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Declining induced abortion rate in Finland: data quality of the Finnish abortion register.

BACKGROUND: Induced abortion rates have declined in Finland since 1973. A possible explanation offered has been that of deteriorating data collection. METHODS: To assess the completeness of the Register, we compared the information from a consecutive sample of hospital records (N = 482) to the Finnish Abortion Register in 18 hospitals in three counties. A smaller consecutive sample (N = 345) was collected from the same hospitals to assess the validity of the Register information. RESULTS: Only five abortions (1 percent) found in the hospitals were not reported in the Abortion Register. A total of 95 percent of all the length of pregnancy (definition problems), the classification of the abortion procedure, and social class (out-of-date classifications). Furthermore, early complications were poorly reported. CONCLUSIONS: The data from the Finnish Abortion Register are a reliable source for monitoring trends in the abortion rate and its variation by subgroups, but are an unreliable source for the study of the medical aspects of induced abortion.

Abortion, Induced↗

Fertility of male workers exposed to cadmium, lead, or manganese.

The effect of exposure to cadmium, lead, or manganese on male reproductive function was examined in 1988-1989 in Belgian blue-collar workers. The workers were exposed to cadmium in two smelters (n = 83; geometric mean urinary cadmium level = 6.94 micrograms/g of creatinine; mean duration of exposure = 24 years), to lead in a battery factory (n = 74; mean blood lead level = 46.3 micrograms/dl; mean duration of exposure = 10.7 years), or to manganese (manganese dioxide) in a dry alkaline battery plant (n = 70; median atmospheric concentration of total manganese dust = 0.71 mg/m3; mean duration of exposure = 6.2 years). Fertility in these workers and in an unexposed population (n = 138) was assessed by examining the birth experiences of their wives through a logistic regression model. The probability of a live birth was not different between the unexposed workers and the cadmium- or manganese-exposed workers before or after the onset of exposure. While the fertility of the lead-exposed workers was somewhat greater than that of the unexposed before the onset of exposure, a significant decrease in fertility was observed during the period of exposure to the metal (odds ratio = 0.65, 95% confidence interval 0.43-0.98).

Adult↗

Fertility rates in 238 HIV-1-seropositive women in Zaire followed for 3 years post-partum.

Birth-control use and fertility rates were prospectively determined in 238 HIV-1-seropositive and 315 HIV-1-seronegative women in Kinshasa, Zaire, during the 36-month period following the delivery of their last live-born child. No women delivered children during the first follow-up year. Birth-control utilization rates (percentage use during total observation time) and fertility rates (annual number of live births per 1000 women of child-bearing age) in the second year of follow-up were 19% (107.4 per 1000) for HIV-1-seropositive women and 16% (144.7 per 1000) for HIV-1-seronegative women. In the third year of follow-up these rates were 26 (271.0 per 1000) and 16% (38.6 per 1000) for HIV-1-seropositive and HIV-1-seronegative women, respectively (P less than 0.05 for the difference in birth-control utilization and fertility rates between seropositive and seronegative women in the third year of follow-up). Seven (2.9%) of the 238 HIV-1-seropositive women initially included in the study brought their sex partners in for HIV-1 testing; three (43%) of these men were found to be HIV-1-seropositive. New HIV-1 infection did not have a dramatic effect on the fertility of seropositive women. The nearly uniform unwillingness of HIV-1-seropositive women to inform husbands or sexual partners of their HIV-1 serostatus accounted in large part for the disappointingly high fertility rates in seropositive women who had been provided with a comprehensive program of HIV counseling and birth control. Counseling services for seropositive women of child-bearing age which do not also include these women's sexual partners are unlikely to have an important impact on their high fertility rates.

AIDS-Related Complex↗

Limnological effects of wood ash application to the subcatchments of boreal, humic lakes.

To assess environmental risks of wood ash, limnological effects of ash application to the drainage basins of two small, humic lakes and one reference lake in southern Finland were examined in this three-year study. Treated areas corresponded to 12 and 19% of the total catchment and the amount of wood ash added was 6400 kg ha(-1). Immediate effects of wood ash on lake water were investigated in three tank experiments each lasting 1.5 wk. In tank experiments, addition of wood ash increased pH, alkalinity, conductivity, and Ca and P concentrations of humic lake water, while growth of phytoplankton decreased. After wood ash application to the subcatchments, pH, alkalinity, conductivity, and concentrations of K+, SO4(2-), and Cl- slightly increased, both in inflowing waters and in the lakes, but no increased leaching of Ca, N, or P from the treated subcatchments occurred. Phytoplankton biomass increased in both experimental lakes in comparison with the reference lake. In the lake with 19% application rate to the catchment, zooplankton biomass also increased. The results indicate that, over the short term, a small-scale ash treatment to a forested drainage basin will not necessarily cause significant changes in the water quality of boreal humic lakes, but at higher application rates, changes in water chemistry and biology are more evident.

Calcium↗

The containment of world population growth.

The world has reached the present position of unprecedentedly rapid population growth not by achieving uniquely high fertility but by bringing about extraordinarily low mortality. The high growth rate and the built-in momentum of the age structure are obstacles to achievement of an acceptable standard of living for most of the world's population. Although government population programs have the potential to curb this growth rate, this potential has not been realized, and such programs are too often perceived both by their administrators and the population concerned as an end in themselves rather than a means toward a better standard of living. It is in this latter perspective, and in the context of the total development process, that population programs should be implemented.

Adult↗

A new method for estimating the trend in the fertility rate.

"This article describes the method devised by Gerard Calot...for estimating monthly TPFRs [total period fertility rates] when only provisional monthly figures for numbers of births are available. The application of the Calot method, together with the US Bureau of the Census X-11 seasonal adjustment package, for computing the trend in the England and Wales fertility rate is also described."

Birth Rate↗

Computing the level and distribution of gains from fertility reduction.

"This paper describes and illustrates new procedures for measuring monetary gains from fertility reduction that can be applied to macromodels of population and development. A previously developed method for calculating the total monetary gain from averted births is reviewed. A new technique for distributing gains between birth-averting households and society at large is explained....A technique for evaluating alternative fertility reduction programs is described. Each of the methods is applied to a macromodel estimated from a cross section of countries."

Birth Rate↗

Survey report: Jordan.

Preliminary results from the 1990 Jordan Population and Family Health Survey show a 20% decline in fertility since the early 1970s. The total fertility rate (TFR, or average lifetime births/woman) declined from 7.7 births in the 1971-1975 period, to 6.6 in 1980-1983, to 5.6 in 1987-1990. A national sample of 6462 evermarried women of childbearing ages were interviewed. More than 1/2 (58%) of respondents had ever used a method of contraception. 35% of married women reported currently using some method of contraception, up from 26% in 1983. The IUD was the most popular modern method--used by 15% of women. Female sterilization (6% of respondents) edged out the pill (5%). These findings show a shift in contraceptive use from the pill to the IUD and female sterilization compared with 1983. In general, older women, those living in big cities, women with a formal education, and those who have children are more likely to use contraception. Compared with other countries, the level of fertility in Jordan is high for the level of contraceptive use. Reliance on traditional methods may account for this difference: 27% were currently using modern methods and 8% traditional. Knowledge of contraceptive methods is high. Almost all women knew of at least 1 method of family planning, either modern or traditional. The pill and IUD were the best-known methods; 98% of the women knew at least 1 of these. The next best-known were traditional methods: periodic abstinence (77%) and withdrawal (69%). Most women who knew a family planning method also knew where to obtain it. For example, more than 94% of those surveyed knew about female sterilization, of whom 85% knew where to go to have it done. The survey showed infant mortality in Jordan had declined to 27/1000 livebirths. Almost all children under 2 had received some vaccinations, and almost all are breastfed for at least some time. There seems to be a strong program prompting diphtheria/pertussis/typhoid, polio, and measles vaccination in Jordan, according to the report. Of all children 12-23 months, 88% had received these vaccinations, although coverage declined with successive doses.

Asia↗

A preference for baby girls.

For the majority of women in Japan, a girl baby is preferable to a boy baby, according to recent findings of a fertility survey conducted by the Institute of Population Problems of the Ministry of Health and Welfare (MOHW). The nationwide survey, carried out in July 1992, found that 75.7% of women would prefer to have a girl baby if they were to have only 1 child--a marked change from 10 years ago when only 48.5% of women said that they would prefer a girl child. Conducted every 5 years, the survey gained responses from 8844 married women under 50 years of age. In giving reasons for wanting a girl child, many women commented that a daughter is more likely to remain closer to parents than a son. The findings of the survey reflect the changes that have taken place in Japanese society in recent years including the emergence of the nuclear family, later marriage, fewer children, and population aging. The survey also found that only 15.2% of marriages currently follow the practice of omiai (arranged marriages), a sharp decrease from 23.6% of 5 years ago. Meanwhile, couples are waiting longer after their first encounter before getting married. According to the survey, couples married during the 1987-1992 period waited an average of 2.97 years after their first encounter, a sharp contrast from the average waiting period of 1.97 years for couples married between 1972-1977. The survey also found that while the total fertility rate has fallen in Japan to 1.50 in 1992 from 1.75 in 1980, fertility for married couples has remained virtually unchanged since 1972 at 2.21.

Asia↗

Contraceptive use and fertility in Honduras, 1981-84.

This paper presents data on contraceptive use and fertility in Honduras obtained from a household survey conducted in 1984, and compares these data with similar information obtained from surveys carried out in 1981 and 1983. About half of the increase that has taken place in contraceptive use in Honduras is accounted for by sterilization. In 1981, 27 percent of women in union aged 15-49 years were practicing contraception; in 1984, the percentage of those 15-44 was 35 percent. The increase in urban areas was smaller (from 47 percent to 51 percent) than in rural areas (from 16 percent to 24 percent). Also, fertility remained almost unchanged in urban areas while declining in rural areas. Information from questions on place of purchase, price, and brand of contraceptive (for orals) was used to determine source of supply. The use of multiple questions to determine source results in a higher percentage of contraceptive use attributed to the Honduran Family Planning Association as compared with answers to a single question. The duration of breastfeeding in Honduras has increased, with the greatest changes occurring among women in urban areas and women with the highest levels of education. Efforts have been made to promote breastfeeding in urban areas and these results suggest that the efforts have been successful.

Adolescent↗