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PubMed2005

[Quality criteria and indicators of women's health care].

In this article, quality criteria and indicators of the basic care of the woman's health are presented with emphasis on the sexual and reproductive health that can be used in the management of supervision practices. In its elaboration, formulations regarding the evaluating practice, the managerial work, the full care to the woman's health (sexual and reproductive) are taken into consideration, besides proposals of the Health Ministry for monitoring the attention to this specific group. It focuses mainly on care and vigilance actions as to the women's health and on organizational and managerial aspects of such care.

Adolescent↗
PubMed1987

[Personal hygiene and sex education of young girls].

Sexual education of girls and guidance for their personal hygiene are closely related. In preventive checkups as well as in the course of each and every consultation, the physician has an opportunity to discuss reproductive health issues first with the mother and then with the daughter. As far as the hygiene of the reproductive organs is concerned, the doctor will find that his initiative is necessary and useful. It contributes to the prevention of diseases and simultaneously to sexual education, because it teaches the girls that these organs are as important and worth to be taken care of as every other part of their body. The physician should provide a model in giving advice on a comfortably uninhibited, yet considerate approach to the own body and, more specifically, to reproductive health care.

Adolescent↗
PubMed1986

Reproductive hazards in the workplace: a case study of women firefighters.

Recent attention has focused on the difficulties of providing equal employment opportunities for women while ensuring reproductive health in the workplace. This paper examines the potential hazards faced by pregnant firefighters and recommends a policy that seeks a reasonable accommodation between employment and fetal and maternal health. The potential hazards faced by firefighters include physical exertion, hyperthermia, and exposure to carbon monoxide and other toxic gases. The ideal policy option for improving reproductive health is to make the workplace safe for all employees. Where this cannot be accomplished and a unique reproductive hazard exists to women during pregnancy, temporary positions should be found that remove the pregnant woman from the hazard while allowing her to continue work.

Abnormalities, Drug-Induced↗
PubMed1998

Human immunodeficiency virus infection and women: a survey of missed opportunities for testing and diagnosis.

OBJECTIVE: Our purpose was to describe factors that prompted testing of women infected with the human immunodeficiency virus and health encounters in which missed opportunities for diagnosis occurred. STUDY DESIGN: An observational investigation of 81 human immunodeficiency virus-infected women in the Chicago area was performed by means of an interviewer-administered survey. Patient demographic data, health history, and health care contacts were elicited. RESULTS: Sixty-five women (80%) had at least one documented missed opportunity during the 12 months before their diagnosis. Seventy-eight percent of those women with missed opportunities had them occur at reproductive health encounters. Of 25 pregnant women pregnant in the year before their eventual diagnosis, 12 failed to be diagnosed during that pregnancy. CONCLUSION: Despite visits to reproductive health care providers, the presence of symptoms suspicious for human immunodeficiency virus disease, high-risk behaviors, and even specific requests for testing by many of the women, numerous opportunities for the earlier diagnosis of human immunodeficiency virus infection were missed.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Effectiveness of a genetics self-instructional module for nurses involved in egg donor screening.

OBJECTIVE: To evaluate the effectiveness of a self-instructional module in increasing nurses' knowledge of genetics. DESIGN: Pretest/posttest study design. Participants completed a pretest questionnaire used to measure baseline knowledge of basic human genetic concepts and risk assessment and collect descriptive data. Participants then reviewed a self-instructional module and completed a posttest questionnaire. SETTING: Study materials were mailed to 262 registered nurses involved in screening egg donors at 177 reproductive health centers in the United States from July to September 2000. PARTICIPANTS: Sixty-five registered nurses working at reproductive health centers. One hundred of 262 eligible nurses completed the pretest (38% return rate) and 65 of these 100 nurses also completed the posttest (65% retention rate). INTERVENTION: A 22-page self-instructional booklet on genetic risk assessment. MAIN OUTCOME MEASURES: Pretest and posttest responses. RESULTS: There was a significant increase of 20.8% in participants' mean knowledge score on the posttest (M = 89.0%, SD = 8%, range = 67%-100%) as compared with the pretest (M = 69.0%, SD = 12%, range = 42%-92%), based on paired t-test analysis (t = 11.74, SE = 0.426, p < .0001). CONCLUSION: A genetics self-instructional module for registered nurses was effective in increasing knowledge of basic human genetic concepts and risk assessment. More in-depth independent study programs in genetics for nurses are recommended.

Curriculum↗
PubMed2006

Assessment of attitudes towards assisted reproduction: a survey among medical students and parous women.

BACKGROUND: The present paper explores attitudes towards different aspects of assisted reproductive technologies among parous women and future doctors (third- and fourth-year medical students). METHODS: We anonymously surveyed 200 parous women who had at least three infants and had given birth at Kuopio University Hospital, and 200 medical students of Kuopio University. RESULTS: The overall response rate was 45%. Most of the medical students were childless (95.7%), unmarried (63.8%), and younger (24 vs. 35 years) compared with the parous women (p < 0.001). Medical students were liberal in questions of who has the right to get infertility treatment: 49% of them would allow the possibility to lesbian couples, 43% to homosexual couples and over 50% to single women. Over 40% of medical students would allow the use of a surrogate mother for lesbian and homosexual couples; the number was under 20% in the group of parous women. Their setting of priorities within the field of reproductive health also showed differences in prostate cancer screening, doctor's appointments for contraception, abortion and menopausal hormone replacement therapy. CONCLUSIONS: Medical students take a rather liberal stance on reproductive issues. On the other hand, baseline attitudes among medical students reveal some degree of subjectivism when it comes to allocation of scarce healthcare resources within the field of reproductive health. Medical education faces a challenge in ensuring that future physicians are able to set priorities and balance resources between preventive medicine and management of specific medical conditions, and to base their attitudes on evidence.

Adult↗
PubMedDate not supplied

[Publications on women, health and gender in Spain (1990-2005)].

BACKGROUND: The studies on women, gender and health are increasingly more frequent in Spain. This research is aimed at ascertaining the topics dealt with in these publications, the disciplines studying said topics, the sex of the leading author and whether these topics have been approached from a gender-related standpoint. METHODS: A search was conducted for published studies in Biomedicine, Sociology, Nursing, Anthropology and Psychology databases. The main key words used were [women or gender] and [health] and [Spain]. Original articles, reviews and monographic studies, both national and international, published within the 1990-2005 period were included. The variables taken into consideration were the topic of study, field of expertise, gender focus and sex of those publishing the work. A total of 298 works were included. RESULTS: The topics dealt with the most were sexual and reproductive health (39.2%) and mental health (12.4%). A total of 58.7% of the works were authored by a woman as the leading author and 47.3% had no gender focus. A total of 85.3% of the publications on sexual and reproductive health do not incorporate the gender standpoint, whilst 94.1% of the works on productive and reproductive work did however include this standpoint. A total of 80.4% of the works in Biomedicine have no gender focus. CONCLUSIONS: Even though they are scarce, the works having a gender focus are signed mostly by women as the leading authors. In the material studied, women's health continues to be confined to reproduction, it being necessary for other factors having a direct bearing on women's health to be included.

Bibliometrics↗
PubMed2002

Utility of participatory rural appraisal for health needs assessment and planning.

BACKGROUND: While poverty and lack of life opportunities are root causes of a high burden of disease and infant and maternal mortality, inadequate health care contributes heavily. Often those who are left without care are those who need it most. Existing health services are managed without taking into account acceptance and need perspectives. This further reduces the effectiveness of and equity in health care. In order to guide the planning of reproductive health services by a national NGO, health needs were assessed in a district in Sindh using a combination of participatory rural appraisal (PRA) and qualitative and quantitative research methods. PRA is considered as a better framework to assess, analyse and develop programs with communities. OBJECTIVE: The objective of PRA was to initiate community involvement and to understand the needs of health care from a community perspective. METHODOLOGY: PRA was conducted with groups of men and women from three rural areas in a district of Sindh, Pakistan using a life cycle framework. The community members identified various stages of their life with the associated health issues. RESULTS: This research was empowering to community members as it facilitated community involvement. The respondents took charge of the process of identification of health needs at PRA sessions. PRA helped identify health problems considered prevalent and important by the community. More importantly, it helped potential service providers and the community to initiate community involvement in planning. CONCLUSION: PRA is not only an effective tool for assessment and analysis of health issues but also a vehicle to promote community involvement. Additionally, participatory methods contribute to understand the context of quantitative data generated for planning purposes.

Adolescent↗
PubMed2005

Perception of peers' behaviour regarding sexual health decision making among female undergraduates in Anambra State, Nigeria.

BACKGROUND: High-risk sexual behaviours are prevalent in tertiary educational institutions in Nigeria, but little is known about the social influences that bear on the reproductive health decision-making and behaviour of the undergraduates. On the other hand, perceptions regarding the behaviour and influence of peers have been documented to be key social factors associated with reproductive health behaviour of young people. OBJECTIVE: This study aimed to assess the perception of Nigerian female undergraduate about sexual behaviours of their peers and the type of influence their peers tend to exert on them. METHOD: The study was cross-sectional in nature and involved 588 randomly selected unmarried female undergraduates in two tertiary institutions in Anambra state, Nigeria. The study instrument was a self-administered questionnaire. Data was analysed using Epi-Info statistical package. RESULTS: Three-quarters of respondents were between 15 and 24 years and the majority were from homes with formally educated parents (91.2 % of mothers and 93.9 % of fathers). Regarding sexual behaviour, 80.1% of respondents indicated that their age mates were already sexually active, and 92 % indicated that most of their friends had regular sexual partners. The use of condoms by sexually active friends was reported by 58.5 % of respondents. Almost half (47.1 %) of respondents indicated that they were under pressure by friends to engage in pre-marital sex, and 22.1 % indicated that the pressure was moderate or severe in degree. However, 64.6 % of respondents indicated that they would receive moderate or lots of support for their friends if they made the decision to abstain from sex. CONCLUSION: Perception of sexual behaviour of peers and the nature of the pressure that peers exert support pre-marital sex. It appears peers would also respect and support the decision of those that choose to practice sexual abstinence.

Adolescent↗
PubMed2005

An assessment of the awareness of sexual and reproductive rights among adolescents in south western Nigeria.

This study, conducted in Ikeja and Ikorodu Local Government Areas of Lagos State, examined the awareness of sexual and reproductive rights among adolescents in south-western Nigeria. A total of 600 in-school and out-of-school adolescents were interviewed using quantitative and qualitative methods. The study revealed that majority of the adolescents were aware of sexual and reproductive health rights (60.3% in Ikeja LGA and 62.3% in Ikorodu LGA) but lacked knowledge of contents of the rights. Majority of them in various categories (by school condition and type of settlement) were not aware of sexual and reproductive health programmes being implemented for adolescents. In addition, those who were aware of such intervention programmes could not access or use the services due to certain sociocultural barriers. The study recommends formulation of appropriate intervention strategies and programmes for adolescents so that they may be aware and knowledgeable of their sexual and reproductive rights.

Adolescent↗
PubMed2003

Sex differences in the experience of testing positive for genital chlamydia infection: a qualitative study with implications for public health and for a national screening programme.

OBJECTIVES: To explore men's and women's accounts of chlamydia testing, with a view to understanding sex differences in attitudes and in behaviours of public health importance. METHODS: Semistructured interviews with 24 heterosexual patients (12 men; 12 women) diagnosed with genital chlamydia infection, at a large sexual health clinic in central London were transcribed and analysed using qualitative thematic analysis. RESULTS: Participants' expressions revealed important sex differences. Women felt anxious about their future reproductive health, feared stigmatisation, and blamed themselves for contracting chlamydia; whereas men generally reported less concern, were unwilling to disclose their condition to sexual partners, and some men projected attributions of blame onto their partners. Delays in seeking care appeared to be related to perceptions of chlamydia as a relatively minor infection, particularly in men. CONCLUSIONS: Health promotion needs to reflect sex and age differences, emphasising the negative consequences of delayed clinic attendance and exposure to repeat infections. For health professionals to respond appropriately and effectively to increasing numbers of chlamydia infections, there is a need to understand men's avoidant attitudes and behaviours in relation to sexual and reproductive health.

Adolescent↗
PubMed1992

Do adolescents understand what physicians say about sexuality and health?

The high rates of adolescent sexual activity, often with adverse medical and social outcomes among minority females, prompted us to survey 160 girls between the ages of 13 and 18 concerning their knowledge of reproductive health terms, anatomy, and body functions. All were patients in a clinic in an inner-city hospital. We hypothesized that adolescents who were older, sexually active, and/or had received formal sex education would be better informed. We used a two-part, self-administered questionnaire. The first part focused on definitions of nine common medical and reproductive health terms; the second focused on definitions of unlabeled anatomic drawings of male and female genitourinary systems. The subjects' responses revealed their lack of information as well as a great deal of misinformation. No statistical differences in knowledge were found related to age, sexual activity status, or formal sex education. Many patients knew only nontechnical and slang terms and did not understand medical terms used by physicians in the clinic. Clinicians should not assume similar patients (minority and poor) know or understand their terminology and should use simple and, if necessary, explicit vocabulary.

Academic Medical Centers↗
PubMed2005

Abortion education in medical schools: a national survey.

OBJECTIVE: This survey was performed to examine the inclusion and extent of abortion education in US medical schools. STUDY DESIGN: A 3-item confidential survey requesting information about abortion education throughout the 4 years of medical school was mailed to the OB-GYN clerkship directors of the 126 accredited US medical schools. RESULTS: Seventy-eight surveys were returned, for a response rate of 62%. Overall, 17% of clerkship directors reported no formal education about abortion either in the preclinical or clinical years. In the third-year OB-GYN rotation, 23% reported no formal education, whereas 32% offered a lecture specifically about abortion. While 45% of third-year rotations offered a clinical experience, participation was generally low. About half of schools offered a fourth-year reproductive health elective, but few students participated. CONCLUSION: Abortion education is limited in US medical schools. As an integral part of women's reproductive health services, abortion education deserves a place in the curricula of all medical schools.

Abortion, Induced↗
PubMed2005

Andropause: invention, prevention, rejuvenation.

There is a growing interest, as well as a booming industry, in the use of testosterone therapy for middle-aged and older men. This interest has led to the definition of a new condition, termed 'andropause', meaning the putative somatic consequences of gradually falling blood testosterone concentrations during male aging. This trend risks replicating both the rejuvenation fads of a century ago and the recent experience in estrogen therapy for menopause that has been propelled for decades by advocacy substituting for reliable scientific evidence. The current status and prospects for androgen therapy in middle-aged and older men should be evaluated critically from the perspective of male reproductive health during aging. This review appraises current knowledge with a focus on the questionable basis for using androgen therapy to improve male reproductive health during aging.

Androgens↗
PubMed2006

Internal migration and contraceptive knowledge and use in Guatemala.

CONTEXT: Levels of modern contraceptive knowledge and use among people living in rural areas of Guatemala differ substantially from those of people living in urban areas. Understanding the pace and extent of rural-to-urban migrants' adoption of urban contraceptive practices is important in determining if there is a strong need for migrant-focused reproductive health programs. METHODS: Bivariate and multivariate analyses of data on 971 married male and female respondents in the 1999 Guatemalan Migration and Reproductive Health Survey were used to examine how migration status and duration of residence in an urban area are associated with knowledge of modern contraceptive methods and current contraceptive use. RESULTS: Migrants' contraceptive knowledge was positively associated with the number of years they had lived in an urban area. Mayan migrants in Guatemala City did not accumulate contraceptive knowledge at the same rate as non-Mayan migrants, perhaps due to cultural and linguistic barriers to obtaining knowledge of and access to contraceptives. Rural-to-urban migrants eventually achieve a level of modern contraceptive use slightly below that of urban nonmigrants, with the level of contraceptive knowledge being an important factor associated with use of modern methods. CONCLUSIONS: Migrants possess limited knowledge of modern contraceptive methods and, therefore, may experience unmet need for contraception or may have a limited choice of modern contraceptive methods during their first years in an urban destination. Programs designed to raise contraceptive awareness and use should target recent migrants--particularly indigenous Mayans--in urban areas.

Adolescent↗
PubMed1999

Effect of a monensin-controlled release capsule on cow health and reproductive performance.

Dry cows and pregnant heifers from 25 farms near Guelph, Ontario, Canada were enrolled in a large, double-blind, randomized clinical trial designed to evaluate the impact of monensin on energy metabolism, health, and production. A total of 503 cows was given monensin in controlled-release capsules, and 507 cows were administered placebo capsules 3 wk before expected calving date. The effects of treatment on health were evaluated using a logistic regression model. Treatment with monensin significantly reduced the incidence of abomasal displacement (OR = 0.41-0.84) and multiple illnesses (OR = 0.38-0.89). Monensin treatment tended to reduce the incidence of clinical ketosis (P = 0.11) and the risk of being culled (P = 0.09) in the first 94 d of lactation. Reproductive performance was analyzed with both a logistic regression model for conception rate and a survival analysis for days to first breeding and days from calving to conception. Treatment with monensin had no significant effect on any measure of reproductive performance.

Abomasum↗