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PubMed2003

Type of cottonseed and level of gossypol in diets of lactating dairy cows: plasma gossypol, health, and reproductive performance.

Objectives were to determine effects of altering gossypol intake by feeding whole linted Upland (WUP) or a 1:2 blend of WUP and cracked Pima (BUPCP) cottonseed on plasma gossypol (PG) concentrations, reproduction, and health of Holstein cows. Cows, 813, on three dairy farms were assigned to one of two diets starting at 13 +/- 11 d in milk for a 170-d experiment. Diets contained 717 and 951 mg of free gossypol/kg of dry matter from WUP and BUPCP, respectively. Concentrations of PG, as well as the proportion of total gossypol (TG) as the minus isomer were higher for cows fed BUPCP vs cows fed WUP. Conception rate at the first postpartum artificial insemination did not differ between treatments. However, cows consuming the higher gossypol diet had reduced subsequent conception rates and a lower pregnancy rate. Incidence of abortions increased in the higher gossypol diet, and cows that aborted or remained open had higher PG concentrations. Increasing PG concentrations resulted in reduced conception rates and extended days open. The probability of conception after the first artificial insemination declined at a decreasing rate as the plasma TG increased. Incidence of health disorders were unaffected by gossypol intake and PG concentrations. Similarly, gossypol intake and PG concentrations had no effect on culling or mortality. Six cows died in each diet, and none had postmortem signs compatible with gossypol toxicity. Consumption of a high gossypol diet for 170 d had no effect on health of lactating dairy cows, but it increased PG concentrations and impaired reproductive performance.

Abortion, Veterinary↗
PubMed2002

Health needs of clients as reported by medical practitioners from two districts of Sindh.

OBJECTIVE: To identify the major health and reproductive health problems for which people consult local medical practitioners. METHODOLOGY: Forty-one practitioners completed a self-administered questionnaire. A startified purposive sample of practitioners was selected by asking the community members from various towns and rural areas to identify practitioners who have most busy practices and are perceived as providing quality care. RESULTS: Nine of the forty-one practitioners were females. Twenty-two were consulted mainly by women and another seventeen by an equal number of women and men. Practitioners pointed to malnutrition, malaria, gastrointestinal and respiratory tract problems as being the most common ailments. They identified menstrual problems, malnutrition among pregnant women, burning micturition and vaginal discharge as the most common reproductive health problems of their clients. Only 16 medical practitioners said that they diagnosed someone in the last one-month as suffering from sexually transmitted infections. CONCLUSION: The survey helped in developing an understanding of health issues from provider perspective. Findings indicate a concordance between what has been revealed by previous population based studies in similar situations and to what health problems practitioners pointed as common. While a comprehensive needs-assessment requires surveys and qualitative interviews with communities, consultations with relatively fewer medical practitioners could also provide a quick and fair approximation of priority health problems in the area.

Family Planning Services↗
PubMed2004

Teaching sex education: are Scottish school nurses prepared for the challenge?

Teaching sex education to school pupils in Scotland continues to be a controversial issue. In reality there is lack of leadership, strategy and an uncoordinated approach to delivering this important topic. The school nurse is frequently identified as a suitable professional to lead the way because it is assumed that school nurses are well educated in the field of sexual and reproductive health. Nationally, little is known about the educational status of Scottish school nurses and there is no research evidence available from which generalisations can be made. This study aims to explore the educational preparation of school nurses that underpins teaching sex education to school pupils in Scotland. A cross-sectional descriptive study was completed in September 1998. The results confirmed that school nurses in Scotland are predominantly female and 70% of the respondents (n=117) were over the age of 40 years of age. No common basic nursing qualification was identified. The majority of school nurses in Scotland perceive sex education to be part of their role and 39% (n=65) testified that specific sexual health training had been undertaken. Many lack confidence in this area of practice and are aware of extensive educational needs in relation to teaching sexual health and reproductive health. Despite these findings 75% (n=126) were actively involved in teaching sex education to school pupils.

Attitude of Health Personnel↗
PubMed2002

Women's health, changes and challenges in health policy development in Lithuania.

Health is a sensitive mirror of social circumstances. This paper looks at the situation of women's health in Lithuania in the context of the social, political and economic transition in the country following independence in 1990, and reforms to the health system. Data since 1990 show that considerable social and demographic inequalities in the health of women exist in Lithuania, with low-educated women and those living in rural areas in the most unfavourable situation, including in relation to reproductive health. Reproductive health issues have received some recognition in recent years, with the main attention and resources directed to the development of a Maternal and Child Health Programme, especially perinatal care and the organisation of neonatology services, which has resulted in a notable decrease in maternal, perinatal and infant mortality. Services for family planning, abortion, infertility, cervical and breast cancer, and violence against women are under-developed. Non-governmental organizations are beginning to be formed to advocate for increased resources and services for reproductive health. Improvements in the health status of Lithuanian women can be expected if attention is paid to social determinants of health.

Female↗
PubMed2002

Gender dimensions of user fees: implications for women's utilization of health care.

This paper looks at the implications of user fees for women's utilization of health care services, based on selected studies in Africa. Lack of access to resources and inequitable decision-making power mean that when poor women face out-of-pocket costs such as user fees when seeking health care, the cost of care may become out of reach. Even though many poor women may be exempt from fees, there is little incentive for providers to apply exemptions, as they too are constrained by restrictive economic and health service conditions. If user fees and other out-of-pocket costs are to be retained in resource-poor settings, there is a need to demonstrate how they can be successfully and equitably implemented. The lack of hard evidence on the impact of user fees on women's health outcomes and reproductive health service utilization reminds us of the urgent need to examine how women cope with health care costs and what trade-offs they make in order to pay for health care. Such studies need to collect gender-disaggregated data in relation to women's health service utilization and in relation to the range of reproductive health services, taking into account not only out-of-pocket fees charged by public health providers but also by private and traditional providers.

Africa↗
PubMed1999

Reaching adolescents: a role for radio.

The radio is a powerful means to reach adolescents and to address their concerns, particularly those that are not being addressed by their families or by the school curriculum. Proving this point is a radio program, "Sandhikhan" (Bengali for adolescence), which aired on national radio covering adolescent health issues, particularly reproductive health. The program's impact was the subject of a WBVHA survey among adolescent radio listeners in West Bengal. About 79% (369 individual listeners) of the respondents rated the radio program very good, with only a negligible 1% describing it as unnecessary. Only 21% of respondents listened to the program alone, with the majority listening in the company of friends, mothers, sisters, brothers, fathers, and other relatives. This suggested a wider group of listeners in addition to the program's primary target audience. Clearly, findings pointed to the effectiveness of teaching adolescent health on the air and the role that was played by WBVHA in developing healthy attitudes and habits among its young audience. The findings of the survey will provide the basis for producing educational materials on reproductive health for students as well as teachers.

Adolescent↗
PubMed2001

Capacity building to improve women's health in rural China.

The Women's Reproductive Health and Development Program (WRDHP) is an ambitious attempt to operationalize two important tenets of health development thinking within a rural reproductive health context. First, it is important for communities to participate in decisions about the services and programs that affect them. Secondly, the complex nature of healthcare is best addressed by intervention processes which call for a multi-functional approach to planning and coordination. In both planning and intervention approach, the WRHDP recognizes the social, cultural and economic realities that affect women's efforts to secure the health and well-being of themselves and their families. The focus of the WRHDP is on capacity-building within a rural reproductive health environment, in this case Yunnan Province in rural China. Rather than using international donor funding to provide a specific intervention, the WRDHP used Ford Foundation funding as a lever to encourage community investment in environmental resources that affect health, to improve the technical skills of individuals within the existing health bureaucracies, and to promote structural changes within existing health and development bureaucracies to support interagency collaboration and community empowerment within the region's health and development agencies. This article describes how the WRHDP created new methods for provincial and local agencies to overcome obstacles and work with one another to improve women's health. It also describes the processes used in the rural areas of Chengjiang and Luliang counties to assess local conditions and needs, and the supported and expanded local efforts in improving woman's reproductive and family health that resulted from the processes.

China↗
PubMedDate not supplied

Reproductive and child health programme.

Reproductive and Child Health Programme is an integrated and comprehensive programme based on realistic decentralised area specific microplanning tailored to meet the local needs. There is adequate emphasis on provision of good quality of services under the programme. The present paper traces the genesis and evolution of the RCH programme followed by its objectives, strategies and components. Various mechanisms for the implementation, monitoring and evaluation of the programme are discussed. The programme is analysed critically and suggestions for improvement are provided.

Adult↗
PubMed1992

Effects of voltages on cows over a complete lactation. 2. Health and reproduction.

For the effects of voltages on health and reproduction, 40 cows in second to fifth lactation were divided into four groups of 10. These included a control group that was not subjected to voltages and three treatment groups that were given either 1, 2, or 4 V at the water bowl. Cows in the treatment groups were exposed during the entire lactation to voltage whenever they drank. Voltages did not sufficiently affect milk yield. General health parameters studied were mastitis, hoof problems, and changes in body weight. Reproductive and calving parameters examined were days to first breeding, days open, services per conception, response to PGF2 alpha, calving intervals, visible abortion, and calves born dead. Voltages did not significantly influence cow health or reproductive performance.

Abortion, Veterinary↗
PubMed1998

Adolescent sexual and reproductive behavior: a review of the evidence from India.

Despite the fact that adolescents represent almost one quarter of the Indian population, their reproductive health needs are poorly understood and ill served. This paper documents the existing research on sexual and reproductive health, explores the knowledge and attitudes among this population in India, and highlights limitations of methodologies currently employed in research on adolescent reproductive health in India. One serious limitation is the lack of attention in almost every dimension of their reproductive health, including sexuality, reproductive morbidity, abortion-seeking and reproductive choice. What is needed is more behavioral research that explores the levels, patterns, and sociocultural factors underlying adolescents' reproductive health; assesses adolescent reproductive health needs and ways in which health and information services can be structured to respond to these needs in light of the social, cultural and economic constraints that adolescents face; and explores appropriate methodological alternatives, recognizing the need for community-based research, as well as the difficulties of conducting such research under the sociocultural constraints prevailing in India. At the same time, this review argues for far more attention within programs to address adolescent reproductive health service and information needs.

Abortion, Induced↗
PubMed1987

Effect of 188-day treatment with somatotropin on health and reproductive performance of lactating dairy cows.

Health and reproductive performance were observed in a lactational study involving 188 d of treatment with bovine somatotropin. Treatments commenced 84 +/- 10 d postpartum and consisted of 27 mg/d of pituitary somatotropin and 0, 13.5, 27, and 40.5 mg/d of recombinantly derived somatotropin (six cows per treatment group). Cows were high yielding (greater than 9600 kg/305 d), and somatotropin increased milk yield by 16 to 41% depending on source and dose. Somatotropin had no discernible effect on mammary health based on somatic cell count and incidence of clinical mastitis. Cows receiving somatotropin averaged 96% conception rate, 2.0 services per conception, and 116 d open, which were comparable to controls. No subclinical or clinical evidence of ketosis or milk fever was observed. Thirty-two blood chemistry and physical examination variables were examined at several intervals during the study and no adverse treatment effects of physiologic importance for any of the variables were observed. Somatotropin treatment had no discernible effect on gestation length or birth weight and growth rate (first 28 d) of calves. Milk yields for the first 60 d postpartum were compared for the period just prior to start of treatment and the lactation subsequent to treatment; no treatment effects were observed. Overall, our results for a well-managed herd demonstrate somatotropin treatment did not cause any serious health effects. However, examination of subtle health effects will require large numbers of animals treated under a range of environmental and management conditions.

Animals↗
PubMed2004

Client satisfaction with reproductive health-care quality: integrating business approaches to modeling and measurement.

Health-care managers are increasingly interested in client perceptions of clinic service quality and satisfaction. While tremendous progress has occurred, additional perspectives on the conceptualization, modeling and measurement of these constructs may further assist health-care managers seeking to provide high-quality care. To that end, this study draws on theories from business and health to develop an integrated model featuring antecedents to and consequences of reproductive health-care client satisfaction. In addition to developing a new model, this study contributes by testing how well Western-based theories of client satisfaction hold in a developing, Asian country. Applied to urban, reproductive health clinic users in Hanoi, Vietnam, test results suggest that hypothesized antecedents such as pre-visit expectations, perceived clinic performance and how much performance exceeds expectations impact client satisfaction. However, the relative importance of these predictors appears to vary depending on a client's level of service-related experience. Finally, higher levels of client satisfaction are positively related to future clinic use intentions. This study demonstrates the value of: (1) incorporating theoretical perspectives from multiple disciplines to model processes underlying health-care satisfaction and (2) field testing those models before implementation. It also furthers research designed to provide health-care managers with actionable measures of the complex processes related to their clients' satisfaction.

Female↗
PubMed2001

Tasting the forbidden fruit: the social context of debut sexual encounters among young persons in a rural Nigerian community.

What circumstances surround the initial sexual encounters of young persons? And what are their implications for adolescent sexual and reproductive health status? These questions, although rarely raised in reproductive health discourse, appear to be critical in broadening the systematic understanding of key issues that impose themselves on adolescent sexual and reproductive health. Against this background, the present study attempts to use the circumstances surrounding the debut sexual encounters of young persons in a rural Nigerian community as an entry point to understanding their vulnerability to sexual and reproductive health problems. Data for the study were gathered using in-depth interviews of 180 persons aged 11-25 years. Emerging evidence shows that first sexual encounter took place under conditions that exposed young people to infections, disability, and even death. The study recommends that there is need to build on the clear evidence that good sex and reproductive health education for young persons delay the onset of sexual activity and makes it safer when it eventually commences.

Adolescent↗
PubMed2006

Ethics of justice and ethics of care. Values and attitudes among midwifery students on adolescent sexuality and abortion in Vietnam and their implications for midwifery education: a survey by questionnaire and interview.

UNLABELLED: Adolescent's sexuality and related reproductive health and rights problems are sensitive issues in Vietnam. Globalisation has had an impact on the lifestyles of young people, and rising numbers of abortion and STI/HIV risks among youth are posing major health concerns in the country. These problems need to be addressed. Midwives belong to a key category of health personnel in Vietnam, whose task it is to promote adolescents' sexual and reproductive health and prevent reproductive ill health. It is important to understand future midwives' perceptions and attitudes in order to improve their education and training programmes. AIM: The aim of this study was to investigate Vietnamese midwifery students' values and attitudes towards adolescent sexuality, abortion and contraception and their views on professional preparation. METHODS: A quantitative survey including 235 midwifery students from four different secondary medical colleges in northern Vietnam was carried out in 2003. A qualitative study addressing similar questions was performed and 18 midwifery students were individually interviewed. FINDINGS: Findings revealed a general disapproval of adolescent pre-marital sexual relations and abortion-'an ethics of justice'-but also an empathic attitude and willingness to support young women, who bear the consequences of unwanted pregnancies and social condemnation-'an ethics of care'. Gender-based imbalance in sexual relationships, limited knowledge about reproductive health issues among youth, and negative societal attitudes were concerns expressed by the students. The students saw their future tasks mainly related to childbearing and less to other reproductive health issues, such as abortion and prevention of STI/HIV. CONCLUSION: Midwifery education in Vietnam should encourage value-reflective thinking around gender inequality and ethical dilemmas, in order to prepare midwives to address adolescents' reproductive health needs.

Abortion, Legal↗
PubMed2026

Expanding vaginal microbiome pangenomes via a custom MIDAS database reveals Lactobacillus crispatus accessory genes associated with cervical dysplasia.

The vaginal microbiome plays a central role in reproductive health. Vaginal microbiome dysbiosis is associated with many adverse reproductive health outcomes, but most studies have focused on associations at the species level. The potential contribution of intraspecies microbial variation, especially gene content differences across bacterial strains, remains underexplored in reproductive health contexts. The Metagenomic Intra-Species Diversity Analysis (MIDAS) framework enables such analyses, but depends on comprehensive reference databases. We constructed a MIDAS-compatible pangenome database from over 18,000 genomes in the Vaginal Microbiome Genome Collection (VMGC). Compared to the Genome Taxonomy Database (GTDB)-derived reference, the VMGC-derived database expanded the pangenomes of prevalent vaginal species, better capturing vaginal-specific intraspecies diversity. Applying this database to vaginal samples from a cervical dysplasia cohort, we identified 13 Lactobacillus crispatus accessory genes significantly associated with cervical dysplasia, including a HicAB toxin-antitoxin system, three transcriptional regulators, and three phage-derived genes. These findings highlight the utility of body site-specific reference resources and shotgun metagenomic sequencing for uncovering intraspecies microbial variation relevant to reproductive health.IMPORTANCEThe vaginal microbiome plays a critical role in reproductive health, and different bacteria from the same species can carry different genes that influence how the strains interact with the host and other microbes. These strain-level differences are often overlooked when microbiomes are analyzed only at the species level. Existing genomic reference databases are heavily biased toward gut and environmental bacteria, leaving the genetic diversity of vaginal microbes understudied. We built a specialized reference database from over 18,000 vaginal bacterial genomes that better reflects this diversity. We then applied this resource to quantify gene-level variation in vaginal samples from a cervical dysplasia cohort. Focusing on Lactobacillus crispatus, a prevalent and often beneficial vaginal species, we identified 13 genes that were more common in women with cervical dysplasia than in controls. This work demonstrates that body site-specific genomic resources are essential for uncovering strain-level bacterial differences relevant to reproductive health.

Lactobacillus crispatus↗