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Sample records for adverse reproductive health

  1. Reproductive health in humans and wildlife: are adverse trends associated with environmental chemical exposure?

    PubMed

    Harrison, P T; Holmes, P; Humfrey, C D

    1997-10-20

    In recent years, evidence from disparate observations has indicated adverse changes in the reproductive health and fecundity of animals and humans. In humans, there is strong evidence for such trends in the incidences of testicular and female breast cancer, and concern has also been expressed regarding semen quality, cryptorchidism, hypospadias and polycystic ovaries. Laboratory studies have indicated that some chemicals in the environment, both natural and synthetic, have the potential to disrupt the endocrine system and that these could, at least theoretically, be partly responsible for the observed changes. Chemicals thus identified include the naturally occurring steroid hormones, phyto- and myco-estrogens, and anthropogenic chemicals such as synthetic hormones, organotins, organochlorine pesticides, polychlorinated biphenyls, dioxins, alkylphenol polyethoxylates, phthalates and bisphenol-A. While there is no direct evidence from human studies to confirm a causal link between exposure and effect, concern exists and is strengthened by reports of adverse reproductive and developmental effects in wildlife, possibly mediated via endocrine disruptive pathways. The development of imposex in neogastropod molluscs exposed to tributyltin has been attributed to such a mechanism and in wild populations of fish, alligators and birds, instances of masculinisation or feminisation in polluted areas have been noted. Among mammals, disturbed fertility of Florida panthers and some marine species has also been reported. A concentrated research and monitoring programme is required to clarify the nature and extent of effects on reproductive health in humans and wildlife, and to assess human and wildlife exposure to relevant naturally occurring or anthropogenic endocrine disrupting substances. This will enable a more robust evaluation of the contribution that environmental chemical exposure may have on adverse trends in the reproductive health of humans and wildlife. PMID:9372623

  2. Adverse health outcomes among cosmetologists and noncosmetologists in the Reproductive Outcomes of Salon Employees (ROSE) study.

    PubMed

    Gallicchio, Lisa; Miller, Susan R; Greene, Teresa; Zacur, Howard; Flaws, Jodi A

    2011-01-01

    The purpose of this study was to examine adverse health outcomes, including those related to cardiovascular and skin health as well as respiratory functions, among cosmetologists aged 21 to 55 yr and to compare data to women of the same age working in other occupations. Self-reported data were analyzed from 450 cosmetologists and 511 women in other occupations who participated in the Reproductive Outcomes of Salon Employees (ROSE) study in Maryland. Odds ratios (OR) and 95% confidence intervals (95% CI) were computed using logistic regression to examine the associations between cosmetologist occupation and each adverse health outcome adjusted for age, education, and smoking status. Cosmetologists were at significantly increased risk of depression compared to noncosmetologists after adjustment for age, education, and smoking status (OR 1.49; 95% CI 1.10, 2.00). There were no statistically significant associations between cosmetology occupation and the other adverse health outcomes, including those related to allergies and skin disorders, in both the unadjusted and adjusted analyses. Cosmetologists may be exposed to chemicals in the salon that lead to depression. Future study needs to be conducted to examine specific chemical exposures in the salon. This will help to provide information required for the development of best occupational safety practices among salon workers. PMID:21120748

  3. Reproductive health care delivery.

    PubMed

    Lindgren, Mark C; Ross, Lawrence S

    2014-02-01

    Most patients in the United States with reproductive health disorders are not covered by their health insurance for these problems. Health insurance plans consider reproductive care as a lifestyle choice not as a disease. If coverage is provided it is, most often, directed to female factor infertility and advanced reproductive techniques, ignoring male factor reproductive disorders. This article reviews the history of reproductive health care delivery and its present state, and considers its possible future direction. PMID:24286778

  4. Men's Reproductive Health

    MedlinePlus

    ... NICHD Research Information Clinical Trials Resources and Publications Men's Reproductive Health: Overview Skip sharing on social media ... Content Reproductive health is an important component of men's overall health and well-being. Too often, males ...

  5. Adverse Reproductive and Developmental Health Outcomes Following Prenatal Exposure to a Hydraulic Fracturing Chemical Mixture in Female C57Bl/6 Mice.

    PubMed

    Kassotis, Christopher D; Bromfield, John J; Klemp, Kara C; Meng, Chun-Xia; Wolfe, Andrew; Zoeller, R Thomas; Balise, Victoria D; Isiguzo, Chiamaka J; Tillitt, Donald E; Nagel, Susan C

    2016-09-01

    Unconventional oil and gas operations using hydraulic fracturing can contaminate surface and groundwater with endocrine-disrupting chemicals. We have previously shown that 23 of 24 commonly used hydraulic fracturing chemicals can activate or inhibit the estrogen, androgen, glucocorticoid, progesterone, and/or thyroid receptors in a human endometrial cancer cell reporter gene assay and that mixtures can behave synergistically, additively, or antagonistically on these receptors. In the current study, pregnant female C57Bl/6 dams were exposed to a mixture of 23 commonly used unconventional oil and gas chemicals at approximately 3, 30, 300, and 3000 μg/kg·d, flutamide at 50 mg/kg·d, or a 0.2% ethanol control vehicle via their drinking water from gestational day 11 through birth. This prenatal exposure to oil and gas operation chemicals suppressed pituitary hormone concentrations across experimental groups (prolactin, LH, FSH, and others), increased body weights, altered uterine and ovary weights, increased heart weights and collagen deposition, disrupted folliculogenesis, and other adverse health effects. This work suggests potential adverse developmental and reproductive health outcomes in humans and animals exposed to these oil and gas operation chemicals, with adverse outcomes observed even in the lowest dose group tested, equivalent to concentrations reported in drinking water sources. These endpoints suggest potential impacts on fertility, as previously observed in the male siblings, which require careful assessment in future studies. PMID:27560547

  6. Adverse reproductive events and electromagnetic radiation

    SciTech Connect

    Stewart, W.; Ouellet-Hellstrom, R.

    1991-07-31

    In 1989 approximately 42,000 questionnaires were mailed to female physical therapists to assess the risk of adverse reproductive effects among those exposed to electromagnetic radiation at radiofrequencies. From the resulting data, the risk of early recognized fetal loss was assessed using a nested case-control design. The cases (1753 miscarriages) were matched to controls (1753 other pregnancies except ectopics) on mothers age at conception and the number of years elapsed between conception and interview. The results of the study indicate that female physical therapists who work with microwave diathermy 6 months prior to the pregnancy and/or during the first trimester were at increased risk of experiencing a recognized early fetal loss, but female physical therapists who work with shortwave diathermy were not at an increased risk. This association was shown to hold even when the mother's age at conception, the number of years elapsed between conception and interview, the number of prior early fetal losses, mother's conditions ever diagnosed, and use of other modalities were controlled. The data also suggest a possible association between exposure to transcutaneous electrical nerve stimulation with an elevated risk of early recognized fetal loss.

  7. TOXICOLOGY OF MALE REPRODUCTIVE DEVELOPMENT: PROFILING 774 CHEMICALS FOR MOLECULAR TARGETS AND ADVERSE OUTCOMES (SOT)

    EPA Science Inventory

    Adverse trends in male reproductive health have been reported for increased rates of testicular germ cell tumor, low semen quality, cryptorchidism, and hypospadias. An association with prenatal environmental exposure has been inferred from human and animal studies underlying male...

  8. Systems Toxicology of Male Reproductive Development: Profiling 774 Chemicals for Molecular Targets and Adverse Outcomes

    EPA Science Inventory

    Adverse trends in male reproductive health have been reported for increased rates of testicular germ cell tumor, low semen quality, cryptorchidism, and hypospadias. An association with prenatal environmental exposure has been inferred from human and animal studies underlying male...

  9. The synthetic progestin megestrol acetate adversely affects zebrafish reproduction.

    PubMed

    Han, Jian; Wang, Qiangwei; Wang, Xianfeng; Li, Yonggang; Wen, Sheng; Liu, Shan; Ying, Guangguo; Guo, Yongyong; Zhou, Bingsheng

    2014-05-01

    Synthetic progestins contaminate the aquatic ecosystem, and may cause adverse health effects on aquatic organisms. Megestrol acetate (MTA) is present in the aquatic environment, but its possible effects on fish reproduction are unknown. In the present study, we investigated the endocrine disruption and impact of MTA on fish reproduction. After a pre-exposure period of 14 days, reproductively mature zebrafish (Danio rerio) (F0) were exposed to MTA at environmental concentrations (33, 100, 333, and 666 ng/L) for 21 days. Egg production was decreased in F0 fish exposed to MTA, with a significant decrease at 666 ng/L. The exposure significantly decreased the circulating concentrations of estradiol (E2) and testosterone (T) in female fish or 11-keto testosterone (11-KT) in male fish. MTA exposure significantly downregulated the transcription of certain genes along the hypothalamic-pituitary-gonadal (HPG) axis. MTA did not affect early embryonic development or hatching success in the F1 generation. The present study showed that MTA is a potent endocrine disruptor in fish, and short-term exposure to MTA could significantly affect reproduction in fish and negatively impact the fish population. PMID:24647012

  10. CRITICAL WINDOWS FOR REPRODUCTIVE HEALTH IN CHILDREN AND ADOLESCENTS

    EPA Science Inventory

    This workgroup report addresses the central question: what are the critical windows during development (pre-conception through puberty) when exposure to xenobiotics may have the greatest adverse impact on subsequent reproductive health. The reproductive system develops in stages...

  11. The epidemiology of disasters and adverse reproductive outcomes: lessons learned.

    PubMed

    Cordero, J F

    1993-07-01

    A disaster has been defined as a disruption of human ecology that exceeds the capacity of the community to function normally. Little is known about the adverse effects of natural disasters on reproductive outcomes. Important lessons can be derived from several disasters caused by human factors, such as the Minamata Bay disaster. Adverse reproductive outcomes include infertility, early pregnancy loss, stillbirths, congenital malformations, and serious developmental disabilities such as cerebral palsy and mental retardation. Recent disasters like the Chernobyl and Bhopal explosions have provided important lessons on the need for accurate and sound information about the risk of prenatal exposures for adverse reproductive outcomes. To study questions of adverse reproductive outcomes and disasters requires a well-planned approach. It should include early development of surveillance for adverse reproductive outcomes, analytic studies on the risk of disasters from direct and indirect effects, sensitive methods to measure early pregnancy loss, and long-term follow-up programs to assess outcomes such as developmental disabilities. PMID:8243383

  12. The epidemiology of disasters and adverse reproductive outcomes: lessons learned.

    PubMed Central

    Cordero, J F

    1993-01-01

    A disaster has been defined as a disruption of human ecology that exceeds the capacity of the community to function normally. Little is known about the adverse effects of natural disasters on reproductive outcomes. Important lessons can be derived from several disasters caused by human factors, such as the Minamata Bay disaster. Adverse reproductive outcomes include infertility, early pregnancy loss, stillbirths, congenital malformations, and serious developmental disabilities such as cerebral palsy and mental retardation. Recent disasters like the Chernobyl and Bhopal explosions have provided important lessons on the need for accurate and sound information about the risk of prenatal exposures for adverse reproductive outcomes. To study questions of adverse reproductive outcomes and disasters requires a well-planned approach. It should include early development of surveillance for adverse reproductive outcomes, analytic studies on the risk of disasters from direct and indirect effects, sensitive methods to measure early pregnancy loss, and long-term follow-up programs to assess outcomes such as developmental disabilities. PMID:8243383

  13. Adverse reproductive outcomes among female veterinarians

    SciTech Connect

    Schenker, M.B.; Samuels, S.J.; Green, R.S.; Wiggins, P. )

    1990-07-01

    Because female veterinarians are exposed to several known reproductive hazards, the authors conducted a reproductive survey of all female graduates of a US veterinary school (n = 537) and law school (comparison group, n = 794). Analysis was confined to pregnancies completed after the second year of professional school and from 1966 to 1986. Based on one randomly chosen eligible pregnancy per woman (veterinarians, n = 176; lawyers, n = 229), spontaneous abortion rates, adjusted for elective abortions, were 13.3% for the veterinarians and 15.1% for the lawyers; these did not differ significantly. A Cox life table regression model controlling for age, smoking, alcohol use, and prior spontaneous abortion also showed no significant difference in spontaneous abortion rates between the two populations. Using all pregnancies, veterinarians who reported performing five or more radiographic examinations per week had a marginally elevated risk of spontaneous abortion, but the statistical significance disappeared when analysis was limited to one random pregnancy per woman. For one random eligible birth per woman, the mean birth weight did not differ significantly between the veterinarians and lawyers, even after controlling for possible confounders in regression analyses. A higher rate of reportable birth defects was observed among the veterinarians than among the lawyers (relative risk = 4.2, 95% confidence interval 1.2-15.1), but this unexpected result must be considered hypothesis-generating. The authors did not find an overall increased risk for spontaneous abortion or low birth weight infants among veterinarians compared with lawyers, but veterinarians who reported performing five or more radiographic examinations per week may have been at increased risk for spontaneous abortion.

  14. Perspectives of reproductive health.

    PubMed

    van Balen, F; Visser, A P

    1997-05-01

    This issue of Patient Education and Counseling is dedicated to reproductive health. The main focus is infertility as it is experienced in different of our world. In western societies, medical breakthroughs give couples with fertility problems a good chance to have a child. However, in many developing societies adequate medical treatment is only available for the upper classes, and many women keep going to traditional healers. In addition, the social consequences of childlessness are much greater than in western societies. Another focus of this issue is negative experiences regarding pregnancy. A very distressing experience is late pregnancy loss. Late pregnancy loss is different from infertility with respect to the tangibility of an object of grief, though it may also result in permanent childlessness. Other aspects of negative pregnancy experiences are exceptional physical reactions and recurrent induced abortions. Furthermore, two other elements of reproductive health are addressed in this issue: STD among female adolescents and gender aspects of gene technology. Finally, the ramifications of these various aspects of reproductive health on education and counseling are discussed. PMID:9197797

  15. Improving worldwide reproductive health.

    PubMed

    Geary, J

    1993-01-01

    The 14th International Federation of Gynaecology and Obstetrics World Congress will be held in Montreal, Canada, in 1994, under the auspices of the Society of Obstetricians and Gynecologists of Canada. The World Congress will 1) promote and facilitate international cooperation in the field of obstetrics and gynecology, 2) develop and improve the exchange of information and ideas, and 3) encourage the adoption of an international perspective on issues of concern. The 1994 program will survey recent research advances and introduce new equipment, instruments, and pharmaceuticals. Issues addressed will include maternal mortality, reproductive technologies, continuing education, malignancy, family planning, and contraception. The Conference's symposia, industry-sponsored events, and cultural activities are being designed to increase speaker-audience interaction and to stimulate debate and the exchange of views. The continuing education goals are 1) to encourage appropriate research with valid and applicable results and 2) to extend the patient-counseling abilities of participating physicians. Canada's socialized health care system, which carefully scrutinizes new expensive technologies, will be highlighted for the international delegates. The scientific program will include 1) general topics 2) reproductive endocrinology, 3) maternal/fetal medicine, and 4) gynecological oncology. Poster sessions followed by open discourses and free communications sessions will facilitate the exchange of views and information. The overall goal of the conference is to improve reproductive health care for mothers and babies worldwide. PMID:12318476

  16. Reproductive health in adolescence.

    PubMed

    Friedman, H L

    1994-01-01

    The health and well-being of adolescents is closely intertwined with their physical, psychological and social development, but this is put at risk by sexual and reproductive health hazards which are increasing in much of the world. Changes in population growth and distribution, the rise of telecommunications, the increase in travel and a decline in the family, as well as a generally earlier start of menarche and later age of marriage are contributing to an increase in unprotected sexual relations before marriage. This, combined with risks from early marriage, result in too early or unwanted pregnancy and childbirth, induced abortion in hazardous circumstances and sexually transmitted diseases, including HIV infection leading to AIDS. With more than half the world's population below the age of 25, and 4 out of 5 young people living in developing countries with inadequate access to prevention and care, there is an urgent need for action. Young women are particularly vulnerable. Mortality and morbidity from early pregnancy whether ending in childbirth or abortion, is much higher for the younger adolescent. Young women, especially those who have less formal education, are more vulnerable to pressures for marriage, or sexual relations before marriage, often with older men. Young people generally lack adequate knowledge about their own development and information on how to get help. Those who could help are rarely trained for working with adolescents, and services which are generally designed for adults or children often deter young people from getting help when they most need it. Policy and legislation relating to sexual and reproductive health issues are often contradictory, and unclear or unenforced.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8085368

  17. Male reproductive health and yoga

    PubMed Central

    Sengupta, Pallav; Chaudhuri, Prasenjit; Bhattacharya, Koushik

    2013-01-01

    Now-a-days reproductive health problems along with infertility in male is very often observed. Various Assisted Reproductive Technologies have been introduced to solve the problem, but common people cannot afford the cost of such procedures. Various ayurvedic and other alternative medicines, along with regular yoga practice are proven to be not only effective to enhance the reproductive health in men to produce a successful pregnancy, but also to regulate sexual desire in men who practice celibacy. Yoga is reported to reduce stress and anxiety, improve autonomic functions by triggering neurohormonal mechanisms by the suppression of sympathetic activity, and even, today, several reports suggested regular yoga practice from childhood is beneficial for reproductive health. In this regard the present review is aimed to provide all the necessary information regarding the effectiveness of yoga practice to have a better reproductive health and to prevent infertility. PMID:23930026

  18. Male reproductive health and environmental xenoestrogens.

    PubMed Central

    Toppari, J; Larsen, J C; Christiansen, P; Giwercman, A; Grandjean, P; Guillette, L J; Jégou, B; Jensen, T K; Jouannet, P; Keiding, N; Leffers, H; McLachlan, J A; Meyer, O; Müller, J; Rajpert-De Meyts, E; Scheike, T; Sharpe, R; Sumpter, J; Skakkebaek, N E

    1996-01-01

    Male reproductive health has deteriorated in many countries during the last few decades. In the 1990s, declining semen quality has been reported from Belgium, Denmark, France, and Great Britain. The incidence of testicular cancer has increased during the same time incidences of hypospadias and cryptorchidism also appear to be increasing. Similar reproductive problems occur in many wildlife species. There are marked geographic differences in the prevalence of male reproductive disorders. While the reasons for these differences are currently unknown, both clinical and laboratory research suggest that the adverse changes may be inter-related and have a common origin in fetal life or childhood. Exposure of the male fetus to supranormal levels of estrogens, such as diethlylstilbestrol, can result in the above-mentioned reproductive defects. The growing number of reports demonstrating that common environmental contaminants and natural factors possess estrogenic activity presents the working hypothesis that the adverse trends in male reproductive health may be, at least in part, associated with exposure to estrogenic or other hormonally active (e.g., antiandrogenic) environmental chemicals during fetal and childhood development. An extensive research program is needed to understand the extent of the problem, its underlying etiology, and the development of a strategy for prevention and intervention. Images Figure 3. A Figure 3. B Figure 3. C Figure 3. D Figure 3. E Figure 3. F PMID:8880001

  19. Zambia moves towards reproductive health.

    PubMed

    1997-01-01

    Several events in Zambia this year have marked the development of an integrated approach to reproductive health. A team met in March to draw up a national safe motherhood policy, plus strategies and guidelines. These were completed by April and are being distributed for comments. Clinical guidelines for safe motherhood in health centers have also been developed. These aim to reduce mortality and morbidity among mothers and infants by helping health workers to provide quality care to women at every stage of pregnancy and delivery. A reproductive health workshop was held in Ngwerere in May to create awareness of the concept of reproductive health, identify reproductive health problems in the area, propose solutions and outline activities. The 75 participants included community health workers, community leaders, teachers, youth leaders, and community members, as well as health workers and policymakers. The workshop was conducted in the local language so that those present were able to participate fully. June 1997 saw the official launch of Zambia's new policy framework, guidelines and strategy on family planning within reproductive health. The country's Minister of Health, Dr. Katele Kalumba, said the family planning guidelines were a sign of the government's commitment to providing a basic health care package for all Zambians. To promote widespread discussion of the whole concept of reproductive health, local newspapers printed feature articles with the headline "Let's talk reproductive health." The articles raised a variety of sensitive issues that ranged from safe sex and adolescent sexuality to safe motherhood and HIV prevention. Plans are going ahead in Zambia for drawing up a national training curriculum for safe motherhood and family planning. The curriculum for health workers will cover both pre-service and in-service training. PMID:12321356

  20. Systems Toxicology of Male Reproductive Development: Profiling 774 Chemicals for Molecular Targets and Adverse Outcomes

    PubMed Central

    Leung, Maxwell C.K.; Phuong, Jimmy; Baker, Nancy C.; Sipes, Nisha S.; Klinefelter, Gary R.; Martin, Matthew T.; McLaurin, Keith W.; Setzer, R. Woodrow; Darney, Sally Perreault; Judson, Richard S.; Knudsen, Thomas B.

    2015-01-01

    Background: Trends in male reproductive health have been reported for increased rates of testicular germ cell tumors, low semen quality, cryptorchidism, and hypospadias, which have been associated with prenatal environmental chemical exposure based on human and animal studies. Objective: In the present study we aimed to identify significant correlations between environmental chemicals, molecular targets, and adverse outcomes across a broad chemical landscape with emphasis on developmental toxicity of the male reproductive system. Methods: We used U.S. EPA’s animal study database (ToxRefDB) and a comprehensive literature analysis to identify 774 chemicals that have been evaluated for adverse effects on male reproductive parameters, and then used U.S. EPA’s in vitro high-throughput screening (HTS) database (ToxCastDB) to profile their bioactivity across approximately 800 molecular and cellular features. Results: A phenotypic hierarchy of testicular atrophy, sperm effects, tumors, and malformations, a composite resembling the human testicular dysgenesis syndrome (TDS) hypothesis, was observed in 281 chemicals. A subset of 54 chemicals with male developmental consequences had in vitro bioactivity on molecular targets that could be condensed into 156 gene annotations in a bipartite network. Conclusion: Computational modeling of available in vivo and in vitro data for chemicals that produce adverse effects on male reproductive end points revealed a phenotypic hierarchy across animal studies consistent with the human TDS hypothesis. We confirmed the known role of estrogen and androgen signaling pathways in rodent TDS, and importantly, broadened the list of molecular targets to include retinoic acid signaling, vascular remodeling proteins, G-protein coupled receptors (GPCRs), and cytochrome P450s. Citation: Leung MC, Phuong J, Baker NC, Sipes NS, Klinefelter GR, Martin MT, McLaurin KW, Setzer RW, Darney SP, Judson RS, Knudsen TB. 2016. Systems toxicology of male

  1. Managed care and reproductive health.

    PubMed

    Cohen, S S; Williams, D R

    1998-01-01

    Managed care poses special challenges to midwives providing reproductive health care. This is owing to the sensitive nature of issues surrounding reproductive health and aspects of managed care that may impede a woman's ability to obtain continuous, confidential, and comprehensive care from the provider of her choice. Variations across payers (ie, Medicare, Medicaid, and commercial insurers) regarding covered benefits and reimbursement of midwifery services also may create obstacles. Furthermore, some physicians and managed care organizations are embracing policies that threaten the ability of midwives to function as primary health care providers for women. Despite these hurdles, midwives have the potential to remain competitive in the new marketplace. This article underscores the importance of being knowledgeable about legislation and policy issues surrounding the financing of midwifery services, quality performance measurement for HMOs as they pertain to reproductive health, and discussions regarding which clinicians should be defined as primary care providers. PMID:9674347

  2. Male reproductive health and infertility.

    PubMed

    Frey, Keith A

    2010-09-01

    Primary care physicians have an essential role and opportunity in positively impacting the reproductive health of men. Although men are less likely than women to consistently seek preventive services, an office visit for any reason should be seen as an opportunity to introduce the idea of reproductive health. Additionally, primary care physicians can and should initiate the diagnostic workup for infertile couples in their practices. The initial assessment for the male partner consists of a thorough history and physical examination and appropriate laboratory tests, including a semen analysis. PMID:20705204

  3. Association of assisted reproductive technology with adverse pregnancy outcomes

    PubMed Central

    Jie, Zhang; Yiling, Ding; Ling, Yu

    2015-01-01

    Background: More and more infertile patients have accepted the assisted reproductive technique (ART) therapy. Concerns have been raised over an increased risk of adverse maternal outcomes in ART populations as compared with natural conception (NC). Objective: The aim was to improve the ART in clinicial work and to reduce the incidence of pregnancy complications in ART group according to analyzing the reasons of high incidence of pregnancy complications in ART group, comparing the incidence of pregnancy complications in different controlled ovarian hyperstimulation (COH) programs and evaluating the effects of ART which attribute to adverse pregnancy outcomes. Materials and Methods: In this prospective population-based cohort study,3216 pregnant women with gestational age ≤12 weeks, regular antenatal examination,and ultrasound identification of intrauterine pregnancy were enrolled from January 2010 to June 2013. According to having ART history, the participantswere divided into two groups: ART group (contains fresh embryo transfer group or frozen-thawed embryo transfer group) and NC group. We compared the incidence of pregnancy complications between different groups and evaluated the factors which could affect the occurrence of these complications. Results: When compared to NC group, significantly increased rates of gestational diabetes mellitus (GDM) (p<0.01), preeclampsia (PE) (p<0.01) and intrahepatic cholestasis of pregnancy (ICP) (p˂0.01) were observed in ART group. There was no significant difference in the incidence of birth defect between the two groups (p=0.07). Multiple pregnancies and Gonadotropin (Gn) were risk factors in GDM, PE, and ICP. The exogenous progesterone treatment had no effect on GDM, PE or ICP. Conclusion: ART increases the risk of adverse maternal complications such as GDM, PE and ICP. The dosages of Gn should be reduced to an extent and the number of embryo implantation should be controlled. Exogenous progesterone treatment is safe

  4. Vitamin D - roles in women's reproductive health?

    PubMed Central

    2011-01-01

    In the past few years a growing interest in vitamin D can be observed in the lay and biomedical literature due to findings demonstrating a low vitamin D status in the population. In addition to its importance for the regulation of calcium and phosphorus homeostasis recent epidemiologic studies have observed relationships between low vitamin D levels and multiple disease states. This secosteroid hormone also regulates the expression of a large number of genes in reproductive tissues implicating a role for vitamin D in female reproduction. In this report we summarize the recent evidence that vitamin D status influences female reproductive and pregnancy outcomes. Human and animal data suggest that low vitamin D status is associated with impaired fertility, endometriosis and polycystic ovary syndrome. Evidence from observational studies shows higher rates of preeclampsia, preterm birth, bacterial vaginosis and gestational diabetes in women with low vitamin D levels. However, confirmation of experimental observations establishing an association of vitamin D deficiency with adverse reproductive outcomes by high quality observational and large-scale randomized clinical trials is still lacking. The determination of optimal 25(OH)D3 levels in the reproductive period and the amount of vitamin D supplementation required to achieve those levels for the numerous actions of vitamin D throughout a woman's life would have important public health implications. PMID:22047005

  5. Endocrine-Disrupting Chemicals and Reproductive Health.

    PubMed

    Zlatnik, Marya G

    2016-07-01

    This review discusses the evidence linking industrial chemicals to a variety of health and reproductive outcomes. Industrial chemical production has increased over the past 30 to 40 years. Basic science, animal models, and epidemiologic data suggest that certain chemicals may act as endocrine disruptors (substances that interfere with normal hormonal action) and may play an etiologic role in a number of conditions whose incidence has also increased during this same period. These include low birth weight, gestational diabetes, obesity, certain cancers, certain birth defects, and neurodevelopmental disorders such as attention deficit disorder and autism. In addition, some environmental chemicals may have epigenetic effects, resulting in transgenerational health impacts. The epidemiologic and experimental evidence that links chemicals such as plasticizers (eg, phthalates and phenols), flame retardants, perfluorinated compounds, and pesticides with adverse reproductive health outcomes is reviewed. Women's health care providers are the liaison between scientific research and their patients; they should educate themselves on the significance of environmental toxins to health. They are ideally positioned, not only to counsel and reassure pregnant women, but also to suggest practicable changes in dietary and lifestyle habits to improve their health. Furthermore, women's health care providers should advocate for regulatory changes that protect women and their families from the health effects of environmental toxins. PMID:27391253

  6. Adverse health consequences of the Iraq War.

    PubMed

    Levy, Barry S; Sidel, Victor W

    2013-03-16

    The adverse health consequences of the Iraq War (2003-11) were profound. We conclude that at least 116,903 Iraqi non-combatants and more than 4800 coalition military personnel died over the 8-year course. Many Iraqi civilians were injured or became ill because of damage to the health-supporting infrastructure of the country, and about 5 million were displaced. More than 31,000 US military personnel were injured and a substantial percentage of those deployed suffered post-traumatic stress disorder, traumatic brain injury, and other neuropsychological disorders and their concomitant psychosocial problems. Many family members of military personnel had psychological problems. Further review of the adverse health consequences of this war could help to minimise the adverse health consequences of, and help to prevent, future wars. PMID:23499043

  7. Post-Disaster Reproductive Health Outcomes

    PubMed Central

    Zotti, Marianne E.; Williams, Amy M.; Robertson, McKaylee; Horney, Jennifer; Hsia, Jason

    2015-01-01

    We examined methodological issues in studies of disaster-related effects on reproductive health outcomes and fertility among women of reproductive age and infants in the United States (US). We conducted a systematic literature review of 1,635 articles and reports published in peer-reviewed journals or by the government from January 1981 through December 2010. We classified the studies using three exposure types: (1) physical exposure to toxicants; (2) psychological trauma; and (3) general exposure to disaster. Fifteen articles met our inclusion criteria concerning research focus and design. Overall studies pertained to eight different disasters, with most (n = 6) focused on the World Trade Center attack. Only one study examined pregnancy loss, i.e., occurrence of spontaneous abortions post-disaster. Most studies focused on associations between disaster and adverse birth outcomes, but two studies pertained only to post-disaster fertility while another two examined it in addition to adverse birth outcomes. In most studies disaster-affected populations were assumed to have experienced psychological trauma, but exposure to trauma was measured in only four studies. Furthermore, effects of both physical exposure to toxicants and psychological trauma on disaster-affected populations were examined in only one study. Effects on birth outcomes were not consistently demonstrated, and study methodologies varied widely. Even so, these studies suggest an association between disasters and reproductive health and highlight the need for further studies to clarify associations. We postulate that post-disaster surveillance among pregnant women could improve our understanding of effects of disaster on the reproductive health of US pregnant women. PMID:22752348

  8. Vitamin D in Reproductive Health and Pregnancy.

    PubMed

    Mousa, Aya; Abell, Sally; Scragg, Robert; de Courten, Barbora

    2016-03-01

    Vitamin D has been primarily known for its role in maintaining calcium and phosphorus homeostasis and promoting healthy bone mineralization. Emerging evidence suggests that vitamin D may have a plethora of other functions including cardiometabolic and immunological effects and a role in modulating human reproductive processes. Despite this, vitamin D deficiency (VDD) remains highly prevalent worldwide due to the limited availability of foods that are naturally high or fortified with vitamin D, increased sun avoidance behaviors and use of sunscreen due to fear of skin cancer, and increased sedentary indoor lifestyles, especially among those of reproductive age. This review examines current and emerging evidence for the role of vitamin D in reproductive health including in fertility, conception, and pregnancy outcomes, and outlines areas for future research. We found that existing evidence is based primarily on animal models and in vitro studies with some recent support from observational studies in humans. While these studies indicate that VDD may be a risk factor for adverse fertility and pregnancy outcomes, there is insufficient evidence to establish causality. Future efforts to clarify the benefits of vitamin D in reproductive health may bring about practical, simple, and cost-effective means of improving fertility and pregnancy outcomes. PMID:27228115

  9. Men's reproductive and sexual health.

    PubMed

    Forrest, K A

    2001-05-01

    A broad definition of men's reproductive and sexual health (MRSH) includes medical (pathophysiological) matters such as sexually transmitted infections (STIs), developmental anomalies, malignancy, trauma, and infertility. It also includes psychosocial concerns: sexuality, contraception, disease prophylaxis, developmental and lifecycle issues, tobacco and drug use, sexual identity and orientation, and partnership issues. College men, of whom a large majority are sexually active, have a range of MRSH needs, including some that are particular to their age and social environment. To reach men effectively requires approaches that are somewhat different from those used with women. Clinicians in college health services are in an excellent position to help young men recognize the importance of reproductive health and sexual responsibility. College health services therefore should offer men screening; clinical diagnosis and treatment for MRSH conditions; and information, education, and counseling services, in a manner designed to meet their unique needs. PMID:11413943

  10. Exposure to Endocrine Disrupting Chemicals and Male Reproductive Health

    PubMed Central

    Jeng, Hueiwang Anna

    2014-01-01

    Endocrine disrupting chemicals (EDCs) can interfere with normal hormonal balance and may exert adverse consequences on humans. The male reproductive system may be susceptible to the effects of such environmental toxicants. This review discusses the recent progress in scientific data mainly from epidemiology studies on the associations between EDCs and male reproductive health and our understanding of possible mechanisms associated with the effects of EDCs on male reproductive health. Finally, the review provides recommendations on future research to enhance our understanding of EDCs and male reproductive health. The review highlights the need for (1) well-defined longitudinal epidemiology studies, with appropriately designed exposure assessment to determine potential causal relationships; (2) chemical and biochemical approaches aimed at a better understanding of the mechanism of action of xenoestrogens with regard to low-dose effects, and assessment of identify genetic susceptibility factors associated with the risk of adverse effects following exposure to EDCs. PMID:24926476

  11. Evidence for adverse reproductive outcomes among women microelectronic assembly workers.

    PubMed Central

    Huel, G; Mergler, D; Bowler, R

    1990-01-01

    Microelectronics assembly entails complex processes where several potentially fetotoxic chemical compounds are used extensively. This study was undertaken to assess the potential adverse reproductive outcomes among former women workers in a microelectronics assembly plant in New Mexico with respect to a comparable population from the same geographical region and to examine the relation between these outcomes and employment history in this plant. After matching a pool of 143 former microelectronic female workers and 105 referents, 90 former microelectronic female worker-referent pairs were constituted (representing 302 and 324 pregnancies in former workers and referents respectively). The odds ratio (for pair matching design) of spontaneous abortion among women workers, before beginning to assemble microelectronic components, was 0.9 (chi 2 = 0.04; NS). After the beginning of employment this odds ratio became 5.6 (chi 2 = 9.8; p less than 1%). This estimated odds ratio decreased to 4.0, taking into account the increased risk for spontaneous abortion in previous pregnancies before employment (chi 2 = 5.4; p less than 5%). It was not possible to determine if this effect was reversible owing to the small number of pairs available after employment. The findings of this study corroborate the results of former studies that suggest a potential association between electronic manufacturing activity and risk of spontaneous abortion. Although the organic solvents were suspected of being the potential risk factor, this study was inconclusive from this point of view. Nevertheless, these investigations may provide some insight into reproductive outcomes among female workers exposed to solvents. PMID:2378817

  12. [Public health ethics and reproduction].

    PubMed

    Alexandrova-Yankulovska, S; Bozhinov, P; Bojinova, S

    2014-01-01

    Medical progress has enabled achievements that were not even thinkable earlier but at the same time society and public health have had to face new challenges. What are we ready to accept in the area of human reproduction? This paper aims at ethical analysis of Bulgarian laws on reproduction. The abortion debate nowadays has got new dimiension focusing not that much on its moral acceptability but rather on the acceptable indications for its performance. Is it ethical to perform abortion in case of undesired gender of the embryo or genetic malformations? Lots of moral issues mark the area of assisted reproduction which is due to the separation of the reproductive functions (ova, sperm and embryo donation, surrogacy), fragmentation of motherhood and fatherhood, differentiation of biological and social parenthood. Defining limits of acceptable interference or non-interference in human reproduction will never be easy, but dynamics of moral judgment shouldn't bother us. The rigidity of moral norms is what should be alarming because it threatens procreative autonomy. PMID:24919342

  13. Young women's reproductive health survey.

    PubMed

    Lewis, H

    1987-08-12

    A survey of reproductive health issues was conducted on 15 year old Hutt Valley secondary school girls by means of a self-administered anonymous questionnaire. The prevalence of sexual intercourse in the sample was 29%. Sixteen percent of the sexually active respondents used no method of contraception. Knowledge of reproductive health facts and contraception was poor both amongst sexually experienced and inexperienced respondents. Twenty-six percent relied on peers for this information, with mothers, teachers and books being other important sources cited. Respondents requested more information on sexually transmitted diseases, contraception and sexual relationships. Most would like this information more readily accessible. Preferred sources of information mentioned were: parents, books, films/videos, family planning clinics and friends. PMID:3455514

  14. Vaginal douching and adverse health effects: a meta-analysis.

    PubMed Central

    Zhang, J; Thomas, A G; Leybovich, E

    1997-01-01

    OBJECTIVES: The meta-analysis described here reviewed the current literature on adverse health effects of vaginal douching. METHODS: Papers published in English from 1965 through 1995 were potentially eligible. RESULTS: One third of White women and two thirds of Black women of reproductive age reported douching regularly. Analyses indicated that vaginal douching increases the overall risk of pelvic inflammatory disease by 73% and the risk of ectopic pregnancy by 76%. Frequent douching was shown to be highly associated with pelvic inflammatory disease and modestly associated with cervical cancer. CONCLUSIONS: Current literature suggests that frequent douching increases the risk of pelvic inflammatory disease, ectopic pregnancy, and, possibly, cervical cancer. PMID:9240115

  15. Child marriage and its association with adverse reproductive outcomes for women in Bangladesh.

    PubMed

    Kamal, S M Mostafa; Hassan, Che Hashim

    2015-03-01

    This study examines the prevalence of child marriage and its effect on reproductive outcomes among women in Bangladesh using the most recent 2011 Bangladesh Demographic and Health Survey data. Both bivariate and multivariate statistical techniques used in the study yielded quantitatively important and reliable estimates of child marriage and its impact on adverse reproductive and health outcomes. Overall, 77% of the marriages among women aged 20 to 49 years old took place before the age of 18 years. Women's education is the most single significant determinant of child marriage. Findings revealed that after being adjusted for sociodemographic factors, child marriage significantly (P < .001) increases the likelihood of stillbirth/miscarriage (odds ratio [OR] = 1.80; 95% confidence interval [CI] = 1.45-2.24) and pregnancy termination (OR = 1.24; 95% CI = 1.12-1.38). Programs should aim to retain girls in school for longer periods not only to raise the age at first marriage but also for sound reproductive health and overall social development of Bangladesh. PMID:24097938

  16. Reducing stigma in reproductive health.

    PubMed

    Cook, Rebecca J; Dickens, Bernard M

    2014-04-01

    Stigmatization marks individuals for disgrace, shame, and even disgust-spoiling or tarnishing their social identities. It can be imposed accidentally by thoughtlessness or insensitivity; incidentally to another purpose; or deliberately to deter or punish conduct considered harmful to actors themselves, others, society, or moral values. Stigma has permeated attitudes toward recipients of sexual and reproductive health services, and at times to service providers. Resort to contraceptive products, to voluntary sterilization and abortion, and now to medically assisted reproductive care to overcome infertility has attracted stigma. Unmarried motherhood has a long history of shame, projected onto the "illegitimate" (bastard) child. The stigma of contracting sexually transmitted infections has been reinvigorated with HIV infection. Gynecologists and their professional associations, ethically committed to uphold human dignity and equality, especially for vulnerable women for whom they care, should be active to guard against, counteract, and relieve stigmatization of their patients and of related service providers. PMID:24513258

  17. Gender violence and reproductive health.

    PubMed

    Diniz, S G; d'Oliveira, A F

    1998-12-01

    The available literature reflects the growing interest in gender violence and reproductive health. Violence is generally studied by identifying pathologies, measuring their demands on services and evaluating their repercussions on fetal outcome. Institutional violence, however, has received little attention and is mainly concerned with the consequences of inappropriate use of technologies. Data from the Sexuality and Health Feminist Collective shows that among patients, 20.5% stated that they have never talked about their sexual life with their partners; 38.3% stated that they have had sexual intercourse against their will, including situations ranging from sexual harassment to rape which was referred by 12.3% of them. One of the most relevant issues arising from the anamnesis and interviews of these women was the violence to which they were submitted by health services. The high prevalence of violent situations indicates the urgency of incorporating an approach which deals with gender violence and promotes the empowerment of women into the routine of reproductive health services. PMID:10075210

  18. Childhood Adversity Accelerates Intended Reproductive Timing in Adolescent Girls without Increasing Interest in Infants

    PubMed Central

    Clutterbuck, Stephanie; Adams, Jean; Nettle, Daniel

    2014-01-01

    Women experiencing greater childhood adversity exhibit faster reproductive trajectories. One possible psychological mechanism underlying this phenomenon is an increased interest in infants. Interest in infants is thought to be an adaptation important for successful rearing as it motivates the acquisition of caretaking skills. We investigated the relationships between childhood adversity, intended reproductive timing and interest in infants in a sample of English adolescent girls. Specifically we sought to investigate the relationship between 1) childhood adversity and intended reproductive timing; 2) childhood adversity and interest in infants; and 3) intended reproductive timing and interest in infants. Additionally we explored different methods of measuring interest in infants using self-reported fondness for babies, a forced choice adult versus infant paper-based preference task and a novel computer based attention task using adult and infant stimuli. In total 357 girls aged nine to 14 years participated in the study, which took place in schools. Participants completed the two interest in infants tasks before moving on to a childhood adversity questionnaire. Girls with more childhood adversity reported earlier ideal ages at parenthood. We found some evidence that, contrary to our predictions, girls with less childhood adversity were more interested in infants. There was no relationship between intended reproductive timing and interest in infants. The different measurements for interest in infants were only weakly related, if at all, highlighting the complexity of measuring this construct. Our findings suggest that rather than interest in infants being a mechanism for the effect of childhood adversity on early reproductive timing it might instead be an indicator of future reproductive strategies. PMID:24454778

  19. Women's health: beyond reproductive years.

    PubMed

    Laskar, Ananya Ray

    2011-01-01

    With changing demographic profile India has more older women than men as life expectancy for women is 67.57 as against 65.46 for men. Gender differences in the aging process reflect biological, economic, and social differences. Both social and health needs of the older women are unique and distinctive as they are vulnerable. The social problems revolve around widowhood, dependency, illiteracy and lack of awareness about the policies and programmes from which they can benefit. Among the medical problems, vision (cataract) and degenerative joint disease top the list, followed by neurological problems. Lifestyle diseases form another single-most important group of health problems in the elderly women. The risk of cardiovascular disease doubles with the outcome being poorer than men. The most common causes of death among women above the age of 60 years are stroke, ischemic heart disease and COPD. Hypertensive heart disease and lower respiratory tract infections contribute to mortality in these women. Common malignancies viz. Cervical, breast and uterus in women are specific to them and account for a sizeable morbidity and mortality. In a study done at Lady Hardinge medical college in Delhi, Hypertension (39.6%) and obesity (12-46.8%) were very common in postmenopausal women. Half or more women had high salt and fat intake, low fruit and vegetable intake and stress. There is a need to recognize the special health needs of the women beyond the reproductive age, to be met through strengthening and reorienting the public health services at all levels starting from primary health care to secondary till tertiary care level with adequate referral linkages. All policies and programs need to have a gender perspective. At present there is lack of sensitization and appropriate training of the health personnel in dealing with the needs of elderly. Women too need to be aware to adopt healthy lifestyle and seek timely care. PMID:22298132

  20. New reproductive technologies: Equity and access to reproductive health care.

    PubMed

    Henifin, M S

    1993-01-01

    While attention has focused on the promise of new reproductive technologies to provide cures for infertility, efforts aimed at preventing infertility have languished, and the major cause of infant morbidity and morality--lack of prenatal care--has worsened. This article explores the social and ethical issues arising out of the uses of three new reproductive technologies: surrogacy, in vitro fertilization, and prenatal screening. In addition, coerced medical interventions during pregnancy are described. Examination of the social circumstances surrounding the use of these medical technologies supports the conclusion that new reproductive technologies have increased, rather than decreased, inequities in access to and allocation of health care resources. PMID:17165238

  1. Trends in reproductive health in Israel: implications for environmental health policy

    PubMed Central

    2012-01-01

    Nearly two decades ago, researchers first reported that endocrine disrupting chemicals in the environment were affecting reproductive health in the general population. The purpose of this article is to examine the evidence of adverse reproductive health trends in Israel and to explore implications for environmental health policy in Israel. We reviewed studies and data in Israel regarding trends in reproductive health indices, specifically: breast and testis cancer, hypospadias, sperm quality, male factor infertility, and age at menarche. The data provide some evidence of adverse reproductive trends in the Israeli population: an increase in testicular cancer from 1990 to 2007, a decrease in age at menarche from 1986 to 2000, an increase in the prevalence of male factor infertility, and some evidence of decreasing sperm counts. However, we note that much of the evidence is limited. The policy implications of reported adverse reproductive health trends possibly related to environmental exposure have been radically different in Europe and the United States. In Europe, such reports led the Parliament of the European Community to adopt a resolution on endocrine disruptors, which emphasizes the application of the Precautionary Principle. U.S. Environmental Protection Agency policy is focused on screening chemicals for endocrine disrupting properties and does not specifically refer to the Precautionary Principle. To date, there has been no formal governmental policy or strategy in Israel regarding endocrine disrupting chemicals. Environmental health policy on endocrine disruptors requires integrating evidence on human reproductive health trends, evidence on adverse reproductive outcomes in wildlife and experimental systems, and data from biomonitoring studies. Despite gaps in evidence and current data, we support a precautionary approach to regulating potential endocrine disrupting chemicals and reducing public exposures, especially in sensitive groups such as children and

  2. Adverse health consequences of the Vietnam War.

    PubMed

    Levy, Barry S; Sidel, Victor W

    2015-01-01

    The 40th anniversary of the end of the Vietnam War is a useful time to review the adverse health consequences of that war and to identify and address serious problems related to armed conflict, such as the protection of noncombatant civilians. More than 58,000 U.S. servicemembers died during the war and more than 150,000 were wounded. Many suffered from posttraumatic stress disorders and other mental disorders and from the long-term consequences of physical injuries. However, morbidity and mortality, although difficult to determine precisely, was substantially higher among the Vietnamese people, with at least two million of them dying during the course of the war. In addition, more than one million Vietnamese were forced to migrate during the war and its aftermath, including many "boat people" who died at sea during attempts to flee. Wars continue to kill and injure large numbers of noncombatant civilians and continue to damage the health-supporting infrastructure of society, expose civilians to toxic chemicals, forcibly displace many people, and divert resources away from services to benefit noncombatant civilians. Health professionals can play important roles in promoting the protection of noncombatant civilians during war and helping to prevent war and create a culture of peace. PMID:26754766

  3. Can Drosophila melanogaster represent a model system for the detection of reproductive adverse drug reactions?

    PubMed

    Avanesian, Agnesa; Semnani, Sahar; Jafari, Mahtab

    2009-08-01

    Once a molecule is identified as a potential drug, the detection of adverse drug reactions is one of the key components of its development and the FDA approval process. We propose using Drosophila melanogaster to screen for reproductive adverse drug reactions in the early stages of drug development. Compared with other non-mammalian models, D. melanogaster has many similarities to the mammalian reproductive system, including putative sex hormones and conserved proteins involved in genitourinary development. Furthermore, the D. melanogaster model would present significant advantages in time efficiency and cost-effectiveness compared with mammalian models. We present data on methotrexate (MTX) reproductive adverse events in multiple animal models, including fruit flies, as proof-of-concept for the use of the D. melanogaster model. PMID:19482095

  4. A Review of Nitrates in Drinking Water: Maternal Exposure and Adverse Reproductive and Developmental Outcomes

    PubMed Central

    Manassaram, Deana M.; Backer, Lorraine C.; Moll, Deborah M.

    2006-01-01

    In this review we present an update on maternal exposure to nitrates in drinking water in relation to possible adverse reproductive and developmental effects, and also discuss nitrates in drinking water in the United States. The current standard for nitrates in drinking water is based on retrospective studies and approximates a level that protects infants from methemoglobinemia, but no safety factor is built into the standard. The current standard applies only to public water systems. Drinking water source was related to nitrate exposure (i.e., private systems water was more likely than community system water to have nitrate levels above the maximum contaminant limit). Animal studies have found adverse reproductive effects resulting from higher doses of nitrate or nitrite. The epidemiologic evidence of a direct exposure–response relationship between drinking water nitrate level and adverse reproductive effect is still not clear. However, some reports have suggested an association between exposure to nitrates in drinking water and spontaneous abortions, intrauterine growth restriction, and various birth defects. Uncertainties in epidemiologic studies include the lack of individual exposure assessment that would rule out confounding of the exposure with some other cause. Nitrates may be just one of the contaminants in drinking water contributing to adverse outcomes. We conclude that the current literature does not provide sufficient evidence of a causal relationship between exposure to nitrates in drinking water and adverse reproductive effects. Future studies incorporating individual exposure assessment about users of private wells—the population most at risk—should be considered. PMID:16507452

  5. Sexual and reproductive health and rights in public health education.

    PubMed

    Allotey, Pascale A; Diniz, Simone; Dejong, Jocelyn; Delvaux, Thérèse; Gruskin, Sofia; Fonn, Sharon

    2011-11-01

    This paper addresses the challenges faced in mainstreaming the teaching of sexual and reproductive health and rights into public health education. For this paper, we define sexual and reproductive health and rights education as including not only its biomedical aspects but also an understanding of its history, values and politics, grounded in gender politics and social justice, addressing sexuality, and placed within a broader context of health systems and global health. Using a case study approach with an opportunistically selected sample of schools of public health within our regional contexts, we examine the status of sexual and reproductive health and rights education and some of the drivers and obstacles to the development and delivery of sexual and reproductive health and rights curricula. Despite diverse national and institutional contexts, there are many commonalities. Teaching of sexual and reproductive health and rights is not fully integrated into core curricula. Existing initiatives rely on personal faculty interest or short-term courses, neither of which are truly sustainable or replicable. We call for a multidisciplinary and more comprehensive integration of sexual and reproductive health and rights in public health education. The education of tomorrow's public health leaders is critical, and a strategy is needed to ensure that they understand and are prepared to engage with the range of sexual and reproductive health and rights issues within their historical and political contexts. PMID:22118142

  6. 40 CFR 350.21 - Adverse health effects.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 28 2011-07-01 2011-07-01 false Adverse health effects. 350.21 Section... RIGHT-TO-KNOW INFORMATION: AND TRADE SECRET DISCLOSURES TO HEALTH PROFESSIONALS Trade Secrecy Claims § 350.21 Adverse health effects. The Governor or State emergency response commission shall identify...

  7. 40 CFR 350.21 - Adverse health effects.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 27 2010-07-01 2010-07-01 false Adverse health effects. 350.21 Section... RIGHT-TO-KNOW INFORMATION: AND TRADE SECRET DISCLOSURES TO HEALTH PROFESSIONALS Trade Secrecy Claims § 350.21 Adverse health effects. The Governor or State emergency response commission shall identify...

  8. 40 CFR 350.21 - Adverse health effects.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 29 2012-07-01 2012-07-01 false Adverse health effects. 350.21 Section... RIGHT-TO-KNOW INFORMATION: AND TRADE SECRET DISCLOSURES TO HEALTH PROFESSIONALS Trade Secrecy Claims § 350.21 Adverse health effects. The Governor or State emergency response commission shall identify...

  9. 40 CFR 350.21 - Adverse health effects.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 29 2013-07-01 2013-07-01 false Adverse health effects. 350.21 Section... RIGHT-TO-KNOW INFORMATION: AND TRADE SECRET DISCLOSURES TO HEALTH PROFESSIONALS Trade Secrecy Claims § 350.21 Adverse health effects. The Governor or State emergency response commission shall identify...

  10. 40 CFR 350.21 - Adverse health effects.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 28 2014-07-01 2014-07-01 false Adverse health effects. 350.21 Section... RIGHT-TO-KNOW INFORMATION: AND TRADE SECRET DISCLOSURES TO HEALTH PROFESSIONALS Trade Secrecy Claims § 350.21 Adverse health effects. The Governor or State emergency response commission shall identify...

  11. The adverse health effects of chronic cannabis use.

    PubMed

    Hall, Wayne; Degenhardt, Louisa

    2014-01-01

    This paper summarizes the most probable of the adverse health effects of regular cannabis use sustained over years, as indicated by epidemiological studies that have established an association between cannabis use and adverse outcomes; ruled out reverse causation; and controlled for plausible alternative explanations. We have also focused on adverse outcomes for which there is good evidence of biological plausibility. The focus is on those adverse health effects of greatest potential public health significance--those that are most likely to occur and to affect a substantial proportion of regular cannabis users. These most probable adverse effects of regular use include a dependence syndrome, impaired respiratory function, cardiovascular disease, adverse effects on adolescent psychosocial development and mental health, and residual cognitive impairment. PMID:23836598

  12. Assessing the reproductive health of men with occupational exposures

    PubMed Central

    Schrader, Steven M; Marlow, Katherine L

    2014-01-01

    The earliest report linking environmental (occupational) exposure to adverse human male reproductive effects dates back to1775 when an English physician, Percival Pott, reported a high incidence of scrotal cancer in chimney sweeps. This observation led to safety regulations in the form of bathing requirements for these workers. The fact that male-mediated reproductive harm in humans may be a result of toxicant exposures did not become firmly established until relatively recently, when Lancranjan studied lead-exposed workers in Romania in 1975, and later in 1977, when Whorton examined the effects of dibromochloropropane (DBCP) on male workers in California. Since these discoveries, several additional human reproductive toxicants have been identified through the convergence of laboratory and observational findings. Many research gaps remain, as the pool of potential human exposures with undetermined effects on male reproduction is vast. This review provides an overview of methods used to study the effects of exposures on male reproduction and their reproductive health, with a primary emphasis on the implementation and interpretation of human studies. Emphasis will be on occupational exposures, although much of the information is also useful in assessing environmental studies, occupational exposures are usually much higher and better defined. PMID:24369130

  13. Reproductive health professionals' adoption of emerging technologies for health promotion.

    PubMed

    Smith, Peggy B; Buzi, Ruth S

    2014-12-01

    The purpose of this study was to assess reproductive health professionals' familiarity with and use of various electronic technologies to support health promotion. The study also examined the relationship between demographic characteristics and attitudes and beliefs of the effectiveness of new technologies and perceived barriers for usage. A total of 165 reproductive health professionals at two conferences related to reproductive health in the United States completed the study survey. Personal and organizational factors affected the adoption of electronic technologies for health promotion. This included lack of knowledge, skills, and confidence as well as privacy concerns. The results of the study also suggested that being from an older generation was associated with having lower levels of knowledge, skills, and confidence in using new media. These findings highlight the importance of creating learning opportunities on the use of new technology for health promotion as well as addressing specific perceived barriers among reproductive health professionals in order to promote the adoption of these technologies. PMID:25411221

  14. Adverse childhood experiences and health anxiety in adulthood.

    PubMed

    Reiser, Sarah J; McMillan, Katherine A; Wright, Kristi D; Asmundson, Gordon J G

    2014-03-01

    Childhood experiences are thought to predispose a person to the development of health anxiety later in life. However, there is a lack of research investigating the influence of specific adverse experiences (e.g., childhood abuse, household dysfunction) on this condition. The current study examined the cumulative influence of multiple types of childhood adversities on health anxiety in adulthood. Adults 18-59 years of age (N=264) completed a battery of measures to assess adverse childhood experiences, health anxiety, and associated constructs (i.e., negative affect and trait anxiety). Significant associations were observed between adverse childhood experiences, health anxiety, and associated constructs. Hierarchical multiple regression analysis indicted that adverse childhood experiences were predictive of health anxiety in adulthood; however, the unique contribution of these experience were no longer significant following the inclusion of the other variables of interest. Subsequently, mediation analyses indicated that both negative affect and trait anxiety independently mediated the relationship between adverse childhood experiences and health anxiety in adulthood. Increased exposure to adverse childhood experiences is associated with higher levels of health anxiety in adulthood; this relationship is mediated through negative affect and trait anxiety. Findings support the long-term negative impact of cumulative adverse childhood experiences and emphasize the importance of addressing negative affect and trait anxiety in efforts to prevent and treat health anxiety. PMID:24011493

  15. Adverse Selection in Health Insurance Markets: A Classroom Experiment

    ERIC Educational Resources Information Center

    Hodgson, Ashley

    2014-01-01

    Adverse selection as it relates to health care policy will be a key economic issue in many upcoming elections. In this article, the author lays out a 30-minute classroom experiment designed for students to experience the kind of elevated prices and market collapse that can result from adverse selection in health insurance markets. The students…

  16. Intimate Partner Violence, PTSD, and Adverse Health Outcomes

    ERIC Educational Resources Information Center

    Dutton, Mary Ann; Green, Bonnie L.; Kaltman, Stacey I.; Roesch, Darren M.; Zeffiro, Thomas A.; Krause, Elizabeth D.

    2006-01-01

    The high prevalence of adverse health outcomes related to intimate partner violence (IPV) is well documented. Yet we know little about the pathways that lead to adverse health outcomes. Research concerning the psychological, biological, neurological, behavioral, and physiological alterations following exposure to IPV--many of which are associated…

  17. Impact of the environment on reproductive health.

    PubMed

    1991-01-01

    The WHO workshop on the impact of the environment on reproductive health is summarized. Topics include the nature of environmental factors affecting reproductive health, environmental factors blamed for declining sperm quantity and quality, the effects of natural and man-made disasters on reproductive health, chemical pollutants, how the environment damages reproductive health, and research needs for better research methodologies and surveillance data. Recommendations are made to: 1) promote international research collaboration with an emphasis on consistency of methodological approaches for assessing developmental and reproductive toxicity, on development of improved surveillance systems and data bases, an strengthening international disaster alert and evaluation systems; 2) promote research capabilities for multidisciplinary studies, for interactive studies of the environment and cellular processes, and for expansion of training and education; and 3) take action on priority problems of exposure to chemical, physical, and biological agents, of exposure to pesticides among specific populations, and of inadequate screening methods for identification of environmental chemicals. The costs of environmental injury to reproduction include subfertility, intrauterine growth retardation, spontaneous abortion, and various birth defects. Developed country's primary threats are from chemical pollution, radiation, and stress. There is a large gap in knowledge. Caution is urged in understanding the direct relationship between environmental causes and infertility. Sexual health is difficult to assess and research is suggested. Exposure to excessive vitamin A and toxic chemicals are cited as agents probably having serious effects on malformations. Sperm quality has declined over the decades; there is speculation about the potential causes. The effects of radiation such as at Chernobyl are described. Toxic chemical exposure such as in Bhopal, India killed thousands. Neurological

  18. The sexuality connection in reproductive health.

    PubMed

    Dixon-Mueller, R

    1993-01-01

    Sexuality and power relations based on gender are relevant to researchers, policymakers, and service providers in the reproductive health field, because they underlie virtually all of the behaviors and conditions that their programs address. Yet, a review of conventional treatments in the demographic and family planning literature reveals that, when they consider these topics at all, researchers typically adopt narrow definitions of sexual behavior and focus almost exclusively on risks of pregnancy and disease. This article proposes an analytic framework as a guide to researchers and family planning providers. It relates four dimensions of sexuality to reproductive health outcomes and concludes that family planning policies and programs should address a broader spectrum of sexual behaviors and meanings, consider questions of sexual enjoyment as well as risk, and confront ideologies of male entitlement that threaten women's sexual and reproductive rights and health. PMID:8296329

  19. Integrating reproductive health: myth and ideology.

    PubMed Central

    Lush, L.; Cleland, J.; Walt, G.; Mayhew, S.

    1999-01-01

    Since 1994, integrating human immunodeficiency virus/sexually transmitted disease (HIV/STD) services with primary health care, as part of reproductive health, has been advocated to address two major public health problems: to control the spread of HIV; and to improve women's reproductive health. However, integration is unlikely to succeed because primary health care and the political context within which this approach is taking place are unsuited to the task. In this paper, a historical comparison is made between the health systems of Ghana, Kenya and Zambia and that of South Africa, to examine progress on integration of HIV/STD services since 1994. Our findings indicate that primary health care in Ghana, Kenya and Zambia has been used mainly by women and children and that integration has meant adding new activities to these services. For the vertical programmes which support these services, integration implies enhanced collaboration rather than merged responsibility. This compromise between comprehensive rhetoric and selective reality has resulted in little change to existing structures and processes; problems with integration have been exacerbated by the activities of external donors. By comparison, in South Africa integration has been achieved through political commitment to primary health care rather than expanding vertical programmes (top-down management systems). The rhetoric of integration has been widely used in reproductive health despite lack of evidence for its feasibility, as a result of the convergence of four agendas: improving family planning quality; the need to improve women's health; the rapid spread of HIV; and conceptual shifts in primary health care. International reproductive health actors, however, have taken little account of political, financial and managerial constraints to implementation in low-income countries. PMID:10534902

  20. Youth reproductive health services in Bulawayo, Zimbabwe.

    PubMed

    Mashamba, Alethea; Robson, Elsbeth

    2002-12-01

    This study examines young people's access to reproductive healthcare services via an urban youth advisory centre in Bulawayo, Zimbabwe. The aim is to explain why teenagers do not always use existing health services. Data from exit questionnaires with users and focus groups with non-users are analysed to evaluate service accessibility. Analysis suggests that even where clinics are spatially accessible, barriers to access include temporal factors, lack of factual knowledge and stigmatisation. The paper concludes that spatial accessibility is not the only factor necessary to ensure equal access to health services. Recommendations are made towards tackling young people's unmet needs for reproductive healthcare services. PMID:12399216

  1. Adverse reproductive outcomes in families of atomic veterans: The feasibility of epidemiologic studies

    SciTech Connect

    1995-12-31

    This is an outstanding report from a distinguished academy committee, which in 71 pages of text provides the scientific basis for the carefully crafted 8-page executive summary. The principles and issues of the required epidemiological study are presented calmly and concisely, as are the ensuing short chapters on radiation biology, genetics and risk estimation, and all other adverse reproductive outcomes. The committee was mandated by Congress to determine the feasibility, cost and duration of a study on adverse reproductive outcomes in families of atomic veteran. The committee found that a scientifically adequate and epidemiologically valid study could not be mounted and the cost would be tens of millions of dollars lasting a decade. The Committee presents a number of well-discussed approaches in support of their position.

  2. Gender issues in reproductive health: a review.

    PubMed

    Adinma, Echendu D; Adinma, Brian-D J I

    2011-01-01

    Gender, for its impact on virtually every contemporary life issue, can rightly be regarded as a foremost component of reproductive health. Reproductive health basically emphasises on people and their rights to sexuality, reproduction, and family planning, and the information to actualize these right, which has been inextricably linked to development at the International Conference on Population and Development (ICPD) held in Cairo, Egypt, in 1994. Women's sexual and reproductive rights became recognised as universal human right, violations of which occur in some reproductive health areas including gender concerns. Gender inequality and inequity encompass gender based violence as well as gender discrimination which cuts across the life cycle of the woman; attitudes, religious and cultural practices of various nations; and issues related to employment, economy, politics, and development. The redress of gender inequality is a collective responsibility of nations and supranational agencies. Nations should adopt a framework hinged on three pedestals--legal, institutional and policy, employing the three recommended approaches of equal treatment, positive action, and gender mainstreaming. PMID:21970255

  3. Maternal Vitamin D Deficiency Programs Reproductive Dysfunction in Female Mice Offspring Through Adverse Effects on the Neuroendocrine Axis.

    PubMed

    Nicholas, Cari; Davis, Joseph; Fisher, Thomas; Segal, Thalia; Petti, Marilena; Sun, Yan; Wolfe, Andrew; Neal-Perry, Genevieve

    2016-04-01

    Vitamin D (VitD) deficiency affects more than 1 billion people worldwide with a higher prevalence in reproductive-aged women and children. The physiological effects of maternal VitD deficiency on the reproductive health of the offspring has not been studied. To determine whether maternal VitD deficiency affects reproductive physiology in female offspring, we monitored the reproductive physiology of C57BL/6J female offspring exposed to diet-induced maternal VitD deficiency at three specific developmental stages: 1) in utero, 2) preweaning, or 3) in utero and preweaning. We hypothesized that exposure to maternal VitD deficiency disrupts reproductive function in exposed female offspring. To test this hypothesis, we assessed vaginal opening and cytology and ovary and pituitary function as well as gonadotropin and gonadal steroid levels in female offspring. The in utero, preweaning, and in utero and preweaning VitD deficiency did not affect puberty. However, all female mice exposed to maternal VitD deficiency developed prolonged and irregular estrous cycles characterized by oligoovulation and extended periods of diestrus. Despite similar gonadal steroid levels and GnRH neuron density, females exposed to maternal VitD deficiency released less LH on the evening of proestrus. When compared with control female offspring, there was no significant difference in the ability of females exposed to maternal VitD deficiency to respond robustly to exogenous GnRH peptide or controlled ovarian hyperstimulation. These findings suggest that maternal VitD deficiency programs reproductive dysfunction in adult female offspring through adverse effects on hypothalamic function. PMID:26741195

  4. Youth Reproductive & Sexual Health in Nigeria

    ERIC Educational Resources Information Center

    Sampson, Melodi

    2010-01-01

    Nearly one third of Nigeria's total population of 148.1 million is between the ages of 10 and 24. Nigerian adolescents' sizeable share of the population makes them integral to the country's social, political and economic development. Nigeria's development is compromised by the sexual and reproductive health issues afflicting its youth. Lack of…

  5. Indonesian survey looks at adolescent reproductive health.

    PubMed

    Achmad, S I; Westley, S B

    1999-10-01

    The Baseline Survey of Young Adult Reproductive Welfare in Indonesia, conducted from September to December 1998, provides information about young Indonesians on topics concerning work, education, marriage, family life, sexuality, fertility, and HIV/AIDS and other sexually transmitted diseases. The survey interviewed 4106 men and 3978 women aged 15-24 years in three provinces of Java. Survey findings showed that 42% of the women and 8% of the men are currently or have been married. There was a strong inverse relationship between marriage and schooling, which suggests that greater educational attainment and a higher average age at marriage are likely to go together. Although most young couples prefer to delay and space births, only half of currently married young women are using any type of contraception. These results indicate that there is a need for better reproductive health care as well as improved reproductive health education. Moreover, the current economic crisis has lead to a decline in the use of the private sector for health care. Instead, young people are using the less-expensive government services, and young women are turning to pharmacies and midwives rather than to private doctors to obtain contraceptives. These findings have several policy implications including the need for reproductive health programs that provide services needed by young people. PMID:12295693

  6. Evidence of Adverse Selection in Iranian Supplementary Health Insurance Market

    PubMed Central

    Mahdavi, Gh; Izadi, Z

    2012-01-01

    Background: Existence or non-existence of adverse selection in insurance market is one of the important cases that have always been considered by insurers. Adverse selection is one of the consequences of asymmetric information. Theory of adverse selection states that high-risk individuals demand the insurance service more than low risk individuals do. Methods: The presence of adverse selection in Iran’s supplementary health insurance market is tested in this paper. The study group consists of 420 practitioner individuals aged 20 to 59. We estimate two logistic regression models in order to determine the effect of individual’s characteristics on decision to purchase health insurance coverage and loss occurrence. Using the correlation between claim occurrence and decision to purchase health insurance, the adverse selection problem in Iranian supplementary health insurance market is examined. Results: Individuals with higher level of education and income level purchase less supplementary health insurance and make fewer claims than others make and there is positive correlation between claim occurrence and decision to purchase supplementary health insurance. Conclusion: Our findings prove the evidence of the presence of adverse selection in Iranian supplementary health insurance market. PMID:23113209

  7. Measuring adverse selection in managed health care.

    PubMed

    Frank, R G; Glazer, J; McGuire, T G

    2000-11-01

    Health plans paid by capitation have an incentive to distort the quality of services they offer to attract profitable and to deter unprofitable enrollees. We characterize plans' rationing as a "shadow price" on access to various areas of care and show how the profit maximizing shadow price depends on the dispersion in health costs, individuals' forecasts of their health costs, the correlation between use in different illness categories, and the risk adjustment system used for payment. These factors are combined in an empirically implementable index that can be used to identify the services that will be most distorted by selection incentives. PMID:11186848

  8. Reproductive Health Risks Associated with Occupational Exposures to Antineoplastic Drugs in Health Care Settings: A Review of the Evidence

    PubMed Central

    Connor, Thomas H.; Lawson, Christina C.; Polovich, Martha; McDiarmid, Melissa A.

    2015-01-01

    Objectives Antineoplastic drugs are known reproductive and developmental toxicants. Our objective was to review the existing literature of reproductive health risks to workers who handle antineoplastic drugs. Methods A structured literature review of 18 peer-reviewed, English language publications of occupational exposure and reproductive outcomes was performed. Results While effect sizes varied with study size and population, occupational exposure to antineoplastic drugs appears to raise the risk of both congenital malformations and miscarriage. Studies of infertility and time-to-pregnancy also suggested an increased risk for sub-fertility. Conclusions Antineoplastic drugs are highly toxic in patients receiving treatment and adverse reproductive effects have been well documented in these patients. Healthcare workers with chronic, low level occupational exposure to these drugs also appear to have an increased risk of adverse reproductive outcomes. Additional precautions to prevent exposure should be considered. PMID:25153300

  9. Potential adverse health effects of wood smoke.

    PubMed

    Pierson, W E; Koenig, J Q; Bardana, E J

    1989-09-01

    The use of wood stoves has increased greatly in the past decade, causing concern in many communities about the health effects of wood smoke. Wood smoke is known to contain such compounds as carbon monoxide, nitrogen oxides, sulfur oxides, aldehydes, polycyclic aromatic hydrocarbons, and fine respirable particulate matter. All of these have been shown to cause deleterious physiologic responses in laboratory studies in humans. Some compounds found in wood smoke--benzo[a]pyrene and formaldehyde--are possible human carcinogens. Fine particulate matter has been associated with decreased pulmonary function in children and with increased chronic lung disease in Nepal, where exposure to very high amounts of wood smoke occurs in residences. Wood smoke fumes, taken from both outdoor and indoor samples, have shown mutagenic activity in short-term bioassay tests. Because of the potential health effects of wood smoke, exposure to this source of air pollution should be minimal. PMID:2686171

  10. Potential adverse health effects of wood smoke.

    PubMed Central

    Pierson, W E; Koenig, J Q; Bardana, E J

    1989-01-01

    The use of wood stoves has increased greatly in the past decade, causing concern in many communities about the health effects of wood smoke. Wood smoke is known to contain such compounds as carbon monoxide, nitrogen oxides, sulfur oxides, aldehydes, polycyclic aromatic hydrocarbons, and fine respirable particulate matter. All of these have been shown to cause deleterious physiologic responses in laboratory studies in humans. Some compounds found in wood smoke--benzo[a]pyrene and formaldehyde--are possible human carcinogens. Fine particulate matter has been associated with decreased pulmonary function in children and with increased chronic lung disease in Nepal, where exposure to very high amounts of wood smoke occurs in residences. Wood smoke fumes, taken from both outdoor and indoor samples, have shown mutagenic activity in short-term bioassay tests. Because of the potential health effects of wood smoke, exposure to this source of air pollution should be minimal. PMID:2686171

  11. Reproductive health in India's primary health care system.

    PubMed

    Rao, M

    1997-01-01

    India's family planning program having reached a dead end, the government of India appointed an expert group to develop a new population policy for the country. While the group's report, submitted in May 1994, proclaimed a new orientation described as pro-poor, pro-nature, and pro-women, the recommendations of the report were criticized as not being serious about gender equity. The government of India, describing a new reproductive health care approach, envisions a paradigm shift in the family planning program strategy. Reproductive health is defined as a state in which people can reproduce and regulate their fertility, women are able to go through pregnancy and childbirth safely, the outcome of pregnancy is successful with regard to maternal and infant survival and well-being, and couples are able to have sexual relations free of the fear of pregnancy and of contracting disease. To further the discussion on the newly initiated reproductive health care approach, the faculty of the Center of Social Medicine and Community Health, School of Social Sciences, Jawaharlal Nehru University, New Delhi, organized a workshop for November 4-5, 1996, on the place of reproductive health in India's primary health care. The workshop brought together public health persons, clinicians, and health and women's rights activists. The author outlines the content of papers presented at the workshop. PMID:9230606

  12. Adverse Health Effects in Relation to Urban Residential Soundscapes

    NASA Astrophysics Data System (ADS)

    SKÅNBERG, A.; ÖHRSTRÖM, E.

    2002-02-01

    Noise pollution from road traffic in residential areas is a growing environmental problem. New approaches to turn the negative trend are needed. The programme “Soundscape Support to Health” will achieve new knowledge about the adverse health effects of noise pollution on humans and will investigate the link between well-being and health and perceived soundscapes for optimizing the acoustic soundscapes in urban residential areas. This paper will briefly present the programme and presents preliminary results from the first study of how various adverse health effects are related to individual noise exposures among individuals in residential areas with and without access to a quiet side of the dwelling.

  13. Long Term Physical Health Consequences of Adverse Childhood Experiences

    PubMed Central

    Monnat, Shannon M.; Chandler, Raeven Faye

    2015-01-01

    This study examined associations between adverse childhood family experiences and adult physical health using data from 52,250 US adults aged 18–64 from the 2009–2012 Behavioral Risk Factor Surveillance System (BRFSS). We found that experiencing childhood physical, verbal, or sexual abuse, witnessing parental domestic violence, experiencing parental divorce, and living with someone who was depressed, abused drugs or alcohol, or who had been incarcerated were associated with one or more of the following health outcomes: self-rated health, functional limitations, diabetes, and heart attack. Adult socioeconomic status and poor mental health and health behaviors significantly mediated several of these associations. The results of this study highlight the importance of family-based adverse childhood experiences on adult health outcomes and suggest that adult SES and stress-related coping behaviors may be crucial links between trauma in the childhood home and adult health. PMID:26500379

  14. Reproductive health and AIDS prevention in sub-Saharan Africa: the case for increased male participation.

    PubMed

    Mbizvo, M T; Bassett, M T

    1996-03-01

    Reproduction is a dual commitment, but so often in much of the world, it is seen as wholly the woman's responsibility. She bears the burden not only of pregnancy and childbirth but also the threats from excessive child bearing, some responsibility for contraception, infertility investigation and often undiagnosed sexually transmitted diseases (STDs) including AIDS. Failure to target men in reproductive health interventions has weakened the impact of reproductive health care programmes. The paper proposes that sophisticated and dynamic strategies in Africa and elsewhere which target women's reproductive health and research (such as control of STDs including AIDS, family planning, infertility investigation) require complementary linkage to the study and education of men. Men's perceptions, as well as determinants of sexual behavioural change and the socioeconomic context in which STDs, including AIDS, become rife, should be reviewed. There is a need to study and foster change to reduce or prevent poor reproductive health outcomes; to identify behaviours which could be adversely affecting women's reproductive health. Issues of gender, identity and tolerance as expressed through sexuality and procreation need to be amplified in the context of present risks in reproductive health. Researchers and providers often ignore the social significance of men. This paper reviews the impact of male dominance, as manifested through reproductive health and sexual decisions, against the background of present reproductive health problems. A research agenda should define factors at both macro and micro levels that interact to adversely impinge on reproductive health outcomes. This should be followed up by well-developed causal models of the determinants of positive reproductive health-promoting behaviours. Behaviour specific influences in sexual partnership include the degree of interpersonal support towards prevention, for example, of STDs, unwanted pregnancy or maternal deaths

  15. Adverse Health Effects of Nighttime Lighting

    NASA Astrophysics Data System (ADS)

    Motta, M.

    2012-06-01

    The effects of poor lighting and glare on public safety are well-known, as are the harmful environmental effects on various species and the environment in general. What is less well-known is the potential harmful medical effects of excessive poor nighttime lighting. A significant body of research has been developed over the last few years regarding this problem. One of the most significant effects is the startling increased risk for breast cancer by excessive exposure to nighttime lighting. The mechanism is felt to be by disruption of the circadian rhythm and suppression of melatonin production from the pineal gland. Melatonin has an anticancer effect that is lost when its production is disrupted. I am in the process of developing a monograph that will summarize this important body of research, to be presented and endorsed by the American Medical Association, and its Council of Science and Public health. This paper is a brief overall summary of this little known potential harmful effect of poor and excessive nighttime lighting.

  16. Adverse health effects of indoor moulds.

    PubMed

    Piecková, Elena

    2012-12-01

    Building associated illnesses - sick building syndrome (SBS) as a common example - are associated with staying in buildings with poor indoor air quality. The importance of indoor fungal growth in this phenomenon continues to be evident, even though no causative relation has been established so far. Indoor humidity is strongly associated with the symptoms of SBS. Fungal metabolites that may induce ill health in susceptible occupants comprise beta-D-glucan, mycotoxins, and volatile organic compounds as known irritants and/or immunomodulators. Indoor toxic fungal metabolites might be located in micromycetal propagules (endometabolites), in (bio-)aerosol, detritus, and house dust (exometabolites) as their particular carriers. It is highly probable that hyphal fragments, dust, and particles able to reach the alveoli have the strongest depository and toxic potential. Most fungal spores are entrapped by the upper respiratory tract and do not reach further than the bronchi because of their size, morphology, and the mode of propagation (such as slime heads and aggreggation). This is why studies of the toxic effects of fungal spores prefer directly applying metabolite mixtures over mimicking real exposure. Chronic low-level exposure to a mixture of fungal toxicants and other indoor stressors may have synergistic effects and lead to severe neuroendocrineimmune changes. PMID:23334050

  17. Prenatal screening, reproductive choice, and public health.

    PubMed

    Wilkinson, Stephen

    2015-01-01

    One widely held view of prenatal screening (PNS) is that its foremost aim is, or should be, to enable reproductive choice; this is the Pure Choice view. The article critiques this position by comparing it with an alternative: Public Health Pluralism. It is argued that there are good reasons to prefer the latter, including the following. (1) Public Health Pluralism does not, as is often supposed, render PNS more vulnerable to eugenics-objections. (2) The Pure Choice view, if followed through to its logical conclusions, may have unpalatable implications, such as extending choice well beyond health screening. (3) Any sensible version of Public Health Pluralism will be capable of taking on board the moral seriousness of abortion and will advocate, where practicable, alternative means of reducing the prevalence of disease and disability. (4) Public Health Pluralism is at least as well-equipped as the Pure Choice model to deal with autonomy and consent issues. PMID:25521971

  18. Prenatal Screening, Reproductive Choice, and Public Health

    PubMed Central

    Wilkinson, Stephen

    2015-01-01

    One widely held view of prenatal screening (PNS) is that its foremost aim is, or should be, to enable reproductive choice; this is the Pure Choice view. The article critiques this position by comparing it with an alternative: Public Health Pluralism. It is argued that there are good reasons to prefer the latter, including the following. (1) Public Health Pluralism does not, as is often supposed, render PNS more vulnerable to eugenics-objections. (2) The Pure Choice view, if followed through to its logical conclusions, may have unpalatable implications, such as extending choice well beyond health screening. (3) Any sensible version of Public Health Pluralism will be capable of taking on board the moral seriousness of abortion and will advocate, where practicable, alternative means of reducing the prevalence of disease and disability. (4) Public Health Pluralism is at least as well-equipped as the Pure Choice model to deal with autonomy and consent issues. PMID:25521971

  19. Sexual and reproductive health and rights in changing health systems.

    PubMed

    Sen, Gita; Govender, Veloshnee

    2015-01-01

    Sexual and reproductive health and rights (SRHR) are centrally important to health. However, there have been significant shortcomings in implementing SRHR to date. In the context of health systems reform and universal health coverage/care (UHC), this paper explores the following questions. What do these changes in health systems thinking mean for SRHR and gender equity in health in the context of renewed calls for increased investments in the health of women and girls? Can SRHR be integrated usefully into the call for UHC, and if so how? Can health systems reforms address the continuing sexual and reproductive ill health and violations of sexual and reproductive rights (SRR)? Conversely, can the attention to individual human rights that is intrinsic to the SRHR agenda and its continuing concerns about equality, quality and accountability provide impetus for strengthening the health system? The paper argues that achieving equity on the UHC path will require a combination of system improvements and services that benefit all, together with special attention to those whose needs are great and who are likely to fall behind in the politics of choice and voice (i.e., progressive universalism paying particular attention to gender inequalities). PMID:25536851

  20. Sexual and reproductive health and rights in changing health systems

    PubMed Central

    Sen, Gita; Govender, Veloshnee

    2015-01-01

    Sexual and reproductive health and rights (SRHR) are centrally important to health. However, there have been significant shortcomings in implementing SRHR to date. In the context of health systems reform and universal health coverage/care (UHC), this paper explores the following questions. What do these changes in health systems thinking mean for SRHR and gender equity in health in the context of renewed calls for increased investments in the health of women and girls? Can SRHR be integrated usefully into the call for UHC, and if so how? Can health systems reforms address the continuing sexual and reproductive ill health and violations of sexual and reproductive rights (SRR)? Conversely, can the attention to individual human rights that is intrinsic to the SRHR agenda and its continuing concerns about equality, quality and accountability provide impetus for strengthening the health system? The paper argues that achieving equity on the UHC path will require a combination of system improvements and services that benefit all, together with special attention to those whose needs are great and who are likely to fall behind in the politics of choice and voice (i.e., progressive universalism paying particular attention to gender inequalities). PMID:25536851

  1. Long-term Adverse Effects of Neonatal Exposure to Bisphenol A on the Murine Female Reproductive Tract

    PubMed Central

    Newbold, Retha R.; Jefferson, Wendy N.; Banks, Elizabeth Padilla

    2007-01-01

    The developing fetus is uniquely sensitive to perturbation by chemicals with hormone-like activity. The adverse effects of prenatal diethylstilbestrol (DES) exposure are a classic example. Since concern has been mounting regarding the human health and environmental effects of bisphenol A (BPA), a high-production-volume chemical with estrogenic activity used in the synthesis of plastics, we investigated its long-term effects in an experimental animal model that was previously shown useful in studying the adverse effects of developmental exposure to DES. Outbred female CD-1 mice were treated on days 1-5 with subcutaneous injections of BPA (10, 100 or 1000 μg/kg/day) dissolved in corn oil or corn oil alone (Control). At 18 months, ovaries and reproductive tract tissues were examined. There was a statistically significant increase in cystic ovaries and cystic endometrial hyperplasia (CEH) in the BPA-100 group as compared to Controls. Progressive proliferative lesion (PPL) of the oviduct and cystic mesonephric (Wolffian) duct remnants were also seen in all of the BPA groups. More severe pathologies of the uterus following neonatal BPA treatment included adenomyosis, leiomyomas, atypical hyperplasia, and stromal polyps. These data suggest that BPA causes long-term adverse effects if exposure occurs during critical periods of differentiation. PMID:17804194

  2. Separate and Cumulative Effects of Adverse Childhood Experiences in Predicting Adult Health and Health Care Utilization

    ERIC Educational Resources Information Center

    Chartier, Mariette J.; Walker, John R.; Naimark, Barbara

    2010-01-01

    Objectives: Objectives of this population-based study were: (1) to examine the relative contribution of childhood abuse and other adverse childhood experiences to poor adult health and increased health care utilization and (2) to examine the cumulative effects of adverse childhood experiences on adult health and health care utilization. Methods:…

  3. Proceedings of the Summit on Environmental Challenges to Reproductive Health and Fertility: Executive Summary

    PubMed Central

    Woodruff, Tracey J.; Carlson, Alison; Schwartz, Jackie M.; Giudice, Linda C.

    2008-01-01

    The 2007 Summit on “Environmental Challenges to Reproductive Health and Fertility” convened scientists, health care professionals, community groups, political representatives and the media to hear presentations on the impact of environmental contaminants on reproductive health and fertility and to discuss opportunities to improve health through research, education, communication and policy. Environmental reproductive health focuses on exposures to environmental contaminants, particularly during critical periods of development, and their potential effects on future reproductive health, including conception, fertility, pregnancy, adolescent development and adult health. Approximately 87,000 chemical substances are registered for use in commerce in the US, with ubiquitous human exposures to environmental contaminants in air, water, food and consumer products. Exposures during critical windows of susceptibility may result in adverse effects with lifelong and even intergenerational health impacts. Effects can include impaired development and function of the reproductive tract and permanently altered gene expression, leading to metabolic and hormonal disorders, reduced fertility and fecundity and illnesses such as testicular, prostate, uterine and cervical cancers later in life. This executive summary reviews effects of pre- and post-natal exposures on male and female reproductive health and provides a series of recommendations for advancing the field in the areas of research, policy, health care and community action. PMID:18275883

  4. Using accountability to improve reproductive health care.

    PubMed

    George, Asha

    2003-05-01

    Accountability is best understood as a referee of the dynamics in two-way relationships, often between unequal partners. The literature on accountability distinguishes between political, fiscal, administrative, legal and constitutional accountability. This paper focuses on accountability mechanisms in health care and how they mediate between service providers and communities and between different kinds of health personnel at the primary health care level. It refers to case studies of participatory processes for improving sexual and reproductive health service delivery. Information, dialogue and negotiation are important elements that enable accountability mechanisms to address problems by supporting change and engagement between participants. In order to succeed, however, efforts towards better accountability that broaden the participation of users must take into account the social contexts and the policy and service delivery systems in which they are applied, address power relations and improve the representation of marginalised groups within communities and service delivery systems. PMID:12800713

  5. Reproductive health, youth, and the law.

    PubMed

    Paxman, J M

    1984-01-01

    This article surveys legal and policy approaches to adolescent health care programs and presents data on the availability of sex education programs, contraception, and abortion for adolescents in selected countries in the developed and developing world. The age at which youth are considered legally able reach independent decisions on matters affecting their health varies from country to country, although there is a trend toward setting the "age of majority" at 18 years. There has also been a trend toward viewing laws that require parental consent to health care and treatment as a barrier to health rather than a form of protection. Alternative legal approaches to the dilemma of consent have included lowering the age of majority for purposes of medical treatment, permitting professionals tojude whether an adolescent has sufficient maturity to give consent, and the use of third-party consent (e.g. child advocate). Cultural diversity mitigates against a universal legal approach to reproductive health education. There is wide variation in the policy response to questions such as whether reproductive health education courses should be permitted within the school curriculum, whether they should be obligatory or elective, if there should be separate courses or integration of fertility-related material into existing courses, and whether the sexes should be separated for instruction. There is awareness that formal sex education programs in a school setting cannot reach the large number of adolescents outside the educational system, but laws regarding public dissemination of reproductive health information are often restrictive. Contraceptive-related law and policy affect who has access to contraception and under what conditions. Abortion law takes 2 different forms: those that establish the retionales on which a given pregnancy may be terminated and those that establish the formal procedural requirements that must be met. It is concluded that, overall, law and policy have

  6. Epigenetics: A key paradigm in reproductive health

    PubMed Central

    Bunkar, Neha; Pathak, Neelam; Lohiya, Nirmal Kumar

    2016-01-01

    It is well established that there is a heritable element of susceptibility to chronic human ailments, yet there is compelling evidence that some components of such heritability are transmitted through non-genetic factors. Due to the complexity of reproductive processes, identifying the inheritance patterns of these factors is not easy. But little doubt exists that besides the genomic backbone, a range of epigenetic cues affect our genetic programme. The inter-generational transmission of epigenetic marks is believed to operate via four principal means that dramatically differ in their information content: DNA methylation, histone modifications, microRNAs and nucleosome positioning. These epigenetic signatures influence the cellular machinery through positive and negative feedback mechanisms either alone or interactively. Understanding how these mechanisms work to activate or deactivate parts of our genetic programme not only on a day-to-day basis but also over generations is an important area of reproductive health research. PMID:27358824

  7. [Toxocariasis: spread and impact on reproductive health].

    PubMed

    Gasanova, T A

    2003-01-01

    To study the prevalence of toxocariasis and its impact on the reproductive health of inhabitants in the Saratov Region, enzyme immunoassay was used to examine 1404 patients, including 210 children, 912 females, and 282 males. Toxocariasis was shown to be a risk factor of male (oligoasthenozoospermia) and female (tuboperitoneal) infertility. The high incidence of toxocariasis in females with reproductive dysfunction (recurrent abortion) and an aggravated obstetric history complicated by chronic renal diseases is indicative of the existence of the urogenital form of toxocariasis. Toxocariasis greatly increases a risk of giving birth to a baby with clinical manifestations of intrauterine infection (IUI), promotes homeostatic disorder and the formation of long-term pathology in babies with IUI. At the same time, there was a significant relationship of abnormal cardiotocograms to toxocariasis and to the presence of Trichomonas, Mycoplasma, Chlamydia, and Cytomegalovirus. PMID:14727482

  8. Speaking out for sexual and reproductive health.

    PubMed

    Nowrojee, S

    1993-01-01

    The view was presented that the living conditions of South Asian women do not allow for information, power, or support for controlling their own sexuality and reproductive health. Western biases are frequently incorporated into women's programs. The Asian rules governing women's sexuality are governed by sexism, racism, and class consciousness. Asian reproductive policies and programs need to break the silences, destroy the stereotypes, and give women control of their own sexuality and health. Cultures in South Asia prevent open discussion of sexuality, and the female body is considered "unclean." The perception of the Asian women who emigrated to the US is replete with visions of exotic sex or tightly controlled segregation. Asian males were denied involvement with American women. American servicemen abroad have used Asian women in the sex industry; the stereotyped Asian woman is "exotically beautiful, submissive, and willing." Stereotyped American pornography depicts female images in the Kama Sutra in a distorted way. The Asian community does not provide women with the information, tools, and services needed for Asian women to protect themselves from the consequences of unwanted and unprotected sex. The Asian community uses fear and shame to control women's sexuality outside the reproductive role. It is difficult for Asian women to exercise control over their own bodies or exercise reproductive choice. Decisions are made by husbands and families and may be dependent on the sex of the children born. Sexually transmitted diseases are not adequately diagnosed or treated. Asian women need to continue to speak out and to challenge the external controls on their sexuality. The consequences of the stereotyping and controls on Asian women's expression of sexuality are negative feelings about sexuality, lack of attention to proper gynecological care, and a lower likelihood of protection against unwanted pregnancy and sexually transmitted diseases. PMID:12290479

  9. Toxic Environmental Chemicals: The Role of Reproductive Health Professionals In Preventing Harmful Exposures

    PubMed Central

    SUTTON, Patrice; WOODRUFF, Tracey J.; PERRON, Joanne; STOTLAND, Naomi; CONRY, Jeanne A.; MILLER, Mark D.; GIUDICE, Linda C.

    2015-01-01

    Every pregnant woman in the U.S. is exposed to many and varied environmental chemicals. Rapidly accumulating scientific evidence documents that widespread exposure to environmental chemicals at levels encountered in daily life can adversely impact reproductive and developmental health. Preconception and prenatal exposure to environmental chemicals are of particular import because they may have a profound and lasting impact on health across the life course. Thus, preventing developmental exposures to environmental chemicals would benefit greatly from the active participation of reproductive health professionals in clinical and policy arenas. PMID:22405527

  10. Mapping of reproductive health financing: methodological challenges.

    PubMed

    Pradhan, Jalandhar; Sidze, Estelle Monique; Khanna, Anoop; Beekink, Erik

    2014-10-01

    Low level of funding for reproductive health (RH) is a cause for concern, given that RH service utilization in the vast majority of the developing world is well below the desired level. Though there is an urgent need to track the domestic and international financial resource flows for RH, the instruments through which financial resources are tracked in developing countries are limited. In this paper we examined the methodological and conceptual challenges of monitoring financial resources for RH services at international and national level. At the international level, there are a number of estimates that highlights the need for financial resources for RH programmes but the estimates vary significantly. At the national level, Reproductive Health Accounts (RHA) in the framework of National Health Accounts (NHA) is considered to be the ideal source to track domestic financial flows for RH activities. However, the weak link between data production by the RHA and its application by the stakeholders as well as lack of political will impedes the institutionalization of RHA at the country level. PMID:25200968

  11. Reproductive health patterns: Georgia versus Australia.

    PubMed

    Asatiani, T; Abuladze, N; Ward, H; Angel, P

    2015-03-01

    The review compares a few reproductive indicators - fertility, abortion and contraception in both a developing (Georgia) and a developed (Australia) country. Fertility, abortion and contraception figures in both countries tend to reflect the attitude and the degree of development of each countries sexual health education and their use of effective contraception. Further research is required to accurately evaluate the need and access of Georgian women to modern methods of family planning and their knowledge of the benefits of modern contraception that can assist to reduce pregnancy termination rate. In Australia better insight is needed on how to facilitate a shift to more efficacious long-term contraceptives across all age groups. PMID:25879552

  12. Childhood adversity and adult health: Evaluating intervening mechanisms.

    PubMed

    Turner, R Jay; Thomas, Courtney S; Brown, Tyson H

    2016-05-01

    Substantial evidence has accumulated supporting a causal link between childhood adversity and risk for poor health years and even decades later. One interpretation of this evidence is that this linkage arises largely or exclusively from a process of biological embedding that is not modifiable by subsequent social context or experience - implying childhood as perhaps the only point at which intervention efforts are likely to be effective. This paper considers the extent to which this long-term association arises from intervening differences in social context and/or environmental experiences - a finding that would suggest that post-childhood prevention efforts may also be effective. Based on the argument that the selected research definition of adult health status may have implications for the early adversity-adult health linkage, we use a representative community sample of black and white adults (N = 1252) to evaluate this relationship across three health indices: doctor diagnosed illnesses, self-rated health, and allostatic load. Results generally indicate that observed relationships between childhood adversity and dimensions of adult health status were totally or almost totally accounted for by variations in adult socioeconomic position (SEP) and adult stress exposure. One exception is the childhood SEP-allostatic load association, for which a statistically significant relationship remained in the context of adult stress and SEP. This lone finding supports a conclusion that the impact of childhood adversity is not always redeemable by subsequent experience. However, in general, analyses suggest the likely utility of interventions beyond childhood aimed at reducing exposure to social stress and improving social and economic standing. Whatever the effects on adult health that derive from biological embedding, they appear to be primarily indirect effects through adult social context and exposure. PMID:27030896

  13. Residential Proximity to Environmental Hazards and Adverse Health Outcomes

    PubMed Central

    Maantay, Juliana A.; Chakraborty, Jayajit

    2011-01-01

    How living near environmental hazards contributes to poorer health and disproportionate health outcomes is an ongoing concern. We conducted a substantive review and critique of the literature regarding residential proximity to environmental hazards and adverse pregnancy outcomes, childhood cancer, cardiovascular and respiratory illnesses, end-stage renal disease, and diabetes. Several studies have found that living near hazardous wastes sites, industrial sites, cropland with pesticide applications, highly trafficked roads, nuclear power plants, and gas stations or repair shops is related to an increased risk of adverse health outcomes. Government agencies should consider these findings in establishing rules and permitting and enforcement procedures to reduce pollution from environmentally burdensome facilities and land uses. PMID:22028451

  14. Energy Drink Consumption: Beneficial and Adverse Health Effects

    PubMed Central

    Alsunni, Ahmed Abdulrahman

    2015-01-01

    Consumption of energy drinks has been increasing dramatically in the last two decades, particularly amongst adolescents and young adults. Energy drinks are aggressively marketed with the claim that these products give an energy boost to improve physical and cognitive performance. However, studies supporting these claims are limited. In fact, several adverse health effects have been related to energy drink; this has raised the question of whether these beverages are safe. This review was carried out to identify and discuss the published articles that examined the beneficial and adverse health effects related to energy drink. It is concluded that although energy drink may have beneficial effects on physical performance, these products also have possible detrimental health consequences. Marketing of energy drinks should be limited or forbidden until independent research confirms their safety, particularly among adolescents. PMID:26715927

  15. Reproductive health of Gulf War veterans.

    PubMed

    Doyle, Patricia; Maconochie, Noreen; Ryan, Margaret

    2006-04-29

    In this review we summarize the scientific literature on reproductive health following deployment to the first Gulf war by armed service personnel. All the studies examined had methodological limitations, making interpretation difficult. Nonetheless we conclude that for male veterans there is no strong or consistent evidence to date for an effect of service in the first Gulf war on the risk of major, clearly defined, birth defects or stillbirth in offspring conceived after deployment. Effects on specific rare defects cannot be excluded at this stage since none of the studies had the statistical power to examine them. For miscarriage and infertility, there is some evidence of small increased risks associated with service, but the role of bias is likely to be strong. For female veterans, there is insufficient information to make robust conclusions, although the weight of evidence to date does not indicate any major problem associated specifically with deployment to the Gulf. None of the studies have been able to examine risk according particular exposures, and so possible associations with specific exposures for smaller groups of exposed veterans cannot be excluded. We suggest that the way forward to address the question of veterans' reproductive health with confidence in the future is prospective surveillance following deployment. Anything less will result in further problems of interpretation and continued anxiety for parents, as well as prospective parents, in the armed forces. PMID:16687262

  16. Reproductive health of Gulf War veterans

    PubMed Central

    Doyle, Patricia; Maconochie, Noreen; Ryan, Margaret

    2006-01-01

    In this review we summarize the scientific literature on reproductive health following deployment to the first Gulf war by armed service personnel. All the studies examined had methodological limitations, making interpretation difficult. Nonetheless we conclude that for male veterans there is no strong or consistent evidence to date for an effect of service in the first Gulf war on the risk of major, clearly defined, birth defects or stillbirth in offspring conceived after deployment. Effects on specific rare defects cannot be excluded at this stage since none of the studies had the statistical power to examine them. For miscarriage and infertility, there is some evidence of small increased risks associated with service, but the role of bias is likely to be strong. For female veterans, there is insufficient information to make robust conclusions, although the weight of evidence to date does not indicate any major problem associated specifically with deployment to the Gulf. None of the studies have been able to examine risk according particular exposures, and so possible associations with specific exposures for smaller groups of exposed veterans cannot be excluded. We suggest that the way forward to address the question of veterans' reproductive health with confidence in the future is prospective surveillance following deployment. Anything less will result in further problems of interpretation and continued anxiety for parents, as well as prospective parents, in the armed forces. PMID:16687262

  17. Doping with anabolic androgenic steroids (AAS): Adverse effects on non-reproductive organs and functions.

    PubMed

    Nieschlag, Eberhard; Vorona, Elena

    2015-09-01

    Since the 1970s anabolic androgenic steroids (AAS) have been abused at ever increasing rates in competitive athletics, in recreational sports and in bodybuilding. Exceedingly high doses are often consumed over long periods, in particular by bodybuilders, causing acute or chronic adverse side effects frequently complicated by additional polypharmacy. This review summarizes side effects on non-reproductive organs and functions; effects on male and female reproduction have been recently reviewed in a parallel paper. Among the most striking AAS side effects are increases in haematocrit and coagulation causing thromboembolism, intracardiac thrombosis and stroke as well as other cardiac disturbances including arrhythmias, cardiomyopathies and possibly sudden death. 17α-alkylated AAS are liver toxic leading to cholestasis, peliosis, adenomas and carcinomas. Hyperbilirubinaemia can cause cholemic nephrosis and kidney failure. AAS abuse may induce exaggerated self-confidence, reckless behavior, aggressiveness and psychotic symptoms. AAS withdrawal may be accompanied by depression and suicidal intentions. Since AAS abuse is not or only reluctantly admitted physicians should be aware of the multitude of serious side effects when confronted with unclear symptoms. PMID:26373946

  18. Predicting adverse drug events from personal health messages.

    PubMed

    Chee, Brant W; Berlin, Richard; Schatz, Bruce

    2011-01-01

    Adverse drug events (ADEs) remain a large problem in the United States, being the fourth leading cause of death, despite post market drug surveillance. Much post consumer drug surveillance relies on self-reported "spontaneous" patient data. Previous work has performed datamining over the FDA's Adverse Event Reporting System (AERS) and other spontaneous reporting systems to identify drug interactions and drugs correlated with high rates of serious adverse events. However, safety problems have resulted from the lack of post marketing surveillance information about drugs, with underreporting rates of up to 98% within such systems. We explore the use of online health forums as a source of data to identify drugs for further FDA scrutiny. In this work we aggregate individuals' opinions and review of drugs similar to crowd intelligence3. We use natural language processing to group drugs discussed in similar ways and are able to successfully identify drugs withdrawn from the market based on messages discussing them before their removal. PMID:22195073

  19. Dose-Dependent Adverse Effects of Salinomycin on Male Reproductive Organs and Fertility in Mice

    PubMed Central

    Ojo, Olajumoke Omolara; Bhadauria, Smrati; Rath, Srikanta Kumar

    2013-01-01

    . Spermatogenesis was however observed in testis 28 days after Salinomycin withdrawal. The results indicate reversible dose-dependent adverse effects of Salinomycin on male reproductive system of mice. PMID:23840907

  20. Linkages among reproductive health, maternal health, and perinatal outcomes.

    PubMed

    Bhutta, Zulfiqar A; Lassi, Zohra S; Blanc, Ann; Donnay, France

    2010-12-01

    Some interventions in women before and during pregnancy may reduce perinatal and neonatal deaths, and recent research has established linkages of reproductive health with maternal, perinatal, and early neonatal health outcomes. In this review, we attempted to analyze the impact of biological, clinical, and epidemiologic aspects of reproductive and maternal health interventions on perinatal and neonatal outcomes through an elucidation of a biological framework for linking reproductive, maternal and newborn health (RHMNH); care strategies and interventions for improved perinatal and neonatal health outcomes; public health implications of these linkages and implementation strategies; and evidence gaps for scaling up such strategies. Approximately 1000 studies (up to June 15, 2010) were reviewed that have addressed an impact of reproductive and maternal health interventions on perinatal and neonatal outcomes. These include systematic reviews, meta-analyses, and stand-alone experimental and observational studies. Evidences were also drawn from recent work undertaken by the Child Health Epidemiology Reference Group (CHERG), the interconnections between maternal and newborn health reviews identified by the Global Alliance for Prevention of Prematurity and Stillbirth (GAPPS), as well as relevant work by the Partnership for Maternal, Newborn and Child Health. Our review amply demonstrates that opportunities for assessing outcomes for both mothers and newborns have been poorly realized and documented. Most of the interventions reviewed will require more greater-quality evidence before solid programmatic recommendations can be made. However, on the basis of our review, birth spacing, prevention of indoor air pollution, prevention of intimate partner violence before and during pregnancy, antenatal care during pregnancy, Doppler ultrasound monitoring during pregnancy, insecticide-treated mosquito nets, birth and newborn care preparedness via community-based intervention

  1. Women still bearing the blows in reproductive health.

    PubMed

    1992-01-01

    Only women can experience the health threats of pregnancy and childbirth. Responsibility for the survival, growth, and development of children falls mainly on their shoulders. Sexually transmitted diseases cause more severe effects in women than men. Women are 3 times more likely to use contraceptives than men Yet female contraceptive methods are more of a threat to health an are male methods. Even though infertility occurs in both men and women, in most countries, women face its negative social and psychological effects more often than do men. Besides, almost everywhere, social and economic indicators show women to be of lower status than men. For example, female literacy rates in developing countries are 33% lower than those of male, even though leaders have known for a long time that female education improves use of health care and family planning services. Furthermore, females are at a disadvantage from birth in terms of education, nutrition, and society which places them at high risk of adverse health. Some societies even endorse method to prevent women from enjoying sexual intercourse. Premarital sex and adolescent pregnancy are increasing worldwide, which adds to women's already high burden. In Argentina, women less than 18 years of age, especially those in rural areas and little education, have higher fertility rates than those older than 18 years. They tend to be ignorant of reproductive processes, but familiar with contraceptives; yet, only 40% of sexually active adolescents had ever used them. Besides, teenage males think that concern about becoming pregnant is the female's responsibility. Indeed, women's status and reproductive health are interrelated. Ability to regulate their own fertility strengthens women's status, but if they cannot do so, they cannot go to school, be employable, or make their own decisions. PMID:12344677

  2. Mercury in fish and adverse reproductive outcomes: results from South Carolina

    PubMed Central

    2014-01-01

    Background Mercury is a metal with widespread distribution in aquatic ecosystems and significant neurodevelopmental toxicity in humans. Fish biomonitoring for total mercury has been conducted in South Carolina (SC) since 1976, and consumption advisories have been posted for many SC waterways. However, there is limited information on the potential reproductive impacts of mercury due to recreational or subsistence fish consumption. Methods To address this issue, geocoded residential locations for live births from the Vital Statistics Registry (1995–2005, N = 362,625) were linked with spatially interpolated total mercury concentrations in fish to estimate potential mercury exposure from consumption of locally caught fish. Generalized estimating equations were used to test the hypothesis that risk of low birth weight (LBW, <2,500 grams) or preterm birth (PTB, <37 weeks clinical gestation) was greater among women living in areas with elevated total mercury in fish, after adjustment for confounding. Separate analyses estimated term LBW and PTB risks using residential proximity to rivers with fish consumption advisories to characterize exposure. Results Term LBW was more likely among women residing in areas in the upper quartile of predicted total mercury in fish (odds ratio [OR] = 1.04; 95% confidence interval [CI]: 1.00-1.09) or within 8 kilometers of a river with a ‘do not eat’ fish advisory (1.05; 1.00-1.11) compared to the lowest quartile, or rivers without fish consumption restrictions, respectively. When stratified by race, risks for term LBW or PTB were 10-18% more likely among African-American (AA) mothers living in areas with the highest total fish mercury concentrations. Conclusions To our knowledge, this is the first study to examine the relationship between fish total mercury concentrations and adverse reproductive outcomes in a large population-based sample that included AA women. The ecologic nature of exposure assessment in this study

  3. Focusing on reproductive health for adolescents.

    PubMed

    1995-06-01

    JOICFP is producing a still photo video consisting of three segments from photos shot in Bangladesh (April 22 - May 2), Thailand (May 2-15), and Mexico (June 29 - July 7) in 1995. The first segment highlights the daily life of a husband, aged 20, and his wife, Moni, aged 14. Moni married at age 13, before the onset of menstruation, and now serves and feeds her husband's large extended family. The Family Planning Association of Bangladesh (FPAB), the local implementing agent of the Sustainable Community-based Family Planning/Maternal and Child Health (FP/MCH) Project with Special Focus on Women, which is supported by the United Nations Population Fund (UNFPA) and executed by JOICFP, introduced Moni to the concept of reproductive health and encouraged her to join other women in activities designed to improve their health and raise their economic status. The second segment depicts the life of a former commercial sex worker who is undergoing occupational skill development training promoted by the Population and Community Development Association. The girl is now a leader of teenagers in her village; she works to change attitudes that sent her to work as a prostitute with an estimated 150,000 other poor rural teenage women. The third segment focuses on teen pregnancy and the efforts of the Mexican Foundation for Family Planning (MEXFAM) in the areas of health care and education for adolescents. PMID:12289887

  4. [World plan for reproductive autonomy and health].

    PubMed

    Ospina, P

    1994-06-01

    The principal objective of the Third International Conference on Population and Development to be held in Cairo in 1994 is to achieve consensus on a Plan of Action to reinforce reproductive rights of individuals, who bear ultimate responsibility for slowing population growth. The Plan of Action should be adopted by all the peoples of the world in order to stabilize population growth during the next twenty years by means of programs to provide family planning and reproductive health services. The preliminary conference document incorporated recommendations and proposals of two preparatory committees, five regional conferences, six expert meetings, 109 countries, and over 400 nongovernmental organizations from around the world. At current rates of growth, the world's 5.7 billion inhabitants will increase to 9.1 billion by the year 2025, vastly increasing pressure on already limited resources and ecosystems. The central theme of the first World Population Conference in Bucharest in 1974 was the close relationship between population growth and socioeconomic development. The 1974 World Population Plan of Action stressed development of strategies to achieve a better quality of life and rapid socioeconomic development. Recommendations of the 1984 World Population Conference in Mexico remained centered on implementation of the Bucharest Plan of Action with a few additions. Although progress has been achieved in meeting the goals of the Bucharest Plan of Action, growth rates of some developing countries have actually increased. Poverty, unemployment, illiteracy, and discrimination against women are still obstacles to socioeconomic development, and contraceptive usage has not reached optimal levels. Urban migration remains excessive. Progress for many countries over the past decade has been directly related to increasing the access of women to health care and family planning. Themes related to women's status and rights will be incorporated in the 1994 Cairo Conference. The

  5. Essential medicines for reproductive health: developing evidence based interagency list

    PubMed Central

    Logez, Sophie; Jayasekar, Shalini; Moller, Helene; Ahmed, Kabir; Patel, Margaret Usher

    2011-01-01

    Objectives: Although poor reproductive health constitutes a significant proportion of the disease burden in developing countries, essential medicines for reproductive health are often not available to the population. The objective was to analyze the guiding principles for developing national Essential Medicines Lists (EML). The second objective was to compare the reproductive health medicines included on these EMLs to the 2002 WHO/UNFPA list of essential drugs and commodities for reproductive health. Another objective was to compare the medicines included in existing international lists of medicines for reproductive health. Methods: The authors calculated the average number of medicines per clinical groups included in 112 national EMLs and compared these average numbers with the number of medicines per clinical group included on the WHO/UNFPA List. Additionally, they compared the content of the lists of medicines for reproductive health developed by various international agencies. Results: In 2003, the review of the 112 EMLs highlighted that medicines for reproductive health were not consistently included. The review of the international lists identified inconsistencies in their recommendations. The reviews’ outcomes became the catalyst for collaboration among international agencies in the development of the first harmonized Interagency List of Essential Medicines for Reproductive Health. Additionally, WHO, UNFPA and PATH published guidelines to support the inclusion of essential medicines for reproductive health in national medicine policies and EMLs. The Interagency List became a key advocacy tool for countries to review their EMLs. In 2009, a UNFPA/WHO assessment on access to reproductive health medicines in six countries demonstrated that the major challenge was that the Interagency List had not been updated recently and was inconsistently used. Conclusion: The addition of cost-effective medicines for reproductive health to EMLs can result in enhanced equity

  6. Neighborhood adversity, child health, and the role for community development.

    PubMed

    Jutte, Douglas P; Miller, Jennifer L; Erickson, David J

    2015-03-01

    Despite medical advances, childhood health and well-being have not been broadly achieved due to rising chronic diseases and conditions related to child poverty. Family and neighborhood living conditions can have lasting consequences for health, with community adversity affecting health outcomes in significant part through stress response and increased allostatic load. Exposure to this "toxic stress" influences gene expression and brain development with direct and indirect negative consequences for health. Ensuring healthy child development requires improving conditions in distressed, high-poverty neighborhoods by reducing children's exposure to neighborhood stressors and supporting good family and caregiver functioning. The community development industry invests more than $200 billion annually in low-income neighborhoods, with the goal of improving living conditions for residents. The most impactful investments have transformed neighborhoods by integrating across sectors to address both the built environment and the social and service environment. By addressing many facets of the social determinants of health at once, these efforts suggest substantial results for children, but health outcomes generally have not been considered or evaluated. Increased partnership between the health sector and community development can bring health outcomes explicitly into focus for community development investments, help optimize intervention strategies for health, and provide natural experiments to build the evidence base for holistic interventions for disadvantaged children. The problems and potential solutions are beyond the scope of practicing pediatricians, but the community development sector stands ready to engage in shared efforts to improve the health and development of our most at-risk children. PMID:25733725

  7. Evaluation of Female Youth Educational Needs about Reproductive Health in Non-Medical Students in the City of Qom

    PubMed Central

    Bazarganipour, Fatemeh; Foroozanfard, Fatemeh; Taghavi, Seyed Abdolvahab; Hekmatzadeh, Fatemeh; Sarviye, Malihe

    2013-01-01

    Objective To evaluate reproductive health education which is essential to the prevention of sexual risk behavior and its associated adverse outcomes of unwanted pregnancy, AIDS and other sexually transmitted disease in adolescents. Little is known about youth educational needs about reproductive health in Iran. The aim of this study is evaluation of female youth educational needs about reproductive health in non-medical universities in the city of Qom, north central of Iran. Materials and methods The study was descriptive-analytical type conducted in nine non-medical universities (400 students). A questionnaire was constructed to meet the purpose of the study based on similar studies of knowledge and attitude in different countries, yet it was modified according to Iranian culture and social norms. Results The findings showed that a majority of participants have moderate knowledge about all components of reproductive health. Approximately, one - third of the participants reported difficulties to discuss about sexual health with mothers. The most of the participants believed insufficient female youth reproductive health services and low knowledge about reproductive health were the main barriers for female youth reproductive health aims. Conclusion The participants in this study are representatives of an important subgroup in Iran in order to evaluate female youth reproductive health educational needs. The study identified many misconception and negative attitude that need to be addressed. A health education program through parents, peers, mass media campaign and more comprehensive family planning curriculum in universities are recommended to overcome misconception and spread awareness. PMID:24971106

  8. Knowledge, attitudes, and practices in reproductive and sexual health

    PubMed Central

    Beckwith, Jessica

    2006-01-01

    To help support and direct the Lions Club's construction of a Community Health Clinic specializing in Reproductive and Sexual Health, this descriptive study began in November of 2004 and was completed in May 2005. The sample consists of 552 high school students in Rumiñahui County, and surveys were used to study four principle themes: reproductive and sexual health education, family planning, sexually transmitted infections, and domestic violence. The results show a widespread lack of accurate and adequate information about reproductive and sexual health. Statistically significant variables studied include sex, age, monthly income, and age of first sexual experience. Female sex, younger age, lower monthly income, and younger age of first sexual experience all contribute to a lower quality of reproductive and sexual health, in terms of having less information about and access to these four aspects of reproductive and sexual health. PMID:18523623

  9. Adverse Childhood Experiences and the Mental Health of Veterans.

    PubMed

    McGuinness, Teena M; Waldrop, Jessica R

    2015-06-01

    Many U.S. Veterans have experienced the burdens of mental illness and suicide. The current article focuses on Veterans who served from 2001-2015. Although combat exposure and suicidal ideation are linked, approximately one half of all suicides among Active Duty service members (who have served since 2001) occurred among those who never deployed. Researchers who sought additional risks for suicide found that Veterans have greater odds of adversities in childhood than the general population. Adverse childhood experiences are stressful and traumatic experiences, including abuse and neglect, as well as witnessing household dysfunction, or growing up with individuals with mental illness or substance abuse. Further, childhood physical abuse has been shown to be a significant predictor for posttraumatic stress disorder and suicide. Adverse childhood experiences confer additional risk for the mental health of service members. Psychiatric nursing implications include the importance of assessing early childhood adversity during psychosocial assessments. Providing trauma-informed strategies for treatment is an essential element of psychiatric nursing care. PMID:26091547

  10. Can aircraft noise less than or equal 115 to dBA adversely affect reproductive outcome in USAF women?

    NASA Astrophysics Data System (ADS)

    Brubaker, P. A.

    1985-06-01

    It has been suggested, mainly through animal studies, that exposure to high noise levels may be associated with lower birth weight, reduced gestational length and other adverse reproductive outcomes. Few studies have been done on humans to show this association. The Air Force employs pregnant women in areas where there is a high potential for exposure to high noise levels. This study proposes a method to determine if there is an association between high frequency noise levels or = 115 dBA and adverse reproductive outcomes through a review of records and self-administered questionnaires in a case-comparison design. Prevelance rates will be calculated and a multiple logistic regression analysis computed for the independent variables that can affect reproduction.

  11. Contributions of the Nurses’ Health Studies to Reproductive Health Research

    PubMed Central

    Rich-Edwards, Janet W.; Gaskins, Audrey J.; Farland, Leslie V.; Terry, Kathryn L.; Zhang, Cuilin; Missmer, Stacey A.

    2016-01-01

    Objectives. To review the Nurses’ Health Study’s (NHS’s) contribution to identifying risk factors and long-term health consequences of reproductive events. Methods. We performed a narrative review of the NHS I, NHS II, NHS3, and Growing Up Today Study (GUTS) publications between 1976 and 2016. Results. Collection of detailed reproductive history to identify breast cancer risk factors allowed the NHS to document an association between menstrual irregularities, a proxy for polycystic ovary syndrome (PCOS), and increased risk of diabetes and cardiovascular disease. The NHS II found that infertility associated with ovulation problems and gestational diabetes are largely preventable through diet and lifestyle modification. It also identified developmental and nutritional risk factors for pregnancy loss, endometriosis, and uterine leiomyomata. As women in NHS II age, it has become possible to address questions regarding long-term health consequences of pregnancy complications and benign gynecologic conditions on chronic disease risk. Furthermore, the NHS3 and GUTS are allowing new lines of research into human fertility, PCOS, and transgenerational effects of environmental exposures. Conclusions. The multigenerational resources of the NHSs and GUTS, including linkages of related individuals across cohorts, can improve women’s health from preconception through late adulthood and onto the next generation. PMID:27459445

  12. Narghile smoking and its adverse health consequences: a literature review.

    PubMed

    Dar-Odeh, N S; Abu-Hammad, O A

    2009-06-13

    Oral squamous cell carcinoma (OSCC) is a world health problem with approximately 50% of patients having a 5-year survival rate. A change in the demographics of the disease is now being recognised, particularly in Europe, where it is increasingly being seen in young males. While a variety of risk factors are important in OSCC, it is tobacco that plays a central part in the pathogenesis of the disease. Narghile is an old form of tobacco use but in the past decade, there has been a resurgence in this form of smoking. The practice is particularly common in young males and females from the Middle East but with the advent of immigration and globalisation, its use is becoming more widespread. It is now not uncommon to see narghile smoking in western countries such as the UK and USA. Studies describing the oral effects of narghile are unfortunately scarce. While adverse effects such as periodontal bone loss and dry socket have been described, its association with OSCC cannot be excluded. Variation in the type of narghile, the type of tobacco and the presence of co-factors such as cigarette smoking may all influence clinical outcome. In the present study, the practice of narghile smoking is reviewed in terms of its effect on health, particularly oral health. The association of narghile smoking and adverse effects on the orofacial region will be outlined, namely, periodontal disease, potentially malignant lesions and oral cancer. PMID:19521371

  13. Predicting Adverse Drug Events from Personal Health Messages

    PubMed Central

    Chee, Brant W.; Berlin, Richard; Schatz, Bruce

    2011-01-01

    Adverse drug events (ADEs) remain a large problem in the United States, being the fourth leading cause of death, despite post market drug surveillance. Much post consumer drug surveillance relies on self-reported “spontaneous” patient data. Previous work has performed datamining over the FDA’s Adverse Event Reporting System (AERS) and other spontaneous reporting systems to identify drug interactions and drugs correlated with high rates of serious adverse events. However, safety problems have resulted from the lack of post marketing surveillance information about drugs, with underreporting rates of up to 98% within such systems1,2. We explore the use of online health forums as a source of data to identify drugs for further FDA scrutiny. In this work we aggregate individuals’ opinions and review of drugs similar to crowd intelligence3. We use natural language processing to group drugs discussed in similar ways and are able to successfully identify drugs withdrawn from the market based on messages discussing them before their removal. PMID:22195073

  14. The Stigma of Reproductive Health Services Utilization by Unmarried Women

    PubMed Central

    Mohammadi, Fatemeh; Kohan, Shahnaz; Mostafavi, Firoozeh; Gholami, Ali

    2016-01-01

    Background: Fear of the stigma associated with reproductive health services has always been one of the reasons why youth and unmarried individuals avoid making use of such services. This stigma imposes a great deal of mental stress, fear, and depression on patients and causes delays in the diagnosis and treatment of their conditions. Objectives: This paper explores the concept of stigma in the context of the utilization of reproductive health services by unmarried women. Patients and Methods: This study is qualitative in nature. Purposive sampling was employed, and semi-structured interviews were conducted with 16 unmarried women, five midwives, and two physicians. The data were analyzed using the conventional content analysis method. Results: Four main categories constituted the general concept concerning the stigma suffered by unmarried women for using reproductive health services, i.e., prevalent stereotypical thinking patterns in society, the fear of being judged and labeled by others, discrimination, and feeling ashamed of seeking reproductive health services. Conclusions: The findings indicated that society associates reproductive health issues with sexual relations, which in turn shapes the stigma and places limitations on unmarried women for using reproductive health services. Thus, while reproductive health services are planned and provided to unmarried women, strategies are demanded for overcoming this stigma. PMID:27247794

  15. Maternal mortality and morbidity. Women's reproductive health in Tanzania.

    PubMed

    Alloo, F

    1994-01-01

    Sexuality is a taboo for women in a patriarchal society. Tanzania has inadequate reproductive health care. Aspects of reproductive health are dealt with in safe motherhood or maternal and child health programs. Tanzania's health policy is based on women as mothers; it does not refer to women's right. For women in Tanzania, reproductive health is the right to live. Thousands of Tanzanian women die every year due to maternal complications. In an effort to contribute to the improvement of the conditions in health institutions and the advancement of women's status in the country, the Tanzania Media Women's Association (TAMWA) and the Medical Women's Association of Tanzania (MEWATA) joined in the organization of a Reproductive Health Meeting in Dar es Salaam. At the conference, major factors causing maternal mortality and morbidity, such as complications of abortion, anaemia in pregnancy, hypertensive disorders in pregnancy and puerperal sepsis, were discussed. A World Health Organization (WHO) report indicated that maternal mortality in Tanzania was 200-400/100,000 live births, while a survey conducted by MEWATA showed that maternal deaths at the Muhimbili Medical Center in the capital were 754/100,000 live births in 1991. Many maternal deaths could be prevented if hospitals were be properly equipped. Tanzanian women's poor health results in large part from their low socioeconomic status, poor nutrition, lack of income and employment. TAMWA chairperson Fatma Alloo and Dr. Kimambo (Ministry of Health) endorsed a national women's health movement to demand a government commitment to a holistic reproductive health policy. PMID:12288398

  16. Male Involvement: Implications for Reproductive and Sexual Health Programs

    ERIC Educational Resources Information Center

    Edmunds, Lena; Rink, Elizabeth; Zukoski, Ann P.

    2004-01-01

    The sexual health needs of young males have been largely ignored in the field of reproductive health. Until recently, the health care needs of females have received the vast majority of attention from public health professionals and organizations with services focused on the prevention of teen pregnancy, sexually transmitted infections, and…

  17. Reproductive health and blurred professional boundaries.

    PubMed

    Chavkin, W; Breitbart, V

    1996-01-01

    We recognize that many of the issues raised are not simple. Our proposal calls for the same thoughtful deliberation applied in other settings to be brought to bear on reproductive health care. Some have already tried alternative approaches. In Albuquerque, New Mexico, a university hospital neonatologist and the district attorney have collaborated to create an alternative to sentencing program for women who are arrested for drug-related crimes and found to be both pregnant and drug addicted. Rather than proceed with criminal sanctions, these women are offered entry into a drug treatment program that is geared to families with young children and run by the pediatrics department. Here, the physician and the district attorney collaboratively responded in ways congruent with the professional integrity of each. In another example in Portland, Oregon, physicians, drug treatment providers, and child protective social service representatives cooperatively defeated a legislative proposal to mandatorily test and report pregnant women for illicit drug use and, instead, formed a task force to jointly develop state policy regarding the issue. Drug use, HIV infection, child abuse, and poverty are all cause for alarm. Yet it is critical that our frustration about these difficult problems not be translated into blaming individuals for "deviance," or into short-term inadequate responses. In developing policy we should consider the impact on the legal and ethical rights and obligations of both patient and physician. For every course, we should evaluate both immediate and long-term efficacy, the consequences for the doctor-patient relationship, and the consequences for medical integrity. In the midst of the present regulatory and fiscal turmoil affecting health care, we urge physicians to be careful and deliberate in the policies they embrace and the actions they take. PMID:8932462

  18. Reproductive health and the environment: Counseling patients about risks.

    PubMed

    Haruty, Bella; Friedman, Julie; Hopp, Stephanie; Daniels, Ryane; Pregler, Janet

    2016-05-01

    Endocrine-disrupting chemicals (EDCs) are associated with reproductive complications such as infertility, pregnancy complications, poor birth outcomes, and child developmental abnormalities, although not all chemicals of concern are EDCs. Pregnant patients and women of childbearing age need reasonable advice about environmental contaminants and reproductive health. PMID:27168513

  19. Should Reproductive Anatomy Be Taught in University Health Courses?

    ERIC Educational Resources Information Center

    Powell, Brent; Fletcher, J. Sue

    2013-01-01

    There has been little research on undergraduate reproductive anatomy education. This pilot study explores knowledge of anatomical reproductive anatomy among university students in a lower division and upper division health course. Using a Qualtrics survey program, a convenience sample of 120 lower division and 157 upper division students for a…

  20. Biomarkers for assessing reproductive development and health: Part 1--Pubertal development.

    PubMed Central

    Rockett, John C; Lynch, Courtney D; Buck, Germaine M

    2004-01-01

    The proposed National Children's Study has helped raise awareness of the issues related to children's health and the importance of monitoring the growth and development of children from preconception through adulthood. Many genetic predispositions can adversely impact the normal development process, and various environmental exposures have been linked to adverse reproductive health in rodent models and a small number of accidental human exposures. To monitor reproductive health and identify adverse effects at the earliest possible juncture, investigators must develop a network of biomarkers covering all stages and aspects of reproductive development and function. Biomarkers are biological indicators that can be measured repeatedly and are informative on one or more aspects of biological development or function. They can range from the anatomical level down to the molecular level and may provide information on the nature of an exposure, the effect of an exposure, or the susceptibility of individuals or populations to the toxic effects of an exposure. In theory, biomarkers can be used to monitor a wide variety of conditions and responses ranging from abnormal development to early indicators of late-onset disease. The main stumbling block with this theory has been finding appropriate biomarkers for particular conditions and exposures. Such biomarkers must be easily accessible, robust, and sensitive. Ideally, they will be expressed across a large section of the population, and can be monitored quickly, easily, conveniently, and with minimal cost. In this review, we discuss some of the current and emerging biomarkers of human pubertal development. PMID:14698938

  1. How Humanae vitae has advanced reproductive health1

    PubMed Central

    Doroski, Derek M.

    2014-01-01

    By encouraging doctors and scientists to improve the regulation of births through the observation of natural fertility rhythms, Humanae vitae promoted the development of natural family planning (NFP). The study of NFP has lead to NFP-based methodologies in reproductive healthcare that are promoting advances in treatment of infertility, miscarriage, and a number of reproductive health disorders. In contrast, the contraceptive mentality has stunted the development of reproductive healthcare. Humanae vitae has provided a great gift to science and reproductive healthcare that all Catholics should be proud of. PMID:25249708

  2. A conceptual framework for the social analysis of reproductive health.

    PubMed

    Price, Neil L; Hawkins, Kirstan

    2007-03-01

    The dominant conceptual framework for understanding reproductive behaviour is highly individualistic. In this article, it is demonstrated that such a conceptualization is flawed, as behaviour is shaped by social relations and institutions. Using ethnographic evidence, the value of a social analysis of the local contexts of reproductive health is highlighted. A framework is set out for conducting such a social analysis, which is capable of generating data necessary to allow health programmes to assess the appropriate means of improving the responsiveness of service-delivery structures to the needs of the most vulnerable. Six key issues are identified in the framework for the analysis of social vulnerability to poor reproductive health outcomes. The key issues are: poverty and livelihood strategies, gender, health-seeking behaviour, reproductive behaviour, and access to services. The article concludes by briefly identifying the key interventions and strategies indicated by such an analysis. PMID:17615901

  3. A Conceptual Framework for the Social Analysis of Reproductive Health

    PubMed Central

    Hawkins, Kirstan

    2007-01-01

    The dominant conceptual framework for understanding reproductive behaviour is highly individualistic. In this article, it is demonstrated that such a conceptualization is flawed, as behaviour is shaped by social relations and institutions. Using ethnographic evidence, the value of a social analysis of the local contexts of reproductive health is highlighted. A framework is set out for conducting such a social analysis, which is capable of generating data necessary to allow health programmes to assess the appropriate means of improving the responsiveness of service-delivery structures to the needs of the most vulnerable. Six key issues are identified in the framework for the analysis of social vulnerability to poor reproductive health outcomes. The key issues are: poverty and livelihood strategies, gender, health-seeking behaviour, reproductive behaviour, and access to services. The article concludes by briefly identifying the key interventions and strategies indicated by such an analysis. PMID:17615901

  4. Reproductive health care and minors' rights.

    PubMed

    Paul, E W; Klassel, D

    1984-01-01

    The right of minors under the US Constitution to reproductive health care services has been established and supersedes any state laws that may conflict with federal constitutional priciples. It has been ruled by the US Supreme Court that minors as well as adults possess a constitutional right to privacy, including the right to choose abortion without 3rd party consent. However, the states of Indiana, Lojisiana, Massachusetts, Missouri, North Dakota, and Rhode Island have enacted judicial bypass schemes that require parental consent for minors' abortions if an alternative procedure is also provided whereby the minor receives a confidential hearing before a neutral 3rd party. Several states further require parental notification for abortion, although legal challenges have been directed against these statutes. In terms of contraception, a New York statute that prohibited the sale of nonprescription contraceptives to those under 16 years of age was ruled to constitute an unconstitutional burden on minors' right to privacy. Moreover, parental consent to contraception cannot be imposed as a requirement in a federally funded family planning program. Attempts are being made to attach a parental consent requirement to family planning services provided under Title X, but this provision is considered to undercut desired adolescent participation in such programs and will be challenged on constitutional grounds. Claims by parents that the provision of contraceptive services to their children on a confidential basis violates parents' right to the care, custody, and nurture of their children have been rejected. Finally, standards promulgated by the American Bar Association provide that a minor of any age consent to medical services or counseling for family planning, contraception, or sexually transmitted diseases, excluding sterilization, and treatment related to pregnancy, including abortion. PMID:12339889

  5. Adverse health effects of anabolic-androgenic steroids.

    PubMed

    van Amsterdam, Jan; Opperhuizen, Antoon; Hartgens, Fred

    2010-06-01

    Anabolic-androgenic steroids (AAS) are synthetic drugs derived from testosterone. Illegally, these drugs are regularly self-administered by body builders and power lifters to enhance their sportive performance. Adverse side effects of AAS include sexual dysfunction, alterations of the cardiovascular system, psyche and behavior, and liver toxicity. However, severe side effects appear only following prolonged use of AAS at high dose and their occurrence is limited. Occasionally, AAS abuse may be linked to certain social and psychological traits of the user, like low self-esteem, low self-confidence, suffered hostility, childhood conduct disorder, and tendency to high-risk behavior. The overwhelming stereotype about AAS is that these compounds cause aggressive behavior in males. However, the underlying personality traits of a specific subgroup of the AAS abusers, who show aggression and hostility, may be relevant, as well. Use of AAS in combination with alcohol largely increases the risk of violence and aggression. The dependence liability of AAS is very low, and withdrawal effects are relatively mild. Based on the scores for acute and chronic adverse health effects, the prevalence of use, social harm and criminality, AAS were ranked among 19 illicit drugs as a group of drugs with a relatively low harm. PMID:20153798

  6. Sexual and Reproductive Health Behaviors of California Community College Students

    ERIC Educational Resources Information Center

    Trieu, Sang Leng; Bratton, Sally; Marshak, Helen Hopp

    2011-01-01

    Objective: To explore the sexual and reproductive health behaviors of students from 13 community college campuses in California. Participants: Heterosexual college students, ages 18 to 24, who have had sexual intercourse (N = 4,487). Methods: The American College Health Association's National College Health Assessment (ACHA-NCHA) survey was…

  7. The role of in-depth reproductive health counseling in addressing reproductive health concerns in female survivors of nongynecologic cancers.

    PubMed

    Shah, M S; Letourneau, J M; Niemasik, E E; Bleil, M; McCulloch, Charles E; Rosen, M P

    2016-01-01

    The purpose of this study was to characterize reproductive concerns among female cancer survivors and determine the role of targeted counseling in improving overall reproductive quality of life (QOL). A survey was administered to women from the California Cancer Registry, ages 18-40, with nongynecologic cancers diagnosed from 1993 to 2007, who received fertility-compromising treatments. In total, 356 women completed the survey, which included questions regarding their reproductive health counseling history and the reproductive concerns scale (RCS), a validated reproductive QOL tool. Factors independently associated with higher RCS scores included a desire for children at the time of diagnosis, posttreatment infertility, treatment with chemoradiation or bone marrow transplant, and income less than $100,000 per year at diagnosis. Among the highest reported reproductive concerns were those related to loss of control over one's reproductive future and concerns about the effect of illness on one's future fertility. Across our population and independent of age, in-depth reproductive health counseling prior to cancer treatment was associated with significantly lower RCS scores. Our findings highlight the importance of early counseling and targeting high-risk groups for additional counseling after completion of cancer treatment. This approach may be an effective strategy for optimizing long-term reproductive QOL in this vulnerable population. PMID:27144587

  8. A life course approach to reproductive health: theory and methods.

    PubMed

    Mishra, Gita D; Cooper, Rachel; Kuh, Diana

    2010-02-01

    Taking a life course approach to the study of reproductive health involves the investigation of factors across life and, also across generations, that influence the timing of menarche, fertility, pregnancy outcomes, gynaecological disorders, and age at menopause. It also recognises the important influence of reproductive health on chronic disease risk in later life. Published literature supports the use of an integrated life course approach to study reproductive health, which examines the whole life course, considers the continuity of reproductive health and the interrelationship between the different markers of this. This is in contrast to more traditional approaches that tend to focus only on contemporary risk factors and which consider each marker of reproductive health separately. For instance, we found evidence linking early life factors such as growth, socioeconomic conditions, and parental divorce with ages at menarche and menopause, although the nature of the relationship differs. We discuss the different theoretical models that are used within life course epidemiology and which postulate pathways linking exposures across the life course to health outcomes, using examples of relevance to the study of reproductive health. These highlight the importance of examining timing of exposures, such as during critical periods in early life, and the temporal order of exposures. How life course frameworks of reproductive health can be developed to help identify hypotheses to be tested is also demonstrated. This approach has implications for the development of effective health policy that moves beyond identifying not only the type of intervention but also the most appropriate time across life to intervene. PMID:20079587

  9. [Sexual and reproductive rights: challenges for health policies].

    PubMed

    Avila, Maria Betânia

    2003-01-01

    This article discusses sexual and reproductive rights in the sense of a stance that assumes a perspective of transformations in social relations, the struggle against prejudices, the guarantee of well-being, and finally the relationship between sexuality, reproduction, and citizenship. The article then proceeds to reflect on health policy challenges in these fields, emphasizing such issues as: guaranteed resources, quality and quantity of health services in response to demands by the population, and cultural changes that produce a new view of the relationship between health professionals and health system clients, based on the principles of citizenship: recognition others as entitled to freedom and equality. PMID:15029365

  10. Inequity in India: the case of maternal and reproductive health

    PubMed Central

    Sanneving, Linda; Trygg, Nadja; Saxena, Deepak; Mavalankar, Dileep; Thomsen, Sarah

    2013-01-01

    Background Millennium Development Goal (MDG) 5 is focused on reducing maternal mortality and achieving universal access to reproductive health care. India has made extensive efforts to achieve MDG 5 and in some regions much progress has been achieved. Progress has been uneven and inequitable however, and many women still lack access to maternal and reproductive health care. Objective In this review, a framework developed by the Commission on Social Determinants of Health (CSDH) is used to categorize and explain determinants of inequity in maternal and reproductive health in India. Design A review of peer-reviewed, published literature was conducted using the electronic databases PubMed and Popline. The search was performed using a carefully developed list of search terms designed to capture published papers from India on: 1) maternal and reproductive health, and 2) equity, including disadvantaged populations. A matrix was developed to sort the relevant information, which was extracted and categorized based on the CSDH framework. In this way, the main sources of inequity in maternal and reproductive health in India and their inter-relationships were determined. Results Five main structural determinants emerged from the analysis as important in understanding equity in India: economic status, gender, education, social status (registered caste or tribe), and age (adolescents). These five determinants were found to be closely interrelated, a feature which was reflected in the literature. Conclusion In India, economic status, gender, and social status are all closely interrelated when influencing use of and access to maternal and reproductive health care. Appropriate attention should be given to how these social determinants interplay in generating and sustaining inequity when designing policies and programs to reach equitable progress toward improved maternal and reproductive health. PMID:23561028

  11. Quality of reproductive health services at commune health stations in Viet Nam: implications for national reproductive health care strategy.

    PubMed

    Ngo, Anh D; Hill, Peter S

    2011-05-01

    This paper presents a qualitative study conducted in 2009 of provider and patient perceptions of primary level reproductive health services provided by commune health stations (CHSs), and the implications for Viet Nam's 2011-2020 National Strategy for Reproductive Health Care. In the three provinces of Thai Nguyen, Thua Thien Hue, and Vinh Long, we interviewed the heads of CHSs, held focus group discussions with midwives and women patients, and observed facilities. Half the 30 CHSs visited were in poor physical condition; the rest were newly renovated. However, the model of service delivery was largely unchanged from ten years before. Many appeared to fall short in meeting patient expectations in terms of modern medical equipment and technology, range of drug supplies, and levels of staff expertise. As a result, many women were turning to private doctors and public hospitals, at least in urban areas, or seeking medication from pharmacies. To make CHS clinics sustainable, promotion of access to reproductive health services should be undertaken concurrently with quality improvement. A responsive payment scheme must also be developed to generate revenues. Efforts should be made to reduce the unnecessary use of more costly services from private clinics and higher level public facilities. PMID:21555086

  12. Effects of the 2010 Haiti Earthquake on Women's Reproductive Health.

    PubMed

    Behrman, Julia Andrea; Weitzman, Abigail

    2016-03-01

    This article explores the effects of the 2010 Haiti earthquake on women's reproductive health, using geocoded data from the 2005 and 2012 Haiti Demographic and Health Surveys. We use geographic variation in the destructiveness of the earthquake to conduct a difference-in-difference analysis. Results indicate that heightened earthquake intensity reduced use of injectables-the most widely used modern contraceptive method in Haiti-and increased current pregnancy and current unwanted pregnancy. Analysis of impact pathways suggests that severe earthquake intensity significantly increased women's unmet need for family planning and reduced their access to condoms. The earthquake also affected other factors that influence reproductive health, including women's ability to negotiate condom use in their partnerships. Our findings highlight how disruptions to health care services following a natural disaster can have negative consequences for women's reproductive health. PMID:27027990

  13. Wealth Index association with gender issues and the reproductive health of Egyptian women.

    PubMed

    Afifi, Mustafa

    2009-03-01

    This study investigated the association of the Wealth Index of married women in Egypt with a number of gender and reproductive health issues found in the 2005 Egypt Demographic Health Survey. The data from a subsample of 5249 currently married women from a total of 19,474 was examined using logistic regression analysis. The women's lowest wealth quintile predicted the intention to continue female genital cutting for their daughters, exposure to physical and sexual marital violence, not being empowered in household decisions, having a higher number of children, having an unintended last child, mothers' maltreatment of their children, the perception of a lack of health-care providers or drugs as an obstacle to receiving care, and not being covered by health insurance. The association of poverty with the aforementioned adverse health outcomes are discussed. Physicians should understand the effect of poverty on health and endeavour to influence policy-makers to reduce the poverty burden on health. PMID:19298306

  14. International Federation of Gynecology and Obstetrics opinion on reproductive health impacts of exposure to toxic environmental chemicals.

    PubMed

    Di Renzo, Gian Carlo; Conry, Jeanne A; Blake, Jennifer; DeFrancesco, Mark S; DeNicola, Nathaniel; Martin, James N; McCue, Kelly A; Richmond, David; Shah, Abid; Sutton, Patrice; Woodruff, Tracey J; van der Poel, Sheryl Ziemin; Giudice, Linda C

    2015-12-01

    Exposure to toxic environmental chemicals during pregnancy and breastfeeding is ubiquitous and is a threat to healthy human reproduction. There are tens of thousands of chemicals in global commerce, and even small exposures to toxic chemicals during pregnancy can trigger adverse health consequences. Exposure to toxic environmental chemicals and related health outcomes are inequitably distributed within and between countries; universally, the consequences of exposure are disproportionately borne by people with low incomes. Discrimination, other social factors, economic factors, and occupation impact risk of exposure and harm. Documented links between prenatal exposure to environmental chemicals and adverse health outcomes span the life course and include impacts on fertility and pregnancy, neurodevelopment, and cancer. The global health and economic burden related to toxic environmental chemicals is in excess of millions of deaths and billions of dollars every year. On the basis of accumulating robust evidence of exposures and adverse health impacts related to toxic environmental chemicals, the International Federation of Gynecology and Obstetrics (FIGO) joins other leading reproductive health professional societies in calling for timely action to prevent harm. FIGO recommends that reproductive and other health professionals advocate for policies to prevent exposure to toxic environmental chemicals, work to ensure a healthy food system for all, make environmental health part of health care, and champion environmental justice. PMID:26433469

  15. Excessive folic acid intake and relation to adverse health outcome.

    PubMed

    Selhub, Jacob; Rosenberg, Irwin H

    2016-07-01

    The recent increase in the intake of folic acid by the general public through fortified foods and supplements, has raised safety concern based on early reports of adverse health outcome in elderly with low B12 status who took high doses of folic acid. These safety concerns are contrary to the 2015 WHO statement that "high folic acid intake has not reliably been shown to be associated with negative healeffects". In the folic acid post-fortification era, we have shown that in elderly participants in NHANES 1999-2002, high plasma folate level is associated with exacerbation of both clinical (anemia and cognitive impairment) and biochemical (high MMA and high Hcy plasma levels) signs of vitamin B12 deficiency. Adverse clinical outcomes in association with high folate intake were also seen among elderly with low plasma B12 levels from the Framingham Original Cohort and in a study from Australia which combined three elderly cohorts. Relation between high folate and adverse biochemical outcomes were also seen in the Sacramento Area Latino Study on Aging (High Hcy, high MMA and lower TC2) and at an outpatient clinic at Yale University where high folate is associated with higher MMA in the elderly but not in the young. Potential detrimental effects of high folic acid intake may not be limited to the elderly nor to those with B12 deficiency. A study from India linked maternal high RBC folate to increased insulin resistance in offspring. Our study suggested that excessive folic acid intake is associated with lower natural killer cells activity in elderly women. In a recent study we found that the risk for unilateral retinoblastoma in offspring is 4 fold higher in women that are homozygotes for the 19 bp deletion in the DHFR gene and took folic acid supplement during pregnancy. In the elderly this polymorphism is associated with lower memory and executive scores, both being significantly worse in those with high plasma folate. These and other data strongly imply that

  16. Inflammatory bowel diseases and reproductive health.

    PubMed

    Kokoszko-Bilska, Agnieszka; Sobkiewicz, Slawomir; Fichna, Jakub

    2016-08-01

    Inflammatory bowel diseases (IBD) constitute a group of chronic intestinal diseases, including Crohn's disease and ulcerative colitis, which typically involve patients of reproductive age and may influence several features of human reproduction. There are many concerns regarding the interactions between the course of IBD, applied treatment (pharmacological or surgical), and fertility, reproductive outcomes, and also neonatal outcomes. To review the literature describing fertility in IBD patients (separately for female and male), and possible infertility treatment in this group of patients, a PubMed search for English only publications (articles and/or abstracts) was conducted. Initially, the titles of publications and their abstracts were screened, and the most appropriate articles were selected and reviewed. Overall, in patients with quiescent IBD, fertility is almost identical to the general population, but particular subgroups of patients (with active disease, on pharmacological treatment, and after pelvic or abdominal surgery) may be affected by reduced fertility. Additionally, patients with IBD have fewer children than the general population, mainly as a result of voluntary childlessness. The main objectives for successful reproductive outcomes in IBD patients are proper guidance and also optimal treatment for achieving and maintaining disease remission. Recently, the European Evidence-Based Consensus on Reproduction and Pregnancy in IBD (the European Crohn's and Colitis Organization Guidelines) has been established to optimize preconceptional counseling and to promote an appropriate clinical management for patients planning to conceive. However, further studies are needed regarding the preservation of fertility in IBD patients and introduction of optimal infertility treatment in this group of patients. PMID:27117378

  17. Reproductive adverse outcome pathways for chemical inhibitors of steroid synthesis in fish

    EPA Science Inventory

    A key physiological process controlling reproductive success of oviparous vertebrates (fish, amphibian, reptiles, birds) involves production of the egg yolk protein precursor vitellogenin (VTG). VTG production is an estrogen receptor (ER)-mediated process that, in females, is con...

  18. ADVERSE EFFECTS OF ENVIRONMENTAL ANTIANDROGENS AND ANDROGENS ON REPRODUCTIVE DEVELOPMENT IN MAMMALS

    EPA Science Inventory

    Within the last decade, several classes of chemicals have been shown in laboratory studies to disrupt reproductive development by acting as androgen receptor (AR) antagonists and/or inhibitors of fetal Leydig cell testosterone production. Some phthalate esters alter gubernacular...

  19. [Network of researchers on the health aspects of reproduction].

    PubMed

    1990-07-01

    A symposium held 3-5 May 1990 commemorated the anniversary of the "Network" by presentations on the health aspects of reproduction in Africa. Prof. Sambra Diarra of the Ivory Coast presented a paper on "Health of Reproduction in Africa, Bi-Dimensional Problems: Biomedical and Social." He stressed the need to emphasize both maternal (MM) and infant mortality (IM) in Africa, where MM rates are 640/100,000 and IMR are 130/1000, because they remain so high. Prof. Fadel Diadhiou of Senegal followed with a paper on "Operations Research on Women's Reproductive Health in Africa." The major themes were that problems in reproductive health have resulted because of the fragmentation between the ecosystem and development and the lack of research is due to the isolation of institutions that lack human and material resources. The 3rd presentation by Prof. Mouhamadou Fall of Senegal on "The Health of Children and the Perspectives for Senegal," focused on the increasing infant and child mortality rates in Senegal (238/1000 in 1981) due to the combination of factors caused by the mother-child syndrome. These are: 1) congenital malformations caused by incest, young or advanced age of mothers; 2) diseases of the mother that cause fetal mortality: diabetes, arterial hypertension, eclampsia; 3) lack of breastfeeding and illiteracy of mothers; 4) public health diseases such as measles, malaria, diarrhea; 5) streptococcic infections and their complications such as anemia and tuberculosis. The last presentation made by Prof. Eusebe Alihonou from Benin on the "Perspectives and Priorities of Reproductive Health in Africa," concluded that the research priorities in Africa should be on health systems that lower utilization rates of services and resources and on epidemiological studies that identify health problems and analyze the risk factors. The Symposium concluded that the research priorities should be: maternal morbidity and mortality; adolescents and reproduction and the morbidity and

  20. Assessment of reproductive health and violence against women among displaced Syrians in Lebanon

    PubMed Central

    2014-01-01

    Background The current conflict in Syria continues to displace thousands to neighboring countries, including Lebanon. Information is needed to provide adequate health and related services particularly to women in this displaced population. Methods We conducted a needs assessment in Lebanon (June-August 2012), administering a cross-sectional survey in six health clinics. Information was collected on reproductive and general health status, conflict violence, stress, and help-seeking behaviors of displaced Syrian women. Bivariate and multivariate analyses were conducted to examine associations between exposure to conflict violence, stress, and reproductive health outcomes. Results We interviewed 452 Syrian refugee women ages 18–45 who had been in Lebanon for an average of 5.1 (± 3.7) months. Reported gynecologic conditions were common, including: menstrual irregularity, 53.5%; severe pelvic pain, 51.6%; and reproductive tract infections, 53.3%. Among the pregnancy subset (n = 74), 39.5% of currently pregnant women experienced complications and 36.8% of those who completed pregnancies experienced delivery/abortion complications. Adverse birth outcomes included: low birthweight, 10.5%; preterm delivery, 26.5%; and infant mortality, 2.9%. Of women who experienced conflict-related violence (30.8%) and non-partner sexual violence (3.1%), the majority did not seek medical care (64.6%). Conflict violence and stress score was significantly associated with reported gynecologic conditions, and stress score was found to mediate the relationship between exposure to conflict violence and self-rated health. Conclusions This study contributes to the understanding of experience of conflict violence among women, stress, and reproductive health needs. Findings demonstrate the need for better targeting of reproductive health services in refugee settings, as well as referral to psychosocial services for survivors of violence. PMID:24552142

  1. Gonadal function and reproductive health in women with HIV infection

    PubMed Central

    Yalamanchi, Swaytha; Dobs, Adrian; Greenblatt, Ruth M.

    2014-01-01

    Synopsis Most HIV infections among women occur early in reproductive life, which highlights the importance of understanding the impact of HIV on reproductive functions, and also the potential implications of reproductive function and aging on the course of HIV disease. HIV infection may influence reproductive biology via multiple mechanisms including: potential directs effects on HIV on the hypothalamic-pituitary-gonadal axes, implications of HIV-related immune dysfunction on reproductive biology, effects of antiretroviral treatments on reproductive functions and the impact of treatment related immune reconstitution on reproductive health. Ovarian function is a crucial component of reproductive biology in women, but standard assessment methods are of limited applicability to women with some chronic diseases, such as HIV. New antiretroviral treatments have the potential to increase the ease of conception planning, and to improve fertility. Drug-drug interactions between antiretroviral medications and hormonal contraceptives are potentially significant and merit careful provider attention. While HIV infection is not a major cause of infertility, high level viremia and low CD4 lymphocyte counts are associated with reduced fertility rates. Conception and pregnancy can now be achieved without transmission of HIV to sexual partner or new born, but complications of pregnancy may be more common in HIV infected women than uninfected women. PMID:25169564

  2. HIV/AIDS, Reproductive and Sexual Health, and the Law

    PubMed Central

    Gostin, Lawrence O.; Hodge, James G.

    2008-01-01

    The law is a frequently overlooked tool for addressing the complex practical and ethical issues that arise from the HIV/AIDS pandemic. The law intersects with reproductive and sexual health issues and HIV/AIDS in many ways. Well-written and rigorously applied laws could benefit persons living with (or at risk of contracting) HIV/AIDS, particularly concerning their reproductive and sexual health. Access to reproductive health services should be a legal right, and discrimination based on HIV status, which undermines access, should be prohibited. Laws against sexual violence and exploitation, which perpetuate the spread of HIV and its negative effects, should be enforced. Finally, a human rights framework should inform the drafting of laws to more effectively protect health. PMID:18703431

  3. HIV/AIDS, reproductive and sexual health, and the law.

    PubMed

    Gable, Lance; Gostin, Lawrence O; Hodge, James G

    2008-10-01

    The law is a frequently overlooked tool for addressing the complex practical and ethical issues that arise from the HIV/AIDS pandemic. The law intersects with reproductive and sexual health issues and HIV/AIDS in many ways. Well-written and rigorously applied laws could benefit persons living with (or at risk of contracting) HIV/AIDS, particularly concerning their reproductive and sexual health. Access to reproductive health services should be a legal right, and discrimination based on HIV status, which undermines access, should be prohibited. Laws against sexual violence and exploitation, which perpetuate the spread of HIV and its negative effects, should be enforced. Finally, a human rights framework should inform the drafting of laws to more effectively protect health. PMID:18703431

  4. Knowledge of adolescent girls regarding reproductive health care.

    PubMed

    Dash, Bijayalakshmi

    2012-01-01

    The period of adolescence (usually 15-19 years) is marked by physiological changes in the body, more so with females. Unfortunately sex and sex education continue to be taboo. A study was therefore conducted among adolescent girls of urban slum area of Niladribihar, Khurda district of Odisha. The sample consisted of 84 adolescent girls. The analysis showed that adolescent girls had average reproductive health care that can lead to numerous health problems and there is dire need of evolving measures to improve their knowledge on reproductive health care. Nursing professionals in hospital setting can significantly contribute in this area. PMID:23534171

  5. An emerging field in religion and reproductive health.

    PubMed

    Gaydos, Laura M; Smith, Alexandria; Hogue, Carol J R; Blevins, John

    2010-12-01

    Separate from scholarship in religion and medicine, a burgeoning field in religion and population health, includes religion and reproductive health. In a survey of existing literature, we analyzed data by religious affiliation, discipline, geography and date. We found 377 peer-reviewed articles; most were categorized as family planning (129), sexual behavior (81), domestic violence (39), pregnancy (46), HIV/AIDS (71), and STDs (61). Most research occurred in North America (188 articles), Africa (52), and Europe (47). Article frequency increased over time, from 3 articles in 1980 to 38 articles in 2008. While field growth is evident, there is still no cohesive "scholarship" in religion and reproductive health. PMID:20094795

  6. Seminal Fluid Signalling in the Female Reproductive Tract: Implications for Reproductive Success and Offspring Health.

    PubMed

    Schjenken, John E; Robertson, Sarah A

    2015-01-01

    Carriage of sperm is not the only function of seminal fluid in mammals. Studies in mice show that at conception, seminal fluid interacts with the female reproductive tract to induce responses which influence whether or not pregnancy will occur, and to set in train effects that help shape subsequent fetal development. In particular, seminal fluid initiates female immune adaptation processes required to tolerate male transplantation antigens present in seminal fluid and inherited by the conceptus. A tolerogenic immune environment to facilitate pregnancy depends on regulatory T cells (Treg cells), which recognise male antigens and function to suppress inflammation and immune rejection responses. The female response to seminal fluid stimulates the generation of Treg cells that protect the conceptus from inflammatory damage, to support implantation and placental development. Seminal fluid also elicits molecular and cellular changes in the oviduct and endometrium that directly promote embryo development and implantation competence. The plasma fraction of seminal fluid plays a key role in this process with soluble factors, including TGFB, prostaglandin-E, and TLR4 ligands, demonstrated to contribute to the peri-conception immune environment. Recent studies show that conception in the absence of seminal plasma in mice impairs embryo development and alters fetal development to impact the phenotype of offspring, with adverse effects on adult metabolic function particularly in males. This review summarises our current understanding of the molecular responses to seminal fluid and how this contributes to the establishment of pregnancy, generation of an immune-regulatory environment and programming long-term offspring health. PMID:26178848

  7. The Core Competencies for Adolescent Sexual and Reproductive Health

    ERIC Educational Resources Information Center

    Elfers, John; Carlton, Lidia; Gibson, Paul; Puffer, Maryjane; Smith, Sharla; Todd, Kay

    2014-01-01

    The Adolescent Sexual Health Work Group commissioned the development of core competencies that define the knowledge, skills, and attitudes necessary for all providers of adolescent sexual and reproductive health. This article describes the background and rationale for this set of competencies, the history and use of competencies, and the process…

  8. Knowledge and Perceptions of Reproductive Health among Latinas

    ERIC Educational Resources Information Center

    Rojas-Guyler, Liliana; Price, Kimberly L. J.; Young, Kathleen; King, Keith A.

    2010-01-01

    Objectives: The purpose of this study was to assess potential relationships among reproductive health knowledge, preventive health behaviors, perceived severity and risk of breast cancer, cervical cancer, and sexually transmitted infections and selected demographical variables and characteristics related to acculturation among Latina immigrants.…

  9. Women and Reproductive Health: A Challenge for the Military.

    ERIC Educational Resources Information Center

    Bassoff, Betty Z.; Ortiz, Elizabeth T.

    Although the military health care system is the second largest in the nation serving approximately 6,000,000 people, little research has examined military reproductive health care services or their quality. Medical services can be provided by regional military medical centers and by base infirmaries and dispensaries. Often base infirmaries and…

  10. Improving maternal, newborn and women's reproductive health in crisis settings

    PubMed Central

    Chi, Primus Che; Urdal, Henrik; Umeora, Odidika Uj; Sundby, Johanne; Spiegel, Paul; Devane, Declan

    2015-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To identify, synthesise and evaluate the effects of health system and other interventions aimed at improving maternal, newborn and women's reproductive health in crisis settings.

  11. [Gender inequality and reproductive health: a perspective for the program].

    PubMed

    Szasz, I

    1993-01-01

    Research on the influence of the social, economic, and cultural context on reproductive health is just beginning in Mexico. Because health risks and damage appear to be associated with living conditions of the population, the mechanisms through which social inequality affects reproductive health should be analyzed. Gender inequality is of particular importance to the study of reproductive health. The construction of feminine identity, centered on motherhood and the ability to relate to others, has decisive consequences for self-esteem, social valuation, and the capacity of women to make decisions and act in their own self interest. The obstacles that women face in making decisions about sexuality and reproduction have psychological, affective, and health costs. Women living in contexts of limited female autonomy are often pressured into early pregnancy and union and to having large families. The need to satisfy expectations for their gender and social position, fear of being devalued or abandoned, and the desire to cement affective relationships may restrict their capacity to exercise their sexuality with autonomy and to separate it from procreation. The low rates of use of contraceptives by men and the almost exclusive focus on women of contraceptive technologies and programs also reflect the inequality of the sexes. The lesser access to resources and exercise of power by women in the household may lead to nutritional disadvantages, and societal standards that tolerate extramarital sexual activity for men but not for women leave women vulnerable to sexually transmitted diseases. The health effects of gender inequalities are magnified by poverty and other forms of social disadvantage. The Program of Reproductive Health and Society aims to contribute to improved reproductive health in the Mexican population through study of the consequences of social and gender inequality. PMID:12289046

  12. Occupational mercury exposure and male reproductive health

    SciTech Connect

    Alcser, K.H.; Brix, K.A.; Fine, L.J.; Kallenbach, L.R.; Wolfe, R.A.

    1989-01-01

    This retrospective cohort study was designed to investigate the relationship of male occupational exposure to elemental mercury and several reproductive outcomes. All subjects worked at least 4 months between 1953 and 1966 at a plant that used elemental mercury; 247 white male employees who had the highest exposures were compared to 255 matched nonexposed employees. Individual exposure to mercury was estimated from urinary mercury measurement records. Information on reproductive history and potential confounding variables was obtained through personal interview with each of the employees and with a subset of their wives. No associations were demonstrated between mercury exposure and decreased fertility or increased rates of major malformations or serious childhood illnesses. After controlling for previous miscarriage history, mercury exposure was not a significant risk factor for miscarriage. Because of this study's potential problems with long-term recall, further studies of the effect of mercury on pregnancy outcome are warranted in other populations.

  13. Legal issues affecting confidentiality and informed consent in reproductive health.

    PubMed

    Rockett, L R

    2000-01-01

    The law governing confidentiality and informed consent has acquired unique characteristics in the area of reproductive health, as a consequence of both the establishment of a constitutional right to privacy in reproductive health matters and the reaction of those politically and morally opposed to the exercise of that right. The primary issues have involved: 1) the right of minors to receive reproductive health services without parental consent, which remains a political battleground; 2) laws requiring physicians to provide information to pregnant patients that is intended, not to inform them of the risks and benefits of the procedure, but to discourage them from obtaining abortions; 3) coerced and prohibited sterilizations; 4) court-ordered contraception and procedures to protect the fetus; and 5) restrictions on counseling about abortion, contraception, sterilization, and other reproductive health services authorized by state conscience or noncompliance clauses that shield such restrictions from the usual ethical, medical, and legal rules governing informed consent. The last area is of profound significance to the ability of women to make informed decisions about their reproductive health options. In the current economic environment, which fuels mergers and acquisitions involving sectarian and nonsectarian institutions, women are increasingly being put at risk as a result of such restrictions. PMID:11070641

  14. Sexual and reproductive health needs of vulnerable youth in Myanmar.

    PubMed

    Hla-Soe-Tint; Phyo-Maung-Thaw; Yin-Thet-Nu-Oo; Ko-Ko-Zaw; Than-Tun-Sein; Thein-Tun

    2008-11-01

    A cross-sectional survey of 56 youth, using participatory research methods, was conducted with the objective to identify the sexual and reproductive health needs among vulnerable youth in Pyin Oo Lwin town in terms of their livelihoods, perceptions about health and health risks, sex practices, perceived health information needs and preferred channels for health information, and visions for their future generation. The results indicated that a majority of young people of both sexes were deficient in knowledge of the locations and functions of reproductive organs. The majority of respondents of both sexes said that their main health concern was AIDS. Pre-marital sex among youth, 16-20 years of age, was identified in our study. Malaria and AIDS were mentioned as information needed by young people. TV and magazines/journals were prioritized as preferred channels of disseminating health messages. Almost all reported that education was the one thing that they wanted for their own children. PMID:19062705

  15. 75 FR 4655 - National Practitioner Data Bank for Adverse Information on Physicians and Other Health Care...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-28

    ... Practitioner Data Bank for Adverse Information on Physicians and Other Health Care Practitioners: Reporting on... Information on Physicians and Other Health Care Practitioners: Reporting on Adverse and Negative Actions... rule revises existing regulations under sections 401 through 432 of the Health Care Quality...

  16. Reproductive Health Management for the Care of Women Veterans.

    PubMed

    Zephyrin, Laurie C

    2016-02-01

    There are more than 2 million women veterans living in the United States. Many women do not identify themselves as veterans. As women's health care providers, it is important to understand and recognize the potentially complex health and social needs of women veterans and the role of military service on their lives. The reproductive health needs of women veterans may be shaped by their military experiences and coexisting medical or mental health conditions. Military sexual trauma and combat exposure are common causes of posttraumatic stress disorder and can affect overall health and well-being. Screening for military service is important in all women, and inclusion of this as a key demographic variable in research and clinical encounters can further inform health care considerations. The following key topics are addressed: who are women veterans, health and social risk factors associated with a history of military service, reproductive health across the life course, military sexual trauma and reproductive health of women veterans, how to take a military history, and the essential role of women's health providers, including obstetrician-gynecologists, in enhancing health systems and providing high-quality care to veterans. PMID:26942369

  17. Metabolic, Digestive, and Reproductive Adverse Events Associated With Antimanic Treatment in Children and Adolescents: A Retrospective Cohort Study

    PubMed Central

    McIntyre, Roger S.

    2010-01-01

    Objective: To identify factors associated with incident metabolic and reproductive adverse events in children and adolescents. Method: A retrospective cohort design evaluating Medicaid medical and pharmacy claims made in South Carolina between January 1996 and December 2005 was employed for 3,657 children and adolescents (aged 17 years old and younger) prescribed 1 of 3 antimanic medications (ie, lithium, carbamazepine, or valproic acid derivatives) and a random sample of 4,500 children and adolescents not treated with psychotropic medications. Results: Compared to the control sample, the treated cohort was more likely to be diagnosed with obesity/weight gain (odds ratio [OR] = 1.89), type 2 diabetes mellitus (OR = 2.50), dyslipidemia (OR = 1.89), nausea (OR = 1.61), anorexia (OR = 3.85), and sexual/reproductive adverse events (OR = 2.04). Within the treated cohort, incident dyslipidemia was more likely for those prescribed carbamazepine (OR = 1.52) compared to valproate and coprescribed antipsychotics (OR = 1.47) or selective serotonin reuptake inhibitors (SSRIs) (OR = 1.49) compared to those not taking antipsychotics or taking serotonin-norepinephrine reuptake inhibitor/heterocyclic (SNRI/other) antidepressants. The odds of developing nausea/vomiting were higher for those prescribed carbamazepine (OR = 1.70) or lithium (OR = 1.49) compared to valproate, and those coprescribed psychostimulants (OR = 1.25) compared to those not taking psychostimulants. The odds of developing obesity/weight gain and type 2 diabetes mellitus were higher for those coprescribed SSRIs (ORs = 1.72, 2.58) or antipsychotics (ORs = 1.69, 1.77) compared to those taking SNRI/other antidepressants or not taking antipsychotics. Incident sexual/reproductive adverse events were more likely for those coprescribed SSRIs (OR = 2.02) compared to those taking SNRI/other antidepressants. Conclusion: Commonly employed psychotropic agents are associated with clinically significant metabolic, digestive

  18. Portrayals of Reproductive and Sexual Health on Primetime Television

    PubMed Central

    Pariera, Katrina L.; Hether, Heather J.; Murphy, Sheila T.; de Castro Buffington, Sandra; Baezconde-Garbanati, Lourdes

    2013-01-01

    Primetime broadcast television provides health information and establishes norms for millions of people in the United States (Beck, 2004; Brodie, et al., 2001; Murphy & Cody, 2003; Rideout, 2008). To understand what people may be learning about reproductive and sexual health, a content analysis was conducted of storylines from the 10 most popular primetime television programs in 2009, 2010 and 2011. Variables that were measured included the frequency of reproductive and sexual health issues, the level of health information, the type of information portrayed, the gain and loss frames, the presence of stigma, the tone, and the type of role model portrayed. Eighty-seven of the 589 health storylines dealt with reproductive and sexual health, and the most common issues were pre- and post-term pregnancy complications. The majority of these storylines had a moderate or weak level of information and included specifics about treatment and symptoms but not prevention. Just over half of the issues were framed in terms of losses, meaning non-adoption of a behavior change will result in negative outcomes. Twenty-four percent of reproductive and sexual health storylines involved stigma -- usually those related to sexually transmitted infections (STIs). Most storylines were portrayed as serious and the majority of issues happened to positive role models. The implications of these portrayals for the viewing public are discussed. PMID:24156468

  19. Chhaupadi Culture and Reproductive Health of Women in Nepal.

    PubMed

    Ranabhat, Chhabi; Kim, Chun-Bae; Choi, Eun Hee; Aryal, Anu; Park, Myung Bae; Doh, Young Ah

    2015-10-01

    Different sociocultural barriers concerning women's health are still prevalent. Chhaupadi culture in Nepal is that threat wherein menstruating women have to live outside of the home in a shed-like dwelling. Our study aims to determine the factors of reproductive health problems related to Chhaupadi. A cross-sectional study was performed with women of menstrual age (N = 672) in Kailali and Bardiya districts of Nepal. Data were collected with stratified sampling and analyzed using SPSS. Reproductive health problems were observed according to the World Health Organization reproductive health protocol. Regression analysis was performed to show the association between relevant variables. Results reveal that one fifth (21%) of households used Chhaupadi. Condition of livelihood, water facility, and access during menstruation and precisely the Chhaupadi stay was associated (P < .001) with the reproductive health problems of women. The study concludes that Chhaupadi is a major threat for women's health. Further research on appropriate strategies against Chhaupadi and menstrual hygiene should be undertaken. PMID:26316503

  20. Experimental Approaches to Systematic Discovery and Development of Reproductive Adverse Outcome Pathways in Fish

    EPA Science Inventory

    Adverse outcome pathways (AOPs) are conceptual frameworks that portray causal and predictive linkages between key events at multiple scales of biological organization that connect molecular initiating events and early cellular perturbations (e.g., initiation of toxicity pathways)...

  1. Reproductive health knowledge, attitudes and practices of Iranian college students.

    PubMed

    Simbar, M; Tehrani, F R; Hashemi, Z

    2005-01-01

    To study reproductive health knowledge, attitudes and practices of youth in the Islamic Republic of Iran, 1111 university students completed a questionnaire with 43 closed questions. The overall mean knowledge score was 54%. Knowledge of males and females, and of married and single students, was similar. Of 664 students answering questions about reproductive health behaviour, 54 (8%) reported having sexual intercourse before marriage; 16% of males and 0.6% of females; 48% of them had used condoms. The majority of students believed that the risk of AIDS and other sexually transmitted infections was moderate but that youth had a low ability to practise healthy behaviour. The majority believed in the benefits of reproductive health knowledge for youth but felt that services were inadequate. PMID:16761658

  2. Environmental conditions and reproductive health outcomes

    EPA Science Inventory

    Environmental exposures range across multiple domains to affect human health. In an effort to learn how environmental factors combine to contribute to health outcomes we constructed a multiple environmental domain index (MEDI) for use in health research. We used principal compone...

  3. Attention-deficit/hyperactivity disorder and adverse health outcomes in adults.

    PubMed

    Spencer, Thomas J; Faraone, Stephen V; Tarko, Laura; McDermott, Katie; Biederman, Joseph

    2014-10-01

    Whereas the adverse impact of attention-deficit/hyperactivity disorder (ADHD) on emotional and psychosocial well-being has been well investigated, its impact on physical health has not. The main aim of this study was to assess the impact of ADHD on lifestyle behaviors and measures of adverse health risk indicators. Subjects were 100 untreated adults with ADHD and 100 adults without ADHD of similar age and sex. Unhealthy lifestyle indicators included assessments of bad health habits, frequency of visits to healthcare providers, and follow through with recommended prophylactic tests. Assessments of adverse health risk indicators included measurements of cardiovascular and metabolic parameters, weight, body mass index, and waist circumference. No differences were identified in health habits between subjects with and without ADHD, but robust differences were found in a wide range of adverse health risk indicators. ADHD is associated with an adverse impact in health risk indicators well known to be associated with high morbidity and mortality. PMID:25211634

  4. 'Halfway people': refugee views of reproductive health services.

    PubMed

    Whelan, A; Blogg, J

    2007-01-01

    The objective of this study was to identify factors that facilitate or hinder access to, use of, and satisfaction with reproductive health services in refugee settings, from the perspective of beneficiaries. Rapid appraisal methods included 46 focus group discussions and interviews with over 800 refugees, audits of 14 health facilities, referral hospital reviews, exit interviews with clients, and interviews with health workers. The study was conducted between February and April 2004 in 11 sites in Uganda, Republic of Congo, and Yemen. Reproductive health was clearly on the policy agenda in all countries with stable refugee sites, but problems with implementation and resources were identified. The quality of services was variable, with high staff turnover in some areas affecting relationships with refugee clients. Referral hospitals in host countries were not all equipped to deal with obstetric and other emergencies of either local or refugee populations, including deficiencies in safe blood supplies and antibiotics. Diagnosis and treatment of STIs and HIV/AIDS was frequently inadequate. Gender based violence was the least well addressed aspect of reproductive health. Interest and knowledge about family planning was high, but acceptance was low. It was concluded that progress has been made in reproductive health services for refugees since 1994, however, urgent advocacy and action is required to sustain and improve the situation. Local implementing partners need more support and supervision to develop appropriate service models and to maintain an acceptable standard of care. PMID:19283634

  5. Depressing Antidepressant: Fluoxetine Affects Serotonin Neurons Causing Adverse Reproductive Responses in Daphnia magna.

    PubMed

    Campos, Bruno; Rivetti, Claudia; Kress, Timm; Barata, Carlos; Dircksen, Heinrich

    2016-06-01

    Selective serotonin reuptake inhibitors (SSRIs) are widely used antidepressants. As endocrine disruptive contaminants in the environment, SSRIs affect reproduction in aquatic organisms. In the water flea Daphnia magna, SSRIs increase offspring production in a food ration-dependent manner. At limiting food conditions, females exposed to SSRIs produce more but smaller offspring, which is a maladaptive life-history strategy. We asked whether increased serotonin levels in newly identified serotonin-neurons in the Daphnia brain mediate these effects. We provide strong evidence that exogenous SSRI fluoxetine selectively increases serotonin-immunoreactivity in identified brain neurons under limiting food conditions thereby leading to maladaptive offspring production. Fluoxetine increases serotonin-immunoreactivity at low food conditions to similar maximal levels as observed under high food conditions and concomitantly enhances offspring production. Sublethal amounts of the neurotoxin 5,7-dihydroxytryptamine known to specifically ablate serotonin-neurons markedly decrease serotonin-immunoreactivity and offspring production, strongly supporting the effect to be serotonin-specific by reversing the reproductive phenotype attained under fluoxetine. Thus, SSRIs impair serotonin-regulation of reproductive investment in a planktonic key organism causing inappropriately increased reproduction with potentially severe ecological impact. PMID:27128505

  6. Adolescent reproductive health in Indonesia: contested values and policy inaction.

    PubMed

    Utomo, Iwu Dwisetyani; McDonald, Peter

    2009-06-01

    This study examines the changing social and political context of adolescent sexual and reproductive health policy in Indonesia. We describe how, in 2001, Indonesia was on the brink of implementing an adolescent reproductive health policy that was consistent with international agreements to which the Indonesian government was a party. Although the health of young Indonesians was known to be at risk, the opportunity for reform passed quickly with the emergence of a new competing force, Middle Eastern fundamentalist Islam. Faced with the risk of regional separatism and competing politico-religious influences, the Indonesian government retreated to the safety of inaction in this area of policy. In the absence of a supportive and committed political environment that reinforces policy specifically targeted to young people's reproductive health, extremist approaches that involve considerable health risk prevailed. The sexual and reproductive values and behaviors that are emerging among single young people in contemporary Indonesia are conditioned by a political context that allows the conflicting forces of traditional Indonesian values, Westernization, and the strong emerging force of fundamentalist Islam to compete for the allegiance of young people. PMID:19662805

  7. Reproductive health and health sector reform in developing countries: establishing a framework for dialogue.

    PubMed Central

    Lubben, Marianne; Mayhew, Susannah H.; Collins, Charles; Green, Andrew

    2002-01-01

    It is not clear how policy-making in the field of reproductive health relates to changes associated with programmes for the reform of the health sector in developing countries. There has been little communication between these two areas, yet policy on reproductive health has to be implemented in the context of structural change. This paper examines factors that limit dialogue between the two areas and proposes the following framework for encouraging it: the identification of policy groups and the development of bases for collaborative links between them; the introduction of a common understanding around relevant policy contexts; reaching agreement on compatible aims relating to reproductive health and health sector change; developing causal links between policy content in reproductive health and health sector change as a basis for evidence-based policy-making; and strengthening policy-making structures, systems, skills, and values. PMID:12219159

  8. How Obamacare will impact reproductive health.

    PubMed

    Brezina, Paul R; Shah, Anish A; Myers, Evan R; Huang, Andy; DeCherney, Alan H

    2013-05-01

    For many years, health care delivery in the United States was accomplished through a complicated and evolving series of publicly and privately available insurance programs. In recent years, the increasing cost of health care as well as the relatively large number of individuals without any health care insurance coverage has prompted repeated attempts to modify or overhaul the current health care delivery paradigm. The largest legislative change to this system occurred on March 23, 2010, when President Barack Obama signed into law the Patient Protection and Affordable Care Act (PPACA).The PPACA is a multifaceted and sweeping piece of legislation. The law introduces a myriad number of changes into both public and private health insurance. Understanding the law, its implications, and how to navigate through these changes is essential to provide high-quality health care to patients. Although the law or parts of it are still at risk of being modified either through judicial or political action, it is important to recognize the current aspects of the law to understand any future modifications. Providing health care coverage in the United States is sure to be as it has always been: a constantly changing and evolving set of private and public policies that carry with them significant complexities and challenges. Health care providers must constantly strive to maximize access to and quality of medical care in whatever paradigm evolves in the future. PMID:23609149

  9. Assessment on the adverse effects of Aminoglycosides and Flouroquinolone on sperm parameters and male reproductive tissue: A systematic review

    PubMed Central

    Khaki, Arash

    2015-01-01

    Background: Antibiotic therapies used in treatment of many diseases have adverse effects on fertility. This review analyzes previous comparative studies that surveyed the effects of two common groups of antibiotics on male fertility. Objective: To evaluate histo-pathological effects of fluoroquinolones and aminoglycosides on sperm parameters and male reproductive tissue. Materials and Methods: Articles about the effects of aminoglycosides and fluoroquinolones on male infertility, sperm parameters, male reproductive tissue, and spermatogenesis in English and Persian languages published on Google Scholar and PubMed databases from January 2000 to December 2013 were assessed. Randomized controlled trials (RCTs) assessing the effects of aminoglycosides or fluoroquinolones on sperm parameters, artificial insemination, and male reproductive tract or RCTs comparing aminoglycosides vs. fluoroquinolones were eligible for inclusion. For ascertaining the reliability of study, data were extracted independently and in duplicate by two investigators. Results: Sperm viability was decreased significantly with streptomycin, gentamicin, and neomycin (p<0.001). Sperm motility was decreased significantly with gentamicin and neomycin (p<0.05). Total sperm count was significantly decreased with ofloxacin, gentamicin, streptomycin, and neomycin (p<0.022). There was significant decrease in post-thawing motility with low dose and high dose of ciprofloxacin. Testis weight was decreased with gentamicin and ofloxacin significantly (p<0.011). There was significant decrease in seminal vesicle weight with gentamicin, neomycin, and ofloxacin (p<0.022). Furthermore, changes in epididymis weight, percentage of total apoptotic cells, and diameter of seminiferous tubule were significant with all drugs including streptomycin, gentamicin, neomycin, and ofloxacin (p<0.05). Conclusion: Streptomycin has less negative effects on cell’s apoptosis and sperm parameters as compared to other drugs. Gentamicin

  10. Use of Adverse Outcome Pathways for Assessing Effects of the Fungicide Propiconazole on Fish Reproduction

    EPA Science Inventory

    Adverse outcome pathways (AOP) are used to describe the linkage of biological events from a molecular initiating point, to individual-level-endpoints relevant to risk assessment. This study was done to assess toxicity outcomes for the conazole fungicide propiconazole based on a p...

  11. Defining Adverse Outcome Pathways for Effects of the Fungicide Propiconazole of Fish Reproduction

    EPA Science Inventory

    Adverse outcome pathways (AOPs) are used to describe the linkage of chemical interactions in terms of molecular initiating events to whole organism responses suitable for risk assessment. This study was conducted to develop AOPs for the model fungicide propiconazole relative to r...

  12. The adverse effects of high fat induced obesity on female reproductive cycle and hormones

    NASA Astrophysics Data System (ADS)

    Donthireddy, Laxminarasimha Reddy

    The prevalence of obesity, an established risk and progression factor for abnormal reproductive cycle and tissue damage in female mice. It leads to earlier puberty, menarche in young females and infertility. There are extensive range of consequences of obesity which includes type-2 diabetes, cardiovascular disease and insulin resistance. Obesity is the interaction between dietary intake, genes, life style and environment. The interplay of hormones estrogen, insulin, and leptin is well known on energy homeostasis and reproduction. The aim of this study is to determine the effect of high fat induced obesity on reproductive cycles and its hormonal abnormalities on mice model. Two week, 3 month and 8 month long normal (WT) and very high fat diet (VHFD) diet course is followed. When mice are fed with very high fat diet, there is a drastic increase in weight within the first week later. There was a significant (p<0.001) increase in leptin levels in 6 month VHFD treated animals. 2 week, 3 month and 6 month time interval pap smear test results showed number of cells, length of estrous cycle and phases of the estrous cycle changes with VHFD mice(n=30) compared to normal diet mice(n=10). These results also indicate that the changes in the reproductive cycles in VHFD treated female mice could be due to the changes in hormones. Histo-pathological analyses of kidney, ovary, liver, pancreas, heart and lungs showed remarkable changes in some tissue on exposure to very high fat. Highly deposited fat packets observed surrounding the hepatocytes and nerve cells.

  13. Predictors of Caregiver Supportive Behaviors towards Reproductive Health Care for Women with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Lin, Lan-Ping; Lin, Pei-Ying; Chu, Cordia M.; Lin, Jin-Ding

    2011-01-01

    Although many previous studies have begun to address the reproductive health needs of women with intellectual disabilities; however, the supportive behaviors of caregivers to assist their reproductive health is not well understood. Data from a cross-sectional survey of ""2009 National Survey on Reproductive Health Care Needs and Health Education…

  14. Promotion of adolescent reproductive health and healthy living. Malaysia.

    PubMed

    1999-12-01

    This article discusses a 3-year project, "Promotion of Adolescent Reproductive Health and Healthy Living," which was implemented by the Federation of Family Planning Associations, Malaysia. The project seeks to achieve the following: 1) development of a reproductive health of adolescent module (RHAM) for trainers and educators; 2) training of trainers; 3) sharing of adolescent reproductive health experiences in Asian countries; and 4) setting up three service models in Sabah, Selangor, and Terengganu to provide reproductive health (RH) care to adolescents and youth. The first part of the RHAM with the trainer's manual has been finalized and will be tested in a workshop. The second part, a teacher's guide, is under preparation. A series of training on the use of the RHAM will be conducted including a 5-day national workshop, which will be followed by several state level workshops. The three service models being set up have specific orientations. The Sabah model is putting up a youth clinic for adolescents within its clinic network. The Selangor model is developing a Youth Resource Center for training and youth involvement in RH activities. Lastly, the Terengganu family planning association (FPA) has developed a Youth Center web site, which features the history, mission, and activities of the Terengganu FPA. PMID:12158246

  15. Developing Multipurpose Reproductive Health Technologies: An Integrated Strategy

    PubMed Central

    Harrison, P. F.; Hemmerling, A.; Romano, J.; Whaley, K. J.; Young Holt, B.

    2013-01-01

    Women worldwide confront two frequently concurrent reproductive health challenges: the need for contraception and for protection from sexually transmitted infections, importantly HIV/AIDS. While conception and infection share the same anatomical site and mode of transmission, there are no reproductive health technologies to date that simultaneously address that reality. Relevant available technologies are either contraceptive or anti-infective, are limited in number, and require different modes of administration and management. These “single-indication” technologies do not therefore fully respond to what is a substantial reproductive health need intimately linked to pivotal events in many women's lives. This paper reviews an integrated attempt to develop multipurpose prevention technologies—“MPTs”—products explicitly designed to simultaneously address the need for both contraception and protection from sexually transmitted infections. It describes an innovative and iterative MPT product development strategy with the following components: identifying different needs for such technologies and global variations in reproductive health priorities, defining “Target Product Profiles” as the framework for a research and development “roadmap,” collating an integrated MPT pipeline and characterizing significant pipeline gaps, exploring anticipated regulatory requirements, prioritizing candidates for problem-solving and resource investments, and implementing an ancillary advocacy agenda to support this breadth of effort. PMID:23533733

  16. Reproductive health: a right for refugees and internally displaced persons.

    PubMed

    Austin, Judy; Guy, Samantha; Lee-Jones, Louise; McGinn, Therese; Schlecht, Jennifer

    2008-05-01

    Continued political and civil unrest in low-resource countries underscores the ongoing need for specialised reproductive health services for displaced people. Displaced women particularly face high maternal mortality, unmet need for family planning, complications following unsafe abortion, and gender-based violence, as well as sexually transmitted diseases, including HIV. Relief and development agencies and UN bodies have developed technical materials, made positive policy changes specific to crisis settings and are working to provide better reproductive health care. Substantial gaps remain, however. The collaboration within the field of reproductive health in crises is notable, with many agencies working in one or more networks. The five-year RAISE Initiative brings together major UN and NGO agencies from the fields of relief and development, and builds on their experience to support reproductive health service delivery, advocacy, clinical training and research. The readiness to use common guidance documents, develop priorities jointly and share resources has led to smoother operations and less overlap than if each agency worked independently. Trends in the field, including greater focus on internally displaced persons and those living in non-camp settings, as well as refugees in camps, the protracted nature of emergencies, and an increasing need for empirical evidence, will influence future progress. PMID:18513603

  17. Cultural Clashes in Reproductive Health Information in Schools

    ERIC Educational Resources Information Center

    Mbananga, Nolwazi

    2004-01-01

    This paper reports on an empirical study that investigated the content of and perceptions about reproductive health information among school teachers and learners in a rural area of South Africa. Qualitative methods were used to assess the dissemination and acceptability of and perceptions about information related to HIV/AIDS, sexuality, family…

  18. A resolution supporting women's reproductive health.

    THOMAS, 113th Congress

    Sen. Boxer, Barbara [D-CA

    2013-02-27

    02/27/2013 Referred to the Committee on Health, Education, Labor, and Pensions. (text of measure as introduced: CR S947) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  19. Ethical issues relating to reproduction control and women's health.

    PubMed

    Schenker, J G; Eisenberg, V H

    1997-07-01

    There are many ethical aspects which derive from the application of reproduction control in women's health. Women's health can be enhanced if women are given the opportunity to make their own reproduction choices about sex, contraception, abortion and application of reproductive technologies. The main issues that raise ethical dilemmas following the development of assisted reproduction techniques are: the right to procreate or reproduce; the process of in vitro fertilization itself-is it morally acceptable to interfere in the reproduction process?; the moral status of the embryo; the involvement of a third party in the reproductive process by genetic material donation; the practice of surrogacy, cryopreservation of pre-embryos; genetic manipulation; experiments on pre-embryos, etc. Induced abortion raises ethical issues related to the rights of the woman versus the rights of the fetus. For those who consider life to begin at conception abortion always equals murder and is therefore forbidden. Those who believe in the absolute autonomy of the woman over her body take the other extreme approach. The discussion surrounding abortion usually centers on whether it should be legal or illegal. Access to safe abortion is critical to the health of women and to their autonomy. The development of new effective contraceptive methods has a profound impact on women's lives. By the use of contraception it is possible to lessen maternal, infant and child mortality and to reduce the prevalence of sexually transmitted diseases. Research and development of new effective reversible contraceptives for women and men is needed. Dissemination of information about the safety and effectiveness of contraceptive methods is of great importance. Female genital mutilation is still practiced worldwide due to customs and tradition among various ethnic groups. The procedure is considered to be medically detrimental to the physical and mental health of women and girls, and is considered by many as

  20. Adverse Life Events and Mental Health in Middle Adolescence

    ERIC Educational Resources Information Center

    Flouri, Eirini; Kallis, Constantinos

    2011-01-01

    This study's aim was to search for the appropriate functional form of the effect of proximal cumulative contextual risk (PCCR), measured with number of adverse life events experienced in the last 6 months, on adolescent psychopathology and prosocial behavior, measured with the Strengths and Difficulties Questionnaire. The study sample was 171 year…

  1. Adverse Effects of Subchronic Dose of Aspirin on Reproductive Profile of Male Rats

    PubMed Central

    Vyas, Archana; Ram, Heera; Purohit, Ashok; Jatwa, Rameshwar

    2016-01-01

    Aspirin (acetylsalicylic acid) is widely used for cardiovascular prophylaxis and as anti-inflammatory pharmaceutical. An investigation was carried out to evaluate the influence of subchronic dose of aspirin on reproductive profile of male rats, if any. Experimental animals were divided into three groups: control and aspirin subchronic dose of 12.5 mg/kg for 30 days and 60 days, respectively, while alterations in sperm dynamics, testicular histopathological and planimetric investigations, body and organs weights, lipid profiles, and hematology were performed as per aimed objectives. Subchronic dose of aspirin reduced sperm density, count, and mobility in cauda epididymis and testis; histopathology and developing primary spermatogonial cells (primary spermatogonia, secondary spermatogonia, and mature spermatocyte) count were also significantly decreased in rats. Hematological investigations revealed hemopoietic abnormalities in 60-day-treated animals along with dysfunctions in hepatic and renal functions. The findings of the present study revealed that administration with subchronic dose of aspirin to male rats resulted in altered reproductive profiles and serum biochemistry. PMID:27190691

  2. Towards universal health coverage for reproductive health services in Ethiopia: two policy recommendations.

    PubMed

    Onarheim, Kristine Husøy; Taddesse, Mieraf; Norheim, Ole Frithjof; Abdullah, Muna; Miljeteig, Ingrid

    2015-01-01

    Reproductive health services are crucial for maternal and child health, but universal health coverage is still not within reach in most societies. Ethiopia's goal of universal health coverage promises access to all necessary services for everyone while providing protection against financial risk. When moving towards universal health coverage, health plans and policies require contextualized knowledge about baseline indicators and their distributions. To understand more about the factors that explain coverage, we study the relationship between socioeconomic and geographic factors and the use of reproductive health services in Ethiopia, and further explore inequalities in reproductive health coverage. Based on these findings, we discuss the normative implications of these findings for health policy. Using population-level data from the Ethiopian Demographic and Health Survey (2011) in a multivariate logistic model, we find that family planning and use of antenatal care are associated with higher wealth, higher education and being employed. Skilled attendance at birth is associated with higher wealth, higher education, and urban location. There is large variation between Addis Ababa (the capital) and other administrative regions. Concentration indices show substantial inequalities in the use of reproductive health services. Decomposition of the concentration indices indicates that difference in wealth is the most important explanatory factor for inequality in reproductive health coverage, but other factors, such as urban setting and previous health care use, are also associated with inequalities. When aiming for universal health coverage, this study shows that different socioeconomic factors as well as health-sector factors should be addressed. Our study re-confirms the importance of a broader approach to reproductive health, and in particular the importance of inequality in wealth and geography. Poor, non-educated, non-employed women in rural areas are

  3. Racial and ethnic health disparities in reproductive medicine: an evidence-based overview.

    PubMed

    Owen, Carter M; Goldstein, Ellen H; Clayton, Janine A; Segars, James H

    2013-09-01

    Racial and ethnic health disparities in reproductive medicine exist across the life span and are costly and burdensome to our healthcare system. Reduction and ultimate elimination of health disparities is a priority of the National Institutes of Health who requires reporting of race and ethnicity for all clinical research it supports. Given the increasing rates of admixture in our population, the definition and subsequent genetic significance of self-reported race and ethnicity used in health disparity research is not straightforward. Some groups have advocated using self-reported ancestry or carefully selected single-nucleotide polymorphisms, also known as ancestry informative markers, to sort individuals into populations. Despite the limitations in our current definitions of race and ethnicity in research, there are several clear examples of health inequalities in reproductive medicine extending from puberty and infertility to obstetric outcomes. We acknowledge that socioeconomic status, education, insurance status, and overall access to care likely contribute to the differences, but these factors do not fully explain the disparities. Epigenetics may provide the biologic link between these environmental factors and the transgenerational disparities that are observed. We propose an integrated view of health disparities across the life span and generations focusing on the metabolic aspects of fetal programming and the effects of environmental exposures. Interventions aimed at improving nutrition and minimizing adverse environmental exposures may act synergistically to reverse the effects of these epigenetic marks and improve the outcome of our future generations. PMID:23934691

  4. Racial and Ethnic Health Disparities in Reproductive Medicine: An Evidence-Based Overview

    PubMed Central

    Owen, Carter M.; Goldstein, Ellen H.; Clayton, Janine A.; Segars, James H.

    2014-01-01

    Racial and ethnic health disparities in reproductive medicine exist across the life span and are costly and burdensome to our healthcare system. Reduction and ultimate elimination of health disparities is a priority of the National Institutes of Health who requires reporting of race and ethnicity for all clinical research it supports. Given the increasing rates of admixture in our population, the definition and subsequent genetic significance of self-reported race and ethnicity used in health disparity research is not straightforward. Some groups have advocated using self-reported ancestry or carefully selected single-nucleotide polymorphisms, also known as ancestry informative markers, to sort individuals into populations. Despite the limitations in our current definitions of race and ethnicity in research, there are several clear examples of health inequalities in reproductive medicine extending from puberty and infertility to obstetric outcomes. We acknowledge that socioeconomic status, education, insurance status, and overall access to care likely contribute to the differences, but these factors do not fully explain the disparities. Epigenetics may provide the biologic link between these environmental factors and the transgenerational disparities that are observed. We propose an integrated view of health disparities across the life span and generations focusing on the metabolic aspects of fetal programming and the effects of environmental exposures. Interventions aimed at improving nutrition and minimizing adverse environmental exposures may act synergistically to reverse the effects of these epigenetic marks and improve the outcome of our future generations. PMID:23934691

  5. Localised hydrogen peroxide sensing for reproductive health

    NASA Astrophysics Data System (ADS)

    Purdey, Malcolm S.; Schartner, Erik P.; Sutton-McDowall, Melanie L.; Ritter, Lesley J.; Thompson, Jeremy G.; Monro, Tanya M.; Abell, Andrew D.

    2015-05-01

    The production of reactive oxygen species (ROS) is known to affect the developmental competence of embryos. Hydrogen peroxide (H2O2) an important reactive oxygen species, is also known to causes DNA damage and defective sperm function. Current techniques require incubating a developing embryo with an organic fluorophore which is potentially hazardous for the embryo. What we need is a localised ROS sensor which does not require fluorophores in solution and hence will allow continuous monitoring of H2O2 production without adversely affect the development of the embryo. Here we report studies on such a fibre-based sensor for the detection of H2O2 that uses a surface-bound aryl boronate fluorophore carboxyperoxyfluor-1(CPF1). Optical fibres present a unique platform due to desirable characteristics as dip sensors in biological solutions. Attempts to functionalise the fibre tips using polyelectrolyte layers and (3-aminopropyl)triethoxysilane (APTES) coatings resulted in a limited signal and poor fluorescent response to H2O2 due to a low tip surface density of the fluorophore. To increase the surface density, CPF1 was integrated into a polymer matrix formed on the fibre tip by a UV-catalysed polymerisation process of acrylamide onto a methacrylate silane layer. The polyacrylamide containing CPF1 gave a much higher surface density than previous surface attachment methods and the sensor was found to effectively detect H2O2. Using this method, biologically relevant concentrations of H2O2 were detected, enabling remote sensing studies into ROS releases from embryos throughout early development.

  6. Disparities in access to reproductive health options for female adolescents.

    PubMed

    Ely, Gretchen E; Dulmus, Catherine N

    2010-05-01

    Fifty percent of female adolescents in the United States have intercourse by age 17, yet they do not have the autonomy under the law to access reproductive healthcare services that can address and prevent the negative consequences often associated with adolescent involvement in sexual activity. This article discusses disparities in access to reproductive health services for adolescents in three areas: abortion, over-the-counter emergency contraception, and the provision of the human papillomavirus vaccine. Suggestions for advocacy efforts necessary to eliminate such health disparities are also presented in an effort to elevate female adolescents to a status where they have the same access to health services that are available to adult women. PMID:20446180

  7. Sexual and reproductive health for all: a call for action.

    PubMed

    Fathalla, Mahmoud F; Sinding, Steven W; Rosenfield, Allan; Fathalla, Mohammed M F

    2006-12-01

    At the United Nations International Conference on Population and Development in Cairo in 1994, the international community agreed to make reproductive health care universally available no later than 2015. After a 5-year review of progress towards implementation of the Cairo programme of action, that commitment was extended to include sexual, as well as reproductive, health and rights. Although progress has been made towards this commitment, it has fallen a long way short of the original goal. We argue that sexual and reproductive health for all is an achievable goal--if cost-effective interventions are properly scaled up; political commitment is revitalised; and financial resources are mobilised, rationally allocated, and more effectively used. National action will need to be backed up by international action. Sustained effort is needed by governments in developing countries and in the donor community, by inter-governmental organisations, non-governmental organisations, civil society groups, the women's health movement, philanthropic foundations, the private for-profit sector, the health profession, and the research community. PMID:17161731

  8. Symptoms of Common Mental Disorders and Adverse Health Behaviours in Male Professional Soccer Players

    PubMed Central

    Gouttebarge, Vincent; Aoki, Haruhito; Kerkhoffs, Gino

    2015-01-01

    To present time, scientific knowledge about symptoms of common mental disorders and adverse health behaviours among professional soccer players is lacking. Consequently, the aim of the study was to determine the prevalence of symptoms of common mental disorders (distress, anxiety/depression, sleep disturbance) and adverse health behaviours (adverse alcohol behaviour, smoking, adverse nutrition behaviour) among professional soccer players, and to explore their associations with potential stressors (severe injury, surgery, life events and career dissatisfaction). Cross-sectional analyses were conducted on baseline questionnaires from an ongoing prospective cohort study among male professional players. Using validated questionnaires to assess symptoms of common mental disorders and adverse health behaviours as well as stressors, an electronic questionnaire was set up and distributed by players’ unions in 11 countries from three continents. Prevalence of symptoms of common mental disorders and adverse health behaviours among professional soccer players ranged from 4% for smoking and 9% for adverse alcohol behaviour to 38% for anxiety/depression and 58% for adverse nutrition behaviour. Significant associations were found for a higher number of severe injuries with distress, anxiety/depression, sleeping disturbance and adverse alcohol behaviour, an increased number of life events with distress, sleeping disturbance, adverse alcohol behaviour and smoking, as well as an elevated level of career dissatisfaction with distress, anxiety/depression and adverse nutrition behaviour. Statistically significant correlations (p<0.01) were found for severe injuries and career dissatisfaction with most symptoms of common mental disorders. High prevalence of symptoms of common mental disorders and adverse health behaviours was found among professional players, confirming a previous pilot-study in a similar study population. PMID:26925182

  9. Bisphenol A and Reproductive Health: Update of Experimental and Human Evidence, 2007–2013

    PubMed Central

    Peretz, Jackye; Vrooman, Lisa; Ricke, William A.; Hunt, Patricia A.; Ehrlich, Shelley; Hauser, Russ; Padmanabhan, Vasantha; Taylor, Hugh S.; Swan, Shanna H.; VandeVoort, Catherine A.

    2014-01-01

    Background: In 2007, an expert panel reviewed associations between bisphenol A (BPA) exposure and reproductive health outcomes. Since then, new studies have been conducted on the impact of BPA on reproduction. Objective: In this review, we summarize data obtained since 2007, focusing on a) findings from human and animal studies, b) the effects of BPA on a variety of reproductive end points, and c) mechanisms of BPA action. Methods: We reviewed the literature published from 2007 to 2013 using a PubMed search based on keywords related to BPA and male and female reproduction. Discussion: Because BPA has been reported to affect the onset of meiosis in both animal and in vitro models, interfere with germ cell nest breakdown in animal models, accelerate follicle transition in several animal species, alter steroidogenesis in multiple animal models and women, and reduce oocyte quality in animal models and women undergoing in vitro fertilization (IVF), we consider it an ovarian toxicant. In addition, strong evidence suggests that BPA is a uterine toxicant because it impaired uterine endometrial proliferation, decreased uterine receptivity, and increased implantation failure in animal models. BPA exposure may be associated with adverse birth outcomes, hyperandrogenism, sexual dysfunction, and impaired implantation in humans, but additional studies are required to confirm these associations. Studies also suggest that BPA may be a testicular toxicant in animal models, but the data in humans are equivocal. Finally, insufficient evidence exists regarding effects of BPA on the oviduct, the placenta, and pubertal development. Conclusion: Based on reports that BPA impacts female reproduction and has the potential to affect male reproductive systems in humans and animals, we conclude that BPA is a reproductive toxicant. Citation: Peretz J, Vrooman L, Ricke WA, Hunt PA, Ehrlich S, Hauser R, Padmanabhan V, Taylor HS, Swan SH, VandeVoort CA, Flaws JA. 2014. Bisphenol A and reproductive

  10. Equity of access to and utilization of reproductive health services in Thailand: national Reproductive Health Survey data, 2006 and 2009.

    PubMed

    Kongsri, Suratchada; Limwattananon, Supon; Sirilak, Supakit; Prakongsai, Phusit; Tangcharoensathien, Viroj

    2011-05-01

    This study assessed trends in equity of access to reproductive health services and service utilization in terms of coverage of family planning, antenatal care and skilled birth attendance in Thailand. Two health indicators were measured: the prevalence of low birthweight and exclusive breastfeeding. Equity was measured against the combined urban-rural areas and geographic regions, women's education level and quintiles of household assets index. The study used data from two nationally representative household surveys, the 2006 and 2009 Reproductive Health Surveys. Very high coverage of family planning (79.6%), universal antenatal care (98.9%) and skilled birth attendance (99.7%), with very small socioeconomic and geographic disparities, were observed. The public sector played a dominant role in maternity care (90.9% of all deliveries in 2009). The private sector also had a role among the higher educated, wealthier women living in urban areas. Public sector facilities, followed by drug stores, were a major supplier of contraception, which had a high use rate. High coverage and low inequity were the result of extensive investment in the health system by successive governments, in particular primary health care at district and sub-district levels, reaching universality by 2002. While maintaining these achievements, methodological improvements in measuring low birthweight and exclusive breastfeeding for future reproductive health surveys are recommended. PMID:21555089

  11. Pupils' Perceptions of Sex and Reproductive Health Education in Primary Schools in Tanzania: A Phenomenological Study

    ERIC Educational Resources Information Center

    Kapinga, Orestes Silverius; Hyera, Daniel Frans

    2015-01-01

    This study explored pupils' perceptions of sex and reproductive health education in primary schools in Tanzania. Specifically, the study aimed at (i) exploring pupils' views on sex and reproductive health education in primary schools; (ii) determining opinions on the appropriateness of sex and reproductive health education for pupils in primary…

  12. Biological control of vaginosis to improve reproductive health

    PubMed Central

    Mastromarino, P.; Hemalatha, R.; Barbonetti, A.; Cinque, B.; Cifone, M.G.; Tammaro, F.; Francavilla, F.

    2014-01-01

    The human vaginal microbiota plays an important role in the maintenance of a woman's health, as well as of her partner's and newborns’. When this predominantly Lactobacillus community is disrupted, decreased in abundance and replaced by different anaerobes, bacterial vaginosis (BV) may occur. BV is associated with ascending infections and obstetrical complications, such as chorioamnionitis and preterm delivery, as well as with urinary tract infections and sexually transmitted infections. In BV the overgrowth of anaerobes produces noxious substances like polyamines and other compounds that trigger the release of pro-inflammatory cytokines interleukin (IL)-1 β and IL-8. BV can profoundly affect, with different mechanisms, all the phases of a woman's life in relation to reproduction, before pregnancy, during fertilization, through and at the end of pregnancy. BV can directly affect fertility, since an ascending dissemination of the involved species may lead to tubal factor infertility. Moreover, the increased risk of acquiring sexually transmitted diseases contributes to damage to reproductive health. Exogenous strains of lactobacilli have been suggested as a means of re-establishing a normal healthy vaginal flora. Carefully selected probiotic strains can eliminate BV and also exert an antiviral effect, thus reducing viral load and preventing foetal and neonatal infection. The administration of beneficial microorganisms (probiotics) can aid recovery from infection and restore and maintain a healthy vaginal ecosystem, thus improving female health also in relation to reproductive health. PMID:25673551

  13. Catalyzing a Reproductive Health and Social Justice Movement.

    PubMed

    Verbiest, Sarah; Malin, Christina Kiko; Drummonds, Mario; Kotelchuck, Milton

    2016-04-01

    Objectives The maternal and child health (MCH) community, partnering with women and their families, has the potential to play a critical role in advancing a new multi-sector social movement focused on creating a women's reproductive and economic justice agenda. Since the turn of the twenty-first century, the MCH field has been planting seeds for change. The time has come for this work to bear fruit as many states are facing stagnant or slow progress in reducing infant mortality, increasing maternal death rates, and growing health inequities. Methods This paper synthesizes three current, interrelated approaches to addressing MCH challenges-life course theory, preconception health, and social justice/reproductive equity. Conclusion Based on these core constructs, the authors offer four directions for advancing efforts to improve MCH outcomes. The first is to ensure access to quality health care for all. The second is to facilitate change through critical conversations about challenging issues such as poverty, racism, sexism, and immigration; the relevance of evidence-based practice in disenfranchised communities; and how we might be perpetuating inequities in our institutions. The third is to develop collaborative spaces in which leaders across diverse sectors can see their roles in creating equitable neighborhood conditions that ensure optimal reproductive choices and outcomes for women and their families. Last, the authors suggest that leaders engage the MCH workforce and its consumers in dialogue and action about local and national policies that address the social determinants of health and how these policies influence reproductive and early childhood outcomes. PMID:26740226

  14. Race, gender, and chains of disadvantage: childhood adversity, social relationships, and health.

    PubMed

    Umberson, Debra; Williams, Kristi; Thomas, Patricia A; Liu, Hui; Thomeer, Mieke Beth

    2014-03-01

    We use a life course approach to guide an investigation of relationships and health at the nexus of race and gender. We consider childhood as a sensitive period in the life course, during which significant adversity may launch chains of disadvantage in relationships throughout the life course that then have cumulative effects on health over time. Data from a nationally representative panel study (Americans' Changing Lives, N = 3,477) reveal substantial disparities between black and white adults, especially pronounced among men, in the quality of close relationships and in the consequences of these relationships for health. Greater childhood adversity helps to explain why black men have worse health than white men, and some of this effect appears to operate through childhood adversity's enduring influence on relationship strain in adulthood. Stress that occurs in adulthood plays a greater role than childhood adversity in explaining racial disparities in health among women. PMID:24578394

  15. Health sector reform and reproductive health in Latin America and the Caribbean: strengthening the links.

    PubMed Central

    Langer, A.; Nigenda, G.; Catino, J.

    2000-01-01

    Many countries in Latin America and the Caribbean (LAC) are currently reforming their national health sectors and also implementing a comprehensive approach to reproductive health care. Three regional workshops to explore how health sector reform could improve reproductive health services have revealed the inherently complex, competing, and political nature of health sector reform and reproductive health. The objectives of reproductive health care can run parallel to those of health sector reform in that both are concerned with promoting equitable access to high quality care by means of integrated approaches to primary health care, and by the involvement of the public in setting health sector priorities. However, there is a serious risk that health reforms will be driven mainly by financial and/or political considerations and not by the need to improve the quality of health services as a basic human right. With only limited changes to the health systems in many Latin American and Caribbean countries and a handful of examples of positive progress resulting from reforms, the gap between rhetoric and practice remains wide. PMID:10859860

  16. The potential of exposure biomarkers in epidemiologic studies of reproductive health.

    PubMed Central

    Hogue, C J; Brewster, M A

    1991-01-01

    To further the development and application of exposure markers in field investigations in reproductive epidemiology, we have synthesized recent examinations of the issues surrounding exposure measurements in reproductive epidemiology. The specific goals of this paper are to define exposure biomarkers and explore their potential uses, particularly as screening tools. The tests for glucaric acid, thioethers, mutagenicity, and porphyrin patterns meet the general criteria for useful exposure screens. For certain xenobiotic agents, these tests accurately differentiate exposure levels, as demonstrated in occupational and environmental epidemiologic studies. As urinary screens, they are noninvasive and applicable on a large scale with current laboratory techniques. For short-term exposure, glucaric acid, thioethers, and mutagenicity tests are useful. Porphyrin patterns may measure cumulative effects as well as current exposure levels. The usefulness of these tests in epidemiologic studies of environmental effects on reproductive health has yet to be studied. To do so, the battery must be standardized for pregnant women, and test results must be correlated with measured adverse reproductive outcomes, such as gestational length and birthweight. This correlation is particularly important because maternal exposure rather than fetal exposure is being measured. The extent to which xenobiotic chemicals cross the placental barrier may vary greatly depending on the type of exposures, timing in pregnancy, and maternal detoxification capability. Without better exposure measures, epidemiologic studies of reproductive health probably will not successfully identify xenobiotic fetotoxic agents in the environment. However, with an adequate battery of nonspecific exposure biomarkers, prospective studies of environmental effects on pregnancy outcomes might be possible.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2050070

  17. Reproductive health care situation in Bosnia-Herzegovina.

    PubMed

    Dizdarevic-Stojkanovic, J

    1999-01-01

    The law legalizing abortion and implementing family planning, passed in former Yugoslavia in 1952, is still in effect in the newly created state of Bosnia-Herzegovina. This law has helped eliminate illegal, i.e. criminal, abortions, but existing arrangements providing family planning and promoting reproductive and sexual health are not effective enough, because too few people know enough about the rights to individual choice in family planning. The primary objective for the next twenty years is to educate the people--women, men and the young--about their rights to reproductive choice and sexual health, and about how to exercise those rights as fully and effectively as possible. Legal and financial assistance from WHO will be welcome, because the post-war Bosnian society and state lack funds for such initiatives. PMID:10536386

  18. Handbook for Educating on Adolescent Reproductive and Sexual Health. Book One, Understanding the Adolescents and Their Reproductive and Sexual Health: Guide to Better Educational Strategies [and] Book Two, Strategies and Materials on Adolescent Reproductive and Sexual Health Education.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Bangkok (Thailand). Clearing House on Population Education and Communication.

    This two-part handbook presents information on educating adolescents about reproductive and sexual health issues. "Book One, Understanding the Adolescents and Their Reproductive and Sexual Health: Guide to Better Educational Strategies" focuses on the demographic profile of adolescents as well as their fertility, sexual behavior, incidence of…

  19. Mechanisms of toxicity of di(2-ethylhexyl) phthalate on the reproductive health of male zebrafish.

    PubMed

    Uren-Webster, Tamsyn M; Lewis, Ceri; Filby, Amy L; Paull, Gregory C; Santos, Eduarda M

    2010-09-01

    Phthalates are ubiquitous in the aquatic environment and are known to adversely affect male reproductive health in mammals through interactions with multiple receptor systems. However, little is known about the risks they pose to fish. This project investigated the effects of di(2-ethylhexyl) phthalate (DEHP), the most commonly used phthalate, on the reproductive health of male zebrafish (Danio rerio). Males were treated with 0.5, 50 and 5000 mg DEHP kg(-1) (body weight) for a period of 10 days via intraperitoneal injection. The effects of the exposure were assessed by analysing fertilisation success, testis histology, sperm DNA integrity and transcript profiles of the liver and testis. A significant increase in the hepatosomatic index and levels of hepatic vitellogenin transcript were observed following exposure to 5000 mg DEHP kg(-1). Exposure to 5000 mg DEHP kg(-1) also resulted in a reduction in fertilisation success of oocytes spawned by untreated females. However, survival and development of the resulting embryos were unaffected by all treatments, and no evidence of DEHP-induced sperm DNA damage was observed. Exposure to 50 and 5000 mg DEHP kg(-1) caused alterations in the proportion of germ cells at specific stages of spermatogenesis in the testis, including a reduction in the proportion of spermatozoa and an increase in the proportion of spermatocytes, suggesting that DEHP may inhibit the progression of meiosis. In parallel, exposure to 5000 mg DEHP kg(-1) increased the levels of two peroxisome proliferator-activated receptor (PPAR) responsive genes (acyl-coenzyme A oxidase 1 (acox1) and enoyl-coenzyme A, hydratase/3-hydroxyacyl coenzyme A dehydrogenase (ehhadh). These data demonstrated that exposure to high concentrations of DEHP disrupts spermatogenesis in adult zebrafish with a consequent decrease in their ability to fertilise oocytes spawned by untreated females. Furthermore, our data suggest that the adverse effects caused by exposure to DEHP are

  20. The binary mixtures of megestrol acetate and 17α-ethynylestradiol adversely affect zebrafish reproduction.

    PubMed

    Hua, Jianghuan; Han, Jian; Wang, Xianfeng; Guo, Yongyong; Zhou, Bingsheng

    2016-06-01

    Synthetic progesterones and estrogens are broadly used bioactive pharmaceutical agents and have been detected in aquatic environments. In the present study, we investigated the combined reproductive effects of megestrol acetate (MTA) and 17α-ethinylestradiol (EE2) on zebrafish. Adult zebrafish were exposed to MTA (33, 100 or 333 ng/L), EE2 (10 ng/L) or a mixture of both (MTA + EE2: 33 + 10, 100 + 10 or 333 + 10 ng/L) for 21 days. Results demonstrated that egg production was significantly reduced by exposure to 10 ng/L EE2, but not MTA. However, a combined exposure to MTA and EE2 caused further reduction of fish fecundity compared to EE2 exposure alone, suggesting an additive effect on egg production when EE2 is supplemented with MTA. Plasma concentrations of 17β-estradiol and testosterone in the females and 11-ketotestosterone in the males were significantly decreased in the groups exposed to EE2 or MTA alone compared with the solvent control, and the plasma concentrations of the three hormones were further reduced in the co-exposure groups relative to the MTA exposure group, but not the EE2 exposure group. These data indicate that the inhibitory effects on plasma concentrations in the co-exposures were predominantly caused by EE2. Furthermore, exposure to MTA and EE2 (alone or in combination) led to histological alterations in the ovaries (decreased vitellogenic/mature oocytes), but not in the testes. This study has important implications for environmental risk assessment of synthetic hormones that are concurrently present in aquatic systems. PMID:27038209

  1. Adverse Health Problems Among Municipality Workers in Alexandria (Egypt)

    PubMed Central

    Abd El-Wahab, Ekram W.; Eassa, Safaa M.; Lotfi, Sameh E.; El Masry, Sanaa A.; Shatat, Hanan Z.; Kotkat, Amira M.

    2014-01-01

    Background: Solid waste management has emerged as an important human and environmental health issue. Municipal solid waste workers (MSWWs) are potentially exposed to a variety of occupational biohazards and safety risks. The aim of this study was to describe health practices and safety measures adopted by workers in the main municipal company in Alexandria (Egypt) as well as the pattern of the encountered work related ill health. Methods: A cross-sectional study was conducted between January and April 2013. We interviewed and evaluated 346 workers serving in about 15 different solid waste management activities regarding personal hygiene, the practice of security and health care measures and the impact of solid waste management. Results: Poor personal hygiene and self-care, inadequate protective and safety measures for potentially hazardous exposure were described. Impact of solid waste management on health of MSWWs entailed high prevalence of gastrointestinal, respiratory, skin and musculoskeletal morbidities. Occurrence of accidents and needle stick injuries amounted to 46.5% and 32.7% respectively. The risk of work related health disorders was notably higher among workers directly exposed to solid waste when compared by a group of low exposure potential particularly for diarrhea (odds ratio [OR] = 2.2, 95% confidence interval [CI] = 1.2-3.8), vomiting (OR = 2.7, 95% CI = 1.1-6.6), abdominal colic (OR = 1.9, 95% CI = 1.1-3.2), dysentery (OR = 3.6, 95% CI = 1.3-10), dyspepsia (OR = 1.8, 95% CI = 1.1-3), low back/sciatic pain (OR = 3.5, 95% CI = 1.8-7), tinnitus (OR = 6.2, 95% CI = 0.3-122) and needle stick injury (OR = 3.4, 95% CI = 2.1-5.5). Conclusions: Workers exposed to solid waste exhibit significant increase in risk of ill health. Physician role and health education could be the key to assure the MSWWs health safety. PMID:24932385

  2. Childhood Adverse Events and Health Outcomes among Methamphetamine-Dependent Men and Women

    ERIC Educational Resources Information Center

    Messina, Nena P.; Marinelli-Casey, Patricia; Hillhouse, Maureen; Ang, Alfonso; Hunter, Jeremy; Rawson, Richard

    2008-01-01

    To describe the prevalence of childhood adverse events (CAEs) among methamphetamine-dependent men and women, and assess the relationship of cumulative CAEs to health problems. Data for 236 men and 351 women were analyzed assessing CAEs. Dependent variables included 14 self-reported health problems or psychiatric symptom domains. Mental health was…

  3. Cumulative Adversity Sensitizes Neural Response to Acute Stress: Association with Health Symptoms

    PubMed Central

    Seo, Dongju; Tsou, Kristen A; Ansell, Emily B; Potenza, Marc N; Sinha, Rajita

    2014-01-01

    Cumulative adversity (CA) increases stress sensitivity and risk of adverse health outcomes. However, neural mechanisms underlying these associations in humans remain unclear. To understand neural responses underlying the link between CA and adverse health symptoms, the current study assessed brain activity during stress and neutral-relaxing states in 75 demographically matched, healthy individuals with high, mid, and low CA (25 in each group), and their health symptoms using the Cornell Medical Index. CA was significantly associated with greater adverse health symptoms (P=0.01) in all participants. Functional magnetic resonance imaging results indicated significant associations between CA scores and increased stress-induced activity in the lateral prefrontal cortex, insula, striatum, right amygdala, hippocampus, and temporal regions in all 75 participants (p<0.05, whole-brain corrected). In addition to these regions, the high vs low CA group comparison revealed decreased stress-induced activity in the medial orbitofrontal cortex (OFC) in the high CA group (p<0.01, whole-brain corrected). Specifically, hypoactive medial OFC and hyperactive right hippocampus responses to stress were each significantly associated with greater adverse health symptoms (p<0.01). Furthermore, an inverse correlation was found between activity in the medial OFC and right hippocampus (p=0.01). These results indicate that high CA sensitizes limbic–striatal responses to acute stress and also identifies an important role for stress-related medial OFC and hippocampus responses in the effects of CA on increasing vulnerability to adverse health consequences. PMID:24051900

  4. Reflections on Future Research in Adolescent Reproductive Health

    PubMed Central

    Gordon, Catherine M.; Loriaux, D. Lynn; Grumbach, Melvin M.; Rogol, Alan D.; Nelson, Lawrence M.

    2009-01-01

    A group of basic scientists, clinicians, clinical investigators, psychologists, patient advocacy groups, and representatives from professional societies and governmental agencies met at the National Institutes of Health in October, 2007 with the long-term goal of having the menstrual cycle accepted and understood as a marker of general health in adolescent girls. An equally important goal was to develop a research agenda for this area of investigation. This chapter comprises the highlights of discussions throughout that meeting, with an emphasis on ideas generated during a final session led by an internationally renowned physician-scientist, in which reports from four breakout groups were presented. The specific goal assigned to each group was to develop an agenda that would set the stage for how research should be conducted over the next 100 years, and to identify the pressing research questions that should be addressed related to the menstrual cycle and adolescent health. The four areas represented in discussion groups included: genetic research; metabolic and reproductive research; emotional health; and the promotion of conduct of clinical research. Insights are also provided by five clinical investigators, including two outside experts, on both topics of priority for a research agenda in the area of adolescent reproductive health, as well as how the research itself should be conducted. PMID:18574236

  5. Urban sprawl and you: how sprawl adversely affects worker health.

    PubMed

    Pohanka, Mary; Fitzgerald, Sheila

    2004-06-01

    Urban sprawl, once thought of as just an environmental issue, is currently gaining momentum as an emerging public health issue worthy of research and political attention. Characteristics seen in sprawling communities include increasing traffic volumes; inadequate public transportation; pedestrian unfriendly streets; and the division of businesses, shops, and homes. These characteristics can affect health in many ways. Greater air pollution contributes to higher asthma and other lung disorder rates. An increased dependence on the automobile encourages a more sedentary lifestyle and can potentially contribute to obesity. The increased danger and stress of long commutes can lead to more accidents, anxiety, and social isolation. Occupational health nurses can become involved by promoting physical activity in the workplace, creating programs for injury prevention and stress management, becoming involved in political smart growth measures, and educating and encouraging colleagues to become active in addressing this issue. PMID:15219110

  6. Conservative litigation against sexual and reproductive health policies in Argentina.

    PubMed

    Peñas Defago, María Angélica; Morán Faúndes, José Manuel

    2014-11-01

    In Argentina, campaigns for the recognition of sexual and reproductive rights have sparked opposition through litigation in which the dynamics of legal action have come from self-proclaimed "pro-life" NGOs, particularly since 1998, when the conservative NGO Portal de Belén successfully achieved the banning of emergency contraception through the courts. The activities of these groups, acting as a "civil arm" of religion, are focused primarily on obstructing access to legally permissible abortions and bringing about the withdrawal of a number of recognized public policies on sexual and reproductive health, particularly the 2002 National Programme for Sexual Health and Responsible Procreation. This paper analyzes the litigation strategies of these conservative NGOs and how their use of the courts in Argentina has changed over the years. It gives examples of efforts in local courts to block individual young women from accessing legal abortion following rape, despite a ruling by the National Supreme Court of Justice in 2012 that no judicial permission is required. In spite of major advances, the renewed influence of the Catholic hierarchy in the Argentine political scene with the accession of the new Pope poses challenges to the work by feminists and women's movements to extend and consolidate sexual and reproductive rights. PMID:25555765

  7. Implications of Type 2 Diabetes on Adolescent Reproductive Health Risk

    PubMed Central

    Downs, Julie S.; Arslanian, Silva; de Bruin, Wändi Bruine; Copeland, Valire Carr; Doswell, Willa; Herman, William; Lain, Kristine; Mansfield, Joan; Murray, Pamela J.; White, Neil; Charron-Prochownik, Denise

    2012-01-01

    Purpose The purpose of this article was to summarize scientific knowledge from an expert panel on reproductive health among adolescents with type 2 diabetes (T2D). Methods Using a mental model approach, a panel of experts—representing perspectives on diabetes, adolescents, preconception counseling, and reproductive health—was convened to discuss reproductive health issues for female adolescents with T2D. Results Several critical issues emerged. Compared with adolescents with type 1 diabetes, (1) adolescents with T2D may perceive their disease as less severe and have less experience managing it, putting them at risk for complications; (2) T2D is more prevalent among African Americans, who may be less trusting of the medical establishment; (3) T2D is associated with obesity, and it is often difficult to change one’s lifestyle within family environments practicing sedentary and dietary behaviors leading to obesity; (4) teens with T2D could be more fertile, because obesity is related to earlier puberty; (5) although obese teens with T2D have a higher risk of polycystic ovary syndrome, which is associated with infertility, treatment with metformin can increase fertility; and (6) women with type 2 diabetes are routinely transferred to insulin before or during pregnancy to allow more intensive management. Conclusions Findings from the expert panel provide compelling reasons to provide early, developmentally appropriate, culturally sensitive preconception counseling for teens with T2D. PMID:20944055

  8. Lead-induced adverse effects on the reproductive system of rats with particular reference to histopathological changes in uterus

    PubMed Central

    Nakade, Udayraj Premdas; Garg, Satish Kumar; Sharma, Abhishek; Choudhury, Soumen; Yadav, Rajkumar Singh; Gupta, Kuldeep; Sood, Naresh

    2015-01-01

    Objectives: This study was undertaken to elucidate the adverse effect of lead on female reproductive system following in vivo exposure in rats. Materials and Methods: Animals of Group II, III and IV received lead acetate in drinking water (30, 100 and 300 ppm, respectively) for 28 days whereas Group I served as control. Lead levels in digested blood and bone samples were measured using atomic absorption spectrophotometer. Results: Marked and a significant decrease in per cent body weight gain was observed in rats of Group IV and III, respectively, compared to that in the control group. Relative uterine weights were found to decrease by 27% in Group III and IV compared to control and low dose lead treated (30 ppm) rats. Lead levels were found to increase in a linear manner in blood along with a marked increase in bone levels in 100 ppm exposure group while there was a decrease in both the blood and bones levels at 300 ppm exposure. Compared to plasma progesterone levels in rats of the control group, a nonsignificant (12.46–21.13%) reduction in plasma progesterone were observed in different lead-treated groups. No apparent gross pathological lesions were observed in any of the vital organs, including uterus. However, histopathological examination of uteri of different groups revealed lead-induced dose-dependent inflammatory changes, which were characterized by thickening of the endometrium, narrowing of uterine lumen, damage to endometrial glands and vacuolar degeneration in endometrial epithelial cells. Conclusion: Findings of this study suggest lead-induced pathophysiological alterations in myometrium, which in turn may affect the reproductive efficiency of animals. PMID:25821306

  9. Social work and adverse childhood experiences research: implications for practice and health policy.

    PubMed

    Larkin, Heather; Felitti, Vincent J; Anda, Robert F

    2014-01-01

    Medical research on "adverse childhood experiences" (ACEs) reveals a compelling relationship between the extent of childhood adversity, adult health risk behaviors, and principal causes of death in the United States. This article provides a selective review of the ACE Study and related social science research to describe how effective social work practice that prevents ACEs and mobilizes resilience and recovery from childhood adversity could support the achievement of national health policy goals. This article applies a biopsychosocial perspective, with an emphasis on mind-body coping processes to demonstrate that social work responses to adverse childhood experiences may contribute to improvement in overall health. Consistent with this framework, the article sets forth prevention and intervention response strategies with individuals, families, communities, and the larger society. Economic research on human capital development is reviewed that suggests significant cost savings may result from effective implementation of these strategies. PMID:24188292

  10. Race, Gender, and Chains of Disadvantage: Childhood Adversity, Social Relationships, and Health

    PubMed Central

    Umberson, Debra; Williams, Kristi; Thomas, Patricia A.; Liu, Hui; Thomeer, Mieke Beth

    2014-01-01

    We use a life course approach to guide an investigation of relationships and health at the nexus of race and gender. We consider childhood as a sensitive period in the life course, during which significant adversity may launch chains of disadvantage in relationships throughout the life course that then have cumulative effects on health over time. Data from a nationally representative panel study (Americans’ Changing Lives, N=3,477) reveal substantial disparities between black and white adults, especially pronounced among men, in the quality of close relationships and in the consequences of these relationships for health. Greater childhood adversity helps to explain why black men have worse health than white men, and some of this effect appears to operate through childhood adversity’s enduring influence on relationship strain in adulthood. Stress that occurs in adulthood plays a greater role than childhood adversity in explaining racial disparities in health among women. PMID:24578394

  11. New Resources on Youth Reproductive Health and HIV Prevention, 2002-2004. YouthLens on Reproductive Health and HIV/AIDS. Number 14

    ERIC Educational Resources Information Center

    Finger, William, Comp.; Tipton, Margaret, Comp.

    2005-01-01

    As a sequel to YouthLens No. 1, New Resources Available on Youth Reproductive Health and HIV Prevention (July 2002), this YouthLens summarizes major reports and resources that have appeared since July 2002. The resources are organized by overview reports, reproductive health resources, and HIV/AIDS resources. [YouthLens is an activity of YouthNet,…

  12. [Ethics and reproductive health: the issue of HPV vaccination].

    PubMed

    Matejić, Bojana; Kesić, Vesna

    2013-01-01

    The ethics of reproductive health covers a wide field of different issues, from the ethical dimensions of assisted reproduction, life of newborns with disabilities to the never-ending debate on the ethical aspects of abortion. Furthermore, increasing attention is paid to the ethical dimensions of using stem cells taken from human embryos, the creation of cloned embryos of patients for possible self-healing, and the increasingly present issue of reproductive cloning. Development of vaccines against human papillomavirus (HPV) has introduced new ethical aspects related to reproductive health and the need for a consensus of clinical and public-healthcare population. Today immunization with HPV vaccine is a measure for the primary prevention of cervical cancer and it provides effective protection against certain types of viruses included in the vaccine. The most often mentioned issues of discussions on ethical concerns about HPV vaccination are the recommended age of girls who should be informed and vaccinated (12-14 years), attitudes and fears of parents concerning discussion with their preadolescent daughters on issues important for their future sexual behavior, dilemma on the vaccination of boys and the role of the chosen pediatrician in providing information on the vaccination. In Serbia, two HPV vaccines have been registered but the vaccination is not compulsory. Up-till-now there has been no researches on the attitudes of physicians and parents about HPV vaccination. Nevertheless, it is very important to initiate education of general and medical public about the fact that the availability of vaccine, even if we disregard all aforementioned dilemmas, does not lead to the neglect of other preventive strategies against cervical cancer, primarily screening. The National Program for Cervical Cancer Prevention involves organized screening, i.e. regular cytological examinations of the cervical smear of all women aged 25-69 years, every three years, regardless of the

  13. Using national and local data to guide reproductive health programs.

    PubMed

    1997-01-01

    This issue of The Family Planning Manager describes the use of national- and local-level data to guide development of reproductive health (RH) programs. The first section explains to family planning (FP) managers the importance of using a broad spectrum of data to guide expansion of FP services to cover a broader range of RH needs. The next section defines the scope of RH services and suggests that a comprehensive RH program may include services in the areas of maternal health, infant health, infant nutrition, adolescent health, and reproductive tract infection/sexually transmitted disease/HIV infection prevention and control. The guide continues by describing the creation of a RH indicator panel template and by selecting program areas and indicators for the panel. Sources of national and regional RH data are offered, and information is given on the choice of appropriate local indicators. A sample of local RH indicators is provided, key terms are defined, and a sample RH indicator panel is illustrated. The next sections cover establishment of performance baselines, setting objectives for each indicator, analyzing the indicator panel data, using the indicator panel for decision-making, using the indicator panel to guide the program, and keeping the indicator panel current. After presenting the contributions of reviewers, this issue ends with a list of sources of national RH data and a checklist for using national and local data. PMID:12293134

  14. Mental health of prisoners: prevalence, adverse outcomes, and interventions.

    PubMed

    Fazel, Seena; Hayes, Adrian J; Bartellas, Katrina; Clerici, Massimo; Trestman, Robert

    2016-09-01

    More than 10 million people are imprisoned worldwide, and the prevalence of all investigated mental disorders is higher in prisoners than in the general population. Although the extent to which prison increases the incidence of mental disorders is uncertain, considerable evidence suggests low rates of identification and treatment of psychiatric disorders. Prisoners are also at increased risk of all-cause mortality, suicide, self-harm, violence, and victimisation, and research has outlined some modifiable risk factors. Few high quality treatment trials have been done on psychiatric disorders in prisoners. Despite this lack of evidence, trial data have shown that opiate substitution treatments reduce substance misuse relapse and possibly reoffending. The mental health needs of women and older adults in prison are distinct, and national policies should be developed to meet these. In this Review, we present clinical, research, and policy recommendations to improve mental health care in prisons. National attempts to meet these recommendations should be annually surveyed. PMID:27426440

  15. Attention-deficit/hyperactivity disorder and adverse health outcomes

    PubMed Central

    Nigg, Joel

    2015-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is defined by extreme levels of inattention–disorganization and/or hyperactivity–impulsivity. In DSM-IV, the diagnostic criteria required impairment in social, academic, or occupational functioning. With DSM-5 publication imminent in 2013, further evaluation of impairment in ADHD is timely. This article reviews the current state of knowledge on health-related impairments of ADHD, including smoking, drug abuse, accidental injury, sleep, obesity, hypertension, diabetes, and suicidal behavior. It concludes by suggesting the need for new avenues of research on mechanisms of association and the potential for ADHD to be an early warning sign for secondary prevention of some poor health outcomes. PMID:23298633

  16. The uses and adverse effects of beryllium on health

    PubMed Central

    Cooper, Ross G.; Harrison, Adrian P.

    2009-01-01

    Context: This review describes the health effects of beryllium exposure in the workplace and the environment. Aim: To collate information on the consequences of occupational and environmental exposure to beryllium on physiological function and well being. Materials and Methods: The criteria used in the current review for selecting articles were adopted from proposed criteria in The International Classification of Functioning, Disability, and Health. Articles were classified based on acute and chronic exposure and toxicity of beryllium. Results: The proportions of utilized and nonutilized articles were tabulated. Years 2001–10 gave the greatest match (45.9%) for methodological parameters, followed by 27.71% for 1991–2000. Years 1971–80 and 1981–90 were not significantly different in the information published and available whereas years 1951–1960 showed a lack of suitable articles. Some articles were published in sources unobtainable through requests at the British Library, and some had no impact factor and were excluded. Conclusion: Beryllium has some useful but undoubtedly harmful effects on health and well-being. Measures need to be taken to prevent hazardous exposure to this element, making its biological monitoring in the workplace essential. PMID:20386622

  17. Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys

    PubMed Central

    Kessler, Ronald C.; McLaughlin, Katie A.; Green, Jennifer Greif; Gruber, Michael J.; Sampson, Nancy A.; Zaslavsky, Alan M.; Aguilar-Gaxiola, Sergio; Alhamzawi, Ali Obaid; Alonso, Jordi; Angermeyer, Matthias; Benjet, Corina; Bromet, Evelyn; Chatterji, Somnath; de Girolamo, Giovanni; Demyttenaere, Koen; Fayyad, John; Florescu, Silvia; Gal, Gilad; Gureje, Oye; Haro, Josep Maria; Hu, Chi-yi; Karam, Elie G.; Kawakami, Norito; Lee, Sing; Lépine, Jean-Pierre; Ormel, Johan; Posada-Villa, José; Sagar, Rajesh; Tsang, Adley; Üstün, T. Bedirhan; Vassilev, Svetlozar; Viana, Maria Carmen; Williams, David R.

    2010-01-01

    Background Although significant associations of childhood adversities with adult mental disorders are widely documented, most studies focus on single childhood adversities predicting single disorders. Aims To examine joint associations of 12 childhood adversities with first onset of 20 DSM–IV disorders in World Mental Health (WMH) Surveys in 21 countries. Method Nationally or regionally representative surveys of 51 945 adults assessed childhood adversities and lifetime DSM–IV disorders with the WHO Composite International Diagnostic Interview (CIDI). Results Childhood adversities were highly prevalent and interrelated. Childhood adversities associated with maladaptive family functioning (e.g. parental mental illness, child abuse, neglect) were the strongest predictors of disorders. Co-occurring childhood adversities associated with maladaptive family functioning had significant subadditive predictive associations and little specificity across disorders. Childhood adversities account for 29.8% of all disorders across countries. Conclusions Childhood adversities have strong associations with all classes of disorders at all life-course stages in all groups of WMH countries. Long-term associations imply the existence of as-yet undetermined mediators. PMID:21037215

  18. Adverse Effects of Methylmercury: Environmental Health Research Implications

    PubMed Central

    Grandjean, Philippe; Satoh, Hiroshi; Murata, Katsuyuki; Eto, Komyo

    2010-01-01

    Background The scientific discoveries of health risks resulting from methylmercury exposure began in 1865 describing ataxia, dysarthria, constriction of visual fields, impaired hearing, and sensory disturbance as symptoms of fatal methylmercury poisoning. Objective Our aim was to examine how knowledge and consensus on methylmercury toxicity have developed in order to identify problems of wider concern in research. Data sources and extraction We tracked key publications that reflected new insights into human methylmercury toxicity. From this evidence, we identified possible caveats of potential significance for environmental health research in general. Synthesis At first, methylmercury research was impaired by inappropriate attention to narrow case definitions and uncertain chemical speciation. It also ignored the link between ecotoxicity and human toxicity. As a result, serious delays affected the recognition of methylmercury as a cause of serious human poisonings in Minamata, Japan. Developmental neurotoxicity was first reported in 1952, but despite accumulating evidence, the vulnerability of the developing nervous system was not taken into account in risk assessment internationally until approximately 50 years later. Imprecision in exposure assessment and other forms of uncertainty tended to cause an underestimation of methylmercury toxicity and repeatedly led to calls for more research rather than prevention. Conclusions Coupled with legal and political rigidity that demanded convincing documentation before considering prevention and compensation, types of uncertainty that are common in environmental research delayed the scientific consensus and were used as an excuse for deferring corrective action. Symptoms of methylmercury toxicity, such as tunnel vision, forgetfulness, and lack of coordination, also seemed to affect environmental health research and its interpretation. PMID:20529764

  19. Cumulative Adverse Financial Circumstances: Associations with Patient Health Status and Behaviors

    ERIC Educational Resources Information Center

    Bisgaier, Joanna; Rhodes, Karin V.

    2011-01-01

    This article examines associations between cumulative adverse financial circumstances and patient health in a sample of 1,506 urban emergency department (ED) patients. Study participants completed a previously validated Social Health Survey between May and October 2009. Five categories of economic deprivation were studied: food insecurity, housing…

  20. Adolescents with Special Needs: Clinical Challenges in Reproductive Health Care.

    PubMed

    Quint, Elisabeth H

    2016-02-01

    Adolescents with special needs have unique reproductive health care needs related to their physical and cognitive issues. This review discusses some of the most common concerns that are encountered in clinical practice, as the clinician will partner with the adolescent and her family to guide her through the pubertal transition and to help navigate the risks and rights of reproduction. Families often seek anticipatory guidance before menarche on menstrual hygiene, abuse risk and sexuality and can be reassured that most teens with special needs do very well with menstruation. The clinician needs to evaluate the teenager's reproductive knowledge as well her risk for abuse and coercion and her ability to consent to sexual activity, if she requests contraception. Menstrual management is mostly based on the impact of the menstrual cycles on the teenager's life and activities. The adolescents may have a decreased ability to tolerate menses or pain, or experience changes in seizure pattern or altered mood. Hormonal treatment is often used to assist with menstrual hygiene, cyclical mood changes or dysmenorrhea. The goal of treatment can be complete amenorrhea, alleviate pain or regulate and decrease menstrual flow. The unique risks and benefits of hormonal treatment for this special population are highlighted. PMID:26542013

  1. National Practitioner Data Bank for Adverse Information on Physicians and other Health Care Practitioners: charge for self-queries. Health Resources and Services Administration, HHS. Final rule.

    PubMed

    1999-03-01

    This final rule amends the existing regulations implementing the Health Care Quality Improvement Act of 1986 (the Act), which established the National Practitioner Data Bank for Adverse Information on Physicians and Other Health Care Practitioners (the Data Bank). The final rule amends the existing fee structure so that the Data Bank can fully recover its costs, as required by law. This rule removes the prohibition against charging for self-queries and, therefore, allows the Data Bank to assess costs in an equitable manner. This is consistent with both the Freedom of Information Act and the Privacy Act which allow the Government to charge fees for the reproduction of records. The Data Bank will continue its current practice of sending to the practitioner in whose name it was submitted--automatically, without a request, and free of charge--a copy of every report received by the Data Bank for purposes of verification and dispute resolution. PMID:10557586

  2. Adverse health effects of air pollutants in a nonsmoking population.

    PubMed

    Pope, C A

    1996-07-17

    Utah Valley has provided an interesting and unique opportunity to evaluate the health effects of respirable particulate air pollution (PM10). Residents of this valley are predominantly nonsmoking members of the Church of Jesus Christ of Latter-day Saints (Mormons). The area has moderately high average PM10 levels with periods of highly elevated PM10 concentrations due to local emissions being trapped in a stagnant air mass near the valley floor during low-level temperature inversion episodes. Due to a labor dispute, there was intermittent operation of the single largest pollution source, an old integrated steel mill. Levels of other common pollutants including sulfur dioxide, ozone, and acidic aerosol are relatively low. Studies specific to Utah Valley have observed that elevated PM10 concentrations are associated with: (1) decreased lung function; (2) increased incidence of respiratory symptoms; (3) increased school absenteeism; (4) increased respiratory hospital admissions; and (5) increased mortality, especially respiratory and cardiovascular mortality. PMID:8711730

  3. Adversity and inflammation among adolescents: a possible pathway to long-term health risk.

    PubMed

    Marsland, Anna L

    2013-06-01

    It has been suggested that childhood adversity programs an inflammatory phenotype characterized by higher levels of systemic inflammation and increased health risk in later life. If this is the case, one might expect associations of early childhood adversity with elevated levels of circulating inflammatory molecules in adolescence. To date, evidence for this association is mixed. This issue of Psychosomatic Medicine includes two studies by Pietras and Goodman and Low et al. that extend the existing literature and provide initial evidence that coping styles and perceived social standing may buffer against the impact of adversity on inflammation among adolescents. The current commentary considers these interesting findings in the context of the existing literature and discusses a critical need for longitudinal studies examining whether individual risk and resilience factors moderate the long-term health effects of childhood adversity, possibly via early programming of inflammatory pathways. PMID:23723363

  4. Coerced first sexual intercourse and selected reproductive health outcomes among young women in KwaZulu-Natal, South Africa.

    PubMed

    Maharaj, Pranitha; Munthree, Chantal

    2007-03-01

    Coercion may play an important role in compelling young women to engage in sexual intercourse at an early age. With a decline in age at first intercourse and increased reporting of coercive first sex, concerns of adverse reproductive health outcomes such as unintended pregnancy and sexually transmitted infections (STIs), including HIV, have become important issues, particularly in the context of a high HIV prevalence. This paper uses data collected in 2001 from the second round of a longitudinal study of 1130 sexually experienced young women in KwaZulu-Natal to investigate the relationship between coerced first intercourse and selected reproductive health outcomes and behaviours. Nearly 46% of all sexually experienced young women had reported that their first sexual encounter had been coerced. Young women who reported being coerced at first sex were significantly more likely to be Black and living in an urban area. Those who had been coerced at first sex were also more likely to report having had an STI and having experienced unintended pregnancy, than those who had not been coerced at first sex. Coercion at first sex is an important social and public health problem that has a serious impact on the reproductive health and behaviours of young women. Interventions should directly address the issue of sexual coercion by ensuring young women are aware of their reproductive rights. PMID:16566848

  5. Health care costs for prostate cancer patients receiving androgen deprivation therapy: treatment and adverse events

    PubMed Central

    Krahn, M.D.; Bremner, K.E.; Luo, J.; Alibhai, S.M.H.

    2014-01-01

    Background Serious adverse events have been associated with androgen deprivation therapy (adt) for prostate cancer (pca), but few studies address the costs of those events. Methods All pca patients (ICD-9-CM 185) in Ontario who started 90 days or more of adt or had orchiectomy at the age of 66 or older during 1995–2005 (n = 26,809) were identified using the Ontario Cancer Registry and drug and hospital data. Diagnosis dates of adverse events—myocardial infarction, acute coronary syndrome, congestive heart failure, stroke, deep vein thrombosis or pulmonary embolism, any diabetes, and fracture or osteoporosis—before and after adt initiation were determined from administrative data. We excluded patients with the same diagnosis before and after adt, and we allocated each patient’s time from adt initiation to death or December 31, 2007, into health states: adt (no adverse event), adt-ae (specified single adverse event), Multiple (>1 event), and Final (≤180 days before death). We used methods for Canadian health administrative data to estimate annual total health care costs during each state, and we examined monthly trends. Results Approximately 50% of 21,811 patients with no pre-adt adverse event developed 1 or more events after adt. The costliest adverse event state was stroke ($26,432/year). Multiple was the most frequent (n = 2,336) and the second most costly health state ($24,374/year). Costs were highest in the first month after diagnosis (from $1,714 for diabetes to $14,068 for myocardial infarction). Costs declined within 18 months, ranging from $784 per 30 days (diabetes) to $1,852 per 30 days (stroke). Adverse events increased the costs of adt by 100% to 265%. Conclusions The economic burden of adverse events is relevant to programs and policies from clinic to government, and that burden merits consideration in the risks and benefits of adt. PMID:24940106

  6. Loss in childbearing among Gambia's kanyalengs: using a stratified reproduction framework to expand the scope of sexual and reproductive health.

    PubMed

    Hough, Carolyn A

    2010-11-01

    This paper draws on ethnographic fieldwork with Gambian women who have experienced infertility and/or child mortality and who have consequently become kanyalengs. Kanyaleng kafoos are groups of women united by their reproductive difficulties whose bold public performances are designed to "beg God" for fertility and for children who will survive. I situate 'kanyalengs' disrupted childbearing within a framework of stratified reproduction, which reveals the tensions between ongoing demands to meet norms of high fertility, women's heavy burden of reproductive disease and the limits of a reproductive public health agenda narrowly focused on family planning and HIV prevention. To ameliorate these tensions, I call for an expansion of the sexual and reproductive health (SRH) agenda in Gambia to include RTI/STI prevention, diagnosis and management. This expansion reflects the goals set out by the Cairo International Conference on Population and Development for a broader approach to reproductive health, the productive potential of linkages between SRH and HIV prevention efforts, as well as the reproductive objectives of Gambian women and men. PMID:20965107

  7. Male Reproductive Health After Childhood, Adolescent, and Young Adult Cancers: A Report From the Children's Oncology Group

    PubMed Central

    Kenney, Lisa B.; Cohen, Laurie E.; Shnorhavorian, Margarett; Metzger, Monika L.; Lockart, Barbara; Hijiya, Nobuko; Duffey-Lind, Eileen; Constine, Louis; Green, Daniel; Meacham, Lillian

    2012-01-01

    The majority of children, adolescents, and young adults diagnosed with cancer will become long-term survivors. Although cancer therapy is associated with many adverse effects, one of the primary concerns of young male cancer survivors is reproductive health. Future fertility is often the focus of concern; however, it must be recognized that all aspects of male health, including pubertal development, testosterone production, and sexual function, can be impaired by cancer therapy. Although pretreatment strategies to preserve reproductive health have been beneficial to some male patients, many survivors remain at risk for long-term reproductive complications. Understanding risk factors and monitoring the reproductive health of young male survivors are important aspects of follow-up care. The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancer (COG-LTFU Guidelines) were created by the COG to provide recommendations for follow-up care of survivors at risk for long-term complications. The male health task force of the COG-LTFU Guidelines, composed of pediatric oncologists, endocrinologists, nurse practitioners, a urologist, and a radiation oncologist, is responsible for updating the COG-LTFU Guidelines every 2 years based on literature review and expert consensus. This review summarizes current task force recommendations for the assessment and management of male reproductive complications after treatment for childhood, adolescent, and young adult cancers. Issues related to male health that are being investigated, but currently not included in the COG-LTFU Guidelines, are also discussed. Ongoing investigation will inform future COG-LTFU Guideline recommendations for follow-up care to improve health and quality of life for male survivors. PMID:22649147

  8. Helping public sector health systems innovate: the strategic approach to strengthening reproductive health policies and programs.

    PubMed

    Fajans, Peter; Simmons, Ruth; Ghiron, Laura

    2006-03-01

    Public sector health systems that provide services to poor and marginalized populations in developing countries face great challenges. Change associated with health sector reform and structural adjustment often leaves these already-strained institutions with fewer resources and insufficient capacity to relieve health burdens. The Strategic Approach to Strengthening Reproductive Health Policies and Programs is a methodological innovation developed by the World Health Organization and its partners to help countries identify and prioritize their reproductive health service needs, test appropriate interventions, and scale up successful innovations to a subnational or national level. The participatory, interdisciplinary, and country-owned process can set in motion much-needed change. We describe key features of this approach, provide illustrations from country experiences, and use insights from the diffusion of innovation literature to explain the approach's dissemination and sustainability. PMID:16449594

  9. Tracking humanitarian funding for reproductive health: a systematic analysis of health and protection proposals from 2002-2013

    PubMed Central

    2015-01-01

    Background The Inter-agency Working Group on Reproductive Health in Crises conducted a ten-year global evaluation of reproductive health in humanitarian settings. This paper examines proposals for reproductive health activities under humanitarian health and protection funding mechanisms for 2002-2013, and the level at which these reproductive health proposals were funded. Methods The study used English and French health and protection proposal data for 2002-2013, extracted from the Financial Tracking Service (FTS) database managed by the United Nations Office for the Coordination of Humanitarian Affairs. Every project was reviewed for relevance against pre-determined reproductive health definitions for 2002-2008. An in-depth analysis was additionally conducted for 2009-2013 through systematically reviewing proposals via a key word search and subsequently classifying them under designated reproductive health categories. Among the relevant reproductive health proposals, counts and proportions were calculated in Excel based on their reproductive health components, primarily by year. Contributions, requests, and unfunded requests were calculated based on the data provided by FTS. Results Among the 11,347 health and protection proposals issued from 345 emergencies between 2002 and 2013, 3,912 were relevant to reproductive health (34.5%). The number of proposals containing reproductive health activities increased by an average of 21.9% per year, while the proportion of health and protection sector appeals containing reproductive health activities increased by an average of 10.1% per year. The total funding request over the 12 years amounted to $4.720 billion USD, of which $2.031 billion USD was received. Among reproductive health components for 2009-2013 proposals, maternal newborn health comprised the largest proportion (56.4%), followed by reproductive health-related gender-based violence (45.9%), HIV/sexually transmitted infections (37.5%), general reproductive health

  10. Female Genital Mutilation Is a Violation of Reproductive Rights of Women: Implications for Health Workers.

    PubMed

    Jungari, Suresh Banayya

    2016-02-01

    Female genital mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia or other injury to the female genital organs for nonmedical reasons. This coercive practice is still prevalent in many parts of the world, in both developed and developing countries. However, FGM is more prevalent in African countries and some Asian countries. In this study, an attempt has been made to understand the prevalence and practice of FGM worldwide and its adverse effects on women's reproductive health. To fulfill the study objectives, the author collected evidence from various studies conducted by international agencies. Many studies found that FGM has no health benefits; is mostly carried out on girls before they reach the age of 15 years; can cause severe bleeding, infections, psychological illness, and infertility; and, most important, can have serious consequences during childbirth. The practice is mainly governed by the traditions and cultures of the communities without having any scientific or medical benefit. In conclusion, FGM is a practice that violates the human and reproductive rights of women. PMID:26946883

  11. Adolescent girls' life aspirations and reproductive health in Nepal.

    PubMed

    Mathur, S; Malhotra, A; Mehta, M

    2001-05-01

    The study described in this paper takes a participatory and positive approach to improving adolescent reproductive health in a rural and urban community in Nepal. It shows that adolescent girls in these communities have dreams and aspirations for a better future and that adults acknowledge and support these ideals. However, social norms and institutions are restrictive, especially for girls, who are often unable to realise their hopes for continuing education, finding better-paid work or delaying marriage and childbearing, and this directly impacts reproductive outcomes. Insight into the broader context of adolescent girls' lives provides a valuable framework for designing positive programmatic actions which take as their entry point the disjuncture between girls' aspirations and realities. Interventions begun in these communities include youth clubs for safe social interaction and literacy classes; training of peer educators to teach life-skills, including for married adolescents; forums for parents, teachers and health service providers to discuss their own concerns and those of adolescents; and work with the community to design programmes that will contribute to greater financial independence and employment opportunities for adolescents. PMID:11468851

  12. 75 FR 22146 - Advisory Committee for Reproductive Health Drugs; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-27

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Advisory Committee for Reproductive Health Drugs; Notice of... to the public. Name of Committee: Advisory Committee for Reproductive Health Drugs. General...

  13. The special programme of research in human reproduction: forty years of activities to achieve reproductive health for all.

    PubMed

    Benagiano, Giuseppe; d'Arcangues, Catherine; Harris Requejo, Jennifer; Schafer, Alessandra; Say, Lale; Merialdi, Mario

    2012-01-01

    The Special Programme of Research in Human Reproduction (HRP), co-sponsored by the UNDP, UNFPA, WHO, and the World Bank, is celebrating 40 years of activities with an expansion of its mandate and new co-sponsors. When it began, in 1972, the main focus was on evaluating the acceptability, effectiveness, and safety of existing fertility-regulating methods, as well as developing new, improved modalities for family planning. In 1994, HRP not only made major contributions to the Plan of Action of the International Conference on Population and Development (ICPD); it also broadened its scope of work to include other aspects of health dealing with sexuality and reproduction, adding a specific perspective on gender issues and human rights. In 2002, HRP's mandate was once again broadened to include sexually transmitted infections and HIV/AIDS and in 2003 it was further expanded to research activities on preventing violence against women and its many dire health consequences. Today, the work of the Programme includes research on: the sexual and reproductive health of adolescents, women, and men; maternal and perinatal health; reproductive tract and sexually transmitted infections (including HIV/AIDS); family planning; infertility; unsafe abortion; sexual health; screening for cancer of the cervix in developing countries, and gender and reproductive rights. Additional activities by the Programme have included: fostering international cooperation in the field of human reproduction; the elaboration of WHO's first Global Reproductive Health Strategy; work leading to the inclusion of ICPD's goal 'reproductive health for all by 2015' into the Millennium Development Goal framework; the promotion of critical interagency statements on the public health, legal, and human rights implications of female genital mutilation and gender-biased sex selection. Finally, HRP has been involved in the creation of guidelines and tools, such as the 'Medical eligibility criteria for contraceptive use

  14. Factors for consideration in the interpretation of the adverse effects of elevated environmental temperatures on reproduction in the male rat

    NASA Astrophysics Data System (ADS)

    Bedrak, E.; Chap, Z.; Fried, K.

    1980-06-01

    Continuous exposure of male rats to an elevated environmental temperature (33 35° C) for 3 weeks led to heat-acclimatized (HA) rats whose serum testosterone concentratrion was significantly lower (P<0.01) than that of control (C) rats (20 22° C). The decrease in the androgen level was independent of major changes in serum FSH and LH concentrations, as well as hypothalamic content of thyrotropin-releasing hormone (THR), gonadotropin-releasing hormone (GnRH) and prostaglandin E2 (PGE2). However, the prostaglandin F2α(PGF2α) content of the hypothalamus of HA rats was significantly lower (P < 0.05) than that of C. The number of receptors for human chorionic gonadotropin (hCG) was significantly lower in testicular tissue of HA rats as compared to C males. Histological examination of the testis disclosed that exposure to heat adversely affected the sperm production and integrity of the Sertoli cells. Activity of enzymes associated with testosterone biosynthesis in testicular tissue of rats incubated at temperatures similar to those prevailing in the scrotum of HA rats resembled the activity of these enzymes observed in HA animals. Catabolism of testosterone was enhanced when kidney and liver of C rats were incubated at temperatures similar to the deep-body temperatures of HA rats, supporting the thesis that acclimatization to heat is coupled, inter alin, with increase androgen catabolism and excretion. It is suggested that the lower reproductive performance of HA rats is associated with several phenomena: a low number of receptors for hCG in the testes, decreased testoster one production rate by the Leydig cells, increased cata bolism and excretion of androgen, and partial atrophy of seminiferous tubules and Sertoli cells. These changes appear to be independent of either alteration in serum gonadotropin concentration or hypothalamic contents of TRH, GnR H and PGE2. The physiological significance in the response of PGF2α awaits further clarification.

  15. Reproduction Does Not Adversely Affect Liver Mitochondrial Respiratory Function but Results in Lipid Peroxidation and Increased Antioxidants in House Mice

    PubMed Central

    Mowry, Annelise V.; Kavazis, Andreas N.; Sirman, Aubrey E.; Potts, Wayne K.; Hood, Wendy R.

    2016-01-01

    Reproduction is thought to come at a cost to longevity. Based on the assumption that increased energy expenditure during reproduction is associated with increased free-radical production by mitochondria, oxidative damage has been suggested to drive this trade-off. We examined the impact of reproduction on liver mitochondrial function by utilizing post-reproductive and non-reproductive house mice (Mus musculus) living under semi-natural conditions. The age-matched post-reproductive and non-reproductive groups were compared after the reproductive females returned to a non-reproductive state, so that both groups were in the same physiological state at the time the liver was collected. Despite increased oxidative damage (p = 0.05) and elevated CuZnSOD (p = 0.002) and catalase (p = 0.04) protein levels, reproduction had no negative impacts on the respiratory function of liver mitochondria. Specifically, in a post-reproductive, maintenance state the mitochondrial coupling (i.e., respiratory control ratio) of mouse livers show no negative impacts of reproduction. In fact, there was a trend (p = 0.059) to suggest increased maximal oxygen consumption by liver mitochondria during the ADP stimulated state (i.e., state 3) in post-reproduction. These findings suggest that oxidative damage may not impair mitochondrial respiratory function and question the role of mitochondria in the trade-off between reproduction and longevity. In addition, the findings highlight the importance of quantifying the respiratory function of mitochondria in addition to measuring oxidative damage. PMID:27537547

  16. Adolescent pregnancies in the Amazon Basin of Ecuador: a rights and gender approach to adolescents' sexual and reproductive health

    PubMed Central

    Goicolea, Isabel

    2010-01-01

    In the Andean region of Latin America over one million adolescent girls get pregnant every year. Adolescent pregnancy (AP) has been associated with adverse health and social outcomes, but it has also been favorably viewed as a pathway to adulthood. AP can also be conceptualized as a marker of inequity, since it disproportionately affects girls from the poorest households and those who have not been able to attend school. Using results from a study carried out in the Amazon Basin of Ecuador, this paper explores APs and adolescents' sexual and reproductive health from a rights and gender approach. The paper points out the main features of a rights and gender approach, and how it can be applied to explore APs. Afterward it describes the methodologies (quantitative and qualitative) and main results of the study, framing the findings within the rights and gender approach. Finally, some implications that could be generalizable to global reserach on APs are highlighted. The application of the rights and gender framework to explore APs contributes to a more integral view of the issue. The rights and gender framework stresses the importance of the interaction between rights-holders and duty-bearers on the realization of sexual and reproductive rights, and acknowledges the importance of gender–power relations on sexual and reproductive decisions. A rights and gender approach could lead to more integral and constructive interventions, and it could also be useful when exploring other sexual and reproductive health matters. PMID:20596248

  17. Community experiences and perceptions of reproductive health vouchers in Kenya

    PubMed Central

    2013-01-01

    Background Research on demand-side health care financing approaches such as output-based aid (OBA) programs have focused on evaluating the role of the programs improving such outcomes as utilization of services and quality of services with limited focus on the experiences and perceptions of the target communities. This paper examines community members’ views of the output-based aid voucher program in Kenya. Methods A household survey was conducted in 2010 among 1,336 women aged 15-49 years living in the catchment areas of contracted health facilities in three districts participating in the voucher program (Kisumu, Kiambu and Kitui). Twenty seven focus group discussions were conducted with voucher users, non-users, opinion leaders and voucher distributors in the three districts as well as in Nairobi. Analysis of the quantitative data involved frequency distributions and cross-tabulations. Qualitative data were transcribed and analyzed by adopting framework analysis and further triangulation of themes across respondents. Results Majority (84%) of survey respondents had heard about the safe motherhood voucher compared to 24% and 1% that had heard about the family planning and gender-based violence recovery services (GBVRS) vouchers respectively. Similarly, 20% of the respondents had used the safe motherhood voucher compared to 2% for family planning and none for the GBVRS vouchers. From the community members’ perspectives, the voucher program is associated with improvements in access to health services for poor women, improved quality of care, and empowerment of women to make health care decisions. However, community members cited difficulties in accessing some accredited health facilities, limitations with the system of selling vouchers, lack of male involvement in women’s reproductive health issues, and poor understanding of the benefits associated with purchasing the voucher. Conclusion The findings of this paper showed that the voucher program in Kenya is

  18. Endocrine-Disrupting Activity of Hydraulic Fracturing Chemicals and Adverse Health Outcomes After Prenatal Exposure in Male Mice.

    PubMed

    Kassotis, Christopher D; Klemp, Kara C; Vu, Danh C; Lin, Chung-Ho; Meng, Chun-Xia; Besch-Williford, Cynthia L; Pinatti, Lisa; Zoeller, R Thomas; Drobnis, Erma Z; Balise, Victoria D; Isiguzo, Chiamaka J; Williams, Michelle A; Tillitt, Donald E; Nagel, Susan C

    2015-12-01

    Oil and natural gas operations have been shown to contaminate surface and ground water with endocrine-disrupting chemicals. In the current study, we fill several gaps in our understanding of the potential environmental impacts related to this process. We measured the endocrine-disrupting activities of 24 chemicals used and/or produced by oil and gas operations for five nuclear receptors using a reporter gene assay in human endometrial cancer cells. We also quantified the concentration of 16 of these chemicals in oil and gas wastewater samples. Finally, we assessed reproductive and developmental outcomes in male C57BL/6J mice after the prenatal exposure to a mixture of these chemicals. We found that 23 commonly used oil and natural gas operation chemicals can activate or inhibit the estrogen, androgen, glucocorticoid, progesterone, and/or thyroid receptors, and mixtures of these chemicals can behave synergistically, additively, or antagonistically in vitro. Prenatal exposure to a mixture of 23 oil and gas operation chemicals at 3, 30, and 300 μg/kg · d caused decreased sperm counts and increased testes, body, heart, and thymus weights and increased serum testosterone in male mice, suggesting multiple organ system impacts. Our results suggest possible adverse developmental and reproductive health outcomes in humans and animals exposed to potential environmentally relevant levels of oil and gas operation chemicals. PMID:26465197

  19. Endocrine-disrupting activity of hydraulic fracturing chemicals and adverse health outcomes after prenatal exposure in male mice

    USGS Publications Warehouse

    Kassotis, Christopher D.; Klemp, Kara C.; Vu, Danh C.; Lin, Chung-Ho; Meng, Chun-Xia; Besch-Williford, Cynthia L.; Pinatti, Lisa; Zoeller, R. Thomas; Drobnis, Erma Z.; Balise, Victoria D.; Isiguzo, Chiamaka J.; Williams, Michelle A.; Tillitt, Donald E.; Nagel, Susan C.

    2015-01-01

    Oil and natural gas operations have been shown to contaminate surface and ground water with endocrine-disrupting chemicals. In the current study, we fill several gaps in our understanding of the potential environmental impacts related to this process. We measured the endocrine-disrupting activities of 24 chemicals used and/or produced by oil and gas operations for five nuclear receptors using a reporter gene assay in human endometrial cancer cells. We also quantified the concentration of 16 of these chemicals in oil and gas wastewater samples. Finally, we assessed reproductive and developmental outcomes in male C57BL/6J mice after the prenatal exposure to a mixture of these chemicals. We found that 23 commonly used oil and natural gas operation chemicals can activate or inhibit the estrogen, androgen, glucocorticoid, progesterone, and/or thyroid receptors, and mixtures of these chemicals can behave synergistically, additively, or antagonistically in vitro. Prenatal exposure to a mixture of 23 oil and gas operation chemicals at 3, 30, and 300 μg/kg · d caused decreased sperm counts and increased testes, body, heart, and thymus weights and increased serum testosterone in male mice, suggesting multiple organ system impacts. Our results suggest possible adverse developmental and reproductive health outcomes in humans and animals exposed to potential environmentally relevant levels of oil and gas operation chemicals.

  20. Provision of Reproductive Health Services for Adolescents--Report of a Study in Two Local Government Areas (LGAs) of Nigeria.

    ERIC Educational Resources Information Center

    Olukoya, Adepeju A.

    1996-01-01

    Studied adolescent reproductive health services in two Nigerian states. Found that adolescents use health facilities mostly for general health problems. Only 6.1% (south) and 31.8% (north) of cases involved reproductive health, the gap attributable to maternity cases of northern married women. Reproductive health problems such as abortion and…

  1. Emergency Department Discharge Diagnosis and Adverse Health Outcomes in Older Adults

    PubMed Central

    Hastings, S. Nicole; Whitson, Heather E.; Purser, Jama L.; Sloane, Richard J.; Johnson, Kimberly S.

    2010-01-01

    Objectives To determine the relationship between the reason for an emergency department (ED) visit and subsequent risk of adverse health outcomes in older adults discharged from the ED. Design Secondary analysis of data from the Medicare Current Beneficiary Survey. Setting ED. Participants One thousand eight hundred fifty-one community-dwelling Medicare fee-for-service enrollees aged 65 and older discharged from the ED between January 2000 and September 2002. Measurements Independent variables were ED discharge diagnosis groups: injury or musculoskeletal (MSK) (e.g., fracture, open wound), chronic condition (e.g., chronic obstructive pulmonary disorder, heart failure), infection, non-MSK symptom (e.g., chest pain, abdominal pain), and unclassified. Adverse health outcomes were hospitalization or death within 30 days of the index ED visit. Results Injury or MSK was the largest ED diagnosis group (31.4%), followed by non-MSK symptom (22.2%), chronic condition (20.9%), and infection (7.8%); 338 (17.8%) had ED discharge diagnoses that were unclassified. In adjusted analyses, a discharge diagnosis of injury or MSK condition was associated with lower risk of subsequent adverse health outcomes (hazard ratio (HR) = 0.69, 95% confidence interval (CI) = 0.50–0.96) than for all other diagnosis groups. Patients seen in the ED for chronic conditions were at greater risk of adverse outcomes (HR = 1.86, 95% CI = 1.37–2.52) than all others. There were no significant differences in risk between patients with infections, those with non-MSK symptoms, and the unclassified group. Conclusion Adverse health outcomes were common in older patients with an ED discharge diagnosis classified as a chronic condition. ED discharge diagnosis may improve risk assessment and inform the development of targeted interventions to reduce adverse health outcomes in older adults discharged from the ED. PMID:19694872

  2. Childhood adversity and behavioral health outcomes for youth: An investigation using state administrative data.

    PubMed

    Lucenko, Barbara A; Sharkova, Irina V; Huber, Alice; Jemelka, Ron; Mancuso, David

    2015-09-01

    This study aimed to measure the relative contribution of adverse experiences to adolescent behavioral health problems using administrative data. Specifically, we sought to understand the predictive value of adverse experiences on the presence of mental health and substance abuse problems for youth receiving publicly funded social and health services. Medicaid claims and other service records were analyzed for 125,123 youth age 12-17 and their biological parents. Measures from administrative records reflected presence of parental domestic violence, mental illness, substance abuse, criminal justice involvement, child abuse and/or neglect, homelessness, and death of a biological parent. Mental health and substance abuse status of adolescents were analyzed as functions of adverse experiences and other youth characteristics using logistic regression. In multivariate analyses, all predictors except parental domestic violence were statistically significant for substance abuse; parental death, parental mental illness, child abuse or neglect and homelessness were statistically significant for mental illness. Odds ratios for child abuse/neglect were particularly high in both models. The ability to identify risks during childhood using administrative data suggests the potential to target prevention and early intervention efforts for children with specific family risk factors who are at increased risk for developing behavioral health problems during adolescence. This study illustrates the utility of administrative data in understanding adverse experiences on children and the advantages and disadvantages of this approach. PMID:26234784

  3. The role of vitamin D in reproductive health--a Trojan Horse or the Golden Fleece?

    PubMed

    Dabrowski, Filip A; Grzechocinska, Barbara; Wielgos, Miroslaw

    2015-06-01

    In the last decade, vitamin D was in the spotlight in many fields of research. Despite numerous publications, its influence on reproductive health remains ambiguous. This paper presents an up-to-date review of current knowledge concerning the role of cholecalciferol in human reproduction. It covers various infertility issues, such as polycystic ovary syndrome, endometriosis, myoma-induced infertility, male infertility, premature ovary failure and in vitro fertilization techniques. Vitamin D deficiency, defined as serum concentration of 25-hydroxycalciferol of less than 50 nmol/L, is commonly noted more frequently than only in fertility clinic patients. It is a global trend that is observed in all age groups. The results of original publications dated up to 2015 have been summarized and discussed in a critical manner. Most experts agree that vitamin D supplementation is a necessity, particularly in women suffering from obesity, insulin resistance or small ovarian reserve, as well as in men with oligo- and asthenozoospermia if serum concentration should fall below 50 nmol/L (normal range up to 125 nmol/L). High concentration of vitamin D and its metabolites in decidua during the 1st trimester suggests its important role in the implantation process and a local immunological embryo-protection. On the other hand, evidence-based research did not prove a significant difference so far in ovulation stimulation or embryo development depending on vitamin D level. In one of the publications, it was also found that vitamin D binding protein (VDBP) has a molecular similarity to anti-sperm antibodies, and another one concluded that both low (<50 nmol/L) and high (>125 nmol/L) concentration of vitamin D are associated with decreased number and quality of spermatozoa in semen. Vitamin D is definitely not a Trojan Horse in reproductive health, since there were no adverse effects reported for vitamin D intake of up to 10,000 IU/day, but to proclaim it the Golden Fleece, more evidence

  4. Gene-environment interactions in male reproductive health: Special reference to the aryl hydrocarbon receptor signaling pathway

    PubMed Central

    Brokken, Leon J S; Giwercman, Yvonne Lundberg

    2014-01-01

    Over the last few decades, there have been numerous reports of adverse effects on the reproductive health of wildlife and laboratory animals caused by exposure to endocrine disrupting chemicals (EDCs). The increasing trends in human male reproductive disorders and the mounting evidence for causative environmental factors have therefore sparked growing interest in the health threat posed to humans by EDCs, which are substances in our food, environment and consumer items that interfere with hormone action, biosynthesis or metabolism, resulting in disrupted tissue homeostasis or reproductive function. The mechanisms of EDCs involve a wide array of actions and pathways. Examples include the estrogenic, androgenic, thyroid and retinoid pathways, in which the EDCs may act directly as agonists or antagonists, or indirectly via other nuclear receptors. Dioxins and dioxin-like EDCs exert their biological and toxicological actions through activation of the aryl hydrocarbon-receptor, which besides inducing transcription of detoxifying enzymes also regulates transcriptional activity of other nuclear receptors. There is increasing evidence that genetic predispositions may modify the susceptibility to adverse effects of toxic chemicals. In this review, potential consequences of hereditary predisposition and EDCs are discussed, with a special focus on the currently available publications on interactions between dioxin and androgen signaling. PMID:24369137

  5. [Young people have the floor. Sexual and reproductive health].

    PubMed

    1995-12-01

    Colombia's population 10-19 years old numbers 7,500,000 and faces numerous problems related to drug addiction, delinquency, violence, alcoholism, smoking, and sexual abuse, as well as ignorance about sexuality and health. The Profamilia center for youth in Bogota carried out a study of sexual and reproductive health with the participation of young people, 13-19 years old, from different social classes. With regard to sexual matters most turned to their mothers and friends, while a substantial proportion did not consult anybody. Only 8% of the young men and 3% of female adolescents who were sexually active used contraceptives, thus the majority risked an unwanted pregnancy. 13.4 years was the age for sexual debut for boys and 14.8 years for girls. It was estimated that each year 78/1000 adolescents had a child in the country. The opinions of young people in the 7th to 10th grade about the prevention of pregnancy were varied. Among 1317 boys 441 cited the condom first followed by oral contraceptives with the condom (322), and abstinence (243). Among 818 girls 252 cited abstinence followed by oral contraceptives (227), and the condom (153). The mentioning of the condom by boys in the first place was probably influenced by publicity, while abstinence considered by girls in the first place was attributable to traditional values. Only 5.1% of the respondents considered sex education as an important matter, indicating a need to promote sex education as fundamental. Profamilia services to young people include sex education, counseling, and advice about reproductive health. For adolescents injectables, the IUD, coitus interruptus, and the rhythm method are not recommended. PMID:12347407

  6. Advocating change in Palestine. Advocacy for reproductive health: Palestine.

    PubMed

    Wolmuth, P

    1996-01-01

    The Palestinian Family Planning and Protection Association (PFPPA) recently implemented a new strategic plan based on the Strategic Plan of the International Planned Parenthood Federation (IPPF) aimed at the empowerment of women. Advocacy is the central part of the program with preparing the services and dealing with the issue of population. In early 1995 a round of meetings in the West Bank and the Gaza Strip launched the plan with new programs for women, youth, men, information, education, and communication, and service provision to start in January 1996. In Gaza the Youth Program is well under way. Five members were selected from each of 50 groups for a 1-week training course in Gaza City in November 1995. The topics included: mutual respect between husband and wife, discussion of the role of family planning in the context of Islam, the rights and wrongs of polygamy, and the hotly debated issue of sex segregation in education. The PFPPA staff was initially apprehensive about the new youth and women's program plans to broaden family planning to women's empowerment and sexual and reproductive health. An IPPF-sponsored video was also shown in Hebron, West Bank, on the problem of early marriage. It featured Palestinian women: one with 12 children who was married at age 13; a mother whose husband wanted to marry off their 12-year-old daughter; and portrayed pressure from husbands and other family members to produce many children. The new strategy engendered debate in the West Bank and Gaza among village women and young people, while in the meantime the training of government health workers started in sexual and reproductive health counseling. In the village of Tkooi, near Bethlehem, a counselor held sessions on the oppression of women and psycho-physiological problems and stress. A lawyer also summarized women's economic and property rights, which most of them were unaware of. PMID:12291097

  7. Self-reported stress and reproductive health of female lawyers.

    PubMed

    Schenker, M B; Eaton, M; Green, R; Samuels, S

    1997-06-01

    We studied the prevalence and relationship of stress and working conditions with adverse reproductive outcomes in a cohort of female US law-school alumnae. A total of 584 female lawyers (74% response), aged 25 to 63, responded to a mailed questionnaire. Job hours per week was a strong predictor of job stress. In a logistic regression analysis, women working > 45 hours/week were five times as likely to report high stress as those working < 35 hours/week. Marriage and length of time on the job showed a small inverse association with stress. Women who worked more than 45 hours/week during their first trimester of pregnancy were more likely to report high stress at work during pregnancy. After being adjusted for confounding factors, weekly job hours during the first trimester of pregnancy showed a strong independent association with spontaneous abortion risk (odds ratio [OR], 3.0; 95% confidence interval [CI], 1.4 to 6.6). Seven or more alcohol drinks/week was also independently associated with spontaneous abortion risk (OR, 4.8; 95% CI, 1.5 to 18.1). Self-reported stress during pregnancy was positively but not statistically significantly associated with spontaneous abortion (OR, 1.4; 95% CI 0.8 to 2.3). PMID:9211214

  8. Juvenile Male Rats Exposed to a Low-Dose Mixture of Twenty-Seven Environmental Chemicals Display Adverse Health Effects.

    PubMed

    Hadrup, Niels; Svingen, Terje; Mandrup, Karen; Skov, Kasper; Pedersen, Mikael; Frederiksen, Hanne; Frandsen, Henrik Lauritz; Vinggaard, Anne Marie

    2016-01-01

    Humans are exposed to a large number of environmental chemicals in their daily life, many of which are readily detectable in blood or urine. It remains uncertain if these chemicals can cause adverse health effects when present together at low doses. In this study we have tested whether a mixture of 27 chemicals administered orally to juvenile male rats for three months could leave a pathophysiological footprint. The mixture contained metals, perfluorinated compounds, PCB, dioxins, pesticides, heterocyclic amines, phthalate, PAHs and others, with a combined dose of 0.16 (Low dose), 0.47 (Mid dose) or 1.6 (High dose) mg/kg bw/day. The lowest dose was designed with the aim of obtaining plasma or urine concentrations in rats at levels approaching those observed in humans. Some single congeners were administered at doses representative of combined doses for chemical groups. With this baseline, we found effects on weight, histology and gene expression in the liver, as well as changes to the blood plasma metabolome in all exposure groups, including low-dose. Additional adverse effects were observed in the higher dosed groups, including enlarged kidneys and alterations to the metabolome. No significant effects on reproductive parameters were observed. PMID:27598887

  9. Tracking Official Development Assistance for Reproductive Health in Conflict-Affected Countries

    PubMed Central

    Patel, Preeti; Roberts, Bayard; Guy, Samantha; Lee-Jones, Louise; Conteh, Lesong

    2009-01-01

    Background Reproductive health needs are particularly acute in countries affected by armed conflict. Reliable information on aid investment for reproductive health in these countries is essential for improving the efficiency and effectiveness of aid. The purpose of this study was to analyse official development assistance (ODA) for reproductive health activities in conflict-affected countries from 2003 to 2006. Methods and Findings The Creditor Reporting System and the Financial Tracking System databases were the chosen data sources for the study. ODA disbursement for reproductive health activities to 18 conflict-affected countries was analysed for 2003, 2004, 2005, and 2006. An average of US$20.8 billion in total ODA was disbursed annually to the 18 conflict-affected countries between 2003 and 2006, of which US$509.3 million (2.4%) was allocated to reproductive health. This represents an annual average of US$1.30 disbursed per capita in the 18 sampled countries for reproductive health activities. Non-conflict-affected least-developed countries received 53.3% more ODA for reproductive health activities than conflict-affected least-developed countries, despite the latter generally having greater reproductive health needs. ODA disbursed for HIV/AIDS prevention and treatment increased by 119.4% from 2003 to 2006. The ODA disbursed for other direct reproductive health activities declined by 35.9% over the same period. Conclusions This study provides evidence of inequity in disbursement of reproductive health ODA between conflict-affected countries and non-conflict-affected countries, and between different reproductive health activities. These findings and the study's recommendations seek to support initiatives to make aid financing more responsive to need in the context of armed conflict. PMID:19513098

  10. Health Monitoring and Management for Manufacturing Workers in Adverse Working Conditions.

    PubMed

    Xu, Xiaoya; Zhong, Miao; Wan, Jiafu; Yi, Minglun; Gao, Tiancheng

    2016-10-01

    In adverse working conditions, environmental parameters such as metallic dust, noise, and environmental temperature, directly affect the health condition of manufacturing workers. It is therefore important to implement health monitoring and management based on important physiological parameters (e.g., heart rate, blood pressure, and body temperature). In recent years, new technologies, such as body area networks, cloud computing, and smart clothing, have allowed the improvement of the quality of services. In this article, we first give five-layer architecture for health monitoring and management of manufacturing workers. Then, we analyze the system implementation process, including environmental data processing, physical condition monitoring and system services and management, and present the corresponding algorithms. Finally, we carry out an evaluation and analysis from the perspective of insurance and compensation for manufacturing workers in adverse working conditions. The proposed scheme will contribute to the improvement of workplace conditions, realize health monitoring and management, and protect the interests of manufacturing workers. PMID:27624491

  11. Adverse health consequences of US Government responses to the 2001 terrorist attacks.

    PubMed

    Levy, Barry S; Sidel, Victor W

    2011-09-01

    In response to the attacks on Sept 11, 2001 (9/11), and the related security concerns, the USA and its coalition partners began a war in Afghanistan and subsequently invaded Iraq. The wars caused many deaths of non-combatant civilians, further damaged the health-supporting infrastructure and the environment (already adversely affected by previous wars), forced many people to migrate, led to violations of human rights, and diverted resources away from important health needs. After 9/11 and the anthrax outbreak shortly afterwards, the USA and other countries have improved emergency preparedness and response capabilities, but these actions have often diverted attention and resources from more urgent health issues. The documentation and dissemination of information about the adverse health effects of these wars and about the diversion of resources could help to mitigate these consequences and prevent their recurrence. PMID:21890059

  12. A Health Care Worker with Ebola Virus Disease and Adverse Prognostic Factors Treated in Sierra Leone.

    PubMed

    O'Shea, Matthew K; Clay, Katherine A; Craig, Darren G; Moore, Alastair J; Lewis, Stephen; Espina, Melanie; Praught, Jeff; Horne, Simon; Kao, Raymond; Johnston, Andrew M

    2016-04-01

    We describe the management of a Sierra Leonean health care worker with severe Ebola virus disease complicated by diarrhea, significant electrolyte disturbances, and falciparum malaria coinfection. With additional resources and staffing, high quality care can be provided to patients with Ebola infection and adverse prognostic factors in west Africa. PMID:26903609

  13. ENVIRONMENTAL POLLUTANTS AND ADVERSE HUMAN HEALTH EFFECTS: HAZARD IDENTIFICATION USING INTERREGION COMPARISONS

    EPA Science Inventory

    Background: Associations between adverse health effects and environmental exposures are difficult to study, because exposures may be widespread, low-dose in nature, and common throughout the study population. Therefore, individual risk-factor epidemiology may not be the right to...

  14. ARE ENVIRONMENTAL EXPOSURES TO CHLOROPHENOXY HERBICIDES ASSOCIATED WITH AN INCREASE IN ADVERSE HUMAN HEALTH EFFECTS?

    EPA Science Inventory

    Background: Associations between adverse health effects and environmental exposures are difficult to study because exposures may be widespread, low-dose in nature, and common throughout the study population. Individual risk-factor epidemiology may not be able to initially ident...

  15. Adverse Childhood Experiences (ACE) and Health-Risk Behaviors among Adults in a Developing Country Setting

    ERIC Educational Resources Information Center

    Ramiro, Laurie S.; Madrid, Bernadette J.; Brown, David W.

    2010-01-01

    Objective: This study aimed to examine the association among adverse childhood experiences, health-risk behaviors, and chronic disease conditions in adult life. Study population: One thousand and sixty-eight (1,068) males and females aged 35 years and older, and residing in selected urban communities in Metro Manila participated in the…

  16. Investing in very young adolescents' sexual and reproductive health

    PubMed Central

    Igras, Susan M.; Macieira, Marjorie; Murphy, Elaine; Lundgren, Rebecka

    2014-01-01

    Very young adolescents (VYAs) between the ages of 10 and 14 represent about half of the 1.2 billion adolescents aged 10–19 in the world today. In lower- and middle-income countries, where most unwanted pregnancies, unsafe abortions, maternal deaths and sexually transmitted infections occur, investment in positive youth development to promote sexual and reproductive health (SRH) is increasing. Most interventions, though, focus on older adolescents, overlooking VYAs. Since early adolescence marks a critical transition between childhood and older adolescence and adulthood, setting the stage for future SRH and gendered attitudes and behaviours, targeted investment in VYAs is imperative to lay foundations for healthy future relationships and positive SRH. This article advocates for such investments and identifies roles that policy-makers, donors, programme designers and researchers and evaluators can play to address the disparity. PMID:24824757

  17. The economic consequences of reproductive health and family planning.

    PubMed

    Canning, David; Schultz, T Paul

    2012-07-14

    We consider the evidence for the effect of access to reproductive health services on the achievement of Millennium Development Goals 1, 2, and 3, which aim to eradicate extreme poverty and hunger, achieve universal primary education, and promote gender equality and empower women. At the household level, controlled trials in Matlab, Bangladesh, and Navrongo, Ghana, have shown that increasing access to family planning services reduces fertility and improves birth spacing. In the Matlab study, findings from long-term follow-up showed that women's earnings, assets, and body-mass indexes, and children's schooling and body-mass indexes, substantially improved in areas with improved access to family planning services compared with outcomes in control areas. At the macroeconomic level, reductions in fertility enhance economic growth as a result of reduced youth dependency and an increased number of women participating in paid labour. PMID:22784535

  18. Models of biobanks and implications for reproductive health innovation.

    PubMed

    Capps, Benjamin

    2015-12-01

    Biobanks are designed with particular purposes in mind. These purposes are reflected in the governance frameworks that define the conditions for participation and access by researchers. In this paper, I analyse two different models: the commercially aligned deCODE biobank and the 'public good' framework of UK Biobank. These diametric models have both featured 'the public interest' as pivotal to their achievements. However, if properly understood, the public interest rhetoric of deCODE actually conflicts with any professed community interest. The reasons why are explained, and the effects this has on conditions for participation are critiqued, before reflecting on how each model might have an impact on reproductive health research. PMID:26670686

  19. IPPF focuses on advocacy. Advocacy for reproductive health: worldwide.

    PubMed

    Puri, S; Ketting, E

    1996-01-01

    The International Planned Parenthood Federation has been advocating human rights since its establishment in 1952. Since the adoption of its global strategic plan, Vision 2000, it has dealt with advocacy in a more systematic manner. Advocacy aims to gain broader support for a cause. In family planning and reproductive health, advocacy is important in counteracting conservative opposition movements. Its most effective tool is high-quality information and services for meeting people's needs. Its target groups are women's groups, youth organizations, parliamentarians, media representatives, and religious leaders. Information, education, and communication (IEC) campaigns differ from advocacy, because the latter is deliberately persuasive and campaign-oriented. An Advocacy Working Group was convened by IPPF and an Advocacy Guide was produced in 1995. Advocacy is needed for the promotion of sexual and reproductive health in the face of opposition from traditional and cultural forces represented by small, vocal, well-financed and organized groups. In 1984 they succeeded in halting funding for IPPF by the United States. This made IPPF resolute in strategic planning and setting goals as contained in Vision 2000. The goals include advocacy for family planning, the prevention of unsafe abortion, women's empowerment, the involvement of youth, the responsibility of men for family life, and the improvement of the status of the female child. The IPPF's 1985 Central Council discussed new initiatives and an Issues Manual was published. The 1989 Members' Assembly held a seminar on critical issues in advocating family planning. A further 1993 resolution urged support for advocacy initiatives. A Public Response Guide was published in 1991 and Language Guidelines were also produced for correct family planning terminology. In addition, an Interregional Training Workshop was held in London in 1995 on the use of the Advocacy Guide. Recommendations were also submitted by participants for

  20. Adverse Childhood Experiences and the Health of University Students in Eight Provinces of Vietnam.

    PubMed

    Tran, Quynh Anh; Dunne, Michael P; Vo, Thang Van; Luu, Ngoc Hoat

    2015-11-01

    Recent systematic reviews have emphasized the need for more research into the health and social impacts of adverse childhood experiences (ACEs) in the Asia-Pacific region. This cross-sectional study was conducted with 2099 young adult students in 8 medical universities throughout Vietnam. An anonymous, self-report questionnaire included the World Health Organization ACE-International Questionnaire and standardized measures of mental and physical health. Three quarters (76%) of the students reported at least one exposure to ACEs; 21% had 4 or more ACEs. The most commonly reported adversities were emotional abuse, physical abuse, and witnessing a household member being treated violently (42.3%, 39.9%, and 34.6%, respectively). Co-occurrence of ACEs had dose-response relationships with poor mental health, suicidal ideation, and low physical health-related quality of life. This first multisite study of ACEs among Vietnamese university students provided evidence that childhood adversity is common and is significantly linked with impaired health and well-being into the early adult years. PMID:26047629

  1. Reproductive Health Issues for Adults with a Common Genomic Disorder: 22q11.2 Deletion Syndrome.

    PubMed

    Chan, Chrystal; Costain, Gregory; Ogura, Lucas; Silversides, Candice K; Chow, Eva W C; Bassett, Anne S

    2015-10-01

    22q11.2 deletion syndrome (22q11.2DS) is the most common microdeletion syndrome in humans. Survival to reproductive age and beyond is now the norm. Several manifestations of this syndrome, such as congenital cardiac disease and neuropsychiatric disorders, may increase risk for adverse pregnancy outcomes in the general population. However, there are limited data on reproductive health in 22q11.2DS. We performed a retrospective chart review for 158 adults with 22q11.2DS (75 male, 83 female; mean age 34.3 years) and extracted key variables relevant to pregnancy and reproductive health. We present four illustrative cases as brief vignettes. There were 25 adults (21 > age 35 years; 21 female) with a history of one or more pregnancies. Outcomes for women with 22q11.2DS, compared with expectations for the general population, showed a significantly elevated prevalence of small for gestational age liveborn offspring (p < 0.001), associated mainly with infants with 22q11.2DS. Stillbirths also showed elevated prevalence (p < 0.05). Not all observed adverse events appeared to be attributable to transmission of the 22q11.2 deletion. Recurring issues relevant to reproductive health in 22q11.2DS included the potential impact of maternal morbidities, inadequate social support, unsafe sexual practices, and delayed diagnosis of 22q11.2DS and/or lack of genetic counseling. These preliminary results emphasize the importance of early diagnosis and long term follow-up that could help facilitate genetic counseling for men and women with 22q11.2DS. We propose initial recommendations for pre-conception management, educational strategies, prenatal planning, and preparation for possible high-risk pregnancy and/or delivery. PMID:25579115

  2. Cardiometabolic health of children conceived by assisted reproductive technologies

    PubMed Central

    Yeung, Edwina H.; Druschel, Charlotte

    2013-01-01

    The cardiometabolic health of children conceived by assisted reproductive technologies (ART) compared with children conceived without medical assistance is unclear. Although the majority of published studies evaluating height, weight, and body mass index have not found differences by method of conception, some studies have indicated differences in adiposity by more direct measures such as skinfolds and dual X-ray absorptiometry. Far fewer studies have investigated other cardiometabolic characteristics, such as blood pressure and measures of lipid and glucose metabolism. Of these studies, some indications of increased blood pressure and recent findings of vascular dysfunction among children conceived by ART compared with children conceived without ART warrant further investigation. Epigenetic differences may be the global mechanism at work, resulting from different aspects of ART treatment, such as ovarian stimulation, in vitro culture, and manipulation of sperm, among other considerations. Fetal growth and placental development may serve as mediators of these effects. Future studies should consider recruiting sufficient numbers of ART and non-ART conceived multiples and collect information on indicators of cardiometabolic health in the parents. Despite some advantages of sibling cohorts in developmental origins research, its feasibility and utility for investigating health of children conceived by ART remains debatable. PMID:23312226

  3. Addressing diversity in adolescent sexual and reproductive health services.

    PubMed

    Laski, Laura; Wong, Sylvia

    2010-07-01

    The social, economic, and biological events that mark adolescence profoundly influence and shape future adult lives. Sexual and reproductive health (SRH) services, education, and other social programs are needed to support young people for a healthy start. As adolescents transition into adulthood, SRH programs and services that have skilled health providers, in combination with other social services including comprehensive sexuality education, can help prevent unwanted pregnancies, maternal mortality and morbidity, as well as sexually transmitted infections including HIV/AIDS. Programs and services can also provide counseling to prevent sexual violence and abuse and deal with its consequences. Adolescent SRH programs can be more effective if the demographic diversity of this age group is studied. Vulnerable adolescents should be targeted as priority recipients of youth-friendly SRH and other social support services. Data demonstrate that adolescent girls living in rural areas who are not in school and who are often married as children are vulnerable to maternal mortality and morbidity, unwanted pregnancies, unsafe abortion, HIV infection, and sexual violence and abuse. Building adolescent capacities and opportunities requires programs that support adolescent social, economic, and health assets so that they can contribute socially and economically to their societies. A healthy adolescent population is critical for low-resource countries, where a rising proportion of the population is under 24 years of age. Recommendations for strengthening the effectiveness of SRH programs detailed at the FIGO World Congress in 2009 are discussed. PMID:20423736

  4. Reproductive Health Education Model in Early Childhood through Education Film "Damar Wulan"

    ERIC Educational Resources Information Center

    Zahrulianingdyah, Atiek

    2015-01-01

    Reproductive health education for early childhood it has been the time to teach, because the demand of the changing times and will affect the child's life when he/she is a teenager. During this time, the reproductive health education, which is in it there is sex education, considered taboo among some communities. They argue that the reproductive…

  5. [Summary and conclusions of the document "Population, reproductive health, and poverty"].

    PubMed

    1998-12-01

    This paper briefly examines the impact on reproductive health of social inequalities and poverty in Latin America and the Caribbean. The need to improve the quality of health services and to develop appropriate programs that promote reproductive rights is emphasized. PMID:12321988

  6. Knowledge, perceptions and attitudes of Islamic scholars towards reproductive health programs in Borno State, Nigeria.

    PubMed

    Mairiga, A G; Kyari, O; Kullima, A; Abdullahi, H

    2007-04-01

    Some reproductive health policies and activities of international development organizations continued to be criticized by some religious groups. Such criticisms can be serious obstacles in the provision of reproductive health and rights information and services in many communities. This study was conducted to find the knowledge, perception and attitude of Islamic scholars on reproductive health programs and to get some suggestions on the scholars' role in the planning and implementation of reproductive health advocacy and programming. The data were collected by in-depth interview with representative sample of selected Muslim scholars in and around Maiduguri town in Bomo State, Nigeria. All the scholars had vague or no idea of what reproductive health is all about. When they were explaining reproductive health, most of the scholars mentioned some of the rights of women especially the need for maintaining the good health of women and their children as reproductive health. Even though they have poor knowledge, all the Muslim scholars interviewed believed that reproductive health is an essential component of healthy living and the programs of the international development organizations are mostly good, but they have reservations and concern to certain campaigns and programs. Scholars that promised their contributions in enhancing reproductive health have a common condition for their continuous support to any international development organization or reproductive health program. Conformity to Islamic norms and principles are prerequisites to their loyalties. The scholars also advised the international development organizations on the need to identify themselves clearly, so that people know from where they are coming, what are their background, and the program that they want to do and the reasons for doing the program in the community. PMID:17982952

  7. Sexual and reproductive health and rights and mHealth in policy and practice in South Africa.

    PubMed

    Waldman, Linda; Stevens, Marion

    2015-05-01

    Information and Communications Technology (ICT) offers enormous opportunity and innovation to improve public health and health systems.This paper explores the intersections between mHealth and sexual and reproductive health and rights in both policy and practice. It is a qualitative study, informed by policy review and key informant interviews. Three case studies provide evidence of what is happening on the ground in relation to ICTs and reproductive health and rights. We argue that in terms of policy, there is little overlap between health rights and communication technology. In the area of practice, however, significant interventions address aspects of reproductive health. At present, the extent to which mHealth addresses the full range of reproductive justice and sexual and reproductive health and rights is limited, particularly in terms of government initiatives. The paper argues that mHealth projects tend to avoid contentious aspects of sexual health, while addressing favourable topics such as pregnancy and motherhood. The ways in which information is framed in mHealth mirrors current gaps within sexual and reproductive health and rights, where a limited and conservative lens predominates, and which may result in narrow programming and implementation of services. PMID:26278837

  8. Dignity and the right of internally displaced adolescents in Colombia to sexual and reproductive health.

    PubMed

    Bosmans, Marleen; Gonzalez, Fernando; Brems, Eva; Temmerman, Marleen

    2012-10-01

    In Colombia, national policies and laws on the protection of vulnerable populations pay specific attention to the sexual and reproductive health needs and rights of internally displaced adolescents. This paper describes how a United Nations Population Fund (UNFPA)-supported programme (September 2000-August 2004) on the sexual and reproductive health of internally displaced adolescents contributed to restoring their dignity as a precursor to promoting their sexual and reproductive health rights. Different forms of the arts were used as basic techniques to discover their body and to provide sexual and reproductive health information and education. The arts were found to play a key role in restoring their dignity. Although dignity appeared to be a determinant of greater awareness of rights, it did not lead to increased empowerment with regard to rights. The availability of and access to sexual and reproductive health services remains a problem and displaced populations continue to have little or no power to hold their authorities accountable. PMID:22329483

  9. Early life adversity reduces stress reactivity and enhances impulsive behavior: Implications for health behaviors

    PubMed Central

    Lovallo, William R.

    2012-01-01

    Altered reactivity to stress, either in the direction of exaggerated reactivity or diminished reactivity, may signal a dysregulation of systems intended to maintain homeostasis and a state of good health. Evidence has accumulated that diminished reactivity to psychosocial stress may signal poor health outcomes. One source of diminished cortisol and autonomic reactivity is the experience of adverse rearing during childhood and adolescence. The Oklahoma Family Health Patterns Project has examined a cohort of 426 healthy young adults with and without a family history of alcoholism. Regardless of family history, persons who had experienced high degrees of adversity prior to age 16 had a constellation of changes including reduced cortisol and heart rate reactivity, diminished cognitive capacity, and unstable regulation of affect, leading to behavioral impulsivity and antisocial tendencies. We present a model whereby this constellation of physiological, cognitive, and affective tendencies is consistent with altered central dopaminergic activity leading to changes in brain function that may foster impulsive and risky behaviors. These in turn may promote greater use of alcohol other drugs along with adopting poor health behaviors. This model provides a pathway from early life adversity to low stress reactivity that forms a basis for risky behaviors and poor health outcomes. PMID:23085387

  10. In utero exposure to persistent organochlorine pollutants and reproductive health in the human male

    PubMed Central

    Vested, Anne; Ramlau-Hansen, Cecilia H; Olsen, Sjurdur F; Bonde, Jens Peter; Støvring, Henrik; Kristensen, Susanne L; Halldorsson, Thorhallur I; Rantakokko, Panu; Kiviranta, Hannu; Ernst, Emil H; Toft, Gunnar

    2014-01-01

    Persistent organochlorine pollutants (POPs) are ubiquitous, bioaccumulative compounds with potential endocrine-disrupting effects. They cross the placental barrier thereby resulting in in utero exposure of the developing fetus. The objective of this study was to investigate whether maternal serum concentrations of polychlorinated biphenyls (PCBs) and p,p′-dichlorodiphenyldichloroethylene (p,p′-DDE) during pregnancy are associated with son's semen quality and reproductive hormone levels. During 2008–2009, we recruited 176 male offspring from a Danish cohort of pregnant women who participated in a study in 1988–1989. Each provided semen and blood samples that were analyzed for sperm concentration, total sperm count, motility, and morphology, and reproductive hormone levels, respectively. The maternal blood samples were collected in pregnancy week 30 and were analyzed for the concentrations of six PCBs (PCB-118, -138, -153, -156, -170, and -180) and p,p′-DDE. The potential associations between in utero exposure to ΣPCBs (pmol/ml), Σdioxin like-(DL) PCBs (PCB-118 and -156) (pmol/ml), and p,p′-DDE and semen quality and reproductive hormone levels were investigated using multiple regression. Maternal median (range) exposure levels of ΣPCB, ΣDL-PCB, and p,p′-DDE were 10.0 (2.1–35.0) pmol/ml, 0.8 (0.2–2.7) pmol/ml, and 8.0 (0.7–55.3) pmol/ml, respectively, reflecting typical background exposure levels in the late 1980s in Denmark. Results suggested that in utero exposure to ΣPCB, ΣDL-PCB, and p,p′-DDE was not statistically significantly associated with semen quality measures or reproductive hormone levels. Thus, results based on maternal PCB and p,p′-DDE concentrations alone are not indicative of long-term consequences for male reproductive health; however, we cannot exclude that these POPs in concert with other endocrine-modulating compounds may have adverse effects. PMID:25190505

  11. In utero exposure to persistent organochlorine pollutants and reproductive health in the human male.

    PubMed

    Vested, Anne; Ramlau-Hansen, Cecilia H; Olsen, Sjurdur F; Bonde, Jens Peter; Støvring, Henrik; Kristensen, Susanne L; Halldorsson, Thorhallur I; Rantakokko, Panu; Kiviranta, Hannu; Ernst, Emil H; Toft, Gunnar

    2014-12-01

    Persistent organochlorine pollutants (POPs) are ubiquitous, bioaccumulative compounds with potential endocrine-disrupting effects. They cross the placental barrier thereby resulting in in utero exposure of the developing fetus. The objective of this study was to investigate whether maternal serum concentrations of polychlorinated biphenyls (PCBs) and p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE) during pregnancy are associated with son's semen quality and reproductive hormone levels. During 2008-2009, we recruited 176 male offspring from a Danish cohort of pregnant women who participated in a study in 1988-1989. Each provided semen and blood samples that were analyzed for sperm concentration, total sperm count, motility, and morphology, and reproductive hormone levels, respectively. The maternal blood samples were collected in pregnancy week 30 and were analyzed for the concentrations of six PCBs (PCB-118, -138, -153, -156, -170, and -180) and p,p'-DDE. The potential associations between in utero exposure to ΣPCBs (pmol/ml), Σdioxin like-(DL) PCBs (PCB-118 and -156) (pmol/ml), and p,p'-DDE and semen quality and reproductive hormone levels were investigated using multiple regression. Maternal median (range) exposure levels of ΣPCB, ΣDL-PCB, and p,p'-DDE were 10.0 (2.1-35.0) pmol/ml, 0.8 (0.2-2.7) pmol/ml, and 8.0 (0.7-55.3) pmol/ml, respectively, reflecting typical background exposure levels in the late 1980s in Denmark. Results suggested that in utero exposure to ΣPCB, ΣDL-PCB, and p,p'-DDE was not statistically significantly associated with semen quality measures or reproductive hormone levels. Thus, results based on maternal PCB and p,p'-DDE concentrations alone are not indicative of long-term consequences for male reproductive health; however, we cannot exclude that these POPs in concert with other endocrine-modulating compounds may have adverse effects. PMID:25190505

  12. Adverse Health Consequences of Performance-Enhancing Drugs: An Endocrine Society Scientific Statement

    PubMed Central

    Pope, Harrison G.; Wood, Ruth I.; Rogol, Alan; Nyberg, Fred; Bowers, Larry

    2014-01-01

    Despite the high prevalence of performance-enhancing drug (PED) use, media attention has focused almost entirely on PED use by elite athletes to illicitly gain a competitive advantage in sports, and not on the health risks of PEDs. There is a widespread misperception that PED use is safe or that adverse effects are manageable. In reality, the vast majority of PED users are not athletes but rather nonathlete weightlifters, and the adverse health effects of PED use are greatly underappreciated. This scientific statement synthesizes available information on the medical consequences of PED use, identifies gaps in knowledge, and aims to focus the attention of the medical community and policymakers on PED use as an important public health problem. PED users frequently consume highly supraphysiologic doses of PEDs, combine them with other PEDs and/or other classical drugs of abuse, and display additional associated risk factors. PED use has been linked to an increased risk of death and a wide variety of cardiovascular, psychiatric, metabolic, endocrine, neurologic, infectious, hepatic, renal, and musculoskeletal disorders. Because randomized trials cannot ethically duplicate the large doses of PEDs and the many factors associated with PED use, we need observational studies to collect valid outcome data on the health risks associated with PEDs. In addition, we need studies regarding the prevalence of PED use, the mechanisms by which PEDs exert their adverse health effects, and the interactive effects of PEDs with sports injuries and other high-risk behaviors. We also need randomized trials to assess therapeutic interventions for treating the adverse effects of PEDs, such as the anabolic-androgen steroid withdrawal syndrome. Finally, we need to raise public awareness of the serious health consequences of PEDs. PMID:24423981

  13. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement.

    PubMed

    Pope, Harrison G; Wood, Ruth I; Rogol, Alan; Nyberg, Fred; Bowers, Larry; Bhasin, Shalender

    2014-06-01

    Despite the high prevalence of performance-enhancing drug (PED) use, media attention has focused almost entirely on PED use by elite athletes to illicitly gain a competitive advantage in sports, and not on the health risks of PEDs. There is a widespread misperception that PED use is safe or that adverse effects are manageable. In reality, the vast majority of PED users are not athletes but rather nonathlete weightlifters, and the adverse health effects of PED use are greatly underappreciated. This scientific statement synthesizes available information on the medical consequences of PED use, identifies gaps in knowledge, and aims to focus the attention of the medical community and policymakers on PED use as an important public health problem. PED users frequently consume highly supraphysiologic doses of PEDs, combine them with other PEDs and/or other classical drugs of abuse, and display additional associated risk factors. PED use has been linked to an increased risk of death and a wide variety of cardiovascular, psychiatric, metabolic, endocrine, neurologic, infectious, hepatic, renal, and musculoskeletal disorders. Because randomized trials cannot ethically duplicate the large doses of PEDs and the many factors associated with PED use, we need observational studies to collect valid outcome data on the health risks associated with PEDs. In addition, we need studies regarding the prevalence of PED use, the mechanisms by which PEDs exert their adverse health effects, and the interactive effects of PEDs with sports injuries and other high-risk behaviors. We also need randomized trials to assess therapeutic interventions for treating the adverse effects of PEDs, such as the anabolic-androgen steroid withdrawal syndrome. Finally, we need to raise public awareness of the serious health consequences of PEDs. PMID:24423981

  14. Reproductive health and pregnancy outcomes among French gulf war veterans

    PubMed Central

    Verret, Catherine; Jutand, Mathe-Aline; De Vigan, Catherine; Bégassat, Marion; Bensefa-Colas, Lynda; Brochard, Patrick; Salamon, Roger

    2008-01-01

    Background Since 1993, many studies on the health of Persian Gulf War veterans (PGWVs) have been undertaken. Some authors have concluded that an association exists between Gulf War service and reported infertility or miscarriage, but that effects on PGWV's children were limited. The present study's objective was to describe the reproductive outcome and health of offspring of French Gulf War veterans. Methods The French Study on the Persian Gulf War (PGW) and its Health Consequences is an exhaustive cross-sectional study on all French PGWVs conducted from 2002 to 2004. Data were collected by postal self-administered questionnaire. A case-control study nested in this cohort was conducted to evaluate the link between PGW-related exposures and fathering a child with a birth defect. Results In the present study, 9% of the 5,666 Gulf veterans who participated reported fertility disorders, and 12% of male veterans reported at least one miscarriage among their partners after the PGW. Overall, 4.2% of fathers reported at least one child with a birth defect conceived after the mission. No PGW-related exposure was associated with any birth defect in children fathered after the PGW mission. Concerning the reported health of children born after the PGW, 1.0% of children presented a pre-term delivery and 2.7% a birth defect. The main birth defects reported were musculoskeletal malformations (0.5%) and urinary system malformations (0.3%). Birth defect incidence in PGWV children conceived after the mission was similar to birth defect incidence described by the Paris Registry of Congenital Malformations, except for Down syndrome (PGWV children incidence was lower than Registry incidence). Conclusion This study did not highlight a high frequency of fertility disorders or miscarriage among French PGW veterans. We found no evidence for a link between paternal exposure during the Gulf War and increased risk of birth defects among French PGWV children. PMID:18442369

  15. Community health insurance as a catalyst for uptake of family planning and reproductive health services: the Obio Cottage Hospital experience.

    PubMed

    Fakunle, B; Okunlola, M A; Fajola, A; Ottih, U; Ilesanmi, A O

    2014-08-01

    Health service delivery in the Niger Delta region of Nigeria has suffered many setbacks. Community participation may help break the barriers limiting access to health services, especially those associated with family planning and reproductive health services. This is a two-year review of family planning and reproductive health services records offered by the Obio Cottage Hospital from the onset of the Community Insurance Scheme (2010-12). Since the inception of the Community Insurance Scheme, there has been an increase in the uptake of family planning methods of more than 50%; 1,274 women in 2011 vs 3,140 in 2012. An increase in number of women seeking reproductive health services was also observed. The Community Health Insurance Scheme (CHIS) at the Obio Cottage Hospital provides evidence for expansion, as seen in the improvement in patronage for family planning and reproductive health services. PMID:24725223

  16. Sexual and reproductive health: Progress and outstanding needs

    PubMed Central

    Snow, Rachel C.; Laski, Laura; Mutumba, Massy

    2015-01-01

    We examine progress towards the 1994 International Conference on Population and Development (ICPD) commitment to provide universal access to sexual and reproductive health (SRH) services by 2014, with an emphasis on changes for those living in poor and emerging economies. Accomplishments include a 45% decline in the maternal mortality ratio (MMR) between 1990 and 2013; 11.5% decline in global unmet need for modern contraception; ~21% increase in skilled birth attendance; and declines in both the case fatality rate and rate of abortion. Yet aggregate gains mask stark inequalities, with low coverage of services for the poorest women. Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 80 developing countries highlight persistent disparities in skilled birth attendance by household wealth: in 70 of 80 countries (88%), ≥80% of women in the highest quintile were attended by a skilled provider at last birth; in only 23 of the same countries (29%) was this the case for women in the lowest wealth quintile. While there have been notable declines in HIV incidence and prevalence, women affected by HIV are too often bereft of other SRH services, including family planning. Achieving universal access to SRH will require substantially greater investment in comprehensive and integrated services that reach the poor. PMID:25555027

  17. Functional Amino Acids in Growth, Reproduction, and Health12

    PubMed Central

    Wu, Guoyao

    2010-01-01

    Amino acids (AA) were traditionally classified as nutritionally essential or nonessential for animals and humans based on nitrogen balance or growth. A key element of this classification is that all nonessential AA (NEAA) were assumed to be synthesized adequately in the body as substrates to meet the needs for protein synthesis. Unfortunately, regulatory roles for AA in nutrition and metabolism have long been ignored. Such conceptual limitations were not recognized until recent seminal findings that dietary glutamine is necessary for intestinal mucosal integrity and dietary arginine is required for maximum neonatal growth and embryonic survival. Some of the traditionally classified NEAA (e.g. glutamine, glutamate, and arginine) play important roles in regulating gene expression, cell signaling, antioxidative responses, and immunity. Additionally, glutamate, glutamine, and aspartate are major metabolic fuels for the small intestine and they, along with glycine, regulate neurological function. Among essential AA (EAA), much emphasis has been placed on leucine (which activates mammalian target of rapamycin to stimulate protein synthesis and inhibit proteolysis) and tryptophan (which modulates neurological and immunological functions through multiple metabolites, including serotonin and melatonin). A growing body of literature leads to a new concept of functional AA, which are defined as those AA that regulate key metabolic pathways to improve health, survival, growth, development, lactation, and reproduction of organisms. Both NEAA and EAA should be considered in the classic “ideal protein” concept or formulation of balanced diets to maximize protein accretion and optimize health in animals and humans. PMID:22043449

  18. Reproductive health risk behavior survey of Colombian high school students.

    PubMed

    Becher, J C; Garcia, J G; Kaplan, D W; Gil, A R; Li, J; Main, D; Herrera, J A; Arias, L; Bromet, A

    1999-03-01

    A survey on the reproductive health risk behaviors of adolescent students in Colombia was conducted. 230 9th and 11th graders participated in a survey using the Centers for Disease Control and Prevention's self-administered Youth Risk Behavior Survey. The sample was composed of 62% females and 38% males, aged 13-18 years. It was found that 29% had engaged in sexual intercourse; among these, 13% were 9th graders and 43% were 11th graders. Increasing age and male gender were significantly correlated with past sexual activity. Older males have more prevalent sexual activity than older females, while younger adolescents showed no gender differences. Male gender was significantly associated with early age of initiation of intercourse. Furthermore, 48% reported using contraception during their last sexual encounter, of which 63% used an effective method (condom, oral contraception, withdrawal) and 37% used a method of low or unknown efficacy. Use of alcohol prior to the last sexual intercourse accounted for 14%. The majority of the participants had discussed or received information on HIV infection at school (92%) or from family (77%). Results showed unmet health needs of the adolescent groups and lower frequency of contraceptive use. PMID:10195806

  19. Lifetime Adversity Leads to Blunted Stress Axis Reactivity: Studies from the Oklahoma Family Health Patterns Project

    PubMed Central

    Lovallo, William R.; Farag, Noha H.; Sorocco, Kristen H.; Cohoon, Andrew J.; Vincent, Andrea S.

    2011-01-01

    Background Can stressful events in early life alter the response characteristics of the human stress axis? Individual differences in stress reactivity are considered potentially important in long-term health and disease, however little is known about the sources of these individual differences. We present evidence that adverse experience in childhood and adolescence can alter core components of the stress axis, including cortisol and heart rate reactivity. Methods We exposed 354 healthy young adults (196 women) to public speaking and mental arithmetic stressors in the laboratory. Stress responses were indexed by self-report, heart rate, and cortisol levels relative to measures on a nonstress control day. Subjects were grouped into those who had experienced 0, 1, or 2 or more significant adverse life events including Physical or Sexual Adversity (mugged, threatened with a weapon, experienced a break-in or robbery; or raped or sexually assaulted by a relative or nonrelative) or Emotional Adversity (separation from biological mother or father for at least 6 months prior to age 15). Results Experience of adversity predicted smaller heart rate and cortisol responses to the stressors in a dose-dependent fashion (0 > 1 > 2 or more events; (Fs = 5.79 and 8.11, ps < .004) for both men and women. This was not explained by differences in socioeconomic status, the underlying cortisol diurnal cycle, or subjective experience during the stress procedure. Conclusion The results indicate a long-term impact of stressful life experience on the reactivity of the human stress axis. PMID:22112928

  20. Asymmetric Information in Iranian’s Health Insurance Market: Testing of Adverse Selection and Moral Hazard

    PubMed Central

    Lotfi, Farhad; Gorji, Hassan Abolghasem; Mahdavi, Ghadir; Hadian, Mohammad

    2015-01-01

    Background: Asymmetric information is one of the most important issues in insurance market which occurred due to inherent characteristics of one of the agents involved in insurance contracts; hence its management requires designing appropriate policies. This phenomenon can lead to the failure of insurance market via its two consequences, namely, adverse selection and moral hazard. Objective: This study was aimed to evaluate the status of asymmetric information in Iran’s health insurance market with respect to the demand for outpatient services. Materials/sPatients and Methods: This research is a cross sectional study conducted on households living in Iran. The data of the research was extracted from the information on household’s budget survey collected by the Statistical Center of Iran in 2012. In this study, the Generalized Method of Moment model was used and the status of adverse selection and moral hazard was evaluated through calculating the latent health status of individuals in each insurance category. To analyze the data, Excel, Eviews and stata11 software were used. Results: The estimation of parameters of the utility function of the demand for outpatient services (visit, medicine, and Para-clinical services) showed that households were more risk averse in the use of outpatient care than other goods and services. After estimating the health status of households based on their health insurance categories, the results showed that rural-insured people had the best health status and people with supplementary insurance had the worst health status. In addition, the comparison of the conditional distribution of latent health status approved the phenomenon of adverse selection in all insurance groups, with the exception of rural insurance. Moreover, calculation of the elasticity of medical expenses to reimbursement rate confirmed the existence of moral hazard phenomenon. Conclusions: Due to the existence of the phenomena of adverse selection and moral hazard

  1. Adverse health effects and unhealthy behaviors among medical students using Facebook.

    PubMed

    Al-Dubai, Sami Abdo Radman; Ganasegeran, Kurubaran; Al-Shagga, Mustafa Ahmed Mahdi; Yadav, Hematram; Arokiasamy, John T

    2013-01-01

    Little is known about the relationships between adverse health effects and unhealthy behaviors among medical students using Facebook. The aim of this study was to determine the associations between adverse health effects and unhealthy behaviors with Facebook use. A cross-sectional study was conducted in a private university in Malaysia among 316 medical students. A self-administered questionnaire was used. It included questions on sociodemographics, pattern of Facebook use, social relationship, unhealthy behaviors, and health effects. Mean age was 20.5 (±2.7) years. All students had a Facebook account. The average daily Facebook surfing hours were 2.5 (±1.7). Significant associations were found between average hours of Facebook surfing and the following factors: isolation from family members and community, refusing to answer calls, musculoskeletal pain, headache, and eye irritation (P < 0.005). The average hours spent on Facebook were significantly associated with holding urination and defecation while online, surfing Facebook until midnight, and postponing, forgetting, or skipping meals (P < 0.005). The average hours spent on Facebook were associated with adverse health effects and unhealthy behaviors among medical students, as well as social isolation from the family and community. PMID:24453859

  2. Adverse Health Effects and Unhealthy Behaviors among Medical Students Using Facebook

    PubMed Central

    Al-Dubai, Sami Abdo Radman; Al-Shagga, Mustafa Ahmed Mahdi; Yadav, Hematram; Arokiasamy, John T.

    2013-01-01

    Little is known about the relationships between adverse health effects and unhealthy behaviors among medical students using Facebook. The aim of this study was to determine the associations between adverse health effects and unhealthy behaviors with Facebook use. A cross-sectional study was conducted in a private university in Malaysia among 316 medical students. A self-administered questionnaire was used. It included questions on sociodemographics, pattern of Facebook use, social relationship, unhealthy behaviors, and health effects. Mean age was 20.5 (±2.7) years. All students had a Facebook account. The average daily Facebook surfing hours were 2.5 (±1.7). Significant associations were found between average hours of Facebook surfing and the following factors: isolation from family members and community, refusing to answer calls, musculoskeletal pain, headache, and eye irritation (P < 0.005). The average hours spent on Facebook were significantly associated with holding urination and defecation while online, surfing Facebook until midnight, and postponing, forgetting, or skipping meals (P < 0.005). The average hours spent on Facebook were associated with adverse health effects and unhealthy behaviors among medical students, as well as social isolation from the family and community. PMID:24453859

  3. Exposure to hazardous substances and male reproductive health: a research framework.

    PubMed Central

    Moline, J M; Golden, A L; Bar-Chama, N; Smith, E; Rauch, M E; Chapin, R E; Perreault, S D; Schrader, S M; Suk, W A; Landrigan, P J

    2000-01-01

    The discovery in the mid-1970s that occupational exposures to pesticides could diminish or destroy the fertility of workers sparked concern about the effects of hazardous substances on male reproductive health. More recently, there is evidence that sperm quantity and quality may have declined worldwide, that the incidence of testicular cancer has progressively increased in many countries, and that other disorders of the male reproductive tract such as hypospadias and cryptorchidism may have also increased. There is growing concern that occupational factors and environmental chemical exposures, including in utero and childhood exposures to compounds with estrogenic activity, may be correlated with these observed changes in male reproductive health and fertility. We review the evidence and methodologies that have contributed to our current understanding of environmental effects on male reproductive health and fertility and discuss the methodologic issues which confront investigators in this area. One of the greatest challenges confronting researchers in this area is assessing and comparing results from existing studies. We elaborate recommendations for future research. Researchers in the field of male reproductive health should continue working to prioritize hazardous substances; elucidate the magnitude of male reproductive health effects, particularly in the areas of testicular cancer, hypospadias, and cryptorchidism; develop biomarkers of exposure to reproductive toxins and of reproductive health effects for research and clinical use; foster collaborative interdisciplinary research; and recognize the importance of standardized laboratory methods and sample archiving. PMID:11017884

  4. FERTILITY INTENTIONS AND EARLY LIFE HEALTH STRESS AMONG WOMEN IN EIGHT INDIAN CITIES: TESTING THE REPRODUCTIVE ACCELERATION HYPOTHESIS.

    PubMed

    Kulathinal, Sangita; Säävälä, Minna

    2015-09-01

    In life history theory, early life adversity is associated with an accelerated reproductive tempo. In harsh and unpredictable conditions in developing societies fertility is generally higher and the reproductive tempo faster than in more secure environments. This paper examines whether differences in female anthropometry, particularly adult height, are associated with fertility intentions of women in urban environments in India. The study population consists of women aged 15-29 (N=4485) in slums and non-slums of eight Indian cities in the National Family Health Survey (NFHS) of 2005-2006. Adult height is taken as a proxy for early childhood health and nutritional condition. Fertility intentions are examined by using two variables: the desire to have a child or another child, and to have it relatively soon, as indicative of accelerated reproductive scheduling. Evidence supporting the acceleration hypothesis is found in two urban frames out of 26 examined in a two-staged multinomial logistic model. In three cases, the relationship between fertility intentions and height is the opposite than expected by the acceleration hypothesis: taller women have a higher predictive probability of desiring a(nother) child and/or narrower birth spacing. Potential explanations for the partly contradictory relationship between the childhood health indicator and fertility intentions are discussed. PMID:25115228

  5. PRIORITIZATION OF NTP REPRODUCTIVE TOXICANTS FOR FIELD STUDIES

    EPA Science Inventory

    Population studies evaluate human reproductive impairment are time consuming,
    expensive, logistically difficult and with limited resources must be prioritized to
    effectivelyprevent the adverse health effects in humans. Interactions among
    health scientists, unions,a...

  6. The Impact of Racism on the Sexual and Reproductive Health of African American Women

    PubMed Central

    Prather, Cynthia; Fuller, Taleria R.; Marshall, Khiya J.; Jeffries, William L.

    2016-01-01

    African American women are disproportionately affected by multiple sexual and reproductive health conditions compared with women of other races/ethnicities. Research suggests that social determinants of health, including poverty, unemployment, and limited education, contribute to health disparities. However, racism is a probable underlying determinant of these social conditions. This article uses a socioecological model to describe racism and its impact on African American women’s sexual and reproductive health. Although similar models have been used for specific infectious and chronic diseases, they have not described how the historical underpinnings of racism affect current sexual and reproductive health outcomes among African American women. We propose a socioecological model that demonstrates how social determinants grounded in racism affect individual behaviors and interpersonal relationships, which may contribute to sexual and reproductive health outcomes. This model provides a perspective to understand how these unique contextual experiences are intertwined with the daily lived experiences of African American women and how they are potentially linked to poor sexual and reproductive health outcomes. The model also presents an opportunity to increase dialog and research among public health practitioners and encourages them to consider the role of these contextual experiences and supportive data when developing prevention interventions. Considerations address the provision of opportunities to promote health equity by reducing the effects of racism and improving African American women’s sexual and reproductive health. PMID:27227533

  7. The Impact of Racism on the Sexual and Reproductive Health of African American Women.

    PubMed

    Prather, Cynthia; Fuller, Taleria R; Marshall, Khiya J; Jeffries, William L

    2016-07-01

    African American women are disproportionately affected by multiple sexual and reproductive health conditions compared with women of other races/ethnicities. Research suggests that social determinants of health, including poverty, unemployment, and limited education, contribute to health disparities. However, racism is a probable underlying determinant of these social conditions. This article uses a socioecological model to describe racism and its impact on African American women's sexual and reproductive health. Although similar models have been used for specific infectious and chronic diseases, they have not described how the historical underpinnings of racism affect current sexual and reproductive health outcomes among African American women. We propose a socioecological model that demonstrates how social determinants grounded in racism affect individual behaviors and interpersonal relationships, which may contribute to sexual and reproductive health outcomes. This model provides a perspective to understand how these unique contextual experiences are intertwined with the daily lived experiences of African American women and how they are potentially linked to poor sexual and reproductive health outcomes. The model also presents an opportunity to increase dialog and research among public health practitioners and encourages them to consider the role of these contextual experiences and supportive data when developing prevention interventions. Considerations address the provision of opportunities to promote health equity by reducing the effects of racism and improving African American women's sexual and reproductive health. PMID:27227533

  8. The experiences of risk managers in providing emotional support for health care workers after adverse events.

    PubMed

    Edrees, Hanan; Brock, Douglas M; Wu, Albert W; McCotter, Patricia I; Hofeldt, Ron; Shannon, Sarah E; Gallagher, Thomas H; White, Andrew A

    2016-04-01

    Risk managers often meet with health care workers who are emotionally traumatized following adverse events. We surveyed members of the American Society for Health care Risk Management (ASHRM) about their training, experience, competence, and comfort with providing emotional support to health care workers. Although risk managers reported feeling comfortable and competent in providing support, nearly all respondents prefer to receive additional training. Risk managers who were comfortable listening to and supporting health care workers were more likely to report prior training. Health care organizations implementing second victim support programs should not rely solely on risk managers to provide support, rather engage and train interested risk managers and provide them with opportunities to practice. PMID:27088771

  9. The green choices project: integrating environmental health education into reproductive health care settings.

    PubMed

    Worthington, Sandra; Armstrong, Kay; Debevec, Elie

    2010-01-01

    A national reproductive health organization developed the Green Choices project to educate staff and clients about how to live in healthier environments by reducing potentially harmful environmental exposures to toxicants. An advisory group, comprised of experts in environmental and reproductive health and literacy, defined the project's scope and common environmental exposures to address. The following educational materials were developed: an online staff environmental health 101 curriculum, an environmental health assessment tool for clients to identify their potential risks, and information sheets for each environmental exposure that described potential risks and ways to reduce risks. Beta-testing methods included baseline and follow-up surveys, one-on-one interviews, focus groups, and recommendations from experts. Staff and client feedback on the educational materials resulted in increased clarity, sensitivity, relevancy, and appeal. Environmental health experts ensured accuracy of information, and reading experts lowered the reading level from 12th to 6th grade. A campaign to disseminate environmental health information and educational materials nationally is under way. PMID:20838173

  10. Some Adverse Effects of Used Engine Oil (Common Waste Pollutant) On Reproduction of Male Sprague Dawley Rats

    PubMed Central

    Akintunde, Wasiu Olalekan; Olugbenga, Ojo A.; Olufemi, Ogundipe O.

    2015-01-01

    degenerated with absence of Lumen. The germinal cell layer consisting of necrosis of spermatogonia and interstitial (Leydig) cells with affected Sertoli cells at different maturation stages. CONCLUSION: Hence, it can be said that there is a negative relation between used engine oil and male reproductive parameters. And it can be concluded that used engine oil should be prevented from leaking, spilling or improperly discarded as through medium it may enter storm water runoff and eventually affect the environmental health receiving water bodies. PMID:27275195

  11. Lifestyle factors and reproductive health: taking control of your fertility

    PubMed Central

    2013-01-01

    Approximately 10 to 15% of couples are impacted by infertility. Recently, the pivotal role that lifestyle factors play in the development of infertility has generated a considerable amount of interest. Lifestyle factors are the modifiable habits and ways of life that can greatly influence overall health and well-being, including fertility. Many lifestyle factors such as the age at which to start a family, nutrition, weight, exercise, psychological stress, environmental and occupational exposures, and others can have substantial effects on fertility; lifestyle factors such as cigarette smoking, illicit drug use, and alcohol and caffeine consumption can negatively influence fertility while others such as preventative care may be beneficial. The present literature review encompasses multiple lifestyle factors and places infertility in context for the couple by focusing on both males and females; it aims to identify the roles that lifestyle factors play in determining reproductive status. The growing interest and amount of research in this field have made it evident that lifestyle factors have a significant impact on fertility. PMID:23870423

  12. Human rights and reproductive health: political realities and pragmatic choices for married adolescent women living in urban slums, Bangladesh

    PubMed Central

    2011-01-01

    Background In Bangladesh, particularly in urban slums, married adolescent women’s human rights to life, health, and reproductive and sexual health remain adversely affected because of the structural inequalities and political economic, social and cultural conditions which shape how rights are understood, negotiated and lived. Methods The focus of the research and methods was anthropological. An initial survey of 153 married adolescent women was carried out and from this group, 50 in-depth interviews were conducted with selected participants and, from the in-depth interviews, a further eight case studies of women and their families were selected for in-depth repeated interviews and case histories. Results This paper speaks of the unanticipated complexities when writing on reproductive rights for poor adolescent women living in the slums, where the discourses on ‘universal human rights’ are often removed from the reality of adolescent women’s everyday lives. Married adolescent women and their families remain extremely vulnerable in the unpredictable, crime-prone and insecure urban slum landscape because of their age, gender and poverty. Adolescent women’s understanding of their rights such as the decision to marry early, have children, terminate pregnancies and engage in risky sexual behaviour, are different from the widely accepted discourse on rights globally, which assumes a particular kind of individual thinking and discourse on rights and a certain autonomy women have over their bodies and their lives. This does not necessarily exist in urban slum populations. Conclusions The lived experiences and decisions made pertaining to sexual and reproductive health and ‘rights’ exercised by married adolescent women, their families and slum communities, allow us to reflect on the disconnect between the international legal human rights frameworks as applied to sexual and reproductive health rights, and how these are played out on the ground. These notions are

  13. Developmental exposure to a mixture of two mechanistically distinct antiandrogens results in cumulative adverse reproductive effects in adult male rats

    EPA Science Inventory

    Typically, toxicological studies have focused on the adverse effects from exposure to single chemicals. However, endocrine disrupting chemicals (EDCs) are detected in the environment as mixtures. Empirical evidence suggests that mixtures of EDCs with the same mechanism of action...

  14. Ten years of democracy in South Africa: documenting transformation in reproductive health policy and status.

    PubMed

    Cooper, Diane; Morroni, Chelsea; Orner, Phyllis; Moodley, Jennifer; Harries, Jane; Cullingworth, Lee; Hoffman, Margaret

    2004-11-01

    The advent of democracy in South Africa in 1994 created a unique opportunity for new lows and policies to be passed. Today, a decade later, South African reproductive health policies and the laws that underwrite them are among the most progressive and comprehensive in the world in terms of the recognition that they give to human rights, including sexual and reproductive rights. This paper documents the changes in health policy and services that have occurred, focusing particularly on key areas of sexual and reproductive health: contraception, maternal health, termination of pregnancy, cervical and breast cancer, gender-based and sexual violence, HIV/AIDS and sexually transmitted infections and infertility. Despite important advances, significant changes in women's reproductive health status are difficult to discern, given the relatively short period of time and the multitude of complex factors that influence health, especially inequalities in socio-economic and gender status. Gaps remain in the implementation of reproductive health policies and in service delivery that need to be addressed in order for meaningful improvements in women's reproductive health status to be achieved. Civil society has played a major role in securing these legislative and policy changes, and health activist groups continue to pressure the government to introduce further changes in policy and service delivery, especially in the area of HIV/AIDS. PMID:15626198

  15. Common Sleep Disorders Increase Risk of Motor Vehicle Crashes and Adverse Health Outcomes in Firefighters

    PubMed Central

    Barger, Laura K.; Rajaratnam, Shantha M.W.; Wang, Wei; O'Brien, Conor S.; Sullivan, Jason P.; Qadri, Salim; Lockley, Steven W.; Czeisler, Charles A.

    2015-01-01

    Study Objectives: Heart attacks and motor vehicle crashes are the leading causes of death in US firefighters. Given that sleep disorders are an independent risk factor for both of these, we examined the prevalence of common sleep disorders in a national sample of firefighters and their association with adverse health and safety outcomes. Methods: Firefighters (n = 6,933) from 66 US fire departments were assessed for common sleep disorders using validated screening tools, as available. Firefighters were also surveyed about health and safety, and documentation was collected for reported motor vehicle crashes. Results: A total of 37.2% of firefighters screened positive for any sleep disorder including obstructive sleep apnea (OSA), 28.4%; insomnia, 6.0%; shift work disorder, 9.1%; and restless legs syndrome, 3.4%. Compared with those who did not screen positive, firefighters who screened positive for a sleep disorder were more likely to report a motor vehicle crash (adjusted odds ratio 2.00, 95% CI 1.29–3.12, p = 0.0021) and were more likely to self-report falling asleep while driving (2.41, 2.06–2.82, p < 0.0001). Firefighters who screened positive for a sleep disorder were more likely to report having cardiovascular disease (2.37, 1.54–3.66, p < 0.0001), diabetes (1.91, 1.31–2.81, p = 0.0009), depression (3.10, 2.49–3.85, p < 0.0001), and anxiety (3.81, 2.87–5.05, p < 0.0001), and to report poorer health status (p < 0.0001) than those who did not screen positive. Adverse health and safety associations persisted when OSA and non-OSA sleep disorders were examined separately. Conclusions: Sleep disorders are prevalent in firefighters and are associated with increased risk of adverse health and safety outcomes. Future research is needed to assess the efficacy of occupational sleep disorders prevention, screening, and treatment programs in fire departments to reduce these safety and health risks. Citation: Barger LK, Rajaratnam SM, Wang W, O'Brien CS

  16. USA President Clinton acts to ensure reproductive health.

    PubMed

    1993-02-01

    In 1984, in Mexico City, the Reagan administration announced its policy prohibiting USAID from supporting any nongovernmental organization which used its own or US funds for any abortion-related activities. Even though this policy was intended to reduce the incidence of abortion, it had the opposite effect because the cut in funding left some areas of the developing world with no family planning services or information at all. Further, this policy resulted in a loss of $17 million (US) or 25% of the budget of the International Planned Parenthood Federation (IPPF). On January 22, 1993, US President Clinton reversed this policy. IPPF considered President Clinton's action to be a significant event for women's health, human rights, and global development. This reversal will provide family planning services to about 300 million couples who want to practice family planning but could not do so because they did not have access to it. SHortly after President Clinton's announcement, IPPF began writing a proposal to USAID for funds to restore programs that the Mexico City policy eliminated. IPPF hoped the reversal would spark international recognition of the need for safe access to abortion. Other actions President Clinton has taken to promote reproductive health are reversing the Reagan and Bush administrations' rule prohibiting abortion counseling at federally-funded clinics, requesting that the US Food and Drug Administration study the possible marketing of RU-486, removing the ban on abortion in military hospitals, approving regulations allowing fetal tissue research, and appointing an abortion rights advocate as Surgeon General. The Catholic Church opposed all of Clinton's abortion policies. However, many congregations, priests, and Vatican officials are dissatisfied with the Pope's anticontraception position. PMID:12286731

  17. Urinary bisphenol A concentrations and early reproductive health outcomes among women undergoing IVF

    PubMed Central

    Ehrlich, Shelley; Williams, Paige L.; Missmer, Stacey A.; Flaws, Jodi A.; Ye, Xiaoyun; Calafat, Antonia M.; Petrozza, John C.; Wright, Diane; Hauser, Russ

    2012-01-01

    STUDY QUESTION In women undergoing IVF, are urinary bisphenol A (BPA) concentrations associated with ovarian response and early reproductive outcomes, including oocyte maturation and fertilization, Day 3 embryo quality and blastocyst formation? SUMMARY ANSWER Higher urinary BPA concentrations were found to be associated with decreased ovarian response, number of fertilized oocytes and decreased blastocyst formation. WHAT IS KNOWN ALREADY Experimental animal and in vitro studies have reported associations between BPA exposure and adverse reproductive outcomes. We previously reported an association between urinary BPA and decreased ovarian response [peak serum estradiol (E2) and oocyte count at the time of retrieval] in women undergoing IVF; however, there are limited human data on reproductive health outcomes, such as fertilization and embryo development. STUDY DESIGN, SIZE AND DURATION Prospective preconception cohort study. One hundred and seventy-four women aged 18–45 years and undergoing 237 IVF cycles were recruited at the Massachusetts General Hospital Fertility Center, Boston, MA, USA, between November 2004 and August 2010. These women were followed until they either had a live birth or discontinued treatment. Cryothaw and donor egg cycles were not included in the analysis. PARTICIPANTS/MATERIALS, SETTINGAND METHODS Urinary BPA concentrations were measured by online solid-phase extraction-high-performance liquid chromatography-isotope dilution-tandem mass spectrometry. Mixed effect models, poisson regression and multivariate logistic regression models were used wherever appropriate to evaluate the association between cycle-specific urinary BPA concentrations and measures of ovarian response, oocyte maturation (metaphase II), fertilization, embryo quality and cleavage rate. We accounted for correlation among multiple IVF cycles in the same woman using generalized estimating equations. MAIN RESULTS AND THE ROLE OF CHANCE The geometric mean (SD) for urinary

  18. Noise monitoring and adverse health effects in residents in different functional areas of Luzhou, China.

    PubMed

    Han, Zhi-Xia; Lei, Zhang-Heng; Zhang, Chun-Lian; Xiong, Wei; Gan, Zhong-Lin; Hu, Ping; Zhang, Qing-Bi

    2015-03-01

    The purpose of the study was to investigate the noise pollution situation and the resulting adverse effect on residents' health in Luzhou, China, to provide data for noise pollution prevention policies and interventions. Four different functional areas (commercial, construction, residential, and transportation hub areas) were chosen to monitor noise level for 3 months. The survey was performed by questionnaire on the spot on randomly selected individuals; it collected data on the impact of noise on residents' health (quality of sleep, high blood pressure, subjective feeling of nervous system damage, and attention) as well as the knowledge of noise-induced health damage, the degree of adaptation to noise, and their solutions. The noise levels of residential, commercial, transportation, and construction areas exceeded the national standards (P < .001). Sleep quality, prevalence of hypertension, and attention in transportation hub areas were significantly different from those in the other 3 areas (P < .05); only 24.46% of people knew the health hazards associated with noise; 64.57% of residents have adapted to the current noise environment. Most of them have to close the doors and windows to reduce noise. The noise pollution situation in Luzhou, China, is serious, especially the traffic noise pollution. Residents pay less attention to it and adopt single measures to reduce the noise. We should work toward the prevention and control of traffic noise and improve the residents' awareness to reduce the adverse health effects of noise. PMID:25504115

  19. The Patient Protection and Affordable Care Act and Reproductive Health: Harnessing Data to Improve Care

    PubMed Central

    Stulberg, Debra

    2013-01-01

    The Patient Protection and Affordable Care Act (PPACA) has great potential to improve reproductive health through several components: expanded coverage of people of reproductive age; required coverage of many reproductive health services; and insurance exchange structures that encourage individuals and states to hold plans and providers accountable. These components can work together to improve reproductive health. But in order for this to work, consumers and states need information with which to assess plans. This review article summarizes state contracting theory and argues that states should use this structure to require health plans to collect and report meaningful data that patients, providers, plans, payers, and third-party researchers can access. Now that the Supreme Court has upheld the PPACA and states must set up health insurance exchanges, populations can benefit from improved care and outcomes through data transparency. PMID:23262767

  20. Predictive modeling of structured electronic health records for adverse drug event detection

    PubMed Central

    2015-01-01

    Background The digitization of healthcare data, resulting from the increasingly widespread adoption of electronic health records, has greatly facilitated its analysis by computational methods and thereby enabled large-scale secondary use thereof. This can be exploited to support public health activities such as pharmacovigilance, wherein the safety of drugs is monitored to inform regulatory decisions about sustained use. To that end, electronic health records have emerged as a potentially valuable data source, providing access to longitudinal observations of patient treatment and drug use. A nascent line of research concerns predictive modeling of healthcare data for the automatic detection of adverse drug events, which presents its own set of challenges: it is not yet clear how to represent the heterogeneous data types in a manner conducive to learning high-performing machine learning models. Methods Datasets from an electronic health record database are used for learning predictive models with the purpose of detecting adverse drug events. The use and representation of two data types, as well as their combination, are studied: clinical codes, describing prescribed drugs and assigned diagnoses, and measurements. Feature selection is conducted on the various types of data to reduce dimensionality and sparsity, while allowing for an in-depth feature analysis of the usefulness of each data type and representation. Results Within each data type, combining multiple representations yields better predictive performance compared to using any single representation. The use of clinical codes for adverse drug event detection significantly outperforms the use of measurements; however, there is no significant difference over datasets between using only clinical codes and their combination with measurements. For certain adverse drug events, the combination does, however, outperform using only clinical codes. Feature selection leads to increased predictive performance for both

  1. 78 FR 7860 - Initial Research on the Long-Term Health Consequences of Exposure to Burn Pits in Iraq and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-04

    ..., circulatory diseases, neurologic diseases, and adverse reproductive and developmental outcomes in the..., respiratory diseases, circulatory diseases, neurologic diseases, and adverse reproductive and developmental... integrated DoD/VA clinical informatics system. VA recognizes that assessment of health outcomes is best...

  2. Physical activity to overcome the adversity of widowhood: Benefits beyond physical health.

    PubMed

    Li, Chu-Shiu; Lee, June Han; Chang, Ly-Yun; Liu, Chwen-Chi; Chan, Yan-Lan; Wen, Christopher; Chiu, Mu-Lin; Tsai, Min Kuang; Tsai, Shan Pou; Wai, Jackson Pui Man; Tsao, Chwen Keng; Wu, Xifeng; Wen, Chi Pang

    2016-08-01

    Widowhood has been increasingly encountered because of increasing longevity of women, often characterized by social stigmatization and poor physical and mental health. However, applied research to overcome its adversity has been quite limited. The goal of this study is to explore the role of physical activity in improving the health of widows.A cohort of 446,582 adults in Taiwan who successively participated in a comprehensive medical screening program starting in 1994, including 232,788 women, was followed up for mortality until 2008. Each individual provided detailed health history, and extensive lab tests results.The number of widows increased with time trend. Every other woman above age 65 was a widow (44%). Widows were less active, more obese, and smoked and drank more, had sleep problems, were more depressed with taking sedatives or psychoactive drugs, leading to more suicides. In the global development of health policies by World Health Organization (WHO), physical activity is one of the main factors to reverse poor health. The poor health of inactive widow was mitigated when becoming fully active in this study. Exercise not only reduced the observed 18% increase in all-cause mortality, but also gained 4 years and as much as 14% mortality advantage over the married but inactive. More importantly, becoming physically active energized their mental status, improved sleep quality and quantity, reduced depressions and the need for psychoactive drugs, and increased socialization circles.Widows, a rapidly growing and socially stigmatized group, suffered from social and financial inequality and tended to develop poorer health. Sustained physical activity could be one of the ways for them to overcome and reverse some of the physical and mental adversities of widowhood, and improve their quality and quantity of life. PMID:27512856

  3. Derivation and evaluation of adverse outcome pathways for the effects of cyclooxygenase inhibitors on reproductive processes in fish

    EPA Science Inventory

    Cyclooxygenase (COX) inhibition is of concern in fish because COX inhibitors (e.g., ibuprofen) are ubiquitous in aquatic systems/fish tissues, and can disrupt synthesis of prostaglandins that modulate a variety of essential biological functions (e.g., reproduction). This study ut...

  4. Endocannabinoids and Reproductive Events in Health and Disease.

    PubMed

    Battista, Natalia; Bari, Monica; Maccarrone, Mauro

    2015-01-01

    The lasting research on the endocannabinoid system (ECS) has now provided solid and convincing evidence that proves the detrimental effects of recreational drug abuse (a growing habit among teenagers) on fertility. Endocannabinoids (eCBs) affect reproductive events from gametogenesis to fertilization, from embryo implantation to the final outcome of pregnancy and, thus, they have been proposed as suitable biomarkers to predict the reproductive potential of male and female gametes in clinical practice. Novel tools for reproductive medicine are highly sought after, and here we report the latest findings on the impact of the ECS on fertility, demonstrating how basic research can be translated into new medical strategies. PMID:26408167

  5. The effect of assisted reproduction treatment on mental health in fertile women

    PubMed Central

    Zivaridelavar, Maryam; Kazemi, Ashraf; Kheirabadi, Gholam Reza

    2016-01-01

    Introduction: The process of assisted reproductive treatment is a stressful situation in the treatment of infertile couples and it would harm the mental health of women. Fertile women who started infertility treatment due to male factor infertility have reported to experience less stress and depression than other women before the assisted reproductive process but considering the cultural and social factors and also the etiology of the assisted reproductive process, it could affect the metal health of these women. Therefore, this study was conducted to evaluate the mental health of fertile women who undergo assisted reproductive treatment due to male factor infertility. Materials and Methods: This study was a prospective study on 70 fertile women who underwent assisted reproductive treatment due to male factor infertility. The exclusion criterion was to stop super ovulation induction. To assess mental health, anxiety and depression dimensions of the general health questionnaire were used. Before starting ovulation induction and after oocyte harvesting, the general health questionnaire was filled by women who were under treatment. Data were analyzed using multi-variable linear regression, paired t-test, and Chi-square. Results: The results showed that the mean score of depression and anxiety before ovulation induction and after oocyte harvesting were not significantly different; but the rate of mental health disorder in the depression dimension was significantly decreased after oocytes harvesting (31.7% vs. 39.7%). Also, there was a significant relation between the level of anxiety and depression before ovulation induction and after oocyte harvesting (P < 0.05). The anxiety level after oocyte harvesting had a positive and significant correlation with the economic situation (P < 0.05). Conclusion: This study revealed that the process of assisted reproductive treatment does not affect the mental health in fertile women independently, but these women start assisted

  6. Association of adverse childhood experiences, age of menarche, and adult reproductive behavior: does the androgen receptor gene play a role?

    PubMed

    Jorm, Anthony F; Christensen, Helen; Rodgers, Bryan; Jacomb, Patricia A; Easteal, Simon

    2004-02-15

    Previous research has reported associations between adverse childhood experiences, early menarche, and early sexual activity. One hypothesis to account for these findings is that an X-linked androgen receptor GGC-repeat polymorphism predisposes fathers to behaviors which include family abandonment and their daughters to earlier menarche and sexual activity and less stable relationships. Retrospective data relevant to this theory were examined from a community survey involving 3,702 women in the age groups 20-24, 40-44, and 60-64 years, and another involving 908 women aged 18-79 years. Earlier age of menarche was found to be associated with adverse childhood experiences and earlier sexual activity. However, the androgen receptor gene polymorphism was unrelated to adverse fathering behavior or to marital breakdown. PMID:14755454

  7. Diagnosed diabetes and ethnic disparities in adverse health behaviors of American women.

    PubMed Central

    Okosun, Ike S.; Glodener, Mark; Dever, G. E. Alan

    2003-01-01

    Despite higher rates of some high-risk lifestyle factors in non-Hispanic black women compared to non-Hispanic white women, no data exist examining the role of diagnosed diseases. Having diabetes diagnosed might motivate women and their providers to work together to lower the women's levels of behavioral risk factors. The purpose of this study was to determine the association between diagnosed diabetes and adverse health behaviors, including smoking, alcohol consumption, and sedentary lifestyle in non-Hispanic white (n=270) and non-Hispanic black (n=149) women with type 2 diabetes. Diagnosed diabetes was defined as answering "yes" to the Third US National Health and Nutrition Examination Survey question: "Have you ever been told by a doctor that you have diabetes or sugar diabetes?" Logistic regression analyses were used to determine the association of diagnosed diabetes with the adverse health behaviors. In this study, non-Hispanic black diabetic women had higher prevalences of smoking, sedentary lifestyle, and lower rates of diagnosed diabetes compared with non-Hispanic white women (P<0.01). Relative to non-Hispanic diabetic white, non-Hispanic diabetic black was associated respectively with 25% and 58% increased odds of smoking and sedentary lifestyle, adjusting for diagnosed diabetes and other confounding variables. Approximately 15% of alcohol consumption and 13% excess sedentary lifestyle in non-Hispanic diabetic blacks were associated with their increased rates of diagnosed diabetes relative to non-Hispanic diabetic whites. These excesses in adverse health behaviors, however, were within what can be explained by chance variation. There were non-significant trends toward less smoking and more sedentary lifestyle. Thus, diabetic women with a diagnosis generally had a worse behavioral risk profile than those without a diagnosis even after controlling multiple confounders. This shows the need for physicians to educate their diabetic patients regarding benefits of

  8. Reproductive Health in the United States: A Review of the Recent Social Work Literature.

    PubMed

    Wright, Rachel L; Bird, Melissa; Frost, Caren J

    2015-10-01

    Reproductive health is an important area affecting a woman's overall health and well-being. The examination of reproductive health and barriers to care is pertinent to the social work profession and should be a focus of social work practice, education, research, and advocacy. The authors conducted a literature search of articles published in the social work literature from 2010 to 2014. The findings reveal important published articles that increase our knowledge of the reproductive health of women in the United States. Most published articles focused on pregnancy and birth outcomes. Articles also addressed sexually transmitted infections; abortion; intimate partner violence; prostitution; access to care; cancer screening; views toward contraception; hysterectomies; breastfeeding; menopause; and the intersection of reproductive rights, religion, and social justice. This review also identified unexamined areas that require further social work attention and consideration. PMID:26489350

  9. Seeking Health Information Online: Association With Young Australian Women’s Physical, Mental, and Reproductive Health

    PubMed Central

    Loxton, Deborah; Dobson, Annette; Mishra, Gita Devi

    2015-01-01

    Background Relatively little is known about the extent to which young adults use the Internet as a health information resource and whether there are factors that distinguish between those who do and do not go online for health information. Objective The aim was to identify the sociodemographic, physical, mental, and reproductive health factors associated with young women’s use of the Internet for health information. Methods We used data from 17,069 young women aged 18-23 years who participated in the Australian Longitudinal Study on Women’s Health. Multivariable logistic regression was used to estimate the association between sociodemographic, physical, mental, and reproductive health factors associated with searching the Internet for health information. Results Overall, 43.54% (7433/17,069) of women used the Internet for health information. Women who used the Internet had higher odds of regular urinary or bowel symptoms (OR 1.44, 95% CI 1.36-1.54), psychological distress (very high distress: OR 1.24, 95% CI 1.13-1.37), self-reported mental health diagnoses (OR 1.16, 95% CI 1.09-1.23), and menstrual symptoms (OR 1.25, 95% CI 1.15-1.36) than women who did not use the Internet for health information. Internet users were less likely to have had blood pressure checks (OR 0.85, 95% CI 0.78-0.93) and skin cancer checks (OR 0.90, 95% CI 0.84-0.97) and to have had a live birth (OR 0.74, 95% CI 0.64-0.86) or pregnancy loss (OR 0.88, 95% CI 0.79-0.98) than non-Internet users. Conclusions Women experiencing “stigmatized” conditions or symptoms were more likely to search the Internet for health information. The Internet may be an acceptable resource that offers “anonymized” information or support to young women and this has important implications for health service providers and public health policy. PMID:25986630

  10. The chasm between public health and reproductive research: what history tells us about Zika virus.

    PubMed

    Burd, Irina; Griffin, Diane

    2016-04-01

    Zika transmission from mother to fetus and its possible sexual transmission have become a media focus in the past months as a major public health concern. While mother-to-fetus transmission, fetal neurologic manifestations or sexual transmission have never been documented for this virus before, other viruses that belong to the same family are very well known to reproductive health workers, clinicians, and researchers. As a member of Flaviviridae family, including hepatitis C and bovine viral diarrhea virus (BVDV), Zika's pathogenesis may have some parallels with these infections which may pose future questions for public health and research. Vertical transmission of hepatitis C virus from mother to child is known to occur in up to 10 % of pregnancies. BVDV, a member of Pestivirus genus of Flaviviridae family is not known to be transmitted to humans but is known for its vertical transmission in cattle. BVDV infection at different stages of gestation may lead to a spectrum of adverse pregnancy outcomes, including pregnancy loss and neurologic manifestations (including deformations such as hydrocephalus and microcephaly) in the offspring. Similar to hepatitis C, which is a virus of Hepacivirus genus, BVDV is capable of persistent infection, meaning that virus may stay in mother and future generations of calves may be infected as well, which may, in turn, result in persistence of infection in offspring. Would this be a case with Zika virus? Along with mother-to-fetus transmission, sexual transmission is a concerning implication for Zika virus. Would woman become a persistent career or male be able to persistently carry virus with its sperm is yet unknown; yet, there is a concern for the reservoir of infection. Animal models of the disease are urgently needed not only to demonstrate the mother-to-fetus transmission and confirm the fetal neurologic manifestations but also to address the effects of virus on life-long host's immunity and reproductive health. Along those

  11. Adverse Health Events Following Intermittent and Continuous Androgen Deprivation in Metastatic Prostate Cancer Patients

    PubMed Central

    Hershman, Dawn L.; Unger, Joseph M.; Wright, Jason D.; Ramsey, Scott; Till, Cathee; Tangen, Catherine M.; Barlow, William E.; Blanke, Charles; Thompson, Ian M; Hussain, Maha

    2016-01-01

    Importance Although intermittent androgen deprivation therapy (ADT) has not been associated with better overall survival in prostate cancer (PC), it has the potential for lower side effects. The incidence of long-term adverse health events has not been reported. Objective Given that older patients are more likely to suffer long-term complications from ADT, we examined long-term late events in elderly patients randomized to intermittent or continuous ADT. Our hypothesis was that late cardiovascular and endocrine events would be lower in patients on intermittent ADT. Design Linkage between patient trial data and corresponding Medicare claims. Setting Multicenter clinical trial. Participants Patients from S9346, a randomized SWOG trial of intermittent vs. continuous ADT in men with metastatic PC. Main Outcomes and Measures The main outcome was to identify long-term adverse health events by treatment arm. Patients were classified as having an adverse health event if they had any hospital claim – or at least 2 physician or outpatient claims at least 30 days apart – for any of the following diagnoses: ischemic and thrombotic events; endocrine events; sexual dysfunction, dementia and depression. To incorporate time from beginning of observation through evidence of an event, we determined the cumulative incidence of each event. Competing risks Cox regression was used, adjusting for covariates. Results In total, n=1134 eligible U.S.-based patients with metastatic PC were randomized to continuous vs. intermittent ADT on S9346. A total of 636 (56%) of trial participants had ≥1 year of continuous Medicare parts A & B coverage and no HMO participation. The median age was 71.3 years. The most common long-term events were hypercholesterolemia (31%) and osteoporosis (19%). The 10-year cumulative incidence of ischemic and thrombotic events differed by arm; 24% for continuous and 33% for intermittent ADT (Hazard Ratio=0.69, p=.02). There were no statistically significant

  12. Universal coverage and its impact on reproductive health services in Thailand.

    PubMed

    Tangcharoensathien, Viroj; Tantivess, Sripen; Teerawattananon, Yot; Auamkul, Nanta; Jongudoumsuk, Pongpisut

    2002-11-01

    Thailand has recently introduced universal health care coverage for 45 million of its people, financed by general tax revenue. A capitation contract model was adopted to purchase ambulatory and hospital care, and preventive care and promotion, including reproductive health services, from public and private service providers. This paper describes the health financing system prior to universal coverage, and the extent to which Thailand has achieved reproductive health objectives prior to this reform. It then analyses the potential impact of universal coverage on reproductive health services. Whether there are positive or negative effects on reproductive health services will depend on the interaction between three key aspects: awareness of entitlement on the part of intended beneficiaries of services, the response of health care providers to capitation, and the capacity of purchasers to monitor and enforce contracts. In rural areas, the district public health system is the sole service provider and the contractual relationship requires trust and positive engagement with purchasers. We recommend an evidence-based approach to fine-tune the reproductive health services benefits package under universal coverage, as well as improved institutional capacity for purchasers and the active participation of civil society and other partners to empower beneficiaries. PMID:12557643

  13. Weight of evidence evaluation of adverse outcome pathways converging at impaired vitellogenin synthesis leading to reproductive impairment

    EPA Science Inventory

    Adverse outcome pathways (AOPs) provide a framework that supports greater use of mechanistic data measured at lower levels of biological organization as a basis for regulatory decision-making. However, it is recognized that different types of regulatory applications and decisions...

  14. Risky Health Behaviors among Mothers-to-Be: The Impact of Adverse Childhood Experiences

    PubMed Central

    Chung, Esther K.; Nurmohamed, Laila; Mathew, Leny; Elo, Irma T.; Coyne, James C.; Culhane, Jennifer F.

    2010-01-01

    Objectives Adverse childhood experiences (ACEs) are risk factors for health problems later in life. This study aims to 1) assess the influence of ACEs on risky health behaviors among mothers-to-be, and 2) determine whether a dose response occurs between ACEs and risky behaviors. Methods Prospective survey of women attending health centers conducted at the first prenatal care visit, and 3 and 11 months postpartum. Surveys obtained information on maternal sociodemographic and health characteristics, and 7 ACEs prior to age 16. Risky behaviors included smoking, alcohol use, marijuana use and other illicit drug use during pregnancy. Results Our sample (n=1,476) consisted of low-income (mean annual personal income: $8272), young (mean age: 24 yrs), African American (71%), single (75%) women. Twenty-three percent of women reported smoking even after finding out they were pregnant, 7% reported alcohol use, and 7% reported illicit drug use during pregnancy. Nearly three-fourths (71%) had one or more ACE(s). There was a higher prevalence of each risky behavior among those exposed to each ACE than among those unexposed. The exception was alcohol use during pregnancy where there was not an increased risk among those exposed when compared to those unexposed to witnessing a shooting or having a guardian in trouble with the law or in jail. The adjusted odds ratio for each risky behavior was greater than 2.5 for those with ≥ 3 ACEs when compared to those without. Conclusions ACEs were associated with risky health behaviors reported by mothers-to-be. Greater efforts should target the prevention of ACEs to lower the risk for adverse health behaviors that have serious consequences for adults and their children. PMID:20599179

  15. Norway at ICPD+10: international assistance for reproductive health does not reflect domestic policies.

    PubMed

    Austveg, Berit; Sundby, Johanne

    2005-05-01

    Norway has a long history of good reproductive health care, with some of the world's best reproductive health indicators. Early reduction of maternal mortality, good services for abortion, contraception and sexually transmitted diseases, a low rate of adolescent pregnancies and a low number people with HIV are examples, achieved through an integrated, publicly provided and funded health care package. Official Norwegian development assistance started in 1952. Emphasis on family planning assistance dates back to 1966, making Norway one of the most consistent donors to family planning and reproductive health programmes. Norway also had a high profile at the International Conference on Population and Development and strongly supported the Programme of Action. Since then, while multilateral support in these areas has stayed high, bilateral support has been downscaled. Overall, international assistance does not reflect the domestic approach to reproductive health services. Norway has given little development support to improvement of maternity services, avoided the issues of abortion and post-coital contraception, and passed up opportunities to support adolescent services. Prevention and treatment of infertility has hardly been an issue. Revitalisation of the reproductive rights discourse in Norway could provide a basis for the protection of reproductive health care domestically, and for policy discussions and decisions in relation to Norway's development assistance. PMID:16035594

  16. Adolescent Family Adversity and Mental Health Problems: The Role of Adaptive Self-Regulation Capacities. The TRAILS Study

    ERIC Educational Resources Information Center

    Bakker, Martin Paul; Ormel, Johan; Verhulst, Frank C.; Oldehinkel, Albertine J.

    2011-01-01

    Adolescent family adversity is a considerable adaptive challenge in an increasingly turbulent developmental period. Using data from a prospective population cohort of 2230 Dutch adolescents, we tested risk-buffering interactions between adolescent family adversity and self-regulation capacities on mental health. We used two adaptive…

  17. Developmental programming of reproductive and metabolic health1,2

    PubMed Central

    Padmanabhan, V.; Veiga-Lopez, A.

    2014-01-01

    The inappropriate programming of the reproductive system by developmental exposure to excess steroid hormones is of concern. Sheep are well suited for investigating developmental origin of reproductive and metabolic disorders. The developmental time line of female sheep (~5 mo gestation and ~7 mo to puberty) is ideal for conducting sequential studies of the progression of metabolic and (or) reproductive disruption from the developmental insult to manifestation of adult consequences. Major benefits of using sheep include knowledge of established critical periods to target adult defects, a rich understanding of reproductive neuroendocrine regulation, availability of non-invasive approaches to monitor follicular dynamics, established surgical approaches to obtain hypophyseal portal blood for measurement of hypothalamic hormones, and the ability to perform studies in natural setting keeping behavioral interactions intact. Of importance is the ability to chronically instrument fetus and mother for determining early endocrine perturbations. Prenatal exposure of the female to excess testosterone (T) leads to an array of adult reproductive disorders that include LH excess, functional hyperandrogenism, neuroendocrine defects, multifollicular ovarian morphology, and corpus luteum dysfunction culminating in early reproductive failure. At the neuroendocrine level all three feedback systems are compromised. At the pituitary level, gonadotrope (LH secretion) sensitivity to GnRH is increased. Multifollicular ovarian morphology stems from persistence of follicles, as well as enhanced follicular recruitment. These defects culminate in progressive loss of cyclicity and reduced fecundity. Prenatal T excess also leads to fetal growth retardation, an early marker of adult reproductive/metabolic diseases, insulin resistance, hypertension and behavioral deficits. Collectively, the reproductive and metabolic deficits of prenatal T-treated sheep provide proof of concept for the

  18. Discussing Women's Reproductive Health, Religion, Roles and Rights: Achieving Women's Empowerment.

    ERIC Educational Resources Information Center

    Sousa, Isabela Cabral Felix de

    1995-01-01

    A health education program in Brazil trained 26 women as community health educators. Only four used their roles to foster social change. Discussing women's reproductive health in the context of religion and social values contributed to successful training; economic and political empowerment was hampered by perpetuation of traditional role…

  19. Chlorinated drinking water, cancers and adverse health outcomes in Gangtok, Sikkim, India.

    PubMed

    Sharma, Rabi N; Goel, Sudha

    2007-10-01

    Long-term impacts of drinking chlorinated water on the incidence of cancers and other adverse health outcomes were assessed in a population-based cross-sectional study. The study was conducted by comparing a group exposed to chlorinated drinking water for more than thirty years with control groups with less or no exposure to chlorine. A house-to-house survey was completed to gather information on residential history, age, education, income, source and extent of treatment of water and health characteristics. All residents below thirty years of age were excluded from the database used for analyses to ensure that the groups were comparable. Fourteen cancer cases were found in the long-term exposed groups of 1085 persons and 9 cancer cases in the two control populations of 725 persons. The odds ratio for cancers (OR) was 1.05 (95% CI = 0.43-2.65) and is not statistically significant. Reciprocal or inverse odds [corrected] ratios for gastrointestinal disorders, kidney problems and skin infections were statistically significant ranging from 2.06 (95% CI = 1.01-4.17) to 2.2 (95% CI = 1.45-3.33). These OR values indicate that there is no significant association between the incidence of cancer and exposure to chlorinated water while chlorinating drinking water significantly reduced the incidence of non-carcinogenic adverse health effects like gastrointestinal diseases, skin infections, and kidney diseases. PMID:18476370

  20. Common variants of the vitamin D binding protein gene and adverse health outcomes

    PubMed Central

    Malik, Suneil; Fu, Lei; Juras, David James; Karmali, Mohamed; Wong, Betty Y. L.; Gozdzik, Agnes

    2013-01-01

    The vitamin D binding protein (DBP) is the major plasma carrier for vitamin D and its metabolites, but it is also an actin scavenger, and is the precursor to the immunomodulatory protein, Gc-MAF. Two missense variants of the DBP gene – rs7041 encoding Asp432Glu and rs4588 encoding Thr436Lys – change the amino acid sequence and alter the protein function. They are common enough to generate population-wide constitutive differences in vitamin D status, based on assay of the serum metabolite, 25-hydroxyvitamin D (25OHD). Whether these variants also influence the role of vitamin D in an immunologic milieu is not known. However, the issue is relevant, given the immunomodulatory effects of DBP and the role of protracted innate immune-related inflammation in response to tissue injury or repeated infection. Indeed, DBP and vitamin D may jointly or independently contribute to a variety of adverse health outcomes unrelated to classical notions of their function in bone and mineral metabolism. This review summarizes the reports to date of associations between DBP variants, and various chronic and infectious diseases. The available information leads us to conclude that DBP variants are a significant and common genetic factor in some common disorders, and therefore, are worthy of closer attention. In view of the heightened interest in vitamin D as a public health target, well-designed studies that look simultaneously at vitamin D and its carrier in relation to genotypes and adverse health outcome should be encouraged. PMID:23427793

  1. Adverse Childhood Experiences and Adult Health Outcomes Among Veteran and Non-Veteran Women

    PubMed Central

    Blosnich, John R.; Dichter, Melissa E.

    2015-01-01

    Abstract Background: Women veterans represent a vulnerable population with unique health needs and disparities in access to care. One constellation of exposures related to subsequent poor health includes adverse childhood experiences (ACEs; e.g., physical and sexual child abuse), though research on impacts of ACEs among women veterans is limited. Methods: Data were drawn from the 2010 Behavioral Risk Factor Surveillance System for the 11 states that included the ACE module (n=36,485). Weighted chi-squared tests and multivariable logistic regression were used to assess the prevalence of ACEs among women veterans compared with women non-veterans and differences in the following outcomes, controlling for ACEs: social support, inadequate sleep, life satisfaction, mental distress, smoking, heavy alcohol use, obesity, diabetes, cardiovascular disease symptoms, asthma, and disability. Results: Women veterans (1.6% of the total sample) reported a higher prevalence of 7 out of 11 childhood adversities and higher mean ACE score than women non-veterans. Women veterans were more likely to be current smokers and report a disability, associations which were attenuated when controlling for ACE. Conclusions: Despite women veterans' higher prevalence of ACE, their health outcomes did not differ substantially from non-veterans. Further research is needed to understand the intersections of traumatic experiences and sources of resilience over the lifecourse among women veterans. PMID:26390379

  2. Adverse health behaviours among colorectal cancer survivors: a case study from Iran

    PubMed Central

    Aminisani, Nayyereh; Nikbakht, Hosseinali A.; Hosseinei, Seidreza R.

    2016-01-01

    Background Cancer survivors are at greater risk of developing secondary tumours, cardiovascular disease, diabetes, and osteoporosis. A part of this is because they share the similar lifestyle factors. The aim of this study was to examine the prevalence of adverse health behaviours and its determinants among colorectal survivors. Methods This cross-sectional study was conducted in Babol city located in North of Iran. The pathologic information and demographic characteristics were collected from the population based-cancer registry. Colorectal cancer (CRC) survivors between 2007–2013 were included in this study. A questionnaire includes socioeconomic status, lifestyle behaviours [smoking, physical activity (PA), fruit & vegetable consumption], and clinical factors were completed via home visit by trained interviewers. Results The majority of CRC survivors were male and were more than 50 years of age, more than half of them resided in urban areas. About 67% of survivors had at least one comorbid condition. In general, the majority of them were not meeting the recommendation for PA (89%), about 87% of them consumed less than 5 daily serving of fruit & vegetable and 14.6% of participants were smoke either cigarette or hookah. Female genders, illiteracy, comorbidities, and place of residency were the most important determinants of having adverse health behaviours. Conclusions The minority of people with CRC were not meeting the PA or 5-A-day recommendations. It is important to notify the health policy makers and to develop a comprehensive educational program to enhance the adherence to healthy lifestyle recommendation among CRC survivors. PMID:27284469

  3. COMPREHENSIVE ADOLESCENT HEALTH PROGRAMS THAT INCLUDE SEXUAL AND REPRODUCTIVE HEALTH SERVICES: A SYSTEMATIC REVIEW

    PubMed Central

    Kågesten, Anna; Parekh, Jenita; Tunçalp, Özge; Turke, Shani; Blum, Robert Wm

    2015-01-01

    Objectives To describe the characteristics and evidence of comprehensive adolescent health (CAH) programs encompassing sexual and reproductive and other health services, educational and social support. Methods Systematic review of peer-reviewed and grey literature on CAH programs (1998-2013). Only programs with experimental, quasi-experimental or pre-post evaluations were included. Two independent reviewers screened 36,119 records and extracted articles using predefined criteria. Data was synthesised into descriptive characteristics; quality was assessed by evidence level (rigorous, strong, modest). Results Data was extracted on 46 programs (181 studies) of which 19 programs were defined as comprehensive; 9 were excluded due to insufficient evaluations. Ten CAH programs met all inclusion criteria. Most were US based; others were implemented in Egypt, Ethiopia and Mexico. Few programs (N=3) displayed rigorous evidence, 5 had strong and 2 had modest evidence. All programs with rigorous/strong evidence directly or indirectly influenced adolescent sexual and reproductive health. Common elements of these programs included: long-term commitment to adolescents, interpersonal connections, community mobilization, and skill-building elements. Conclusion The long term impact of many CAH programs cannot be proven due to insufficient evaluations. Evaluation approaches that take into account the complex operating conditions of many programs are needed to better understand mechanisms behind program effects. PMID:25320876

  4. Early-Life Adversity and Physical and Emotional Health Across the Lifespan: A Neuroimmune Network Hypothesis.

    PubMed

    Nusslock, Robin; Miller, Gregory E

    2016-07-01

    Children who experience chronic stressors are vulnerable to emotional and physical health problems across the lifespan. This phenomenon raises questions for scientists and clinicians alike. How does adversity get under the skin of the developing child? Through what mechanisms does it confer vulnerability to a heterogeneous set of mental and physical illnesses? And how does it instantiate risk across different life stages, engendering vulnerability to conditions that develop shortly after stressor exposure-like depression-and conditions that manifest decades later, like heart disease? Although answers to these questions have started to emerge, research has typically focused on single diseases or organ systems. To understand the plethora of health problems associated with childhood adversity, we argue that the field needs a second generation of research that recognizes multidirectional transactions among biological systems. To help facilitate this process, we propose a neuroimmune network hypothesis as a heuristic framework for organizing knowledge from disparate literatures and as a springboard for generating integrative research. Drawing on existing data, we argue that early-life adversity amplifies crosstalk between peripheral inflammation and neural circuitries subserving threat-related, reward-related, and executive control-related processes. This crosstalk results in chronic low-grade inflammation, thereby contributing to adiposity, insulin resistance, and other predisease states. In the brain, inflammatory mediators act on cortico-amygdala threat and cortico-basal ganglia reward, circuitries in a manner that predisposes individuals to self-medicating behaviors like smoking, drug use, and consumption of high-fat diets. Acting in concert with inflammation, these behaviors accelerate the pathogenesis of emotional and physical health problems. PMID:26166230

  5. Unintended Pregnancy and Its Adverse Social and Economic Consequences on Health System: A Narrative Review Article

    PubMed Central

    YAZDKHASTI, Mansureh; POURREZA, Abolghasem; PIRAK, Arezoo; ABDI, Fatemeh

    2015-01-01

    Abstract Unintended pregnancy is among the most troubling public health problems and a major reproductive health issue worldwide imposing appreciable socioeconomic burden on individuals and society. Governments generally plan to control growth of births (especially wanted births as well as orphans and illegitimate births) imposing extra burden on public funding of the governments which inevitably affects economic efficiency and leads to economic slowdown, too. The present narrative review focuses on socioeconomic impacts of unintended pregnancy from the health system perspective. Follow of Computerized searches of Academic, 53 scientific journals were found in various databases including PubMed, EMBASE, ISI, Iranian databases, IPPE, UNFPA (1985-2013). Original articles, review articles, published books about the purpose of the paper were used. During this search, 20 studies were found which met the inclusion criteria. Unintended pregnancy is one of the most critical challenges facing the public health system that imposes substantial financial and social costs on society. On the other hand, affecting fertility indicators, it causes reduced quality of life and workforce efficiency. Therefore lowering the incidence of intended pregnancies correlates with elevating economic growth, socio-economic development and promoting public health. Regarding recent policy changes in Iran on family planning programs and adopting a new approach in increasing population may place the country at a higher risk of increasing the rate of unintended pregnancy. Hence, all governmental plans and initiatives of public policy must be regulated intelligently and logically aiming to make saving in public spending and reduce healthcare cost inflation. PMID:26060771

  6. Unintended Pregnancy and Its Adverse Social and Economic Consequences on Health System: A Narrative Review Article.

    PubMed

    Yazdkhasti, Mansureh; Pourreza, Abolghasem; Pirak, Arezoo; Abdi, Fatemeh

    2015-01-01

    Unintended pregnancy is among the most troubling public health problems and a major reproductive health issue worldwide imposing appreciable socioeconomic burden on individuals and society. Governments generally plan to control growth of births (especially wanted births as well as orphans and illegitimate births) imposing extra burden on public funding of the governments which inevitably affects economic efficiency and leads to economic slowdown, too. The present narrative review focuses on socioeconomic impacts of unintended pregnancy from the health system perspective. Follow of Computerized searches of Academic, 53 scientific journals were found in various databases including PubMed, EMBASE, ISI, Iranian databases, IPPE, UNFPA (1985-2013). Original articles, review articles, published books about the purpose of the paper were used. During this search, 20 studies were found which met the inclusion criteria. Unintended pregnancy is one of the most critical challenges facing the public health system that imposes substantial financial and social costs on society. On the other hand, affecting fertility indicators, it causes reduced quality of life and workforce efficiency. Therefore lowering the incidence of intended pregnancies correlates with elevating economic growth, socio-economic development and promoting public health. Regarding recent policy changes in Iran on family planning programs and adopting a new approach in increasing population may place the country at a higher risk of increasing the rate of unintended pregnancy. Hence, all governmental plans and initiatives of public policy must be regulated intelligently and logically aiming to make saving in public spending and reduce healthcare cost inflation. PMID:26060771

  7. Back to basics: HIV/AIDS belongs with sexual and reproductive health

    PubMed Central

    Germain, Adrienne; Sen, Gita

    2009-01-01

    Abstract The Programme of Action of the International Conference on Population and Development (ICPD) held in Cairo in 1994 offers a comprehensive framework for achieving sexual and reproductive health and rights, including the prevention and treatment of HIV/AIDS, and for advancing other development goals. The United Nations Millennium Development Goals now incorporate a target of universal access to sexual and reproductive health within the goal of improving maternal health, but combating HIV remains a separate project with malaria and tuberculosis. We present a brief history of key decisions made by WHO, other United Nations’ agencies, the United Nations Millennium Project and major donors that have led to the separation of HIV/AIDS from its logical programmatic base in sexual and reproductive health and rights. This fragmentation does a disservice to the achievement of both sets of goals and objectives. In urging a return to the original ICPD construct as a framework for action, we call for renewed leadership commitment, investment in health systems to deliver comprehensive sexual and reproductive health services, including HIV/AIDS prevention and treatment, comprehensive youth programmes, streamlined country strategies and donor support. All investments in research, policies and programmes should build systematically on the natural synergies inherent in the ICPD model to maximize their effectiveness and efficiency and to strengthen the capacity of health systems to deliver universally accessible sexual and reproductive health information and services. PMID:20072769

  8. Adverse health behaviours are associated with depression and anxiety in multiple sclerosis: A prospective multisite study

    PubMed Central

    McKay, Kyla A.; Tremlett, Helen; Fisk, John D.; Patten, Scott B.; Fiest, Kirsten; Berrigan, Lindsay; Marrie, Ruth Ann

    2015-01-01

    Background: Depression and anxiety are common among people with multiple sclerosis (MS), as are adverse health behaviours, but the associations between these factors are unclear. Objective: To evaluate the associations between cigarette smoking, alcohol use, and depression and anxiety in MS in a cross-Canada prospective study. Methods: From July 2010 to March 2011 we recruited consecutive MS patients from four MS clinics. At three visits over two years, clinical and demographic information was collected, and participants completed questionnaires regarding health behaviours and mental health. Results: Of 949 participants, 75.2% were women, with a mean age of 48.6 years; most had a relapsing−remitting course (72.4%). Alcohol dependence was associated with increased odds of anxiety (OR: 1.84; 95% CI: 1.32–2.58) and depression (OR: 1.53; 95% CI: 1.05–2.23) adjusting for age, sex, Expanded Disability Status Scale (EDSS), and smoking status. Smoking was associated with increased odds of anxiety (OR: 1.29; 95% CI: 1.02–1.63) and depression (OR: 1.37; 95% CI: 1.04–1.78) adjusting for age, sex, EDSS, and alcohol dependence. Alcohol dependence was associated with an increased incidence of depression but not anxiety. Depression was associated with an increased incidence of alcohol dependence. Conclusion: Alcohol dependence and smoking were associated with anxiety and depression. Awareness of the effects of adverse health behaviours on mental health in MS might help target counselling and support for those ‘at risk’. PMID:26245214

  9. Reproduction at an advanced maternal age and maternal health.

    PubMed

    Sauer, Mark V

    2015-05-01

    Advanced age is a risk factor for female infertility, pregnancy loss, fetal anomalies, stillbirth, and obstetric complications. These concerns are based on centuries-old observations, yet women are delaying childbearing to pursue educational and career goals in greater numbers than ever before. As a result, reproductive medicine specialists are treating more patients with age-related infertility and recurrent pregnancy loss, while obstetricians are faced with managing pregnancies often complicated by both age and comorbidities. The media portrayal of a youthful but older woman, able to schedule her reproductive needs and balance family and job, has fueled the myth that "you can have it all," rarely characterizing the perils inherent to advanced-age reproduction. Reproductive medicine specialists and obstetrician/gynecologists should promote more realistic views of the evidence-based realities of advanced maternal age pregnancy, including its high-risk nature and often compromised outcomes. Doctors should also actively educate both patients and the public that there is a real danger of childlessness if individuals choose to delay reproduction. PMID:25934599

  10. The Reproductive System [and] Instructor's Guide: The Reproductive System. Health Occupations Education Module. Instructional Materials in Anatomy and Physiology for Pennsylvania Health Occupations Programs.

    ERIC Educational Resources Information Center

    National Evaluation Systems, Inc., Amherst, MA.

    This module on the reproductive system is one of 17 modules designed for individualized instruction in health occupations education programs at both the secondary and postsecondary levels. It is part of an eight-unit miniseries on anatomy and physiology within the series of 17 modules. Following a preface which explains to the student how to use…

  11. Adverse or acceptable: negotiating access to a post-apartheid health care contract

    PubMed Central

    2014-01-01

    Background As in many fragile and post-conflict countries, South Africa’s social contract has formally changed from authoritarianism to democracy, yet access to services, including health care, remains inequitable and contested. We examine access barriers to quality health services and draw on social contract theory to explore ways in which a post-apartheid health care contract is narrated, practiced and negotiated by patients and providers. We consider implications for conceptualizing and promoting more inclusive, equitable health services in a post-conflict setting. Methods Using in-depth interviews with 45 patients and 67 providers, and field observations from twelve health facilities in one rural and two urban sub-districts, we explore access narratives of those seeking and delivering – negotiating - maternal health, tuberculosis and antiretroviral services in South Africa. Results Although South Africa’s right to access to health care is constitutionally guaranteed, in practice, a post-apartheid health care contract is not automatically or unconditionally inclusive. Access barriers, including poverty, an under-resourced, hierarchical health system, the nature of illness and treatment, and negative attitudes and actions, create conditions for insecure or adverse incorporation into this contract, or even exclusion (sometimes temporary) from health care services. Such barriers are exacerbated by differences in the expectations that patients and providers have of each other and the contract, leading to differing, potentially conflicting, identities of inclusion and exclusion: defaulting versus suffering patients, uncaring versus overstretched providers. Conversely, caring, respectful communication, individual acts of kindness, and institutional flexibility and leadership may mitigate key access barriers and limit threats to the contract, fostering more positive forms of inclusion and facilitating easier access to health care. Conclusions Building health in

  12. Human rights and the politics of risk and blame: lessons from the international reproductive health movement.

    PubMed

    Freedman, L P

    1997-01-01

    Recent debates about the "politicization" of public health obscure the ways in which epidemiological concepts of risk are routinely used in the legal and political systems to apportion blame and responsibility for poor health. This article uses the example of reproductive health and rights to argue that new understandings of the connection between socioeconomic conditions and poor health will only generate change when they are reframed into political claims and pressed by social movements. In this connection, human rights language, principles, and practice hold great potential for the US reproductive rights movement, which has sometimes been constrained by the narrow scope of court rulings. PMID:9354044

  13. Reproductive Health is in Your Hands: the national media campaign in Bolivia.

    PubMed

    Valente, T W; Saba, W P

    1997-01-01

    To strengthen awareness of the National Reproductive Health Program, the Bolivian Government launched a mass media campaign aimed at low- and middle-income males and females 18-35 years of age. Specific objectives of the campaign were to increase positive attitudes toward reproductive health, knowledge of at least one benefit of reproductive health and where to obtain these services, knowledge of where to obtain family planning services, partner communication about reproductive health, and use of reproductive health services at health centers. To facilitate understanding of family planning decision making in Bolivia, 16 focus groups were conducted and all campaign materials were pretested. The campaign included 11 television spots, 44 radio spots, leaflets and posters, videos for clinic waiting rooms, and audiotapes for use on city buses. A survey conducted immediately after the communication campaign of 2354 men and women from seven urban areas indicated 85% had been exposed to the campaign; family planning was the most frequently remembered message. A positive attitude toward reproductive health increased from 86% at baseline to 91% after the campaign. The percentage of women 18-35 years old who reported speaking to someone other than their partner about reproductive health in the past 6 months increased from 71% to 82%, while the percentage of male respondents who stated they definitely intended to use or continue to use contraception in the future rose from 25% to 60%. Family planning use among those most exposed to the campaign increased from 5.4% to 8.7%. Given the success of this campaign, the challenge is to meet the increased demand for quality services. PMID:12347727

  14. Female Reproductive Health After Childhood, Adolescent, and Young Adult Cancers: Guidelines for the Assessment and Management of Female Reproductive Complications

    PubMed Central

    Metzger, Monika L.; Meacham, Lillian R.; Patterson, Briana; Casillas, Jacqueline S.; Constine, Louis S.; Hijiya, Nobuko; Kenney, Lisa B.; Leonard, Marcia; Lockart, Barbara A.; Likes, Wendy; Green, Daniel M.

    2013-01-01

    Purpose As more young female patients with cancer survive their primary disease, concerns about reproductive health related to primary therapy gain relevance. Cancer therapy can often affect reproductive organs, leading to impaired pubertal development, hormonal regulation, fertility, and sexual function, affecting quality of life. Methods The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancer (COG-LTFU Guidelines) are evidence-based recommendations for screening and management of late effects of therapeutic exposures. The guidelines are updated every 2 years by a multidisciplinary panel based on current literature review and expert consensus. Results This review summarizes the current task force recommendations for the assessment and management of female reproductive complications after treatment for childhood, adolescent, and young adult cancers. Experimental pretreatment as well as post-treatment fertility preservation strategies, including barriers and ethical considerations, which are not included in the COG-LTFU Guidelines, are also discussed. Conclusion Ongoing research will continue to inform COG-LTFU Guideline recommendations for follow-up care of female survivors of childhood cancer to improve their health and quality of life. PMID:23382474

  15. Evidence Report: Risk of Crew Adverse Health Event Due to Altered Immune Response

    NASA Technical Reports Server (NTRS)

    Crucian, Brian; Sams, Clarence F.

    2013-01-01

    The Risk of Crew Adverse Health Event Due to Altered Immune Response is identified by the National Aeronautics and Space Administration (NASA) Human Research Program (HRP) as a recognized risk to human health and performance in space. The HRP Program Requirements Document (PRD) defines these risks. This Evidence Report provides a summary of the evidence that has been used to identify and characterize this risk. It is known that human immune function is altered in- and post-flight, but it is unclear at present if such alterations lead to increased susceptibility to disease. Reactivation of latent viruses has been documented in crewmembers, although this reactivation has not been directly correlated with immune changes or with observed diseases. As described in this report, further research is required to better characterize the relationships between altered immune response and susceptibility to disease during and after spaceflight. This is particularly important for future deep-space exploration missions.

  16. Adverse factors and the mental health of older people: implications for social policy and professional practice.

    PubMed

    Clarke, J

    2005-06-01

    Defining 'older people' as a homogenous group is problematic; it can lead to stereotypical and stigmatizing perceptions of what old age is, attracting consequent negative attitudes to later life. Nevertheless, evidence suggests that some in the older age bracket are subject to particular stressors and physical changes that can adversely affect their mental health. This paper will consider challenges to mental health in older age groups and particularly the phenomenon of dementia. The role and influence of diagnosis, social policy and professional practice will also be addressed and suggestions will be made as to how people could improve their responses to either the predisposition to or the actual occurrence of mental distress in later life. In addition, it is argued that person-centredness is important as the caring/cultural medium through which provisions and policies are mediated: that obtaining appropriate balances between corporate and individual contributions and interventions must constitute the context wherein future developments lie. PMID:15876235

  17. Diagnostic criteria for adverse health effects in the environs of wind turbines.

    PubMed

    McMurtry, Robert Y; Krogh, Carmen Me

    2014-10-01

    In an effort to address climate change, governments have pursued policies that seek to reduce greenhouse gases. Alternative energy, including wind power, has been proposed by some as the preferred approach. Few would debate the need to reduce air pollution, but the means of achieving this reduction is important not only for efficiency but also for health protection. The topic of adverse health effects in the environs of industrial wind turbines (AHE/IWT) has proven to be controversial and can present physicians with challenges regarding the management of an exposure to IWT. Rural physicians in particular must be aware of the possibility of people presenting to their practices with a variety of sometimes confusing complaints. An earlier version of the diagnostic criteria for AHE/IWT was published in August 2011. A revised case definition and a model for a study to establish a confirmed diagnosis is proposed. PMID:25383200

  18. Diagnostic criteria for adverse health effects in the environs of wind turbines

    PubMed Central

    Krogh, Carmen ME

    2014-01-01

    Summary In an effort to address climate change, governments have pursued policies that seek to reduce greenhouse gases. Alternative energy, including wind power, has been proposed by some as the preferred approach. Few would debate the need to reduce air pollution, but the means of achieving this reduction is important not only for efficiency but also for health protection. The topic of adverse health effects in the environs of industrial wind turbines (AHE/IWT) has proven to be controversial and can present physicians with challenges regarding the management of an exposure to IWT. Rural physicians in particular must be aware of the possibility of people presenting to their practices with a variety of sometimes confusing complaints. An earlier version of the diagnostic criteria for AHE/IWT was published in August 2011. A revised case definition and a model for a study to establish a confirmed diagnosis is proposed. PMID:25383200

  19. Oculocutaneous albinism in sub-Saharan Africa: adverse sun-associated health effects and photoprotection.

    PubMed

    Wright, Caradee Y; Norval, Mary; Hertle, Richard W

    2015-01-01

    Oculocutaneous albinism (OCA) is a genetically inherited autosomal recessive condition. Individuals with OCA lack melanin and therefore are susceptible to the harmful effects of solar ultraviolet radiation, including extreme sun sensitivity, photophobia and skin cancer. OCA is a grave public health issue in sub-Saharan Africa with a prevalence as high as 1 in 1000 in some tribes. This article considers the characteristics and prevalence of OCA in sub-Saharan African countries. Sun-induced adverse health effects in the skin and eyes of OCA individuals are reviewed. Sun exposure behavior and the use of photoprotection for the skin and eyes are discussed to highlight the major challenges experienced by these at-risk individuals and how these might be best resolved. PMID:25298350

  20. Adverse pregnancy outcomes with assisted reproductive technology in non-obese women with polycystic ovary syndrome: a case-control study

    PubMed Central

    Han, Ae Ra; Cha, Sun Wha; Park, Chan Woo; Kim, Jin Yeong; Yang, Kwang Moon; Song, In Ok; Koong, Mi Kyoung; Kang, Inn Soo

    2011-01-01

    Objective To investigate adverse pregnancy outcomes in non-obese women with polycystic ovary syndrome (PCOS) compared with obese-PCOS and control groups. Methods Women with PCOS who underwent assisted reproductive technology (ART) from August, 2003 to December, 2007, were considered. A total of 336 women with PCOS were included in the study group and 1,003 infertile women who had tubal factor as an indication for ART were collected as controls. They were divided into four groups: a non-obese PCOS group, obese-PCOS group, non-obese tubal factor group, and obese tubal factor group, with obesity defined by a body mass index over 25 kg/m2, and reviewed focusing on the basal characteristics, ART outcomes, and adverse pregnancy outcomes. Results There was no difference among the groups' the clinical pregnancy rate or live birth rate. Regarding adverse pregnancy outcomes, the miscarriage rate, multiple pregnancy rate, and prevalence of preterm delivery and pregnancy induced hypertension were not different among the four groups. The incidence of small for gestational age infant was higher in the PCOS groups than the tubal factor groups (p<0.02). On the other hand, the morbidity of gestational diabetes mellitus (GDM) was not high in the non-obese PCOS group but was in the obese groups. And in the obese PCOS group, the newborns were heavier than in the other groups (p<0.02). Conclusion Non-obese PCOS presents many differences compared with obese PCOS, not only in the IVF-parameters but also in the morbidity of adverse pregnancy outcomes, especially in GDM and fetal macrosomia. PMID:22384427

  1. Exploring the relationship between childhood adversity and oral health: An anecdotal approach and integrative view.

    PubMed

    Kirkengen, Anna Luise; Lygre, Henning

    2015-08-01

    During the past two decades, increasing recognition has been given to a relationship between oral health and systemic diseases. Associated systemic conditions include cardiovascular disease, diabetes, low birth weight and preterm births, respiratory diseases, rheumatoid arthritis, obesity, osteoporosis, and, in particular among oral conditions, periodontal disease. Low-grade inflammation is a common denominator linking these disorders. Applying an anecdotal approach and an integrative view, the medical and dental histories of two women document increasing ill health subsequent to incidences of maltreatment and sexual abuse, including oral penetration, at an early age. Comprehensive oral rehabilitation was required in both cases. These cases open for medical insight with regard to their implicit patho-physiology, when integrated with current evidence from neuroscience, endocrinology, and immunology, converging in the concepts of allostasis and allostatic load. In cases such as those presented in this paper, primary care physicians (family doctors, General Practitioners) and dentists may be the first to identify an etiological pattern. This report underlines the importance of increased and enhanced multidisciplinary research cooperation among health professionals. Our hypothesis is that childhood adversity may affect all aspects of human health, including adult oral health. PMID:25978926

  2. Female Adolescents' Educational Choices about Reproductive Health Modules

    ERIC Educational Resources Information Center

    Gold, Melanie A.; Chiappetta, Laurel; Young, Amanda J.; Zuckoff, Allan; DiClemente, Carlo C.

    2008-01-01

    Purpose: To assess girls' reproductive educational choices, satisfaction with choice, and relationship between demographics, module choice, and satisfaction. Methods: We recruited 286 girls, aged 13 to 21 years, from a hospital-based adolescent clinic, from advertisements, and by word of mouth. At enrollment, participants completed a 60-minute…

  3. A youth-led reproductive health program in a university setting

    PubMed Central

    Djalalinia, Shirin; Ramezani Tehrani, Fahimeh; Malekafzali, Hossein; Hashemi, Zeynab; Peykari, Niloofar

    2015-01-01

    Background: Reproductive health problems affect youths in all countries. There is an urgent need to enhance youths reproductive health services to provide a healthy life for this group. In this regard, the present study aimed to evaluate the Reproductive Health Peer Education Program based on the opinion of university students. Methods: This interventional study was conducted in Qazvin University of Medical Sciences through the peer education method. The participants of this study were 24 peer educators who received training in a 40 hour peer educator training course. The peer education program was implemented in the university. In order to evaluate this community- based intervention, 329 students were selected through the stratified sampling method and their opinion was assessed. Descriptive statistical methods were used by SPSS software for data analysis. Results: The results of the study revealed that peer education was accepted by 64.7% (n= 213) of the students, according to their opinion. The educational priorities of the students were as follows: pre-marriage counseling (78%, n= 166); STI/AIDS (17%, n= 36); and contraception (5%, n= 11). The peer education program was recognized as the most required reproductive health service in the university by 55.3% (n= 118) of the students. They believed that the most important duties of the peer educators were: education (33.5%, n= 71); counseling (30.4%, n= 65); referring to a counseling center (21.6%, n= 46) and referring to a therapeutic center (14.5%, n= 31). Also, the students stated that confidentiality (53%, n= 113), suitable communication (26%, n= 55) and sufficient knowledge (21%, n= 45) were desired characteristics for the peer educators. Conclusion: According to the students' opinion, peer education could provide suitable reproductive health services and could also be beneficial for reproductive health promotion and might reinforce positive behaviors in youths. Reproductive health peer- counseling is a

  4. A Comparative Study on Knowledge about Reproductive Health among Urban and Rural Women of Bangladesh

    PubMed Central

    Haque, Monoarul; Hossain, Sharmin; Rumana Ahmed, Kazi; Sultana, Taslima; Chowdhury, Hasina Akhter; Akter, Jesmin

    2015-01-01

    Objective: To compare the level of knowledge on reproductive health among urban and rural women of selected area of Bangladesh. Materials and methods: A descriptive cross-sectional study was undertaken among 200 women selected purposively from different rural and urban areas of Bangladesh. Data were collected using a semi-structured interviewer-administered questionnaire by face to face interview. Knowledge level was analyzed according to poor, moderate and good knowledge by pre-defined knowledge scoring. Results: Mean age of the respondents was 26 years and majority (66%) of them was housewives. Most of them (61%) had completed their primary level education. Around three-fourth of them belongs to lower-middle income group. Overall level of reproductive health knowledge was more evident among urban reproductive aged women than rural counterparts (p < 0.001). Moreover, significant knowledge gap was found regarding family planning (p = 0.005), care during pregnancy (p < 0.001), safe motherhood (p = 0.002), newborn care (p = 0.009) and birth spacing (p <0.001) between urban and rural women. Family members were the major source of information in both groups. Conclusion: A wide knowledge gap was found between Bangladeshi urban and rural respondents regarding their reproductive behaviors. Government and concerned organizations should promote and strengthen various health education programs to focus on reproductive health, especially among reproductive aged women in rural area. PMID:25904966

  5. The Catholic Church and reproductive health and rights in Timor-Leste: contestation, negotiation and cooperation.

    PubMed

    Richards, Esther

    2015-01-01

    In Timor-Leste, high fertility, high maternal mortality and low levels of contraceptive prevalence demonstrate the importance of exploring perceptions, policies and practices around reproductive health and rights. This paper explores the influence of the Catholic Church on reproductive decision-making at different levels of policy and practice. Utilising a feminist qualitative research methodology, in-depth interviews were conducted with a range of participants including nuns and priests, Timorese women and men of different ages and backgrounds and local and national stakeholders working in reproductive health and women's rights. Findings reveal that the Church is reported to play a significant role in reproductive health and rights decision-making at all levels of society, from policy-making to the reproductive decisions made by individual Timorese women and men. Nevertheless, the translation of Church teachings into practice, particularly by nuns, priests and Timorese men and women, reveal a range of attitudes and opinions; some that support and others that contest official Catholic doctrine. In light of the significant influence of the Timorese Catholic Church on policy and practice at many levels of society, there is a need to prioritise the development of rights-based strategies to improve reproductive health services in Timor-Leste. PMID:25339187

  6. The use of reproductive healthcare at commune health stations in a changing health system in Vietnam

    PubMed Central

    2011-01-01

    Background With health sector reform in Vietnam moving towards greater pluralism, commune health stations (CHSs) have been subject to growing competition from private health services and increasing numbers of patients bypassing CHSs for higher-level health facilities. This study describes the pattern of reproductive health (RH) and family planning (FP) service utilization among women at CHSs and other health facilities, and explores socio-demographic determinants of RH service utilization at the CHS level. Methods This study was based on a cross-sectional survey conducted in Thua Thien Hue and Vinh Long provinces, using a multi-stage cluster sampling technique. Questionnaire-based interviews with 978 ever-married women at reproductive age provided data on socio-demographic characteristics, current use of FP methods, history of RH service use, and the health facility attended for their most recent services. Multiple logistic regression analyses were used to identify socio-demographic determinants of their use of CHS RH services. Results Eighty nine percent of ever-married women reported current use of birth control with 49% choosing intra-uterine device (IUD). Eighty nine percent of pregnant women attended facility-based antenatal care (ANC) with 62% having at least 3 check-ups during their latest pregnancy. Ninety one percent of mothers had their last delivery in a health facility. Seventy-one percent of respondents used CHS for IUD insertion, 55% for antenatal check-ups, and 77% gynecological examination. District and provincial/central hospitals dominated the provision of delivery service, used by 57% of mothers for their latest delivery. The percentage of women opting for private ANC services was reported at 35%, though the use of private delivery services was low (11%). Women who were farmers, earning a lower income, having more than 2 children, and living in a rural area were more likely than others to use ANC, delivery, and/or gynecological check-up services

  7. Adverse inpatient outcomes during the transition to a new electronic health record system: observational study

    PubMed Central

    Barnett, Michael L; Mehrotra, Ateev

    2016-01-01

    Objective To assess the short term association of inpatient implementation of electronic health records (EHRs) with patient outcomes of mortality, readmissions, and adverse safety events. Design Observational study with difference-in-differences analysis. Setting Medicare, 2011-12. Participants Patients admitted to 17 study hospitals with a verifiable “go live” date for implementation of inpatient EHRs during 2011-12, and 399 control hospitals in the same hospital referral region. Main outcome measures All cause readmission within 30 days of discharge, all cause mortality within 30 days of admission, and adverse safety events as defined by the patient safety for selected indicators (PSI)-90 composite measure among Medicare beneficiaries admitted to one of these hospitals 90 days before and 90 days after implementation of the EHRs (n=28 235 and 26 453 admissions), compared with the control group of all contemporaneous admissions to hospitals in the same hospital referral region (n=284 632 and 276 513 admissions). Analyses were adjusted for beneficiaries’ sociodemographic and clinical characteristics. Results Before and after implementation, characteristics of admissions were similar in both study and control hospitals. Among study hospitals, unadjusted 30 day mortality (6.74% to 7.15%, P=0.06) and adverse safety event rates (10.5 to 11.4 events per 1000 admissions, P=0.34) did not significantly change after implementation of EHRs. There was an unadjusted decrease in 30 day readmission rates, from 19.9% to 19.0% post-implementation (P=0.02). In difference-in-differences analysis, however, there was no significant change in any outcome between pre-implementation and post-implementation periods (all P≥0.13). Conclusions Despite concerns that implementation of EHRs might adversely impact patient care during the acute transition period, we found no overall negative association of such implementation on short term inpatient mortality, adverse safety

  8. Women's well-being and reproductive health in Indian mining community: need for empowerment.

    PubMed

    D'Souza, Melba Sheila; Karkada, Subrahmanya Nairy; Somayaji, Ganesha; Venkatesaperumal, Ramesh

    2013-01-01

    This paper is a qualitative study of women's well-being and reproductive health status among married women in mining communities in India. An exploratory qualitative research design was conducted using purposive sampling among 40 selected married women in a rural Indian mining community. Ethical permission was obtained from Goa University. A semi-structured indepth interview guide was used to gather women's experiences and perceptions regarding well-being and reproductive health in 2010. These interviews were audiotaped, transcribed, verified, coded and then analyzed using qualitative content analysis. Early marriage, increased fertility, less birth intervals, son preference and lack of decision-making regarding reproductive health choices were found to affect women's reproductive health. Domestic violence, gender preference, husbands drinking behaviors, and low spousal communication were common experiences considered by women as factors leading to poor quality of marital relationship. Four main themes in confronting women's well-being are poor literacy and mobility, low employment and income generating opportunities, poor reproductive health choices and preferences and poor quality of martial relationships and communication. These determinants of physical, psychological and cultural well-being should be an essential part of nursing assessment in the primary care settings for informed actions. Nursing interventions should be directed towards participatory approach, informed decision making and empowering women towards better health and well-being in the mining community. PMID:23602071

  9. Women’s well-being and reproductive health in Indian mining community: need for empowerment

    PubMed Central

    2013-01-01

    This paper is a qualitative study of women’s well-being and reproductive health status among married women in mining communities in India. An exploratory qualitative research design was conducted using purposive sampling among 40 selected married women in a rural Indian mining community. Ethical permission was obtained from Goa University. A semi-structured indepth interview guide was used to gather women’s experiences and perceptions regarding well-being and reproductive health in 2010. These interviews were audiotaped, transcribed, verified, coded and then analyzed using qualitative content analysis. Early marriage, increased fertility, less birth intervals, son preference and lack of decision-making regarding reproductive health choices were found to affect women’s reproductive health. Domestic violence, gender preference, husbands drinking behaviors, and low spousal communication were common experiences considered by women as factors leading to poor quality of marital relationship. Four main themes in confronting women’s well-being are poor literacy and mobility, low employment and income generating opportunities, poor reproductive health choices and preferences and poor quality of martial relationships and communication. These determinants of physical, psychological and cultural well-being should be an essential part of nursing assessment in the primary care settings for informed actions. Nursing interventions should be directed towards participatory approach, informed decision making and empowering women towards better health and well-being in the mining community. PMID:23602071

  10. Global Association of Cold Spells and Adverse Health Effects: A Systematic Review and Meta-Analysis

    PubMed Central

    Ryti, Niilo R.I.; Guo, Yuming; Jaakkola, Jouni J.K.

    2015-01-01

    Background There is substantial evidence that mortality increases in low temperatures. Less is known about the role of prolonged cold periods denoted as cold spells. Objective We conducted the first systematic review and meta-analysis to summarize the evidence on the adverse health effects of cold spells in varying climates. Data sources and extraction Four databases (Ovid Medline, PubMed, Scopus, Web of Science) were searched for all years and languages available. “Cold spell” was defined as an event below a temperature threshold lasting for a minimum duration of 2 days. Of 1,527 identified articles, 26 satisfied our eligibility criteria for the systematic review, and 9 were eligible for meta-analyses. The articles were grouped by the three main study questions into Overall-effect Group, Added-effect Group, and Temperature-change-effect Group. Data synthesis Based on random-effects models in the meta-analyses, cold spells were associated with increased mortality from all or all nonaccidental causes (summary rate ratio = 1.10; 95% CI: 1.04, 1.17 based on 9 estimates from five studies), cardiovascular diseases (1.11; 95% CI: 1.03, 1.19; 12 estimates from eight studies), and respiratory diseases (1.21; 95% CI: 0.97, 1.51; 8 estimates from four studies). Estimated associations were stronger for people ≥ 65 years of age (1.06; 95% CI: 1.00, 1.12) than for people 0–64 years of age (1.01; 95% CI: 1.00, 1.03). Study-specific effect estimates from a limited number of studies suggested an increased morbidity related to cold spells, but it was not possible to quantitatively summarize the evidence. Conclusions Cold spells are associated with increased mortality rates in populations around the world. The body of evidence suggests that cold spells also have other adverse health effects. There was substantial heterogeneity among the studies, which should be taken into account in the interpretation of the results. Citation Ryti NR, Guo Y, Jaakkola JJ. 2016. Global

  11. The experiences of women of reproductive age regarding health-promoting behaviours: A qualitative study

    PubMed Central

    2012-01-01

    Background Health promotion is critical for community and family health. Health-promoting behaviours provide solutions for maintaining and promoting health. Although several studies have addressed the frequency and different types of health-promoting behaviours in women, little information is available about their experiences. This study aimed to explore the experiences of women of reproductive age regarding health-promoting behaviours. Methods In the present study, which was conducted in Tehran, Iran, 15 females, who were selected purposefully, participated in individual in-depth, semi-structured interviews. The interviews were recorded, transcribed verbatim, and analysed using conventional content analysis. Results Nine main categories were derived from the analysis, including establishing an appropriate eating pattern, establishing a balanced rest/activity pattern, spirituality, stress management, personal sensitivity and responsibility, establishing an appropriate pattern of social interactions, practicing safe and healthy recreations, feeling improvement in physical-functional health, and feeling improvement in emotional and psychological health. The first 7 categories represent the nature and types of real health-promoting behaviours in women of reproductive age, whereas the last 2 constitute feeling and understanding of the implementation of these behaviours. Conclusion The study findings show that the women experience improvement in physical-functional, emotional, and psychological health by implementing health-promoting behaviours. It is therefore necessary to introduce strategies in the context of the community culture for improving different aspects of health-promoting behaviours in women of reproductive age to maintain and improve their overall health. PMID:22846587

  12. Setting the stage for chronic health problems: cumulative childhood adversity among homeless adults with mental illness in Vancouver, British Columbia

    PubMed Central

    2014-01-01

    Background It is well documented that childhood abuse, neglect and household dysfunction are disproportionately present in the backgrounds of homeless adults, and that these experiences adversely impact child development and a wide range of adult outcomes. However, few studies have examined the cumulative impact of adverse childhood experiences on homeless adults with mental illness. This study examines adverse events in childhood as predictors of duration of homelessness, psychiatric and substance use disorders, and physical health in a sample of homeless adults with mental illness. Methods This study was conducted using baseline data from a randomized controlled trial in Vancouver, British Columbia for participants who completed the Adverse Childhood Experiences (ACE) scale at 18 months follow-up (n = 364). Primary outcomes included current mental disorders; substance use including type, frequency and severity; physical health; duration of homelessness; and vocational functioning. Results In multivariable regression models, ACE total score independently predicted a range of mental health, physical health, and substance use problems, and marginally predicted duration of homelessness. Conclusions Adverse childhood experiences are overrepresented among homeless adults with complex comorbidities and chronic homelessness. Our findings are consistent with a growing body of literature indicating that childhood traumas are potent risk factors for a number of adult health and psychiatric problems, particularly substance use problems. Results are discussed in the context of cumulative adversity and self-trauma theory. Trials registration This trial has been registered with the International Standard Randomized Control Trial Number Register and assigned ISRCTN42520374. PMID:24726046

  13. Adverse health effects of spousal violence among women attending Saudi Arabian primary health-care clinics.

    PubMed

    Eldoseri, H M; Tufts, K A; Zhang, Q; Fish, J N

    2014-11-01

    This study aimed to investigate the frequency of spousal violence among Saudi women and document the related health effects and injuries, as well as their attitudes to gender and violence. Structured interviews were conducted with 200 ever-married women recruited from primary-care centres in Jeddah. Nearly half of the surveyed women (44.5%) reported ever experiencing physical violence from their spouse. Although 37 women (18.5%) had received violence-related injuries, only 6.5% had reported these injuries to a health-care provider. Victims of spousal violence had poor perceptions of their overall health, and reported pain or discomfort, antidepressant use and suicidal thoughts. Women mostly disagreed with the presented justifications for wife-beating. However, the association between gender attitudes and spousal violence was not significant. The results of this study support calls for integration of education about partner violence into health-care curricula to enhance the access and quality of services. PMID:25601810

  14. Useful biomarkers for assessing the adverse health effects of PCBs in allergic children: pediatric molecular epidemiology.

    PubMed

    Tsuji, Mayumi

    2015-01-01

    The incidences of childhood allergies have been increasing in recent years in many parts of the world. The development of allergic disorders is attributed to a complex series of interactions between individuals' genetic backgrounds and their immune and psychoneurotic responses to environmental factors. Among the various possible environmental causes of childhood allergies, the early exposure of developing infants to air pollutants and the presence of persistent chemical pollutants such as pesticides have been suggested most frequently. Therefore, it is very important to obtain epidemiological evidence of direct associations between clearly defined adverse health effects and exposure to low levels of pollutants. However, there are no useful biomarkers for assessing such associations. Thus, we planned to establish reliable health-related biomarkers that could be used to investigate these relationships in children. The serum concentrations of several sub-types of polychlorinated biphenyl (PCB) congeners were found to be significantly correlated with interleukin (IL)-8 mRNA expression among asthmatic children. In addition, IL-22 mRNA expression was found to be particularly useful for detecting the effects of environmental pollutants, especially PCB congeners, in a sub-population of vulnerable children who exhibited positive immunoglobulin E (IgE) responses to milk or egg. Furthermore, we detected significant differences in IL-22 mRNA expression between the IgE-negative non-asthmatic subjects and the asthmatic children who exhibited positive IgE reactions toward egg or milk. In conclusion, IL-8 and IL-22 mRNA expressions could be useful biomarkers for detecting sub-populations of children who are particularly vulnerable to the adverse health effects of environmental pollutants, especially PCBs. PMID:25344634

  15. Critical windows of exposure for children's health: the reproductive system in animals and humans.

    PubMed Central

    Pryor, J L; Hughes, C; Foster, W; Hales, B F; Robaire, B

    2000-01-01

    Drugs and environmental chemicals can adversely affect the reproductive system. Currently, available data indicate that the consequences of exposure depend on the nature of the chemical, its target, and the timing of exposure relative to critical windows in development of the reproductive system. The reproductive system is designed to produce gametes in far greater excess than would seem to be necessary for the survival of species. Ten to hundreds of millions of spermatozoa are generated daily by most adult male mammals, yet very few of these germ cells succeed in transmitting their genetic material to the next generation. Although the number of oocytes produced in mammalian females is more limited, and their production occurs only during fetal life, most ovaries contain several orders of magnitude more oocytes than ever will be fertilized. Toxicant exposures may affect critical events in the development of the reproductive system, ranging from early primordial germ cell determination to gonadal differentiation, gametogenesis, external genitalia, or signaling events regulating sexual behavior. Although there are differences between the human reproductive system and that of the usual animal models, such models have been extremely useful in assessing risks for key human reproductive and developmental processes. The objectives for future studies should include the elucidation of the specific cellular and molecular targets of known toxicants; the design of a systematic approach to the identification of reproductive toxicants; and the development of sensitive, specific, and predictive animal models, minimally invasive surrogate markers, or in vitro tests to assess reproductive system function during embryonic, postnatal, and adult life. Images Figure 1 Figure 2 PMID:10852849

  16. 77 FR 6804 - Advisory Committee for Reproductive Health Drugs; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-09

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Advisory Committee for Reproductive Health Drugs; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice announces a forthcoming meeting of a public advisory committee of...

  17. 78 FR 734 - Advisory Committee for Reproductive Health Drugs; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-04

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Advisory Committee for Reproductive Health Drugs; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice announces a forthcoming meeting of a public advisory committee of...

  18. The Teen Outreach Reproductive Challenge: Improving Adolescent Health Care Delivery through Peer Education Projects

    ERIC Educational Resources Information Center

    DeMairo, Pauline; Dischell, Jackie; Jouthe, Sorahya A.; Horner, Andrea

    2008-01-01

    The Teen Outreach Reproductive CHallenge (TORCH) is a peer education program that provides information on various topics relevant to adolescent sexual health to a diverse audience, ranging from teens to health care providers. This information is disseminated through various projects by a group of New York City high-school students who are…

  19. 75 FR 22146 - Advisory Committee for Reproductive Health Drugs; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-27

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Advisory Committee for Reproductive Health Drugs; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice announces a forthcoming meeting of a public advisory committee...

  20. Sexual and Reproductive Health Behaviors of Asian Pacific Islander Community College Students

    ERIC Educational Resources Information Center

    Trieu, Sang Leng; Marshak, Helen Hopp; Bratton, Sally I.

    2013-01-01

    Analyzed were the sexual and reproductive health behaviors of Asian Pacific Islander (API) California community college students who took the National College Health Assessment (NCHA) survey. This was done to identify characteristics related to sexual behavior and choice of birth control and examine the association between condom use and history…

  1. Ensuring Rights: Improving Access to Sexual and Reproductive Health Services for Female International Students in Australia

    ERIC Educational Resources Information Center

    Poljski, Carolyn; Quiazon, Regina; Tran, Chau

    2014-01-01

    Drawing on the research and advocacy work being conducted by the Multicultural Centre for Women's Health (MCWH), a national community-based organization in Victoria, Australia, the paper analyzes female international students' experiences with accessing sexual and reproductive health information and services. Accessibility of sexual and…

  2. Associations between Anticholinergic Burden and Adverse Health Outcomes in Parkinson Disease

    PubMed Central

    Crispo, James A. G.; Willis, Allison W.; Thibault, Dylan P.; Fortin, Yannick; Hays, Harlen D.; McNair, Douglas S.; Bjerre, Lise M.; Kohen, Dafna E.; Perez-Lloret, Santiago; Mattison, Donald R.; Krewski, Daniel

    2016-01-01

    Background Elderly adults should avoid medications with anticholinergic effects since they may increase the risk of adverse events, including falls, delirium, and cognitive impairment. However, data on anticholinergic burden are limited in subpopulations, such as individuals with Parkinson disease (PD). The objective of this study was to determine whether anticholinergic burden was associated with adverse outcomes in a PD inpatient population. Methods Using the Cerner Health Facts® database, we retrospectively examined anticholinergic medication use, diagnoses, and hospital revisits within a cohort of 16,302 PD inpatients admitted to a Cerner hospital between 2000 and 2011. Anticholinergic burden was computed using the Anticholinergic Risk Scale (ARS). Primary outcomes were associations between ARS score and diagnosis of fracture and delirium. Secondary outcomes included associations between ARS score and 30-day hospital revisits. Results Many individuals (57.8%) were prescribed non-PD medications with moderate to very strong anticholinergic potential. Individuals with the greatest ARS score (≥4) were more likely to be diagnosed with fractures (adjusted odds ratio (AOR): 1.56, 95% CI: 1.29–1.88) and delirium (AOR: 1.61, 95% CI: 1.08–2.40) relative to those with no anticholinergic burden. Similarly, inpatients with the greatest ARS score were more likely to visit the emergency department (adjusted hazard ratio (AHR): 1.32, 95% CI: 1.10–1.58) and be readmitted (AHR: 1.16, 95% CI: 1.01–1.33) within 30-days of discharge. Conclusions We found a positive association between increased anticholinergic burden and adverse outcomes among individuals with PD. Additional pharmacovigilance studies are needed to better understand risks associated with anticholinergic medication use in PD. PMID:26939130

  3. Pathways from childhood abuse and other adversities to adult health risks: The role of adult socioeconomic conditions.

    PubMed

    Font, Sarah A; Maguire-Jack, Kathryn

    2016-01-01

    Adverse childhood experiences (ACEs), including child abuse, have been linked with poor health outcomes in adulthood. The mechanisms that explain these relations are less understood. This study assesses whether associations of ACEs and health risks are mediated by adult socioeconomic conditions, and whether these pathways are different for maltreatment than for other types of adversities. Using the Behavioral Risk Factor Surveillance System 2012 survey (N=29,229), we employ structural equation modeling to (1) estimate associations of the number and type of ACEs with five health risks-depression, obesity, tobacco use, binge drinking, and self-reported sub-optimal health; and (2) assess whether adult socioeconomic conditions-marriage, divorce and separation, educational attainment, income and insurance status-mediate those associations. Findings suggest both direct and indirect associations between ACEs and health risks. At high numbers of ACEs, 15-20% of the association between number of ACEs and adult health risks was attributable to socioeconomic conditions. Associations of three ACEs (exposure to domestic violence, parental divorce, and residing with a person who was incarcerated) with health risks were nearly entirely explained by socioeconomic conditions in adulthood. However, child physical, emotional, and sexual abuse were significantly associated with several adult health risks, beyond the effects of other adversities, and socioeconomic conditions explained only a small portion of these associations. These findings suggest that the pathways to poor adult health differ by types of ACEs, and that childhood abuse is more likely than other adversities to have a direct impact. PMID:26059537

  4. Exploring Somali women's reproductive health knowledge and experiences: results from focus group discussions in Mogadishu.

    PubMed

    Gure, Faduma; Yusuf, Marian; Foster, Angel M

    2015-11-01

    With a total fertility ratio of 6.7 children per woman, a maternal mortality ratio over 1,000 deaths per 100,000 live births, high rates of sexual and gender-based violence, and the lowest contraceptive prevalence rate in the world, women's reproductive health indices in Somalia prove alarming. The voices of women living in Somalia have long been neglected and we undertook this qualitative study to explore women's reproductive health knowledge and experiences. In 2014, we conducted four focus group discussions with 21 married and unmarried women of reproductive age living in Mogadishu, Somalia. Discussions took place in Somali and we used a constant comparative approach to analyse the discussions for content and themes. Our findings reveal that misinformation, restrictive policies, mistrust of clinicians, and prohibitively expensive services shape women's experiences and health-seeking behaviours. Women identified the need for culturally resonant reproductive health information and services as a significant priority. As Somalia begins to emerge from over two decades of civil war, it is imperative that comprehensive reproductive health issues are included on the national agenda and that women's perspectives are incorporated into future policies and interventions. PMID:26719005

  5. Detection of Pharmacovigilance-Related adverse Events Using Electronic Health Records and automated Methods

    PubMed Central

    Haerian, K; Varn, D; Vaidya, S; Ena, L; Chase, HS; Friedman, C

    2013-01-01

    Electronic health records (EHRs) are an important source of data for detection of adverse drug reactions (ADRs). However, adverse events are frequently due not to medications but to the patients’ underlying conditions. Mining to detect ADRs from EHR data must account for confounders. We developed an automated method using natural-language processing (NLP) and a knowledge source to differentiate cases in which the patient’s disease is responsible for the event rather than a drug. Our method was applied to 199,920 hospitalization records, concentrating on two serious ADRs: rhabdomyolysis (n = 687) and agranulocytosis (n = 772). Our method automatically identified 75% of the cases, those with disease etiology. The sensitivity and specificity were 93.8% (confidence interval: 88.9-96.7%) and 91.8% (confidence interval: 84.0-96.2%), respectively. The method resulted in considerable saving of time: for every 1 h spent in development, there was a saving of at least 20 h in manual review. The review of the remaining 25% of the cases therefore became more feasible, allowing us to identify the medications that had caused the ADRs. PMID:22713699

  6. Reproductive health care for asylum-seeking women - a challenge for health professionals

    PubMed Central

    2010-01-01

    Background Dealing with pregnancy, childbirth and the care of newborn babies is a challenge for female asylum seekers and their health care providers. The aim of our study was to identify reproductive health issues in a population of women seeking asylum in Switzerland, and to examine the care they received. The women were insured through a special Health Maintenance Organisation (HMO) and were attending the Women's Clinic of the University Hospital in Basel. We also investigated how the health professionals involved perceived the experience of providing health care for these patients. Methods A mixed methods approach combined the analysis of quantitative descriptive data and qualitative data obtained from semi-structured interviews with health care providers and from patients' files. We analysed the records of 80 asylum-seeking patients attending the Women's Clinic insured through an HMO. We conducted semi-structured interviews with 10 care providers from different professional groups. Quantitative data were analysed descriptively. Qualitative data analysis was guided by Grounded Theory. Results The principal health problems among the asylum seekers were a high rate of induced abortions (2.5 times higher than in the local population), due to inadequate contraception, and psychosocial stress due to the experience of forced migration and their current difficult life situation. The language barriers were identified as a major difficulty for health professionals in providing care. Health care providers also faced major emotional challenges when taking care of asylum seekers. Additional problems for physicians were that they were often required to act in an official capacity on behalf of the authorities in charge of the asylum process, and they also had to make decisions about controlling expenditure to fulfil the requirements of the HMO. They felt that these decisions sometimes conflicted with their duty towards the patient. Conclusion Health policies for asylum

  7. The Yin: An adverse health perspective of nanoceria: uptake, distribution, accumulation, and mechanisms of its toxicity

    PubMed Central

    Yokel, Robert A.; Hussain, Salik; Garantziotis, Stavros; Demokritou, Philip; Castranova, Vincent; Cassee, Flemming R.

    2014-01-01

    Ce3+, which becomes more relevant as particle size decreases and the ratio of surface area to volume increases. Given its biopersistence and resulting increased toxicity with time, there is a risk that long-term exposure to low nanoceria levels may eventually lead to adverse health effects. This critical review provides recommendations for research to resolve some of the many unknowns of nanoceria’s fate and adverse effects. PMID:25243070

  8. [Sexual and reproductive health and the economic crisis in Spain. SESPAS report 2014].

    PubMed

    Larrañaga, Isabel; Martín, Unai; Bacigalupe, Amaia

    2014-06-01

    Sexual and reproductive health (SRH) is protected by the public authorities to ensure that people enjoy a free, satisfying, and safe sexual life. Despite the approval of the National Sexual and Reproductive Health Strategy in 2011, the progress achieved may be jeopardized by recent proposals for legislative changes affecting this area (abortion Law and 16/2012 Law) and by the impact of the current economic crisis. This article aims to describe the current situation of sexual and reproductive health in the Spanish population and to identify the potential impact of the economic crisis. To this end, we used the following information sources: the National Sexual Health Survey, the DAPHNE surveys, births and fetal deaths statistics from the Spanish National Institute of Statistics, the Registry of Voluntary Pregnancy Interruptions, reports from the National Epidemiology Center, and the National AIDS Registry. Sexual health and the availability of information are rated as good by the Spanish population. Among young people, schools and health services have become less important as information sources and the internet has become more important. Since the beginning of the crisis, contraceptive use and fertility have declined and maternity has been delayed. The economic crisis seems to have affected some indicators of sexual and reproductive health. However, the potential effects on other indicators should continue to be monitored because insufficient time may have passed for accurate determination of the full effect of the crisis. PMID:24864000

  9. The Efficiency of Reproduction Health Education Given to Adolescents during the Postpartum Period.

    PubMed

    Topatan, Serap; Demirci, Nurdan

    2015-10-01

    Our research, partly experimental and partly prospective, was conducted for the purpose of evaluating the efficiency of reproductive health education given to adolescents during the postpartum period. The study comprised with 120 adolescents aged 15 to 19 (60 experimental group, 60 control group). Follow-up was conducted every 3 months for a total of 12 months, and the study concluded with 55 individuals from the experimental group and 46 individuals from the control group having participated fully, for the full 12 months. At the end of the research, it was found that the reproductive health knowledge of the experimental (103.10 ± 11.43) and control (99.15 ± 9.53) groups were similar before education. A statistically significant difference was also found between the total points for the scale determining the reproductive health of the experimental and control groups before and after education (P < .001). The socio-demographic variables affecting the total points for the scale determining the reproductive health-protective behavior of women were evaluated by multiple regression analysis; the most effective variables were found to be age and educational status. A statistically significant difference was also found between the total points for the family planning behavior scale of the experimental and control groups before and after education (P < .001). From this, it was understood that reproductive health education given during the postpartum and follow-up periods has a positive effect on adolescents' developing reproductive health behaviors and on creating knowledge and awareness related to family planning behavior. But there needs to be follow-up and supporting specific for adolescents in the current health system. PMID:26173382

  10. Leveraging the biology of adversity to address the roots of disparities in health and development

    PubMed Central

    Shonkoff, Jack P.

    2012-01-01

    Extensive evidence that personal experiences and environmental exposures are embedded biologically (for better or for worse) and the cumulative knowledge of more than four decades of intervention research provide a promising opportunity to mobilize evolving scientific insights to catalyze a new era of more effective early childhood policy and practice. Drawing on emerging hypotheses about causal mechanisms that link early adversity with lifelong impairments in learning, behavior, and health, this paper proposes an enhanced theory of change to promote better outcomes for vulnerable, young children by strengthening caregiver and community capacities to reduce or mitigate the impacts of toxic stress, rather than simply providing developmental enrichment for the children and parenting education for their mothers. PMID:23045654

  11. Depression and Risk for Adverse Falls in Older Home Health Care Patients

    PubMed Central

    Byers, Amy L.; Sheeran, Thomas; Mlodzianowski, Amy E.; Meyers, Barnett S.; Nassisi, Pamella; Bruce, Martha L.

    2013-01-01

    Because falls are highly prevalent, harmful events for older adults, identification of patients at risk is a high priority for home health care agencies. Using routine administrative data, we demonstrated that patients with depressive symptoms on the Outcome and Assessment Information Set are at risk for falls. A prospective case-control study that matched 54 patients who experienced an adverse fall with 854 controls showed that patients who fell had twice the odds of being depressed (odds ratio = 1.90, 95% confidence interval = 1.01 to 3.59). Bowel incontinence, high medical comorbidity, stair use, injury and poisoning, memory deficit, and antipsychotic medication use were also predictors, but no association was found for antidepressant medications. These data suggest the potential benefit of including depression screening for multifactorial fall prevention interventions. PMID:20077999

  12. Adverse health effects of Asian dust particles and heavy metals in Japan.

    PubMed

    Onishi, Kazunari; Otani, Shinji; Yoshida, Atsushi; Mu, Haosheng; Kurozawa, Youichi

    2015-03-01

    Asian dust events are now considered an environmental problem rather than a natural seasonal phenomenon. In this study, we evaluated the associations between daily adverse health effects and Asian dust events in Yonago, Japan. Participants included 54 healthy volunteers, who were distributed survey sheets on nasal, ocular, respiratory, and skin effects in February 2009. Moreover, we collected meteorological and air pollutant (nitric oxide, sulfur dioxide, suspended particulate matter) data and determined pollen and metallic element concentrations in total suspended particulates. Both soil-derived metals (Fe, Ca, Al) and contaminating metals (Pb, Cr, Mn, Ni, Zn) were significantly increased on Asian dust days. Multiple regression analyses showed that the score of the skin effect was significantly associated with the levels of suspended particulate matter and Ni. The results show that increased air pollutants on Asian dust days may have skin effects. PMID:22865718

  13. Self-Focused and Other-Focused Resiliency: Plausible Mechanisms Linking Early Family Adversity to Health Problems in College Women

    ERIC Educational Resources Information Center

    Coleman, Sulamunn R. M.; Zawadzki, Matthew J.; Heron, Kristin E.; Vartanian, Lenny R.; Smyth, Joshua M.

    2016-01-01

    Objectives: This study examined whether self-focused and other-focused resiliency help explain how early family adversity relates to perceived stress, subjective health, and health behaviors in college women. Participants: Female students (N = 795) participated between October 2009 and May 2010. Methods: Participants completed self-report measures…

  14. [Reproductive health: a contribution to the evaluation of a virtual library].

    PubMed

    Alvarez, Maria do Carmo Avamilano; Cuenca, Angela Maria Belloni; Noronha, Daisy Pires; Schor, Néia

    2007-10-01

    Virtual libraries have been implemented in an attempt to organize scientific information found in the Internet, including the Biblioteca Virtual de Saúde Reprodutiva (BVSR), or Virtual Library on Reproductive Health. The aim is to provide quality information to researchers in the reproductive health field. The current study evaluates the use of the BVSR, emphasizing the users' expectations, difficulties, and suggestions. The study adopted a qualitative methodology. The focus group technique was applied to Internet chat groups through which reproductive health researchers communicated. Users expressed their expectations regarding information, highlighting the lack of time and the need to quickly obtain precise data. Use of virtual libraries for research increases where there is more trust in the institutions responsible for maintaining them. Researchers suggested the following: greater dissemination of the BVSR, publication of an electronic newsletter, and creation of a communications channel between the BVSR and users in order to foster intelligent collective communication. PMID:17891293

  15. Measuring reproductive health: review of community-based approaches to assessing morbidity.

    PubMed Central

    Sadana, R.

    2000-01-01

    This article begins by reviewing selected past approaches to estimating the prevalence of a range of morbidities through the use of household or community-based interview surveys in developed and developing countries. Subsequently, it reviews epidemiological studies that have used a range of methods to estimate the prevalence of reproductive morbidities. A detailed review of recent community or hospital based health interview validation studies that compare self-reported, clinical and laboratory measures is presented. Studies from Bangladesh, Bolivia, China, Egypt, India, Indonesia, Nigeria, Philippines and Turkey provide empirical evidence that self-reported morbidity and observed morbidity measure different phenomena and therefore different aspects of reproductive health and illness. Rather than estimating the prevalence of morbidity, interview-based surveys may provide useful information about the disability or burden associated with reproductive health and illness. PMID:10859858

  16. The role of parliamentarians in promoting sexual and reproductive health and rights.

    PubMed

    McCafferty, Christine

    2009-08-01

    Parliamentarians are central to the full implementation of the International Conference on Population and Development Programme of Action (ICPD PoA). We promote, review, and adopt sexual and reproductive health and rights (SRHR) legislation, including budget appropriations. Parliamentarians also approve policies formulated by government and endorse resolutions and statements in support of SRHR. All Party Parliamentary Groups on Population, Development, and Reproductive Health have now been established in nearly 100 countries to promote the ICPD PoA. Examples are given of successful SRHR parliamentary advocacy in the UK, Europe, and internationally. The biggest constraint to achieving universal access to reproductive health services by 2015 (the new MDG 5 target) remains ideological-driven campaigns across Europe and the USA. Politicians must be brave and speak out against misinformation or ill-informed and ideological-driven campaigns that mitigate the promotion of women's SRHR. PMID:19535070

  17. Litigating reproductive and developmental health in the aftermath of UAW versus Johnson Controls.

    PubMed Central

    Clauss, C A; Berzon, M; Bertin, J

    1993-01-01

    In a major decision handed down last term (International Union [UAW] versus Johnson Controls, Inc.), the Supreme Court ruled that employment practices excluding fertile or pregnant women from the workplace because of alleged concerns for fetal health constitute illegal sex discrimination. We analyze the three opinions in the case and explain why the decision was an essential first step to promoting reproductive and developmental health in the workplace. Continued progress toward eliminating or reducing reproductive occupational risks will require comprehensive legal strategies involving private lawsuits, governmental regulation and enforcement actions, and new legislation designed to preserve the existing rights of workers and to obtain new and additional protections. Finally, we caution that, in designing such strategies, it will be important to avoid solutions that either shift responsibility for reproductive health to workers, rather than to employers, or that undermine other important legal rights. PMID:8243393

  18. Perceptions of men on role of religious leaders in reproductive health issues in rural Pakistan.

    PubMed

    Ali, Moazzam; Ushijima, Hiroshi

    2005-01-01

    Religion holds unique importance in people's lives, and has been cited as an important factor in reproductive health. Pakistan has a Muslim majority and the character of the country is strongly marked by Islam. In rural areas, where the majority of the population reside, religious leaders are considered as opinion makers. The perception of adult males regarding the influence of the 'religious factor' in their use of modern contraceptive methods, and their views on the role of religious leaders in community education, were explored through a cross-sectional survey conducted in twelve rural districts of Pakistan in 2000. A sample of 180 married adult males participated in the study through consecutive sampling. The study was qualitative, utilizing tools such as in-depth and key-informant interviews. The majority of men interviewed considered that religious leaders were against fertility control, and 29% cited religion as a reason for their non-use of modern contraceptives. Respondents also suggested that the involvement of religious leaders in reproductive health programmes is essential for the programmes' effectiveness in rural areas. They thought that religious leaders could contribute positively to community education, and suggested ways in which they could educate the community in reproductive health issues. They also suggested various channels through which religious leaders could be approached to convince them to cooperate in reproductive health programmes. The study concludes that involving religious leaders in rural settings could enable reproductive health programmes and services to reach more conservative groups in society, and thus contribute effectively to bringing about positive change in the attitudes of Pakistani society towards reproductive health. PMID:15688575

  19. Sexual and reproductive health issues facing Southeast Asian beer promoters: a qualitative pilot study

    PubMed Central

    2010-01-01

    Background In Southeast Asia, hundreds of thousands of young rural women migrate from their villages to the larger cities in search of work. Many find employment with beer companies or in the clubs where beer is sold, promoting the sale of beer. Previous research suggests these young migrants are in a highly vulnerable position. This paper will describe the findings of an October 2009 meeting to develop a research agenda on the sexual and reproductive health of beer promoters and a subsequent pilot study of focus groups with beer promoters to review this agenda. Methods Participants of the research meeting representing beer promoters, academics, non-governmental organizations (NGOs), government and the beer industry from Cambodia, Thailand, Laos, and Vietnam collaborated in the development of three key research themes. The themes were verified in focus group discussions with beer promoters organized by local research partners in all four countries. The focus group participants were asked what they felt were the key sexual and reproductive health issues facing them in a non-directive and unstructured manner, and then asked to comment more specifically on the research priorities developed at the meeting. The focus groups were recorded digitally, transcribed, and translated into English. The data were analyzed by coding for common themes and then developing matrices to compare themes between groups. Results The participants of the meeting identified three key research themes: occupational health (including harassment and violence, working conditions, and fair pay), gender and social norms (focusing on the impact of power relations between the genders on women's health), and reproductive health (knowledge and access to reproductive health care services). The participants in the focus groups in all four countries agreed that these were key priorities for them, though the emphasis on the most important issues varied between groups of women. Sexual harassment in the

  20. Cumulative burden of lifetime adversities: Trauma and mental health in low-SES African Americans and Latino/as.

    PubMed

    Myers, Hector F; Wyatt, Gail E; Ullman, Jodie B; Loeb, Tamra B; Chin, Dorothy; Prause, Nicole; Zhang, Muyu; Williams, John K; Slavich, George M; Liu, Honghu

    2015-05-01

    This study examined the utility of a lifetime cumulative adversities and trauma model in predicting the severity of mental health symptoms of depression, anxiety, and posttraumatic stress disorder. We also tested whether ethnicity and gender moderate the effects of this stress exposure construct on mental health using multigroup structural equation modeling. A sample of 500 low-socioeconomic status African American and Latino men and women with histories of adversities and trauma were recruited and assessed with a standard battery of self-report measures of stress and mental health. Multiple-group structural equation models indicated good overall model fit. As hypothesized, experiences of discrimination, childhood family adversities, childhood sexual abuse, other childhood trauma, and chronic stresses all loaded on the latent cumulative burden of adversities and trauma construct (CBAT). The CBAT stress exposure index in turn predicted the mental health status latent variable. Although there were several significant univariate ethnic and gender differences, and ethnic and gender differences were observed on several paths, there were no significant ethnic differences in the final model fit of the data. These findings highlight the deleterious consequences of cumulative stress and trauma for mental health and underscore a need to assess these constructs in selecting appropriate clinical interventions for reducing mental health disparities and improving human health. PMID:25961869

  1. Cumulative Burden of Lifetime Adversities: Trauma and Mental Health in Low-SES African Americans and Latino/as

    PubMed Central

    Myers, Hector F.; Wyatt, Gail E.; Ullman, Jodie B.; Loeb, Tamra B.; Chin, Dorothy; Prause, Nicole; Zhang, Muyu; Williams, John K.; Slavich, George M.; Liu, Honghu

    2015-01-01

    This study examined the utility of a lifetime cumulative adversities and trauma model in predicting the severity of mental health symptoms of depression, anxiety, and posttraumatic stress disorder. We also tested whether ethnicity and gender moderate the effects of this stress exposure construct on mental health using multigroup structural equation modeling. A sample of 500 low-socioeconomic status African American and Latino men and women with histories of adversities and trauma were recruited and assessed with a standard battery of self-report measures of stress and mental health. Multiple-group structural equation models indicated good overall model fit. As hypothesized, experiences of discrimination, childhood family adversities, childhood sexual abuse, other childhood trauma, and chronic stresses all loaded on the latent cumulative burden of adversities and trauma construct (CBAT). The CBAT stress exposure index in turn predicted the mental health status latent variable. Although there were several significant univariate ethnic and gender differences, and ethnic and gender differences were observed on several paths, there were no significant ethnic differences in the final model fit of the data. These findings highlight the deleterious consequences of cumulative stress and trauma for mental health and underscore a need to assess these constructs in selecting appropriate clinical interventions for reducing mental health disparities and improving human health. PMID:25961869

  2. The Role of Gender Empowerment on Reproductive Health Outcomes in Urban Nigeria

    PubMed Central

    Speizer, Ilene S.; Fotso, Jean-Christophe; Akiode, Akinsewa; Saad, Abdulmumin; Calhoun, Lisa; Irani, Laili

    2014-01-01

    Objectives To date, limited evidence is available for urban populations in sub-Saharan Africa, specifically research into the association between urban women’s empowerment and reproductive health outcomes. The objective of this study is to investigate whether women’s empowerment in urban Nigerian settings is associated with family planning use and maternal health behaviors. Moreover, we examine whether different effects of empowerment exist by region of residence. Methods This study uses baseline household survey data from the Measurement, Learning & Evaluation Project (MLE) for the Nigerian Urban Reproductive Health Initiative (NURHI) being implemented in six major cities. We examine four dimensions of empowerment: economic freedom, attitudes towards domestic violence, partner prohibitions and decision-making. We determine if the empowerment dimensions have different effects on reproductive health outcomes by region of residence using multivariate analyses. Results Results indicate that more empowered women are more likely to use modern contraception, deliver in a health facility and have a skilled attendant at birth. These trends vary by empowerment dimension and by city/region in Nigeria. Conclusions We conclude by discussing the implications of these findings on future programs seeking to improve reproductive health outcomes in urban Nigeria and beyond. PMID:23576403

  3. Conflict and development: challenges in responding to sexual and reproductive health needs in Timor-Leste.

    PubMed

    Wayte, Kayli; Zwi, Anthony B; Belton, Suzanne; Martins, Joao; Martins, Nelson; Whelan, Anna; Kelly, Paul M

    2008-05-01

    In April and May 2006, internal conflict in Timor-Leste led to the displacement of approximately 150,000 people, around 15% of the population. The violence was most intense in Dili, the capital, where many residents were displaced into camps in the city or to the districts. Research utilising in-depth qualitative interviews, service statistics and document review was conducted from September 2006 to February 2007 to assess the health sector's response to reproductive health needs during the crisis. The study revealed an emphasis on antenatal care and a maternity waiting camp for pregnant women, but the relative neglect of other areas of reproductive health. There remains a need for improved coordination, increased dialogue and advocacy around sensitive reproductive health issues as well as greater participation of the health sector in response to gender-based violence. Strengthening neglected areas and including all components of sexual and reproductive health in coordination structures will provide a stronger foundation through which to respond to any future crises in Timor-Leste. PMID:18513610

  4. Occupational Therapy and Sexual and Reproductive Health Promotion in Adolescence: A Case Study.

    PubMed

    Gontijo, Daniela Tavares; de Sena e Vasconcelos, Anna Carolina; Monteiro, Rosana Juliet Silva; Facundes, Vera Lúcia Dutra; Trajano, Maria de Fátima Cordeiro; de Lima, Luciane Soares

    2016-03-01

    Occupational therapy can contribute to sexual and reproductive health through health education. The purpose of this study was to describe an occupational therapy intervention aimed at sexual and reproductive health promotion in adolescents. Fifty-eight adolescents were involved in the study, before, during and after the interventions. Educative activities such as puzzles, storytelling, mime and board games were used, which occupational therapy faculty and students had constructed. The games were employed as mediators for gaining knowledge in sexual and reproductive health. Outcome was measured using a questionnaire, audio recordings and field diaries. The data were analysed by descriptive statistics and thematic content analysis. The results showed the adolescents' increased knowledge of sexual and reproductive health information immediately after the intervention. The thematic analysis was grouped into three categories: the adolescents' initial expectations regarding the project, reflections on the process experienced during the interventions and use of educational games by occupational therapists. The importance of rapport and dialogue was highlighted in the construction of interventions based on participatory methods. The absence of a longitudinal follow-up is a limitation in this study. Further research is important to systematically assess sexual health promotion strategies in adolescence. PMID:26174484

  5. Nurse-midwives' attitudes towards adolescent sexual and reproductive health needs in Kenya and Zambia.

    PubMed

    Warenius, Linnéa U; Faxelid, Elisabeth A; Chishimba, Petronella N; Musandu, Joyce O; Ong'any, Antony A; Nissen, Eva B-M

    2006-05-01

    Adolescent sexuality is a highly charged moral issue in Kenya and Zambia. Nurse-midwives are the core health care providers of adolescent sexual and reproductive health services but public health facilities are under-utilised by adolescents. The aim of this study was to investigate attitudes among Kenyan and Zambian nurse-midwives (n=820) toward adolescent sexual and reproductive health problems, in order to improve services for adolescents. Data were collected through a questionnaire. Findings revealed that nurse-midwives disapproved of adolescent sexual activity, including masturbation, contraceptive use and abortion, but also had a pragmatic attitude to handling these issues. Those with more education and those who had received continuing education on adolescent sexuality and reproduction showed a tendency towards more youth-friendly attitudes. We suggest that critical thinking around the cultural and moral dimensions of adolescent sexuality should be emphasised in undergraduate training and continuing education, to help nurse-midwives to deal more empathetically with the reality of adolescent sexuality. Those in nursing and other leadership positions could also play an important role in encouraging wider social discussion of these matters. This would create an environment that is more tolerant of adolescent sexuality and that recognises the beneficial public health effect for adolescents of greater access to youth-friendly sexual and reproductive health services. PMID:16713886

  6. The role of gender empowerment on reproductive health outcomes in urban Nigeria.

    PubMed

    Corroon, Meghan; Speizer, Ilene S; Fotso, Jean-Christophe; Akiode, Akinsewa; Saad, Abdulmumin; Calhoun, Lisa; Irani, Laili

    2014-01-01

    To date, limited evidence is available for urban populations in sub-Saharan Africa, specifically research into the association between urban women's empowerment and reproductive health outcomes. The objective of this study is to investigate whether women's empowerment in urban Nigerian settings is associated with family planning use and maternal health behaviors. Moreover, we examine whether different effects of empowerment exist by region of residence. This study uses baseline household survey data from the Measurement, Learning and Evaluation Project for the Nigerian Urban Reproductive Health Initiative being implemented in six major cities. We examine four dimensions of empowerment: economic freedom, attitudes towards domestic violence, partner prohibitions and decision-making. We determine if the empowerment dimensions have different effects on reproductive health outcomes by region of residence using multivariate analyses. Results indicate that more empowered women are more likely to use modern contraception, deliver in a health facility and have a skilled attendant at birth. These trends vary by empowerment dimension and by city/region in Nigeria. We conclude by discussing the implications of these findings on future programs seeking to improve reproductive health outcomes in urban Nigeria and beyond. PMID:23576403

  7. Reproductive health for refugees by refugees in Guinea III: maternal health

    PubMed Central

    2011-01-01

    Background Maternal mortality can be particularly high in conflict and chronic emergency settings, partly due to inaccessible maternal care. This paper examines associations of refugee-led health education, formal education, age, and parity on maternal knowledge, attitudes, and practices among reproductive-age women in refugee camps in Guinea. Methods Data comes from a 1999 cross-sectional survey of 444 female refugees in 23 camps. Associations of reported maternal health outcomes with exposure to health education (exposed versus unexposed), formal education (none versus some), age (adolescent versus adult), or parity (nulliparous, parous, grand multiparous), were analysed using logistic regression. Results No significant differences were found in maternal knowledge or attitudes. Virtually all respondents said pregnant women should attend antenatal care and knew the importance of tetanus vaccination. Most recognised abdominal pain (75%) and headaches (24%) as maternal danger signs and recommended facility attendance for danger signs. Most had last delivered at a facility (67%), mainly for safety reasons (99%). Higher odds of facility delivery were found for those exposed to RHG health education (adjusted odds ratio 2.03, 95%CI 1.23-3.01), formally educated (adjusted OR 1.93, 95%CI 1.05-3.92), or grand multipara (adjusted OR 2.13, 95%CI 1.21-3.75). Main reasons for delivering at home were distance to a facility (94%) and privacy (55%). Conclusions Refugee-led maternal health education appeared to increase facility delivery for these refugee women. Improved knowledge of danger signs and the importance of skilled birth attendance, while vital, may be less important in chronic emergency settings than improving facility access where quality of care is acceptable. PMID:21486433

  8. Adverse health effects of fluoro-edenitic fibers: epidemiological evidence and public health priorities.

    PubMed

    Bruno, Caterina; Comba, Pietro; Zona, Amerigo

    2006-09-01

    Subsequent to the detection of a cluster of mesothelioma cases in the Sicilian town of Biancavilla, located at the slopes of Etna volcano, ad hoc epidemiological studies and environmental monitoring suggested an etiological role of an asbestiform fiber present in a stone quarry. The fiber was shown to constitute a new mineral species named fluoro-edenite. Fluoro-edenitic fibers were found in the materials extracted from the quarry and used in the local building industry, as well as in soils. Besides the risk of mesothelioma, residents in Biancavilla showed a significantly increased mortality from chronic obstructive pulmonary disease, which was particularly evident among women. In the light of these findings, Biancavilla was defined a site of national interest for environmental reclamation. The first preventive action involved termination of quarrying activity, covering with asphalt of roads previously paved with local soil materials, and removal of sources of dust in the urban area. Concurrent to the implementation of environmental cleanup, some specific "second generation" studies are now being designed and performed, namely morbidity surveys based on hospital discharge cards, monitoring of fibers in sputum and health surveillance in selected population groups. In this frame, special emphasis is given to the issue of communication, both to the general public and to target groups like family doctors, teachers, and media professionals. This experience could represent a useful basis for the elaboration of a strategy to approach similar environmental issues. PMID:17119254

  9. [A sociological study of factors affecting reproductive health of female teenagers and young women].

    PubMed

    Nizamov, I G; Chechulina, O V

    2003-01-01

    The reproductive health of teenagers deserves a special attention and must be regarded from the viewpoint of their future prospects as well as their social and cultural media. The mentioned social-and-cultural factors affecting the teenagers' attitude towards sexuality and preconditioning their access to information and services of healthcare have an impact on the status of their reproductive health and on their general well-being, including the ability of teenagers to avoid an undesired pregnancy or sexually transmitted diseases. PMID:12882120

  10. The effects of disaster on women's reproductive health in developing countries.

    PubMed

    Swatzyna, Ronald J; Pillai, Vijayan Kumara

    2013-07-01

    The objective of this study is to empirically test the effects of disasters which include natural as well as human made disasters such as armed conflict on women's reproductive health in developing countries. Data from 128 developing countries are used. It was found that average number of deaths from natural disasters and armed conflict in the East Asia and Pacific region was not significantly different from the rest of the developing world. The data are examined using structural equation analysis. This study finds that 'armed conflict' in developing countries presents significant reproductive health risks. The implications are discussed. PMID:23777727

  11. The Effects of Disaster on Women's Reproductive Health in Developing Countries

    PubMed Central

    Swatzyna, Ronald J.; Pillai, Vijayan K.

    2013-01-01

    The objective of this study is to empirically test the effects of disasters which include natural as well as human made disasters such as armed conflict on women's reproductive health in developing countries. Data from 128 developing countries are used. It was found that average number of deaths from natural disasters and armed conflict in the East Asia and Pacific region was not significantly different from the rest of the developing world. The data are examined using structural equation analysis. This study finds that ‘armed conflict’ in developing countries presents significant reproductive health risks. The implications are discussed. PMID:23777727

  12. The appropriateness of gatekeeping in the provision of reproductive health care for adolescents in Lithuania:the general practice perspective

    PubMed Central

    Jaruseviciene, Lina; Levasseur, Gwenola

    2006-01-01

    Background Adolescents' consultation of primary health care services remains problematic despite their accessibility. The reproductive health service seeking behavior of adolescents is the object of much research but little is known about how this behavior is influenced by the gatekeeping system. This study aimed to explore general practitioners' perceptions of the appropriateness of gatekeeping in adolescent reproductive health care. Methods Twenty in-depth interviews regarding factors affecting adolescent reproductive health care were carried out on a diverse sample of general practitioners and analyzed using grounded theory. Results The analysis identified several factors that shaped GPs' negative attitude to gatekeeping in adolescent reproductive health care. Its appropriateness in this field was questionable due to a lack of willingness on the part of GPs to provide reproductive health services for teenagers, their insufficient training, inadequately equipped surgeries and low perceived support for reproductive health service provision. Conclusion Since factors for improving adolescent reproductive health concern not only physicians but also the health system and policy levels, complex measures should be designed to overcome these barriers. Discussion of a flexible model of gatekeeping, encompassing both co-ordination of care provided by GPs and the possibility of patients' self-referral, should be included in the political agenda. Adolescents tend to under-use rather than over-use reproductive health services and every effort should be made to facilitate the accessibility of such services. PMID:16536876

  13. Adverse childhood experiences, chronic diseases, and risky health behaviors in Saudi Arabian adults: a pilot study.

    PubMed

    Almuneef, Maha; Qayad, Mohammed; Aleissa, Majid; Albuhairan, Fadia

    2014-11-01

    Adverse childhood experiences (ACEs) have been linked with risky health behaviors and the development of chronic diseases in adulthood. This study examined associations between ACEs, chronic diseases, and risky behaviors in adults living in Riyadh, Saudi Arabia in 2012 using the ACE International Questionnaire (ACE-IQ). A cross-sectional design was used, and adults who were at least 18 years of age were eligible to participate. ACEs event scores were measured for neglect, household dysfunction, abuse (physical, sexual, and emotional), and peer and community violence. The ACE-IQ was supplemented with questions on risky health behaviors, chronic diseases, and mood. A total of 931 subjects completed the questionnaire (a completion rate of 88%); 57% of the sample was female, 90% was younger than 45 years, 86% had at least a college education, 80% were Saudi nationals, and 58% were married. One-third of the participants (32%) had been exposed to 4 or more ACEs, and 10%, 17%, and 23% had been exposed to 3, 2, or 1 ACEs respectively. Only 18% did not have an ACE. The prevalence of risky health behaviors ranged between 4% and 22%. The prevalence of self-reported chronic diseases ranged between 6% and 17%. Being exposed to 4 or more ACEs increased the risk of having chronic diseases by 2-11 fold, and increased risky health behaviors by 8-21 fold. The findings of this study will contribute to the planning and development of programs to prevent child maltreatment and to alleviate the burden of chronic diseases in adults. PMID:24974249

  14. Exposures of children to organophosphate pesticides and their potential adverse health effects.

    PubMed Central

    Eskenazi, B; Bradman, A; Castorina, R

    1999-01-01

    Recent studies show that young children can be exposed to pesticides during normal oral exploration of their environment and their level of dermal contact with floors and other surfaces. Children living in agricultural areas may be exposed to higher pesticide levels than other children because of pesticides tracked into their homes by household members, by pesticide drift, by breast milk from their farmworker mother, or by playing in nearby fields. Nevertheless, few studies have assessed the extent of children's pesticide exposure, and no studies have examined whether there are adverse health effects of chronic exposure. There is substantial toxicologic evidence that repeated low-level exposure to organophosphate (OP) pesticides may affect neurodevelopment and growth in developing animals. For example, animal studies have reported neurobehavorial effects such as impairment on maze performance, locomotion, and balance in neonates exposed (italic)in utero(/italic) and during early postnatal life. Possible mechanisms for these effects include inhibition of brain acetylcholinesterase, downregulation of muscarinic receptors, decreased brain DNA synthesis, and reduced brain weight in offspring. Research findings also suggest that it is biologically plausible that OP exposure may be related to respiratory disease in children through dysregulation of the autonomic nervous system. The University of California Berkeley Center for Children's Environmental Health Research is working to build a community-university partnership to study the environmental health of rural children. This Center for the Health Assessment of Mothers and Children of Salinas, or CHAMACOS in Monterey County, California, will assess (italic)in utero(/italic) and postnatal OP pesticide exposure and the relationship of exposure to neurodevelopment, growth, and symptoms of respiratory illness in children. The ultimate goal of the center is to translate research findings into a reduction of children

  15. The reproductive health needs of refugees: emerging consensus attracts predictable controversy.

    PubMed

    Cohen, S A

    1998-10-01

    According to the UN High Commissioner for Refugees, there are approximately 40 million refugees and other internally displaced people worldwide, with the overwhelming majority coming from and still living in developed countries. 80% of all refugees are estimated to be women and children. Many refugees spend months and even years in what are designed to be temporary settings where efforts are made to accommodate their basic needs such as food, clean water, shelter, security, and primary health care during emergency situations. Women refugees, however, have certain unique needs beyond what traditionally have been considered basic in relief programs. Many women in developing countries suffer considerable health risks during the best of times due to their poverty or low social status. When fleeing conflict or natural disaster, their health status is at even higher risk of being compromised by severe living conditions and the complete absence of reproductive health services. The recognition that women refugees often face serious and sometimes life-threatening reproductive health-related situations led to the development of a field manual on reproductive health for use at the local level. Planned for publication in late 1998 or early 1999, the guide will describe the goals of a minimum array of reproductive health services in the early phase of an emergency and provide direct guidance on care relating to sexual violence, STDs, family planning, adolescents' needs, and other reproductive health concerns such as female genital mutilation and treatment for septic and incomplete abortion. The manual has garnered worldwide attention and support, as well as scrutiny by abortion opponents in the US, in particular New Jersey Republican Representative Chris Smith. PMID:12348740

  16. Mental Health and Childhood Adversities: A Longitudinal Study in Kabul, Afghanistan

    PubMed Central

    Panter-Brick, Catherine; Goodman, Anna; Tol, Wietse; Eggerman, Mark

    2011-01-01

    Objective To identify prospective predictors of mental health in Kabul, Afghanistan. Method Using stratified random-sampling in schools, mental health and life events for 11-to 16-year-old students and their caregivers were assessed. In 2007, 1 year after baseline, the retention rate was 64% (n = 115 boys, 119 girls, 234 adults) with no evidence of selection bias. Self- and caregiver-rated child mental health (Strengths and Difficulties Questionnaire), depressive (Depression Self-Rating Scale), and posttraumatic stress (Child Revised Impact of Events Scale) symptoms and caregiver mental health (Self-Report Questionnaire) were assessed. Lifetime trauma and past-year traumatic, stressful, and protective experiences were assessed. Results With the exception of posttraumatic stress, one-year trajectories for all mental health outcomes showed significant improvement (p < .001). Family violence had a striking impact on the Strengths and Difficulties Questionnaire data, raising caregiver-rated scores by 3.14 points (confidence interval [CI] 2.21–4.08) or half a standard deviation, and self-rated scores by 1.26 points (CI 0.50–2.03); past-year traumatic beatings independently raised self-rated scores by 1.85 points (CI 0.03–3.66). A major family conflict raised depression scores by 2.75 points (CI 0.89–4.61), two thirds of a standard deviation, whereas improved family life had protective effects. Posttraumatic stress symptom scores, however, were solely contingent on lifetime trauma, with more than three events raising scores by 5.38 points (CI 1.76–9.00). Conclusions Family violence predicted changes in mental health problems other than posttraumatic stress symptoms in a cohort that showed resilience to substantial socioeconomic and war-related stressors. The importance of prospectively identifying impacts of specific types of childhood adversities on mental health outcomes is highlighted to strengthen evidence on key modifiable factors for intervention in war

  17. The Development of Countermeasures for Space Radiation Induced Adverse Health Effects

    NASA Astrophysics Data System (ADS)

    Kennedy, Ann

    The Development of Countermeasures for Space Radiation Induced Adverse Health Effects Ann R. Kennedy Department of Radiation Oncology, University of Pennsylvania School of Medicine, 195 John Morgan Building, 3620 Hamilton Walk, Philadelphia, PA, United States 19104-6072 The development of countermeasures for radiation induced adverse health effects is a lengthy process, particularly when the countermeasure/drug has not yet been evaluated in human trials. One example of a drug developed from the bench to the clinic is the soybean-derived Bowman-Birk inhibitor (BBI), which has been developed as a countermeasure for radiation induced cancer. It was originally identified as a compound/drug that could prevent the radiation induced carcinogenic process in an in vitro assay system in 1975. The first observation that BBI could inhibit carcinogenesis in animals was in 1985. BBI received Investigational New Drug (IND) Status with the U.S. Food and Drug Administration (FDA) in 1992 (after several years of negotiation with the FDA about the potential IND status of the drug), and human trials began at that time. Phase I, II and III human trials utilizing BBI have been performed under several INDs with the FDA, and an ongoing Phase III trial will be ending in the very near future. Thus, the drug has been in development for 35 years at this point, and it is still not a prescription drug on the market which is available for human use. A somewhat less time-consuming process is to evaluate compounds that are on the GRAS (Generally Recognized as Safe) list. These compounds would include some over-the-counter medications, such as antioxidant vitamins utilized in human trials at the levels for which Recommended Dietary Allowances (RDAs) have been established. To determine whether GRAS substances are able to have beneficial effects on radiation induced adverse health effects, it is still likely to be a lengthy process involving many years to potentially decades of human trial work. The

  18. The Development of Countermeasures for Space Radiation Induced Adverse Health Effects

    NASA Astrophysics Data System (ADS)

    Kennedy, Ann

    The Development of Countermeasures for Space Radiation Induced Adverse Health Effects Ann R. Kennedy Department of Radiation Oncology, University of Pennsylvania School of Medicine, 195 John Morgan Building, 3620 Hamilton Walk, Philadelphia, PA, United States 19104-6072 The development of countermeasures for radiation induced adverse health effects is a lengthy process, particularly when the countermeasure/drug has not yet been evaluated in human trials. One example of a drug developed from the bench to the clinic is the soybean-derived Bowman-Birk inhibitor (BBI), which has been developed as a countermeasure for radiation induced cancer. It was originally identified as a compound/drug that could prevent the radiation induced carcinogenic process in an in vitro assay system in 1975. The first observation that BBI could inhibit carcinogenesis in animals was in 1985. BBI received Investigational New Drug (IND) Status with the U.S. Food and Drug Administration (FDA) in 1992 (after several years of negotiation with the FDA about the potential IND status of the drug), and human trials began at that time. Phase I, II and III human trials utilizing BBI have been performed under several INDs with the FDA, and an ongoing Phase III trial will be ending in the very near future. Thus, the drug has been in development for 35 years at this point, and it is still not a prescription drug on the market which is available for human use. A somewhat less time-consuming process is to evaluate compounds that are on the GRAS (Generally Recognized as Safe) list. These compounds would include some over-the-counter medications, such as antioxidant vitamins utilized in human trials at the levels for which Recommended Dietary Allowances (RDAs) have been established. To determine whether GRAS substances are able to have beneficial effects on radiation induced adverse health effects, it is still likely to be a lengthy process involving many years to potentially decades of human trial work. The

  19. Ontologies to capture adverse events following immunisation (AEFI) from real world health data.

    PubMed

    Liyanage, Harshana; de Lusignan, Simon

    2014-01-01

    Immunisation is an important part of health care and adverse events following immunisation (AEFI) are relatively rare. AEFI can be detected through long term follow up of a cohort or from looking for signals from real world, routine data; from different health systems using a variety of clinical coding systems. Mapping these is a challenging aspect of integrating data across borders. Ontological representations of clinical concepts provide a method to map similar concepts, in this case AEFI across different coding systems. We describe a method using ontologies to be flag definite, probable or possible cases. We use Guillain-Barre syndrome (GBS) as an AEFI to illustrate this method, and the Brighton collaboration's case definition of GBS as the gold standard. Our method can be used to flag definite, probable or possible cases of GBS. Whilst there has been much research into the use of ontologies in immunisation these have focussed on database interrogation; where ours looks to identify varying signal strength. PMID:24743070

  20. Striving against adversity: the dynamics of migration, health and poverty in rural South Africa

    PubMed Central

    Collinson, Mark A.

    2010-01-01

    This article is a review of the PhD thesis of Mark Collinson, titled, ‘Striving against adversity: the dynamics of migration, health and poverty in rural South Africa’. The findings show that in rural South Africa, temporary migration has a major impact on household well-being and health. Remittances from migrants make a significant difference to socioeconomic status (SES) in households left behind by the migrant. For the poorest households the key factors improving SES are government grants and female temporary migration, while for the less poor it is male temporary migration and local employment. Migration is associated with HIV but not in straightforward ways. Migrants that return more frequently may be less exposed to outside partners and therefore less implicated in the HIV epidemic. There are links between migration and mortality patterns, including a higher risk of dying for returnee migrants compared with permanent residents. A mother's migration impacts significantly on child survival for South African and former refugee parents, but there is an additional mortality risk for children of Mozambican former refugees. It is recommended that national censuses and surveys account for temporary migration when collecting information on household membership, because different migration types have different outcomes. Without discriminating between different migration types, the implications for sending and receiving communities will remain lost to policy-makers. PMID:20531981

  1. Striving against adversity: the dynamics of migration, health and poverty in rural South Africa.

    PubMed

    Collinson, Mark A

    2010-01-01

    This article is a review of the PhD thesis of Mark Collinson, titled, 'Striving against adversity: the dynamics of migration, health and poverty in rural South Africa'. The findings show that in rural South Africa, temporary migration has a major impact on household well-being and health. Remittances from migrants make a significant difference to socioeconomic status (SES) in households left behind by the migrant. For the poorest households the key factors improving SES are government grants and female temporary migration, while for the less poor it is male temporary migration and local employment. Migration is associated with HIV but not in straightforward ways. Migrants that return more frequently may be less exposed to outside partners and therefore less implicated in the HIV epidemic. There are links between migration and mortality patterns, including a higher risk of dying for returnee migrants compared with permanent residents. A mother's migration impacts significantly on child survival for South African and former refugee parents, but there is an additional mortality risk for children of Mozambican former refugees. It is recommended that national censuses and surveys account for temporary migration when collecting information on household membership, because different migration types have different outcomes. Without discriminating between different migration types, the implications for sending and receiving communities will remain lost to policy-makers. PMID:20531981

  2. Adverse effect of air pollution on respiratory health of primary school children in Taiwan.

    PubMed Central

    Chen, P C; Lai, Y M; Wang, J D; Yang, C Y; Hwang, J S; Kuo, H W; Huang, S L; Chan, C C

    1998-01-01

    This study is a part of the Study On Air Pollution and Health In Taiwan (SOAP&HIT), an ongoing research project involving cooperation of several universities in Taiwan. In this study, the objective was to evaluate the effects of ambient air pollution on respiratory symptoms and diseases of school children, in addition to considering indoor air pollution. Six communities were selected: one community located in a rural area (Taihsi), two in urban areas (Keelung and Sanchung), and the other three in petrochemical industrial areas (Toufen, Jenwu, and Linyuan). We sampled 5,072 primary school students in six communities from the main study population of SOAP&HIT. Respiratory health was assessed by evaluation of the children's respiratory symptoms and diseases using a parent-completed questionnaire. Data were analyzed using logistic regression analysis to compute odds ratios of adverse effect. The school children in the urban communities had significantly more respiratory symptoms (day or night cough, chronic cough, shortness of breath, and nasal symptoms) and diseases (sinusitis, wheezing or asthma, allergic rhinitis, and bronchitis) when compared with those living in the rural community. However, only nasal symptoms of children living in the petrochemical communities were more prevalent than in those living in the rural community. Although the association with ambient air pollution is suggestive, the cross-sectional study cannot confirm a causal relationship; thus further studies are needed. PMID:9618349

  3. Adverse human health effects associated with molds in the indoor environment.

    PubMed

    Hardin, Bryan D; Kelman, Bruce J; Saxon, Andrew

    2003-05-01

    inhalation exposure to fungi, bacteria, and other organic matter, usually in industrial or agricultural settings. Molds growing indoors are believed by some to cause building-related symptoms. Despite a voluminous literature on the subject, the causal association remains weak and unproven, particularly with respect to causation by mycotoxins. One mold in particular, Stachybotrys chartarum, is blamed for a diverse array of maladies when it is found indoors. Despite its well-known ability to produce mycotoxins under appropriate growth conditions, years of intensive study have failed to establish exposure to S. chartarum in home, school, or office environments as a cause of adverse human health effects. Levels of exposure in the indoor environment, dose-response data in animals, and dose-rate considerations suggest that delivery by the inhalation route of a toxic dose of mycotoxins in the indoor environment is highly unlikely at best, even for the hypothetically most vulnerable subpopulations. Mold spores are present in all indoor environments and cannot be eliminated from them. Normal building materials and furnishings provide ample nutrition for many species of molds, but they can grow and amplify indoors only when there is an adequate supply of moisture. Where mold grows indoors there is an inappropriate source of water that must be corrected before remediation of the mold colonization can succeed. Mold growth in the home, school, or office environment should not be tolerated because mold physically destroys the building materials on which it grows, mold growth is unsightly and may produce offensive odors, and mold is likely to sensitize and produce allergic responses in allergic individuals. Except for persons with severely impaired immune systems, indoor mold is not a source of fungal infections. Current scientific evidence does not support the proposition that human health has been adversely affected by inhaled mycotoxins in home, school, or office environments. PMID

  4. Relationships between early foal health, future performance and their dams reproductive health.

    PubMed

    Hemberg, E; Kindahl, H; Lundeheim, N; Einarsson, S

    2010-10-01

    The objectives of this study were to investigate: (i) relationships between early foal health and their dams' reproductive health at mating/conception as well as after parturition and (ii) health status during early foal life and its association with performance as an adult. The study included 35 foals showing clinical symptoms indicating septicaemia, sometimes in combination with other disturbances, within their first 18 h postpartum (Group I). Eighty-eight foals that were healthy during their first few days of life were used as control (Group II). All foals were born in the same region of Sweden and during the same period, and were expected to become performance athletes based upon the pedigree of their parents. Cytological and bacteriological examination of uterus at the time of mating/insemination at which the foal was conceived, revealed no difference between dams of Group I and Group II foals. Within 2-3 days after parturition, 29% and 4% of dams (p < 0.001) of Group I and Group II foals had metritis, respectively. At 30 days post-parturition, 64% of the dams of Group I foals and 32% of the dams of Group II foals (p = 0.002) had cytological indication of endometritis, and 57% of the dams of Group I foals and 21% of the dams of Group II foals (p < 0.001) showed bacterial growth upon culture. Altogether 29% of the Group I foals and 7% of the Group II foals were killed or died before 2 years of age (p = 0.001). The majority of the remaining Group I foals were poor performers and some were used just for pleasure riding. It is hypothesized that (i) mares--delivering foals that compromised within their first 18 h postpartum--might have suffered from an ascending infection during late gestation and (ii) health status during early foal life might be associated with their performance as adult. PMID:19416490

  5. Yes we can! Successful examples of disallowing 'conscientious objection' in reproductive health care.

    PubMed

    Fiala, Christian; Gemzell Danielsson, Kristina; Heikinheimo, Oskari; Guðmundsson, Jens A; Arthur, Joyce

    2016-06-01

    Reproductive health care is the only field in medicine where health care professionals (HCPs) are allowed to limit a patient's access to a legal medical treatment - usually abortion or contraception - by citing their 'freedom of conscience.' However, the authors' position is that 'conscientious objection' ('CO') in reproductive health care should be called dishonourable disobedience because it violates medical ethics and the right to lawful health care, and should therefore be disallowed. Three countries - Sweden, Finland, and Iceland - do not generally permit HCPs in the public health care system to refuse to perform a legal medical service for reasons of 'CO' when the service is part of their professional duties. The purpose of investigating the laws and experiences of these countries was to show that disallowing 'CO' is workable and beneficial. It facilitates good access to reproductive health services because it reduces barriers and delays. Other benefits include the prioritisation of evidence-based medicine, rational arguments, and democratic laws over faith-based refusals. Most notably, disallowing 'CO' protects women's basic human rights, avoiding both discrimination and harms to health. Finally, holding HCPs accountable for their professional obligations to patients does not result in negative impacts. Almost all HCPs and medical students in Sweden, Finland, and Iceland who object to abortion or contraception are able to find work in another field of medicine. The key to successfully disallowing 'CO' is a country's strong prior acceptance of women's civil rights, including their right to health care. PMID:26838273

  6. Are reproductive health NGOs in Uganda able to engage in the health SWAp?

    PubMed

    Mugisha, Frank; Birungi, Harriet; Askew, Ian

    2005-01-01

    This paper explores the ability for reproductive health (RH) non-governmental organizations (NGO) in Uganda to survive in the context of SWAp and decentralization. The authors argue that, contrary to the perceptions that this context may increase NGO's financial vulnerability, a SWAp and a decentralized system may provide an opportunity that should be embraced by NGOs to enhance their sustainability and effectiveness by reducing their current dependency on donor funding. The paper discusses the systemic weaknesses of many NGOs that currently make them vulnerable, and observes that unless these weaknesses are addressed, such NGOs will lose their space in the SWAp and decentralization arena. The authors suggest that NGOs need to recognize the opportunities that participating in public-private partnerships through a SWAp can offer them for long-term and significant funding. They need also to develop their capacity to pro-actively participate in a SWAp and decentralized context by becoming more entrepreneurial in nature, through re-orienting their organizational philosophies and strategic planning and budgeting so as to be able to partner effectively with the public sector in accessing funds made available through health sector reform. PMID:16138736

  7. Latino community health workers and the promotion of sexual and reproductive health.

    PubMed

    Lechuga, Julia; Garcia, Dina; Owczarzak, Jill; Barker, Maria; Benson, Meghan

    2015-05-01

    Community health worker (CHW) programs have existed for over 50 years across the world. However, only recently has research evidence documented their effectiveness. Research is still needed to identify issues related to implementation and sustainability of CHW programs. This article explores the role and challenges of U.S. Latino CHWs trained to deliver a comprehensive sexual and reproductive health educational intervention to Latino families. We conducted a semistructured interview with a purposive convenience sample of 19 CHWs. Findings suggest that CHWs occupy roles that go beyond those they were trained for. CHWs serve not only as educators but also as providers of social support, facilitators of access to resources, patient navigators, and civil rights advocates. Lack of clarity of the role of a CHW influenced perceptions of adequacy of compensation, training, and integration into the agency that trained them. Policy facilitating the standardization of the CHW occupational category and role expectations is imperative to ensure successful implementation and sustainability of U.S. CHW programs. PMID:25663055

  8. Reproductive health financing in Kenya: an analysis of national commitments, donor assistance, and the resources tracking process.

    PubMed

    Sidze, Estelle M; Pradhan, Jalandhar; Beekink, Erik; Maina, Thomas M; Maina, Beatrice W

    2013-11-01

    Understanding the flow of resources at the country level to reproductive health is essential for effective financing of this key component of health. This paper gives a comprehensive picture of the allocation of resources for reproductive health in Kenya and the challenges faced in the resource-tracking process. Data are drawn from Kenyan budget estimates, reproductive health accounts, and the Resource Flows Project database and compare budgets and spending in 2005-06 with 2009-10. Despite policies and programmes in place since 1994, services for family planning, maternity care and infant and child health face serious challenges. As regards health financing, the government spends less than the average in sub-Saharan Africa, while donor assistance and out-of-pocket expenditure for health are high. Donor assistance to Kenya has increased over the years, but the percentage of funds devoted to reproductive health is lower than it was in 2005. We recommend an increase in the budget and spending for reproductive health in order to achieve MDG targets on maternal mortality and universal access to reproductive health in Kenya. Safety nets for the poor are also needed to reduce the burden of spending by households. Lastly, we recommend the generation of more comprehensive reproductive health accounts on a regular basis. PMID:24315070

  9. Sexual and Reproductive Health Information Sources Preferred by Out-of-School Adolescents in Rural Southwest Uganda

    ERIC Educational Resources Information Center

    Nobelius, Ann-Maree; Kalina, Bessie; Pool, Robert; Whitworth, Jimmy; Chesters, Janice; Power, Robert

    2010-01-01

    This paper defines how out-of-school adolescents from Masaka District in rural southwest Uganda currently receive sexual and reproductive health information and how they would prefer to receive that information. Information adolescents feel they lack falls into three broad categories: sexual and reproductive health issues, the negotiation of sex…

  10. Sexual and Reproductive Health Behaviors among Teen and Young Adult Men: A Descriptive Portrait. Research Brief. Publication #2008-34

    ERIC Educational Resources Information Center

    Manlove, Jennifer; Terry-Humen, Elizabeth; Ikramullah, Erum; Holcombe, Emily

    2008-01-01

    When it comes to the reproductive health behaviors of teens and young adults, far more public attention has focused on women than on men. That's not surprising. After all, men don't actually have the babies. Yet the importance of understanding men's reproductive health behaviors should not be overlooked, given their potential implications for men…

  11. Strengthening public health education in population and reproductive health through an innovative academic partnership in Africa: the Gates partners experience.

    PubMed

    Oni, Gbolahan; Fatusi, Adesegun; Tsui, Amy; Enquselassie, Fikre; Ojengbede, Oladosu; Agbenyega, Tsiri; Ojofeitimi, Ebenezer; Taulo, Frank; Quakyi, Isabella

    2011-01-01

    Poor reproductive health constitutes one of the leading public health problems in the world, particularly in sub-Saharan Africa (SSA). We report here an academic partnership that commenced in 2003 between a US institution and six universities in SSA. The partnership addresses the human resources development challenge in Africa by strengthening public health education and research capacity to improve population and reproductive health (PRH) outcomes in low-resource settings. The partnership's core activities focused on increasing access to quality education, strengthening health research capacity and translating scholarship and science into policy and practices. Partnership programmes focused on the educational dimension of the human resources equation provide students with improved learning facilities and enhanced work environments and also provide faculty with opportunities for professional development and an enhanced capacity for curriculum delivery. By 2007, 48 faculty members from the six universities in SSA attended PRH courses at Johns Hopkins University, 93 PRH courses were offered across the six universities, 625 of their master's students elected PRH concentrations and 158 had graduated. With the graduation of these and future student cohorts, the universities in SSA will systematically be expanding the number of public health practitioners and strengthening programme effectiveness to resolve reproductive health needs. Some challenges facing the partnership are described in this article. PMID:20614360

  12. USE AND PERCEPTIONS OF SEXUAL AND REPRODUCTIVE HEALTH SERVICES AMONG YOUNG NORTHERN THAI PEOPLE

    PubMed Central

    Tangmunkongvorakul, Arunrat; Banwell, Cathy; Carmichael, Gordon; Utomo, Iwu Dwisetyani; Seubsman, Sam-Ang; Kelly, Matthew; Sleigh, Adrian

    2013-01-01

    This study sheds light on obstacles to safe sexual health for young Thais and their need for appropriate sexual and reproductive health services. The study population was 1,745 unmarried adolescents aged 17-20 who resided or worked in Chiang Mai, the major city in northern Thailand. The study used quantitative and qualitative methods to explore the vulnerability of sexually active adolescents as well as the lack of support and care for them from parents and health providers. We found that young Thais still prefer pharmacies for self-medication and use government health care facilities as a last resort. Current health services are not suitable for young people in northern Thailand because they lack privacy and impose judgemental attitudes, especially towards sexually active adolescent females. Current programs for adolescent sexual and reproductive health focus on education and counselling and do not provide appropriate privacy or clinical care. There is a pressing need for advocacy, policy support for the development of youth-friendly sexual and reproductive health services in Thailand. PMID:23082599

  13. SEMEN QUALITY AND REPRODUCTIVE HEALTH OF YOUNG CZECH MEN EXPOSED TO SEASONAL AIR POLLUTION

    EPA Science Inventory

    Semen quality and reproductive health of young Czech men exposed to seasonal air pollution.

    Selevan SG, Borkovec L, Slott VL, Zudova Z, Rubes J, Evenson DP, Perreault SD.

    U.S. Environmental Protection Agency, Washington, DC 20460, USA.

    This study of male repr...

  14. Production, reproduction, health, and growth traits in backcross holstein x jersey cows and their holstein contemporaries

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A total of 648 purebred Holstein and 319 backcross Holstein × Jersey dairy cattle were compared for production, reproduction, health, linear type, and growth traits. Animals were born between 2003 and 2009 and were housed in the University of Wisconsin–Madison Integrated Dairy Facility. All animals ...

  15. Population, sexual and reproductive health, rights and sustainable development: forging a common agenda.

    PubMed

    Newman, Karen; Fisher, Sarah; Mayhew, Susannah; Stephenson, Judith

    2014-05-01

    This article suggests that sexual and reproductive health and rights activists seeking to influence the post-2015 international development paradigm must work with sustainable development advocates concerned with a range of issues, including climate change, environmental issues, and food and water security, and that a way of building bridges with these communities is to demonstrate how sexual and reproductive health and rights are relevant for these issues. An understanding of population dynamics, including urbanization and migration, as well as population growth, can help to clarify these links. This article therefore suggests that whether or not sexual and reproductive health and rights activists can overcome resistance to discussing "population", become more knowledgeable about other sustainable development issues, and work with others in those fields to advance the global sustainable development agenda are crucial questions for the coming months. The article also contends that it is possible to care about population dynamics (including ageing and problems faced by countries with a high proportion of young people) and care about human rights at the same time. It expresses concern that, if sexual and reproductive health and rights advocates do not participate in the population dynamics discourse, the field will be left free for those for whom respecting and protecting rights may be less of a priority. PMID:24908456

  16. Perilous plasticizers - are phthalate esters a risk for human reproductive health?

    EPA Science Inventory

    Phthalate diesters are high-production volume chemicals used to impart flexibility to polyvinyl chloride plastic (e.g. children’s toys and medical tubing) as well as other products (e.g. health and beauty products). Certain phthalate esters inhibit reproductive development in la...

  17. Perilous plastics - are phthalate esters a risk for human reproductive health?

    EPA Science Inventory

    Phthalate diesters are high-production volume chemicals used to impart flexibility to polyvinyl chloride plastic (e.g. children’s toys and medical tubing) and are also found in other products (e.g. health and beauty products). Certain phthalate esters inhibit reproductive develop...

  18. A State Level Investigation of the Associations among Intellectual Capital, Religiosity and Reproductive Health

    ERIC Educational Resources Information Center

    Reeve, Charlie L.; Basalik, Debra

    2011-01-01

    The current study examines the degree to which state intellectual capital, state religiosity and reproductive health form a meaningful nexus of ecological relations. Though the specific magnitude of effects vary across outcomes, results from hierarchical regression analyses were consistent with the hypothesized path model indicating that a state's…

  19. Sexual Violence and Reproductive Health among Young People in Three Communities in Jamaica

    ERIC Educational Resources Information Center

    Geary, Cynthia Waszak; Wedderburn, Maxine; McCarraher, Donna; Cuthbertson, Carmen; Pottinger, Audrey

    2006-01-01

    A secondary analysis of data collected from 1,130 young people ages 15 to 24 in a population-based household survey to assess the reproductive health needs of young people in three communities in Jamaica was conducted to determine the relationships among three measures of sexual violence, background variables, three measures of sexual risk taking…

  20. Sexual and Reproductive Health Problems of Female University Students in Iran: A Qualitative Study

    PubMed Central

    Yari, Fatemeh; Moghadam, Zahra B.; Parvizi, Soror; Nayeri, Nahid D.; Rezaei, Elham

    2015-01-01

    Objective: Youth is defined as the time of transition into adulthood and an important period in a person’s life. During this period new behavior is learned easier than adulthood. Therefore, special attention has to be necessarily paid to this period in order to promote the health. Addressing adolescent reproductive health issues is also a critical factor Methods: This research was a qualitative study conducted from January 2014 to July 2014. Data from focus group discussions and semi-structured interviews with 25 female students and 10 key members of the university (including university authorities, consultants, reproductive health professionals and university officials) was collected and all interviews were recorded, formulated and classified. Results: The mean age of participants was 22.43 years. A total of 8 students majored in geology, 5 majored in chemistry, 3 in statistics, 3 in mathematics, and 6 in biology. 17 had a bachelor’s degree, 3 master’s degree and 5 doctorate degree. Majority of students (82.4%) were never married and 23 of them lived in dormitories. The following three main themes were extracted from the interviews: Reproduction thought as pregnancy; the taboo of sex; and inappropriate relation between parents and children. Conclusion: Most participants stressed the need to provide reproductive health services for young girls. PMID:25946946

  1. Understanding of Parents and Adults on the Down Syndrome Female Sexual Reproductive Health

    ERIC Educational Resources Information Center

    Zhagan, Madhya

    2013-01-01

    The purpose of this study is to determine the understanding of reproductive health among parents and female adolescents with Down syndrome. This cross-sectional study involved 22 parents and 22 female adolescents with Down syndrome in Kuala Lumpur, Malaysia. The parents were required to fill up the socio-demographic information in questionnaire…

  2. The Power of Plain Talk: Exploring One Program' Influence on the Adolescent Reproductive Health Field

    ERIC Educational Resources Information Center

    Summerville, Geri; Canova, Karen

    2006-01-01

    Launched by the Annie E. Casey Foundation in the early 1990s, Plain Talk is a community-based initiative that seeks to reduce the incidence of teen pregnancy and STDs by improving adult/teen communication about sex. A key component of the program is parental involvement--which was once seen by many in the adolescent reproductive health (ARH) field…

  3. Stakeholder Perceptions and Attitudes towards Sexual and Reproductive Health Education in Namibia

    ERIC Educational Resources Information Center

    Mufune, Pempelani

    2008-01-01

    Sexual and reproductive health (SRH) education is one way Namibia combats HIV/AIDS. This exploratory study had two objectives: to investigate attitudes and perceptions towards sex education, and to see what purpose sex education serves in Namibia. To what extent do stakeholders support sex education in Namibia? What kind of obstacles exists to SRH…

  4. Sexual and Reproductive Health Education: Opinions of Students and Educators in Bolgatanga Municipality, Northern Ghana

    ERIC Educational Resources Information Center

    van der Geugten, Jolien; Dijkstra, Marlies; van Meijel, Berno; den Uyl, Marion H. G.; de Vries, Nanne K.

    2015-01-01

    There have been few assessments of sexual and reproductive health (SRH) education programmes in sub-Saharan Africa from the students' and educators' perspective. This study examined students' opinions on an SRH programme in northern Ghana and explored the facilitators and barriers for educators regarding the implementation of the…

  5. Reproductive Health Education and Services Needs of Internally Displaced Persons and Refugees following Disaster

    ERIC Educational Resources Information Center

    Westhoff, Wayne W.; Lopez, Guillermo E.; Zapata, Lauren B.; Wilke Corvin, Jaime A.; Allen, Peter; McDermott, Robert J.

    2008-01-01

    Background: Following the occurrence of natural or man-made disaster, relief worker priorities include providing water, food, shelter, and immunizations for displaced persons. Like these essential initiatives, reproductive health education and services must also be incorporated into recovery efforts. Purpose: This study examined reproductive…

  6. Sexual reproductive health service provision to young people in Kenya; health service providers’ experiences

    PubMed Central

    2013-01-01

    Background Addressing the sexual and reproductive health (SRH) needs of young people remains a challenge for most developing countries. This study explored the perceptions and experiences of Health Service Providers (HSP) in providing SRH services to young people in Kenya. Methods Qualitative study conducted in eight health facilities; five from Nairobi and three rural district hospitals in Laikipia, Meru Central, and Kirinyaga. Nineteen in-depth interviews (IDI) and two focus group discussions (FGD) were conducted with HSPs. Interviews were tape recorded and transcribed. Data was coded and analysed using the thematic framework approach. Results The majority of HSPs were aware of the youth friendly service (YFS) concept but not of the supporting national policies and guidelines. HSP felt they lacked competency in providing SRH services to young people especially regarding counselling and interpersonal communication. HSPs were conservative with regards to providing SRH services to young people particularly contraception. HSP reported being torn between personal feelings, cultural and religious values and beliefs and their wish to respect young people’s rights to accessing and obtaining SRH services. Conclusion Supporting youth friendly policies and competency based training of HSP are two common approaches used to improve SRH services for adolescents. However, these may not be sufficient to change HSPs’ attitude to adolescents seeking help. There is need to address the cultural, religious and traditional value systems that prevent HSPs from providing good quality and comprehensive SRH services to young people. Training updates should include sessions that enable HSPs to evaluate how their personal and cultural values and beliefs influence practice. PMID:24229365

  7. Female Reproductive System

    MedlinePlus

    ... How Can I Help a Friend Who Cuts? Female Reproductive System KidsHealth > For Teens > Female Reproductive System Print A ... and female reproductive systems. continue What Is the Female Reproductive System? Most species have two sexes: male and female. ...

  8. Supporting breastfeeding in emergencies: protecting women's reproductive rights and maternal and infant health.

    PubMed

    Gribble, Karleen D; McGrath, Marie; MacLaine, Ali; Lhotska, Lida

    2011-10-01

    Women have the right to support that enables them to breastfeed. Supporting breastfeeding in emergencies is important because artificial feeding places mothers and children at risk. In emergencies, artificial feeding is dangerous to the infant, difficult and requires substantial resources. In contrast, breastfeeding guards infant health. It is also protective against postpartum haemorrhage, maternal depletion, maternal anaemia and closely spaced births and should therefore concern not only nutritionists, but also those involved in reproductive health. However, it is common for women's ability to breastfeed to be undermined in emergencies by the indiscriminate distribution of breast-milk substitutes and the absence of breastfeeding support. Controlling the distribution of breast-milk substitutes, providing supportive environments, and appropriate medical and practical assistance to breastfeeding women safeguards the health and well-being of mothers and babies. Greater collaboration between the nutrition and reproductive health sectors is required to promote best practice in protecting breastfeeding women and their children in emergencies. PMID:21913933

  9. Community reactions to reproductive health care at three school-based clinics in Louisiana.

    PubMed

    Zeanah, P D; Morse, E V; Simon, P M; Stock, M; Pratt, J L; Sterne, S

    1996-09-01

    Despite the growing success of school-based health care during the past two decades, the issue of providing reproductive health care at school-based health centers remains controversial. In this article, focus group data from three school-based centers in Louisiana, each in different stages of development, demonstrates how the controversies about reproductive health may frame more general concerns about school-based care. In addition, community readiness to address directly problematic sexual behavior relates not only to the specific needs and priorities of the community but to recognition of the negative effect of the consequences of sexual behavior such as pregnancy, high drop out, and absenteeism rates on a community's educational, rather than social, goals and values. PMID:8884662

  10. Reproductive tourism in Argentina: clinic accreditation and its implications for consumers, health professionals and policy makers.

    PubMed

    Smith, Elise; Behrmann, Jason; Martin, Carolina; Williams-Jones, Bryn

    2010-08-01

    A subcategory of medical tourism, reproductive tourism has been the subject of much public and policy debate in recent years. Specific concerns include: the exploitation of individuals and communities, access to needed health care services, fair allocation of limited resources, and the quality and safety of services provided by private clinics. To date, the focus of attention has been on the thriving medical and reproductive tourism sectors in Asia and Eastern Europe; there has been much less consideration given to more recent 'players' in Latin America, notably fertility clinics in Chile, Brazil, Mexico and Argentina. In this paper, we examine the context-specific ethical and policy implications of private Argentinean fertility clinics that market reproductive services via the internet. Whether or not one agrees that reproductive services should be made available as consumer goods, the fact is that they are provided as such by private clinics around the world. We argue that basic national regulatory mechanisms are required in countries such as Argentina that are marketing fertility services to local and international publics. Specifically, regular oversight of all fertility clinics is essential to ensure that consumer information is accurate and that marketed services are safe and effective. It is in the best interests of consumers, health professionals and policy makers that the reproductive tourism industry adopts safe and responsible medical practices. PMID:19508291

  11. Peripheral Reproductive Organ Health and Melatonin: Ready for Prime Time

    PubMed Central

    Reiter, Russel J.; Rosales-Corral, Sergio A.; Manchester, Lucien C.; Tan, Dun-Xian

    2013-01-01

    Melatonin has a wide variety of beneficial actions at the level of the gonads and their adnexa. Some actions are mediated via its classic membrane melatonin receptors while others seem to be receptor-independent. This review summarizes many of the published reports which confirm that melatonin, which is produced in the ovary, aids in advancing follicular maturation and preserving the integrity of the ovum prior to and at the time of ovulation. Likewise, when ova are collected for in vitro fertilization-embryo transfer, treating them with melatonin improves implantation and pregnancy rates. Melatonin synthesis as well as its receptors have also been identified in the placenta. In this organ, melatonin seems to be of particular importance for the maintenance of the optimal turnover of cells in the villous trophoblast via its ability to regulate apoptosis. For male gametes, melatonin has also proven useful in protecting them from oxidative damage and preserving their viability. Incubation of ejaculated animal sperm improves their motility and prolongs their viability. For human sperm as well, melatonin is also a valuable agent for protecting them from free radical damage. In general, the direct actions of melatonin on the gonads and adnexa of mammals indicate it is an important agent for maintaining optimal reproductive physiology. PMID:23549263

  12. Causal Factors and Adverse Events of Aviation Accidents and Incidents Related to Integrated Vehicle Health Management

    NASA Technical Reports Server (NTRS)

    Reveley, Mary S.; Briggs, Jeffrey L.; Evans, Joni K.; Jones, Sharon M.; Kurtoglu, Tolga; Leone, Karen M.; Sandifer, Carl E.

    2011-01-01

    Causal factors in aviation accidents and incidents related to system/component failure/malfunction (SCFM) were examined for Federal Aviation Regulation Parts 121 and 135 operations to establish future requirements for the NASA Aviation Safety Program s Integrated Vehicle Health Management (IVHM) Project. Data analyzed includes National Transportation Safety Board (NSTB) accident data (1988 to 2003), Federal Aviation Administration (FAA) incident data (1988 to 2003), and Aviation Safety Reporting System (ASRS) incident data (1993 to 2008). Failure modes and effects analyses were examined to identify possible modes of SCFM. A table of potential adverse conditions was developed to help evaluate IVHM research technologies. Tables present details of specific SCFM for the incidents and accidents. Of the 370 NTSB accidents affected by SCFM, 48 percent involved the engine or fuel system, and 31 percent involved landing gear or hydraulic failure and malfunctions. A total of 35 percent of all SCFM accidents were caused by improper maintenance. Of the 7732 FAA database incidents affected by SCFM, 33 percent involved landing gear or hydraulics, and 33 percent involved the engine and fuel system. The most frequent SCFM found in ASRS were turbine engine, pressurization system, hydraulic main system, flight management system/flight management computer, and engine. Because the IVHM Project does not address maintenance issues, and landing gear and hydraulic systems accidents are usually not fatal, the focus of research should be those SCFMs that occur in the engine/fuel and flight control/structures systems as well as power systems.

  13. Women convicted for violent offenses: Adverse childhood experiences, low level of education and poor mental health

    PubMed Central

    2009-01-01

    Background In past years, the female offender population has grown, leading to an increased interest in the characteristics of female offenders. The aim of this study was to assess the prevalence of female violent offending in a Swiss offender population and to compare possible socio-demographic and offense-related gender differences. Methods Descriptive and bivariate logistic regression analyses were performed for a representative sample of N = 203 violent offenders convicted in Zurich, Switzerland. Results 7.9% (N = 16) of the sample were female. Significant gender differences were found: Female offenders were more likely to be married, less educated, to have suffered from adverse childhood experiences and to be in poor mental health. Female violent offending was less heterogeneous than male violent offending, in fact there were only three types of violent offenses females were convicted for in our sample: One third were convicted of murder, one third for arson and only one woman was convicted of a sex offense. Conclusions The results of our study point toward a gender-specific theory of female offending, as well as toward the importance of developing models for explaining female criminal behavior, which need to be implemented in treatment plans and intervention strategies regarding female offenders. PMID:20028499

  14. Manipulations to reduce simulator-related transient adverse health effects during simulated driving.

    PubMed

    Jäger, M; Gruber, N; Müri, R; Mosimann, U P; Nef, T

    2014-07-01

    User comfort during simulated driving is of key importance, since reduced comfort can confound the experiment and increase dropout rates. A common comfort-affecting factor is simulator-related transient adverse health effect (SHE). In this study, we propose and evaluate methods to adapt a virtual driving scene to reduce SHEs. In contrast to the manufacturer-provided high-sensory conflict scene (high-SCS), we developed a low-sensory conflict scene (low-SCS). Twenty young, healthy participants drove in both the high-SCS and the low-SCS scene for 10 min on two different days (same time of day, randomized order). Before and after driving, participants rated SHEs by completing the Simulator Sickness Questionnaire (SSQ). During driving, several physiological parameters were recorded. After driving in the high-SCS, the SSQ score increased in average by 129.4 (122.9 %, p = 0.002) compared to an increase of 5.0 (3.4 %, p = 0.878) after driving in the low-SCS. In the low-SCS, skin conductance decreased by 13.8 % (p < 0.01) and saccade amplitudes increased by 16.1 % (p < 0.01). Results show that the investigated methods reduce SHEs in a younger population, and the low-SCS is well accepted by the users. We expect that these measures will improve user comfort. PMID:24888755

  15. Using AHRQ patient safety indicators to detect postdischarge adverse events in the Veterans Health Administration.

    PubMed

    Mull, Hillary J; Borzecki, Ann M; Chen, Qi; Shin, Marlena H; Rosen, Amy K

    2014-01-01

    Patient safety indicators (PSIs) use inpatient administrative data to flag cases with potentially preventable adverse events (AEs) attributable to hospital care. This study explored how many AEs the PSIs identified in the 30 days post discharge. PSI software was run on Veterans Health Administration 2003-2007 administrative data for 10 recently validated PSIs. Among PSI-eligible index hospitalizations not flagged with an AE, this study evaluated how many AEs occurred within 1 to 14 and 15 to 30 days post discharge using inpatient and outpatient administrative data. Considering all PSI-eligible index hospitalizations, 11 141 postdischarge AEs were identified, compared with 40 578 inpatient-flagged AEs. More than 60% of postdischarge AEs were detected within 14 days of discharge. The majority of postdischarge AEs were decubitus ulcers and postoperative pulmonary embolisms or deep vein thromboses. Extending PSI algorithms to the postdischarge period may provide a more complete picture of hospital quality. Future work should use chart review to validate postdischarge PSI events. PMID:23939485

  16. View changes and educational demands on sexual/reproductive health of students at Shanghai Jiaotong University

    PubMed Central

    Wang, Hongxiang; Chen, Bin; Xu, Yong; Miao, Qing; Wu, Zhenming; Ju, Qiang; Huang, Yiran

    2015-01-01

    Objectives: To determine whether the attitudes to sexual and reproductive health of a cohort of university students had changed from 2005 to 2013. Methods: Questionnaires (1,000) on sexual and reproductive health attitudes were randomly distributed to students at Shanghai Jiaotong University in May 2013. All participants volunteered for the study and their answers were anonymous. The questionnaire contents included personal information and 72 MCQs, which covered four categories: knowledge about sexual/reproductive health and STDs; attitude to sexual behavior; attitudes to pornographic books/movies; desire of the participants for education on sexual/reproductive health. The participants had not received sexual/reproductive health education since their admission to the university. Their study majors were broadly similar to those participants in the April 2005 survey. The high sensitivity of the content of the questionnaire made it imperative to maintain anonymity and high security of the collected data. Results: The return rate of questionnaires were 98% (request age from 19~21 years). Personal hygiene was much greater in females than in males. The proportion of females and males who held a positive attitude to premarital sexual behavior was significantly increased (P < 0.0001). 80% of the participants understood the need to use condoms with strangers; however, still high proportion of participants lacked of this knowledge (P = 0.142). About one third of the participants still did not believe that unmarried pregnancy was acceptable (no significant change from 2005 to 2013). There was significantly improved knowledge about the way in which AIDS spreads. Conclusions: College students are more open today compared to the 2003 survey. A higher level of sexual knowledge has been achieved but there scope for further improvement. Sex education should be based on the actual needs of young people, teaching reforms, and special attention paid to practical teaching. PMID

  17. Reproductive health of adolescents in Russia: statistics, problems and prospects of improvement.

    PubMed

    Radzinskiy, V E; Khamoshina, M B; Arkhipova, M P; Lichak, N V

    2014-10-01

    At the beginning of the 21st century we still face the problem of reproductive health of women, children and adolescents in Russia. Final overcoming of the "Russian Cross" primarily relates to preventing further decline of women in reproductive age and children aged 0-17 years.The following medico-social determinants of women's reproductive health are considered: family prosperity, somatic growth and sexual maturation, chronic extragenital diseases, sexual and reproductive behavior, environmental wellbeing of territory and gynecological care organization. Analysis of gynecological morbidity of Russian girls and adolescents at the beginning of this century spots an upward trend. The results of our anonymous questionnaire survey of socially adapted students among 3327 girls of 13-19 years testify that 59.9% of respondents in this age cohort do not practice daily genitalia toilet. According to our population-based studies, 24.0% of women have first pregnancy at the juvenile age followed by labor in 18.4% of young women, abortion in 81.6%. Menstrual disorders represent the most common symptoms and strong indications of reproductive health problems related, inter alia, to progesterone deficiency which can lead to serious consequences (infertility, miscarriage, breast disease). The choice of medication for the menstrual disorders treatment should consider instruction indications, the lack of limitations and contraindications, need for contraception, concomitant diseases and states, proved efficacy of the medication. Prospects of solving reproductive and demographic problems in the twenty-first century are largely beyond the control of clinicians being aggravated by unresolved environmental and social problems. PMID:25200817

  18. Reproductive Health Decision-Making in Perinatally HIV-Infected Adolescents and Young Adults

    PubMed Central

    Wiener, Lori; Zadeh, Sima; Albright, Jamie; Mellins, Claude Ann; Mancilla, Michael; Tepper, Vicki; Trexler, Connie; Purdy, Julia; Osherow, Janet; Lovelace, Susan; Kapetanovic, Suad

    2013-01-01

    With widespread access to antiretroviral therapy in the United States, many perinatally HIV-infected (PHIV+) children are surviving into adolescence and adulthood, becoming sexually active and making decisions about their reproductive health. The literature focusing on the reproductive decisions of individuals behaviorally infected with HIV can serve as a springboard for understanding the decision-making process of PHIV+ youth. Yet, there are many differences that critically distinguish reproductive health and related decision-making of PHIV+ youth. Given the potential public health implications of their reproductive decisions, better understanding of factors influencing the decision-making process is needed to help inform the development of salient treatment and prevention interventions. To begin addressing this understudied area, a “think tank” session, comprised of clinicians, medical providers, and researchers with expertise in the area of adolescent HIV, was held in Bethesda, MD, on September 21, 2011. The focus was to explore what is known about factors that influence the reproductive decision-making of PHIV+ adolescents and young adults, determine what important data are needed in order to develop appropriate intervention for PHIV+ youth having children, and to recommend future directions for the field in terms of designing and carrying out collaborative studies. In this report, we summarize the findings from this meeting. The paper is organized around the key themes that emerged, including utilizing a developmental perspective to create an operational definition of reproductive decision-making, integration of psychosocial services with medical management, and how to design future research studies. Case examples are presented and model program components proposed. PMID:22736033

  19. Linkages Within the Reproductive and Maternal Health Continuum of Care in Bangladesh.

    PubMed

    McDougal, Lotus; Rusch, Melanie L A; Silverman, Jay G; Raj, Anita

    2016-07-01

    The continuum of care (CoC) is a fundamental approach to reproductive, maternal, newborn, and child health policy and programs, but linkages along the CoC are inadequately understood. This article assesses linkages in reproductive and maternal health (RMH) services in Bangladesh using the 2011 Bangladesh Demographic and Health Survey (n = 7170). Antenatal care (ANC) was positively associated with skilled birth attendance (SBA) among both pre-pregnancy contraceptive users and nonusers. Among women who used pre-pregnancy contraceptives but did not receive skilled ANC, there was a 26% decreased odds of SBA. Pre-pregnancy contraceptive use increased the odds of postpartum contraceptive use, but neither ANC nor SBA was associated with postpartum contraceptive use. There are clear linkages within maternal health services and within reproductive health services, but linkages across life stages were variable. Removing barriers to accessing health services early and addressing barriers in the transitions within RMH care will facilitate sustained engagement along the CoC. PMID:27371578

  20. Rights of HIV positive people to sexual and reproductive health: parenthood.

    PubMed

    Segurado, Aluisio Cotrim; Paiva, Vera

    2007-05-01

    In many areas of the globe most HIV infection is transmitted sexually or in association with pregnancy, childbirth and breastfeeding, raising the need for sexual and reproductive health and HIV/AIDS initiatives to be mutually reinforcing. Many people with HIV, who are in good health, will want to have children, and highly active antiretroviral therapy provides women and men living with AIDS the possibility of envisaging new life projects such as parenthood, because of a return to health. However, there are still difficult choices to face concerning sexuality, parenthood desires and family life. Structural, social and cultural issues, as well as the lack of programmatic support, hinder the fulfilment of the right to quality sexual and reproductive health care and support for having a family. This paper addresses the continuum of care involved in parenthood for people living with HIV, from pregnancy to infant and child care, and provides evidence-based examples of policies and programmes that integrate sexual and reproductive health interventions with HIV/AIDS care in order to support parenthood. Focusing on parenthood for people living with and affected by HIV, that is, focusing on the couple rather than the woman as the unit of care, the individual or the set of adults who are responsible for raising children, would be an innovative programmatic advance. Going beyond maternal and child health care to providing care and support for parents and others who are responsible for raising children is especially relevant for those living with HIV infection. PMID:17531747

  1. Introduction: Mental health counseling in third party reproduction.

    PubMed

    Schlaff, William D; Braverman, Andrea Mechanick

    2015-09-01

    Mental health professionals serve an important role in guiding intended parents through a myriad of considerations from donor or surrogate selection to issues of disclosure with children. This role has evolved due to many considerations including evolving practice and ethics guidelines, as well as other factors such as access to the internet. This Views and Reviews will explore how team care, inclusive of the mental health professional, serves the interests of patients and provides a strong foundation for families created with the help of donors and/or surrogates. PMID:26239022

  2. Using the Personal Background Preparation Survey to Identify Health Science Professions Students at Risk for Adverse Academic Events

    ERIC Educational Resources Information Center

    Johnson, Craig W.; Johnson, Ronald; McKee, John C.; Kim, Mira

    2009-01-01

    In the first predictive validity study of a diagnostic and prescriptive instrument for averting adverse academic status events (AASE) among multiple populations of diverse health science professions students, entering matriculates' personal background and preparation survey (PBPS) scores consistently significantly predicted 1st- or 2nd-year AASE.…

  3. Toward a Case Definition of Adverse Health Effects in the Environs of Industrial Wind Turbines: Facilitating a Clinical Diagnosis

    ERIC Educational Resources Information Center

    McMurtry, Robert Y.

    2011-01-01

    Internationally, there are reports of adverse health effects (AHE) in the environs of industrial wind turbines (IWT). There was multidisciplinary confirmation of the key characteristics of the AHE at the first international symposium on AHE/IWT. The symptoms being reported are consistent internationally and are characterized by crossover findings…

  4. Methodological issues in studies of air pollution and reproductive health

    EPA Science Inventory

    In the past decade there have been an increasing number of scientific studies describing possible effects of air pollution on perinatal health. These papers have mostly focused on commonly monitored air pollutants, primarily ozone (O3), particulate matter (PM), sulfur dioxide (S...

  5. Primary Care Physicians’ Perceptions of Barriers To Preventive Reproductive Health Care In Rural Communities

    PubMed Central

    Chuang, Cynthia H.; Hwang, Sandra W.; McCall-Hosenfeld, Jennifer S.; Rosenwasser, Lara; Hillemeier, Marianne M.; Weisman, Carol S.

    2013-01-01

    CONTEXT Women residing in rural areas are less likely than urban women to receive preventive reproductive health care, but reasons for this disparity remain largely unexplored. METHODS In 2010, semistructured interviews were conducted with 19 rural primary care physicians in central Pennsylvania regarding their experiences in two domains of preventive reproductive health—contraceptive care and preconception care. Major themes were identified using a modified grounded theory approach. RESULTS Physicians perceived that they had a greater role in providing contraceptive care than did nonrural physicians and that contraceptives were widely accessible to patients in their communities; however, the scope of contraceptive services they provided varied widely. Participants were aware of the importance of optimal health prior to pregnancy, but most did not routinely initiate preconception counseling. Physicians perceived rural community norms of unintended pregnancies, large families, and indifference toward career and educational goals for young women as the biggest barriers to both contraceptive and preconception care, as these attitudes resulted in a lack of patient interest in family planning. Lack of time and resources were identified as additional barriers to providing preconception care. CONCLUSIONS Rural women’s low use of contraceptive and preconception care services may reflect that preventive reproductive health care is not a priority in rural communities, rather than that it is inaccessible. E3 orts to motivate rural women to engage in reproductive life planning, including more proactive counseling by providers, merit examination as ways to improve use of services. PMID:22681422

  6. The global reproductive health market: U.S. media framings and public discourses about transnational surrogacy.

    PubMed

    Markens, Susan

    2012-06-01

    During the first decade of the 21st century a new "dramatic story" about the growing global surrogacy industry brought renewed attention to surrogacy as a social problem and a health policy issue. This paper asks: What cultural assumptions about gender, family and the global reproductive health market are revealed in current U.S. media coverage of and public discourses about surrogacy? From a qualitative analysis of prominent news accounts of surrogacy that were published in 2008, New York Times articles and blogs published on the topic between 2006 and 2010, and over 1000 online reader comments to these articles, I identify key frames used to discursively construct and debate the international surrogacy market. This study reveals the distinct contrast between the occasions when reproductive labor is rhetorically distanced from commodification processes and when it is linked to those processes. The findings contribute to intersectional analyses of assisted reproductive practices and women's health/bodies/gametes. In particular, this study's analysis of recent media framings of and public discourses about surrogacy across the globe serves as another illustration that national/classed/racialized bodies continue to be reproductively stratified via differently gendered discourses about women, motherhood and family. PMID:22014871

  7. The Holy See on sexual and reproductive health rights: conservative in position, dynamic in response.

    PubMed

    Coates, Amy L; Hill, Peter S; Rushton, Simon; Balen, Julie

    2014-11-01

    The Holy See has engaged extensively in United Nations negotiations on issues concerning sexual and reproductive health rights as they have emerged and evolved in a dynamic global agenda over the past two decades. A meta-narrative review of the mission's official statements was conducted to examine the positions, discourses and tensions across the broad range of agendas. The Holy See represents a fundamentally conservative and stable position on a range of sexual and reproductive health rights concerns. However, the mission has been dynamic in the ways in which it has forwarded its arguments, increasingly relying upon secularised technical claims and empirical evidence; strategically interpreting human rights norms in ways consistent with its own position; and framing sexuality and reproduction in the context of "the family". Seen in the broader context of a "religious resurgence" in international relations, and in light of the fact that the Holy See has frequently sought to form alliances with conservative State and non-State actors, these findings make an important contribution to understanding the slow progress as well as the potential obstacles that lie ahead in the battle to realise sexual and reproductive health rights in a changing global political environment. PMID:25555769

  8. Development of Quantitative Adverse Outcome Pathways Using Health-Protective Assumptions to Fill Data Gaps

    EPA Science Inventory

    In an adverse outcome pathway (AOP), the target site dose participates in a molecular initiating event (MIE), which in turn triggers a sequence of key events leading to an adverse outcome (AO). Quantitative AOPs (QAOP) are needed if AOP characterization is to address risk as well...

  9. Addressing Structural and Environmental Factors for Adolescent Sexual and Reproductive Health in Low- and Middle-Income Countries.

    PubMed

    Sommer, Marni; Mmari, Kristin

    2015-10-01

    A deeper understanding of how structure and environment shape the sexual and reproductive health vulnerabilities of youths across a range of outcomes has implications for the development of successful policies and programs. We have discussed some of the key structural and environmental factors that influence the sexual and reproductive health of adolescents, particularly in low- and middle-income countries, and the importance of engaging adolescents in identifying solutions. We have highlighted 2 case studies that describe structural or environmental approaches to improving adolescent sexual and reproductive health and made recommendations to more systematically incorporate attention to structure and environment to improve global adolescent health. PMID:26270290

  10. Early Life Adversity Contributes to Impaired Cognition and Impulsive Behavior: Studies from the Oklahoma Family Health Patterns Project

    PubMed Central

    Lovallo, William R.; Farag, Noha H.; Sorocco, Kristen H.; Acheson, Ashley; Cohoon, Andrew J.; Vincent, Andrea S.

    2012-01-01

    Background Stressful early life experience may have adverse consequences in adulthood and may contribute to behavioral characteristics that increase vulnerability to alcoholism. We examined early life adverse experience in relation to cognitive deficits and impulsive behaviors with a reference to risk factors for alcoholism. Methods We tested 386 healthy young adults (18 – 30 years of age; 224 women; 171 family history positive for alcoholism) using a composite measure of adverse life experience (low socioeconomic status plus personally experienced adverse events including physical and sexual abuse and separation from parents) as a predictor of performance on the Shipley Institute of Living scale, the Stroop color-word task, and a delay-discounting task assessing preference for smaller immediate rewards in favor of larger delayed rewards. Body mass index was examined as an early indicator of altered health behavior. Results Greater levels of adversity predicted higher Stroop interference scores (F = 3.07, p = .048), faster discounting of delayed rewards (F = 3.79, p = .024), lower Shipley mental age scores (F = 4.01, p = .019), and higher body mass indexes in those with a family history of alcoholism (F = 3.40, p = .035). These effects were not explained by age, sex, race, education, or depression. Conclusion The results indicate a long-term impact of stressful life experience on cognitive function, impulsive behaviors, and early health indicators that may contribute to risk in persons with a family history of alcoholism. PMID:23126641

  11. Health assessment of gasoline and fuel oxygenate vapors: Reproductive toxicity assessment

    PubMed Central

    Gray, Thomas M.; Steup, David; Roberts, Linda G.; O'Callaghan, James P.; Hoffman, Gary; Schreiner, Ceinwen A.; Clark, Charles R.

    2016-01-01

    Vapor condensates of baseline gasoline (BGVC), or gasoline-blended with methyl tertiary butyl ether (G/MTBE), ethyl t-butyl ether (G/ETBE), t-amyl methyl ether (G/TAME), diisopropyl ether (G/DIPE), ethanol (G/EtOH), or t-butyl alcohol (G/TBA) were evaluated for reproductive toxicity in rats at target concentrations of 2000, 10,000, or 20,000 mg/m3, 6 h/day, 7 days/week. BGVC and G/MTBE were assessed over two generations, the others for one generation. BGVC and G/MTBE F1 offspring were evaluated for neuropathology and changes in regional brain glial fibrillary acidic protein content. No neurotoxicity was observed. Male kidney weight was increased consistent with light hydrocarbon nephropathy. In adult rats, decreased body weight gain and increased liver weight were seen. Spleen weight decreased in adults and pups exposed to G/TBA. No pathological changes to reproductive organs occurred in any study. Decreased food consumption was seen in G/TAME lactating females. Transient decreases in G/TAME off-spring weights were observed during lactation. Except for a minor increase in time to mating in G/TBA which did not affect other reproductive parameters, there were no adverse reproductive findings. The NOAEL for reproductive and offspring parameters was 20,000 mg/m3 for all vapor condensates except for lower offspring NOAELs of 10,000 mg/m3 for G/TBA and 2000 mg/m3 for G/TAME. PMID:24813181

  12. Health assessment of gasoline and fuel oxygenate vapors: reproductive toxicity assessment.

    PubMed

    Gray, Thomas M; Steup, David; Roberts, Linda G; O'Callaghan, James P; Hoffman, Gary; Schreiner, Ceinwen A; Clark, Charles R

    2014-11-01

    Vapor condensates of baseline gasoline (BGVC), or gasoline-blended with methyl tertiary butyl ether (G/MTBE), ethyl t-butyl ether (G/ETBE), t-amyl methyl ether (G/TAME), diisopropyl ether (G/DIPE), ethanol (G/EtOH), or t-butyl alcohol (G/TBA) were evaluated for reproductive toxicity in rats at target concentrations of 2000, 10,000, or 20,000mg/m(3), 6h/day, 7days/week. BGVC and G/MTBE were assessed over two generations, the others for one generation. BGVC and G/MTBE F1 offspring were evaluated for neuropathology and changes in regional brain glial fibrillary acidic protein content. No neurotoxicity was observed. Male kidney weight was increased consistent with light hydrocarbon nephropathy. In adult rats, decreased body weight gain and increased liver weight were seen. Spleen weight decreased in adults and pups exposed to G/TBA. No pathological changes to reproductive organs occurred in any study. Decreased food consumption was seen in G/TAME lactating females. Transient decreases in G/TAME offspring weights were observed during lactation. Except for a minor increase in time to mating in G/TBA which did not affect other reproductive parameters, there were no adverse reproductive findings. The NOAEL for reproductive and offspring parameters was 20,000mg/m(3) for all vapor condensates except for lower offspring NOAELs of 10,000mg/m(3) for G/TBA and 2000mg/m(3) for G/TAME. PMID:24813181

  13. Assessing public and private sector contributions in reproductive health financing and utilization for six sub-Saharan African countries.

    PubMed

    Nguyen, Ha; Snider, Jeremy; Ravishankar, Nirmala; Magvanjav, Oyunbileg

    2011-05-01

    The present study provides evidence to support enhanced attention to reproductive health and comprehensive measures to increase access to quality reproductive health services. We compare and contrast the financing and utilization of reproductive health services in six sub-Saharan African countries using data from National Health Accounts and Demographic and Health Surveys. Spending on reproductive health in 2006 ranged from US$4 per woman of reproductive age in Ethiopia to US$17 in Uganda. These are below the necessary level for assuring adequate services given that an internationally recommended spending level for family planning alone was US$16 for 2006. Moreover, reproductive health spending shows signs of decline in tandem with insufficient improvement in service utilization. Public providers played a predominant role in antenatal and delivery care for institutional births, but home deliveries with unqualified attendants dominated. The private sector was a major supplier of condoms, oral pills and IUDs. Private clinics, pharmacies and drug vendors were important sources of STI treatment. The findings highlight the need to commit greatly increased funding for reproductive health services as well as more policy attention to the contribution of public, private and informal providers and the role of collaboration among them to expand access to services for under-served populations. PMID:21555087

  14. Indigenous Women of Latin America: Unintended Pregnancy, Unsafe Abortion, and Reproductive Health Outcomes

    PubMed Central

    Wurtz, Heather

    2013-01-01

    Indigenous women in Latin America have poorer reproductive health outcomes than the general population and face considerable barriers in accessing adequate health services. Indigenous women have high rates of adolescent fertility and unintended pregnancy and may face increased risks for morbidity and mortality related to unsafe abortion. However, research among this population, particularly focusing on social and cultural implications of unwanted pregnancy and unsafe abortion, is significantly limited. This article reviews the literature on unsafe abortion in Latin America and describes successful interventions to ameliorate reproductive health outcomes within Indigenous communities. It also explores important implications for future research. Shedding light on the circumstances, perspectives, and lived realities of Indigenous women of childbearing age, could encourage further qualitative investigation and mitigate negative outcomes through improved understanding of the topic, targeted culturally appropriate interventions, and recommendations for future policy and programming reformations. PMID:23772229

  15. Bringing X, Y, Z Generations Together to Facilitate School-Based Sexual and Reproductive Health Education.

    PubMed

    Akbari Kamrani, Mahnaz; Yahya, Sharifah Syed

    2016-01-01

    This generic qualitative study explores the perspective of Malaysian teachers regarding the constraints of the current school-based sexual and reproductive health education in secondary schools of Klang-Valley Malaysia. For this study, in-depth interviews were conducted with twenty eight science teachers of government schools. The majority of participants named the teaching strategy and capacity of teachers, the lack of co-operation from the school and parents, limited resources in teaching and students themselves as some of the challenges. We concluded that if sexual health education is to be effective, it needs to be provided by people who have some specialized training. The teachers should be trained to teach sexual reproductive health education classes at the basic level, and in-service training for teachers already in the field should be intensified. Local adaptation to culture, language, religion, and so forth is often necessary. PMID:27157180

  16. Chlamydia trachomatis and Genital Mycoplasmas: Pathogens with an Impact on Human Reproductive Health

    PubMed Central

    Ljubin-Sternak, Sunčanica; Meštrović, Tomislav

    2014-01-01

    The most prevalent, curable sexually important diseases are those caused by Chlamydia trachomatis (C. trachomatis) and genital mycoplasmas. An important characteristic of these infections is their ability to cause long-term sequels in upper genital tract, thus potentially affecting the reproductive health in both sexes. Pelvic inflammatory disease (PID), tubal factor infertility (TFI), and ectopic pregnancy (EP) are well documented complications of C. trachomatis infection in women. The role of genital mycoplasmas in development of PID, TFI, and EP requires further evaluation, but growing evidence supports a significant role for these in the pathogenesis of chorioamnionitis, premature membrane rupture, and preterm labor in pregnant woman. Both C. trachomatis and genital mycoplasmas can affect the quality of sperm and possibly influence the fertility of men. For the purpose of this paper, basic, epidemiologic, clinical, therapeutic, and public health issue of these infections were reviewed and discussed, focusing on their impact on human reproductive health. PMID:25614838

  17. Facilitators and Inhibitors of Health-promoting Behaviors: The Experience of Iranian Women of Reproductive Age

    PubMed Central

    Baheiraei, Azam; Mirghafourvand, Mojgan; Charandabi, Sakineh Mohammad-Alizadeh; Mohammadi, Eesa

    2013-01-01

    Background: There is scant information on the facilitators and inhibitors of health-promoting behaviors among reproductive-aged Iranian women. This study aims to explore the experience of factors influencing health-promoting behaviors among Iranian women of reproductive age from a qualitative perspective. Methods: This study was performed in Tehran in 2011, over about 8 months. Qualitative methods, specifically in-depth interviews, were used to gather data on 15 women of reproductive age. Data continued to be collected until introduction of new information ceased. The interviews were recorded, transcribed verbatim, and analyzed by conventional content analysis. Results: The reported factors were categorized into four main groups and 12 subgroups: (1) personal barriers (lack of time, school or work duties, lack of preparation or motivation, physical disability); (2) socio-environmental barriers (family responsibilities, environmental pressures, high-costs and financial pressures); (3) personal facilitators (personal interest and motivation, experience of disease); and (4) socio-environmental facilitators (family and social support networks, encouraging and motivating environment, media, and public education). Conclusions: In these women's experience, factors influencing health-promoting behaviors were either facilitators or inhibitors; most were inhibitors. The findings of this study show that, in addition to personal factors, the pursuit of health-promoting behaviors is affected by socio-environmental factors. These results will be useful in designing interventions and plans for women's health promotion that focus on the improvement of their environment and the modification of social factors. PMID:24049620

  18. Assessment of Sexual and Reproductive Health Status of Street Children in Addis Ababa

    PubMed Central

    Habtamu, Demelash; Adamu, Addisie

    2013-01-01

    Street children worldwide do not have the information, skills, health services, and support they need to go through sexual development during adolescence. This study is undertaken to systematically investigate the fit between street children's sexual and reproductive health needs and the existing services. A cross-sectional study was conducted among 422 street children and four service providers. About 72.5% of the respondents were sexually active during data collection and 84.3% of males and 85.7% of females tended to have multiple sexual partners. More than two-thirds (67.3%) of the participants had used at least one type of substance. History of substance use (OR = 2.5; 95% CI = 1.42–4.56) and being on the street for the first one to three years (OR = 5.9; 95% CI = 1.41–7.22) increased the likelihood of having sexual activity. More than half (64.9%) of the street children did not attend any kind of sexual or reproductive health education programs. Lack of information on available services (26.5%) was the biggest barrier for utilization of local sexual and reproductive health services. From the individual interview with coordinator, the financial and networking problems were hindering the service delivery for street children. In conclusion, street children who are special high risk group have not been targeted and hence continue to remain vulnerable and lacking in sexual and reproductive health services and sexual health services are poorly advertised and delivered to them. PMID:26316958

  19. Assessment of Sexual and Reproductive Health Status of Street Children in Addis Ababa.

    PubMed

    Habtamu, Demelash; Adamu, Addisie

    2013-01-01

    Street children worldwide do not have the information, skills, health services, and support they need to go through sexual development during adolescence. This study is undertaken to systematically investigate the fit between street children's sexual and reproductive health needs and the existing services. A cross-sectional study was conducted among 422 street children and four service providers. About 72.5% of the respondents were sexually active during data collection and 84.3% of males and 85.7% of females tended to have multiple sexual partners. More than two-thirds (67.3%) of the participants had used at least one type of substance. History of substance use (OR = 2.5; 95% CI = 1.42-4.56) and being on the street for the first one to three years (OR = 5.9; 95% CI = 1.41-7.22) increased the likelihood of having sexual activity. More than half (64.9%) of the street children did not attend any kind of sexual or reproductive health education programs. Lack of information on available services (26.5%) was the biggest barrier for utilization of local sexual and reproductive health services. From the individual interview with coordinator, the financial and networking problems were hindering the service delivery for street children. In conclusion, street children who are special high risk group have not been targeted and hence continue to remain vulnerable and lacking in sexual and reproductive health services and sexual health services are poorly advertised and delivered to them. PMID:26316958

  20. Medicinal plants used in Northern Peru for reproductive problems and female health

    PubMed Central

    2010-01-01

    Infections of the reproductive tract, complications after childbirth, and reproductive problems continue to be a major health challenge worldwide. An impressive number of plant species is traditionally used to remedy such afflictions, and some have been investigated for their efficacy with positive results. A total of 105 plant species belonging to 91 genera and 62 families were documented and identified as herbal remedies for reproductive problems in Northern Peru. Most species used were Asteraceae (9.52%), followed by Lamiaceae and Fabaceae (8.57% and 6.67%). The most important families are clearly represented very similarly to their overall importance in the local pharmacopoeia. The majority of herbal preparations for reproductive afflictions were prepared from the leaves of plants (22.72%), the whole plant (21.97%), and stems (21.21%), while other plant parts were used less frequently. More than 60% of the cases fresh plant material was used to prepare remedies. Over 70% of the remedies were applied orally, while the remaining ones were applied topically. Many remedies were prepared as mixtures of multiple ingredients. Little scientific evidence exists to prove the efficacy of the species employed as reproductive disorder remedies in Northern Peru. Only 34% of the plants found or their congeners have been studied at all for their medicinal properties. The information gained on frequently used traditional remedies might give some leads for future targets for further analysis in order to develop new drugs. PMID:21040536

  1. Risk of Adverse Health and Performance Effects of Celestial Dust Exposure

    NASA Technical Reports Server (NTRS)

    Scully, Robert R.; Meyers, Valerie E.

    2015-01-01

    silica (Permissible Exposure Limit [PEL] 0.05 mg/m3) but more toxic than the nuisance dust titanium dioxide (TiO2 [PEL 5.0 mg/m3]). A PEL for episodic exposure to airborne lunar dust during a six-month stay on the lunar surface was established, in consultation with an independent, extramural panel of expert pulmonary toxicologists, at 0.3 mg/m3. The PEL provided for lunar dust is limited to the conditions and exposure specified therefore additional research remains to be accomplished with lunar dust to further address the issues of activation, address other areas of more unique lunar geology (Glotch et al., 2010; Greenhagen et al., 2010), examine potential toxicological effects of inhaled or ingested dust upon other organ systems, such cardiovascular, nervous systems, and examine effects of acute exposure to massive doses of dust such as may occur during off-nominal situations. Work to support the establishment of PELs for Martian dust and dusts of asteroids remains to be accomplished. The literature that describes health effects of exposure to toxic terrestrial dusts provides substantial basis for concern that prolonged exposure to respirable celestial dust could be detrimental to human health. Celestial bodies where a substantial portion of the dust is in the respirable range or where the dusts have large reactive surface areas or contain transition metals or volatile organics, represent greater risks of adverse effects from exposure to the dust. It is possible that in addition to adverse effects to the respiratory system, inhalation and ingestion of celestial dusts could pose risks to other systems

  2. Women Who Have Sex with Women in Kenya and Their Sexual and Reproductive Health

    PubMed Central

    Zaidi, Sidra S.; Ocholla, Akinyi M.; Otieno, Rena A.

    2016-01-01

    Abstract Purpose: To describe sexual and reproductive health characteristics of women who have sex with women (WSW) in Kenya's three most populous cities: Kisumu, Mombasa, and Nairobi. Although the last decade has shown an upsurge of health-related research studies in African sexual minority populations, these studies have generally concentrated on the health status of men who have sex with men to the exclusion of WSW. This study presents the first findings on Kenyan WSW's sexual and reproductive health. Methods: A community-based, cross-sectional survey was conducted among 280 women who were at least 18 years old, had at least one female sexual partner in the past three years, and were Kenyan residents. Results: A significant proportion of participants reported that they had at least one male sexual partner in the past three years (38.9%), ever had an abortion (13.2%), been infected with at least one sexually transmitted infection (STI) in the past three years (33.9%), and been tested for HIV at least once (88.9%). Of the women who reported having been tested for HIV, 9.4% (7.5% of the total sample) received a positive test result. Some women noted that they were open with their doctors about their sexual orientation, and that their doctors had not reacted negatively to this information. Conclusion: WSW in Kenya are at risk for negative sexual and reproductive health outcomes, including HIV, STIs, unplanned pregnancy, and unsafe abortion, positioning these women as a critical population for public health efforts. Some WSW actively exercise their agency in making important health decisions. Therefore, this study indicates a need to incorporate WSW's health concerns within Kenyan national health policy programming. PMID:26684690

  3. Getting the basic rights – the role of water, sanitation and hygiene in maternal and reproductive health: a conceptual framework

    PubMed Central

    Campbell, Oona M R; Benova, Lenka; Gon, Giorgia; Afsana, Kaosar; Cumming, Oliver

    2015-01-01

    Objective To explore linkages between water, sanitation and hygiene (WASH) and maternal and perinatal health via a conceptual approach and a scoping review. Methods We developed a conceptual framework iteratively, amalgamating three literature-based lenses. We then searched literature and identified risk factors potentially linked to maternal and perinatal health. We conducted a systematic scoping review for all chemical and biological WASH risk factors identified using text and MeSH terms, limiting results to systematic reviews or meta-analyses. The remaining 10 complex behavioural associations were not reviewed systematically. Results The main ways poor WASH could lead to adverse outcomes are via two non-exclusive categories: 1. ‘In-water’ associations: (a) Inorganic contaminants, and (b) ‘water-system’ related infections, (c) ‘water-based’ infections, and (d) ‘water borne’ infections. 2. ‘Behaviour’ associations: (e) Behaviours leading to water-washed infections, (f) Water-related insect-vector infections, and (g-i) Behaviours leading to non-infectious diseases/conditions. We added a gender inequality and a life course lens to the above framework to identify whether WASH affected health of mothers in particular, and acted beyond the immediate effects. This framework led us to identifying 77 risk mechanisms (67 chemical or biological factors and 10 complex behavioural factors) linking WASH to maternal and perinatal health outcomes. Conclusion WASH affects the risk of adverse maternal and perinatal health outcomes; these exposures are multiple and overlapping and may be distant from the immediate health outcome. Much of the evidence is weak, based on observational studies and anecdotal evidence, with relatively few systematic reviews. New systematic reviews are required to assess the quality of existing evidence more rigorously, and primary research is required to investigate the magnitude of effects of particular WASH exposures on specific

  4. Adverse health effects due to arsenic exposure: Modification by dietary supplementation of jaggery in mice

    SciTech Connect

    Singh, Nrashant; Kumar, D.; Lal, Kewal; Raisuddin, S.; Sahu, Anand P.

    2010-02-01

    Populations of villages of eastern India and Bangladesh and many other parts of the world are exposed to arsenic mainly through drinking water. Due to non-availability of safe drinking water they are compelled to depend on arsenic-contaminated water. Generally, poverty level is high in those areas and situation is compounded by the lack of proper nutrition. The hypothesis that the deleterious health effects of arsenic can be prevented by modification of dietary factors with the availability of an affordable and indigenous functional food jaggery (sugarcane juice) has been tested in the present study. Jaggery contains polyphenols, vitamin C, carotene and other biologically active components. Arsenic as sodium-m-arsenite at low (0.05 ppm) and high (5 ppm) doses was orally administered to Swiss male albino mice, alone and in combination with jaggery feeding (250 mg/mice), consecutively for 180 days. The serum levels of total antioxidant, glutathione peroxidase and glutathione reductase were substantially reduced in arsenic-exposed groups, while supplementation of jaggery enhanced their levels in combined treatment groups. The serum levels of interleukin-1beta, interleukin-6 and TNF-alpha were significantly increased in arsenic-exposed groups, while in the arsenic-exposed and jaggery supplemented groups their levels were normal. The comet assay in bone marrow cells showed the genotoxic effects of arsenic, whereas combination with jaggery feeding lessened the DNA damage. Histopathologically, the lung of arsenic-exposed mice showed the necrosis and degenerative changes in bronchiolar epithelium with emphysema and thickening of alveolar septa which was effectively antagonized by jaggery feeding. These results demonstrate that jaggery, a natural functional food, effectively antagonizes many of the adverse effects of arsenic.

  5. Identification of Major Adverse Kidney Events Within the Electronic Health Record.

    PubMed

    Semler, Matthew W; Rice, Todd W; Shaw, Andrew D; Siew, Edward D; Self, Wesley H; Kumar, Avinash B; Byrne, Daniel W; Ehrenfeld, Jesse M; Wanderer, Jonathan P

    2016-07-01

    Acute kidney injury is common among critically ill adults and is associated with increased mortality and morbidity. The Major Adverse Kidney Events by 30 days (MAKE30) composite of death, new renal replacement therapy, or persistent renal dysfunction is recommended as a patient-centered outcome for pragmatic trials involving acute kidney injury. Accurate electronic detection of the MAKE30 endpoint using data within the electronic health record (EHR) could facilitate the use of the EHR in large-scale kidney injury research. In an observational study using prospectively collected data from 200 admissions to a single medical intensive care unit, we tested the performance of electronically-extracted data in identifying the MAKE30 composite compared to the reference standard of two-physician manual chart review. The incidence of MAKE30 on manual-review was 16 %, which included 8.5 % for in-hospital mortality, 3.5 % for new renal replacement therapy, and 8.5 % for persistent renal dysfunction. There was strong agreement between the electronic and manual assessment of MAKE30 (98.5 % agreement [95 % CI 96.5-100.0 %]; kappa 0.95 [95 % CI 0.87-1.00]; P < 0.001), with only three patients misclassified by electronic assessment. Performance of the electronic MAKE30 assessment was similar among patients with and without CKD and with and without a measured serum creatinine in the 12 months prior to hospital admission. In summary, accurately identifying the MAKE30 composite outcome using EHR data collected as a part of routine care appears feasible. PMID:27234478

  6. Aging male bodies, health and the reproduction of age relations.

    PubMed

    Pietilä, Ilkka; Ojala, Hanna; King, Neal; Calasanti, Toni

    2013-08-01

    This article explores the ways in which a group of male factory workers uses bodies as bases for hierarchical categorization of men by age in their talk of mundane aspects of their lives. Analysis of interviews about health (4 focus groups and 5 personal interviews) with Finnish working-class men under 40 years old shows that they portray age groups to which they do not belong as careless, even irresponsible toward health and its maintenance. As they categorize youth and old people by age, they leave themselves unmarked by it, providing no vocabulary to describe their own group. Despite their tendency to distance themselves particularly from old people, they also distinguish among older men by familiarity, providing relatively nuanced accounts of their fathers' aging. We discuss the marking of age groups in terms of social inequality and talk of fathers in terms of intergenerational relations. Even family ties among men of diverse ages involve ageism, which familiarity serves both to mitigate and to make less visible. This article documents the maintenance of age inequality in everyday, mundane behavior. PMID:23849422

  7. ‘First, do no harm’: are disability assessments associated with adverse trends in mental health? A longitudinal ecological study

    PubMed Central

    Barr, B; Taylor-Robinson, D; Stuckler, D; Loopstra, R; Reeves, A; Whitehead, M

    2016-01-01

    Background In England between 2010 and 2013, just over one million recipients of the main out-of-work disability benefit had their eligibility reassessed using a new functional checklist—the Work Capability Assessment. Doctors and disability rights organisations have raised concerns that this has had an adverse effect on the mental health of claimants, but there are no population level studies exploring the health effects of this or similar policies. Method We used multivariable regression to investigate whether variation in the trend in reassessments in each of 149 local authorities in England was associated with differences in local trends in suicides, self-reported mental health problems and antidepressant prescribing rates, while adjusting for baseline conditions and trends in other factors known to influence mental ill-health. Results Each additional 10 000 people reassessed in each area was associated with an additional 6 suicides (95% CI 2 to 9), 2700 cases of reported mental health problems (95% CI 548 to 4840), and the prescribing of an additional 7020 antidepressant items (95% CI 3930 to 10100). The reassessment process was associated with the greatest increases in these adverse mental health outcomes in the most deprived areas of the country, widening health inequalities. Conclusions The programme of reassessing people on disability benefits using the Work Capability Assessment was independently associated with an increase in suicides, self-reported mental health problems and antidepressant prescribing. This policy may have had serious adverse consequences for mental health in England, which could outweigh any benefits that arise from moving people off disability benefits. PMID:26573235

  8. [Sexuality, reproductive health and violence against the African Brazilian women: aspects of interest for nursing care].

    PubMed

    da Cruz, Isabel Cristina Fonseca

    2004-12-01

    Based on the referential of the critical racial theory, a review of the literature was made with the objective of searching for information that leads to an affirmative professional action against racism and sexism, based on scientific evidences and culturally competent. It was evidenced that the sexuality, reproductive health and violence against African Brazilian women are themes with scarce literature, suggesting that racism and sexism occur by the omission and negligence of State to weigh on African Brazilian women's mobilization. The study concluded that institutional discrimination in health needs to be neutralized by affirmative actions regarding to African Brazilian women that must be implemented or strengthen to promote equity in health. PMID:15689003

  9. BIOMARKERS FOR ASSESSING REPRODUCTIVE DEVELOPMENT AND HEALTH: PART 1 - PUBERTAL DEVELOPMENT

    EPA Science Inventory

    The proposed National Children?s Study has helped raise awareness of the issues related to children?s health and the importance of monitoring the growth and development of children from preconception through to adulthood. Many genetic predispositions can adversely impact the nor...

  10. Availability of Reproductive Health Care Services at Schools and Subsequent Birth Outcomes among Adolescent Mothers

    ERIC Educational Resources Information Center

    Madkour, Aubrey S.; Xie, Yiqiong; Harville, Emily W.

    2016-01-01

    Background: Adverse birth outcomes are more common among adolescent versus adult mothers, but little is known about school-based services that may improve birth outcomes in this group. Methods: Data from Waves I and IV of the National Longitudinal Study of Adolescent Health were analyzed. Girls and women who gave birth to singleton live infants…

  11. Do sugar-sweetened beverages cause adverse health outcomes in adults? A systematic review protocol

    PubMed Central

    2014-01-01

    Background Chronic diseases, such as cardiovascular disease and type 2 diabetes, impose significant burden to public health. Most chronic diseases are associated with underlying preventable risk factors, such as elevated blood pressure, blood glucose, and lipids, physical inactivity, excessive sedentary behaviours, overweight and obesity, and tobacco usage. Sugar-sweetened beverages are known to be significant sources of additional caloric intake, and given recent attention to their contribution in the development of chronic diseases, a systematic review is warranted. We will assess whether the consumption of sugar-sweetened beverages in adults is associated with adverse health outcomes and what the potential moderating factors are. Methods/Design Of interest are studies addressing sugar-sweetened beverage consumption, taking a broad perspective. Both direct consumption studies as well as those evaluating interventions that influence consumption (e.g. school policy, educational) will be relevant. Non-specific or multi-faceted behavioural, educational, or policy interventions may also be included subject to the level of evidence that exists for the other interventions/exposures. Comparisons of interest and endpoints of interest are pre-specified. We will include randomized controlled trials, controlled clinical trials, interrupted time series studies, controlled before-after studies, prospective and retrospective comparative cohort studies, case-control studies, and nested case-control designs. The MEDLINE®, Embase, The Cochrane Library, CINAHL, ERIC, and PsycINFO® databases and grey literature sources will be searched. The processes for selecting studies, abstracting data, and resolving conflicts are described. We will assess risk of bias using design-specific tools. To determine sets of confounding variables that should be adjusted for, we have developed causal directed acyclic graphs and will use those to inform our risk of bias assessments. Meta-analysis will

  12. Community Health Workers and Health Care Delivery: Evaluation of a Women's Reproductive Health Care Project in a Developing Country

    PubMed Central

    Wajid, Abdul; White, Franklin; Karim, Mehtab S.

    2013-01-01

    Background As part of the mid-term evaluation of a Women's Health Care Project, a study was conducted to compare the utilization of maternal and neonatal health (MNH) services in two areas with different levels of service in Punjab, Pakistan. Methods A cross-sectional survey was conducted to interview Married Women of Reproductive Age (MWRA). Information was collected on MWRA knowledge regarding danger signs during pregnancy, delivery, postnatal periods, and MNH care seeking behavior. After comparing MNH service utilization, the two areas were compared using a logistic regression model, to identify the association of different factors with the intervention after controlling for socio-demographic, economic factors and distance of the MWRA residence to a health care facility. Results The demographic characteristics of women in the two areas were similar, although socioeconomic status as indicated by level of education and better household amenities, was higher in the intervention area. Consequently, on univariate analysis, utilization of MNH services: antenatal care, TT vaccination, institutional delivery and use of modern contraceptives were higher in the intervention than control area. Nonetheless, multivariable analysis controlling for confounders such as socioeconomic status revealed that utilization of antenatal care services at health centers and TT vaccination during pregnancy are significantly associated with the intervention. Conclusions Our findings suggest positive changes in health care seeking behavior of women and families with respect to MNH. Some aspects of care still require attention, such as knowledge about danger signs and neonatal care, especially umbilical cord care. Despite overall success achieved so far in response to the Millennium Development Goals, over the past two decades decreases in maternal mortality are far from the 2015 target. This report identifies some of the key factors to improving MNH and serves as an interim measure of a

  13. Health and Reproductive Assessment of Selected Puerto Rican Parrots ( Amazona vittata ) in Captivity.

    PubMed

    Clubb, Susan; Velez, Jafet; Garner, Michael M; Zaias, Julia; Cray, Carolyn

    2015-12-01

    The Puerto Rican parrot ( Amazona vittata ) has become an iconic and high-profile conservation species. The cornerstone of the recovery plan for this critically endangered species is an active captive breeding program, management of the wild population, and a long-term reintroduction program. In 2002, 40 adult Puerto Rican parrots that had not produced viable offspring were selected for reproductive assessment at 2 aviary populations in Puerto Rico (Iguaca and Río Abajo), which are the only sources of parrots for release. The goal was to enhance reproductive potential and produce productive pairings in an attempt to augment the population growth and provide ample individuals for reintroduction. Seven Hispanolian Amazon parrots ( Amazona ventralis ) that were used as surrogate parents for the Puerto Rican parrots were also included in the study. This assessment included physical examination, endoscopic evaluation, hematologic and plasma biochemical profiles, viral screening, and hormonal assays. Results of general physical examination and hematologic and plasma biochemical testing revealed overall good health and condition of this subset of the population of Puerto Rican parrots; no major infectious diseases were found. Endoscopic examination also revealed overall good health and condition, especially of females. The apparent low fertility of male birds warrants further investigation. The findings helped to define causes of reproductive failure in the selected pairs and individual birds. New pairings resulting from the assessment helped to augment reproduction of this critically endangered species. PMID:26771321

  14. Sexual and reproductive health and rights of older men and women: addressing a policy blind spot.

    PubMed

    Aboderin, Isabella

    2014-11-01

    Global debate on required policy responses to issues of older persons has intensified over the past 15 years, fuelled by a growing awareness of the rapid ageing of populations. Health has been a central focus, but scrutiny of global policies, human rights instruments and reports reveals that just as older people are excluded from sexual and reproductive health and rights agendas, so are issues of sexual and reproductive health and rights wholly marginal to current agendas focused on older people. A critical question is whether the policy lacuna reflects a dearth of research evidence or a faulty translation of existing knowledge. A reading of the current research landscape and literature, summarised in this paper, strongly suggests it is the former. To be sure, sexuality in old age is a burgeoning field of scientific inquiry. What the existing knowledge and discourse fail to provide is an engagement with, and elucidation of, the broader sexual and reproductive health and rights agenda as it relates to older persons. A concerted research effort is needed to provide a basis for developing policy guidance and for pinpointing essential indicators and establishing necessary data systems to enable a routine tracking of progress. PMID:25555775

  15. Beyond Informed Consent: Ethical Considerations in the Design and Implementation of Sexual and Reproductive Health Research Among Adolescents

    PubMed Central

    Folayan, Morenike Oluwatoyin; Haire, Bridget; Harrison, Abigail; Fatusi, Olawunmi; Brown, Brandon

    2015-01-01

    Interest in addressing the ethical issues related to adolescents’ engagement in research, especially sexual and reproductive health and rights (SRHR) research is increasing in view of the need to design and implement research that address peculiar SRHR needs of adolescents. These needs include issues of sexually transmitted infections, HIV, AIDS, adverse pregnancy outcomes, community, family and relationship violence and mental health. Unfortunately, adolescents’ voluntary participation in research has been limited due to their perceived potential to be coerced into participation, and concerns that they may not fully comprehend the issues related to research risks. As such, many of the regulations for engaging research participants have been defined by age rather than due consideration of psychological development. This paper examines the various potential ethical issues that may impact on decision making when adolescents are engaged in research. These include the need to minimise therapeutic misconception, considerations for recruitment and retention, types and amounts for reimbursement, and engagement of communities of adolescents on advisory boards of studies that involve their population. The potential challenges associated with recruitment of adolescents in early child marriages were also highlighted. PMID:26050384

  16. A ‘Mystery Client’ Evaluation of Adolescent Sexual and Reproductive Health services in Health Facilities from Two Regions in Tanzania

    PubMed Central

    Mchome, Zaina; Richards, Esther; Nnko, Soori; Dusabe, John; Mapella, Elizabeth; Obasi, Angela

    2015-01-01

    Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people’s access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region) trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning). The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers’ mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people’s efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed. PMID:25803689

  17. Association Between Availability and Quality of Health Services in Schools and Reproductive Health Outcomes Among Students: A Multilevel Observational Study

    PubMed Central

    Robinson, Elizabeth; Lawler, Catriona; Bagshaw, Sue; Farrant, Bridget; Bell, Fionna; Dawson, Dianne; Nicholson, Diana; Hart, Mo; Fleming, Theresa; Ameratunga, Shanthi; Clark, Terryann; Kekus, Maria; Utter, Jennifer

    2012-01-01

    Objectives. We determined the association between availability and quality of school health services and reproductive health outcomes among sexually active students. Methods. We used a 2-stage random sampling cluster design to collect nationally representative data from 9107 students from 96 New Zealand high schools. Students self-reported whether they were sexually active, how often they used condoms or contraception, and their involvement in pregnancy. School administrators completed questionnaires on their school-based health services, including doctor and nursing hours per week, team-based services, and health screening. We conducted analyses using multilevel models controlling for individual variables, with schools treated as random effects. Results. There was an inverse association between hours of nursing and doctor time and pregnancy involvement among sexually active students, with fewer pregnancies among students in schools with more than 10 hours of nursing and doctor time per 100 students. There was no association between doctor visits, team-based services, health screening, and reproductive health outcomes. Conclusions. School health services are associated with fewer pregnancies among students, but only when the availability of doctor and nursing time exceeds 10 hours per 100 students per week. PMID:22897539

  18. Advancing the sexual and reproductive health and human rights of women living with HIV

    PubMed Central

    Loutfy, Mona; Khosla, Rajat; Narasimhan, Manjulaa

    2015-01-01

    Introduction Many women living with HIV can have safe, healthy and satisfying sexual and reproductive health, but there is still a long way to go for this to be a reality, especially for the most vulnerable amongst them who face repeated violations of their rights. Discussion The contributions in this Supplement from researchers, clinicians, programme managers, policy makers, and women living with HIV demands an important appreciation that the field of sexual and reproductive health and human rights for women living with HIV is complex on many levels, and women living with HIV form a very diverse community. Conclusions The manuscripts emphasize that attention must be paid to the following critical dimensions: 1) Placing human rights and gender equality at the centre of a comprehensive approach to health programming, in particular in relation to sexuality and sexual health; 2) Ensuring health systems responsiveness to minimizing inequalities in access to health care and quality of care that often do not meet the needs of women living with HIV; 3) Engaging and empowering women living with HIV in the development of policies and programmes that affect them; and 4) Strengthening monitoring, evaluation and accountability procedures to provide good quality data and ensuring remedies for violations of health and human rights of women living with HIV. PMID:26643465

  19. Measuring improvements in sexual and reproductive health and rights in sub-Saharan Africa.

    PubMed

    Seims, Sara; Khadduri, Rolla

    2012-12-01

    Recent studies on development aid from European donors revealed that their funding of the health sector in sub-Saharan Africa rarely includes performance measures suitable for tracking operational progress in improving sexual and reproductive health and rights. Analysis of health sector agreements verifies this. Particularly lacking are metrics related to four critically important areas: (1) reducing mortality and morbidity from unsafe abortion, (2) preventing and treating gender-based violence, (3) reducing unwanted pregnancies among the poorest women, and (4) reducing unwanted pregnancies among adolescents. During 2011 and the first half of 2012, the authors interviewed 85 experts in health service delivery, ministries of health, human rights, development economics and social science from sub-Saharan Africa, Europe and the United States. We asked them to identify measures to assess progress in these areas, and built on their responses to propose up to four practical performance measures for each of the areas, for inclusion in