Dichlorodihydrofluorescein and dihydrorhodamine 123 are sensitive indicators of peroxynitrite in vitro: implications for intracellular measurement of reactive nitrogen and oxygen species

This article describes the use and prescribing of menopausal and postmenopausal hormone therapy (HT) in one example country, Finland, and the trends and levels of HT use in other western countries for comparison. Previously published studies were reviewed and reanalyzed, and some additional unpublished data from Finnish surveys were compiled. The use of HT increased in Finland up to 1994. In Finland the initiative for HT use came more often from physicians than women themselves, physicians valued HT more than women, women's period of use of HT was shorter than physicians' recommendations, women's reasons for using HT were usually to treat symptoms, but physicians considered HT also useful in the prevention of later diseases. Gynecologists were more favorable toward HT than other physicians. HT has become common in very different times in different countries, but with the exception of the US experience in the 1970s, the trend has been towards increasing use. One motivation to do surveys on physicians' prescribing or women's use of HT has been to facilitate HT use. The large variation in HT use may reflect the uncertainty concerning its true value. The reasons for the large-scale prevention with HT have not been systematically studied, but it is likely due to various social and commercial forces.     

Iron supplementation during pregnancy. Standards and alternatives]

CONTEXT: Contraceptive use has been legal in France for the past 30 years, and patterns of use changed substantially from the 1960s to the 1980s. Given the rapidity with which use patterns change and the possible impact of rising concern about infection with HIV and other sexually transmitted diseases, it is important to determine trends of contraceptive practice into the 1990s. METHODS: A total of 5,900 French households were selected in 1994 for inclusion in the Fertility and Family Survey. Respondents were questioned about their contraceptive use patterns and family formation status. The results were compared with those of comparable surveys conducted in 1978 and 1988. RESULTS: Two-thirds of French women used some form of reversible contraceptive method in 1994. Oral contraceptive use has grown steadily in France: About 40% of women aged 20-44 reported using the pill alone or combined with another method in 1994, compared with 34% in 1988 and 28% in 1978. Condom use has also been on the rise: Nearly 8% of women were using condoms alone or combined with another method in 1994, up from 5% in 1988 and 6% in 1978. IUD use has declined from 19% in 1988 to 16% in 1994, and both male and female sterilizations remain rare. CONCLUSIONS: Contraceptive behavior in France appears unique among developed countries, with fairly high levels of oral contraceptive use--even among older women--relatively high levels of IUD use and little reliance on either male or female sterilization. As with other countries, however, condom use has climbed in recent years, and is especially common at first intercourse.     

Practical experiences with sexual sterilization following directives of the Ministry of Health 5/72, Codex paragraphy 27, law 20/66

In 1975, 35 women were administered artificial sterilizations using the Pomeroy technique, 6 for health reasons and 29 for socioeconomic reasons. All patients had already experienced 5 or more births and rejected any proposed contraceptives. Protocol for the operation under the sterilization law includes the patients nationality, IQ, reason for sterilization, and recommendations of the local board of Social Health. Sterilizations took place 1-2 days after birth, using general anesthesia and lasting approximately 15 minutes. Of the 29 women administered the operation for other than medical reasons, none experienced either early or late complications.     

The determinants of IUD discontinuation in China: a discrete-time competing risk model analysis

This research examines the social, demographic, and family-planning-program factors that influence the occurrence of IUD discontinuation among Chinese women, using a sample of 14,639 IUD use segments from the 1988 Chinese National Survey of Fertility and Contraceptive Prevalence. A discrete-time competing-risk event history method is employed to identify the determinants of IUD discontinuation by five kinds of reasons: contraceptive failure, expulsion, switching method, side-effects and other nonmethod-related reasons. The predictors of IUD discontinuation suggest that a number of mechanisms are in operation. Some of the determinants may reflect the effects of the family planning program; some may illustrate women's physiological and biological reactions to IUD's; some may be related to women's previous history of contraceptive use; and still others may indicate social characteristics of women that lead them to have their IUD's removed.     

Dual-method use among an ethnically diverse group of women at risk of HIV infection

CONTEXT: Few U.S. women protect themselves against both pregnancy and sexually transmitted diseases (STDs) by using an efficient contraceptive method and a condom. Understanding the factors that influence dual-method use could help improve interventions aimed at encouraging protective behaviors. METHODS: Interviews were conducted with 552 low-income women at risk of HIV who attended public health or economic assistance facilities in Miami in 1994 and 1995. Multinomial logit analyses were used to determine the influence of women's background characteristics, perceived vulnerability to pregnancy and AIDS, and relationship characteristics on the odds of dual-method use. RESULTS: Overall, 20% of the women used dual methods. Women who were not married, who worried about both pregnancy and AIDS, who had ever had an STD, who were confident they could refuse a sexual encounter in the absence of a condom and who made family planning decisions jointly with their partner were the most likely to use dual methods rather than a single method (odds ratios, 2.0-3.5); those who considered the condom only somewhat effective in preventing AIDS or who shared economic decision-making with their partner were the least likely to use dual methods rather than a single method (0.5-0.6). The results were generally similar in analyses examining the odds of dual-method use involving an efficient contraceptive, except that black and Hispanic women were significantly more likely than whites to use condoms in conjunction with efficient contraceptives (3.3-7.1). CONCLUSIONS: Both women's individual characteristics and the context of their sexual relationships influence whether they simultaneously protect themselves from pregnancy and HIV. The involvement of male partners in family planning decision-making and women's control over economic decision-making ensure greater protection against HIV infection.     

A comparison of definable traits in women requesting reversal of sterilization and women satisfied with sterilization

More women of reproductive age are being sterilized. Some of these women regret the decision and subsequently request a reversal of sterilization, whereas others do not. This study was undertaken to develop a profile of easily definable traits of 159 women who requested a reversal of sterilization and compare it with that of 160 women who apparently were satisfied with sterilization. Statistically significant differences were found. Remarriage was the most common cause for regret among women in the group which requested reversal of sterilization. Women in this group married younger, completed their family earlier, and were sterilized at a younger age. These women had significantly fewer live children and had undergone more therapeutic abortions (p less than 0.005).     

Hepatitis C--role of perinatal transmission

Increasing family planning acceptance and efficacy is considered a key public health issue in many Pacific island nations. To assess the structure of family planning acceptance in Samoa, structured interviews were conducted with 155 reproductive age women from seven villages in both rural and urban settings. The survey data show accord with returns on contraceptive use from Samoan clinics, and demonstrate that awareness and use of contraception have increased markedly in the previous decade but desired family size remains high in younger women. A notable feature of the Samoan women's contraceptive experience is the lack of diversity of reported contraceptive behaviours and attitudes based on age, urban versus rural residence, and education.     

Attitudes of men towards family planning in Mbeya region, Tanzania: a rural-urban comparison of qualitative data

Family planning programmes in Tanzania date back to the 1950s. By the early 1990s, however, only 5-10% of women of childbearing age used contraceptives in the country. Low contraceptive prevalence in Tanzania is reportedly attributable to men's opposition to family planning. This paper employs focus groups to explore the role of Tanzanian men in family planning. More specifically, it presents a rural-urban comparison of the attitudes of men in Mbeya region, Tanzania, to family size preference, sex composition, partners' communication on family planning matters and contraceptive behavior. Findings indicate that men express positive attitudes towards fertility-regulating methods. There is, moreover, little rural-urban variation in male attitudes towards family planning in the study area. Possible reasons for this normative convergence (including structural similarities and rural-urban migration between the two communities) are discussed.     

Gender, socioeconomic status and family status as determinants of food behaviour

This study examines social structural and family status factors as determinants of food behaviour. The data were derived from the FINMONICA Risk Factor Survey, collected in Finland in spring 1992. A multidimensional framework of the determinants of food behaviour was used, including social structural position, family status and gender. The associations between the determinants of food behaviour were estimated by multivariate logistic regression models, adjusted for age and regional differences. Food behaviour was measured by an index including six food items which were chosen based on Finnish dietary guidelines. In general, women's food behaviour was more in accordance with the dietary guidelines than that of men. The pattern of association between educational level and food behaviour was similar for both genders, but slightly stronger for men than women. Employment status was associated only with women's food behaviour, but the tendency was the same for men. Marital status was associated with men's as well as women's food behaviour. The food behaviour of married men and women was more in line with the dietary guidelines than the food behaviour of those who had been previously married. Parental status, however, was only associated with women's food behaviour, that is, the food behaviour of women with young children was more closely in line with the dietary guidelines than that of the rest of the women.     

Increased incidence of alcohol-related deaths from accidents and violence in subjects with ankylosing spondylitis

Subjects with ankylosing spondylitis (AS) have an increased incidence of deaths from accidents and violence, which is due in part, but perhaps not entirely, to the vulnerability of the affected spine to fractures. The present study covered all the 71 subjects (58 men and 13 women) who had died in Finland in 1989 and who were entitled under the nationwide sickness insurance scheme to receive specially reimbursed medication for AS. The death certificates of an earlier cohort study dealing with mortality in AS were also re-examined. Sixteen subjects (14 men and two women) in the 1989 mortality series had died of accidents and violence. Nine of the deaths (three accidents, two suicides and four alcohol poisonings) were alcohol related. The relative risk of such deaths in subjects with AS compared to the Finnish population as a whole was 2.64 (95% confidence interval 1.44-4.84). In the cohort study, 16 deaths had been due to accidents and violence, the expected number being 11.4. Eight of the 16 deaths had been alcohol related. Uncontrolled use of alcohol is an important determinant in the surplus of deaths from accidents and violence in Finnish patients with AS.     

The power of confession: the role of the criminal law and courtpractices in the production of knowledge concerning sexuality between women: Finland, in the 1950s

The article discusses a number of court cases on women's same-sex fornication in the Finnish countryside in the 1950s. Based on a close reading of the minutes of the police investigations and the court records, the article shows how the notion of sexual acts between women, and the notion of certain modes of conduct as "sexual," were constructed in these proceedings. The authorities could conceive sexual relations only in terms of the "heterosexual matrix" (cf. Judith Butler); hence they assumed that the alleged sexual encounters between the women were a copy of a heterosexual sexual intercourse. As for the accused women, many of whom were connected with a Christian sect, they often insisted that the physical expressions of their mutual affection were not sexual, and they opposed the interpretation that their conduct might have anything to do with homosexuality, which they considered a pathology. As the women nevertheless often ended up repenting their conduct, they reproduced the conventional image of sexually passive "soft" woman, though perhaps partly because of strategic reasons.     

Contraceptive practice after clinic discontinuation

A follow-up study was conducted of clients who stopped attending 4 family planning clinics in Washington County, Oregon, a predominantly white, middle-class suburban community. Clients had enrolled in the program between 1971-74, and dropped out by April 1975. 29% of the women (746) who were overdue for a return visit by more than 3 months (i.e. inactive clients) were contacted by phone and mail. No significant social or demographic differences were found between active and inactive clients or between dropouts who were contacted and those who were not. 71% of all program enrollees dropped out by the end of 3 years. However, 90% of the sample were either using contraception or not at risk of an unwanted pregnancy for a variety of reasons. The remaining 10% were either unprotected or already pregnant with an unplanned pregnancy (2%). The women at risk and not using contraception were more likely to be young, poorly educated, single, and recent enrollees in the family planning program. No other social or economic differences affected the comparison of the 2 groups. Most users continued to use the same method of contraception they had used before. However, a significantly smaller proportion of women were using the pill, a slightly larger proportion were using IUD and 6% more clients were sterilized. The most common reasons for leaving the program were the decision to use a private physician and relocation. Among women at risk, the most common reason was worry about the contraceptive method, especially the pill. New sources of care included private physicians (71%, but 1/3 of these women were disatisfied with their doctors' care or fees), public health clinic not part of the family planning program (21%) and drugstores. A very few women reported no alternate source of care.     

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.     

Sketching the framework for a history and sociology of homosexualities in the Nordic countries

Homosexual acts between women were criminalized in Finland in the 1889 Penal Code which also criminalized men's homosexual acts for the first time explicitly in Finnish legislation. The inclusion of women in the Penal Code took place without much ado. In the article it is argued that the uncomplicated juxtaposing of men and women was due to the legacy of a cultural pattern where man and woman, as categories, were not in an all-pervasive polarity to each other, for example, in sexual subjectivity. A cultural pattern of low gender polarization was typical of preindustrial rural culture, and it can help us apprehend also certain other features in contemporary Finnish social and political life, for example, women obtaining a general franchise and eligibility for the parliament first in the world, in 1906. A modern image of "public man" and "private woman" was only making its way in Finnish society; hence, there was not much anxiety at women's entry in politics, or, for that matter, at their potential for (homo)sexual subjectivity becoming recognized publicly in criminal law.     

Body mass and social class: a comparison of Finland and Sweden in the 1990s

High physical weight affects public health as well as people's social relations. This study seeks to examine the distribution of physical weight across the social structure in Finland and Sweden in the early 1990s. We compare physical weight, classified by overweight and obesity, 1) between men and women, 2) between different age groups, and 3) between social classes in these two countries. Comparable interview surveys were conducted in Finland 1994 (N = 8,650, response rate 73%) and in Sweden 1991 (N = 5,306, response rate 79%). Physical weight, overweight and obesity of populations are described in terms of body mass index (BMI = weight (kg)/height (m2)). The average BMI is higher in Finnish men (25.6) and women (24.6) than in their Swedish counterparts (24.6 and 23.2, respectively). In both countries, the average BMI is higher in men than in women below the age of about 55-64 years. In both countries and in both genders the average BMI is higher, the higher the age. The level of overweight as well as obesity is lower in Sweden than in Finland. Social class differences can be found in both countries. The odds ratio for overweight is higher in Finnish male and female farmers (OR = 1.57 and 1.94, respectively) as compared to upper white collars (OR = 1.0). In Sweden, high odds ratio for overweight can be found among male entrepreneurs (OR = 1.80) and female unskilled manuals (OR = 2.65). Obesity varies by social class in Swedish men and women as well as in Finnish women, but not in Finnish men. The results show that Finnish men and women are more often overweight and obese than their Swedish counterparts, but social class differences in overweight and obesity are larger in Sweden than in Finland.     

Contraceptive use and attitudes in Great Britain

In order to update current knowledge on contraceptive use and attitudes in Great Britain (i.e. England, Scotland and Wales), a survey was conducted among 1753 randomly selected British women aged 15-45. Replies were received from 967 women (55.2%). Seventy-three percent (73%) of fertile, sexually active women who wished to avoid pregnancy were using reliable methods of contraception, viz. oral contraceptives (OCs), intrauterine devices (IUDs) or sterilization. However, it was found that adolescents and women over 40 who wished to avoid pregnancy were, nevertheless, especially likely not to be using any contraceptive method at all. The women surveyed were concerned about weight gain, cardiovascular and cancer risks associated with OC use, and infection and infertility risks associated with IUD use. Sixty percent (60%) perceived sterilization as a major and risky surgical operation. It was concluded that contraceptive practice in Britain had not improved greatly in recent years. The latest scientific findings regarding the true advantages and disadvantages of OCs, IUDs and sterilization, therefore, need to be brought to the attention of the lay public more effectively. Special efforts need to be directed towards providing adolescents and women over 40 with proper information. Physicians and the mass media could play a considerable role in this respect.     

Experience with the trans-uterine tubal coagulation with high frequency current and the thermo method under hysteroscopic control (author''s transl)

With the aid of the carbon dioxide hysteroscope, 152 patients underwent transuterine tubal sterilization. 106 women had high frequency current coagulations of the tubes. At follow-up examinations 62 tubes were occluded and 30 showed a unilateral tubal occlusion. These results did not improve by using the thermo coagulation method since only 10 out of 24 patients showed bilateral tubal occlusion and two unilateral tubal occlusions. Up to 20 months following the transuterine tubal sterilization, 28 of the 152 women became pregnant. Of these, 16 became pregnant in spite of hysterosalpingographic evidence of bilateral tubal occlusion. Two patients required emegency laparotomies because of small bowel injuries. Within the coagulation times and temperature ranges used in this series, the results of trans-uterine tubal sterilization are unsatisfactory. It is possible that other types of hysteroscopic tubal sterilizations which are now being developed will be more successful.     

Planned condom use among women undergoing tubal sterilization

BACKGROUND AND OBJECTIVES: Women who are undergoing tubal sterilization are at risk for various sexually transmitted diseases (STDs) if they do not use a barrier method of contraception. There is a paucity of data concerning dual use of condoms among sterilized women. GOAL: Planned use of condoms for protection against STDs was examined among 2,782 women undergoing surgical sterilization from 1991 to 1996. STUDY DESIGN: Cross-sectional survey. RESULTS: Planned condom use increased significantly over the 6-year study period. Of women who were using condoms before sterilization (n = 646), nearly half indicated no plans to do so after becoming sterilized. Thus, 11% of the total sample experienced an increased risk for exposure to human immunodeficiency virus or other STDs. Condom abandonment was significantly higher among Hispanic and married women. Multiple regression analysis was used to examine the association between condom use and various characteristics. Factors associated with future condom use were younger age, black ethnicity, being unmarried, previous STD, not having a steady partner, higher number of previous sexual partners, having used condoms for disease prevention in the past, and lack of partner involvement in the decision to undergo sterilization. CONCLUSIONS: Use of condoms among sterilized women appears to be on the rise, women at higher risk for disease are more likely than others to be using condoms, and only a small group of women experience an increased risk for exposure to disease as a result of selecting this permanent method of contraception.     

The risk of ectopic pregnancy after tubal sterilization. U.S. Collaborative Review of Sterilization Working Group

BACKGROUND: Tubal sterilization is an increasingly common method of contraception in the United States. Although pregnancy after sterilization is uncommon, it can occur and may be ectopic. We used data from the U.S. Collaborative Review of Sterilization to estimate the risk of ectopic pregnancy in women who had undergone the common types of tubal sterilization. METHODS: A total of 10,685 women undergoing tubal sterilization were followed in a multicenter, prospective cohort study. We intended to follow all the women for 5 years by means of annual telephone interviews; for women enrolled early in the study, we attempted an additional follow-up telephone interview 8 to 14 years after sterilization. To assess the risk of ectopic pregnancy in these women, we used cumulative life-table probabilities and proportional-hazards analysis. RESULTS: There were 47 ectopic pregnancies in the 10,685 women; the 10-year cumulative probability of ectopic pregnancy for all methods of tubal sterilization combined was 7.3 per 1000 procedures. The cumulative probability varied substantially according to the method of sterilization and the woman's age at the time of sterilization. Women sterilized by bipolar tubal coagulation before the age of 30 years had a probability of ectopic pregnancy that was 27 times as high as that among women of similar age who underwent postpartum partial salpingectomy (31.9 vs. 1.2 ectopic pregnancies per 1000 procedures). The annual rate of ectopic pregnancy for all methods combined in the 4th through 10th years after sterilization was no lower than that in the first 3 years. CONCLUSIONS: A history of tubal sterilization does not rule out the possibility of ectopic pregnancy, even many years after the procedure.     

Social class differences in health and functional disability among older men and women

The aims of the study were to describe the health of older men and women and to investigate the social patterning of health and functional disability among older men and women, with special reference to social class differences. The data were derived from the 1994 nationwide Finnish Survey on Living Conditions (N = 1,448). Functional disability, limiting long-standing illness, and self-assessed health were used as health measures. Sociodemographic measures were social class, marital status, and urbanization. The age-adjusted social class differences were clear. Farmers and workers reported more functional disability and poorer health than did the white-collar class. Differences were somewhat smaller among women than among men. Social class was a stronger determinant than urbanization and marital status of functional disability and health.