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Title: Expanding access to injectable contraceptives.
Author: United States. Agency for International Development [USAID]
Source: [Washington, D.C.], USAID, [2009]. [2] p.
Abstract: A technical consultation, co-sponsored by the World Health Organization (WHO), USAID, and Family Health International (FHI), was held June 15-17, 2009, at the WHO in Geneva to review the evidence and programmatic experience for community-based provision of injectable contraceptives. Thirty technical and program experts from countries and organizations reviewed the scientific evidence and experiences from programs that provided injectable contraceptives through community-based health workers (CHWs). This evidence and programmatic experience came from Africa, Asia, and Latin America and focused on depotmedroxyprogesterone acetate (DMPA). The evidence consistently showed that given appropriate training, CHWs can screen clients effectively, provide DMPA injections safely, and counsel on side effects appropriately, demonstrating competence equivalent to higher level facility-based providers of DMPA. Continuation of use of DMPA by clients of CHWs was as long as those of clients receiving injections at clinics. In addition, the vast majority of clients expressed satisfaction with CHW provision of DMPA. The Consultation concluded that sufficient evidence existed for national policies to support the introduction, continuation, and scale-up of community-based provision of progestin-only injectable contraceptives, especially DMPA. Provision of DMPA by CHWs will expand choice for underserved populations and contribute to reducing the unmet need for family planning. Operational guidelines for family planning should therefore reflect that appropriately trained CHWs can safely initiate use of DMPA and provide reinjection. (Excerpt)
Language: English
Keywords:
GLOBAL | SUMMARY REPORT | CONFERENCES AND CONGRESSES | COMMUNITY WORKERS | WHO | INJECTABLES | DEPO-PROVERA | SAFETY | CONTRACEPTION CONTINUATION | TRAINING ACTIVITIES | COUNSELING | FAMILY PLANNING POLICY | Health Personnel | Delivery of Health Care | Health | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Public Health | Contraceptive Usage | Training Programs | Education | Clinic Activities | Program Activities | Programs | Organization and Administration | Population Policy | Social Policy | Policy
Document Number: 331839

Title: Community-based health workers can safely and effectively administer injectable contraceptives: Conclusions from a technical consultation.
Author: World Health Organization [WHO]; United States. Agency for International Development [USAID]; Family Health International [FHI]
Source: Research Triangle Park, North Carolina, FHI, 2009. 4 p.
Abstract: In June 2009, a technical consultation held at the World Health Organization (WHO) in Geneva concluded that evidence supports the introduction, continuation, and scale-up of community-based provision of progestin-only injectable contraceptives. The group of 30 technical and programme experts reviewed scientific and programmatic experience, which largely focused on the progestin-only injectable, depot-medroxyprogesterone acetate (DMPA). The experts found that community-based provision of progestin-only injectable contraceptives by appropriately trained community health workers (CHWs) is safe, effective, and acceptable. Such services should be part of a family planning programme offering a range of contraceptive methods. (Excerpt)
Language: English
Keywords:
GLOBAL | CONFERENCES AND CONGRESSES | COMMUNITY WORKERS | WHO | INJECTABLES | DEPO-PROVERA | NEEDS | SAFETY | CONTRACEPTION CONTINUATION | TRAINING ACTIVITIES | MONITORING | FAMILY PLANNING POLICY | Health Personnel | Delivery of Health Care | Health | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Economic Factors | Public Health | Contraceptive Usage | Training Programs | Education | Evaluation | Population Policy | Social Policy | Policy
Document Number: 331834

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Peer Reviewed

Title: Enhanced immunogenicity of an oral inactivated cholera vaccine in infants in Bangladesh obtained by zinc supplementation and by temporary withholding breast-feeding.
Author: Ahmed T; Svennerholm AM; Al Tarique A; Sultana GN; Qadri F
Source: Vaccine. 2009 Feb 25;27(9):1433-9.
Abstract: The killed oral cholera vaccine Dukoral is recommended for adults and only children over 2 years of age, although cholera is seen frequently in younger children and there is an urgent need for a vaccine for them. Since decreased immunogenicity of oral vaccines in children in developing countries is a critical problem, we tested interventions to enhance responses to Dukoral. We evaluated the effect on the immune responses by temporarily withholding breast-feeding or by giving zinc supplementation. Two doses of Dukoral consisting of killed cholera vibrios and cholera B subunit were given to 6-18 months old Bangladeshi children (n=340) and safety and immunogenicity studied. Our results showed that two doses of the vaccine were safe and induced antibacterial (vibriocidal) antibody responses in 57% and antitoxin responses in 85% of the children. Immune responses were comparable after intake of one and two doses. Temporary withholding breast-feeding for 3 h before immunization or supplementation with 20 mg of zinc per day for 42 days resulted in increased magnitude of vibriocidal antibodies (77% and 79% responders, respectively). Administration of vaccines without buffer or in water did not result in reduction of vibriocidal responses. This study demonstrates that the vaccine is safe and immunogenic in children under 2 years of age and that simple interventions can enhance immune responses in young children.
Language: English
Keywords:
BANGLADESH | RESEARCH REPORT | INFANT | CHOLERA | ZINC | HUMAN MILK | VACCINES | ADMINISTRATION AND DOSAGE | CONTRACEPTIVE USE-EFFECTIVENESS | AUTOIMMUNE RESPONSE | SAFETY | Developing Countries | Asia, Southern | Asia | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Bacterial and Fungal Diseases | Infections | Diseases | Metals | Vitamins and Minerals | Physiology | Biology | Lactation | Maternal Physiology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Treatment | Contraceptive Effectiveness | Contraception | Family Planning | Antibodies | Immunologic Factors | Immunity | Immune System | Public Health
Document Number: 341051

Peer Reviewed

Title: Preventing transfusion-transmitted HIV infection in Latin America and the Caribbean: issues associated with blood donor interviews and sex between men.
Author: Alonso M; Mazin R; Md RM; Cruz JR
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 May 1;51 Suppl 1:S67-72.
Abstract: BACKGROUND: Blood-borne transmission is the most efficient route for acquiring HIV infection, particularly through transfusion. Availability of noninfectious blood units for hemotherapy is a necessary condition for efficient functioning of health services. They have the obligation to ensure that the blood supply is safe, which includes interviewing potential donors to ascertain whether they might be at risk of being HIV infected. The interview procedures demand that blood services staff inquire potential blood donors about sexual practices associated to HIV transmission. Assumptions and misconceptions may unnecessary exclude adequate donors. METHODS: Review of published and unpublished country reports in Latin America regarding blood safety and deferral criteria related to same sexual behavior among males. RESULTS: An analysis of criteria for deferral of potential blood donors shows inconsistencies that may impact the necessary safe blood supply. CONCLUSIONS: The blood donor deferral criteria should be revised according to relevant epidemiological evidence and social legitimacy. Personnel in blood banks and hemotherapy services should be educated to conduct appropriate interviews for accepting or deferring potential donors. Potential donors and the public should be knowledgeable for them to understand the reasons why some individuals may be deferred. Health authorities should work to reduce the stigma associated with HIV, prioritize building strong and meaningful partnerships with civil society, and engage diverse sectors in the national AIDS response.
Language: English
Keywords:
LATIN AMERICA | CARIBBEAN | RESEARCH REPORT | MEN HAVING SEX WITH MEN | HIV INFECTIONS | HIV TRANSMISSION | BLOOD DONORS | SAFETY | STIGMA | HOMOSEXUALS | BLOOD TRANSFUSION | Americas | Developing Countries | Sex Behavior | Behavior | Viral Diseases | Diseases | Blood Supply | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health | Social Problems | Sociocultural Factors | Treatment
Document Number: 341318

Title: Collecting reliable information about violence against women safely in household interviews: experience from a large-scale national survey in South Asia.
Author: Andersson N; Cockcroft A; Ansari N; Omer K; Chaudhry UU; Khan A; Pearson L
Source: Violence Against Women. 2009 Apr;15(4):482-96.
Abstract: This article describes the first national survey of violence against women in Pakistan from 2001 to 2004 covering 23,430 women. The survey took account of methodological and ethical recommendations, ensuring privacy of interviews through one person interviewing the mother-in-law while another interviewed the eligible woman privately. The training module for interviewers focused on empathy with respondents, notably increasing disclosure rates. Only 3% of women declined to participate, and 1% were not permitted to participate. Among women who disclosed physical violence, only one third had previously told anyone. Surveys of violence against women in Pakistan not using methods to minimize underreporting could seriously underestimate prevalence.
Language: English
Keywords:
PAKISTAN | RESEARCH REPORT | DATA COLLECTION | DATA QUALITY | RELIABILITY | DOMESTIC VIOLENCE | VIOLENCE AGAINST WOMEN | SAFETY | INTERVIEWS | PROGRAM EVALUATION | Developing Countries | Asia, Southern | Asia | Research Methodology | Data Analysis | Measurement | Crime | Social Problems | Sociocultural Factors | Public Health | Health | Programs | Organization and Administration
Document Number: 341635

Title: Hysteroscopic female sterilization with Essure in an outpatient setting.
Author: Andersson S; Eriksson S; Mints M
Source: Acta Obstetricia Et Gynecologica Scandinavica. 2009;88(6):743-6.
Abstract: The aim of this study is to evaluate the short and long-term results of hysteroscopic sterilization in an outpatient setting. Sixty-one women underwent hysteroscopic sterilization. At follow-up, all of the women were asked to complete a questionnaire concerning possible pregnancy, bleeding patterns, side-effects, or need for further therapy after sterilization. Technical feasibility, complications, patient satisfaction, and tubal occlusion based on X-ray or ultrasound were measured. Fifty-eight (95%) women were sterilized according to this method. Successful bilateral device placement was achieved in 52 women (85%) during the first attempt and in six (9.8%) during the second. A total of 50 (81.9%) women submitted completed outcome questionnaires. The mean follow-up period was 23 (range 7-67) months. No pregnancies were reported. All questionnaire respondents expressed overall satisfaction with the procedure. To conclude, Essure sterilization is a safe effective method for female sterilization thatis feasible in the outpatient setting.
Language: English
Keywords:
SWEDEN | RESEARCH REPORT | CLIENTS | FEMALE STERILIZATION | HYSTEROSCOPY | COMPLICATIONS | SIDE EFFECTS | TUBAL OCCLUSION | SATISFACTION | SAFETY | Developed Countries | Europe, Northern | Europe | Program Activities | Programs | Organization and Administration | Sterilization, Sexual | Family Planning | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Diseases | Treatment | Psychological Factors | Behavior | Public Health
Document Number: 341444

10.

Peer Reviewed

Title: Ovarian activity and safety of a novel levonorgestrel/ethinyl estradiol continuous oral contraceptive regimen.
Author: Archer DF; Kovalevsky G; Ballagh SA; Grubb GS
Source: Contraception. 2009 Sep;80(3):245-53.
Abstract: BACKGROUND: A continuous regimen of oral levonorgestrel (LNG) 90 mcg/ethinyl estradiol (EE) 20 mcg was evaluated for inhibition of ovulation, time to return to ovulation after stopping treatment and safety. STUDY DESIGN: This open-label study was conducted in healthy women aged 18-35 years. Ovulation was documented before treatment, and then participants received oral tablets containing LNG 90 mcg/EE 20 mcg to be taken continuously for three 28-day intervals. Ovarian activity was assessed three times per week during the treatment period with transvaginal ultrasound scans and measurements of serum 17beta-estradiol, progesterone, follicle-stimulating hormone and luteinizing hormone concentrations. Safety assessments included physical examinations, laboratory evaluations and adverse event records. RESULTS: Thirty-seven of the 58 subjects who received treatment met predefined criteria for efficacy analysis. No on-treatment ovulations occurred in the efficacy or intent-to-treat population. There was evidence of ovulation within 37 days of stopping treatment for 46 (98%) of 47 subjects evaluated posttreatment. The final subject with a history of polycystic ovarian syndrome ovulated by Day 66. The safety profile observed during this 84-day continuous regimen was similar to that seen with other low-dose oral contraceptives administered in a cyclic regimen. CONCLUSIONS: The continuous LNG/EE regimen completely inhibited ovulation, with little evidence of follicular development and with rapid return of ovulatory capacity after stopping treatment.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | WOMEN | ORAL CONTRACEPTIVES | LEVONORGESTREL | ETHINYL ESTRADIOL | SAFETY | ULTRASONICS | OVARIAN EFFECTS | TREATMENT | Developed Countries | North America | Americas | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Estrogen | Public Health | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology
Document Number: 342575

11.

Title: Seeking safety and empathy: adolescent health seeking behavior during pregnancy and early motherhood in central Uganda.
Author: Atuyambe L; Mirembe F; Annika J; Kirumira EK; Faxelid E
Source: Journal of Adolescence. 2009;32:781-796.
Abstract: Purpose: To explore adolescent health seeking behavior during pregnancy and early motherhood in order to contribute to health policy formulation and improved access to health care. This will in long-term have an impact on the reduction of morbidity and mortality among adolescent mothers and their newborns. Methods: This was a qualitative study that employed focus group discussions (FGDs) among adolescent girls (10-19 years) and key informant (KI) interviews with health workers. Age for FGD participants ranged from 16 to 19 years. The FGD participants were recruited while seeking antenatal care for their first pregnancy or immunization service for their first child, not being older than 6 months. Six health facilities were selected. Key informants were purposefully selected on the basis of being in-charge of maternity units. Thirteen FGDs comprising of a total of 92 adolescent girls were conducted. The FGDs were held with homogeneously constituted categories; married pregnant adolescents (5), unmarried pregnant adolescents (3) and married or not married adolescents with children (5). Semi structured interviews were held with six KIs who were in-charge of maternity units of health facilities. Latent content analysis technique was used for data analysis. Results: Two main themes emerged; ?feeling exposed and powerless?, and ?seeking safety and empathy?. The categories identified in the first theme were ?the dilemma of becoming an adolescent mother? and ?lack of decision power?. In the second theme the following categories were identified: ?cultural practices and beliefs about birth?, ?expectations and experiences?, ?transport, a key determinant to health seeking?, and ?dealing with constraints?. Adolescents felt exposed and powerless due to the dilemma of early motherhood and lack of decision making power. The adolescent mothers seemed to be in continuous quest for safety and empathy. In so doing they are part of cultural practices and beliefs about birth. They had expectations about the health care services but their experiences of the services were rather negative. Transport was a key determinant for health seeking and adolescents to some extent had learnt how to cope with constraints they face. Conclusion and implications: Pregnant adolescents seek health care in both modern and traditional health sectors in order to get safety and empathy. However, our findings indicate that they mostly utilize the traditional sector because it is most accessible in terms of distance, cost and cultural context. Adolescent mothers are disempowered in decision making because of their pregnancy state which often puts them in dilemma. We therefore suggest that policy makers need to improve health systems (including the traditional sector) especially maternal health services for adolescent girls. Improved infrastructure and attitudes of health worker as well as training in delivery of adolescent health services is critical.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | QUALITATIVE RESEARCH | ADOLESCENTS | YOUTH | PREGNANCY | SAFETY | SAFE MOTHERHOOD | MATERNAL HEALTH | HEALTH SERVICES | UTILIZATION OF HEALTH CARE | PROGRAM EVALUATION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Reproduction | Public Health | Health | Delivery of Health Care | Programs | Organization and Administration
Document Number: 340225

12.

Title: Water safety plan manual: Step-by-step risk management for drinking-water suppliers.
Author: Bartram J; Corrales L; Davison A; Deere D; Drury D
Source: Geneva, Switzerland, World Health Organization [WHO], 2009. 101 p.
Abstract: The most effective means of consistently ensuring the safety of a drinking-water supply is through the use of a comprehensive risk assessment and risk management approach that encompasses all steps in water supply from catchment to consumer. In these Guidelines, such approaches are called water safety plans (WSPs). The aim of this Manual is to provide that practical guidance to facilitate WSP development focusing particularly on organized water supplies managed by a water utility or similar entity. (Excerpts)
Language: English
Keywords:
GLOBAL | MANUAL | CASE STUDIES | WATER SUPPLY | SAFETY | PLANNING | QUALITY CONTROL | RISK ASSESSMENT | STANDARDS | MONITORING | MANAGEMENT | PROCEDURES | Studies | Research Methodology | Natural Resources | Environment | Public Health | Health | Organization and Administration | Evaluation
Document Number: 331413

13.

Peer Reviewed

Title: Safety of late second-trimester pregnancy termination by laminaria dilatation and evacuation in patients with previous multiple cesarean sections.
Author: Ben-Ami I; Schneider D; Svirsky R; Smorgick N; Pansky M; Halperin R
Source: American Journal of Obstetrics and Gynecology. 2009 Aug;201(2):154.e1-5.
Abstract: OBJECTIVE: To assess whether there is an increased perioperative risk in termination of late second-trimester pregnancy after multiple cesarean sections by laminaria dilatation and evacuation. STUDY DESIGN: During the period between January 2002 and June 2008, 636 consecutive patients underwent late second-trimester (17-24 weeks) pregnancy terminations by dilatation and evacuation. Patients were divided into 3 subgroups: those with no previous cesarean section (n = 545), those with 1 previous cesarean section (n = 59), and those with several previous cesarean sections (n = 32). RESULTS: There were no significant differences in major perioperative complications, such as anesthetic complications, need for blood transfusion, and cervical lacerations comparing the 3 subgroups. Importantly, there were neither cases of uterine perforation nor retained products of conception in the 3 subgroups. CONCLUSION: Late second-trimester pregnancy termination after multiple cesarean sections by laminaria dilatation and evacuation is probably not associated with an increased perioperative risk. Larger studies are needed to empower this study.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | CLIENTS | WOMEN | PREGNANCY, SECOND TRIMESTER | CESAREAN SECTION | ABORTION | SAFETY | UTERINE EFFECTS | Developed Countries | North America | Americas | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Pregnancy | Reproduction | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning | Public Health | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology
Document Number: 342611 Notification

14.

15.

Peer Reviewed

Title: Quinacrine sterilization for human immunodeficiency virus-positive women.
Author: de Magalhaes DR; de Carvalho Ferreira CR; Barbosa Magalhaes E; Camargos AF; Lippes J; Carvalho Ferreira D
Source: Fertility and Sterility. 2009 Jul;92(1):108-15.
Abstract: OBJECTIVE: To evaluate the safety of nonsurgical quinacrine sterilization for HIV-positive (HIV+) women. DESIGN: An open trial of quinacrine sterilization was carried out in women infected with HIV and women who were HIV negative (HIV-). Comparison of the results with the two groups provided an assessment of the safety and effectiveness of quinacrine sterilization for HIV+ women. SETTING: University Medical School outpatient services. PATIENT(S): A total of 258 women who desired sterilization were offered quinacrine sterilization as a means of limiting family size. Sixty-four were HIV+, and 194 were HIV-. Women who were HIV+ had CD4 counts >200 and were otherwise healthy. INTERVENTION(S): A modified Copper T intrauterine device inserter was used to place 252 mg of quinacrine, divided into seven pellets (36 mg each) into the uterine cavity. Three insertions of this formulation were performed, 1 month apart. Viral load and CD8 and CD4 lymphocytes were measured both before and after quinacrine sterilization and at follow-up visits. Pregnancies and adverse events were recorded carefully. A decrement life table was made to statistically analyze results. RESULT(S) AND MAIN OUTCOME MEASURE(S): No serious adverse event occurred in any patient in this study. Adverse effects related to quinacrine sterilization were abdominal cramping, vulvar itching, nausea, and vaginal bleeding. Vaginal bleeding was the only short-term side effect noted to occur more frequently in HIV-infected women after quinacrine sterilization. Among HIV+ women, 35.9% had complaints of increased bleeding, whereas only 8.2% of those who were HIV- had such complaints, which probably were insertion related. Viral load and the CD4+ and CD8+ lymphocyte measures displayed no statistically significant difference after quinacrine sterilization. CONCLUSION(S): Quinacrine sterilization is a safe method for the sterilization of HIV-infected women and has no short-term effect on the pathology of the disease.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | CLINICAL TRIALS | PERSONS LIVING WITH HIV/AIDS | WOMEN | QUINACRINE STERILIZATION | SAFETY | ANTIRETROVIRAL THERAPY | SIDE EFFECTS | INSERTION | ULTRASONICS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Clinical Research | Research Methodology | HIV Infections | Viral Diseases | Diseases | Demographic Factors | Population | Female Sterilization | Sterilization, Sexual | Family Planning | Public Health | Health | HIV | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 342325

16.

Title: Seroprevalence of human immunodeficiency virus and syphilis in blood donors of Delhi [letter]
Author: Ekadashi R; Langer S
Source: Indian Journal of Medical Microbiology. 2009 Apr-Jun;27(2):167-8.
Abstract: Transfusion of blood and blood products is a life saving measure that benefits numerous patients worldwide. At the same time it is an important mode of infection to the recipients. In up to 15% of the total patients infected with human immunodeficiency virus (HIV), blood transfusion has been the route of transmission. Syphilis positivity varies from 0.8% in voluntary donors to more than 15% in paid commercial donors. Although HIV infection has been reported in all groups of blood donors in Delhi, it is particularly high among replacement donors. Concealing the medical history by professional or replacement donors pose a great threat to safe blood supply. Problems are also due to the prevalence of asymptomatic carriers in the society, blood donations during the window period, genetic variability in the viral strains and laboratory errors. Only few reports are available regarding the trend of HIV seropositivity and syphilis serology, particularly in blood donors from northern India. In this study, we aimed to assess the prevalence and trend of HIV and syphilis over 4 years, 2004-2007, among blood donors of Central Delhi. A total of 13,672 blood units were collected from blood donors during the period from January 1 2004 to December 31 2007 at the blood bank of Delhi Heart and Lung Institute in New Delhi, India. This is a tertiary care level hospital super specializing in heart and lung ailments. Blood donors were either replacement or voluntary. Care was taken to exclude professional donors by taking appropriate history and examination. (excerpt)
Language: English
Keywords:
INDIA | CRITIQUE | BLOOD DONORS | HIV TRANSMISSION | SYPHILIS | HIV | LABORATORY PROCEDURES | SCREENING | SAFETY | PREVENTION AND CONTROL | Asia, Southern | Asia | Developing Countries | Blood Supply | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Public Health
Document Number: 341204

17.

Title: Barriers to best outcomes in breastfeeding for Maori: mothers' perceptions, whanau perceptions, and services.
Author: Glover M; Waldon J; Manaena-Biddle H; Holdaway M; Cunningham C
Source: Journal of Human Lactation. 2009 Aug;25(3):307-16.
Abstract: This research explores the perceptions of New Zealand Maori women and their whanau (customary Maori extended family) toward barriers to achieving best outcomes in infant feeding: exclusively breastfed infants at 6 months. Interviews are undertaken with 59 Maori women who have given birth in the previous 3 years and 27 whanau members. Although mothers and whanau members feel positively toward breastfeeding and generally expect to breastfeed exclusively, these expectations are unmet in many cases because of lack of support when establishing breastfeeding; lack of support when life circumstances change; lack of timely, culturally relevant, and comprehensible information; confusion about smoking while breastfeeding; uncertainty about the safety of bed-sharing, and perceived lack of acceptability of breastfeeding in public. The relatively high rates of tobacco use by Maori create a tension for breastfeeding mothers, cited by some as a reason for ending breastfeeding prematurely.
Language: English
Keywords:
NEW ZEALAND | RESEARCH REPORT | MOTHERS | INFANT | BREASTFEEDING | TOBACCO USE | SAFETY | Oceania | Developed Countries | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Behavior | Public Health
Document Number: 342916

18.

Peer Reviewed

Title: [Sexuality, bodily experiences, and gender: an ethnographic study of persons living with HIV in Greater Metropolitan Buenos Aires, Argentina] Sexualidad, experiencias corporales y g�nero: un estudio etnogr�fi co entre personas viviendo con VIH en el �rea Metropolitana de Buenos Aires, Argentina.
Author: Grimberg M
Source: Cadernos�de Saude Publica. 2009 Jan;25(1):133-141.
Abstract: Based on the results of an ethnographic study on daily experience with HIV in Greater Metropolitan Buenos Aires, Argentina, the article discusses behavioral approaches that reduce the sexuality of persons living with HIV to an issue of safety and protection. By articulating a social construction perspective and the notion of hegemony, the author proposes that sexuality can be understood as a process of individual and social construction shaped by power relations and social regulations. The analysis of the experiences of living with HIV in marginalized populations shows how chronic social inequality, violence, discrimination, and stigmatization generate particular characteristics of sexual issues. These social processes become driving forces that shape sexual experience as a field of danger, repression, and restriction rather than pleasure and exploration. Finally, daily confrontation with social metaphors places strain on gender relations, practices, and identities.
Language: Portuguese
Keywords:
ARGENTINA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | ETHNIC GROUPS | SEXUALITY | SEX BEHAVIOR | SAFETY | INEQUALITIES | South America, Southern | South America | Latin America | Americas | Developing Countries | HIV Infections | Viral Diseases | Diseases | Cultural Background | Population Characteristics | Demographic Factors | Population | Personality | Psychological Factors | Behavior | Public Health | Health | Socioeconomic Factors | Economic Factors
Document Number: 341871

19.
Peer Reviewed

Title: [Sexuality, bodily experiences, and gender: an ethnographic study of persons living with HIV in Greater Metropolitan Buenos Aires, Argentina] Sexualidad, experiencias corporales y genero: un estudio etnografico entre
Author: Grimberg M
Source: Cadernos De Saude Publica. 2009 Jan;25(1):133-41.
Abstract: Based on the results of an ethnographic study on daily experience with HIV in Greater Metropolitan Buenos Aires, Argentina, the article discusses behavioral approaches that reduce the sexuality of persons living with HIV to an issue of safety and protection. By articulating a social construction perspective and the notion of hegemony, the author proposes that sexuality can be understood as a process of individual and social construction shaped by power relations and social regulations. The analysis of the experiences of living with HIV in marginalized populations shows how chronic social inequality, violence, discrimination, and stigmatization generate particular characteristics of sexual issues. These social processes become driving forces that shape sexual experience as a field of danger, repression, and restriction rather than pleasure and exploration. Finally, daily confrontation with social metaphors places strain on gender relations, practices, and identities.
Language: Spanish
Keywords:
ARGENTINA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | SEXUALITY | BEHAVIOR CHANGE | SAFETY | SOCIAL DISCRIMINATION | STIGMA | INEQUALITIES | VIOLENCE | PROGRAM APPROPRIATENESS | South America, Southern | South America | Latin America | Americas | Developing Countries | HIV Infections | Viral Diseases | Diseases | Personality | Psychological Factors | Behavior | Public Health | Health | Social Problems | Sociocultural Factors | Socioeconomic Factors | Economic Factors | Program Evaluation | Programs | Organization and Administration
Document Number: 342671

20.

21.

Peer Reviewed

Title: Health care providers' attitudes towards termination of pregnancy: A qualitative study in South Africa.
Author: Harries J; Stinson K; Orner P
Source: BMC Public Health. 2009 Aug 18;9(1):296.
Abstract: ABSTRACT: BACKGROUND: Despite changes to the abortion legislation in South Africa in 1996, barriers to women accessing abortion services still exist including provider opposition to abortions and a shortage of trained and willing abortion care providers. The dearth of abortion providers undermines the availability of safe, legal abortion, and has serious implications for women's access to abortion services and health service planning. In South Africa, little is known about the personal and professional attitudes of individuals who are currently working in abortion service provision. Exploring the factors which determine health care providers' involvement or disengagement in abortion services may facilitate improvement in the planning and provision of future services. METHODS: Qualitative research methods were used to collect data. Thirty four in-depth interviews and one focus group discussion were conducted during 2006 and 2007 with health care providers who were involved in a range of abortion provision in the Western Cape Province, South Africa. Data were analysed using a thematic analysis approach. RESULTS: Complex patterns of service delivery were prevalent throughout many of the health care facilities, and fragmented levels of service provision operated in order to accommodate health care providers' willingness to be involved in different aspects of abortion provision. Related to this was the need expressed by many providers for dedicated, stand-alone abortion clinics thereby creating a more supportive environment for both clients and providers. Almost all providers were concerned about the numerous difficulties women faced in seeking an abortion and their general quality of care. An overriding concern was poor pre and post abortion counselling including contraceptive counselling and provision. CONCLUSIONS: This is the first known qualitative study undertaken in South Africa exploring providers' attitudes towards abortion and adds to the body of information addressing the barriers to safe abortion services. In order to sustain a pool of abortion providers, programmes which both attract prospective abortion providers, and retain existing providers, needs to be developed and financial compensation for abortion care providers needs to be considered.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | QUALITATIVE RESEARCH | HEALTH PERSONNEL | HEALTH SERVICES | DELIVERY OF HEALTH CARE | ABORTION | ATTITUDES | SAFETY | POSTABORTION CARE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Health | Fertility Control, Postconception | Family Planning | Psychological Factors | Behavior | Public Health
Document Number: 342550 Notification

22.

Peer Reviewed

Title: The evidence-based review of second-trimester abortion missed some important evidence.
Author: Hern WM
Source: American Journal of Obstetrics and Gynecology. 2009 Aug 14;
Abstract: This letter to the editor focuses on a review of recent advances in second-trimester abortions by Cassing Hammond. It concludes that his review does not include several specifically relevant clinical reports and clinical experiences of nearly 4,000 patients in second- and third- trimester abortion were omitted from this review.
Language: English
Keywords:
UNITED STATES OF AMERICA | LITERATURE REVIEW | CRITIQUE | PREGNANCY, SECOND TRIMESTER | ABORTION | SAFETY | RISK FACTORS | Developed Countries | North America | Americas | Pregnancy | Reproduction | Fertility Control, Postconception | Family Planning | Public Health | Health
Document Number: 342548 Notification

23.

Title: Cost-effectiveness analysis of alternative first-trimester pregnancy termination strategies in Mexico City.
Author: Hu D; Grossman D; Levin C; Blanchard K; Goldie SJ
Source: BJOG. 2009 May;116(6):768-79.
Abstract: OBJECTIVE: To assess the comparative health and economic outcomes associated with three alternative first-trimester abortion techniques in Mexico City and to examine the policy implications of increasing access to safe abortion modalities within a restrictive setting. DESIGN: Cost-effectiveness analysis. SETTING: Mexico City. POPULATION: Reproductive-aged women with unintended pregnancy seeking first-trimester abortion. METHODS: Synthesising the best available data, a computer-based model simulates induced abortion and its potential complications and is used to assess the cost-effectiveness of alternative safe modalities for first-trimester pregnancy termination: (1) hospital-based dilatation and curettage (D&C), (2) hospital-based manual vacuum aspiration (MVA), (3) clinic-based MVA and (4) medical abortion using vaginal misoprostol. MAIN OUTCOME MEASURES: Number of complications, lifetime costs, life expectancy, quality-adjusted life expectancy. RESULTS: In comparison to the magnitude of health gains associated with all safe abortion modalities, the relative differences between strategies were more pronounced in terms of their economic costs. Assuming all options were equally available, clinic-based MVA was the least costly and most effective. Medical abortion with misoprostol provided comparable benefits to D&C, but cost substantially less. Enhanced access to safe abortion was always more influential than shifting between safe abortion modalities. CONCLUSIONS: This study demonstrates that the provision of safe abortion is cost-effective and will result in reduced complications, decreased mortality and substantial cost savings compared with unsafe abortion. In Mexico City, shifting from a practice of hospital-based D&C to clinic-based MVA and enhancing access to medical abortion will have the best chance to minimise abortion-related morbidity and mortality.
Language: English
Keywords:
MEXICO | RESEARCH REPORT | COST EFFECTIVENESS | ABORTION | PREGNANCY, FIRST TRIMESTER | HEALTH | ECONOMIC FACTORS | SAFETY | North America | Americas | Developing Countries | Evaluation Indexes | Quantitative Evaluation | Evaluation | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Public Health
Document Number: 342068 Notification

24.

Peer Reviewed

Title: Hormonal contraceptive use among women with liver tumors: a systematic review.
Author: Kapp N; Curtis KM
Source: Contraception. 2009 Oct;80(4):387-90.
Abstract: BACKGROUND: The review was conducted to evaluate from the literature the safety of hormonal methods of contraception in women with liver tumors, specifically in benign and malignant disease. STUDY DESIGN: We searched PubMed and Cochrane databases to find all articles published from database inception through July 2008 that were relevant to hormonal contraception use and liver tumors. RESULTS: Of 148 articles, three publications of two studies met the criteria for inclusion in this review; both investigated the use of hormonal contraception in women with the benign liver tumor focal nodular hyperplasia (FNH). In one small, retrospective case series, use of combined oral contraceptives (COCs) over a 4-year average follow-up was not associated with a change in either the number or size of hepatic lesions. In another case series, use of either COCs or progestogen-only contraceptives (POCs) after FNH diagnosis had no influence on disease progression or resolution. CONCLUSIONS: The studies identified examined oral contraceptive use among women with FNH. We did not identify any studies of hormonal contraceptive use among women with hepatocellular adenoma or with malignant liver tumors. Limited, poor-quality evidence suggests that for women with FNH, use of low-dose COCs or POCs does not appear to influence either liver lesion resolution or progression.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | LITERATURE REVIEW | CONTRACEPTIVE USAGE | LIVER NEOPLASMS | ORAL CONTRACEPTIVES | SAFETY | Developed Countries | North America | Americas | Contraception | Family Planning | Neoplasms | Diseases | Contraceptive Methods | Public Health | Health
Document Number: 342767

25.
Title: Studies of assisted reproduction techniques (ART) for HIV-1-discordant couples using washed sperm and the nested PCR method: a comparison of the pregnancy rates in HIV-1-discordant couples and control couples.
Author: Kashima K; Takakuwa K; Suzuki M; Makino M; Kaneko S; Kato S; Hanabusa H; Tanaka K
Source: Japanese Journal of Infectious Diseases. 2009 May;62(3):173-6.
Abstract: In this study, the efficacy and safety of assisted reproduction techniques with the sperm-washing method and nested PCR assay were evaluated in HIV-1-discordant couples, as many HIV-1-positive people of reproductive age are getting married and wish to have children safely. Twenty-seven HIV-1-discordant couples (husband, positive; wife, negative) were enrolled in this study. The spermatozoa were separated from semen samples by density gradient centrifugation and the swim-up method. HIV-1 RNA and proviral DNA were checked using nested PCR with a detection limit of one copy before fertilization and before embryo transfer. Clinical outcomes were compared with those of matched control couples. Thirty-eight cycles of in vitro fertilization or intracytoplasmic sperm injection were performed in HIV-1-discordant couples, where the pregnancy rates per embryo transfer and per couple were 60.6 and 63.0%, respectively. These rates were significantly higher than those in control couples (P<0.05). Furthermore, all of the females and babies remained HIV-1 negative throughout the study period. Our data strongly suggest that this technique will allow HIV-1-discordant couples to conceive more safely and effectively.
Language: English
Keywords:
JAPAN | RESEARCH REPORT | CONTROL GROUPS | COUPLES | PERSONS LIVING WITH HIV/AIDS | REPRODUCTIVE TECHNOLOGIES | SAFETY | HIV INFECTIONS | SPERMATOZOA | SEMEN | EMBRYO TRANSFER | IN VITRO | PREGNANCY RATE | Asia, Eastern | Asia | Developed Countries | Research Methodology | Family Characteristics | Family and Household | Sociocultural Factors | Viral Diseases | Diseases | Reproduction | Public Health | Health | Germ Cells | Genitalia | Urogenital System | Physiology | Biology | Seminal Vesicles | Genitalia, Male | Clinical Research | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population
Document Number: 342657

26.

Peer Reviewed

Title: Adding the female condom to the public health agenda on prevention of HIV and other sexually transmitted infections among men and women during anal intercourse.
Author: Kelvin EA; Smith RA; Mantell JE; Stein ZA
Source: American Journal of Public Health. 2009 Jun;99(6):985-7.
Abstract: Legal barriers to conducting public health research on methods of protection for anal intercourse were lifted in the United States in 2003 when the US Supreme Court invalidated all state antisodomy laws. Although research funding has been available for the development of rectal microbicides, the female condom, which has already been approved for vaginal use, has not been evaluated for anal use. Although there is no evidence that the female condom is safe for anal intercourse, it has already been taken up for off-label use by some men who have sex with men. This demonstrates the urgent need for more protection options for anal intercourse and, more immediately, the need to evaluate the safety and efficacy of the female condom for anal intercourse.
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | PUBLIC HEALTH | COURT DECISION | ANAL SEX | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | FEMALE CONDOMS | SAFETY | MICROBICIDES | Developed Countries | North America | Americas | Health | Litigation | Political Factors | Sociocultural Factors | Sex Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Vaginal Barrier Methods | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 341644

27.
Title: Review of maternal deaths from unsafe abortion in Jos, Nigeria.
Author: Kigbu JH; Daru PH; Ujah IA
Source: Nigerian Journal of Medicine. 2009 Jan-Mar;18(1):103-6.
Abstract: BACKGROUND: Unsafe Abortion assumes one of the lead causes of maternal deaths so long as contraceptive services remain low or unavailable and abortion laws remain restrictive. This study seeks to highlight abortion mortality, the practice of contraception amongst these women and complications arising from unsafe abortion. METHOD: This is a retrospective review of abortion related deaths in Jos University Teaching Hospital over a five year period (1st December 1989 to 30th November 2004). Patients files were retrieved from the hospital records and were reviewed in relation to socio demographic profile, clinical features and cause of death. RESULTS: Fourteen cases of abortion related deaths out of a total number of 188 induced abortion cases. The case fatality rate was 7.4% with abortion mortality of 74.4/100,000 deliveries. It constituted 12.8% of maternal deaths during the period. Seventy eight point six percent (78.6%) were below 24 years, while 85.7% of the patients were nulliparous. Ninety two point nine percent (92.9%) and 57.1% were single and dependent respectively. Fifty seven point one percent had never practiced contraception and 35.7% had previous pregnancy terminated. In 64.3%, the index pregnancy was terminated at 9 weeks and above because the pregnancies were unwanted in all (100%) cases. In 78.6% of cases the pregnancies were terminated by quacks. Forty two point nine percent (42.9%) presented after a week of termination. The causes of death were septicemia (71.4%), and hypovolaemic shock (28.6%). The average duration of hospital stay before demise was 5.6 days. CONCLUSION: Unsafe abortion is a public health problem in Jos and policy makers should promote contraception and review existing abortion laws.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | RETROSPECTIVE STUDIES | MATERNAL MORTALITY | ABORTION | SAFETY | RISK FACTORS | DEATH RATE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Public Health | Health
Document Number: 341718 Notification

28.

Title: Factors influencing women's decision to have a home birth in rural Turkey.
Author: Kukulu K; Oncel S
Source: Midwifery. 2009 Feb;25(1):32-8.
Abstract: OBJECTIVE: to ascertain the reasons why mothers choose to have a home birth and the factors that influence these reasons. METHODS: this cross-sectional study involved 392 women and was conducted between June and September 2003 in a rural setting in Turkey. The data were collected using a questionnaire developed by the authors. The questionnaire included demographic information, obstetric background, the reasons for deciding to give birth at home as well as questions on who encouraged the decision to give birth at home and who assisted in the home births. FINDINGS: the decision to have a home birth is related to economic difficulties and the desire to benefit from the assistance of neighbours. Women who had experienced both planned and unplanned home births reported that home birth was unsafe. CONCLUSION: preliminary information is provided about women having home births that may inform practitioners' educational efforts and future research.
Language: English
Keywords:
TURKEY | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | PREGNANT WOMEN | SOCIAL NETWORKS | FRIENDS AND RELATIVES | HOME CARE | CHILDBIRTH | DECISION MAKING | HOME ECONOMICS | PERCEPTION | SAFETY | Europe, Southeastern | Europe | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Family and Household | Sociocultural Factors | Care and Support | Health Services | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Behavior | Microeconomic Factors | Economic Factors | Psychological Factors | Public Health
Document Number: 331292

29.

Peer Reviewed

Title: Safety, tolerability and effectiveness of generic HAART in HIV-infected children in South India.
Author: Kumarasamy N; Venkatesh KK; Devaleenol B; Poongulali S; Mothi SN; Solomon S
Source: Journal of Tropical Pediatrics. 2009 Jun;55(3):155-9.
Abstract: HIV-infected children in resource-limited settings are increasingly gaining greater access to highly active antiretroviral therapy (HAART) but documented longitudinal data remains limited. We aimed to study the clinical and immunological outcomes among 67 South Indian HIV-infected children with >18 months of follow-up on HAART at a tertiary HIV care program. The median CD4 cell count at enrolment was 290 cells microl(-1) and at treatment initiation was 225 cells microl(-1). Patients demonstrated a significant rise in their CD4 cell counts between treatment initiation and after 6 months (701 cells microll(-1); p = 0.007), 12 months (741 cells microl(-1); p = 0.037), and 18 months of therapy (718 cells microl(-1); p = 0.005). The most common adverse events to therapy were nausea (20.9%) and rash (25.4%). Over one-fifth of patients (25.4%) substituted therapy due to toxicities and 19.4% of patients switched to second-line protease inhibitor-containing regimens. In this South Indian pediatric cohort, generic HAART was safe, effective and relatively well tolerated.
Language: English
Keywords:
INDIA | RESEARCH REPORT | COHORT ANALYSIS | CHILDREN | PERSONS LIVING WITH HIV/AIDS | CLIENTS | ANTIRETROVIRAL THERAPY | IMMUNOLOGICAL EFFECTS | SIDE EFFECTS | SAFETY | Asia, Southern | Asia | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | HIV | Immunity | Immune System | Physiology | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health
Document Number: 341971

30.

Title: Occupational transmission of bloodborne diseases to healthcare workers in developing countries: meeting the challenges.
Author: Lee R
Source: Journal of Hospital Infection. 2009 Aug;72(4):285-91.
Abstract: Healthcare workers have increased chance of acquiring bloodborne pathogens through occupational exposure in developing countries due to a combination of increased risk and fewer safety precautions. As loss of workers can seriously undermine developing health systems, it is important that risks are minimised. A literature search was conducted to investigate the risks of transmission of three pathogens: human immunodeficiency virus, hepatitis B and hepatitis C viruses; and to identify factors that influenced the risk with reference to developing countries. There are many difficulties faced by developing countries in minimising the risk of occupational exposure. Efforts have been made to address the problems both on international and national levels. It is imperative that all healthcare workers are protected in order to prevent the loss of such a crucial component of developing healthcare systems.
Language: English
Keywords:
DEVELOPING COUNTRIES | LITERATURE REVIEW | HEALTH PERSONNEL | HIV INFECTIONS | HEPATITIS | OCCUPATIONAL HEALTH | INFECTION TRANSMISSION | RISK FACTORS | NEEDLE PIERCING | SAFETY | UNIVERSAL PRECAUTIONS | WHO | HEALTH POLICY | Delivery of Health Care | Health | Viral Diseases | Diseases | Infections | Risk Behavior | Behavior | Public Health | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Policy
Document Number: 342909


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