| 1. Title: Quality-of-life assessment of family adopters through user perspectives in the District of Karimnagar. Author: Avasarala K Source: Indian Journal of Community Medicine. 2009 Jan;34(1):24-28. Abstract: Background: Small families adopting family planning are usually considered happy families. They are expected to lead a better qualitative life. Quality-of-life (QOL) is routinely assessed for knowing patients' health status. Recently, the QOL concept has become increasingly popular for evaluating the impact of public health interventions. Hitherto, QOL is usually assessed by means of program achievements or indicators, which may sometimes be misleading. Hence, the new culture of QOL assessment by means of user perspectives is now becoming popular. Research Questions: 1) Is the quality-of-life of family planning (FP) adopters better than that of non-FP adopters? 2) Are the user perspectives helpful in QOL assessment? Materials and Methods: A cross-sectional descriptive study was carried out among 50 FP adopting families and 50 non-FP adopting families from the village of Vutoor and the city of Karimnagar in Andhra Pradesh. Sampling Methods: Random sampling, Proportions and Chi square test. Results: Program perspectives revealed a better standard of living for FP adopters because they have amenities like housing, television, and vehicles and less mortality and morbidity (P < 0.001). However, they lack positive feelings towards life, general adaptation, personal relationships, and leisure opportunities. Finally, self-assessment by FP adopters themselves revealed no significant increase in their qualitative life after family planning (P = 0.05). Conclusions: While assessing the impact of a health program on quality-of-life, multiple methods of assessments including user perspectives are better than program indicators alone. Language: English Keywords: INDIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CLIENTS | FAMILY PLANNING | QUALITY OF LIFE | LIFE STYLE | SOCIOECONOMIC FACTORS | Asia, Southern | Asia | Developing Countries | Research Methodology | Program Activities | Programs | Organization and Administration | Social Welfare | Economic Factors | Behavior Document Number: 328705 |
2.  Peer Reviewed Title: Quality of life and social support among patients receiving antiretroviral therapy in Western Uganda. Author: Bajunirwe F; Tisch DJ; King CH; Arts EJ; Debanne SM; Sethi AK Source: AIDS Care. 2009 Mar;21(3):271-9. Abstract: Quality of life (QOL) among patients with HIV/AIDS has been shown to improve once treatment with antiretroviral therapy (ART) has been initiated. We conducted a cross-sectional study in Western Uganda to examine the factors associated with QOL among patients who had received ART for the duration of at least six months. We interviewed 330 patients attending the HIV/AIDS clinic at two government-supported hospitals in Western Uganda. We measured QOL using a culturally adapted version of the Medical Outcomes Study (MOS-HIV) tool and calculated the physical health summary (PHS) and mental health summary (MHS) scores. In addition, data were collected on sociodemographic factors, three-day self-reported adherence, social support, sexual behavior, CD4 count and viral load. Informational social support was significantly positively correlated with PHS (p=0.001) and MHS (p=0.002). Affectionate support was also significantly positively correlated to PHS (p=0.05) and MHS (p=0.03) but tangible support was not (PHS p value=0.85 and MHS p value=0.31). In the univariate analysis, older age, rural dwelling, alcohol use, CD4 count less than 200, and ART duration of less than one year were significantly associated with lower PHS scores. Lower PHS scores were also associated with sexual inactivity. In multivariate analysis, higher scores on informational social support and CD4> or =200 were associated with higher PHS score and past or recent alcohol consumption was associated with lower scores on MHS. Optimizing ART to restore CD4 count and provision of informational and affectionate social support but not tangible support, to HIV/AIDS patients may improve their QOL. Language: English Keywords: UGANDA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CLIENTS | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | HIV INFECTIONS | QUALITY OF LIFE | CARE AND SUPPORT | SEX BEHAVIOR | HEALTH | MENTAL HEALTH | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Program Activities | Programs | Organization and Administration | HIV | Viral Diseases | Diseases | Behavior | Social Welfare | Economic Factors | Health Services | Delivery of Health Care Document Number: 341987 |
| 3. Title: [Contraceptive compliance - why is contraceptive failure still so frequent?] Kontrazeptive Compliance - warum kommt es immer wieder zum Versagen der Author: Bitzer J Source: therapeutische Umschau. Revue therapeutique. 2009 Feb;66(2):137-43. Abstract: Contraceptive compliance is defined as the correct use (according to the method specific prescriptions given by a medical professional and/or in written form as patient information leaflet) of a contraceptive method. Non-compliance describes a mismatch between the real behaviour of a user and the correct or ideal behaviour. There are various indicators that in general contraceptive compliance is far from ideal. Many studies report a rate of unintended pregnancies of 50%, half of them terminating in abortion. The abortion rate remains high even in countries with availability of advanced contraceptive technology. Especially with hormonal contraception and barrier methods the gap between correct and real use is large. Discontinuation rates per year reach up to 50%. Reasons for Non Compliance are (a) Lack of motivation to prevent a pregnancy due to ambivalence regarding the wish for a child as well as sexual and relationship issues (b) Cognitive factors (False information, misconceptions, irrational fears) (c) Difficult or lacking access to contraceptive methods (d) Behavioral errors and mistakes (Forgetting, loosing etc.) and (e) Side effects of the methods used. Three strategies to improve compliance can be distinguished: (a) Improving counselling; (b) Developing contraceptive methods which demand a low level of compliant behaviour by the user; (c) Improving quality of life of users by minimizing the negative side effects and maximizing the non contraceptive health benefits. Language: German Keywords: BRAZIL | RESEARCH REPORT | CONTRACEPTION FAILURE | USER COMPLIANCE | PRESCRIPTIONS | CONTRACEPTIVE METHODS | QUALITY OF LIFE | PREGNANCY, UNPLANNED | CONTRACEPTIVE EFFECTIVENESS | Developing Countries | South America, Eastern | South America | Latin America | Americas | Contraceptive Usage | Contraception | Family Planning | Behavior | Distributional Activities | Program Activities | Programs | Organization and Administration | Social Welfare | Economic Factors | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population Document Number: 329568 |
| 4. Peer Reviewed Title: Do men and women with HIV differ in their quality of life? A study from south India. Author: Chandra PS; Satyanarayana VA; Satishchandra P; Satish KS; Kumar M Source: AIDS and Behavior. 2009 Feb;13(1):110-117. Abstract: This paper examined gender differences in Quality of Life (QOL) among people living with HIV/ AIDS in South India using the locally validated version of the WHO Quality of Life Instrument for HIV (WHOQOLHIV 120). Participants (N = 109) were men and women with HIV1 Clade C infection participating in a cohort study. There was no gender difference in CD4 counts or use of antiretroviral therapy. Of the 29 facets of QOL, men reported significantly higher QOL in the following facetspositive feeling, sexual activity, financial resources and transport, while women reported significantly higher QOL on the forgiveness and blame facet. Of the six domains of QOL, men reported better quality of life in the environmental domain while women had higher scores on the spirituality/religion and personal beliefs domain. Understanding these gender differences may provide potentially useful information for tailoring interventions to enhance QOL among people infected with HIV/AIDS. Language: English Keywords: INDIA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | SEX FACTORS | QUALITY OF LIFE | HIV | Developing Countries | Asia, Southern | Asia | HIV Infections | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Social Welfare | Economic Factors Document Number: 330154 |
| 5. Peer Reviewed Title: Induced abortion and intimate relationship quality in the Chicago Health and Social Life Survey. Author: Coleman PK; Rue VM; Coyle CT Source: Public Health. 2009 Apr;123(4):331-8. Abstract: OBJECTIVES: To examine associations between abortion and relationship functioning. STUDY DESIGN: Independent variables included abortion in a previous relationship and abortion in a current relationship. Perceptions of quality-of-life changes associated with terminating the relationship, conflict, aggressiveness and sexual dysfunction were the outcome measures. METHODS: Data were derived from interviews with an ethnically diverse urban sample of men (n=658) and women (n=906). Surveys were conducted in person using computer-assisted personal interview technology by the National Opinion Research Center affiliated with the University of Chicago, USA. RESULTS: For men and women, the experience of an abortion in a previous relationship was related to negative outcomes in the current relationship; perceptions of improved quality of life if the current relationship also ended and intimate partner violence. Experience of an abortion within a current relationship was associated with 116% and 196% increased risk of arguing about children for women and men, respectively. Among females, experience of an abortion within a current relationship was associated with increased risk for various forms of sexual dysfunction (122-182%), increased risk of arguments about money (75%), increased risk of conflict about the partner's relatives (80%), and increased risk of arguing about the respondent's relatives (99%). Men whose current partners had experienced an abortion were more likely to report jealousy (96% greater risk) and conflict about drugs (385% greater risk). CONCLUSION: Abortion may play a vital role in understanding the aetiology of relationship problems. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | COUPLES | ABORTION | DOMESTIC VIOLENCE | PHYSICAL ABUSE | QUALITY OF LIFE | Developed Countries | North America | Americas | Family Characteristics | Family and Household | Sociocultural Factors | Fertility Control, Postconception | Family Planning | Crime | Social Problems | Violence | Behavior | Social Welfare | Economic Factors Document Number: 341821 Notification |
| 6. Title: Consequences of thrombophilia screening for life quality in women before prescription of oral contraceptives and family members of VTE patients. Author: Eichinger S Source: Hamostaseologie. 2009 Feb;29(1):110-1. Abstract: A large number of hereditary and acquired alterations in the coagulation system that are associated with an increased risk of venous thrombosis have been described. Screening for these thrombophilic defects has become particularly popular in women before the prescription of oral contraceptives. The relevance of the results with regard to the management of the patients remains, however, to be questioned. In a recent review of six articles that were aimed to determine the nature and extent of psychological impact of thrombophilia screening, no valid conclusions could be drawn about the psychological impact due to heterogeneity of the data and lack of methodological accuracy. We performed a questionnaire-based study in 247 women with and in 132 women without factor V Leiden who were referred for factor V Leiden testing before oral contraceptive intake. A large proportion (76%) of the women reported being emotionally disturbed by genetic testing. 16% of women with wildtype factor V were discouraged from OC use, while 3% of women with factor V Leiden were encouraged to take OC. This indicates that recommendations after testing are not consistently driven by the test result, which compromises the quality of patient care. Given the large number of women who are taking oral contraceptives unequivocal guidelines for counseling prior to their prescription are urgently needed. These guidelines should integrate the risks and benefits of oral contraceptives but also the impact of screening on quality of life and aspects of counselling. Language: English Keywords: AUSTRIA | RESEARCH REPORT | WOMEN | ORAL CONTRACEPTIVES | COUNSELING | THROMBOSIS | RISK FACTORS | SCREENING | GENETIC TECHNIQUES | EMOTIONS | QUALITY OF LIFE | Developed Countries | Europe, Central | Europe | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Clinic Activities | Program Activities | Programs | Organization and Administration | Thromboembolism | Embolism | Vascular Diseases | Diseases | Health | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Laboratory Examinations and Diagnoses | Psychological Factors | Behavior | Social Welfare | Economic Factors Document Number: 329794 |
| 7. Peer Reviewed Title: Stress, needs, and quality of life of family members caring for adults living with HIV/AIDS in Taiwan. Author: Feng MC; Feng JY; Chen TC; Lu PL; Ko NY; Chen YH Source: AIDS Care. 2009 Apr;21(4):482-9. Abstract: The stress, needs and quality of life (QoL) of family members of people living with HIV/AIDS (PLWHA) are critical to explore in Taiwan where home care projects are not available to help the PLWHA families. We examined the extent of stress, needs, QoL and its correlates that family caregivers of PLWHA experienced with structural questionnaires survey. A total of 50 family caregivers of PLWHA visiting a medical center in Taiwan participated in the study from October 2005 to August 2006. Family caregivers felt most stressful on disclosure and stigma issues, and most worried about patients' interpersonal relationships. The most important needs were care-related needs including knowledge of the disease progression, methods of examination and treatment, and the related side effects. The level of stress significantly positively correlated with needs, and negatively correlated with QoL. Availability of alternative manpower to care PLWHA and being PLWHA's parents were two significant factors affecting family caregivers' QoL. In conclusion, family members of PLWHA experienced high level of stress, enormous caring needs, and poor QoL. A family-centered care for PLWHA and their families in the community is crucial to improve quality of care and to prevent family's overload, particularly for families with no alternative manpower and for those being PLWHA's parents. Language: English Keywords: TAIWAN | RESEARCH REPORT | STATISTICAL STUDIES | FRIENDS AND RELATIVES | PERSONS LIVING WITH HIV/AIDS | CARE AND SUPPORT | INTERPERSONAL RELATIONS | STRESS | QUALITY OF LIFE | NEEDS | STIGMA | INTERVIEWS | Asia, Eastern | Asia | Developed Countries | Studies | Research Methodology | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Health Services | Delivery of Health Care | Health | Behavior | Psychological Factors | Social Welfare | Economic Factors | Social Problems | Data Collection Document Number: 341833 |
| 8. Title: Humanizing HIV/AIDS and its (re)stigmatizing effects: HIV public 'positive' speaking in India. Author: Finn M; Sarangi S Source: Health. 2009 Jan;13(1):47-65. Abstract: Social stigma has been inextricably linked with HIV and AIDS since the epidemic erupted in the early 1980s. The stigma that has built up around HIV and AIDS is generally regarded as having a negative impact on the quality of life of HIV-positive people and on general prevention efforts. Current attempts to combat HIV-related stigma focus on increasing the acceptance of HIV among the stigmatizing public and stigmatized individuals alike. In this, the global HIV-positive community is being increasingly called upon to ;humanize' the virus, not least through public displays of HIV 'positive' health and public ;positive' speaking. This article critically explores the constitutive effects and inherent power relations of HIV Positive Speakers' Bureaus (PSBs) as a platform for such a display. Adopting a post-structuralist discourse analytic approach, we explore accounts of positive-speaking and HIV health from HIV-related non-government organizations in India and in PSB training manuals. In particular, we highlight ways in which positive-speaking in India can be seen to have significant (re)stigmatizing effects by way of ambivalent and hyper-real configurations of HIV 'positive' identity and life. Language: English Keywords: INDIA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | STIGMA | SOCIAL DISCRIMINATION | QUALITY OF LIFE | HIV INFECTIONS | AIDS | Asia, Southern | Asia | Developing Countries | Viral Diseases | Diseases | Social Problems | Sociocultural Factors | Social Welfare | Economic Factors Document Number: 331203 |
| 9. Peer Reviewed Title: Use of the Levonorgestrel-IUS in the treatment of menorrhagia: assessment of quality of life in Turkish users. Author: Gorgen H; Api M; Akca A; Cetin A Source: Archives of Gynecology and Obstetrics. 2009 Jun;279(6):835-40. Abstract: OBJECTIVE: The aim of the present study was to measure the treatment of menorrhagia and health-related quality of life (QoL) in Levonorgestrel-releasing intrauterine system (LNG-IUS) in Turkish women. MATERIALS AND METHODS: We recruited 66 premenopausal women, aged 26-55 years, who had sought care in the previous year for menorrhagia. All patients were asked to complete a visual analog scale (VAS) form regarding pelvic pain, sexual life (libido) and general feeling of health. Patients filled the VAS form before LNG-IUS insertion and after 6 months. RESULTS: After the 6-month visit, PBAC score was condirebly decreased (p < 0.001). Six (10%) of the 60 patients PBAC score was higher than 75. VAS score for pelvic pain decreased from baseline to 6-month follow-up (4.32-3.55), and the libido and general feeling of health increased (4.27-4.95 and 3.47-6.87, respectively). CONCLUSION: The LNG-IUS device in the trearment of menorrhagia has cost effective, less side effects and increse in the QoL. Language: English Keywords: TURKEY | RESEARCH REPORT | CLINICAL RESEARCH | CLIENTS | MENORRHAGIA | TREATMENT | IUD, HORMONE RELEASING | LEVONORGESTREL | IUD SIDE EFFECTS | QUALITY OF LIFE | PAIN | SEX BEHAVIOR | Europe, Southeastern | Europe | Developing Countries | Research Methodology | Program Activities | Programs | Organization and Administration | Menstruation Disorders | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | IUD | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Social Welfare | Economic Factors | Signs and Symptoms | Behavior Document Number: 342109 |
| 10. Peer Reviewed Title: Changing health status and health expectancies among older adults in China: gender differences from 1992 to 2002. Author: Gu D; Dupre ME; Warner DF; Zeng Y Source: Social Science and Medicine. 2009 Jun;68(12):2170-9. Abstract: Numerous studies document improvements in health status and health expectancies among older adults over time. However, most evidence is from developed nations and gender differences in health trends are often inconsistent. It remains unknown whether changes in health in developing countries resemble Western trends or whether patterns of health improvement are unique to the country's epidemiologic transition and gender norms. Using two nationally representative samples of non-institutionalized adults in China aged 65 years and older, this study investigates gender differences in the improvements in disability, chronic disease prevalence, and self-rated health from 1992 to 2002. Results from multivariate logistic regression models show that all three indicators of health improved over the 10-year period, with the largest improvement in self-rated health. With the exception of disability, the health of women improved more than men. Using Sullivan's decomposition methods, we also show that active life expectancy, disease-free life expectancy, and healthy life expectancy increased over this decade and were patterned differently according to gender. Overall, the findings demonstrate that China experienced broad health improvements during its early stages of the epidemiologic transition and that these changes were not uniform by gender. We discuss the public health implications of the findings in the context of China's rapidly aging population. Language: English Keywords: CHINA | RESEARCH REPORT | MULTIVARIATE ANALYSIS | ADULTS | GENDER ISSUES | LIFE EXPECTANCY | DISEASES | LIFE STYLE | QUALITY OF LIFE | DEMOGRAPHIC AGING | Asia, Eastern | Asia | Developing Countries | Data Analysis | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Sociocultural Factors | Length of Life | Mortality | Population Dynamics | Behavior | Social Welfare | Economic Factors Document Number: 342740 |
| 11. Title: In search of health: quality of life among postpartum Palestinian women. Author: Hammoudeh W; Mataria A; Wick L; Giacaman R Source: Expert Review of Pharmacoeconomics and Outcomes Research. 2009 Apr;9(2):123-32. Abstract: OBJECTIVES: The postpartum period is a very important period for the health of the mother and the newborn. Despite its importance, research on this period is limited and tends to be more focused on biomedical aspects of the postpartum period. In the Occupied Palestinian Territory, little is known regarding women's postpartum wellbeing. This study utilizes the Maternal Postpartum Quality-of-Life instrument to assess Palestinian women's postpartum quality of life and the factors associated with variations in their quality-of-life scores. METHODS: A cross-sectional survey utilizing the adapted Maternal Postpartum Quality-of-Life Questionnaire was completed in the Occupied Palestinian Territory with a final sample size of 1020 women. RESULTS: The mean overall quality-of-life score for the sample was 21.53 (maximum = 30), suggesting that women are slightly satisfied with their lives in the postpartum period. Main variations in quality-of-life scores were associated with regional district, refugee status, the loss of a relative due to Israeli occupation violence, standard of living and pregnancy wantedness. CONCLUSION: The results of this study highlight the diversity and complexity of the social context, in particular the region where women live, and the issue of pregnancy wantedness in postpartum quality of life. They also call into question the services currently offered to postpartum women. Language: English Keywords: WEST BANK | GAZA | RESEARCH REPORT | SAMPLING STUDIES | POSTPARTUM WOMEN | FRIENDS AND RELATIVES | QUALITY OF LIFE | QUESTIONNAIRES | CARE AND SUPPORT | STANDARD OF LIVING | SOCIOECONOMIC STATUS | Developing Countries | Middle East | Studies | Research Methodology | Puerperium | Reproduction | Family and Household | Sociocultural Factors | Social Welfare | Economic Factors | Health Services | Delivery of Health Care | Health | Socioeconomic Factors Document Number: 342478 |
| 12. Peer Reviewed Title: Improvement in quality-of-life questionnaire measures in obese adolescent females with polycystic ovary syndrome treated with lifestyle changes and oral contraceptives, with or without metformin. Author: Harris-Glocker M; Davidson K; Kochman L; Guzick D; Hoeger K Source: Fertility and Sterility. 2009 Sep 23; Abstract: We studied the effect of metformin or placebo in a lifestyle modification program combined with oral contraceptives (OC) on quality-of-life parameters measured by the polycystic ovary syndrome (PCOS) questionnaire in obese adolescent women with validated PCOS. The quality-of-life indicators were measured at baseline and conclusion for five domains on the PCOS questionnaire, with equal improvement in scores in both placebo and metformin groups, suggesting that the addition of metformin does not add improvement to quality-of-life measures above those observed with lifestyle modification and OC treatment. Language: English Keywords: BULGARIA | RESEARCH REPORT | QUESTIONNAIRES | ADOLESCENTS | QUALITY OF LIFE | LIFE STYLE | OVARIAN CYSTS | ORAL CONTRACEPTIVES | CHANGES | Developing Countries | Europe, Southeastern | Europe | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Social Welfare | Economic Factors | Behavior | Diseases | Contraceptive Methods | Contraception | Family Planning | Social Change | Sociocultural Factors Document Number: 342996 |
| 13. Title: Patterns of postnatal growth in HIV-infected and HIV-exposed children. Author: Isanaka S; Duggan C; Fawzi WW Source: Nutrition Reviews. 2009 Jun;67(6):343-59. Abstract: HIV infection can contribute to disturbances in both linear growth and weight gain in early childhood, with disturbances often apparent as early as 3 months of age. There is little evidence for a difference in the early growth of HIV-exposed but uninfected children compared to healthy controls. Owing to the close association of growth with immune function and clinical progression, an understanding of growth patterns may be an important tool to ensure the provision of appropriate care to HIV-infected and exposed children. Timely growth monitoring may be used to improve the clinical course and quality of life of these children. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | LONGITUDINAL STUDIES | CHILDREN | PERSONS LIVING WITH HIV/AIDS | EXPOSURE | HIV INFECTIONS | GROWTH | CHILD DEVELOPMENT | QUALITY OF LIFE | MONITORING | BODY WEIGHT | Africa | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Risk Factors | Health | Biology | Social Welfare | Economic Factors | Evaluation | Physiology Document Number: 342157 |
14.  Title: Girls’ success: Mentoring guide for life skills. Author: Kays L Source: Washington, D.C., Academy for Educational Development [AED], Center for Gender Equity, 2009. [115] p. Abstract: This guide discusses mentoring girls to help them develop important life skills. Some of the topics covered include healthy living, inner strength, making good choices, reproductive health, and sexuality. The guide provides discussion questions about each topic and learning activities that can be conducted in mentoring sessions or when girls are in school or with their families. Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | ADOLESCENTS, FEMALE | REPRODUCTIVE HEALTH | HUMAN RIGHTS | SEXUALITY | PUBERTY | NUTRITION | RISK REDUCTION BEHAVIOR | HYGIENE | DIET | SANITATION | WATER QUALITY | QUALITY OF LIFE | COUNSELING | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Political Factors | Sociocultural Factors | Personality | Psychological Factors | Behavior | Reproduction | Public Health | Water | Natural Resources | Environment | Social Welfare | Economic Factors | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 331823 |
| 15. Title: [Long-cycle treatment in oral contraception] Langzyklus bei Ovulationshemmern. Author: Kuhl H; Birkhauser M; Mueck A; Neulen J; Thaler C Source: therapeutische Umschau. Revue therapeutique. 2009 Feb;66(2):101-8. Abstract: Surveys show that most women desire a change in their menstrual pattern in the sense that they would prefer less menstruations or even amenorrhea. On this behalf, there is no difference between women having spontaneous natural cycles and women taking the pill. The main reasons are less menstrual bleedings, better hygienic conditions, a better quality of life and less blood loss. In women wanting regular monthly periods, the opinion is dominant that suppression of menstrual bleedings is "unnatural". It is therefore primordial to inform women that contraceptive safety is even increased in users following the long-cycle principal and that a fertility decrease has not to be feared. The benefit of the long-cyle OC is a reduction of the hormonal fluctuations induced by the pill-free interval with its consecutive somatic and mental symptoms, as well as an increased contraceptive safety. The following cycle- and menstruation-dependent symptoms as listed as an indication for the long-cycle use: Endometriosis, hypermenorrhea, dysmenorrhea, hemorrhagic diathesis, uterine fibroma, polyzystic ovary syndrom, migraine due to estrogen-deficiency in the pill-free interval as well as premenstrual syndrome. Language: German Keywords: RESEARCH REPORT | SURVEYS | WOMEN | AMENORRHEA | MENSTRUATION | BLEEDING | QUALITY OF LIFE | CONTRACEPTIVE SAFETY | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Menstruation Disorders | Diseases | Reproduction | Signs and Symptoms | Social Welfare | Economic Factors | Safety | Public Health | Health Document Number: 329572 |
| 16. Title: Usefulness of highly active antiretroviral therapy on health-related quality of life of adult recipients in Tanzania. Author: Magafu MG; Moji K; Igumbor EU; Hashizume M; Mizota T; Komazawa O; Cai G; Yamamoto T Source: AIDS Patient Care and STDs. 2009 Jul;23(7):563-70. Abstract: This study assessed health-related quality of life (HRQOL) of highly active antiretroviral therapy (HAART) recipients aged 18 or older and associated factors, 2 years after HAART administration had started in Kagera, Tanzania. Using the 36-Item Short Form Health Survey (SF-36), 329 HAART recipients were interviewed in May 2007. Questions on sociodemographic characteristics, chronic diseases (besides HIV/AIDS), HAART side effects and adherence to antiretroviral drugs were added. Treatment data, the first and latest available CD4 counts were retrieved from patients' records. Gender and age-adjusted mean scale scores of the sample were compared to those of the general Tanzanian population of the late 1990 s using t test. Logistic regression was used to explore the effect of sex, age, education level, income, chronic diseases, CD4 count, HAART side effects and adherence to antiretroviral drugs on recipients' physical functioning and mental health scale scores. The mean scale scores of HAART recipients were generally lower than those of the general population except for general health perceptions (p = 0.191) and mental health (p = 0.161). HAART recipients with chronic disease comorbidity were more likely to score below the general population's mean score for mental health (p = 0.007). While the effect of chronic disease comorbidity on physical functioning among those who recorded a CD4 count increase was negative (odds ratio [OR] = 13.6, 95% confidence interval [CI] = 3.7, 49.9), there was no effect on those who did not have such an increase. The control of chronic diseases among recipients should be given priority to improve their HRQOL. Language: English Keywords: TANZANIA | RESEARCH REPORT | HEALTH SURVEYS | CLIENTS | SOCIOECONOMIC FACTORS | DISEASES | HIV INFECTIONS | AIDS | HIV | ANTIRETROVIRAL THERAPY | TREATMENT | QUALITY OF LIFE | PERCEPTION | MENTAL HEALTH | TESTING | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Health | Program Activities | Programs | Organization and Administration | Economic Factors | Viral Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Social Welfare | Psychological Factors | Behavior | Measurement | Research Methodology Document Number: 342980 |
| 17. Peer Reviewed Title: The United Nations Convention on the Rights of the Child and HIV/AIDS [editorial] Author: McMillan AS; Simkiss D Source: Journal of Tropical Pediatrics. 2009 Apr;55(2):71-2. Abstract: The authors provide recommendations to promote children's right to life and survival, children's best interests and children's participation and non-discrimination through sex education. They also outline ideas that may be developed on the issues for children orphaned by HIV to promote the child's right to life. Language: English Keywords: GLOBAL | UN | UNAIDS | CRITIQUE | CHILDREN | HUMAN RIGHTS | HIV INFECTIONS | AIDS | QUALITY OF LIFE | CHILD HEALTH | INTERVENTIONS | PREVENTION AND CONTROL | International Agencies | Organizations | Political Factors | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Social Welfare | Economic Factors | Health | Programs | Organization and Administration Document Number: 341012 |
| 18. Title: Developing countries need better antiretroviral drugs [letter] Author: Myken N; Sundbeck B; Mpumilwa G; Andersson R Source: Journal of the International Association of Physicians in AIDS Care. 2009 Jan-Feb;8(1):23-24. Abstract: In most developing countries, antiretroviral therapy (ART) consists of a fixed-dose 3-drug combination of stavudine (d4T), lamivudine (3TC), and nevirapine (NVP). Because of the high risk of polyneuropathy and lipoatrophy combined mainly with d4T this combination has been replaced by tenofovir-based or abacavir-based drug combinations in the developed countries. The risk of neuropathy is increasing by time on d4T. The prevalence of liopdystrophy was also related to time on ART in a study from Rwanda, where 86% of the patients were receiving d4T resulting in 70% of the patients suffering from this adverse effect after >72 weeks on ART. A cross-sectional study was conducted in November-December, 2007, at the Ilembula Lutheran Hospital in rural Tanzania by using a standardized structured questionnaire covering self-reported adherence and side effects, subject health status, and disclosure of HIV-positive test. A total of 97 patients were included in the study; 69% of them were women. The mean age in our study population was 42 years and the median duration of treatment was 15(range 12-20) months. Most of them received a combination of d4T, 3TC, and NVP. In all, 80% (95% confidence interval [CI]: 72-88) reported illness as the reason for HIV test with no difference between women and men. A total of 92% of the patients had >95% estimated adherence level. In all 97% of the patients had experienced positive effects since the start of treatment. Of these, almost half of them experienced >3 positive effects. The most frequent was more energy (75%), followed by increased appetite (65%), feeling happier (51%), and better sleep (50%). A total of 81 (84%) patients had experienced negative effects of the ART. Almost half of these, 36 patients, had only experienced 1 negative side effect and 13% of the patients had experienced >5 side effects. A total of 90% of the women compared to 70% of the men in the study had experienced negative effects from treatment. The general health status increased significantly (P < .001) during the time of treatment, but half of the patients suffered from polyneuropathy (Figure 1). In our study, the frequency of lipodystrophy was still low after a median of 15 months on ART, but it can also reflect that our method mainly based on a questionnaire was not sensitive enough to detect this side effect. At the time of follow-up, the positive effects are still more marked than the side effects among these patients, with most cases that started ART because of illness. The increasing prevalence of polyneuropathy and lipodystrophy with time on d4T treatment will probably lead to more dominating adverse effects in the future with a risk of low quality of life, reduced adherence, and development of antiviral resistance. As second-line ART is rarely offered in developing countries, it is even more critical to have an optimal first-line treatment with as low risk of side effects as possible. To provide sustainable ART to all patients all over the world, agreements are urgently needed between pharmaceutical companies, health departments, and funding organizations such as the Global Fund to fight AIDS, Tuberculosis, and Malaria. The study has been supported by a grant from the University of Gothenburg. (full-text) Language: English Keywords: DEVELOPING COUNTRIES | SUMMARY REPORT | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL DRUGS | SIDE EFFECTS | QUALITY OF LIFE | HEALTH | TREATMENT | Research Methodology | HIV Infections | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Social Welfare | Economic Factors Document Number: 331326 |
| 19. Peer Reviewed Title: Maternal and child health in the occupied Palestinian territory. Author: Rahim HF; Wick L; Halileh S; Hassan-Bitar S; Chekir H; Watt G; Khawaja M Source: Lancet. 2009 Mar 14;373(9667):967-77. Abstract: The Countdown to 2015 intervention coverage indicators in the occupied Palestinian territory are similar to those of other Arab countries, although there are gaps in continuity and quality of services across the continuum of the perinatal period. Since the mid 1990s, however, access to maternity facilities has become increasingly unpredictable. Mortality rates for infants (age Language: English Keywords: MIDDLE EAST | RESEARCH REPORT | INTERVENTIONS | MATERNAL HEALTH | CHILD HEALTH | MATERNAL-CHILD HEALTH SERVICES | QUALITY OF HEALTH CARE | DELIVERY OF HEALTH CARE | QUALITY OF LIFE | STANDARDS | PROGRAM ACCESSIBILITY | Programs | Organization and Administration | Health | Primary Health Care | Health Services | Health Services Evaluation | Program Evaluation | Social Welfare | Economic Factors | Research Methodology Document Number: 330802 |
| 20. Peer Reviewed Title: The influence of partner relationship quality on fertility. Author: Rijken AJ; Liefbroer AC Source: European Journal of Population. 2009 Feb;25(1):27-44. Abstract: This study examines whether partner relationship quality influences fertility, and if so, in which direction and which aspects of relationship quality are relevant. Competing hypotheses are tested. One hypothesis assumes that higher relationship quality leads to higher rates of childbearing, as a high-quality relationship offers the most favourable environment to raise children. An opposite hypothesis expects that lower relationship quality leads to higher rates of childbearing, as couples might have children in order to improve their relationship. Hazard analyses are performed using three waves of the Panel Study on Social Integration in the Netherlands. Findings indicate that positive as well as negative interaction between partners has a negative effect on first- and higher-order birth rates. This suggests that couples are most likely to have children if they do not have too much negative interaction, but neither interact in a very positive way. Value consensus negatively influences higher-order birth rates. Language: English Keywords: NETHERLANDS | RESEARCH REPORT | COUPLES | FERTILITY | INTERPERSONAL RELATIONS | QUALITY OF LIFE | IMPACT | Europe, Western | Europe | Developed Countries | Family Characteristics | Family and Household | Sociocultural Factors | Population Dynamics | Demographic Factors | Population | Behavior | Social Welfare | Economic Factors | Communication Document Number: 331295 |
| 21. Title: Symptoms and quality of life of people living with HIV infection in Puerto Rico. Author: Rivero-Mendez M; Portillo C; Solis-Baez SS; Wantland D; Holzemer WL Source: Puerto Rico Health Sciences Journal. 2009 Mar;28(1):54-9. Abstract: BACKGROUND: People living with HIV infection are confronted with physical and psychological symptoms that impact their quality of life. This study explored the symptom experience of people living with HIV infection in Puerto Rico and its correlation with quality of life. METHODS: A cross-sectional descriptive design was used to survey 44 men, women, and transgender people living with HIV infection. Measures included a demographic questionnaire, sign and symptom checklist, and a quality of life instrument. RESULTS: The sample was 50% male with a mean age of 42.1 years; the participants had been living with HIV infection an average for 9.8 years. The top five symptoms reported by the sample included: muscle aches (81.8%), depression (77.2%), weakness (70.5%), fear/worries (70.5), and difficulty concentrating (65.9%). Symptom frequency was significantly related to four dimensions of quality of life: overall function (r = -0.58), life satisfaction (r = -0.59), health worries (r = 0.32) and HIV medication worries (r = 0.59). The symptom experience was not related to financial worries, disclosure worries, or sexual functioning. Individuals who reported taking HIV medications reported significantly fewer symptoms than those not taking HIV medications (t = 3.061, df=42, p < 0.01). CONCLUSIONS: These results suggest that people living with HIV infection in Puerto Rico experience a wide array of physical and psychological symptoms and that these symptoms have a correlation with their perceived quality of life. Better management of symptoms may have an impact on perceived quality of life for people living with HIV infection. Language: English Keywords: PUERTO RICO | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | EVALUATION INDEXES | PERSONS LIVING WITH HIV/AIDS | QUALITY OF LIFE | SIGNS AND SYMPTOMS | HIV INFECTIONS | PSYCHOLOGICAL FACTORS | DEMOGRAPHIC FACTORS | HEALTH STATUS INDEXES | DEPRESSION | PAIN | ANTIRETROVIRAL THERAPY | Caribbean | Americas | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Quantitative Evaluation | Evaluation | Viral Diseases | Diseases | Social Welfare | Economic Factors | Behavior | Population | Health | Mental Disorders | HIV Document Number: 341065 |
| 22. Title: Maternal autonomy is inversely related to child stunting in Andhra Pradesh, India. Author: Shroff M; Griffiths P; Adair L; Suchindran C; Bentley M Source: Maternal and Child Nutrition. 2009 Jan;5(1):64-74. Abstract: Child stunting, an outcome of chronic undernutrition, contributes to poor quality of life, morbidity and mortality. In South Asia, the low status of women is thought to be one of the primary determinants of undernutrition across the lifespan. Low female status can result in compromised health outcomes for women, which in turn are related to lower infant birthweight and may affect the quality of infant care and nutrition. Maternal autonomy (defined as a woman's personal power in the household and her ability to influence and change her environment) is likely an important factor influencing child care and ultimately infant and child health outcomes. To examine the relationship between maternal autonomy and child stunting in Andhra Pradesh, India, we analysed data from National Family Health Survey (NFHS)-2. We used cross-sectional demographic, health and anthropometric information for mothers and their oldest child <36 months (n = 821) from NFHS-2. The main explanatory variables of autonomy are presented by four dimensions - decision making, permission to travel, attitude towards domestic violence and financial autonomy - constructed using seven binary variables. Logistic regression models were used to test associations between indicators of female autonomy and the risk of having a stunted child. Women with higher autonomy {indicated by access to money [odds ratio (OR) = 0.731; 95% confidence interval (CI) 0.546, 0.981] and freedom to choose to go to the market [OR = 0.593; 95% CI 0.376, 0.933]} were significantly less likely to have a stunted child, after controlling for household socio-economic status and mother's education. In this south Indian state, two dimensions of female autonomy have an independent effect on child growth, suggesting the need for interventions that increase women's financial and physical autonomy. Language: English Keywords: INDIA | RESEARCH REPORT | ANTHROPOMETRY | PREGNANT WOMEN | CHILDREN | MATERNAL NUTRITION | MALNUTRITION | BODY HEIGHT | BODY WEIGHT | QUALITY OF LIFE | MORBIDITY | EVALUATION | Asia, Southern | Asia | Developing Countries | Measurement | Research Methodology | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Nutrition | Health | Nutrition Disorders | Diseases | Physiology | Biology | Social Welfare | Economic Factors Document Number: 330818 |
| 23. Peer Reviewed Title: A longitudinal quality-of-life study of HIV-infected persons in South India: the case for comprehensive clinical care and support services. Author: Solomon S; Batavia A; Venkatesh KK; Brown L; Verma P; Cecelia AJ; Daly C; Mahendra VS; Kumarasamy N; Mayer KH Source: AIDS Education and Prevention. 2009 Apr;21(2):104-12. Abstract: This study longitudinally assesses the quality of life (QOL) of HIV-infected individuals in a resource-limited setting prior to the extensive generic roll-out of highly active antiretroviral therapy. Data was collected on 136 individuals receiving clinical care at Y.R. Gaitonde Centre for AIDS Research and Education YRG CARE, a large community-based HIV tertiary care referral center in Chennai, South India. The QOL questionnaire was administered to participants at baseline, 6-months follow-up, and 12-month follow-up, and analysis of variance was used to assess for significant differences in mean QOL scores for each of these visits. Study findings showed that QOL scores significantly improved in all five domains of the questionnaire between participants' baseline visit, second interview, and third interviews (p < 0.01). We conclude that a multidisciplinary approach to managing HIV infection can enhance patients' QOL, independent of antiretroviral therapy. Language: English Keywords: INDIA | RESEARCH REPORT | LONGITUDINAL STUDIES | PERSONS LIVING WITH HIV/AIDS | QUALITY OF LIFE | CARE AND SUPPORT | COUNSELING | HEALTH | INTERPERSONAL RELATIONS | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Social Welfare | Economic Factors | Health Services | Delivery of Health Care | Clinic Activities | Program Activities | Programs | Organization and Administration | Behavior Document Number: 341681 |
| 24. Peer Reviewed Title: Psycho-social impact and quality of life of people living with HIV/AIDS in South India. Author: Subramanian T; Gupte MD; Dorairaj VS; Periannan V; Mathai AK Source: AIDS Care. 2009 Apr;21(4):473-81. Abstract: This study examines psycho-social impact of HIV and quality of life of 646 HIV-infected persons from a major government sexually transmitted disease (STD) clinic in South India. In this cross-sectional study, data was collected using interview schedule and scales. Nearly 70% had problems in parenting their children after acquiring the infection. Most (88%) of the respondents reported of seeking help from their family members, relatives or close friends at the time of their illness. Among the four categories of stigma, most of them (96%) reported perceived stigma whereas actual stigma was mentioned by only 33%. All four categories of stigma were experienced on a higher proportion by females than males (p<0.05). Each type of stigma was significantly associated with each domain of quality of life of the respondents (p<0.005). Respondents who reported of actual stigma (33%) had significantly good quality of life in their physical domain (49%), psychological domain (48%) and environmental domain (44%). Multivariate analysis showed that gender and marital status had significant association with quality of life. The findings of the study underscore the need for enabling environment through "human force" to uplift their social status and to have a better quality of life. Language: English Keywords: INDIA | RESEARCH REPORT | ADULTS | PERSONS LIVING WITH HIV/AIDS | PSYCHOSOCIAL FACTORS | QUALITY OF LIFE | STIGMA | SEX FACTORS | MARITAL STATUS | INTERVIEWS | Asia, Southern | Asia | Developing Countries | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Behavior | Social Welfare | Economic Factors | Social Problems | Sociocultural Factors | Nuptiality | Data Collection | Research Methodology Document Number: 341825 |
| 25. Peer Reviewed Title: The International Classification of Function Disability and Health (ICF) in adults visiting the HIV outpatient clinic at a regional hospital in Johannesburg, South Africa. Author: Van As M; Myezwa H; Stewart A; Maleka D; Musenge E Source: AIDS Care. 2009 Jan;21(1):50-8. Abstract: In 2005, 16.6% of South Africans between 15 and 49 years of age were HIV positive. The advent of anti-retroviral therapy has led to improved longevity, CD4 counts and clinical well-being of people living with HIV/AIDS (PLWHA). Physical impairments, activity limitations and participation restrictions of PLWHA have profound effects on the Health-related Quality of Life and functional abilities of those with the disease, and understanding thereof may assist in the formulation of rehabilitation protocols, health care interventions as well as vocational and legislative policies. The International Classification of Function, Disability and Health (ICF) is a standardised tool, endorsed by the World Health Assembly for international use, which aims to classify functioning and disability. It is structured to assess body functions and structure, functional activities and associated personal and environmental factors.This study aimed to develop a profile of the level of functional activity, using the ICF Checklist, of an urban cohort of 45 South African individuals who are HIV positive attending an outpatient clinic at the Helen Joseph Memorial Hospital, Gauteng, South Africa. The results showed a high prevalence of physical impairments, participation restrictions and selective activity limitations and that environmental factors influence their level of ability. Specific impairments where patients had problems were mental functions (69% (n=31), sensory and pain -- 71% (n=32), digestive and metabolic functions 45% (n=20) and neuromuscular 27% (n=12). Activity limitations included major life areas' 58% (n=26), interpersonal relationships 56% (n=25), mobility 40% (n=18) and general tasks and demands 38% (n=17). Limitations in mobility were significantly associated with problems of sensory functions (p=0.05), pain (p=0.006), neuromusculoskeletal and movement-related functions (p=0.006), muscle power (p=0.006) as well as energy and drive functions (p=0.001). The study identifies the level of function and ability of PLWHA, clinical markers, and how these affect the physical, psychological and social functioning of this population. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | SOCIAL BEHAVIOR | OBSTACLES | INTERPERSONAL RELATIONS | PSYCHOLOGICAL FACTORS | QUALITY OF LIFE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Viral Diseases | Diseases | Behavior | Organization and Administration | Social Welfare | Economic Factors Document Number: 331212 |
| 26. Title: A Qualitative Analysis of the Economic Impact of HIV and Antiretroviral Therapy on Individuals and Households in Uganda. Author: Wagner G; Ryan G; Huynh A; Kityo C; Mugyenyi P Source: AIDS Patient Care and STDs. 2009 Aug 10; Abstract: Abstract Despite the acceleration of antiretroviral therapy (ART) scale-up in sub-Saharan Africa, little is known about the social and economic effects of ART on individuals and households. In January 2008, we conducted semistructured interviews with 24 adult ART clients attending urban and rural HIV clinics operated by Joint Clinical Research Center in Uganda. Using content analysis we explored changes in physical health, work activity and asset management from before HIV to after ART. Twenty-one (88%) participants were working prior to HIV (mostly microenterprises and subsistence farming), of whom 18 had to stop work at least temporarily after onset of HIV. After ART, 20 (83% of the sample) were engaged in some type of work, but for many it was not at the same level as before HIV. Also, most that previously had salaried employment were unable to return to the formal labor market. Two thirds of the sample reported having to sell off at least some of their land, capital, or household property after HIV, and few were able to buy it back after ART. A majority (67%) reported that economic support from family was instrumental after the onset of HIV, and for 38% this support continued to be necessary after ART. These findings highlight that while ART helps people to regain a capacity to work, other economic supports are needed to enable individuals and households to reestablish their livelihoods, especially in resource-constrained settings. Language: English Keywords: UGANDA | RESEARCH REPORT | INTERVIEWS | QUALITATIVE RESEARCH | HOUSEHOLDS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | IMPACT | ECONOMIC FACTORS | QUALITY OF LIFE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Research Methodology | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | HIV | Communication | Social Welfare Document Number: 342532 |
| 27. Title: HIV-related lipodystrophy in Africa and Asia. Author: Womack J Source: AIDS Reader. 2009 Apr;19(4):131-9, 148-52. Abstract: This article reviews the medical literature for information about lipodystrophy in Africa and Asia. These 2 regions were selected because both are of particular interest to the declaration for universal access. Africa represents the epidemic's epicenter. Asia, especially India and China, will soon have HIV / AIDS prevalence rates that will outstrip those seen in the rest of the world combined. The methodology is summarized first: how articles were selected, the inclusion and exclusion criteria used, and how information was synthesized. The results and discussion focus on 3 specific areas: how lipodystrophy is defined and measured, the study populations, and the persons excluded from these studies. A summary of what is and what is not yet known about lipodystrophy in Africa and Asia is also included. Language: English Keywords: AFRICA | ASIA | LITERATURE REVIEW | UNAIDS | PERSONS LIVING WITH HIV/AIDS | LIPID METABOLIC EFFECTS | GLUCOSE METABOLISM EFFECTS | DIABETES | HEART DISEASES | RISK FACTORS | PREVENTION AND CONTROL | QUALITY OF LIFE | TREATMENT | OBSTACLES | Developing Countries | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Lipids | Physiology | Biology | Carbohydrate Metabolic Effects | Metabolic Effects | Health | Social Welfare | Economic Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Organization and Administration Document Number: 341055 |
| 28. Peer Reviewed Title: Physical and emotional health outcomes after 12 months of public-sector antiretroviral treatment in the Free State Province of South Africa: a longitudinal study using structural equation modelling. Author: Wouters E; Heunis C; van Rensburg D; Meulemans H Source: BMC Public Health. 2009;9:103. Abstract: BACKGROUND: African and Asian cohort studies have demonstrated the clinical efficacy of antiretroviral treatment (ART) in resource-limited settings. However, reports of the long-term changes in the physical and emotional quality of life (QoL) of patients on ART in these settings are still scarce. In this study, we assessed the physical and emotional QoL after six and 12 months of ART of a sample of 268 patients enrolled in South Africa's public-sector ART programme. The study also tested the impact of the adverse effects of medication on patients' physical and emotional QoL. METHODS: A stratified random sample of 268 patients undergoing ART was interviewed at baseline (< 6 months ART) and follow-up (< 12 months ART). A model of the relationships between the duration of ART, the adverse effects of medication, and physical and emotional QoL (measured using EUROQOL-5D) was tested using structural equation modelling. RESULTS: The improved physical and emotional QoL shown at baseline was sustained over the 12-month study period, because treatment duration was not significantly associated with changes in the patients' QoL. Physical QoL significantly and positively influenced the patients' emotional QoL (subjective well-being [SWB]) (beta = 0.33, P < 0.01). Longitudinal data showed that patients reported significantly fewer adverse effects at follow-up than at baseline (beta = -0.38, P < 0.001) and that these adverse effects negatively influenced physical (beta = -0.27, P < 0.01) and emotional QoL (beta = -0.15, P < 0.05). CONCLUSION: This study provides evidence that the South African public-sector ART programme is effective in delivering sustained improvement in patient well-being. However, the results should encourage clinicians and lay health workers to be vigilant regarding the adverse effects of treatment, because they can seriously affect physical and emotional QoL. Language: English Keywords: SOUTH AFRICA | ASIA | RESEARCH REPORT | CLIENTS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | TREATMENT | SIDE EFFECTS | QUALITY OF LIFE | PROGRAM EFFECTIVENESS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Social Welfare | Economic Factors | Program Evaluation Document Number: 342913 |
| 29. Peer Reviewed Title: The lived experience of Malawian women with obstetric fistula. Author: Yeakey MP; Chipeta E; Taulo F; Tsui AO Source: Culture, Health and Sexuality. 2009 May 14;:1. Abstract: Data on women who experience obstetric fistula paints an often tragic picture. The majority of previous research has focused on facility-based data from women receiving surgical treatment. The goal of this qualitative study was to gain an understanding of the lived experience of obstetric fistula in Malawi. Forty-five women living with fistula were interviewed in their homes to learn how the condition affected them and their families on a daily basis. Findings indicate that the experiences of Malawian women with fistula were more varied than anticipated. Concerning relationships with husbands and family, we found high rates of divorce and stigma, yet these outcomes were far from universal or inevitable. Many women, in addition to their families, discussed high levels of support from those individuals closest to them. Nonetheless, many women experienced the fistula as a direct assault on their ability to fulfil social expectations of them as women, wives and mothers. Women identified fertility and continued childbearing as central concerns. The data suggest that we cannot discount the experiences of women living with fistula from continued participation in marriage, community and childbearing. Programmes for outreach and services should consider a broadened range of outcomes of women living with fistula. Language: English Keywords: MALAWI | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | SPOUSE | VESICOVAGINAL FISTULA | PREGNANCY COMPLICATIONS | FAMILY RELATIONSHIPS | STIGMA | DIVORCE | SPOUSAL SUPPORT | FEMALE ROLE | FERTILITY | QUALITY OF LIFE | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | Urogenital Effects | Urogenital System | Physiology | Biology | Diseases | Social Problems | Nuptiality | Microeconomic Factors | Social Behavior | Behavior | Population Dynamics | Social Welfare Document Number: 341494 |
| 30. Peer Reviewed Title: Impact of different contraceptive methods on quality of life in rural women of the Jiangsu province in China. Author: Zhao J; Li Y; Wu Y; Zhou J; Ba L; Gu X; Wang W; Yao H; Ren N; Chen J; Xu L Source: Contraception. 2009 Aug;80(2):180-6. Abstract: BACKGROUND: The combined oral contraceptives (COCs) and intrauterine devices (IUDs) are the most common contraceptive methods used by women. Women's choices of contraceptive method are largely affected by the safety and efficacy of contraceptive methods as well as by change in women's quality of life. However, there are still scanty data focusing on the impact of COC or IUD on quality of life in women, especially in China. The aim of this study was to evaluate the impact of desogestrel and ethinyl estradiol tablets (Marvelon) and Yuangong-Cu220 IUD (YCu220 IUD) on quality of life in rural women of the Jiangsu province in China. STUDY DESIGN: In this prospective cohort study, 784 COC users and 910 YCu220 IUD users were included. The women filled up quality-of-life questionnaires (Quality of Life Enjoyment and Satisfaction Questionnaire) before and after use of contraceptive methods. RESULTS: Significant score changes in physical health, mood, work/school/labor, living situation, vision, general well-being and overall satisfaction were noted as significant improvements after COC use in women (p<.05), and the largest improvements were in physical health and living situation; all item scores except for work/school/labor, household activities and leisure time activities had improved statistically from baseline in YCu220 IUD users (p<.05). For COC users, the proportions of women with total quality-of-life scores >/=57 before and after COC use were 11.50% and 11.79%, respectively; but the proportion of YCu220 IUD users with total quality-of-life scores >/=57 increased from 4.40% to 12.04%. Compared to women without contraceptive use history, women with past OC and/or IUD use had a significantly higher difference in the total quality-of-life scores. CONCLUSIONS: COC and YCu220 IUD could significantly improve overall quality of life in rural women of the Jiangsu province. Language: English Keywords: CHINA | RESEARCH REPORT | PROSPECTIVE STUDIES | RURAL POPULATION | CURRENTLY MARRIED | WOMEN | ORAL CONTRACEPTIVES, COMBINED | IUD, COPPER RELEASING | QUALITY OF LIFE | SATISFACTION | QUESTIONNAIRES | Asia, Eastern | Asia | Developing Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Marital Status | Nuptiality | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | IUD | Social Welfare | Economic Factors | Psychological Factors | Behavior Document Number: 342304 |
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