... pregnancy resulted after a traumatic event such as rape or incest The woman may not wish to ... American College of Obstetricians and Gynecologists. Clinical management guidelines of obstetrician-gynecologists. Medical management of abortion. Obstet Gynecol . 2005 ...
We describe five pitfalls of medical abortion: ectopic pregnancy not terminated after misoprostol, but without negative side-effects; long-term vaginal blood loss with suspicious retained products which disappeared spontaneously; a patient with uterus myomatatosus with severe pain and retained products in the uterus; repetition of misoprostol because of retained products in the uterus after two weeks and an allergic reaction to methotrexate. Despite these pitfalls, there are enough benefits to consider medical abortion with methotrexate and misoprostol as a safe method with a high success rate of more than 91% and a good alternative for surgical abortion. An invasive procedure is not necessary, there are no long-term complications and it can be performed at an earlier stage, which makes it more acceptable in society. In Curaçao, where abortion is legally restricted, medical abortion is performed with methotrexate and misoprostol. In countries where abortion is legal, mifepristone and misoprostol are the first choice. PMID:20583695
Boersma, A A; Meyboom-de Jong, B
Second trimester abortion remains a common procedure worldwide. Dilatation and evacuation (D&E) is the surgical method of choice, if the surgical expertise and facilities are available. Adequate cervical dilatation preoperatively is a prerequisite for a safe D&E. Medical abortion using misoprostol together with mifepristone is the medical method of choice. The recommended regimen is 200mg mifepristone followed by 800 microg of vaginal misoprostol 36-48 h later. Subsequent doses of 400 microg of misoprostol can be given orally every 3h up to a maximum of four more doses. Proper preoperative assessment would not only help to provide safe abortion treatment, but it also guides the choice of method. If the expertise and facilities of both methods are available, both methods should be discussed and offered to the patient so that the patient can make an informed choice. PMID:20347397
Lee, Vivian C Y; Ng, Ernest H Y; Ho, P C
A structured literature review was undertaken to determine, in the context of early medical abortion, the proportion of women who require analgesia, the predictors of analgesia requirement and the most appropriate analgesia regimen. Studies from different centers show wide variations in analgesia use, but, overall, around 75% of women use narcotic analgesics on the day of prostaglandin administration. Differences are
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.
The National Hospital Discharge Survey records for medical-legal, spontaneous, and "other" abortions (ICDA-8 640-641, 643, and 644 respectively) for 1970-1977 were analyzed to investigate the impact of liberalized access to abortion on abortion-related morbidity in the United States. The analysis suggests that in census regions where an increase in medical-legal abortions performed in hospitals occurred over the study period there was an associated decreased likelihood of a "spontaneous" or "other" abortion. The spontaneous and "other" abortion codes appear to have been used synonymously and a small number of each used to classify complications of both illegal and legal abortions performed outside hospitals. There was a significant reduction in length of stay for spontaneous and other abortions between 1970 and 1977. This is suggestive of decreasing severe presenting symptomatology for complicated abortion. The study further suggests that: during 1970-77 illegal abortions were largely replaced by legal procedures; increases in legal abortions beyond those replacing illegal have not resulted in increased rates of hospitalization for complicated abortion; and, the case morbidity rate for legal abortion appears to have declined. PMID:7053616
Bracken, M B; Freeman, D H; Hellenbrand, K
Background Abortion is a serious public health issue, and it poses high risks to the health and life of women. Yet safe abortion services are not readily available because few doctors are trained to provide such services. Many doctors are unaware of laws pertaining to abortion. This article reports survey findings on Malaysian medical students’ attitudes toward abortion education and presents a case for including abortion education in medical schools. Methods and Results A survey on knowledge of and attitudes toward abortion among medical students was conducted in two public universities and a private university in Malaysia in 2011. A total of 1,060 students returned the completed questionnaires. The survey covered about 90% of medical students in Years 1, 3, and 5 in the three universities. About 90% of the students wanted more training on the general knowledge and legal aspects of abortion, and pre-and post-abortion counseling. Overall, 75.9% and 81.0% of the students were in favor of including in medical education the training on surgical abortion techniques and medical abortion, respectively. Only 2.4% and 1.7% were opposed to the inclusion of training of these two methods in the curriculum. The remaining respondents were neutral in their stand. Desire for more abortion education was associated with students’ pro-choice index, their intention to provide abortion services in future practice, and year of study. However, students’ attitudes toward abortion were not significantly associated with gender, type of university, or ethnicity. Conclusions Most students wanted more training on abortion. Some students also expressed their intention to provide abortion counseling and services in their future practice. Their desire for more training on abortion should be taken into account in the new curriculum. Abortion education is an important step towards making available safe abortion services to enable women to exercise their reproductive rights. PMID:23300600
Tey, Nai-peng; Yew, Siew-yong; Low, Wah-yun; Su'ut, Lela; Renjhen, Prachi; Huang, M. S. L.; Tong, Wen-ting; Lai, Siow-li
Short-term quality of life following abortion is poorly characterized. We conducted a prospective cohort study to evaluate 97 U.S. women who selected either medical abortion with mifepristone and misoprostol or surgical abortion up to 9 weeks gestation in a private-practice setting. Women choosing medical abortion and those choosing surgical abortion with local anesthesia were similar on most baseline characteristics. Eighty-five participants completed a standardized quality of life assessments three times over 1 month. The 30-item questionnaire yielded scores for global health, emotional, social, cognitive and physical functioning and for specific symptom scales. At baseline, participants reported many symptoms and functional limitations during the previous week. Subjects in both treatment groups experienced clinically and statistically significant improvements on all scales at follow-up. Surgical abortion patients had worse scores on three of five function scales and several symptom scales at baseline compared to medical abortion patients. Differences in baseline scores between the medical and surgical abortion patients disappeared during follow-up. A surprising finding was that partner knowledge of the pregnancy at the time the abortion appointment was made was associated with significantly worse scores on most of the function and symptom scales. These results provide substantial reassurance that women undergoing abortion experience a marked improvement in their quality of life after the abortion. Women choosing medical or surgical abortion report very similar quality of life improvements. PMID:12521657
Westhoff, Carolyn; Picardo, Lucy; Morrow, Ellen
Seven prospective cohort studies (12484 cases) were included in this review of the respective effects on the next pregnancy of medical and surgical abortion in early pregnancy. The incidence of miscarriage and postpartum hemorrhage was significantly lower in the pregnancy following a medical abortion. No other significant differences were found. With respect to the outcome of the next pregnancy, first-trimester
Changping Gan; Yan Zou; Shangchun Wu; Youping Li; Qing Liu
Abortion is legally restricted in most of Latin America where 95% of the 4.4 million abortions performed annually are unsafe. Medical abortion (MA) refers to the use of a drug or a combination of drugs to terminate pregnancy. Mifepristone followed by misoprostol is the most effective and recommended regime. In settings where mifepristone is not available, misoprostol alone is used.Medical abortion has radically changed abortion practices worldwide, and particularly in legally restricted contexts. In Latin America women have been using misoprostol for self-induced home abortions for over two decades.This article summarizes the findings of a literature review on women's experiences with medical abortion in Latin American countries where voluntary abortion is illegal.Women's personal experiences with medical abortion are diverse and vary according to context, age, reproductive history, social and educational level, knowledge about medical abortion, and the physical, emotional, and social circumstances linked to the pregnancy. But most importantly, experiences are determined by whether or not women have the chance to access: 1) a medically supervised abortion in a clandestine clinic or 2) complete and accurate information on medical abortion. Other key factors are access to economic resources and emotional support.Women value the safety and effectiveness of MA as well as the privacy that it allows and the possibility of having their partner, a friend or a person of their choice nearby during the process. Women perceive MA as less painful, easier, safer, more practical, less expensive, more natural and less traumatic than other abortion methods. The fact that it is self-induced and that it avoids surgery are also pointed out as advantages. Main disadvantages identified by women are that MA is painful and takes time to complete. Other negatively evaluated aspects have to do with side effects, prolonged bleeding, the possibility that it might not be effective, and the fact that some women eventually need to seek medical care at a hospital where they might be sanctioned for having an abortion and even reported to the police. PMID:23259660
Zamberlin, Nina; Romero, Mariana; Ramos, Silvina
. With this in mind, interprofessional education is another important aspect of medical education. We strive20132014 O.H.S.U. Medical Student Procedure Guide #12;2013-2014 Medical Student Procedure Guide 1 Oregon Health & Science University School of Medicine - Medical Student Procedure Guide Welcome
Chapman, Michael S.
Background & objectives: Medical abortion though legalized in India, is still not very popular. A disadvantage of medical abortion is the longer duration of bleeding compared with surgical abortion which may reduce acceptability. Due consideration needs to be given to the issues related to medical abortion for improving the reproductive health status of women suffering from consequences of unsafe and
Suneeta Mittal; Sonika Agarwal; Sunesh Kumar; Ashima Batra
Abstract Objective To examine the acceptability and feasibility of early medical abortion using mifepristone and misoprostol in Azerbaijan. Methods A total of 863 women in Baku and two regions of Azerbaijan who sought termination of gestations up to 63 days were enrolled in the study. In the capital, women swallowed 200 mg mifepristone in the clinic and were given the option of taking 800 ?g misoprostol buccally either at the clinic or at home 24-48 hours later. In the regions, women were given the option of taking both drugs at home. Follow-up visits were to take place two weeks after mifepristone administration to determine abortion status. Results Seventy-four percent of women in the regions chose home administration of mifepristone, and 92% of women from all locations selected misoprostol home administration. Ninety-seven percent of women had complete abortions, and 97% were satisfied or very satisfied with the method. The vast majority of participants preferred medical abortion for a future procedure (96%). Nearly all women (98%) would recommend medical abortion for pregnancy termination to a friend. Conclusion Mifepristone-misoprostol medical abortion with the option of home administration of both drugs is an acceptable and feasible option for women in Azerbaijan. PMID:25047120
Louie, Karmen S; Tsereteli, Tamar; Chong, Erica; Aliyeva, Faiza; Rzayeva, Gulnara; Winikoff, Beverly
Medical tourism in Ireland, like in many Western states, is built around assumptions about individual agency, choice, possibility, and mobility. One specific form of medical tourism—the flow of women from Ireland traveling in order to secure an abortion—disrupts and contradicts these assumptions. One legacy of the bitter, contentious political and legal battles surrounding abortion in Ireland in the 1980s and 1990s has been securing the right of mobility for all pregnant Irish citizens to cross international borders to secure an abortion. However, these mobility rights are contingent upon nationality, social class, and race, and they have enabled successive Irish governments to avoid any responsibility for providing safe, legal, and affordable abortion services in Ireland. Nearly twenty years after the X case discussed here, the pregnant female body moving over international borders—entering and leaving the state—is still interpreted as problematic and threatening to the Irish state. PMID:21114071
Gilmartin, Mary; White, Allen
A majority of the unsafe abortions are performed by untrained birth attendants or quacks leading to complications in a large proportion of these cases. Complications like bowel injury, bladder injury, uterine perforation, and septic abortion are mostly caused by unskilled hands and are detected immediately or within few days of the procedure, owing to the need for tertiary level care. Here we present a very interesting case of unsafe abortion induced by a Ryle's tube in a 32-year-old lady, which was diagnosed five years after the procedure. Considering its atypical presentation, it is the first case of its kind in the literature. The details of the case and its management are described along with appropriate pictures. PMID:24649386
Nayak, Prasanta Kumar; Mitra, Subarna; Padma, Alaganandam; Agrawal, Sarita
Objective: Medication abortion with mifepristone and misoprostol has been available in the United States since 2000. The authors reviewed the first 46 medication abortion cases conducted at a university-based student health care clinic to determine the safety and feasibility of medication abortion in this type of clinical setting. Participants:…
Godfrey, Emily M.; Bordoloi, Anita; Moorthie, Mydhili; Pela, Emily
We evaluated the use of curettage in second trimester medical induced abortions retrospectively in 186 women at Herning Hospital, Denmark. Curettage was carried out in a total of 55% of the women. The incidence of curettage was associated with low gestational age (r?=?0.32, p?0.001) but not with age, parity, and BMI. The average incidence of curettage dropped from 62% to 25% at the time before 2007 compared with the time after 2007 (p?0.001). The indications for abortion were not associated with subsequent use of curettage. PMID:25200978
Rasmussen, Anna Lund; Frostholm, Gitte Thöger; Lauszus, Finn Friis
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
The objective of this study was to determine the knowledge, attitude and practice of private medical practitioners in Enugu, South-eastern Nigeria, on abortion and post-abortion care. It was a cross-sectional study of private medical practitioners in the study area using self-administered structured questionnaires. The results showed that 32.3% of the doctors terminate unwanted pregnancies when requested to do so. The majority of them (51.6%) use D&C in combination with manual vacuum aspiration for the termination of pregnancies in the first trimester. A total of 61 (63.5%) respondents offered various types of post-abortal care (PAC) services, while 42 (43.8%) of them screened women with abortion complications for sexually transmitted infections. For the doctors who do not terminate unwanted pregnancies, their main reasons were religious and moral considerations rather than obedience to the Nigerian abortion laws. We conclude that the majority of private medical practitioners in Enugu, South-eastern Nigeria, do not terminate unwanted pregnancies because of their religious beliefs. PMID:19603321
Onah, H E; Ogbuokiri, C M; Obi, S N; Oguanuo, T C
Background Twin gestation is not considered a contraindication to medical abortion with mifepristone and misoprostol. However, data comparing the efficacy of medical abortion for singleton gestations as compared with multiple gestations are limited. We examined medical abortion outcomes for twin gestations through 63 days. Study Design We performed a secondary analysis of treatment efficacy and side effects using pooled data from two randomized medical abortion trials. All subjects received mifepristone 200 mg orally and misoprostol 800 mcg vaginally. Outcomes in women with singleton and twin gestations were compared. Results Of 2208 subjects, 24 (1.1%) women had twins. Treatment success was not statistically different for twin and singleton gestations (91% vs. 97%, p=0.19). Perceived bleeding and pain were not significantly different between groups. Conclusions Treatment success of medical abortion for twins is not significantly different than for singletons, although small differences cannot be excluded due to the limited number of twins. PMID:22018125
Hayes, Jennifer L.; Achilles, Sharon L.; Creinin, Mitchell D.; Reeves, Matthew F.
A combination of antiprogesterone mifepristone and prostaglandin analogue misoprostol provides an effective non surgical method for termination of pregnancy up to gestational age of 63 days. The objective of this study was to assess the efficacy of this medical regimen for termination of pregnancy up to 63 days of pregnancy. A hospital based prospective study was carried out in department of obstetrics and gynecology at Nepal Medical College Teaching Hospital (NMCTH) for a period of one year where 100 women requesting for medical abortion were enrolled. The medical regimen used was mifepristone 200 mg orally followed 24 hours later by misoprostol 800 micrograms administered buccally. Most of the women were in age group 20-29 years (50%), were nulliparous (81%) and were within 42 days of pregnancy (47%). The overall success rate of this regimen was 93.6%. Where success was defined as achieving complete abortion without needing surgical evacuation. Surgical evacuation was needed in 6 (6.4%) patients i.e. 5 for incomplete abortion and one for continued viable pregnancy. The combination of oral mifepristone 200mg followed 24 hours later by buccal misoprostol 800mcg is effective method of medical termination of pregnancy. PMID:22808819
Giri, A; Tuladhar, H; Tuladhar, A S; Maharjan, M; Dhakal, N
If you are pregnant and near 40 years old there is 1/137 chance that your child may have Down's syndrome, or 1/65 chance he will have a physical or mental problem. There are tests that can indicate these problems but they increase the risk of spontaneous abortion. A woman should not be forced to carry an unwanted child, and the needs of childless couples should not be addressed in abortion discussions. The Roe v. Wade case made the distinction of not having to determine when life begins, but when it can be sustained outside the body. The Missouri statute states that human life begins at conception, an unborn child has protectable life interests and the parents of that child have protectable life interests of the unborn child in relation to life, health and its well being. States that are really concerned with the interests of unborn children should improve prenatal care, educate teens on contraception, AIDS, and be concerned about violent behavior and smoking. Voters in Michigan and Arkansas approved a law to stop the use of public funds for abortion, other than saving the mother's life. Pro- choice advocates are concerned that the conservative appointees to the supreme court will reverse the previous decision. PMID:10294684
Wilson, E L
Introduction: In Nepal medical abortion has been approved for use since 2009. There were many cases coming to Tribhuvan University Teaching Hospital coming with problems and complications following medical abortion. Thus the objective of this study was to analyze the cases that came to TUTH following medical abortion with problems and complications. Methods: This is a prospective study conducted in the Department of Obstetrics and Gynecology of TUTH. Study was carried from 1st August 2011 to 30th November 2012. Women who came to TUTH with any complaints following medical abortion were interviewed, examined and treatment provided. Relevant clinical finding were noted. Results: There were a total of 57 cases during the study. Most (66.6%) of the women were in age group 20-29 years age. There were 45 (79%) women who had abortion up to 9 weeks. Medical shop was the main place where most of the women (45.6%) directly come to know about medical abortion. More than 34 (77.2%) received the service from medical shops without any supervision. Most 31 (54.4%) presented with incomplete abortion. There were three cases of continuing pregnancy and four presented with ectopic pregnancy. Eighteen (31.6%) cases needed admission. Fifty six percent of the cases were treated with manual vacuum aspiration, six cases underwent laparotomy and there was one maternal mortality. Conclusions: There is a need for proper dissemination and implementation of guideline for management of these women and adequate supervision to reduce the problems and complications. Keywords: complications; incomplete abortion; medical abortion; problems. PMID:24907952
Ojha, N; Bista, K Db
ABORTION COST LIST I Hartford Sites: 1. Hartford Gyn Center 860-525-1900 Medical- $550 + $30 if Rh for Abortion info/scheduling 1-877-529-3689 www.ppct.org Procedure Sites in Norwich, New Haven, West Hartford. Both, Dr. Byrd and Dr. Flagg are willing to perform therapeutic abortions. Dr. Beverly Byrd 852
Induced abortion is one of the most difficult sociomedical problems facing the Indonesian government. While well-known in traditional society, the practice was discouraged by all Indonesian religious groups, and forbidden by the Dutch colonial authorities. Although abortion was technically illegal under the criminal code, a judicial interpretation in the early 1970s permitted medical professionals to offer the procedure so long as they were discreet and careful. The numbers of medical abortions carried out in Indonesia rose dramatically, and there was evidence of matching declines in the incidence of morbidity and mortality caused by dangerous illegal procedures. Medical and community groups campaigned for a more liberal abortion law to protect legal practitioners and stamp out illegal traditional practices. Their efforts appeared to bear fruit in the draft Health Law, but when the law was passed by the legislature in late 1992, the issue was again clouded by contradictions and inconsistencies. PMID:8212094
Hull, T H; Sarwono, S W; Widyantoro, N
Uterine artery pseudoaneurysm (UAP) can occur after cesarean section or traumatic delivery, usually manifesting as postpartum hemorrhage. Here we report a patient with UAP possibly caused by septic abortion. She had high fever and bleeding with positive urine pregnancy test. We diagnosed this condition as septic abortion. Ultrasound revealed an intrauterine echogenic mass and color Doppler revealed swirling blood flow within the mass. Contrast-enhanced computed tomography showed a heterogeneously enhanced intrauterine mass. Selective internal iliac artery angiography revealed contrast medium within the mass immediately after medium injection. Bilateral uterine artery embolization was performed, after which medium no longer accumulated in the uterus, and hemostasis was achieved, confirming the diagnosis as UAP. Antibiotic treatment ameliorated the infection and the uterine content was expelled and absorbed. UAP can occur even without preceding procedures and may manifest abortive, and not postpartum, hemorrhage. UAP may be hidden behind septic abortion. PMID:24118644
Matsubara, Shigeki; Nakata, Manabu; Baba, Yosuke; Suzuki, Haruna; Nakamura, Hiroyasu; Suzuki, Mitsuaki
Second trimester abortions constitute 10-15% of all induced abortions worldwide but are responsible for two-thirds of major abortion-related complications. During the last decade, medical methods for second trimester induced abortion have been considerably improved and become safe and more accessible. Today, in most cases, safe and efficient medical abortion services can be offered or improved by minor changes in existing health care facilities. Second trimester medical abortion can be provided by a nurse-midwife with the back-up of a gynaecologist. Because of the potential for heavy vaginal bleeding and serious complications, it is advisable that second trimester terminations take place in a health care facility where blood transfusion and emergency surgery (including laparotomy) are available. This article provides basic information on regimens recommended for second trimester medical abortion. The combination of mifepristone and misoprostol is now an established and highly effective method for second trimester abortion. Where mifepristone is not available or affordable, misoprostol alone has also been shown to be effective, although a higher total dose is needed and efficacy is lower than for the combined regimen. Therefore, whenever possible, the combined regimen should be used. Efforts should be made to reduce unnecessary surgical evacuation of the uterus after expulsion of the fetus. Future studies should focus on improving pain management, the treatment of women with failed medical abortion after 24 hours, and the safety of medical abortion regimens in women with a previous caesarean section or uterine scar. PMID:18772097
Gemzell-Danielsson, Kristina; Lalitkumar, Sujata
Background Today, a large proportion of early abortions are medical terminations, in accordance to the woman's choice. Intrauterine contraceptives (IUC) provide highly effective, reversible, long-acting contraception. However, the effects of timing of IUC insertion after medical abortion are not known. Methods Women undergoing medical abortion with mifepristone and misoprostol up to 63 days gestation and opting for IUC were randomised to early insertion (day 5–9 after mifepristone) or delayed (routine) insertion (at 3–4 weeks after mifepristone). The primary outcome was the rate of IUC expulsion at six months after IUC insertion. Results A total of 129 women were randomized, and 116 women had a successful IUC insertion. There was no difference in expulsion rate between early (9.7%) vs. delayed (7.4%) IUC insertion (risk difference ?9.2–13.4). Furthermore, 1.5% of women randomized to early and 11.5% to delayed insertion did not attend the follow up (proportion difference 10.0%, 95% CI: 1.8–20.6%, p?=?0.015), and a higher proportion of women (41%) had had unprotected intercourse prior to returning for insertion in the delayed group compared with the early group (16%) (p?=?0.015). Adverse events were rare and did not differ between the groups. Conclusions Early insertion of IUC after medical abortion was safe and well tolerated with no increased incidence for expulsions or complications. Women were more likely to return for the IUC insertion if scheduled early after the abortion, and less likely to have had an unprotected intercourse prior to the IUC insertion. Early insertion should be offered as a routine for women undergoing first trimester medical abortion. Trial Registration ClinicalTrials.gov NCT01537562 PMID:23155432
Saav, Ingrid; Stephansson, Olof; Gemzell-Danielsson, Kristina
Objective To determine the risks of short term adverse events in adolescent and older women undergoing medical abortion. Design Population based retrospective cohort study. Setting Finnish abortion register 2000-6. Participants All women (n=27?030) undergoing medical abortion during 2000-6, with only the first induced abortion analysed for each woman. Main outcome measures Incidence of adverse events (haemorrhage, infection, incomplete abortion, surgical evacuation, psychiatric morbidity, injury, thromboembolic disease, and death) among adolescent (<18 years) and older (?18 years) women through record linkage of Finnish registries and genital Chlamydia trachomatis infections detected concomitantly with abortion and linked with data from the abortion register for 2004-6. Results During 2000-6, 3024 adolescents and 24?006 adults underwent at least one medical abortion. The rate of chlamydia infections was higher in the adolescent cohort (5.7% v 3.7%, P<0.001). The incidence of adverse events among adolescents was similar or lower than that among the adults. The risks of haemorrhage (adjusted odds ratio 0.87, 95% confidence interval 0.77 to 0.99), incomplete abortion (0.69, 0.59 to 0.82), and surgical evacuation (0.78, 0.67 to 0.90) were lower in the adolescent cohort. In subgroup analysis of primigravid women, the risks of incomplete abortion (0.68, 0.56 to 0.81) and surgical evacuation (0.75, 0.64 to 0.88) were lower in the adolescent cohort. In logistic regression, duration of gestation was the most important risk factor for infection, incomplete abortion, and surgical evacuation. Conclusions The incidence of adverse events after medical abortion was similar or lower among adolescents than among older women. Thus, medical abortion seems to be at least as safe in adolescents as it is in adults. PMID:21508042
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
Abstract Objectives To evaluate pain and other early adverse events associated with different regimens of medical abortion up to nine weeks of amenorrhoea. Methods The literature was searched for comparative studies of medical abortion using mifepristone followed by the prostaglandin analogue misoprostol. Publications, which included pain assessment were further analysed. Results Of the 1459 publications on medical abortion identified, only 23 comparative, prospective trials corresponded to the inclusion criteria. Patients in these studies received different dosages of mifepristone in combination with different dosages of misoprostol administered via diverse routes or at various intervals. Information on pain level was reported in 12/23 papers (52%), information regarding systematic administration of analgesics in 12/23 articles (52%) and information concerning analgesia used was available for only 10/23 studies (43%). Conclusions Neither pain nor its treatment are systematically reported in clinical trials of medical abortion; this shortcoming reflects a neglect of the individual pain perception. When data are mentioned, they are too inconsistent to allow for any comparison between different treatment protocols. Standardised evaluation of pain is needed and the correlation between the dosage of misoprostol and the intensity of pain must be assessed in future studies. PMID:25180961
Fiala, Christian; Cameron, Sharon; Bombas, Teresa; Parachini, Mirella; Saya, Laurence; Gemzell-Danielsson, Kristina
IntroductionTo increase access to safe abortion in rural India, the feasibility and acceptability of mifepristone–misoprostol abortion was assessed in a typical government run primary health center (PHC) in Nagpur district, Maharashtra State, that does not offer surgical abortion services and must refer off-site for emergency and backup services.
Shuchita Mundle; Batya Elul; Abhijeet Anand; Shveta Kalyanwala; Suresh Ughade
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). PMID:24775430
Klausen, Susanne M
Background Increasing access to safe abortion services is the most effective way of preventing the burden of unsafe abortion, which is achieved by increasing safe choices for pregnancy termination. Medical abortion for termination of early abortion is said to safe, effective, and acceptable to women in several countries. In Ethiopia, however, medical methods have, until recently, never been used. For this reason it is important to assess women's preferences and the acceptability of medical abortion and manual vacuum aspiration (MVA) in the early first trimester pregnancy termination and factors affecting acceptability of medical and MVA abortion services. Methods A prospective study was conducted in two hospitals and two clinics from March 2009 to November 2009. The study population consisted of 414 subjects over the age of 18 with intrauterine pregnancies of up to 63 days' estimated gestation. Of these 251 subjects received mifepristone and misoprostol and 159 subjects received MVA. Questionnaires regarding expectations and experiences were administered before the abortion and at the 2-week follow-up visit. Results The study groups were similar with respect to age, marital status, educational status, religion and ethnicity. Their mean age was about 23, majority in both group completed secondary education and about half were married. Place of residence and duration of pregnancy were associated with method choice. Subjects undergoing medical abortions reported significantly greater satisfaction than those undergoing surgical abortions (91.2% vs 82.4%; P < .001). Of those women who had medical abortion, (83.3%) would choose the method again if needed, and (77.4%) of those who had MVA would also choose the method again. Ninety four percent of women who had medical abortion and 86.8% of those who had MVA would recommend the method to their friends. Conclusions Women receiving medical abortion were more satisfied with their method and more likely to choose the same method again than were subjects undergoing surgical abortion. We conclude that medical abortion can be used widely as an alternative method for early pregnancy termination. PMID:21639888
Clinical language applied to early pregnancy loss changed in late twentieth century Britain when doctors consciously began using the term ‘miscarriage’ instead of ‘abortion’ to refer to this subject. Medical professionals at the time and since have claimed this change as an intuitive empathic response to women's experiences. However, a reading of medical journals and textbooks from the era reveals how the change in clinical language reflected legal, technological, professional and social developments. The shift in language is better understood in the context of these historical developments, rather than as the consequence of more empathic medical care for women who experience miscarriage. PMID:23429567
Objective To study the efficacy of a low dose of mifepristone (100 mg) in combination with misoprostol, in women undergoing medical termination of pregnancy up to gestation of 49 days. Material and Methods A prospective study was performed in 50 women (mean age 26.54±3.68 years) with single intrauterine pregnancy of up to 49 days of gestation, presenting to our institution between November 2007 and October 2009. 100 mg mifepristone was given orally, followed 24 hours later by 400 micrograms misoprostol vaginally. Misoprostol 400 micrograms was repeated vaginally on the third day if indicated. The primary outcome of complete abortion rate and secondary outcomes of induction-abortion interval and adverse effects, especially bleeding, were assessed. Results Mean period of gestation was 38.74±3.90 days. None of the women expelled the products of conception before misoprostol insertion. A second dose of misoprostol was needed in four patients. Complete abortion was achieved in 94.00% of patients, incomplete abortion in 4% and missed abortion in 2%. Approximately all the women reported one or more adverse effects but none of them had any serious ones, the most common being pain in 42 (84%) women followed by nausea, vomiting, fever and diarrhoea in 12 (24%), 6 (12%), 4 (8%) and 3 (6%) women respectively. The overall acceptability rate of the dosing regimen in our study was 94%. Conclusion A regimen of low dose mifepristone (100 mg) followed 24 hours later by vaginal misoprostol can be safely and effectively used for early abortion. PMID:24591937
Goel, Anupama; Mittal, Sandhya; Taneja, Bk; Singhal, Manisha
National politics in the US, Poland, and Ireland have in recent years been afire with debate over abortion. Conflicting abortion laws almost scuttled the reunification of Germany. This paper describes how the abortion debate took hold in post-Communist Poland and how the issue came to be so entrenched in US politics in the wake of the US Supreme Court's 1973 decision on abortion in the case of Roe vs. Wade. It focuses upon abortion mainly as a method of birth control which women have always sought when needed regardless of the procedure's legal status. The controversies and campaigns recorded and the ideas offered focus upon women's access to affordable, safe, and legal abortion. The author argues that Poland is no place to be a woman and presents sections on the country's church, government, and medical profession; Roe vs. Wade; who opposes abortion rights and their broad success; the 1992 US presidential election; Bill Clinton's presidency; why the abortion debate has been different in Britain; and new issues on abortion. PMID:12290677
This study surveyed all family physicians, obstetrician-gynecologists, and general surgeons practicing in rural Idaho in 1994. Although most respondents provided a wide range of reproductive health services, less than 4% performed abortions, so most rural Idaho women wanting abortions must travel long distances for this procedure. Physicians report that they do not provide abortion services because of both their own moral objections and local community opposition to the procedure. Yet 26% of the respondents indicated interest in using RU-486 for abortions when it becomes available. This suggests that the development of acceptable medical abortifacients may improve access to this procedure even in very conservative rural areas. PMID:7573629
Rosenblatt, R A; Mattis, R; Hart, L G
How responsive are political lawmakers to an abortion issue that is potentially less salient to the public or in the media? Targeted Regulation of Abortion Providers (or TRAP) laws impose physical plant and personnel regulations and requirements on abortion providers that exceed those imposed on other comparable health care providers or outpatient medical facilities. Using event history analysis, this article
Marshall H. Medoff
Emergency Physician Awareness treatments and medicationsEmergency Physician Awareness of Prehospital Procedures and Medicationsemergency department (ED) and provide many different procedures and medications
Waldron, Rachel; Sixsmith, Diane
Objective: Abortion can be a difficult event to cope with and can lead to the development of psychological disturbance. The aim of this prospective and longitudinal study was to assess and to predict Posttraumatic Stress Disorder (PTSD) symptoms following abortion. Moreover, this study aimed to assess whether the type of abortion had an impact on women’s experience. Method: Eighty-six women
C. Rousset; C. Brulfert; N. Séjourné; N. Goutaudier; H. Chabrol
Objective: Abortion can be a difficult event to cope with and can lead to the development of psychological disturbance. The aim of this prospective and longitudinal study was to assess and to predict Posttraumatic Stress Disorder (PTSD) symptoms following abortion. Moreover, this study aimed to assess whether the type of abortion had an impact on women’s experience. Method: Eighty-six women
C. Rousset; C. Brulfert; N. Séjourné; N. Goutaudier; H. Chabrol
The experience with 107 saline instillation abortions at Kapiolani Maternity and Gynecologic Hospital in Honolulu, during the first 7 months of 1972 is reviewed. 57.9% of the patients were primigravidas and 40.2% were multigravidas. Estimated length of gestation ranged from 14 to 23 weeks, with a mean of 17.7. 87/8% of the women were successfully aborted on the initial attempt, while technical difficulty with amniocentesis prevented the instillation of saline in 10.3%, and the method itself failed for 2. 30% of the primary attempts at abortion failed when gestation length was estimated at 15 to 16 weeks compared to a 7% failure rate at 17 to 18 weeks; no failures occurred at 19 weeks or more. Mean induction-abortion interval was 25.7 hours; gravidity appeared to exert little influence. 32.7% of the patients displayed postabortive complications which were defined by the following criteria: 1) failure of amniocentesis or failure to abort; 2) accidental intravascular injection of saline and immediate reaction consistent with this clinical syndrome; 3) fever, any recorded temperature of 100.6 degrees Farenheit or greater; 4) retained tissue; 5) hemorrhage, a decrease in hemoglobin of 2 gm or more. 14% of the women developed fever while failed abortion occurred for 12.1% and 10.3% displayed more than 1 complication. The highest complication rate (40%) occurred in 13-16 week gestation group; the lowest (29.6%) in the 17-20 weeks interval. A greater risk was found to exist for the very young patient (15 years and under) and the older patient (age 30 and over); complication rates were 50% and 40% respectively, compared to a rate of 25% for age 29. The group of patients having greater than 150 cc of amniotic fluid removed and greater than 150 cc of hypertonic saline instilled had the shortest interval to abortion. While complications encountered in this series of 107 patients were mainly minor, it should be noted that the incidence of these complications as well as the induction-abortion interval determine the length of hospitalization and consequently the cost of the procedure. Early abortion procedures reduce both cost and risk of complications. PMID:4746228
Hooper, T I; Smith, R G; Pion, R J
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. PMID:24886393
...2010-07-01 true Procedures for obtaining medical care. 564.40 Section 564.40...RESERVES NATIONAL GUARD REGULATIONS Medical Attendance and Burial § 564.40 Procedures for obtaining medical care. (a) When a...
...2009-07-01 true Procedures for obtaining medical care. 564.40 Section 564.40...RESERVES NATIONAL GUARD REGULATIONS Medical Attendance and Burial § 564.40 Procedures for obtaining medical care. (a) When a...
Objective Approximately 18% of maternal deaths in East Africa is attributable to unsafe abortion. Availability of comprehensive abortion care (CAC) services at all levels of the healthcare system, including medical abortion, has the potential to increase access to safe abortion thereby reducing the burden of unsafe abortion. This study sought to assess trends in abortion-related morbidity indicators in referral hospitals. Design Researchers conducted a secondary data analysis on retrospectively collected data. Methods Data analysed were collected from four hospitals in the Tigray region of Ethiopia that took part in a CAC pilot project. Providers were trained in mid-2009 to provide abortion services using all available technologies. Data records from hospitals were collected in 2012 for the years 2006 through 2012; 2006/2007 data were too sparse to include in the analyses. Results Trends in abortion-related services show a significant decrease in treatment of incomplete abortion, inverting the relationship between safe terminations and treatment of incompletes as a percentage of total abortions. Medication abortion was nearly non-existent in 2008, but increased steadily, representing 80% of total procedures in 2012. The inclusion of medication abortion and availability of CAC also contributed to a decline in inpatient procedures and prevalence of complications. Conclusions The trends observed in the data demonstrate how increased availability of CAC services at all levels of the healthcare system, among other factors, can contribute to reductions in the burden of unsafe abortion at referral hospitals. PMID:23883881
Prata, Ndola; Bell, Suzanne; Gessessew, Amanual
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
Background The purpose of this study was to investigate attributes of public service providers associated with the provision of medical abortion in Vietnam. Methods We conducted a cross-sectional study via interviewer-administered questionnaire among abortion providers from public health facilities in Hanoi, Khanh Hoa, and Ho Chi Minh City in Vietnam between August 2011 and January 2012. We recruited abortion providers at all levels of Vietnam’s public health service delivery system. Participants were questioned about their medical abortion provision practices and perspectives regarding abortion methods. Results A total of 905 providers from 62 health facilities were included, comprising 525 (58.0%) from Hanoi, 122 (13.5%) from Khanh Hoa, and 258 (28.5%) from Ho Chi Minh City. The majority of providers were female (96.7%), aged ?25 years (94%), married (84.4%), and had at least one child (89%); 68.9% of providers offered only manual vacuum aspiration and 31.1% performed both medical abortion and manual vacuum aspiration. Those performing both methods included physicians (74.5%), midwives (21.7%), and nurses (3.9%). Unadjusted analyses showed that female providers (odds ratio 0.1; 95% confidence interval 0.01–0.30) and providers in rural settings (odds ratio 0.3; 95% confidence interval 0.08–0.79) were less likely to provide medical abortion than their counterparts. Obstetricians and gynecologists were more likely to provide medical abortion than providers with nursing/midwifery training (odds ratio 22.2; 95% confidence interval 3.81–129.41). The most frequently cited advantages of medical abortion for providers were that no surgical skills are required (61.7%) and client satisfaction is better (61.0%). Conclusion Provision of medical abortion in Vietnam is lower than provision of manual vacuum aspiration. While the majority of abortion providers are female midwives in Vietnam, medical abortion provision is concentrated in urban settings among physicians. Individuals providing medical abortion found that the method yields high client satisfaction. PMID:25152635
Ngo, Thoai D; Free, Caroline; Le, Hoan T; Edwards, Phil; Pham, Kiet HT; Nguyen, Yen BT; Nguyen, Thang H
Background Medical abortion is legal in South Africa but access and acceptability are hampered by the current protocol requiring a follow-up visit to assess abortion completion. Objective To assess the feasibility and efficacy of information and follow-up provided via mobile phone after medical abortion in a randomized controlled trial (RCT). Methods Mobile phones were used in three ways in the study: (1) coaching women through medical abortion using short message service (SMS; text messages); (2) a questionnaire to assess abortion completion via unstructured supplementary service data (USSD, a protocol used by GSM mobile telephones that allows the user to interact with a server via text-based menus) and the South African mobile instant message and social networking application Mxit; and (3) family planning information via SMS, mobisite and Mxit. A needs and context assessment was done to learn about women’s experiences undergoing medical abortion and their use of mobile phones. After development, the mobile interventions were piloted. Recruitment was done by field workers at the clinics. In the RCT, women were interviewed at baseline and exit. Computer logs were also analyzed. All study participants received standard of care at the clinics. Results In the RCT, 234 women were randomized to the intervention group. Eight did not receive the intervention due to invalid numbers, mis-registration, system failure, or opt-out, leaving 226 participants receiving the full intervention. Of the 226, 190 returned and were interviewed at their clinic follow-up visit. The SMSs were highly acceptable, with 97.9% (186/190) saying that the SMSs helped them through the medical abortion. In terms of mobile phone privacy, 86.3% (202/234) said that it was not likely or possible that someone would see SMSs on their phone, although at exit, 20% (38/190) indicated that they had worried about phone privacy. Having been given training at baseline and subsequently asked via SMS to complete the self-assessment questionnaire, 90.3% (204/226) attempted it, and of those, 86.3% (176/204) reached an endpoint of the questionnaire. For the family planning information, a preference for SMS was indicated by study clients, although the publicly available Mxit/mobisite was heavily used (813,375 pages were viewed) over the study duration. Conclusions SMS provided a good medium for timed, "push" information that guided and supported women through medical abortion. Women were able to perform a self-assessment questionnaire via mobile phones if provided training and prompted by SMS. Phone privacy needs to be protected in similar settings. This study may contribute to the successful expansion of medical abortion provision aided by mobile phones. Trial Registration Pan African Clinical Trials Registry (PACTR): PACTR201302000427144; http://www.pactr.org/ATMWeb/appmanager/atm/atmregistry?dar=true&tNo=PACTR201302000427144 (Archived by WebCite at http://www.webcitation.org/6N0fnZfzm). PMID:25098569
Background In response to concerns about serious infections following medical abortion, in early 2006 Planned Parenthood changed the route of misoprostol administration from vaginal to buccal and required either routine antibiotic coverage or universal screening and treatment for chlamydia; in July 2007, Planned Parenthood began requiring routine antibiotic coverage for all medical abortions. We previously reported a pronounced drop in the rate of serious infection following the adoption of these new infection control measures. Our objective here is to assess whether the degree of severity of the serious infections differed in the three infection-control groups (vaginal misoprostol and no antibiotics, buccal misoprostol and screen-and-treat, buccal misoprostol and routine antibiotics) or, equivalently, to assess whether the declines in rates of serious infections after the adoption of new infection control measures differed across degree of severity categories. Of particular importance is whether the new infection control measures selectively reduced the least severe serious infections but did not diminish the rate of the most severe infections. Methods We performed a retrospective analysis assessing the degree of severity of infections before infection controls were implemented and after each of the two new measures was adopted: buccal administration of antibiotics with either screen-and-treat or routine antibiotic coverage. We ranked the severity of infection from 1 (when treatment occurred in an emergency department) to 4 (when death occurred). We compared the distribution of the severity of serious infections in the three infection control groups (none, buccal misoprostol and screen-and-treat, buccal misoprostol and routine antibiotics), or, equivalently, assessed whether the declines in rates of serious infections after the adoption of new infection control measures differed across degree of severity categories using the Jonckheere-Terpstra test for a doubly ordered 4×3 table. Results The distribution of infection by severity was the same for all three infection control groups. Likewise, when the two new infection control groups—buccal misoprostol plus either screen-and-treat or routine antibiotics—were combined, the distribution of infection by severity was the same before and after the new measures were implemented. Conclusion The pronounced decline in the rate of serious infections occurred in each category of severity. PMID:21397090
Fjerstad, Mary; Trussell, James; Lichtenberg, E Steve; Sivin, Irving; Cullins, Vanessa
National and international courts and tribunals are increasingly ruling that although states may aim to deter unlawful abortion by criminal penalties, they bear a parallel duty to inform physicians and patients of when abortion is lawful. The fear is that women are unjustly denied safe medical procedures to which they are legally entitled, because without such information physicians are deterred from involvement. With particular attention to the European Court of Human Rights, the UN Human Rights Committee, the Constitutional Court of Colombia, the Northern Ireland Court of Appeal, and the US Supreme Court, decisions are explained that show the responsibility of states to make rights to legal abortion transparent. Litigants are persuading judges to apply rights to reproductive health and human rights to require states' explanations of when abortion is lawful, and governments are increasingly inspired to publicize regulations or guidelines on when abortion will attract neither police nor prosecutors' scrutiny. PMID:17889879
Cook, R J; Erdman, J N; Dickens, B M
Tay?Sachs is a fatal genetic ailment preponderant among Jews. Modern medical techniques can detect carriers of the disease as well as identify affected fetuses, permitting the option of abortion. Abortion, however, is more than a simple medical procedure. It also has ethical and religious implications and these have a long history of discussion within Jewish tradition. While all forms of
a 17-year-old gravida 1, para 0, single white girl who had undergone criminal abortion, presented at the hospital with high fever and red urine. Her vital signs were monitored and laboratory tests were performed. A total abdominal hysterectomy and salpingo-oophorectomy were performed because of gangrenous uterus and ovaries. The patient developed postoperative complications and blood transfusion was performed. The criminal abortion was induced using some type of liquid (eg., Lysol) that was injected into the uterus transvaginally. The use of Lysol, soap and detergents in criminal abortion produces an area of tissue necrosis. The compounds are also absorbed into the bloodstream. The necrotic tissue is susceptible to infection, while the part which is absorbed into the bloodstream is nephrotoxic, hepatotoxic and produces hemolysis. Common complications of septic abortion are pelvic abscesses; metastatic abscesses; tetanus; renal insufficiency; cortical necrosis; and acute tubular necrosis. Coagulation abnormalities, as well as the psychological, economic and legal aspects of septic abortion are also discussed. It is hoped that all physicians would actively support legislation which would liberalize abortion laws. PMID:5506161
Sachs, F L; Landsberg, L
A story is recounted of how 1 physician, trained for and concerned about the preservation of life and health, dealt with question of voluntary abortion. Abortion is easy and safe, and if accomplished with all of the modern medical safeguards, abortion in the 1st 3 months of gestation is 10 times safer for a woman than continuing through a normal pregnancy and delivery. abortion from 13 weeks onwards is at least as safe as having a normal pregnancy and delivery. Thus, it is a medical fact that abortion does not exact a penalty from the woman. If she makes the decision early and is aborted in the 1st trimester, her safety is enhanced. This is the reasoning that influenced the justices of the Supreme Court of the US to arrive at the landmark decisions that now are law. If everyone agreed with what is legal and justifiable, this discussion would not bt taking place. Responsible people differ widely in their response to the questions of whether a fetus can be considered alive and is a fetus entitled to the same protection as that afforded any living person. A logical starting place is the moment of conception. Some people have argued that conception alone is not enough and that the conceptus cannot be considered "human" until implantation occurs. Various timetables have been suggested. 1 is that the fetus becomes "human" and assumes rights when it develops a human appearance. Another proposal is that the detection of fetal electrical brain activity be taken as a landmark. In traditional Judaism, a conceptus of up to 40 days has been considered to be nothing but an amorphous fluid. Temporally, the the next possible criterion for the assumption of rights by the fetus could be fetal movement. Viability, the ability of the fetus to survive if separated from the mother, has also been proposed as a criterion for granting rights to the fetus. All of these suggest that to define "human life" results not in an absolute truth but in answers which change with time, culture, technical ability, and even with underlying motivation. This physician can defend to himself that any woman has a right toprotect herself against the dangers of childbearing, that such risks can only be assumed voluntarily, and that this position has traditional roots. But the ethical questions continue. A society's desire for population increase should not be enforced upon the bodies of its women. This physician concurs with the judicial decision that society's interest in abortion should be confined to insuring the safety of the procedure and to treating abortion equally with all other medical procedures. At the same time abortion poses professional ethical problems for the physician. Such problems should be resolved privately between the physician and the patient. PMID:6608671
Rovinsky, J J
BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) inhibit the biosynthesis of prostaglandins and concerns have been expressed that they might attenuate the effects of exogenous prostaglandins. This randomized study was conducted to evaluate whether NSAID given during medical abortion with mifepristone\\/misoprostol in the second trimester has a negative effect on the efficacy of the abortifacient by prolonging the induction-to-abortion interval. METHODS: Seventy-four
C. Fiala; M. L. Swahn; O. Stephansson; K. Gemzell-Danielsson
Abortion has been legalized in Nepal since September 2002 by 11th amendment to the Muluki Ain. The present study was conducted in Paropakar Shree Panch Indra Rajya Laxmi Devi Maternity Hospital to assess the magnitude of induced abortion, its causes and the types of complications, in the post legalization phase. Prospective descriptive analyses of the patients who were admitted with history of induced abortion from 16th Dec 2003 to 13th March 2004 was carried out. A total of 305 cases of abortion complications were admitted during the three-month study period, which is 39.7% of the total gynaecological admissions (768). Of these 31 (10.25%) patients had history of induced abortion. Half of the induced abortion cases (52%) were of age group 21-29 yrs and 42% had three or more children. 39% of the cases had history of induced abortion at more than 12 weeks and almost half of the cases (48%) had history of family planning. The most common reason for seeking abortion was too many children (59%) followed by illegitimate pregnancy (16%). Twenty-one patients gave history of abortion being performed by doctors and the most common method used was D and C (75%). 77% of cases presented as incomplete abortion and one case presented with uterine perforation, bowel injury and peritonitis. Twenty patients had evacuation under sedation while five had manual vacuum aspiration (MVA); one patient required laparatomy. In two third of the patients intravenous fluid and antibiotics were used. Four patients required blood transfusion. Abortion complications constitute almost 40% of the total gynaecological admissions. Ten percent of the abortion cases had history of induced abortion. Medical persons, mainly doctors, performed most of the cases of induced abortion and D and C was the most commonly used method. However the patients had faced various types of complications. Untrained provider, resulting in serious life threatening injuries, performed more than a third of the cases of induced abortion at more than twelve weeks gestation. This points to the need for improved monitoring of the quality of services provided, and adherence to the criteria set by the procedural order. PMID:15821380
Ojha, N; Sharma, S; Paudel, J
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
Globally, abortion mortality accounts for at least 13% of all maternal mortality. Unsafe abortion procedures, untrained abortion providers, restrictive abortion laws and high mortality and morbidity from abortion tend to occur together. Preventing mortality and morbidity from abortion in countries where these remain high is a matter of good public health policy and medical practice, and constitutes an important part of safe motherhood initiatives. This article examines the changes in policy and health service provision required to make abortions safe. It is based on a wide-ranging review of published and unpublished sources. In order to be effective, public health measures must take into account the reasons why women have abortions, the kind of abortion services required and at what stages of pregnancy, the types of abortion service providers needed, and training, cost and counselling issues. The transition from unsafe to safe abortions demands the following: changes at national policy level; abortion training for service providers and the provision of services at the appropriate primary level health service delivery points; and ensuring that women access these services instead of those of untrained providers. Public awareness that abortion services are available is a crucial element of this transition, particularly among adolescent and single women, who tend to have less access to reproductive health services generally. PMID:10859852
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.
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
This case study presents a young woman who developed a severe obsessive-compulsive disorder after a routine medical procedure. It is suggested that this procedure brought back repressed guilt from three abortions and thus led to the onset of symptoms. The case is discussed in relationship to available research and theory. PMID:2751012
McCraw, R K
The US Supreme Court's 1973 Roe v Wade decision had clear implications for American women's reproductive rights and physician ability to carry out patient choices. Its effect on physician abortion training was less apparent. In an effort to increase patient access to abortions after Roe, provision shifted from hospitals to nonhospital clinics. However, these procedures and patients were taken out of the medical education realm, and physicians became vulnerable to intimidation. The consequent provider shortage created an unexpected barrier to abortion access. Medical Students for Choice was founded in 1993 to increase abortion-training opportunities for medical students and residents. Its mission ensures that motivated medical students will learn and a growing number of physicians will commit to comprehensive abortion provision. PMID:23327239
Aksel, Sarp; Fein, Lydia; Ketterer, Em; Young, Emily; Backus, Lois
Study objective: We examine the effect of a preclinical emergency procedures course on students' clinical procedural skills and medical knowledge. Methods: This is a retrospective review of evaluation forms for a cohort of 86 students graduating from medical school at an academic center. A cross section of students (n=57) taking a clinical emergency medicine rotation over a 4-year period was
Theresa M. van der Vlugt; Phillip M. Harter
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...
12 Banks and Banking 7 2010-01-01 2010-01-01 false Special procedure...Medical records. 1102.104 Section 1102.104 Banks and Banking FEDERAL FINANCIAL INSTITUTIONS EXAMINATION COUNCIL APPRAISER REGULATION...
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)
Discussions with several groups of low-income, middle-aged women in various countries of Latin America showed that most disapproved of abortion. In the course of group discussions about the motives of women who seek abortions and the psychological and sanitary conditions under which abortion occurs, however, their disapproval became less categorical. They began to accept the need to decriminalize abortion in order to protect women. The majority, strongly influenced by the Catholic Church, believed that human life begins at conception. Others disapproved of abortion because they feared it would be used as a birth control method and would encourage promiscuity. Most disapproved of abortion for single women attempting to escape family or social censure of unmarried motherhood. Fear of health effects or death from abortion and fear of divine punishment were also mentioned. Recognition of the anguish and pain suffered by women deciding to seek abortion and the difficulty of providing for the material and other needs of many children were factors that led to reconsideration of the wholesale condemnation of abortion. The women realized that such condemnations never take the woman's circumstances into account. Some of the women felt that aborting an unwanted pregnancy would be preferable to abandoning or neglecting an unwanted child. Many of the women came to feel that abortion should be legalized at least under some circumstances. PMID:12348503
For decades, the induction of fetal demise has been used before both surgical and medical second-trimester abortion. Intracardiac potassium chloride and intrafetal or intra-amniotic digoxin injections are the pharmacologic agents used most often to induce fetal demise. In the last several years, induction of fetal demise has become more common before second-trimester abortion. The only randomized, placebo-controlled trial of induced fetal demise before surgical abortion used a 1 mg injection of intra-amniotic digoxin before surgical abortion at 20-23 weeks' gestation and found no difference in procedure duration, difficulty, estimated blood loss, pain scores or complications between groups. Inducing demise before induction terminations at near viable gestational ages to avoid signs of life at delivery is practiced widely. The role of inducing demise before dilation and evacuation (D&E) remains unclear, except for legal considerations in the United States when an intact delivery is intended. There is a discrepancy between the one published randomized trial that used 1 mg intra-amniotic digoxin that showed no improvement in D&E outcomes and observational studies using different routes, doses and pre-abortion intervals that have made claims for its use. Additional randomized trials might provide clearer evidence upon which to make further recommendations about any role of inducing demise before surgical abortion. At the current time, the Society of Family Planning recommends that pharmacokinetic studies followed by randomized controlled trials be conducted to assess the safety and efficacy of feticidal agents to improve abortion safety. PMID:20472112
Diedrich, Justin; Drey, Eleanor
The rising costs of medical treatment in the United States are fueling a movement to outsource medical treatment. Estimates of the number of Americans traveling overseas for treatment range from 50,000 to 500,000. Charges for common procedures such as heart bypass can be $11,000 in Thailand compared to $130,000 in the United States. Knee…
In Planned Parenthood vs. Casey, the US Supreme Court upheld all but 1 provision of Pennsylvania law that further restricts access to abortion. The law has a 24-hour waiting period, parental consent for minors with a judicial bypass, husband notification, and the circumstances of each abortion are to be reported to the state for statistical purposes. The Court overturned the husband notification provision even though it had a bypass procedure. The most important aspect of the decision was the change from the strict scrutiny in which abortion was to be left alone unless the state could show a compelling need to regulate it to an undue burden test in which the state is allowed to regulate abortion so long as it does not place an undue burden on women trying to seek abortion services. The 24-hour waiting period was upheld; however, it was also acknowledged that since 83% of women live in counties without abortion services, this may turn out to be an undue burden and it is open to review at later date when statistical evidence is available. The Opinion was written by Justices O'Connor, Kennedy, and Souter. Chief Justice Rehnquist and Justices Scalia, White, and Thomas dissented saying that the undue burden standard was unprecedented in constitutional law and undefinable in practice. It is likely now that the Court will begin writing abortion policy as it clarifies each specific point of the law rather than ruling on fundamental legal principles. PMID:1351612
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. PMID:25035759
Waldron, Rachel; Sixsmith, Diane M.
Background To determine the advanced life support procedures provided by an Emergency Medical Service (EMS) and a Helicopter Emergency Medical Service (HEMS) for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures restricted to the HEMS-physician and procedures for which the HEMS is more experienced than the EMS. Methods Prospective study of a consecutive group of children examined and treated by the HEMS of the eastern region of the Netherlands. Data regarding type of emergency, physiological parameters, NACA scores, treatment, and 24-hour survival were collected and subsequently analysed. Results Of the 558 children examined and treated by the HEMS on scene, 79% had a NACA score of IV-VII. 65% of the children had one or more advanced life support procedures restricted to the HEMS and 78% of the children had one or more procedures for which the HEMS is more experienced than the EMS. The HEMS intubated 38% of all children, and 23% of the children intubated and ventilated by the EMS needed emergency correction because of potentially lethal complications. The HEMS provided the greater part of intraosseous access, as the EMS paramedics almost exclusively reserved this procedure for children in cardiopulmonary resuscitation. The EMS provided pain management only to children older than four years of age, but a larger group was in need of analgesia upon arrival of the HEMS, and was subsequently treated by the HEMS. Conclusions The Helicopter Emergency Medical Service of the eastern region of the Netherlands brings essential medical expertise in the field not provided by the emergency medical service. The Emergency Medical Service does not provide a significant quantity of procedures obviously needed by the paediatric patient. PMID:20211021
This article examines Soviet reproductive politics after the Communist regime legalized abortion in 1955. The regime's new abortion policy did not result in an end to the condemnation of abortion in official discourse. The government instead launched an extensive campaign against abortion. Why did authorities bother legalizing the procedure if they still disapproved of it so strongly? Using archival sources, public health materials, and medical as well as popular journals to investigate the antiabortion campaign, this article argues that the Soviet government sought to regulate gender and sexuality through medical intervention and health "education" rather than prohibition and force in the post-Stalin era. It also explores how the antiabortion public health campaign produced "knowledge" not only about the procedure and its effects, but also about gender and sexuality, subjecting both women and men to new pressures and regulatory norms. PMID:22145180
Randall, Amy E
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. Based on personal experiences and personal communications from other doctors since 1993, when I began working as an abortion provider, the practical realities of second trimester abortion and case histories of women seeking second trimester abortion are also described. Recommendations include expanding the cadre of service providers to non-allopathic clinicians and trained nurses, introducing second trimester medical abortion into the public health system, replacing ethacridine lactate with mifepristone-misoprostol, values clarification among providers to challenge stigma and poor treatment of women seeking second trimester abortion, and raising awareness that abortion is legal in the second trimester and is mostly not requested for reasons of sex selection. PMID:18772082
Dalvie, Suchitra S
...medical care; employee's duty to notify employer...AND PROCEDURE Medical Care and Supervision Medical...for requesting medical care; employee's duty to notify employer...thereof to the district director having...
This paper examines the extent to which there may be differences in attitudes toward abortion and intentions when one is faced with making an abortion decision for oneself. Data from a 1977 national survey were used. The results indicated that while such differences existed only on a limited scale in medically indicated situations of abortion, discretionary situations had a sizable
B. K. Singh; J. Sherwood Williams
The author discusses the characteristics and feelings of women undergoing abortion. She mentions the decisions which counselors must help such women face, the information they must be given, and the types of support they need. Increased counseling services are needed, she feels, for the markedly increased number of women seeking abortions. (EK)
Brashear, Diane B.
The medical records of 2055 patients undergoing late abortions were reviewed. These represented 15% of all abortions induced over 10 years. In 52%, abortion was performed between 13-16 weeks, and in 25% at or after 20 weeks. Abortion was requested for risk to health in 55% and for failed contraception in 40%. Surgical techniques were used in 39%. There was a trend to use vaginal surgical procedures increasingly, and intraamniotic saline decreasingly. Extraamniotic ethacridine lactate was used in 12%. Because of the cost, prostaglandin infusions were restricted to 2.5%. Planned evacuation of retained products following a medical procedure was performed in 71%; concomitant sterilization in 24%. The complication rate settled at 11% of which 4% were retained products of conception. Complications increased overall with advancing gestational age, and particularly from 15 weeks onward with vacuum aspiration (p0.05) and with dilatation and curettage (p0.05). Cervical injury increased with advancing gestation (p=0.01). In developing nations, there is a pressing need to educate illiterate women to request abortion earlier. PMID:12283425
Bhathena, R K; Sheriar, N K; Guillebaud, J
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
In the US, a new antiabortion strategy of using legislative and judicial forums to change the rhetoric of abortion rather than using abortion rhetoric to change the law arose out of disappointment when the 1992 Casey decision failed to overturn Roe. This new approach is crystallized by the 1995 introduction of federal legislation (vetoed by the President) to ban so-called "partial-birth" abortions. Opponents to this late-term procedure undertaken to preserve a women's life or health distinguish intact dilatation and extraction from induced labor to terminate a nonviable pregnancy (failing to recognize the lack of ethical difference) and make inaccurate political statements linking the abortion procedure to infanticide. When the ban was reintroduced to Congress in 1997, the previously silent American Medical Association agreed to support the bill if two "physician-friendly" amendments were added, but the American College of Obstetricians and Gynecologists made it clear that it is "inappropriate, ill advised, and dangerous" for legislative bodies to intervene into medical decision-making. The new version of the bill shifted the focus to all abortions after viability unless they are necessary to protect the mother from grievous harm to her physical (not mental) health, thus limiting the reach of the Roe decision. Clinton vetoed this bill also. Such legislation would be unlikely to prevent even one abortion, and its importance rests in its view of the proper role of government in regulating health care. This follows previous efforts to reframe the abortion debate by creating a dichotomy that marginalizes either women or fetuses and shifts the focus to another issue. PMID:9673308
Annas, G J
Despite 30 years of liberal legislation, the majority of women in India still lack access to safe abortion care. This paper critically reviews the history of abortion law and policy in India since the 1960s and research on abortion service delivery. Amendments in 2002 and 2003 to the 1971 Medical Termination of Pregnancy Act, including devolution of regulation of abortion
Siddhivinayak S Hirve
The rising costs of medical treatment in the United States are fueling a movement to outsource medical treatment. Estimates of the number of Americans traveling overseas for treatment range from 50,000 to 500,000. Charges for common procedures such as heart bypass can be $11,000 in Thailand compared to $130,000 in the United States. Knee replacement in the United States can cost $40,000 compared to $13,000 in Singapore.A new industry, medical tourism, has been created to advise patients on the appropriate facility in the right country for their condition, handle all travel arrangements, teleconference with physicians, and send medical records. To respond to the growth in medical travel, the Joint Commission (formerly the Joint Commission on Accreditation of Health Care Organizations) initiated the Joint Commission International (JCI) to accredit hospitals worldwide. Although outcome statistics from hospitals outside the United States are rare, first-person reports on quality are numerous. Making surgery possible for uninsured and underinsured individuals or self-insured state, municipal, and private entities is a major benefit of medical tourism. Mitigating against medical travel are the lack of legal remedies in place for malpractice and the possibility that travel itself can impose risk to patients. For example, lengthy air flights where the patient is in a fixed position for hours at a time can cause embolisms. If the trend toward medical tourism continues, continuing education, credentialing, and certification services may be required to help assure patient safety. PMID:18521877
by significantly decreasing procedure time and reducing the frequency of medical errors by up to sixfold comparedPhysically-based Simulation of Medical Procedures for Training and Planning The Challenge Computer simulations of medical procedures enable physicians and other clinicians to train in a controlled environment
Whitton, Mary C.
Medical termination of pregnancy in the second trimester is a painful and a time-consuming procedure. This study comprises 110 consecutive second trimester terminations of pregnancy performed 1994-96. In 76 women (69%) the procedure was a legal abortion due to foetal malformations, 25 women (23%) had an intrauterine foetal death, and in 9 (8%) cases pregnancy was terminated because of persisting drainage of amniotic fluid. All cases with intrauterine foetal death and early drainage of amniotic fluid were successfully treated after application of up to five vagitories of gemeprost (mean 2.8 vagitories; mean induction-abortion interval 8.9 hours). In patients undergoing abortion due to foetal malformations, the mean induction-abortion time was longer (mean 22.7 hours, mean 5.2 vagitories) and 20% did not respond adequately to prostaglandin. Our results show that gemeprost is an efficient means of terminating a pregnancy in cases of foetal death or pre-term amniorrhea, but that it is less efficient in inducing abortion. PMID:10613090
Heimstad, R K; Backe, B; Skjeldestad, F E
Background Internet surveys that draw from traditionally generated samples provide the unique conditions to engage adolescents in exploration of sensitive health topics. Methods We examined awareness of unwanted pregnancy, abortion behaviour, methods, and attitudes toward specific legal indications for abortion via a school-based internet survey among 378 adolescents aged 12–21 years in three Rio de Janeiro public schools. Results Forty-five percent knew peers who had undergone an abortion. Most students (66.0%) did not disclose abortion method knowledge. However, girls (aOR 4.2, 95% CI 2.4-7.2), those who had experienced their sexual debut (aOR1.76, 95% CI 1.1-3.0), and those attending a prestigious magnet school (aOR 2.7 95% CI 1.4-6.3) were more likely to report methods. Most abortion methods (79.3%) reported were ineffective, obsolete, and/or unsafe. Herbs (e.g. marijuana tea), over-the-counter medications, surgical procedures, foreign objects and blunt trauma were reported. Most techniques (85.2%) were perceived to be dangerous, including methods recommended by the World Health Organization. A majority (61.4%) supported Brazil’s existing law permitting abortion in the case of rape. There was no association between gender, age, sexual debut, parental education or socioeconomic status and attitudes toward legal abortion. However, students at the magnet school supported twice as many legal indications (2.7, SE.27) suggesting a likely role of peers and/or educators in shaping abortion views. Conclusions Abortion knowledge and attitudes are not driven simply by age, religion or class, but rather a complex interplay that includes both social spaces and gender. Prevention of abortion morbidity and mortality among adolescents requires comprehensive sexuality and reproductive health education that includes factual distinctions between safe and unsafe abortion methods. PMID:24521075
The recent Supreme Court decision upholding Roe v. Wade and in particular, the dissent by Justice Sandra Day O'Connor, sheds new light on the issue of abortion. Let us consider any stage of a pregnancy when abortion is medically safe for the mother. If at that stage it is also medically viable to save the fetus, is an abortion performed
Patricia H. Werhane
Background Every year 42 million women with unintended pregnancies choose abortion, and fifty percent of these procedures, 20 million are unsafe. An unsafe abortion is defined as a procedure for terminating an unintended pregnancy carried out either by person lacking the necessary skills or in an environment that does not conform to minimal medical standards or both. Pakistan is the one of the six countries where more than 50% of the world’s all maternal deaths occur. It is estimated that 890,000 induced abortions are performed annually in Pakistan, and estimate an annual abortion rate of 29 per 1000 women aged 15-49. Case presentation Here we present a case report of a 29-year old woman who underwent an unsafe abortion for unintended pregnancy resulting in uterine perforation. The unskilled provider pulled out her bowel through vagina after perforating the uterus, as a result she lost major portion of her small intestine resulting in short bowel syndrome. Conclusion The law of Pakistan only allows abortion during early stages of pregnancy for purpose of saving the life of a mother but does not cater for cases of rape, incest and fetal abnormalities or social reasons. Only legalization of abortion is not sufficient, preventing unintended pregnancy should be the priority of all the nations and for this reason contraception should be widely accessible. Practitioners need to become better trained in safer abortion methods and be to able transfer the patient to health facility when complications occur. PMID:24131627
One known complication of induced abortion is upper genital tract infection, which is relatively uncommon in the current era of safe, legal abortion. Currently, rates of upper genital tract infection in the setting of legal induced abortion in the United States are generally less than 1%. Randomized controlled trials support the use of prophylactic antibiotics for surgical abortion in the first trimester. For medical abortion, treatment-dose antibiotics may lower the risk of serious infection. However, the number-needed-to-treat is high. Consequently, the balance of risk and benefits warrants further investigation. Perioperative oral doxycycline given up to 12 h before a surgical abortion appears to effectively reduce infectious risk. Antibiotics that are continued after the procedure for extended durations meet the definition for a treatment regimen rather than a prophylactic regimen. Prophylactic efficacy of antibiotics begun after abortion has not been demonstrated in controlled trials. Thus, the current evidence supports pre-procedure but not post-procedure antibiotics for the purpose of prophylaxis. No controlled studies have examined the efficacy of antibiotic prophylaxis for induced surgical abortion beyond 15 weeks of gestation. The risk of infection is not altered when an intrauterine device is inserted immediately post-procedure. The presence of Chlamydia trachomatis, Neisseria gonorrhoeae or acute cervicitis carries a significant risk of upper genital tract infection; this risk is significantly reduced with antibiotic prophylaxis. Women with bacterial vaginosis (BV) also have an elevated risk of post-procedural infection as compared with women without BV; however, additional prophylactic antibiotics for women with known BV has not been shown to reduce their risk further than with use of typical pre-procedure antibiotic prophylaxis. Accordingly, evidence to support pre-procedure screening for BV is lacking. Neither povidone-iodine nor chlorhexidine have been shown to alter the risk of infection when used as cervicovaginal preparation. However, chlorhexidine appears to be more effective than povidone iodine at reducing bacteria within the vagina. The Society of Family Planning recommends the routine use of antibiotic prophylaxis, preferably with doxycycline, before surgical abortion. Use of treatment doses of antibiotics with medical abortion may decrease the rare risk of serious infection but universal requirement for such treatment has not been established. PMID:21397086
Achilles, Sharon L; Reeves, Matthew F
Simplified follow-up after medical abortion using a low-sensitivity urinary pregnancy test and a pictorial instruction sheet in Rajasthan, India - study protocol and intervention adaptation of a randomised control trial
Background The World Health Organisation suggests that simplification of the medical abortion regime will contribute to an increased acceptability of medical abortion, among women as well as providers. It is expected that a home-based follow-up after a medical abortion will increase the willingness to opt for medical abortion as well as decrease the workload and service costs in the clinic. Methods/Design This study protocol describes a study that is a randomised, controlled, non-superiority trial. Women screened to participate in the study are those with unwanted pregnancies and gestational ages equal to or less than nine weeks. The randomisation list will be generated using a computerized random number generator and opaque sealed envelopes with group allocation will be prepared. Randomization of the study participants will occur after the first clinical encounter with the doctor. Eligible women randomised to the home-based assessment group will use a low-sensitivity pregnancy test and a pictorial instruction sheet at home, while the women in the clinic follow-up group will return to the clinic for routine follow-up carried out by a doctor. The primary objective of the study this study protocol describes is to evaluate the efficacy of home-based assessment using a low-sensitivity pregnancy test and a pictorial instruction sheet 10–14 days after an early medical abortion. Providers or research assistants will not be blinded during outcome assessment. To ensure feasibility of the self-assessment intervention an adaption phase took place at the selected study sites before study initiation. This resulted in an optimized, tailor-made intervention and in the development of the pictorial instruction sheet with a guide on how to use the low-sensitivity pregnancy test and the danger signs after a medical abortion. Discussion In this paper, we will describe the study protocol for a randomised control trial investigating the efficacy of simplified follow-up in terms of home-based assessment, 10–14 days after a medical abortion. Moreover, a description of the adaptation phase is included for a better understanding of the implementation of the intervention in a setting where literacy is low and the road-connections are poor. Trial registration Clinicaltrials.gov NCT01827995. Registered 04 May 2013. PMID:25127545
Sporadic spontaneous abortion has been accorded relatively little scientific attention but has widespread prevalence and great personal impact. The physician must be continually vigilant to consider possibilities for Rh0(D) sensitization and offer prophylaxis when appropriate. The most immediate problems include differential diagnosis, haemorrhage, and infection, while later issues focus on counselling and subsequent pregnancies. Serious physical and psychological morbidity can be averted by the conscientious care of couples experiencing spontaneous pregnancy loss. PMID:3086012
Laferla, J J
The Irish Medical Council has undertaken accreditation inspections of Irish medical schools on a regular basis since 1996. This document is a summary of the accreditation standards, a guide to the process for those involved and an overview of the complexity of the many elements involved in educating a doctor. It should be read in conjunction with previous Medical Council publications on medical education. It also provides the basis for the Evaluation System for Visitors 2003. The Medial Council's prime role is the protection of the public interest in relation to the practice of medicine. The Medical Council scrutinises medical schools. It has an important advocacy role with government, with the universities which operate medical schools and with the professionals involved to improve the standards and delivery of medical education. PMID:16315617
The following guidelines reflect a collation of the evaluable medical literature about surgical abortion prior to 7 weeks of gestation. Early surgical abortion carries lower risks of morbidity and mortality than procedures performed later in gestation. Surgical abortion is safe, practicable and successful as early as 3 weeks from the start of last menses (no gestational sac visible on vaginal ultrasound) provided that (a) routine sensitive pregnancy testing verifies pregnancy, (b) the tissue aspirate is immediately examined for the presence of a gestational sac plus villi and (c) a protocol to identify ectopic pregnancy expeditiously--including calculation of readily obtained serial serum quantitative human chorionic gonadotropin titers when clinically appropriate--is in place and strictly adhered to. Manual and electric vacuum aspiration methods for early abortion demonstrate comparable efficacy, safety and acceptability. Current data are inadequate to determine if any of the following techniques substantially improve procedure success or safety: use of rigid versus flexible cannulae, light metallic curettage following uterine aspiration, uterine sounding or routine use of intraoperative ultrasound. PMID:23574709
Lichtenberg, E Steve; Paul, Maureen
A doctor who performed an abortion in Poland faces two years in prison and the loss of his medical license for up to 10 years if he is found guilty of violating the new abortion laws introduced in 1993 after a lengthy campaign by the Catholic church and the Christian Democratic Union party. The new laws permit abortion when the pregnancy threatens the life of the mother, presents a serious health threat to the mother, is the result of rape or incest, or will result in the birth of a irreversibly and seriously malformed fetus. In this case, the woman had the abortion because she could not afford to support the child on her own; her former lover faces two years in prison if he is convicted of having paid for the operation. The new law follows a 40-year period of liberal abortion laws under the communist regime when abortion was seen as a form of contraception; an estimated 100,000 abortions occurred in the 1980s. The number of recorded abortions decreased to 777 (nine were in contravention of the law) in 1993. However, some abortions have gone underground; this one surfaced because of an angry former lover. Doctors can now charge two months' salary for the illegal operation, forcing many of the women go to Russia, Belarus, or the Ukraine where the operation is cheaper. Other women take matters into their own hands; one woman murdered the baby she would have aborted earlier. PMID:7787640
Abortion traditionally means, "to miscarry" and is still known as a problem which societies has been trying to reduce its rate by using legal means. Despite the pregnant women and fetuses have being historically supported; abortion was firstly criminalized in 1926 in Iran, 20 years after establishment of modern legal system. During next 53 years this situation changed dramatically, so in 1979, the time of Islamic Revolution, aborting fetuses before 12 weeks and therapeutic abortion (TA) during all the pregnancy length was legitimate, based on regulations that used medical justification. After 1979 the situation changed into a totally conservative and restrictive approach and new Islamic concepts as "Blood Money" and "Ensoulment" entered the legal debates around abortion. During the next 33 years, again a trend of decriminalization for the act of abortion has been continuing. Reduction of punishments and omitting retaliation for criminal abortions, recognizing fetal and maternal medical indications including some immunologic problems as legitimate reasons for aborting fetuses before 4 months and omitting the fathers' consent as a necessary condition for TA are among these changes. The start point for this decriminalization process was public and professional need, which was responded by religious government, firstly by issuing juristic rulings (Fatwas) as a non-official way, followed by ratification of "Therapeutic Abortion Act" (TAA) and other regulations as an official pathway. Here, we have reviewed this trend of decriminalization, the role of public and professional request in initiating such process and the rule-based language of TAA. PMID:24338232
Abbasi, Mahmoud; Shamsi Gooshki, Ehsan; Allahbedashti, Neda
Because of psychological reactions in the nursing staff working with abortion patients, mental health consultations were requested by several hospitals in Hawaii after abortion became legal. Many of the nurses had strong emotional reactions to the abortion work. They reacted more strongly to saline abortions than to suction curettage because of the similarity to actual labor. Many of the nurses had trouble switching roles from traditional obstetric nurses to working with abortion patients. The authors concluded that "it is crucial to include nurses in the policy making processes... The option of not working on abortion cases must be kept open." Abortion cases should be segregated from general maternity cases to help avoid some of the conflicts in nursing care. The emphasis should be on first trimester abortions for medical and psychological reasons. More research is needed on the woman's attitude toward abortion and pregnancy, with special reference to delay in discovering pregnancy. PMID:5558613
McDermott, J F; Char, W F
. In this dissertation, we combine ideas from robotics, physically-based modeling, and operations research to develop newPlanning and Optimization Algorithms for Image-Guided Medical Procedures by Ron Alterovitz B-Guided Medical Procedures Copyright c 2006 by Ron Alterovitz #12;Abstract Planning and Optimization Algorithms
9 out of 15 known free standing abortion clinics in the Washington, D.c. metro area were surveyed by a multidisciplinary team to determine whether prescribed health and safety standards for health care facilities are being adhered to. The minimum space requirements of 80 sq ft for medical examination and/or treatment rooms were not met by 4 clinics and inadequate lighting was found in 2 clinics. Although all facilities exhibited evidence of an effective housekeeping program, 8 clinics did not have effective preventive maintenance program for mechanical equipment and medical devices. 1 clinic had inadequate ventilation system and 6 had inadequate handwashing facilities. All had effective solid waste management systems. 6 clinics regularly conduct microbiological monitoring programs (eg, swabbing walls, doorknobs and heating units; sterilization of surgical instruments) but 3 lacked vigilant supervision of sterilizing equipment and procedures. 2 clinics did not have properly grounded or insulated electrical equipment for minimizing electrical shock. Insect and rodent control in all clinics was good. Overall, the housekeeping programs were considered to be constant, thorough, well-conceived and well executed. Implications of the findings were discussed. PMID:10305534
Walker, B; Gordon, T J; Preuss, J
The medical profession classifi es abortion as induced or spontaneous. The lay public, however, tends to equate the term abortion\\u000a with one that is induced, whether therapeutically, self, or criminal, and to associate the term miscarriage with spontaneous\\u000a abortion (Beard et al. 1985).\\u000a \\u000a Spontaneous abortion is usually defi ned as the involuntary loss of a conceptus before the fetus has
T. Yee Khong
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.
Parkinson, D.K.; Grennan, M.J.
PurposeResident physicians learn to perform inpatient bedside procedures in a manner that is neither standardized nor rigorous. As a result, residents may be unskilled and uncomfortable performing procedures. This study characterizes residents’ comfort performing medical procedures and identifies factors associated with lack of comfort.
Grace C. Huang; C. Christopher Smith; Craig E. Gordon; David J. Feller-Kopman; Roger B. Davis; Russell S. Phillips; Saul N. Weingart
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
Since the 1973 Supreme Court decision legalizing abortion, medical and scientific developments have focused greater public and professional attention on the status of the fetus. Their cumulative effect may influence legal, social, and moral thought and set the stage for a change in public opinion and a challenge to legalized abortion. There is as yet no inexorable convergence of medical data and legal opinion that would undermine the rational of Roe v. Wade. But the prochoice movement must find room for an open airing of the moral questions if abortion is to remain what it should be--a legally acceptable act. PMID:3514547
emergency department (ED) care depends on effective handoff communicationemergency medical services handover of trauma patients. Prehospital communicationEmergency Physician Awareness received 35% of the time. 16 The ideal handover with respect to communication
Waldron, Rachel; Sixsmith, Diane
The intracarotid amobarbital procedure (IAP) is routinely conducted as part of the presurgical evaluation of pediatric patients with epilepsy. The aim of the present study was to investigate the possibility that anesthetization failures are the result of interactions of carbonic anhydrase-inhibiting (CAI) medications with sodium amobarbital. An archival review of 81 cases conducted between 1999 and 2008 was performed across two pediatric epilepsy centers. chi(2) analysis was used to assess whether CAI medications interfered with the outcome of these procedures. Of 81 patients, 85.2% had conclusive findings. All of the remaining 14.8% with anesthetization failures were taking CAI medications at the time of the procedure. However, 53.8% of patients taking CAI medications had conclusive results. This suggests that these medications may interact with sodium amobarbital, raising the possibility of anesthetization failures in children prescribed CAI medications. PMID:19208439
Burns, Thomas G; Lee, Gregory P; McCormick, Megan L; Pettoni, Ashley N; Flamini, J Robert; Cohen, Morris
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
A practicing physician reviews the contribution of Jewish ethics, as it relates to the structure of Jewish law, to the issue of abortion. The topics approached include the status of the fetus, the relationship of fetus to mother, abortion and murder, therapeutic abortion, and the rights of the mother. The discussion describes rabbinic answers to abortion requests and is followed
Tomas J. Silber
Background Rural induced abortion service has declined in Canada. Factors influencing abortion provision by rural physicians are unknown. This study assessed distribution, practice, and experiences among rural compared to urban abortion providers in the Canadian province of British Columbia (BC). Methods We used mixed methods to assess physicians on the BC registry of abortion providers. In 2011 we distributed a previously-published questionnaire and conducted semi-structured interviews. Results Surveys were returned by 39/46 (85%) of BC abortion providers. Half were family physicians, within both rural and urban cohorts. One-quarter (17/67) of rural hospitals offer abortion service. Medical abortions comprised 14.7% of total reported abortions. The three largest urban areas reported 90% of all abortions, although only 57% of reproductive age women reside in the associated health authority regions. Each rural physician provided on average 76 (SD 52) abortions annually, including 35 (SD 30) medical abortions. Rural physicians provided surgical abortions in operating rooms, often using general anaesthesia, while urban physicians provided the same services primarily in ambulatory settings using local anaesthesia. Rural providers reported health system barriers, particularly relating to operating room logistics. Urban providers reported occasional anonymous harassment and violence. Conclusions Medical abortions represented 15% of all BC abortions, a larger proportion than previously reported (under 4%) for Canada. Rural physicians describe addressable barriers to service provision that may explain the declining accessibility of rural abortion services. Moving rural surgical abortions out of operating rooms and into local ambulatory care settings has the potential to improve care and costs, while reducing logistical challenges facing rural physicians. PMID:23840578
Norman, Wendy V.; Soon, Judith A.; Maughn, Nanamma; Dressler, Jennifer
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
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. PMID:3048126
Cook, R J; Dickens, B M
We use unique data on abortions performed in New York State from 1971–1975 to demonstrate that women travelled hundreds of miles for a legal abortion before Roe. A100- 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
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.
Adverse Drug Events (ADEs) are currently considered as a major public health issue, resulting in endangering patients' safety and significant healthcare costs. The EU-funded project PSIP (Patient Safety through Intelligent Procedures in Medication) aims to develop intelligent mechanisms towards preventing ADEs, aiming to improve the entire Prescription - Dispensation - Administration - Compliance (PDAC) medication chain. In this regard, PSIP
Vassilis Koutkias; Katerina Lazou; Vassilis Kilintzis; Régis Beuscart; Nicos Maglaveras
A series of workshops demonstrating technical skills and practical procedures in internal medicine was conducted for fourth-year medical students. The workshops provided the students the chance to observe and in some situations to perform the technical procedures under supervision before beginning their residencies. (Author/MLW)
Frank, Stuart; Rabinovich, Sergio
Background and methodologyThere is growing interest in the UK towards increasing treatment options for women undergoing abortion and miscarriage. Such options include home medical treatment and surgery under local anaesthesia (LA). This study aimed to gauge views of women undergoing abortion and treatment for miscarriage at the Royal Infirmary Edinburgh towards medical treatment at home, and surgery under LA, to
Kate Levine; Sharon T Cameron
In 1991, 4158 women from Ireland and 1766 from Northern Ireland traveled to England for abortions. This situation has been ignored by Irish authorities. The 1992 case of the 14-year old seeking an abortion in England finally caught legal attention. This study attempts to help define who these abortion seekers are. Questionnaires from 200 Irish abortion seeking women attending private Marie Stopes clinics in London and the British Pregnancy Advisory Services clinic in Liverpool between September 1988 and December 1990 were analyzed. Findings pertain to demographic characteristics, characteristics of first intercourse, family discussion of sexual activity, and contraceptive use. From this limited sample, it appears that Irish women are sexually reserved and without access to modern methods of birth control and abortion. Sex is associated with shame and guilt. 23% had intercourse before the age of 18 years and 42% after the age of 20. 76% were single and 16% were currently married. 95% were Catholic; 33% had been to church the preceding Sunday and 68% within the past month. Basic information about menstruation is also limited and procedures such as dilatation and curettage may be performed selectively. 28% of married women were uninformed about menstruation prior to its onset. Only 24% had been using birth control around the time of pregnancy. The reason for nonuse was frequently the unexpectedness of intercourse. 62% of adults and 66% of women believe in legalizing abortion in Ireland. British groups have tried to break through the abortion information ban by sending telephone numbers of abortion clinics to Irish firms for distribution to employees. On November 25, 1992, in the general election, there was approval of constitutional amendments guaranteeing the right to travel for abortions and to receive information on abortion access. The amendment to allow abortion to save the life of the mother was not accepted. PMID:1483530
Currently, paper-based and/or electronic together with telecommunications links to Earth-based physicians are used to assist astronaut crews perform diagnosis and treatment of medical conditions during space travel. However, these have limitations, especially during long duration missions in which telecommunications to earth-based physicians can be delayed. We describe an experimental technology called GuideView in which clinical guidelines are presented in a structured, interactive, multi-modal format and, in each step, clinical instructions are provided simultaneously in voice, text, pictures video or animations. An example application of the system to diagnosis and treatment of space Decompression Sickness is presented. Astronauts performing space walks from the International Space Station are at risk for decompression sickness because the atmospheric pressure of the Extra-vehicular Activity space- suit is significantly less that that of the interior of the Station. PMID:19048089
Iyengar, M S; Carruth, T N; Florez-Arango, J; Dunn, K
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; OQuinn, Veronica
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
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
The purpose of this study was to explore the reasons women in rural, southern Gabon, Africa, chose to terminate their pregnancies, the methods used to induce abortions, and postabortion effects experienced by these women. Abortion is illegal in this country. A descriptive qualitative design guided the methodology for this study. Five women with a history of induced abortion were interviewed in-depth for their abortion story. Reasons cited for an abortion included lack of financial and partner support. Abortion methods included oral, rectal, and vaginal concoctions of leaves, bark, and water and over-the-counter medications, including misoprostol. Affects were physical, spiritual, and relational. Health care professionals need to provide women with guidance for appropriate contraceptive usage. Abortion after-care of women with physical and spiritual needs is important. Future research is suggested on the use of misoprostol in Gabon to understand its affects on women's reproductive health. PMID:17202528
Hess, Rosanna F
Abortion is illegal in Burkina Faso except in cases of incest, rape, fetal defect, or when the woman's life or physical health is endangered. As a result, abortion procedures are often conducted illegally and unsafely and measuring incidence proves difficult. We estimate incidence of abortion and associated morbidity using two methodologies. The first is the Abortion Incidence Complications Method (AICM), which uses information on women hospitalized for abortion-related complications as well as health professionals' assessments of the proportion of women who seek treatment for complications from unsafe abortions. The second is the Anonymous Third Party Reporting (ATPR) method, which entails surveying women about their confidantes' abortions. We conclude that the AICM yields a more accurate result. We estimate that 87,200 abortion procedures were carried out in 2008, representing 25 for every 1,000 women aged 15-49. More than one in four procedures resulted in complications treated at a health facility. The abortion rate estimated using the ATPR approach was 72 percent of that estimated with the AICM. The ATPR method yields information on the characteristics of the women who have abortions as well as the providers and methods they use. PMID:21972666
Sedgh, Gilda; Rossier, Clémentine; Kaboré, Idrissa; Bankole, Akinrinola; Mikulich, Meridith
Test Procedure for Â§170.302.e Maintain active medication allergy list APPROVED Version 1.1 September 24, 2010 1 Test Procedure for Â§170.302 (e) Maintain active medication allergy list This document and Human Services (HHS) on July 28, 2010. Â§170.302 (e) Maintain active medication allergy list. Enable
Test Procedure for Â§170.302.j Medication Reconciliation APPROVED Version 1.1 September 24, 2010 1 Test Procedure for Â§170.302 (j) Medication Reconciliation This document describes the test and Human Services (HHS) on July 28, 2010. Â§170.302 (j) Medication Reconciliation. Enable a user
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
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
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
EMERGENCY PROCEDURES POLICE/FIRE/MEDICAL EMERGENCY DIAL: 716-645-2222 For Non-Emergency Hazardous. Hall Directors & Resident Advisers. Local Media/Campus TV/Radio Broadcasts. HOSTILE INTRUDER Remain. ONLY ONE PERSON from the room should call police at 645- 2222 and tell them where you are, where
Oh, Kwang W.
Evaluations of procedures in medical image processing are notoriously difficult and often unconvincing. From a detailed bibliographic study, we analyzed the way evaluation studies are conducted and extracted a number of entities common to any evaluation protocol. From this analysis, we propose here a generic evaluation model (GEM). The GEM includes the notion of hierarchical evaluation, identifies the components which
Irene Buvat; Virginie Chameroy; Florent Aubry; Melanie Pelegrini; Georges El Fakhri; Celine Huguenin; Habib Benali; Andrew Todd-Pokropek; Robert di Paola
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.
This piece describes abortion practices in use from the 1600s to the 19th century among the inhabitants of North America. The abortive techniques of women from different ethnic and racial groups as found in historical literature are revealed. Thus, the point is made that abortion is not simply a "now issue" that effects select women. Instead, it is demonstrated that it is a widespread practice as solidly rooted in our past as it is in the present. PMID:10297561
Background: Though the Penal Code of Pakistan makes provision for abortion if the life of the mother is endan- gered, yet the fact that no data is available concerning legally induced therapeutic abortion, indicates restrictive interpretation of the law by the medical profession. There is considerable difference of opinion regarding med- ical indication for termination of pregnancy among practicing gynecologists
According to international news sources, Cambodia's parliament approved a law limiting the circumstances under which abortions can be performed on October 6 . Members of parliament say the new law, the first ever passed regulating abortion in Cambodia, is intended to reduce maternal morality rates from abortions performed by unlicensed health practitioners under unsanitary conditions. Local news outlets report that the Cambodian Health Ministry estimates the maternal mortality at 4.7 deaths per 1000 live births. The rate in the US is 0.12 deaths per 1000 live births. The law requires that abortions be performed by licensed health professionals in hospitals and certified clinics within the first trimester of pregnancy, and that women under the age of 18 must obtain parental consent. The new law also sets harsh penalties for those who harm women during illegal procedures--up to 5 years in prison if a woman is injured and up to 10 years if she dies. Opponents of the law say they fear that the new restrictions will push abortion even further underground, as the hospital system cannot handle the current demand for abortion. PMID:12292784
The issue of conscientious objection in Spain has been used by pro-choice groups against objecting health personnel as one of the obstacles to the implementation of the abortion law, a misnomer. At present objection is massive in the public sector; 95% of abortions are carried out in private clinics with highly lucrative returns; abortion tourism has decreased; and false objection has proliferated in the public sector when the objector performs abortions in the private sector for high fees. The legal framework for conscientious objection is absent in Spain. Neither Article 417 of the Penal Code depenalizing abortion, nor the Ministerial Decree of July 31, 1985, nor the Royal Decree of November 21, 1986 recognize such a concept. However, the ruling of the Constitutional Court on April 11, 1985 confirmed that such objection can be exercised with independence. Some authors refer to the applicability of Law No. 48 of December 16, 1984 that regulates conscientious objection in military service to health personnel. The future law concerning the fundamental right of ideological and religious liberty embodied in Article 16.1 of the Constitution has to be revised. A draft bill was submitted in the Congress or Representatives concerning this issue on May 3, 1985 that recognizes the right of medical personnel to object to abortion without career repercussions. Another draft bill was introduced on April 17, 1985 that would allow the nonparticipation of medical personnel in the interruption of pregnancy, however, they would be prohibited from practicing such in the private hospitals. Neither of these proposed bills became law. Professional groups either object unequivocally, or do not object at all, or object on an ethical level but do not object to therapeutic abortion. The resolution of this issue has to be by consensus and not by imposition. PMID:1565971
Serrano Gil, A; García Casado, M L
Stigma discredits individuals, communities, and institutions and marks them as inferior. The stigma surrounding abortion plays a critical role in its social, medical, and legal marginalization around the world. Based on the existing field of knowledge, in June 19, 2012, researchers, practitioners, and advocates from 11 countries participated in an intensive meeting on abortion stigma to refine a conceptual framework for abortion stigma and set a future learning agenda to guide research and programmatic efforts to address abortion stigma. PMID:25062399
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
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
chapter17- chapter introduces distributed transactions involve more one server. Distributed transactions flat nested. atomic commit protocol cooperactive procedure set servers involved distributed transaction. enables servers reach joint decision whether transaction committed aborted. chapter describes two-phase commit protocol. commonly atomic commit protocol. section concurrency control distributed transactions discusses locking timestamp ordering optimistic concurrency control extended distributed transactions.
Search instead for chapter17- chapter introduces distributed transactions involve more one server. Distributed transactions flat nested. atomic commit protocol cooperactive procedure set servers involved distributed transaction. enables servers reach joint decision whether transaction committed aborted. chapter describes two-phase commit protocol. commonly atomic commit protocol. section concurrency control distributed transactions discusses locking timestamp ordering optimistic concurrency control extended distributed transactions. ?
It was hypothesised that the problems occurring in an abortion situation might be even more pronounced at a repeat abortion. Forty-five women with repeated abortion and 92 women seeking their first abortion have been studied as regards their psycho-social background, the present social situation, sexual history, the present pregnancy and their experience of contraceptives. The groups differed significantly only in
L. Jacobsson; B. Schoultz; F. Solheim
Texas A&M Veterinary Medical Diagnostic Laboratory Procedures 34.07.99.V0.01 Emergency Management Laboratory Procedures 34.07.99.V0.01 Emergency Management Page 1 of 5 PROCEDURE STATEMENT Texas A 1.0) and develop (offÂcampus locations) emergency management plans and emergency alert systems (EAS
We investigated disparities in the prescription of analgesics following dental procedures that were expected to cause acute post-operative pain. Patients over the age of 19 years who had been treated by surgical and/or endodontic dental procedures were included in this study. We reviewed 900 consecutive charts and abstracted data on procedures, patients, and providers. We used chi-square and logistic regression models for analyses. There were 485 White subjects 357 African-American subjects included in this review; 81% of the African-American and 78% of White patients received a post-operative narcotic prescription (p=0.56). In multivariate regression models, patients over age 45 (p=0.003), those with insurance that covered medication and those with pre-existing pain (p=0.004) were more likely to receive narcotic analgesics. Students prescribed more narcotics than residents (p=0.001). No differences were found by race in prescribing analgesics. PMID:21371065
Barasch, Andrei; Safford, Monika M.; McNeal, Sandre F.; Robinson, Michelle; Grant, Vivian S.; Gilbert, Gregg H.
Experience with 50 first time aborters, 50 second time aborters, and 50 third time aborters residing in an urban area of Copenhagen suggests that women having a repeat abortion are more similar than dissimilar to women having a first induced abortion. There were no differences in socioeconomic status, educational level, or stated reasons for choosing abortion (usually socioeconomic and family considerations). Though similar to first and second time aborters in their life situations and greater contraceptive risk-taking, third timers seemed to become pregnant more readily. They were also less willing to be interviewed. Related studies and suggestions for postabortion counseling are discussed. PMID:9197806
Osler, M; David, H P; Morgall, J M
Unsafe abortions remain a major public health problem in countries with very restrictive abortion laws. In Brazil, parliamentarians - who have the power to change the law - are influenced by "public opinion", often obtained through surveys and opinion polls. This paper presents the findings from two studies. One was carried out in February-December 2010 among 1,660 public servants and the other in February-July 2011 with 874 medical students from three medical schools, both in São Paulo State, Brazil. Both groups of respondents were asked two sets of questions to obtain their opinion about abortion: 1) under which circumstances abortion should be permitted by law, and 2) whether or not women in general and women they knew who had had an abortion should be punished with prison, as Brazilian law mandates. The differences in their answers were enormous: the majority of respondents were against putting women who have had abortions in prison. Almost 60% of civil servants and 25% of medical students knew at least one woman who had had an illegal abortion; 85% of medical students and 83% of civil servants thought this person(s) should not be jailed. Brazilian parliamentarians who are currently reviewing a reform in the Penal Code need to have this information urgently. PMID:24315072
Faúndes, Aníbal; Duarte, Graciana Alves; de Sousa, Maria Helena; Soares Camargo, Rodrigo Paupério; Pacagnella, Rodolfo Carvalho
This study uses pooled time-series data to estimate the effects of various restrictive abortion laws on the demand for abortion.\\u000a This study differs from prior pooled time-series cross-section research in that it explicitly includes the price of an abortion\\u000a in the abortion demand equation. State Medicaid funding is found to increase the abortion demand of women of childbearing\\u000a age; while
Marshall H. Medoff
... states have enacted bans on procedures called “partial-birth” abortions, with 14 state laws (GA, IN, KS, LA, MS, MT, NM, ND, OH, OK, SC, SD, TN, UT) in effect. All include an exception to the ban: four ...
Brief procedures for evaluating medication efficacy may reveal which candidate drugs warrant further testing in clinical trials and which do not. We previously carried out a study of smoking abstinence, involving the nicotine patch, and established the sensitivity of our procedure. In this study, we sought to cross-validate our earlier work by comparing short-term smoking abstinence due to varenicline (relative to placebo) in smokers with high intrinsic quit interest (n = 57) and those with low intrinsic quit interest (n = 67). All the subjects were randomly assigned to either abstinence reinforcement ($12/day) or no reinforcement. In a crossover design, all the subjects participated in two 3-week phases: ad libitum smoking (week 1), dose run-up of varenicline (1.0 mg b.i.d.) or placebo (week 2), and quit attempt on medication verified daily by carbon monoxide <5 ppm (week 3). As with the nicotine patch in the previous study, varenicline (relative to placebo) increased abstinence more effectively in those with high intrinsic quit interest than in those with low quit interest but did not affect abstinence due to reinforcement. These data confirm the feasibility of a brief, sensitive test of the efficacy of cessation medications in smokers with high quit interest. PMID:20485335
Perkins, K A; Lerman, C; Fonte, C A; Mercincavage, M; Stitzer, M L; Chengappa, K N R; Jain, A
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. PMID:21818194
Hänsel, Mike; Klupp, S.; Graupner, Anke; Dieter, Peter; Koch, Thea
In the US attitudes toward abortion in the 1980s seem to have reached a more liberal plateau, much more favored than in the 1960s or earlier, but not longer moving in a liberal direction. Catholic attitudes basically have followed the same trend. Traditionally Catholic support has been slightly lower than Protestant, and both are less inclined to support abortion than Jews or the nonreligious. During the 1970s support among non-black Catholics averaged about 10 percentage points below non-black Protestants. Blacks tend to be anti-abortion and thereby lower support among Protestants as a whole. A comparison of Protestants and Catholics of both races shows fewer religious differences -- about 7 percentage points. There are some indications that this gap may be closing. In 1982, for the 1st time, support for abortions for social reasons, such as poverty, not wanting to marry, or not wanting more children, was as high among Catholics as among Protestants. 1 of the factors contributing to this narrowing gap has been the higher level of support for abortion among younger Catholics. Protestants show little variation on abortion attitudes, with those over age 65 being slightly less supportive. Among Catholics, support drops rapidly with age. This moderate and possibly vanishing difference between Catholics and Protestants contrasts sharply with the official positions of their respective churches. The Catholic Church takes an absolute moral position against abortion, while most Protestant churches take no doctrinaire position on abortion. Several, such as the Unitarians and Episcopalians, lean toward a pro-choice position as a matter of social policy, though fundamentalist sects take strong anti-abortion stances. Few Catholics agree with their church's absolutist anti-abortion position. The big split on abortion comes between what are sometimes termed the "hard" abortion reasons -- mother's health endangered, serious defect in fetus, rape, or incest. Support among Catholics for "hard" reasons ranges from about 80-88%. Abortion for social reasons such as poverty or not wanting additional children ranges from 35-50%. Catholic support for abortion also varies by geographical region, community type, and ethnic group. Support tends to be strongest in the Northeast, in large cities, and among descendants of immigrants from Italy, Eastern Europe, and France. Support is weakest among Catholics in the Southwest, in small towns or rural areas, and among the Irish and Hispanics, especially Mexican-Americans. Among Catholics, many factors cause opinion to deviate from the national average. A 2nd major political implication is the comparative dedication or commitment of supporters and opponents. Analysis of election returns in 1978 in particular failed to demonstrate any measurable anti-abortion vote, but this does not mean that in a particular constituency it could not be made a serious issue. PMID:12178931
Smith, T W
Medicare coverage policies of medical procedures can be promulgated at a national level by the Centers of Medicare and Medicaid Services (CMS) as National Coverage Determinations (NCDs) or at a local level by Medicare ...
Díaz Treviño, Rafael
Whilst the medical indications for therapeutic abortion and the legal limitations set vary enormously from one country to another there is in general an undoubted trend towards giving the pregnant woman herself a greater say in the decision. During the first year of the operation of the Abortion Act, 1967, in England some 72 pregnant women were referred to the author and his colleagues for a recommendation on abortion. A psychiatric examination and follow-up over a period of one year was made both in those cases where abortion was performed as well as in those cases who were refused therapeutic abortion. In this communication a comparison is made between the reactions and outcome in the two groups. A provisional conclusion is reached that no significant psychiatric disturbance could be attributed to the performance of the operation or on the other hand to refusal of the woman's request. PMID:1236478
Iran has had replacement fertility since 2000. Upholding a small family size has led some couples to terminate unwanted pregnancies. Abortion is, however, permitted only on medical grounds in Iran. Using data from the Iran Low Fertility Survey, this study assessed sociodemographic correlates of abortion among a random sample of 5526 ever-married women aged 15-54 years, and used in-depth interviews to explore reasons for and psychological consequences of abortion among 40 women who had experienced an unintended pregnancy. Although social and economic concerns were the main reasons cited for seeking abortion, women experienced anxiety and depression when seeking pregnancy termination and thereafter. Social stigmatization arose from a belief that abortion is sinful and that misfortune experienced thereafter is punishment. Inadequate knowledge and misunderstanding of relevant Sharia laws discouraged women from seeking care when they experienced complications. Iran's reproductive health policies should be revised to integrate pre- and postabortion counseling. PMID:22920623
Hosseini-Chavoshi, Meimanat; Abbasi-Shavazi, Mohammad Jalal; Glazebrook, Diana; McDonald, Peter
In both the Republic of Ireland and the North of Ireland, it is impossible to obtain a legal abortion unless the life of the mother would otherwise be lost. Thus, an estimated 10-12,000 women travel from Ireland to England each year to have an abortion. These women can receive support from the Irish Women's Abortion Support Group (IWASG) which is made up of volunteer women who are Irish or of Irish descent. The IWASG provides accommodations, emotional and practical support, and information about how to obtain an abortion in the UK. It makes appointments, negotiates fees, and monitors services offered. The group can also provide financial assistance to women in need. IWASG liaises with pro-choice groups in Ireland, such as the underground Women's Information Network (WIN), which has branches in Dublin, Galway, and Cork. WIN provides confidential, nondirective counseling to women in need. Abortion is a very difficult choice for Irish women because of the legal strictures and because of the guilt which often results from government and religious propaganda. The prospect of finding their way around London is often as daunting to the Irish women as the procedure itself, and many of the women travel to England absolutely alone with no one at home even aware of what they are doing. IWASG is seeking new members to help them support these women. For information, write IWASG, 52 Featherstone Street, London ECIY 8RT. PMID:12222519
The pathological investigation of deaths following surgery, anaesthesia, and medical procedures is discussed. The definition of "postoperative death" is examined and the classification of deaths following procedures detailed. The review of individual cases is described and the overall approach to necropsy and interpretation considered. There are specific sections dealing with the cardiovascular system (including air embolism, perioperative myocardial infarction, cardiac pacemakers, central venous catheters, cardiac surgery, heart valve replacement, angioplasty, and vascular surgery); respiratory system (postoperative pneumonia, pulmonary embolism, pneumothorax); central nervous system (dissection of cervical spinal cord), hepatobiliary and gastrointestinal system; musculoskeletal system; and head and neck region. Deaths associated with anaesthesia are classified and the specific problems of epidural anaesthesia and malignant hyperthermia discussed. The article concludes with a section on the recording of necropsy findings and their communication to clinicians and medicolegal authorities. PMID:10655984
Start, R D; Cross, S S
In Jewish law right and wrong, good and evil, are absolute values which transcend time, place, and environment. They defy definition by human intuition or expediency. Jewish law derives from the Divine revelation at Mount Sinai as expounded by sages faithful to, and authorized by, its writ. The Talmud rules that if a woman is in hard travail, and her life must be saved, the child must be aborted and extracted. The mother's life comes first. The fetus is not a human life until it is born. But 19th century Rabbinical works state that it is immoral to destroy a monster child. Modern rabbis are unanimous in condemning abortion, feticide, or infanticide as an unconscionable attack on human life. However, Jewish law allows abortion if the pregnancy will cause severe psychological damage to the mother. No civilized society could survive without laws which occasionally cause some suffering or personal anguish. One human life is worth a million lives, because each life is infinite in value. In cases of rape or incest Jewish law still does not sanction abortion. Man's procreative responsibilities are serious and carry rights and obligations which would be upset by liberalized abortion laws. If a person kills a person who is mortally wounded, the killer is guilty of a moral offense. PMID:12309928
This paper uses data on the distribution of abortions by weeks of gestation to examine the relationship between abortion restrictions and the timing of abortions. State-level data from 1974 to 1997 indicate that adoption of parental involvement laws for minors or enforcement of mandatory waiting periods is positively associated with the post-first trimester percentage of abortions. However, autocorrelation-corrected specifications indicate
Marianne Bitler; Madeline Zavodny
Situations Consider the two following hypothetical situations involving women considering abortion: 1. The first woman is forty-five years old, happily married to a financially secure husband, and holds a part-time job. She is already a mother, with a...'s substance use and past abortions), and the decision of the mother for a lifestyle change for the better, Hare would probably conclude that the future child of the second woman will be better off than the present one. Having this child now would likely...
Rovie, Eric M.
Attitudes toward the desirability of abortion were significaantly related to sex, college, classification, level of church activity, residence background, family size, exposure to abortion, and attitude toward premarital sex. The data suggest an increasing acceptance of abortion in the future. (Author)
Maxwell, Joseph W.
Mosher's Forced-Choice Sex Guilt Inventory was administered to 45 clients of a university problem pregnancy counseling service who were planning to have abortions and to 47 sexually active nonpregnant university coeds. Sex guilt was found to be significantly higher for abortion Ss than for nonpregnant Ss. It was also found that for each type of contraceptive, abortion Ss had higher
This study evaluated changes in menstrual cycle function and gynecologic abnormalities following medical termination of pregnancy. Of the 500 abortions, 90 by dilation and evacuation, 120 by intraamniotic hypertonic saline infusion, 210 by prostaglandin, and 180 by extraovular ethacridine lactate. Each case was followed for 1 year after the abortion procedure. All cases were 24-26 years of age. The menstrual cycle was considered to be irregular if the cycle was deferred by more than 7 days, with the irregularity persisting for more than 3 cycles. Changes in menstrual cycle function were considered significant if the duration of flow altered by more than or less than 1 day after abortion than that of the previous cycle. Both the dilatation and evacuation and intraamniotic hypertonic saline infusion procedures were associated with significant changes from regular to irregular cycles. This change occurred in 26.6% of women having the former procedure and 42.5% of those undergoing the latter procedure. Increased menstrual flow was noted in 26.6% of women undergoing dilatation and evacuation and in 26.5% of those receiving suction evacuation. Saline infusion abortion was followed by an absence of menstruation in 3 cases. The durationof the menstrual flow was significantly increased in 29.5% of women undergoing suction evacuation and in 23.4% of those receiving dilatation and evacuation. A high increase in the severity of dysmenorrhea was reported by 20% of cases receiving the menstrual regulation procedure and 50% of those undergoing saline infusion. However, a decrease in dysmenorrhea severity was noted for dilatation and evacuation (50%) and prostaglandin abortion (37.5%,. The incidence of gynecologic abnormalities noted at follow-up visits, most of which were related to infection, was highest among women who underwent both the dilatation and evacuation and saline infusion procedures. PMID:6747323
Mitra, J; Mondal, A; Khara, B N; Chandra De, R
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
Legal, procedural, and institutional restrictions on safe abortion services—such as laws forbidding the practice or policies preventing donors from supporting groups who provide legal services—remain a major access barrier for women worldwide. However, even when abortion services are legal, women face social and cultural barriers to accessing safe abortion services and preventing unwanted pregnancy. Interpersonal communication interventions play an important
Allison Bingham; Jennifer Kidwell Drake; Lorelei Goodyear; C. Y. Gopinath; Anne Kaufman; Sanju Bhattarai
Background: Induced Abortion for social reasons is spreading all over the world. It is estimated that globally 50 million unborn babies are killed annually, resulting in the deaths of 200,000 pregnant women and the suffering of millions. The complications of illegal abortion are very serious. Abortion is still used in many countries as a means of family planning. The medical reasons for abortion are limited and con-sti-tute a small proportion of all abortion cases. This paper discusses the different views on abortion, its history, its evolution over time, and the present legal circumstances. The emphasis is on the situation in Islamic countries and the effect of Islamic Fatwas on abortion. PMID:23008648
Albar, Mohammed A.
Since prehistorical era, the human has desired to control reproduction artificially. However, abortion, one of the productive methods has been prohibited to a certain degree by law in some countries, but the operation of abortion has been done in practice. Also, controversial arguments on legitimacy of abortion have been raised. In Korea, physicians operates abortions more than 2 million times each year. In spite of serious social problems, arguments on abortion have not been common yet. The efforts to find a good solution for abortion have not been very sufficient. Therefore, this study is to investigate the concerns for the conditions of abortion since 1945 (this year is the independent one from Japan's government) through a historical perspective and to suggest the efficient direction in policy. Since 1945, many women have had no choice but abortion for their basic life. The Korean government of legislated the Crimes of Abortion in Criminal Law in 1953. However, the number of women who underwent abortion increased since 1962 due to the governmental Family Planning Policy. In addition, the Mother and Fatherless Child Health Act was enacted in 1973 that tolerated abortion to some extent. The disparate treatment of abortion between Criminal Lam and the governmental policy fueled the confusion to potentially pregnant women. The first reason why Korean women choose abortion is wrongful pregnancy. Compared to other counties, in Korea, abortion were operated for sex selection. To conclude, it is important to be implement positive sex education, proper contraception education by government and social publicization of arguments on abortion. PMID:15005096
Jeon, Hyo Suk; Seo, Hong Gwan
BACKGROUND: Although abortion or termination of pregnancy (TOP) has become an increasingly normalized component of women's health care over the past forty years, insufficient attention has been paid to women's experiences of surgical or medical methods of TOP. OBJECTIVE: To undertake a narrative review of qualitative studies of women's experiences of TOP and their perspectives on surgical or medical methods.
Mabel LS Lie; Stephen C Robson; Carl R May
This study examines the contextual and ideological dimensions of attitudes toward discretionary abortion using two national\\u000a surveys. The abortion attitudes are dichotomized in terms of consistent opposition versus consistent support. Discriminant\\u000a analysis, partial correlations, and stepwise regression procedures are used in the analysis. Findings indicate that education\\u000a and attendance at religious services are the two most significant contextual dimensions and
B. Krishna Singh; Peter J. Leahy
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 for follow-up interviews. From the interviews, more than 600 statements concerning motives and reactions to medical procedures with the dead body were listed. These statements were summarized in 20 motive categories, in which 17 the nature of the motives were negative to organ donation and three promoting such a procedure. The categories were then analyzed and interpreted within a frame of reference of psychodynamic defense theory. In several cases it was possible to relate them to common death anxiety defenses. Six different motive complexes were extracted. These are called (1) illusion of lingering life; (2) protection of the value of the individual; (3) distrust, anxiety and alienation; (4) respecting the limits set by Nature or God; (5) altruism; and (6) rationality. Individuals not willing to donate their own organs were judged as either (a) reacting out of strenthened death anxiety defenses, or (b) as having a special outlook on life, where the idea of what is 'natural' was emphasized. The adverse reactions of the positive attitude group were seen as initial reactions perceived as derivations of common death anxiety defenses and weakened when confronted with altruistic and fact-stressing arguments. In the 'undecided group' of 14 persons, 11 arrived at a definite opinion. Seven decided for organ donation when their mistaken beliefs were corrected or when they took time to work through their initial uneasiness, while 4 persons actually were clearly negative. Three still remained uncertain. The stability of these attitudes seems to be high, often being experienced as a part of one's philosophy of life. PMID:8042059
Surveys conducted in Mexico by GIRE in 1992, 1994, and 1995 reveal that over 80% of the national population believes only a woman or a woman and her partner should make abortion decisions. Neither the government, the Church, nor physicians should intervene. Public opinion and the documented social and public health consequences of illegal abortion demonstrate the obsolescence of laws penalizing abortion. Mexico does not have a direct means of converting the opinions of the population into votes and laws. In place of referendums, committees of specialists have been convened; they are limited in number and ability to represent diverse groups, and oriented above all to the losses and gains of political and parliamentary disputes. The electoral reform of 1995-96 was a good example of the question under debate getting lost in partisan maneuvering. The Federal District and four states have initiated development of the referendum process, but the procedures have been too cumbersome and the results disappointing. In the current day, opinions are often formed not by following a rational process, but by bombardment with advertising appealing to irrational emotions. The democratic effects of referendum should be furthered by guaranteeing fair and exhaustive exposure of all points of view before the vote is held. GIRE recommends that a referendum on decriminalization of abortion should be preceded by a period of at least two years for public debate and reflection, and that the Federal Electoral Institute should organize the debate and the referendum. PMID:12349540
...furnished by other agencies; medical records. 792.57...furnished by other agencies; medical records. (a...appropriate agency prior to making a decision to disclose or refuse...system manager. (b) Medical records may be...
...furnished by other agencies; medical records. 792.57...furnished by other agencies; medical records. (a...appropriate agency prior to making a decision to disclose or refuse...system manager. (b) Medical records may be...
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Introduction Tomophobia refers to fear or anxiety caused by forthcoming surgical procedures and/or medical interventions. Case presentation We present the case of a 69-year-old Caucasian man who refused urgently indicated medical intervention because of severe tomophobia. Conclusion Due to the rising number of surgical interventions in modern medicine, as well as the high number of unrecognised cases of tomophobia, this common but underdiagnosed anxiety disorder should be highlighted. PMID:20062769
An assessment of abortion outcomes and costs to the health care system in Mexico City was conducted in 2005 at a mix of public and private facilities prior to the legalisation of abortion. Data were obtained from hospital staff, administrative records and patients. Direct cost estimates included personnel, drugs, disposable supplies, and medical equipment for inducing abortion or treating incomplete abortions and other complications. Indirect patient costs for travel, childcare and lost wages were also estimated. The average cost per abortion with dilatation and curettage was 143 US dollars. For manual vacuum aspiration it was 111 US dollars in three public hospitals and 53 US dollars at a private clinic. The average cost of medical abortion with misoprostol alone was 79 US dollars. The average cost of treating severe abortion complications at the public hospitals ranged from 601 US dollars to over 2,100 US dollars. Increasing access to manual vacuum aspiration and early abortion with misoprostol could reduce government costs by 62%, with potential savings of up to 1.6 million US dollars per year. Reducing complications by improving access to safe services in outpatient settings would further reduce the costs of abortion care, with significant benefits both to Mexico's health care system and women seeking abortion. Additional research is needed to explore whether cost savings have been realised post-legalisation. PMID:19523589
Levin, Carol; Grossman, Daniel; Berdichevsky, Karla; Diaz, Claudia; Aracena, Belkis; Garcia, Sandra G; Goodyear, Lorelei
Abortion was made legal on request in Mongolia in 1989, following the collapse of the socialist regime, and later bound by a range of regulations. Concerned about the high number of abortions and inadequate quality of care in abortion services, the Ministry of Health applied the World Health Organization's Strategic Approach to issues related to abortion and contraception in 2003. The aim was to develop policies and programmes to reduce unintended pregnancies, mitigate complications from unsafe abortion, and improve the quality of abortion and contraception services for all socio-economic groups, including adolescents. This paper describes the changes that arose from a strategic assessment, highlighting the introduction of mifepristone-misoprostol for second trimester abortion. The aim was to replace mini-caesarean section and intra-uterine injection of Rivanol (ethacridine lactate), so that second trimester abortions could take place earlier than at 20 weeks gestation. National standards and guidelines for comprehensive abortion care were developed, the national pre-service training curriculum was harmonized with the new guidelines, at least one-third of the country's obstetrician-gynaecologists were trained in manual vacuum aspiration and medical abortion, and three model comprehensive abortion care units were established to provide high quality services to women, high quality training for providers and serve as nodes for further scaling up. PMID:18772093
Tsogt, Bazarragchaa; Seded, Khishgee; Johnson, Brooke R
This paper tried to collect, classify and analyse the discourse about abortion in 1920~1930. In Korea, modern medical abortion operation started in 1920~30s. At that time abortion was prohibited by the Japanese Government-General of Korea, because the Japanese Government-General of Korea needed large population which was used for labor and exploitation. Hence, the Empire of Japan de-penalized Japanese criminal law related to birth control but Korean law was not revised between 1910~1945. Nevertheless, there were quite a few women who wanted abortion when they had children born in sin or they were too poor to raise their children, so they had abortion secretly. At that time the women generally had abortion through toxic drugs or foods and violence (dropping from a high place or beating their stomach). But high class women did it by medical operation. In 1920s, there was few Korean (modern) medical doctors who could operate for abortion, instead Japanese immigrant medical doctors did it--as the newspaper of that time showed(there were many pieces of news that Japanese doctor who helped abortion was arrested by the police). As time went by Korean doctors got their say about the technique and various knowledge of abortion in newspapers, magazines, and academic Journals; this was especially the case starting in 1930. It is worth noting that they were sometimes arrested for illegal abortion operations. Furthermore, from the late 1920s the insist that abortion should be permitted for women and poor people, appeared. This insist was affected by Japan, the Soviet Union and other countries which was generous with abortion. PMID:23695751
Lee, Young- Ah
Poland's "anti-abortion" law, which has been in effect since March 1993, is one of the most restrictive in Europe. Under this law, abortion is allowed only when there is justifiable suspicion that the pregnancy constitutes a threat to the life or a serious threat to the health of the mother, that the fetus is irreversibly damaged, or that the pregnancy resulted from an illegal act. Nevertheless, women continue to seek abortions at all costs, and the anti-abortion law has led to creation of "underground" abortion services and "abortion tourism." The existence of underground abortion services (with most available in large cities) is documented through the proliferation of advertisements that contain certain catch phrases, through the testimony of women who have received abortions from private gynecologists, through anonymous statements issued by physicians who perform abortions, and by a government report. Abortion costs range from US$400-800, whereas an average monthly salary in Poland is US$300. As an alternative, an estimated 16,000 Polish women travel to neighboring countries to receive an abortion. The social consequences of the anti-abortion law include an increasing number of abandoned children or infants and an increasing number of teenage pregnancies and late pregnancies. The anti-abortion law has proved to be more restrictive in practice than on paper as women with a right to legal abortion and all the required documentation are refused the procedure. Affected women fail to lodge complaints with the Ministry of Health because they want to put the situation behind them or because they are afraid they will be prosecuted. Other effects of the law are that Poles live in permanent fear of pregnancy and suffer terrible guilt when they resort to abortion. Many obstacles impede use of contraceptives in Poland, and implementation of mandated sex education is chaotic and uneven with most teachers justifiably claiming that they are unqualified to teach this subject. PMID:12222281
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
This study examines the association between religion and attitudes toward the practice of abortion and abortion policy in Brazil. Drawing upon data from the 2002 Brazilian Social Research Survey (BSRS), we test a number of hypotheses with regard to the role of religion on opposition to the practice of abortion and its legalization. Findings indicate that frequently attending Pentecostals demonstrate the strongest opposition to the practice of abortion and both frequently attending Pentecostals and Catholics demonstrate the strongest opposition to its legalization. Additional religious factors, such as a commitment to biblical literalism, were also found to be significantly associated with opposition to both abortion issues. Ultimately, the findings have implications for the future of public policy on abortion and other contentious social issues in Brazil. PMID:22303535
Ogland, Curtis P; Verona, Ana Paula
Objectives. We examined the factors influencing delay in seeking abortion and the outcomes for women denied abortion care because of gestational age limits at abortion facilities. Methods. We compared women who presented for abortion care who were under the facilities’ gestational age limits and received an abortion (n?=?452) with those who were just over the gestational age limits and were denied an abortion (n?=?231) at 30 US facilities. We described reasons for delay in seeking services. We examined the determinants of obtaining an abortion elsewhere after being denied one because of facility gestational age limits. We then estimated the national incidence of being denied an abortion because of facility gestational age limits. Results. Adolescents and women who did not recognize their pregnancies early were most likely to delay seeking care. The most common reason for delay was having to raise money for travel and procedure costs. We estimated that each year more than 4000 US women are denied an abortion because of facility gestational limits and must carry unwanted pregnancies to term. Conclusions. Many state laws restrict abortions based on gestational age, and new laws are lowering limits further. The incidence of being denied abortion will likely increase, disproportionately affecting young and poor women. PMID:23948000
Weitz, Tracy A.; Jones, Rachel K.; Barar, Rana E.; Foster, Diana Greene
A literature survey has been conducted to estimate the incidence of breakpoints in aborters. Out of 9,012 cases that could be evaluated, about 4.0% had chromosomal abnormalities, which is significantly higher as compared to the normal population (1–0.5%). The structural anomalies were 7 times higher than numerical abnormalities. Thirty-seven percent of the rearrangements were in males while 63.0% were in
V. S. Venkatraj; R. S. Verma
Variations in the availability of abortion providers may impact the demand for abortions since greater provider availability reduces the travel cost associated with obtaining an abortion. This paper applies a fertility-control model to estimate the responsiveness of abortion demand to travel-cost variations using individual data from all births and abortions of women over age 20 in the state of Texas
Robert W. Brown; R. Todd Jewell; Jeffrey J. Rous
Since abortion is an important aspect of women's control over reproduction, barriers to abortion threaten women's efforts to attain equality. The ensuing discussion rests upon 2 assumptions: 1) That women want and need control over their reproductive capacity, and 2) that women want personal access to abortion and desire the availability of abortion to women generally. Under Roe v. Wade, abortions can only be performed if physicians choose to do them; this has left 4/5ths of US counties without an abortion provider. Roe neither compelled the availability of abortion services to all interested women, nor did it establish a "women's entitlement to an abortion based on her decision... "While the liberal solution in the Law may provide formal new rights, these rights are often ineffective because they fail to address attitudes firmly rooted in the social structure. Feminists' radical, self-help approach of becoming their own abortion providers offers a limited solution because of 1) geography and regional culture: the "paucity of abortion providers is likely to be replicated for feminist health collectives"; 2) the legal risk in underground institutions; and 3) the woman's choice, i.e., will the tradition-minded women use an alternative medical facility? Finally, "the woman's own decision-making process may be the ultimate barrier to abortion." The high visibility and intense emotions brought to contemporary abortion discussions in the post-Roe era may be far more chilling to individual decision than the relative silence of the 1950s. Psychological, as well as physical, availability of abortion must be kept in mind. For the future, social scientists can provide awareness of the social context in which the legal definition of abortion rights confronts the lives of women. PMID:12317577
Lamanna, M A
End-of-life medical expenses are a significant proportion of all health care expenditures. These costs were studied using costs of services from Medicare claims and cause of death (CoD) from death certificates. In the absence of a unique identifier linking the two datasets, common variables identified unique matches for only 33% of deaths. The remaining cases formed cells with multiple cases (32% in cells with an equal number of cases from each file and 35% in cells with an unequal number). We sampled from the joint posterior distribution of model parameters and the permutations that link cases from the two files within each cell. The linking models included the regression of location of death on CoD and other parameters, and the regression of cost measures with a monotone missing data pattern on CoD and other demographic characteristics. Permutations were sampled by enumerating the exact distribution for small cells and by the Metropolis algorithm for large cells. Sparse matrix data structures enabled efficient calculations despite the large dataset (?1.7 million cases). The procedure generates m datasets in which the matches between the two files are imputed. The m datasets can be analyzed independently and results combined using Rubin's multiple imputation rules. Our approach can be applied in other file linking applications. PMID:23645944
Gutman, Roee; Afendulis, Christopher C.; Zaslavsky, Alan M.
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.
In many countries, reproductive health services do not actively include post-abortion family planning services for women who are treated for complications of unsafe abortion. This greatly increases the risk of further unintended pregnancies and unsafe abortions. The authors, drawing on the recommendations of a meeting of experts, make a plea for bridging the gap and dealing more realistically with this urgent need. PMID:7873025
McLaurin, K E; Senanayake, P; Toubia, N; Ladipo, O A
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
P. Gädicke; R. Vidal; G. Monti
The Indian Medical Termination of Pregnancy (MTP) Act came into force in 1972, in response to the high mortality and morbidity associated with illegal abortion. However, 25 years on, both restrictions in the law and the way it is implemented through service delivery have failed to meet the abortion needs of large numbers of women. Using data from a larger
Manisha Gupte; Sunita Bandewar; Hemlata Pisal
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
C. E. Joffe; T. A. Weitz; C. L. Stacey
This article traces the establishment of abortion clinics following Roe v Wade. Abortion clinics followed one of two models: (1) a medical model in which physicians emphasized the delivery of high quality medical services, contrasting their clinics with the back-alley abortion services that had sent many women to hospital emergency rooms prior to legalization, or (2) a feminist model in which clinics emphasized education and the dissemination of information to empower women patients and change the structure of women's health care. Male physicians and feminists came together in the newly established abortion services and argued over the priorities and characteristics of health care delivery. A broad range of clinics emerged, from feminist clinics to medical offices run by traditional male physicians to for-profit clinics. The establishment of the National Abortion Federation in the mid-1970s created a national forum of health professionals and contributed to the broadening of the discussion and the adoption of compromises as both feminists and physicians influenced each other's practices. PMID:23327251
Davis examines a view held in common by those she classifies as "restrictives," "moderates," and "permissives," that the right of self-defense justifies a pregnant woman's seeking an abortion when her life is at risk. While maintaining that abortion to preserve a woman's life is morally defensible, she argues that the doctrine of self-defense has been misapplied because the entitlement to self-defense has been misunderstood, and because the woman-fetus relationship precludes regarding the problem of abortion as simply a balancing of rights. She concludes that the defense of therapeutic abortion is neither straightforward nor unproblematic. PMID:11655659
The topic of abortion stigma has caught the attention of researchers and activists working on reproductive health and rights around the world. But as research on abortion stigma grows, I fear that the concept is in danger of becoming so large and all-encompassing that it may mask deeply rooted inequalities. In addition, abortion stigma may be seen as too complex and tangled an issue, thereby leading to paralysis. It is important that we become more precise in our understanding of abortion stigma so that we can carry out better research to understand and measure it, design interventions to mitigate it, and evaluate those interventions. PMID:24183406
Procedural Sedation by Registered Nurses in the Interventional Radiology Setting: Incorporating Evidence-Based Practice Regarding Medication Selection, Fasting, and Mitigating Cardiorespiratory Complications
Registered nurses administer procedural sedation in the interventional radiology setting to manage a patient's pain and anxiety to facilitate the performance of unpleasant but necessary procedural interventions in a safe, effective, and humane fashion. The nurse who is administering procedural sedation should maintain competency regarding knowledge of the medications being administered for procedural sedation, knowledge of the drugs required to
James M. Hall
... (1) Psychiatric emergencies. (i) During a psychiatric emergency, psychiatric medication may be administered only...effective. If psychiatric medication is still recommended after the psychiatric emergency, and the emergency...
... (1) Psychiatric emergencies. (i) During a psychiatric emergency, psychiatric medication may be administered only...effective. If psychiatric medication is still recommended after the psychiatric emergency, and the emergency...
...INSTITUTIONAL MANAGEMENT MISCELLANEOUS Birth Control, Pregnancy, Child Placement, and Abortion § 551.23 Abortion...counseling to aid her in making the decision whether to carry the pregnancy to full term or to have an elective abortion. If an...
Functional analysis methods were used to monitor medication used to reduce vocal and physical tics of a child with Tourettes Syndrome. Post-medication results demonstrated a reduced level of tics by the participant. Although preliminary, the findings suggest that functional analysis methods can be used to monitor the effects of medication in…
Anderson, Mark T.; Vu, Chau; Derby, K. Mark; Goris, Mary; McLaughlin, T. F.
Abortion is forbidden under normal circumstances by nearly all the major world religions. Traditionally, abortion was not deemed permissible by Muslim scholars. Shiite scholars considered it forbidden after implantation of the fertilised ovum. However, Sunni scholars have held various opinions on the matter, but all agreed that after 4?months gestation abortion was not permitted. In addition, classical Islamic scholarship had only considered threats to maternal health as a reason for therapeutic abortion. Recently, scholars have begun to consider the effect of severe fetal deformities on the mother, the families and society. This has led some scholars to reconsider the prohibition on abortion in limited circumstances. This article reviews the Islamic basis for the prohibition of abortion and the reasons for its justification. Contemporary rulings from leading Shiite scholars and from the Sunni school of thought are presented and reviewed. The status of abortion in Muslim countries is reviewed, with special emphasis on the therapeutic abortion law passed by the Iranian Parliament in 2003. This law approved therapeutic abortion before 16?weeks of gestation under limited circumstances, including medical conditions related to fetal and maternal health. Recent measures in Iran provide an opportunity for the Muslim scholars in other countries to review their traditional stance on abortion. PMID:17074823
Hedayat, K M; Shooshtarizadeh, P; Raza, M
Abortion is forbidden under normal circumstances by nearly all the major world religions. Traditionally, abortion was not deemed permissible by Muslim scholars. Shiite scholars considered it forbidden after implantation of the fertilised ovum. However, Sunni scholars have held various opinions on the matter, but all agreed that after 4 months gestation abortion was not permitted. In addition, classical Islamic scholarship had only considered threats to maternal health as a reason for therapeutic abortion. Recently, scholars have begun to consider the effect of severe fetal deformities on the mother, the families and society. This has led some scholars to reconsider the prohibition on abortion in limited circumstances. This article reviews the Islamic basis for the prohibition of abortion and the reasons for its justification. Contemporary rulings from leading Shiite scholars and from the Sunni school of thought are presented and reviewed. The status of abortion in Muslim countries is reviewed, with special emphasis on the therapeutic abortion law passed by the Iranian Parliament in 2003. This law approved therapeutic abortion before 16 weeks of gestation under limited circumstances, including medical conditions related to fetal and maternal health. Recent measures in Iran provide an opportunity for the Muslim scholars in other countries to review their traditional stance on abortion. PMID:17074823
Hedayat, K M; Shooshtarizadeh, P; Raza, M
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. PMID:23499047
Becker, Davida; Diaz-Olavarrieta, Claudia; Garcia, Sandra G.; Harper, Cynthia 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.
The media play a significant part in shaping public perceptions of health issues, and abortion attracts continued media interest. Detailed examination of media constructions of abortion may help to identify emerging public discourse. Qualitative content analysis was used to examine if and how the print media in contributes to the stigmatisation of abortion. Articles from seven British and five Scottish national newspapers from 2010 were analysed for overall framings of abortion and emergent themes, including potentially stigmatising discursive constructs and language. Abortion was found to be presented using predominantly negative language and discursive associations as ‘risky’, and in association with other ‘discredited’ social practices. Key perspectives were found to be absent or marginalised, including those of women who have sought abortion. Few articles framed abortion as a positive and legitimate choice. Negative media representations of abortion contribute to the stigmatisation of the procedure and of women who have it, and reflect a discrediting of women's reproductive decision-making. There is a need to challenge the notion that abortion stigma is inevitable, and to encourage positive framings of abortion in the media and other public discourse. PMID:25115952
Purcell, Carrie; Hilton, Shona; McDaid, Lisa
n Overall rates of abortion in the United States peaked soon after the procedure was legalized in 1973, remained fairly constant through the 1980s, and have declined steadily since then. However, the overall rate masks large differences and varying patterns across time for demo- graphic subgroups. n A substantial drop in the abortion rates of teenagers and women aged 20-24
Stanley K. Henshaw; Kathryn Kost
The objectives of the present clinical study were to evaluate the safety and efficacy of misoprostol (Cytotec) self-administered into the vagina for medical abortion in adolescents under the age of 18 years. After obtaining written consent from the patients and parents or guardians, a group of 150 adolescents with gestations between 35 and 63 days received 800 microg of vaginal misoprostol every 24 h, up to a maximum of three main doses, for abortion. Outcomes assessed included successful abortion (complete abortion without surgery), side-effects, decrease in hemoglobin, mean time of vaginal bleeding, mean expulsion time and mean time for the return of menses. Complete abortion occurred in 133/150 (88.7%, 95% confidence interval 82-93) patients. The frequencies of nausea, vomiting and diarrhea were statistically significantly higher when compared to those obtained for adult females. Vaginal bleeding lasted for 12.7 +/- 5.7 days (median 12 days, range 1-23 days). The mean expulsion time was 6.8 +/- 2.4 h (median 6 h, range 3-14 h) for those who aborted after the first misoprostol dose. The mean time for the return of menses, for those who aborted with misoprostol, was 34.7 +/- 3.4 days. The mean decrease in hemoglobin was statistically significant (p = 0.001), but had no clinical relevance. Taking into account the high abortion rate obtained, we could conclude that misoprostol alone is a valid method for terminating unwanted pregnancies in adolescents under the age of 18 years. PMID:11245549
Velazco, A; Varela, L; Tanda, R; Sánchez, C; Barambio, S; Chami, S; Valero, F; Aragón, S; Marí, J; Carbonell, J L
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
Most literature dealing with the attitudes of the mass public toward abortion addresses the question in terms of the individual woman seeking termination. This study attempts to explain attitudes when abortion is framed as a public policy question. Three dependent variables are investigated. These are the issues of public funding, when human life begins, and the Human Life Amendment. This
Jerome S. Legge Jr
The debate over abortion remains controversial as ever. This article offers an explanation of the main Islamic attitudes towards abortion and areas of need to change in the related rules and regulations in Islamic communities with a special attention to Iran. A selected collection of Islamic references, as well as discussions with experts have been used as a basis for
A number of questions relating to providing abortion information to teenagers can be raised from legal, ethical and philosophical standpoints. The purpose of this article is to examine abortion information-giving from the perspective of counseling and guidance theory and practice. (Author)
Wolleat, Patricia L.
for External Employment Approved: December 28, 2012 Next Scheduled Review: December 28, 2014 Texas A&M Veterinary Medical Diagnostic Lab Procedures 33.04.01.A0.01 Use of Agency Resources for External Employment Resources for External Employment, and this procedure, Texas A&M Veterinary Medical Diagnostic Laboratory
ObjectivesTo describe and compare current legal procedures for notifying, controlling and evaluating (NCE-procedures) euthanasia in Belgium and the Netherlands, and to discuss the implications for a safe and controllable euthanasia practice.
Tinne Smets; Johan Bilsen; Joachim Cohen; Mette L. Rurup; Els De Keyser; L. H. J. Deliens
... allow the adopting parents to pay the birth mother’s legal and medical fees. Some states allow other fees and expenses to be paid, such as counseling. However, it is not legal for anyone to make money from an adoption. If I am considering abortion, what should I know about my state’s laws? ...
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 of illegal manipulation, given the availability of legal pregnancy termination. Antibiotics and transfusions are available, should complications arise in conservatively managed cases. Two prospective randomized trials suggest that conservative management may be advantageous for women who have stable vital signs without evidence of infection. They will have fewer perforations and, possibly, fewer infections and uterine synechiae with expectant or medical management. Larger trials should be undertaken to critically assess surgical evacuation compared to medical management, factoring in the psychologic impact of treatment. We believe that medical management will prove to be the most appropriate treatment for uncomplicated spontaneous incomplete abortion in the 21st century. PMID:9822516
Ballagh, S A; Harris, H A; Demasio, K
This report describes the social and demographic characteristics of 457 unmarried women who underwent a first trimester induced abortion at hospitals and family planning clinics in Sichuan province, China. The data show a very low level of medical complications. However, improved access to contraception for unmarried women is needed in order to reduce the incidence of unintended pregnancies and induced
Luo Lin; Wu Shi-Zhong; Chen Xiao-Qing; Li Min-Xiang; Thomas W. Pullum
The psychological consequences of induced abortion are complex and subject to both considerable controversy and methodological criticisms. While many women report feelings of relief immediately after the procedure, others report feelings of anxiety, which they attribute to their abortions. The purpose of the present study was to examine risk of generalized anxiety following unintended pregnancies ending in abortion or childbirth
Jesse R. Cougle; David C. Reardon; Priscilla K. Coleman
A program for withdrawal of sedative/hypnotic medication was investigated in elderly women, ages 64 to 91. The sleep cycles of 10 drug withdrawal (DW) and 10 non-drug withdrawal (N-DW) subjects were monitored for a 24-hour period for 5 successive weeks, using a nonintrusive recording procedure. The first 2 baseline weeks were followed by 1 week of half-dose, then 2 weeks of full withdrawal for the DW group. The results indicated no demonstrable effect on sleep, sleep complaints, levels of depression, or daytime sleepiness on the DW group. The conclusion is that the procedure of withdrawal from sleep medication over a 2-week period, combined with the use of a substitute pill to maintain the ritual of nightly pill-taking, is appropriate and effective for long-term elderly users. PMID:9814275
Tabloski, P A; Cooke, K M; Thoman, E B
6.1 To safeguard the health and safety of staff, students and visitors in line with the University's policy on the Disposal of Hazardous Medical Waste within their Schools. 7.1.2 Protective Clothing Hazardous medical waste must be handled only by persons wearing the appropriate protective clothing
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
Abstract Objective To determine what proportion of women seeking induced abortion in the Calgary census metropolitan area were immigrants. Design For 2 months, eligible women were asked to complete a questionnaire. Women who refused were asked to provide their country of birth (COB) to assess for selection bias. Setting Two abortion clinics in Calgary, Alta. Participants Women presenting at or less than 15 weeks’ gestational age for induced abortion for maternal indications. Main outcome measures The primary outcome was the proportion of women seeking induced abortion services who were immigrants. Secondary outcomes compared socioeconomic characteristics and contraception use between immigrant and Canadian-born women. Results A total of 752 women either completed a questionnaire (78.6%) or provided their COB (21.4%). Overall, 28.9% of women living in the Calgary census metropolitan area who completed the questionnaire were immigrants, less than the 31.2% background proportion of immigrant women of childbearing age. However, 46.0% of women who provided only COB were immigrants. When these data were combined, 34.2% of women presenting for induced abortion identified as immigrant, a proportion not significantly different from the background proportion (P = .127). Immigrant women presenting for induced abortion tended to be older, more educated, married with children, and have increased parity. They were similar to Canadian-born women in number of previous abortions, income status, and employment status. Conclusion This study suggests that immigrant women in Calgary are not presenting for induced abortion in disproportionately higher numbers, which differs from existing European literature. This is likely owing to differing socioeconomic characteristics among the immigrant women in our study from what have been previously described in the literature (typically lower socioeconomic status). Much still needs to be explored with regard to factors influencing the use of abortion services by immigrant women. PMID:25217694
du Prey, Beatrice; Talavlikar, Rachel; Mangat, Rupinder; Freiheit, Elizabeth A.; Drummond, Neil
On March 20, the House voted 295-136 in favor of HR 1122, "The Partial-Birth Abortion Ban Act of 1997." As a result of a last-minute substitution, the bill that was approved is identical to HR 1833, the legislation that passed the House and Senate last year but failed to muster enough votes to override President Clinton's veto (see RFN V/8). HR 1122 would prohibit a physician from using the method--which, as described, suggests but does not accurately define the abortion procedure known as intact dilation and evacuation--unless a woman's life is endangered and no other procedure would suffice. Violators would be penalized with a fine and/or up to two years in prison. In addition, the bill provides grounds on which a woman's husband (or, if she is under 18, her parents) may obtain relief in a civil suit. The substitute bill came in place of HR 929, which passed the House Judiciary Committee on March 12 (see RFN VI/5). With minor differences, that measure also targeted the abortion procedure known as intact dilation and evacuation, and it, too, was vague enough to outlaw other second-trimester abortion methods. With the change, anti-choice leaders in Congress appear to be holding members who oppose the ban, and the president, politically accountable for maintaining their position in the face of a renewed discussion of the number of such procedures performed. Five representatives--Rodney Frelinghuysen (R-NJ), Martin Frost (D-TX), Sue Kelly (R-NY), Christopher Shays (R-CT), and Peter Visclosky (D-IN)--succumbed and voted in favor of a ban after opposing it last year. With or without their switch, the margin of victory is sufficient to override the veto promised by President Clinton. But while the equivalent bill in the Senate, S 6, is likely to also be approved, it is believed that its proponents are several votes shy off a veto-proof margin. S 6 is currently under consideration in the Senate Judiciary Committee. PMID:12292216
The Cardinal of Milan and the linguist and writer Umberto Eco maintained a correspondence in the mid-1990s in connection with the Italian magazine ¿Liberal¿. One of the issues discussed was the conflict between belief in the value of human life and existing abortion legislation. Umberto Eco stated that he would do all in his power to dissuade a woman pregnant with his child from having an abortion, regardless of the personal cost to the parents, because the birth of a child is a miracle. He would not, however, feel capable of imposing his ethical position on anyone else. Terrible moments occur in which women have a right to make autonomous decisions concerning their bodies, their feelings, their futures. Those who disagree cite the right to life, a rather vague concept about which even atheists can be enthusiastic. The moment at which a new human being is formed has been brought to the center of Catholic theology, despite its uncertainty; the beginning of a new life may always need to be understood as a process whose end result is the newborn. Only the mother should decide at what moment the process may be interrupted. The cardinal¿s response distinguished between psychic and physical life, on the one hand, and life participating in the life of God on the other. The threshold is the moment of conception, reflecting a continuity of identity. The new being is worthy of respect. Any violation of the affection and care owed to the being can only be experienced as a profound suffering and painful laceration that may never heal. The response of Eco is unknown. PMID:12349541
The Pregnancy Discrimination Act of 1978 amended Title 7 of the Civil Rights Act requires that pregnancy-related medical care be covered on the same basis as other medical conditions under any employee comprehensive insurance plan. However, employers may limit insurance coverage of abortion to those situations "where the life of the mother would be endangered if the fetus were carried to term or where medical complications have arisen from an abortion". The National Conference of Catholic Bishops and the U.S. Catholic Conference filed a class action suit against the federal government on June 21, 1979 charging that the abortion provisions of the new law and the guidelines issued in March by the Equal Employment Opportunity Commission are unconstitutional, because they constitute "government coercion and compulsion to affirm what is contrary to one's moral, ethical or religious convictions". Government attorneys who will be defending the law agreed not to enforce the abortion provisions until their constitutionality has been determined. PMID:12309472
Background A system providing disabled persons with control of various assistive devices with the tongue has been developed at Aalborg University in Denmark. The system requires an activation unit attached to the tongue with a small piercing. The aim of this study was to establish and evaluate a safe and tolerable procedure for medical tongue piercing and to evaluate the expected and perceived procedural discomfort. Methods Four tetraplegic subjects volunteered for the study. A surgical protocol for a safe insertion of a tongue barbell piercing was presented using sterilized instruments and piercing parts. Moreover, post-procedural observations of participant complications such as bleeding, edema, and infection were recorded. Finally, procedural discomforts were monitored by VAS scores of pain, changes in taste and speech as well as problems related to hitting the teeth. Results The piercings were all successfully inserted in less than 5 min and the pain level was moderate compared with oral injections. No bleeding, infection, embedding of the piercing, or tooth/gingival injuries were encountered; a moderate edema was found in one case without affecting the speech. In two cases the piercing rod later had to be replaced by a shorter rod, because participants complained that the rod hit their teeth. The replacements prevented further problems. Moreover, loosening of balls was encountered, which could be prevented with the addition of dental glue. No cases of swallowing or aspiration of the piercing parts were recorded. Conclusions The procedure proved simple, fast, and safe for insertion of tongue piercings for tetraplegic subjects in a clinical setting. The procedure represented several precautions in order to avoid risks in these susceptible participants with possible co-morbidity. No serious complications were encountered, and the procedure was found tolerable to the participants. The procedure may be used in future studies with tongue piercings being a prerequisite for similar systems, and this may include insertion in an out-patient setting. PMID:24684776
Background The WHO estimates that 13% of maternal mortality is due to unsafe abortion, but challenges with measurement and data quality persist. To our knowledge, no systematic assessment of the validity of studies reporting estimates of abortion-related mortality exists. Study Design To be included in this study, articles had to meet the following criteria: (1) published between September 1st, 2000-December 1st, 2011; (2) utilized data from a country where abortion is “considered unsafe”; (3) specified and enumerated causes of maternal death including “abortion”; (4) enumerated ?100 maternal deaths; (5) a quantitative research study; (6) published in a peer-reviewed journal. Results 7,438 articles were initially identified. Thirty-six studies were ultimately included. Overall, studies rated “Very Good” found the highest estimates of abortion related mortality (median 16%, range 1–27.4%). Studies rated “Very Poor” found the lowest overall proportion of abortion related deaths (median: 2%, range 1.3–9.4%). Conclusions Improvements in the quality of data collection would facilitate better understanding global abortion-related mortality. Until improved data exist, better reporting of study procedures and standardization of the definition of abortion and abortion-related mortality should be encouraged. PMID:23341939
Gerdts, Caitlin; Vohra, Divya; Ahern, Jennifer
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
ABSTRACT Background On January 1, 2000, Texas began enforcement of a law that requires physicians to notify a parent of a minor,child seeking an abortion at least 48 hours before the procedure. Methods
Theodore Joyce; Robert Kaestner; Silvie Colman
Between 1972 and 1987 a total of 417 patients at the Department of Obstetrics and Gynaecology, Görlitz Hospital, changed their minds about an abortion after discussion with their doctor (average 5%, 1977 11.8%). A random survey (n = 176) was analysed, bearing in mind the medical and social aspects as well as the main reason for the planned abortion. It was established that the duration of pregnancy and birth in women who had changed the duration of pregnancy and birth in women who had changed their minds about an abortion did not differ from that of women who had not considered termination. However, a higher level of social care was needed. PMID:2038904
This paper does not attempt to deal with the legitimate ethical or moral debate on abortion. Utilizing abortion as a subject I will show how science and medicine in general, and abortion in particular, were used as weapons of mass destruction by Nazi physicians in their zeal to comply with the political climate of the time. Nazi policy on abortion and childbirth was just one of the methods devised and designed to ensure the extermination of those whom the Nazis deemed had "lives not worth living." Physicians implemented these policies, not with the fate of their patients in mind, but rather in the name of the "state." When discussing pregnancy, abortion and childbirth during the Holocaust it is imperative to include an essay of how these issues affected the Jewish prisoner doctors in the ghettos and camps. Nazi policy dictated their actions too. From an extensive search of their testimonies, I conclude that for these doctors ethical discourse comprised a fundamental component of their functioning. I do not propose to judge them in any way and one should not, in my opinion, argue whether their behavior was or was not morally acceptable under such duress; nevertheless, unlike their Nazi counterparts, a key theme in their testimonies was to "keep their medical values." PMID:17402341
A group of 36 patients who had had at least two consecutive spontaneous abortions and who desired to have children was subjected to a psychosomatic investigation before a biomedical diagnostic screening programme was started. A semi-structured interview regarding sociodemographic data, current relationship, social support, education, occupation and medical anamnesis was carried out. In addition, all women completed four standardized questionnaires on the topics of anxiety, somatization disorder, life satisfaction and depression. A control group of 36 women, matched for age and occupation, was subjected to the same psychosomatic investigation. The findings of the diagnostic screening programme showed that 16 women had abortions because of physical abnormality, and 15 women had no physically confirmed cause (in five women, the investigations were not completed). Following recurrent spontaneous abortion, 18 women had a successful pregnancy within 2 years, and 18 women were still childless. The comparison between patients and the control group revealed that patients with recurrent abortion were significantly more satisfied with their life quality regarding leisure time, financial situation and occupation. No significant differences were observed in any other variables. Patients who suffered spontaneous abortions due to a physical disorder showed partner relationship of longer duration, and more frequent miscarriages. Women with successful pregnancy within 2 years after recurrent miscarriage were significantly younger and had fewer physically related abortions compared with women who remained childless. In summary, psychological factors seem to be of subordinate importance as a cause for recurrent spontaneous abortion. Moreover, physical abnormalities in the reproductive system have a predominant impact on the prediction of a future successful pregnancy. PMID:9194676
Bergant, A M; Reinstadler, K; Moncayo, H E; Sölder, E; Heim, K; Ulmer, H; Hinterhuber, H; Dapunt, O
Aim In this study, we aimed to establish a mouse model of repeated medical termination of pregnancy in order to determine subsequent outcomes. Methods A model of mifepristone (RU 486)-induced medical abortion was established in BALB/c mice to facilitate the investigation of the impact of medical abortion on subsequent pregnancies, including litter sizes and newborn birth weights. Pregnant mice were sacrificed to examine midterm pregnancy status, investigate the frequency of fetal resorption, and measure placental function gene expression by real-time PCR and immunohistochemistry. Offspring liver mRNA was harvested for real-time PCR to determine gene expression and assess the effects of abortion on offspring development. Results Mice subjected to 2 previous medical abortions experienced spontaneous abortions in subsequent pregnancies. Medical abortion caused reduced reproductive capacity and affected placental dysfunction, with reduced expression of tissue factor (TF) and genes encoding proteins involved in metabolic functions relevant to pregnancy, such as 11?-hydroxysteroid dehydrogenase 1/2 (11?-HSD1/2) and glucocorticoid receptor (GR). Reduced expression was also observed for platelet endothelial cell adhesion molecule-1 (CD31) and vascular endothelial growth factor (VEGF). In offspring from subsequent pregnancies, genes involved in lipid metabolism, which may enhance key lipid transcription factors, such as PPARA and PPARG, as well as GR/11?-HSD1, were downregulated in the liver. In addition, the sperm motility of the F1 males reduced. Conclusion Repeated medical abortion impaired the reproductive function of female mice, significantly affecting the outcomes of subsequent pregnancies. The impact of repeated abortions on the offspring of subsequent pregnancies was also noteworthy and deserves further exploration. Thus, this model provides a useful means to study the mechanisms underlying the above phenomena, which will ultimately benefit the health of women and their children. PMID:23119001
Lv, Fang; Xu, Xiangbo; Zhang, Shucheng; Wang, Lili; Wang, Ning; He, Bin; Wang, Jiedong
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
Mismatches between the needs of public health systems and student interests have led to renewed study on the factors predicting career specializations among medical students. While most work examines career and lifestyle values, emotional proclivities may be important; disgust sensitivity may help explain preferences for careers with greater and…
Consedine, Nathan S.; Windsor, John A.
This prospective study assessed the morbidity and mortality associated with 192 consecutive tracheotomies. Complications were assessed including intraoperative and/or postoperative bleeding, infection, tracheoinnominate fistulae, tracheoesophageal fistulae, dislodgement of the tracheotomy tube, pneumothorax, wound infection and obstruction of the airway. 16% of the tracheotomy procedures resulted in complications. 22 tracheotomy procedures (11%) resulted in postoperative bleeding, 6 procedures (3%) had intraoperative bleeding which exceeded an estimated blood loss of 5 cc and 2 procedures (1%) developed a tracheoesophageal fistula. One patient (0.5%) experienced airway distress related to obstruction of the airway proximal to the tracheotomy tube. No patients required a return to the operating room to manage their complication, no patients developed a tracheoinnominate fistula and none of the tracheotomy sites became infected. The post tracheotomy ventilator wean to trach-collar supplemental oxygen protocol was accomplished with a mean of 6 days in 119 patients for whom data was available. Results demonstrate that the open tracheotomy procedure is a safe and frequently life saving manoeuvre in situations with an unsecured airway, and it provides better outcomes in patients requiring long term ventilatory support. Mortality rates are low and its potential morbidity is exceeded by its benefits. PMID:22554996
Oreadi, D; Carlson, E R
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
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
Global progress to reduce maternal deaths from unsafe abortion is inadequate. Clarifying abortion values and attitudes, using updated WHO safe abortion technical guidance, networking with other providers, and securing adequate abortion and contraceptive supplies can support providers to put induced abortion, postabortion care, and contraceptive skills into practice. Revised national guidelines based on updated WHO guidance can support women's healthcare providers to offer safe abortion for all legal indications and other measures to protect women's life and health. Recommendations of the United Nations and partner agencies can be used to support integration of abortion into other health programs, to expand provision of abortion care by midlevel providers, such as midwives, and to advocate for resources and results based on an expanded reproductive, maternal, newborn, and child health Continuum of Care. Together, these efforts can generate concerted progress toward eliminating unsafe abortion, which is an entirely preventable cause of maternal mortality. PMID:23507550
Medical procedures in outpatient settings have limited options of managing pain and anxiety pharmacologically. We therefore assessed whether this can be achieved by adjunct self-hypnotic relaxation in a common and particularly anxiety provoking procedure. 236 women referred for large core needle breast biopsy to an urban tertiary university-affiliated medical center were prospectively randomized to receive standard care (n=76), structured empathic attention (n= 82), or self-hypnotic relaxation (n=78) during their procedures. Patients’ self-ratings at 10 minute-intervals of pain and anxiety on 0–10 verbal analog scales with 0=no pain/anxiety at all, 10=worst pain/anxiety possible, were compared in an ordinal logistic regression model. Women’s anxiety increased significantly in the standard group (logit slope = 0.18, p < 0.001), did not change in the empathy group (slope = ?0.04, p = 0.45), and decreased significantly in the hypnosis group (slope = ?0.27, p < 0.001). Pain increased significantly in all three groups (logit slopes: standard care = 0.53, empathy = 0.37, hypnosis = 0.34; all p < 0.001) though less steeply with hypnosis and empathy than standard care (p = 0.024 and p = 0.018 respectively). Room time and cost were not significantly different in an univariate ANOVA despite hypnosis and empathy requiring an additional professional: 46 minutes/$161 for standard care, 43 minutes/$163 for empathy, and 39 minutes/$152 for hypnosis. We conclude that, while both structured empathy and hypnosis decrease procedural pain and anxiety, hypnosis provides more powerful anxiety relief without undue cost and thus appears attractive for outpatient pain management. PMID:16959427
Lang, Elvira V.; Berbaum, Kevin S.; Faintuch, Salomao; Hatsiopoulou, Olga; Halsey, Noami; Li, Xinyu; Berbaum, Michael L.; Laser, Eleanor; Baum, Janet
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
CUSUM procedures which are based on standardized statistics are often supposed to have expectation zero and being normally distributed. If these conditions are not satisfied it can have serious consequences on the determination of proper alarming bounds and on the frequency of false alarms. Here a CUSUM method for detecting outbreaks in health events is presented when the latter are
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
The increased use of screening tests for drug use or antibodies to the HTLV-III (AIDS) virus, as well as pre-employment polygraph testing, has raised concerns about the reliability of the results of these procedures. This paper reviews the mathematical model underlying the analysis of data from screening tests. In addition to the known formulas for the proportion of positive (negative)
Joseph L. Gastwirth
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
New optical full-field shape measurement systems allow transient shape capture at rates between 15 and 30 Hz. These frequency rates are enough to monitor controlled movements used e.g. for medical examination purposes. In this paper we present a set of algorithms which may be applied for processing of data gathered by fringe projection method implemented for lower limbs shape measurement. The purpose of presented algorithms is to locate anatomical structures based on the limb shape and its deformation in time. The algorithms are based on local surface curvature calculation and analysis of curvature maps changes during the measurement sequence. One of anatomical structure of high medical interest that is possible to scan and analyze, is patella. Tracking of patella position and orientation under dynamic conditions may lead to detect pathological patella movements and help in knee joint disease diagnosis. Therefore the usefulness of the algorithms developed was proven at examples of patella localization and monitoring.
Witkowski, Marcin; Kujawi?ska, Malgorzata; Rapp, Walter; Sitnik, Robert
Prenatal diagnosis (PD) provides the physician information on whether the unborn fetus has a genetic or chromosomal disorder, and offers patients a new option: selective abortion. In the present study, we analyzed the answers Mexican geneticists provided to a few selected questions from a multinational survey designed by Wertz and Fletcher [1988: Am J Hum Genet 42:592-600]. The selected questions were related to the use of PD, the acceptance of selective abortion, and the self-reported directiveness of counselling following the diagnosis of a fetal anomaly. Our results show that the great majority of Mexican geneticists participating in the study agree with PD when medically indicated, but not on free demand. Specific cases stimulated the group on thinking more than the general statements provided in the survey. Although the majority agreed that PD should be available to all women, when faced with cases of nonmorbid maternal anxiety, paternity testing, and sex selection, the proportion of geneticists willing to perform the test decreased substantially. When counselling patients on a fetal anomaly, the minority would be as unbiased as possible, and this seems to be the tendency in developing countries where counselling, as stated in the respondents' comments, reflects the belief that the goal of genetics is the prevention of or opposition to abortion. Counselling was influenced by the severity of the disorder. The geneticists' personal attitude toward abortion in the same situations was stronger than when counselling others. Analysis of directiveness in counselling for fetal anomaly showed that older geneticists, with more years of experience in medical genetics, were more likely to be neutral. When counselling directively, the group showed an overall direction toward continuing affected pregnancies. However, older geneticists and those with more than 10 years of practice were more likely than their younger counterparts to counsel towards terminating affected pregnancies. In personal situations of fetal disorder, the general tendency was to abort; however, geneticists seeing more than 5 patients per week, and those who believe that religion is important, were more likely to reject abortion. The sample is representative of Mexican geneticists, and the main limitation of this study is that the geneticists have very little experience in PD, and that their responses were mostly based on theory. However, their opinions may influence the demand and the availability of PD and abortion, as well as the possibility of legalization of abortion on the basis of a fetal defect. PMID:9482653
Carnevale, A; Lisker, R; Villa, A R; Armendares, S
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. PMID:24800079
Hambisa, Mitiku Teshome; Semahegn, Agumasie
Lymphoedema of the arm is a potentially serious consequence of any axillary procedure performed during the management of breast cancer. In an attempt to reduce its incidence and severity, patients are instructed to avoid venepunctures and blood pressure measurements on the treated arm. These precautions are not possible in some patients and attempts to adhere to them can cause discomfort, anxiety and stress for both patients and their health-care workers. The strength with which these recommendations are made is in contrast to the level of evidence underpinning them. This paper reviews this evidence regarding the safety, or lack thereof, of blood pressure monitoring and intravenous puncture in women who have had axillary surgery. With this evidence generally being anecdotal in nature, there appears to be no rigorous evidence-based support for the risk-reduction behaviours of avoiding blood pressure monitoring and venepuncture in the affected arm in the prevention of lymphoedema after axillary procedure. A clinical trial was proposed to investigate whether such avoidance measures were valuable, but failed during its inception. There remains a need for research from prospective trials on this controversial topic to determine the most appropriate patient recommendations that should be provided after axillary procedure regarding the risks for development of lymphoedema. PMID:24274353
Cheng, Chris-Tin; Deitch, Jessica M; Haines, Ian E; Porter, David J; Kilbreath, Sharon L
In The Netherlands the threat of terrorist attacks also exist. Both doctors and hospitals alike should be prepared for such attacks both on the logistical as well as the medical level. Most terrorist attacks are carried out with explosives. This results in many victims and in cases of explosions in closed or semi-closed areas, often results in complex medical problems in many of the victims. An explosion that occurs as the result ofa bomb detonating can result in 4 patterns of injury: the primary explosion injury caused by the pressure of the blast, the secondary injuries caused by flying debris, the tertiary injuries caused by the explosion wind, and the quaternary caused by heat and fire. Common injuries seen following an explosion include: lung damage, neurological damage, abdominal injuries, bone fractures and skeletal damage and crush-syndrome. The triage occurs at the site of the explosion as well as on arrival in hospital. One especially important aspect of this is the sorting and selecting between victims who are likely to develop complex problems and who therefore need to receive aggressive treatment in a specially equipped centre and those patients for whom the nearest emergency department will suffice their needs. The triage should be repeated considering the possibility that initial estimates on these points may have been wrong. Epidemiological research should be carried out for each attack in order to make an inventory of the number of victims, the injuries incurred, the assessment of the effects of the medical help received and an assessment of the effectiveness of the total aid received. PMID:16892611
Giard, R W M; Overbeke, A J P M
Background and aim It is important to find economical methods in early Phase 2 studies to screen drugs potentially useful to aid smoking cessation. A method has been developed that detects efficacy of varenicline and nicotine patch. This study aimed to evaluate whether the method would detect efficacy of bupropion and correctly identify lack of efficacy of modafinil. Design Using a within-subject double crossover design, smokers attempted to quit during each treatment, with bupropion (150 mg b.i.d.), modafinil (100 mg b.i.d.), or placebo (double-blind, counter-balanced order). In each of three medication periods, all smoked with no drug on week 1 (baseline or washout), began dose run-up on week 2, and tried to quit every day during week 3. Setting A university research center in the United States. Participants Forty-five adult smokers high in quit interest. Measurements Abstinence was verified daily each quit week by self-report of no smoking over the prior 24 hr and CO<5 ppm. Findings Compared with placebo, bupropion did (F(1,44)=6.98, p=.01), but modafinil did not (F(1,44)=.29, p=.60), increase the number of abstinent days. Also, bupropion (versus placebo) significantly increased the number of those able to maintain continuous abstinence on all 5 days throughout the quit week (11 vs 4), Z= 2.11, p <.05, while modafinil did not (6). Conclusions Assessing days abstinent during 1 week of use of medication versus placebo in a cross-over design could be a useful early Phase 2 study design for discriminating between medications useful vs not useful in aiding smoking cessation. PMID:23773319
Perkins, Kenneth A.; Lerman, Caryn; Karelitz, Joshua L.; Jao, Nancy C.; Chengappa, K.N. Roy; Sparks, Garrett M.
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
Between 1890 and 1945 the number of induced (criminal) abortions increased in Amsterdam; from 1945 up until the 1960s the number decreased slightly. In 1965 the number of induced abortions that took place in Amsterdam was estimated at more than 2000. Complications were frequent and included infections, septicaemia, damage caused by injected soap and sometimes air embolism. Women in Amsterdam often used primitive methods of contraception, but effective methods, such as condoms and diaphragms, were also used to some degree. Oral contraception was introduced in The Netherlands in 1962. Its use increased rapidly and consequently many doctors were confronted with problems surrounding contraception, including failures and abortion requests. After a television programme on abortion in 1967, requests for abortion surged. Hospitals set up multidisciplinary abortion committees to assess the requests, but soon it became evident that the women themselves were better able to judge whether they should undergo the procedure. Abortion clinics were established outside hospitals. Support from the feminist movement played a role after changes were already underway. The nationwide number of abortions increased to 21,000 in 1972 and to about 25,000 in the 1990s. The number remained stable, even among teenagers, because caregivers placed a great deal of emphasis on adequate contraception. PMID:16566423
Treffers, P E
There is a difference between ethics and morals. Morality represents an absolute, whereas ethics and ethical behavior are decided by a cultural consensus. Legality equates with ethical but not necessarily moral behavior. Even 1, such as a clergyman, who believes that killing is wrong morally can and should participate in counseling women regarding abortion. For 1 reason, it is a decision to be made by the woman involved not by the clergyman who has never stood in her position. Secondly, humans live in this world and are sinful. They can strive for perfection without achieving it. The church can state that abortion is immoral, even when it is the only or the best solution in certain circumstances. The church must also offer forgiveness if an individual chooses abortion. PMID:10236747
Mays, L H
Abortable Reader-Writer Locks are No More Complex Than Abortable Mutex Locks Dartmouth Computer on designing abortable mutual exclusion locks, and fairly efficient algorithms of O(log n) RMR complexity have). The abort feature is just as important for a reader-writer lock as it is for a mutual exclusion lock
Diagnosing Abortion Problems Abortions can represent a significant loss of (potential) income- hood of diagnosing the cause of any abortions that may occur. In some situations, the prompt diagnosis of an abortion may help reduce the severity of an impending outbreak. Well-kept records can be very useful
Of 881 Chinese handwritten volumes with medical texts of the 17th through mid-20th century held by Staatsbibliothek zu Berlin and Ethnologisches Museum Berlin-Dahlem, 48 volumes include prescriptions for induced abortion. A comparison shows that these records are significantly different from references to abortion in Chinese printed medical texts of pre-modern times. For example, the percentage of recipes recommended for artificial abortions in handwritten texts is significantly higher than those in printed medical books. Authors of handwritten texts used 25 terms to designate artificial abortion, with the term da tai [see text], lit.: "to strike the fetus", occurring most frequently. Its meaning is well defined, in contrast to other terms used, such as duo tai [see text], lit: "to make a fetus fall", xia tai [see text], lit. "to bring a fetus down", und duan chan [see text], lit., to interrupt birthing", which is mostly used to indicate a temporary or permanent sterilization. Pre-modern Chinese medicine has not generally abstained from inducing abortions; physicians showed a differentiating attitude. While abortions were descibed as "things a [physician with an attitude of] humaneness will not do", in case a pregnancy was seen as too risky for a woman she was offered medication to terminate this pregnancy. The commercial application of abortifacients has been recorded in China since ancient times. A request for such services has continued over time for various reasons, including so-called illegitimate pregnancies, and those by nuns, widows and prostitutes. In general, recipes to induce abortions documented in printed medical literature have mild effects and are to be ingested orally. In comparison, those recommended in handwritten texts are rather toxic. Possibly to minimize the negative side-effects of such medication, practitioners of folk medicine developed mechanical devices to perform "external", i.e., vaginal approaches. PMID:24195336
This paper discusses the controversy of the banning of ¿partial-birth abortion¿ in the state of Nebraska. This controversy arises as a result of how several major news sources described the Nebraska statute--that is, as a pre-viability abortion ban, and not a ban on late-term abortion procedures. This issue did not only occur in Nebraska, but also in Michigan when abortion opponents simultaneously initiated a publicity scheme to mislead the public into believing the ban was about ¿gruesome¿ late-term procedures. The deceptive term ¿partial-birth abortion¿, also seemed to suggest abortions performed on viable fetuses and the language describing the ban was confusing and slippery. In response to this controversy, Janet Benshoof, the president of the Center for Reproductive Law and Policy (CRLP) immediately made a statement to counteract the allegation imposed by abortion opponents. Also, CRLP Communications Deputy Director Margie Kelly spends a considerable amount of time informing the press of the extreme measures of the laws. PMID:12322529
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
This study examines the impact of various restrictive abortion laws on nonmarital childbearing since the passage of the 1996 welfare reform bill. The empirical results find that the price of an abortion, a Medicaid funding restriction, and a waiting period law are associated with a decrease in a state's nonmarital birthrate. The negative effects of restrictive abortion laws on a
Marshall H. Medoff
Measured psychological sequelae to induced abortion among women pregnant out of wedlock, using the Minnesota Multiphasic Personality Inventory and questions specific to willingness to repeat abortion under similar circumstances. Analyses indicated no relation between objective and subjective indicators. Affectivity after induced abortion had…
Robbins, James M.
Recurrent pregnancy loss associated with immunologic abnormalities has been termed immunologic abortion. Immunologic abortion occurs primarily in women over the age of 30 years and may affect either natural or in-vitro fertilization (IVF)-induced pregnancy. In this article, we review the humoral and cellular immunologic abnormalities that have been associated with this form of recurrent abortion, and we discuss treatment options
Raphael B. Stricker; Alex Steinleitner; Edward E. Winger
Background: Abortion is a public health concern because of its impact on maternal morbidity and mortality. Each year, about 79 million unintended pregnancies, excluding miscarriage, occur worldwide. More than half of these unintended pregnancies end in abortion. The purpose of this study was to determine the ever-event incidence of abortion (spontaneous and induced) and some related factors in a population-based
Marzieh Nojomi; Abdolrasool Akbarian; Safiyeh Ashory-Moghadam
This review examines the relationship between maternal alcohol consumption during pregnancy and spontaneous abortions. Although very high spontaneous abortion rates have been reported for alcoholic women, it is still uncertain if this is due to the direct effects of alcohol or the indirect effects of alcoholism-re lated disorders such as cirrhosis. The higher rates of spontaneous abortion among alcoholics may
ERNEST L. ABEL
Abortions in Cattle Max Irsik DVM, MAB Beef Cattle Extension Veterinarian University of Florida College of Veterinary Medicine Abortion is the premature expulsion of the fetus from the dam and usually have died in-utero due to disease and was expelled. Depending upon the cause of "abortion" a cow may
Watson, Craig A.
OBJECTIVE: Previous reports have suggested that serum CA 125 levels in patients who spontaneously abort in the first trimester of pregnancy differ from the levels of patients who successfully complete their pregnancies. Low CA 125 levels have been suggested to predict spontaneous abortion, although an increased rate of first-trimester spontaneous abortion has also been reported in women with elevated CA
Mark D. Hornstein; Jerome H. Check; Joseph A. Hill
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
Adam F. Dissel
Recent media coverage and case reports have highlighted women's attempts to end their pregnancies by self-inducing abortions in the United States. This study explored women's motivations for attempting self-induction of abortion. We surveyed women in clinic waiting rooms in Boston, San Francisco, New York, and a city in Texas to identify women who had attempted self-induction. We conducted 30 in-depth interviews and inductively analyzed the data. Median age at time of self-induction attempt was 19 years. Between 1979 and 2008, the women used a variety of methods, including medications, malta beverage, herbs, physical manipulation and, increasingly, misoprostol. Reasons to self-induce included a desire to avoid abortion clinics, obstacles to accessing clinical services, especially due to young age and financial barriers, and a preference for self-induction. The methods used were generally readily accessible but mostly ineffective and occasionally unsafe. Of the 23 with confirmed pregnancies, three reported a successful abortion not requiring clinical care. Only one reported medical complications in the United States. Most would not self-induce again and recommended clinic-based services. Efforts should be made to inform women about and improve access to clinic-based abortion services, particularly for medical abortion, which may appeal to women who are drawn to self-induction because it is natural, non-invasive and private. PMID:21111358
Grossman, Daniel; Holt, Kelsey; Peña, Melanie; Lara, Diana; Veatch, Maggie; Córdova, Denisse; Gold, Marji; Winikoff, Beverly; Blanchard, Kelly
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
The aim of this study was to explore effective ways to prevent conflicts between patients and healthcare professionals by analyzing 836 malpractice cases. The analysis revealed two points that especially influence court decisions: disease prognosis and inadequate informed consent. Regarding prognosis, decisions are more in favor of the defendant (medical institution) in diseases with poor prognoses, such as sepsis and anaphylaxis, than in diseases with typically good prognoses, such as acute epiglottitis and strangulation ileus. Regarding insufficient informed consent, the cases fell into two groups, emergency and non-emergency. The non-emergency group consisted of cases such as preventative treatments for brain aneurysms and acute pancreatitis-related endoscopic retrograde cholangiopancreatography (ERCP), where essential information to consent to treatment, especially the prognosis with no treatment, was not given, despite sufficient time. The emergency group consisted of cases, such as acute coronary syndrome, especially treated by percutaneous coronary intervention (PCI), where there was not sufficient time to provide to patients information about treatments. This is the most difficult type of case and a subject for future efforts at clinical sites. PMID:25154246
Human rights protections have developed to resist governmental intrusion in private life and choices. Abortion laws have evolved in legal practice to protect not fetuses as such but state interests, particularly in prenatal life. National and international tribunals are increasingly called upon to resolve conflicts between state enforcement of continuation of pregnancy against women's wishes and women's reproductive choices. Legal
R. J Cook; B. M Dickens
2 groups of patients are at risk of traumatic complication after midtrimester abortion: older multiparous women (uterine ruptures) and young primigravid women (cervical ruptures). While the occurrence of uterine ruptures in the former class can be reduced by selective use of abortifacient agents, and avoidance of amnioinfusions and intravenous oxytocin, the occurrence of cervical ruptures continues to be high. From May 1974 through May 1978, 780 women underwent midtrimester abortion by various techniques. 12 patients (1.5%) sustained cervical injuries, 11 of whom were nulliparous aged 16 to 25 years. Intra-amniotic and extra-ovular methods alike produced cervical injuries. The combined method of induction increases the likelihood of damaging the cervix. Oxytocic augmentation, however, does not appear to increase its incidence. Nor does a shorter induction-abortion interval, according to the evidence. Since laminaria tents did not prevent cervical injuries, none of the presently available methods offers any protection. Nevertheless, it may be that cervical injuries can be prevented if midtrimester abortions are undertaken between 13 and 15 weeks of pregnancy. Cervical ruptures can also go unnoticed and cause future obstetric problems; the authors therefore emphasize the importance of routine cervical inspection in all patients. PMID:12335921
Rajan, R; Usha, K R
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
The use of placebos in therapy or research poses ethical questions. What are the benefits and the costs in ethical terms of condoning deception of the patient or subject? What does the deception mean for the patient's or subject's right to give informed consent to his treatment? Doctors are rightly expected to disclose to their patient facts which would in their judgement best enable him to give informed consent to treatment. On occasion, the degree of this disclosure may be limited by the need to avoid hazarding the success of treatment of an unstable patient whose condition threatens his life, but doctors should have no right to withhold information just to prevent a patient refusing consent to therapy. No such limitation should apply in experiments where full disclosure must operate to enable the subject to give his informed consent. The potential medical benefits for the patient of placebo therapy have to be weighed against all the ethical costs of the deception and dishonesty involved, including the longer term repercussions on doctor/patient trust: similar ethical costs may arise in experiments involving the use of placebos without disclosure of this as a possibility to the subject. Deception is ethically degrading to both parties not only being a breach of trust, but denying the moral autonomy of the patient or subject to make his own choice. The writer concludes that placebos should be used only with full disclosure and consent whether in therapy or in research, and that this need not impede the success of either. PMID:739513
NASA's vision for space exploration (February 2004) calls for development of a new crew exploration vehicle, sustained lunar operations, and human exploration of Mars. To meet the challenges of planned sustained operations as well as the limited communications between Earth and the crew (e.g., Mars exploration), many systems will require crews to operate in an autonomous environment. It has been estimated that once every 2.4 years a major medical issue will occur while in space. NASA's future travels, especially to Mars, will begin to push this timeframe. Therefore, now is the time for investigating technologies and systems that will support crews in these environments. Therefore, this summer two studies were conducted to evaluate the technology and systems that may be used by crews in future missions. The first study evaluated three commercial Indoor Positioning Systems (IPS) (Versus, Ekahau, and Radianse) that can track equipment and people within a facility. While similar to Global Positioning Systems (GPS), the specific technology used is different. Several conclusions can be drawn from the evaluation conducted, but in summary it is clear that none of the systems provides a complete solution in meeting the tracking and technology integration requirements of NASA. From a functional performance (e.g., system meets user needs) evaluation perspective, Versus performed fairly well on all performance measures as compared to Ekahau and Radianse. However, the system only provides tracking at the room level. Thus, Versus does not provide the level of fidelity required for tracking assets or people for NASA requirements. From an engineering implementation perspective, Ekahau is far simpler to implement that the other two systems because of its wi-fi design (e.g., no required runs of cable). By looking at these two perspectives, one finds there was no clear system that met NASA requirements. Thus it would be premature to suggest that any of these systems are ready for implementation and further study is required.
This article was written in support of a claim forwarded by Joan Callahan that fetal intracardiac potassium chloride injection (KCl injection) should be offered to women undergoing second-trimester abortion. Callahan provides three positive arguments for use of the technique: maternal safety, the short-term interests of fetuses, and the longterm interests of fetuses who survive the abortion. The author of this article notes that the fact that KCl injection is currently the safest procedure for the mother is argument enough in favor of offering the procedure. Even physicians who object to the procedure are obligated to inform their patients about it and should be encouraged to help their patients locate a physician willing to perform KCl injection. Callahan's argument about fetal pain is sound but unnecessary as long as KCl injection remains the safest procedure for the mother. The argument about preventing longterm suffering for fetuses who survive late abortion is the weakest because it is impossible to determine whether the fetuses would be better off dead or alive. Hospitals can resolve some of the dilemmas which are associated with KCl injection by having a well thought out and clearly communicated policy about resuscitation of an aborted fetus. Callahan argues that the policy should be a blanket "do not resuscitate." The author is less sure that a blanket policy in either direction would be correct. Since it is impossible to know in advance what is best for the child, other factors must determine whether one policy is preferable to another. These include legal considerations such as the Americans with Disabilities Act which prohibits discrimination against disabled individuals in hospitals. PMID:8605391
The presence of significant intensities of un-bunched beam is a potentially serious issue in the LHC. Procedures using damper kickers for cleaning both the Abort Gap (AG) and the buckets targeted for injection, are currently in operation at flat bottom. Recent observations of relatively high population of the AG during physics runs brought up the need for AG cleaning during luminosity operation. In this paper the results of experimental studies performed in October 2011 are presented.
Bartmann, W; Bracco, C; Bravin, E; Goddard, B; Höfle, W; Jacquet, D; Jeff, A; Kain, V; Meddahi, M; Roncarolo, F; Uythoven, J; Valuch, D; Gianfelice-Wendt, E
The 2 primary sources of data on the number of abortions performed in the US--the Centers for Disease Control (CDC) and the Alan Guttmacher Institute (AGI)--provide conflicting information on abortion trends. According to CDC, the number of abortions performed in the US declined between 1982 and 1983 for the first time since record keeping began in 1969. The AGI showed a slight increase in these two years, an increase that has continued through 1985. However, both of these sources show that the rapid increase in abortions experienced during the 1970s has levelled off and the ratio of abortions to births and to pregnancies has declined. Political opposition to abortion may have produced a reluctance on the part of providers to report data on abortions performed, thus accounting for the lower CDC estimate. Possible explanations for a levelling off of abortion rates and ratios in recent years include improved ability to prevent unwanted pregnancies, a greater tendency to carry unwanted pregnancies to term, and a decline in the availability of abortions due to economic and political pressures. The number of abortion providers identified by AGI has dropped from a peak of 2908 in 1982 to 2680 in 1985. The characteristics of women seeking abortions have also changed. Women who obtained legal abortions in 1983 were more likely to be unmarried, black, and over age 20 years than their 1973 counterparts. Also, women in 1983 were more likely to seek abortion in the first 10 weeks and to use abortion to prevent a first birth than in 1973. PMID:12268741
Haub, C; Kent, M
Unsafe abortion's significant contribution to maternal mortality and morbidity was a critical factor leading to liberalization of Nepal's restrictive abortion law in 2002. Careful, comprehensive planning among a range of multisectoral stakeholders, led by Nepal's Ministry of Health and Population, enabled the country subsequently to introduce and scale up safe abortion services in a remarkably short timeframe. This paper examines factors that contributed to rapid, successful implementation of legal abortion in this mountainous republic, including deliberate attention to the key areas of policy, health system capacity, equipment and supplies, and information dissemination. Important elements of this successful model of scaling up safe legal abortion include: the pre-existence of postabortion care services, through which health-care providers were already familiar with the main clinical technique for safe abortion; government leadership in coordinating complementary contributions from a wide range of public- and private-sector actors; reliance on public-health evidence in formulating policies governing abortion provision, which led to the embrace of medical abortion and authorization of midlevel providers as key strategies for decentralizing care; and integration of abortion care into existing Safe Motherhood and the broader health system. While challenges remain in ensuring that all Nepali women can readily exercise their legal right to early pregnancy termination, the national safe abortion program has already yielded strong positive results. Nepal's experience making high-quality abortion care widely accessible in a short period of time offers important lessons for other countries seeking to reduce maternal mortality and morbidity from unsafe abortion and to achieve Millennium Development Goals. PMID:22475782
Abstract Objective To investigate the risk of developing a depression after induced abortion. Methods A prospective cohort study conducted in Curaçao which involved 92 women having an induced abortion and 37 women delivering after an unplanned or unwanted pregnancy, who served as controls. All participants completed the Center of Epidemiological Studies Depression (CES-D) scale before and two to three weeks after the abortion or delivery. Results Following the abortion, significantly fewer women were at risk of depression (30%) as compared to when still pregnant (60%). Mean depression scores were significantly lower after- than before the procedure. The likelihood of depression post-abortum (30%) was similar to that after delivery of an unplanned/unwanted child (22%). Even though women in the abortion group more often reported having suffered from depression in the past than controls, they were not at greater risk of depression after their pregnancy had ended. Conclusion Curaçao women's risk of developing a depression following an (early) induced abortion is not greater than that after carrying to term an unplanned/unwanted pregnancy. We recommend that the results of this study be taken into account in case the Curaçao government should consider legalisation of induced abortion in the near future. PMID:24981412
Boersma, Adriana A; van den Berg, Desirée; van Lunsen, Rik H W; Laan, Ellen T M
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
The Roman Catholic Church has held the most absolute and extreme position against abortion taken by any religious group. Opposition to abortion by US Catholic bishops has been unflagging since Roe vs. Wade was decided. The current strategy embraced by the bishops is to restrict access to abortion as a prelude to attaining a complete ban on the procedure. The bishops, of course, have a political and constitutional right to champion public policy issues. This ability is limited only by the laws regarding tax-exempt status which make it impossible for the bishops to endorse political candidates. Opponents of the positions of the bishops, in turn, have a right to challenge their positions. The bishops, acting jointly as the United States Catholic Conference (USCC), express their own opinions, not the opinions of the 53 million US Catholics and have been criticized by both conservative and progressive groups in the church. Since women can not become Catholic bishops, or even priests, they are excluded from meetings of the USCC. Catholic lay groups have expressed the view that there is more than one legitimate Catholic position regarding abortion and have even filed briefs in favor of retaining the decision reached in Roe vs. Wade. The bishops, however, are able to draw on a multitude of institutions to further their view and have enhanced the operations of their 28 statewide lobbying offices as the abortion battle has shifted to the states. The Webster decision signaled a return of the bishops to a prominent position in the anti-abortion campaign. Prior to Webster, they kept their distance from the Protestant religious right. With Webster, the bishops felt the time was right to press hard to further restrictions to access to abortion. As they began to apply pressure, a pro-choice backlash developed, with leading Catholic politicians adopting strong pro-choice positions. The bishops reacted by taking such aggressive actions as denouncing certain politicians by name. This behavior caused even more alienation of middle-of-the-road Catholics from the bishops' position. The bishops tried to recover by hiring a professional public relations firm and the pollster used by the Reagan administration. The public relations firm was dismissed within a year. Religious observers wonder why the church is so adamantly against abortion in every circumstance, despite the beliefs of its members. In fact, in 1974, the Congregation for the Doctrine of the Faith noted the church's opposition to abortion but fell short of calling it murder and was honest about the church's ambiguity over the personhood of a fetus or at what stage in development the creator endows a fetus with a soul. This question has been debated by theologians since the early centuries of the church. Even the current Pope favors the term "that which is in the process of becoming" when discussing a fetus. In addition, church history and positions regarding the possibility of a "just war" make the church's adherence to the impossibility of a "just abortion" hard to justify. This hard-line position has removed the church from a position in which it could help women and society understand the values which must underly every decision to have an abortion. PMID:8274867
Access to abortion services in the United States continues to decline. It does so not because of significant changes in legislation or court rulings but because fewer and fewer physicians wish to perform abortions and because most states now have "conscientious objection" legislation that makes it easy for physicians to refuse to do so. We argue in this paper that physicians have an obligation to perform all socially sanctioned medical services, including abortions, and thus that the burden of justification lies upon those who wish to be excused from that obligation. That is, such persons should have to show how requiring them to perform abortions would represent a serious threat to their fundamental moral or religious beliefs. We use current California law as an example of legislation that does not take physicians' obligations into account and thus allows them too easily to declare conscientious objection. PMID:8731539
Meyers, C; Woods, R D
In Canada the declining birthrate and the increase in life expectancy is producing a steady change in the distribution of the population. Every country needs a balance between different age groups to maintain an equilibrium between the working and nonworking sectors. When the pyramid is reversed and the older members outnumber the supporting group, the care of the elderly rests primarily with the government. This is Canada's situation. The main factor in the growth of the population has been natural increase (or the excess of births over deaths), but this has declined progressively, from 23/1000 population in 1961 to only 8.3/1000 in 1977. Since the crude death rate has leveled off since 1967, the reason for this decline is the significant reduction in the number of births. The "baby boom" of the 1950s increased the number of women currently in the reproductive years, but there has been a progressive decrease in fertility rates. The main reasons for this decrease are the availability of better contraceptive methods and the liberalization of abortion laws in 1969. Each year an average of 60,000 therapeutic abortions are performed in Canada. If therapeutic abortions were included among other causes of death, they would represent the 2nd most frequent cause of death. Statistics Canada has projected that the annual rate of population growth in 2026 will have a negative value of 0.1 in spite of a presumed constant net immigration of 50,000 annually. Emigration also plays an important role, yet it is difficult to estimate because the only statements required when a Canadian resident leaves the country are those on an income tax return. At least 48,000 Canadians emigrated each year between 1966-76. If the present age distribution of the Canadian population is analyzed, and these figures are projected to the year 2026, one observes a significant increase in the elderly age groups and a significant decrease in the groups of working age. The slowdown in population growth and the changes to the age group distribution will require modifications in health care facilities. The elderly make more demands on physicians' services than other age groups, and their medical problems persist longer. Other social problems faced by the elderly in areas such as housing, jobs, clothing, and nutrition will necessitate radical structural changes to society. PMID:6861040
Del Campo, C
A case of inversion of the uterus following abortion is reported. The 35-year old patient, admitted October 10, 1978 to the Medical College and Hospitals in Calcutta, India was referred by a private practitioner with a history of amenorrhea for 16 weeks, bleeding for 3 days, expulsion of the fetus 3 days earlier, and something coming down per vaginum for 2 days. The patient was para 4+0 (all full term normal deliveries) and home delivery for the last child 1 1/2 years earlier. She had a history of regular menstrual periods. Her general condition was poor. The examination revealed a gangrenous mass coming out of the vulva with a very offensive smell. There was a raw surface on which placenta like tissue was attached. No active bleeding was seen. Fundus and cervix of the uterus could not be felt. On rectal examination the uterus could not be felt, a cup-like depression was felt at the site of the uterus. The provision diagnosis was inversion of uterus following abortion. Treatment was started with sedatives and antibiotics, and arrangements were made for a blood transfusion. The vaginal mass was covered with glycerine and acriflavine gauze, and a hysterectomy was decided upon after improvement of her general condition and control of the infection. On October 14th, the patient was placed in knee chest position and posterior vaginal wall was retracted with Sims' speculum when the inverted lump was spontaneously reduced within the vagina. The inverted uterus was felt in the region of the vaginal vault. Glycerine acriflavine pack was given which was taken out and repack was given daily until the operation. The hysterectomy was performed on October 23rd. The abdomen was opened up by a transverse incision and the pelvis was explored. In the region of the uterus a cup-shaped depression was noted. Tubes and ovaries of both sides were seen hanging laterally from the cupped area. The left tube was found congested and thickened. Reduction of uterus was done by making a vertical incision over the posterior rim of cervix and with pressure from below by a sponge holding forceps by an assistant. The uterus was found to be just bulky. A total hysterectomy was performed. The postoperative period was uneventful. The histopathological report showed chorionic villi with degeneration and necrosis. In the case reported, etiology of inversion of the uterus following an abortion may be because of a lack of muscle tone along with traction of placental tissue by a traditional midwife. PMID:7169538
Gupta, A S; Datta, N; Ghosh, D
Sixteen cases of intestinal injuries following illegally induced abortion are reviewed. They constituted 2% of all such cases in the study period. Ten were terminal ileal injuries while six were colonic. Colonic injuries were predominantly encountered in the first trimester. The relative fixity of the terminal ileum and pelvic colon may be a factor in the determination of the site of injury. Morbidity and mortality are related to both gestational age and site of injury. PMID:6152800
Imoedemhe, D A; Ezimokhai, M; Okpere, E E; Aboh, I F
Although abortion remains legal and available to women, access to services is limited by restrictive factors such as parental consent and notification laws, mandatory delay requirements, insurance regulations\\/bans, and postviability testing requirements. This study employed a hierarchical linear modeling (HLM) with all states over a six-year period 1988-2000. It found the variable parental consent statistically significant. Consistent with its focus
D. Lynn Jackson
This paper concerns the medical, religious, and social discourse around abortion. The primary goal of this paper is to better understand how seven of the world's major religious traditions (Roman Catholic, Lutheran, Jewish, Islamic, Buddhist, Confucian, and Hindu) address abortion 'in the clinic'. We do not aim to critique these commentaries but to draw out some of the themes that resonate through the commentaries and place these within complex social contexts. We consider the intersection of ontology and morality; the construction of women's selfhood; the integration of religious beliefs and practices in a secular world. We suggest that for many women, religious doctrine may be balanced with secular logic as both are important and inextricably linked determinants of decision making about the termination of pregnancy. PMID:19641993
Stephens, Moira; Jordens, Christopher F C; Kerridge, Ian H; Ankeny, Rachel A
Introduction: In spite of legalising abortion and making safe abortion available at affordable price at accessible distance to almost everyone, unsafe abortion especially second trimester abortion is still a big health problem in Nepal. Objective: The objective of the study is to fi nd the demographic profi le, reasons for seeking abortion and to see the effectiveness of Misoprostol in
V Shrivastava; L Bajracharya; S Thapa
Abortion Rights in Latin America (NYT) 539 words Published: January 6, 2006 For proof that criminalizing abortion doesn't reduce abortion rates and only endangers the lives of women, consider Latin America. In most of the region, abortions are a crime, but the abortion rate is far higher than in Western
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. PMID:23758786
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
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
The use of the personal dose equivalent Hp(10), as measured by one or more dosimeters, in estimating the effective dose equivalent H(E) and the effective dose E was examined for situations in which a protective apron is worn by the monitored person during medical procedures. The photon energy range considered was between 0.03-1.0 MeV. Several methods recommended in the technical literature for this purpose were assessed and their ability to provide reasonable estimates for H(E) and E were compared. The assessments were theoretical and used Monte Carlo transport methods and an anthropomorphic phantom to calculate H(E), E, and Hp(10). The results showed that all of the recommended methods, using either one or more dosimeters, were applicable to this situation but that most gave good results only within limited photon energy ranges, outside of which they either considerably over-or under-estimated the doses. Some provided good estimates over the entire energy range considered. PMID:12467294
Sherbini, Sami; DeCicco, Joseph
An AbortAn Abort--Aware Model ofAware Model of Transactional ProgrammingTransactional Programming Â An abort-aware semantics for transactions Â· Part 2: TSMs = Transactional State Machines Â A finite-terminating transactions (known) Â Ignores STM/HTM aborted transactions: for responsiveness, "abort" cannot be equal
Rajamani, Sriram K.
This study examines the impact of various restrictive abortion laws on nonmarital childbearing since the passage of the 1996 welfare reform bill. The empirical results find that the price of an abortion, a Medicaid funding restriction, and a waiting period law are associated with a decrease in a state's nonmarital birthrate. The negative effects of restrictive abortion laws on a state's nonmarital birthrate are found to occur in various age groups. These findings are consistent with the hypothesis that restrictive abortion laws induce unmarried women to change their level of unprotected sexual activity or contraceptive behavior, thereby reducing the likelihood of an unwanted nonmarital pregnancy. PMID:20818592
Medoff, Marshall H
After the fall of Communism in Poland, the Catholic church exerted pressure to increase its influence in public life. One way in which this pressure has manifested itself has been in the passing of a restrictive abortion bill which was signed into law on February 15, 1993. Abortion had been legalized in Poland in 1956 and was used as a means of birth control because of a lack of availability and use of contraceptives. The number of abortions performed was variously reported as 60,000 - 300,000/year. In 1990, the Ministry of Health imposed restrictions on abortions at publicly funded hospitals, and 3 deaths were reported from self-induced abortions. In 1 year (1989-90), the number of induced abortions at 1 hospital dropped from 71 to 19, while the number of self-induced abortions increased from 48 to 85. Further restrictions were introduced in May 1992 as part of the "Ethical Code for Physicians," which allows abortions only in cases where the mother's life or health is in danger or in cases or rape. This code brought abortions to a halt at publicly funded hospitals and doubled or even tripled the cost of private abortions. Women have been refused abortions in tragic and life=threatening situations since the code was adopted. When an outright anti family planning bill was drafted in November 1992, the Polish citizenry collected 1,300,000 signatures to force a referendum. The referendum was not held, but the bill was defeated. The amended bill which passed allows abortions in publicly funded hospitals only when the mother's life or health is in danger and in cases of rape, incest, or incurable deformity of the fetus. The implications of this law remain unclear, since its language is strange and vague. The reproductive rights of Polish women face a further threat because the Catholic church is working to limit the availability of contraceptive methods which they deem to be "early abortives." On the other side of the issue, the Federation for Women and Planned Parenthood was established in 1992 and presently has 9 member organizations dedicated to reestablishing legal abortion and to helping women avoid unwanted pregnancies through sex education and contraception. Polls show that the new abortion law dose not reflect the favorable attitude of a majority of the Polish people toward legal abortion. It is unfortunate that Polish women will now have to fight for the rights that were once given to them. PMID:12287103
Courts and legal tribunals increasingly decline to serve as religious or moral guardians, and require social evidence to support litigants' claims. Recent cases on emergency contraception and abortion are examined to show how judicial interpretations can take account of evidence of the impact that different understandings of the law will have for how ordinary people can plan their lives and reproductive choices. In an emergency contraception case, an interpretation was rejected that would have criminalized choices that millions of decent, law-abiding physicians, pharmacists and women routinely make. In an abortion case, three judges unanimously rejected a government ministry's defence of compliance with the law because the ministry had failed to investigate the needs within its jurisdiction for legal clarity, lawful services, and its responsibility to women returning from having lawful procedures elsewhere. In both cases, litigants prevailed who showed factual evidence that their claims better promoted reproductive health and choice. PMID:16546189
Cook, R J; Dickens, B M; Erdman, J N
... —(1) Life of mother. FFP is available in expenditures for abortion services when a physician has found that the abortion is necessary to save the life of the mother. (2) Rape or...in expenditures for abortion services...
... —(1) Life of mother. FFP is available in expenditures for abortion services when a physician has found that the abortion is necessary to save the life of the mother. (2) Rape or...in expenditures for abortion services...
A cross-sectional study was carried out in Kisii District in the western part of Kenya between April 1 and April 28, 1991, with the objectives of ascertaining the attitude of nurses towards induced abortion, patients, and their involvement in abortion. Data were collected using a structured, self-administered questionnaire. All nurses present at the various institutions were recruited. A total of 218 nurses were recruited into the study. 75-83% were married, female nurses younger than 40, and therefore in the reproductive age group. 134 (61.5%) nurses were Protestant and 51% worked in the government district hospital. The nurses displayed a deficient knowledge of all aspects of induced abortion. Among clinically safe methods only intraamniotic saline instillation and dilation and curettage were mentioned by 4% and 11%, respectively. This deficiency in knowledge may be explained by the fact that most nurses work in the government hospitals, where induced abortion is not a routine procedure. Only 26-28% of the nurses thought it was safe to induce abortion at 1 and 2 months of gestation. 31-43% either did not know or were uncertain. Abortion is illegal in Kenya except when the life of the mother is in danger. Most nurses seemed to favor the law. A previous study in Nairobi revealed that only 38% of the nurses favored abortion on demand under a liberalized abortion law. 24 (11%) of nurses admitted to have induced abortion before. Their knowledge of induced abortion needs to be improved in order to prevent an increase in mortality and morbidity associated with improperly performed abortions. PMID:12346088
Kidula, N A; Kamau, R K; Ojwang, S B; Mwathe, E G
Since the early 1990s, minimally invasive techniques have been increasingly used in ever more and diversified fields of application. These techniques have some shared characteristics (predominant role of medical imaging, intensive use of new communication technologies, a multidisciplinary medical and scientific framework, etc.) but also shared specific problems (high-tech tools unfamiliar to the medical users, a major and long period
JEAN ROUSSEAU; MAXIMILIEN VERMANDEL; NACIM BETROUNI; PATRICK DUBOIS
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.
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
Maternal mortality and morbidity are the leading causes of death and illness, respectively, among women of reproductive age in many countries throughout the world. Of all maternal deaths, those related to unsafe abortions are the most widely underestimated, but they are also the most largely preventable. Medical abortion is a safe and reliable method for termination of a pregnancy in early gestation, although it is important to be aware of signs and symptoms of severe infection and toxic shock syndrome after the medical termination of pregnancy; case studies in literature are rarely fatal events. We report the first case of septic shock syndrome following a clandestine pregnancy termination with a misoprostol-only regimen (12 tablets 200 ?g each). Autopsy findings and histopathological examination proved that the woman died from septic shock. This case suggests to improve the forensic investigations in case of unsafe, often clandestine, abortion is suspected. PMID:25041279
Cittadini, Francesca; Loyola, Giovanni; Caradonna, Letizia; Minelli, Natalia; Rossi, Riccardo
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.
The present article describes the decommissioning of a compact, self-shielded, 11 MeV medical cyclotron. A Monte Carlo simulation of the possible nuclear reactions was performed in order to plan the decommissioning activities. In the course of the cyclotron dismantling, cyclotron components, shields, and floor concrete samples were measured. Residual activities were analyzed with a Ge(Li) detector and compared with simulation data. Doses to staff involved in the decommissioning procedure were monitored by individual TL dosimeters. The simulations identified five radioactive nuclides in shields and floor concrete: 55Fe and 45Ca (beta emitters, total specific activity: 2.29 x 10(4) Bq kg) and 152Eu, 154Eu, 60Co (gamma emitters, total specific activity: 1.62 x 10(3) Bq kg-1). Gamma-ray spectrometry confirmed the presence of gamma emitters, corresponding to a total specific activity of 3.40 x 10(2) Bq kg-1. The presence of the radioisotope 124Sb in the lead contained in the shield structure, corresponding to a simulated specific activity of 9.38 x 10(3) Bq kg-1, was experimentally confirmed. The measured dose from external exposure of the involved staff was <20 muSv, in accordance with the expected range of values between 10 and 20 muSv. The measured dose from intake was negligible. Finally, the decommissioning of the 11 MeV cyclotron does not represent a risk for the involved staff, but due to the presence of long-lived radioisotopes, the cyclotron components are to be treated as low level radioactive waste and stored in an authorized storage area. PMID:16691108
Calandrino, R; del Vecchio, A; Savi, A; Todde, S; Griffoni, V; Brambilla, S; Parisi, R; Simone, G; Fazio, F
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. PMID:24971223
Ikeako, LC; Onoh, R; Ezegwui, HU; Ezeonu, PO
We explored how low-income abortion clients in states where public funding was and was not available perceived the role of public funding for abortion. From October 2010 through February 2011, we conducted 71 semi-structured in-depth telephone interviews with low-income abortion clients in Arizona, Florida, New York, and Oregon. Women reported weighing numerous factors when determining which circumstances warranted public funding. Though most women generally supported coverage, they deviated from their initial support when asked about particular circumstances. Respondents felt most strongly that abortion should not be covered when a woman could not afford another child or was pregnant outside of a romantic relationship. Participants used disparaging language to describe the presumed behavior of women faced with unintended pregnancies. In seeking to discredit "other" women's abortions, women revealed the complex nature of abortion stigma. We propose that women's abortion experiences and subsequent opinions on coverage indicated three distinct manifestations of abortion stigma: women (1) resisted the prominent discourse that marks women who have had abortions as selfish and irresponsible; (2) internalized societal norms that stereotype women based on the circumstances surrounding the abortion; and (3) reproduced stigma by distancing themselves from the negative stereotypes associated with women who have had abortions. PMID:25068780
Nickerson, Adrianne; Manski, Ruth; Dennis, Amanda
In 2004, the Italian Parliament enacted a law regulating medically assisted reproduction. Although the law recognizes as legal certain assisted reproduction techniques, several other procedures are implicitly or expressly banned: oocyte and sperm donation, using embryos for the scientific research purposes and reproductive cloning. In this article, I outline the new legal framework, pointing out some of the shortcomings of its provisions, such as the failure to define what an 'embryo' is, the contradictions between this law and the law on abortion, the opportunity for Italian couples to circumvent some of the prohibitions by resorting to 'reproductive tourism', and the central role that physicians play in the new legal framework. PMID:15790606
This study attempts to ascertain the reasons that l ead women to abortion and assess the extent of the involvement of their husband or male partner in the pregnancy decision making. A total 304 of women who received safe abortion services during the eigh t-month period from 8 clinics of Family Planning Association of Nepal (FPAN) constitute the sample s
Nirmal Duwadi; Paban Sun Shrestha
an abort message. In such a situation, we want to investigate methods to effectively withdraw or minimizeAborting a Message Flowing Through Social Communities Cindy Hui Rutgers University Piscataway, New source. There is a trade off between a fast effective spread of actionable information and the ability
Aborting a Message Flowing Through Social Communities Cindy Hui, Malik Magdon-Ismail, William A message directly from the information source. There is a trade off between a fast effective spread in designing a useful abort mechanism. Index Terms--agent-based simulation, information diffusion, information
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 paper argues that the central issue in the abortion debate has not changed since 1967 when the English parliament enacted the Abortion Act. That central issue concerns the moral status of the human fetus. The debate here is not, it is argued, primarily a moral debate, but rather a metaphysical debate and\\/or a theological debate—though one with massive moral
Public rhetoric on abortion and the journalistic coverage of it has matured in tone and content over the years since women's magazines first broke a long public silence on the issue in the 1940s. Since the 1970s, extremist views on abortion have dominated the press. But new common ground arguments represent an emergence of the feminine ethical response of care
Maggie Jones Patterson; Megan Williams Hall
The Angels asked God: Is there a solution for the abortion debate? God: Yes, of course my Angels. It will be resolved. The Angels: When? God: Not in my lifetime. (Oktay Kadayifçi) The abortion debate is an emotional, sensitive and complicated issue that interests society and religion. Our intention is not to convince you to accept either side of the
Oktay Kadayifçi; Orellana Kadayifçi; Ibrahim Ferhat Ürünsak
In early 2010, the Nebraska state legislature passed a new abortion restricting law asserting a new, compelling state interest in preventing fetal pain. In this article, we review existing constitutional abortion doctrine and note difficulties presented by persistent legal attention to a socially derived viability construct. We then offer a substantive biological, ethical, and legal critique of the new fetal pain rationale. PMID:21561518
Cohen, I Glenn; Sayeed, Sadath
ABORTING CONFLICTING TRANSACTIONS IN AN STM PPOPP'09 2/17/2009 Hany Ramadan, Indrajit Roy, Emmett Witchel University of Texas at Austin Maurice Herlihy Brown University Committing #12;TM AND ITS DISCONTENTS Contention is a challenge for TM Performance suffers due to aborts/stalls Transactions become
2 Abstract: The present study was carried out on a flock of sheep and goats suffered from late abortion with incidences of 35.6 and 43.7%, respectively. Toxoplasmosis was a prime suspect. Blood samples were taken from infected dams for serological examination. Tissue samples were collected from internal organs of aborted feti for bacteriological examination, PCR and histopathological study. Serological examinations
Y. F. Ahmed; S. M. Sokkar; H. M. Desouky; A. H. Soror
In the third stage of labour we must expect an increase of blood lost and placental retentions after preceded interruption. An accumulation of manual detaching of placenta we ascertained for preceded abortion only. In the childbed we found an certained increase of disturbances in uterine involution. We think, that some consequences for medical care in pregnancies, following abortion and interruption, are very important. PMID:961165
Abstract Objective To improve understanding of the attitudes, beliefs, and experiences of Muslim patients presenting for abortion. Design Exploratory study in which participants completed questionnaires about their attitudes, beliefs, and experiences. Setting Two urban, free-standing abortion clinics. Participants Fifty-three self-identified Muslim patients presenting for abortion. Main outcome measures Women’s background, beliefs, and attitudes toward their religion and toward abortion; levels of anxiety, depression, and guilt, scored on a scale of 0 to 10; and degree of pro-choice or anti-choice attitude toward abortion, assessed by having respondents identify under which circumstances a woman should be able to have an abortion. Results The 53 women in this study were a diverse group, aged 17 to 47 years, born in 17 different countries, with a range of beliefs and attitudes toward abortion. As found in previous studies, women who were less pro-choice (identified fewer acceptable reasons to have an abortion) had higher anxiety and guilt scores than more pro-choice women did: 6.9 versus 4.9 (P = .01) and 6.9 versus 3.6 (P = .004), respectively. Women who said they strongly agreed that abortion was against Islamic principles also had higher anxiety and guilt scores: 9.3 versus 5.9 (P = .03) and 9.5 versus 5.3 (P = .03), respectively. Conclusion Canadian Muslim women presenting for abortion come from many countries and schools of Islam. The group of Muslim women that we surveyed was so diverse that no generalizations can be made about them. Their attitudes toward abortion ranged from being completely pro-choice to believing abortion is wrong unless it is done to save a woman’s life. Many said they found their religion to be a source of comfort as well as a source of guilt, turning to prayer and meditation to cope with their feelings about the abortion. It is important that physicians caring for Muslim women understand that their patients come from a variety of backgrounds and can have widely differing beliefs. It might be helpful to be aware that patients who hold more anti-choice beliefs are likely to experience more anxiety and guilt related to their abortion than pro-choice patients do. PMID:21626898
Wiebe, Ellen; Najafi, Roya; Soheil, Naghma; Kamani, Alya
The study describes the loss of productive time and income related to abortion care and care-seeking among 110 women presenting at public and private sector abortion providers in Cambodia. Data were collected through women's exit interviews, and descriptive analysis was used to examine lost time and income against a number of explanatory variables, such as gestational age of pregnancy, type of abortion provider and facility, type of uterine evacuation procedure, number of health visits, and the woman's occupation. Results indicate that lost time and earnings increase with the number of visits to obtain the termination, gestational age, and selection of a private physician or non-governmental organization clinic. Lost time and earnings also vary by the woman's type of employment. The study underscores the need for safer, accessible, and more affordable abortion services in order to ensure that these services are available for all women. Even in the Cambodian context, where abortion is unrestricted during the first trimester of pregnancy, the study findings show that the process of searching for and obtaining high-quality abortion care was unnecessarily complicated and costly to women and their household members. PMID:18308261
Potdar, Rukmini; Fetters, Tamara; Phirun, Lam
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. PMID:24491470
Daniel, Sharon; Koren, Gideon; Lunenfeld, Eitan; Bilenko, Natalya; Ratzon, Ronit; Levy, Amalia
Currently Catholic bishops are applying an inconsistent ethical paradigm to the issues of war and abortion. Based on the seamless garment theory war, abortion and capital punishment are all immoral acts because they are of the same garment. They are all "killing acts" and as such they are immoral. However there is within the Catholic paradigm the idea of a just war. The just war theory states that the destruction of human life in war is justified if it is for a greater good. However abortion has no exceptions, there is no just abortion in the rules of the Catholic Church. The author takes the just war doctrine as presented by the Catholic Church and shows how it could easily apply to abortion. Both war and abortion involve the taking of a human life, but in the case of war the taking of a life is justified if it is done to protect your own life. The same exception in abortion would be to allow abortion when the mother's life is in danger. yet no such exception exists. The just war theory further states that was is necessary to protect national integrity, particularly if the violation erodes the quality of life for its citizens. The same exception for abortion would include allowing abortions for women who already have more children then they can care for or if having the child would erode the quality of life for the woman. Other aspects of the just war theory include the competence and goals of the national leaders. Women must also be allowed to be competent moral agents. Proponents of the seamless garment theory will bring up the fact that in a just war only combatants die yet the fetus is innocent. But no war has ever been fought without the loss of innocent civilians. PMID:12178844
Opposition to abortion is often tied to opposition to contraception. This is because opinions on abortion do not occur in isolation, they are part of a world view that is against sex for pleasure, and therefore against contraception. Many anti-abortion groups are under the false impression that contraception increases the number of abortions. There is no scientific evidence for this claim. It is also common sense that contraception prevents abortion because it prevents so many unwanted pregnancies. If a woman uses contraceptives, she must not want to be pregnant. Therefore, every cycle she has without becoming pregnant is the prevention of an unwanted pregnancy. In the 1960s the early studies of the pill had 6000 cycles without a single pregnancy. The anti-abortion lobby has had an influence on the politics of the US concerning abortion and it is also having an effect on the politics of contraception. Many anti-abortion groups are against premarital sex and advocate abstinence as the preferable method but there is no evidence that abstinence is an effective method of preventing unwanted pregnancies, especially in teens. Contraceptive research is being hindered by political pressure from anti-abortion groups. Postovulatory contraceptive research is prohibited in many facilities. The National Academy of Science's Institute of Medicine in Washington, DC published an extensive report detailing the problems of getting new contraceptives researched and developed in the US. The report notes that federal funding for contraceptive development rose only $6 million between 1973-87, from $7.4 to $13.2 million. While there are a wide variety of problems, pressure from anti-abortion groups is considered to have had an adverse affect. Many groups advocate drug company boycotts. PMID:12317308
Background and purpose: Dexamethasone is known to produce analgesic effects, but the optimal analgesic dosage of dexamethasone remains unclear, especially in patients without postoperative use of other analgesics. The purpose of this study was to explore the effective analgesic dose of dexamethasone in day surgery patients undergoing painless abortion. Methods: 287 patients undergoing painless abortion were randomly assigned to one of four groups: control group receiving saline and dexamethasone groups receiving 0.1, 0.15, or 0.2 mg/kg dexamethasone. Drugs were intravenously injected 30 min before induction of anesthesia. All patients underwent the same anesthesia procedure using propofol and remifentan. The visual analogue scale (VAS) scores and occurrence of nausea, vomiting and drug-induced side effects were recorded at 1, 2 and 24 h after operation. Results: There were no significant differences in patient’s clinical characteristics, surgical features and frequency of occurrence of nausea and vomiting among the four groups (P > 0.05). The VAS scores at rest and during coughing at 2 h after operation (time of discharge from the hospital) were significantly lower in patients receiving 0.2 mg/kg dexamethasone compared with control patients (P < 0.05). Conclusion: Intravenous injection of 0.2 mg/kg dexamethasone before induction of anesthesia can significantly reduce the VAS scores at 2 h after painless abortion.
Quan, Zhe-Feng; Tian, Ming; Chi, Ping; Li, Xin; He, Hai-Li
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. PMID:24886273
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
Since the dawn of medicine, medical rights and ethics have always been one of mankind's concerns. In any civilisation, attention paid to medical laws and ethics depends on the progress of human values and the advancement of medical science. The history of various civilisations teaches that each had its own views on medical ethics, but most had something in common. Ancient civilisations such as Greece, Rome, or Assyria did not consider the foetus to be alive and therefore to have human rights. In contrast, ancient Persians valued the foetus as a living person equal to others. Accordingly, they brought laws against abortion, even in cases of sexual abuse. Furthermore, abortion was considered to be a murder and punishments were meted out to the mother, father, and the person performing it. PMID:24304111
Yarmohammadi, Hassan; Zargaran, Arman; Vatanpour, Azadeh; Abedini, Ehsan; Adhami, Siamak
Purpose This study aims to assess the effects of obtaining an abortion versus being denied an abortion on self-esteem and life satisfaction. Methods We present the first 2.5 years of a 5-year longitudinal telephone-interview study that follows 956 women who sought an abortion from 30 facilities across the USA. We examine the self-esteem and life satisfaction trajectories of women who sought and received abortions just under the facility’s gestational age limit, of women who sought and received abortions in their first trimester of pregnancy, and of women who sought abortions just beyond the facility gestational limit and were denied an abortion. We use adjusted mixed effects linear regression analyses to assess whether the trajectories of women who sought and obtained an abortion differ from those who were denied one. Results Women denied an abortion initially reported lower self-esteem and life satisfaction than women who sought and obtained an abortion. For all study groups, except those who obtained first trimester abortions, self-esteem and life satisfaction improved over time. The initially lower levels of self-esteem and life satisfaction among women denied an abortion improved more rapidly reaching similar levels as those obtaining abortions at 6 months to one year after abortion seeking. For women obtaining first trimester abortions, initially higher levels of life satisfaction remained steady over time. Conclusions There is no evidence that abortion harms women’s self-esteem or life satisfaction in the short term. PMID:24740325
Biggs, M. A.; Upadhyay, Ushma D.; Steinberg, Julia R.; Foster, Diana G.
Examined feelings of well-being in 217 women who had abortions. Results suggest that, compared to women who have not had abortions, those who choose abortion feel more negatively. Of women choosing abortion, those who are already mothers are most likely to be depressed and lonely, followed by those from lower educational and socioeconomic…
On Avoiding Spare Aborts in Transactional Memory Idit Keidar Dept. of Electrical Engineering a theory for un- derstanding aborts in transactional memory systems (TMs). Existing TMs may abort many transactions that could, in fact, commit without violating correctness. We call such unnecessary aborts spare
NASAfacts National Aeronautics and Space Administration Pad Abort 1 Ensuring Astronaut Safety NASA are safe for human use. Pad Abort 1, a flight test being conducted to validate the Orion crew exploration vehicle's launch abort system, will be conducted at the Orion Abort Flight Test launch complex 32E
Solo-fast Universal Constructions for Deterministic Abortable Objects Claire Capdevielle, Colette. In this paper we study efficient implementations for deterministic abortable objects. Deterministic abortable abort to indicate that the operation failed (and did not take effect) when there is contention
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…
STUDY OBJECTIVE--The aim was to determine whether induced abortions could increase the risk of secondary infertility. DESIGN--This was a case-control study; cases were women with secondary infertility, individually matched to two controls who were currently pregnant. Each participant was interviewed by one of two medical doctors using a questionnaire that sought information on their demographic, socioeconomic, medical, and reproductive status.
A Tzonou; C C Hsieh; D Trichopoulos; D Aravandinos; A Kalandidi; D Margaris; M Goldman; N Toupadaki
This research examines 23 different laws passed by state governments in an effort to restrict the number of abortions. It assesses both laws passed and laws actually enforced after the Supreme Court permitted states to restrict access to abortion in 1989. None of the policy actions by state governments has had a significant impact on the incidence of abortion from 1982 to 1992. Abortion rates continue to reflect past abortion rates, the number of abortion providers, whether the state funds abortions for Medicaid-eligible women, urbanism, and racial composition of the population. Recent restrictive policies have not affected these trends. PMID:8875064
Meier, K J; Haider-Markel, D P; Stanislawski, A J; McFarlane, D R
The purpose of this study is to empirically examine the attitudinal foundations of “pro-life” people who support capital punishment. To abortion opponents, the procedure represents the deliberate killing of human beings and should be a punishable criminal offense. According to death penalty supporters, the capital defendant deserves the ultimate punishment because he or she has destroyed innocent human life. Although
Kimberly J. Cook
Summary An immunohistochemistry (IHC) procedure for the detection of Campylobacter fetus antigens using an avidin-biotin com- plex technique was performed on formalin fixed bovine and ovine fetal tissues from 26 natural cases of Campylobacter spp. abortion (four ovine and 22 bovine). The species of Campy- lobacter isolated included C. fetus ssp. venerealis from 13 bovine fetuses, C. fetus ssp. fetus
C. M. Campero; M. L. Anderson; R. L. Walker; P. C. Blanchard; L. Barbano; P. Chiu; A. Martinez; G. Combessies; J. C. Bardon; J. Cordeviola
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 (4th 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
The decision of the US Supreme Court in Roe vs. Wade called upon a woman's right to privacy to assert a woman's right to a previability abortion in a framework based upon a consideration of the trimester of the pregnancy. A state policy or abortion law would only survive a constitutional challenge if it passed the exacting test of serving a "compelling state interest." The Court's decision in Roe grew out of an analysis which ignored the possibility that women as individuals would be able to arrive at an abortion decision for themselves. Instead, a physician's right to exercise medical judgement and perform a first-trimester abortion upon request was upheld. The decision of the Court in Planned Parenthood of Southeastern Pennsylvania vs. Casey upheld the constitutionality of abortion but allowed states to impose abortion regulations which would only be invalid if they imposed an "undue burden" upon women. In Casey, the Court linked the abortion decision to the concept of liberty embodied in the 14th Amendment. Thus, the abortion decision is seen as solely a woman's rather than a medical decision undertaken only with the guidance of a physician. The Court acknowledged that its ruling in Roe was sound and that there was no compelling reason to overturn it. This allowed the Court to maintain its legitimacy and, thus, its authority and sense of responsibility to the people who had acted in good faith under Roe. The new "undue burden" test was applied to the Pennsylvania statutes, and the real experiences of individual women were called into play to explain why spousal notification would pose an undue burden but the informed consent requirement would not. This test will likely continue to reflect the real experiences of women and reveal the underpinnings of state regulations (such as the "repugnant" view of a woman's status within a marriage forwarded by the proposed spousal consent requirement). Unlike Roe, which resulted in delineation and polarization of the "prochoice" and "prolife" positions in the abortion debate, the "undue burden" test may achieve reconciliation of these views in light of the commonality of women's experience. PMID:8293219
Martin, P A
Variations in the availability of abortion providers may impact the demand for abortions since greater provider availability reduces the travel cost associated with acquiring an abortion. This paper applies a fertility-control model to estimate the responsiveness of abortion demand to travel-cost variations using county-level data on the state of Texas. Abortion rates as well as pregnancy rates appear to be
ROBERT W. BROWN; R. TODD JEWELL
Background Although abortion or termination of pregnancy (TOP) has become an increasingly normalized component of women's health care over the past forty years, insufficient attention has been paid to women's experiences of surgical or medical methods of TOP. Objective To undertake a narrative review of qualitative studies of women's experiences of TOP and their perspectives on surgical or medical methods. Methods Keyword searches of Medline, CINAHL, ISI, and IBSS databases. Manual searches of other relevant journals and reference lists of primary articles. Results Qualitative studies (n = 18) on women's experiences of abortion were identified. Analysis of the results of studies reviewed revealed three main themes: experiential factors that promote or inhibit the choice to seek TOP; experiences of TOP; and experiential aspects of the environment in which TOP takes place. Conclusion Women's choices about TOP are mainly pragmatic ones that are related to negotiating finite personal and family and emotional resources. Women who are well informed and supported in their choices experience good psychosocial outcomes from TOP. Home TOP using mifepristone appears attractive to women who are concerned about professionals' negative attitudes and lack of privacy in formal healthcare settings but also leads to concerns about management and safety. PMID:18637178
Lie, Mabel LS; Robson, Stephen C; May, Carl R
This commentary describes the various manifestations of the stigmatization and marginalized status of abortion providers in relation to mainstream medicine. The article also addresses some of the current efforts to respond to this stigmatization. PMID:25061870
... Clinical Trials NCI Publications Español Abortion, Miscarriage, and Breast Cancer Risk Introduction A woman’s hormone levels normally change ... that may influence a woman’s chances of developing breast cancer later in life. As a result, over several ...
The paper proposes a socioeconomic framework of supply, demand, and regulation to explain the development of sex-selective abortion in several parts of the world. The framework is then applied to three countries of southern Caucasus (Armenia, Azerbaijan, and Georgia) where sex-selective abortion has developed since the collapse of the Soviet Union. The authors argue that sex-selective abortion cannot be explained simply by patriarchal social systems, sex discrimination, or son preference. The emphasis is put on the long-term acceptability of abortion in the region, on acceptability of sex-screening by both the medical establishment and by the population, on newly imported techniques of sex-screening, and on the changing demand for children associated with the major economic and social changes that followed the dismantlement of the Soviet Union. PMID:25349481
Hohmann, Sophie A; Lefevre, Cecile A; Garenne, Michel L
In light of liberalized abortion legislation, the author considers the potential for increased 3rd-trimester abortion rates in England. The paper refers specifically to the Human Fertilization and Embryology Bill passed by the House of Lords on October 18, 1990. The Bill allows abortion during the 1st 24 weeks of pregnancy if risk is posed to the mother or existing children's physical or mental health. The 24-week limit is not, however, applicable when the mother is a risk of grave permanent injury or death, or in the case of substantial risk of serious handicap in the child. 3rd-trimester abortion rates will not change in the former cases, while the latter involve more complex ethics and decision-making on the part of the mother and obstetrician. While screening for malformation should provide relatively definite diagnoses within 24 weeks, some structural abnormalities may only be discovered incidentally much later in term. Incurable, yet not necessarily lethal conditions such as osteochondrodysplasias, central nervous system malformation, inborn errors of metabolism, and chromosomal anomalies may present intervention dilemmas, yet remain legal grounds for abortion within the 24-week period at the wish of the mother. 3rd-trimester abortion, however, demands consideration of the expected severity of physical and mental impairment,the child's life expectation, gestation at diagnosis, the mother's obstetric history, and that active steps such as intra-cardiac injection will be needed to kill the fetus. The pediatrician, geneticist, or surgeon are recommended for inclusion in counseling. Finally, comparing England's 1989 experience with 3rd- trimester abortions to Scotland's, where restrictive legislation has not been in effect, abortion law liberalization is not expected to extensively increase the number of late terminations. PMID:2252917
Hall, M H
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.
This document summarizes a sample of significant activities and events undertaken by Roman Catholics in response to the US Supreme Court's Roe vs. Wade decision legalizing induced abortion. The summaries begin with the 1966 creation of the National Right to Life Committee and cover opposition of Catholic bishops to the Roe decision, the organization of the National Committee for a Human Life Amendment (NCHLA), the mock investiture of a female pope by Catholics for a Free Choice, dismissal of a pro-life priest from the Jesuits, excommunication of various women because of their work with pro-choice agencies or ones that provided abortion services, meetings of the National Conference of Catholic Bishops (NCCB) with presidential candidates, NCHLA lobbying for the Hyde Amendment, open letters and advertisements published by CFC, the effort of Abortion Rights Mobilization to strip the Catholic church of its tax-exempt status, the Vatican order for all priests to leave political office, actions taken by nuns to support the pro-choice position, the proposal of the "seamless garment" argument under the principle of the "consistent ethic of life," initiation of the post-abortion reconciliation project, the actions of Catholic politicians, the filing of amicus curiae briefs, support of bishops for Operation Rescue, forums on abortion conducted by an Archbishop, the Catholic Statement on Pluralism and Abortion, targeting by bishops of pro-choice candidates for sanctions and excommunication, testimony and lobbying in opposition of the Freedom of Choice Act, false accusations about the 1994 International Conference on Population and Development leveled by bishops, lobbying by bishops in support of a ban on late-term abortions, lobbying to increase the access of low-income women to abortion, and consideration by the bishops of reinstituting "meatless Fridays" to express Catholic opposition to "attacks on human life and dignity." PMID:12178893
Hisel, L M
In 1993, a restrictive abortion law was enacted in Poland. The law allows abortion in public hospitals when 3 physicians certify that the life or health of the woman is at stake, the fetus has a serious and irreversible malformation (supported by prenatal tests in cases of known history of genetic conditions), or a public prosecutor formally proves that a criminal act (i.e., rape or incest) caused the pregnancy. Physicians who perform illegal abortions can be imprisoned up to 2 years and, in cases where the woman dies from complications, up to 10 years. The law calls for the government to offer sex education and to guarantee access to contraceptives nationwide, to which the Catholic Bishops object. Schools have yet to implement sex education. Interviews show that much political and governmental instability exists in Poland. Politicians tend to be passive to prevent political conflict and reduce tensions with the Catholic Church. Women who have enough money and have an unwanted pregnancy can still obtain an abortion within Poland or across the border. Infanticide and infant abandonment are increasing. Illegal adoption is occurring. No one has been arrested for performing clandestine abortions. Young, poor, and rural women are confused and anxious. Many physicians fear referring women for legal abortions. Some hospitals refuse to allow any abortion. Poland is still a patriarchal, conservative country. Most women who use birth control use the rhythm method and withdrawal. Counseling centers are closing. Public educational resources are scarce. Recorded miscarriages have risen from 51,802 in 1992 to 53,027 in 1993. The Ministries of Health and Justice object to the new law. In 1994, the president vetoed a law that would have allowed abortions on social grounds. The birth rate fell from 13.4 to 12.8 births/1000 between 1992 and 1993. The public now ranks the Church behind the military, the police, and the government ombudsman in public trust. PMID:7985218
David, H P; Titkow, A
Abortion rates are increasing all around the world, especially for young women. Our proposals for public policies to reduce\\u000a unwanted pregnancies are based on an analysis of the socio-economic determinants of abortion rates. Special attention is paid\\u000a to regional levels of alcohol consumption, living conditions, and public spending on health and education. We carry out estimations\\u000a using data on regions
Ana I. Gil-Lacruz; Marta Gil-Lacruz; Estrella Bernal-Cuenca
Summary Fifty mothers (study group) who suffered a threatened abortion whose pregnancy continued at least till 28 weeks gestation\\u000a were compared to the next matched delivered mother (control group). Study mothers were at risk of perinatal death from abruptio\\u000a placentae, post-partum haemorrhage, retained placentas and a small baby. Those study mothers with severe symptoms delivered\\u000a earlier.\\u000a \\u000a Abortion is the commonest cause
P. Bowe; H. Murphy
Because of their similar timing in pregnancy, spontaneous and induced abortions can be viewed as competing outcomes. Some\\u000a intended abortion operations are anticipated by earlier miscarriages while some potential miscarriages are forestalled by\\u000a earlier deliberate interruptions of pregnancy. Previous treatments of this competition are reviewed, and a new analysis is\\u000a made on the basis of New York data. A simple
R. G. Potter; K. Ford; B. Moots
Objective: This study examines the association between dietary habits and risk of spontaneous abortion. Design: Hospital-based case-control study. Setting: Obstetric hospitals in Milan, Italy. Subjects: Cases were: 912 women admitted for spontaneous abortion (within the 12th week of gestation). Controls were: women who gave birth at term to healthy infants on randomly selected days at the same hospitals where cases
Elisabetta Di Cintio; Fabio Parazzini; Liliane Chatenoud; Matteo Surace; Guido Benzi; Giovanni Zanconato; Carlo La Vecchia
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
Evidence is reviewed supporting the safety and efficacy of minimally invasive transurethral microwave thermotherapy and medical management in patients with benign prostatic hyperplasia. Recent data indicate more pronounced long-term beneficial effects of microwave treatment. ?-Blockade, however, offers more rapid onset of action than does microwave treatment. Neoadjuvant and adjuvant ?-blocker therapy can accelerate symptom and flow rate improvement in patients undergoing microwave treatment. Compared with medical management, microwave treatment also appears to possess greater versatility, allowing patients who fall within a broad range of baseline symptom severities and prostate sizes to be treated with a high probability of success. PMID:16985749
Djavan, Bob; Marberger, Michael
In this article we explore how nurse practitioners, physician assistants, and nurse midwives in California (collectively referred to as clinicians) developed confidence while learning to provide vacuum aspiration abortion. We interviewed clinicians (n = 30) who worked in reproductive health care settings and had participated in a large abortion-training study. Although the training had moral and political significance for the trainees, in this article we focus on their experience of skill development and how they gained confidence and competence in aspiration abortion, a procedure typically performed by physicians. We argue that confidence is not one dimensional. Understanding the diverse ways in which clinicians arrive at confidence might inform health care training and education generally. By examining attained competency from the clinicians' perspectives, we continue the discussion within the social science of health care and medicine about how clinicians know what they know and what expertise feels like to them. PMID:24265103
Freedman, Lori; Levi, Amy
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.
The Beam Loss Monitoring system (BLM) for the LHC consists of about 3600 Ionization Chambers (IC) located around the ring. Its main purpose is to request a beam abort when the measured losses exceed a certain threshold. The BLM detectors integrate the measured signals in 12 different time intervals (running from 40us to 83.8s) enabling for a different set of abort thresholds depending on the duration of the beam loss. Furthermore, 32 energy levels running from 450GeV to 7TeV account for the fact that the energy density of a particle shower increases with the energy of the primary particle, i.e. the beam energy. Thus, a set of ! 3600 × 12 × 32 = 1.3 · 106 thresholds must be handled. These thresholds are highly critical for the safety of the machine and depend to a large part on human judgment, which cannot be replaced by automatic test procedures. The BLM team has defined well established procedures to compute, set and check new BLM thresholds, in order to avoid and/or find non-conformities due to manipulat...
Nebot Del Busto, E; Holzer, EB; Zamantzas, C; Kruk, G; Nordt, A; Sapinski, M; Nemcic, M; Orecka, A; Jackson, S; Roderick, C; Skaugen, A
This article discusses a clinical trial with the abortifacient agent ethacridine lactate as it was used for midtrimester abortion in Calcutta during the period January-July 1980. Results are then compared with intraamniotic hypertonic saline. 130 subjects were divided into 2 groups--Group 1 (60 women) were terminated with ethacridine lactate and group 2 (70 women) were terminated with saline. In cases where the patient complained of pain, analgesia was administered. In both groups, the largest concentration of women fell in the age groups 16-20 and 21-25. Similarly, single women were the largest representation in both groups although the saline group included more widows. Ethacridine lactate can be administered earlier in the 2nd trimester than saline. With it, expulsion occurred within 36 hours in 56.6% of the cases as compared with 22.9% in group 2. Both groups required the same amount of assistance with oxytocin. In group 1, there were only 3 cases (5%) of minor complications whereas in group 2, 19 cases (27.1%) developed complications. This alone strongly recommends ethacridine lactate as the preferred abortifacient. The success rate was 98%. Thus, ethacridine lactate appears to be a safe and effective agent for pregnancy termination during the 2nd trimester. PMID:7142727
Goswami, B K; Raha, A; Gupta, A; Mukherjee, K
Abortion has been reported to cause post-traumatic stress disorders in women. The manifestation of these disorders is usually delayed, and the causative effect of abortion is largely denied. Such denial is a major contributing factor to the development of the stress. This paper seeks to provide a model for assessment, treatment, and evaluation of therapeutic effectiveness that can be used when post-traumatic stress is diagnosed as a result of abortion. The possibilities of a delayed stress reaction should be examined when clients experience 1) flashbacks of the surgical procedure, people involved, or physical surroundings; 2) nightmares of being trapped in a man-made disaster and being unable to help others who are suffering from, participating in, or witnessing a terrorist act, ritual murder, or human sacrifice; 3) the sudden onset of sadomasochistic interactions or accident proneness where the client receives punishment/pain to alleviate hidden guilt; 4) sexual dysfunctions with no physiological basis; 5) uncharacteristic emotional outbursts; 6) the sudden onset of psychosomatic symptoms, and 7) impacted grief reactions. A detailed case study is presented to illustrate a number of clinical issues relevant to the treatment of a couple which had unresolved feelings about the wife's abortion before she met the husband and the abortion of the husband's girlfriend before he met his wife. Clinical experience suggests that the resolution of this conflict can be accomplished through short-term therapy, and further research is being conducted to determine how well treatment gains are being maintained. PMID:12288495
Bagarozzi, D A
Scheduling outpatients and medical operation rooms has the following structure: N users are given appointment times to use a facility, the duration required by the facility to service each user is stochastic. The system incurs a “user idle cost” if a user arriving at the appointed time finds the facility still engaged by preceding users, while a “facility idle cost”
Hon-Shiang Lau; Amy Hing-Ling Lau
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. PMID:21699701
In 1981, The Alan Guttmacher Institute (AGI), in collaboration with the National Abortion Federation (NAF), conducted a survey of 240 abortion clinics to update information about clinic structure and the relationship of structural characteristics to services, policies and fees. The clinics surveyed were a stratified random sample of all non-hospital abortion facilities that provided 400 or more abortions in the United States in 1980. Among the findings are the following: Thirty-one percent of the clinics reported that they are nonprofit or tax-exempt corporations. The nonprofit clinics are not significantly different from for-profit clinics in either the number of patients they serve or the region of the country in which they are located. Twenty percent of facilities, although regarded as clinics by the AGI for research purposes, define themselves as physicians' offices. These offices are more often located in the West and have smaller caseloads than other clinics. They are also disproportionately located in states with high abortion rates, which suggests that private physicians in these states are more willing than doctors in other states to provide relatively large numbers of abortions in their offices. Two-thirds of the clinics are licensed, most of them by states, but some by cities and counties. Licensed clinics have larger caseloads than nonlicensed facilities, but they are no different in terms of the other characteristics measured in the study, including services offered and fee structure. Fifty-four percent of clinics provide abortions after 12 weeks since the last menstrual period (LMP), and 24 percent, past 14 weeks.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6926970
Henshaw, S K
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
... and Procedures General Procedures Blood Tests Imaging Tests Nuclear Medicine Scans Anxiety Around Medical Procedures Treatment Options Treatment ... Tests: CT Scan Echocardiogram MRI SPECT Scan Ultrasound Nuclear Medicine Scans: Bone Scan PET Scan Gallium Scan MIBG ...
Many midwives routinely perform a vaginal examination during birth to check for the nuchal cord. Such an invasive procedure would only be consistent with midwifery philosophy if it was common to find a nuchal cord so tight that the only alternative is to cut in order to allow the birth of the baby. A tight nuchal cord, however, seems to
Elaine Jefford; Kathleen Fahy; Deborah Sundin
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
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. PMID:2064975
Cordier, S; Deplan, F; Mandereau, L; Hemon, D
The aim of the study was to assess the effectiveness of an integrated care pathway (ICP) for delivery of evidence-based practice in abortion care. All women re-admitted after an abortion had their records audited for adherence to national and local guidelines using information in the ICP and general gynaecology case notes. A total of 100 women were re-admitted into the gynaecological wards of hospitals in Hull and East Riding of Yorkshire after an abortion, between January 2000 and December 2006. Out of 8,476 medical or surgical induced abortions undertaken at 14 weeks gestation or under, the overall readmission rate was 1.2%. The ICP showed that 97% of women had chlamydia screening prior to the abortion; all women had a contraceptive discussion and 43% left using a long-acting reversible method of contraception (LARC). However, data outside the care pathway was not documented, and hence the standard of care given on readmission was difficult to locate and variable in quality. The ICP clinical record is demonstrated to be a useful tool for high quality record-keeping and ensuring all patients receive the same standard of pre-assessment care. Although this service has an acceptably low-risk profile in terms of re-admission, we propose the addition of a re-admission episode to the current ICP to further enhance clinical care post-abortion. PMID:20455726
Graham, O; Jayadeva, P; Guthrie, K
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 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
...abortion is necessary to save the life of the mother. (2) Rape or incest. FFP is available in expenditures for abortion services performed to terminate a pregnancy resulting from an act of rape or incest. (c) Partial Federal funding...
Presents two studies of the relationship between student nurses' attitudes and patient perception with regard to abortion. Results indicate that the student nurses' judgments were related to their prevailing attitude toward abortion and to their religiosity. (Author/MA)
Fischer, Edward H.
Certificate of Admission or Certificate of Enrollment For Academic Research Abroad Request for Leave Medical Certificate Other than those above* Request for Leave of Absence: Please contact the respective #12;Procedures for Leave of Absence (1) Procedures
The views of morality enunciated by the Protestant and Catholic churches in the process of France's abortion law revision are examined through an analysis of the testimony of each church and its moral theologians during hearings held from July-November 1973 by the Commission of Cultural, Family, and Social Affairs of the National Assembly concerning the proposed abortion legislation. The offical Catholic Church position, which restated a neoscholastic philosophy with its theory of human nature, natural law, natural right, and natural morality, was opposed by 2 priests who participated as members of other organizations. The moral principles behind the official Catholic position included the sacred and absolute principle of respect for life, the beginning of human life at conception, and the responsibility to protect the fetus as a human being. Internal Catholic challenges to the official position appeared to rest principally on the question of when life begins but also touched on the inappropriateness of viewing unwanted pregnancy as a punishment for sexual activity, the constant recourse to authority of the church, and the reluctance to reexamine questions on new evidence. Faced with the likely replacement of abortion law consistent with Catholic morality by 1 seriously at variance, the French Church and state while justifying their organized opposition to any change. The right of the church to impose its views on the legislature and on society, the view of the cultural context of abortion as a degradation of public attitudes expressed in rejection of children, the necessary connections between sexuality and fertility, the necessity for women to be able to control their fertility if they were to participate fully in society, the debased conditions in which thousands of illegal abortions occurred or the exaggeration of such conditions were other issues. Proposed legislation on abortion was opposed by the official Catholic position, which instead called for a vaguely defined social and family policy. Issues raised in the testimony of representatives of Protestant groups included the idea that each person is responsible for interpreting the will of God in complex situations, limits to the idea that life is a blessing of God, the right of women and couples to control their fertility, and abortion as a last resort. The Protestant position in favor of liberalization of the law held that existing repressive laws were untenable given the perils of illegal abortions and the fundamental modifications in relations between man and nature brought about by science. The Protestant church, a minority in France, took a more active role than the Catholic in suggesting specific legislation. PMID:12339249
Abortion in single girls in an increasing problem in Hong Kong. This paper is an attempt to look at the psychosocial factors in sexual behavior in a selected sample of girls. Of 100 girls requesting an abortion, 70% were educated to Form III level (grade 10 U.S. equivalent) and these did not come from broken or disturbed homes. The adequacy of their prepregnancy use of contraception was significantly and positively related to their level of formal education. These girls were all made pregnant by their boy-friends. Some aspects of their sexual behavior are described. PMID:7096165
Tang, G W
Unsafe abortion has a global incidence of about 20 million cases annually, out of which 97% cases are reported from developing nations. There are many reports showing the occurrence of bowel or uterine perforation in such instances, but most of them have concentrated upon surgical or obstetric complications. We report a case of unsafe abortion with ruptured uterus, intra-abdominal foetus, and bowel infarction that developed intraoperative cardiac arrest during the emergency laparotomy. This case highlights anaesthetic challenges in managing such critically ill-patients.
Jain, Gaurav; Varshney, Rohit; Sharma, Rina; Nath, Jayati
The aim was to identify from empirical research that used quantitative or qualitative methods the reasons women give for having\\u000a an abortion. A search was conducted of peer-reviewed, English language publications indexed in eight computerized databases\\u000a with publication date 1996–2008, using keywords ‘abortion’ and ‘reason’ (Medline: ‘induced abortion’ OR ‘termination of pregnancy’\\u000a OR ‘elective abortion’ and ‘reason’). Inclusion criteria were
Maggie Kirkman; Heather Rowe; Annarella Hardiman; Shelley Mallett; Doreen Rosenthal
In Gonzales v. Carhart, the Supreme Court upheld a federal ban on a type of second-trimester abortion that many physicians believe is safer for their patients. Carhart presented a watershed moment in abortion law, because it marks the Supreme Court’s first use of the anti-abortion movement’s “woman-protective” rationale to uphold a ban on abortion and the first time since Roe
Abortion, particularly late-term abortion, and neonaticide, selective non-treatment of newborns, are feasible management strategies for fetuses or newborns diagnosed with severe abnormalities. However, policy varies considerably among developed nations. This article examines abortion and neonatal policy in four nations: Israel, the US, the UK and Denmark. In Israel, late-term abortion is permitted while non-treatment of newborns is prohibited. In the
Michael L. Gross
A population-based cohort study investigated postnatal depression in Brazilian women who attempted an abortion. Participants' views and actions on abortion were assessed during pregnancy and postnatal depression was evaluated with the Edinburgh Postnatal Depression Scale. An unsuccessful abortion attempt was associated with postnatal depression (adjusted OR = 1.6, 95% CI 1.0-2.5). In Brazil abortion is illegal under most circumstances. PMID:21357883
Ludermir, Ana Bernarda; Araya, Ricardo; de Araújo, Thália Velho Barreto; Valongueiro, Sandra Alves; Lewis, Glyn
An aborted fetus of 7 months gestation, the associated placenta, and a single blood sample from the dam were submitted for diagnostic investigation to the diagnostic laboratory of the Lombardy and Emilia-Romagna Experimental Zooprophylactic Institute in Parma, Italy. The serum was negative for Neospora caninum, Coxiella burnetii, Chlamydophila abortus, Bovine herpesvirus 1 (BHV-1), Bovine viral diarrhea virus (BVDV), Brucella abortus, and Brucella melitensis. Fetal tissues and placental cotyledons were pooled and tested by polymerase chain reaction (PCR) for the presence of BHV-1, Bovine herpesvirus 4, BVDV, N. caninum, C. burnetii, Chlamydophila spp., Schmallemberg virus, and Leptospira interrogans. All PCR assays were negative. Bacteriological examinations performed on the fetal organs revealed a pure growth of Staphylococcus lugdunensis in all organs cultured. In human beings, S. lugdunensis is responsible for community-acquired and nosocomial infections, in both immunocompetent and immunocompromised patients. In veterinary medicine, the pathogenic potential of S. lugdunensis has not been fully investigated. The incidence of S. lugdunensis is regarded as being underreported because it could be easily misidentified as Staphylococcus aureus. The current report documents the ability of S. lugdunensis to cause abortion in cattle, indicating the need for accurate diagnostic procedures to identify this emerging and zoonotic pathogen whose incidence is likely underestimated in both human and veterinary medicine. PMID:25292193
Ardigò, Paolo; D'Incau, Mario; Pongolini, Stefano
In this Journal in 1972, 100 leaders in obstetrics and gynecology published a compelling statement that recognized the legalization of abortion in several states and anticipated the 1973 Supreme Court decision in Roe v Wade. They projected the numbers of legal abortions that likely would be required by women in the United States and described the role of the teaching hospital in meeting that responsibility. They wrote to express their concern for women's health in a new legal and medical era of reproductive control and to define the responsibilities of academic obstetrician-gynecologists. Forty years later, 100 professors examine the statement of their predecessors in light of medical advances and legal changes and suggest a further course of action for obstetrician gynecologists. PMID:24034806
Sex Selective Abortions, Fertility and Birth Spacing Claus C PÂ¨ortner Department of Economics under the title "The Determinants of Sex Selective Abortions." #12;Abstract Previous research on sex selective abortions has ignored the interactions between fertility, birth spacing and sex selection
Chile is one of the last countries in the world where abortion is absolutely illegal. This paper reports on a study of 80 women who were prosecuted in Santiago for having had an abortion, mostly young women, eight of whom became pregnant following rape; 40 women who were prosecuted for performing abortions, almost all older women; and 12 mainly friends
On 25 July 2001 the Polish Federation for Women and Family Planning organised a Tribunal on Abortion Rights in Warsaw, to publicise the negative consequences of the criminalisation 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
Françoise Girard; Wanda Nowicka
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
Locating the issue of abortion in a global public policy context, with the array of public health, human rights, and social questions that are implicated, is the aim of this paper. Abortion laws around the world have been liberalized since the 1950s, with a resultant decrease in abortion-related mortality among women. The proportion of the world's…
Jacobson, Jodi L.
Previous research has shown that public opinion on abortion is not a simply a dichotomy of pro-life and pro-choice. Instead, there appears to be three general attitudes: absolutist (opposing abortion in all cases, including rape), situationalist (opposing abortion for all cases except \\
Schedulability Analysis of CAN with Non-abortable Transmission Requests Dawood A. Khan INRIA / INPL, in reality, CAN controllers may have some characteristics, such as non- abortable transmit buffers, which may break this assumption. This paper provides analysis for networks that contain nodes with non-abortable
Paris-Sud XI, UniversitÃ© de
EA 4272 The Impact of Legalized Abortion on Child Health Outcomes and Abandonment. Evidence from,version1-7Apr2010 #12;The Impact of Legalized Abortion on Child Health Outcomes and Abandonment. Evidence and a unique census of institutionalized children to analyze the impact of abortion legalization in Romania
Paris-Sud XI, UniversitÃ© de
Article de synthÃ¨se DIAGNOSTIC DE LA CHLAMYDIOSE ABORTIVE Annie RODOLAKIS INRA, centre de ToursI abortive infections of ruminants are presented in this review. Plan 1. Diagnostic indirect 1.1. Diagnostic commencent Ã©galement Ã Ãªtre appliquÃ©es en mÃ©decine vÃ©tÃ©rinaire pour le diagnostic de la chlamydiose abortive
Paris-Sud XI, UniversitÃ© de
Powered Safe Abort for Autonomous Rendezvous of Spacecraft Louis Breger and Jonathan P. How MIT-optimized rendezvous trajectories. These trajectories guarantee the existence of known powered abort trajectories the existence of known active safe abort trajectories for a large class of possible spacecraft anomalies
How, Jonathan P.
Abortions in Cattle, a Review Max Irsik DVM, MAB Beef Cattle Extension Veterinarian University of Florida College of Veterinary Medicine Abortion is the premature expulsion of the fetus from the dam have died in-utero due to disease and was expelled. Depending upon the cause of "abortion" a cow may
Watson, Craig A.
ABORTED FRUITS OF OPUNTIA MICRODASYS (CACTACEAE): INSURANCE AGAINST REPRODUCTIVE FAILURE 1 N, but plantlet provenance did not. The high fruit abortion rate resulting from environmental and maternal effects provided suitable conditions for establishment of plantlets. Key words: clonal propagation; fruit abortion
Mandujano, MarÃa del Carmen
DIAGNOSTIC ALLERGIQUE DE LA CHLAMYDIOSE ABORTIVE DE LA CHEVRE Annie RODOLAKIS, J. DUFRENOY A (France) Summary ALLERGIC DIAGNOSIS OF ABORTIVE CHLAMYDIAL INFECTION IN THE GOAT. ― A delayed. Introduction. Le diagnostic immunologique de la Chla- mydiose abortive est rÃ©alisÃ© tant chez la chÃ¨vre que chez
Paris-Sud XI, UniversitÃ© de
Review article Lelystad virus and the porcine epidemic abortion and respiratory syndrome G abortion and respiratory syndrome and porcine reproduc- tive and respiratory syndrome. The virus is a small pigs. Clinical signs of an infection with Le- lystad virus are characterized by late term abortions
Paris-Sud XI, UniversitÃ© de
Resets vs. Aborts in Linear Temporal Logic Roy Armoni1 , Doron Bustan2 , Orna Kupferman3 of Pnueli's LTL. Both ForSpec and Sugar 2.0 directly support reset/abort signals, in which a check for a property may be terminated and declared successful by a reset/abort sig- nal, provided the check has
Review article Recent advances on ovine chlamydial abortion Annie Rodolakisa Jesus Salinasb John on ovine chlamydial abortion. Concerning chlamy- dial taxonomy, with the recent advances due, with the kinetics of placental col- onization and placental pathology leading to abortion in ruminants. Studies
Paris-Sud XI, UniversitÃ© de
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
way serious infection or blood transfusion are. The riskblood transfusion, emergency room treatment, intravenous antibiotics administration, infection,blood transfusion, emergency room [ER] treatment, intravenous antibiotics administration, infection
Creinin, Mitchell David
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.
In his classic paper, 'Why abortion is immoral', Don Marquis argues that what makes killing an adult seriously immoral is that it deprives the victim of the valuable future he/she would have otherwise had. Moreover, Marquis contends, because abortion deprives a fetus of the very same thing, aborting a fetus is just as seriously wrong as killing an adult. Marquis' argument has received a great deal of critical attention in the two decades since its publication. Nonetheless, there is a potential challenge to it that seems to have gone unnoticed. A significant percentage of fetuses are lost to spontaneous abortion. Once we bring this fact to our attention, it becomes less clear whether Marquis can use his account of the wrongness of killing to show that abortion is the moral equivalent of murder. In this paper, I explore the relevance of the rate of spontaneous abortion to Marquis' classic anti-abortion argument. I introduce a case I call Unexpected Death in which someone is about to commit murder, but, just as the would-be murderer is about to strike, his would-be victim dies unexpectedly. I then ask: what does Marquis' account of killing imply about the moral status of what the would-be murderer was about to do? I consider four responses Marquis could give to this question, and I examine what implications these responses have for Marquis' strategy of using his account of the wrongness of killing an adult to show that abortion is in the same moral category. PMID:23038800
Coleman, Mary Clayton
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
This commentary explores what a world without abortion stigma might look like at the individual, community and institutional level. The article further articulates the need for interdisciplinary collaboration for developing a vision, research agenda, and intervention strategy for change. PMID:25061760
In her paper, Professor Kimberly J. Cook uses statistics to illustrate the role the Christian Right plays in the public discourse over two issues permeated with religious overtones: abortion and the death penalty. She shows how the Christian Right's approach to these issues is based on an ideological notion of 'Justice \\
Kimberly J. Cook
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
Successful sessions often require the counselor to engage in interdisciplinary exchange (1) to gain critical information and (2) to explore models and new ways of lookingat issues. This article offers one example of the interdisciplinary venture on the abortion issue. Far-reaching decisions are sometimes made in an inescapable climate of ambiguity. Often pastoral counseling proves most useful when counselor and
Anthony Picchioni; Joe Barnhart
The purpose of this study was to investigate the psychological and emotional effects of abortion on women who terminated their pregnancies for social, economic, or personal reasons. These effects were determined, in part, by an analysis of the woman's concept of self, the external support given, and the various coping mechanisms utilized in the…
Arafat, Ibtihaj S.; Chireau, Ruby M.
Objective To estimate the association between over-the-counter nonsteroidal anti-inflammatory drug (NSAID) exposure during the early first-trimester and risk for spontaneous abortion (gestation prior to 20 weeks) in a prospective cohort. Methods Women were enrolled in the Right from the Start study (2004–2010). Exposure data regarding over-the-counter NSAID use from the last menstrual period through the 6th week of pregnancy were obtained from intake and first-trimester interviews. Pregnancy outcomes were self-reported and verified by medical records. Gestational age was determined from last menstrual period. Stage of development prior to loss was determined from study ultrasound. Cox proportional hazards regression models were used to estimate the association between NSAID exposure and pregnancy outcome, taking into account candidate confounders. Results Among 2,780 pregnancies, 367 women (13%) experienced an spontaneous abortion. NSAID exposure was reported by 1,185 (43%) women. NSAID exposure was not associated with spontaneous abortion risk in unadjusted models (hazard ratio [HR] = 1.01, 95% confidence interval [CI] 0.82, 1.24) or models adjusted for maternal age (adjusted [aHR] = 1.00, 95% CI 0.81, 1.23). Conclusions Our findings suggest that use of non-prescription over-the-counter NSAIDs in early pregnancy does not put women at increased risk of spontaneous abortion. PMID:22914399
Velez Edwards, Digna R.; Aldridge, Tiara; Baird, Donna D.; Funk, Michele Jonsson; Savitz, David A.; Hartmann, Katherine E.
A paid advertisement, appearing in "The New York Times" on October 4, 1984 under the sponsorship of a group called Catholics for a Free Choice, contended that there is more than 1 legitimate, i.e., theologically and ethically defensible, viewpoint on abortion within the Roman Catholic tradition. The advertisement called for a dialogue on abortion among Catholics; a dialogue that would acknowledge this situation of pluralism, not only in regard to practice (Catholics have about the same proportion of abortions as Protestants in the US) but in regard to the ethical state of the question. The ad explicitly asked for the cessation of institutional sanctions against those with dissenting positions on abortion. In the months following the ad's appearance, its admonition that dissenters should not be penalized has not been heeded. The chief initiative in this repression has come from the Vatican. In early December 1984 there arrived in the mailboxes of the religious superiors or bishops of the 4 priests and brothers and most of the 24 nuns who signed the statement a letter from the head of the Vatican's Sacred Congregation for Religious and Secular Institutes. This letter, dated November 30, 1984, stated that the position taken in "The New York Times" advertisement was "in contradiction to the teachings of the Church" and that the ad's signers were "seriously lacking in religious submission to the mind of the Magisterium." Any signer who declined to make a public retraction was to be warned by the superior with an explicit threat of dismissal from his/her religious community. The 2 priests and the 2 brothers made "pro forma" statements of retraction. None of the nuns who signed was willing to do so. When the nun-signers, through their religious superiors, indicated that they would not retract the statement nor would the superiors threaten them with dismissal, the Sacred Congregation appeared to back off. To date, none of the nuns has fully complied with the request to affirm the church's teaching authority on abortion, and none has been dismissed from her order. Yet, the Vatican clearly is not pleased with this insubordination. By January 1985 it was evident that reprisals against the lay signers were beginning also. Various incidents directed against the signers have led the signers and their supporters to redirect their attention from the question of pluralism on abortion to the right of dissent itself. A network calling itself the Committee of Concerned Catholics is gathering signatures for a new "New York Times" ad. The new ad will repeat the 1st ad's statement on pluralism in regard to abortion, adding to it a statement of solidarity with the original signers and a defense of the right to dissent. PMID:12178934
Ruether, R R