| 1. Peer Reviewed Title: Emergence of a peak in early infant mortality due to HIV/AIDS in South Africa. Author: Bourne DE; Thompson M; Brody LL; Cotton M; Draper B; Laubscher R; Abdullah MF; Myers JE Source: AIDS. 2009 Jan 2;23(1):101-6. Abstract: OBJECTIVES: South Africa has among the highest levels of HIV prevalence in the world. Our objectives are to describe the distribution of South African infant and child mortality by age at fine resolution, to identify any trends over recent time and to examine these trends for HIV-associated and non HIV-associated causes of mortality. METHODS: A retrospective review of vital registration data was conducted. All registered postneonatal deaths under 1 year of age in South Africa for the period 1997-2002 were analysed by age in months using a generalized linear model with a log link and Poisson family. RESULTS: Postneonatal mortality increased each year over the period 1997-2002. A peak in HIV-related deaths was observed, centred at 2-3 months of age, rising monotonically over time. CONCLUSION: We interpret the peak in mortality at 2-3 months as an indicator for paediatric AIDS in a South African population with high HIV prevalence and where other causes of death are not sufficiently high to mask HIV effects. Intrauterine and intrapartum infection may contribute to this peak. It is potentially a useful surveillance tool, not requiring an exact cause of death. The findings also illustrate the need for early treatment of mother and child in settings with very high HIV prevalence. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | RETROSPECTIVE STUDIES | LINEAR REGRESSION | INFANT | PERSONS LIVING WITH HIV/AIDS | INFANT MORTALITY | AIDS | CAUSES OF DEATH | CHILD MORTALITY | VITAL STATISTICS | MOTHER-TO-CHILD TRANSMISSION | DEATH RATE | AGE SPECIFIC DEATH RATE | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Studies | Statistical Regression | Data Analysis | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Mortality | Population Dynamics | Population Statistics | Transmission | Infections Document Number: 330334 |
2.  Peer Reviewed Title: An event-level analysis of condom use as a function of mood, alcohol use, and safer sex negotiations. Author: Schroder KE; Johnson CJ; Wiebe JS Source: Archives of Sexual Behavior. 2009 Apr;38(2):283-9. Abstract: Daily self-reports of condom-protected intercourse were analyzed as a function of emotional states, alcohol consumption, and safer sex negotiations in a sample of single, low-income Hispanic students. The sample included 15 women and 17 men who reported a minimum of four sexual episodes as well as inconsistent condom use over a 3-month self-reporting period. The analyses focused on 829 days out of 2,586 daily self-reports on which sexual intercourse was reported. Hierarchical linear modeling was used to predict condom-protected intercourse as a function of mood states, substance use, and safer sex negotiations. Safer sex negotiation was the strongest positive predictor of condom use. Contrary to expectation, unprotected intercourse was less likely to occur in episodes characterized by greater negative affect and more likely in episodes in which greater positive mood was reported. No main effect of alcohol consumption on safer sex was observed; however, an interaction between alcohol consumption and positive mood emerged, indicating that unprotected intercourse was most likely to occur when positive mood was combined with alcohol consumption. The results contradict the assumption that emotional distress predicts engagement in more risky sexual behavior and indicate that safer sex negotiations are likely to outweigh any effects of mood or alcohol consumption on subsequent condom use. Language: English Keywords: TEXAS | RESEARCH REPORT | KAP SURVEYS | EVENT HISTORY ANALYSIS | LINEAR REGRESSION | HISPANICS | STUDENTS | CONDOM USE | PARTNER COMMUNICATION | ALCOHOL USE AND ABUSE | SAFER SEX | EMOTIONS | STRESS | RISK BEHAVIOR | SEX BEHAVIOR | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Analysis | Statistical Regression | Data Analysis | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Education | Risk Reduction Behavior | Behavior | Interpersonal Relations | Psychological Factors Document Number: 330970 |
| 3. Title: Demographic and illness-related variables associated with HIV-related fatigue. Author: Harmon JL; Barroso J; Pence BW; Leserman J; Salahuddin N Source: Journal of the Association of Nurses in AIDS Care. 2008 Mar-Apr;19(2):90-97. Abstract: Fatigue is one of the most debilitating symptoms suffered by those with HIV-infection, yet little is known about its correlates. The primary aims of this study were to describe the degree to which fatigue affects daily functioning and the demographic and illness-related predictors of fatigue. The sample (n = 128) was composed of primarily poor, unemployed people of color. Fatigue most often interfered with the ability to think quickly, perform household chores, exercise, work, engage in recreational activities, walk, plan activities, and think clearly. The consequences of fatigue were highest for lowered motivation, difficulty concentrating, increased drowsiness, losing patience, and interference with work, family, and social life. Multiple linear regression analyses showed statistically significant associations of employment status, monthly income, current antidepressant use, and number of years living with HIV infection as predictors of fatigue. These must be better understood to develop interventions to successfully ameliorate HIV-related fatigue. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | LINEAR REGRESSION | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | AIDS | FATIGUE | DEMOGRAPHIC FACTORS | Developed Countries | North America | Americas | Statistical Regression | Data Analysis | Research Methodology | Viral Diseases | Diseases | Signs and Symptoms | Population Document Number: 325226 |
| 4. Peer Reviewed Title: Lack of an adverse effect of Giardia intestinalis infection on the health of Peruvian children. Author: Hollm-Delgado MG; Gilman RH; Bern C; Cabrera L; Sterling CR Source: American Journal of Epidemiology. 2008 Sep 15;168(6):647-655. Abstract: Giardia intestinalis is a common gastrointestinal protozoan worldwide, but its effects on childhood growth in developing countries are not clearly understood. The authors aimed to describe its effects on child growth. They followed 220 Peruvian children daily for diarrhea, weekly for stool samples, and monthly for anthropometry. The authors modeled the effect of nutritional status on the risk of Giardia infection and the risk of diarrhea attributable to Giardia using negative binomial regression. They modeled the effects of Giardia infection on growth using linear regression, with 85% of children becoming infected with Giardia and 87% of these becoming reinfected. In multivariable analysis, the risk of Giardia infection did not vary with weight for age (relative risk = 1.00, 95% confidence interval: 0.89, 1.12) or height for age (relative risk = 0.92, 95% confidence interval: 0.82, 1.04). Giardiasis did not affect growth at 1 or 2 months following the first infection at any age interval. The longitudinal prevalence of Giardia between 6 and 24 months of age was not associated with height gain in that interval (p = 0.981). Giardia was not associated with an increased risk of diarrhea at any age interval. Study results question the importance of Giardia as a childhood pathogen in developing countries where giardiasis is hyperendemic. (author's) Language: English Keywords: PERU | DEVELOPING COUNTRIES | RESEARCH REPORT | LINEAR REGRESSION | PARASITIC DISEASES | CHILD | GROWTH | CHILD DEVELOPMENT | GASTROINTESTINAL EFFECTS | DIARRHEA | ANTHROPOMETRY | MALNUTRITION | RISK ASSESSMENT | South America, Western | South America | Latin America | Americas | Statistical Regression | Data Analysis | Research Methodology | Diseases | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Biology | Physiology | Measurement | Nutrition Disorders | Evaluation Document Number: 328164 |
| 5. Peer Reviewed Title: Refining the criteria for stalled fertility declines: An application to rural KwaZulu-Natal, South Africa, 1990 -- 2005. Author: Moultrie TA; Hosegood V; McGrath N; Hill C; Herbst K Source: Studies in Family Planning. 2008 Mar;39(1):39-48. Abstract: Stalled fertility declines have been identified in several regions across the developing world, but the current conceptualization of a stalled fertility decline is poorly theorized and does not lend itself to objective measurement. We propose a more rigorous and statistically testable definition of stalled fertility decline that can be applied to time-series data. We then illustrate the utility of our definition through its application to data from rural South Africa for the period 1990-2005 collected from a demographic surveillance site. Application of the approach suggests that fertility decline has indeed stalled in rural KwaZulu-Natal, at about three children per woman. The stall, some 20 percent above the replacement fertility level, does not appear to be associated with a rise in wanted fertility or attenuated access to contraceptive methods. This identification of a stalled fertility decline provides the first evidence of such a stall in southern Africa, the region with the lowest fertilitylevels in sub-Saharan Africa. (author's) Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | LINEAR REGRESSION | RURAL POPULATION | FERTILITY DECLINE | FERTILITY RATE | CONTRACEPTIVE USAGE | FERTILITY DETERMINANTS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Statistical Regression | Data Analysis | Research Methodology | Population Characteristics | Demographic Factors | Population | Fertility Changes | Fertility | Population Dynamics | Birth Rate | Fertility Measurements | Contraception | Family Planning Document Number: 324216 |
6.  Title: Adult education and child mortality in India: The influence of caste, household wealth, and urbanization. Author: Singh-Manoux A; Dugravot A; Smith GD; Subramanyam M; Subramanian SV Source: Epidemiology. 2008 Mar;19(2):294-301. Abstract: Although socioeconomic position is generally found to be related to health, the associations can be different for different measures of socioeconomic position. We examined the association between adult education and child mortality, and the influence of other socioeconomic markers (caste, household wealth, and urbanization) on this association. Data were drawn from the 1998-1999 Indian National Family Health Survey, conducted in 26 states and comprising 66,367 children age 5 years or under. Adult education, for the head of household and spouse, was categorized into 0, 1-8, and 9 or more years of schooling. We used logistic regression to estimate associations between education and child mortality in analysis adjusted for other socioeconomic markers. Effect modification by caste, household wealth, and urbanization was assessed by fitting an interaction term with education. Compared with those who had no education, 9 or more years of education for the head of household and for the spouse were associated with lower child mortality (odds ratio [OR] = 0.54; 95% confidence interval [CI] = 0.48-0.62 and OR = 0.44; 95% CI = 0.36-0.54, respectively) in analyses adjusted for age, sex, and state of residence. Further adjustments for caste and urbanization attenuated these associations slightly; when adjustments were made for household wealth the associations were attenuated more substantially. Nevertheless, in fully adjusted models, 9 or more years of education for the head of household (OR = 0.81; 95% CI = 0.70-0.93) and the spouse (OR = 0.75; 95% CI = 0.60-0.94) remained associated with lower child mortality. There was no effect modification of this association by caste, household wealth, and urbanization. Adult education has a protective association with child mortality in India. Caste, household wealth, and urbanization do not modify or completely attenuate this association. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | HEALTH SURVEYS | LINEAR REGRESSION | CHILD MORTALITY | SOCIOECONOMIC STATUS | EDUCATIONAL STATUS | CASTE | INCOME | URBANIZATION | Developing Countries | Asia, Southern | Asia | Health | Statistical Regression | Data Analysis | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | Socioeconomic Factors | Economic Factors | Social Class | Urban Population Distribution | Population Distribution | Geographic Factors Document Number: 325025 |
| 7. Peer Reviewed Title: Size at birth, infant, early and later childhood growth and adult body composition: A prospective study in a stunted population. Author: Corvalan C; Gregory CO; Ramirez-Zea M; Martorell R; Stein AD Source: International Journal of Epidemiology. 2007 Jun;36(3):550-557. Abstract: Pre-natal and post-natal growth are associated with adult body composition, but the relative importance of growth in different periods of childhood is still unclear, particularly in stunted populations. We studied 358 women and 352 men measured as children in 1969-77 in four villages in Guatemala, and re-measured as adults in 2002-04 (mean age 32.7 years). We determined the associations of body mass index (BMI) and length at birth, and changes in BMI and length during infancy (0-1.0 year) and early (1.0-3.0 years) and later (3.0-7.0 years) childhood, with adult BMI (aBMI), percentage of body fat (aPBF), abdominal circumference (aAC) and fat-free mass (aFFM). Prevalence of stunting was high (64% at 3 years; HAZ less than -2SD). Obesity (WHZ greater than 2SD) prevalence in childhood was less than 2%, while overweight prevalence in adulthood was 52%. BMI at birth was positively associated with aBMI and aFFM while length at birth was positively associated with aAC and aFFM. Increased BMI in infancy and later childhood were positively associated with all four adult body composition measures; associations in later childhood with fatness and abdominal fatness were stronger than those with aFFM. Change in length during infancy and early childhood was positively associated with all four adult body composition outcomes; the associations with aFFM were stronger than those with fat mass. Increases in BMI between 3.0 and 7.0 years had stronger associations with adult fat mass and abdominal fat than with aFFM; increases in length prior to age 3.0 years were most strongly associated with increases in aFFM. (author's) Language: English Keywords: GUATEMALA | RESEARCH REPORT | COHORT ANALYSIS | QUANTITATIVE RESEARCH | LINEAR REGRESSION | ADULTS | BODY WEIGHT | BODY HEIGHT | OBESITY | GROWTH | BIRTH WEIGHT | CHILD NUTRITION | Central America | Latin America | Americas | Developing Countries | Research Methodology | Statistical Regression | Data Analysis | Age Factors | Population Characteristics | Demographic Factors | Population | Physiology | Biology | Child Development | Nutrition | Health Document Number: 313750 |
| 8. Peer Reviewed Title: Effect of pregnancy on HIV disease progression and survival among women in rural Uganda. Author: Van der Paal L; Shafer LA; Mayanja BN; Whitworth JA; Grosskurth H Source: Tropical Medicine and International Health. 2007 Aug;12(8):920-928. Abstract: The objective was to investigate the effect of pregnancy on HIV disease progression and survival among HIV-infected women in rural Uganda, prior to the introduction of anti-retroviral therapy (ART). From a clinical cohort established in 1990, we selected records from HIV-infected women of reproductive age. We conducted two analyses: (1) all HIV-infected cases contributing to analysis of CD4 decline, using a linear regression model with random intercepts and slopes; (b) incident cases with known date of seroconversion contributed to analyses of median time to CD4 less than 200 cells/microl, AIDS and death. A total of 139 women were included in the analysis of CD4 decline. Women who subsequently became pregnant had higher CD4 counts at enrolment and had a slower CD4 decline than those who did not become pregnant. In women who became pregnant, CD4 decline was faster after pregnancy than before (P less than 0.0001). The survival analyses showed no significant differences between women who became pregnant and those who did not with respect to median time to CD4 count less than 200, AIDS or death. The initial comparative immunological advantage possessed by fertile women before they become pregnant is subsequently lost as a result of their pregnancy. Women should be informed about the potential negative effect of pregnancy on their immunological status and should be offered contraception. In resource-limited settings, women determined to become pregnant should be given priority for ART if eligible. (author's) Language: English Keywords: UGANDA | RESEARCH REPORT | COHORT ANALYSIS | CLINICAL TRIALS | LINEAR REGRESSION | WOMEN | PERSONS LIVING WITH HIV/AIDS | RURAL POPULATION | HIV | AIDS | PREGNANCY | IMMUNOLOGICAL EFFECTS | IMMUNOLOGIC FACTORS | RISK FACTORS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Research Methodology | Clinical Research | Statistical Regression | Data Analysis | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Population Characteristics | Reproduction | Immunity | Immune System | Physiology | Biology Document Number: 313771 |
| 9. Peer Reviewed Title: Applying a data duplication technique in linear regression analysis of waiting time to pregnancy. Author: Awang H Source: Journal of Biosocial Science. 2005;37:471-479. Abstract: This analysis demonstrates the application of a data duplication technique in linear regression with censored observations of the waiting time to third pregnancy ending in two outcome types, using data from Malaysia. The linear model not only confirmed the results obtained by the Cox proportional hazards model, but also identified two additional significant factors. The method provides a useful alternative when Cox proportionality assumption of the hazards is violated. (author's) Language: English Keywords: MALAYSIA | RESEARCH REPORT | LINEAR REGRESSION | PREGNANT WOMEN | PREGNANCY | BIRTH INTERVALS | PREGNANCY OUTCOMES | Developing Countries | Asia, Southeastern | Asia | Statistical Regression | Data Analysis | Research Methodology | Population Characteristics | Demographic Factors | Population | Reproduction | Fertility Measurements | Fertility | Population Dynamics Document Number: 289684 |
| 10. Peer Reviewed Title: Evolution of uterine cervical cancer mortality from 1979 to 1998 in the state of Rio Grande do Sul, Brazil. Author: Kalakun L; Bozzetti MC Source: Cadernos de Saude Publica. 2005 Jan-Feb;21(1):299-309. Abstract: A decrease in uterine cervical cancer (CC) mortality has been observed in developed countries. However, mortality data in Brazil suggest that CC is one of the most frequent causes of cancer death in women; it is the fourth cause of death from cancer in women in Rio Grande Sul State. A time-trend ecological study was performed to analyze CC mortality trends in Rio Grande do Sul from 1979 to 1998. Data were collected from the Mortality Information System, Brazilian Ministry of Health (DATASUS). Standardized mortality ratios were calculated and linear regression was used for time-trend analysis. The impact of cervical cancer death on life expectancy was also estimated for the study population using potential years of life lost (PYLL). Standardized mortality ratios during the study period revealed a positive linear trend of 0.17, and the mean annual mortality rate was 7.58/100,000. Cervical cancer accounted for 21.9 ± 1.33 PYLL during the period. In conclusion, although CC is a preventable and curable disease, an increase is observed in mortality from this cause in Rio Grande do Sul State, which may suggest failure in screening programs for cervical cancer. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | LINEAR REGRESSION | WOMEN | CERVICAL CANCER | MORTALITY | INCIDENCE | PUBLIC HEALTH | South America, Eastern | South America | Latin America | Americas | Developing Countries | Statistical Regression | Data Analysis | Research Methodology | Demographic Factors | Population | Cancer | Neoplasms | Diseases | Population Dynamics | Measurement | Health Document Number: 282040 |
| 11. Title: Child mortality in developing countries: challenges and policy options. Author: Oloo JA Source: Eastern Africa Social Science Research Review. 2005 Jun;21(2):1-17. Abstract: The objective of this study is to understand determinants of mortality rates of children under the age of five years in developing countries. The study uses secondary data to investigate the relationship between under-five mortality rates and such socioeconomic variables as fertility, literacy, immunization, access to clean drinking water, HIV/AIDS prevalence, and human and material resources using linear regression analysis. Results show that while most of these variables have a significant relationship with under-five mortality rate, the proportion of doctors for every 100,000 population, and health expenditure per capita have an insignificant predictive value. Conclusion: Reducing child mortality rates requires multiple intervention strategies, such as access to safe drinking water, improvement in education opportunities, family planning, and tackling HIV/AIDS. (author's) Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | LINEAR REGRESSION | INFANT MORTALITY | CHILD MORTALITY | FERTILITY | POLICY | UN | Statistical Regression | Data Analysis | Research Methodology | Mortality | Population Dynamics | Demographic Factors | Population | International Agencies | Organizations Document Number: 292518 |
| 12. Title: Gender, lineage, and fertility-related outcomes in Ghana. Author: Takyi BK; Dodoo FN Source: Journal of Marriage and Family. 2005 Feb;67(1):251-257. Abstract: A growing literature examines the empirical relationship between the joint reproductive preferences of marital partners and reproductive outcomes in Africa. Less explored is how spousal power in decision making may be influenced by lineage type. Using pooled data from Ghana, we investigate how lineage affects gendered reproductive decision outcomes and find some evidence that matrilineal women are more able than nonmatrilineal women to translate their reproductive preferences into action consistent with their goals. (author's) Language: English Keywords: GHANA | RESEARCH REPORT | LINEAR REGRESSION | COUPLES | WOMEN | MEN | GENDER ISSUES | FAMILY PLANNING | FERTILITY DETERMINANTS | REPRODUCTIVE BEHAVIOR | DECISION MAKING | MALE ROLE | PATRIARCHY | MATRIARCHY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Statistical Regression | Data Analysis | Research Methodology | Family Characteristics | Family and Household | Demographic Factors | Population | Fertility | Population Dynamics | Behavior | Social Behavior Document Number: 283349 |
| 13. Peer Reviewed Title: Relating health policy to women's health outcomes. Author: Wisdom JP; Berlin M; Lapidus JA Source: Social Science and Medicine. 2005 Oct;61(8):1776-1784. Abstract: Individuals’ social and economic circumstances, including socioeconomic status and medical care availability, are central to health outcomes, particularly for women. These factors are often mediated by governmental policies. This exploratory study found associations between women’s health outcomes and state-level policies related to women’s health. Outcomes were mortality rates for four leading causes of death for women in the US (heart disease, stroke, lung cancer, and breast cancer), infant mortality, and a mental health outcome variable. State policies on key women’s health issues were evaluated on the degree to which they adequately protected women’s health. Our regression models accounted for significant variance in mortality rates and substantial variance in the mental health outcome. Policies affecting access to care (Medicaid eligibility and efforts to expand Medicaid) and community (environmental health tracking and violence against women) were significantly associated with mortality outcomes. State health policies should be examined further for their relationship to health outcomes. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | LINEAR REGRESSION | WOMEN | HEALTH POLICY | WOMEN'S HEALTH | SOCIOECONOMIC FACTORS | MORTALITY | MENTAL HEALTH | CHRONIC DISEASES | DOMESTIC VIOLENCE | HEALTH STATUS INDEXES | North America | Americas | Developed Countries | Statistical Regression | Data Analysis | Research Methodology | Demographic Factors | Population | Policy | Health | Economic Factors | Population Dynamics | Diseases | Crime | Social Problems Document Number: 288951 |
| 14. Title: Health sector policy in the first decade of Nepal's multiparty democracy. Does clear enunciation of health priorities matter? Author: Adhikari SR; Maskay NM Source: Health Policy. 2004 Apr;68(1):103-112. Abstract: Nepal experienced a significant political regime shift in 1990 from the partyless Panchyat system to the present multiparty form of democracy. While political instability existed in the decade of the 1990s, reflected in the approximately one government per year, there had been continued enunciation of health policy priorities toward the rural sector, as reflected in the Nepal National Health Policy, 1991 and subsequent plans. The objective of the paper is to assess whether clear enunciation of health priorities have translated into beneficial health outcomes, reflected in reduction of the child death rate, child morality rate, infant mortality rate and increase in the life expectancy rate. This question is assessed empirically over the 10-year period of fiscal year 1989/1990 to 1999/2000 using mainly secondary data published by His Majesty’s Government of Nepal (HMG/N), through the perspectives of input–output model and extension of health services, along with an indicative regression of a Nepalese health production function. The results (i.e. empirical observations) suggest that while there have been clear enunciation of health priorities, there have not been significant positive effects on health sector outcomes. The paper ends with a number of recommendations and concludes with the necessity for effective and appropriate implementation. (author's) Language: English Keywords: NEPAL | RESEARCH REPORT | LINEAR REGRESSION | CHILD | INFANT | POLITICAL FACTORS | HEALTH POLICY | DEMOCRACY | GOALS | CHILD MORTALITY | INFANT MORTALITY | LIFE EXPECTANCY | Developing Countries | Asia, Southern | Asia | Statistical Regression | Data Analysis | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Policy | Political Systems | Planning | Organization and Administration | Mortality | Population Dynamics | Length of Life Document Number: 191298 |
| 15. Title: Family planning field workers in Bangladesh as influence agents: some policy implications. Author: Andaleeb SS Source: Journal of Health and Population in Developing Countries. 2004 May 4;:[20] p.. Abstract: The family planning program in Bangladesh is one of the country’s success stories. However, in the quest to gain cost efficiencies, there are suggestions to scale back the role of the family planning field workers so that clients receive health and family planning services from fixed facilities established throughout the country. It is hoped, as a result, that clients will adopt more permanent methods of contraception. What are the implications of scaling back the role of the field worker? Over nearly three decades, they have helped shape the demographic transition underway in Bangladesh. As the most direct point of contact with their clients and devoting much of their time to building ongoing relationships, the social capital the filed workers have apparently built and the consequent influence they may have over fertility behavior is likely to be substantial. Under the circumstances, dissipation of this social capital would represent to the program the loss of an intangible asset of great magnitude. This study examines, from the fieldworkers' perspectives, the extent of influence they have over their clients and the factors that explain their influence. Policy implications are discussed in view of the findings. (author's) Language: English Keywords: BANGLADESH | RESEARCH REPORT | LINEAR REGRESSION | FIELD WORKERS | CLIENTS | INFLUENTIALS | FAMILY PLANNING PROGRAMS | PROGRAM DESIGN | PROGRAM EFFECTIVENESS | FERTILITY DETERMINANTS | CONTRACEPTIVE PREVALENCE | Asia, Southern | Asia | Developing Countries | Statistical Regression | Data Analysis | Research Methodology | Health Personnel | Delivery of Health Care | Health | Program Activities | Programs | Organization and Administration | Knowledge Sources | Communication | Family Planning | Program Evaluation | Fertility | Population Dynamics | Demographic Factors | Population | Contraceptive Usage | Contraception Document Number: 193874 |
| 16. Peer Reviewed Title: Stress and health-related quality of life among HIV-infected persons in Hong Kong. Author: Au A; Chan I; Li P; Chung R; Po LM Source: AIDS and Behavior. 2004 Jun;8(2):119-129. Abstract: This study examines the relationships among illness-related factors, stress, health-related quality of life (HRQOL), and psychological distress in persons infected with the human immunodeficiency virus (HIV) living in Hong Kong (N = 55). Participants completed questionnaires including a Symptom Checklist, Modified HIV Stressor Scale (HIVSS), Medical Outcomes Study Short-Form 36 (SF-36), and the Hospital Anxiety and Depression Scale (HADS). In addition, CD4 count information was obtained. Multiple regression analyses were used to model the SF-36 and HADS scores as a function of illness-related factors as well as the stress count and intensity. The number of symptoms was found to be inversely related to SF-36 general health and positively related to the HADS anxiety score. However, CD4 count did not have any significant association with any of the scales on the HRQOL or psychological distress. After controlling for the effect of symptoms, the HIVSS stress count still accounted significantly for additional variance in both HADS anxiety and depression as well as the SF-36 social functioning and role-emotional scores. The study supports the possible contribution of psychosocial factors to the HRQOL and psychological distress after controlling for illness-related factors. Results are discussed in the context of characteristic social factors and services in Hong Kong. (author's) Language: English Keywords: HONG KONG | RESEARCH REPORT | LINEAR REGRESSION | PERSONS LIVING WITH HIV/AIDS | QUALITY OF LIFE | STRESS | PSYCHOLOGICAL FACTORS | DEPRESSION | ANXIETY DISORDERS | PSYCHOSOCIAL FACTORS | Developed Countries | Asia, Eastern | Asia | Statistical Regression | Data Analysis | Research Methodology | HIV Infections | Viral Diseases | Diseases | Social Welfare | Economic Factors | Behavior | Mental Disorders Document Number: 194124 |
| 17. Title: The mass media and HIV/AIDS prevention in Ghana. Author: Benefo KD Source: Journal of Health and Population in Developing Countries. 2004 May;:[18] p.. Abstract: The study uses logistic regression to examine how exposure to HIV/AIDS information in the mass media influences knowledge of the disease and risk behaviours in Ghana, a West African country at a relatively early stage of the epidemic. It finds that mass media exposure increases awareness of partner fidelity, condom use and avoidance of parenteral threats as ways of preventing infection and promotes condom use and partner fidelity as likely behavioural responses to the epidemic. Exposure to multiple channels reinforces media messages about safe sex and HIV/AIDS. Radio media seem to be the most powerful sources of information about the epidemic. They reach more people than television and print media and have larger effects on individuals' knowledge base and behaviour. However, the mass media influence has limits. Mass media exposure has no impacts on awareness and interest in abstinence and avoidance of commercial sex which means that they fail to address the needs of the poor women and the young who are the core sources of infection in the Ghanaian epidemic. I speculate that the structure of mass media effects observed may suggest that the national response to the campaign has been driven as much by political exigencies as by the logic of epidemiology. (author's) Language: English Keywords: GHANA | RESEARCH REPORT | LINEAR REGRESSION | HIV PREVENTION | AIDS PREVENTION | MASS MEDIA | KNOWLEDGE | RISK BEHAVIOR | SEX BEHAVIOR | PUBLIC HEALTH | CAMPAIGNS | PROGRAM EFFECTIVENESS | FIDELITY | CONDOM USE | SAFER SEX | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Statistical Regression | Data Analysis | Research Methodology | HIV Infections | Viral Diseases | Diseases | AIDS | Communication | Behavior | Health | Communication Programs | Program Evaluation | Programs | Organization and Administration | Risk Reduction Behavior Document Number: 193875 |
| 18. Title: Human prenatal investment affected by maternal age and parity. Author: Braza F Source: Human Ecology. 2004 Apr;32(2):163-175. Abstract: This paper investigates the effects of mother’s age and parity on the prenatal allocation of resources in sons and daughters using a sample of 6994 in 20- to 34-year-old mothers from Granada (Spain). This study tests the Trivers–Willard allocation model, which predicts that, depending on the mother’s condition, there can be a bias from 50/50 expected investment in the sexes. The results show that mothers of 25–29 age class produce relatively heavier sons compared to younger mothers, suggesting a bias in the allocation of resources before birth favoring neonate boys. This extra investment in boys appears to be related more to the mother’s age than to her parity. Offspring of multiparous mothers had shorter gestation length, but multiparous mothers of the 25–29 age class had boys with a longer gestation than the younger ones. The 25–29 age class mothers are in the peak of fertility and they are presumably in better condition than the other mothers in the study sample. The results suggest that Granada women performed a sex-biased prenatal investment favoring sons by prolonging the gestation period. An index of boys’ extra birth weight is proposed as a suitable variable to measure the maternal prenatal investment. (author's) Language: English Keywords: SPAIN | RESEARCH REPORT | LINEAR REGRESSION | MOTHERS | INFANT | CHILD, MALE | CHILD, FEMALE | GENDER ISSUES | SEX FACTORS | PARITY | MATERNAL AGE | BIRTH WEIGHT | RESOURCE ALLOCATION | ANTENATAL CARE | Developed Countries | Europe, Southwestern | Europe | Statistical Regression | Data Analysis | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Child | Fertility Measurements | Fertility | Population Dynamics | Parental Age | Body Weight | Physiology | Biology | Financial Activities | Economic Factors | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health Document Number: 193877 |
| 19. Peer Reviewed Title: Accuracy of home pregnancy tests at the time of missed menses. Author: Cole LA; Khanlian SA; Sutton JM; Davies S; Rayburn WF Source: American Journal of Obstetrics and Gynecology. 2004 Jan;190(1):100-105. Abstract: The purpose of this study was to investigate the validity of home pregnancy tests (HPTs) around the time of the missed menses. Levels of human chorionic gonadotropin (hCG) were determined in urine around the time of the missed menses, and 5th and 95th centiles were calculated. In a blind study evaluating 18 brands of HPTs, each was tested six times with .ve concentrations of hCG, 0 to 100 mIU/mL. Sensitivity was de.ned as the concentration at which six of six brands gave positive results, at the suggested reading time or at an extended time. It was estimated that a sensitivity of 12.5 mIU/mL was needed to detect 95% of pregnancies at the time of missing menses. Only 1 of 18 HPTs had this sensitivity. If faintly discernible results considered, 2 of 18 brands gave false-positive or invalid results. Clear positive results were given by only 44% of the brands at 100 mIU/mL hCG. If one accepted faintly discernible and extended reading times, all brands responded at 100 mIU/mL. A test with 100 mIU/mL sensitivity would detect approximately 16% of pregnancies at the time of missed menses. The utility of HPTs is questioned. Clinicians need to be aware of the limitations of current HPT brands. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | LINEAR REGRESSION | DATA ANALYSIS | WOMEN | GONADOTROPINS, CHORIONIC | PREGNANCY TESTS | EVALUATION | MEASUREMENT | Developed Countries | North America | Americas | Statistical Regression | Research Methodology | Demographic Factors | Population | Gonadotropins | Hormones | Endocrine System | Physiology | Biology | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses Document Number: 190302 |
| 20. Peer Reviewed Title: Methodology for estimating regional and global trends of child malnutrition. Author: de Onis M; Blössner M; Borghi E; Morris R; Frongillo EA Source: International Journal of Epidemiology. 2004;33(6):1260-1270. Abstract: Child malnutrition is an important indicator for monitoring progress towards the Millennium Development Goals (MDG). This paper describes the methodology developed by the World Health Organization (WHO) to derive global and regional trends of child stunting and underweight, and reports trends in prevalence and numbers affected for 1990–2005. National prevalence data from 139 countries were extracted from the WHO Global Database on Child Growth and Malnutrition. A total of 419 and 388 survey data points were available for underweight and stunting, respectively. To estimate trends we used linear mixed-effect models allowing for random effects at country level and for heterogeneous covariance structures. One model was fitted for each United Nation’s region using the logit transform of the prevalence and results back-transformed to the original scale. Best models were selected based on explicit statistical and graphical criteria. During 1990–2000 global stunting and underweight prevalences declined from 34% to 27% and 27% to 22%, respectively. Large declines were achieved in Eastern and South-eastern Asia, while South-central Asia continued to suffer very high levels of malnutrition. Substantial improvements were also made in Latin America and the Caribbean, whereas in Africa numbers of stunted and underweight children increased from 40 to 45, and 25 to 31 million, respectively. Linear mixed-effect models made best use of all available information. Trends are uneven across regions, with some showing a need for more concerted and efficient interventions to meet the MDG of reducing levels of child malnutrition by half between 1990 and 2015. (author's) Language: English Keywords: DEVELOPING COUNTRIES | METHODOLOGICAL STUDIES | LINEAR REGRESSION | CHILD | MALNUTRITION | ESTIMATION TECHNIQUES | THEORETICAL MODELS | BODY WEIGHT | BODY HEIGHT | WHO | Statistical Regression | Data Analysis | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition Disorders | Diseases | Physiology | Biology | UN | International Agencies | Organizations Document Number: 281096 |
| 21. Peer Reviewed Title: Decreased HIV transmission after a policy of providing free access to highly active antiretroviral therapy in Taiwan. Author: Fang CT; Hsu HM; Twu SJ; Chen MY; Chang YY Source: Journal of Infectious Diseases. 2004 Sep 1;190(5):879-885. Abstract: Taiwan established a nationwide surveillance system for human immunodeficiency virus (HIV) infection in 1989 and adopted a policy to provide all HIV-infected citizens with free access to highly active antiretroviral therapy (HAART) beginning in April 1997. This provided an opportunity to determine the effect of the widespread use of HAART on the evolution of the HIV epidemic. We analyzed national HIV surveillance data. The HIV transmission rate was estimated by use of an exponential model of HIV epidemic evolution, with statistical projection over the interval between infection and detection to fit the surveillance data. By the end of 2002, the cumulative number of HIV-infected citizens in Taiwan had reached 4390 (0.019% of the total population). After free access to HAART was established, the estimated HIV transmission rate decreased by 53% (0.391 vs. 0.184 new cases/prevalent case-year [95% confidence interval, 31%–65%]). There was no statistically significant change in the incidence of syphilis, in the general population or among HIV-positive patients, during the same period. Providing free HAART to all HIV-infected citizens was associated with a 53% decrease in the HIV transmission rate and contributed to the control of the HIV epidemic in Taiwan. (author's) Language: English Keywords: TAIWAN | RESEARCH REPORT | LINEAR REGRESSION | PERSONS LIVING WITH HIV/AIDS | HEALTH POLICY | HIV PREVENTION | EPIDEMICS | ANTIRETROVIRAL THERAPY | DELIVERY OF HEALTH CARE | PROGRAM ACCESSIBILITY | DISEASE TRANSMISSION CONTROL | Asia, Eastern | Asia | Developed Countries | Statistical Regression | Data Analysis | Research Methodology | HIV Infections | Viral Diseases | Diseases | Policy | HIV | Health | Program Evaluation | Programs | Organization and Administration | Prevention and Control Document Number: 195912 |
| 22. Peer Reviewed Title: Housing conditions, perceived stress, smoking, and alcohol: determinants of fetal growth in northwest Russia. Author: Grjibovski A; Bygren LO; Svartbo B; Magnus P Source: Acta Obstetrica et Gynecologica Scandinavica. 2004;83:1159-1166. Abstract: Social determinants of health have become important in countries of the former Soviet Union during the time of transition. This article estimates the influence of living conditions, smoking, alcohol, and maternal stress on fetal growth indices in an urban Russian setting. All pregnant women registered at antenatal care centres in Severodvinsk (Northwest Russia) and their infants comprised the study base (n = 1399). Multivariate linear regression analysis was applied to quantify the effects of the studied factors on birth weight and the ponderal index (PI) adjusted for maternal education, age, occupation, marital status, parity, pre-pregnancy weight, paternal employment, gestational age, and others. Infants of smoking mothers were 126 g lighter compared with non-smokers [95% confidence interval (CI): -198; -54]. On average, birth weight decreased 27 g per cigarette smoked during pregnancy. Living in shared apartments, living in crowded housing situations, and perceived stress were associated significantly with birth weight loss: -89 g (95% CI: -153; -25), -82 g (95% CI: -136; -28), and -61 g (95% CI: -116; -7), respectively. A positive association between maternal alcohol consumption and birth weight was found. Living with parents was associated positively with both birthweight and PI. Infants whose fathers consumed more than 100 ml of absolute alcohol per week were thinner at birth compared with those of non-drinking and moderate drinking fathers. Poor housing conditions, maternal stress, smoking, and alcohol consumption are independent determinants of fetal growth in Northwest Russia. (author's) Language: English Keywords: RUSSIA | RESEARCH REPORT | LINEAR REGRESSION | PREGNANT WOMEN | FETUS | ANTENATAL CARE | BIRTH WEIGHT | SOCIOECONOMIC FACTORS | TOBACCO USE | ALCOHOL USE AND ABUSE | LIFE STYLE | HOUSING | Developing Countries | Asia, Northern | Asia | Statistical Regression | Data Analysis | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Body Weight | Physiology | Biology | Economic Factors | Behavior | Residence Characteristics | Population Distribution | Geographic Factors Document Number: 279331 |
| 23. Peer Reviewed Title: The impact of adult mortality on household dissolution and migration in rural South Africa. Author: Hosegood V; McGrath N; Herbst K; Timaeus IM Source: AIDS. 2004 Jul 23;18(11):1585-1590. Abstract: Objective: To investigate the effect of adult death on household dissolution and migration. Design: Demographic surveillance of the population in a rural area of northern KwaZulu Natal, South Africa. Methods: Data on households resident in the surveillance area on 1 January 2000 were used to examine the effect of adult mortality and household risk factors on household dissolution and mobility between January 2000 and October 2002. Cox regression models were used to assess the risk of household dissolution and migration, controlling for multiple risk factors including causes of death, household composition and household assets. Results: By October 2002, 238 households (2%) had dissolved and 874 (8%) migrated out of the area; 21% (2179) of all households had at least one adult death (18 years and older). Households where one or more adult members died during the follow-up period were four times more likely to dissolve, after controlling for household and community level risk factors [4.3; 95% confidence interval, (CI), 3.3–5.7]. The risk of dissolution was significantly higher in households with multiple deaths (2.3; 95% CI, 1.3–4.3). There were no significant differential risks associated with cause of death, age or sex of the deceased. Adult mortality in the household was not associated with migration. Conclusions: Poorer households, as measured by asset ownership, and households trying to cope with adult deaths are vulnerable to dissolution. The dramatic increase in adult mortality attributable to AIDS will increase the number of households that do not survive as a functional and cohesive social group. (author's) Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | LINEAR REGRESSION | ADULTS | RURAL POPULATION | MORTALITY | FAMILY AND HOUSEHOLD | MIGRATION | SOCIOECONOMIC STATUS | AIDS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Statistical Regression | Data Analysis | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Population Dynamics | Socioeconomic Factors | Economic Factors | HIV Infections | Viral Diseases | Diseases Document Number: 194947 |
| 24. Peer Reviewed Title: Inequality and leprosy in northeast Brazil: an ecological study. [Desigualdad y lepra en el nordeste brasileño: estudio ambiental] Author: Kerr-Pontes LR; Montenegro AC; Barreto ML; Werneck GL; Feldmeier H Source: International Journal of Epidemiology. 2004 Apr;33(2):262-269. Abstract: Leprosy is an important public health problem in many developing countries and many features of its determinants are still obscure. To investigate whether the incidence of leprosy is related to certain environmental and socioeconomic determinants, an ecological study was undertaken in 165 municipalities of the state of Ceará, Brazil. Social, economic, education, sanitation, demography, meteorology, and health data were collected. The dependent variable was the average incidence rate of leprosy from 1991 to 1999. Simple and multiple linear regressions were performed to assess the relationship between the dependent and the independent variables. The average incidence rate for all the municipalities for the 1991-1999 period, varied from 0.06 to 14.68 per 10 000 persons per year. The level of inequality (ß = 1.67, P = 0.011), the mean years of study among the population >/=25 years old (ß = 1.35, P < 0.001), the population growth from 1991 to 1996 (ß = 0.02, P = 0.007), the percentage of children 7-14 years old that did not go to the school (ß = 0.02, P = 0.028), and the presence of a railroad in the municipality (ß = 0.45, P = 0.038) were found to be predictors of the incidence rate of leprosy in Ceará. Our findings fit the assumption that, in Ceará, leprosy is associated with a high level of poverty and uncontrolled urbanization. We put forward the hypothesis that urbanization increases not only social inequality eventually leading to strong polarization, but also excludes people from social and material opportunities. Apparently, such deprivations render them susceptible for leprosy. (author's) Spanish Abstract: La lepra es un importante problema de salud pública en numerosos países en vías de desarrollo y aún se ignoran muchas de las características de sus factores determinantes. Se realizó un estudio en 165 municipios del estado de Ceará, Brasil, para investigar la posible incidencia de lepra en relación con determinantes ambientales y socioeconómicos específicos. Se recopilaron datos sociales, económicos, educativos, demográficos, meteorológicos, de salud y de servicios sanitarios. La variable dependiente fue la tasa de incidencia promedio de lepra desde 1991 hasta 1999. Se realizaron regresiones lineales simples y múltiples para determinar la relación entre las variables dependientes e independientes. La tasa de incidencia promedio para todos los municipios en el período 1991-1999 varió de 0,06 a 14,68 cada 10.000 personas por año. Los predictores de la tasa de incidencia de lepra detectados en Ceará fueron el nivel de desigualdad (ß = 1,67; P = 0,011), los años promedio de estudio en la población >/=25 años de edad (ß = 1,35; P < 0,001), el crecimiento demográfico de 1991 a 1996 (ß = 0,02; P = 0,007), el porcentaje de niños de 7 a 14 años que no asistían a la escuela (ß = 0,02; P = 0,028), y la presencia de una estación ferroviaria en el municipio (ß = 0,45; P = 0,038). Nuestros resultados avalan la presunción de que, en Ceará, la lepra se asocia a un alto nivel de pobreza y a la urbanización descontrolada. Sugerimos la hipótesis de que la urbanización no sólo aumenta la desigualdad social, generadora de una fuerte polarización, sino que priva a las personas de oportunidades sociales y materiales. Aparentemente, tal privación las torna susceptibles a la lepra. (del autor) Language: English Keywords: BRAZIL | RESEARCH REPORT | LINEAR REGRESSION | LOW INCOME POPULATION | URBAN POPULATION | LEPROSY | INEQUALITIES | POVERTY | ECOLOGY | URBANIZATION | INCOME DISTRIBUTION | EDUCATIONAL STATUS | RAILROAD | Developing Countries | South America, Eastern | South America | Latin America | Americas | Statistical Regression | Data Analysis | Research Methodology | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Population Characteristics | Demographic Factors | Population | Bacterial and Fungal Diseases | Infections | Diseases | Environment | Urban Population Distribution | Population Distribution | Geographic Factors | Income | Transportation Document Number: 191748 |
| 25. Title: Impact of various sources of AIDS information among ever married men and women in Bangladesh. Author: Khan MM; Kabir M; Mori M Source: Journal of Health and Population in Developing Countries. 2004 Mar 9;:[14] p.. Abstract: This study examined the impact of various sources of AIDS information among ever married men and women in Bangladesh using nationally representative data. Logistic regression analysis identified that television, radio, and newspaper/magazines were the effective way to disseminate the AIDS related information. Exposure to two or more sources of AIDS information were found highly effective compared with only one source. Therefore this study underscores the need for disseminating suitable AIDS messages from multiple sources simultaneously. (author's) Language: English Keywords: BANGLADESH | RESEARCH REPORT | LINEAR REGRESSION | MEN | WOMEN | EVER MARRIED | AIDS PREVENTION | MASS MEDIA | PROGRAM EFFECTIVENESS | INFORMATION DISTRIBUTION | Asia, Southern | Asia | Developing Countries | Statistical Regression | Data Analysis | Research Methodology | Demographic Factors | Population | Marital Status | Nuptiality | AIDS | HIV Infections | Viral Diseases | Diseases | Communication | Program Evaluation | Programs | Organization and Administration Document Number: 193903 |
| 26. Peer Reviewed Title: Family planning in the southeast Anatolian Project Region. Author: Özgür S; Bozkurt AÍ; Sahinöz S; Özçirpici B; Sahinöz T Source: European Journal of Contraception and Reproductive Health Care. 2004;9:78-88. Abstract: The aim of this study was to evaluate contraceptive use by women reproductive age in the Southeast Anatolian Project Region and the promotion of the use family planning services. An optimum sample size to represent the rural and urban area of the region was determined and the sample was chosen by sampling method proportional to the size. A total of 1126 houses were visited and questions about reproductive health were asked of 1019 ever-married (currently married, widows and divorced) women. The study showed that 48.2% of the ever-married women of reproductive age had never used any method of family planning; 37.4% were currently using a family planning method, and 14.4% had used a family planning method in the past. Of the women who were currently using a family planning method, 73.1% were using an effective method. The result of the logistic regression analysis showed that educational level, knowledge of Turkish, type of residence, and total number of living children were the main variables that affected the use of family planning methods. Use of family planning methods in the region was not at the expected level. In order to decrease the barriers to family planning in developing countries, we must provide obtainable, acceptable, integrated health services. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | LINEAR REGRESSION | WOMEN | EVER MARRIED | CONTRACEPTIVE USAGE | FAMILY PLANNING PROGRAMS | UTILIZATION OF HEALTH CARE | EDUCATIONAL STATUS | LANGUAGE | KNOWLEDGE | Developing Countries | Europe, Southeastern | Europe | Statistical Regression | Data Analysis | Research Methodology | Demographic Factors | Population | Marital Status | Nuptiality | Contraception | Family Planning | Programs | Organization and Administration | Health Services | Delivery of Health Care | Health | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Communication Document Number: 194130 |
| 27. Title: Caesarian sections in Mexico: tendencies, levels, and related factors. Las cesáreas en México: tendencias, niveles y factores asociados. Author: Puentes-Rosas E; Gómez-Dantés O; Garrido-Latorre F Source: Salud Pública de México. 2004 Jan-Feb;46(1):16-22. Abstract: The objective was to describe the rate of caesarean sections in Mexico in the last 10 years and evaluate its relationship with several socioeconomic variables, type of health care services, and specialists’ availability. The Ministry of Health’s register of births was used as source of information. The dependent variable was the type of delivery (vaginal or caesarean). The independent variables were: gross domestic product, human development index, illiteracy percentage among women, social exclusion index and, gynecology and obstetrics specialists supply. Correlations between variables were evaluated using Pearson’s parametric test and Spearman range test. A lineal multiple regression was used to model the national caesarean data of 1999. National caesarean percentage increased in the last 10 years at an annual rate of 1%. It was considerably higher in social security institutions and the private sector. Caesareans percentages in 1999 were slightly above 35%. The highest values were those of the private sector with 53%, followed by social security institutions, with 38.2%. The variables more strongly associated with C sections were GDP, specialists’ availability and human development index. It seems reasonable to advocate for a widespread descent in caesarean sections in Mexico. Important declines in certain contexts have been witnessed by implementing measures such as a second opinion before any C-section, a precise definition of the reasons for using it, and the monitoring of individual caesarean percentage among hospital obstetricians. (author's) Spanish Abstract: El objeto del estudio fue analizar el índice de cesáreas en México en los últimos 10 años y evaluar su relación con distintas variables socioeconómicas, con el tipo de servicio de atención de la salud y con la disponibilidad de especialistas. La fuente de información fue el registro de nacimientos de la Secretaría de Salud. La variable dependiente fue el tipo de parto (vaginal o por cesárea). Las variables independientes fueron el producto bruto interno (PBI), el índice de desarrollo humano, el porcentaje de analfabetismo de las mujeres, el índice de exclusión social y la disponibilidad de ginecólogos y obstetras. Las correlaciones entre las variables en estudio se evaluaron mediante la prueba paramétrica de Pearson y la prueba por rangos de Spearman. Con los datos nacionales sobre cesáreas de 1999 se realizó un análisis de regresión lineal múltiple. El porcentaje de nacimientos por cesárea en el ámbito nacional se incrementó en los últimos 10 años a un ritmo de 1% anual. El incremento fue considerablemente mayor en las instituciones de seguridad social y en el sector privado. El porcentaje de cesáreas en 1999 fue ligeramente superior al 35%. Los valores más altos correspondieron al sector privado con el 53%, seguido por las instituciones de seguridad social con el 38,2%. Las variables que se asociaron más fuertemente con el porcentaje de cesáreas fueron el producto bruto interno, la disponibilidad de especialistas y el índice de desarrollo humano. Los resultados indican que es razonable promover acciones tendientes a reducir el índice de cesáreas en México. En algunos contextos esta práctica se ha reducido considerablemente gracias a medidas como solicitar una segunda opinión antes de realizar una cesárea, definir exactamente las razones para llevarla a cabo y controlar los porcentajes individuales de cesáreas entre los obstetras de los hospitales. (del autor) Language: English Keywords: MEXICO | RESEARCH REPORT | LINEAR REGRESSION | PREGNANT WOMEN | CESAREAN SECTION | SOCIOECONOMIC FACTORS | PRIVATE SECTOR | PUBLIC SECTOR | UTILIZATION OF HEALTH CARE | Central America | Latin America | Americas | Developing Countries | Statistical Regression | Data Analysis | Research Methodology | Population Characteristics | Demographic Factors | Population | Obstetrical Surgery | Surgery | Treatment | Economic Factors | Macroeconomic Factors | Health Services | Delivery of Health Care | Health Document Number: 284302 |
| 28. Peer Reviewed Title: Paternal age and child death: the stillbirth case. Author: Rychtaríková J; Gourbin C; Wunsch G Source: European Journal of Population. 2004;20:23-33. Abstract: Previous research has shown an association between paternal age and neonatal mortality controlling for age of mother and other confounding factors. As this association is possibly of a biological nature, one would also expect to find a significant relationship between paternal age and foetal mortality, stillbirth in particular. The present research is based on a Czech individual data set for the period 1986–1990. The risk of stillbirth is examined using logistic regression, taking account of both parental ages, sex of the foetus, birth order, prematurity, and education of parents. It is shown that, in this data set, there is a significant relation between age of father and risk of stillbirth. (author's) Language: English Keywords: CZECH REPUBLIC | RESEARCH REPORT | LINEAR REGRESSION | FATHERS | INFANT | PATERNAL AGE | MATERNAL AGE | NEONATAL MORTALITY | FETAL DEATH | RISK FACTORS | SEX FACTORS | BIRTH ORDER | EDUCATIONAL STATUS | Europe, Central | Europe | Developing Countries | Statistical Regression | Data Analysis | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parental Age | Infant Mortality | Mortality | Population Dynamics | Biology | Socioeconomic Status | Socioeconomic Factors | Economic Factors Document Number: 194927 |
| 29. Title: Sterilisation of intellectually disabled women. Author: Servais L; Leach R; Jacques D; Roussaux JP Source: European Psychiatry. 2004 Nov;19(7):428-432. Abstract: Objectives. - To point out the proportion of intellectually disabled women (IDW) who are sterilised, and the medical and social factors associated with an increased probability to be sterilised. Study design. - A population- based study among 97% of IDW aged 18-46, attending government-accredited institutions in the region of Brussels-Capital and the province of Walloon Brabant (Belgium). Results. - Among the IDW included in this study, 22.2% are sterilised, which is superior to the 7% in the general Belgian population. Factors associated with an increased probability to be sterilised are: living in an institution, having a higher intellectual quotient (IQ), being enrolled in an institution where sexual intercourse is authorised and attending an institution where contraception is required. The last three factors are significant only among women living in institutions and the last two, only in women with severe disability. Among IDW using contraception, no factor was associated with a greater probability to be sterilised. Conclusions. - The prevalence of sterilisation among IDW is three times higher than that in the Belgian population and it is mainly correlated with factors related to the institution where these women live, especially the severely disabled. (author's) Language: English Keywords: BELGIUM | RESEARCH REPORT | LINEAR REGRESSION | WOMEN | DISABLED PERSONS AND DISABILITIES | FEMALE STERILIZATION | PREVALENCE | MENTAL RETARDATION | SEXUAL INTERCOURSE | CONTRACEPTION | Developed Countries | Europe, Western | Europe | Statistical Regression | Data Analysis | Research Methodology | Demographic Factors | Population | Population Characteristics | Sterilization, Sexual | Family Planning | Measurement | Intelligence | Personality | Psychological Factors | Behavior | Reproduction Document Number: 283342 |
| 30. Peer Reviewed Title: Pathogen-specific induction of CD154 is impaired in CD4+ T cells from human immunodeficiency virus-infected patients. Author: Subauste CS; Wessendarp M; Portilllo J; Andrade RM; Hinds LM Source: Journal of Infectious Diseases. 2004 Jan 1;189(1):61-70. Abstract: The pathogenesis of immunodeficiency associated with human immunodeficiency virus (HIV) infection remains incompletely understood. CD154, a molecule that is expressed primarily on activated CD4/+ T cells, is pivotal for regulation of cell-mediated and humoral immunity and is crucial for control of many opportunistic infections. We investigated whether CD4/+ T cells from HIV-infected patients exhibit defective induction of CD154 in response to opportunistic pathogens. Incubation of purified human CD4+ T cells with monocytes plus antigenic preparations of either Candida albicans, cytomegalovirus, or Toxoplasma gondii resulted in induction of CD154. Expression of CD154 in response to these pathogens was impaired in CD4/+ T cells from HIV-infected patients. This defect correlated with decreased production of interleukin (IL)–12 and interferon (IFN)–g in response to T. gondii. Recombinant CD154 partially restored secretion of IL-12 and IFN-g in response to T. gondii in cells from HIV-infected patients. Together, defective induction of CD154 is likely to contribute to impaired cell-mediated immunity against opportunistic pathogens in HIV-infected patients. (author's) Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL RESEARCH | LINEAR REGRESSION | PERSONS LIVING WITH HIV/AIDS | CLIENTS | HIV INFECTIONS | ANTIRETROVIRAL THERAPY | ANTIGENS | IMMUNITY | EVALUATION | CYTOLOGY | Developed Countries | North America | Americas | Research Methodology | Statistical Regression | Data Analysis | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | HIV | Immunologic Factors | Immune System | Physiology | Biology Document Number: 190343 |
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