Fertility and contraception: The experience of Spanish women born in the first half of the twentieth century.

New data based on retrospective interviews with older informants enable us to review the history of contraceptive use among Spanish women over much of the twentieth century. This source is unique because it includes cohorts of women whose reproductive lives took place before, during, and after the baby boom. Traditional contraceptive methods (withdrawal and periodic abstinence) were central to the experience of the first set of women, while the last set made full use of modern as well as some traditional methods. For the first cohorts, traditional methods spearheaded the historic decline in fertility, while among the last set of women modern methods led to a precipitous decline towards the below-replacement fertility that continues in Spain today. There is no evidence that the modest increases in fertility during the baby boom in Spain were the result of a decline in the use of contraception among married women.

Endoworm: A new semi-autonomous enteroscopy device.

Using enteroscopes with therapeutic capacity to explore the small intestine entails certain limitations, including long exploration times, patient discomfort, the need for sedation, a high percentage of incomplete explorations and a long learning curve. This article describes the advances and setbacks encountered in designing the new Endoworm enteroscopy system, a semi-autonomous device consisting of a control unit and three cavities that inflate and deflate in such a way that the bowel retracts over the endoscope. The system can be adapted to any commercial enteroscope. Endoworm was tested in different intestine models: a polymethyl methacrylate rigid tube, an in vitro polyester urethane model, an ex vivo pig model and an in vivo animal model. The general behavior of the prototype was evaluated by experienced medical personnel. The mean distance covered through the lumen was measured in each cycle. The system was found to have excellent performance in the rigid tube and in the in vitro model. The ex vivo tests showed that the behavior depended largely on the mechanical properties of the lumen, while the in vivo experiments suggest that the device will require further modifications to improve its performance.

Contextual determinants of psychopathology. The singularity of attachment as a predictor of mental dysfunction.

The general aim of this research is to evaluate the singular weight of attachment relationships in psychopathology, to determine the point to which these relationships cannot be subsumed by other variables that are famously related to attachment, such as experience of stressful life events, social support, and coping styles. 172 people treated in mental health centers provided data related to these four aspects and about manifestations of psychopathology. Multiple linear regression analyses determined that 51% of the variance in the level of symptomatology is explained with six variables: two related to adult attachment (fear of rejection and abandonment in romantic relationships, and the degree of similarity to the fearful prototype), one related to social support (family appreciation), one to life events (overall perceived stress), and two to coping style (cognitive restructuring and social withdrawal). Fear of rejection was the variable accounting for the most variance. The findings suggest that adult attachment is a non-redundant individual factor associated with manifestations of psychological dysfunction and highlight the desirability of taking attachment history into account in clinical practice.

Agency in Fertility Decisions in Western Europe During the Demographic Transition: A Comparative Perspective.

We use a set of linked reproductive histories taken from Sweden, the Netherlands, and Spain for the period 1871-1960 to address key issues regarding how reproductive change was linked specifically to mortality and survivorship and more generally to individual agency. Using event-history analysis, this study investigates how the propensity to have additional children was influenced by the number of surviving offspring when reproductive decisions were made. The results suggest that couples were continuously regulating their fertility to achieve reproductive goals. Families experiencing child fatalities show significant increases in the hazard of additional births. In addition, the sex composition of the surviving sibset also appears to have influenced reproductive decisions in a significant but changing way. The findings offer strong proof of active decision-making during the demographic transition and provide an important contribution to the literature on the role of mortality for reproductive change.

Tratamiento médico y quirúrgico de la recidiva del virus de la hepatitis C sobre el injerto hepático tras el trasplante / No disponible

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Incidence, risk factors, and outcome of chronic rejection during antiviral therapy for posttransplant recurrent hepatitis C.

Antiviral therapy for recurrent hepatitis C in liver transplantation has been associated with the development of chronic rejection. The aim of this study was to assess the incidence, evolution, and risk factors associated with the development of chronic rejection during posttransplant hepatitis C virus antiviral therapy. Seventy-nine patients with posttransplant recurrent hepatitis C who were treated with pegylated interferon and ribavirin were prospectively followed. Liver biopsy was performed before antiviral therapy was initiated and when liver tests worsened during therapy. Pretransplant and posttransplant factors were analyzed as potential risk factors for the development of chronic rejection. Seven of 79 patients (9%) developed chronic rejection during antiviral therapy. The mean time from the start of treatment to the development of chronic rejection was 5.8 months (3-12 months). An analysis of factors associated with the development of chronic rejection showed that the use of cyclosporine as immunosuppression therapy (6 of 19 patients who received cyclosporine developed chronic rejection in comparison with only 1 of 57 patients who received tacrolimus; P = 0.0013), achievement of sustained virological response (P = 0.043), and ribavirin discontinuation (P = 0.027) were associated with the development of chronic rejection. In conclusion, the development of chronic rejection during posttransplant pegylated interferon and ribavirin therapy is a severe complication. The use of cyclosporine, ribavirin discontinuation, and viral infection elimination seem to be associated with the development of this complication. Liver Transpl 15:948-955, 2009. (c) 2009 AASLD.

Intergenerational Transmission of Reproductive Traits in Spain during the Demographic Transition.

In this paper intergenerational dimensions of reproductive behavior are studied within the context of the experience of a mid-sized Spanish town just before and during the demographic transition. Different indicators of reproduction are used in bivariate and multivariate approaches. Fertility shows a small, often statistically significant intergenerational dimension, with stronger effects working through women and their mothers than those stemming from the families of their husbands. These effects are materialized mainly through duration-related fertility variables, are singularly absent for variables such as age at first birth or birth intervals, and are much stronger in the case of firstborn daughters than with later siblings. There is a substantial increase in the strength of intergenerational effects during the course of the demographic transition, most visible in age at last birth and duration of reproduction (between women and their mothers), as well as in the effects working through the families of their husbands. These results underscore the on-going importance of biological dimensions of reproduction as well as the way attitudes toward reproduction are taught within the family. The changes identified in this study suggest that the transmission of values and attitudes became more important for reproductive outcomes during this period of demographic modernization.

Factors related to inbreeding components from isonymy in an urban population: Aranjuez (Spain).

An isonymic analysis has been carried out using a sample of 1529 reconstituted families residing during 1870-1964 in Aranjuez, an urban area situated south of Madrid, Spain. The random, non-random and total-components inbreeding coefficients from isonymy were obtained and the various combinations of surnames compared in order to infer the patri- or matrilocal pattern of residence. Throughout the period studied the random component of inbreeding (F(r)) has not changed, in contrast to the non-random component (F(n)), thus suggesting the latter could be responsible for the reduction of total inbreeding. Using several methodological approaches (biplot analysis, alpha, nu and percentage of immigrants) the predominance of the immigration of grooms was interpreted in terms of Aranjuez as a matrilocal pattern of residence. From this study it can also be concluded that surnames provided by reconstituted families are good estimators of inbreeding and migration.