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The possible effects of environmental estrogen disrupters on reproductive health.

The term environmental estrogen refers to chemical substances that exhibit some degree of estrogen-like activity. The primary emphasis for potential adverse effects resulting from exposure to environmental estrogens is on in utero exposure because such exposures can occur during critical periods of organogenesis. Assessment of biological plausibility can be based, in part, on the extensive data on the effects of diethylstilbestrol (DES). The available evidence is too limited to judge with any confidence whether sperm counts have declined during the past 50 years. Based on both animal and human data with DES, it is biologically plausible that in utero exposures to exogenous estrogenic compounds are capable of reducing sperm production in adult men. However, the apparent existence of a maternal dose threshold for DES-induced effects on sperm count undermines the likelihood that environmental estrogens, which are substantially less potent, are capable of causing similar effects.

Animals↗

A pilot of audio computer-assisted self-interview for youth reproductive health research in Vietnam.

PURPOSE: Several recent adolescent health studies in Vietnam have shown low levels of premarital sex among youth compared to neighboring countries and other regions of the world. One possible explanation for these findings is that adolescents in Vietnam are less willing to reveal their true behaviors. This study aims to assess the level of reporting of sensitive behaviors/events using three methods of survey data collection: face-to-face interviewer-administered (IA), paper-and-pencil self-administered (SA) and AudioComputerAssisted Self Interview (ACASI). METHODS: A randomized experiment was undertaken in Gialam, a suburb of Hanoi, among a sample of 2,394 youth ages 15 to 24 years. Respondents were randomly assigned to one of three interviewing methods, with females and males evaluated separately. RESULTS: ACASI showed certain advantages with regard to respondent attitudes and perceptions of sensitive topics. ACAI also revealed higher prevalence rates for sensitive and stigmatized behaviors. Among those in the pencil and paper survey group it is estimated that 12.9% of unmarried males and 3.4% of unmarried females have had premarital sex. The rate found by using ACASI is higher at 17.1% in males (95% CI: 13.5-21.4) and 4.5% in females (95% CI: 2.7-7.3). Using ACASI, unmarried males also reported higher levels of risky sexual relations. For example, 7.8% confirmed visiting sex workers compared with only 1.2% in SA group and 3.9% in IA group. Additionally, ACASI respondents reported having had more sex partners by age group, gender and marital status. CONCLUSIONS: When coupled with the emerging data from around the world, the present findings suggest that researchers should consider using ACASI for future studies dealing with sensitive and stigmatized topics.

Adolescent↗

The interface between legal and ethical issues in reproductive health.

In a time of rapid change in the health care delivery system, health care professionals are challenged to fully understand their legal and ethical obligations for practice. The interface between law and ethics as it affects professional practice is complex and confusing. Three areas of legal and ethical interface and their associated history are explored: laws affecting scope of practice and the ethical obligation to provide access to care; laws affecting informed consent and the ethical obligation to respect autonomy; and laws limiting disclosure of personal identifiable information and the ethical obligation to protect privacy. A trend toward the use of statutes to protect and enforce patient rights has emerged, which has altered and limited professional practice.

Delivery of Health Care↗

Reproductive health.

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Family Characteristics↗