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1.
Ecotoxicol Environ Saf ; 214: 112094, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33677382

RESUMEN

Honey has multifaceted nutritional and medicinal values; however, its quality is hinged on the floral origin of the nectar. Taking advantage of the large areas that they cover; honeybees are often used as bioindicators of environmental contamination. The focus of the present paper was to examine the quality of honey from within the vicinity of an abandoned pesticide store in Masindi District in western Uganda. Surficial soils (<20 cm depths) and honey samples were collected from within the vicinity of the abandoned pesticide store and analysed for organochlorine pesticide (OCP) residues using gas chromatograph coupled to an electron capture detector (GC-ECD). The mean level of ∑DDTs in all the soil samples was 503.6 µg/kg dry weight (d.w). ∑DDTs contributed 92.2% to the ∑OCPs contamination loads in the soil samples, and others (lindane, aldrin, dieldrin, and endosulfans) contributed only 7.8%. Ratio (p, p'-DDE+p, p'-DDD)/p, p'-DDT of 1.54 suggested historical DDT input in the area. In all the honey samples, the mean level of ∑DDTs was 20.9 µg/kg. ∑DDTs contributed 43.3% to ∑OCPs contamination loads in the honey samples, followed by lindane (29.8%), endosulfans (23.6%) and dieldrin (3.2%), with corresponding mean levels of 14.4, 11.4 and 1.55 µg/kg, respectively. Reproductive risk assessment was done based on the hazard quotient (HQ) and hazard index (HI) procedure. In our study, the calculated HIs for adults (102.38), and children (90.33) suggested high potential health risks to the honey consumers. Lindane, endosulfan and p, p'-DDD detected in the honey samples at levels exceeding the acute reference dose (ARfD) are known risk factors for spontaneous abortion, reduced implantation, menstrual cycle shortening, impaired semen quality, and prostate cancer in exposed individuals and experimental animal models.


Asunto(s)
Exposición Dietética/estadística & datos numéricos , Miel/análisis , Hidrocarburos Clorados/análisis , Residuos de Plaguicidas/análisis , Adulto , Aldrín/análisis , Animales , Niño , DDT/análisis , Diclorodifenil Dicloroetileno/análisis , Dieldrín/análisis , Endosulfano/análisis , Biomarcadores Ambientales , Monitoreo del Ambiente/métodos , Femenino , Hexaclorociclohexano/análisis , Humanos , Masculino , Plaguicidas/análisis , Salud Reproductiva , Análisis de Semen , Suelo , Uganda
2.
Reprod Health ; 18(1): 47, 2021 Feb 23.
Artículo en Inglés | MEDLINE | ID: mdl-33622376

RESUMEN

BACKGROUND: Integrating family planning into child immunization services may address unmet need for contraception by offering family planning information and services to postpartum women during routine child immunization visits. However, policies and programs promoting integration are often based on insubstantial or conflicting evidence about its effects on service delivery and health outcomes. While integration models vary, many studies measure integration as binary (a facility is integrated or not) rather than a multidimensional and varying continuum. It is thus challenging to ascertain the determinants and effects of integrated service delivery. This study creates Facility and Provider Integration Indexes, which measure capacity to support integrated family planning and child immunization services and applies them to analyze the extent of integration across 400 health facilities. METHODS: This study utilizes cross-sectional health facility (N = 400; 58% hospitals, 42% primary healthcare centers) and healthcare provider (N = 1479) survey data that were collected in six urban areas of Nigeria for the impact evaluation of the Nigerian Urban Reproductive Health Initiative. Principal Component Analysis was used to develop Provider and Facility Integration Indexes that estimate the extent of integration in these health facilities. The Provider Integration Index measures provider skills and practices that support integrated service delivery while the Facility Integration Index measures facility norms that support integrated service delivery. Index scores range from zero (low) to ten (high). RESULTS: Mean Provider Integration Index score is 5.42 (SD 3.10), and mean Facility Integration Index score is 6.22 (SD 2.72). Twenty-three percent of facilities were classified as having low Provider Integration scores, 32% as medium, and 45% as high. Fourteen percent of facilities were classified as having low Facility Integration scores, 38% as medium, and 48% as high. CONCLUSION: Many facilities in our sample have achieved high levels of integration, while many others have not. Results suggest that using more nuanced measures of integration may (a) more accurately reflect true variation in integration within and across health facilities, (b) enable more precise measurement of the determinants or effects of integration, and (c) provide more tailored, actionable information about how best to improve integration. Overall, results reinforce the importance of utilizing more nuanced measures of facility-level integration.


Asunto(s)
Prestación Integrada de Atención de Salud , Servicios de Planificación Familiar , Administración de Instituciones de Salud , Programas de Inmunización , Servicios de Salud Reproductiva , Adulto , Niño , Preescolar , Estudios Transversales , Prestación Integrada de Atención de Salud/organización & administración , Prestación Integrada de Atención de Salud/normas , Servicios de Planificación Familiar/organización & administración , Servicios de Planificación Familiar/normas , Servicios de Planificación Familiar/provisión & distribución , Femenino , Instituciones de Salud/normas , Administración de Instituciones de Salud/métodos , Administración de Instituciones de Salud/normas , Indicadores de Salud , Humanos , Programas de Inmunización/organización & administración , Programas de Inmunización/normas , Programas de Inmunización/provisión & distribución , Lactante , Recién Nacido , Masculino , Nigeria/epidemiología , Embarazo , Salud Reproductiva/normas , Servicios de Salud Reproductiva/organización & administración , Servicios de Salud Reproductiva/normas , Servicios de Salud Reproductiva/provisión & distribución , Encuestas y Cuestionarios , Población Urbana/estadística & datos numéricos , Vacunación/métodos , Vacunación/estadística & datos numéricos
3.
Sex Reprod Health Matters ; 29(1): 1881210, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33599196

RESUMEN

The COVID-19 pandemic has substantially strained health systems across the globe. In particular, documented disruptions to voluntary family planning and reproductive health care due to competing health priorities, service disruptions, stockouts, and lockdowns are significantly impacting reproductive, maternal, newborn, and child health. As governments and family planning programmes grapple with how best to respond to the direct and indirect effects of the pandemic on family planning and reproductive health (FP/RH), the implementation and adaptation of evidence-based practices is crucial. In this commentary, we outline applications of the High Impact Practices in Family Planning (HIPs) towards COVID-19 response efforts. The HIPs are a set of evidence-based family planning practices which reflect global expert consensus on what works in family planning programming. Drawing upon preliminary COVID-19 data, documented experiences from prior health emergencies, and recommended programme adaptations from a variety of global health partners, we outline situations where specific HIPs may assist family planning programme managers in developing context-specific and evidence-based responses to COVID-19-related impacts on FP/RH, with the ultimate goal of ensuring the accessibility, availability, and continuity of voluntary family planning services across the world.


Asunto(s)
/epidemiología , Servicios de Planificación Familiar/tendencias , Servicios de Salud Materna/tendencias , Calidad de la Atención de Salud/tendencias , Salud Reproductiva/tendencias , Anticoncepción/tendencias , Femenino , Accesibilidad a los Servicios de Salud/tendencias , Humanos , Pandemias/estadística & datos numéricos
4.
Adv Exp Med Biol ; 1300: 205-229, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33523436

RESUMEN

Environmental endocrine-disrupting chemicals (EDCs) are xenobiotic compounds that are frequently contacted in daily life. With the species and quantity of substances created and utilized by human beings significantly surpassing the self-purification capacity of nature, a large number of hazardous substances are enriched in the human body through the respiratory tract, digestive tract, and skin. Some of these compounds cause many problems endangering female reproductive health by simulating/antagonizing endogenous hormones or affecting the synthesis, metabolism, and bioavailability of endogenous hormones, including reproductive disorders, fetal birth defects, fetal developmental abnormalities, endocrine and metabolic disorders, and even gynecological malignancies. Therefore, the study of the relationship between environmental EDCs and female reproductive diseases and related mechanisms is of considerable significance to women, children health care, and improve the quality of the population.


Asunto(s)
Disruptores Endocrinos , Contaminantes Ambientales , Niño , Disruptores Endocrinos/toxicidad , Sistema Endocrino , Exposición a Riesgos Ambientales/efectos adversos , Contaminantes Ambientales/toxicidad , Femenino , Hormonas/farmacología , Humanos , Reproducción , Salud Reproductiva
6.
BMJ Open ; 11(2): e042649, 2021 02 05.
Artículo en Inglés | MEDLINE | ID: mdl-33550252

RESUMEN

INTRODUCTION: Global commitments have established goals of achieving universal sexual and reproductive health and rights (SRHR) access, but critical obstacles remain. Emergency contraception and induced abortion are overlooked in policy and research. Men's roles in the SRHR of others are significant, particularly as obstacles to universal SRHR. Evidence on gender, masculinities and SRHR is essential to understand and reduce the barriers faced by individuals seeking to avoid the conception or continuation of a pregnancy. METHODS AND ANALYSIS: This study aims to understand men's masculinities and their relationships with emergency contraception and abortion. The protocol presents a multimethod study of men aged over 18 years in James Town, Accra, Ghana. In response to the COVID-19 pandemic, the research will use two mobile-based methods: a survey and in-depth interviews. Using respondent-driven sampling, an estimated 789 men will be recruited to participate in the survey, asking questions on their knowledge, attitude, behaviours and roles in emergency contraception and abortion. In-depth interviews focused on constructions of masculinity will be conducted with a purposive sample of men who participated in the survey. Data will be analysed concurrently using multiple regression analyses of quantitative data and abductive analysis of qualitative data. ETHICS AND DISSEMINATION: Ethical approval has been granted by the London School of Economics and Political Science and the Ghana Health Service. The findings in this study will: engage with emerging research on masculinities and SRHR in Ghana and elsewhere; offer methodological insight for future research; and provide evidence to inform interventions to reduce obstacles for emergency contraception and abortion care seekers. Dissemination will occur at all levels-policy, academic, community-including multiple academic articles, policy briefs, workshops and presentations, conference papers, and theatre/radio-based performances of key messages.


Asunto(s)
Aborto Inducido , Teléfono Celular , Anticoncepción Postcoital , Conocimientos, Actitudes y Práctica en Salud , Masculinidad , Femenino , Ghana , Accesibilidad a los Servicios de Salud , Humanos , Entrevistas como Asunto , Londres , Masculino , Embarazo , Salud Reproductiva , Proyectos de Investigación , Encuestas y Cuestionarios
7.
Reprod Health ; 18(1): 26, 2021 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-33618726

RESUMEN

BACKGROUND: A coherent sexuality education program for adolescents is part of their sexual and reproductive rights and can help them have a healthier future. Therefore, the aim of this study was to explore the perspectives and intervention preferences of Iranian stakeholders regarding comprehensive sexuality education (CSE) in male adolescents based on the IMB model (information, motivation, behavioral skills). METHODS: This study was a qualitative study that was analyzed through a directed content analysis approach. Individual interviews and focused group discussions (FGDs) were used for data collection. The data were collected through in-depth semi-structured interviews with stakeholders in two schools and the Education Department in Sari and the Ministry of Health and Ministry of Education in Tehran from March 2019 to August 2019. Data saturation was achieved after 28 interviews and 1 FGDs with 9 participants. Finally, two sets of data were coded and analyzed using directed content analysis. RESULTS: In this study, five themes emerged as (1) role of institutions; (2) role of organizations; (3) need for stakeholder's partnership; (4) need for adolescent sexuality socialization management; and (5) need for enhancing the teachers' professional competence, which seemed to influence the implementation of CSE in male adolescents. Participants also expressed a number of intervention preferences for CSE. The most important of these was the change in macro policies, helping to create a culture against all forms of violence and breaking the taboo of sexuality education for children and adolescents. CONCLUSIONS: The results of this study revealed the need for a CSE program for adolescents' sexuality socialization. The finding showed that teachers required training to enhance their professional competence about sexuality issues. Therefore, it is necessary to design and implement culture-appropriate skill based programs to enhance the teachers' professional competence regarding the adolescents' sexual health.


Asunto(s)
Actitud Frente a la Salud , Percepción , Salud Reproductiva/educación , Educación Sexual , Salud Sexual/educación , Adolescente , Conducta del Adolescente/fisiología , Conducta del Adolescente/psicología , Niño , Grupos Focales , Conocimientos, Actitudes y Práctica en Salud , Humanos , Entrevistas como Asunto , Irán , Masculino , Motivación/fisiología , Investigación Cualitativa , Servicios de Salud Escolar , Educación Sexual/métodos , Conducta Sexual/psicología , Participación de los Interesados , Adulto Joven
8.
Reprod Health ; 18(1): 49, 2021 Feb 24.
Artículo en Inglés | MEDLINE | ID: mdl-33627155

RESUMEN

INTRODUCTION: Both inpatient and outpatient providers may be at increased risk of stress, anxiety and depression from their roles as health providers during the COVID-19 epidemic. This study explores how the US COVID-19 epidemic has increased feelings of stress, anxiety and depression among outpatient reproductive health providers. METHODS: We conducted a survey with open-ended responses among outpatient reproductive health providers across the U.S. engaged in contraceptive care to collect data on their experiences with stress, anxiety and depression during the COVID-19 epidemic. The study population included physicians, nurses, social workers, and other health professions [n = 288]. Data were collected from April 21st-June 24th 2020. We used content analysis of free text responses among providers reporting increased stress, anxiety or depression. RESULTS: Two-thirds (184) of providers reported increased stress and one-third (96) reported increased anxiety or depression related to care provision during the COVID-19 epidemic. The major sources of stress, anxiety and depression were due to patient care, worry about becoming infected or infecting family members, work- and home-related concerns, experiencing provider burnout, and fear of the unknown. Concerns about quality of patient care, providers' changing responsibilities, lack of personal protective equipment, and difficulty coping with co-worker illness and absence all contributed to provider stress and anxiety. Worries about unemployment and childcare responsibilities were also highlighted. Providers attributed their stress, anxiety or depression to feeling overwhelmed, being unable to focus, lacking sleep, and worrying about the unknown. CONCLUSIONS: US outpatient providers are experiencing significant stress, anxiety, and depression during the US COVID-19 epidemic. Policy and programmatic responses are urgently needed to address the widespread adverse mental health consequences of this epidemic on outpatient providers, including reproductive health providers, across the US. Both inpatient and outpatient providers may be at increased risk of stress, anxiety and depression from their roles as health providers during the COVID-19 epidemic. This study explores how the US COVID-19 epidemic has increased feelings of stress, anxiety and depression among outpatient reproductive health providers across the US. We conducted a survey from April 21st to June 24th, 2020 among outpatient reproductive health providers, including physicians, nurses, social workers and other health professions. We asked open-ended questions to understand why providers reported increased stress, anxiety and/or depression. Two-thirds (184) of providers reported increased stress and one-third (96) reported increased anxiety or depression from care provision during the COVID-19 epidemic. Major sources of stress, anxiety and depression were due to patient care, worry about becoming infected or infecting family members, work- and home-related concerns, experiencing provider burnout, and fear of the unknown. Concerns about quality of patient care, providers' changing responsibilities, lack of personal protective equipment, and difficulty coping with co-worker illness and absence all contributed to provider stress and anxiety. Worries about unemployment and childcare responsibilities were also highlighted. Providers attributed their stress, anxiety or depression to feeling overwhelmed, being unable to focus, lacking sleep, and worrying about the unknown. This study highlights that US outpatient reproductive health providers are experiencing significant stress, anxiety, and depression during the US COVID-19 epidemic. Policy and programmatic responses are urgently needed to address the widespread adverse mental health consequences of this epidemic on outpatient providers, including reproductive health providers, across the US.


Asunto(s)
/psicología , Personal de Salud/psicología , Salud Mental/estadística & datos numéricos , Salud Reproductiva , Adulto , Atención Ambulatoria/psicología , Ansiedad/epidemiología , Depresión/epidemiología , Grupos Étnicos/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estrés Psicológico/epidemiología , Encuestas y Cuestionarios , Estados Unidos/epidemiología
9.
Artículo en Ruso | MEDLINE | ID: mdl-33591663

RESUMEN

The young generation aged 16-24 years is the main demographic national reserve for coming decades. Hence, the purpose of the study is to investigate attitude of modern youth exemplified by students of medical university to establishing family, marriage and birth of children, and also their awareness about issues of reproductive health and training of couple to birth of healthy progeny considering modern approaches of personalized "4P Medicine". The survey of medical students was carried out on the basis of sampling of 193 students in November 2019 to February 2020. The survey data was processed using software SPSS 21. The indices of descriptive and analytical statistics were calculated to analyze study results. The low awareness of medical students on issues of pregravid training and modern approaches of personalized «4P Medicine¼ was established. Despite the fact that significant number of students understand importance of improving their awareness of reproductive health and pregravid training from positions of "4P Medicine", about quarter of all respondents never pondered about these issues. The majority of respondents lead healthy life-style and understand its importance for their health, including reproductive health. The students have positive attitudes to establishment of family and birth of children. It is necessary to improve awareness of medical students of reproductive health, pregravid training and main principles of personalized "4P Medicine".


Asunto(s)
Medicina , Estudiantes de Medicina , Adolescente , Adulto , Niño , Conocimientos, Actitudes y Práctica en Salud , Humanos , Salud Reproductiva , Encuestas y Cuestionarios , Universidades , Adulto Joven
10.
Adv Exp Med Biol ; 1300: 3-19, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33523427

RESUMEN

In this Chapter, we systematically and comprehensively described various environmental harmful factors. They were classified into four aspects: physical factors, chemical factors, biological factors, and physiological and psychological stress factors. Their classification, modes of presence, toxicity and carcinogenicity, routes of exposure to human and toxic effects on the female reproductive health were introduced. It is expected that the exposure routes could be controlled and eliminated, and the pathogenic mechanism of environmental harmful factors should be investigated and explained to protect female reproductive health.


Asunto(s)
Exposición a Riesgos Ambientales , Salud Reproductiva , Exposición a Riesgos Ambientales/efectos adversos , Femenino , Humanos , Reproducción , Salud de la Mujer
11.
Artículo en Inglés | MEDLINE | ID: mdl-33540735

RESUMEN

In Australia, 1.5 generation migrants (those who migrated as children) often enter a new cultural and religious environment, with its own set of constructs of sexual and reproductive health (SRH), at a crucial time in their psychosexual development-puberty/adolescence. Therefore, 1.5 generation migrants may thus have to contend with constructions of SRH from at least two cultures which may be at conflict on the matter. This study was designed to investigate the role of culture and religion on sexual and reproductive health indicators and help-seeking amongst 1.5 generation migrants. An online survey was completed by 111 participants who answered questions about their cultural connectedness, religion, sexual and reproductive health and help-seeking. Kruskall-Wallis tests were used to analyse the data. There was no significant difference between ethnocultural groups or levels of cultural connectedness in relation to sexual and reproductive health help-seeking attitudes. The results do suggest differences between religious groups in regard to seeking help specifically from participants' parents. Notably, participants who reported having 'no religion' were more likely to seek help with sexual and reproductive health matters from their parent(s). Managing cross-cultural experiences is often noted in the extant literature as a barrier to sexual and reproductive health help-seeking. However, while cultural norms of migrants' country of origin can remain strong, it is religion that seems to have more of an impact on how 1.5 generation migrants seek help for SRH issues. The findings suggest that 1.5 generation migrants may not need to adapt their religious beliefs or practices, despite entering a new ethnocultural environment. Given that religion can play a role in the participants' sexual and reproductive health, religious organizations are well-placed to encourage young migrants to adopt help-seeking attitudes.


Asunto(s)
Salud Reproductiva , Migrantes , Adolescente , Australia , Niño , Cultura , Conocimientos, Actitudes y Práctica en Salud , Humanos , Proyectos Piloto , Religión , Conducta Sexual
12.
Patient Educ Couns ; 104(3): 460-463, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33422368

RESUMEN

OBJECTIVE: To elucidate whether Amazon's virtual assistant, Alexa, provides evidence-based support as a supplement to provider-facilitated prenatal care, during the COVID-19 pandemic. METHODS: Using a conceptual content analysis approach, a query of 40 questions, relating to all phases of pregnancy, was collected from Alexa by two independent investigators, using two unique devices, over a one-week period between May 20, 2020 and May 27, 2020. Alexa's responses were matched to the evidence-based content from the American College of Obstetricians and Gynecologists (ACOG) and reviewed by a Certified Nurse Midwife for completeness and currency. RESULTS: Of the 40 questions asked of Alexa, it was unable to answer 14 questions (35%). A total of 21 out of the 40 responses (52%) were not evidence-based and three COVID-specific questions (about 1%) were answered incorrectly or insufficiently. Four questions (10%) were answered accurately. CONCLUSION: Alexa was largely unable to provide evidence-based answers to commonly asked pregnancy questions and, in many cases, supplied inaccurate, incomplete, or completely unrelated answers that could further confuse health consumers. PRACTICE IMPLICATIONS: Ensuring that mobile health (mhealth) tools, such as Amazon Alexa, are evidence-based and credible in answering common prenatal questions has important implications for this pandemic and future consumer needs.


Asunto(s)
Atención Prenatal/métodos , Telemedicina , Femenino , Promoción de la Salud , Humanos , Pandemias , Embarazo , Salud Reproductiva
13.
Open Biol ; 11(1): 200347, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33465325

RESUMEN

Coronavirus disease 2019 (COVID-19) has emerged as a new public health crisis, threatening almost all aspects of human life. Originating in bats, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmitted to humans through unknown intermediate hosts, where it is primarily known to cause pneumonia-like complications in the respiratory system. Organ-to-organ transmission has not been ruled out, thereby raising the possibility of the impact of SARS-CoV-2 infection on multiple organ systems. The male reproductive system has been hypothesized to be a potential target of SARS-CoV-2 infection, which is supported by some preliminary evidence. This may pose a global threat to male fertility potential, as men are more prone to SARS-CoV-2 infection than women, especially those of reproductive age. Preliminary reports have also indicated the possibility of sexual transmission of SARS-CoV-2. It may cause severe complications in infected couples. This review focuses on the pathophysiology of potential SARS-CoV-2 infection in the reproductive organs of males along with their invasion mechanisms. The risks of COVID-19 on male fertility as well as the differences in vulnerability to SARS-CoV-2 infection compared with females have also been highlighted.


Asunto(s)
/patología , Salud Reproductiva , /patogenicidad , /inmunología , Citocinas/metabolismo , Fragmentación del ADN , Humanos , Linfocitos/metabolismo , Linfocitos/virología , Masculino , Estrés Oxidativo , Espermatozoides/fisiología , Espermatozoides/virología
15.
Int J Mol Sci ; 22(2)2021 Jan 19.
Artículo en Inglés | MEDLINE | ID: mdl-33477832

RESUMEN

Mammalian reproductive health affects the entire reproductive cycle starting with the ovarian function through implantation and fetal growth. Various environmental and physiological factors contribute to disturbed reproductive health status leading to infertility problems in mammalian species. In the last couple of decades a significant number of studies have been conducted to investigate the transcriptome of reproductive tissues and organs in relation to the various reproductive health issues including endometritis, polycystic ovarian syndrome (PCOS), intrauterine growth restriction (IUGR), preeclampsia, and various age-associated reproductive disorders. Among others, the post-transcriptional regulation of genes by small noncoding miRNAs contributes to the observed transcriptome dysregulation associated with reproductive pathophysiological conditions. MicroRNAs as a class of non-coding RNAs are also known to be involved in various pathophysiological conditions either in cellular cytoplasm or they can be released to the extracellular fluid via membrane-bounded extracellular vesicles and proteins. The present review summarizes the cellular and extracellular miRNAs and their association with the etiology of major reproductive pathologies including PCOS, endometritis, IUGR and age-associated disorders in various mammalian species.


Asunto(s)
Genitales/metabolismo , MicroARNs/genética , Reproducción/genética , Salud Reproductiva , Animales , Implantación del Embrión/genética , Femenino , Regulación de la Expresión Génica/genética , Redes Reguladoras de Genes/genética , Humanos , Síndrome del Ovario Poliquístico/genética , Síndrome del Ovario Poliquístico/patología , Embarazo
16.
JMIR Mhealth Uhealth ; 9(1): e19109, 2021 01 15.
Artículo en Inglés | MEDLINE | ID: mdl-33448930

RESUMEN

BACKGROUND: Digital health usability assessments can help explain how well mobile health (mHealth) apps targeting young people with sexual and reproductive health (SRH) information performed and whether the intended purpose was achieved. However, few digital health assessments have been conducted to evaluate young people's perceptions regarding mHealth system interactions and content relevance on a wide range of SRH topics. In addition, the majority of randomized controlled trials (RCTs) have focused on push messaging platforms; therefore, the mHealth field lacks sufficient RCTs investigating on-demand mHealth SRH platforms. OBJECTIVE: The objective of this study was to explore young people's experiences using an on-demand SRH mHealth platform in Kenya. METHODS: We used qualitative data related to the usability of an mHealth platform, Adolescent/Youth Reproductive Mobile Access and Delivery Initiatives for Love and Life Outcome (ARMADILLO), collected at the end of the intervention period. A total of 30 in-depth interviews (IDIs) were held with the intervention participants (15 women and 15 men) to elicit their experiences, opinions, and perspectives on the design and content of the ARMADILLO platform. The study participants were randomly selected from a list of intervention arm participants to participate in the IDIs. The interviews were later transcribed verbatim, translated into English, and coded and analyzed thematically using NVivo version 12 software (QSR International). RESULTS: Respondents reported varied user experiences and levels of satisfaction, ranging from ease of use by the majority of the respondents to systematic frustrations that prevented some participants from progressing to other stages. Interesting features of the mHealth platform included the immediate response participants received when requesting messages, weekly remunerated quizzes, and perceived ability of educative and informative content and messages to change behaviors. Proposed enhancements to the platform included revising some concepts and words for easy understanding and increasing the interactivity of the platform, whereby young people could seek clarity when they came across difficult terms or had additional questions about the information they received. CONCLUSIONS: The importance of understanding the range of health literacy and technological variations when dealing with young people cannot be overemphasized. Young people, as mHealth end users, must be considered throughout intervention development to achieve optimum functionality. In addition, young people targeted with mHealth SRH interventions must be sensitized to the interactions on mHealth platforms or any other digital health apps if implemented in a nonresearch setting for optimal use by the targeted audience.


Asunto(s)
Teléfono Celular , Salud Reproductiva , Telemedicina , Envío de Mensajes de Texto , Adolescente , Adulto , Prestación de Atención de Salud , Femenino , Humanos , Entrevistas como Asunto , Kenia , Masculino , Investigación Cualitativa , Servicios de Salud Reproductiva/organización & administración , Adulto Joven
17.
Ecotoxicol Environ Saf ; 208: 111632, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33396152

RESUMEN

Titanium (Ti) is commonly used in additives in the form of titanium dioxide (TiO2). However, our understanding of the effect of Ti on reproductive health remains limited. This nested case-control study, performed in a Ti mining exposure field, investigated the association between maternal blood Ti concentration and the risk of low birth weight (LBW), as well as the potential biological mechanism. A total of 45 women who delivered LBW infants (cases) and 352 women with normal birth weight infants (controls) were included. We collected maternal peripheral blood samples in the first or early second trimester to measure Ti concentration in serum (Tisr) and blood cells (Tibc), as well as inflammatory, lipid, and oxidative stress biomarkers thereof. The demographic characteristics of the women included in the study were also obtained. The results showed that the median total blood Ti concentration (Titb) in the case group was significantly higher than that in the control group (134 vs. 129 ng/mL, P = 0.039). A higher Titb level was associated with a greater risk of LBW [odds ratio = 2.62; 95% confidence interval (CI): 1.16-5.90], but no such association was observed for Tisr or Tibc after adjusting for potential confounders. The serum lipid biomarkers TC, TG, and total lipids (TL) were all negatively associated with Tisr and Titb. Serum 8-OHdG was positively associated with Tibc. We concluded that a high Titb during early pregnancy may increase the risk of LBW. Lipid metabolism and oxidative stress may play an important role in the adverse health effects associated with Ti exposure. Thus, our results merit more attention to the probable adverse effects of titanium exposure during pregnancy.


Asunto(s)
Recién Nacido de Bajo Peso , Exposición Materna/efectos adversos , Salud Reproductiva , Titanio/toxicidad , Adulto , Estudios de Casos y Controles , China , Femenino , Humanos , Recién Nacido , Metabolismo de los Lípidos/efectos de los fármacos , Oportunidad Relativa , Estrés Oxidativo/efectos de los fármacos , Embarazo , Titanio/sangre
19.
JAMA Netw Open ; 3(12): e2027928, 2020 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-33346844

RESUMEN

Importance: Menstrual cycle dysfunction is associated with insulin resistance, a key feature early in the pathogenesis of type 2 diabetes. However, the evidence linking irregular and long menstrual cycles with type 2 diabetes is scarce and inconsistent. Objectives: To evaluate the associations between menstrual cycle characteristics at different points throughout a woman's reproductive life span and risk of type 2 diabetes and the extent to which this association is modified by lifestyle factors. Design, Setting, and Participants: This prospective cohort study included 75 546 premenopausal US female nurses participating in the Nurses' Health Study II from 1993 to June 30, 2017. Data analysis was performed from February 1 to December 30, 2019. Exposures: Self-reported usual length and regularity of menstrual cycles at the age ranges of 14 to 17 years, 18 to 22 years, and 29 to 46 years. Main Outcomes and Measures: Incident type 2 diabetes identified through self-report and confirmed by validated supplemental questionnaires. Results: Among the 75 546 women in the study at baseline, the mean (SD) age was 37.9 (4.6) years (range, 29.0-46.0 years). A total of 5608 participants (7.4%) had documented new cases of type 2 diabetes during 1 639 485 person-years of follow-up. After adjustment for potential confounders, women reporting always having irregular menstrual cycles between the age ranges of 14 to 17 years, 18 to 22 years, and 29 to 46 years were, respectively, 32% (95% CI, 22%-44%), 41% (95% CI, 23%-62%), and 66% (95% CI, 49%-84%) more likely to develop type 2 diabetes than women reporting very regular cycles (within 3-4 days of expected period) in the same age range. Similarly, women reporting a usual cycle length of 40 days or more between the age ranges of 18 to 22 years and 29 to 46 years were, respectively, 37% (95% CI, 19%-57%) and 50% (95% CI, 36%-65%) more likely to develop type 2 diabetes during follow-up compared with women reporting a usual cycle length of 26 to 31 days in the same age ranges. These associations appeared to be stronger among women with overweight or obesity, a low-quality diet, and low levels of physical activity. The relative excess risk of type 2 diabetes due to the interaction between irregular and long menstrual cycles and the overall unhealthy lifestyle score was 0.73 (95% CI, 0.57-0.89) and 0.68 (95% CI, 0.54-0.83), respectively. Conclusions and Relevance: In this cohort study of US female nurses participating in the Nurses' Health Study II, irregular and long menstrual cycles throughout life were associated with a greater risk of type 2 diabetes, particularly among women with overweight or obesity, a low-quality diet, and low levels of physical activity.


Asunto(s)
Diabetes Mellitus Tipo 2/etiología , Ciclo Menstrual , Trastornos de la Menstruación/complicaciones , Adolescente , Adulto , Diabetes Mellitus Tipo 2/epidemiología , Dieta/efectos adversos , Femenino , Humanos , Incidencia , Estilo de Vida , Trastornos de la Menstruación/epidemiología , Trastornos de la Menstruación/fisiopatología , Persona de Mediana Edad , Enfermeras y Enfermeros/estadística & datos numéricos , Obesidad/complicaciones , Obesidad/fisiopatología , Sobrepeso/complicaciones , Sobrepeso/fisiopatología , Estudios Prospectivos , Salud Reproductiva , Factores de Riesgo , Estados Unidos/epidemiología , Adulto Joven
20.
Zhonghua Nan Ke Xue ; 26(3): 195-199, 2020 Mar.
Artículo en Chino | MEDLINE | ID: mdl-33346955

RESUMEN

In December 2019, the novel coronavirus pneumonia broke out in Wuhan, Hubei, and then spread across China and the world, which posed a threat to public health and safety.The symptoms caused by the novel coronavirus (SARS-CoV-2) mainly involve the respiratory system, but no literature has been reported whether it can induce pathological changes in the male reproductive system. According to the fact that SARS-CoV-2 can infect the cells expressing angiotensin-converting enzyme 2 (ACE2), which can be distributed in the corpus cavernosum, testis and other male reproductive organs and may also participate in erectile function, spermatogenesis, sperm motility and androgen metabolism through the ACE2-Ang-(1-7)-Mas axis in the renin-angiotensin system(RAS), it can be deduced that SARS-CoV-2 may affect these physiological processes of male reproduction.


Asunto(s)
/fisiopatología , Salud Reproductiva , Humanos , Masculino , Sistema Renina-Angiotensina , Motilidad Espermática
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