International family planning perspectives最新文献

Background: Danlou tablet (DLT), the traditional Chinese medicine has been commonly used for dyslipidemia, atherosclerosis, and coronary heart disease. Whether it was effective against vascular injury caused by CIH has remained unknown. The aim of the current study was to observe the effects of DLT on chronic intermittent hypoxia (CIH)-induced vascular injury via regulation of blood lipids and to explore potential mechanisms.

Methods: Sixteen 12-week-old male ApoE^-/- mice were randomly divided into four groups. The sham group was exposed to normal room air, whereas the other three groups were exposed to CIH. Mice in the CIH + normal saline (NS) group were gavaged with NS. Mice in the CIH + Angptl4-ab group were intraperitoneally injected with Angptl4-antibody. Mice in the CIH + DLT group were gavaged with DLT. After four weeks of intervention, serum lipid concentrations, and serum lipoprotein lipase (LPL) activity were detected. The changes in atherosclerosis in vascular tissue were detected by hematoxylin and eosin (H&E) staining. Quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot analysis were applied to detect the expression levels of hypoxia-induciblefactor-1 (HIF-1), factor-inhibiting HIF-1 (FIH-1), angiopoietin-like 4 (Angptl4), and LPL in different tissues.

Results: CIH exposure increases serum lipid levels, decreases serum LPL activity, and exacerbates atherosclerosis. Both Angptl4-ab and DLT treatment reversed the changes in lipid concentration, LPL activity, and atherosclerosis caused by CIH. In the epididymal fat pad, CIH exposure decreased the expression of FIH-1 and increased the expression of HIF-1, whereas DLT treatment increased the expression of FIH-1 and LPL and inhibited the expression of HIF-1 and Angptl4. In heart tissue, the expression levels of LPL and Angptl4 were not affected by modeling or treatment.

Conclusions: DLT improved vascular damage by improving the increase in blood lipids induced by CIH, potentially by upregulating FIH-1 and downregulating HIF-1 and Angptl4 in adipose tissue. Therefore, DLT may be a promising agent for the prevention and treatment of CIH-induced vascular injury.

¹⁷⁷Lu-PSMA-617 radioligand therapy is a novel treatment for end-stage prostate cancer, which could also be applied to patients with hormone-sensitive prostate cancer with high expression levels of prostate-specific membrane antigen (PSMA). In this perspective, we review the recent results of toxicity, radiation doses, and treatment effect of ¹⁷⁷Lu-PSMA in patients with low volume metastatic hormone-sensitive prostate cancer. Moreover, we present long-term follow-up data, such as toxicity and time without androgen deprivation therapy (ADT), of the patients who participated in this trial. Overall, ¹⁷⁷Lu-PSMA appeared to be a feasible and safe treatment modality in this setting, as well as in long-term follow-up. We observed that men with a prostate-specific antigen (PSA) response of more than 50% seemed to especially benefit from this therapy by postponing ADT and thus preserving the quality of life.

Background: The aim of the study was to prepare and design a Polish version of the Psychological Capital Questionnaire. The psychometric tool allows synthetic assessment of four personal resources known to play a significant role in effective functioning, viz. self-efficacy, hope, optimism and resilience.

Participants and procedure: The psychometric properties of the questionnaire were developed in two studies, the first one involving 308 people (166 women and 142 men) and the second involving 206 people (111 women and 95 men).

Results: Confirmatory factor analysis confirmed that the tool has a four-component structure with an overall score. It is characterized by satisfactory internal consistency (α = .73-.86), stability (rtt = .85-.92) and construct validity.

Conclusions: The Psychological Capital Questionnaire is a reliable and valid tool that can be used in research and in practice.

Context: Despite the relevance of the timing of first intercourse for the risk of HIV infection, few studies have examined postponement of first sex as a strategy to prevent infection.

Methods: Survey data collected in October 2003 from 8,183 standard six and standard seven students aged 11-17 in 160 schools in Nyanza Province, Kenya, were used in logit and log-normal hazard models to understand the factors that influence the timing of first sexual intercourse.

Results: Both males and females who rejected myths about HIV transmission, those who experienced less sexual pressure and those who did not know anyone who had died of AIDS, as well as males who had a stronger belief in their ability to abstain, were more likely to postpone sexual intercourse than were young people who lacked those characteristics. Although lower levels of perceived HIV risk were associated with early sexual initiation, adolescents who felt they were at no risk of HIV infection were most likely to postpone initiation. The pattern of associations across gender suggests that males are pressured into very early sexual activity to prove their maturity, although males who had confidence that they could abstain were more likely to do so. Females, however, were not able to translate belief in their ability to abstain into abstinence and were influenced to engage in intercourse by social and environmental pressures.

Conclusions: To support delays in sexual initiation, HIV prevention programming and policy need to be focused on dispelling myths about HIV transmission and countering the gendered pressures that young people feel to initiate sexual activity during their early adolescence.

Context: Contraceptive use among young couples in India is low, and early childbearing and short birth intervals are common. The PRACHAR Project, an ongoing intervention in Bihar, seeks to increase contraceptive use for delaying and spacing births through communication interventions.

Methods: Random samples of married women younger than 25 with no more than one child were surveyed in 2002-2003, before PRACHAR was implemented (N=1,995), and in 2004, 21-27 months after implementation (N=2,080). Contraceptive demand and use, and related attitudes and knowledge, were assessed in the two surveys in both intervention areas and comparison areas. Logistic regression was used to assess the effect of the interventions on these indicators.

Results: Contraceptive use was very low (2-6%) at baseline in both comparison and intervention areas. Demand for contraception increased from 25% at baseline to 40% at follow-up in intervention areas, but remained virtually unchanged in comparison areas. At follow-up, contraceptive use had risen in both areas, but the adjusted odds of use in intervention areas were 3.8 times those in comparison areas. Women in intervention areas had elevated odds of knowing that fertility varies during the menstrual cycle, and of agreeing that early childbirth can be harmful and that contraceptive use is necessary and safe for delaying first births (odds ratios, 1.6-3.0).

Conclusion: Culturally appropriate, community-based communication programs that target youth and those who influence their decisions can create demand for contraception among young couples and lead to increased contraceptive use.

Context: In Mexico, where abortion remains largely illegal and clandestine, reliable data on induced abortion and related morbidity are critical for informing policies and programs. The only available national estimate of abortion is for 1990, and demographic and socioeconomic changes since then have likely affected abortion incidence.

Methods: This study used official statistics on women treated for abortion-related complications in public hospitals in 2006 and data from a survey of informed health professionals. Indirect estimation techniques were used to calculate national and regional abortion measures, which were compared with 1990 estimates.

Results: In 2006, an estimated 150,000 women were treated for induced abortion complications in public-sector hospitals, and one in every 5.8 women having an induced abortion were estimated to have received such treatment. The estimated total number of induced abortions in 2006 was 875,000, and the abortion rate was 33 per 1,000 women aged 15-44. Between 1990 and 2006, the abortion rate increased by 33% (from a rate of 25). The severity of morbidity due to unsafe abortion declined (as seen in shorter hospital stays), but the annual rate of hospitalization did not-it was 5.4 per 1,000 women in 1990 and 5.7 in 2006. The abortion rate was similar to the national average in three regions (34-36), but substantially lower in one (25 in the South/East region).

Conclusions: Clandestine abortion continues to negatively affect women's health in Mexico. Recommended responses include broadening the legal criteria for abortion throughout Mexico, improving contraceptive and postabortion services, and expanding training in the provision of safe abortion, including medical abortion.

Context: Inaccurate reporting of sexual behavior creates a misleading picture of individuals' risk for STI infection. Despite a substantial body of U.S. research on the consistency of self-reports of sensitive behavior, only a few such studies have been conducted in developing countries.

Methods: Consistency in the reporting of sexual activity and other sensitive behaviors was assessed among 818 women aged 18-40 who enrolled in 2004 in a study examining STI screening and diagnosis in São Paulo, Brazil. Participants were randomized into face-to-face interview and audio computer-assisted self-interview (audio-CASI) groups, and a six-week follow-up interview was conducted using audio-CASI for all participants. Differences between groups were assessed using t tests, and logistic regression analyses were used to estimate the likelihood of inconsistency within the enrollment interview and between the enrollment and follow-up interviews.

Results: Consistency in reporting at the enrollment interview was higher in the face-to-face group than in the audio-CASI group, likely because interviewers prompted women to reconcile discrepant responses, whereas the audio-CASI program did not enforce logical consistency. However, consistency between enrollment and follow-up was significantly lower in the face-to-face group for abortion, marijuana use, transactional sex, coerced sex and number of lifetime sexual partners, because of increased reporting at follow-up using audio-CASI.

Conclusion: Although the analysis of internal consistency at enrollment suggests that computerized interviewing may increase random measurement error, it appears to reduce social desirability bias and encourage higher reporting of sensitive behaviors.

Context: Ideal family size and desire for an additional child are the two most commonly used fertility preference indicators. However, little is known about the consistency over time of responses to each measure, the consistency between the two indicators or the predictive value of these indicators in India.

Method: Longitudinal data from the 1998-1999 National Family Health Survey and a follow-up survey conducted four years later were analyzed to determine the consistency of responses to the two fertility preference indicators (both over time and between indicators) and to determine whether baseline responses were associated with subsequent fertility, unwanted births and contraceptive use.

Results: Responses on the measure of ideal family size were consistent at the two time points for 53% of nonsterilized women. Eighty-two percent of women who explicitly said in 1998 that they did not desire more children responded identically in 2002, although about half of these women had given birth in the intervening period. The indicators were associated with each other: Among women with at least one son, 79% of those who had attained or surpassed their ideal family size said they wanted to stop childbearing, compared with 18% of those who had not. Both indicators predicted future fertility, unwanted births and contraceptive use, particularly among women who had a son.

Conclusion: Both indicators are useful in understanding future fertility behavior. As the prevalence of son preference declines in India, the predictive ability of the indicators is likely to improve.