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1.
BMC Pregnancy Childbirth ; 24(1): 223, 2024 Mar 27.
Article in English | MEDLINE | ID: mdl-38539104

ABSTRACT

BACKGROUND: One of the most significant demographic challenges over the past three decades has been the substantial reduction in fertility rates, worldwidely. As a developing country, Iran has also experienced a rapid decline in fertility over the past decades. Understanding factors influencing fertility is essential for development programs. Moreover, it's crucial to study the parameters that affect the intention for childbearing in any society. Therefore, through a systematic scoping review, the present study investigates the factors influencing couples' decisions toward childbearing. METHODS: This study was a systematic scoping review conducted in 2023. To design and conduct this scoping review, Joanna Briggs Institute's Protocol (Institute TJB, The Joanna Briggs Institute Reviewers ' manual 2015; methodology for JBI scoping reviews, 2015) was used and the framework presented by Levac et al. (2010) was also used as a guide for conducting this review. Studies were searched in three main databases including ISI Web of Sciences, PubMed, and Scopus, using a predefined search strategy. Google Scholar was also used for complementary search. The search period was from 2002 to 2022. RESULTS: A total of 18,454 studies were identified across three primary databases. After evaluating articles in three distinct phases based on title, abstract, and full-text, 46 articles were deemed eligible for inclusion in the scoping review. The qualitative analysis of the collected data from the selected studies through the scoping review led to classifying factors influencing households' desire for childbearing into eight main themes and 101 sub-themes. The main themes associated with factors impacting households' intention for childbearing encompass individual determinants, demographic and familial influencing factors, cultural elements, social factors, health-related aspects, economic considerations, insurance-related variables, and government support/incentive policies. CONCLUSIONS: Comprehensive and holistic attention from governments and officials toward the various factors affecting households' intention and behavior regarding childbearing appears beneficial and effective. Furthermore, given the relative ineffectiveness of some of the current government's supportive/incentive policies to increase couples' desire for childbearing, it seems necessary to review and amend these policies. This review should address the most significant challenges and factors contributing to couples' reluctance to childbearing or strengthen factors that can play a substantial role in fostering fertility and childbearing desires.


Subject(s)
Decision Making , Humans , Female , Male , Iran , Family Characteristics , Reproductive Behavior/psychology , Intention , Pregnancy , Adult
2.
J Chem Neuroanat ; 128: 102208, 2023 03.
Article in English | MEDLINE | ID: mdl-36476756

ABSTRACT

The hypothalamus plays a role in reproductive cycle control, and it is a site of action of steroid hormones. Throughout the production of melanin-concentrating hormone (MCH), the hypothalamus shows adaptive changes during lactation. Therefore, in this work, we aimed to test the effects of estrogen and progesterone manipulation on MCH-immunoreactive (ir) neurons in hypothalamic brain areas related to reproductive behavior and on the MCH serum concentration. Our results show that the removal of steroid hormones by ovariectomy increases the number of MCH-ir neurons in the medial preoptic area (MPOA) and incerto-hypothalamic area (IHy) but not in the anterior part of the paraventricular nucleus of the hypothalamus (PVHa). The MCH in the serum levels also increases. In accordance, the injection of estradiol alone or estradiol and progesterone decreased the number of MCH-ir neurons in the MPOA and IHy, as well as its serum levels. The MPOA and IHy are the brain areas targeted by the steroid hormone inhibitory effect of the MCH system during lactation. This effect is also reflected in the MCH serum levels.


Subject(s)
Hypothalamic Hormones , Reproductive Behavior , Female , Humans , Progesterone , Lactation , Pituitary Hormones , Hypothalamic Hormones/metabolism , Hypothalamus/metabolism , Melanins , Estrogens , Neurons/metabolism , Estradiol
3.
Article in English | AIM | ID: biblio-1396529

ABSTRACT

Background: Sensitivity to women's cultural needs and expectations by care providers is essential. Skilled birth services for women are as essential as traditional birth services. Therefore, collaborative skilled and cultural care optimises childbearing experiences. Aim: This study explored the experiences of birth attendants (BAs) with sensitivity to cultural practices (CPs) during pregnancy and birth among the Keiyo community in Kenya. Setting: The study was conducted in the purposively selected public health centres and dispensaries offering maternity services and the villages in Keiyo South Sub County in Kenya. Methods: A qualitative interpretive phenomenological study of BAs was conducted. Iterative and inductive interviews using a semistructured guide were conducted with 11 skilled BAs (SBAs) and eight traditional BAs (TBAs). Audio-recorded interviews were transcribed and analysed using ATLAS.ti software version 8.4.4 (1135), following Van Manen's five thematic analysis steps. Results: Three themes emerged: birth attendants' cultural encounters, response to cultural encounters and collaboration. Birth attendants' responses to different cultural encounters revealed their awareness of CPs. The response was experienced as a sensitivity to the need for a triad (woman, TBAs and SBAs) collaborative care, enabling collaborative, woman-centred and culturally safe care. Conclusion: Birth attendants are exposed to cultural encounters, and their responses determine their awareness of enabling sensitive care for optimal childbearing experiences. The study illuminated the need for further collaborative engagements between the BAs and the community to facilitate positive experiences by women through woman-centred, culturally safe care.


Subject(s)
Pregnant Women , Reproductive Behavior , Culturally Competent Care , Midwifery
4.
BMC Pregnancy Childbirth ; 21(1): 492, 2021 Jul 07.
Article in English | MEDLINE | ID: mdl-34233654

ABSTRACT

BACKGROUND: While the potential adverse outcomes of prenatal exposure to unhealthy lifestyle are widely evidenced, little is known about these exposures in the periconception period. We investigated the associations between lifestyle behaviours and adverse pregnancy outcomes with a unique distinction between preconceptional- and prenatal lifestyle behaviours. METHODS: A secondary analysis took place within a prospective multicentre cohort study in the Netherlands, including 3,684 pregnant women. Baseline characteristics and preconceptional and first trimester lifestyle behaviours were assessed through a self-administered questionnaire in the first trimester. Adverse pregnancy outcomes (hypertensive disorders in pregnancy (HDP), small for gestational age (SGA), gestational diabetes (GDM) and spontaneous preterm birth (sPTB)) were reported by healthcare professionals. Data were collected between 2012 and 2014 and analysed using multivariate logistic regression. RESULTS: Women who are overweight, and especially obese, have the highest odds of developing any adverse pregnancy outcome (adjusted odds ratio (aOR) 1.61 (95 % Confidence Interval (CI) 1.31-1.99) and aOR 2.85 (95 %CI 2.20-3.68), respectively), particularly HDP and GDM. Women who prenatally continued smoking attained higher odds for SGA (aOR 1.91 (95 %CI 1.05-1.15)) compared to the reference group, but these odds decreased when women prenatally quit smoking (aOR 1.14 (95 %CI 0.59-2.21)). Women who did not use folic acid supplements tended to have a higher odds of developing adverse pregnancy outcomes (aOR 1.28 (95 %CI 0.97-1.69)), while women who prenatally started folic acid supplements did not (aOR 1.01 (95 %CI 0.82-1.25)). CONCLUSIONS: Our results indicate that smoking cessation, having a normal body mass index (BMI) and initiating folic acid supplements preconceptionally may decrease the risk of adverse pregnancy outcomes. Therefore, intervening as early as the preconception period could benefit the health of future generations.


Subject(s)
Health Behavior/physiology , Life Style , Pregnancy Complications/epidemiology , Pregnancy Outcome/epidemiology , Reproductive Behavior/physiology , Adult , Diabetes, Gestational/epidemiology , Diabetes, Gestational/etiology , Dietary Supplements/statistics & numerical data , Female , Folic Acid/therapeutic use , Humans , Hypertension, Pregnancy-Induced/epidemiology , Hypertension, Pregnancy-Induced/etiology , Infant, Newborn , Infant, Small for Gestational Age , Logistic Models , Netherlands/epidemiology , Obesity/complications , Odds Ratio , Preconception Care/statistics & numerical data , Pregnancy , Pregnancy Complications/etiology , Pregnancy Trimester, First , Premature Birth/epidemiology , Premature Birth/etiology , Prospective Studies , Smoking/adverse effects , Smoking Cessation
5.
BMJ Open ; 9(4): e025005, 2019 04 24.
Article in English | MEDLINE | ID: mdl-31023753

ABSTRACT

OBJECTIVES: To assess the knowledge and intake of folic acid among teachers of childbearing age and to identify barriers to folic acid intake. SETTING: Governmental schools, which included 14 primary models, 29 primary, 14 preparatory and 16 secondary schools. The proportion of teachers in each stratum was then determined, and a stratified random sampling design had been used with proportional allocation. STUDY DESIGN: Cross-sectional study PARTICIPANTS: A total of 406 non-pregnant teachers of childbearing age enrolled in the study. A validated questionnaire in the Arabic language was used. RESULTS: The overall response rate was 98%. About 34.6% reported the optimal period in which they should take folic acid, 28.3% reported the correct intake duration and only 29.5% could name food rich in folic acid. Friends and healthcare providers were the main sources of information for the participants; however, 44% said that they did not receive enough information from their healthcare providers. CONCLUSION: There is a lack of knowledge and poor intake of folic acid among the participants. In particular, they lacked information about the appropriate time to start folic acid supplementations, the duration of intake and the folic acid-rich food. The most common reason being the limited advice given by their healthcare providers.Awareness campaigns are recommended to emphasise the role of healthcare providers in counselling women about the proper use of folic acid before pregnancy.


Subject(s)
Dietary Supplements , Folic Acid/therapeutic use , Health Knowledge, Attitudes, Practice , Neural Tube Defects/prevention & control , Preconception Care , Reproductive Behavior , Women, Working , Adult , Cross-Sectional Studies , Female , Humans , Qatar/epidemiology , School Teachers , Surveys and Questionnaires , Young Adult
6.
Midwifery ; 75: 52-58, 2019 Aug.
Article in English | MEDLINE | ID: mdl-31003022

ABSTRACT

OBJECTIVE: The purpose of this article is to establish a body of literature exploring the emergent topic of Indigenous doulas, in relation to Indigenous communities in remote locations, where women are routinely evacuated and no longer supported to give birth. In doing so the article will synthesise and critique key concepts in the literature and identify gaps for prioritisation in future research. DESIGN: The methodology is influenced by Indigenous, decolonising and feminist theoretical standpoints. A combined methodological approach of an integrative and scoping literature review was undertaken. Only published research, grey literature and grey data written in English and created between the years 2000 and 2018 was included. The search engines used were CINAHL plus, MEDLINE full text, Informat, Cochrane, Google Scholar and Google Search. SETTING: Resources originating from only Canada and America identified and despite regional similarities, no literature from Australia or Greenland was sourced. PARTICIPANTS: Of the entirety of identified resources two author's Indigenous identity was readily identifiable; and in the research articles there was a total of 191 research participants identified as Indigenous. Much of the grey literature and grey data included quotations from Indigenous women. INTERVENTIONS (IF APPROPRIATE): N/A. MEASUREMENTS AND FINDINGS: Key concepts about the role and practice of Indigenous doulas were identified: reclaiming and supporting cultural practices; sovereignty over lands and bodies; strengthening families, training, work models and defiance of evacuation policies on the pathway to returning birth. Critique of these concepts suggests that Indigenous doulas have a unique role and practice scope in Western maternity care, which is readily distinguished from standard doula practice. Research gaps worthy of future research prioritisation include: Indigenous women's perspectives as recipients of Indigenous doula care, Indigenous doulas as a pathway into midwifery, escort policy and impacts on Indigenous doula provision; evaluation and alternative research settings. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The role and practice of Indigenous doulas offers a promising approach to redressing the colonisation of Indigenous childbirth while contributing to improving Indigenous maternal and infant outcomes. Indigenous doula practice shares many best-practice characteristics with Indigenous Healing Programs and as such is also likely to also promote inter-generational healing. Most of the resources located were descriptive, but this emergent topic is worthy of further applied research.


Subject(s)
Doulas , Maternal Health Services/supply & distribution , Medicine, Traditional/methods , Female , Humans , Maternal Health Services/standards , Maternal Health Services/trends , Medicine, Traditional/standards , Pregnancy , Professional Role , Reproductive Behavior
7.
Nutrients ; 10(9)2018 Sep 08.
Article in English | MEDLINE | ID: mdl-30205553

ABSTRACT

In Low and Lower-Middle-Income countries, the prevalence of anaemia in infancy remains high. In early childhood anaemia cause irreversible cognitive deficits and represents a higher risk of child mortality. The consequences of anaemia in infancy are a major barrier to overcome poverty traps. The aim of this study was to analyse, based on a multi-level approach, different factors associated with anaemia in children 6⁻23 months old based on recent available Standard Demographic Health Surveys (S-DHS). We identified 52 S-DHS that had complete information in all covariates of interest in our analysis between 2005 and 2015. We performed traditional logistic regressions and multilevel logistic regression analyses to study the association between haemoglobin concentrations and household, child, maternal, socio-demographic variables. In our sample, 70% of the 6⁻23 months-old children were anaemic. Child anaemia was strongly associated with maternal anaemia, household wealth, maternal education and low birth weight. Children fed with fortified foods, potatoes and other tubers had significantly lower rates of anaemia. Improving overall household living conditions, increasing maternal education, delaying childbearing and introducing iron rich foods at six months of age may reduce the likelihood of anaemia in toddlerhood.


Subject(s)
Anemia/epidemiology , Educational Status , Family Characteristics , Income , Maternal Health , Adolescent , Adult , Anemia/blood , Anemia/diagnosis , Anemia/prevention & control , Biomarkers/blood , Birth Weight , Cross-Sectional Studies , Female , Food, Fortified , Health Status , Health Surveys , Hemoglobins/analysis , Humans , Infant , Infant Nutritional Physiological Phenomena , Infant, Low Birth Weight , Infant, Newborn , Male , Maternal Age , Middle Aged , Nutritional Status , Poverty , Prevalence , Protective Factors , Reproductive Behavior , Risk Factors , Young Adult
8.
Science ; 358(6363): 659-662, 2017 11 03.
Article in English | MEDLINE | ID: mdl-28982795

ABSTRACT

Present-day hunter-gatherers (HGs) live in multilevel social groups essential to sustain a population structure characterized by limited levels of within-band relatedness and inbreeding. When these wider social networks evolved among HGs is unknown. To investigate whether the contemporary HG strategy was already present in the Upper Paleolithic, we used complete genome sequences from Sunghir, a site dated to ~34,000 years before the present, containing multiple anatomically modern human individuals. We show that individuals at Sunghir derive from a population of small effective size, with limited kinship and levels of inbreeding similar to HG populations. Our findings suggest that Upper Paleolithic social organization was similar to that of living HGs, with limited relatedness within residential groups embedded in a larger mating network.


Subject(s)
Genome, Human , Reproductive Behavior/history , Social Behavior/history , DNA, Ancient , History, Ancient , Humans , Population Density , Russia
9.
Rev. Salusvita (Online) ; 36(4): 1067-1080, 2017.
Article in Portuguese | LILACS | ID: biblio-1022054

ABSTRACT

Introdução: a redução dos esteroides sexuais ocasionada pelo hipogonadismo se associa a depressão. Tratamentos alternativos com plantas medicinais como o extrato do Tribulus terrestris (TT) tem sido frequentemente usado por pessoas nesta condição. Objetivo: este estudo teve por objetivo investigar a influência do declínio de testosterona, da suplementação com TT e propionato de testosterona no comportamento de animais. Método: foram utilizados 40 camundongos da linhagem Swiss, machos, divididos em quatro grupos. Os grupos controle e castrado receberam veículo aquoso; o grupo TT recebeu 10 mg/kg do extrato da planta e o grupo propionato de testosterona foi tratado com 20 mg/kg deste fármaco. A avaliação comportamental foi feita pelo teste do nado forçado. Após trinta dias de tratamento, foi coletado sangue para dosagem de testosterona livre. Resultado e Discussão: os resultados evidenciaram efeito antidepressivo significativo nos animais castrados e suplementados com propionato de testosterona. Houve também significância no efeito depressivo nos animais tratados com TT; redução significativa na concentração de testosterona nos animais castrados e aumento significativo nos animais do grupo TT e propionato de testosterona. Conclusão: conclui-se que a castração, suplementação com TT e propionato de testosterona apresentaram suposta capacidade de alterar o comportamento e modificar as concentrações sérias de testosterona.


Introcution: the reduction of sexual steroids caused by hypogonadism is associated with depression. Alternative treatments with medicinal plants like Tribulus terrestris (TT) extract have often been used by people in this condition. Objective: this study aimed to investigate the influence of testosterone decline, supplementation with TT and testosterone propionate on animal behavior. Method: fourty Swiss male mice were divided into four groups. The control and castrated groups received aqueous vehicle; the TT group received 10 mg / kg of the plant extract and the testosterone propionate group was treated with 20 mg / kg of this drug. Behavioral assessment was performed by the forced swim test. After 30 days of treatment, blood was collected for free testosterone dosing. Results and Discussion: the results showed a significant antidepressant effect in castrated animals supplemented with testosterone propionate. There was also significance in the depressive effect in animals treated with TT; significant reduction in the concentration of testosterone in castrated animals and a significant increase in the animals of the TT group and testosterone propionate. Conclusion: it was concluded that castration, supplementation with TT and testosterone propionate presented a supposed capacity to alter the behavior and modify serum concentrations of testosterone.


Subject(s)
Mice , Tribulus , Reproductive Behavior , Mice
10.
Article in English | MEDLINE | ID: mdl-27531686

ABSTRACT

In this chapter, taking a life cycle and both civil society and medically oriented approach, we will discuss the contribution of the hypertensive disorders of pregnancy (HDPs) to maternal, perinatal and newborn mortality and morbidity. Here we review various interventions and approaches to preventing deaths due to HDPs and discuss effectiveness, resource needs and long-term sustainability of the different approaches. Societal approaches, addressing sustainable development goals (SDGs) 2.2 (malnutrition), 3.7 (access to sexual and reproductive care), 3.8 (universal health coverage) and 3c (health workforce strengthening), are required to achieve SDGs 3.1 (maternal survival), 3.2 (perinatal survival) and 3.4 (reduced impact of non-communicable diseases (NCDs)). Medical solutions require greater clarity around the classification of the HDPs, increased frequency of effective antenatal visits, mandatory responses to the HDPs when encountered, prompt provision of life-saving interventions and sustained surveillance for NCD risk for women with a history of the HDPs.


Subject(s)
Aspirin/therapeutic use , Calcium/therapeutic use , Eclampsia/therapy , Maternal Death/prevention & control , Perinatal Death/prevention & control , Platelet Aggregation Inhibitors/therapeutic use , Pre-Eclampsia/therapy , Birth Intervals , Cardiotocography , Dietary Supplements , Eclampsia/diagnosis , Eclampsia/prevention & control , Female , Food Supply , Health Facilities , Humans , Hypertension/complications , Hypertension/diagnosis , Hypertension/therapy , Hypertension, Pregnancy-Induced/diagnosis , Hypertension, Pregnancy-Induced/prevention & control , Hypertension, Pregnancy-Induced/therapy , Infant, Newborn , Mass Screening , Maternal Death/etiology , Obesity , Patient Participation , Perinatal Death/etiology , Pre-Eclampsia/diagnosis , Pre-Eclampsia/prevention & control , Preconception Care , Pregnancy , Pregnancy Complications, Cardiovascular/diagnosis , Pregnancy Complications, Cardiovascular/therapy , Prenatal Care , Proteinuria/diagnosis , Reproductive Behavior , Stillbirth
11.
BMC Pregnancy Childbirth ; 16(1): 195, 2016 07 29.
Article in English | MEDLINE | ID: mdl-27473473

ABSTRACT

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 ).


Subject(s)
Bariatric Surgery , Obesity/surgery , Pregnancy Complications/etiology , Reproductive Behavior/statistics & numerical data , Adolescent , Adult , Breast Feeding , Clinical Protocols , Diet/statistics & numerical data , Dietary Supplements/statistics & numerical data , Female , Humans , Life Style , Menstrual Cycle , Middle Aged , Milk, Human/chemistry , Obesity/complications , Obesity/physiopathology , Postoperative Period , Pregnancy , Pregnancy Outcome , Preoperative Period , Prospective Studies , Sexual Behavior , Young Adult
13.
Article in English | AIM | ID: biblio-1257815

ABSTRACT

Background: Globally, there is evidence that three micronutrients deficiencies are of public health concern among children. They are vitamin A; iodine and iron deficiencies. Communities particularly affected are those in situations where poverty, unemployment, civil unrest, war and exploitation remain endemic. Malnutrition is an impediment to productivity; economic growth and poverty eradication. It is estimated that 32% of the global burden would be removed by eliminating malnutrition; including micronutrients deficiencies. Setting: The study was carried out in NkowaNkowa township of Mopani District, Limpopo Province, South Africa.Aim: The main objective was to determine the women's knowledge on food fortification. Methods: The study design was descriptive. The snowballing method was used to identify women of child-bearing age. Data were collected from 120 participants using a questionnaire. The questionnaire consisted of socio-demographic; general questions on women's knowledge on food fortification. The questionnaire was administered by the researcher using the local language Xitsonga. Results: The findings of the study revealed that a majority of 204 (57.0%) of the participants were able to define food fortification correctly while 257 (72.0%) of the participants knew which foods are fortified as well as the benefits of a food fortification programme. The majority (252 [70.0%]) of the participants knew that maize meal is one of the food vehicle used for fortification in South Africa. Conclusion: Most of the questions were answered correctly by more than 50.0% of the participants. The researcher deduced that the study participants are knowledgeable about food fortification based on the response given in relation to the programme


Subject(s)
Food, Fortified , Knowledge , Micronutrients , Reproductive Behavior , South Africa
14.
BMC Pregnancy Childbirth ; 15: 236, 2015 Oct 02.
Article in English | MEDLINE | ID: mdl-26432278

ABSTRACT

BACKGROUND: Despite the importance attributed to good pre-pregnancy care and its potential to improve pregnancy and child health outcomes, relatively little is known about why women invest in pre-pregnancy health and care. We sought to gain insight into why women invested in pre-pregnancy health and care. METHODS: We carried out 20 qualitative in-depth interviews with pregnant or recently pregnant women who were drawn from a survey of antenatal clinic attendees in London, UK. Interviewees were purposively sampled to include high and low investors in pre-pregnancy health and care, with variation in age, partnership status, ethnicity and pre-existing medical conditions. Data analysis was conducted using the Framework method. RESULTS: We identified three groups in relation to pre-pregnancy health and care: 1) The "prepared" group, who had high levels of pregnancy planning and mostly positive attitudes to micronutrient supplementation outside of pregnancy, carried out pre-pregnancy activities such as taking folic acid and making changes to diet and lifestyle. 2) The "poor knowledge" group, who also had high levels of pregnancy planning, did not carry out pre-pregnancy activities and described themselves as having poor knowledge. Elsewhere in their interviews they expressed a strong dislike of micronutrient supplementation. 3) The "absent pre-pregnancy period" group, had the lowest levels of pregnancy planning and also expressed anti-supplement views. Even discussing the pre-pregnancy period with this group was difficult as responses to questions quickly shifted to focus on pregnancy itself. Knowledge of folic acid was poor in all groups. CONCLUSION: Different pre-pregnancy care approaches are likely to be needed for each of the groups. Among the "prepared" group, who were proactive and receptive to health messages, greater availability of information and better response from health professionals could improve the range of pre-pregnancy activities carried out. Among the "poor knowledge" group, better response from health professionals might yield greater uptake of pre-pregnancy information. A different, general health strategy might be more appropriate for the "absent pre-pregnancy period" group. The fact that general attitudes to micronutrient supplementation were closely related to whether or not women invested in pre-pregnancy health and care was an unanticipated finding and warrants further investigation.


Subject(s)
Family Planning Services/statistics & numerical data , Health Knowledge, Attitudes, Practice , Preconception Care/statistics & numerical data , Reproductive Behavior/psychology , Adult , Dietary Supplements , Family Planning Services/methods , Female , Folic Acid/therapeutic use , Humans , London , Preconception Care/methods , Pregnancy , Qualitative Research , Vitamin B Complex/therapeutic use , Young Adult
15.
Bioethics ; 29(1): 26-35, 2015 Jan.
Article in English | MEDLINE | ID: mdl-25521971

ABSTRACT

One widely held view of prenatal screening (PNS) is that its foremost aim is, or should be, to enable reproductive choice; this is the Pure Choice view. The article critiques this position by comparing it with an alternative: Public Health Pluralism. It is argued that there are good reasons to prefer the latter, including the following. (1) Public Health Pluralism does not, as is often supposed, render PNS more vulnerable to eugenics-objections. (2) The Pure Choice view, if followed through to its logical conclusions, may have unpalatable implications, such as extending choice well beyond health screening. (3) Any sensible version of Public Health Pluralism will be capable of taking on board the moral seriousness of abortion and will advocate, where practicable, alternative means of reducing the prevalence of disease and disability. (4) Public Health Pluralism is at least as well-equipped as the Pure Choice model to deal with autonomy and consent issues.


Subject(s)
Abortion, Eugenic/ethics , Choice Behavior/ethics , Congenital Abnormalities/diagnosis , Disabled Persons , Informed Consent/ethics , Personal Autonomy , Pregnant Women , Prenatal Diagnosis/ethics , Public Health/ethics , Social Discrimination , Comprehension , Congenital Abnormalities/genetics , Cultural Diversity , Decision Making/ethics , Dissent and Disputes , Down Syndrome/diagnosis , Eugenics , Female , Genetic Testing/ethics , Humans , Information Seeking Behavior , Morals , National Health Programs/ethics , Pregnancy , Pregnant Women/psychology , Reproductive Behavior/ethics , United Kingdom
16.
Bioethics ; 29(1): 46-55, 2015 Jan.
Article in English | MEDLINE | ID: mdl-25521973

ABSTRACT

Prenatal screening for foetal abnormalities such as Down's syndrome differs from other forms of population screening in that the usual aim of achieving health gains through treatment or prevention does not seem to apply. This type of screening leads to no other options but the choice between continuing or terminating the pregnancy and can only be morally justified if its aim is to provide meaningful options for reproductive choice to pregnant women and their partners. However, this aim should not be understood as maximizing reproductive choice per se. Only if understood as allowing prospective parents to avoid suffering related to living with (a child with) serious disorders and handicaps can prenatal screening be a publicly or collectively funded programme. The alternative of moving prenatal testing outside the healthcare system into the private sector is problematic, as it makes these tests accessible only to those who can afford to pay for it. New developments in prenatal screening will have to be assessed in terms of whether and to what extent they either contribute to or undermine the stated aim of providing meaningful options for reproductive choice. In the light of this criterion, this article discusses the introduction of the new non-invasive prenatal test (NIPT), the tendency to widen the scope of follow-up testing, as well as the possible future scenarios of genome-wide screening and 'prenatal personalised medicine'. The article ends with recommendations for further debate, research and analysis.


Subject(s)
Choice Behavior/ethics , Congenital Abnormalities/diagnosis , Disabled Persons , Genetic Testing/ethics , Mass Screening/ethics , Personal Autonomy , Pregnant Women , Prenatal Diagnosis/ethics , Private Sector , Public Health , Abortion, Eugenic/economics , Abortion, Eugenic/ethics , Adult , Congenital Abnormalities/genetics , Decision Making/ethics , Disabled Persons/psychology , Dissent and Disputes , Female , Genetic Testing/economics , Genetic Testing/methods , Genetic Testing/trends , Heterozygote , Humans , Information Seeking Behavior/ethics , Mass Screening/economics , Mass Screening/methods , Mass Screening/trends , National Health Programs , Precision Medicine/ethics , Precision Medicine/methods , Precision Medicine/trends , Pregnancy , Pregnant Women/psychology , Prenatal Diagnosis/economics , Prenatal Diagnosis/methods , Prenatal Diagnosis/trends , Public Health/ethics , Public Health/methods , Public Health/trends , Reproductive Behavior/ethics
17.
Rev. bras. plantas med ; 17(4,supl.1): 713-721, 2015. tab, graf
Article in Portuguese | LILACS | ID: lil-770375

ABSTRACT

RESUMO O gênero Aloe, originário principalmente da África, tem atualmente uma ampla distribuição no mundo. No entanto, são poucas as regiões que têm realizado estudos quanto ao sistema reprodutivo. O objetivo do presente trabalho foi analisar as características e o comportamento reprodutivo de Aloe saponaria em Florianópolis, Santa Catarina. Foram conduzidos estudos sobre sua morfologia e biologia floral, visitantes florais e sistema reprodutivo. Esta espécie apresentou uma inflorescência por planta, com um comprimento de 105 ± 0,1 cm e 267 ± 92,7 flores. A razão pólen/óvulo sugere que a espécie é xenogâmica. O volume e concentração de sólidos solúveis totais do néctar potencial foi 16,6 ± 6,3 μL e 22 ± 2,4 °Brix respectivamente. O néctar instantâneo não apresentou diferenças significativas nos períodos avaliados (9:00h e 15:00h) e o estigma permaneceu receptivo até o segundo dia após a antese. Foram coletados 110 insetos visitantes florais, dos quais 61,8% foram indivíduos de Trigona spinipes. Entretanto, nos testes de polinização não foi observada frutificação efetiva, indicando que a propagação vegetativa é o principal tipo de reprodução usado nessa população. Isto pode estar relacionado a um mecanismo de autoincompatibilidade esporofítica, a anormalidades cromossômicas durante a formação do pólen, as condições climáticas, e a escassa variabilidade genética no local de estudo.


ABSTRACT The Aloe genus, originating mainly from Africa, currently has a wide distribution in the world. However, in few regions studies about the reproductive system have been carried on. The aim e of this study was to analyze the characteristics and reproductive performance of the Aloesaponaria in Florianópolis, Santa Catarina. The morphology, floral biology, flower visitors and the reproductive system were determined. The plants presented an inflorescence per plant, with 105 ± 0,1 cm in length and 267 ± 92.7 flowers. The pollen/ovule ratio suggested that the species is xenogamic. The volume and concentration of total soluble solids in the potential nectar were 16.6 ± 6.3 μL and 22 ± 2.4°Brix, respectively. The instant nectar showed no significant differences between the evaluated periods (9:00h and 15:00h) and the stigma remained receptive until the second day the after anthesis. 110 insects were collected, from which 61.8% were from theTrigona spinipesspecies. However, in the pollination tests the fruit set was not observation, indicating that vegetative propagation is the main type of reproduction used by this population. This may be related to a mechanism of sporophytic self-incompatibility, to chromosomal abnormalities during the formation of pollen, to weather conditions, and to the low genetic variability at the study site.


Subject(s)
Reproductive Behavior/classification , Aloe/classification , Pollination , Inflorescence
18.
Hum Nat ; 25(1): 80-99, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24402403

ABSTRACT

For more than 100,000 years, H. sapiens lived as foragers, in small family groups with low reproductive variance. A minority of men were able to father children by two or three women; and a majority of men and women were able to breed. But after the origin of farming around 10,000 years ago, reproductive variance increased. In civilizations which began in Mesopotamia, Egypt, India, and China, and then moved on to Greece and Rome, kings collected thousands of women, whose children were supported and guarded by thousands of eunuchs. Just a few hundred years ago, that trend reversed. Obligate sterility ended, and reproductive variance declined. For H. sapiens, as for other organisms, eusociality seems to be an effect of ecological constraints. Civilizations rose up in lake and river valleys, hemmed in by mountains and deserts. Egalitarianism became an option after empty habitats opened up.


Subject(s)
Civilization/history , Cooperative Behavior , Reproductive Behavior/history , China , Egypt, Ancient , Female , Greece, Ancient , History, Ancient , Humans , India , Male , Mesopotamia , Reproduction , Rome
19.
Demography ; 51(1): 3-25, 2014 Feb.
Article in English | MEDLINE | ID: mdl-24338643

ABSTRACT

Demography and culture have had a long but ambivalent relationship. Cultural influences are widely recognized as important for demographic outcomes but are often "backgrounded" in demographic research. I argue that progress toward a more successful integration is feasible and suggest a network model of culture as a potential tool. The network model bridges both traditional (holistic and institutional) and contemporary (tool kit) models of culture used in the social sciences and offers a simple vocabulary for a diverse set of cultural concepts, such as attitudes, beliefs, and norms, as well as quantitative measures of how culture is organized. The proposed model conceptualizes culture as a nested network of meanings represented by schemas that range in complexity from simple concepts to multifaceted cultural models. I illustrate the potential value of a model using accounts of the cultural changes underpinning the transformation of marriage in the United States and point to developments in the social, cognitive, and computational sciences that could facilitate the application of the model in empirical demographic research.


Subject(s)
Attitude , Behavior , Culture , Demography , Family Characteristics , Gender Identity , Humans , Marriage/psychology , Marriage/statistics & numerical data , Population Dynamics , Reproductive Behavior/psychology , Reproductive Behavior/statistics & numerical data , Social Change , Social Environment , United States
20.
Minerva Ginecol ; 64(6): 455-60, 2012 Dec.
Article in English | MEDLINE | ID: mdl-23232530

ABSTRACT

Treatment advances in assisted reproductive technology (ART) such as oocyte donation and gestational surrogacy have introduced a new cohort of intended parents and new family constellations. Who these parents are and how their children are doing is the focus of this paper. Special emphasis will be paid to the impact of delayed parenthood on oocyte donation, the increasing numbers of gestational surrogacy participants (intended parents and surrogates), and the growing numbers of gay male couples seeking fatherhood through ART. While it appears that children of these new family constellations are doing well, research is limited and longitudinal studies of their health and well being are needed.


Subject(s)
Adult Children/psychology , Parents/psychology , Reproductive Techniques, Assisted , Adolescent , Adult , Child , Child Development , Divorce , Female , Fertilization in Vitro/psychology , Gender Identity , Homosexuality, Male/psychology , Humans , Infant, Newborn , Male , Oocyte Donation/psychology , Parent-Child Relations , Pregnancy , Reproductive Behavior/psychology , Reproductive Techniques, Assisted/psychology , Reproductive Techniques, Assisted/trends , Social Adjustment , Surrogate Mothers/psychology , Treatment Outcome
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