of wholesale abortions. Herein, we present a reframing of the abortion debate that better encompasses these conditions and offers a more nuanced position. PMID:20561739
Jotkowitz, Alan; Zivotofsky, Ari Z
Preparing toddler for test/procedure; Test/procedure preparation - toddler; Preparing for a medical test or procedure - toddler ... Before the test, know that your child probably will cry. Even if you prepare, your child may feel some discomfort or ...
Background In March 2002, Nepal's Parliament approved legislation to permit abortion on request up to 12 weeks of pregnancy. Between 2004 and 2007, 176 comprehensive abortion care (CAC) service sites were established in Nepal, leading to a rise in safe, legal abortions. Though monitoring systems have been developed, reporting of complications has not always been complete or accurate. The purpose of this study was to report the frequency and type of abortion complications arising from CAC procedures in different types of facilities in Nepal. Methods A total of 7,386 CAC clients from a sample of facilities across Nepal were enrolled over a three-month period in 2008. Data collection included an initial health questionnaire at the time of abortion care and a follow-up questionnaire assessing complications, administered two weeks after the abortion procedure. A total of 7,007 women (95%) were successfully followed up. Complication rates were assessed overall and by facility type. Multivariable logistic regression was used to assess the association between experiencing a complication and client demographic and facility characteristics. Results Among the 7,007 clients who were successfully followed, only 1.87% (n = 131) experienced signs and symptoms of complications at the two-week follow up, the most common being retained products of conception (1.37%), suspected sepsis (0.39%), offensive discharge (0.51%) and moderate bleeding (0.26%). Women receiving care at non-governmental organization (NGO) facilities were less likely to experience complications than women at government facilities, adjusting for individual and facility characteristics (AOR = 0.18; 95% CI: 0.08-0.40). Compared to women receiving CAC at 4-5 weeks gestation, women at 10-12 weeks gestation were more likely to experience complications, adjusting for individual and facility characteristics (AOR = 4.21; 95% CI: 1.38-12.82). Conclusions The abortion complication rate in Nepali CAC facilities is low and similar to other settings; however, significant differences in complication rates were observed by facility type and gestational age. Interventions such as supportive supervision to improve providers' uterine evacuation skills and investment in equipment for infection control may lower complication rates in government facilities. In addition, there should be increased focus on early pregnancy detection and access to CAC services early in pregnancy in order to prevent complications.
The aerodynamic database for the Orion Launch Abort System (LAS) was developed largely from wind tunnel tests involving powered jet simulations of the rocket exhaust plumes, supported by computational fluid dynamics (CFD) simulations. The LAS contains three solid rocket motors used in various phases of an abort to provide propulsion, steering, and Launch Abort Tower (LAT) jettison from the Crew Module (CM). This paper describes a pair of wind tunnel experiments performed at transonic and supersonic speeds to determine the aerodynamic effects due to proximity and jet interactions during LAT jettison from the CM at the end of an abort. The tests were run using two different scale models at angles of attack from 150deg to 200deg , sideslip angles from -10deg to +10deg , and a range of powered thrust levels from the jettison motors to match various jet simulation parameters with flight values. Separation movements between the CM and LAT included axial and vertical translations as well as relative pitch angle between the two bodies. The paper details aspects of the model design, nozzle scaling methodology, instrumentation, testing procedures, and data reduction. Sample data are shown to highlight trends seen in the results.
Rhode, Matthew N.; Chan, David T.; Niskey, Charles J.; Wilson, Thomas M.
This report describes a study undertaken to assess student choices in medical ethical dilemmas. Medical ethical dilemmas are interpreted to include problems such as abortion, euthanasia, sterilization, experimentation on humans, allocation of scarce medical resources, and physician and health personnel training. The major purpose of the study was…
Woloshin, Phyllis Lerman
After 12 years, the US citizens elected a pro-choice president and preserved the already pro-choice Congress even though new people constitute 25% of the House of Representatives. The Congress gained even more pro-choice members. The abortion issue played an important secondary role (preceded by the economy) in the national elections, but was more important at the state level in many states. For example, voters overwhelmingly chose to preserve access to legal abortion in Arizona (69.31%) and Maryland (62.38%). In addition, 4 new women Senators and a Senator-elect from Colorado publicly proclaimed their pro-choice stance. The states of Missouri, North Carolina, and North Dakota elected pro-choice governors resulting in 30 pro-choice US governors and 20 antiabortion governors. President-elect Clinton can unilaterally repeal 2 of Bush's executive orders: the gag rule and the ban on fetal tissue transplantation research. He will need Congress' support to renew the Title X family planning program, to grant public funding for medically necessary abortions for poor women again, and the pass of the Freedom of Choice Act. Congress and the new president face the obstacle of convincing the public of the damage to basic rights done by the Supreme Court as evidenced by abortion rulings. They also need to lead the pro-choice groups to begin concentrating on how to prevent unwanted pregnancies so as to reduce the number of abortions and the needs of all women who want and need access to safe abortion. The Republican party's great hostility toward abortion and its intolerance for a variety of beliefs and life styles alienated most US citizens. Recent political losses are motivating the Republican party to reorganize but it depends on the moderates' ability and willingness to reclaim the party. PMID:12285933
Unsafe abortion is a very important public health issue in the Central America and Caribbean region, where the use of modern contraceptive methods remains low and the restrictive legal framework reduces access to safe abortion. The International Federation of Gynecology and Obstetrics (FIGO) Initiative for the Prevention of Unsafe Abortion and its Consequences is contributing toward resolving this problem by strengthening collaboration between medical societies, representatives of each country's Ministry of Health, and local and international agencies. In the 8 countries that decided to join this initiative in 2008, progress has been achieved in improving access to modern contraceptive methods, increasing the use of manual vacuum aspiration and misoprostol, and updating guidelines on postabortion care. PMID:24745695
de Gil, Marina Padilla
In a pilotstudy about medical, psychological and psychosocial factors in spontaneous and recurrent spontaneous abortions 47 women were investigated. 26 of them had one, 14 tow and 7 three or more recurrent spontaneous abortions. Etiologic factors were unknown in about 90% of the cases. Illnesses observed were allergies, thyroid diseases and infections. An influence of social and psychosocial factors could not be proved in our sample. Psychological relevant factors were higher levels of fear and depressive and evasive coping strategies in pregnancy. Certain personality traits (vulnerability, nervousness and tendency to psychosomatic reactions) were found in women with three or more recurrent abortions. All patients showed depressive reactions to pregnancy loss. In a further investigation well defined subgroups of patients shall be compared. The results can serve as guidelines in pregnancy counselling. PMID:3223117
Läpple, M; Krumbacher, K
It has been demonstrated that psychological and psychosocial factors are implicated in spontaneous and recurrent spontaneous abortions. According to these results we showed in our review, that certain psychological disorders, such as anxiety and nervousness, psychosomatic and personality disorders, negative attitude towards sexuality and pregnancy, parental conflicts and others may impair pregnancy outcome. Severe psychological and psychiatric problems prior to pregnancy were rarely evidenced, in opposite, depressive reactions after pregnancy loss frequently observed. The results suggest possible interactions between etiologic and psychoreactive parameters. Relations between nervous system and reproductive organs may explain influences of stress upon pregnancy outcome, as elevated stress hormones (catecholamines, cortisol) are able to reduce fetal vascularisation and oxygen supply and possibly induce labour and abortion. These observations are of interest, because in a considerable number of cases cannot be found. Adequate counseling and therapeutics may help overcome depressive reactions after pregnancy loss and avoid further complications. PMID:3071041
Läpple, M; Lukesch, H
Spontaneous abortion (SAb) is the most common complication of early pregnancy. Numerous risk factors are associated with an increased risk of pregnancy loss such as: Blighted ovum. The aim of this study was to determine the frequency of balanced chromosomal translocations in couples with a history of recurrent spontaneous abortions and ultrasound diagnosed blighted ovum. Sixty Eight couples with the history of spontaneous abortion (diagnosed blighted ovum) were selected and introduced into this survey during 2007-2012 at Medical Genetics department of Mashhad University of Medical Sciences. Giemsa banding technique was used to search for chromosomal balanced translocations. Demographic assessment has not shown any age difference between blighted ovum suffering couples and general population. Consanguineous marriages in blighted ovum suffering couples was significantly higher (P value <0.001) than non-consanguineous marriages (68.5% versus 31.5%), while in general population 62% of were non-consanguineous. The incidences of balanced chromosomal rearrangements as well as the rate of chromosome 9 inversion were 8.3 percent each, in non-consanguineous Blighted ovum suffering couples and the remaining (83.4%) showed normal karyotypes. There was no chromosome 9 inversion in consanguineous blighted ovum suffering couples and the incidence of balanced chromosomal rearrangements was 2.3%. With regard to relatively low incidence of balanced chromosomal rearrangements in consanguineous couples with blighted ovum, it would be reasonable to suggest that single gene determinants may play an important role in such pregnancy complications rather than chromosomal disorders. PMID:24551808
Shekoohi, Sahar; Mojarrad, Majid; Raoofian, Reza; Ahmadzadeh, Shahab; Mirzaie, Salmah; Hassanzadeh-Nazarabadi, Mohammad
This article presents estimates based on the research conducted in 2010 of the cost to the Ugandan health system of providing post-abortion care (PAC), filling a gap in knowledge of the cost of unsafe abortion. Thirty-nine public and private health facilities were sampled representing three levels of health care, and data were collected on drugs, supplies, material, personnel time and out-of-pocket expenses. In addition, direct non-medical costs in the form of overhead and capital costs were also measured. Our results show that the average annual PAC cost per client, across five types of abortion complications, was $131. The total cost of PAC nationally, including direct non-medical costs, was estimated to be $13.9 million per year. Satisfying all demand for PAC would raise the national cost to $20.8 million per year. This shows that PAC consumes a substantial portion of the total expenditure in reproductive health in Uganda. Investing more resources in family planning programmes to prevent unwanted and mistimed pregnancies would help reduce health systems costs.
Vlassoff, Michael; Mugisha, Frederick; Sundaram, Aparna; Bankole, Akinrinola; Singh, Susheela; Amanya, Leo; Kiggundu, Charles; Mirembe, Florence
Spontaneous abortion (SAb) is the most common complication of early pregnancy. Numerous risk factors are associated with an increased risk of pregnancy loss such as: Blighted ovum. The aim of this study was to determine the frequency of balanced chromosomal translocations in couples with a history of recurrent spontaneous abortions and ultrasound diagnosed blighted ovum. Sixty Eight couples with the history of spontaneous abortion (diagnosed blighted ovum) were selected and introduced into this survey during 2007-2012 at Medical Genetics department of Mashhad University of Medical Sciences. Giemsa banding technique was used to search for chromosomal balanced translocations. Demographic assessment has not shown any age difference between blighted ovum suffering couples and general population. Consanguineous marriages in blighted ovum suffering couples was significantly higher (P value <0.001) than non-consanguineous marriages (68.5% versus 31.5%), while in general population 62% of were non-consanguineous. The incidences of balanced chromosomal rearrangements as well as the rate of chromosome 9 inversion were 8.3 percent each, in non-consanguineous Blighted ovum suffering couples and the remaining (83.4%) showed normal karyotypes. There was no chromosome 9 inversion in consanguineous blighted ovum suffering couples and the incidence of balanced chromosomal rearrangements was 2.3%. With regard to relatively low incidence of balanced chromosomal rearrangements in consanguineous couples with blighted ovum, it would be reasonable to suggest that single gene determinants may play an important role in such pregnancy complications rather than chromosomal disorders.
Shekoohi, Sahar; Mojarrad, Majid; Raoofian, Reza; Ahmadzadeh, Shahab; Mirzaie, Salmah; Hassanzadeh-Nazarabadi, Mohammad
Pregnancy interruption before fetal viability limit is inherent to a multidisciplinary reflection, due to the conflicts involved. Portuguese laws have been altered along time in the way of women's health protection, allowing the needed information and support towards a free, informed and enlightened decision. Deontological determinants about health professionals towards abortion indicate the practice accordingly the law. Nevertheless, it is safeguarded their right to consciousness objection. Ethical discussion about abortion, in its different ways, includes the concern about the value of intrauterine human life, and also the respect for individual autonomy. Even though the debate about intrauterine human life moral status is viewed from different theories and points of view, it is concluded that different perspectives about this matter are acceptable, in an interpersonal diversity valorization point of view. PMID:22863486
Canário, Catarina; Figueiredo, Bárbara; Ricou, Miguel
We report two cases of women positive for anticardiolipin antibodies who experienced recurrent abortion whose husbands had isodicentric chromosome 15 aberrations who eventually had successful pregnancies. Two women were referred to our hospital due to their medical history of recurrent abortion. Both were diagnosed as being positive for anticardiolipin antibodies and their husbands with isodicentric chromosome 15. After both patients were treated with a Japanese herbal medicine (Sairei-to) and low-dose aspirin for the positive anticardiolipin antibodies, they delivered appropriate-for-date infants at term gestation. Although both husbands were revealed to have isodicentric chromosome 15, and coincidentally both wives were positive for anticardiolipin antibodies, their next pregnancies continued uneventfully as a result of the treatment. PMID:24888951
Nonaka, Taro; Ooki, Izumi; Enomoto, Takayuki; Takakuwa, Koichi
Recurrent spontaneous abortion (RSA) has various complicated causes, and more and more researches are focused on its etiology. Genetic factors are the most common risk factors of RSA; immune factors, infection factors, male factors and female factors play an important role; environmental pollution and some other unknown factors may also be conspirators. This article presents an overview on the possible risk factors of RSA. PMID:24010215
Gu, Chun-Hui; Liang, Wen-Jun; Fu, Lu-Lu; Zheng, Lian-Wen
Serological investigation by the indirect haemagglutination test forToxoplasma antibodies was carried out in a flock of dairy goats. Antibody titres ranging from 1:4 to 1:1,024 were found in 34% of 371 apparently healthy animals. High antibody titres of 1:256 suggestive of recent infection were noted in 18 (4.9%) animals including 13 nannies. The occurrence of a number of non-brucella abortions
M. B. Chhabra; R. M. Bhardwaj; O. P. Gautam; R. P. Gupta
New perspectives have been envisioned for the TOP instrumental technique, through the utilization of pharmacologic products, whose property is to dilatate the cervix. Misoprostol or mifepristone, when administrated to a patient a few hours before a TOP by uterine suction curettage, enables a dilatation of the cervix in such a way that it allows the surgically induced abortion to be carried out with local anesthesia, under optimal comfort conditions for the patients as well as for the operator. PMID:9532883
Lefebvre, P; Monniez, N; Norel, G; Prévost, D; Scharfman, W
Provisional estimates from the 2001 census of India, which showed unusually high sex ratios for young children, have sparked renewed concern about the growing use of sex-selective abortions to satisfy parental preferences for sons. According to the 1998-99 National Family Health Survey (NFHS-2), in recent years the sex ratio at birth in India has been abnormally high (107-121 males per
Fred Arnold; Sunita Kishor; T. K. Roy
Abortion is carried out daily in Nigeria despite the restrictive abortion law. This study was carried out to obtain information on societal attitude to the issues of family planning, unwanted pregnancy, abortion, adoption of children and laws relating to them. Focus group discussions were held in south-western Nigeria among 11 sub-groups. Participants felt that there was high prevalence of unwanted pregnancy and abortion particularly among youths. They had high level awareness of contraceptives and ascribed its low use to negative side effects, high cost and provider bias. Christians favoured planning of pregnancies while the Muslims did not. Majority of the respondents had negative perception of induced abortion. Some of them supported abortion if the education of the young girl would be disrupted, if paternity of pregnancy is in dispute, or if it would save the family from shame. Participants supported the enactment of laws that would make adoption of unwanted children easier. PMID:16104663
Oye-Adeniran, Boniface A; Adewole, Isaac F; Umoh, Augustine V; Iwere, Ngozi; Gbadegesin, Abidoye
A simulation study has been made to determine a pilot's ability to control a low L/D vehicle to a desired point on the earth with initial conditions ranging from parabolic orbits to abort conditions along the boost phase of a deep-space mission. The program was conducted to develop procedures which would allow the pilot to perform the energy management functions required while avoiding the high deceleration or skipout region and to determine the information display required to aid the pilot in flying these procedures. The abort conditions studied extend from a region of relatively high flight-path angles at suborbital velocities while leaving the atmosphere to a region between orbital and near-escape velocity outside the atmosphere. The conditions studied included guidance from suborbital and superorbital aborts as well as guidance following return from a deepspace mission. In this paper, the role of the human pilot?s ability to combine safe return abort procedures with guidance procedures has been investigated. The range capability from various abort and entry conditions is also presented.
Young, J. W.; Goode, M. W.
Bioethics is a relatively new way of thinking about relationships in medical practice. It enables reflection on ethical conflicts, and opens up management options without dictating rules. Despite this historical context, medical ethics has been sidelined in the course of the development of bioethics. Bioethical reflection does not automatically result in changes to conflict resolution in daily doctor-patient relationships. However, these reflections are important because they promote the search for a "moral consensus" that establishes new ethical rules for day-to-day medical practice. We suggest that there is no conflict between bioethics and medical ethics; rather, these areas interact to establish new standards of behaviour among physicians. The legalisation of orthothanasia in Brazil is one example of how this theory of moral consensus might operate. On the other hand, the legal battle on abortion illustrates how the law cannot change without such a moral consensus. PMID:23439203
Miziara, Ivan Dieb; Miziara, Carmen Silvia Molleis Galego
Ascending infections of equine uterus frequently result in placentitis and abortions; most of these infections are bacterial and are less commonly due to fungi. This report describes an abortion case in an Arab mare due to Candida guilliermondii that was diagnosed via cytological, histological, cultural and biomolecular assays. The histological lesions found were severe necrotizing placentitis associated with fetal pneumonia. To our knowledge this is the first case of C. guilliermondii abortion reported in equine species.
Stefanetti, Valentina; Marenzoni, Maria Luisa; Lepri, Elvio; Coletti, Mauro; Casagrande Proietti, Patrizia; Agnetti, Francesco; Crotti, Silvia; Pitzurra, Lucia; Del Sero, Andrea; Passamonti, Fabrizio
Ascending infections of equine uterus frequently result in placentitis and abortions; most of these infections are bacterial and are less commonly due to fungi. This report describes an abortion case in an Arab mare due to Candida guilliermondii that was diagnosed via cytological, histological, cultural and biomolecular assays. The histological lesions found were severe necrotizing placentitis associated with fetal pneumonia. To our knowledge this is the first case of C. guilliermondii abortion reported in equine species. PMID:24707460
Stefanetti, Valentina; Marenzoni, Maria Luisa; Lepri, Elvio; Coletti, Mauro; Casagrande Proietti, Patrizia; Agnetti, Francesco; Crotti, Silvia; Pitzurra, Lucia; Del Sero, Andrea; Passamonti, Fabrizio
Background Misoprostol has become a popular over the counter self-administered abortifacient in Ghana. This study aimed to compare the socio-demographic characteristics and clinical complications associated with misoprostol and non-misoprostol induced abortions among patients admitted to a tertiary public health facility in Ghana. Methods This was a cross sectional study conducted at the gynaecological ward of Komfo Anokye Teaching Hospital (KATH), over a four-month period using a structured pre-tested questionnaire. Data were analysed using Chi-square, Fisher’s exact and student t-tests. Factors associated with severe morbidity were examined using Poisson regression with robust error variance to estimate crude and adjusted relative risks (RRs) with 95% confidence intervals (CIs). P < 0.05 was considered statistically significant. Results Overall, 126 misoprostol users and 126 misoprostol non-users were recruited into the study. About 71% of the clients had self-induced abortions. Misoprostol users were more likely to be younger (p < 0.001), single (p < 0.001), nulliparous (p = 0.001), of higher educational background (p = 0.001), and unemployed (p < 0.001), than misoprostol non-users. Misoprostol users were more likely than non-users to undergo termination of pregnancy because they wanted to continue schooling (p < 0.001) or were not earning regular income to support a family (p = 0.001). Overall, 182 (72.2%) of the women (79.4% misoprostol users vs. 65.1% misoprostol non-users; p = 0.01) suffered severe morbidity. Nulliparous women (adjusted RR, 1.28; 95% CI, 1.08-1.52) and those who had induced abortion after 12 weeks’ gestation (adjusted RR, 1.36; 95% CI, 1.18-1.57) were at increased risks of experiencing severe morbidity. The association between mode of abortion induction and severe morbidity was not statistically significant (p = 0.06). Conclusion Self-induced abortions using misoprostol is a common practice among women in this study; nearly three quarters of them suffered severe morbidity. Nonetheless, severe morbidity among misoprostol users and non-users did not differ significantly but was directly related to the gestational age at which the induced abortions occurred. Health education on the dangers of self-induced abortions and appropriate use of medication abortion could help reduce complications associated with induced abortions in Ghana.
Modern medical practice is becoming increasingly pluralistic and diverse. Hence, cultural competency and awareness are given more focus in physician training seminars and within medical school curricula. A renewed interest in describing the varied ethical constructs of specific populations has taken place within medical literature. This paper aims to provide an overview of Islamic Medical Ethics. Beginning with a definition of Islamic Medical Ethics, the reader will be introduced to the scope of Islamic Medical Ethics literature, from that aimed at developing moral character to writings grounded in Islamic law. In the latter form, there is an attempt to derive an Islamic perspective on bioethical issues such as abortion, gender relations within the patient-doctor relationship, end-of-life care and euthanasia. It is hoped that the insights gained will aid both clinicians and ethicists to better understand the Islamic paradigm of medical ethics and thereby positively affect patient care. PMID:17845488
Padela, Aasim I
A study was performed to assess the effect of booster configuration on the ascent abort process. A generic abort event sequence was created and booster related risk drivers were identified. Three model boosters were considered in light of the risk drivers: a solid rocket motor configuration, a side mount combination solid and liquid configuration, and a stacked liquid configuration. The primary risk drivers included explosive fireball, overpressure, and fragment effects and booster-crew module re-contact. Risk drivers that were not specifically booster dependent were not addressed. The solid rocket configuration had the most benign influence on an abort while the side mount architecture provided the most challenging abort environment.
Mathias, Donovan L.; Lawrence, Scott L.
On 25 July 2001 the Polish Federation for Women and Family Planning organised a Tribunal on Abortion Rights in Warsaw, to publicize the negative consequences of the criminalization of abortion in Poland. A panel of Polish and foreign experts heard the testimonials of seven Polish women's experiences under the 1993 "Anti-Abortion Act". Only two of the seven women were able to tell their stories in person. One died in 2001, at the age of 21, of an unsafe abortion. One is legally blind after having carried her last pregnancy to term. One is in prison for infanticide, which in all likelihood was committed by her boyfriend. National and foreign journalists were in attendance, as well as observers from all walks of life--writers, students, mothers, activists, feminists, husbands. The evidence was clear and compelling. Restrictive abortion laws make abortion unsafe by pushing it underground, endanger women's health, create a climate where even those services that are allowed by law-become unavailable, and contravene standards set by international human rights law. The restrictive abortion law in Poland has not increased the number of births; it has only caused women and their families suffering. The Tribunal brought the issue of abortion into the media prior to an election campaign and galvanised Polish and other Eastern European women's groups to become more active in defence of abortion rights. PMID:12369330
Girard, Françoise; Nowicka, Wanda
The present contribution is part of a research developed with qualitative social research methods. It offers part of the results attained in a study performed at a clinic belonging to Mexico City´s Government, and explores the effects on staff of the implementation of Legal Pregnancy Termination (ILE, for its initials in Spanish). The results highlights that, besides diminishing health risks in the women who abort, the use of misoprostol prompted assertive attitudes in many women, that reduced the negative effects produced by the stigma of abortion. It also acknowledges the persistence of stigma in the opinions of the health personnel. The empowering of the self-image of women who become subject to this procedure is due to the full exercise of their legal right. PMID:24912521
In the UK, regulation of clinical services is being restructured. We consider two clinical procedures, abortion and IVF treatment, which have similar ethical and political sensitivities. We consider factors including the law, licensing, inspection, amount of paperwork and reporting requirements, the reception by practitioners and costs, to establish which field has the greater 'regulatory burden'. We test them based on scientific, ethical, social, political factors that might explain differences. We find that regulatory burden borne by IVF services is greater than in abortion, but none of the explanatory theses can provide a justification of this phenomenon. We offer an alternative explanation based on regulatory 'overspill' from research regulation and policy making, conceptualisation of risk regulation and a high public profile that locks a regulator into self-preservation. PMID:21948200
Sethe, Sebastian; Murdoch, Alison
As the Russian Space Agency (RSA) and the U.S. National Aviation and Space Administration (NASA) began in the mid 1990s to plan a preliminary cooperative flight program in anticipation of the International Space Station, programmatic and philosophical differences became apparent in the technical and medical approaches of the two agencies. This paper briefly describes some of these differences and the process by which the two sides resolved differences in their approaches to the medical selection and certification of Shuttle-Mir crew members. These negotiations formed the basis for developing policies on other aspects of the medical support function for international missions, including crew training, preflight and postflight data collection, and rehabilitation protocols. The experience gained through this cooperative effort has been invaluable for developing medical care capabilities for the International Space Station.
Morgun, V. V.; Voronin, L. I.; Kaspransky, R. R.; Pool, S. L.; Barratt, M. R.; Novinkov, O. L.
The videotape and the booklet have been designed as a flexible supplement to nursing education classes that cover emergency evacuation procedures, policies, and regulations at each Veterans Administration Medical Center. The objective of the program is to...
Background Air pollution is a major health challenge worldwide and has previously been strongly associated with adverse reproductive health. This study aimed to examine the association between spontaneous abortion and seasonal variation of air pollutants in Ulaanbaatar, Mongolia. Methods Monthly average O3, SO2, NO2, CO, PM10 and PM2.5 levels were measured at Mongolian Government Air Quality Monitoring stations. The medical records of 1219 women admitted to the hospital due to spontaneous abortion between 2009–2011 were examined retrospectively. Fetal deaths per calendar month from January-December, 2011 were counted and correlated with mean monthly levels of various air pollutants by means of regression analysis. Results Regression of ambient pollutants against fetal death as a dose–response toxicity curve revealed very strong dose–response correlations for SO2 r?>?0.9 (p?0.001) while similarly strongly significant correlation coefficients were found for NO2 (r?>?0.8), CO (r?>?0.9), PM10 (r?>?0.9) and PM2.5 (r?>?0.8), (p?0.001), indicating a strong correlation between air pollution and decreased fetal wellbeing. Conclusion The present study identified alarmingly strong statistical correlations between ambient air pollutants and spontaneous abortion. Further studies need to be done to examine possible correlations between personal exposure to air pollutants and pregnancy loss.
During a highly contested process, abortion was partially decriminalised in Colombia in 2006 by the Constitutional Court: when the pregnancy threatens a woman's life or health, in cases of severe fetal malformations incompatible with life, and in cases of rape, incest or unwanted insemination. However, Colombian women still face obstacles to accessing abortion services. This is illustrated by 36 cases of women who in 2006-08 were denied the right to a lawful termination of pregnancy, or had unjustified obstacles put in their path which delayed the termination, which are analysed in this article. We argue that the obstacles resulted from fundamental disagreements about abortion and misunderstandings regarding the ethical, legal and medical requirements arising from the Court's decision. In order to avoid obstacles such as demands for a judge's authorisation, institutional claims of conscientious objection, rejection of a claim of rape, or refusal of health insurance coverage for a legal termination, which constitute discrimination against women, three main strategies are suggested: public ownership of the Court's decision by all Colombian citizens, a professional approach by those involved in the provision of services in line with the law, and monitoring of its implementation by governmental and non-governmental organisations. PMID:21111356
Amado, Eduardo Díaz; Calderón García, Maria Cristina; Cristancho, Katherine Romero; Salas, Elena Prada; Hauzeur, Eliane Barreto
Background Some, though not all studies have reported an increased risk for mental health problems after an induced abortion. Problems with design and data have compromised these studies and the generalisation of their results. Methods The Finnish Medication and Pregnancy database (N = 622 671 births and 114 518 induced abortions for other than fetal reasons) in 1996-2006 was utilised to study the use of psychotropic drugs in the three months before a pregnancy ending in a birth or an induced abortion. Results In total 2.1% of women with a birth and 5.1% of women with an induced abortion had used a psychotropic medicine 0-3 months before pregnancy. Psychotropic drug users terminated their pregnancies (30.9%) more often than other pregnant women (15.5%). Adjustment for background characteristics explained one third of this elevated risk, but the risk remained significantly increased among users of psychotropic medicine (OR 1.94, 95% confidence intervals 1.87-2.02). A similar risk was found for first pregnancies (30.1% vs. 18.9%; adjusted OR 1.53, 95% confidence intervals 1.42-1.65). The rate for terminating pregnancy was the highest for women using hypnotics and sedatives (35.6% for all pregnancies and 29.1% for first pregnancies), followed by antipsychotics (33.9% and 36.0%) and antidepressants (32.0% and 32.1%). Conclusions The observed increased risk for induced abortion among women with psychotropic medication highlighs the importance to acknowledge the mental health needs of women seeking an induced abortion. Further studies are needed to establish the impact of pre-existing differences in mental health on mental health outcomes of induced abortions compared to outcomes of pregnancies ending in a birth.
This article examines the debate among physicians over abortion, from the turn of the nineteenth century through to the 1930s, especially in the Academia Nacional de Medicina (National Academy of Medicine). Considered a crime, abortion was seen as something that threatened the dominance of husbands over wives and the control over medical practice in relation to the female body. Midwives, seen as the propagators of the techniques of medical termination of pregnancy, were opposed as a serious threat to the established gender order. Ten theses of the Faculdade de Medicina do Rio de Janeiro were analyzed, as well as the bulletins of the Academia Nacional de Medicina and articles published in the Correio da Manhã and O Globo newspapers. PMID:23184238
Silva, Marinete Dos Santos
Developed and administered Reasoning about Abortion Questionnaire (RAQ) to measure how persons view abortions. Pilot tested the RAQ on 134 college students and modified scale on basis of data. Administered revised RAQ to college students (N=230) replicating factor pattern and obtaining evidence for validity of polarity scores through structured…
Parsons, Nancy K.; And Others
Data from a sample of students showed that males' abortion attitudes are related primarily to their degree of conventionality; females' abortion attitudes are related to sex-role conventionality, the value of children in their life plans, the "right to life" issue, and sexual and general conventionality. (Author)
Finlay, Barbara Agresti
Discusses the U.S. Supreme Court's recent indication of willingness to accept state restrictions on a woman's right to abortion. Presents several key reasons why parental involvement should not be legally required for minors' abortions, and suggests that family practitioners are in an excellent position to inform the public and policymakers about…
A study of 2620 pregnancies ending in spontaneous abortion revealed a CNS defect in 3.6% of embryos and fetuses, and 3% of all complete conceptuses. The type of malformation observed varied with the gestational age at expulsion, encephaloceles being predominant in earlier specimens, while more typical anencephalus and spina bifida were more common among later abortions. Chromosome abnormalities were found
M R Creasy; E D Alberman
SUMMARY The eect of spontaneous abortion on the dairy industry is substantial, costing the industry on the order of $200 million per year in California alone. We analyse data from a cohort study of nine dairy herds in Central California. A key feature of the analysis is the observation that only a relatively small proportion of cows will abort (around
Timothy Hanson; Edward J. Bedrick; Wesley O. Johnson; Mark C. Thurmond
The Orion Pad Abort 1 (PA-1) flight test was designed as an early demonstration of the Launch Abort System (LAS) for the Orion capsule. The LAS was designed developed and manufactured by the Lockheed Martin/Orbital Sciences team. At inception it was reali...
A. P. T. Taylor J. Johnston R. Sinclair
A Return-to-Launch-Site (RTLS) abort with three Space Shuttle Main Engines (SSME) operational was examined. The results are trajectories and main engine cutoff conditions that are approximately the same as for a two SSME case. Requiring the three SSME solution to match the two SSME abort eliminates additional crew training and is accomplished with negligible software impact.
Carter, J. F.; Bown, R. L.
In a series of 2922 karyotyped spontaneous abortions, 62 were found to be trisomic for chromosome 13, 46 having a simple trisomy and 16 a translocation trisomy. The epidemiology of this series of trisomy 13 conceptuses is presented and compared to that of trisomy 13 ascertained from other populations. In most compared parameters the trisomy 13 spontaneous abortions are very
P A Jacobs; T J Hassold; A Henry; D Pettay; N Takaesu
Safe abortion services are only legal in Nigeria to save the life of the woman. Widespread incidence of unsafe induced abortions often results in death or irreparable harm to women. The Campaign Against Unwanted Pregnancy (CAUP) was launched on 17 August 1991 to address this public health crisis through advocacy for reform of the abortion law, research, education and preparation of service providers, and development of a constituency to support provision of safe abortion to the full extent of the law. CAUP commissioned an evaluation in 2004 to examine and analyse the work of the campaign during its 14 years of existence, which included a review of documents, a participatory learning workshop with CAUP, and almost 50 interviews with different stakeholders. This article, adapted from the evaluation report, tells how CAUP took a taboo topic and, in the midst of an extremely complex political and cultural environment, made it a legitimate subject for public discussion and debate. The Campaign undertook groundbreaking research on abortion in Nigeria. Service providers are being trained to provide, to the full extent of the law, safe abortions and post-abortion care, and advocacy efforts are continuing to lay the groundwork for improving the abortion law. PMID:15938176
Oye-Adeniran, Boniface A; Long, Carolyn M; Adewole, Isaac F
Prior research has focused primarily on the mental health consequences of abortion; little is known about mental health before abortion. In this study, the psychiatric history of women who have had an abortion is investigated. 325 Women who recently had an abortion were compared with 1902 women from the population-based Netherlands Mental Health Survey and Incidence Study (NEMESIS-2). Lifetime prevalence estimates of various mental disorders were measured using the Composite International Diagnostic Interview 3.0. Compared to the reference sample, women in the abortion sample were three times more likely to report a history of any mental disorder (OR = 3.06, 95% CI = 2.36-3.98). The highest odds were found for conduct disorder (OR = 6.97, 95% CI = 4.41-11.01) and drug dependence (OR = 4.96, 95% CI = 2.55-9.66). Similar results were found for lifetime-minus-last-year prevalence estimates and for women who had first-time abortions only. The results support the notion that psychiatric history may explain associations that have been found between abortion and mental health. Psychiatric history should therefore be taken into account when investigating the mental health consequences of abortion. PMID:23941742
van Ditzhuijzen, Jenneke; ten Have, Margreet; de Graaf, Ron; van Nijnatten, Carolus H C J; Vollebergh, Wilma A M
This study investigated a potential Launch Abort System (LAS) Concept of Operations and abort parachute architecture. The purpose of the study was to look at the concept of jettisoning the LAS tower forward (Reverse LAS or RLAS) into the free-stream flow ...
D. K. Litton R. G. Winski S. A. O'Keefe
The article lists recommendations for dealing with methodological aspects of an abortion survey and makes suggestions for testing and validating the survey questionnaire. The recommendations are based on the experience of the Brazilian Abortion Survey (PNA), a random sample household survey that used the ballot-box technique and covered adult women in all urban areas of the country. PMID:22872333
Medeiros, Marcelo; Diniz, Debora