Reproductive health care and minors' rights.
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OBJECTIVES: To report teen pregnancy and sexually transmitted infections (STI) rates among Manitoba adolescents, and associated factors including rates of sexual intercourse and contraceptive use. METHODS: Teen pregnancy rates in females aged 15 to 19 for the fiscal years 1994/95 through 1998/99 were derived from the Population Health Research Data Repository and reported by geographical areas and income quintiles. Premature mortality rate (PMR) and the Socioeconomic Factor Index (SEFI) measured the overall health and socioeconomic well-being of regional populations. Data on sexual activity and contraceptive use were derived from the 1996 National Population Health Survey for males and females ages 15 through 19 years. RESULTS: The teen pregnancy rate for Manitoba was 63.2/1000, varying by geography and inversely correlated with income, PMR, and SEFI. 39% (95% CI 33-45) of teens reported sexual intercourse, with higher rates in urban areas (46%, 95 % CI 35-57) and the North (48%, 95% CI 36-60) compared to South Rural (30%, 95% CI 25-34), and in low-income families (68%, 95% CI 53-83) compared with middle/high (33%, 95% CI 26-40). For sexually active females, 42% (95% CI 28-57) used the birth control pill, with higher rates in low-income families (70%, 95% CI 50-90) compared to middle/high income (31%, 95% CI 14-48). Condom use (at last sexual intercourse) was reported by 82% (95% CI 72-92) of adolescents, with trends (though not statistically significant) to lower use in low-income families and the North. CONCLUSION: Reliance on the pill for contraception, combined with low rates of condom use, are public health concerns for adolescents where STI and unintended pregnancy rates are high.
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OBJECTIVE: A prognosis of the development of perinatal care in the Czech Republic until 2010 DESIGN: An epidemiological study to be used as a basis for the prognosis. SETTING: Mother and Child Care Institute, Prague. METHODS: The primary source data on the indicators of the level of perinatal care as well as on some circumstances under which this care is being developed and on which their prognosis is based were drawn from the information obtained from their annual nationwide analysis. RESULTS: The prognosis of the development of perinatal care until 2010 builds on the previous prognosis from the period 1980-2000, whose results, when analysed retrospectively, proved a significant dependence of professional development on political, demographic, social and economic circumstances. Increase of the level of perinatal care, evaluated according to internationally recognised criteria, resulted in decreasing the maternal, perinatal and infant mortality rates to levels reported by a few countries in the world. The fact that these levels have been stagnating since 2000 is a result of two conflicting processes. On one hand, there is the improvement in the standard of care; on the other hand, there is deterioration in some of the above-mentioned circumstances. The fact that the reserves for further decrease in professional care have been used up and, conversely, the risk that some of the above-mentioned circumstances will deteriorate have raised concerns that some of the indicators of this care will deteriorate as shown by the extrapolation of the trend in these indicators prevalent in the last years carried out for the period until 2010. Two prognoses with differently serious impacts were formulated on the basis of this extrapolation. CONCLUSION: The development of perinatal care is dependent on the circumstances under which it is being developed. The fact that the reserves in development and organisation of this specific field have been used up, which resulted in decreasing the maternal, perinatal and infant mortality rates to levels, which are among the lowest ones in the world, and, conversely, the deterioration in some of the above-mentioned circumstances have raised concerns that the internationally recognised indicators of this care will deteriorate.
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It is widely accepted that micronutrients have a major function in many periods of women's life, particularly during pregnancy and lactation. Inadequate stores or intake of micronutrients might have adverse effects both to the mother (hypertension, anemia, complications of labor) and the fetus (congenital malformations, pre-term delivery, intrauterine growth retardation). The effect of improper nutrition is influenced by gestational age, severity of deficiency, or both. Generally, the daily requirements in minerals and trace elements are easily met in women having a balanced diet. Such diet during pregnancy should provide the recommended daily allowance of all nutrients except elemental iron. Consequently, deficiency states are supposed to be rare in developed countries, and supplementation should be made on an individual basis. On the other hand, nutritional deficiencies during pregnancy might be difficult to detect. Studies from developing countries where micronutrient malnutrition is common during pregnancy gave us strong evidence that supplementation of certain trace elements and minerals could prevent some of the most severe adverse pregnancy outcomes. While some micronutrients have been studied extensively (e.g. calcium, iron, zinc, iodine), much less is known about others. It has been shown that multiple micronutrient deficiencies, rather than single deficiencies, are common. Our knowledge about the significance of interactions between micronutrients in relation to pregnancy outcome is limited. The role of these interactions in improving pregnancy outcome need to be investigated more precisely. According to the summarized data, the potential benefits of routine supplementation seem to outweigh any potential adverse reaction that can be attributed to their consumption.
The aim of the present study was to describe the development and evaluation of a program designed to prevent HIV/AIDS. A participatory action research (PAR) approach was used in collaboration with ten schools in Chiang Mai Province, Thailand, to develop a youth- adult partnership with schools (YAPS) model. The YAPS model included curricula using participatory learning experiences, edutainment approaches, and skills building strategies for enhancing youth leaders'capacities. Results showed that the YAPS model was effective in leadership role preparation and in empowering youth leaders to undertake activities on their own, initiate creativity and share knowledge on sexuality education and HIV prevention messages with students in schools. The use of partnerships and the participatory process mobilized parents, teachers, and school administrators to play a proactive role in sexuality education and HIV prevention for early adolescents in schools, resulting in the integration of the program into the school system.
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Women and men have special needs in rehabilitation. Women's needs, however, have received far less attention in the scientific community and medical literature. This section, edited by Sandra Cole, PhD,(*) highlights some of the unique concerns of women who live with physical disabilities.
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