| 1. Title: Mainstreaming early and exclusive breastfeeding for improving child survival. Author: Dadhich JP; Agarwal RK Source: Indian Pediatrics. 2009 Jan;46(1):11-7. Abstract: India is home to maximum number of under-five deaths and underweight children in the world. In 2006, for the first time, the number of children in the world dying before their fifth birthday fell below 10 million, to 9.7 million annually. South Asia's contribution to this figure was 3.1 million out of which 2.1 million deaths occurred in India i.e., 21 percent of the global burden of under five deaths. Most of these deaths occur during the neonatal period. A reduction in the number of deaths among the under-five children reflects the country's progress on the fourth Millennium Development Goal (MDG 4). About 55 million, or one-third of the world's underweight children under the age of five years, live in India. Malnutrition has been estimated to be an underlying cause of up to 50-60 percent of under five deaths. The number of young underweight children reflects the country's progress on the first Millennium Development Goal (MDG 1), which deals with eradication of extreme poverty and hunger. In India, the average annual rate of decline in malnutrition has been around 0.9% since 1990. Considerably accelerated progress is needed for India to meet its MDG target of halving the percentage of underweight children by 2015. Despite breastfeeding's numerous recognized advantages, early and exclusive breastfeeding rates in most states of the India are low. There are many gaps in policy and programs related to infant and young child feeding in India. The big challenge is how to mainstream IYCF counseling and support interventions to help women to succeed both in early and exclusive breastfeeding. The rationale for supporting a major program to protect, promote and support breastfeeding action, backed by a budgetary support, is compelling for our country. Child health and development policies should urgently address this major concern. Language: English Keywords: INDIA | RECOMMENDATIONS | HEALTH SURVEYS | MOTHERS | INFANT | BREASTFEEDING, EXCLUSIVE | CHILD SURVIVAL | MALNUTRITION | BODY WEIGHT | TIME FACTORS | POSTPARTUM PROGRAMS | LONGTERM EFFECTS | INTELLIGENCE | HIV PREVENTION | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | Asia, Southern | Asia | Developing Countries | Health | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Breastfeeding | Infant Nutrition | Nutrition | Survivorship | Length of Life | Mortality | Population Dynamics | Nutrition Disorders | Diseases | Physiology | Biology | Family Planning Programs | Family Planning | Personality | Psychological Factors | Behavior | HIV Infections | Viral Diseases | Disease Transmission Control | Prevention and Control Document Number: 331250 |
2.  Title: Epidemiology of non-alcoholic fatty liver disease in China. Author: Fan JG; Farrell GC Source: Journal of Hepatology. 2009 Jan;50(1):204-10. Abstract: Fatty liver (steatosis) is highly prevalent in China and is more often linked to obesity than to alcoholism. Among more affluent regions of China, the community prevalence of non-alcoholic fatty liver disease (NAFLD) is approximately 15%. With the increasing pandemic of obesity, the prevalence of NAFLD has approximately doubled in the past decade. The risk factors resemble those in other ethnic populations, but it is important to note that ethnic-specific definitions of central obesity, obesity and metabolic syndrome are more useful in assessment of Chinese people. The full range of histological manifestations of NAFLD has been demonstrated in Chinese patients, but to date hepatic severity is generally mild. In contrast to chronic hepatitis C, steatosis is less common in patients with chronic hepatitis B; it is associated with metabolic, and not viral factors and does not appear to affect disease severity. Although long-term outcomes of NAFLD in Chinese populations remain unclear, it may be a predictor of metabolic disorders, diabetes and cardiovascular disease. Public health interventions are therefore indicated to halt or reverse the national trend of obesity in China so as to improve liver as well as metabolic health. Language: English Keywords: CHINA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | ETHNIC GROUPS | PREVALENCE | HEPATIC EFFECTS | OBESITY | RISK FACTORS | CULTURE | LIPID METABOLIC EFFECTS | HEPATITIS | METABOLIC EFFECTS | LONGTERM EFFECTS | DIABETES | CARDIOVASCULAR EFFECTS | Asia, Eastern | Asia | Developing Countries | Research Methodology | Cultural Background | Population Characteristics | Demographic Factors | Population | Measurement | Physiology | Biology | Body Weight | Sociocultural Factors | Lipids | Viral Diseases | Diseases | Time Factors | Population Dynamics Document Number: 330390 |
| 3. Title: Long-term follow-up of a peer-led HIV/AIDS prevention program for married women in rural China. Author: Hong H; Ji GP; Ye DQ Source: International Journal of Gynaecology and Obstetrics. 2009 Apr 3; Abstract: Women are infected with HIV at increasing rates worldwide, and the incidence of new AIDS cases has been rising faster for women than for men. In China, rural married women may become infected with HIV and other sexually transmitted infections (STIs) when their husbands return home after working in cities. Studies have demonstrated that many married rural women know little about condom use or STIs, and that their low level of knowledge puts them at risk. Since HIV is mainly sexually transmitted and there is neither an effective vaccine nor a cure for HIV/AIDS, the most important way to control HIV/AIDS is to decrease high-risk sexual behavior by improving women's HIV/AIDS-related knowledge and attitudes. In 2007 and 2008, we conducted a follow-up study with 737 married women in North Anhui, China, to evaluate the long-term effects of a peer education program for married women. (excerpt) Language: English Keywords: CHINA | RESEARCH REPORT | KAP SURVEYS | FOLLOW-UP STUDIES | CURRENTLY MARRIED | WOMEN IN DEVELOPMENT | PEER EDUCATORS | RURAL POPULATION | PERSONS LIVING WITH HIV/AIDS | HIV PREVENTION | LONGTERM EFFECTS | CONDOM USE | KNOWLEDGE | ATTITUDES | Asia, Eastern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Marital Status | Nuptiality | Demographic Factors | Population | Economic Development | Economic Factors | Education | Population Characteristics | HIV Infections | Viral Diseases | Diseases | Time Factors | Population Dynamics | Risk Reduction Behavior | Behavior | Sociocultural Factors | Psychological Factors Document Number: 341463 |
| 4. Peer Reviewed Title: Effect of etonogestrel contraceptive implant (Implanon) on portal blood flow and liver functions. Author: Nasr A; Nafeh HM Source: Contraception. 2009 Mar;79(3):236-9. Abstract: BACKGROUND: This study was conducted to evaluate changes in portal blood flow and liver functions among women using Implanon for 2 years. STUDY DESIGN: Fifty healthy Implanon users were enrolled in this longitudinal study and followed up for 24 months. Portal blood flow, assessed by color Doppler; prothrombin time and concentration; serum albumin; bilirubin; gamma-glutamyl transferase (GGT); alanine aminotransferase (ALT); and aspartate aminotransferase (AST) were measured before and 24 months after insertion. RESULTS: After 24 months of Implanon insertion, there were no significant changes in portal blood flow, serum albumin, prothrombin time or concentration. However, there was a significant increase in serum levels of total and unconjugated bilirubin and GGT and a significant decrease in ALT and AST levels. All levels, however, remained within the normal range of values. CONCLUSIONS: Implanon use for 2 years does not seem to influence portal hemodynamics. Changes in serum levels of bilirubin, GGT, ALT and AST are unlikely to be of clinical significance. Language: English Keywords: EGYPT | RESEARCH REPORT | CLINICAL RESEARCH | LONGITUDINAL STUDIES | WOMEN IN DEVELOPMENT | CONTRACEPTIVE IMPLANTS | VASCULAR DISEASES | HEPATIC EFFECTS | LONGTERM EFFECTS | SERUM PROTEIN EFFECTS | THROMBOSIS | TIME FACTORS | BILIRUBINEMIA | Developing Countries | Africa, North | Africa | Research Methodology | Studies | Economic Development | Economic Factors | Contraceptive Methods | Contraception | Family Planning | Diseases | Physiology | Biology | Population Dynamics | Demographic Factors | Population | Hematological Effects | Hemic System | Thromboembolism | Embolism Document Number: 330053 |
| 5. Title: Polyelectrolyte polymer properties in relation to male contraceptive RISUG action. Author: Roy S; Ghosh D; Guha SK Source: Colloids and Surfaces. B, Biointerfaces. 2009 Feb 15;69(1):77-84. Abstract: RISUG a polyelectrolytic hydrogel (styrene maleic anhydride and dimethyl sulfoxide) has proven to be efficacious as a contraceptive for a long term when injected into the lumen of vas deferens. Currently it is in advanced phase III clinical trials in India. Present investigation analyzes the swelling characteristics of RISUG hydrogel in different pH buffers and various biological fluids to understand its retention in the vas deferens as reported in previous studies. Significant variation in degree of swelling and equilibrium swelling ratio with transformation of Fickian to non-Fickian mode of diffusion was observed with increased pH. This might be due to ionization of carboxylic groups at high pH resulting in increased electrostatic repulsive force and high osmotic pressure inside the hydrogel network affecting its physical cross-linking and increases the free volume. Conversely, at low pH the dissociation of carboxylic group is limited making the hydrogel more stable. Interaction with various biomolecules present in various biological fluids was also studied. SEM, AFM and FTIR were used to analyze the topological and structural parameters of the polymer in different mediums. Loosening of structure and increasing porosity with significant adsorption of various biomolecules was observed. AFM revealed a significant change in overall roughness of polymer surface on interaction with different biological fluids. These observations suggest that the swelling and increased roughness will lead to increased resistance to sperm movement in the vas deferens. Language: English Keywords: INDIA | RESEARCH REPORT | CLINICAL TRIALS | MEN | CONTRACEPTIVE AGENTS, MALE | LONGTERM EFFECTS | INJECTABLES | SPERM IMMOBILIZING AGENTS | Asia, Southern | Asia | Developing Countries | Clinical Research | Research Methodology | Demographic Factors | Population | Contraceptive Agents | Contraception | Family Planning | Time Factors | Population Dynamics | Contraceptive Methods | Spermicidal Contraceptive Agents Document Number: 330994 |
| 7. Peer Reviewed Title: Long-term oral contraceptive pills and postoperative pain management after laparoscopic excision of ovarian endometrioma: a randomized controlled trial. Author: Seracchioli R; Mabrouk M; Frasca C; Manuzzi L; Savelli L; Venturoli S Source: Fertility and Sterility. 2009 May 12; Abstract: OBJECTIVE: To evaluate postoperative long-term cyclic and continuous administration of combined oral contraceptive (OC) pills in preventing endometriosis-related pain recurrence. DESIGN: Prospective, randomized, controlled trial. SETTING: Tertiary care university hospital. PATIENT(S): Three hundred eleven women who underwent laparoscopic excision for symptomatic ovarian endometrioma. INTERVENTION(S): Patients were randomly divided into three groups: nonuser group receiving no therapy, and cyclic user group and continuous user group receiving low-dose, monophasic OC pills for 24 months in either cyclic or continuous administration. MAIN OUTCOME MEASURE(S): Presence and intensity of dysmenorrhea, dyspareunia, and chronic pelvic pain were assessed by a 10-point visual analogue scale (VAS) at 6, 12, 18, and 24 months postoperatively. RESULT(S): A significant reduction in recurrence rate and VAS scores for dysmenorrhea was evident in the continuous users versus the other groups at 6 months, and in cyclic users versus nonusers at 18 months postoperatively. No significant differences in recurrence rate and VAS scores for dyspareunia and chronic pelvic pain were demonstrated among the groups. The increase of VAS scores from 6-24 months during the study period for dysmenorrhea, dyspareunia, and chronic pelvic pain was significantly higher in nonusers than in the other groups. CONCLUSION(S): Long-term postoperative use of OC pills can reduce the frequency and the severity of recurrent endometriosis-related dysmenorrhea. Language: English Keywords: ITALY | RESEARCH REPORT | CLINICAL TRIALS | WOMEN | LONGTERM EFFECTS | PAIN | GYNECOLOGIC SURGERY | POSTOPERATIVE PROCEDURES | LAPAROSCOPY | OVARIAN CANCER | ORAL CONTRACEPTIVES, COMBINED | ANALGESIA | ENDOMETRIAL CANCER | ENDOMETRIOSIS | DYSMENORRHEA | Developed Countries | Europe, Southern | Europe | Clinical Research | Research Methodology | Demographic Factors | Population | Time Factors | Population Dynamics | Signs and Symptoms | Diseases | Urogenital Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Cancer | Neoplasms | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Menstruation Disorders Document Number: 341141 |
| 8. Peer Reviewed Title: DOES FAMINE HAVE A LONG-TERM EFFECT ON COHORT MORTALITY? EVIDENCE FROM THE 1959-1961 GREAT LEAP FORWARD FAMINE IN CHINA. Author: Song S Source: Journal of Biosocial Science. 2009 Mar 23;41:469-491. Abstract: SummaryUsing retrospective individual mortality records of three cohorts of newborns (1954-1958, 1959-1962 and 1963-1967) from a large national fertility survey conducted in 1988 in China, this paper examines the effect of being conceived or born during the 1959-1961 Great Leap Forward Famine on postnatal mortality. The results show strong evidence of a short-term (period) effect of the famine, caused directly by starvation or severe malnutrition during the period of the famine. After controlling for period mortality fluctuation, however, the famine-born cohort does not show higher mortality than either the pre-famine or the post-famine cohort. Aggregate-level cross-temporal comparisons using published cohort population counts from China's 1982 Census, 1990 Census, 1995 micro-Census, 2000 Census and 2005 micro-Census lead to the same conclusion. The relevance of these new findings for the 'fetal origins' hypothesis and the selection effect hypothesis is discussed. Language: English Keywords: CHINA | RESEARCH REPORT | COHORT ANALYSIS | RETROSPECTIVE STUDIES | FERTILITY SURVEYS | LONGITUDINAL STUDIES | POPULATION | POLITICAL SYSTEMS | FAMINE | LONGTERM EFFECTS | MORTALITY | DEATH RATE | CENSUS | Asia, Eastern | Asia | Developing Countries | Research Methodology | Studies | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Political Factors | Sociocultural Factors | Food Supply | Natural Resources | Environment | Time Factors | Population Statistics Document Number: 341482 |
| 9. Title: Oral contraceptive use and incident urinary incontinence in premenopausal women. Author: Townsend MK; Curhan GC; Resnick NM; Grodstein F Source: Journal of Urology. 2009 May;181(5):2170-5. Abstract: PURPOSE: Recent data in postmenopausal women indicate that current and past use of exogenous hormones is related to urinary incontinence risk. Little is known about exogenous hormones and risk of urinary incontinence in younger women. We investigated the association between oral contraceptive pills and incident urinary incontinence in premenopausal women enrolled in the Nurses' Health Study II. MATERIALS AND METHODS: Participants reported use of oral contraceptive pills from 1989 to 2001. Among 21,864 premenopausal women 37 to 54 years old reporting no urinary incontinence in 2001 we identified 749 with incident urinary incontinence at least weekly between 2001 and 2003. Odds ratios and 95% confidence intervals were estimated using multivariable logistic regression. RESULTS: Women who had ever used oral contraceptive pills had a statistically significant 27% (95% CI 1-59) increased odds of experiencing urinary incontinence at least weekly compared with those who never used oral contraceptive pills. In women with 10 or more years of use the odds ratio increased to 1.48 (95% CI 1.13-1.95). Ever using oral contraceptive pills was specifically associated with urgency urinary incontinence (OR 2.48, 95% CI 1.07-5.76) rather than stress urinary incontinence (OR 1.04, 95% CI 0.78-1.40). Although we had limited information on urinary tract infection, control for urinary tract infection did not alter these findings. CONCLUSIONS: Use of oral contraceptive pills may be associated with a modest increase in the odds of urinary incontinence among premenopausal women. However, this is one of the first reports of such an association and, thus, further research is needed to confirm our findings and investigate possible mechanisms. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | LONGITUDINAL STUDIES | STATISTICAL REGRESSION | WOMEN | PREVALENCE | CONTRACEPTIVE USAGE | ORAL CONTRACEPTIVES, SIDE EFFECTS | UROGENITAL EFFECTS | LONGTERM EFFECTS | CONTRACEPTIVE SAFETY | Developed Countries | North America | Americas | Research Methodology | Studies | Data Analysis | Demographic Factors | Population | Measurement | Contraception | Family Planning | Safety | Public Health | Health | Urogenital System | Physiology | Biology | Time Factors | Population Dynamics Document Number: 331234 |
| 10. Title: Discordant immunologic and virologic responses to antiretroviral therapy and associated mortality in a large treatment program in Rwanda [letter] Author: van Griensven J; Zachariah R; Rasschaert F; Reid T Source: Journal of Acquired Immune Deficiency Syndromes. 2009 Apr 15;50(5):556-8. Abstract: Discordant responders and concordant nonresponders are a population at risk in low-income countries meriting targeted medical attention. Better understanding of the mechanisms underlying discordant responses would allow the design of management strategies to reduce associated mortality in low-income countries. With currently more than 3 million patients on highly active antiretroviral treatment in low-income countries, of whom, approximately 1 in 3 (30%) might be discordant responders who are at relatively high risk of death even while on ART, this issue is of high relevance to clinical management and public health. (excerpt) Language: English Keywords: RWANDA | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | LONGITUDINAL STUDIES | PERSONS LIVING WITH HIV/AIDS | URBAN POPULATION | ANTIRETROVIRAL THERAPY | DEATH RATE | IMMUNOLOGICAL EFFECTS | VIRAL DISEASES | LONGTERM EFFECTS | USER COMPLIANCE | AGE FACTORS | SEX FACTORS | Africa, Central | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Studies | HIV Infections | Diseases | Population Characteristics | Demographic Factors | Population | HIV | Mortality | Population Dynamics | Immunity | Immune System | Physiology | Biology | Time Factors | Behavior Document Number: 331233 |
11.  Title: The state of female youth in northern Uganda: Findings from the Survey of War-Affected Youth (SWAY) Phase II. Author: Annan J; Blattman C; Carlson K; Mazurana D Source: [Medford, Massachusetts], Tufts University, Feinstein International Center, 2008 Apr. [109] p. Abstract: The Survey for War Affected Youth (SWAY) is a research program dedicated to evidence-based humanitarian aid and development. SWAY employs new data, tools, and analysis to improve the design and targeting of protection, assistance, and reintegration programs for youth in northern Uganda. Youth have been both the primary victims and the primary actors in the protracted war between the Government of Uganda (GoU) and the Lord's Resistance Army (LRA). It is not clear, however, exactly who is suffering, how much, and in what ways. We also have little sense of the magnitude, incidence, and nature of the violence, trauma, and suffering of youth in northern Uganda. Our understanding of the effects of war on women and girls is especially lacking, whether they abducted or impacted in other ways. Government and NGO officials admit that they have little sense of the true scale of the problems facing young women and the proportion of females facing particular vulnerabilities. As a result, programming is based on immediate and observable needs and possibly erroneous assumptions about who requires assistance and what assistance they need. Likewise, with only rough measures of well-being available, targeting of services has been crude. The overarching purpose of SWAY is to work with service providers to generate better evidence-based programming. This report begins with a section describing methodology, before proceeding to theme-focused sections. As peace talks being brokered by the Government of Southern Sudan offer the prospect of an end to one of Africa's longest conflicts, we conclude by offering specific recommendations to the GoU and international and local agencies operating in northern Uganda. (excerpt) Language: English Keywords: UGANDA | TECHNICAL REPORT | SURVEYS | ADOLESCENTS, FEMALE | YOUTH | INTERNALLY DISPLACED PERSONS | WAR | VIOLENCE | STRESS | LONGTERM EFFECTS | PSYCHOLOGICAL FACTORS | LIVELIHOOD | EDUCATIONAL STATUS | MENTAL HEALTH | SEXUAL EXPLOITATION | NEEDS ASSESSMENT | RECOMMENDATIONS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Sampling Studies | Studies | Research Methodology | Adolescents | Age Factors | Population Characteristics | Demographic Factors | Population | Settlement and Resettlement | Migration | Population Dynamics | Political Factors | Sociocultural Factors | Behavior | Time Factors | Resources | Organization and Administration | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Health | Evaluation Document Number: 327510 |
| 12. Title: Health and civil war in rural Burundi. Author: Bundervoet T; Verwimp P; Akresh R Source: Brighton, United Kingdom, University of Sussex, Institute of Development Studies, Micro Level Analysis of Violent Conflict [MICROCON], 2008 Apr. 50 p. (MICROCON Research Working Paper No. 5) Abstract: We combine household survey data with event data on the timing and location of armed conflicts to examine the impact of Burundi's civil war on children's health status. The identification strategy exploits exogenous variation in the war's timing across provinces and the exposure of children's birth cohorts to the fighting. After controlling for province of residence, birth cohort, individual and household characteristics, and province-specific time trends, we find an additional month of war exposure decreases children's height for age z-scores by 0.047 standard deviations compared to non-exposed children. The effect is robust to specifications exploiting alternative sources of exogenous variation. (author's) Language: English Keywords: BURUNDI | RESEARCH REPORT | KAP SURVEYS | CHILD HEALTH | WAR | TIME FACTORS | MALNUTRITION | GROWTH | LONGTERM EFFECTS | BODY HEIGHT | AGE FACTORS | ECONOMIC FACTORS | MICROECONOMIC FACTORS | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Sampling Studies | Studies | Research Methodology | Health | Political Factors | Sociocultural Factors | Population Dynamics | Demographic Factors | Population | Nutrition Disorders | Diseases | Child Development | Biology Document Number: 326623 |
| 13. Peer Reviewed Title: Five-year outcomes of initial patients treated in Botswana's National Antiretroviral Treatment Program. Author: Bussmann H; Wester CW; Ndwapi N; Grundmann N; Gaolathe T; Puvimanasinghe J; Avalos A; Mine M; Seipone K; Essex M; Degruttola V; Marlink RG Source: AIDS. 2008 Nov 12;22(17):2303-11. Abstract: BACKGROUND: Antiretroviral treatment (ART) initiatives have now been established in many sub-Saharan African countries showing early benefits. To date, few results are available concerning long-term clinical outcomes in these treatment programs. METHODS: Response to ART is described in the first HIV-1C-infected adults enrolled in the Botswana Antiretroviral Treatment Program in 2002. Data analysis was conducted on available longitudinal data up to 1st April 2007. RESULTS: Six hundred thirty-three severely immunodeficient patients with a median CD4+ cell count of 67 cells/microl were initiated on non-nucleoside reverse transcriptase inhibitor-based combination ART and followed for a median of 41.9 months. The median CD4+ cell count increases were 169, 302, and 337 cells/microl at 1, 3, and 5 years, respectively. The percentages of patients with a viral load of less than 400 copies/ml at 1, 3, and 5 years were 91.3, 90.1, and 98.3%, respectively. Seventy-five percent of patients did not miss a single, or missed only one, monthly ART pickup per year with a mean pickup rate of 92.5%. The Kaplan-Meier survival estimates [95% confidence interval (CI)] at 1, 3, and 5 years were 82.7% (81.2 and 84.3%), 79.3% (77.6 and 81.0%), and 79.0% (77.3 and 80.7%), respectively. At 6 months, the risk of treatment modification for anemia was 6.94% (5.9 and 8.0%) for cutaneous hypersensitivity reactions, 1.3% (0.8 and 1.7%), and 1.1% (0.7 and 1.6%) for hepatotoxicity. CONCLUSION: This initial group of adults on ART in Botswana had excellent sustained immunologic, virologic, and clinical outcomes for up to 5 years of follow-up with low mortality among those surviving into the second year of ART. Language: English Keywords: BOTSWANA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | LONGTERM EFFECTS | LONGITUDINAL STUDIES | PERSONS LIVING WITH HIV/AIDS | ADULTS | PREVALENCE | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | ANEMIA | HEPATIC EFFECTS | TOXICITY | NEUROLOGIC EFFECTS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Time Factors | Population Dynamics | Demographic Factors | Population | Studies | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Age Factors | Population Characteristics | Measurement | HIV | Behavior | Physiology | Biology Document Number: 330278 |
| 14. Peer Reviewed Title: Long-term follow-up study on peer-led school-based HIV/AIDS prevention among youths in Shanghai. Author: Cai Y; Hong H; Shi R; Ye X; Xu G; Li S; Shen L Source: International Journal of STD and AIDS. 2008 Dec;19(12):848-850. Abstract: To determine both the short- and long-term effects of a peer education program, the authors conducted a follow-up study to evaluate the related knowledge, attitudes, and intended behavior related to HIV/AIDS among senior high-school students in Shanghai, China. They selected 1,950 students from 10 senior high schools, from whom 968 students were selected at random for the intervention group and 982 students for the control group. The same questionnaires were given to both groups before the intervention, one month after, and one year later. In the intervention group, the knowledge score on reproductive health, HIV/AIDS, and sexually transmitted infection rose from 21.66 to 31.72 one month later. After one year it was still 30.97. After both the one month and one-year follow-up intervention, the authors also found that more students declared that they would use condoms during sexual intercourse than did students in the control group. No change was seen in either knowledge or behavior intention in the control group. These results showed that peer education on HIV/AIDS prevention among high-school students is both effective in promoting knowledge and in changing behavior intention over the long term. Language: English Keywords: CHINA | RESEARCH REPORT | KAP SURVEYS | LONGITUDINAL STUDIES | FOLLOW-UP STUDIES | CASE CONTROL STUDIES | PEER EDUCATORS | ADOLESCENTS | HIV PREVENTION | LONGTERM EFFECTS | SCHOOL-BASED SERVICES | KNOWLEDGE | ATTITUDES | SEX BEHAVIOR | CONDOM USE | Asia, Eastern | Asia | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Education | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Time Factors | Population Dynamics | Programs | Organization and Administration | Sociocultural Factors | Psychological Factors | Behavior | Risk Reduction Behavior Document Number: 328802 |
| 15. Peer Reviewed Title: Abortion and long-term mental health outcomes: a systematic review of the evidence. Author: Charles VE; Polis CB; Sridhara SK; Blum RW Source: Contraception. 2008 Dec;78(6):436-450. Abstract: Claims that women who have elective abortions will experience psychological distress have fueled much of the recent debate on abortion. It has been argued that the emotional sequelae of abortion may not occur until months or years after the event. Despite unclear evidence on such a phenomenon, adverse mental health outcomes of abortion have been used as a rationale for policy-making. We systematically searched for articles focused on the potential association between abortion and long-term mental health outcomes published between January 1, 1989 and August 1, 2008 and reviewed 21 studies that met the inclusion criteria. We rated the study quality based on methodological factors necessary to appropriately explore the research question. Studies were rated as Excellent (no studies), Very Good (4 studies), Fair (8 studies), Poor (8 studies), or Very Poor (1 study). A clear trend emerges from this systematic review: the highest quality studies had findings that were mostly neutral, suggesting few, if any, differences between women who had abortions and their respective comparison groups in terms of mental health sequelae. Conversely, studies with the most flawed methodology found negative mental health sequelae of abortion. Language: English Keywords: UNITED STATES OF AMERICA | LITERATURE REVIEW | METHODOLOGICAL STUDIES | CLINICAL RESEARCH | CASE CONTROL STUDIES | WOMEN | ABORTION | MENTAL HEALTH | POSTABORTION | PSYCHOLOGICAL FACTORS | EMOTIONS | LONGTERM EFFECTS | VALIDITY | SAMPLING ERRORS | Developed Countries | North America | Americas | Research Methodology | Studies | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Health | Reproduction | Behavior | Time Factors | Population Dynamics | Measurement | Error Sources Document Number: 326176 Notification |
| 16. Title: Abortion and mental health disorders: evidence from a 30-year longitudinal study. Author: Fergusson DM; Horwood LJ; Boden JM Source: British Journal of Psychiatry. 2008 Dec;193(6):444-51. Abstract: BACKGROUND: Research on the links between abortion and mental health has been limited by design problems and relatively weak evidence. AIMS: To examine the links between pregnancy outcomes and mental health outcomes. METHOD: Data were gathered on the pregnancy and mental health history of a birth cohort of over 500 women studied to the age of 30. RESULTS: After adjustment for confounding, abortion was associated with a small increase in the risk of mental disorders; women who had had abortions had rates of mental disorder that were about 30% higher. There were no consistent associations between other pregnancy outcomes and mental health. Estimates of attributable risk indicated that exposure to abortion accounted for 1.5% to 5.5% of the overall rate of mental disorders. CONCLUSIONS: The evidence is consistent with the view that abortion may be associated with a small increase in risk of mental disorders. Other pregnancy outcomes were not related to increased risk of mental health problems. Language: English Keywords: NEW ZEALAND | RESEARCH REPORT | LONGITUDINAL STUDIES | COHORT ANALYSIS | COMPARATIVE STUDIES | WOMEN | ABORTION | MENTAL DISORDERS | RISK FACTORS | LONGTERM EFFECTS | PREGNANCY OUTCOMES | Developed Countries | Oceania | Studies | Research Methodology | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Diseases | Biology | Time Factors | Population Dynamics | Pregnancy | Reproduction Document Number: 330067 Notification |
| 17. Peer Reviewed Title: Community factors affecting long-lasting impregnated mosquito net use for malaria control in Sri Lanka. Author: Fernando SD; Abeyasinghe RR; Galappaththy GN; Gunawardena N; Rajapakse LC Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2008 Nov;102(11):1081-8. Abstract: The Anti Malaria Campaign distributed approximately 300,000 long-lasting impregnated nets (LLINs) to malaria-endemic areas in Sri Lanka during the years 2005 to 2007. We conducted a community-based cross-sectional survey among 2467 households distributed among the three major ethnic groups of Sri Lanka to study the perceptions and practices with regard to the use of LLINs in order to improve their use. In a majority of households the number of LLINs available was not sufficient for the number of people, although there was a small percentage of households that had excess nets. The information and advice given at the time of distribution regarding use of the nets differed amongst the three groups and was not consistent. Dissemination of this knowledge within the family was not observed. A relationship between knowledge regarding LLINs and reported practices on washing and drying of LLINs was found. It was noted that net shape may influence net use, with cone shaped nets being more popular. Efforts to increase knowledge on LLINs using behaviour change communication techniques would have more effectively contributed to achieve planned outcomes. Proper use of LLINs will undoubtedly contribute to further reduction of malaria in Sri Lanka. Language: English Keywords: SRI LANKA | RESEARCH REPORT | KAP SURVEYS | LONGITUDINAL STUDIES | CROSS SECTIONAL ANALYSIS | COMMUNITY | HOUSEHOLDS | MALARIA PREVENTION | BED NETS | PESTICIDES | LONGTERM EFFECTS | PERCEPTION | BEHAVIOR | KNOWLEDGE | ATTITUDES | Developing Countries | Asia, Southern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Residence Characteristics | Population Distribution | Geographic Factors | Population | Family and Household | Sociocultural Factors | Malaria | Parasitic Diseases | Diseases | Parasite Control | Public Health | Health | Ingredients and Chemicals | Time Factors | Population Dynamics | Demographic Factors | Psychological Factors Document Number: 330407 |
| 18. Peer Reviewed Title: The long-term social and economic impact of HIV on the spouses of infected individuals in northern Malawi. Author: Floyd S; Crampin AC; Glynn JR; Mwenebabu M; Mnkhondia S Source: Tropical Medicine and International Health. 2008 Apr;13(4):1-12. Abstract: The objective was to assess the social and economic impact of HIV-related illness and death on the spouses of HIV-infected individuals. From population-based surveys in the 1980s in Karonga district, northern Malawi, 197 'index individuals' were identified as HIV-positive. A total of 396 HIV-negative 'index individuals' were selected as a comparison group. These individuals, and their spouses and children, were followed up in 1998-2000, in a retrospective cohort study. All analyses compared spouses of HIV-positive indexes with those of HIV-negative indexes. By 1998-2000, most marriages involving an HIV-positive index individual had ended in widowhood. Twenty-Six percent of the wives of HIV-positive index men experienced household dissolution precipitated by widowhood, compared with 5% of the wives of HIV-negative index men. Corresponding percentages for husbands of index women were 14% and 1%. Widow inheritance was uncommon. The remarriage rate among separated or widowed wives of HIV-positive index men was half that of such wives of HIV-negative index men. About 30% of surviving wives of HIV-positive index men were household heads at the time of follow-up, compared with 5% of such wives of HIV-negative index men. Almost all these women were widows who lost their husband when greater than 35 years old, and they had relatively few household assets. The social and economic impact of HIV on the spouses of HIV-infected individuals in rural northern Malawi is substantial. Interventions that strengthen society's ability to absorb and support widows and widowers, and their dependents, without necessarily involving the traditional coping mechanism of remarriage, are essential. (author's) Language: English Keywords: MALAWI | RESEARCH REPORT | RETROSPECTIVE STUDIES | COHORT ANALYSIS | HIV | PERSONS LIVING WITH HIV/AIDS | SPOUSE | SOCIOECONOMIC FACTORS | PSYCHOSOCIAL FACTORS | LONGTERM EFFECTS | FAMILY RELATIONSHIPS | MARRIAGE PATTERNS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Family Characteristics | Family and Household | Sociocultural Factors | Economic Factors | Behavior | Time Factors | Population Dynamics | Demographic Factors | Population | Marriage | Nuptiality Document Number: 324189 |
| 19. Peer Reviewed Title: The effects of unintended pregnancy on infant, child, and parental health: A review of the literature. Author: Gipson JD; Koenig MA; Hindin MJ Source: Studies in Family Planning. 2008 Mar;39(1):18-38. Abstract: This article provides a critical review of studies assessing the effects of unintended pregnancy on the health of infants, children, and parents in developed and developing countries. A framework for determining and measuring the pathways between unintended pregnancy and future health outcomes is outlined. The review highlights persistent gaps in the literature, indicating a need for more studies in developing countries and for further research to assess the impact of unintended pregnancy on parental health and long-term health outcomes for children and families. The challenges in measuring and assessing these health impacts are also discussed, highlighting avenues in which further research efforts could substantially bolster existing knowledge. (author's) Language: English Keywords: GLOBAL | RESEARCH REPORT | LITERATURE REVIEW | PREGNANCY, UNPLANNED | PREGNANCY, UNWANTED | LONGTERM EFFECTS | INFANT HEALTH | CHILD HEALTH | MATERNAL HEALTH | FERTILITY PREFERENCES | MEASUREMENT | TIME FACTORS | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Health | Research Methodology Document Number: 324221 |
| 20. Peer Reviewed Title: Attitudes of women in Scotland to contraception: a qualitative study to explore the acceptability of long-acting methods. Author: Glasier A; Scorer J; Bigrigg A Source: Journal of Family Planning and Reproductive Health Care. 2008 Oct;34(4):213-7. Abstract: BACKGROUND AND METHODOLOGY: Long-acting reversible contraception (LARC) (i.e. injections, implants and intrauterine methods) has the potential to reduce unintended pregnancies but in the UK these methods are under-used. To inform a campaign planned to increase awareness of LARC, eight focus discussion groups were held with 55 women in two cities in Scotland, UK. Trained interviewers sought spontaneous views of unintended pregnancy and contraception in general, and condoms and pills in particular, and attitudes towards health professionals giving contraceptive advice. Attitudes towards LARC were discussed both before and after women were given detailed information about the methods. RESULTS: Women recognised the importance of using contraception but admitted to taking risks. Pills and condoms were familiar and acceptable despite undesirable side effects. Women were poorly informed about LARC, had firm but incorrect beliefs about their safety and side effects, disliked any method which involved an invasive procedure and/or vaginal examination, and had rather a low opinion of advice given by health professionals. Accurate information was not wholly successful in dispelling negative views of LARC. DISCUSSION AND CONCLUSIONS: Many factors influence contraceptive choice. Attitudes towards methods are complex and may be difficult to change. Some barriers to LARC, including the need to see a health professional, cannot be overcome but giving more information about ease of use, reversibility, effects on weight and the positive experiences of other women, as well as describing these methods as lasting rather than long-acting, may help improve acceptability. Language: English Keywords: SCOTLAND | RESEARCH REPORT | FOCUS GROUPS | WOMEN | ATTITUDES | SATISFACTION | LONGTERM EFFECTS | CONTRACEPTIVE IMPLANTS | INJECTABLES | IUD | CAMPAIGNS | KNOWLEDGE | BELIEFS | CONTRACEPTIVE SAFETY | CONTRACEPTIVE AGENTS, SIDE EFFECTS | Developed Countries | United Kingdom | Europe, Western | Europe | Data Collection | Research Methodology | Demographic Factors | Population | Psychological Factors | Behavior | Time Factors | Population Dynamics | Contraceptive Methods | Contraception | Family Planning | Communication Programs | Communication | Sociocultural Factors | Culture | Safety | Public Health | Health | Contraceptive Agents Document Number: 329394 |
| 21. Peer Reviewed Title: Effects of prolonged and exclusive breastfeeding on child behavior and maternal adjustment: Evidence from a large, randomized trial. Author: Kramer MS; Fombonne E; Igumnov S; Vanilovich I; Matush L Source: Pediatrics. 2008 Mar;121(3):e435-e440. Abstract: The objective of this study was to assess the long-term effects of breastfeeding on child behavior and maternal adjustment. We followed up children who were in the Promotion of Breastfeeding Intervention Trial, a cluster-randomized trial of a breastfeeding promotion intervention based on the World Health Organization/United Nations Children's Fund Baby-Friendly Hospital Initiative. A total of 17 046 healthy, breastfeeding mother-infant pairs were enrolled from 31 Belarussian maternity hospitals and affiliated polyclinics; 13 889 (81.5%) were followed up at 6.5 years. Mothers and teachers completed the Strengths and Difficulties Questionnaire and supplemental questions bearing on internalizing and externalizing behavioral problems. Mothers also responded to questions concerning their relationships to their partner and child and their breastfeeding of subsequently born children. The experimental intervention led to a large increase in exclusive breastfeeding at 3 months (43.3% vs 6.4%) and a significantly higher prevalence of any breastfeeding at all ages up to and including 12 months. No significant treatment effects were observed on either the mother or the teacher Strengths and Difficulties Questionnaire ratings of total difficulties, emotional symptoms, conduct problems, hyperactivity, peer problems, or prosocial behavior or on the supplemental behavioral questions. We found no evidence of treatment effects on the parent's marriage or on the mother's satisfaction with her relationships with her partner or child, but the experimental intervention significantly increased the duration of any breastfeeding, and mothers in the experimental group were nearly twice as likely to breastfeed exclusively the next-born child for at least 3 months. On the basis of the largest randomized trial ever conducted in the area of human lactation, we found no evidence of risks or benefits of prolonged and exclusive breastfeeding for child and maternal behavior. Breastfeeding promotion does, however, favorably affect breastfeeding of the subsequent child. (author's) Language: English Keywords: BELARUS | RESEARCH REPORT | CLINICAL TRIALS | CHILDREN | BREASTFEEDING | INTERVENTIONS | INFANT NUTRITION | LONGTERM EFFECTS | CHILD DEVELOPMENT | BEHAVIOR | Developing Countries | Europe, Eastern | Europe | Clinical Research | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition | Health | Programs | Organization and Administration | Time Factors | Population Dynamics | Biology Document Number: 324223 |
| 22. Title: The impact and cumulative effects of intimate partner abuse during pregnancy on health-related quality of life among Hong Kong Chinese women. Author: Lau Y; Wong DF; Chan KS Source: Midwifery. 2008 Mar;24(1):22-37. Abstract: The objective was to explore the prevalence of intimate partner abuse during pregnancy and to examine the effect and cumulative effects of different types of intimate partner abuse on health-related quality of life. A retrospective, cross-sectional, comparative design was used for the study. The setting used was three postnatal wards of a university-affiliated regional public hospital in Hong Kong. The participants were a community-based sample (n = 1200) of postnatal women. The women were identified as abused or non-abused using the Abuse Assessment Screen Questionnaire (AAS), and various types of abuse were elaborated using the Revised Conflict Tactics Scale (CTS-2). The Medical Outcomes Study Short-form 36 Health Survey (SF-36) measured the health-related quality of life. The prevalence rate of intimate partner abuse during pregnancy was 134 out of 1200 (11.2%, 95% confidence interval [CI] 9.4-13.0%). They consisted of an only psychologically abused group (32.1%, 95% CI 24.2-40.0%), an only physically abused group (20.9%, 95% CI 14.0-27.8%), and a combined psychological and physically abused group (47.0%, 95% CI 38.5-55.5%). Over half of the women (53.0%, 95% CI 44.5-61.5%) experienced more than one type of abuse. Women who had experienced different types of intimate partner abuse were associated with lower scores in the majority of domains and the subscales of the SF-36 (p less than 0.05), and there was a cumulative effect of abuse on the health-related quality of life of the women. The problem of intimate partner abuse during pregnancy is similar to most Western countries, and the negative effect of different types of such abuse on the health-related quality of life over time seems to be cumulative. Implications for practice: the relatively poor health-related quality of life of the abused women highlights the necessity of developing a checklist or a structured questionnaire that will assist in the detection of different types and combinations of intimate partner abuse, and that will be helpful in the development of more effective preventive interventions or programmes. (author's) Language: English Keywords: HONG KONG | RESEARCH REPORT | RETROSPECTIVE STUDIES | CROSS SECTIONAL ANALYSIS | POSTPARTUM WOMEN | PREGNANCY | VIOLENCE AGAINST WOMEN | PREVALENCE | LONGTERM EFFECTS | HEALTH | QUALITY OF LIFE | Asia, Eastern | Asia | Developed Countries | Studies | Research Methodology | Puerperium | Reproduction | Domestic Violence | Crime | Social Problems | Sociocultural Factors | Measurement | Time Factors | Population Dynamics | Demographic Factors | Population | Social Welfare | Economic Factors Document Number: 324225 |
| 23. Title: Spontaneous perforated pyometra with an intrauterine device in menopause: a case report. Author: Li CH; Chang WC Source: Japanese Journal of Infectious Diseases. 2008 Nov;61(6):477-8. Abstract: Spontaneous perforation of the uterus is rare and only several cases have been reported in the English medical literature. Most of the patients had gynecological malignancy and almost all were associated with cervical occlusion. We report a case of diffuse peritonitis resulting from spontaneously perforated pyometra with an intrauterine device (IUD) inserted for more than two decades. This case differs from others in that the cervical canal was not occluded. In the absence of other possible causes of uterine perforation, the etiology in this case is mostly likely hemorrhagic necrosis related to the long-term IUD. Language: English Keywords: TAIWAN | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | WOMEN IN DEVELOPMENT | MENOPAUSE | UTERINE PERFORATION | IUD COMPLICATIONS | PERITONEAL DISEASES | CERVICAL EFFECTS | LONGTERM EFFECTS | Asia, Eastern | Asia | Developed Countries | Research Methodology | Studies | Economic Development | Economic Factors | Reproduction | Perforations | Diseases | IUD | Contraceptive Methods | Contraception | Family Planning | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Time Factors | Population Dynamics | Demographic Factors | Population Document Number: 329813 |
| 24. Peer Reviewed Title: The long-term effects of intimate partner violence on adolescent mothers' depressive symptoms. Author: Lindhorst T; Oxford M Source: Social Science and Medicine. 2008 Mar;66(6):1322-1333. Abstract: Adolescent mothers are at high risk of experiencing intimate partner violence (IPV) which may increase their likelihood of depressive symptoms in adulthood, yet little is known about the long-term effects of IPV on adolescent mothers' trajectories of depressive symptoms. The study reported here uses prospective data spanning 14 years from a study of 229 adolescent mothers from Washington State, USA to evaluate the effects of adolescent exposure to IPV on the trajectories of depressive symptoms over time, as well as the likelihood of depressive symptoms at age 28 years. After controlling for levels of economic insecurity, the results indicate that adolescent IPV and an early vulnerability to depression were significantly related to the intercept, but not the slope of the adult depressive symptom trajectories. Both cumulative and concurrent IPV predicted the likelihood of depressive symptoms at age 28 years. Follow-up analyses indicate that adolescent IPV is associated with greater levels of adult IPV, and that women who report both adolescent and adult IPV have the highest mean levels of depressive symptoms. These findings suggest that exposure to IPV in adolescence may alter the life course of young women, increasing their risk for continuing exposure to intimate partner violence in adulthood and its concomitant negative mental health effects. Efforts aimed at prevention and early intervention in IPV among adolescent mothers are important components of the clinical care of young mothers. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | PROSPECTIVE STUDIES | LONGITUDINAL STUDIES | ADOLESCENTS, FEMALE | MOTHERS | VIOLENCE AGAINST WOMEN | DEPRESSION | POVERTY | RISK FACTORS | LONGTERM EFFECTS | MENTAL HEALTH | Developed Countries | North America | Americas | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Domestic Violence | Crime | Social Problems | Mental Disorders | Diseases | Socioeconomic Factors | Economic Factors | Biology | Time Factors | Population Dynamics | Health Document Number: 324158 |
| 25. Title: Combined oral contraceptive use and epithelial ovarian cancer risk: Time-related effects. Author: Lurie G; Wilkens LR; Thompson PJ; McDuffie KE; Carney ME Source: Epidemiology. 2008 Mar;19(2):237-243. Abstract: Although the protective effect of oral contraceptives (OCs) use against epithelial ovarian cancer is well-established, there remain gaps in our understanding of the contributions of time-related characteristics of OC use to risk. This population-based case-control study, carried out in Hawaii and Los Angeles 1993-2006, included 813 cases of epithelial ovarian cancer and 992 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression. Epithelial ovarian cancer risk was reduced 5 or more years after initiation of OC use (OR = 0.18; CI = 0.08-0.39). Each year of use provided a 5% reduction (CI = 2%-8%) in risk. A positive gradient in risk with time since first OC use was independent of duration of OC use. The inverse association of OCs with risk was attenuated decades after last use, but was not affected by age at first or last use. OC use for less than 1 year was associated with decreased ovarian cancer risk (OR = 0.45; CI = 0.26-0.79) only among recent users (less than or equal to 20 years from diagnosis/interview). Women who used OCs for a year or more were protected for at least 3 decades after they stopped use. Reduction in epithelial ovarian cancer risk associated with OC use became apparent after a short latency period and short duration of use, and was long-lasting. Time since first use and time since last use seem to modify the association of OCs with ovarian cancer risk independently of duration of use. (author's) Language: English Keywords: UNITED STATES OF AMERICA | HAWAII | CALIFORNIA | RESEARCH REPORT | WOMEN | OVARIAN CANCER | ORAL CONTRACEPTIVES | RISK FACTORS | TIME FACTORS | LONGTERM EFFECTS | Developed Countries | North America | Americas | Demographic Factors | Population | Cancer | Neoplasms | Diseases | Contraceptive Methods | Contraception | Family Planning | Biology | Population Dynamics Document Number: 325019 |
| 26. Peer Reviewed Title: Women's awareness of long-acting, reversible contraceptive methods (LARCs) in community family planning clinics and general practice. Author: Mansour D; Rosales C; Cox M Source: European Journal of Contraception and Reproductive Health Care. 2008 Dec;13(4):396-9. Abstract: OBJECTIVES: To investigate whether awareness and choice of long-acting reversible contraceptives (LARCs) of women attending a community family planning clinic differ from those of women seeing general practitioners (GPs). METHODS: Information was collected from women in their reproductive years about their current contraceptive method, their awareness of LARCs and whether they felt well informed about their options. After additional information was provided the respondents were asked whether they would consider changing their method and if their GP offered this option. RESULTS: Questionnaires were completed by 177 women attending a city-centre contraception and sexual health (CASH) clinic (n = 96) and a GP's surgery in a neighbouring city (n = 81). Forty percent of women in the CASH cohort and 6% in the primary care group were using LARCs. Women attending the CASH service were more aware of their contraceptive options and felt better informed but less than 50% in either group had heard of the levonorgestrel-releasing intrauterine system. At least 50% of women would consider using a LARC yet few knew if their GP fitted/provided these methods. CONCLUSION: LARC usage was considerably higher in CASH services compared to primary care. Those providing contraceptive care should give up-to-date information covering all methods and referral to local specialist services, as appropriate. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | KAP SURVEYS | COMPARATIVE STUDIES | WOMEN | KNOWLEDGE | COMMUNITY HEALTH SERVICES | FAMILY PLANNING CENTERS | LONGTERM EFFECTS | REVERSIBILITY | CONTRACEPTIVE METHODS | CONTRACEPTIVE AVAILABILITY | CONTRACEPTIVE METHOD SWITCHING | LEVONORGESTREL | IUD, HORMONE RELEASING | Developed Countries | Europe, Western | Europe | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Sociocultural Factors | Primary Health Care | Health Services | Delivery of Health Care | Health | Health Facilities | Time Factors | Population Dynamics | Family Planning | Contraception | Contraceptive Usage | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | IUD Document Number: 331100 |
| 27. Peer Reviewed Title: The cost-effectiveness of long-acting reversible contraceptive methods in the UK: Analysis based on a decision-analytic model developed for a National Institute for Health and Clinical Excellence (NICE) clinical practice guideline. Author: Mavranezouli I Source: Human Reproduction. 2008;23(6):1338-1345. Abstract: Long-acting reversible contraceptive (LARC) methods are highly effective in preventing unintended pregnancies. However, their uptake is low in much of the developed world. This study aimed at assessing the cost-effectiveness of LARC methods from the British National Health Service (NHS) perspective. A decision-analytic model was constructed to estimate the relative cost-effectiveness of the copper intrauterine device (IUD), the levonorgestrel intrauterine system (LNG-IUS), the etonogestrel subdermal implant and the depot medroxyprogesterone acetate injection (DMPA). Comparisons with the combined oral contraceptive pill (COC) and female sterilization were also performed. Effectiveness data were derived from a systematic literature review. Costs were based on UK national sources and expert opinion. LARC methods dominated COC (i.e. they were more effective and less costly). Female sterilization dominated LARC methods beyond 5 years of contraceptive protection. DMPA and LNG-IUS were the least cost-effective LARC methods. The incremental cost-effectiveness ratio of implant (most effective LARC method) versus IUD (cheapest LARC method) was pound13 206 per unintended pregnancy averted for 1 year of use and decreased until implant dominated IUD in 15 years. Discontinuation was a key determinant of the cost-effectiveness of LARC methods. LARC methods are cost-effective from the British NHS perspective. Practices improving user satisfaction and continuation of LARC method use should be identified and promoted. (author's) Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | WOMEN | CONTRACEPTIVE METHODS | IUD | COST EFFECTIVENESS | LONGTERM EFFECTS | PREGNANCY, UNWANTED | FEMALE STERILIZATION | Developed Countries | Europe, Western | Europe | Demographic Factors | Population | Contraception | Family Planning | Evaluation Indexes | Quantitative Evaluation | Evaluation | Time Factors | Population Dynamics | Reproductive Behavior | Fertility | Sterilization, Sexual Document Number: 326850 |
| 28. Peer Reviewed Title: Long-term immunologic response to antiretroviral therapy in low-income countries: a collaborative analysis of prospective studies. Author: Nash D; Katyal M; Brinkhof MW; Keiser O; May M; Hughes R; Dabis F; Wood R; Sprinz E; Schechter M; Egger M Source: AIDS. 2008 Nov 12;22(17):2291-302. Abstract: BACKGROUND: Few data are available on the long-term immunologic response to antiretroviral therapy (ART) in resource-limited settings, where ART is being rapidly scaled up using a public health approach, with a limited repertoire of drugs. OBJECTIVES: To describe immunologic response to ART among ART patients in a network of cohorts from sub-Saharan Africa, Latin America, and Asia. STUDY POPULATION/METHODS: Treatment-naive patients aged 15 and older from 27 treatment programs were eligible. Multilevel, linear mixed models were used to assess associations between predictor variables and CD4 cell count trajectories following ART initiation. RESULTS: Of 29 175 patients initiating ART, 8933 (31%) were excluded due to insufficient follow-up time and early lost to follow-up or death. The remaining 19 967 patients contributed 39 200 person-years on ART and 71 067 CD4 cell count measurements. The median baseline CD4 cell count was 114 cells/microl, with 35% having less than 100 cells/microl. Substantial intersite variation in baseline CD4 cell count was observed (range 61-181 cells/microl). Women had higher median baseline CD4 cell counts than men (121 vs. 104 cells/microl). The median CD4 cell count increased from 114 cells/microl at ART initiation to 230 [interquartile range (IQR) 144-338] at 6 months, 263 (IQR 175-376) at 1 year, 336 (IQR 224-472) at 2 years, 372 (IQR 242-537) at 3 years, 377 (IQR 221-561) at 4 years, and 395 (IQR 240-592) at 5 years. In multivariable models, baseline CD4 cell count was the most important determinant of subsequent CD4 cell count trajectories. CONCLUSION: These data demonstrate robust and sustained CD4 response to ART among patients remaining on therapy. Public health and programmatic interventions leading to earlier HIV diagnosis and initiation of ART could substantially improve patient outcomes in resource-limited settings. Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | LONGITUDINAL STUDIES | MULTIVARIATE ANALYSIS | PERSONS LIVING WITH HIV/AIDS | LONGTERM EFFECTS | ANTIRETROVIRAL THERAPY | HIV INFECTIONS | IMMUNOLOGICAL EFFECTS | IMMUNITY, CELLULAR | SEX FACTORS | TIME FACTORS | Research Methodology | Studies | Data Analysis | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Population Dynamics | Demographic Factors | Population | HIV | Immunity | Immune System | Physiology | Biology | Population Characteristics Document Number: 330279 |
| 29. Peer Reviewed Title: Update on female sterilisation: Report from an international symposium on considerations for assessing long-term failure rates. Author: O'Brien S; Gupta J; Najia S; Yehia M Source: Journal of Family Planning and Reproductive Health Care. 2008;34(1):13-18. Abstract: The 6th International Scientific Meeting of the Royal College of Obstetricians and Gynaecologists (RCOG) took place in September 2005 in Cairo, Egypt. During the meeting, a sponsored symposium entitled 'The changing face of female sterilisation: meeting the needs of the 21st century woman' (sponsored by Femcare-Nikomed Ltd, manufacturer of the Filshie clip) provided an overview of the different methods of long-term contraception with a focus on female sterilisation. Here we report the main observations of the symposium, including recommendations for factors that should be considered when assessing the long-term failure rates associated with female sterilisation. Over the past few decades, rapid advances in technology have allowed the development of a number of different contraceptive methods that are available for use today. The choice of contraception is influenced by a number of factors, including age, sexual lifestyle, relationship type, family status and medical history. In addition, as part of the necessary counselling of any family planning programme, it is essential that provision of unbiased accurate information be provided so that women can make informed decisions on long-term contraception. (excerpt) Language: English Keywords: GLOBAL | LITERATURE REVIEW | CONFERENCES AND CONGRESSES | FEMALE STERILIZATION | LONGTERM EFFECTS | CONTRACEPTION FAILURE | CONTRACEPTIVE EFFECTIVENESS | CONTRACEPTIVE SAFETY | LAPAROSCOPY | HYSTEROSCOPY | Sterilization, Sexual | Family Planning | Time Factors | Population Dynamics | Demographic Factors | Population | Contraceptive Usage | Contraception | Safety | Public Health | Health | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 323462 |
| 30. Title: Effect of highly active antiretroviral therapy on CD4 count and weight in AIDS patients seen at the UITH, Ilorin. Author: Olawumi HO; Olatunji PO; Salami AK; Odeigah L; Iseniyi JO Source: Nigerian Journal of Clinical Practice. 2008 Dec;11(4):312-5. Abstract: OBJECTIVE: To determine the response on treatment-naive HIV/AIDS patients to the Highly Active Antiretroviral Therapy (HAART) in terms of CD4 Count and Weight gain over a period of 2 1/2 years. METHODS: Patients with Acquired Immunodeficiency Syndrome (AIDS) were recruited under the Federal Government Highly Active Antiretroviral Therapy (HAART) programme at the University of Ilorin Teaching Hospital. The treatment regimen included Lamivudine, Starvudine and Nevirapine. The patients' responses were evaluated with respect to CD4 count and weight over the period of treatment. The diagnosis of HIV/AIDS was made on the basis of reactivity with two different ELISA reagents, and CD4 count was done with Dynal T4 Quant method. The weights (kg.) of the patients were taken at monthly visit. RESULTS: The duration of treatment for the patients analysed ranged from 1 month to 14 months. Analysis of CD4 count was possible in 105 patients. The mean post treatment CD4 count and weight were significantly higher than the pre-treatment values (p < 0.001 and p < 1.01) respectively. There were significant positive correlations (p < 0.05 and p < 0.001) between increases in CD4 count and weight respectively, and duration of treatment. In eight (8) patients, CD4 Count reduced or remained the same in spite of treatment. CONCLUSION: The HAART regime is associated with increase in CD4 Count and weight gain. While increases in CD4 Count and weight correlated with duration of therapy, there was no correlation between CD4 Count increase and weight gain. Language: English Keywords: NIGERIA | RESEARCH REPORT | CLINICAL RESEARCH | LONGITUDINAL STUDIES | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | AIDS PREVENTION | GOVERNMENT PROGRAMS | BODY WEIGHT | TIME FACTORS | LONGTERM EFFECTS | Developing Countries | |