1.  Title: Polyurethane intravaginal ring for controlled delivery of dapivirine, a nonnucleoside reverse transcriptase inhibitor of HIV-1. Author: Gupta KM; Pearce SM; Poursaid AE; Aliyar HA; Tresco PA; Mitchnik MA; Kiser PF Source: Journal of Pharmaceutical Sciences. 2008 Oct;97(10):4228-39. Abstract: Women-controlled methods for prevention of male-to-female sexual transmission of HIV-1 are urgently needed. Providing inhibitory concentrations of HIV-1 reverse transcriptase inhibitors to impede the replication of the virus in the female genital tissue offers a mechanism for prophylaxis of HIV-1. To this end, an intravaginal ring device that can provide long duration delivery of dapivirine, a nonnucleoside reverse transcriptase inhibitor of HIV-1, was developed utilizing a medical-grade polyether urethane. Monolithic intravaginal rings were fabricated and sustained release with cumulative flux linear with time was demonstrated under sink conditions for a period of 30 days. The release rate was directly proportional to the amount of drug loaded. Another release study conducted for a week utilizing liposome dispersions as sink conditions, to mimic the partitioning of dapivirine into vaginal tissue, also demonstrated release rates constant with time. These results qualify polyether urethanes for development of intravaginal rings for sustained delivery of microbicidal agents. Language: English Keywords: UTAH | RESEARCH REPORT | WOMEN | VAGINAL RING | MICROBICIDES | BIODEGRADABLE DELIVERY SYSTEMS | HIV PREVENTION | Developed Countries | United States of America | North America | Americas | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases Document Number: 329591 |
| 2. Peer Reviewed Title: A randomized trial of tramadol versus ibuprofen as an adjunct to pain control during vacuum aspiration abortion. Author: Romero I; Turok D; Gilliam M Source: Contraception. 2008 Jan;77(1):56-59. Abstract: The study was conducted to determine whether tramadol is more effective than ibuprofen for reducing pain during uterine aspiration for abortion. Women presenting to a community-based abortion clinic were invited to participate in this double-blind, randomized trial. Following informed consent, subjects were randomly assigned to receive either 50 mg tramadol or 800 mg ibuprofen orally in addition to the standard clinic analgesic protocol. The primary outcome was pain as verbally rated on a scale from 0 to 10. Measurements were obtained immediately after and 30 min postprocedure. One hundred fifty-eight women were enrolled, 80 women were randomized to ibuprofen and 78 women, to tramadol. Immediately after the procedure, the mean pain scores in both treatment groups were 4.9 (95% CI=4.3-5.5). Thirty min postoperatively the mean pain score in the ibuprofen group was 2.8 compared to 3.6 in the tramadol group (p=.04). There was no difference in immediate postprocedure pain between women receiving tramadol or ibuprofen. Ibuprofen is somewhat more effective than tramadol at reducing pain 30 min following surgical abortion. (author's) Language: English Keywords: UNITED STATES OF AMERICA | UTAH | RESEARCH REPORT | ABORTION | OBSTETRICAL SURGERY | PAIN | TREATMENT | Developed Countries | North America | Americas | Fertility Control, Postconception | Family Planning | Surgery | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases Document Number: 323060 Notification |
| 3. Peer Reviewed Title: Hypoactive sexual dysfunction in a young woman. Author: Laine H; Jones KP Source: Obstetrics and Gynecology. 2007 Feb 1;109(2 Pt 1):415-418. Abstract: Currently, experts consider normal female sexual response to be circular, rather than linear. This model incorporates the importance of emotional intimacy, sexual stimuli, and relationship satisfaction. It acknowledges that, compared with male sexual functioning, female sexual functioning proceeds in a more complex and circuitous manner and is affected by numerous psychosocial issues. Women may enter the cycle at multiple points and their goal is not necessarily orgasm, but personal satisfaction, which may include physical or emotional satisfaction or both. Sexual activity in women does not always or even usually arise from innate sexual drive. Sexual desire in women often begins from a position of sexual neutrality and arises in response to the right approach at the "right time" from an emotionally safe partner. Spontaneous sexual desire leading to arousal has a broad spectrum in frequency across women and may be related to the menstrual cycle, peaking mid-cycle. Spontaneous sexual desire generally increases with a new relationship and decreases with age. (excerpt) Language: English Keywords: UTAH | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | WOMEN | SEXUALITY | PSYCHOLOGICAL FACTORS | COITAL FREQUENCY | SIGNS AND SYMPTOMS | EXAMINATIONS AND DIAGNOSES | TREATMENT | CONTRACEPTIVE AGENTS, SIDE EFFECTS | RISK FACTORS | TESTOSTERONE | Developed Countries | United States of America | North America | Americas | Research Methodology | Studies | Demographic Factors | Population | Personality | Behavior | Sex Behavior | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Agents | Contraception | Family Planning | Biology | Androgens | Hormones | Endocrine System | Physiology Document Number: 312128 |
| 4. Peer Reviewed Title: Effects of dietary calcium intervention on adolescent mothers and newborns: a randomized controlled trial. Author: Chan GM; McElligott K; McNaught T; Gill G Source: Obstetrics and Gynecology. 2006 Sep;108(3 Pt 1):565-571. Abstract: The objective was to evaluate the effects of dietary calcium (Ca) intervention on adolescent pregnant mothers and their newborns. Seventy-two pregnant adolescent mothers were randomized into one of 3 groups: control, orange juice fortified with calcium, and dairy. The orange juice and dairy groups were required to take more than 1,200 mg Ca. Calcium tablets were added for those not able to meet required Ca. Maternal and infant weight, length, and blood pressure (BP) were recorded. Maternal dietary records were evaluated. Mother's blood was drawn for serum Ca, phosphate (P), magnesium (Mg), and vitamin 25-hydroxyvitamin D (D). Cord blood was collected for serum Ca and D. Newborn total body Ca was determined. All mothers were similar in weight, height, and BP. Mothers in the orange juice plus calcium and dairy groups had higher intakes of Ca (1,472 mg and 1,771 mg) than controls (862 mg). One half of the mothers in the orange juice plus calcium group required Ca tablets. Mothers in the dairy group had higher intakes of P, D, and Mg, higher serum folate and D, and higher cord D levels. Mothers in the orange juice plus calcium group had higher serum P but lower serum folate and D. Infants (3,517 ± 273 g) in the dairy group were heavier than infants in the control (3,277 ± 177 g) and orange juice plus calcium (3,292 ± 165 g) groups. Infants in the dairy group had higher total body calcium than control infants. Calcium diet supplemented with dairy products during adolescent pregnancy resulted in higher maternal vitamin D and folate serum levels and higher newborn weight and bone mineralization compared with controls. (author's) Language: English Keywords: UTAH | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | INFANT | ADOLESCENTS, FEMALE | PREGNANT WOMEN | ADOLESCENT PREGNANCY | DIET | MATERNAL NUTRITION | ANTHROPOMETRY | SERUM CALCIUM LEVEL | FOOD SUPPLEMENTATION | VITAMIN D | SERUM FOLATE LEVEL | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Adolescents | Reproductive Behavior | Fertility | Population Dynamics | Nutrition | Health | Measurement | Hemic System | Physiology | Biology | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Vitamins and Minerals Document Number: 306610 |
5.  Title: What if: How declines in teen births have improved poverty and child well-being in Utah. Author: National Campaign to Prevent Teen Pregnancy Source: Washington, D.C., National Campaign to Prevent Teen Pregnancy, 2005 Apr. 3 p. Abstract: Years of research have closely linked teen pregnancy and early childbearing to a host of other critical social issues, including overall child health and well-being, out-of-wedlock births, educational attainment and workforce readiness, responsible fatherhood, and poverty in particular -- especially child poverty. For example, young children born to a mother who is a teenager, is not married, and did not finish high school are nine times more likely to be poor than children born to mothers without these three risk factors. Adolescent pregnancy and childbearing cost taxpayers at least $7 billion annually and place a serious economic burden on schools and on health, welfare and social service systems. The U.S. teen birth rate declined by 30 percent between 1991 and 2002--a significant decrease that has made major contributions to American communities. Illustrating this very point, the U.S. Congress' Joint Economic Committee completed an analysis in April 2004 that the National Campaign in turn summarized. The congressional study posed an intriguing question: if the nation's teen birth rate had remained at its 1991 level through 2002 (rather than decreasing as it did), how many more children would have been born to teen mothers and to single mothers, and what would have been the effect on poverty and on the living arrangements of children? Findings included the following: if teen birth rates had not declined nationally by 30 percent during that time, there would have been an additional 1.2 million more children born to teen mothers, approximately 460,000 additional children in poverty and almost 700,000 more children living with a single mother. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | UTAH | RESEARCH REPORT | ADOLESCENTS, FEMALE | ADOLESCENT PREGNANCY | ONE PARENT FAMILY | BIRTH RATE | POVERTY | CHILD HEALTH | SOCIOECONOMIC FACTORS | CAMPAIGNS | FERTILITY DECLINE | North America | Americas | Developed Countries | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Family Characteristics | Family and Household | Sociocultural Factors | Fertility Measurements | Economic Factors | Health | Communication Programs | Communication | Fertility Changes Document Number: 307012 |
| 6. Peer Reviewed Title: Theory of national development and societal stratification. Author: Haller AO; Sharda BD Source: Population Review. 2005;44(2):[23] p.. Abstract: It has long been conjectured, in one form or another, that development tends to de-stratify a nation: that the higher its level of development, the less stratified--less unequal--it is. Recent findings on the factor structure of indicators of National Development (ND) indicate that it consists of two dimensions, Domestic Development (DD) and International Authority (IA), not merely the single one, DD, that ND is commonly believed to be. Building on this finding and on current societal stratification theory, the paper examines the main sociological conjectures concerning the effects of development on the multidimensional structure of stratification, and proposes a set of hypotheses predicting the effects of each ND dimension on each dimension of stratification systems. (author's) Language: English Keywords: UNITED STATES OF AMERICA | UTAH | RESEARCH REPORT | ANALYSIS | DEVELOPMENT PLANNING | SOCIAL POLICY | MODERNIZATION | SOCIAL CHANGE | IMPACT | Developed Countries | North America | Americas | Research Methodology | Economic Factors | Policy | Political Factors | Sociocultural Factors | Communication Document Number: 297134 |
| 7. Title: Gynecological care for adolescents with disability: physician comfort, perceived barriers, and potential solutions. Author: Shah P; Norlin C; Logsdon V; Samson-Fang L Source: Journal of Pediatric and Adolescent Gynecology. 2005;18:101-104. Abstract: The goal of this study was to assess the barriers to gynecologic care for adolescents with disability in this state. Providers of gynecologic care in Utah were surveyed to assess existing conditions, attitudes, and comfort levels regarding this population. The survey was completed by 136 gynecologic clinicians (50% return rate). The comfort level among surveyed clinicians in providing gynecological care to disabled adolescents was relatively low, even for routine screening. Respondents identified the following as barriers to providing this care: time, reimbursement, inadequate knowledge, and disability-related issues (office access and preference to not serve this population). Suggested solutions included: continuing education programs, consultation to practices on serving both youth and individuals with disability, and better billing mechanisms. While many of the surveyed clinicians are comfortable providing care to adolescents with disability, a substantial number are not. Respondents perceive many barriers to providing care to this population, though the barriers appear modifiable. Potential interventions were identified which should be tested for their effectiveness in improving access to quality care for this underserved population. (author's) Language: English Keywords: UTAH | RESEARCH REPORT | KAP SURVEYS | ADOLESCENTS, FEMALE | HEALTH PERSONNEL | DISABLED PERSONS AND DISABILITIES | GYNECOLOGY | STAFF ATTITUDE | KNOWLEDGE | REFERRAL AND CONSULTATION | FEES | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Medicine | Health Services | Attitudes | Psychological Factors | Behavior | Program Activities | Programs | Organization and Administration | Financial Activities | Economic Factors Document Number: 286987 |
| 8. Peer Reviewed Title: Effect of interpregnancy interval on birth outcomes: findings from three recent US studies. Author: Zhu BP Source: International Journal of Gynecology and Obstetrics. 2005 Apr;89 Suppl 1:S25-S33. Abstract: The relationship between interpregnancy interval and adverse birth outcomes (i.e., low birth weight, preterm birth, and small size for gestational age) was examined in three recent studies conducted in Utah and Michigan of the United States. These studies were conducted among different populations, used different study designs (i.e., cross-sectional and retrospective cohort designs), and addressed several other methodological limitations in the previously published literature. In addition, the data were stratified by, and controlled for, several maternal reproductive risk factors. A J-shaped relationship between interpregnancy interval and adverse birth outcomes was observed in all three studies. The risk for adverse birth outcomes is lowest when the interpregnancy interval was 18—23 months and increased when the interval departed from 18—23 months. This J-shaped relationship existed at levels of maternal reproductive risk factors and after these risk factors were controlled for using logistic regression. Based on the consistency of the findings from all three studies, it appears that the J-shaped relationship between interpregnancy interval and adverse birth outcomes is causal. This information can be used by health care providers and public health programs to counsel and educate women who recently gave births on reducing the risk for adverse birth outcomes by means of appropriate pregnancy spacing. (author's) Language: English Keywords: UNITED STATES OF AMERICA | UTAH | MICHIGAN | RESEARCH REPORT | PREGNANCY | LOW BIRTH WEIGHT | GESTATIONAL AGE | PREGNANCY OUTCOMES | PREMATURE BIRTH | RISK FACTORS | Developed Countries | North America | Americas | Reproduction | Birth Weight | Body Weight | Physiology | Biology | Fetus Document Number: 288019 |
| 9. Title: Predicting the use of sexual initiation tactics in a sample of college women. Author: Anderson PB; Newton M Source: Electronic Journal of Human Sexuality. 2004 May 1;7:[19] p.. Abstract: Significant attention has been focused on women's initiation of sexual contact with men and the point at which this initiation becomes sexual aggression. The purpose of this study was to examine possible predictors of the use of three conceptually distinct sets of sexual initiation tactics: seduction, coercion, and force. Relationships between women's personal characteristics, future expectancies about sex and relationships, the 'rehearsal behavior' of telephone calling patterns in adolescence, sexual self-esteem, past abuse, and past sexual abuse were related to measures of women's sexual initiation and aggression. Survey respondents were 272, mostly white women students with a mean age of 26 years. A complex relationship emerged between predictor and outcome variables. Social learning theory is utilized to interpret the findings and recommend future research directions. (author's) Language: English Keywords: UNITED STATES OF AMERICA | UTAH | LOUISIANA | RESEARCH REPORT | RESEARCH METHODOLOGY | STUDENTS | WOMEN | SEXUALITY | DEMOGRAPHICS | FIRST INTERCOURSE | SEXUAL ABUSE | Developed Countries | North America | Americas | Education | Demographic Factors | Population | Personality | Psychological Factors | Behavior | Demography | Social Sciences | Science | Sociocultural Factors | Sex Behavior | Crime | Social Problems Document Number: 297105 |
| 10. Title: Associations between breast cancer risk factors and religious practices in Utah. Author: Daniels M; Merrill RM; Lyon JL; Stanford JB; White GL Jr Source: Preventive Medicine. 2004 Jan;38(1):28-38. Abstract: Background. Utah has the lowest female malignant breast cancer incidence rates in the United States, due in part to low rates among women who are members of the Church of Jesus Christ of Latter-day Saints (LDS or Mormon). Several established reproductive and non-reproductive breast cancer risk factors may be lower among LDS women because of their religious doctrine related to marriage, family, and health. This paper investigates the association between selected breast cancer risk factors and religious preference and religiosity in Utah. Methods. A 37-item anonymous cross-sectional telephone survey was developed and conducted during March and April 2002. Results are based on 848 non-Hispanic white female respondents. Results. Number of births (parity), prevalence of breastfeeding, and lifetime total duration of breastfeeding were highest among LDS women who attended church weekly. Average months of breastfeeding per child were greatest among weekly church attendees, regardless of religious preference. Oral contraceptive use and total duration of hormone replacement therapy use were greatest for individuals of any religion attending church less than weekly and for individuals with no religious preference. Comparisons of divergent reproductive behaviors between LDS and non-LDS, and between weekly and less than weekly church goers, provide strong support for the relatively low breast cancer incidence rates previously identified among LDS and, therefore, in Utah. Conclusions. High parity and breastfeeding coincide with comparatively low breast cancer incidence rates among LDS and are consistent with recent findings of the Collaborative Group on Hormonal Factors in Breast Cancer, showing the primary role parity and breastfeeding play in reducing breast cancer. (author's) Language: English Keywords: UTAH | UNITED STATES OF AMERICA | RESEARCH REPORT | HEALTH SURVEYS | WOMEN | ORAL CONTRACEPTIVES | REPRODUCTIVE BEHAVIOR | PARITY | BREASTFEEDING | BREAST CANCER | RELIGIOUS ASPECTS | CHURCH OF THE LATTER-DAY SAINTS | Developed Countries | North America | Americas | Health | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Fertility | Population Dynamics | Fertility Measurements | Infant Nutrition | Nutrition | Cancer | Neoplasms | Diseases | Religion | Christianity Document Number: 277768 |
| 11. Title: State facts about abortion: Utah. Author: Alan Guttmacher Institute [AGI] Source: [New York, New York], AGI, 2003. 3 p. (State Facts about Abortion) Abstract: This article presents background information about the frequency of abortion in the United States, followed by statistics on abortion frequency, abortion services, and restrictions on abortion for the United States as a whole and Utah specifically. Language: English Keywords: UNITED STATES OF AMERICA | UTAH | PAMPHLETS | ADULTS | WOMEN | ABORTION | PREGNANCY | PREGNANCY, UNWANTED | PREGNANCY OUTCOMES | CONTRACEPTIVE USAGE | HEALTH FACILITIES | ABORTION LAW | North America | Americas | Developed Countries | Printed Media | Mass Media | Communication | Age Factors | Population Characteristics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Reproduction | Reproductive Behavior | Fertility | Population Dynamics | Contraception | Delivery of Health Care | Health Document Number: 175662 Notification |
| 13. Title: Epilepsy in adolescents: hormonal considerations. Author: Logsdon-Pokorny VK Source: Journal of Pediatric and Adolescent Gynecology. 2000 Feb;13(1):9-13. Abstract: A correlation between seizure disorders and reproductive hormones has been recognized for centuries. Through basic scientific and clinical studies, an understanding of the interrelationships has become clearer. Puberty does not increase the incidence of seizures. Catamenial seizures, when diagnosed, may be improved with hormonal manipulation. Therapeutic regimens for those treated unsuccessfully with antiepileptic therapy need continued validation. Patients with seizure disorders have an increased incidence of menstrual disorders. Hormonal contraception is not contraindicated in this population, yet requires a more cautious approach to avoid failure. (author's) Language: English Keywords: UNITED STATES OF AMERICA | UTAH | RESEARCH REPORT | ADOLESCENTS | NEUROLOGIC EFFECTS | HORMONES | TREATMENT | North America | Americas | Developed Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Physiology | Biology | Endocrine System | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 299785 |
| 14. Peer Reviewed Title: Defining dimensions of pregnancy intendedness. Author: Stanford JB; Hobbs R; Jameson P; DeWitt MJ; Fischer RC Source: MATERNAL AND CHILD HEALTH JOURNAL. 2000 Sep;4(3):183-9. Abstract: The classification scheme used by the National Survey of Family Growth (NSFG) is a well-established system for defining the intendedness of pregnancy, but its clinical relevance is uncertain. The purpose of this study was to explore how women conceptualize the intention status of their pregnancies and how their concepts relate to the classification scheme used by the NSFG. This qualitative study used in-depth, semistructured, open-ended interviews with 27 pregnant women seeking prenatal care or abortion. Sampling was based on ethnicity (Caucasian or Hispanic), education, religiosity, and NSFG intention status (intended, mistimed, or unwanted). Five qualitative dimensions of pregnancy intendedness emerged: preconception desire for pregnancy, steps taken to prepare for pregnancy, fertility behavior and expectations, postconception desire for pregnancy, and adaptation to pregnancy and baby. The relationship of these qualitative dimensions to the NSFG categories was varied and complex, particularly for the NSFG mistimed category. Women indicated that their partners had a strong influence on preconception and postconception desire for pregnancy. Further research is needed to develop measures of pregnancy intendedness that accurately reflect the needs and priorities of women. Research that addresses male perspectives and influence is of particular importance. (author's) Language: English Keywords: UTAH | UNITED STATES OF AMERICA | RESEARCH REPORT | INTERVIEWS | PREGNANCY, PLANNED | PREGNANCY, UNWANTED | PREGNANT WOMEN | ATTITUDES | WOMEN | Developed Countries | North America | Americas | Data Collection | Research Methodology | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Population Characteristics | Psychological Factors | Behavior Document Number: 153062 |
| 15. Title: Exploring the concepts of intended, planned, and wanted pregnancy. Author: Fischer RC; Stanford JB; Jameson P; DeWitt MJ Source: JOURNAL OF FAMILY PRACTICE.. 1999 Feb;48(2):117-22. Abstract: This qualitative study using in-depth semistructured interviews determined how women define the intention status of current, past, and hypothetical pregnancies. The study population included 18 women, primarily in their first trimester, seeking prenatal care, elective abortion, or pregnancy testing. Findings demonstrated three major themes emerging from the interviews: 1) definition of terms related to pregnancy varied substantially among women and seemed to be highly correlated to social and cultural influences; 2) the concepts of wanted and unwanted pregnancy were qualitatively distinct from the concepts of planned and unplanned pregnancy and seemed to be more relevant to the decision to continue or abort the pregnancy; and 3) attitudes of male partners toward the pregnancies were very influential in how women defined their pregnancies. Language: English Keywords: UTAH | UNITED STATES OF AMERICA | RESEARCH REPORT | INTERVIEWS | WOMEN | PREGNANCY, PLANNED | PREGNANCY, UNPLANNED | PERCEPTION | Developed Countries | North America | Americas | Data Collection | Research Methodology | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Psychological Factors | Behavior Document Number: 147124 |
| 16. Title: Study: wait 18 mos. for pregnancy. Author: Johnson LA Source: [Unpublished] 1999 Feb 25. Associated Press news report. [2] p. Abstract: A study by the Centers for Disease Control and Prevention concluded that mothers should wait at least 18 months after giving birth to become pregnant again, with the wait between birth and pregnancy being best at 18-23 months. The study was based on 173,205 births in Utah during 1989-96. Researchers found that having babies too close together or too far apart can both be bad for the infant's health, increasing the risk of premature or undersized babies which can cause long-term health problems, even death. Mothers who became pregnant again within 6 months had a 30-40% greater chance of producing premature or undersized babies, while those who waited 10 years for another child were twice as likely to have an unusually small baby and 50% more likely to deliver prematurely. Language: English Keywords: UTAH | UNITED STATES OF AMERICA | MATERNAL HEALTH | BIRTH SPACING | PREGNANCY | CHILD HEALTH | Developed Countries | North America | Americas | Health | Family Planning | Reproduction Document Number: 147302 |
| 17. Title: The interval between pregnancies and the outcome of subsequent births [editorial] Author: Klebanoff MA Source: NEW ENGLAND JOURNAL OF MEDICINE. 1999 Feb 25;340(8):643-4. Abstract: This editorial reviews a report in the New England Journal of Medicine that sought to determine the optimal pregnancy interval in humans. The researchers analyzed 173,205 birth certificates for 1989-96 in Utah and found that infants conceived less than 6 months postpartum had a 30-40% higher risk of low birth weight, premature birth, or small size for gestational age than infants conceived 18-23 months postpartum. The risk of these poor outcomes nearly doubled for infants conceived after an interval of 120 months. The women with these extreme birth intervals shared a high-risk demographic profile by being at the extremes of reproductive age, unmarried, smokers, and less educated. Had the available data allowed consideration of the impact of socioeconomic or psychological stress, the risks associated with the extreme intervals may have been reduced. In addition, the reasons why 10 years would pass between the birth of children may be important determinants of risk themselves. This study did not have access to data on the outcomes of the previous birth, which may provide the best markers of increased risk in subsequent pregnancies. This report indicates that health care providers should counsel women that they may become pregnant soon after delivery (27 days) and offer them a temporary supply of contraceptives. Also, women with extreme birth intervals should be considered at risk of potentially remediable medical and social conditions associated with poor pregnancy outcomes. Language: English Keywords: UNITED STATES OF AMERICA | UTAH | LITERATURE REVIEW | PREGNANCY INTERVALS | PREGNANCY OUTCOMES | COUNSELING | WOMEN | Developed Countries | North America | Americas | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Pregnancy | Reproduction | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 141481 |
| 18. Title: Effect of the interval between pregnancies on perinatal outcomes. Author: Zhu BP; Rolfs RT; Nangle BE; Horan JM Source: NEW ENGLAND JOURNAL OF MEDICINE. 1999 Feb 25;340(8):589-94. Abstract: The relationship between short intervals between pregnancies and adverse perinatal outcomes is analyzed using data from the birth certificates of 173,205 singleton infants born alive to multiparous mothers in Utah from 1989 to 1996. Factors examined included low birth weight, preterm birth, and small size for gestational age. The results showed that "infants conceived 18 to 23 months after a previous live birth had the lowest risks of adverse perinatal outcomes; shorter and longer interpregnancy intervals were associated with higher risks." (EXCERPT) Language: English Keywords: UNITED STATES OF AMERICA | UTAH | BIRTH INTERVALS | CHILD HEALTH | LOW BIRTH WEIGHT | PREMATURE BIRTH | SIZE | GESTATIONAL AGE | BIRTH SPACING | Developed Countries | North America | Americas | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Health | Birth Weight | Body Weight | Physiology | Biology | Pregnancy Outcomes | Pregnancy | Reproduction | Examinations and Diagnoses | Fetus | Family Planning Document Number: 161033 |
| 19. Title: Risk factors for short interpregnancy interval -- Utah, June 1996 - June 1997. Author: Duncan J; Nangle B; Streeter N; Bloebaum L; Tingey DC; Olson JA Source: MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT. 1998 Nov 6;47(43):930-4. Abstract: The Utah (US) Medicaid program provides pregnancy-related coverage to women with household incomes 133% or less of the federal poverty level; however, Medicaid coverage of family planning (FP) and other services ends 2 months after delivery for women who are not otherwise eligible. To determine whether increased access to FP services would benefit Medicaid recipients, a comparative study was conducted of the inter-pregnancy intervals of Utah residents whose most recent pregnancy was covered by Medicaid and those of all other state residents. Data for infants born live to Utah mothers in a 12-month period in 1995-96 were matched to the Medicaid eligibility database. A short inter-pregnancy interval was defined as less than 12 months between delivery dates of consecutive live-born infants minus the gestational age of the most recent child. Of the 21,846 infants (51.5% of total births during the study period) eligible for inclusion, 3916 (17.9%) were born after a pregnancy interval of 12 months or less. 22.9% of mothers were Medicaid recipients. Medicaid recipients 20 years of age and above were nearly twice as likely as nonrecipients to have a short inter-pregnancy interval (odds ratio, 1.6; 95% confidence interval, 1.5-1.8). The risk of a short inter-pregnancy interval was also elevated among mothers from racial and ethnic minority groups. Access to FP services after a pregnancy could be enhanced by extending Medicaid coverage for a longer period after delivery or increasing the availability of FP services for low-income women. Language: English Keywords: UTAH | UNITED STATES OF AMERICA | RESEARCH REPORT | COMPARATIVE STUDIES | PREGNANCY | BIRTH INTERVALS | BIRTH SPACING | TITLE 19 MEDICAL ASSISTANCE | LOW INCOME POPULATION | RISK FACTORS | FAMILY PLANNING PROGRAMS | WOMEN | Developed Countries | North America | Americas | Studies | Research Methodology | Reproduction | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Family Planning | Public Assistance | Government Financing | Financial Activities | Economic Factors | Social Class | Socioeconomic Status | Socioeconomic Factors | Biology | Programs | Organization and Administration Document Number: 138073 |
| 20. Title: Appeals court invalidates Utah ban on late abortions. Source: REPRODUCTIVE FREEDOM NEWS. 1997 Jan 17;6(1):2-3. Abstract: On December 23, 1996, the US Court of Appeals for the Tenth Circuit ruled that a 1991 Utah law that bans all abortions after 20 weeks of pregnancy (except when necessary to save the woman's life, prevent "grave damage" to her health, or prevent the birth of a child with "grave defects") is unconstitutional. The three-judge panel reaffirmed that viability determinations must be left to a physician's medical judgment and not be dictated by the state. Typically, viability occurs between weeks 24-28 of pregnancy. According to a precedent established by the US Supreme Court in 1992's Planned Parenthood vs. Casey, a state may not unduly restrict access to abortion prior to fetal viability; even after viability, a woman's health must be the primary consideration. Language: English Keywords: UTAH | UNITED STATES OF AMERICA | ABORTION LAW | ABORTION | TIME FACTORS | North America | Americas | Developed Countries | Fertility Control, Postconception | Family Planning | Population Dynamics | Demographic Factors | Population Document Number: 120363 Notification |
| 21. Title: Laparoscopic tubal ligation in a minimally invasive surgical unit under local anesthesia compared to a conventional operating room approach under general anesthesia. Author: Hatasaka HH; Sharp HT; Dowling DD; Teahon K; Peterson CM Source: JOURNAL OF LAPAROENDOSCOPIC AND ADVANCED SURGICAL TECHNIQUES. PART A. 1997 Oct;7(5):295-9. Abstract: The costs, operating and recovery times, safety, and acceptability of minimally invasive laparoscopic tubal ligation under sedation and local anesthesia (n = 7) and conventional laparoscopic operating room-based tubal ligation under general anesthesia (n = 7) were compared in sterilization seekers recruited from University of Utah (US) clinics. The mean cost of minimally invasive tubal ligation was significantly lower (US$1615) than that for the conventional technique ($2820). Surgical times were similar (means, 32.9 and 40.4 minutes, respectively); however, the mean total in-room time required was significantly greater for the operating room-based procedure (84 minutes) than the procedure room technique (60 minutes). Moreover, mean recovery time was longer for women who underwent general compared with local anesthesia (48 vs. 14 minutes). There were no complications in either group. Patient satisfaction with tubal ligation, assessed both in the recovery room and 1 week postoperatively, was similar in both groups. The minimally invasive technique is easy for medical residents to learn, safe, associated with significant cost reductions, acceptable to patients, and advantageous in terms of staff time. It is estimated that exclusive use of minimally invasive tubal ligation at the University of Utah Hospital would save $50,000 each year. Language: English Keywords: UTAH | UNITED STATES OF AMERICA | RESEARCH REPORT | COMPARATIVE STUDIES | LAPAROSCOPY | TUBAL LIGATION | ANESTHESIA | TIME FACTORS | SATISFACTION | TUBAL OCCLUSION | Developed Countries | North America | Americas | Studies | Research Methodology | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Female Sterilization | Sterilization, Sexual | Family Planning | Treatment | Population Dynamics | Demographic Factors | Population | Psychological Factors | Behavior Document Number: 130929 |
| 22. Title: Forced counseling, delays continue as mainstays of antiabortion agenda. Author: Saul R Source: STATE REPRODUCTIVE HEALTH MONITOR. 1997 Jun;8(2):8-9. Abstract: The US Supreme Court's 1983 decision in the Akron case enjoined states from requiring that women seeking abortions submit to extensive biased counseling and waiting periods. The 1992 Casey ruling, however, found that a state can regulate abortion services so long as the regulations do not place an "undue burden" on the woman seeking abortion. Since then, 8 states have increased the total to 11 that mandate an enforced counseling/waiting period, and 9 more states have enacted counseling requirements but no mandated delay. In 1997, Florida enacted expanded "informed consent" provisions that force a woman to submit to state-scripted counseling. A lawsuit has already been filed to challenge this law. In Kansas, North Dakota, and Utah, existing counseling/waiting period policies were amended to make them more stringent. Similar legislation is pending but unlikely to be enacted in California and North Carolina, while legislators in Ohio are creating an amendment to require face-to-face counseling. Counseling/waiting period legislation died after serious consideration in Alabama, Arizona, Maine, and Virginia. A US District Court judge upheld Wisconsin's law mandating a 24-hour waiting period and state-scripted counseling while voicing her dismay about the law. The judge did, however, rule against several specific counseling requirements and delayed the law's implementation until she could review the state-scripted materials. A ruling in Michigan that upheld the state's counseling/waiting period has been appealed to Michigan's Supreme Court. Language: English Keywords: UNITED STATES OF AMERICA | FLORIDA | KANSAS | NORTH DAKOTA | UTAH | WISCONSIN | MICHIGAN | ABORTION | ABORTION LAW | LEGISLATION | COURT DECISION | INFORMED CONSENT | COUNSELING | TIME FACTORS | North America | Americas | Developed Countries | Fertility Control, Postconception | Family Planning | Litigation | Clinic Activities | Program Activities | Programs | Organization and Administration | Population Dynamics | Demographic Factors | Population Document Number: 126062 Notification |
| 23. Title: Supreme Court issues limited ruling in challenge to Utah abortion ban. Source: REPRODUCTIVE FREEDOM NEWS. 1996 Jun 28;5(11):2. Abstract: A law passed in Utah in 1991 which prohibited abortion except in cases of life endangerment, rape, incest, risk of grave damage to a woman's medical health, or grave fetal defects. The exceptions for women who had been sexually abused were eliminated after 20 weeks gestation. In December 1992, US District Court Judge J. Thomas Greene found the ban unconstitutional as applied to abortions prior to 20 weeks but upheld it as applied to procedures after that point in pregnancy. A three-judge appellate panel later reversed the district court decision in August 1995 on the argument that the prohibition on post-20-week abortions could not stand independent of the ban on earlier procedures. The appeals court also struck down a requirement that physicians performing those abortions allowed after viability use the method most likely to give the fetus the best chance of survival, unless it would endanger a woman's life or cause grave damage to her medical health. In an unsigned opinion issued on June 17, 1996, the US Supreme Court reversed the appeals court decision which struck down Utah's original 1991 ban on abortions. Five justices ruling in Leavitt v. Jane L. found that the US Court of Appeals for the Tenth Circuit misapplied Utah precedent when it found that the criminal abortion statute could not be divided into two separate abortion bans, one before and one after 20 weeks gestation. Health care providers will now argue that the ban on post-20-week abortions should be struck down on constitutional grounds. This is the first challenge to a state abortion law to come under High Court review since Planned Parenthood v. Casey in 1992. Language: English Keywords: UTAH | UNITED STATES OF AMERICA | COURT DECISION | ABORTION LAW | ABORTION | North America | Americas | Developed Countries | Litigation | Fertility Control, Postconception | Family Planning Document Number: 114627 Notification |
| 24. Title: Navajo Nation expands family planning services. Author: Haws J; Crawford G Source: AVSC NEWS. 1996 Summer;34(2):3, 6. Abstract: An AVSC training program, conducted in cooperation with the Navajo Nation Family Planning Corporation (NNFPC), has the potential to profoundly affect sterilization provision and acceptability on the Navajo Nation reservation. AVSC trained a family physician from the Northern Navajo Medical Center (New Mexico) in the no-scalpel vasectomy technique. This physician expects to provide 30 such sterilizations in the one-year period following the training and is preparing to teach reservation physicians from other health centers to perform the procedure. In addition, a joint AVSC-NNFPC course on sterilization counseling was presented to 30 nursing staff from the New Mexico Center. Central to this training was consideration of the obstacles to sterilization acceptance posed by Navajo cultural beliefs. Sensitivity to some women's desire to keep the procedure private, due to concerns their husbands will abandon them if they can no longer bear children, and to the potential need to include mothers and grandmothers in counseling sessions, is required. Also salient for female counselors and nurses are cultural taboos against a woman discussing sexual matters with a man with whom she is not intimate. In late 1996, AVSC will provide a sterilization counseling update for all NNFPC counselors working at centers throughout the four-state reservation. Language: English Keywords: UNITED STATES OF AMERICA | ARIZONA | COLORADO | NEW MEXICO | UTAH | NATIVE AMERICANS | FAMILY PLANNING PROGRAMS | VASECTOMY | COUNSELING | CULTURE | Developed Countries | North America | Americas | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Family Planning | Programs | Organization and Administration | Male Sterilization | Sterilization, Sexual | Clinic Activities | Program Activities Document Number: 120380 |
| 25. Title: Appeals court finds Utah late abortion restrictions unconstitutional. Source: REPRODUCTIVE FREEDOM NEWS. 1995 Sep 15;4(16):2. Abstract: In an opinion issued on August 2, 1995, a three judge panel of the US Court of Appeals for the Tenth Circuit found invalid several portions of Utah's 1991 criminal abortion ban that applied to pregnancy terminations after the twentieth week as well as prohibiting fetal diagnosis and treatment. The unanimous decision marks the first time that a federal appellate panel has applied the US Supreme Court's 1992 decision in Planned Parenthood vs. Casey to restrictions on abortions performed late in pregnancy. In December 1992, Judge Thomas Greene of the US District Court for the District of Utah relied upon Casey to find unconstitutional the Utah legislature's 1991 attempt to ban virtually all abortions. At the same time, however, the district court rewrote the abortion ban to prohibit procedures after the twentieth week of pregnancy except to save a woman's life, to prevent grave damage to her health, in cases of rape or incest, or to prevent the birth of a child with grave defects. The district court also upheld a ban on fetal experimentation and a requirement that physicians performing later abortions use the method most likely to give the fetus the best chance of survival. Judge Greene's decision was stayed pending negotiations over possible settlement and plaintiffs' appeal in the case. Overturning the lower court's holdings, the appeals court found that Judge Greene's revision of the abortion ban was an improper use of judicial power; that the prohibition on so-called fetal experimentation is unconstitutionally vague; and that the restrictions on post-viability abortions are invalid because they constitute an undue burden. In a separate opinion, the appeals court reversed Judge Greene's unprecedented 1993 order awarding attorneys fees to the State of Utah and sanctioning plaintiffs in Jane L. vs. Bangerter for raising alternative legal claims under which the abortion ban might have been found unconstitutional. Language: English Keywords: UNITED STATES OF AMERICA | UTAH | COURT DECISION | ABORTION LAW | ABORTION | CRIME | FETAL VIABILITY | North America | Americas | Developed Countries | Litigation | Fertility Control, Postconception | Family Planning | Social Problems | Fetus | Pregnancy | Reproduction Document Number: 108118 Notification |
| 26. Title: Utah's ban on abortion coverage for low-income women challenged. Source: REPRODUCTIVE FREEDOM NEWS. 1995 Feb 10;4(3):2. Abstract: On January 30 (1995) two women's health care providers, a rape crisis center, and a YWCA-run battered women's shelter asked the federal district court in Utah to declare invalid and enjoin enforcement of the state's virtual ban on abortion coverage for Medicaid-eligible women. The plaintiffs argue that Utah's criminal prohibition on state Medicaid coverage for abortion--except when the procedure is necessary to prevent a woman's death--violates federal Medicaid law because it does not cover abortions for survivors of rape or incest. The Hyde Amendment has provided federal Medicaid funds for abortions in cases of rape and incest since 1993, and federal courts have since ruled against eight other states that refused to cover those procedures. In late December, Utah was one of seven states notified by the federal Health Care Financing Administration (HCFA) that the state is "out of compliance" with federal Medicaid law. With nearly 46 rapes per 100,000 people, Utah has one of the highest rates of rape in the country. CRLP (Center for Reproductive Law and Policy) has previously filed lawsuits in Utah challenging the state's 1991 abortion ban and a 1993 mandatory delay and biased counseling requirement. Plaintiffs in Utah Women's Clinic v. Graham are represented by CRLP's Eve Gartner, with Salt Lake City attorneys Howard Lundgren and Jeffrey Oritt. (full text) Language: English Keywords: UNITED STATES OF AMERICA | UTAH | ABORTION LAW | TITLE 19 MEDICAL ASSISTANCE | RAPE | Developed Countries | North America | Americas | Fertility Control, Postconception | Family Planning | Public Assistance | Government Financing | Financial Activities | Economic Factors | Crime | Social Problems Document Number: 102444 |
| 27. Peer Reviewed Title: Association of young maternal age with adverse reproductive outcomes. Author: Fraser AM; Brockert JE; Ward RH Source: NEW ENGLAND JOURNAL OF MEDICINE. 1995 Apr 27;332(17):1113-7. Abstract: Pregnancy in adolescence is associated with an excess risk of poor outcomes, including low birth weight and prematurity. Whether this association simply reflects the deleterious sociodemographic environment of most pregnant teenagers or whether biologic immaturity is also causally implicated is not known. To determine whether a young age confers an intrinsic risk of adverse outcomes of pregnancy, the authors performed stratified analyses of 134,088 White girls and women, 13-24 years old, in Utah who delivered singleton, first-born children between 1970 and 1990. Relative risk for subgroups of this study population was examined to eliminate the confounding influence of marital status, educational level, and the adequacy of prenatal care. The adjusted relative risk for the entire study group was calculated as the weighted average of the stratum-specific risks. Among White married mothers with educational levels appropriate for their ages who received adequate prenatal care, younger teenage mothers (13-17 years of age) had a significantly higher risk (p < 0.001) than mothers who were 20-24 years of age of delivering an infant who had low birth weight (relative risk, 1.7; 95% confidence interval, 1.5-2.0) who was delivered prematurely (relative risk, 1.9; 95% confidence interval, 1.7-2.1), or who was small for gestational age (relative risk, 1.3; 95% confidence interval, 1.2-1.4). Older teenage mothers (18-19 years of age) also had a significant increase in these risks. Even though sociodemographic variables associated with teenage pregnancy increase the risk of adverse outcomes, the relative risk remained significantly elevated for both younger and older teenage mothers after adjustment for marital status, level of education, and adequacy of prenatal care. In a study of mothers 13-24 years old who had the characteristics of most White, middle-class Americans, a younger age conferred an increased risk of adverse pregnancy outcomes that was independent of important confounding sociodemographic factors. (author's) Language: English Keywords: UNITED STATES OF AMERICA | UTAH | COHORT ANALYSIS | ADOLESCENT PREGNANCY | AGE FACTORS | PREGNANCY OUTCOMES | SOCIOECONOMIC FACTORS | LOW BIRTH WEIGHT | Developed Countries | North America | Americas | Research Methodology | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Population Characteristics | Pregnancy | Reproduction | Economic Factors | Birth Weight | Body Weight | Physiology | Biology Document Number: 104244 |
| 28. Title: Culture as a determinant of reasons for migration. Author: Kontuly T; Smith KR; Heaton TB Source: SOCIAL SCIENCE JOURNAL. 1995;32(2):179-93. Abstract: "This article evaluates the importance of cultural factors in the destination selection process for migrants moving into and returning to the state of Utah." Data are from a representative, state-wide survey of 525 Utah households undertaken in 1986. The results show that "although economic reasons for selecting Utah as a destination predominate, culture and family play an important secondary role. Mormons are more likely to report cultural and family reasons for moving to Utah, while non-Mormons are more likely to move for employment and education reasons. Distance from the state and time since arrival are the most important determinants of reasons for migration to Utah." (EXCERPT) Language: English Keywords: UNITED STATES OF AMERICA | UTAH | CULTURAL BACKGROUND | INTERNAL MIGRATION | RELIGION | CHURCH OF THE LATTER-DAY SAINTS | DESTINATION | Developed Countries | North America | Americas | Population Characteristics | Demographic Factors | Population | Migration | Population Dynamics | Christianity Document Number: 242558 |
| 29. Title: Metabolic parameter, bleeding, and weight changes in U.S. women using progestin only contraceptives. Author: Mainwaring R; Hales HA; Stevenson K; Hatasaka HH; Poulson AM; Jones KP; Peterson CM Source: CONTRACEPTION. 1995 Mar;51(3):149-53. Abstract: During March 1991-April 1992, health workers recruited 71 women aged 16-43 (98% Caucasian) attending the University of Utah Obstetrics and Gynecology Clinic for a clinical study examining metabolic parameters, menstruation disorders, and changes in weight after 12 months of use of a progestin-only contraceptive. The progestin-only contraceptives (number of women using each) included Norplant contraceptive implants (44), Depo-Provera (22), and a mini-pill (norethindrone) (5). Metabolic parameters were total cholesterol, triglycerides, high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), sex hormone binding globulin, apolipoprotein A-1, apolipoprotein B-100, and total and direct bilirubin. The only groups investigated for metabolic parameters were Norplant users and Depo-Provera users. Metabolic parameters did not change significantly after progestin use. No group experienced significant weight gain. However, one woman gained more than 60 pounds in the Norplant group and one woman gained more than 40 pounds in the Depo-Provera group. Depo-Provera users had significantly fewer total days of blood loss than Norplant users during months 5-12 (p < 0.02) and mini-pill users during months 6-10 (p < 0.04). Mini-pill users and Norplant users had similar bleeding patterns, except during months 11-12, when Norplant users had more bleeding than mini-pill users (e.g., month 12, 9 vs. 0 days). The total days of blood loss was 8.7 for Norplant users, 3.5 for Depo-Provera users, and 10.2 for mini-pill users. Less than 10% of Norplant users and mini-pill users experienced amenorrhea, while amenorrhea increased after 120 days in Depo-Provera users (p < 0.001). After 1 year, the Norplant and mini-pill groups had more excessive prolonged (>10 days) bleeding than the Depo-Provera group (29% and 50%, respectively, vs. 11%). Language: English Keywords: UNITED STATES OF AMERICA | UTAH | RESEARCH REPORT | CLINICAL RESEARCH | LOW-DOSE PROGESTINS | CONTRACEPTIVE IMPLANTS | LEVONORGESTREL | DEPO-PROVERA | ORAL CONTRACEPTIVES | NORETHINDRONE | METABOLIC EFFECTS | BLEEDING | MENSTRUATION DISORDERS | BODY WEIGHT | CHANGES | Developed Countries | North America | Americas | Research Methodology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Contraceptive Methods | Medroxyprogesterone Acetate | Physiology | Biology | Signs and Symptoms | Diseases | Social Change Document Number: 103296 |
| 30. Title: 1990 census of population. Social and economic characteristics: Utah. Author: United States. Bureau of the Census Source: Washington, D.C., Bureau of the Census, 1993 Sep. [xxvi], 504, [95] p. Abstract: This is one in a series of publications presenting results from the 1990 U.S. census on social and economic characteristics of the population by state. This volume contains data for Utah concerning social characteristics, including foreign-born status, place of residence in 1985, language, educational status, and fertility; labor force and commuting; occupation, income, and poverty status; and ethnic groups. Most of these data are also presented separately by major ethnic group. (ANNOTATION) Language: English Keywords: UNITED STATES OF AMERICA | UTAH | CENSUS | GOVERNMENT PUBLICATION | TABLES AND CHARTS | POPULATION CHARACTERISTICS | SOCIOECONOMIC FACTORS | FOREIGNERS | PLACE OF BIRTH | RESIDENCE CHARACTERISTICS | MIGRATION | LANGUAGE | EDUCATIONAL STATUS | FERTILITY | LABOR FORCE | COMMUTING | OCCUPATIONS | INCOME | POVERTY | ETHNIC GROUPS | STATISTICS | Developed Countries | North America | Americas | Population Statistics | Research Methodology | Demographic Factors | Population | Economic Factors | Nationality | Population Distribution | Geographic Factors | Population Dynamics | Communication | Socioeconomic Status | Human Resources | Behavior | Cultural Background Document Number: 239243 |
 |
||
 |
Information & Knowledge for Optimal Health (INFO) Project 111 Market Place Suite 310, Baltimore, MD 21202 Phone: 410-659-6300 Fax: 410-659-6266 Security & Privacy Policy |  |