Attitudes of general practitioners in Northern Ireland toward abortion and family planning

A survey of the attitudes and practices of general practitioners in Northern Ireland regarding contraception and abortion was carried out in 1994 and 1995 with a randomized sample of 154 physicians. The vast majority of doctors who received requests for contraceptives from their patients fulfilled those request (94%). Overall, 13% of the doctors said a married patient had requested an abortion in the past three months, and 34% had had a similar request from an unmarried patient. Two-thirds thought that a woman together with her physician should decide whether to terminate a pregnancy, 19% did not think the choice should be left with the woman and her physician and 13% were undecided. Sixty-six percent believed that a joint strategy of improving contraceptive use and reducing premarital intercourse is the best approach for preventing unwanted pregnancy among teenagers, 21% specified only improving contraceptive use and 13% indicated only reducing premarital intercourse.     

The incidence of HIV infection among women using family planning methods in Dar es Salaam, Tanzania

Animal caps isolated from Xenopus laevis embryos at the blastula stage were treated sequentially with NH4Cl, a known cement gland inducer, and with 12-O-tetradecanoyl phorbol-13-acetate (TPA), a known neural inducer. The two artificial inducers were also used in reverse order to see if they can mimic the natural inducers acting during the progressive determination of the ectodermal organ. Immunofluorescence and whole-mount in situ hybridization were used to study the expression of tubulin, taken to indicate an early step on the pathway of cell elongation, and neural cell adhesion molecule (N-CAM) taken to indicate an early step in the determination of the nervous system. The expression of XCG-1, a marker of early specification of the cement gland, was also studied. The results showed that the two artificial inducers can mimic the effects of the natural inducers in animal cap explants. The TPA behaves like a neural inducer, reducing the number and the extension of the cement gland when added to the medium in addition to NH4Cl, before or after NH4Cl treatment. In the process of cement gland/neural induction, it is possible to redirect the ectoderm already specified as cement gland to neural tissue, but it does not seem possible to respecify the neural tissue as cement gland. Moreover, the animal caps were also cut into dorsal and ventral parts and the two halves were treated separately. The results were similar to those obtained with treatment of the entire animal cap, suggesting that a dorsal-ventral pattern is not yet established before the gastrula stage, and that in normal embryos there are boundaries between the effects of different inducers.     

Attitudes towards pelvic examination in a random sample of Swedish women

In acute pancreatitis, particularly in severe cases, polymorphonuclear neutrophil (PMN) elastase induces tissue damage in remote organs such as the lung, as well in the pancreas itself. Therefore, we examined the therapeutic effect of a specific synthetic inhibitor of PMN elastase (ONO-5046: Ono Pharmaceuticals, Osaka, Japan) on the lung, liver, and kidney, as well as pancreas, in severe hemorrhagic pancreatitis in dogs. Acute hemorrhagic pancreatitis was induced by the injection of a mixture of autologous bile and porcine trypsin into the main pancreatic duct. Lipopolysaccharide (LPS) was administered intravenously as a septic challenge. Two animal groups were used. In one group, continuous infusion of ONO-5046 was started prior to the injection of LPS (ONO group). In the other group (control), saline was infused instead. At the end of the experiment (330 min after the injection of bile and trypsin), the pancreas revealed severe hemorrhagic pancreatitis, and a large amount of bloody ascites had accumulated in the peritoneal cavity. The white blood cell count was markedly reduced in response to the induction of pancreatitis, and was decreased further by the septic attack, irrespective of the administration of ONO-5046, although the count increased again in the ONO group. Serum levels of amylase and alpha2-macroglobulin-trypsin complex increased similarly in both groups following administration of bile and trypsin. Serum Ca levels decreased in both groups. At the end of the experiment, the wet weight of the lung was slightly higher in the control group (without ONO-5046). Microscopically, the pancreas showed severe hemorrhage accompanied by extensive interstitial edema in both groups. The lung and liver demonstrated mild infiltration of inflammatory cells in the interstitium in both groups, although the inflammatory change in the liver was slightly milder in the ONO group. These findings indicate that severe hemorrhagic pancreatitis cannot be alleviated by the administration of a specific inhibitor of PMN elastase alone, although this may lessen damage to remote organs such as the liver and lung. The white blood cell count decreased markedly after the induction of acute pancreatitis, and much more after a septic challenge. This seems to be closely related to the accumulation of bloody ascites in the peritoneal cavity.     

Male involvement in family planning: a case study spanning five generations of a south Indian family

Neospora caninum is a coccidial protozoan parasite that infects a large range of mammals including dogs, cats, mice, and cattle. Morphologically, N. caninum appears indistinguishable from Toxoplasma gondii, although they are genetically distinct. To date there have been no reported cases of this infection in humans, although nonhuman primates may be susceptible to infection. Inbred A/J mice develop no clinical and little histologic evidence of infection in spite of a high-dose inoculum of N. caninum. Splenocytes obtained from infected mice proliferate in vitro in response to both N. caninum and T. gondii-soluble antigen. A transient state of T cell hyporesponsiveness to parasite antigen and mitogen was observed at Day 7 p.i. This downregulatory response could be partially reversed by the addition of the nitric oxide antagonist LNMMA, but not antibody to IL-10. Mice infected with N. caninum produce significant quantities of IL-12 and IFN gamma, most evident shortly after infection. In vivo, antibody to IL-12 is able to neutralize immune resistance to the parasite. Moreover, in vivo depletion of IFN gamma with antibody renders the mice susceptible to infection. These observations suggest that N. caninum induces a T cell immune response in the infected host that is at least partially mediated by IL-12 and IFN gamma.     

The impact of a family planning multimedia campaign in Bamako, Mali

An integrated multimedia campaign featuring family planning messages saturated the 900,000-person city of Bamako, Mali, for three months during the spring of 1993. With traditional theater and music, family planning messages were repeatedly broadcast on radio and television that conveyed information about modern contraceptive methods, the need for male sexual responsibility, the health and economic advantages of family planning, the need for communication between spouses, and that Islam, the predominant faith of Mali, does not oppose family planning. A separate sample pretest-post-test quasi-experimental research design was used to evaluate the effects of the campaign and exposure to specific messages on changes in contraceptive knowledge, attitudes, and practice. Results indicate a high level of exposure to and agreement with the messages. A dramatic drop was found in the proportion of men and women who believe that Islam opposes family planning. Logistic regression results indicate that contraceptive knowledge and use and more favorable attitudes toward family planning are positively associated with intensity of exposure to the project interventions, after controlling for relevant variables.     

Current and past depression as predictors of family functioning: A comparison of men and women in a community sample.

The association between family functioning and parental depression has primarily been studied in samples of women. In particular, very little research exists that examines how parent gender and past diagnoses of depression are related to family functioning. The family relationships of 469 couples from a community sample were examined using self- and partner report measures of the marital relationship and youth report and interviewer-rated measures of the parent-youth relationship. Both currently and formerly depressed men and women were shown to have poorer family functioning than nondepressed and never depressed individuals, respectively. Interactions of gender and depression status indicated that depression and poorer marital functioning were more strongly related for women than for men, but there were few gender differences in the parent-youth relationship. The results highlight the need for further research on men's family functioning and suggest that targeting current depressive symptoms in treatment may not be sufficient to resolve marital and parent-youth difficulties that endure after depressive episodes remit. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Socioeconomic development, status of women, family planning, and fertility in Bangladesh: a district level analysis

In this paper we examine the effects of socioeconomic development, the status of women, and family planning on fertility and the extent to which these effects vary among the nineteen districts of Bangladesh. The 1983 and 1991 Bangladesh Contraceptive Prevalence Survey data are used to examine the effects of these factors on differences in contraceptive use among currently married women aged 15-49. The proportion of currently married women aged 15-49 using contraception was 46.3 per cent in 1991, a considerable increase from 26.5 per cent in 1983. Contraceptive use rates for all the districts increased substantially over the period between 1983 and 1991 and the gap between Dhaka's rate and those of other districts was narrower in 1991 than in 1983. An analytical model composed of socioeconomic development, status of women, and family planning variables is tested using logistic regression. The logit model is used to evaluate the effects of a selected group of variables on the probability of using contraceptive methods. The analysis demonstrates clearly that socioeconomic development and women's status significantly impact the use of contraceptive methods in Bangladesh. The results also suggest that better-educated, employed women are more likely to use contraception than those who have little or no formal education and who are not employed. In 1983, rural-urban differences in contraceptive use were significant, but in 1991 area of residence was not significant, which suggests that family planning programs may have played an important role in providing contraceptive information and technology to rural areas. Our analysis also suggests that family planning programs operated more efficiently in some districts than in others, and regional differences remained important in 1991 as they were in 1983. Decomposition analysis suggests that shifts in population structure favored increased contraceptive use in Bangladesh. This analysis also indicates that change in rate is also important, contributing about 21 per cent of the overall increase in contraceptive use.     

Attitudes to the use of dummies in New Zealand; a qualitative study

AIMS: To explore experiences with, and attitudes to, the use of dummies (pacifiers). METHODS: Seven focus group discussions were held with groups of mothers and of health professionals. RESULTS: Most mothers and health care workers had a generally negative view of dummy use. This related particularly to dislike of toddlers with them and practical issues such as getting lost or dirty. All would allow their use in a very unsettled baby. No mothers had personally experienced problems with breastfeeding due to the use of a dummy, but concern about this possibility was expressed by some health care workers. Recommendations varied about the length of time that dummies need to be avoided. CONCLUSIONS: Mothers in New Zealand use dummies selectively for their infants and were concerned with issues of weaning the baby from the dummy, keeping it clean and not losing it. In analysing the relationships between dummy use and breastfeeding it is important to take into consideration the context of dummy use.     

Participative style of management in a family planning program

In 1973, a small-scale project to involve family planning staff in program management was introduced in the Sangam primary health center in Andhra Pradesh by the Adminstrative Staff College of India, Hyderabad. Through group meetings, involving all levels of health center personnel, problem areas were identified and analysed and solutions sought. On the basis of recommendations made by the groups, a work plan was drawn up. Monthly review meetings were held to discuss progress in implementing the plan. The project was found to have a positive effect on staff morale and commitment, and program acceptance levels increased. In light of the success of the project at Sangam, a proposal has been submitted to the government to expand the project to other primary health centers in the district.     

Attitudes of neurologists, psychiatrists, and psychotherapists towards predictive testing for Huntington's disease in Germany

Predictive testing for Huntington's disease (HD) in Germany is performed by genetic counsellors, neurologists, psychiatrists, and psychotherapists. In order to evaluate the attitudes of neurologists, psychiatrists, and psychotherapists in Germany towards predictive testing for HD, a postal questionnaire was sent to this group. Two German Bundesl?nder were chosen, Baden Württemberg (BW) and Niedersachsen (NS). Of 469 persons interviewed the response rate was 32.6%. The questionnaire consisted of 17 items assessing sociodemographic data, acquaintance with HD patients, lay organisations, attitudes towards genetic counselling, presymptomatic and prenatal DNA testing, and reproduction of persons at risk for HD. More than 70% of the subjects were well informed about predictive DNA testing but knowledge about the details of the test procedure, especially the World Federation of Neurology (WFN) and International Huntington Association (IHA)1 recommendations, was quite low (11.8%). Nevertheless, the majority would recommend predictive testing for HD although they anticipated problems for the probands. The majority of our respondents favoured psychological test and post-test counselling for those tested. Concerning reproduction, most subjects favoured prenatal testing or that persons at risk should refrain from having children. We found that the opinions of practitioners and at risk persons differed with respect to the predictive DNA test and, particularly, to prenatal testing. Therefore the testing procedure could be improved if practitioners were better informed about the DNA test in general and about the attitudes and wishes of their patients.     

Reproduction, risk and reality: family planning and reproductive health in northern Vietnam

In collaboration with the National Committee for Population and Family Planning, a study was conducted in 1994 in two Vietnamese communes to provide community level information on women's reproductive health and behaviors. A survey of 504 rural and 523 urban women collected five-year histories of reproduction, contraception, abortion and symptoms of Reproductive Tract Infections (RTI). This analysis focuses on the relationships between women's individual characteristics, use of family planning and abortion, and reported RTI symptoms. The findings reveal that IUDs do not raise women's likelihood of experiencing RTI symptoms in either commune. A recent abortion, however, strongly increases women's likelihood of having RTI symptoms in the rural commune, while low-socioeconomic status is associated with RTI symptoms in the urban commune.     

Correlates of battering among 997 men: family history, adjustment, and attitudinal differences

In order to identify the characteristics associated with physical abuse of female partners, a detailed questionnaire was administered to 997 men who were recruited from either a forensic out-patient clinic (780) or from a community based employment center (217). This questionnaire sampled family and personal history, criminal behavior, psychopathology, and attitudes towards violence. Based upon self-report, the sample was divided into 184 non-abusive men, 517 moderately abusive men, and 296 severely abusive men. The full sample (997) was randomly divided into two subsamples and then, using a cross-validation design, group differences were identified in both subsamples on 46 of the 93 variables examined in this study. All significant effects were linear, such that the average scores of the severely abusive men were worse than the scores of the abusive men who, in turn, scored worse than the non-abusive men. In general, both groups of abusive men reported high rates of violence during childhood (both as victims and perpetrators), antisocial personality disorder, subjective distress, marital maladjustment, attitudes tolerant of spouse assault, and a range of impulsive behaviors (impulsive violence, substance abuse, motor vehicle accidents). The factors that correlated with abuse in the total sample also correlated with abuse in the community sample.     

Clinical features in panic disorder with agoraphobia: a comparison of men and women

This study compared 96 women and 58 men suffering from panic disorder with agoraphobia. Participants completed questionnaires assessing various clinical features associated with panic disorder with agoraphobia (PDA), general adjustment, and drug/alcohol use. Results showed that PDA is a more severe condition in women. Women reported more severe agoraphobic avoidance when facing situations or places alone, more catastrophic thoughts, more body sensations, and higher scores on the Fear Survey Schedule. Also, women more often had a comorbid social phobia or posttraumatic stress disorder. The lower agoraphobic avoidance of men was associated with their alcohol use. However, there were no differences between genders in other dimensions, including depression, situational and trait anxiety, stressful life events, social self-esteem, marital adjustment, and drug use.     

Predictions of hospital mortality rates: a comparison of data sources

BACKGROUND: Complementary medicine is increasingly popular with patients and with GPs, although it still remains mainly in the private sector. Few data are available from the private sector about patient-consulting patterns and outcome. OBJECTIVES: We aimed to describe detailed consulting patterns, help-seeking behaviour and outcome of care for patients attending a group of private complementary practitioners in a single general practice surgery. METHOD: Prospective data on consulting patterns were collected from all 147 new patients attending complementary practitioners over a 12-month period. For the first 30 weeks of this period, additional information on help-seeking behaviour and outcome, as measured by the SF-36 health survey and Measure Yourself Medical Outcome Profile (MYMOP), was collected by questionnaires from 46 out of the 68 new patients. The same information was collected from a systematic one-in-seven sample of GP patients. RESULTS: Patients seen by complementary practitioners did not vary significantly in sex and age from GP patients, except in the low numbers of children. Almost half the patients had been symptomatic for over a year and musculoskeletal disorders accounted for 66% of problems; but there was much variation between the therapies. The average number of visits per patient was three for osteopathy and homeopathy but eight for acupuncture and reflexology. The change in MYMOP scores after four weeks showed a statistically significant improvement in both complementary and GP patients, which was to similar degrees except that the mean change in well-being was significantly greater for complementary patients. CONCLUSION: Prospective data collection in single settings adds valuable information to a little-researched area. This study illustrates how individual each complementary therapy is in its patient characteristics, problem category and length of treatment. The particular improvement in well-being with complementary therapy requires confirmation in other studies.     

The psychological well-being of women of Menoufiya, Egypt: Relationships with family planning.

Researchers surveyed the psychological well-being of 795 women of reproductive age from Menoufiya, Egypt. Five years earlier, these women had provided data relevant to their family planning behavior. This analysis links these data sets to investigate the impact of family planning on women's sense of well-being, within the context of beliefs about appropriate gender-related behaviors. Well-being measures are derived for trait and state dimensions. Use of family planning and number of children born within the preceding 5 years predicted state ratings of happiness, and number of children predicted anxious pride. Neither are related to any of the trait ratings. Further, 3 different gender-role attitudes are vital to the explanation of how women define and feel good about themselves. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Baroreceptor reflex function in young normotensive men with a family history of hypertension

The purpose of this study is to evaluate the baroreflex function using lower body negative pressure (LBNP) and neck suction in young normotensive men with or without a family history of hypertension. Twenty-two young normotensive men with a family history of hypertension (FH+) and eight young normotensive men who had no family history of hypertension (FH-) were studied. FH(+) consisted of men who had a family history of hypertension within second degree relatives. We studied cardiopulmonary baroreflex function using LBNP and carotid sinus baroreflex function using neck suction and evaluated the reflex function under stimulated conditions using both LBNP and neck suction at the same time. Systolic arterial pressure (SAP)(F = 5.42, p < 0.0001) and pulse pressure (PP)(F = 15.57, p < 0.0001) decreased similarly in both groups in response to LBNP. SAP and PP responses to LBNP were not significantly affected by the family history of hypertension. Diastolic arterial pressure (DAP) increased (F = 2.89, p < 0.005) in both groups. There was a relationship between the LBNP level and family history of hypertension (F = 2.53, p < 0.013), and the increment in DAP during LBNP -30, -40 mmHg was larger in the FH(+) group. Through mean arterial pressure (MAP) was not effected by LBNP, there LBNP level was related to the family history of hypertension (F = 2.23, p < 0.02). Heart rate increased progressively (F = 25.7, p < 0.0001) with increasing levels of LBNP; however, these changes did not differ significantly in either group.(ABSTRACT TRUNCATED AT 250 WORDS)     

Utilisation of family planning services at the teaching hospital in Blantyre, Malawi

In the whole of 1993, there were a total of 1533 new clients who attended the family planning clinic at the Queen Elizabeth Central Teaching Hospital in Blantyre, Malawi. They formed 23.0% of the total client-visits for the year. 305 women had surgical contraception (bilateral tubal ligation) for various reasons, but mainly on request for family limitation. The ages of the new clients ranged from 15 to 49 years. Adolescents (< 20 years old) formed only 9.0%, while those aged > 35 years formed 22.0%. Their parity ranged from 0 to 11, with 58.0% of them being para 1 to 4. The grandmultiparae (para > 5) formed 31.0%. The oral pill was the most favoured method (42.0%), followed by depo-provera (31.0%) and sterilisation (21.0%). Though the majority of the clients who chose the oral pill were aged less than 30 years, about 6.0% were aged > 35 years. Likewise about 15.0% of those who took oral pills were para > 5, i.e. grandmultiparae. These are women who should have either stopped producing a long time back or been counselled to have tubal ligation rather than these temporary methods, when seen in the clinic then. Amongst all the client-visits for the year, oral pill and depo-provera were the two most popular methods, 42.0% and 41.0%, respectively. The ratio, between the clients who discontinued the method they were on and the new clients was 1:6.8, and that of drop-out/new clients was 1:2.4, which are quite high. The rate of absenteeism was also high at 29.0% of the total client-visits.(ABSTRACT TRUNCATED AT 250 WORDS)     

Quantitative and qualitative comparison of spontaneous and chemical-induced specific-locus mutation in the ad-3 region of heterokaryon 12 of Neurospora crassa

The data from forward-mutation experiments to obtain specific-locus mutations at two closely linked loci in the adenine-3 (ad-3) region of heterokaryon 12 (H-12) of Neurospora crassa have been tabulated to determine the relative frequencies and mutational spectra of ad-3 mutants occurring spontaneously and those induced by 22 different chemical treatments. Previous studies have demonstrated that specific-locus mutations at these two loci result from 5 major genotypic classes, namely two classes of gene/point mutations (ad-3AR and ad-3BR), and 3 classes of multilocus deletion mutations ([ad-3A]IR, [ad-3B]IR and [ad-3A ad-3B]IR). In addition, prior studies have demonstrated that some chemical mutagens induced ad-3 mutants exclusively, or almost exclusively, by gene/point mutation and other chemical mutagens by gene/point mutation and multilocus deletion mutation. In the latter cases, there was wide variation in the percentages of ad-3 mutants in these 5 major genotypic classes. Two comparative methods of analysis that also were used to compare spontaneous and chemical-induced ad-3 mutational spectra included X2-tests on the numbers of ad-3 mutants resulting in the following two sets of ratios: (1) gene/point mutations and multilocus deletion mutations; and (2) complementing and non-complementing ad-3BR, mutants. Combination of the p-values from X2-tests for these two methods of comparison demonstrated that all 22 chemicals induce a spectrum of ad-3 mutants that is qualitatively different from that occurring spontaneously. In addition, these same two methods of comparison have been used to compare the mutagenic effects of each of the 22 chemical treatments with each other. Combination of the data from these two methods of comparison has demonstrated that 93.1% (215/231) of the pairwise combinations of these 22 chemicals were different from each other. The implication of these experimental data on the induction of specific-locus mutations in somatic cells of Neurospora for genetic risk assessment exercises is discussed.