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PubMed2005

Is an interdisciplinary session on ethics and law in obstetrics and gynaecology effective?

OBJECTIVE: To evaluate the effects of an interdisciplinary session on medical ethics and legal issues related to obstetrics and gynaecology on medical students' knowledge, attitudes, and behaviours. METHODS: Second-year medical students at the University of Alberta were asked to complete surveys before and after an interdisciplinary panel session on ethics and legal issues in reproductive health. Survey questions were related to knowledge of ethics and law, attitudes toward controversial topics in reproductive health, and predicted behaviours in specific clinical scenarios. In the postsession survey, students were asked to evaluate the session's usefulness and impact. RESULTS: Fifty-seven students completed both the pre- and postsession surveys. Most students listed family, religion, culture, peer groups, scientific thought and theory, and school and education as influences on their own personal ethics and morality. Fifty-five students (97%) stated that the panel session was useful. Most students (79%) reported that the session increased their knowledge of ethical and legal issues in reproductive health. Many students felt that the panel session would change the way they practise in similar clinical situations (63%). The panel session appeared to affect knowledge and predicted behaviour. CONCLUSION: A large-group interdisciplinary panel session can influence medical students' knowledge and future behaviours related to ethics and law in obstetrics and gynaecology. Medical students gave this session a high rating.

Adult↗
PubMed1995

Workshop on perinatal exposure to dioxin-like compounds. II. Reproductive effects.

This summary report focuses on current studies on reproductive effects reported at the workshop on Perinatal Exposure to Dioxin-like Compounds and supporting data noted in the discussion. Recent laboratory studies have suggested that altered development (e.g., low birth weight, spontaneous abortion, congenital malformation) and reproductive health (e.g., fertility, sex organ development, reproductive behavior) may be among the most sensitive end points when examining the effects of dioxinlike compounds. Thus, future research should target the reproductive health of both males and females exposed postnatally and prenatally. Studies in humans are needed and are on-going. In animal models, postnatal exposure to dioxin or dioxinlike compounds has been associated with abnormal spermatogenesis and abnormal testicular morphology and size in males and with reduced fertility and endometriosis in females. In utero exposure may also produce profound reproductive consequences in both males and females including delays in sexual maturation, abnormalities in development of sexual organs, and abnormal sexual behavior. The mechanism by which dioxin-like compounds cause reproductive effects is not well delineated.

Animals↗
PubMed1999

Improving reproductive sexual health: a primary goal at the beginning of the new millennium.

At the beginning of the millennium, it is important that experts and official organizations direct their strategic plans towards the improvement of reproductive sexual health. Adolescents represent the major target of these plans in an effort to improve their sexual behavior. Sexually transmitted diseases must be reduced since their prevalence is very high in certain eastern European countries. These plans should be considered together with the development of new fertility control methods which provide at the same time bactericidal and antiviral properties. Education, provided especially through the media, should be considered a tool for the improvement of the present situation.

Adolescent↗
PubMed2001

Hormones and testis development and the possible adverse effects of environmental chemicals.

Development of a fetus into a phenotypic male depends, first, on testis formation and second, on hormone production by the fetal testis. Disorders of testicular hormone production or action can lead in severe cases to phenotypic abnormalities or can predispose towards impaired reproductive health. Evidence for deteriorating human male reproductive health, especially an increase in testicular cancer, points to disturbed (hormonal) development of the fetal testis. By comparison of testicular dysgenesis in humans and exposure to certain phthalates in fetal rats, the similarities in outcomes and testicular cell-cell disruption are highlighted as are the pathways via which oestrogenic and (especially) anti-androgenic environmental chemicals might act to induce such changes. The susceptibility of sperm production in adulthood to 'hormonal' disruption in fetal and neonatal life is also discussed. Though it is concluded that no direct evidence links human exposure to environmental chemicals and male reproductive disorders that stem from disturbed testis development, this is based mainly on lack of information. Using the example of phthalates, for which new data have emerged, it is argued that until the appropriate in vivo studies are undertaken, the safety of hormonally active environmental chemicals, especially in mixtures, will continue to give cause for concern as far as testicular development is concerned.

Animals↗
PubMed2006

Teachers' attitude is not an impediment to adolescent sexuality education in Enugu, Nigeria.

Studies have shown that adolescents in Nigeria have poor knowledge of reproductive health issues and that there was a need to provide them with correct broad-based information on reproductive health as part of a nationally-approved school curriculum. However, the non-application of the curriculum on sexuality education in many secondary schools in Nigeria has been blamed on a negative attitude of teachers. This study was undertaken to determine the attitude of secondary school teachers in Enugu, South-eastern Nigeria, to adolescent sexuality education and to determine whether this depends on their socio-demographic characteristics. A cross-sectional study of the attitude of teachers to adolescent sexuality education was done. A total of 249 teachers were studied. Their mean age was 38.7 years +/- 8.08 SD. Two hundred and ten teachers (84%) were females. Two hundred and twenty-four teachers (90%) were married and 168 (67.5%) were of Roman Catholic faith. The awareness of reproductive health activities was high. There was a high proportion of respondents who approved of sexuality education for adolescents (77.5%) and an equally high proportion who believed that it was important (89%). One hundred and ninety-eight (79%) of the respondents were willing to teach sexuality education. The attitude to sexuality education was independent of religion, sex or marital status (p>0.05). It was concluded that secondary school teachers in Enugu urban were willing to offer sexuality education to adolescents under their care irrespective of their religion, sex or marital status. It is, therefore, recommended that teachers in Enugu be given the necessary special training in the teaching of sexuality education now and that sexuality education be officially incorporated into the school curriculum in Enugu, preferably as part of moral studies.

Adolescent↗
PubMed2002

Survival, growth, health, and reproduction following nursery rearing compared with mother rearing in pigtailed monkeys (Macaca nemestrina).

Nursery-reared primates do not experience psychological "maternal bonding" or immunological benefits of breast milk, so they are expected to be inferior to mother-raised monkeys in growth, health, survival, reproduction, and maternal abilities. Studies of nursery-reared monkeys support aspects of this prediction for infants deprived of social contact or raised in pairs. We present colony record data on 1,187 mother and 506 nursery-raised monkeys, 2-10 yr of age, living in mixed groups. We found no group differences in survival, growth, clinical treatments for disease or bite wounds, or pregnancy outcome and neonatal deaths. Nursery males given breeding opportunities produced an average of 24 offspring. In addition to 24-hr personnel present on every day of the year, we believe that three of our procedures account for differences between our results and other reports. Our infants received 1) intensive human handling, 2) daily social interaction in a playroom, and 3) success and failure experience during learning and cognitive testing. We do not advocate rearing primates without mothers, but we conclude that these procedures are sufficient for producing physical health and adaptive juvenile and adult social skills in nursery-raised monkeys.

Animal Husbandry↗
PubMed2005

Contraception for college students.

An important issue for human beings is the acquisition of normal sexual health, including the understanding and application of reproductive health when needed. Comprehensive sexuality education is not a topic provided to many children, adolescents, or college students in the United States, however. Students who were sexually active in high school may continue to be at risk for unwanted pregnancies and sexually transmitted diseases in their college life; those who chose abstinence in high school may abandon this concept in college, choosing coital behavior at all levels of university life-freshman through graduate levels. Most American college students are sexually active and many have multiple partners. This article reviews current contraceptive methods available to college students. College health providers and pediatricians are urged to be vigilant about the reproductive health needs of the college students they serve.

Contraception↗
PubMed2001

Adolescents in China.

This paper reviews the nature and explores the context of, and reactions to, reproductive health education in China by both the target population of adolescents at school and the wider public. The debate about reproductive health education and its content is taking place within the context of rapid behavioural and sociological changes in China which, in turn is, generating conflicting demands concerning the need for education by the population and the control of the population by the government. Foucault's theories on sexuality and discipline are found to be useful in exploring the subject of reproductive health education in China.

Adolescent↗
PubMed1978

Occupational hazards to reproduction and health in anaesthetists and paediatricians.

A mail questionnaire was sent to Finnish anaesthetists and paediatricians to evaluate the risks of reproductive, teratogenic and health complications related to the professions. The incidence of diagnosed spontaneous miscarriages in anaesthetists' families was 10.2% of all pregnancies and it was 13.2% in paediatricians' families. Smoking seemed to increase markedly the incidence of spontaneous miscarriages, which was 22.9% in smoking female anaesthetists and 17.2% in smoking female paediatricians. The gestation times in cases of both full-term pregnancies and miscarriages were shorter in the anaesthetist group than those in the paediatrician group. Congenital abnormalities appeared at an equal rate in both anaesthetist and paediatrician groups, but strikingly, there were nine musculoskeletal abnormalities in the anaesthetists' children compared to no such defects in paediatricians' children. Serious diseases occurred at low frequencies, but three cases of hepatic jaundice and three cases of viral myocarditis in anaesthetists indicate possible infectious hazards to health in anaesthetic work. Different infectious diseases to the respiratory and urinary tracts were commonest among paediatricians. Cancer was not reported in the anaesthetist group. The study does not indicate that gas pollution in operating rooms is harmful to the personnel.

Abortion, Spontaneous↗
PubMed2006

Cesarean delivery on request: reproductive consequences.

OBJECTIVE: The objective of this review is to examine the long term reproductive health consequences of cesarean delivery on maternal request. FINDINGS: In the first delivery, cesarean delivery appears to hold small risk of reproductive complications compared to vaginal delivery. Primary cesarean delivery can affect subsequent pregnancies. The most serious reproductive health consequences of prior cesarean delivery occur in subsequent pregnancies. These complications include: unexplained fetal death apparent from 34 weeks gestation onward; abnormalities of placentation which increase with a greater number of cesarean deliveries; risk of uterine rupture and uterine scar dehiscence. CONCLUSIONS: Primary cesarean delivery carries risk for subsequent pregnancies. While the studies reviewed do not specifically refer to cesarean delivery on request, it is likely that the results would be similar. Overall, in considering the specific question of long term reproductive health, the risks of maternal request cesarean delivery outweigh the benefits.

Cesarean Section↗
PubMed1990

Health and reproductive performance of dairy cows treated for up to two consecutive lactations with bovine somatotropin.

Forty-three purebred Holstein cows were put on an rbST milk production trial. There were 15 control cows (saline-injected), 15 cows injected with 10.3 mg rbST/d and 13 cows injected with 20.6 mg rbST/d. Injections were initiated between wk 4 and 5 of lactation and continued for 266 consecutive days. Fourteen of the rbST-treated cows were treated with one of three dosages of rbST in the previous lactation (10.3, 20.6, or 41.2 rbST/d). The objective of this study was to determine the health and reproductive efficiency of cows treated with rbST for up to two consecutive lactations relative to control cows. The incidence of 11 health-related variables before, during, and after the 38-wk injection period were not different among treatment groups. Previous treatment with rbST had no effect on reproductive variables; however, there was evidence that injections with the highest dosage of rbST in the current lactation resulted in lowered reproductive efficiency. It is possible that the effects of rbST on early lactation energy and nitrogen balance have confounding effects on the estrous cycle.

Animals↗
PubMed2005

Contraceptive issues of youth and adolescents in developing countries: highlights from the Philippines and other Asian countries.

This article highlights contraceptive issues in Asia, home to some 700 million adolescents. It starts with a description of the socio-cultural milieu of adolescents in South and Southeast Asia, their knowledge and use of contraceptives, the myriad barriers to access, and the many innovative programs to broaden contraceptive availability. The reproductive health needs of adolescents in poor countries cannot be solved by merely supplying them with contraceptives--these needs can only be fully addressed in the context of gender equality, poverty alleviation and the conviction that investing in the reproductive health of adolescents is a most urgent priority. Investing in the reproductive health of adolescents will have an impact not only on birth and abortion rates, maternal health, and the spread of STI/HIV but also on the demographics and economic development of the region--and beyond.

Adolescent↗
PubMed1991

Reproductive hazards of fire fighting. I. Non-chemical hazards.

Fire fighters are regularly exposed to chemical and non-chemical agents that have known or suspected adverse effects on reproductive health. Although chemical agents have received some attention, non-chemical hazards such as heat, noise, and physical exertion have only recently been examined for their reproductive effects. There is evidence that heat, noise, and physical exertion may affect various endpoints of reproductive health, including fertility, fetal loss, and growth parameters of the offspring. In particular, hyperthermia, a major fire fighting hazard, has been shown to impair male fertility and may also be teratogenic. Further study of the potential reproductive effects of this and other common non-chemical agents in the fire environment is needed to ensure the reproductive health of male and female fire fighters.

Animals↗
PubMed2002

Impact of exposure to endocrine disrupters in utero and in childhood on adult reproduction.

Recent reports have demonstrated a decline in human male reproductive health: high and probably increasing prevalence of cryptorchidism and hypospadias, low and probably decreasing semen quality, a rising incidence of testicular cancer and a growing demand for assisted reproduction. These changes seem to be interrelated and may be symptoms of a common underlying entity, the testicular dysgenesis syndrome, with foundations in fetal life due to adverse environmental influences. Wildlife experience and animal studies have provided evidence that fetal or perinatal exposure to endocrine disrupters results in disturbed sexual differentiation and urogenital malformations followed by decreased reproductive health in adult life. This chapter reviews existing evidence for a connection between (i) exposure to endocrine disrupters in fetal life and childhood and (ii) adult reproductive health in humans. This topic is not only relevant to basic scientists but also to clinical endocrinologists, who should also be encouraged to participate in research concerning this problem.

Adult↗
PubMed2006

Utility of urinary 1-naphthol and 2-naphthol levels to assess environmental carbaryl and naphthalene exposure in an epidemiology study.

We recently reported associations between urinary 1-naphthol (1N) levels and several intermediate measures of male reproductive health, namely sperm motility, serum testosterone levels, and sperm DNA damage. However, because 1N is a major urinary metabolite of both naphthalene and the insecticide carbaryl, exposure misclassification stemming from differences in exposure source was probable and interpretation of the results was limited. As naphthalene, but not carbaryl, is also metabolized to 2-naphthol (2N), the relationship of urinary 1N to 2N within an individual may give information about source of 1N. Utilizing data from two previous studies that measured both 1N and 2N in urine of men exposed to either carbaryl or naphthalene, the present study employed several methods to differentiate urinary 1N arising from exposures to carbaryl and naphthalene among men in the reproductive health study. When re-evaluating the reproductive health data, techniques for identifying 1N source involved exploring interaction terms, stratifying the data set based on 1N/2N ratios, and performing an exposure calibration using a linear 1N to 2N relationship from a study of workers exposed to naphthalene in jet fuel. Despite some inconsistencies between the methods used to distinguish 1N source, we found that 1N from carbaryl exposure is likely responsible for the previously observed association between 1N and sperm motility, whereas 1N from naphthalene exposure is likely accountable for the association between 1N and sperm DNA damage. We demonstrate that studies of health effects associated with carbaryl should utilize a 1N/2N ratio to identify subgroups in which carbaryl is the primary source of 1N. Conversely, studies of naphthalene-related outcomes may utilize 2N levels to estimate exposure.

Adult↗
PubMed1997

Tanzania marks 10 years of progress in safe motherhood.

The 19th anniversary of the Safe Motherhood Initiative was marked in Tanzania this year. In addition to special celebrations, the anniversary was also marked by the launching of a campaign to eliminate female genital mutilation. The celebrations, which lasted several weeks, were inaugurated by a statement from the Minister of Health, Dr. Aaron Chiduo. The events included the showing of video films on sexual and reproductive health in 7 primary and 8 secondary schools, as well as public showings. Traditional birth attendants and nurse-midwives in one district were shown the safe motherhood film "Why did Mrs. X die?" Panel discussions on safe motherhood were broadcast on the radio in both English and Swahili. Posters and leaflets were distributed on various aspects of reproductive health. A press conference with representatives of the Tanzanian Ministry of Women's Affairs and Ministry of Health, together with representatives of WHO and UNICEF, focused on safe motherhood and female genital mutilation. The meeting attracted 100 journalists. The celebrations ended with a day of traditional dances and songs to mark the 10th anniversary of safe motherhood. A statement from the Minister of Health stressed that female genital mutilation "has no religious or scientific value" and needs to be stopped. The practice has been officially banned in Tanzania since the 1970s but is still prevalent in certain regions of the country.

Africa↗