National and regional economic inequalities in first- and second-hand tobacco consumption among women of reproductive ages in Iran.

INTRODUCTION: The epidemic of tobacco consumption is one of the major public health threats the world has been facing so far. This study was performed to investigate the economic inequalities in tobacco consumption among women of reproductive ages at national and regional levels in Iran. METHODS: We used data from 10,339 women of reproductive ages (18-49 years) who participated in Iran's 7th Non-Communicable Disease Risk Factor Surveillance (STEPS). Wagstaff normalized concentration index and decomposition method were applied to measure economic inequalities in first- and second-hand tobacco consumption and determine their corresponding contributory factors, respectively. RESULTS: The prevalence of women's first-hand tobacco consumption, and their exposure to second-hand smoke in the home, and workplace were 3.6%, 28.3%, and 8.4%, respectively. First- and second-hand tobacco consumption was significantly more concentrated among low-economic women. Exposure to home second-hand smoke, education, and economic status had the largest contributions to the measured inequality in first-hand tobacco consumption (48.9%, 38.9%, and 30.8%, respectively). The measured inequality in women's secondhand smoke exposure at home was explained by their level of education (43.8%), economic status (30.3%), and residency in rural areas (18%), and at work by residency in rural areas (42.2%), economic status (38.8%), and level of education (32%). Our results also revealed diversity in the geographical distribution of inequalities in rural and urban areas and five regions of the country. CONCLUSION: The present study highlighted the need for more enforcement of tobacco control rules and increasing tobacco taxes as general measures. Furthermore, there is a need for gender-sensitive initiatives at national and regional levels to educate, support, and empower low-economic women and households for tobacco cessation, and complying with restrictive smoking rules.

Dietary diversity and micronutrients adequacy among the women of reproductive age at St. Martin's island in Bangladesh.

Minimum dietary diversity for women, an important dimension of diet quality, has been widely used as a proxy indicator for micronutrient adequacy. In low- and middle-income countries (LMICs), women of reproductive age (WRA) particularly are at high risk of inadequate micronutrient intake resulting from poor diversified diets. Therefore, the present study aimed to assess dietary diversity and micronutrients adequacy in the diets of WRA of St. Martin's island, along with their socio-economic determinants. A cross-sectional study was conducted on a representative sample of 201 WRA living at St. Martin's island. Utilizing the Estimated Average Requirement (EAR) cut-point approach, the adequacy of micronutrient intake was evaluated from observed 24-h recall dietary data. The recent guideline of FAO was employed to evaluate Minimum Dietary Diversity for Women (MDD-W). Binary logistic regression and multiple linear regression analyses were performed to identify socio-economic determinants of MDD-W and micronutrients adequacy. The mean (SD) dietary diversity score was 4.25 (1.17) and about 40.3% of the participants met the MDD-W cut-off. Starchy staples (100%), meat/poultry/fish (87%), and other vegetables (79%) were consumed more frequently, while, the least reported food groups were dairy (2%), nuts and seeds (11%), and vitamin A-rich fruits and vegetables (11%). Except for Niacin, intake of all micronutrients was inadequate, with an inadequacy prevalence of 36-100%. Educational level, and decision-making role of women were significantly related to their dietary diversity. On the other hand, age, decision-making role, and MDD-W were important determinants of micronutrient adequacy. In conclusion, the WRA of St. Martin's island consumed neither a sufficient amount of micronutrients nor an adequate diversity of foods. In addition, several socio-economic components are linked with dietary diversity and micronutrient adequacy. Therefore, attention is needed to decide on the best strategies to improve the quality of diet and dietary diversity for WRA in this setting.

Changes in causes of pregnancy-related and maternal mortality in Zimbabwe 2007-08 to 2018-19: findings from two reproductive age mortality surveys.

BACKGROUND: Reducing maternal mortality is a priority of Sustainable Development Goal 3.1 which requires frequent epidemiological analysis of trends and patterns of the causes of maternal deaths. We conducted two reproductive age mortality surveys to analyse the epidemiology of maternal mortality in Zimbabwe and analysed the changes in the causes of deaths between 2007-08 and 2018-19. METHODS: We performed a before and after analysis of the causes of death among women of reproductive ages (WRAs) (12-49 years), and pregnant women from the two surveys implemented in 11 districts, selected using multi-stage cluster sampling from each province of Zimbabwe (n=10); an additional district selected from Harare. We calculated mortality incidence rates and incidence rate ratios per 10000 WRAs and pregnant women (with 95% confidence intervals), in international classification of disease groups, using negative binomial models, and compared them between the two surveys. We also calculated maternal mortality ratios, per 100 000 live births, for selected causes of pregnancy-related deaths. RESULTS: We identified 6188 deaths among WRAs and 325 PRDs in 2007-08, and 1856 and 137 respectively in 2018-19. Mortality in the WRAs decreased by 82% in diseases of the respiratory system and 81% in certain infectious or parasitic diseases' groups, which include HIV/AIDS and malaria. Pregnancy-related deaths decreased by 84% in the indirect causes group and by 61% in the direct causes group, and HIV/AIDS-related deaths decreased by 91% in pregnant women. Direct causes of death still had a three-fold MMR than indirect causes (151 vs. 51 deaths per 100 000) in 2018-19. CONCLUSION: Zimbabwe experienced a decline in both direct and indirect causes of pregnancy-related deaths. Deaths from indirect causes declined mainly due to a reduction in HIV/AIDS-related and malaria mortality, while deaths from direct causes declined because of a reduction in obstetric haemorrhage and pregnancy-related infections. Ongoing interventions ought to improve the coverage and quality of maternal care in Zimbabwe, to further reduce deaths from direct causes.

Time trends of perfluoroalkyl substances in blood in 30-year old Norwegian men and women in the period 1986-2007.

Biomonitoring studies are helpful tools and can increase our knowledge on time trends in human blood concentrations of PFASs: how they relate to emission trends and the potential prenatal exposure for future generations. In this study, serum was sampled in cross-sections of men and women who were 30 years old in each of the years 1986, 1994, 2001, and 2007 in Northern Norway and analyzed for 23 PFASs. Differences in serum concentrations across sampling years were investigated graphically and with significance testing and compared with those observed in our previous longitudinal study using repeated individual measurements in older men in the same years. The results demonstrate overall increasing blood burdens of PFASs in men and women in reproductively active ages during 1986-2001 and decreases until 2007. However, longer chained PFASs were still increasing in 2007 indicating divergent time trends between the different PFASs, underlining the importance of continued biomonitoring. Comparisons between 30-year-old men and older men within the same population demonstrated variation in time trends in the exact same years, underlining that biomonitoring studies must regard historic exposures and birth cohort effects.

Especificidad de pruebas rápidas y confirmatorias de vih/sida de pacientes femeninas en edades reproductivas del hospital general esmeraldas sur / Specificity of rapid and confirmatory hiv / aids tests of female patients in reproductive ages of the General Hospital Esmeraldas Sur

EL Virus de Inmunodeficiencia Humana, constituye un grave problema de salud a nivel mundial. El VIH, es una patología que ataca las células CD4 del sistema inmunitario, ocasionando un desperfecto en el sistema inmune, lo cual hace más fácil la llegada de infecciones o enfermedades oportunistas. Objetivo: Conocer la especificidad de las pruebas rápidas y pruebas confirmatorias de pacientes con VIH en edades reproductivas del Hospital General Esmeraldas Sur, en el área de laboratorio clínico. Metodología: Es un estudio Cuantitativo, de corte longitudinal retrospectivo, con alcance descriptivo, que permitió ordenar, interpretar y tabular los resultados de las pruebas rápidas y pruebas confirmatorias de VIH/sida de pacientes femeninas en edades reproductivas. Evidenciándose la falta de información en el registro de pacientes con VIH/sida del HGES, de los datos estadísticos, en 49 pacientes femeninas registras en el HGES. Resultados: El estudio indica que existe un predominio de pacientes con VIH/sida 30 casos corresponde a pacientes al grupo etario ≤ 30 años, seguido por 12 casos que corresponde a pacientes del grupo etario ≤ 40 años, mientras que los pacientes del grupo etario ≤ 45 representan un 8% (4 casos) y el 6% (3 casos) corresponde a pacientes ≤ 20. El 61% corresponde a ≤ 30 años, en segundo lugar, con el 25% las ≤ 40 años. Conclusiones: Los registros observados en el HGES, durante el proceso de investigación, no fueron suficientes para alcanzar el objetivo propuesto, para tal efecto es necesario disponer de los registros completos de los pacientes con VIH/sida en todas las pruebas, según en algoritmo de la OMS. Además, de brindar confianza a la ciudadanía con resultados de calidad, se debe utilizar recursos tecnológicos y demás instrumentos que permitan al profesional de salud, dar un diagnóstico correcto y oportuno. Todo enmarcado en la ética principal, la conservación de la vida(AU)

The Human Immunodeficiency Virus constitutes a serious health problem worldwide. HIV is a pathology that attacks the CD4 cells of the immune system, causing damage to the immune system, which makes it easier for infections or opportunistic diseases to arrive. Objective: To know the specificity of the rapid tests and confirmatory tests of patients with HIV in reproductive ages of the General Hospital Esmeraldas Sur, in the clinical laboratory area. Methodology: It is a quantitative study, retrospective longitudinal section, with descriptive scope, which allowed ordering, interpreting and tabulating the results of rapid tests and confirmatory tests of HIV / AIDS of female patients of reproductive ages. Evidence of the lack of information in the registry of patients with HIV / AIDS of the HGES, of the statistical data, in 49 female patients registered in the HGES. Results: The study indicates that there is a predominance of patients with HIV / AIDS. 30 cases correspond to patients in the age group ≤ 30 years, followed by 12 cases corresponding to patients in the age group ≤ 40 years, while patients in the age group ≤ 45 represent 8% (4 cases) and 6% (3 cases) correspond to patients ≤ 20. 61% correspond to ≤ 30 years, secondly, with 25% those ≤ 40 years. Conclusions: The records observed in the HGES, during the research process, were not sufficient to achieve the proposed objective, for this purpose, it is necessary to have complete records of patients with HIV / AIDS in all tests, according to the algorithm of The OMS. In addition, to provide confidence to the public with quality results, technological resources and other instruments must be use that allow the health professional to give a correct and timely diagnosis. All framed in the main ethic, the conservation of life(AU)

Hormonal Contraceptive Use Among Women of Older Reproductive Age: Considering Risks and Benefits.

As women approach menopause, fertility declines but pregnancy can still occur. Maternal and infant risks are increased among women of older reproductive age compared with younger women. A high proportion of pregnancies among women of older reproductive age are unintended and these pregnancies can also be associated with negative maternal and infant consequences. However, women and their healthcare providers may have concerns about risks associated with contraceptive use, particularly combined hormonal contraceptives, among women of older reproductive age who already may be at increased risk for conditions such as cardiovascular disease and breast cancer. Nonetheless, available evidence does not suggest that hormonal contraceptive use among women of older reproductive age substantially increases age-related risks of cardiovascular events or breast cancer. CDC recommends that contraception is still needed for women older than 44 years who have not reached menopause and wish to avoid pregnancy, and that based on age alone, all contraceptive methods are considered safe or generally safe for use by women of older reproductive age.

Effectiveness of presence of physician and midwife in quantity and quality of family planning services in health care centers.

BACKGROUND AND AIM: Iran's health sector has been engaging the services of physicians and midwives in healthcare centers since 2005, with the hope of improving the quantity and quality of family planning services. The aim of this study was to assess the effect of serving physicians and midwives on the quantity and quality of family planning services in the healthcare centers of Iran. MATERIALS AND METHODS: The present cross-sectional study (Jan 2010 until Sep 2011) was carried out on 600 eligible families who were clients of healthcare centers of Tabriz, Azarshahr and Osku, cities of Northwest Iran from 2006 until 2011, in two groups (before and after). Some of the characteristics of the participants and the data on the quality and quantity of family planning services provided were grouped in a checklist of 16 variables by comparing the patients' past medical histories. RESULTS: In comparison with 3 years prior to engaging physician and midwife services in health care centers, the Couple Year Protection (CYP) and the quantity of family planning service indexes significantly increased among eligible families. The family size of participants declined significantly after family physicians and midwives became available in the healthcare centers (P < 0.005). CONCLUSION: Our findings showed some improvement in the quantity of services without any noticeable changes in the quality of services provided as a consequence of this huge intervention. Therefore, it is suggested that there should be proper oversight of the duties of the health team in order to keep a close watch on primary healthcare, design of proper mechanisms for collecting and maintaining performance reports and statistics, and continuously monitor and control the quality of services.

Knowledge, attitude and practices of adults of the reproductive years on reproductive health matters, with emphasis on HIV infected people in a Caribbean society.

BACKGROUND: South and Southeast Asia represent the largest number of new HIV infections, while Sub-Saharan Africa represents the highest rate of new infections, followed by Latin America and the Caribbean. Yet no study that has emerged in the Caribbean has comprehensively examined young people's sexual and reproductive health attitudes, knowledge and practices, comparing the result with those who are HIV infected. AIM: The present study examines core issues of sexual and reproductive health among youths, particularly with respect to HIV. MATERIAL AND METHODS: The sample was 1,800 respondents ages 15-49 years. Multivariate logistic regressions were fitted using one outcome measure: self-reported confirmed positive HIV test results. RESULTS: Almost 34% of the sample had been tested for HIV, and 16.9% had done this in the past 12 months. Only 0.2% of the sample knew that they were HIV positive and 4% had positive HIV test results when they did the test. Of those with a positive HIV test result, 58.1% were females. Approximately 16% of those with HIV have had an STI infection in the past, and 61% were actively practicing religion. The mean age of first sexual relations for the sample was 15.4 years (SD = 3.2 years), and 15.6 years for those infected with HIV. Four variables emerged as statistically significant factors of Jamaicans' willingness to do an HIV test in the future. CONCLUSION: The findings of this research are far-reaching and can be used to guide public health policy formulation.

Investigation and analysis in the sexual life quality of females at the reproductive ages after cervix cancer operation / 中国实用护理杂志

Objective To explore the sexual life quality of females at the reproductive ages after cervix cancer operation and supply evidence for establishment of correspondindg nursing measure. Methods We investigated the frequency of sexual life and satisfaction degree of sexual life in 40 females at the reproductive ages after cervix cancer operation by face-to-face investigations using questionnaires before and 4 months after operations. Then the difference of sexual life quality before and after operation were compared and analyzed. Results The frequency of sexual life (P＜0.01,P＜0.05) and satisfaction degree of sexual life (P＜0.01,P＜0.05) were evidently decreased. The sexual life quality was lower than that before operation. Conclusion The sexual life quality could be affected by many factors such as economic conditions, culture background, sexual conceptions and the attitude of their partners.