Women's Health and Ulcerative Colitis.

Although ulcerative colitis affects males and females at similar rates, certain sex-specific differences influence the disease-related risks and experiences of females with ulcerative colitis. This article reviews topics that affect females with ulcerative colitis, including the impact of disease on the menstrual cycle, fertility, child bearing, sexual health, and recommendations for health care maintenance.

Migración internacional y fecundidad: el caso de la migración boliviana, paraguaya y peruana en la Ciudad de Buenos Aires en el período reciente / International migration and fertility: the case of the bolivian, paraguayan and peruvian migration in the City of Buenos Aires in the recent period

Este trabajo analiza la fecundidad de mujeres migrantes nacidas en Bolivia, Paraguay y Perú, residentes en la Ciudad Autónoma de Buenos Aires durante la primera década del siglo XXI. A través de un análisis de período (2001 y 2010) y de cohorte de mujeres que han concluido su ciclo reproductivo (1951-1955 y 1961-1965), se examinan indicadores de nivel, estructura por edad e intensidad de este componente. Se establece una comparación con la fecundidad de la población nativa argentina y de los respectivos países de origen de las migrantes, tomando como referencia conceptual cuatro modelos que intentan explicar la interacción entre la migración internacional y la fecundidad. En congruencia con los antecedentes en la materia, los resultados muestran que la fecundidad de las migrantes es mayor que la de las mujeres autóctonas y posee una estructura precoz en relación con estas. Asimismo,la fecundidad de los distintos colectivos analizados es menor y posee una estructura por edad más envejecida en comparación con la población femenina de origen. (AU)

Declining realisation of reproductive intentions with age.

STUDY QUESTION: What is the likelihood of having a child within 4 years for men and women with strong short-term reproductive intentions, and how is it affected by age? SUMMARY ANSWER: For women, the likelihood of realising reproductive intentions decreased steeply from age 35: the effect of age was weak and not significant for men. WHAT IS KNOWN ALREADY: Men and women are postponing childbearing until later ages. For women, this trend is associated with a higher risk that childbearing plans will not be realised due to increased levels of infertility and pregnancy complications. STUDY DESIGN, SIZE, DURATION: This study analyses two waves of the nationally representative Household, Income and Labour Dynamics in Australia (HILDA) survey. The analytical sample interviewed in 2011 included 447 men aged 18-45 and 528 women aged 18-41. These respondents expressed a strong intention to have a child in the next 3 years. We followed them up in 2015 to track whether their reproductive intention was achieved or revised. PARTICIPANTS/MATERIALS, SETTINGS, METHODS: Multinomial logistic regression is used to account for the three possible outcomes: (i) having a child, (ii) not having a child but still intending to have one in the future and (iii) not having a child and no longer intending to have one. We analyse how age, parity, partnership status, education, perceived ability to conceive, self-rated health, BMI and smoking status are related to realising or changing reproductive intentions. MAIN RESULTS AND THE ROLE OF CHANCE: Almost two-thirds of men and women realised their strong short-term fertility plans within 4 years. There was a steep age-related decline in realising reproductive intentions for women in their mid- and late-30s, whereas men maintained a relatively high probability of having the child they intended until age 45. Women aged 38-41 who planned to have a child were the most likely to change their plan within 4 years. The probability of realising reproductive intention was highest for married and highly educated men and women and for those with one child. LIMITATIONS, REASONS FOR CAUTION: Our study cannot separate biological, social and cultural reasons for not realising reproductive intentions. Men and women adjust their intentions in response to their actual circumstances, but also in line with their perceived ability to have a child or under the influence of broader social norms on reproductive age. WIDER IMPLICATIONS OF THE FINDINGS: Our results give a new perspective on the ability of men and women to realise their reproductive plans in the context of childbearing postponement. They confirm the inequality in the individual consequences of delayed reproduction between men and women. They inform medical practitioners and counsellors about the complex biological, social and normative barriers to reproduction among women at higher childbearing ages. STUDY FUNDING/COMPETING INTEREST(S): This research was partly supported by a Research School of Social Sciences Visiting Fellowship at the Australian National University and an Australian Research Council Discovery Project (DP150104248). Éva Beaujouan's work was partly funded by the Austrian Science Fund (FWF) project 'Later Fertility in Europe' (Grant agreement no. P31171-G29). This paper uses unit record data from the HILDA Survey. The HILDA Project was initiated and is funded by the Australian Government Department of Social Services (DSS) and is managed by the Melbourne Institute of Applied Economic and Social Research (Melbourne Institute). The findings and views reported in this paper, however, are those of the authors and should not be attributed to either DSS or the Melbourne Institute. The authors have no conflicts of interest.

Caracterización de la conducta sexual y reproductiva en adolescentes femeninas de 12 a 15 años / Characterization of the sexual and reproductive behavior in female teenagers aged 12-15 years

RESUMEN Introducción: la sexualidad constituye una dimensión integral de las personas y está presente desde el momento de la concepción hasta la muerte. Objetivo: caracterizar la conducta sexual y reproductiva en adolescentes femeninas. Materiales y métodos: se realizó un estudio descriptivo transversal en 53 estudiantes femeninas, de 12 a 15 años de edad, en la secundaria básica "Paquito Rosales Benítez", Manzanillo, Granma, en el año 2017. Resultados: la edad media fue 1,15 años, el 67,93 % de las adolescentes mantenían relaciones sexuales con una edad media de la sexarquia de 13,53 años. La "atracción física" fue el principal motivo para el inicio de las relaciones sexuales. El 36,11 % de las adolescentes no utilizaban algún método anticonceptivo y las tabletas anticonceptivas fueron las más utilizadas. El 22,22 % de las féminas habían tenido, al menos, un embarazo. Conclusiones: las adolescentes de la secundaria básica "Paquito Rosales" mantiene una conducta sexual adecuada.

ABSTRACT Introduction: sexuality is an integral dimension of the persons that is present from the moment of conception until death. Objective: to characterize sexual and reproductive behavior in female teenagers. Materials and methods: a descriptive, cross-sectional study was carried out in 53 female students, aged 12 to 15 years, who study at "Paquito Rosales" Junior High School, Manzanillo, Granma, in 1917. Results: the average age was 1,15 years. 67.93 % of the female teenagers had sexual relationships for a first time at an average age of 13.53 %. Physical attraction was the main motive for the beginning of sexual relationships. 36.11 % of teenagers did not use any contraceptive method being birth-control pills the most used one. 22.22 % of the teenagers had had, at least, one pregnancy. Conclusions: female teenagers of "Paquito Rosales" Junior High School have an appropriate sexual behavior.

Análise dos indicadores de saúde sexual e reprodutiva de adolescentes brasileiros, 2009, 2012 e 2015 / Analysis of sexual and reproductive health indicators of Brazilian adolescents, 2009, 2012 and 2015

RESUMO: Objetivo: Analisar indicadores de saúde sexual e reprodutiva de adolescentes com base nos dados da Pesquisa Nacional de Saúde do Escolar (PeNSE) em 2015, comparando-os aos de 2009 e 2012. Métodos: Estudo transversal que analisou dados de escolares do nono ano da PeNSE 2015, 2012 e 2009. Estimou-se a prevalência com intervalos de confiança de 95% para indicadores de iniciação sexual, uso do preservativo na última relação sexual, ter recebido orientação para gravidez, infecções sexualmente transmissíveis e preservativo grátis nas três edições. Prevalências dos indicadores de 2015 foram estimadas segundo sexo, dependência administrativa da escola e região. Utilizou-se o teste do χ2 de Pearson para diferenças estatísticas. Resultados: A prevalência de iniciação sexual apresentou queda, de 30,5% em 2009 para 27,5% em 2015, assim como do uso de preservativo, de 75,9 para 66,2%. Notou-se queda da orientação para prevenção de gravidez nas escolas públicas, de 81,1 para 79,3% e de preservativo gratuito nas escolas privadas, de 65,4 para 57,3%. Cerca de 30% relataram uso combinado de preservativo e outro método e 19,5% não fizeram uso de método algum. Observou-se que meninos apresentaram maior prevalência de iniciação sexual, maior número de parceiros e menor uso de preservativo. As regiões norte, nordeste e centro-oeste apresentaram pior desempenho dos indicadores. Conclusão: Evidenciou-se diminuição da iniciação sexual e do uso de preservativo entre adolescentes, maior vulnerabilidade às infecções sexualmente transmissíveis nos meninos e à gravidez entre as adolescentes de escolas públicas.

ABSTRACT: Objective: To analyze sexual and reproductive health indicators of adolescents based on data from the National School-based Health Survey (PeNSE) in 2015, comparing them to the data from 2009 and 2012. Methods: Cross-sectional study that has analyzed data from 9th grade students from PeNSE 2015, 2012 and 2009. We estimated prevalence and 95% confidence intervals for the following indicators: sexual initiation, condom use in the last sexual intercourse, counseling for pregnancy, sexually transmitted infections and free condoms in the three rounds of the survey. Prevalence of all indicators accessed in 2015 was estimated according to sex, type of school and region. Pearson's χ2 test was used. Results: The prevalence of sexual initiation reported by adolescents has decreased from 30.5%, in 2009, to 27.5%, in 2015, as well as the use of condom in the last intercourse, from 75.9 to 66.2%, respectively. In respect to counseling, there was a reduction regarding pregnancy prevention in public schools, from 81.1 to 79.3% and in relation to free condom in private schools, from 65.4 to 57.3%. About 30% reported using both condom and another contraceptive method, and 19.5% did not use any method. Boys presented greater prevalence of sexual initiation, higher number of partners and reduced prevalence of condom use. Adolescents living in North, Northeast and Central-West regions presented worse indicators. Conclusion: There was a reduction in sexual initiation and condom use among Brazilian adolescents, boys were more vulnerable to sexually transmitted infections, and girls from public schools were more vulnerable to pregnancy.

Reproductive Investment and Health Costs in Roma Women.

In this paper, we examine whether variation in reproductive investment affects the health of Roma women using a dataset collected through original anthropological fieldwork among Roma women in Serbia. Data were collected in 2014-2016 in several Roma semi-urban settlements in central Serbia. The sample consisted of 468 Roma women, averaging 44 years of age. We collected demographic data (age, school levels, socioeconomic status), risk behaviors (smoking and alcohol consumption), marital status, and reproductive history variables (the timing of reproduction, the intensity of reproduction, reproductive effort and investment after birth), in addition to self-reported health, height, and weight. Data analyses showed that somatic, short-term costs of reproduction were revealed in this population, while evolutionary, long-term costs were unobservable-contrariwise, Roma women in poor health contributed more to the gene pool of the next generation than their healthy counterparts. Our findings appear to be consistent with simple trade-off models that suggest inverse relationships between reproductive effort and health. Thus, personal sacrifice-poor health as an outcome-seems crucial for greater reproductive success.

¿Es hora de usar indicadores refinados para estudiar la fecundidad en América Latina? / Is it time to use more refined indicators to study fertility in Latin America? / Chegou a hora de usar indicadores ajustados para estudar a fecundidade na América Latina?

Resumen El artículo discute la pertinencia de los llamados indicadores refinados de fecundidad para evaluar el nivel de la fecundidad en los países de América Latina. La principal ventaja de estos indicadores es su capacidad de identificar cuánto del cambio en la tasa global de fecundidad se debe a cambios en la intensidad y cuánto a cambios en el calendario. Los países de muy baja fecundidad están culminando un proceso de postergación de la maternidad que solo pudo ser descrito adecuadamente una vez que surgieron estos indicadores. A pesar de que en América Latina hay indicios de que en algunos países se comienza a procesar la postergación de la fecundidad, es aún muy limitada la capacidad de elaborar indicadores refinados y no abunda la discusión sobre sus virtudes, desventajas y potencialidades. Con la intención de sistematizar la acumulación al respecto y fomentar el debate, en este artículo se presentan las principales características de estas medidas y se discute cuáles indicadores serían los más adecuados para evaluar las tendencias de la fecundidad en la región y cómo podrían difundirse de modo de evitar equívocos en su interpretación. Nuestra principal conclusión es que a corto plazo resulta más urgente contar con indicadores de intensidad y calendario por orden de nacimiento que apelar a medidas sintéticas refinadas.

Resumo O artigo discute a pertinência do uso dos chamados indicadores refinados da fecundidade para avaliar o nível de fecundidade dos países latino-americanos. A maior vantagem desses indicadores é a sua capacidade de identificar quanto da mudança na taxa total de fecundidade deve-se à alteração da intensidade e quanto à alteração do calendário da fecundidade. Os países de fecundidade muito baixa estão finalizando um processo de postergação da maternidade (posponement transtion) que só conseguiu ser adequadamente descrito a partir do surgimento dos indicadores ajustados pelo efeito tempo. Embora na América Latina existam sinais de que alguns países começam a processar a postergação da maternidade, ainda é muito limitada a capacidade dos países da região para elaborar indicadores ajustados e, certamente, é quase inexistente a discussão sobre as suas vantagens, desvantagens e potencialidades. Com o objetivo de sistematizar a acumulação sobre esta questão e estimular o debate, apresenta-se as principais características das medidas ajustadas e discute quais os indicadores mais adequados para avaliar as tendências da fecundidade na região e como podem ser difundidos de modo a evitar equívocos em sua interpretação. A principal conclusão é que, para avançar hoje na análise da fecundidade latino-americana, o mais urgente a curto prazo é contar com indicadores de intensidade e calendário segundo ordem de nascimento, mais do que com indicadores sintéticos ajustados por tempo.

Abstract The article discusses the appropriateness of refined fertility indicators to evaluate fertility level in Latin American countries. The main advantage of refined indicators is their ability to quantify the proportion of fertility change that is attributable to changes in the quantum of fertility and the proportion that is attributable to changes in the calendar. Lowest-low fertility countries are completing a process of fertility postponement that could only be accurately described when such refined indicators came into use. Despite indications that fertility postponement started in some Latin-American countries, the ability to produce refined estimators for the region is very limited, and a discussion on their advantages, disadvantages and potential is needed. The main properties of these measures are discussed, also which are the ones most appropriate to analyze fertility trends in the region, and how to avoid misleading interpretations. Our main conclusion is that, in the short term, it is more urgent to estimate tempo and quantum indicators by birth order, rather than estimating refined synthetic measures.

Reproductive behaviors and risk of developing breast cancer according to tumor subtype: A systematic review and meta-analysis of epidemiological studies.

BACKGROUND: Breast cancer is composed of distinct subtypes defined mainly based on the expression of hormone receptors (HR) and HER2. For years, reproductive factors were shown to impact breast cancer risk but it is unclear whether this differs according to tumor subtype. In this meta-analysis we evaluated the association between parity, age at first birth, breastfeeding and the risk of developing breast cancer according to tumor subtype. METHODS: PubMed and Embase were searched to identify epidemiological studies that evaluated the impact of parity and/or age at first birth and/or breastfeeding on breast cancer risk with available information on HR and HER2. Tumor subtypes were defined as: luminal (HR-positive, HER2-negative or HER2-positive), HER2 (HR-negative, HER2-positive) and triple-negative (HR-negative, HER2-negative). Summary risk estimates (pooled OR [pOR]) and 95% confidence intervals (CI) were calculated using random effects models. The MOOSE guidelines were applied. RESULTS: This meta-analysis evaluated 15 studies, including 21,941 breast cancer patients and 864,177 controls. Parity was associated with a 25% reduced risk of developing luminal subtype (pOR 0.75; 95% CI, 0.70-0.81; p<0.0001). Advanced age at first birth was associated with an increased risk of developing luminal subtype (pOR 1.15; 95% CI, 1.00-1.32; p=0.05). Ever breastfeeding was associated with a reduced risk of developing both luminal (pOR 0.77; 95% CI, 0.66-0.88; p=0.003) and triple-negative (pOR 0.79, 95% CI, 0.66-0.94; p=0.01) subtypes. CONCLUSIONS: The reproductive behaviors impact the risk of developing breast cancer but this varies according to subtype.

AURORA: bariatric surgery registration in women of reproductive age - a multicenter prospective cohort study.

BACKGROUND: The expansion of the obesity epidemic is accompanied with an increase in bariatric procedures, in particular in women of reproductive age. The weight loss induced by the surgery is believed to reverse the negative impact of overweight and obesity on female reproduction, however, research is limited to in particular retrospective cohort studies and a growing number of small case-series and case-(control) studies. METHODS/DESIGN: AURORA is a multicenter prospective cohort study. The main objective is to collect long-term data on reproductive outcomes before and after bariatric surgery and in a subsequent pregnancy. Women aged 18-45 years are invited to participate at 4 possible inclusion moments: 1) before surgery, 2) after surgery, 3) before 15 weeks of pregnancy and 4) in the immediate postpartum period (day 3-4). Depending on the time of inclusion, data are collected before surgery (T1), 3 weeks and 3, 6, 12 or x months after surgery (T2-T5) and during the first, second and third trimester of pregnancy (T6-T8), at delivery (T9) and 6 weeks and 6 months after delivery (T10-T11). Online questionnaires are send on the different measuring moments. Data are collected on contraception, menstrual cycle, sexuality, intention of becoming pregnant, diet, physical activity, lifestyle, psycho-social characteristics and dietary supplement intake. Fasting blood samples determine levels of vitamin A, D, E, K, B-1, B-12 and folate, albumin, total protein, coagulation parameters, magnesium, calcium, zinc and glucose. Participants are weighted every measuring moment. Fetal ultrasounds and pregnancy course and complications are reported every trimester of pregnancy. Breastfeeding is recorded and breast milk composition in the postpartum period is studied. DISCUSSION: AURORA is a multicenter prospective cohort study extensively monitoring women before undergoing bariatric surgery until a subsequent pregnancy and postpartum period. TRIAL REGISTRATION: Retrospectively registered (July 2015 - NCT02515214 ).

Reproduction and marriage among male survivors of cancer in childhood, adolescence and young adulthood: a national cohort study.

BACKGROUND: Increased survival after cancer in young age has made long-term follow-up studies of high external validity important. In this national cohort study, we explored the impact of cancer in young age on reproduction and marital status in male survivors. METHODS: Hazard ratios (HRs) and relative risks (RRs) of reproductive and marital outcomes were studied for male survivors of cancer in young age (<25 years) and cancer-free male comparisons, born during 1965-1985, by linking compulsory national registries in Norway. RESULTS: Male cancer survivors (n=2687) had reduced paternity (HR: 0.72, 95% confidence interval (CI): 0.68-0.76). This was most apparent in survivors of testicular cancer, brain tumours, lymphoma, leukemia and bone tumours, and when diagnosed with cancer before 15 years of age. Male cancer survivors were more likely to avail of assisted reproduction (RR: 3.32, 95% CI: 2.68-4.11). There was no increased risk of perinatal death, congenital malformations, being small for gestational age, of low birth weight or preterm birth in their first offspring. Male cancer survivors were less likely to marry (HR: 0.93, 95% CI: 0.86-1.00), in particular brain tumour survivors. CONCLUSIONS: In this national cohort study, we demonstrated reduced paternity and increased use of assisted reproduction among male cancer survivors, but no adverse outcome for their first offspring at birth.

Birth trends and factors affecting childbearing among thoracic surgeons.

BACKGROUND: As more women enter the thoracic surgery profession, issues affecting childbearing become increasingly important. We set out to assess birth trends and factors affecting childbearing among thoracic surgeons. METHODS: A 33-question anonymous survey was sent to women diplomats of American Board of Thoracic Surgery, residents in Thoracic Surgery Residents Association, and members of Women in Thoracic Surgery. Findings were compared with national norms. RESULTS: There were a total of 113 respondents (88 women, 25 men). Of 69% (61 of 88) of women and 88% (22 of 25) of men who desired children, 98% (60 of 61) of women versus 50% (11 of 22) of men delayed pregnancy (p < 0.0001). Eighty-two percent (72 of 88) of women versus 60% (15 of 25) of men felt their career would be adversely affected, with 6% (54 of 88) of women versus 16% (4 of 25) of men reporting that pregnancy would be viewed unfavorably among peers (p < 0.03 and p < 0.0001, respectively). Of women of childbearing age, 28% (15 of 54) utilized assisted reproductive technology (national average 12%, p < 0.0002). The total fertility rate was 0.6 ± 0.2 children per woman whereas the national rate was 1.9. The average age at first-childbirth was 34.3 ± 0.7 years, while the national norm was 25.4. CONCLUSIONS: Women thoracic surgeons begin their family later in life and have fewer children compared with the national average. These findings are likely related to the perception that their career would be adversely affected and to advanced maternal age. Residency programs and practice groups should strive to develop policies that support childbearing earlier in training as the number of women thoracic surgeons grows.

Desire for children, difficulties achieving a pregnancy, and infertility distress 3 to 7 years after cancer diagnosis.

PURPOSE: The aim was to investigate desire for children, difficulties achieving a pregnancy, and infertility distress among survivors 3 to 7 years after cancer treatment in reproductive age. METHODS: Cancer survivors were identified in national population-based cancer registries. Eligible subjects presented with selected cancer diagnoses between 2003 and 2007 between the ages of 18 to 45. A postal questionnaire including study-specific questions, the Short-Form 36 Health Survey and the Fertility Problem Inventory, was sent to 810 survivors, and 484 participated (60 % response). RESULTS: Most survivors who had a pretreatment desire for children still wanted children 3-7 years after treatment, and this group was characterized by young age and being childless at diagnosis. In addition, a substantial group of survivors (n = 55, 17 %) that did not have a pretreatment desire for children had changed their mind about wanting children after treatment. About a third of the survivors with a desire to have children had experienced difficulties achieving a pregnancy after the cancer treatment, and an unfulfilled desire to have children was associated with worse mental health. Survivors presently facing difficulties achieving a pregnancy reported moderate levels of infertility distress and expressed low interest in using gamete donation. CONCLUSIONS: Health professionals in cancer care need to be aware that patients' plans for future children may change, particularly if they are young and childless. All patients of reproductive age should be provided with adequate information about the impact of cancer treatment on future fertility and fertility preservation.

Levantamento qualitativo e reprodutivo da ornitofauna dos parques tarquínio joslin dos santos e parque ecológico paulo gorski, Cascavel - PR / Qualitative and reproductive survey of ornithofauna at parque tarquínio joslin dos santos and parque ecológico paulo gorski, Cascavel - PR / Alzamiento cualitativo y reproductivo de la ornitofauna de los parques tarquínio joslin dos santos y parque ecológico paulo gorski, Cascavel - PR

O presente estudo tem como objetivo o levantamento qualitativo e caracterização do comportamento reprodutivo da ornitofauna de hábitos diurnos no Parque Tarquínio Joslin dos Santos (P1) e no Parque Ecológico Paulo Gorski (P2), em Cascavel – PR, a fim de identificar interferências antrópicas na conservação e na diversidade nos parques urbanos. A composição da ornitofauna e o comportamento reprodutivo foram realizados por observações diretas auxiliadas com um guia de identificação de aves. Em P1 registrou-se 38 espécies, 20 famílias, destas destacam-se Basileuterus flaveolus e Sporophila plumbea que se encontram ameaçadas de extinção, e Dendroica estriata, por ser uma ave migratória. No P2 registrou-se 37 espécies pertencentes a 21 famílias. A reprodução foi analisada em dois parâmetros, nidificação e comportamento. Além disso obtidos dados morfométricos como altura em relação ao solo, topo/base, profundidade da câmara oológica, diâmetro maior e menor, substrato de apoio e material de construção dos ninhos, se estes ninhos se encontravam ativos quantificava- -se o número de ovos e o padrão de coloração. No P1 ocorreu nidificação de Zenaida auriculata, Furnarius rufus, Pitangus sulphuratus e Machetornis rixosa, apenas da primeira foi possível coletar dados morfométricos e comportamentais. Já no P2 nidificaram Zenaida auriculata, Furnarius rufus, Machetornis rixosa, Megarhynchus pitangua, Turdus rufiventris, Crotophaga ani e Butorides striata, sendo também possível apenas a coleta de dados morfométricos em ninhos de Zenaida, desta e das demais foram registrados comportamentos de defesa do ninho e incubação de ninhegos e ovos. Ressalta-se a importância da conservação dos parques urbanos para manutenção da biodiversidade de aves local.

This study aims to survey and qualitatively characterize the reproductive behavior of the diurnal ornithofauna at Parque Tarquínio Joslin dos Santos (P1) and Parque Ecológico Paulo Gorski (P2) in the city of Cascavel – PR, in order to identify anthropogenic interference in the conservation and diversity of urban parks. The bird composition and reproductive behavior were assessed by direct observations with the aid of a guide for identifying birds. In P1, a total of 38 species were recorded, from 20 families. Among these, it is important to highlight Basileuterus flaveolus and Sporophila plumbea, which are endangered, and Dendroica estriata, a migratory bird. In P2, a total of 37 species were recorded, belonging to 21 families. Reproduction was analyzed using two parameters - nesting and behavior. Morphometric data, such as height from the ground, top/bottom, depth of oologic chamber, with larger and smaller diameter, supporting substrate and construction material of nests. If these nests were considered active, the number and color pattern of eggs were quantified. In P1, nesting of Zenaida auriculata, Furnarius rufus, Pitangus sulphuratus and Machetornis rixosa, were found only, but it was only possible to collect morphometric and behavioral data from the first species. However, in P2, nests of Zenaida auriculata, Furnarius rufus, Machetornis rixosa, Megarhynchus pitangua, Turdus rufiventris, Crotophaga ani and Butorides striata were found, with morphometric data being collected only from Zenaida nests. From this species and the other ones, it was possible to record the behaviors of nest defense and incubation of eggs and hatchlings. It is important to emphasize the need to preserve urban parks for the maintenance of the biodiversity of local birds.

Esta investigación ha tenido como objetivo el alzamiento cualitativo y caracterización del comportamiento reproductivo de la ornitofauna de hábitos diurnos en el Parque Tarquínio Joslin dos Santos (P1) y en el Parque Ecológico Paulo Gorski (P2), en Cascavel – PR, a fin de identificar interferencias antrópicas en la conservación y en la diversidad de bosques urbanos. La composición de la ornitofauna y el comportamiento reproductivo han sido realizados a través de observaciones directas, auxiliadas con un guía de identificación de aves. En P1 se registró 38 especies, 20 familias de estas se destacan Basileuterus flaveolus y Sporophila plúmbea que se encuentran amenazadas de extinción, y Dendroica estriata, por ser un ave migratoria. En el P2 se registró 37 especies pertenecientes a 21 familias. La reproducción ha sido analizada en dos parámetros: nidificación y comportamiento. Además de eso, obtenidos datos morfo métricos como altura en relación al suelo, topo, base, profundidad de la cámara, diámetro mayor y menor, substrato de apoyo y material de construcción de los nidos, si estos nidos se encontraban activos se cuantificaba el número de huevos y el estándar de coloración. En el P1 ocurrió nidificación de Zenaida auriculata, Furnarius rufus, Pitangus sulphuratus e Machetornis rixosa, solo de la primera ha sido posible recoger datos morfo métricos y de comportamiento. Ya en el P2 nidificaron Zenaida auriculata, Furnarius rufus, Machetornis rixosa, Megarhynchus pitangua, Turdus rufiventris, Crotophaga ani y Butorides striata, siendo posible recoger datos morfo métricos en nidos de Zenaida, de esta y de las demás han sido registrados comportamientos de defensa del nido e incubación de pichones y huevos. Se destaca la importancia de la conservación de los bosques urbanos para manutención de la biodiversidad de aves local.

Pregnancy planning, smoking behaviour during pregnancy, and neonatal outcome: UK Millennium Cohort Study.

BACKGROUND: Pre-pregnancy health and care are important for the health of the future generations. Smoking during pregnancy has been well-researched and there is clear evidence of harm. But there has been little research on the health impact of planning for pregnancy. This study aims to investigate the independent effects of pregnancy planning and smoking during pregnancy on neonatal outcome. METHODS: This analysis made use of data from the UK Millennium Cohort Study. The study sample consisted of 18,178 singleton babies born in UK between 2000 and 2001. The neonatal outcomes of interest were low birthweight (<2.5 Kg) and pre-term birth (<37 completed weeks gestation). Logistic regression was used to estimate the association between pregnancy planning and/or smoking and neonatal outcome. Adjusted odds ratios were used to calculate population attributable risk fractions (PAFs). RESULTS: 43% of mothers did not plan their pregnancy and 34% were smoking just before and/or during pregnancy. Planners were half as likely to be smokers just before pregnancy, and more likely to give up or reduce the amount smoked if smokers. Unplanned pregnancies had 24% increased odds of low birth weight and prematurity compared to planned pregnancies (AORLBW1.24, 95% CI 1.04-1.48; AORPREM1.24, 95% CI 1.05-1.45), independent of smoking status. The odds of low birth weight for babies of mothers who were smoking just before pregnancy was 91% higher than that of mothers who were not (AORLBW1.91, 95% CI 1.56-2.34). Women who quit or reduced the amount smoked during pregnancy lowered the risk of a low birth weight baby by one third (AORLBW0.66, 95% CI 0.51-0.85) compared with women whose smoking level did not change. Smaller effects were found for prematurity. If all women planned their pregnancy and did not smoke before or during pregnancy, 30% of low birthweight and 14% of prematurity could, in theory, be avoided. CONCLUSIONS: Planning a pregnancy and avoiding smoking during pregnancy has clear, independent, health benefits for babies. Quitting or reducing the amount smoked during pregnancy can reduce the risk of low birthweight.

Epidemiological correlates of breast cancer in South India.

BACKGROUND: Breast cancer is the most frequent cancer in women globally and represents the second leading cause of cancer death among women (after lung cancer). India is going through epidemiologic transition. It is reported that the incidence of breast cancer is rising rapidly as a result of changes in reproductive risk factors, dietary habits and increasing life expectancy, acting in concert with genetic factors. MATERIALS AND METHODS: In order to understand the existing epidemiological correlates of breast cancer in South India, a systematic review of evidence available on epidemiologic correlates of breast cancer addressing incidence, prevalence, and associated factors like age, reproductive factors, cultural and religious factors was performed with specific focus on screening procedures in southern India. RESULTS: An increase in breast cancer incidence due to various modifiable risk factors was noted, especially in women over 40 years of age, with late stage of presentation, lack of awareness about screening, costs, fear and stigma associated with the disease serving as major barriers for early presentation. CONCLUSIONS: Educational strategies should be aimed at modifying the life style, early planning of pregnancy, promoting breast feeding and physical activity. It is very important to obtain reliable data for planning policies, decision-making and setting up the priorities.

Characteristics of first-time fathers of advanced age: a Norwegian population-based study.

BACKGROUND: The modern phenomenon of delayed parenthood applies not only to women but also to men, but less is known about what characterises men who are expecting their first child at an advanced age. This study investigates the sociodemographic characteristics, health behaviour, health problems, social relationships and timing of pregnancy in older first-time fathers. METHODS: A cross-sectional study was conducted of 14 832 men who were expecting their first child, based on data from the Norwegian Mother and Child Cohort Study (MoBa) carried out by the Norwegian Institute of Public Health. Data were collected in 2005-2008 by means of a questionnaire in gestational week 17-18 of their partner's pregnancy, and from the Norwegian Medical Birth Register. The distribution of background variables was investigated across the age span of 25 years and above. Men of advanced age (35-39 years) and very advanced age (40 years or more) were compared with men aged 25-34 years by means of bivariate and multivariate logistic regression analyses. RESULTS: The following factors were found to be associated with having the first child at an advanced or very advanced age: being unmarried or non-cohabitant, negative health behaviour (overweight, obesity, smoking, frequent alcohol intake), physical and mental health problems (lower back pain, cardiovascular diseases, high blood pressure, sleeping problems, previous depressive symptoms), few social contacts and dissatisfaction with partner relationship. There were mixed associations for socioeconomic status: several proxy measures of high socioeconomic status (e.g. income >65,000 €, self-employment) were associated with having the first child at an advanced or very advanced age, as were several other proxy measures of low socioeconomic status (e.g. unemployment, low level of education, immigrant background).The odds of the child being conceived after in vitro fertilisation were threefold in men aged 34-39 and fourfold from 40 years and above. CONCLUSIONS: Men who expect their first baby at an advanced or very advanced age constitute a socioeconomically heterogeneous group with more health problems and more risky health behaviour than younger men. Since older men often have their first child with a woman of advanced age, in whom similar characteristics have been reported, their combined risk of adverse perinatal outcomes needs further attention by clinicians and researchers.

[Data for the decrease of "voluntary childlessness" in inflammatory bowel disease]. / Adatok az "önként vállalt gyermektelenség" csökkentésére gyulladásos bélbetegségben.

Inflammatory bowel disease is a chronic disorder affecting young adults in their reproductive years, hence its populational consequences are not negligible. While fertility in inflammatory bowel disease is the same as in the general population (except for male patients with sulphasalazine treatment and females with ileum-pouch anal anastomosis), "voluntary childlessness" is higher, 14-18%. Patients require accurate counseling addressing fertility, pregnancy course and outcome. They need to be informed appropriately about risks and benefits of medications in inflammatory bowel disease in order to assist their decision making, decrease "voluntary childlessness" and improve compliance. Authors review the issues related to fertility, outcome of pregnancy, medical treatment options before and during pregnancy as well as during breastfeeding in inflammatory bowel disease.

Childbearing and pregnancy characteristics of female orthopaedic surgeons.

BACKGROUND: The number of women entering orthopaedic surgery is steadily increasing. Information regarding pregnancy and childbearing is important to understand as it increasingly affects residency programs, clinical practices, and the female surgeons and their offspring. METHODS: One thousand and twenty-one female surgeons completed an anonymous, voluntary, 199-item online survey distributed via individual female surgeon interest groups and word of mouth in nine specialties: general surgery, gynecology, neurosurgery, ophthalmology, orthopaedics, otolaryngology, plastic surgery, podiatry, and urology. Two hundred and twenty-three survey responses from orthopaedic surgeons were compared with those of the other surgical specialists as well as American Pregnancy Association national data to assess differences, if any, in pregnancy characteristics, demographics, and satisfaction. RESULTS: The overall reported complication rate for all pregnancies among orthopaedic surgeons was significantly higher than the rate in the general American population (31.2% [eighty-two of 263] compared with 14.5%). There was an increased risk of preterm delivery among orthopaedic surgeons compared with a cohort of the general U.S. population matched according to age, race, health, and socioeconomic status (risk ratio, 2.5; 95% confidence interval [CI], 1.3 to 4.6). There was an increased risk of preterm labor and preterm delivery among women who reported working more than sixty hours per week (odds ratio, 4.95; 95% CI, 1.4 to 36.6). Female orthopaedic surgeons took shorter maternity leave during training than during clinical practice (median, four compared with seven weeks). The mean duration of breastfeeding was significantly shorter during training than during clinical practice (4.7 compared with 8.3 months, p = 0.03). CONCLUSIONS: Female orthopaedic surgeons had an increased risk of pregnancy complications, particularly preterm delivery, compared with the general U.S. population. We found an increased risk of increased risk of preterm labor and delivery in surgeons working more than sixty hours per week during pregnancy.

Delayed child-bearing.

OBJECTIVE: To provide an overview of delayed child-bearing and to describe the implications for women and health care providers. OPTIONS: Delayed child-bearing, which has increased greatly in recent decades, is associated with an increased risk of infertility, pregnancy complications, and adverse pregnancy outcome. This guideline provides information that will optimize the counselling and care of Canadian women with respect to their reproductive choices. OUTCOMES: Maternal age is the most important determinant of fertility, and obstetric and perinatal risks increase with maternal age. Many women are unaware of the success rates or limitations of assisted reproductive technology and of the increased medical risks of delayed child-bearing, including multiple births, preterm delivery, stillbirth, and Caesarean section. This guideline provides a framework to address these issues. EVIDENCE: Studies published between 2000 and August 2010 were retrieved through searches of PubMed and the Cochrane Library using appropriate key words (delayed child-bearing, deferred pregnancy, maternal age, assisted reproductive technology, infertility, and multiple births) and MeSH terms (maternal age, reproductive behaviour, fertility). The Internet was also searched using similar key words, and national and international medical specialty societies were searched for clinical practice guidelines and position statements. Data were extracted based on the aims, sample, authors, year, and results. VALUES: The quality of evidence was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). SPONSOR: The Society of Obstetricians and Gynaecologists of Canada. RECOMMENDATIONS 1. Women who delay child-bearing are at increased risk of infertility. Prospective parents, especially women, should know that their fecundity and fertility begin to decline significantly after 32 years of age. Prospective parents should know that assisted reproductive technologies cannot guarantee a live birth or completely compensate for age-related decline in fertility. (II-2A) 2. A fertility evaluation should be initiated after 6 months of unprotected intercourse without conception in women 35 to 37 years of age, and earlier in women > 37 years of age. (II-2A) 3. Prospective parents should be informed that semen quality and male fertility deteriorate with advancing age and that the risk of genetic disorders in offspring increases. (II-2A) 4. Women ≥ 35 years of age should be offered screening for fetal aneuploidy and undergo a detailed second trimester ultrasound examination to look for significant fetal birth defects (particularly cardiac defects). (II-1A) 5. Delayed child-bearing is associated with increased obstetrical and perinatal complications. Care providers need to be aware of these complications and adjust obstetrical management protocols to ensure optimal maternal and perinatal outcomes. (II-2A) 6. All adults of reproductive age should be aware of the obstetrical and perinatal risks of advanced maternal age so they can make informed decisions about the timing of child-bearing. (II-2A) 7. Strategies to improve informed decision-making by prospective parents should be designed, implemented, and evaluated. These strategies should provide opportunity for adults to understand the potential medical, social, and economic consequences of child-bearing throughout the reproductive years. (III-B) 8. Barriers to healthy reproduction, including workplace policies, should be reviewed to optimize the likelihood of healthy pregnancies. (III-C).