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Interest holder-driven research priorities in sexual and reproductive health for migrant and refugee adolescents and young adults in Australia.

OBJECTIVE: To identify and prioritise sexual and reproductive health research priorities for migrant and refugee adolescents and young adults in Australia using a priority setting partnership approach. METHODS: A James Lind Alliance priority setting partnership was conducted with 92 interest holders: 31 youth from migrant and refugee backgrounds and 61 professionals (healthcare providers, researchers, policymakers and community leaders), recruited online and in-person. The priority setting partnership process included a rapid evidence scan, an online uncertainty survey, evidence verification, interim prioritisation and a final consensus workshop. RESULTS: Eighty-three research uncertainties yielded 11 final priorities across four sexual and reproductive health domains: sexual and reproductive health literacy, sexual violence prevention, accessible services and maternal health. A striking divergence emerged between youth and professional priorities only 3 achieved combined high-priority consensus. Youth prioritised a broader range of topics, including abortion access (rated high by youth but low by professionals), while professionals prioritised fewer areas. Two priorities achieved consensus: community-based maternal health support and barriers to reporting gender-based violence. CONCLUSION: This is the first priority setting partnership to identify sexual and reproductive health research priorities for migrant and refugee youth in Australia and to uniquely highlight substantial misalignment between youth and professional priorities. IMPLICATIONS FOR PUBLIC HEALTH: These identified priorities provide a foundation for targeted research, culturally responsive policy and more equitable sexual and reproductive health service provision for migrant and refugee adolescents and young adults.

Australia

Exploring Primary Care Clinicians' Sexual and Reproductive Health Care Delivery to Male Adolescents and Young Adults.

INTRODUCTION: Despite existing guidance for adolescent sexual and reproductive health (SRH) care, male adolescent SRH care receipt is inadequate. Limited research has explored factors affecting clinicians' provision of SRH care to male adolescents, specifically. METHODS: This mixed-method study with 12 primary care clinicians included a brief survey assessing care delivery practices and confidence, followed by an in-depth interview to explore factors affecting SRH care delivery. RESULTS: Clinicians reported high confidence delivering male adolescent SRH care (mean ± SD: 8.31 ± 1.71 out of 10), but delivered only about half the recommended services (20 items out of 38). Factors influencing care delivery included gaps in education/training, assumptions about male SRH care, and behavioral constraints at various levels. DISCUSSION: Findings underscore the need to strengthen male adolescent SRH care by enhancing provider training, increasing clinic-level supports, and addressing structural barriers. CONCLUSIONS: Findings can inform strategies to improve the quality and comprehensiveness of SRH services for male adolescents in primary care settings.

Humans

Reproductive health: a global overview.

A global overview of reproductive health outlines major challenges for action. Worldwide, 60 million to 80 million couples suffer from infertility. At the same time, there is a striking unmet need for contraception in developing countries. Unsafe abortion practices result in between 115,000 and 204,000 deaths each year. Female genital mutilation in one form or another continues to exist in around 40 countries. A second generation of organisms has now made sexually transmitted diseases the most common group of notifiable diseases in most countries. For the year 2000, it is projected that there will be a cumulative total of about 40 million HIV infections in men, women and children. About half a million women die each year because of complications related to pregnancy and childbirth. A total of about 15 million infants and children die annually, mostly from preventable childhood diseases. At least 17% of all babies in developing countries are born with a low birth weight.

Acquired Immunodeficiency Syndrome

Sentinel surveillance of human immunodeficiency virus infection in women seeking reproductive health services in the United States, 1988-1989. The Field Services Branch.

Cases of AIDS among women of reproductive age have increased dramatically since 1981; nearly a third of all cases among females were reported in 1990 alone. Surveillance of human immunodeficiency virus (HIV) infection among women is essential for monitoring the spread of HIV over time and identifying specific populations and geographic areas in need of HIV counseling, testing, and prevention services. Blinded (unlinked) serologic surveys were conducted in the United States and Puerto Rico in sentinel clinics providing reproductive health services to women, including family planning, prenatal care, and abortion services. Seventy-eight of 94 clinics (83%) in 30 cities conducting surveys during 1988 and 1989 detected at least one HIV-positive woman. Clinic-specific prevalence ranged from 0-2.28% (median 0.22%), with rates over 1% occurring in clinics predominantly on the East Coast and in Puerto Rico. Seroprevalence varied by primary type of service, race-ethnicity, and age group. Median rates were higher in clinics offering prenatal services and lower in abortion and family planning clinics in the same cities. In general, women 25-29 years of age showed the highest median rate of infection (0.32%), and rates were higher among black women (median 0.34%) than among Hispanic (median 0.11%) and white women (median 0%). Our data indicate the need to educate women about recognizing and reducing their risk of HIV infection. Reproductive health clinics with high seroprevalence should implement voluntary HIV counseling and testing with appropriate follow-up clinical evaluation and referral for infected women. Clinics with low prevalence should seize the opportunity to enhance HIV education and prevention efforts.

Abortion, Legal

Adolescent reproductive health: roles for school personnel in prevention and early intervention.

The practical roles school staff can play in addressing adolescent reproductive health issues such as teen-age pregnancy, STDs, and HIV/AIDS are reviewed. Particular attention is given to identification and assessment of adolescents most at risk for pregnancy, STDs, and HIV/AIDS, and the regulations that address protection of students' privacy in this area.

Acquired Immunodeficiency Syndrome

Reproductive health issues. Workplace perspectives.

In light of heightened employee awareness and the broad scope of reproductive health issues in the workplace, occupational health professionals may be called on more than ever before to answer questions, make policies, and provide authoritative counseling. Occupational health nurses must evaluate sources of information and critically examine published research about both occupational and non-occupational concerns to provide accurate information. Occupational health nurses are in a position to provide reproductive counseling, and are ideally suited to coordinate counseling activities through the occupational health service with other members of the team--physicians, industrial hygienists, and human resources personnel.

Counseling

Toward an ecology of women's reproductive health.

Medical ecology has been one of the dominant theoretical strands in medical anthropology since the 1960s. It has come to be identified with a rather narrow range of research issues, concerning such matters as adaptation to climate and infectious disease, and has dealt with small-scale foraging societies. An ecological model has potential for dealing broadly with other health issues, in the case explored here, women's reproductive health, a topic that has frequently been approached from either a cultural or biological standpoint rather than the integrated one advocated here.

Anthropology

Building families-Implementing balanced sexual and reproductive health: A Joint IFFS and ISA Scientific Statement.

One of the main initiatives of the World Health Organization (WHO) is the promotion of Sexual and Reproductive Health (SRH). Sexuality, infertility, and contraception are three interconnected pillars of SRH, each essential for achieving global equity in family planning and family building. This scientific Statement, jointly developed by the International Federation of Fertility Societies (IFFS) and the International Society of Andrology (ISA), advocates for inclusive, evidence-based care for all individuals and couples, regardless of geography or socioeconomic status. The Statement underscores the need to enhance practitioner and policymaker education to support access to infertility evaluations and treatments for both men and women and to promote the availability of comprehensive contraceptive services for all in need. The Statement addresses three core domains: sexuality, infertility, and contraception. It emphasizes a biopsychosocial approach to SRH, highlighting the complex interplay between sexual function and fertility. Infertility is a multifactorial condition requiring early, holistic, and multidisciplinary management, including integrated male and female evaluations, medically assisted reproduction, and fertility preservation strategies. Contraception is explored through the lens of global unmet needs, expanding options for male contraceptives, and the importance of socio-culturally sensitive education and counseling. The joint efforts of the IFFS and ISA call for couple-centered SRH, acknowledging the sociocultural and policy challenges that affect access to care in a region-specific manner. This Statement aims to serve as a clinical and advocacy guide for practitioners and stakeholders, reinforcing that reproductive autonomy and access to care are vital components and duties for policymakers when developing public health strategies.

contraception

Building Families-Implementing Balanced Sexual and Reproductive Health: A Joint IFFS and ISA Scientific Statement.

One of the main initiatives of the World Health Organization (WHO) is the promotion of Sexual and Reproductive Health (SRH). Sexuality, infertility, and contraception are three interconnected pillars of SRH, each essential for achieving global equity in family planning and family building. This scientific Statement, jointly developed by the International Federation of Fertility Societies (IFFS) and the International Society of Andrology (ISA), advocates for inclusive, evidence-based care for all individuals and couples, regardless of geography or socioeconomic status. The Statement underscores the need to enhance practitioner and policymaker education to support access to infertility evaluations and treatments for both men and women and to promote the availability of comprehensive contraceptive services for all in need. The Statement addresses three core domains: sexuality, infertility, and contraception. It emphasizes a biopsychosocial approach to SRH, highlighting the complex interplay between sexual function and fertility. Infertility is a multifactorial condition requiring early, holistic, and multidisciplinary management, including integrated male and female evaluations, medically assisted reproduction, and fertility preservation strategies. Contraception is explored through the lens of global unmet needs, expanding options for male contraceptives, and the importance of socio-culturally sensitive education and counseling. The joint efforts of the IFFS and ISA call for couple-centered SRH, acknowledging the sociocultural and policy challenges that affect access to care in a region-specific manner. This Statement aims to serve as a clinical and advocacy guide for practitioners and stakeholders, reinforcing that reproductive autonomy and access to care are vital components and duties for policymakers when developing public health strategies.

contraception

A reallocation of rights in industries with reproductive health hazards.

The U.S. Supreme Court ruling in United Automobile Workers versus Johnson Controls prohibits hiring policies that exclude fertile women from industries posing reproductive health risks to workers and fetuses. Many toxic substances that threaten the developing fetus also pose risks to adult male and female workers. Exclusionary employment policies are socially undesirable for the following reasons: they may lead to worse reproductive outcomes if the indirect effects of lower wages and less adequate health insurance in the alternative available jobs are considered. Second, the effect of such policies could damage the individual woman's overall well-being through its economic impact and her potential loss in autonomy. Third, occupational segregation into less hazardous but lower-paying jobs reinforces gender stereotypes that are restrictive to women. The Supreme Court ruling in the Johnson Controls case reaffirms the importance of the Civil Rights Act as both a shield against unfair treatment for individual women and a commitment to eradicate sexist attitudes and economic inequality throughout society.

Employment

Effects of silage diets on health, reproduction, and blood metabolites of dairy cattle.

Forty-eight Hostein dairy cows were assigned uniformly by parity and calving date to three forage treatments for three lactations. Forage treatments were corn silage (F-I), corn silage plus Hay-crop silage (-f-II), and corn silage plus hay (F-III). Records of health and reproductive data were kept to evaluate dietary effects. During the third lactation six animals in each treatment were blood-sampled on a 4-day interval from 24 days prepartum to 60 days postpartum to determine metabolites. Reproductive traits were similar among the treatment groups as were occurrences of mastitis. Corn silage and hay-crop silage cows had more ketosis than hay cows. Corn silage cows had more parturient paresis than the other two groups, and abomasal displacement occurred only in the corn silage group. There were differences in concentrations of plasma metabolites among treatments; however, they appeared to be within normal ranges, and no pathological implications were obvious. Blood pH, blood packed cell volume, blood alkaline reserve, and pH values were similar among treatment groups. Histological evaluation of hepatic and endocrine tissues revealed no treatment effects.

Abomasum

The obstetrician-gynecologist and reproductive health. Presidential address.

The sources of nutrition and energy on this planet are limited and already in short supply. Improvement in the health and welfare of individuals and of nations will not be possible unless man promptly and effectively decreases the numbers of children being born to numbers that can be adequately fed and provided a chance of individual development. Currently available knowledge and methodologies do provide effective means of limiting human reproduction to the number of children for whom a family unit can adequately care. Gynecologists and obstetricians might well assume a more significant role in helping to limit the numbers of children being born so that populations can be adequately fed and more individuals will have opportunity to realize health and a hope of individual achievement. Man's current needs, as well as the gynecologist-obstetrician's capabilities, suggest designation of "reproductive health" as a specialty within gynecology and obstetrics, because the management of fertility should be recognized as a major responsibility of the gynecologist and obstetrician.

Adult

[Reproductive health survey of young adults in greater Santiago].

In 1988 a survey was carried out in order to obtain information on knowledge about reproduction, sexual activity, attitudes, and use of contraceptive methods among residents between 15 and 24 years of age in Greater Santiago. For this purpose, a multistage, self-weighted, non-replacement probability sample was chosen from the entire Santiago urban area. After 2,898 households were visited, 865 women and 800 men were selected and interviewed. For the interview, a questionnaire with 156 questions was developed; many questions were similar to those included in similar surveys in Brazil and Guatemala. The interviewers were professionals who had received prior training. Although 75% of the interviewees had attended sex education classes, they had erroneous ideas on various basic subjects. Sixty-nine percent of the women interviewed had undergone menarche before attending these classes. In addition, 35.4% of the women and 65.0% of the men had had sexual relations prior to marriage, and less than 20% had used any contraceptive method. More than 60% of the interviewees who had children had conceived them before marrying. These findings point up the necessity of offering sex education classes for children and young people, as well as facilitating their access to family planning services, in order to decrease the number of illegitimate and unwanted children that are born in Chile.

Acquired Immunodeficiency Syndrome