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PubMed1998

Psychological outcomes following missed abortions and provision of follow-up care.

This cross-sectional study of 204 women who had experienced a missed abortion, diagnosed at 10-14 weeks of pregnancy, examined the availability and desirability of routine follow-up care, and whether such care is associated with reduced psychological morbidity in the aftermath of miscarriage. Clinically elevated anxiety and depression were observed in 45% and 15% of women, respectively, and the mean score of grief was 2.52 which is similar to that observed in people who suffer death of a close relative. A follow-up appointment after the miscarriage was thought to have been desirable by 92% of women but was offered to only 30%. No significant association between such care and reduced psychological morbidity was identified. However, there were significantly more women with clinically elevated levels of anxiety among those who felt that they were not provided with an opportunity to discuss their feelings during the follow-up, suggesting that such a follow-up either had a deleterious effect on women's psychological state or the distress itself led to such a perception of care. One-third of women in our sample would have liked psychological counselling to help them deal with the emotional aspects of their loss.

Abortion, Missed↗

PubMed1987

Plasma reproductive hormones in normal and vasectomized Chinese males.

Plasma reproductive hormones (testosterone, LH, FSH and prolactin) were measured in 298 normal healthy males aged 30-73 years from rural areas of Sichuan Province, People's Republic of China, and in 505 similar men vasectomized between 1 year and 25 years previously. Age-related increases in LH and FSH but not in testosterone or prolactin were noted in normal men. No adverse effects of vasectomy were observed apart from a 16% increase in mean LH levels in the vasectomized compared to non-vasectomized men of similar ages.

Adult↗

PubMed1995

Rural migration and agrarian reform in Russia: a research note.

This study focuses primarily on trends in rural-urban migration in Russia and the former Soviet Union. "New data suggest that a historic shift in migration patterns is underway in Russia, a change that may have profound long-term effects on agrarian reform and the nature of the Russian countryside. We begin with a short review of past rural migration trends and the rural demographic situation, in part using archival data for an oblast in central Russia. We will then present new data on rural migration. Finally, we assess the implications of rural migratory trends for agrarian reform in Russia."

Agriculture↗

PubMed1982

Outcome of delivery subsequent to induced vacuum-aspiration abortion in parous women.

In a historical prospective study covering 1970-1978, the authors evaluated the outcome of delivery to 429 parous women subsequent to a legally induced first-trimester vacuum-aspiration abortion during 1970-1975 in Uppsala County, Sweden. This outcome was compared with the outcome of delivery to 391 randomly chosen matched parous women and that of all parous women in Sweden in 1975. Confounding variables were controlled for in multiple regression analysis using infant birth weight and gestational duration as dependent variables. In this analysis, no harmful effects of vacuum-aspiration abortion were found. Pre-term deliveries and low birth weight infants did not occur more frequently after such abortions. The study did not disclose any association between vacuum-aspiration abortion in parous women and an unfavorable outcome of subsequent delivery.

Abortion, Induced↗

PubMedDate not supplied

The long-term demographic role of community-based family planning in rural Bangladesh.

Experimental studies demonstrating the effectiveness of nonclinical distribution of contraceptives are typically conducted in settings where contraceptive use is low and unmet need is extensive. Determining the long-term role of active outreach programs after initial demand is met represents an increasingly important policy issue in Asia, where contraceptive prevalence is high and fixed service points are conveniently available. This article examines the long-term rationale for household family planning in Bangladesh-where growing use of contraceptives, rapid fertility decline, and normative change in reproductive preferences are in progress, bringing into question the rationale for large-scale deployment of paid outreach workers. Longitudinal data are analyzed that record outreach encounters and contraceptive use dynamics in a large rural population. Findings demonstrate that outreach has a continuing impact on program effectiveness, even after a decade of household visitation. The policy implications of this finding are reviewed.

Adult↗

PubMed1992

Long-run impacts of AIDS.

"Over the next century, the impact of the AIDS epidemic on the supply of and returns to factors of production may be significant. Public policies might offset some of the long run impacts, especially if initiated early in the epidemic. History suggests the types of economic effects that can occur in the long run and the limits of public policies' effectiveness in controlling diseases of this type. The models developed here to show possible long run time paths for the epidemic also imply a long-run equilibrium, a concept not appreciated in most disciplines. Because data deficiencies make long run numerical forecasting highly controversial, this paper uses history and modeling to emphasize qualitative understanding of the epidemic."

Acquired Immunodeficiency Syndrome↗

PubMed1994

Australian immigration between globalization and recession.

"This report has given some idea of the wide-ranging discussions at the Second National Immigration Outlook Conference [held in Sydney, Australia, in 1993], and of the way they reflect vital political, economic, and social issues in a country built upon mass immigration. The strains of globalization, geopolitical reorientation, and economic restructuring are having decisive effects on policies of immigration and multiculturalism. The consequences of such changes are difficult to predict, but in the authors' opinion they could lead to the breakdown of the 'Australian model' which has been remarkably successful in incorporating very large numbers of newcomers from varied backgrounds. The result might be considerable hardship and social tension."

Acculturation↗

PubMed1990

Long-term effects of food supplementation and psychosocial intervention on the physical growth of Colombian infants at risk of malnutrition.

280 Colombian infants at risk of malnutrition were randomly assigned to 1 of 4 experimental groups formed by the presence/absence of 2 interventions: (1) food supplementation for the entire family, from mid-pregnancy until the target child was 3 years old, and (2) a twice-weekly home-visiting program to promote cognitive development, from birth until age 3. All families received free medical care and were studied prospectively. At 3 years of age, children who had received food supplementation averaged 2.6 cm and 642 grams larger than controls. Home visiting and supplementation together reduced the number of children with severe growth retardation. 3 years after intervention (age 6), supplementation effects remained. Children in the home visit condition had become larger than controls, by 1.7 cm and 448 grams. The interactive effect to reduce stunting was marginally significant at this age, and the overall distribution of scores was improved. Other results suggest that changes in family functioning as well as biological mechanisms account for the observed pattern of results.

Body Height↗

PubMed1992

Population growth with variable family size.

"The Sharpe-Lotka continuous time deterministic model of population growth is developed to take account of some possible forms of mother-daughter fertility association.... Model specific results relating the intergenerational fertility effect to the long term population growth rate and magnitude are established. The quantitative implications of the theory are illustrated by a consideration of a general bilinear form of A and in this context numerical results illustrating the finite time growth and also the long term distribution of fertility levels in the stable female population are obtained. In particular, it is shown that different fertility specific subpopulations can coexist indefinitely."

Demography↗

PubMed2001

Effects of antipsychotic treatment on membrane phospholipid metabolism in schizophrenia.

Several studies have shown an increased membrane phospholipid turnover in brain and blood cells of schizophrenic patients. However the specificity of these findings for schizophrenia and the effects of longterm antipsychotic treatment had yet to be demonstrated. In the present study we measured the concentrations of phospholipids in platelet membranes from 67 neuroleptic-free schizophrenic patients compared to both healthy and psychiatric controls, followed by repeated measurements during a 6 months antipsychotic treatment period. At baseline, levels of the main phospholipid components phosphatidylcholine (PC) and phosphatidylethanolamine (PE) were decreased and lysophosphatidylcholine (LPC), a major breakdown product of phospholipid metabolism, was increased in schizophrenic patients compared to healthy and to psychiatric controls, suggesting a specificity of the findings for schizophrenia. During the first 3-weeks on antipsychotic drug treatment LPC levels decreased to control values, but increased again during the following 6 months, reaching significantly higher levels than controls at the end of this period. Thus, at least in peripheral cells an increased breakdown of phospholipids in schizophrenia appears to be present during the acute episode, being influenced only by initial antipsychotic treatment, but without evidence of a long lasting treatment effect on membrane metabolism.

Adult↗

PubMed1984

The Oxford-Family Planning Association contraceptive study.

The Oxford-Family Planning Association contraceptive study involves over 17 000 women who were recruited at 17 clinics in England and Scotland during the interval 1968-74 and have been followed up ever since. This paper describes the survey methods, the characteristics of the participants, the progress of the study, the main results and publications to date, and the proposals for future work. Although the study was originally mainly concerned with the benefits and risks of oral contraceptives it has, in fact, contributed to knowledge about a wide variety of birth control methods. The data on efficacy are of special value in that they cover all methods of contraception in common use and have been derived from a homogeneous and closely observed population. The mortality figures, while limited in extent, have supplemented the findings in the Royal College of General Practitioners study. Reports on morbidity from many different diseases have been published; these have documented both beneficial and harmful effects of various contraceptive methods. The study data on return of fertility after discontinuation of contraception are unique, while contributions have also been made to knowledge about outcome of pregnancy in those stopping contraception to have a planned baby or becoming accidentally pregnant while using a birth control method. The study, which is supported by the Medical Research Council, is currently funded until mid-1989.

Adult↗

PubMed1984

The effects of estrogen on single dose dimethylnitrosamine carcinogenesis in male inbred Crl/CDF rats.

The effect of longterm estrogen treatment (estradiol valerate) on male rats injected i.p. once with dimethylnitrosamine (DMN, 30 mg/kg, with protein starvation), was studied in 167 male inbred Crl/CDF rats. DMN was given at 40 days (immature rats) or at 90 days (mature rats) to investigate the action of carcinogen and hormone at different stages of development. Estrogen reduced life expectancy of male animals, and was associated with greatly increased breast tumour incidence (to 30%) compared with controls (3%, p less than 0.01). DMN alone enhanced lung tumorigenesis (p less than 0.001) and chronic estrogen treatment significantly reduced both the incidence and multiplicity of DMN-induced lung tumours in male rats (p less than 0.001). Also, estrogen treatment lowered the incidence of spontaneous lung tumours (p less than 0.005). The higher incidence of animals with kidney tubular adenomas and carcinomas induced by DMN in both mature and immature rats was statistically significant (p less than 0.001), but estrogen and the age at carcinogen treatment had no effect. Lethal mesenchymal kidney tumours developed in immature rats exposed to DMN (p less than 0.001), but only developed in mature DMN-treated rats if they received estrogen as well.

Adenoma↗

PubMed1990

Barrier and spermicidal contraceptive methods and risk of invasive cervical cancer.

The effects of barrier and spermicidal methods of contraception on cervical cancer risk were examined by studying 479 cases of histologically confirmed invasive cervical cancer cases and 788 random digit dialing controls. In addition to a detailed history of contraceptive practices, information was available on numerous potential confounders, including demographic characteristics, sexual behavior, reproductive factors, Pap smear screening history, and smoking. After adjustment for relevant confounders, diaphragm and condom use were found not to be significantly associated with risk of cervical cancer. Although there was a small reduction in risk (OR = 0.8) associated with long-term use (5+ years) of the diaphragm, the effect appeared to relate to concomitant spermicide use, since there was evidence of further decreases in risk for women using spermicides alone for extended periods (OR = 0.7 for 5+ years). Effects were only seen among subjects of higher income and education levels, suggesting that patterns of usage may be important. The potential ability of spermicides to reduce cervical cancer risk by neutralizing viral agents warrants further attention.

Adult↗

PubMed1976

Vasectomy: a long-term study of its effects on testicular endocrine function in man.

Plasma testosterone, luteinizing hormone (L.H.) and follicle stimulating (F.S.H.) were measured before operation in 39 males, aged 26 to 53 years with 2 to 5 children, seeking vasectomy for contraceptive purposes. These measurements were repeated at 3 and 12 months after vasectomy. Levels of L.H. at 12 months were significantly higher than pre-vasectomy levels, suggesting some degree of decreased Leydig cell function. However, testosterone and F.S.H. levels were similar at the three sampling times. Continuing yearly measurements for at least 5 years are planned.

Adult↗

PubMed1980

[Drug-induced disturbances of the coagulation system (author's transl)].

Side-effects of longterm therapy on the coagulation system become manifest either as hemorrhages or as an increased risk of thromboembolism. The most frequent drug-induced coagulation defect is thrombopathia. The most important drug-induced plasmatic coagulation disorders are caused by anti-coagulants and therefore predictable. In patients exposed to hemorrhage risk, non-steroidal antiphlogistics are not contraindicated since they entail inhibition of platelet aggregation and prolonged hemorrhage time. High doses of penicillin G and the semisynthetic penicillins can lead to hemorrhage in patients with renal insufficiency. Corticosteroids and contraceptives however tend to induce hypercoagulability.

Adrenal Cortex Hormones↗

PubMed1996

Alcohol and sexual victimization: a longitudinal study of Norwegian girls.

In a study of sexual victimization and alcohol consumption, a population sample of Norwegian adolescents from the Oslo area was followed-up through five data collections over a 6-year time span. By means of generalized structural equation modeling, alcohol-related predictors and consequences of sexual assaults were investigated; 17% of the girls reported that they had been sexually assaulted at some time: 7% in childhood, 6% in early adolescence (13-16 years) and 4% in late adolescence (17-19 years). Only 1% of the boys reported having been sexually victimized. Female childhood sex victims reported increased alcohol consumption from their mid-teens, with dramatic increase in alcohol-related problems (using DSM-III-R criteria) at the end of their teens. However, the analyses showed that alcohol consumption was not influenced by childhood sexual abuse when parental use of tobacco and alcohol and normative standards imparted to their children were taken into consideration as confounding variables. There was, on the other hand, a strong effect on alcohol problems. Thus, the victims of childhood sexual abuse seem to be at high risk for alcohol abuse and dependency. Further, early alcohol debut and high alcohol consumption combined with permissive parental norms increased the risk of sexual assault in early adolescence. The girls who were assaulted in early adolescence also reported a high number of sexual partners and early intercourse debut. There was no increase in subsequent alcohol consumption after assaults in this group. Late adolescent victims did not report increased alcohol consumption either prior to or after the assault.

Adolescent↗

PubMed1983

The long-term effects of vasectomy on sexual behaviour.

Two hundred soldiers of the Sri Lanka Army who had undergone vasectomy at least 4 years earlier were interviewed by a pretested questionnaire to determine the incidence and nature of any changes in sexual behaviour after the operation. Fifty-six percent reported some change in their sexual behaviour after vasectomy. A decreased frequency of intercourse being reported by 15%, a decreased sexual desire by 19% and changes in sexual behaviour during intercourse by 33%. Seven percent reported that their wives had noticed an alteration in sexual behaviour after operation. In spite of these changes in sexual behaviour after vasectomy the majority of men (92%) reported satisfaction with the operation, which is an indication that changes in sexual behaviour cannot be attributed directly to vasectomy.

Adaptation, Psychological↗

PubMed1995

Population growth and the benefits from optimally priced externalities.

"In this article we show that, considering only economic effects, even if population growth, by natural increase or immigration, increases congestion, pollution, and other forms of external costs, that provided pre-existing citizens own the resources giving rise to the externalities, and provided they efficiently price usage of such, that existing citizens must, in net average terms, be better off with population growth than without it. In simple terms the increased revenues they gain from efficient pricing at increased demand levels will be strictly greater than the monetary value of the increased external costs together with the higher tax costs they incur as consumers of the resources."

Cost-Benefit Analysis↗