After Cairo: women's reproductive and sexual health, rights, and empowerment.
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Biomedical subjects
Publications and source records attributed to A G Rosenfield.
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There are a number of important ethical issues involved in the area of women's reproductive health care. Only a few of these could be covered in this short paper. Abortion is perhaps the most controversial issue of all and raises a number of ethical issues related to the rights of the woman versus the rights of the fetus. Since abortion is legal in the United States, the issue of the role of the obstetrician-gynecologist is discussed, particularly as related to the shortage of physicians willing to perform the procedure and the paucity of abortion training in obstetrics/gynecology residency programs. Other issues discussed include teen pregnancy, contraceptive research and pharmaceutical company contraceptive pricing strategies, high rates of maternal mortality in the developing world and human immunodeficiency virus and acquired immunodeficiency syndrome among women and children.
The authors used the Center for Epidemiological Studies Depression Scale to measure the level of depressive symptoms in a self-referred clinic population whose socioeconomic status was low. They found that the population suffered a high degree of depression and that the diagnosis of major affective syndrome predominated. The depression scale used was found to be a good indicator of probable depression in this population. The authors suggest further investigation of the linkage between socioeconomic status and affective disorder.
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Analyses made of the pattern and frequency of visits to the intensive care nursery by mothers of 78 very low birth weight (< 1,500 grams) infants found initial visiting rates to be low, averaging less than 1 visit per week. Visits increased during the early part of the infant's hospitalization. However, visits of mothers whose infants received an early stimulation program continued to increase until the infant was discharged. Visiting was found to be uncorrelated with medical, socioeconomic, or demographic variables, but was apparently related to the significantly higher state levels exhibited by stimulated infants.
Previous investigators have reported unfavorable neurologic and developmental outcome of small-for-gestational age (SGA) infants (birth weight less than 1,500 grams born at term or at less than 30 weeks. of gestation. Since obstetrical considerations for the delivery of a SGA fetus often arise between 30 and 38 weeks, the outcome of these survivors becomes a relevant issue. In 1975 and 1976, twenty-eight of 47 such infants survived and 21 were followed sequentially during the first two years. Their birth weight was 1,220 +/- 195 grams (mean +/- S.D.) and the gestation 33.4 +/- 2 weeks. Each SGA infant was paired with a birth weight-matched appropriate-for-gestation (AGA) infant whose birth weight was 1,195 +/- 190 grams and gestation 29 +/- 2 weeks. The weight, length, and head circumference of the SGA infants attained the tenth percentile by 6 to 8 months and were similar to the AGA group. Quarterly neurologic examinations showed similar findings during the first year in the two groups. At 2 years, two SGA (diplegia) and one AGA (hemiplegia) infants were abnormal. The quarterly Bayley scores of the SGA infants were lower during the first 18 months but at 24 months, the two groups had similar scores. The favorable outcome in preterm SGA infants weighing less than 1,500 grams may serve as useful information in making clinical decisions for the management of mothers with suspected intrauterine growth retardation.
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While oral contraceptives have been widely available in rural Thailand since their distribution by lower level paramedical health workers was authorized in 1970, the IUD has been restricted to large, urban clinics staffed by physicians. A study was conducted in 1972-73 to evaluate the performance of nurse-midwives in IUD (Copper T) insertion and to assess the reaction of acceptors and the likely effects on the National Family Planning Program. It was found that nurse-midwives were competent to insert Copper Ts and handle early complications. Acceptor continuation rates were very high and nurse-midwife acceptors clearly preferred IUD insertion by a female health worker. Programmatic evidence suggests that using nurse-midwives more extensively for Copper T insertion would increase IUD acceptance at no cost to the existing loop program.
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To assess the psycholinguistic and perceptual aspects of their differential performance, 12 normal and 12 learning disabled children in elementary school were tested on a visual-motor task, both with and without an added verbal component. No differences were found for motor performance in any condition, but significant differences were found for linguistic performance during the combined task. The power of linguistic performance during the combined task to serve as a means of diagnosis for learning disabilities was explained as an indication of delayed development of the ability to superimpose process upon process.
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