WorldWideScience

Sample records for pregnancy prevention efforts

  1. Down With Teen Pregnancy, Up With Mobility: Teen Pregnancy Prevention Efforts in Gaston County, North Carolina.

    Science.gov (United States)

    Dobbins, Christopher C; Kenney, Brittain N; Meier, Carrie E; Taormina, Velma V

    Unintended pregnancies are typically associated with poor health outcomes for mothers and babies, and they also limit the social mobility of women and their families. Gaston County has achieved great success in reducing both teen pregnancies and unintended pregnancies among low-income women through the Gaston Youth Connected project and the local health department's push to increase accessibility to long-acting reversible contraception. Reductions in the racial disparities in teen pregnancy rates, higher graduation rates for females, and fewer pregnancies among low-income women all indicate a potential for better reproductive health to increase the social mobility of Gaston County women. The ability to clearly connect health outcomes to long-term social improvements helps create sustainable community buy-in and should be a priority in public health initiatives.

  2. Strategies to Build Readiness in Community Mobilization Efforts for Implementation in a Multi-Year Teen Pregnancy Prevention Initiative.

    Science.gov (United States)

    Bhuiya, Nazmim; House, L Duane; Desmarais, Jeffrey; Fletcher, Erica; Conlin, Maeve; Perez-McAdoo, Sarah; Waggett, Jessica; Tendulkar, Shalini A

    2017-03-01

    This paper describes an assessment of community readiness to implement a community-wide teen pregnancy prevention initiative, Youth First, and presents strategies used to enhance this readiness as informed by the assessment. Twenty-five community stakeholder interviews were conducted to assess four domains of readiness: (1) attitudes, perception, and knowledge of teen pregnancy; (2) perceived level of readiness; (3) resources, existing and current efforts; and (4) leadership. Interview transcripts were coded and analyzed to identify key themes. Stakeholders acknowledged teen pregnancy as an issue but lacked contextual information. They also perceived the community as ready to address the issue and recognized some organizations already championing efforts. However, many key players were not involved, and ongoing data collection to assess teen pregnancy and prevention efforts was limited. Though many stakeholders were ready to engage in teen pregnancy prevention efforts, they required additional information and training to appropriately address the issue. In response to the assessment findings, several strategies were applied to address readiness and build Youth First partners' capacity to implement the community-wide initiative. Thus, to successfully implement community-wide prevention efforts, it is valuable to assess the level of community readiness to address health issues. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  3. Approaches to adolescent pregnancy prevention.

    Science.gov (United States)

    Haffner, D; Casey, S

    1986-09-01

    The US has one of the highest teenage pregnancy rates in the industrialized world, over 1,000,000 a year. This can add to social problems including poverty, unemployment, family breakup, juvenile crime, school dropouts, and child abuse. In several studies various approaches have been developed and it is concluded that teens must not only be given the knowledge to avoid teen pregnancies, but the motivation to do so. Sex education is an important part of pregnancy prevention, but few programs go beyond the facts of reproduction and less than 14% of them are 40 hours long. Studies have shown mixed results as to the effect of education on teen pregnancy. There are many programs that have been developed by different communities, including computer programs and youth service agencies. Religious groups also play an important part in sex education and they have some distinct advantages in affecting teens' sexual values and activities. Education programs for teen's parents appear to be very important since studies show when sexuality is discussed at home, the teens begin activity later and use birth control more. Clinics have had difficulty recruiting and retaining teen patients and devote special attention to establishing a rapport with them. The school-based clinic is becoming increasingly popular and can provide birth control counseling, contraceptives, family planning clinic referral, examinations, pregnancy testing, and prenatal care. There success is due to confidentiality, convenience, and comprehensive service. However, since nearly all efforts on teen pregnancy prevention are directed at girls, 1/2 of those involved in teen pregnancies--males--are not participating in programs. This must change for longterm success of these programs and also the involvement of the community and media.

  4. Social Determinants and Teen Pregnancy Prevention.

    Science.gov (United States)

    Fuller, Taleria R; White, Carla P; Chu, Jocelyn; Dean, Deborah; Clemmons, Naomi; Chaparro, Carmen; Thames, Jessica L; Henderson, Anitra Belle; King, Pebbles

    2016-12-01

    Addressing the social determinants of health (SDOH) that influence teen pregnancy is paramount to eliminating disparities and achieving health equity. Expanding prevention efforts from purely individual behavior change to improving the social, political, economic, and built environments in which people live, learn, work, and play may better equip vulnerable youth to adopt and sustain healthy decisions. In 2010, the Centers for Disease Control and Prevention in partnership with the Office of Adolescent Health funded state- and community-based organizations to develop and implement the Teen Pregnancy Prevention Community-Wide Initiative. This effort approached teen pregnancy from an SDOH perspective, by identifying contextual factors that influence teen pregnancy and other adverse sexual health outcomes among vulnerable youth. Strategies included, but were not limited to, conducting a root cause analysis and establishing nontraditional partnerships to address determinants identified by community members. This article describes the value of an SDOH approach for achieving health equity, explains the integration of such an approach into community-level teen pregnancy prevention activities, and highlights two project partners' efforts to establish and nurture nontraditional partnerships to address specific SDOH.

  5. Net benefits of wildfire prevention education efforts

    Science.gov (United States)

    Jeffrey P. Prestemon; David T. Butry; Karen L. Abt; Ronda. Sutphen

    2010-01-01

    Wildfire prevention education efforts involve a variety of methods, including airing public service announcements, distributing brochures, and making presentations, which are intended to reduce the occurrence of certain kinds of wildfires. A Poisson model of preventable Florida wildfires from 2002 to 2007 by fire management region was developed. Controlling for...

  6. Prevention of Infection in Pregnancy

    Directory of Open Access Journals (Sweden)

    William J. Ledger

    1997-01-01

    Full Text Available We believe the prevention of infection-related adverse pregnancy outcome is the most important focus for obstetricians today. An emphasis upon immunization of susceptible women, prevention of transmissible disease by modification of patient behavior, and identification and treatment of silent infections should become standards of practice. This will require educational initiatives for physicians and their patients as well as continued clinical trials to determine costs and effectiveness.

  7. Primary prevention of adolescent pregnancy.

    Science.gov (United States)

    Schinke, S P; Blythe, B J; Gilchrist, L D; Burt, G A

    1981-01-01

    Teenage pregnancy is associated with many health, emotional and socioeconomic problems including higher rates of anemia, labor complications, mortality, legal and social struggles and hhigher divorce rates. Professional social workers need strategies to help teenagers avoid early, unwanted pregnancy. This paper offers promising experential and research backing for a primary prevention group work strategy for all adolescents. Social and health programs overlook educational, cognitive anc interpersonal factors biasing youths' ability to comprehend and regulate contraception. Primary prevention to assist adolescents in thinking analytically about their sexual behavior must stress problem solving and decision-making as well as facts about human reproduction and birth control. To implement decisions, youths also need interpersonal communication skills. Small groups are ideal for delivering cognitive-behavioral primary prevention. This approach is based on the premise that youths become pregnant not because of a lack of relevant information, but because they lack cognitive and behavioral skills necessary to use information. Group work involving role-playing helps develop communication skills. Results from 2 field studies describe short-term and longitudinal benefits of the prevention strategy. Professionals can reach significant numbers of youth in this way. By treating sexual issues and the risk of pregnancy as normal in adolescence, social workers can introduce information and pertinent skills to all teenagers. No one is singled out as deviant and the group format enables young people to discuss taboo topics, discovering what the norms are and gradually learning how to deal with peers, family members, techers and others. Adolescents in primary prevention groups gained knowledge, cognitive skills and communication acumen. Improved attitudes toward family planning, increased regular contraception and less unsafe sex resulted from this cognitive-behavioral approach

  8. Preventing Illegitimate Teenage Pregnancy Through Systems Interaction

    Science.gov (United States)

    Jarvis, D. L.

    1971-01-01

    Social workers, Cooperating with doctors, nurses, hospital social workers and educators in other helping systems, conducted a demonstration project described here, aimed at preventing illegitimate teenage pregnancy. (Author)

  9. Preventing Illegitimate Teenage Pregnancy Through Systems Interaction

    Science.gov (United States)

    Jarvis, D. L.

    1971-01-01

    Social workers, Cooperating with doctors, nurses, hospital social workers and educators in other helping systems, conducted a demonstration project described here, aimed at preventing illegitimate teenage pregnancy. (Author)

  10. Preventing urinary incontinence during pregnancy and postpartum

    DEFF Research Database (Denmark)

    Wesnes, Stian Langeland; Lose, Gunnar

    2013-01-01

    : women should be advised not to smoke before or during pregnancy (grade B), aim at normal weight before pregnancy (grade B), and aim at regaining prepregnancy weight postpartum (grade B). Occasional low-intensity training should be advocated (grade B), and constipation should be avoided during pregnancy......Urinary incontinence (UI) is a common condition in association with pregnancy. Incident UI in pregnancy or postpartum are significant risk factors for UI later in life. Epidemiological studies on UI during pregnancy and postpartum list numerous variables associated with UI. For women, the main...... (grade B) and postpartum (grade C). Women should be advised to perform pelvic floor muscle training during pregnancy and postpartum (grade A) and to use perineal warm packs during delivery (grade B). Cesarean section to prevent UI cannot be recommended (grade D). If lifestyle recommendations...

  11. Sustaining Teen Pregnancy Prevention Programs in Schools: Needs and Barriers Identified by School Leaders

    Science.gov (United States)

    Craft, Lesley R.; Brandt, Heather M.; Prince, Mary

    2016-01-01

    Background: To reduce teen pregnancy rates, prevention programs must be consistently available to large numbers of youth. However, prevention efforts have been historically conducted with little emphasis on ensuring program sustainability. This study examined the needs and barriers to sustaining teen pregnancy prevention (TPP) programming in…

  12. Ten Tips to Prevent Infections During Pregnancy

    Centers for Disease Control (CDC) Podcasts

    2007-12-14

    This podcast gives 10 tips for preventing infections during pregnancy.  Created: 12/14/2007 by National Center for Birth Defects and Developmental Disabilities (NCBDDD).   Date Released: 1/10/2008.

  13. Battling Obesity : efforts in preventing knee osteoarthritis

    OpenAIRE

    Vos, Bastiaan

    2017-01-01

    markdownabstractThis thesis describes the results of the first preventive randomized controlled trial worldwide in the field of knee osteoarthritis. The preventive effectiveness of a tailor-made lifestyle intervention, consisting of diet and exercise, is described in detail. Short-term results are briefly discussed, but the focus is on long-term results and the achieved behavioural changes in lifestyle. Additionally, the preventive effect of oral glucosamine sulfate on incident knee osteoarth...

  14. Battling Obesity : efforts in preventing knee osteoarthritis

    NARCIS (Netherlands)

    B.C. de Vos (Bastiaan)

    2017-01-01

    markdownabstractThis thesis describes the results of the first preventive randomized controlled trial worldwide in the field of knee osteoarthritis. The preventive effectiveness of a tailor-made lifestyle intervention, consisting of diet and exercise, is described in detail. Short-term results are

  15. AIDSCAP initiative expands prevention efforts for women.

    Science.gov (United States)

    1995-01-01

    By 2000, women will likely comprise 50% of HIV-infected persons worldwide. Women, regardless of number of sexual partners, are especially vulnerable to HIV. One act of intercourse puts women at an 18 times greater risk than men of acquiring HIV. Traditional gender roles denying women the power to protect their own health exacerbate their biological susceptibility to HIV infection. AIDSCAP's Women's Initiative (AWI) aims to secure culturally and gender-sensitive AIDSCAP interventions and strategies and to advance AIDSCAP's leadership role in developing HIV/AIDS prevention models for women. More than 50% of AIDSCAP current projects target women. AWI integrates a broader gender perspective into AIDSCAP's project design, technical assistance, evaluation and monitoring, and policy projects. It has expanded target women's groups beyond the groups traditionally considered at high risk. To date, various AIDSCAP projects have trained and educated about one million women. The Christian Reformed World Relief Committee (CRWRC) is involved in HIV/AIDS prevention activities. Its AIDS and Sexually Transmitted Disease (STD) Health Promotion Prevention Program with Market Women in Senegal targets self-employed market women and urban female youth in Dakar, Kaoloack, and Thies. CRWRC worked with two women's groups to develop a sexual health promotion package with HIV/AIDS and STD IEC (information, education, and communication) materials and has trained 20 facilitators to use the promotion package. It helps the two collaborating groups to develop their organization capacities so they can implement and evaluate sustainable HIV/STD prevention programs. AIDSCAP also supports training of Kenyan family planning provider activities in HIV prevention of the JSI Family Planning Sector Project. It collaborates with the Center of Women Workers in Haiti to provide women factory workers IEC and condoms to promote risk reduction behavior. AWI also conducts research and policy activities (e

  16. Legal liability for failure to prevent pregnancy (wrongful pregnancy

    Directory of Open Access Journals (Sweden)

    Lodewicus Charl Coetzee

    2017-05-01

    Full Text Available Can the conception of a child ever constitute damage recoverable in law? This article considers the liability of healthcare practitioners for failing to prevent a pregnancy. Developments leading to the recognition of wrongful pregnancy as a cause of (legal action in South Africa (SA, are briefly outlined. The salient points of the relevant judgments by SA courts are set out to expose the rationale underlying the judgments and to highlight that recognition of liability for wrongful pregnancy resulted from an application of fair and equitable principles of general application. Conduct that could expose practitioners to liability is identified from reported cases and inferred from general principles laid down in case law.

  17. Adoption of an Evidence-Based Teen Pregnancy Prevention Curriculum: A Case Study in a South Carolina School District

    Science.gov (United States)

    Workman, Lauren M.; Flynn, Shannon; Kenison, Kelli; Prince, Mary

    2015-01-01

    Continued efforts are needed to reduce teenage pregnancy in the United States. Implementation of evidence-based curricula in schools is one strategy toward meeting this goal. In 2010, the South Carolina Campaign to Prevent Teen Pregnancy (SC Campaign) received funding to implement a teen pregnancy prevention (TPP) curriculum. Congruent with South…

  18. Adoption of an Evidence-Based Teen Pregnancy Prevention Curriculum: A Case Study in a South Carolina School District

    Science.gov (United States)

    Workman, Lauren M.; Flynn, Shannon; Kenison, Kelli; Prince, Mary

    2015-01-01

    Continued efforts are needed to reduce teenage pregnancy in the United States. Implementation of evidence-based curricula in schools is one strategy toward meeting this goal. In 2010, the South Carolina Campaign to Prevent Teen Pregnancy (SC Campaign) received funding to implement a teen pregnancy prevention (TPP) curriculum. Congruent with South…

  19. Prevention of preterm delivery in twin pregnancy.

    Science.gov (United States)

    Rode, Line; Tabor, Ann

    2014-02-01

    The incidence of twin gestation has increased markedly over the past decades, mostly because of increased use of assisted reproductive technologies. Twin pregnancies are at increased risk of preterm delivery (i.e. birth before 37 weeks of gestation). Multiple gestations therefore account for 2-3% of all pregnancies but constitute at least 10% of cases of preterm delivery. Complications from preterm birth are not limited to the neonatal period, such as in retinopathy of prematurity, intraventricular haemorrhage, necrotising enterocolitis, respiratory disorder and sepsis; they can also constitute sequelae such as abnormal neurophysiological development in early childhood and underachievement in school. Several treatment modalities have been proposed in singleton high-risk pregnancies. The mechanism of initiating labour may, however, be different in singleton and twin gestations. Therefore, it is mandatory to evaluate the proposed treatments in randomised trials of multiple gestations. In this chapter, we describe the results of trials to prevent preterm delivery in twin pregnancies.

  20. Preventing Pregnancy in Younger Teens PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2014-04-08

    This 60 second public service announcement is based on the April 2014 CDC Vital Signs report. Births to teens are declining, still, more than 305,000 teens ages 15 to 19 gave birth. This program discusses what health care providers, parents, and teens can do to help prevent teen pregnancy.  Created: 4/8/2014 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/8/2014.

  1. The prevention of teenage pregnancy in adolescent's view

    National Research Council Canada - National Science Library

    Fiedler, Milla Wildemberg; Araújo, Alisson; Souza, Márcia Christina Caetano de

    2015-01-01

    ...: perception about the importance of preventing teenage pregnancy, knowledge about the use of contraception methods, use of contraceptives methods, barriers to access to health services for the prevention of pregnancy...

  2. Preventing Teen Pregnancy PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2015-04-07

    This 60 second public service announcement is based on the April 2015 CDC Vital Signs report. Teen births in the U.S. have declined, but still, more than 273,000 infants were born to teens ages 15 to 19 in 2013. Learn about the most effective types of birth control.  Created: 4/7/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/7/2015.

  3. Preventing Alcohol-Exposed Pregnancy among American-Indian Youth

    Science.gov (United States)

    Jensen, Jamie; Kenyon, DenYelle Baete; Hanson, Jessica D.

    2016-01-01

    Research has determined that the prevention of alcohol-exposed pregnancies (AEP) must occur preconceptually, either by reducing alcohol intake in women planning pregnancy or at risk for becoming pregnant, or by preventing pregnancy in women drinking at risky levels. One such AEP prevention programme with non-pregnant American-Indian (AI) women is…

  4. Prevention of preterm delivery in twin pregnancy

    DEFF Research Database (Denmark)

    Rode, Line; Tabor, Ann

    2014-01-01

    The incidence of twin gestation has increased markedly over the past decades, mostly because of increased use of assisted reproductive technologies. Twin pregnancies are at increased risk of preterm delivery (i.e. birth before 37 weeks of gestation). Multiple gestations therefore account for 2......-3% of all pregnancies but constitute at least 10% of cases of preterm delivery. Complications from preterm birth are not limited to the neonatal period, such as in retinopathy of prematurity, intraventricular haemorrhage, necrotising enterocolitis, respiratory disorder and sepsis; they can also constitute......, it is mandatory to evaluate the proposed treatments in randomised trials of multiple gestations. In this chapter, we describe the results of trials to prevent preterm delivery in twin pregnancies....

  5. Progestogens and early pregnancy:prevention and treatment

    Institute of Scientific and Technical Information of China (English)

    Adolf E.Schindler

    2013-01-01

    During human and mammalian pregnancy,endogenous progesterone is the dominant hormone since it is not only essential for conception and implantation,but also needed throughout pregnancy.Progesterone provided the effects of prevention and treatment in human pregnancy by certain mechanisms.If one considers prevention or treatment with progestogens in human pregnancy,that all progestogens are progestogenic,if one condsiders the progestogens for prevention and therapeutic approaches,nowadays,only two progenstogens can be considered fully suitable for prevention and treatment in human pregnancy:progesterone and dydrogesteone.This review introduced the mechanism of progesterone and dydrogesterone in pregnancy and treatment in human.

  6. Why We Need Evidence-Based, Community-Wide Approaches for Prevention of Teen Pregnancy.

    Science.gov (United States)

    Barfield, Wanda D; Warner, Lee; Kappeler, Evelyn

    2017-03-01

    Teen pregnancy and childbearing have declined over the past two decades to historic lows. The most recent declines have occurred during a time of coordinated national efforts focused on teen pregnancy. This article highlights a federal partnership to reduce teen pregnancy through the implementation of innovative, evidence-based approaches in affected communities, with a focus on reaching African-American and Latino/Hispanic youth. This initiative has the potential to transform the design and implementation of future teen pregnancy prevention efforts and provide a model that can be replicated in communities across the nation.

  7. The Moderating Effects of School Climate on Bullying Prevention Efforts

    Science.gov (United States)

    Low, Sabina; Van Ryzin, Mark

    2014-01-01

    Bullying prevention efforts have yielded mixed effects over the last 20 years. Program effectiveness is driven by a number of factors (e.g., program elements and implementation), but there remains a dearth of understanding regarding the role of school climate on the impact of bullying prevention programs. This gap is surprising, given research…

  8. Longevity, genes and efforts: an optimal taxation approach to prevention.

    Science.gov (United States)

    Leroux, M-L; Pestieau, P; Ponthiere, G

    2011-01-01

    This paper applies the analytical tools of optimal taxation theory to the design of the optimal subsidy on preventive behaviours, in an economy where longevity varies across agents, and depends on preventive expenditures and on longevity genes. Public intervention can be here justified on three grounds: corrections for misperceptions of the survival process and for externalities related to individual preventive behaviour, and redistribution across both earnings and genetic dimensions. The optimal subsidy on preventive expenditures is shown to depend on the combined impacts of misperception, externalities and self-selection. It is generally optimal to subsidize preventive efforts to an extent depending on the degree of individual myopia, on how productivity and genes are correlated, and on the complementarity of genes and preventive efforts in the survival function.

  9. Teenage pregnancy prevention: the role of young men.

    Science.gov (United States)

    Vargas, Gabriela; Borus, Joshua; Charlton, Brittany M

    2017-08-01

    Although teenage pregnancy is declining in many parts of the world, it remains associated with considerable social, health, and economic outcomes. Pregnancy prevention efforts focus primarily on young women, with minimal attention to young men. This review highlights recent literature pertaining to the role of young men in pregnancy prevention. Young men have varying views on contraception as well as which partner(s) should be responsible for its use. Limited contraception knowledge reduces young men's sexual health communication as well as their contraception use. Healthcare providers play a major role as one of the main sources of sexual health information for young men, but there are gaps in young men's sexual health care so new guidelines have emerged. Recent literature highlights young men's range of views on contraception as well as their low sexual health knowledge and sexual health communication. To address teenage pregnancy and improve young men's overall wellness, healthcare providers should routinely address sexual health. Healthcare providers may use our newly proposed acronym, HIS BESTT, (Hello. Initiate. Sexual health assessment. Both condoms and female dependent methods. Examine genitals. STI screening. Talking to partner(s). Talking to parent(s) or guardians), to incorporate current clinical recommendations.

  10. Sexual Risk Behavior: HIV, STD, & Teen Pregnancy Prevention

    Science.gov (United States)

    ... Glance Project Connect Sexual Health STD Teen Pregnancy Sexual Risk Behaviors: HIV, STD, & Teen Pregnancy Prevention Recommend ... Tweet Share Compartir Many young people engage in sexual risk behaviors that can result in unintended health ...

  11. Mobilizing communities: an overview of the Community Coalition Partnership Programs for the Prevention of Teen Pregnancy.

    Science.gov (United States)

    Cassell, Carol; Santelli, John; Gilbert, Brenda Colley; Dalmat, Michael; Mezoff, Jane; Schauer, Mary

    2005-09-01

    The Community Coalition Partnership Programs for the Prevention of Teen Pregnancy (CCPP) was a seven-year (1995-2002) demonstration program funded by the Centers for Disease Control and Prevention (CDC) Division of Reproductive Health conducted in 13 U.S cities. The purpose of the CCPP was to demonstrate whether community partners could mobilize and organize community resources in support of comprehensive, effective, and sustainable programs for the prevention of initial and subsequent pregnancies. This article provides a descriptive overview of the program origins, intentions, and efforts over its planning and implementation phases, including specific program requirements, needs and assets assessments, intervention focus, CDC support for evaluation efforts, implementation challenges, and ideas for translation and dissemination. CDC hopes that the experiences gained from this effort lead to a greater understanding of how to mobilize community coalitions as an intervention to prevent teen pregnancy and address other public health needs.

  12. [Toxoplasmosis in pregnancy. Prevention, diagnosis, and therapy].

    Science.gov (United States)

    Russo, M

    1994-01-01

    Toxoplasmosis is a worldwide health problem. Infection of a pregnant woman can result in severe fetal morbidity or in subclinical neonatal infection; most subclinical cases will develop ocular and neurological sequelae. Fetal infection and clinical outcome is related to when in pregnancy toxoplasmosis was acquired. The risk of transmission increases from 14% in the first trimester to 29% in the second and 59% in the third. Conversely, clinical damage decreases from about 80% in the first to 10% in the third trimester, but up to 50% of patients with subclinical congenital toxoplasmosis will develop neurologic and ocular sequelae. Congenital toxoplasmosis can be prevented by identification of non immune women at the beginning of pregnancy, by giving information on how to avoid the infection and by a serological follow-up until the delivery. Serological follow-up is based on repeated testing for specific IgG and IgM, but other serologic methods are necessary to differentiate between acute and chronic infections and possibly on a single serum sample. Procedures to detect fetal infection are ultrasound examination, cordocentesis and amniocentesis; prenatal diagnosis relies on demonstration of toxoplasma in fetal blood or amniotic fluid by mouse inoculation. Very promising results have recently obtained by the PCR-method applied to amniotic fluid samples. All strongly suspected cases of acquired toxoplasmosis in pregnancy have to be treated.

  13. [The legal framework to prevent teenage pregnancies].

    Science.gov (United States)

    Leal, Ingrid; Luttges, Carolina; Troncoso, Paulina; Leyton, Carolina; Molina, Temistocles; Eguiguren, Pamela

    2016-05-01

    There are legal regulations about sexual and reproductive rights of adolescents. However, this legal framework (LF) may have contradictory elements: there are laws assuring confidentiality and access to contraception at any age but there are other laws that consider any sexual contact with an adolescent younger than 14 a sexual assault, whose report to the legal authorities in mandatory. To explore the knowledge and clinical practice of primary health care (PHC) providers regarding prevention of teenage pregnancy. Qualitative study collecting data using semi-structured interviews made to midwives and directors of PHC centers. Analysis of the data was based on Grounded Theory. There is a differentiated clinical care for pregnancy prevention among adolescents if they are over 14 years old. This is due to the LF, specifically to the sexual crime’s law (19,927) and the law about regulation of the fertility (20,418). The differences affect health care, access and counseling about contraception and confidentiality. Healthcare of teenagers under the age of 14 is perceived as problematic for providers, due to the possible legal implications. The LF causes insecurity on health care providers and derives in a differentiated clinical approach according to the patient´s age. This is a barrier to provide timely and confidential access to counseling and contraception.

  14. Focus on young men in pregnancy prevention.

    Science.gov (United States)

    1999-08-01

    The Mexican American Community Services Agency's (MACSA) male involvement program aims to delay early sexual activities among young boys, educate young males on personal sexual responsibility, prevent the spread of sexually transmitted diseases and unplanned pregnancies, and promote fatherhood responsibility. 40% of the population in the project area, Santa Clara County, belong to ethnic minorities. The program's target population is divided into three age ranges: 10-14, 15-19, and 20-24 year olds. Boys in the 10-14 year old range are accessed through programs at middle schools, community centers and MACSA centers. The 15-19 year age group are reached through the juvenile probation department, its own youth center, community health fairs and service organizations, and local high schools. Young men aged 20-24 years are channeled through adult education classes, incarceration facilities, trade and special training schools, community centers and other MACSA programs. MACSA programs "Be Proud, Be Responsible" and "Independent Thinking Skills" are presented to young men who are prone to gang activity and drug use. Part of the program offered at Elmwood Correctional Facility focuses on issues aside from pregnancy prevention and encourages young men to plan for their future through sessions on earning high school equivalency certification, on anger management, and on substance abuse.

  15. Teenage Pregnancy in Canada and Quebec: The role of prevention in reducing teenage pregnancy

    OpenAIRE

    Guilbert, Edith; Forget,Gilles

    1991-01-01

    In 1987, there were 36 694 known pregnancies in Canada among women aged 15 to 19. Although the Canadian teenage pregnancy rate decreased from 1980 to 1987, it remains three times higher than that of the industrialized country with the lowest rate. Health professionals, social workers, and educators can have an important role in preventing teenage pregnancy.

  16. Teenage Pregnancy in Canada and Quebec: The role of prevention in reducing teenage pregnancy

    OpenAIRE

    Guilbert, Edith; Forget,Gilles

    1991-01-01

    In 1987, there were 36 694 known pregnancies in Canada among women aged 15 to 19. Although the Canadian teenage pregnancy rate decreased from 1980 to 1987, it remains three times higher than that of the industrialized country with the lowest rate. Health professionals, social workers, and educators can have an important role in preventing teenage pregnancy.

  17. Periodontal treatment for preventing adverse pregnancy outcomes

    DEFF Research Database (Denmark)

    Schwendicke, Falk; Karimbux, Nadeem; Allareddy, Veerasathpurush

    2015-01-01

    OBJECTIVES: Periodontal treatment might reduce adverse pregnancy outcomes. The efficacy of periodontal treatment to prevent preterm birth, low birth weight, and perinatal mortality was evaluated using meta-analysis and trial sequential analysis. METHODS: An existing systematic review was updated...... risk of random errors. RESULTS: Thirteen randomized clinical trials evaluating 6283 pregnant women were meta-analyzed. Four and nine trials had low and high risk of bias, respectively. Overall, periodontal treatment had no significant effect on preterm birth (odds ratio [95% confidence interval] 0.......79 [0.57-1.10]) or low birth weight (0.69 [0.43-1.13]). Trial sequential analysis demonstrated that futility was not reached for any of the outcomes. For populations with moderate occurrence (periodontal treatment was not efficacious for any of the outcomes...

  18. A comparison of pregnancy prevention programmes in Europe

    NARCIS (Netherlands)

    Crijns, Ineke; Zomerdijk, Inge; Sturkenboom, Miriam; de Jong-van den Berg, Lolkje; Straus, Sabine

    2014-01-01

    Background: Pregnancy prevention programmes (PPP) can be imposed by regulatory authorities to minimise the risk of exposure to teratogenic drugs during pregnancy, thus preventing congenital anomalies. The objective of this study was to explore the reasons to request PPPs in the EU and the elements t

  19. Preventing adolescent pregnancy with social and cognitive skills.

    Science.gov (United States)

    Barth, R P; Fetro, J V; Leland, N; Volkan, K

    1992-04-01

    A 15-session sex education program was delivered by teachers to 586 10th graders using techniques based on social learning theory, including modeling, in-class and out-of-class practice of skills for abstaining from sexual intercourse, and for contraception. Knowledge about reproduction and birth control, intentions to use skills to avoid pregnancy, and communication with parents about pregnancy prevention were significantly greater at posttest and 6-month follow-up for the trained group than for the control group. Members of the trained group tended to use birth control more often, especially those who started to have sexual intercourse subsequent to the program. No differences in the frequency of sexual intercourse, pregnancy scares, or pregnancies were found. Satisfaction with the program was high. Although skill training by itself may not be sufficient to significantly prevent pregnancies, this program offers promise of being a useful component of combined school, home, and community activities to prevent pregnancy.

  20. Intermittent preventive treatment for the prevention of malaria during pregnancy in high transmission areas

    Directory of Open Access Journals (Sweden)

    Massougbodji Achille

    2007-12-01

    Full Text Available Abstract Malaria in pregnancy is one of the major causes of maternal morbidity and adverse birth outcomes. In high transmission areas, its prevention has recently changed, moving from a weekly or bimonthly chemoprophylaxis to intermittent preventive treatment (IPTp. IPTp consists in the administration of a single curative dose of an efficacious anti-malarial drug at least twice during pregnancy – regardless of whether the woman is infected or not. The drug is administered under supervision during antenatal care visits. Sulphadoxine-pyrimethamine (SP is the drug currently recommended by the WHO. While SP-IPTp seems an adequate strategy, there are many issues still to be explored to optimize it. This paper reviewed data on IPTp efficacy and discussed how to improve it. In particular, the determination of both the optimal number of doses and time of administration of the drug is essential, and this has not yet been done. As both foetal growth and deleterious effects of malaria are maximum in late pregnancy women should particularly be protected during this period. Monitoring of IPTp efficacy should be applied to all women, and not only to primi- and secondigravidae, as it has not been definitively established that multigravidae are not at risk for malaria morbidity and mortality. In HIV-positive women, there is an urgent need for specific information on drug administration patterns (need for higher doses, possible interference with sulpha-based prophylaxis of opportunistic infections. Because of the growing level of resistance of parasites to SP, alternative drugs for IPTp are urgently needed. Mefloquine is presently one of the most attractive options because of its long half life, high efficacy in sub-Saharan Africa and safety during pregnancy. Also, efforts should be made to increase IPTp coverage by improving the practices of health care workers, the motivation of women and their perception of malaria complications in pregnancy. Because IPTp

  1. The moderating effects of school climate on bullying prevention efforts.

    Science.gov (United States)

    Low, Sabina; Van Ryzin, Mark

    2014-09-01

    Bullying prevention efforts have yielded mixed effects over the last 20 years. Program effectiveness is driven by a number of factors (e.g., program elements and implementation), but there remains a dearth of understanding regarding the role of school climate on the impact of bullying prevention programs. This gap is surprising, given research suggesting that bullying problems and climate are strongly related. The current study examines the moderating role of school climate on the impacts of a stand-alone bullying prevention curriculum. In addition, the current study examined 2 different dimensions of school climate across both student and staff perceptions. Data for this study were derived from a Steps to Respect (STR) randomized efficacy trial that was conducted in 33 elementary schools over a 1-year period. Schools were randomly assigned to intervention or wait-listed control condition. Outcome measures (pre-to-post) were obtained from (a) all school staff, (b) a randomly selected subset of 3rd-5th grade teachers in each school, and (c) all students in classrooms of selected teachers. Multilevel analyses revealed that psychosocial climate was strongly related to reductions in bullying-related attitudes and behaviors. Intervention status yielded only 1 significant main effect, although, STR schools with positive psychosocial climate at baseline had less victimization at posttest. Policies/administrative commitment to bullying were related to reduced perpetration among all schools. Findings suggest positive psychosocial climate (from both staff and student perspective) plays a foundational role in bullying prevention, and can optimize effects of stand-alone programs. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  2. Teenage Pregnancy Prevention and Adolescents' Sexual Outcomes: An Experiential Approach

    Science.gov (United States)

    Somers, Cheryl L.

    2006-01-01

    This study evaluates the effectiveness of an experiential approach to teen pregnancy (TP) prevention called "Baby Think It Over," a computerized infant simulator, on adolescents' attitudes and behaviors regarding teen pregnancy and sexuality. Recently, a more realistic model called "Real Care Baby" was developed. The small amount of research on…

  3. The Carerra Model: A Success in Pregnancy Prevention.

    Science.gov (United States)

    Elling, Duane M.

    This document outlines the development, evaluation, and replication of the Carrera model for pregnancy prevention. The Carerra model helps teens avoid pregnancy by empowering them to develop and reach personal goals, and by providing them with information on sexual issues, including abstinence, contraception, and the consequences of sexual…

  4. Listening to youth: teen perspectives on pregnancy prevention.

    Science.gov (United States)

    Hacker, K A; Amare, Y; Strunk, N; Horst, L

    2000-04-01

    To ascertain views of public high school students on preventing teen pregnancy. The authors hypothesized that students at varying risk for pregnancy (e.g., abstinent, consistent contraceptors, inconsistent contraceptors) would have differing views which would have implications for future pregnancy prevention programming. A 75-question anonymous survey designed for this study was administered in six Boston high schools. The sample consisted of 49% females and 51% males in 10th and 11th grades from diverse racial and ethnic backgrounds. One thousand surveys were received and analyzed using Chi-square tests to assess statistically significant differences in student responses. Sixty-three percent of the students had had sexual intercourse: 72% of males and 54% of females. Of these, 35% were consistent contraceptors and 65% were inconsistent. Students believed that having more information on pregnancy and birth control (52%), education about relationships (33%), parental communication (32%), improved contraceptive access (31%), and education about parenting realities (30%) would prevent teen pregnancy. Abstinent teens were more likely (58%) to say that information on pregnancy and birth control was important (pteens were more likely (40%) to identify greater access to birth control (p Teens using contraception were also more likely to be having frequent conversations with parents (49%) (pTeens report that having more information from parents, school, and health arenas can prevent pregnancy. Abstinent, consistent contraceptors, and inconsistent contraceptors have different preferences regarding strategies. This information has important implications for educational content and policy discussions.

  5. CDC Vital Signs: Preventing Teen Pregnancy

    Science.gov (United States)

    ... 0:60 seconds] On Other Web Sites MedlinePlus - Teenage Pregnancy MedlinePlus - Birth Control The Doctor's Channel: CDC Vital Signs Long Acting Reversible Contraception [VIDEO - 3:30 minutes] Top of ... HHS/Open USA.gov Top

  6. Progestogens to prevent preterm birth in twin pregnancies

    DEFF Research Database (Denmark)

    Schuit, Ewoud; Stock, Sarah; Groenwold, Rolf H H;

    2012-01-01

    Preterm birth is the principal factor contributing to adverse outcomes in multiple pregnancies. Randomized controlled trials of progestogens to prevent preterm birth in twin pregnancies have shown no clear benefits. However, individual studies have not had sufficient power to evaluate potential b...... benefits in women at particular high risk of early delivery (for example, women with a previous preterm birth or short cervix) or to determine adverse effects for rare outcomes such as intrauterine death....

  7. Practical Approaches to Evaluating Progress and Outcomes in Community-Wide Teen Pregnancy Prevention Initiatives.

    Science.gov (United States)

    Tevendale, Heather D; Condron, D Susanne; Garraza, Lucas Godoy; House, L Duane; Romero, Lisa M; Brooks, Megan A M; Walrath, Christine

    2017-03-01

    This paper presents an overview of the key evaluation components for a set of community-wide teen pregnancy prevention initiatives. We first describe the performance measures selected to assess progress toward meeting short-term objectives on the reach and quality of implementation of evidence-based teen pregnancy prevention interventions and adolescent reproductive health services. Next, we describe an evaluation that will compare teen birth rates in intervention communities relative to synthetic control communities. Synthetic controls are developed via a data-driven technique that constructs control communities by combining information from a pool of communities that are similar to the intervention community. Finally, we share lessons learned thus far in the evaluation of the project, with a focus on those lessons that may be valuable for local communities evaluating efforts to reduce teen pregnancy.

  8. Preventing Teenage Pregnancy: A Team Approach

    OpenAIRE

    Anderson, Cheryl

    1986-01-01

    By age 16 one in three adolescents have experienced sexual intercourse. Because one-third of these sexually active teens never use contraception, they have a five-times greater risk of pregnancy than teenagers who take contraceptive measures. In 1982, one in 23 Canadian teenage girls became pregnant. Teenagers' reasons for not using contraceptives include fear of parents learning about their sexual activity, lack of knowledge about contraception, and lack of self-esteem. Parents, educators an...

  9. Preventing Teenage Pregnancy: A Team Approach

    OpenAIRE

    Anderson, Cheryl

    1986-01-01

    By age 16 one in three adolescents have experienced sexual intercourse. Because one-third of these sexually active teens never use contraception, they have a five-times greater risk of pregnancy than teenagers who take contraceptive measures. In 1982, one in 23 Canadian teenage girls became pregnant. Teenagers' reasons for not using contraceptives include fear of parents learning about their sexual activity, lack of knowledge about contraception, and lack of self-esteem. Parents, educators an...

  10. Prevention of Primary Cytomegalovirus Infection in Pregnancy

    Directory of Open Access Journals (Sweden)

    Maria Grazia Revello

    2015-09-01

    Interpretation: This controlled study provides evidence that an intervention based on the identification and hygiene counseling of CMV-seronegative pregnant women significantly prevents maternal infection. While waiting for CMV vaccine to become available, the intervention described may represent a responsible and acceptable primary prevention strategy to reduce congenital CMV.

  11. Stretch marks during pregnancy: a review of topical prevention.

    Science.gov (United States)

    Korgavkar, K; Wang, F

    2015-03-01

    Striae gravidarum (SG), or stretch marks developing during pregnancy, affect up to 90% of women. While not medically dangerous, SG can be disfiguring, causing emotional and psychological distress. However, studies specifically addressing the prevention of SG, especially during pregnancy, are sparse. Furthermore, the molecular pathogenesis of SG is unclear and may differ from that of striae from other causes. Considering these factors, we review topical modalities that have been used specifically for preventing SG during pregnancy. We identify two major strategies (end points) addressed by these modalities, namely (i) preventing the de novo development of SG and (ii) reducing the severity of SG that have recently developed. We also identify risk factors for the development of SG and suggest that pregnant women with these risk factors are an appropriate target population for prevention. In reviewing the literature, we find that there is limited evidence that centella, and possibly massage with bitter almond oil, may prevent SG and/or reduce their severity. There is weak evidence that hyaluronic acid prevents SG. Tretinoin holds promise for reducing the severity of new-onset SG, but its use is limited by its pregnancy category. Finally, cocoa butter and olive oil are not effective for preventing SG or reducing the severity of lesions. We conclude that reliable methods for preventing SG are scarce. Furthermore, available topical modalities generally lack strong evidence from rigorous, well-designed, randomized controlled trials with ample numbers of subjects. Thus, further research is necessary to elucidate SG pathogenesis, which may lead to effective prevention modalities.

  12. Adolescent Sexuality: Pregnancy, Sexually Transmitted Diseases, and Prevention.

    Science.gov (United States)

    Santelli, John S.; And Others

    1992-01-01

    Special edition discusses adolescent sexuality, focusing on pregnancy, sexually transmitted diseases, and prevention. The articles focus on demographics, risk factors, school-based risk reduction programs, contraception, early intervention, options, school-based prenatal and postpartum care programs, teenage parenting, abortion, HIV and AIDS,…

  13. Interventions for preventing recurrent urinary tract infection during pregnancy

    NARCIS (Netherlands)

    Schneeberger, Caroline; Geerlings, Suzanne E.; Middleton, Philippa; Crowther, Caroline A.

    2015-01-01

    Background Recurrent urinary tract infections (RUTI) are common in women who are pregnant and may cause serious adverse pregnancy outcomes for both mother and child including preterm birth and small-for-gestational-age babies. Interventions used to prevent RUTI in women who are pregnant can be

  14. Interventions for preventing recurrent urinary tract infection during pregnancy

    NARCIS (Netherlands)

    Schneeberger, Caroline; Geerlings, Suzanne E.; Middleton, Philippa; Crowther, Caroline A.

    2015-01-01

    Background Recurrent urinary tract infections (RUTI) are common in women who are pregnant and may cause serious adverse pregnancy outcomes for both mother and child including preterm birth and small-for-gestational-age babies. Interventions used to prevent RUTI in women who are pregnant can be pharm

  15. The prevention of teenage pregnancy in adolescent's view

    OpenAIRE

    Fiedler,Milla Wildemberg; Araújo,Alisson; Souza,Márcia Christina Caetano de

    2015-01-01

    The objective of the research is to understand the vision of adolescents on the prevention of adolescent pregnancy in a school in the municipality of Divinópolis, Minas Gerais. This is a descriptive study, exploratory, with a qualitative approach, with 14 adolescents. Semistructured interviews. Data were analyzed and interpreted by discourse analysis. The analysis of the reports of the subjects interviewed originated four empirical categories: perception about the importance of preventing tee...

  16. Vital Signs-Preventing Pregnancy in Younger Teens

    Centers for Disease Control (CDC) Podcasts

    2014-04-08

    This podcast is based on the April 2014 CDC Vital Signs report. Births to teens are declining, still, in 2012, more than 86,000 teens ages 15 to 17 gave birth. This program discusses what health care providers, parents, and teens can do to help prevent teen pregnancy.  Created: 4/8/2014 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/8/2014.

  17. Historical context for the creation of the Office of Adolescent Health and the Teen Pregnancy Prevention Program.

    Science.gov (United States)

    Kappeler, Evelyn M; Farb, Amy Feldman

    2014-03-01

    In Fiscal Year 2010, Federal funds were dedicated to support evidence-based approaches to effectively target teen pregnancy prevention and resulted in the establishment of the Office of Adolescent Health (OAH) and the Teen Pregnancy Prevention (TPP) Program. Through the tiered TPP Program, OAH supports replication and evaluation of programs using models whose effectiveness has been demonstrated through rigorous evaluation and the development and testing of promising or innovative pregnancy prevention strategies and approaches. This article documents the creation of OAH and the development of the TPP Program, the identification of a TPP evidence base, current program and evaluation efforts at OAH, and government coordination and partnerships related to reducing teen pregnancy. This article is of interest to those working to improve the health and wellbeing of adolescents.

  18. Mechanisms of Biliary Plastic Stent Occlusion and Efforts at Prevention

    Science.gov (United States)

    Kwon, Chang-Il; Lehman, Glen A.

    2016-01-01

    Biliary stenting via endoscopic retrograde cholangiopancreatography has greatly improved the quality of patient care over the last 30 years. Plastic stent occlusion limits the life span of such stents. Attempts to improve plastic stent patency duration have mostly failed. Metal stents (self-expandable metal stents [SEMSs]) have therefore replaced plastic stents, especially for malignant biliary strictures. SEMS are at least 10 times more expensive than plastic stents. In this focused review, we will discuss basic mechanisms of plastic stent occlusion, along with a systematic summary of previous efforts and related studies to improve stent patency and potential new techniques to overcome existing limitations. PMID:27000422

  19. Cyberbullying Prevention and Intervention Efforts: Current Knowledge and Future Directions.

    Science.gov (United States)

    Espelage, Dorothy L; Hong, Jun Sung

    2017-06-01

    Bullying is a serious public health concern that is associated with significant negative mental, social, and physical outcomes. Technological advances have increased adolescents' use of social media, and online communication platforms have exposed adolescents to another mode of bullying- cyberbullying. Prevention and intervention materials, from websites and tip sheets to classroom curriculum, have been developed to help youth, parents, and teachers address cyberbullying. While youth and parents are willing to disclose their experiences with bullying to their health care providers, these disclosures need to be taken seriously and handled in a caring manner. Health care providers need to include questions about bullying on intake forms to encourage these disclosures. The aim of this article is to examine the current status of cyberbullying prevention and intervention. Research support for several school-based intervention programs is summarised. Recommendations for future research are provided.

  20. [Nutritional dynamic monitoring during pregnancy: a personalized intervention of prevention].

    Science.gov (United States)

    De Cristofaro, Paolo; Pompilii, Sonia; Di Bonifacio, M Teresa; Malatesta, Guido; Pantoni, Natascia; Xhebraj, Elona; Dragani, Beatrice

    2008-06-01

    Obesity is an increasing condition spreading out in all of the world, independently by race, sex and age. Obesity in pregnancy represent a risk condition for both mother and her offspring. All of the studies are observational and show intervention strategies on weight gain improvement during gestational period, a current topic, but still controversial. Our study is based on nutritional dynamic monitoring during pregnancy in order to improve health and wellbeing status of both mother and her offspring, through an early and efficacy prevention.

  1. Aspirin for Prevention of Preeclampsia in Lupus Pregnancy

    Directory of Open Access Journals (Sweden)

    Amelie M. Schramm

    2014-01-01

    Full Text Available Preeclampsia, the onset of hypertension and proteinuria during pregnancy, is a common medical disorder with high maternal and fetal mortality and morbidity. The underlying pathology remains poorly understood and includes inflammation, endothelial dysfunction, and an unbalanced thromboxane A2/prostacyclin ratio. For women with systemic lupus erythematosus (SLE, particularly those with preexisting renal disease or with active lupus, the risk of developing preeclampsia is up to 14% higher than it is among healthy individuals. The mechanism is still unknown and the data for preventing preeclampsia in lupus pregnancies are rare. Modulating the impaired thromboxane A2/prostacyclin ratio by administration of low-dose aspirin appears to be the current best option for the prevention of preeclampsia. After providing an overview of the pathogenesis of preeclampsia, preeclampsia in lupus pregnancies, and previous trials for prevention of preeclampsia with aspirin treatment, we recommend low-dose aspirin administration for all lupus patients starting prior to 16 weeks of gestation. Patients with SLE and antiphospholipid syndrome should receive treatment with heparin and low-dose aspirin during pregnancy.

  2. Vital Signs-Preventing Teen Pregnancy

    Centers for Disease Control (CDC) Podcasts

    2015-04-07

    This podcast is based on the April 2015 CDC Vital Signs report. Teen births in the U.S. have declined, but still, more than 273,000 infants were born to teens ages 15 to 19 in 2013. Learn about the most effective types of birth control.  Created: 4/7/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/7/2015.

  3. Condoms Prevent More Than Pregnancy, HIV

    Institute of Scientific and Technical Information of China (English)

    Randy; Dotinga; 费国飞

    2004-01-01

    避孕套在安全性行为中起到至关重要的作用,它既可避孕,又可预防艾滋病。但最近一项研究表明,它的功效远远不止如此:People who consistentlyused condoms got fewer cases of gonorrhea and chlamydia than those who usedthem only occasionally.Condoms also prevented transmission of genital herpes inmen and possibly in women,too.

  4. The battle scars of pregnancy: can they be prevented?

    Science.gov (United States)

    Razi, Emma

    2012-05-01

    I have feared developing stretch marks since my first pregnancy. Getting to grips with my changing shape was a big challenge, but I was safe in the knowledge that post-pregnancy I could work towards losing the weight. But stretch marks are permanent, and to me-disfiguring. I researched how stretch marks can be prevented and after finding little evidence for a particular cream or lotion: I scanned forums and asked friends what worked for them. Many people claimed that by keeping skin hydrated and supple, the dreaded stretch marks can be kept at bay or at least to a minimum. So I opted for regularly massaging oil across vulnerable areas and maintaining a balanced diet, including drinking lots of water. I was lucky the first time round; time will tell if my skincare routine will work for my second pregnancy.

  5. [International community efforts in prevention of nuclear terrorism].

    Science.gov (United States)

    Ilijas, Boris

    2006-06-01

    Terrorism is now a global threat, spreading its shadows over regions which were previously regarded as the exclusive domain of the military superpowers. One of the prime threats is nuclear terrorism, using nuclear or radiological agents. To assess the threat, it is important to include all factors that make it possible. A nuclear terrorist attack can be conducted in three basic ways, by detonation of a nuclear weapon, by sabotage or diversion of a nuclear facility or by dispersion of radioactive material into the environment (radiological weapon). Each possibility is specific and with different consequences. Nuclear terrorism can be prevented by establishing a global system which requires from all countries to strictly follow international rules of trading, storing and using nuclear and radioactive materials and to produce an efficient national legislation. The United Nations have provided a basis for such legislation in the form of the International Convention for the Suppression of Acts of Nuclear Terrorism.

  6. Efforts to Improve Immunization Coverage during Pregnancy among Ob-Gyns

    Directory of Open Access Journals (Sweden)

    Katherine M. Jones

    2016-01-01

    Full Text Available Background. Influenza and Tdap vaccines are vital factors for improving maternal and neonatal health outcomes. Methods. A prospective, longitudinal study was conducted to determine whether the American College of Obstetricians and Gynecologists’ (ACOG’s efforts to increase ob-gyn use of their immunization toolkits and vaccination administration were successful. Pre- and postintervention questionnaires were mailed to a random sample of 1,500 ACOG members between August 2012 and July 2015. Results. Significantly more postintervention survey ob-gyns reported that they received the immunization toolkits than preintervention survey ob-gyns (84.5% versus 67.0%, p<.001. The large majority of ob-gyns from both surveys (76.9% versus 78.9% reported that they offered or planned to offer influenza vaccinations to their patients for the 2012-2013 and 2014-2015 flu seasons. Postintervention survey respondents were significantly more likely than preintervention survey participants to report that they routinely offer Tdap vaccinations to all patients during pregnancy (76.8% versus 59.3%, p<.001. Conclusion. ACOG’s efforts to improve ob-gyn use of immunization toolkits and vaccine administration appear to have been successful in several ways. ACOG’s toolkits are an example of an effective intervention to overcome barriers to offering vaccines and help improve influenza and Tdap immunization coverage for pregnant women.

  7. Shifting the paradigm in Oregon from teen pregnancy prevention to youth sexual health.

    Science.gov (United States)

    Nystrom, Robert J; Duke, Jessica E A; Victor, Brad

    2013-01-01

    Oregon's work on teen pregnancy prevention during the previous 20 years has shifted from a risk-focused paradigm to a youth development model that places young people at the center of their sexual health and well-being. During 2005, the Oregon Governor's Office requested that an ad hoc committee of state agency and private partners develop recommendations for the next phase of teen pregnancy prevention. As a result of that collaborative effort, engagement of young people, and community input, the Oregon Youth Sexual Health Plan was released in 2009. The plan focuses on development of young people and embraces sexuality as a natural part of adolescent development. The plan's five goals and eight objectives guide the work of state agencies and partners addressing youth sexual health. Oregon's development of a statewide plan can serve as a framework for other states and entities to address all aspects of youth sexual health.

  8. Evaluation of malaria prevention strategies during pregnancy in Ndola, Zambia

    Science.gov (United States)

    Mulamba, Mwamba

    2010-01-01

    ABSTRACT Background Malaria in pregnancy is associated with many negative outcomes for the woman, foetus and neonate. Intermittent preventive treatment during pregnancy (IPTp) using three doses of sulfadoxine/pyrimethamine (SP), insecticide-treated mosquito nets (ITNs) and indoor residual spray (IRS), constitute the main strategies used to prevent malaria. The aim of this study is to evaluate the effectiveness of these strategies for the reduction of malaria prevalence in pregnant women. Methods A questionnaire on socio-demographic information, history of malaria during current pregnancy and prevention strategies used was administered to 450 consecutive patients admitted into labour wards at three local clinics. From the antenatal cards, information was collected on the last menstrual period, date of each dose of SP taken, gravidity, and HIV status. A blood slide to detect Plasmodium was then collected from each woman after consent. Results Of the participants in the study, 2.4% had a positive blood slide at term and 15.8% reported malaria during pregnancy. All the participants took at least one dose of SP with 87.6% completing the stipulated three doses. The mean gestational ages for each dose were 22.1 (SD 4.6), 29.1 (SD 4.4) and 34.4 (SD 3.9) weeks for the first, second and third dose respectively. With regard to ITNs, 79.5% had one, but only 74.1% used it regularly. IRS was completed in all three of the clinics’ catchment areas. Only 23.4% used commercial insecticide. Conclusion The measured prevalence of malaria at term in Ndola was remarkably low, although the self-reported rate during pregnancy was still high. The national targets for accessing IPTp were exceeded, although the timing of each dose needs to be improved. Access to ITNs was high, but usage needs to increase.

  9. Evaluation of malaria prevention strategies during pregnancy in Ndola, Zambia

    Directory of Open Access Journals (Sweden)

    Mwamba Mulamba

    2010-03-01

    Full Text Available Background: Malaria in pregnancy is associated with many negative outcomes for the woman,foetus and neonate. Intermittent preventive treatment during pregnancy (IPTp using three doses of sulfadoxine/pyrimethamine (SP, insecticide-treated mosquito nets (ITNs and indoor residual spray (IRS, constitute the main strategies used to prevent malaria. The aim of this study is to evaluate the effectiveness of these strategies for the reduction of malaria prevalence in pregnant women.Methods: A questionnaire on socio-demographic information, history of malaria during current pregnancy and prevention strategies used was administered to 450 consecutive patients admitted into labour wards at three local clinics. From the antenatal cards, information was collected on the last menstrual period, date of each dose of SP taken, gravidity, and HIV status. A blood slide to detect Plasmodium was then collected from each woman after consent.Results: Of the participants in the study, 2.4% had a positive blood slide at term and 15.8% reported malaria during pregnancy. All the participants took at least one dose of SP with 87.6% completing the stipulated three doses. The mean gestational ages for each dose were 22.1 (SD 4.6, 29.1 (SD 4.4and 34.4 (SD 3.9 weeks for the first, second and third dose respectively. With regard to ITNs, 79.5% had one, but only 74.1% used it regularly. IRS was completed in all three of the clinics’ catchment areas. Only 23.4% used commercial insecticide.Conclusion: The measured prevalence of malaria at term in Ndola was remarkably low, although the self-reported rate during pregnancy was still high. The national targets for accessing IPTp were exceeded, although the timing of each dose needs to be improved. Access to ITNs was high, but usage needs to increase.

  10. Implementing intermittent preventive treatment for malaria in pregnancy

    DEFF Research Database (Denmark)

    Mubyazi, Godfrey Martin; Magnussen, Pascal; Goodman, Catherine;

    2008-01-01

    INTRODUCTION: Implementing Intermittent Preventive Treatment for malaria in Pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) through antenatal care (ANC) clinics is recommended for malaria endemic countries. Vast biomedical literature on malaria prevention focuses more on the epidemiological...... of the recommended interventions. OBJECTIVE: To review literature on policy advances, achievements, constraints and challenges to malaria IPTp implementation, emphasising on its operational feasibility in the context of health-care financing, provision and uptake, resource constraints and psychosocial factors...... and other discriminatory socio-cultural values on pregnancy; target users, perceptions and attitudes towards SP, malaria, and quality of ANC; supply and cost of SP at health facilities; understaffing and demoralised staff; ambiguity and impracticability of user-fee exemption policy guidelines on essential...

  11. Availability and utilization of malaria prevention strategies in pregnancy in eastern India

    Directory of Open Access Journals (Sweden)

    Yeboah-Antwi Kojo

    2010-09-01

    . Conclusions A disconnect remains between routine antenatal practices in India and known strategies to prevent and treat malaria in pregnancy. Prevention strategies, in particular the use of insecticide-treated bednets, are underutilized. Gaps highlighted by this study combined with recent estimates of the prevalence of malaria during pregnancy in these areas should be used to revise governmental policy and target increased educational efforts among health care workers and pregnant women.

  12. Calculating Minimum Detectable Impacts in Teen Pregnancy Prevention Impact Evaluations

    OpenAIRE

    Lorenzo Moreno; Russell Cole

    2014-01-01

    This brief provides an overview of how researchers can calculate the minimum detectable impacts (MDIs), which are related to power calculations, for Teen Pregnancy Prevention (TPP) evaluations. It describes a tool that evaluators can use for their own MDI calculations, and includes examples that highlight how to use the tool. A technical appendix provides more details on the formulae in the tool that inform MDI calculations.

  13. Calculating Minimum Detectable Impacts in Teen Pregnancy Prevention Impact Evaluations

    OpenAIRE

    Lorenzo Moreno; Russell Cole

    2014-01-01

    This brief provides an overview of how researchers can calculate the minimum detectable impacts (MDIs), which are related to power calculations, for Teen Pregnancy Prevention (TPP) evaluations. It describes a tool that evaluators can use for their own MDI calculations, and includes examples that highlight how to use the tool. A technical appendix provides more details on the formulae in the tool that inform MDI calculations.

  14. Transcervical administration of polidocanol foam prevents pregnancy in female baboons.

    Science.gov (United States)

    Jensen, Jeffrey T; Hanna, Carol; Yao, Shan; Thompson, Emily; Bauer, Cassondra; Slayden, Ov D

    2016-11-01

    Our objective was to conduct a pilot study to determine if transcervical administration of polidocanol foam (PF) with or without doxycycline or benzalkonium chloride (BZK) would prevent pregnancy in baboons. In study phase 1, adult cycling baboons underwent a hysterosalpingogram to evaluate tubal patency prior to transcervical infusion of 20 mL of 5% PF followed by 1 mL of saline containing 100 mg doxycycline (5%/doxy; n=5), 3% PF plus doxycycline (3%/doxy; n=4), 3% PF with 0.01% BZK (3%/BZK; n=4) or no additional treatment (control; n=9). Immediately following treatment, animals received intramuscular depot medroxyprogesterone acetate (DMPA, 2 mg/kg) to suppress cyclicity during healing and were then socially housed with males of proven fertility. The primary outcome was pregnancy within six cycles of resumption of menses (efficacy phase 1). During study phase 2, PF-treated females from study phase 1 contributed additional cycles (6-8) of exposure (efficacy phase 2), and 5 control females who had recovered from medical abortion (after study phase 1 pregnancy) were subsequently treated with 5% PF (with DMPA) and exposed to breeding (efficacy phase 1; n=3 six cycles, n=2 five cycles). All females resumed normal menstrual cycles and mating activity after DMPA. During efficacy phase 1, 7/9 (78%) control females became pregnant. In contrast, fewer pregnancies occurred in PF-treated females: 5% PF 0/5 (0%), 5%/doxy 1/5 (20%), 3%/doxy 1/4 (25%) and 3%/BZK 1/4 (25%). During efficacy phase 2, only one additional pregnancy occurred (3%/BZK). A single transcervical treatment with 5% PF prevented pregnancy in most baboons. Cotreatment with doxycycline or BZK did not improve results. Transcervical intrauterine administration of PF resulted in a high rate of tubal occlusion with prevention of pregnancy; refinements are needed to increase the contraceptive rate following a single treatment to near 100%. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights

  15. Not Just Another Single Issue: Teen Pregnancy Prevention's Link to Other Critical Social Issues.

    Science.gov (United States)

    National Campaign To Prevent Teen Pregnancy, Washington, DC.

    This report discusses critical social issues linked to teen pregnancy, explaining that teen pregnancy prevention should be viewed as working to improve these social issues. After providing general background on teen pregnancy, the report offers five fact sheets: (1) "Teen Pregnancy, Welfare Dependency, and Poverty" (continuing to reduce…

  16. All together now. An integrated approach to preventing adolescent pregnancy and STD/HIV infection.

    Science.gov (United States)

    Fisher, W A

    1990-01-01

    2 outcomes of the high level of unprotected sexual activity among US adolescents--teenage pregnancy and infection with sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV)--are produced by similar behavioral factors. Among these are an unwillingness to acknowledge in advance sexual activity, a failure to seek out necessary preventive knowledge, an unwillingness to engage in preventive behaviors such as use of condoms or other contraceptives, and a lack of communication about sexuality in adolescent relationships. Despite this overlap, health educators and service providers have failed to develop an integrated approach for dealing with adolescent pregnancy and STD/HIV risk. Proposed is a sequence of preventive behaviors and skills to be taught to teenagers, including acceptance of their sexuality, education regarding sex-related preventive options, an active commitment to engage in preventive behaviors, the negotiation of sex-related prevention with one's partner, performance of public preventive acts such as condom purchase, consistent practice and reinforcement of preventive behaviors, and the ability to shift preventive "scripts." At the same time, programs must address the potential psychological obstacles to the performance of sex-related preventive behaviors--e.g., negative feeling about sexuality, misinformation coupled with cognitive immaturity, and mass media images and fantasies. Program interventions can be delivered most efficiently through the public school system, with linkages to birth control clinics, STD clinics, HIV testing centers, and drug treatment programs. The type of sexuality education proposed--provision of relevant information that teenagers can actively translate into preventive behaviors--should be anticipated to produce more resistance from conservative community forces than traditional educational efforts.

  17. Using Film Clips to Teach Teen Pregnancy Prevention: "The Gloucester 18" at a Teen Summit

    Science.gov (United States)

    Herrman, Judith W.; Moore, Christopher C.; Anthony, Becky

    2012-01-01

    Teaching pregnancy prevention to large groups offers many challenges. This article describes the use of film clips, with guided discussion, to teach pregnancy prevention. In order to analyze the costs associated with teen pregnancy, a film clip discussion session based with the film "The Gloucester 18" was the keynote of a youth summit. The lesson…

  18. Girls' Participation in Sports: An Important Tool in Teen Pregnancy Prevention. Policy Brief.

    Science.gov (United States)

    Solomon, Nancy M.

    This policy brief highlights the interrelationship between sports participation and teen pregnancy prevention, noting barriers that have prevented sports from being utilized in teen pregnancy prevention. Discrimination against girls and women in school sports persists 30 years after Congress enacted Title IX, and this prevents girls and young…

  19. Teen Pregnancy Prevention: Implementation of a Multicomponent, Community-Wide Approach.

    Science.gov (United States)

    Mueller, Trisha; Tevendale, Heather D; Fuller, Taleria R; House, L Duane; Romero, Lisa M; Brittain, Anna; Varanasi, Bala

    2017-03-01

    This article provides an overview and description of implementation activities of the multicomponent, community-wide initiatives of the Teenage Pregnancy Prevention Program initiated in 2010 by the Office of Adolescent Health and the Centers for Disease Control and Prevention. The community-wide initiatives applied the Interactive Systems Framework for dissemination and implementation through training and technical assistance on the key elements of the initiative: implementation of evidence-based teen pregnancy prevention (TPP) interventions; enhancing quality of and access to youth-friendly reproductive health services; educating stakeholders about TPP; working with youth in communities most at risk of teen pregnancy; and mobilizing the community to garner support. Of nearly 12,000 hours of training and technical assistance provided, the majority was for selecting, implementing, and evaluating an evidence-based TPP program. Real-world implementation of a community-wide approach to TPP takes time and effort. This report describes implementation within each of the components and shares lessons learned during planning and implementation phases of the initiative.

  20. Implementing intermittent preventive treatment for malaria in pregnancy

    DEFF Research Database (Denmark)

    Mubyazi, Godfrey Martin; Magnussen, Pascal; Goodman, Catherine

    2008-01-01

    of the recommended interventions. OBJECTIVE: To review literature on policy advances, achievements, constraints and challenges to malaria IPTp implementation, emphasising on its operational feasibility in the context of health-care financing, provision and uptake, resource constraints and psychosocial factors...... in Africa. RESULTS: The importance of IPTp in preventing unnecessary anaemia, morbidity and mortality in pregnancy and improving childbirth outcomes is highly acknowledged, although the following factors appear to be the main constraints to IPTp service delivery and uptake: cost of accessing ANC; myths...... and other discriminatory socio-cultural values on pregnancy; target users, perceptions and attitudes towards SP, malaria, and quality of ANC; supply and cost of SP at health facilities; understaffing and demoralised staff; ambiguity and impracticability of user-fee exemption policy guidelines on essential...

  1. Exploring the Identity-Theft Prevention Efforts of Consumers in the United States

    Science.gov (United States)

    Lewis, Jacquelyne L.

    2011-01-01

    Identity theft is quite expensive and devastating for victims; unfortunately, it is also a rapidly growing crime. Much of the prior research on identity theft has focused on legislative efforts that may prevent the crime. However, limited research exists on what consumers perceive as identity prevention and the measures they take to prevent…

  2. Factors influencing the usage of different types of malaria prevention methods during pregnancy in Kenya.

    Science.gov (United States)

    Choonara, Shakira; Odimegwu, Clifford Obby; Elwange, Bob Charlestine

    2015-06-01

    In sub-Saharan Africa, malaria is a leading cause of morbidity and mortality, which, during pregnancy, is associated with adverse health outcomes for both mother and foetus. Utilization of Insecticide Treated Nets (ITNs) and Intermittent Preventive Therapy (IPTp) is advocated to prevent malaria during pregnancy. To examine factors which influence the use of different types of malaria prevention methods among pregnant women in Kenya. This study used 2008-09 Kenya Demographic and Health survey. Pregnant women aged 15-49 years were included (622 women). Distribution of the study population was assessed in frequency tables. Bivariate and multivariate logistic regression analysis was employed. Fifty-two percent of women used ITNs and 38.5% reported uptake of IPTp. In multivariate analysis age, malaria risk areas, religion, education and income influenced ITN usage, whereas only age, malaria risk areas and marital status were found to influence IPTP uptake. ITN use and IPTp uptake were well below the 80% Kenya Malaria Strategy 2006 target. In an effort to increase uptake it is vital for future research to understand reasons for low usage and uptake of malaria prevention programmes so as to enable policy-makers to make informed decisions.

  3. Malaria prevention with IPTp during pregnancy reduces neonatal mortality.

    Directory of Open Access Journals (Sweden)

    Clara Menéndez

    Full Text Available BACKGROUND: In the global context of a reduction of under-five mortality, neonatal mortality is an increasingly relevant component of this mortality. Malaria in pregnancy may affect neonatal survival, though no strong evidence exists to support this association. METHODS: In the context of a randomised, placebo-controlled trial of intermittent preventive treatment (IPTp with sulphadoxine-pyrimethamine (SP in 1030 Mozambican pregnant women, 997 newborns were followed up until 12 months of age. There were 500 live borns to women who received placebo and 497 to those who received SP. FINDINGS: There were 58 infant deaths; 60.4% occurred in children born to women who received placebo and 39.6% to women who received IPTp (p = 0.136. There were 25 neonatal deaths; 72% occurred in the placebo group and 28% in the IPTp group (p = 0.041. Of the 20 deaths that occurred in the first week of life, 75% were babies born to women in the placebo group and 25% to those in the IPTp group (p = 0.039. IPTp reduced neonatal mortality by 61.3% (95% CI 7.4%, 83.8%; p = 0.024]. CONCLUSIONS: Malaria prevention with SP in pregnancy can reduce neonatal mortality. Mechanisms associated with increased malaria infection at the end of pregnancy may explain the excess mortality in the malaria less protected group. Alternatively, SP may have reduced the risk of neonatal infections. These findings are of relevance to promote the implementation of IPTp with SP, and provide insights into the understanding of the pathophysiological mechanisms through which maternal malaria affects fetal and neonatal health. TRIAL REGISTRATION: ClinicalTrials.gov NCT00209781.

  4. Micronutrient deficiencies in pregnancy worldwide: health effects and prevention

    Science.gov (United States)

    Gernand, Alison D.; Schulze, Kerry J.; Stewart, Christine P.; West, Keith P.; Christian, Parul

    2016-01-01

    Micronutrients, vitamins and minerals accessible from the diet, are essential for biologic activity. Micronutrient status varies widely throughout pregnancy and across populations. Women in low-income countries often enter pregnancy malnourished, and the demands of gestation can exacerbate micronutrient deficiencies with health consequences to the fetus. Examples of efficacious single micronutrient interventions include folic acid to prevent neural tube defects, iodine to prevent cretinism, zinc to reduce of preterm birth, and iron to reduce the risk of low birth weight. Folic acid and vitamin D might also increase birth weight. While extensive mechanism and association research links antenatal multiple micronutrients to plausible materno-fetal health advantages, hypothesized benefits have often been absent, minimal or unexpected in trials. These findings suggest a role for population context in determining health responses and extensive gaps in knowledge. Multiple micronutrient supplements reduce risks of being born low birth weight, small for gestational age or stillborn in undernourished settings, and justify micronutrient interventions with antenatal care. Measurable health effects of gestational micronutrient exposure may persist into childhood but few data exists on potential long-term benefits. In this Review, we discuss micronutrient intake recommendations, risks and consequences of deficiencies, and the effects of interventions with a particular emphasis on offspring. PMID:27032981

  5. Micronutrient deficiencies in pregnancy worldwide: health effects and prevention.

    Science.gov (United States)

    Gernand, Alison D; Schulze, Kerry J; Stewart, Christine P; West, Keith P; Christian, Parul

    2016-05-01

    Micronutrients, vitamins and minerals accessible from the diet, are essential for biologic activity. Micronutrient status varies widely throughout pregnancy and across populations. Women in low-income countries often enter pregnancy malnourished, and the demands of gestation can exacerbate micronutrient deficiencies with health consequences for the fetus. Examples of efficacious single micronutrient interventions include folic acid to prevent neural tube defects, iodine to prevent cretinism, zinc to reduce risk of preterm birth, and iron to reduce the risk of low birth weight. Folic acid and vitamin D might also increase birth weight. While extensive mechanistic and association research links multiple antenatal micronutrients with plausible materno-fetal health advantages, hypothesized benefits have often been absent, minimal or unexpected in trials. These findings suggest a role for population context in determining health responses and filling extensive gaps in knowledge. Multiple micronutrient supplements reduce the risks of being born with low birth weight, small for gestational age or stillborn in undernourished settings, and justify micronutrient interventions with antenatal care. Measurable health effects of gestational micronutrient exposure might persist into childhood but few data exists on potential long-term benefits. In this Review, we discuss micronutrient intake recommendations, risks and consequences of deficiencies, and the effects of interventions with a particular emphasis on offspring.

  6. Efficacy and safety of serial membrane sweeping to prevent post term pregnancy: a randomised study

    Directory of Open Access Journals (Sweden)

    Sabita Saichandran

    2015-12-01

    Conclusions: Serial membrane sweeping is both safe and effective in the prevention of pregnancy beyond 41 weeks. Hence reduces the post term pregnancy, need for induction of labour and related risks in low pregnancies. [Int J Reprod Contracept Obstet Gynecol 2015; 4(6.000: 1882-1886

  7. Pregnancy prevention and condom use practices among HIV-infected women on antiretroviral therapy seeking family planning in Lilongwe, Malawi.

    Directory of Open Access Journals (Sweden)

    Lisa B Haddad

    Full Text Available Programs for integration of family planning into HIV care must recognize current practices and desires among clients to appropriately target and tailor interventions. We sought to evaluate fertility intentions, unintended pregnancy, contraceptive and condom use among a cohort of HIV-infected women seeking family planning services within an antiretroviral therapy (ART clinic.200 women completed an interviewer-administered questionnaire during enrollment into a prospective contraceptive study at the Lighthouse Clinic, an HIV/ART clinic in Lilongwe, Malawi, between August and December 2010.Most women (95% did not desire future pregnancy. Prior reported unintended pregnancy rates were high (69% unplanned and 61% unhappy with timing of last pregnancy. Condom use was inconsistent, even among couples with discordant HIV status, with lack of use often attributed to partner's refusal. Higher education, older age, lower parity and having an HIV negative partner were factors associated with consistent condom usage.High rates of unintended pregnancy among these women underscore the need for integ rating family planning, sexually transmitted infection (STI prevention, and HIV services. Contraceptive access and use, including condoms, must be improved with specific efforts to enlist partner support. Messages regarding the importance of condom usage in conjunction with more effective modern contraceptive methods for both infection and pregnancy prevention must continue to be reinforced over the course of ongoing ART treatment.

  8. Developing a prevention synthesis and translation system to promote science-based approaches to teen pregnancy, HIV and STI prevention.

    Science.gov (United States)

    Lewis, Kelly M; Lesesne, Catherine A; Zahniser, S Christine; Wilson, Mary Martha; Desiderio, Gina; Wandersman, Abraham; Green, Diane C

    2012-12-01

    The Interactive Systems Framework for Dissemination and Implementation (ISF) is a multi-system framework that can guide research-to-practice efforts by building and supporting the work of three interacting systems: the Prevention Delivery, Support, and Synthesis and Translation Systems. The Synthesis and Translation system is vital to bridging science and practice, yet how to develop it and train support system partners to use it is under-researched. This article bridges this gap by offering a case example of the planning, development, and use of a synthesis and translation product called Promoting Science-based Approaches to Teen Pregnancy Prevention using Getting To Outcomes. The case presented documents the process used for developing the synthesis and translation product, reports on efforts to engage the Prevention Support system to use the product, and how we approached building interaction between the Synthesis and Translation System and the Support System partners. Practice-oriented evaluation data are also presented. Implications for practice, policy and research are discussed.

  9. [Pregnancy: a model of prevention of HIV transmission].

    Science.gov (United States)

    Mandelbrot, Laurent

    2014-01-01

    Antiretroviral drugs are primarily used to treat people living with HIV but can also reduce the risk of transmission. The first application of this prophylactic approach was in the prevention of mother-to-child transmission, which comprises three components: 1) antiretroviral therapy during pregnancy to reduce maternal viral load, 2) pre-exposure prophylactic treatment of the fetus in utero and intrapartum, and 3) postexposure neonatal treatment. This has resulted in a sharp reduction in mother-to-child transmission, to well below 1 % in France today. "Treatment as prevention" (TASP) is now widely recommended to prevent sexual transmission to partners of people living with HIV articularly when a couple wishes to have children. Achieving and sustaining undetectable viral load is an important means of reducing the risk of sexual transmission in serodiscordant couples and also of controlling the pandemic worldwide. The other uses of antiretroviral drugs to protect HIV-negative people at risk include post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP). Prevention has both individual and collective dimensions and involves several components, including behavioral changes, serological testing, and use of antiretrovirals.

  10. U.S. teen pregnancy: studies point to new prevention approaches.

    Science.gov (United States)

    1988-01-01

    The US has the highest rate of teenage pregnancy in the developed world, and although there is no consensus on the best solution, promising prevention approaches are being offered. 1 in 10 teenaged girls in the US becomes pregnant each year, and more than 1/2 of these pregnancies end in abortion or miscarriage. In a 1986 survey of US teens aged 12 to 17, 1/3 of the sexually active reported using contraceptives all the time, and 27% said they never used them. 24% of the teens cited embarrassment and fear of parental disapproval as reasons for not using contraceptives, while almost 40% said they did not want to use them. 1/4 reportedly lacked knowledge about contraceptives. A successful approach, which increased contraceptive use among teens and helped reduce adolescent pregnancies, involved a school-based clinic in Minnesota. It provided information about sex and birth control, and referred students to a clinic for contraceptive services. Another effective approach provided a combination of sex education and accessible family planning services in 2 Baltimore schools. It resulted in reduced teenage pregnancy rates and a small decrease in the age at 1st intercourse. Programs designed to encourage postponement of sexual activity, and resistance of peer pressure, as well as efforts to promote responsible decision-making and communication between parents and children, are thought to have potential. The "life options" strategy targets girls with low educational ambitions, who are from poor families since study results indicate a high rate of pregnancy among this group. The approach is to help young people develop values and self-esteem, and work toward realistic goals.

  11. National Campaign to Prevent Teen and Unplanned Pregnancy

    Science.gov (United States)

    ... TheNC@20 Close Making the Case Teen Pregnancy Unplanned Pregnancy Public Cost National & State Data U.S. teen pregnancy ... the IUD a first line of defense against unplanned pregnancy. It won't be easy. TIME Magazine The ...

  12. Lifestyle intervention to prevent obesity during pregnancy: Implications and recommendations for research and implementation.

    Science.gov (United States)

    Hill, Briony; McPhie, Skye; Moran, Lisa J; Harrison, Paul; Huang, Terry T-K; Teede, Helena; Skouteris, Helen

    2016-09-28

    Maternal obesity and excessive gestational weight gain (GWG) are significant contributors to the global obesity epidemic. However, isolated lifestyle interventions to address this in pregnancy appear to have only modest benefit and responses can be variable. This paper aims to address the question of why the success of lifestyle interventions to prevent excessive GWG is suboptimal and variable. We suggest that there are inherent barriers to lifestyle change within pregnancy as a life stage, including the short window available for habit formation; the choice for women not to prioritise their weight; competing demands including physiological, financial, relationship, and social situations; and lack of self-efficacy among healthcare professionals on this topic. In order to address this problem, we propose that just like all successful public health approaches seeking to change behaviour, individual lifestyle interventions must be provided in the context of a supportive environment that enables, incentivises and rewards healthy changes. Future research should focus on a systems approach that integrates the needs of individuals with the context within which they exist. Borrowing from the social marketing principle of 'audience segmentation', we also need to truly understand the needs of individuals to design appropriately tailored interventions. This approach should also be applied to the preconception period for comprehensive prevention approaches. Additionally, relevant policy needs to reflect the changing evidence-based climate. Interventions in the clinical setting need to be integrally linked to multipronged obesity prevention efforts in the community, so that healthy weight goals are reinforced throughout the system.

  13. Thyroid screening in pregnancy - a compulsory preventive activity

    Directory of Open Access Journals (Sweden)

    Scrinic Olesea

    2015-08-01

    Full Text Available Obiectives: To assess the prevalence of thyroid dysfunction in a group of pregnant women, originating from Dobrogea region of southeastern Romania, considered to be an area without iodine deficiency, including the Black Sea area. Materials and methods: We enrolled 324 pregnant women in different trimesters of pregnancy. Each case was reviewed by a detailed madical history, clinical examination and by serum dosage of thyroid hormones: TSH, FT4, and the antithyroidperoxidase. They were evaluated by comparison with trimester -specific reference range for TSH recommended by American Thyroid Association, then the results were compared with those obtained using the manufacturers reference range. Abortion rate was also analysed. Results: The prevalence of thyroid dysfunction was different in all the 3 trimesters: subclinical hypothyroidism being the most frequently approx. 24% of all cases; 7% of pregnant women had overt hypothyroidism. Incidence of thyrotoxicosis in entire study cases was approx. 5.5%. The most frecvent thyroid autoimune disorders were Hashimoto thyroiditis: 42 % - I trimester, 26,6% in II trimester and about 12,5 % in III-trimester; Graves disease have an incidence of only 0,9 % (n=3.The difference between reference methods eluded a lower number of cases using manufactures reference range for TSH (P< 0,001, but higher for recommended trimester - specific TSH value, confirming the undervalueted hypothesis. The risk of misclassifying the hypothyroidism is between 3 %-8 %. Conclusion: Necessity for thyroid hormone dosage periodic/trimesterly/ in pregnancy is a preventive measure. The reference values for hormonal dosage requires trimester-specific assessment. The possibility of hormonal disorders during pregnancy is common. The need for specific therapy at diagnosis depends on the nature of hormonal disorder. Further precautions are needed in pregnant women with known autoimmune thyroid disorder or newly diagnosed

  14. Interventions for preventing recurrent urinary tract infection during pregnancy.

    Science.gov (United States)

    Schneeberger, Caroline; Geerlings, Suzanne E; Middleton, Philippa; Crowther, Caroline A

    2015-07-26

    Recurrent urinary tract infections (RUTI) are common in women who are pregnant and may cause serious adverse pregnancy outcomes for both mother and child including preterm birth and small-for-gestational-age babies. Interventions used to prevent RUTI in women who are pregnant can be pharmacological (antibiotics) or non-pharmacological (cranberry products, acupuncture, probiotics and behavioural modifications). So far little is known about the best way to prevent RUTI in pregnant women. To assess the effects of interventions for preventing RUTI in pregnant women.The primary maternal outcomes were RUTI before birth (variously defined) and preterm birth (before 37 weeks). The primary infant outcomes were small-for-gestational age and total mortality. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (20 May 2015) and reference lists of retrieved articles. Published, unpublished and ongoing randomised controlled trials (RCTs), quasi-RCTs, clustered-randomised trials and abstracts of any intervention (pharmacological and non-pharmacological) for preventing RUTI during pregnancy (compared with another intervention, placebo or with usual care). Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. The review included one trial involving 200 women and was at moderate to high risk of bias.The trial compared a daily dose of nitrofurantoin and close surveillance (regular clinic visit, urine cultures and antibiotics when a positive culture was found) with close surveillance only. No significant differences were found for the primary outcomes: recurrent pyelonephritis (risk ratio (RR) 0.89, 95% confidence interval (CI) 0.31 to 2.53; one study, 167 women), RUTI before birth (RR 0.30, 95% CI 0.06 to 1.38; one study, 167 women), and preterm birth (before 37 weeks) (RR 1.18, 95% CI 0.42 to 3.35; one study, 147 women). The overall quality of evidence for these outcomes as assessed using

  15. School-age pregnancy: why hasn't prevention worked?

    Science.gov (United States)

    Males, M

    1993-12-01

    Adolescent pregnancy or sexually transmitted disease (STD) reduction has not occurred, despite sexuality education and abstinence programs, and intensive publicity and community initiatives. An obstacle to adolescent pregnancy, STD, and childbearing prevention is the assumption that adolescent sexuality is a closed system of activity among peers. When a nation is consumed with the preoccupation of condoms versus chastity debates, and is ignoring high poverty levels and abuse of the young, adolescent girls will seek escape from harsh childhoods in early family formation with young adult men. There is a high correlation between poverty rates and teenage birth, AIDS, and STD rates. Schools are not able to produce magical solutions to teenage pregnancy when adult lawmakers abnegate their responsibility to provide for youth well-being. Adolescent pregnancy will occur regardless of the expansion of curative programs such as school-based clinics; fundamental changes in assumptions, attitudes, and policies are needed. Beneficial aspects of programming appear to be fact-based sexuality and contraceptive education, counseling and referrals for youths with histories of child abuse, and child care classes and flexible school schedules for parenting students. A statistical profile in California indicates that 85% of all fathers of babies born to girls between ages of 11 and 18 years were adults. More than 50% of mothers aged 11-15 years were impregnated by adult men. Fathers' average age for births among junior high school mothers was 15-26 years, when the youngest and the oldest 2.5% of fathers are eliminated. There is a greater likelihood that a man older than 23 years will impregnate a junior high girl than will a junior high boy. The partner age gap is greatest among the very young girls. The California profile of father's age is similar to birth patterns in other states and similar to the national average. An examination of STDs shows a higher rate of STDs among females

  16. Practitioners' Perspectives on Cultural Sensitivity in Latina/o Teen Pregnancy Prevention

    Science.gov (United States)

    Wilkinson-Lee, Ada M.; Russell, Stephen T.; Lee, Faye C. H.

    2006-01-01

    This study examined practitioners' understandings of cultural sensitivity in the context of pregnancy prevention programs for Latina teens. Fifty-eight practitioners from teen pregnancy prevention programs in California were interviewed in a guided conversation format. Three themes emerged in our analysis. First, practitioners' definitions of…

  17. Preventing Unplanned Pregnancy and Completing College: An Evaluation of Online Lessons. 2nd Edition

    Science.gov (United States)

    Antonishak, Jill; Connolly, Chelsey

    2014-01-01

    The National Campaign to Prevent Teen and Unplanned Pregnancy published free online lessons that help students take action to prevent unplanned pregnancy and complete their education. From the fall of 2012 to the spring of 2014, approximately 2,800 students took the online lessons and participated in pre- and post-lesson evaluation surveys at four…

  18. The Role of Social-Emotional Learning in Bullying Prevention Efforts

    Science.gov (United States)

    Smith, Brian H.; Low, Sabina

    2013-01-01

    This article examines how social emotional learning contributes to bullying prevention efforts in schools. Bullying behavior is impacted by multiple levels of the social-ecology of schools. Social emotional learning (SEL) is a structured way to improve a wide range of students' social and emotional competencies and impact bullying at the…

  19. Federal Agency Efforts to Advance Media Literacy in Substance Abuse Prevention

    Science.gov (United States)

    Levitt, Alan; Denniston, Bob

    2014-01-01

    This article describes and reflects upon efforts to generate greater support for media literacy and critical thinking within the strategies and programs of the Federal government in the early 1990s to about 2005 primarily among agencies with an interest in youth substance abuse prevention. Beginning with their personal reflections on discovering…

  20. Effortful Control, Social Information Processing, and the Prevention of Aggression in Elementary Schools

    Science.gov (United States)

    Ellis, Alan Reid

    2012-01-01

    Early aggression is a problem in its own right and a risk factor for further developmental problems. Although both effortful control and social information processing (SIP) skills are negatively associated with aggression and are targeted by aggression prevention programs, little is known about the relation between them or about their joint…

  1. Asian/Pacific islander youth violence prevention center: community mobilization efforts to reduce and prevent youth violence.

    Science.gov (United States)

    Lai, Mary H

    2008-03-01

    Although youth violence is a serious concern in the United States, Asian American and Pacific Islander (AAPI) youth have generally been neglected as a demographic group for scholarly inquiry or community mobilization efforts. This lack of attention in the violence prevention field is indicative of two perceptual impediments with which AAPI communities have struggled for decades: (1) That AAPIs represent a relatively small portion of the United States population, and (2) That AAPIs are stereotyped as "model minorities" who do not encounter serious social obstacles and who lack ethnic heterogeneity. This paper challenges these concerns, and describes two community mobilization efforts to prevent youth violence in AAPI communities. Both of these efforts were carried out from 2000 to 2003 by the University of Hawaii, Asian/Pacific Islander Youth Violence Prevention Center. Findings from these mobilization efforts highlight the need for long-term university-community commitments, in which university entities take a leadership role in disaggregating AAPI juvenile justice data. Another critical need is to work with previously marginalized ethnic groups within the AAPI population.

  2. School-based teenage pregnancy prevention programs: a systematic review of randomized controlled trials.

    Science.gov (United States)

    Bennett, Sylvana E; Assefi, Nassim P

    2005-01-01

    We compared school-based abstinence-only programs with those including contraceptive information (abstinence-plus) to determine which has the greatest impact on teen pregnancy. The United States has one of the highest rates of teen pregnancy in the industrialized world. Programs aimed at reducing the rate of teen pregnancy include a myriad of approaches including encouraging abstinence, providing education about birth control, promoting community service activities, and teaching skills to cope with peer pressure. We systematically reviewed all published randomized controlled trials of secondary-school-based teen pregnancy prevention programs in the United States that used sexual behavior, contraceptive knowledge, contraceptive use, and pregnancy rates as outcomes.

  3. [State of suicide and effective efforts in suicide prevention in psychiatric hospitals and clinics].

    Science.gov (United States)

    Orui, Masatsugu; Hirokawa, Seiko; Akazawa, Masato; Tachimori, Hisateru; Kawano, Kenji; Mori, Takao; Akita, Hiroya; Takeshima, Tadashi

    2012-01-01

    Although factors related to suicide are complicated, mental health disorders are an important risk factor. It is anticipated that suicide prevention measures will be implemented from the perspective of improved psychiatric medicine. No national-scale study has been carried out in Japan on the state of psychiatric medicine and its influence on suicide since 2000. Moreover, many efforts not intended for suicide prevention have been shown to be effective for this purpose. Here, we conducted surveys to obtain basic data on suicide prevention and improvements in mental health care among 1,728 psychiatric hospitals and clinics in Japan in 2010. The incidence of suicide in psychiatric hospitals and clinics from January to December 2009 was estimated to be 100.5 for outpatients and 154.5 for inpatients per 100,000 patients. Regarding the duration from consultation to suicide, 87% of outpatients committed suicide less than one month following their last consultation. Moreover, approximately two-thirds of patients had undergone consultations for more than one year. A number of suicides in psychiatric hospitals and clinics occurred while patients were continuously undergoing treatment. Efforts shown to be effective in suicide prevention included risk assessment with multiple medical staff (i.e., doctors and nurses), a 24-hour crisis line, and a follow-up system for discontinued outpatients. We expect that the results of this survey will aid in the implementation of effective suicide prevention in psychiatric medicine.

  4. Halfway There: A Prescription for Continued Progress in Preventing Teen Pregnancy.

    Science.gov (United States)

    National Campaign To Prevent Teen Pregnancy, Washington, DC.

    This report offers findings and recommendations by the National Campaign To Prevent Teen Pregnancy. Nearly one million teens become pregnant annually. The teen birth rate increased 24 percent between 1986-91 and has fallen 20 percent since then. Overall, too many parents and adult leaders do not take a strong stand against teen pregnancy. Strident…

  5. Parental Support for Teenage Pregnancy Prevention Programmes in South Carolina Public Middle Schools

    Science.gov (United States)

    Rose, India; Prince, Mary; Flynn, Shannon; Kershner, Sarah; Taylor, Doug

    2014-01-01

    Teenage pregnancy is a major public health issue in the USA; this is especially true in the state of South Carolina (SC). Research shows that well developed, good-quality teenage pregnancy prevention (TPP) programmes can be effective in modifying young people's sexual behaviour. While several quantitative studies have examined parents' perceptions…

  6. Parental Support for Teenage Pregnancy Prevention Programmes in South Carolina Public Middle Schools

    Science.gov (United States)

    Rose, India; Prince, Mary; Flynn, Shannon; Kershner, Sarah; Taylor, Doug

    2014-01-01

    Teenage pregnancy is a major public health issue in the USA; this is especially true in the state of South Carolina (SC). Research shows that well developed, good-quality teenage pregnancy prevention (TPP) programmes can be effective in modifying young people's sexual behaviour. While several quantitative studies have examined parents' perceptions…

  7. Prevalence and Prevention of Malaria in Pregnancy in Edo State ...

    African Journals Online (AJOL)

    Erah

    The observational/longitudinal study was undertaken in Igueben Local Government Area (LGA), Edo. State ... Plasmodium falciparum in pregnancy is ... dependent on pre- pregnancy immunity. ... have shown that prevalence of infection ... among pregnant women and their infants. ... in the study giving 94.1% response rate.

  8. How active resisters and organizational constipators affect health care-acquired infection prevention efforts.

    Science.gov (United States)

    Saint, Sanjay; Kowalski, Christine P; Banaszak-Holl, Jane; Forman, Jane; Damschroder, Laura; Krein, Sarah L

    2009-05-01

    As of October 2008, hospitals in the United States no longer receive Medicare reimbursement for certain types of health care-associated infection (HAI), thereby heightening the need for effective prevention efforts. The mere existence of evidence-based practices, however, does not always result in the use of such practices because of the complexities inherent in translating evidence into practice. A qualitative study was conducted to determine the barriers to implementing evidence-based practices to prevent HAI, with a specific focus on the role played by hospital personnel. In-depth phone and in-person interviews were conducted between October 2006 and September 2007 with 86 participants (31 physicians) including chief executive officers, chiefs of staff, hospital epidemiologists, infection control professionals, intensive care unit directors, nurse managers, and frontline physicians and nurses, in 14 hospitals. Active resistance to evidence-based practice change was pervasive. Successful efforts to overcome active resisters included benchmarking infection rates, identifying effective champions, and participating in collaborative efforts. Organizational constipators-mid- to high-level executives who act as insidious barriers to change-also increased the difficulty in implementing change. Recognizing the presence of constipators is often the first step in addressing the problem but can be followed with including the organizational constipator early in group discussions to improve communication and obtain buy-in, working around the individual, and terminating the constipator's employment. Two types of personnel-active resistors and organizational constipators-impeded HAI prevention activities, and several approaches were used to overcome those barriers. Hospital administrators and patient safety leaders can use the findings to more successfully structure activities that prevent HAI in their hospitals.

  9. [Toxoplasmosis in pregnancy: prevention, prenatal diagnosis and treatment].

    Science.gov (United States)

    Hohlfeld, P; Biedermann, K; Extermann, P; Gyr, T

    1995-01-01

    Maternal infection with Toxoplasma gondii acquired during pregnancy occurs in more than 500 women per year in Switzerland. Systematic screening at the beginning of pregnancy allows the introduction of health education programs. The screening during pregnancy is performed to diagnose primary maternal infections and to propose prenatal diagnosis and treatment. The administration of specific antibiotherapy during pregnancy (spiramycine or the association of pyrimethamine and sulfonamides) significantly reduces the risk of fetal infection. Prenatal diagnosis of congenital toxoplasmosis is possible and reliable. It avoids unnecessary termination of pregnancy when the fetus is not infected and specific therapy in case of infection (association of pyrimethamine and sulfonamides). Prenatal treatment may be proposed without prenatal diagnosis as of the 16th week of gestation. In any case, prenatal treatment seems to reduce the incidence of severe congenital toxoplasmosis.

  10. Access to information and decision making on teenage pregnancy prevention by females in Tshwane.

    Science.gov (United States)

    Masemola-Yende, J P F; Mataboge, Sanah M

    2015-11-05

    The increase in the number of teenage pregnancies and its negative consequences has encouraged various researchers to explore the possible causes of teenage pregnancy. Findings from previously-conducted research have indicated different preventable factors that predispose female teenagers to pregnancy, such as staff attitudes and the lack of information resulting from poor access to health facilities. To explore and describe access to information and decision making on teenage pregnancy prevention by females using a primary healthcare clinic in Tshwane, South Africa. In this study, the researchers used a descriptive qualitative and exploratory research design to explore and describe the verbal reports regarding prevention of teenage pregnancy by females using a primary healthcare clinic in Tshwane, South Africa. Face-to-face semistructured interviews were conducted with 15 female participants aged between 15 and 26, who had been pregnant once or more during their teens. Two themes emerged, namely, access to information and decision making by female teenagers. Five categories that emerged were: access to information on pregnancy prevention; ignoring of provided information; the use of alternative medicine with hormonal contraception; personal reasons for use and non-use of contraception; and decisions made by teenagers to not fall pregnant. Females in this study fell pregnant in their teens, even though they had access to information. Given the complexity of this problem, female teenagers should use their families as primary sources of information for reproductive health promotion and educational institutions should build on this to aid the prevention of teenage pregnancy.

  11. Prevention of Hypertensive Disorders of Pregnancy : a Novel Application of the Polypill Concept

    NARCIS (Netherlands)

    Browne, J L; Klipstein-Grobusch, K; Franx, A; Grobbee, D E

    2016-01-01

    Nearly all of the annual 287,000 global maternal deaths are preventable. Hypertensive disorders of pregnancy (HDP) are among the major causes. A novel fixed-dose combination pill or polypill to prevent cardiovascular disease is a promising strategy for prevention of HDP. The aim of this study was to

  12. Prevention of Hypertensive Disorders of Pregnancy : a Novel Application of the Polypill Concept

    NARCIS (Netherlands)

    Browne, J L; Klipstein-Grobusch, K; Franx, A; Grobbee, D E

    Nearly all of the annual 287,000 global maternal deaths are preventable. Hypertensive disorders of pregnancy (HDP) are among the major causes. A novel fixed-dose combination pill or polypill to prevent cardiovascular disease is a promising strategy for prevention of HDP. The aim of this study was to

  13. Prevention and management of malaria during pregnancy: findings from qualitative studies in Ghana and Malawi

    NARCIS (Netherlands)

    C. Pell; A. Meñaca; N.A. Afrah; L. Manda-Taylor; S. Chatio; F. Were; A. Hodgson; M.J. Hamel; L. Kalilani; H. Tagbor; R. Pool

    2013-01-01

    Background In endemic regions of sub-Saharan Africa, malaria during pregnancy (MiP) is a major preventable cause of maternal and infant morbidity and mortality. Current recommended MiP prevention and control includes intermittent preventive treatment (IPTp), distribution of insecticide-treated bed n

  14. Shifting the Paradigm in Oregon from Teen Pregnancy Prevention to Youth Sexual Health

    National Research Council Canada - National Science Library

    Robert J. Nystrom; Jessica E.A. Duke; Brad Victor

    2013-01-01

    Oregon's work on teen pregnancy prevention during the previous 20 years has shifted from a risk-focused paradigm to a youth development model that places young people at the center of their sexual health and well-being...

  15. Improving the Rigor of Quasi-Experimental Impact Evaluations: Lessons for Teen Pregnancy Prevention Researchers

    OpenAIRE

    Brian Goesling; Joanne Lee

    2015-01-01

    This research brief highlights three ways to improve the rigor of quasi-experimental impact evaluations of social and public health interventions, focusing specifically on evaluations of teen pregnancy prevention programs.

  16. Prevention of pregnancy in cats using aglepristone on days 5 and 6 after mating.

    Science.gov (United States)

    Goericke-Pesch, Sandra; Georgiev, Plamen; Wehrend, Axel

    2010-07-15

    The aim of this study was to test for the efficacy of aglepristone treatment for prevention of early pregnancy in the cat. Eleven cats (Gr. 1) were treated with 10 mg/kg aglepristone on days 5 and 6 after mating, 17 cats (Gr. 2) were used as untreated controls. Blood samples for progesterone (P4) determination were collected from 6 cats of Gr. 1 and 9 cats of Gr. 2, respectively. Ultrasound examination on day 25 revealed no pregnancy in any of the treated cats. In both groups, P4 concentrations increased from day 5 (before treatment) to day 20 (P pregnancy was 56.4 (4.7) d, ranging from 5-325 d. Pregnancy rates after the next estrus following treatment were 64 and 82% after the first and second estrus, respectively. No major treatment-related side effects were observed. In conclusion, treatment was found to be highly effective for prevention of early pregnancy.

  17. State and local law enforcement agency efforts to prevent sales to obviously intoxicated patrons.

    Science.gov (United States)

    Lenk, Kathleen M; Toomey, Traci L; Nelson, Toben F; Jones-Webb, Rhonda; Erickson, Darin J

    2014-04-01

    Alcohol sales to intoxicated patrons are illegal and may lead to public health issues such as traffic crashes and violence. Over the past several decades, considerable effort has been made to reduce alcohol sales to underage persons but less attention has been given to the issue of sales to obviously intoxicated patrons. Studies have found a high likelihood of sales to obviously intoxicated patrons (i.e., overservice), but little is known about efforts by enforcement agencies to reduce these sales. We conducted a survey of statewide alcohol enforcement agencies and local law enforcement agencies across the US to assess their strategies for enforcing laws prohibiting alcohol sales to intoxicated patrons at licensed alcohol establishments. We randomly sampled 1,631 local agencies (1,082 participated), and surveyed all 49 statewide agencies that conduct alcohol enforcement. Sales to obviously intoxicated patrons were reported to be somewhat or very common in their jurisdiction by 55 % of local agencies and 90 % of state agencies. Twenty percent of local and 60 % of state agencies reported conducting enforcement efforts to reduce sales to obviously intoxicated patrons in the past year. Among these agencies, fewer than half used specific enforcement strategies on at least a monthly basis to prevent overservice of alcohol. Among local agencies, enforcement efforts were more common among agencies that had a full-time officer specifically assigned to carry out alcohol enforcement efforts. Enforcement of laws prohibiting alcohol sales to obviously intoxicated patrons is an underutilized strategy to reduce alcohol-related problems, especially among local law enforcement agencies.

  18. Mobile Phone Apps for the Prevention of Unintended Pregnancy: A Systematic Review and Content Analysis.

    Science.gov (United States)

    Mangone, Emily Rose; Lebrun, Victoria; Muessig, Kathryn E

    2016-01-19

    Over 50% of pregnancies in the United States are unintended, meaning that the pregnancy is mistimed, unplanned, or unwanted. Unintended pregnancy increases health risks for mother and child, leads to high economic costs for society, and increases social disparities. Mobile phone ownership is rapidly increasing, providing opportunities to reach at-risk populations with reproductive health information and tailored unintended pregnancy prevention interventions through mobile phone apps. However, apps that offer support for unintended pregnancy prevention remain unevaluated. To identify, describe, and evaluate mobile phone apps that purport to help users prevent unintended pregnancy. We conducted an extensive search of the Apple iTunes and Android Google Play stores for apps that explicitly included or advertised pregnancy prevention or decision-making support in the context of fertility information/tracking, birth control reminders, contraceptive information, pregnancy decision-making, abortion information or counseling, sexual communication/negotiation, and pregnancy tests. We excluded apps that targeted medical professionals or that cost more than US $1.99. Eligible apps were downloaded and categorized by primary purpose. Data extraction was performed on a minimum of 143 attributes in 3 domains: (1) pregnancy prevention best practices, (2) contraceptive methods and clinical services, and (3) user interface. Apps were assigned points for their inclusion of features overall and for pregnancy prevention best practices and contraceptive information. Our search identified 6805 app descriptions in iTunes and Google Play. Of these, 218 unique apps met inclusion criteria and were included in the review. Apps were grouped into 9 categories: fertility trackers (n=72), centers and resources (n=38), birth control reminders (n=35), general sexual and reproductive health (SRH) information (n=17), SRH information targeted specifically to young adults (YA) (n=16), contraceptive

  19. A Novel Integration Effort to Reduce the Risk for Alcohol-Exposed Pregnancy Among Women Attending Urban STD Clinics

    Science.gov (United States)

    Hutton, Heidi E.; Chander, Geetanjali; Green, Patricia P.; Hutsell, Catherine A.; Weingarten, Kimberly

    2014-01-01

    Alcohol-exposed pregnancy (AEP) is a significant public health problem in the United States. Sexually transmitted disease (STD) clinics serve female clients with a high prevalence of heavy alcohol consumption coupled with ineffective contraceptive use. Project CHOICES (Changing High-Risk AlcOhol Use and Increasing Contraception Effectiveness) is an evidence-based, brief intervention to lower risk of AEP by targeting alcohol and contraceptive behaviors through motivational interviewing and individualized feedback. We describe our experience integrating and implementing CHOICES in STD clinics. This endeavor aligns with CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention's program collaboration and service integration strategic priority to strengthen collaborative work across disease areas and integrate services provided by related programs at the client level. PMID:24385650

  20. Mechanism and preclinical prevention of increased breast cancer risk caused by pregnancy.

    Science.gov (United States)

    Haricharan, Svasti; Dong, Jie; Hein, Sarah; Reddy, Jay P; Du, Zhijun; Toneff, Michael; Holloway, Kimberly; Hilsenbeck, Susan G; Huang, Shixia; Atkinson, Rachel; Woodward, Wendy; Jindal, Sonali; Borges, Virginia F; Gutierrez, Carolina; Zhang, Hong; Schedin, Pepper J; Osborne, C Kent; Tweardy, David J; Li, Yi

    2013-12-31

    While a first pregnancy before age 22 lowers breast cancer risk, a pregnancy after age 35 significantly increases life-long breast cancer risk. Pregnancy causes several changes to the normal breast that raise barriers to transformation, but how pregnancy can also increase cancer risk remains unclear. We show in mice that pregnancy has different effects on the few early lesions that have already developed in the otherwise normal breast-it causes apoptosis evasion and accelerated progression to cancer. The apoptosis evasion is due to the normally tightly controlled STAT5 signaling going astray-these precancerous cells activate STAT5 in response to pregnancy/lactation hormones and maintain STAT5 activation even during involution, thus preventing the apoptosis normally initiated by oncoprotein and involution. Short-term anti-STAT5 treatment of lactation-completed mice bearing early lesions eliminates the increased risk after a pregnancy. This chemoprevention strategy has important implications for preventing increased human breast cancer risk caused by pregnancy. DOI: http://dx.doi.org/10.7554/eLife.00996.001.

  1. Rethinking school-based health centers as complex adaptive systems: maximizing opportunities for the prevention of teen pregnancy and sexually transmitted infections.

    Science.gov (United States)

    Daley, Alison Moriarty

    2012-01-01

    This article examines school-based health centers (SBHCs) as complex adaptive systems, the current gaps that exist in contraceptive access, and the potential to maximize this community resource in teen pregnancy and sexually transmitted infection (STI) prevention efforts. Adolescent pregnancy is a major public health challenge for the United States. Existing community resources need to be considered for their potential to impact teen pregnancy and STI prevention efforts. SBHCs are one such community resource to be leveraged in these efforts. They offer adolescent-friendly primary care services and are responsive to the diverse needs of the adolescents utilizing them. However, current restrictions on contraceptive availability limit the ability of SBHCs to maximize opportunities for comprehensive reproductive care and create missed opportunities for pregnancy and STI prevention. A clinical case explores the current models of health care services related to contraceptive care provided in SBHCs and the ability to meet or miss the needs of an adolescent seeking reproductive care in a SBHC.

  2. Determinants of use of insecticide treated nets for the prevention of malaria in pregnancy: Jinja, Uganda.

    Directory of Open Access Journals (Sweden)

    Laura R Sangaré

    Full Text Available BACKGROUND: One established means of preventing the adverse consequences of malaria during pregnancy is sleeping under an insecticide treated net (ITN throughout pregnancy. Despite increased access to this intervention over time, consistent ITN use during pregnancy remains relatively uncommon in sub-Saharan Africa. METHODOLOGY/PRINCIPAL FINDINGS: We sought to identify determinants of ITN use during pregnancy. Utilizing a population-based random sample, we interviewed 500 women living in Jinja, Uganda, who had been pregnant in the past year. ITN ownership at the start of pregnancy was reported by 359 women (72% and 28 women (20% acquired an ITN after the first trimester of pregnancy. Among 387 ITN owners, 73% reported either always sleeping under the ITN during all trimesters of pregnancy, or after acquiring their net. Owning more than 1 net was slightly associated with always sleeping under an ITN during pregnancy (RR: 1.13; 95% CI: 1.00, 1.28. Women who always slept under an ITN during pregnancy were more likely to be influenced by an advertisement on the radio/poster than being given an ITN free of charge (RR: 1.48; 95% CI: 1.24, 1.76. No differences were found between other socio-demographic factors, pregnancy history, ANC use or socio-cultural factors. CONCLUSIONS/SIGNIFICANCE: While self-reported ITN ownership and use was common throughout pregnancy, we were unable to pinpoint why a sizable fraction of Ugandan women did not always adhere to recommendations for use of an ITN during pregnancy. More data are needed on the capacity of individual households to support the installation of ITNs which may provide insight into interventions targeted at improving the convenience and adherence of daily ITN use.

  3. Screening for Syphilis Infection in Pregnancy : US Preventive Services Task Force Reaffirmation Recommendation Statement

    NARCIS (Netherlands)

    Calonge, Ned; Petitti, Diana B.; DeWitt, Thomas G.; Dietrich, Allen; Gregory, Kimberly D.; Grossman, David; Isham, George; LeFevre, Michael L.; Leipzig, Rosanne; Marion, Lucy N.; Melnyk, Bernadette; Moyer, Virginia A.; Ockene, Judith K.; Sawaya, George F.; Schwartz, J. Sanford; Wilt, Timothy

    2009-01-01

    Description: Update of the 2004 U. S. Preventive Services Task Force statement about screening for syphilis in pregnancy. Methods: The U. S. Preventive Services Task Force did a targeted literature search for evidence on the benefits of screening, the harms of screening, and the harms of treatment o

  4. Beyond Evidence-Based Interventions for Teen Pregnancy Prevention

    Directory of Open Access Journals (Sweden)

    Emily Scribner-O'Pray

    2017-04-01

    Full Text Available This article examines how the field of adolescent sexual health came to embrace evidence-based interventions (EBIs; whether or not this approach is effective in meeting the needs of adolescents, especially those at high risk for teen pregnancy; concerns related to the scaling up of EBIs; and identifies issues which must be resolved as we move forward.

  5. Preventing Adolescent Pregnancy: A Role for Social Work Services.

    Science.gov (United States)

    Edelman, Marion Wright

    1988-01-01

    For poor and minority teenagers the lack of adequate life options may increase their desire for early pregnancy. Since teen mothers face probable poverty and single parenthood, it is imperative that schools and school social workers provide counseling, health services, and work preparation as well as academic skills training. (VM)

  6. Social Action Research and Prevention of Unplanned Pregnancies.

    Science.gov (United States)

    Bailey, Bruce E.; And Others

    Many teenagers have unplanned, unwanted pregnancies. Research has shown that effective contraceptive use is hampered by a lack of knowledge and by negative attitudes. Providing accurate information does not necessarily lead to contraceptive use. This two-phase study attempted to assess contraceptive behavior, knowledge, and beliefs. In the first…

  7. Evaluation of an integrated services program to prevent subsequent pregnancy and birth among urban teen mothers.

    Science.gov (United States)

    Patchen, Loral; Letourneau, Kathryn; Berggren, Erica

    2013-01-01

    This article details the evaluation of a clinical services program for teen mothers in the District of Columbia. The program's primary objectives are to prevent unintended subsequent pregnancy and to promote contraceptive utilization. We calculated contraceptive utilization at 6, 12, 18, and 24 months after delivery, as well as occurrence of subsequent pregnancy and birth. Nearly seven in ten (69.5%) teen mothers used contraception at 24 months after delivery, and 57.1% of contraceptive users elected long-acting reversible contraception. In the 24-month follow-up period, 19.3% experienced at least one subsequent pregnancy and 8.0% experienced a subsequent birth. These results suggest that an integrated clinical services model may contribute to sustained contraceptive use and may prove beneficial in preventing subsequent teen pregnancy and birth.

  8. Evaluating Teen Pregnancy Prevention Programs: Decades of Evolving Strategies and Practices

    Directory of Open Access Journals (Sweden)

    Susan Philliber

    2015-09-01

    Full Text Available This paper reviews the changing strategies for both process and outcome evaluations of teen pregnancy prevention programs over the past few decades. Implementation evaluations have emphasized discovery of what program attributes are most effective in reducing teen pregnancy and its antecedents. Outcome evaluations have moved from collecting data to measure knowledge, attitudes, and program satisfaction to measuring behavior change including postponement of sexual involvement, increased used of contraception, or reduction in teen pregnancy. High quality randomized control trials or quasi-experimental designs are being increasingly emphasized, as are sophisticated analysis techniques using multi-variate analyses, controls for cluster sampling, and other strategies designed to build a more solid knowledge base about how to prevent early pregnancy.

  9. Performing Drug Safety Research During Pregnancy and Lactation: Biomedical HIV Prevention Research as a Template.

    Science.gov (United States)

    Beigi, Richard H; Noguchi, Lisa; Brown, Gina; Piper, Jeanna; Watts, D Heather

    2016-07-01

    Evidence-based guidance regarding use of nearly all pharmaceuticals by pregnant and lactating women is limited. Models for performing research may assist in filling these knowledge gaps. Internationally, reproductive age women are at high risk of human immunodeficiency virus (HIV) acquisition. Susceptibility to HIV infection may be increased during pregnancy, and risk of maternal-child transmission is increased with incident HIV infection during pregnancy and lactation. A multidisciplinary meeting of experts was convened at the United States National Institutes of Health to consider paradigms for drug research in pregnancy and lactation applicable to HIV prevention. This report summarizes the meeting proceedings and describes a framework for research on candidate HIV prevention agent use during pregnancy and lactation that may also have broader applications to other pharmaceutical products.

  10. Systematic review of progesterone for the prevention of preterm birth in singleton pregnancies

    DEFF Research Database (Denmark)

    Rode, Line; Langhoff-Roos, Jens; Andersson, Charlotte

    2009-01-01

    . SEARCH STRATEGY: A search in the PubMed, Embase, and Cochrane database was performed using the keywords: pregnancy, progesterone, preterm birth/preterm delivery, preterm labor, controlled trial, and randomized controlled trial. SELECTION CRITERIA: Studies on singleton pregnancies. DATA COLLECTION...... AND ANALYSIS: A meta-analysis was performed on randomized trials including singleton pregnancies with previous preterm birth. MAIN RESULTS: Two new randomized controlled trials of women with previous preterm birth were added to the four analyzed in the Cochrane review, and the meta-analysis of all six studies......BACKGROUND: A Cochrane review in 2006 concluded that further knowledge is required before recommendation can be made with regard to progesterone in the prevention of preterm birth. OBJECTIVE: To provide an update on the preventive effect of progesterone on preterm birth in singleton pregnancies...

  11. Understanding and preventing teenage pregnancy and sexually transmissible disease/AIDS.

    Science.gov (United States)

    Fisher, W A

    1989-01-01

    Most Canadian teenagers have sexual intercourse, but a great many do not reliably use contraception or exercise precautions against sexually transmitted disease (STD). The predictable result of this pattern of behavior is a high level of teenage pregnancy and infection with STDs, accompanied by equally predictable sequelae such as abortion, teenage parenthood, and welfare dependence. This chapter describes the problems of teenage pregnancy and STDs, presents a model for understanding why teenagers expose themselves to these risks, and closes with a discussion of a theory-based intervention to reduce adolescent pregnancy and STD infection. Interventions to promote prevention of pregnancy and STDs must change the way teens feel, think, and fantasize about preventive behavior. Moreover, it is necessary to deliver and reinforce continuously age-appropriate interventions, to yoke interventions to existing community resources, and to overcome potential political resistance to relevant interventions.

  12. Measures Taken to Prevent Zika Virus Infection During Pregnancy - Puerto Rico, 2016.

    Science.gov (United States)

    D'Angelo, Denise V; Salvesen von Essen, Beatriz; Lamias, Mark J; Shulman, Holly; Hernandez-Virella, Wanda I; Taraporewalla, Aspy J; Vargas, Manuel I; Harrison, Leslie; Ellington, Sascha R; Soto, Leslianne; Williams, Tanya; Rodriguez, Aurea; Shapiro-Mendoza, Carrie K; Rivera, Brenda; Cox, Shanna; Pazol, Karen; Rice, Marion E; Dee, Deborah L; Romero, Lisa; Lathrop, Eva; Barfield, Wanda; Smith, Ruben A; Jamieson, Denise J; Honein, Margaret A; Deseda, Carmen; Warner, Lee

    2017-06-09

    Zika virus infection during pregnancy remains a serious health threat in Puerto Rico. Infection during pregnancy can cause microcephaly, brain abnormalities, and other severe birth defects (1). From January 1, 2016 through March 29, 2017, Puerto Rico reported approximately 3,300 pregnant women with laboratory evidence of possible Zika virus infection (2). There is currently no vaccine or intervention to prevent the adverse effects of Zika virus infection during pregnancy; therefore, prevention has been the focus of public health activities, especially for pregnant women (3). CDC and the Puerto Rico Department of Health analyzed data from the Pregnancy Risk Assessment Monitoring System Zika Postpartum Emergency Response (PRAMS-ZPER) survey conducted from August through December 2016 among Puerto Rico residents with a live birth. Most women (98.1%) reported using at least one measure to avoid mosquitos in their home environment. However, only 45.8% of women reported wearing mosquito repellent daily, and 11.5% reported wearing pants and shirts with long sleeves daily. Approximately one third (38.5%) reported abstaining from sex or using condoms consistently throughout pregnancy. Overall, 76.9% of women reported having been tested for Zika virus by their health care provider during the first or second trimester of pregnancy. These results can be used to assess and refine Zika virus infection prevention messaging and interventions for pregnant women and to reinforce measures to promote prenatal testing for Zika.

  13. Prevention and control of malaria in pregnancy - new threats, new opportunities?

    Science.gov (United States)

    Rogerson, Stephen J; Unger, Holger W

    2017-04-01

    Over 100 million women and their babies are at risk of malaria in pregnancy each year. Malaria prevention in pregnancy relies on long-lasting insecticidal nets (LLINs), and, in Africa, intermittent preventive treatment in pregnancy (IPTp). Increasing resistance of malaria parasites to sulfadoxine-pyrimethamine, the only drug endorsed for IPTp, and increasing mosquito resistance to pyrethroids used in LLINs, threaten the efficacy of these proven strategies, while operational challenges restrict their implementation in areas of great need. Areas Covered: This review summarizes strategies for malaria prevention in pregnancy (both currently used and those undergoing preclinical and clinical evaluation), primarily drawing on publications and study protocols from the last decade. Challenges associated with each strategy are discussed, including the particular problem of HIV and malaria in pregnancy, and areas of further research are highlighted. Expert Commentary: Alternative drugs for IPTp are needed. Dihydroartemisinin-piperaquine is particularly promising, but requires further evaluation, and might contribute to artemisinin resistance. Intermittent screening and treatment in pregnancy (ISTp) is an alternative to IPTp that could reduce unnecessary antenatal drug exposure and resistance risk, but it is not recommended with current, insensitive screening tests. Optimal strategies for areas of low or declining malaria transmission remain to be determined.

  14. Why Do We Report Suicides and How Can We Facilitate Suicide Prevention Efforts?

    Science.gov (United States)

    Cheng, Qijin; Fu, King-wa; Caine, Eric; Yip, Paul S. F.

    2014-01-01

    Background The Hong Kong news media report suicide-related events more frequently and sensationally than Western countries. Little is known about Hong Kong media professionals’ experiences and thoughts about such reporting. Aims To understand Hong Kong media professionals’ experiences and perceptions of suicide reporting and whether the news media can be better engaged into suicide prevention. Method We conducted three focus groups of journalists from both the Cantonese and English language news media. Data were analyzed using grounded theory methods. Results We discerned three rationales from participants regarding their intense coverage of suicide-related events: (1) satisfying commercial competitiveness, (2) addressing social problems, and (3) responding to readers’ interests. The first rationale was a dominant and vigorous motivating factor, and often influenced suicide reporting among local Cantonese media. Media professionals recommended engagement strategies targeted at frontline journalists, media managers, and general media consumers. Conclusion We see potential to involve news media professionals in Hong Kong as working partners in suicide prevention. To succeed, this effort requires engagement in a proactive, consistent, and sustained fashion. PMID:24322824

  15. Bankruptcy Prevention: New Effort to Reflect on Legal and Social Changes.

    Science.gov (United States)

    Kliestik, Tomas; Misankova, Maria; Valaskova, Katarina; Svabova, Lucia

    2017-04-10

    Every corporation has an economic and moral responsibility to its stockholders to perform well financially. However, the number of bankruptcies in Slovakia has been growing for several years without an apparent macroeconomic cause. To prevent a rapid denigration and to prevent the outflow of foreign capital, various efforts are being zealously implemented. Robust analysis using conventional bankruptcy prediction tools revealed that the existing models are adaptable to local conditions, particularly local legislation. Furthermore, it was confirmed that most of these outdated tools have sufficient capability to warn of impending financial problems several years in advance. A novel bankruptcy prediction tool that outperforms the conventional models was developed. However, it is increasingly challenging to predict bankruptcy risk as corporations have become more global and more complex and as they have developed sophisticated schemes to hide their actual situations under the guise of "optimization" for tax authorities. Nevertheless, scepticism remains because economic engineers have established bankruptcy as a strategy to limit the liability resulting from court-imposed penalties.

  16. American Indian Substance Abuse Prevention Efforts: A Review of Programs, 2003-2013.

    Science.gov (United States)

    Walsh, Margaret L; Baldwin, Julie A

    2015-01-01

    The purpose of the review was to assess substance abuse prevention (SAP) efforts in American Indian and Alaska Native (AI/AN) communities from 2003-2013. In the past, many SAP programs were unable to meet the unique cultural needs of AI/AN communities adequately. It has been suggested that a disconnect may exist between the theories that are used to guide development of prevention programs in AI/AN communities and culturally appropriate theoretical constructs of AI/AN worldviews. To explore this possible disconnect further, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to assess a total of 18 articles (N = 31 programs) on program location and method, participant characteristics, described program cultural elements, use of theory, program outcomes, program measures, and future recommendations. Results indicated that SAP programs in AI/AN communities vary widely in their use of theory, implementation strategies, view and definition of cultural constructs, overall evaluational rigor, and reporting methods. Future research is needed to integrate appropriate theory and cultural elements into SAP programs to tie them to measurable outcomes for AI/AN communities.

  17. Sexual Health and Responsibility Program (SHARP): preventing HIV, STIs, and unplanned pregnancies in the navy and marine corps.

    Science.gov (United States)

    MacDonald, Michael R Bob

    2013-01-01

    In 1999, the Navy and Marine Corps Public Health Center converted an HIV train-the-trainer program into a broader effort of preventing not just HIV, but also other sexually transmitted infections (STIs) and unplanned pregnancies. The premise for this broader approach was that a more comprehensive sexual health promotion message of STI, HIV, and unplanned pregnancy prevention is more likely to include at least one personally relevant concern for any given individual and is, therefore, more likely to be internalized and acted upon by the greatest number of individuals, and that risk reduction for any one of these consequences of sexual activity may reduce risk for all. This new effort was labeled the Sexual Health and Responsibility Program (SHARP). Within the Navy and Marine Corps, SHARP has become a focal and trusted source of sexual health promotion products, consultative services, and training, as well as a conduit for multidisciplinary collaboration and coordination. The existence of this central sexual health program normalizes integrated and comprehensive sexual health messages, enables efficiencies, promotes program and policy uniformity, and provides a forum for cross-organizational collaboration and continuous improvement.

  18. Sexual Health and Responsibility Program (SHARP): Preventing HIV, STIs, and Unplanned Pregnancies in the Navy and Marine Corps

    Science.gov (United States)

    MacDonald, Michael R. (Bob)

    2013-01-01

    In 1999, the Navy and Marine Corps Public Health Center converted an HIV train-the-trainer program into a broader effort of preventing not just HIV, but also other sexually transmitted infections (STIs) and unplanned pregnancies. The premise for this broader approach was that a more comprehensive sexual health promotion message of STI, HIV, and unplanned pregnancy prevention is more likely to include at least one personally relevant concern for any given individual and is, therefore, more likely to be internalized and acted upon by the greatest number of individuals, and that risk reduction for any one of these consequences of sexual activity may reduce risk for all. This new effort was labeled the Sexual Health and Responsibility Program (SHARP). Within the Navy and Marine Corps, SHARP has become a focal and trusted source of sexual health promotion products, consultative services, and training, as well as a conduit for multidisciplinary collaboration and coordination. The existence of this central sexual health program normalizes integrated and comprehensive sexual health messages, enables efficiencies, promotes program and policy uniformity, and provides a forum for cross-organizational collaboration and continuous improvement. PMID:23450888

  19. Access to information and decision making on teenage pregnancy prevention by females in Tshwane

    Directory of Open Access Journals (Sweden)

    J.P.F. Masemola-Yende

    2015-07-01

    Full Text Available Background: The increase in the number of teenage pregnancies and its negative consequences has encouraged various researchers to explore the possible causes of teenage pregnancy. Findings from previously-conducted research have indicated different preventable factors that predispose female teenagers to pregnancy, such as staff attitudes and the lack of information resulting from poor access to health facilities.Objective: To explore and describe access to information and decision making on teenage pregnancy prevention by females using a primary healthcare clinic in Tshwane, South Africa.Method: In this study, the researchers used a descriptive qualitative and exploratory research design to explore and describe the verbal reports regarding prevention of teenage pregnancy by females using a primary healthcare clinic in Tshwane, South Africa. Face-to-face semistructured interviews were conducted with 15 female participants aged between 15 and 26, who had been pregnant once or more during their teens.Results: Two themes emerged, namely, access to information and decision making by female teenagers. Five categories that emerged were: access to information on pregnancy prevention; ignoring of provided information; the use of alternative medicine with hormonal contraception; personal reasons for use and non-use of contraception; and decisions made by teenagers to not fall pregnant. Females in this study fell pregnant in their teens, even though they had access to information.Conclusion: Given the complexity of this problem, female teenagers should use their families as primary sources of information for reproductive health promotion and educational institutions should build on this to aid the prevention of teenage pregnancy.

  20. A Systematic Review of Apps using Mobile Criteria for Adolescent Pregnancy Prevention (mCAPP).

    Science.gov (United States)

    Chen, Elizabeth; Mangone, Emily Rose

    2016-11-10

    Adolescents in the United States and globally represent a high-risk population for unintended pregnancy, which leads to high social, economic, and health costs. Access to smartphone apps is rapidly increasing among youth, but little is known about the strategies that apps employ to prevent pregnancy among adolescents and young adults. Further, there are no guidelines on best practices for adolescent and young adult pregnancy prevention through mobile apps. This review developed a preliminary evaluation framework for the assessment of mobile apps for adolescent and young adult pregnancy prevention and used this framework to assess available apps in the Apple App Store and Google Play that targeted adolescents and young adults with family planning and pregnancy prevention support. We developed an assessment rubric called Mobile Criteria for Adolescent Pregnancy Prevention (mCAPP) for data extraction using evidence-based and promising best practices from the literature. mCAPP comprises 4 domains: (1) app characteristics, (2) user interface features, (3) adolescent pregnancy prevention best practices, and (4) general sexual and reproductive health (SRH) features. For inclusion in the review, apps that advertised pregnancy prevention services and explicitly mentioned youth, were in English, and were free were systematically identified in the Apple App Store and Google Play in 2015. Screening, data extraction, and 4 interrater reliability checks were conducted by 2 reviewers. Each app was assessed for 92 facets of the mCAPP checklist. Our search returned 4043 app descriptions in the Apple App Store (462) and Google Play (3581). After screening for inclusion criteria, 22 unique apps were included in our analysis. Included apps targeted teens in primarily developed countries, and the most common user interface features were clinic and health service locators. While app strengths included provision of SRH education, description of modern contraceptives, and some use of

  1. The Zika virus and pregnancy: evidence, management, and prevention.

    Science.gov (United States)

    Citil Dogan, Ayse; Wayne, Sandra; Bauer, Samuel; Ogunyemi, Dotun; Kulkharni, Santosh K; Maulik, Devika; Carpenter, Christopher F; Bahado-Singh, Ray O

    2017-02-01

    To comprehensively review the available evidence and existing consensus reports and guidelines regarding the pregnancy and reproductive implications of the mosquito-transmitted Zika virus (ZIKV) infection. A primary focus was to provide pertinent information to aid clinicians in the management of pregnancies at risk for, exposed to, or with confirmed ZIKV infection. An extensive literature review was performed using Pubmed. Practice guidelines and consensus reports were accessed from international, national, and professional organizations' websites. The clinical articles for ZIKV infection testing varied from case reports to small epidemiologic studies. A ZIKV epidemic has been declared in several countries in the Americas. Fifty-two travel-associated ZIKV infection cases have been reported throughout the USA (as of February 10, 2016). The consequences of congenital fetal/newborn ZIKV infection could potentially have devastating consequences including miscarriage, fetal death, and major anomalies such as microcephaly, brain and brain-stem defects, and long-term neurologic sequelae. While not definitive, current evidence suggests the existence of nonvector-borne transmission through sexual activity with an infected male partner. For women at risk for sexual transmission, condom use is advised, especially during pregnancy. While ZIKV infection appears to be a mild disease in the general population the potential consequences to the fetus and newborn could be profound. Management guidelines are currently evolving and will be significantly impacted as new evidence develops. It is therefore imperative that obstetric health-care providers keep abreast of this rapidly evolving information landscape that has so far characterized this outbreak.

  2. Mobilizing Communities in Support of Teen Pregnancy Prevention: "Communitywide Initiatives" Findings.

    Science.gov (United States)

    Saunders, Edward J

    2016-08-16

    The U.S. Office of Adolescent Health and the Centers for Disease Control continue to promote a community mobilization model in support of teen pregnancy prevention in new grant initiatives. The most recent federal grant program-the "Communitywide Initiatives (2010-2015)" grant-promoted pregnancy prevention using three teams within the nine targeted communities to promote evidence-based sexuality education programs and enhanced access to contraceptive services among adolescents. The "lessons" reported in this article are compiled from three key informant interviews conducted with all project coordinators over the course of the 5 years (2010-2015) that this grant was implemented. Both successes and challenges to community mobilization in support of teen pregnancy prevention are presented and discussed.

  3. [Skills development: strategy for health promotion and prevention of pregnancy in adolescence].

    Science.gov (United States)

    Gurgel, Maria Glêdes Ibiapina; Alves, Maria Dalva Santos; Moura, Escolástica Rejane Ferreira; Pinheiro, Patrícia Neyva da Costa; Rego, Rita Maria Viana

    2010-12-01

    Working with the development of skills in sexual and reproductive health of adolescents from the perspective of health promotion for the prevention of the precocious pregnancy is a challenge to the nurse. To attend the group on psychosocial and biological transformation, we must consider their particular demands and growth for the protagonists: nurse and adolescent. The study aims to analyze the practice of the nurse in the prevention of the precocious pregnancy in view of skills development. This is a descriptive and exploratory research, with a qualitative approach, developed in Fortaleza, Ceará, Brazil, using the technique of the focal group, whose analysis was performed by means of discursive practices and maps of association of ideas. The results revealed that the promotion of adolescent health is worked out in the nursing consultation and adolescents groups, being this a creative, appropriate interactive space for the development of skills regarding sexuality and the prevention of precocious pregnancy.

  4. Progesterone for the prevention of preterm birth in women with multiple pregnancies: the AMPHIA trial

    Directory of Open Access Journals (Sweden)

    Scheepers Hubertina CJ

    2007-06-01

    Full Text Available Abstract Background 15% of multiple pregnancies ends in a preterm delivery, which can lead to mortality and severe long term neonatal morbidity. At present, no generally accepted strategy for the prevention of preterm birth in multiple pregnancies exists. Prophylactic administration of 17-alpha hydroxyprogesterone caproate (17OHPC has proven to be effective in the prevention of preterm birth in women with singleton pregnancies with a previous preterm delivery. At present, there are no data on the effectiveness of progesterone in the prevention of preterm birth in multiple pregnancies. Methods/Design We aim to investigate the hypothesis that 17OHPC will reduce the incidence of the composite neonatal morbidity of neonates by reducing the early preterm birth rate in multiple pregnancies. Women with a multiple pregnancy at a gestational age between 15 and 20 weeks of gestation will be entered in a placebo-controlled, double blinded randomised study comparing weekly 250 mg 17OHPC intramuscular injections from 16–20 weeks up to 36 weeks of gestation versus placebo. At study entry, cervical length will be measured. The primary outcome is composite bad neonatal condition (perinatal death or severe morbidity. Secondary outcome measures are time to delivery, preterm birth rate before 32 and 37 weeks, days of admission in neonatal intensive care unit, maternal morbidity, maternal admission days for preterm labour and costs. We need to include 660 women to indicate a reduction in bad neonatal outcome from 15% to 8%. Analysis will be by intention to treat. We will also analyse whether the treatment effect is dependent on cervical length. Discussion This trial will provide evidence as to whether or not 17OHPC-treatment is an effective means of preventing bad neonatal outcome due to preterm birth in multiple pregnancies. Trial registration Current Controlled Trials ISRCTN40512715

  5. A review of stroke and pregnancy: incidence, management and prevention.

    Science.gov (United States)

    Moatti, Zoe; Gupta, Manish; Yadava, Rajendra; Thamban, Sujatha

    2014-10-01

    Stroke, defined as a focal or global disturbance of cerebral function lasting over 24h resulting from disruption of its blood supply, is a devastating event for a pregnant woman. This can result in long-term disability or death, and impact on her family and unborn child. In addition to pre-existing patient risk factors, the hypercoagulable state and pre-eclampsia need to be taken into account. The patterns and types of stroke affect pregnant women differ from the non-pregnant female population of child-bearing age. Like other thrombo-embolic diseases in pregnancy, stroke is essentially a disease of the puerperium. Population studies have estimated the risk of stroke at between 21.2 and 46.2 per 100,000. The US Nationwide Inpatient Sample, identified 2850 pregnancies complicated by stroke in the United States in 2000-2001, for a rate of 34.2 per 100,000 deliveries. There were 117 deaths, a mortality rate of 1.4 per 100,000. Both the mortality and disability rates were higher than previously reported, with 10-13% of women dying. With the increasing prevalence of obesity, hypertension and cardiac disease amongst women of child-bearing age, so is the incidence of stroke during pregnancy and the puerperium. In the United States, an alarming trend toward higher numbers of stroke hospitalizations during the last decade was demonstrated in studies from 1995 to 1996 and 2006 to 2007. The rate of all types of stroke increased by 47% among antenatal hospitalizations, and by 83% among post-partum hospitalizations. Hypertensive disorders, obesity and heart disease complicated 32% of antenatal admissions and 53% of post-partum admissions. In addition to pre-existing patient risk factors, the hypercoagulable state and pre-eclampsia need to be taken into account. The patterns and types of stroke affect pregnant women differ from the non-pregnant female population of child-bearing age. Like other thrombo-embolic diseases in pregnancy, stroke is essentially a disease of the

  6. Study of Continuance Rate and Related Causes of Discontinuance of Pregnancy Prevention Methods among Women in Yazd

    Directory of Open Access Journals (Sweden)

    H Fallahzadeh

    2008-04-01

    Full Text Available Introduction: From maturity to menopause, women are worried about pregnancy. Abstinence from sex or use of pregnancy prevention methods are choices for them. As abstinence is impossible, the only remaining choice is use of pregnancy prevention methods. Effective control of pregnancy is really essential for the health of mother and infant and also control of unplanned increase in population. Regarding the importance of continuance rate of pregnancy prevention methods (OCP, IUD, Condom &DMPA & the reasons for their disruption, this study was carried out with the aim of determining the continuance rate and reasons for discontinuance of pregnancy prevention methods in Yazd women. Methods: This was a cross-sectional study. Six urban health care centers of Yazd were selected as study clusters and information of 15-49 year old women using the pregnancy prevention methods (OCP, IUD, Condom& injection was collected via a questionnaire. The data collected was analyzed by Coplan- Mayer statistic method and variance analysis test. Results: Pregnancy prevention methods were most prevalent in the 25-34 years old age group (57%. Mean duration of pregnancy prevention method usage was 27.98 months using Caplan-mayer method with a median of 24 months. 86.3% for 6 months, 72.8% for 12 months, 62.5% for 18 months, 47.9% for 24 months, 39.9% for 30 months and 37% for 37 months had used four certain methods of pregnancy prevention (OCP, IUD, Condom and Injection. The reasons of discontinuance were disease (15.6% for OCPS, bleeding (27% for IUD, unwanted pregnancy (21% for Condoms and also disease (75% for Injection method. Discussion: According to the results, not only education programs regarding family planning before starting each pregnancy prevention method to women is recommended, but a complete incentive consultation about these methods is essential. This educational & consultation programs should be implemented initially for women using OCP method.

  7. Molecular pathways involved in pregnancy-induced prevention against breast cancer

    Directory of Open Access Journals (Sweden)

    Maria eBarton

    2014-12-01

    Full Text Available Pregnancy produces a protective effect against breast cancer in women who had their first full term pregnancy in their middle twenties. Postponement of the first delivery increases a woman’s breast cancer risk. Also, transiently, during the postpartum period, the risk of developing breast cancer increases. This transient increased risk is taken over by a long lasting protective period. The genomic profile of parous women has shown pregnancy induces a long lasting genomic signature that explains the preventive effect on breast cancer. This signature reveals that the differentiation process, conferred by earlier full term pregnancy, is centered in chromatin remodeling. The chromatin remodeling process may be the ultimate step mediating the protection of the breast against developing breast cancer in postmenopausal years.

  8. [Venous thromboembolism prevention in pregnancy and the postpartum period in Primary and Specialized Care].

    Science.gov (United States)

    Gallo-Vallejo, J L; Naveiro-Fuentes, M; Puertas-Prieto, A; Gallo-Vallejo, F J

    2016-11-23

    After noting that there are a number of risk factors for venous thromboembolism disease during pregnancy, it emphasizes primary prevention and treatment of this serious condition during pregnancy and the postpartum period are essential to reduce maternal morbidity and mortality. Low molecular-weight heparins are under the anticoagulant of choice in pregnancy. Your prescription may make both the primary care physician, as the hematologist and obstetrician. As for prescribing terms, an application protocol in both primary and specialized, multidisciplinary care, based on the existing literature on the subject is presented, which indicated that the hypercoagulable disorders associated with some of the risk factors, forced to do thromboprophylaxis with low molecular-weight heparins throughout pregnancy and the postpartum period presented. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Should drinking during pregnancy be criminalised to prevent fetal ...

    African Journals Online (AJOL)

    2016-05-26

    May 26, 2016 ... is a lead ing common preventable cause of mental disability and ... of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa ... Should women be banned from, and/or punished for drinking during ...

  10. Screening for Hepatitis B Virus Infection in Pregnancy : US Preventive Services Task Force Reaffirmation Recommendation Statement

    NARCIS (Netherlands)

    Calonge, Ned; Petitti, Diana B.; DeWitt, Thomas G.; Dietrich, Allen J.; Gregory, Kimberly D.; Grossman, David; Isham, George; LeFevre, Michael L.; Leipzig, Rosanne M.; Marion, Lucy N.; Melnyk, Bernadette; Moyer, Virginia A.; Ockene, Judith K.; Sawaya, George F.; Schwartz, J. Sanford; Wilt, Timothy

    2009-01-01

    Description: Reaffirmation of the 2004 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for hepatitis B virus hepatitis B virus infection in pregnancy. Methods: The USPSTF performed a brief literature update, including a search for new and substantial evidence on the benefits

  11. Influence of Professional Preparation and Class Structure on HIV, STD, and Pregnancy Prevention Education

    Science.gov (United States)

    Rhodes, Darson L.; Jozkowski, Kristen N.; Hammig, Bart J.; Ogletree, Roberta J.; Fogarty, Erin C.

    2014-01-01

    Objective: The purpose of this study was to determine if education about human immunodeficiency virus (HIV)/sexually transmitted disease (STD) and pregnancy prevention is dependent on professional preparation and/or class structure. Design: A secondary data analysis of the 2006 School Health Policies and Programmes Study (SHPPS) was conducted.…

  12. Comparing School-Based Teen Pregnancy Prevention Programming: Mixed Outcomes in an At-Risk State

    Science.gov (United States)

    Oman, Roy F.; Merritt, Breanca T.; Fluhr, Janene; Williams, Jean M.

    2015-01-01

    Background: The purpose of this study is to compare the effectiveness of a national comprehensive teen pregnancy prevention (TPP) intervention to a national abstinence-only TPP intervention on middle school students' knowledge, attitudes, and behaviors related to teen sexual behaviors in a state with high teen birth rates. Methods: Pre- and…

  13. Experiences of Peer Evaluation of the Leicester Teenage Pregnancy Prevention Strategy

    Science.gov (United States)

    Fleming, Jennie; Chong, Hannah Goodman; Skinner, Alison

    2009-01-01

    The Centre for Social Action was commissioned by the Leicester City Council to evaluate its Teenage Pregnancy Prevention Strategy. This was a multi-stage project with a central element of consulting with young people. This article outlines the process that was followed in order to recruit, train and support young people through the process of…

  14. Influence of Professional Preparation and Class Structure on HIV, STD, and Pregnancy Prevention Education

    Science.gov (United States)

    Rhodes, Darson L.; Jozkowski, Kristen N.; Hammig, Bart J.; Ogletree, Roberta J.; Fogarty, Erin C.

    2014-01-01

    Objective: The purpose of this study was to determine if education about human immunodeficiency virus (HIV)/sexually transmitted disease (STD) and pregnancy prevention is dependent on professional preparation and/or class structure. Design: A secondary data analysis of the 2006 School Health Policies and Programmes Study (SHPPS) was conducted.…

  15. Mediation Analysis of an Adolescent HIV/STI/Pregnancy Prevention Intervention

    Science.gov (United States)

    Glassman, Jill R.; Franks, Heather M.; Baumler, Elizabeth R.; Coyle, Karin K.

    2014-01-01

    Most interventions designed to prevent HIV/STI/pregnancy risk behaviours in young people have multiple components based on psychosocial theories (e.g. social cognitive theory) dictating sets of mediating variables to influence to achieve desired changes in behaviours. Mediation analysis is a method for investigating the extent to which a variable…

  16. Romantic Relationships: An Important Context for HIV/STI and Pregnancy Prevention Programmes with Young People

    Science.gov (United States)

    Coyle, Karin K.; Anderson, Pamela M.; Franks, Heather M.; Glassman, Jill; Walker, James D.; Charles, Vignetta Eugenia

    2014-01-01

    Romantic relationships are central in the lives of young people. This paper uses data on romantic relationships from urban youth in the USA to illustrate how using a relationships perspective in HIV/STI and pregnancy prevention programmes broadens the skills and content covered, and contextualises the learning to enhance relevance and use.…

  17. Romantic Relationships: An Important Context for HIV/STI and Pregnancy Prevention Programmes with Young People

    Science.gov (United States)

    Coyle, Karin K.; Anderson, Pamela M.; Franks, Heather M.; Glassman, Jill; Walker, James D.; Charles, Vignetta Eugenia

    2014-01-01

    Romantic relationships are central in the lives of young people. This paper uses data on romantic relationships from urban youth in the USA to illustrate how using a relationships perspective in HIV/STI and pregnancy prevention programmes broadens the skills and content covered, and contextualises the learning to enhance relevance and use.…

  18. Mediation Analysis of an Adolescent HIV/STI/Pregnancy Prevention Intervention

    Science.gov (United States)

    Glassman, Jill R.; Franks, Heather M.; Baumler, Elizabeth R.; Coyle, Karin K.

    2014-01-01

    Most interventions designed to prevent HIV/STI/pregnancy risk behaviours in young people have multiple components based on psychosocial theories (e.g. social cognitive theory) dictating sets of mediating variables to influence to achieve desired changes in behaviours. Mediation analysis is a method for investigating the extent to which a variable…

  19. Prevention of cardiovascular risk in women who had hypertension during pregnancy after 36 weeks gestation

    NARCIS (Netherlands)

    van Kesteren, Floortje; Visser, Sanne; Hermes, Wietske; Franx, Arie; van Pampus, Maria G.; Poppel, Mireille N. M.; Tamsma, Jouke T.; Mol, Ben W.; de Groot, Christianne J.

    2015-01-01

    Objective: To analyse preventive interventions of women with cardiovascular risk factors postpartum. Methods: 3.5 years postpartum, women with history of hypertension in pregnancy were invited for a questionnaire, 1 year after a cardiovascular risk assessment. Results: Two hundred and fifty-seven wo

  20. Can the First Pregnancy of a Young Adolescent Be Prevented? A Question Which Must Be Answered

    Science.gov (United States)

    Baizerman, Michael

    1977-01-01

    The literature on adolescent cognitive development and issues related to the prevention of teenage pregnancy are briefly discussed. The author outlines relevant questions which should be understood by professionals working in sex education and human services programs, and presents implications for research. (GDC)

  1. The PASHA Program Sourcebook: Promising Teen Pregnancy and STD/HIV/AIDS Prevention Programs.

    Science.gov (United States)

    Card, Josefina J., Ed.; Becker, Stephani R., Ed.; Hill, Denise M. K., Ed.

    By providing in-depth descriptions of the 23 promising programs available from the Program Archive on Sexuality, Health and Adolescence (PASHA), the "PASHA Program Sourcebook" offers practitioners a detailed look at "what works" to prevent pregnancy and sexually transmitted diseases/human immunodeficiency virus and acquired immune deficiency…

  2. Screening for Hepatitis B Virus Infection in Pregnancy : US Preventive Services Task Force Reaffirmation Recommendation Statement

    NARCIS (Netherlands)

    Calonge, Ned; Petitti, Diana B.; DeWitt, Thomas G.; Dietrich, Allen J.; Gregory, Kimberly D.; Grossman, David; Isham, George; LeFevre, Michael L.; Leipzig, Rosanne M.; Marion, Lucy N.; Melnyk, Bernadette; Moyer, Virginia A.; Ockene, Judith K.; Sawaya, George F.; Schwartz, J. Sanford; Wilt, Timothy

    2009-01-01

    Description: Reaffirmation of the 2004 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for hepatitis B virus hepatitis B virus infection in pregnancy. Methods: The USPSTF performed a brief literature update, including a search for new and substantial evidence on the benefits

  3. SHPPS 2006: School Health Policies and Programs Study--Pregnancy Prevention

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports 2006 study results in the area of pregnancy prevention, covering the following topics: (1) Health Education; and (2) Health Services…

  4. Experiences of Peer Evaluation of the Leicester Teenage Pregnancy Prevention Strategy

    Science.gov (United States)

    Fleming, Jennie; Chong, Hannah Goodman; Skinner, Alison

    2009-01-01

    The Centre for Social Action was commissioned by the Leicester City Council to evaluate its Teenage Pregnancy Prevention Strategy. This was a multi-stage project with a central element of consulting with young people. This article outlines the process that was followed in order to recruit, train and support young people through the process of…

  5. Comparing School-Based Teen Pregnancy Prevention Programming: Mixed Outcomes in an At-Risk State

    Science.gov (United States)

    Oman, Roy F.; Merritt, Breanca T.; Fluhr, Janene; Williams, Jean M.

    2015-01-01

    Background: The purpose of this study is to compare the effectiveness of a national comprehensive teen pregnancy prevention (TPP) intervention to a national abstinence-only TPP intervention on middle school students' knowledge, attitudes, and behaviors related to teen sexual behaviors in a state with high teen birth rates. Methods: Pre- and…

  6. Anticoagulants to prevent recurrent placenta-mediated pregnancy complications: Is it time to put the needles away?

    Science.gov (United States)

    Skeith, Leslie; Rodger, Marc

    2017-03-01

    Placenta-mediated pregnancy complications, such as pre-eclampsia, placental abruption, birth of a small-for-gestational age infant and late pregnancy loss, are common and carry significant morbidity and mortality. The etiology of placenta-mediated pregnancy complications is likely multifactorial and may include abnormal coagulation activation of the maternal-fetal interface. The use of antepartum low-molecular-weight heparin (LMWH) prophylaxis to prevent recurrent placenta-mediated pregnancy complications has become common practice despite limited and conflicting evidence to support its use. This paper reviews the evidence, including recently published data from an individual patient level meta-analysis, which challenges the role of LMWH in preventing recurrent placenta-mediated pregnancy complications. Incorporating this recent evidence, we recommend against the use of LMWH to prevent recurrent placenta-mediated pregnancy complications in women with and without inherited thrombophilia.

  7. Contraceptive Use and Pregnancy Incidence Among Women Participating in an HIV Prevention Trial.

    Science.gov (United States)

    Akello, Carolyne A; Bunge, Katherine E; Nakabiito, Clemensia; Mirembe, Brenda G; Fowler, Mary Glenn; Mishra, Anupam; Marrazzo, Jeanne; Chirenje, Zvavahera M; Celum, Connie; Balkus, Jennifer E

    2017-06-01

    Recent HIV prevention trials required use of effective contraceptive methods to fulfill eligibility for enrollment. We compared pregnancy rates in a subset of participants enrolled in the Microbicide Trials Network protocol (MTN-003), a randomized trial of chemoprophylaxis to prevent HIV acquisition among women aged 18-45 years who initiated depot medroxyprogesterone acetate (DMPA) or combined oral contraceptives (COCs) at enrollment, relative to those already using DMPA or COCs. Data were analyzed from MTN-003 participants from Uganda. Before enrollment, information on contraceptive type and initiation date was obtained. Urine pregnancy tests were performed at monthly follow-up visits. Cox proportional hazards models were used to compare pregnancy incidence among new users (initiated ≤60 days before enrollment) and established users (initiated >60 days before enrollment). Of 322 women enrolled, 296 were COC or DMPA users, 82 (28%) were new users, and 214 (72%) were established users. Pregnancy incidence was higher among new contraceptive users compared to established users (20.70% vs. 10.55%; adjusted hazard ratio [HR] = 1.66; 95% confidence interval [95% CI] 0.93-2.96). Among DMPA users, pregnancy incidence was 10.20% in new users versus 3.48% in established users (HR = 2.56; 95% CI 0.86-7.65). Among new COC users, pregnancy incidence was 42.67% in new users versus 23.67% in established COC users (adjusted HR = 1.74; 95% CI 0.87-3.48). New contraceptive users, regardless of method, at the Uganda MTN-003 site had an increased pregnancy risk compared to established users, which may be due to contraceptive initiation primarily for trial eligibility. New users may benefit from intensive contraceptive counseling and additional contraceptive options, including longer acting reversible contraceptives.

  8. Where do youth in foster care receive information about preventing unplanned pregnancy and sexually transmitted infections?

    Science.gov (United States)

    Hudson, Angela L

    2012-10-01

    Adolescents in foster care are at risk for unplanned pregnancy and sexually transmitted infections, including HIV infection. A study using a qualitative method was conducted to describe how and where foster youth receive reproductive health and risk reduction information to prevent pregnancy and sexually transmitted infections. Participants also were asked to describe their relationship with their primary health care provider while they were in foster care. Nineteen young adults, recently emancipated from foster care, participated in individual interviews. Using grounded theory as the method of analysis, three thematic categories were generated: discomfort visiting and disclosing, receiving and not receiving the bare essentials, and learning prevention from community others. Recommendations include primary health care providers providing a confidential space for foster youth to disclose sexual activity and more opportunities for foster youth to receive reproductive and risk prevention information in the school setting.

  9. Prevalence and prevention of malaria in pregnancy in Edo State, Nigeria.

    Science.gov (United States)

    Wagbatsoma, V A; Omoike, B I

    2008-12-01

    The observational/longitudinal study was undertaken in Igueben Local Government Area (LGA), Edo State, Nigeria. The objective of the study was to determine the effect of prevention on the prevalence of malaria during pregnancy. The study population comprised 4 groups viz; Group l, had 100 women protected with Insecticide Treated bed Nets (ITNs); Group 2, another 100 treated with Sulphadoxine - pyrimethamine (SP); Group 3, 100 protected with both ITN and SP, while Group 4, were 100 unprotected others who served as control. Venous blood was collected 7 days to expected date of delivery while placental blood was collected after delivery from the subjects for parasitaemia determination. Findings showed that all protective devices used were effective against malaria. Prevention used against malaria in pregnancy is a sure safe guard against maternal morbidity/mortality and should be encouraged. It is therefore, recommended that pregnant women should be health educated to appreciate the need for malaria prevention.

  10. Pregnancy

    DEFF Research Database (Denmark)

    Palmer, Keith T; Bonzini, Matteo; Bonde, Jens Peter Ellekilde

    2013-01-01

    Most pregnant women are exposed to some physical activity at work. This Concise Guidance is aimed at doctors advising healthy women with uncomplicated singleton pregnancies about the risks arising from five common workplace exposures (prolonged working hours, shift work, lifting, standing and heavy...... on pregnancy. Moreover, moderate physical exercise is thought to be healthy in pregnancy and most pregnant women undertake some physical work at home. The guidelines provide risk estimates and advice on counselling....

  11. A quarter century of HIV prevention intervention efforts among children and adolescents across the globe.

    Science.gov (United States)

    Stanton, Bonita; Li, Xiaoming

    2014-01-01

    In 1988 a group of pediatricians, developmental, clinical, child and social psychologists, anthropologists and health educators began researching in Baltimore, Maryland on an HIV prevention intervention, Focus on Youth. Over the next 25 years the questions being addressed by Focus on Youth, reflected those of the global HIV research experience. During the first phase, the questions being addressed by the broader research community included: Can HIV risk behaviors be purposefully impacted by behavioral interventions? If so, how do successful interventions differ from those that are not effective? Are theory-based interventions more likely to be effective than information-only based interventions? Can theories be translated into culturally and developmentally appropriate interventions including those that are appropriate for children and adolescents? Should parents be involved--and if so, how? During its next phase, the Focus on Youth team increasingly became concerned with a disturbing reality. A large number of interventions had been developed and some had been shown to have evidence of impact. But virtually all of these interventions had been conducted in the USA or Europe. The questions facing researchers included: With the global burden of HIV disproportionately impacting Low and Middle Income Countries (LMIC), especially those in southern Africa, the Caribbean and parts of Asia, what is known about the effectiveness of western-based interventions in these culturally, racially and economically disparate settings? With the exciting proliferation of interventions, federal agencies in the USA and international agencies including UNAIDS realized the importance of assessing the research portfolio and developing metrics of effectiveness. The questions during this phase included: What is an "effective" intervention? How are effective interventions implemented in a new setting? This phase merged with the next phase as researchers and public health workers realized that

  12. Gluten-Free Diet Only during Pregnancy Efficiently Prevents Diabetes in NOD Mouse Offspring

    DEFF Research Database (Denmark)

    Antvorskov, Julie C; Josefsen, Knud; Haupt-Jorgensen, Martin

    2016-01-01

    Studies have documented that the pathogenesis of autoimmune diabetes is influenced by the intake of gluten. Aims. To investigate the importance of gluten exposure during pregnancy and the subsequent development of autoimmune diabetes in offspring. Methods. Nonobese diabetic mice were divided into 7...... groups to receive combinations of gluten-free and standard diet before, during, or after pregnancy. Diabetes incidence in offspring was followed in each group (n = 16-27) for 310 days. Insulitis score and intestinal expression of T-cell transcription factors (RT-QPCR) were evaluated in animals from...... the different diet groups. Results. If mothers were fed a gluten-free diet only during pregnancy, the development of autoimmune diabetes in offspring was almost completely prevented with an incidence reduction from 62.5% in gluten-consuming mice to 8.3% (p gluten-free group. The islets...

  13. Gluten-Free Diet Only during Pregnancy Efficiently Prevents Diabetes in NOD Mouse Offspring

    DEFF Research Database (Denmark)

    Antvorskov, Julie C; Josefsen, Knud; Haupt-Jorgensen, Martin

    2016-01-01

    Studies have documented that the pathogenesis of autoimmune diabetes is influenced by the intake of gluten. Aims. To investigate the importance of gluten exposure during pregnancy and the subsequent development of autoimmune diabetes in offspring. Methods. Nonobese diabetic mice were divided into 7...... groups to receive combinations of gluten-free and standard diet before, during, or after pregnancy. Diabetes incidence in offspring was followed in each group (n = 16 - 27) for 310 days. Insulitis score and intestinal expression of T-cell transcription factors (RT-QPCR) were evaluated in animals from...... the different diet groups. Results. If mothers were fed a gluten-free diet only during pregnancy, the development of autoimmune diabetes in offspring was almost completely prevented with an incidence reduction from 62.5% in gluten-consuming mice to 8.3% (p gluten-free group. The islets...

  14. Managing Obesity in Pregnancy: A Change in Focus from Harm Minimization to Prevention.

    Science.gov (United States)

    Grivell, Rosalie M; O'Brien, Cecelia M; Dodd, Jodie M

    2016-03-01

    Obesity represents a significant global health problem, contributing to the overall burden of disease worldwide and a 30% increase in cost of health care provision. Over 50% of women who enter pregnancy are classified as overweight or obese resulting in short and long term effects on maternal and child health outcomes.There is a substantial amount of literature focusing on interventions in the antenatal period have been associated with modest changes in weight gain during pregnancy. There has been little effect on clinical pregnancy and birth outcomes.The article discusses the evidence supporting the shift from harm minimization via antenatal intervention, to one of prevention by targeting the time prior to conception to optimize maternal weight. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  15. Supply-related drivers of staff motivation for providing intermittent preventive treatment of malaria during pregnancy in Tanzania

    DEFF Research Database (Denmark)

    Mubyazi, Godfrey M; Bloch, Paul; Byskov, Jens;

    2012-01-01

    their public facility counterparts. Employees in public HFs more acknowledged availability of clinical officers, nurses and midwives than their private facility counterparts. More results are presented and discussed. CONCLUSION: The study shows conditions related to staffing levels, health infrastructure...... and essential supplies being among the key determinants or drivers of frontline HWs' motivation to deliver ANC services in both private and public HFs. Efforts of the government to meet the maternal health related Millennium Development Goals and targets for specific interventions need to address challenges......ABSTRACT: BACKGROUND: Since its introduction in the national antenatal care (ANC) system in Tanzania in 2001, little evidence is documented regarding the motivation and performance of health workers (HWs) in the provision of intermittent preventive treatment of malaria during pregnancy (IPTp...

  16. Implementation of Community-Wide Teen Pregnancy Prevention Initiatives: Focus on Partnerships.

    Science.gov (United States)

    Tevendale, Heather D; Fuller, Taleria R; House, L Duane; Dee, Deborah L; Koumans, Emilia H

    2017-03-01

    Seeking to reduce teen pregnancy and births in communities with rates above the national average, the Centers for Disease Control and Prevention, in partnership with the U.S. Department of Health and Human Services Office of Adolescent Health Teen Pregnancy Prevention Program, developed a joint funding opportunity through which grantees worked to implement and test an approach involving community-wide teen pregnancy prevention initiatives. Once these projects had been in the field for 2.5 years, Centers for Disease Control and Prevention staff developed plans for a supplemental issue of the Journal of Adolescent Health to present findings from and lessons learned during implementation of the community-wide initiatives. When the articles included in the supplemental issue are considered together, common themes emerge, particularly those related to initiating, building, and maintaining strong partnerships. Themes seen across articles include the importance of (1) sharing local data with partners to advance initiative implementation, (2) defining partner roles from the beginning of the initiatives, (3) developing teams that include community partners to provide direction to the initiatives, and (4) addressing challenges to maintaining strong partnerships including partner staff turnover and delays in implementation.

  17. [Care of pregnancy and prevention of lamb diseases in goats].

    Science.gov (United States)

    Elze, K; Krische, G

    1995-12-01

    The breeding of dairy goats has spread in Saxony for over 200 years. Recently the keeping of bigger flocks (30-300 animals) for milk and cheese production has become more common. Within the care of the pregnant she goats the feeding recommendation is a main point of the veterinary herd management. The special performances done by the pregnant animals are discussed. The daily need of energy intake is given with about 11 Megajoule Nettoenergy-lactation as well as the daily need of protein with 230 g. Additionally the minimal daily intake of minerals and vitamins is mentioned. Supervising she goats during lambing and avoiding temperatures lower than 18 degrees C in the stables is considered as necessary to prevent hypoglycemia of the newborn lambs. The enzootic process of Clostridium-perfringens-type-B-infection is discussed in connection with the intake of colostrum and the increasing density of pathogen microorganism during the lambing period.

  18. The Family Festival Prevention Model: Findings from a Pilot of a Teenage Pregnancy Prevention Programme Conceptualised by and for Mexican American Communities

    Science.gov (United States)

    Murphy-Erby, Yvette; Stauss, Kim; Koh, Eun

    2015-01-01

    Despite an overall reduction in teenage pregnancy rates in the USA, the decrease for young women of Mexican heritage in the USA has been less significant than the decrease for their White and African-American peers. Furthermore, the availability of teenage pregnancy prevention models that are conceptualised specifically for people of Mexican…

  19. The Family Festival Prevention Model: Findings from a Pilot of a Teenage Pregnancy Prevention Programme Conceptualised by and for Mexican American Communities

    Science.gov (United States)

    Murphy-Erby, Yvette; Stauss, Kim; Koh, Eun

    2015-01-01

    Despite an overall reduction in teenage pregnancy rates in the USA, the decrease for young women of Mexican heritage in the USA has been less significant than the decrease for their White and African-American peers. Furthermore, the availability of teenage pregnancy prevention models that are conceptualised specifically for people of Mexican…

  20. Docosahexaenoic Acid Supplementation Early in Pregnancy May Prevent Deep Placentation Disorders

    Directory of Open Access Journals (Sweden)

    Jorge A. Carvajal

    2014-01-01

    Full Text Available Uteroplacental ischemia may cause preterm birth, either due to preterm labor, preterm premature rupture of membranes, or medical indication (in the presence of preeclampsia or fetal growth restriction. Uteroplacental ischemia is the product of defective deep placentation, a failure of invasion, and transformation of the spiral arteries by the trophoblast. The failure of normal placentation generates a series of clinical abnormalities nowadays called “deep placentation disorders”; they include preeclampsia, fetal growth restriction, preterm labor, preterm premature rupture of membranes, in utero fetal death, and placental abruption. Early reports suggested that a LC-PUFAs (long chain polyunsaturated fatty acids rich diet reduces the incidence of deep placentation disorders. Recent randomized controlled trials are inconsistent to show the benefit of docosahexaenoic acid (DHA supplementation during pregnancy to prevent deep placentation disorders, but most of them showed that DHA supplementation was associated with lower risk of early preterm birth. We postulate that DHA supplementation, early in pregnancy, may reduce the incidence of deep placentation disorders. If our hypothesis is correct, DHA supplementation, early in pregnancy, will become a safe and effective strategy for primary prevention of highly relevant pregnancy diseases, such as preterm birth, preeclampsia, and fetal growth restriction.

  1. Prevention of Infectious Mastitis by Oral Administration of Lactobacillus salivarius PS2 During Late Pregnancy.

    Science.gov (United States)

    Fernández, Leónides; Cárdenas, Nivia; Arroyo, Rebeca; Manzano, Susana; Jiménez, Esther; Martín, Virginia; Rodríguez, Juan Miguel

    2016-03-01

    Previous studies have shown that oral administration of lactobacilli can be an efficient approach to treat lactational infectious mastitis. In this trial, we have evaluated the potential of Lactobacillus salivarius PS2 to prevent this condition when orally administered during late pregnancy to women who had experienced infectious mastitis after previous pregnancies. In this study, 108 pregnant women were randomly assigned to one of 2 groups. Those in the probiotic group (n = 55) ingested daily 9 log10 colony-forming units of L. salivarius PS2 from approximately week 30 of pregnancy until delivery, whereas those in the placebo group (n = 53) received a placebo. The occurrence of mastitis was evaluated during the first 3 months after delivery. Globally, 44 of 108 women (41%) developed mastitis; however, the percentage of women with mastitis in the probiotic group (25% [n = 14]) was significantly lower than in the control group (57% [n = 30]). When mastitis occurred, the milk bacterial counts in the probiotic group were significantly lower than those obtained in the placebo group. Oral administration of L. salivarius PS2 during late pregnancy appears to be an efficient method to prevent infectious mastitis in a susceptible population. NCT01505361. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  2. A decade of malaria during pregnancy in Brazil: what has been done concerning prevention and management

    Directory of Open Access Journals (Sweden)

    Paola Marchesini

    2014-08-01

    Full Text Available In Brazil, malaria remains a disease of major epidemiological importance because of the high number of cases in the Amazonian Region. Plasmodium spp infections during pregnancy are a significant public health problem with substantial risks for the pregnant woman, the foetus and the newborn child. In Brazil, the control of malaria during pregnancy is primarily achieved by prompt and effective treatment of the acute episodes. Thus, to assure rapid diagnosis and treatment for pregnant women with malaria, one of the recommended strategy for low transmission areas by World Health Organization and as part of a strategy by the Ministry of Health, the National Malaria Control Program has focused on integrative measures with woman and reproductive health. Here, we discuss the approach for the prevention and management of malaria during pregnancy in Brazil over the last 10 years (2003-2012 using morbidity data from Malaria Health Information System. Improving the efficiency and quality of healthcare and education and the consolidation of prevention programmes will be challenges in the control of malaria during pregnancy in the next decade.

  3. A decade of malaria during pregnancy in Brazil: what has been done concerning prevention and management.

    Science.gov (United States)

    Marchesini, Paola; Costa, Fabio Trindade Maranhão; Marinho, Claudio Romero Farias

    2014-08-01

    In Brazil, malaria remains a disease of major epidemiological importance because of the high number of cases in the Amazonian Region. Plasmodium spp infections during pregnancy are a significant public health problem with substantial risks for the pregnant woman, the foetus and the newborn child. In Brazil, the control of malaria during pregnancy is primarily achieved by prompt and effective treatment of the acute episodes. Thus, to assure rapid diagnosis and treatment for pregnant women with malaria, one of the recommended strategy for low transmission areas by World Health Organization and as part of a strategy by the Ministry of Health, the National Malaria Control Program has focused on integrative measures with woman and reproductive health. Here, we discuss the approach for the prevention and management of malaria during pregnancy in Brazil over the last 10 years (2003-2012) using morbidity data from Malaria Health Information System. Improving the efficiency and quality of healthcare and education and the consolidation of prevention programmes will be challenges in the control of malaria during pregnancy in the next decade.

  4. Awareness of prevention of teenage pregnancy amongst secondary school learners in Makhado municipality

    Directory of Open Access Journals (Sweden)

    Giliana M. Maxwell

    2016-03-01

    Full Text Available Background: Sexuality plays a very significant role in the lives of both boys and girls. It is, therefore, considered important for schools to recognise and accept sexuality as part of the development process of the child. Professor Kader Asmal (previous South African Minister of Education suggested that the earlier the school begins to teach learners about sexuality, the better because they can be easily misled by their peers if proper guidance regarding their sexuality is not given.Aim: The current study was conducted to assess the awareness of teenagers on the prevention of teenage pregnancy (TP in six secondary school learners situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province.Setting: The study was conducted at six secondary schools situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province in 2014.Methodology: A quantitative descriptive survey study was conducted where data were collected, using self-administered questionnaires, from 381 systematically sampled participants from six secondary schools situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province. Data were analysed descriptively using the Statistical Package for the Social Sciences (SPSS software, version 22.0. Necessary approval procedures and ethical clearance were obtained prior to data collection.Results: Ninety-four percent of participants agreed that TP can be prevented through abstaining from sex, whilst 65% of participants agreed that TP could be prevented by using contraceptives such as pills and injections. Eighty-three percent of participants agreed that T Pcould be prevented through the use of condoms. Seventy-four percent participants disagreed that bathing after sex prevents teenage pregnancies. Furthermore, 28% participants agreed that TP can be prevented by oral sex.Conclusion: The conclusion drawn was that learners are aware of the measures for preventing TP

  5. Bullying Prevention: A Call for Collaborative Efforts between School Nurses and School Psychologists

    Science.gov (United States)

    Kub, Joan; Feldman, Marissa A.

    2015-01-01

    Bullying among children and adolescents is recognized as a significant global public health problem, as it has serious health consequences. Schools are important sites in which to address violence prevention, specifically bullying prevention, and to promote positive youth development. The Ottawa Charter for Health Promotion outlines five action…

  6. Evaluating a Student Assistance Program (SAP) as Part of a Larger Prevention Effort: Growing Up Well.

    Science.gov (United States)

    Horowitz, Jordan E.

    This project, funded by the Office for Substance Abuse Prevention (OSAP), is a comprehensive, multilevel prevention model for elementary school students, grades K-6. The project is based on OSAP's risk and resiliency factor model in which factors presumed to predispose youth toward or away from alcohol and other drug (AOD) use are influenced,…

  7. Evaluating a Student Assistance Program (SAP) as Part of a Larger Prevention Effort: Growing Up Well.

    Science.gov (United States)

    Horowitz, Jordan E.

    This project, funded by the Office for Substance Abuse Prevention (OSAP), is a comprehensive, multilevel prevention model for elementary school students, grades K-6. The project is based on OSAP's risk and resiliency factor model in which factors presumed to predispose youth toward or away from alcohol and other drug (AOD) use are influenced,…

  8. Effects of a teenage pregnancy prevention program in KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Taylor, Myra; Jinabhai, Champak; Dlamini, Siyabonga; Sathiparsad, Reshma; Eggers, Matthijs S; De Vries, Hein

    2014-01-01

    Researchers aimed to determine the effects of a teenage pregnancy (TP) prevention program for 816 high school students attending 16 KwaZulu-Natal, South African schools through a randomized control trial. Data were collected at baseline and at the 8-month follow-up in 2009. Results were calculated using multivariate analyses of program effects employing Mplus 6, and indicated significantly healthier attitudes, including intentions to abstain from sex whilst at school, plans to communicate with partners about teenage pregnancy, and increased reports of condom use. Researchers thus provide some support for the effectiveness of a TP prevention program that should be further strengthened in a comprehensive approach that includes schools and families.

  9. Treatment and prevention of malaria in pregnancy in the private health sector in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K; Buregyeya, Esther; Rutebemberwa, Elizeus;

    2016-01-01

    and prevention practices for malaria among pregnant women. The main study outcome was the proportion of private health facilities who prescribe treatment of fever among pregnant women as recommended in the guidelines. RESULTS: A total of 241 private health facilities were surveyed; 70.5 % were registered drug...... clinics and pharmacies for prevention of malaria in pregnancy. Few facilities had malaria treatment guidelines; (44.1 % of private clinics, 17.9 % of drug shops, and 41.7 % at pharmacies. Knowledge of people at risk of malaria, P = 0.02 and availability of malaria treatment guidelines, P = 0.03 were......BACKGROUND: Malaria in pregnancy is a major public health problem in Uganda; and it is the leading cause of anaemia among pregnant women and low birth weight in infants. Previous studies have noted poor quality of care in the private sector. Thus there is need to explore ways of improving quality...

  10. Developing and maintaining state-wide adolescent pregnancy prevention coalitions: a preliminary investigation.

    Science.gov (United States)

    Nezlek, J B; Galano, J

    1993-09-01

    This paper presents the results of a study of state-wide adolescent pregnancy prevention coalitions. Key informants in five states throughout the southern United States were given semi-structured interviews regarding the adolescent pregnancy prevention coalitions in their states. From these interviews and other documents, conclusions were drawn regarding the nature and importance of the environments within which these coalitions operate, the universe of activities in which coalitions engage, and the stages of development of these coalitions. Katz and Kahn's model of social organizations served as the basis for understanding coalitions in terms of these three considerations. Future research should consider the utility of organizational models that can explain more fully the organization--committee hybrid structure that tends to characterize these coalitions.

  11. Prevention of spina bifida: folic acid intake during pregnancy in Gulu district, northern Uganda

    OpenAIRE

    Bannink, Femke; Larok, Rita; Karibari, Peter; Bauwens, Lieven; Van Hove, Geert

    2015-01-01

    Introduction The intake of folic acid before conception and during the first trimester of pregnancy can prevent spina bifida. This paper describes folic acid intake in women in Gulu district in northern Uganda. Methods Structured interviews were held with 394 women attending antenatal care (ANC), 15 mothers of children with spina bifida, and 35 health workers in 2012 and 2013. SPSS16 was used for data analysis. Results 1/4 mothers of children with spina bifida took folic acid during late preg...

  12. The Relationship Between Pregnancy Prevention and STI/HIV Prevention and Sexual Risk Behavior Among American Indian Men.

    Science.gov (United States)

    Rink, Elizabeth; FourStar, Kristofer; Anastario, Michael P

    2017-01-01

    We examined the relationship between American Indian men's attitudes toward pregnancy prevention, STI/HIV prevention, and sexual risk behavior. Attention was given to: (1) attitudes and intentions to use condoms and sexual risk behavior; (2) STI/HIV prevention characteristics and sexual risk behavior; (3) attitudes toward abstinence and monogamy and sexual risk behavior; and (4) decision-making in relationships and sexual risk behavior. Our sample included 120 heterosexual American Indian men aged 18 to 24 living on a reservation. Data were collected during in-depth interviews. A community-based participatory research framework was used to ensure the relevancy and acceptability of the study given the sensitivity of the topic. Results demonstrated that attitudinal factors were associated with sexual risk behavior, particularly inconsistent condom use. Attitudes associated with consistent condom use suggested greater levels of positive dispositions toward prevention and intention to use condoms. Consistent condom use was associated with more cautious attitudes toward sex with multiple sex partners. Study results suggested that American Indian men who reported sex with multiple partners exhibited a set of attitudes and beliefs toward pregnancy prevention and STI/HIV prevention that corresponded with a disposition resulting from their behaviors, in that engaging in sexual risk behavior elevated their levels of risk perception. Our findings suggest that heterosexual American Indian men living in rural environments need sexual and reproductive health programs and clinical services that address differing attitudes toward condom use within the context of multiple sex partners and sexual risk behavior. © 2015 National Rural Health Association.

  13. Decreasing Sex Bias through Education for Parenthood or Prevention of Adolescent Pregnancy: A Developmental Model with Integrative Strategies.

    Science.gov (United States)

    Weinstein, Estelle; Rosen, Efrem

    1994-01-01

    Identifies need for more research, education, and services for males about adolescent pregnancy and parenthood to augment their social and familial learning experiences. Makes case for more participation by schools in achieving better balance between males and females in preparing for parenthood or prevention of pregnancy. Describes…

  14. Prevention of spina bifida: folic acid intake during pregnancy in Gulu district, northern Uganda.

    Science.gov (United States)

    Bannink, Femke; Larok, Rita; Kirabira, Peter; Bauwens, Lieven; van Hove, Geert

    2015-01-01

    The intake of folic acid before conception and during the first trimester of pregnancy can prevent spina bifida. This paper describes folic acid intake in women in Gulu district in northern Uganda. Structured interviews were held with 394 women attending antenatal care (ANC), 15 mothers of children with spina bifida, and 35 health workers in 2012 and 2013. SPSS16 was used for data analysis. 1/4 mothers of children with spina bifida took folic acid during late pregnancy, none preconception. None had knowledge about folic acid and spina bifida prevention. 33.5% of women attending ANC had ever heard about spina bifida, 1% knew folic acid intake can prevent spina bifida. 42.4% took folic acid supplements in late pregnancy, 8.1% during the first trimester, none preconception. All women said to have eaten food rich in folic acid. None were aware about fortified foods. 7% of health workers understood the importance of early folic acid intake. All health workers recommended folic acid intake to women attending ANC. 20% of the health workers and 25% of the women said folic acid supplements are not always available. Folic acid intake is limited in northern Uganda. This is attributed to limited education and understanding of women and health workers about the importance of early folic acid intake, late presentation of women at ANC, poor supply chain and dilapidated health services caused by war and poverty. A combination of food fortification, sensitization of health workers, women, and improving folic acid supply is recommended.

  15. Preventing adolescent pregnancy: biological, social, cultural, and political influences on age at first sexual intercourse.

    Science.gov (United States)

    Pires, Raquel; Araújo-Pedrosa, Anabela; Pereira, Joana; Canavarro, Maria Cristina

    2014-08-01

    Age at first sexual intercourse (AFSI) is the initial factor related to adolescents' sexual life that may increase the risk of adolescent pregnancy. We explored the biological, social, cultural, and political predictors of AFSI addressing several gaps that prevent us from generalizing the results of past research to adolescent pregnancy prevention. We also explored the moderating effects of cultural variables on the links between social and political predictors and AFSI. Our sample consisted of 889 Portuguese female adolescents aged 12-19. Earlier age at menarche, non-intact family structure, maternal history of adolescent pregnancy, lower maternal emotional warmth, absence of religious involvement, and living in Portugal's mainland and in a legal context penalizing abortion predicted earlier AFSI. School attendance predicted earlier AFSI among adolescents of European ethnic origin; adolescents of non-European ethnic origin presented the opposite, but non-significant, pattern. These findings suggest that, in addition to isolated characteristics, factors from different ecological contexts should be considered when planning interventions designed to foster healthy and informed transitions to sexual initiation and prevent the related risks of unwanted outcomes. We discuss implications for future research and practice.

  16. Preventing malaria in pregnancy through community-directed interventions: evidence from Akwa Ibom State, Nigeria

    Directory of Open Access Journals (Sweden)

    Ishola Gbenga

    2011-08-01

    Full Text Available Abstract Background Despite massive anti-malaria campaigns across the subcontinent, effective access to intermittent preventive treatment (IPTp and insecticide-treated nets (ITNs among pregnant women remain low in large parts of sub-Saharan Africa. The slow uptake of malaria prevention products appears to reflect lack of knowledge and resistance to behavioural change, as well as poor access to resources, and limited support of programmes by local communities and authorities. Methods A recent community-based programme in Akwa Ibom State, Nigeria, is analysed to determine the degree to which community-directed interventions can improve access to malaria prevention in pregnancy. Six local government areas in Southern Nigeria were selected for a malaria in pregnancy prevention intervention. Three of these local government areas were selected for a complementary community-directed intervention (CDI programme. Under the CDI programme, volunteer community-directed distributors (CDDs were appointed by each village and kindred in the treatment areas and trained to deliver ITNs and IPTp drugs as well as basic counseling services to pregnant women. Findings Relative to women in the control area, an additional 7.4 percent of women slept under a net during pregnancy in the treatment areas (95% CI [0.035, 0.115], p-value Conclusion The presented results suggest that the inclusion of community-based programmes can substantially increase effective access to malaria prevention, and also increase access to formal health care access in general, and antenatal care attendance in particular in combination with supply side interventions. Given the relatively modest financial commitments they require, community-directed programmes appear to be a cost-effective way to improve malaria prevention; the participatory approach underlying CDI programmes also promises to strengthen ties between the formal health sector and local communities.

  17. Knowledge and attitude of young people regarding HIV prevention and unwanted pregnancy in Bobo-Dioulasso, Burkina Faso

    Science.gov (United States)

    Come Yélian Adohinzin, Clétus; Meda, Nicolas; Anicet Ouédraogo, Georges; Gaston Belem, Adrien Marie; Sombié, Issiaka; Berthé, Abdramane; Bakwin Kandala, Ngianga; Damienne Avimadjenon, Georgette; Fond-Harmant, Laurence

    2016-10-19

    Introduction: Despite health education efforts, young people are still faced with major health problems. The objective of this study was to assess the knowledge and attitude regarding HIV prevention and unwanted pregnancy among young people in Bobo-Dioulasso, Burkina Faso. Methods: Based on two-level sampling, representing 94,947 households in the Bobo-Dioulasso municipality, 573 young people between the ages of 15 and 24 years were interviewed. This data collection was conducted from September 2014 to January 2015 in the three districts of the municipality. A questionnaire was used to assess the knowledge and attitudes of young people. Results: The interviewees had a poor knowledge about HIV transmission and prevention and contraception Very few young people (9%) had complete knowledge about the modes of transmission and 5% had no knowledge. Persistent misperceptions about the effectiveness of condoms (25%) and contraception (32%) did not prevent some young people from using them (79% used condoms and 46% used contraceptives). Knowledge and attitudes of young people regarding HIV and contraception varied according to age, sex, education level and type of parental supervision. Conclusion: A significant proportion of young people still has incomplete knowledge about HIV/AIDS and contraception. Actions designed to reinforce the knowledge of young people are of paramount importance. The capacities of parents and healthcare providers also need to be reinforced to improve the quality of relationship with young people.

  18. Sexual Health Outcomes at 24 Months for a Clinic-Linked Intervention to Prevent Pregnancy Risk Behaviors

    Science.gov (United States)

    Sieving, Renee E.; McRee, Annie-Laurie; McMorris, Barbara J.; Beckman, Kara J.; Pettingell, Sandra L.; Bearinger, Linda H.; Garwick, Ann W.; Oliphant, Jennifer A.; Plowman, Shari; Resnick, Michael D.; Secor-Turner, Molly

    2015-01-01

    Importance Preventing early pregnancy among vulnerable adolescents requires innovative and sustained approaches. Prime Time, a youth development intervention, aims to reduce pregnancy risk among adolescent girls seeking clinic services who are at high risk for pregnancy. Objective To evaluate sexual risk behaviors and related outcomes with a 24-month postbaseline survey, 6 months after the conclusion of the Prime Time intervention. Design Randomized controlled trial. Setting Community and school-based primary care clinics. Participants Of 253 sexually active 13- to 17-year-old girls meeting specified risk criteria, 236 (93.3%) completed the 24-month follow-up survey. Intervention Offered during an 18-month period, Prime Time includes case management and youth leadership programs. Main Outcome Measures Self-reported consistency of condom, hormonal, and dual-method contraceptive use with most recent male sex partner and number of male sex partners in the past 6 months. Results At 24-month follow-up, the intervention group reported significantly more consistent use of condoms, hormonal contraception, and dual-method contraception than the control group. Intervention participants also reported improvements in family connectedness and self-efficacy to refuse unwanted sex, and reductions in the perceived importance of having sex. No between-group differences were found in the number of recent male sex partners. Conclusions and Relevance This study contributes to what has been a dearth of evidence regarding youth development interventions offered through clinic settings, where access to high-risk adolescents is plentiful but few efforts have emphasized a dual approach of strengthening sexual and nonsexual protective factors while addressing risk. Findings suggest that health services grounded in a youth development framework can lead to long-term reductions in sexual risk among vulnerable youth. PMID:23440337

  19. Mind-body interventions during pregnancy for preventing or treating women's anxiety.

    Science.gov (United States)

    Marc, Isabelle; Toureche, Narimane; Ernst, Edzard; Hodnett, Ellen D; Blanchet, Claudine; Dodin, Sylvie; Njoya, Merlin M

    2011-07-06

    Anxiety during pregnancy is a common problem. Anxiety and stress could have consequences on the course of the pregnancy and the later development of the child. Anxiety responds well to treatments such as cognitive behavioral therapy and/or medication. Non-pharmacological interventions such as mind-body interventions, known to decrease anxiety in several clinical situations, might be offered for treating and preventing anxiety during pregnancy. To assess the benefits of mind-body interventions during pregnancy in preventing or treating women's anxiety and in influencing perinatal outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 November 2010), MEDLINE (1950 to 30 November 2010), EMBASE (1974 to 30 November 2010), the National Center for Complementary and Alternative Medicine (NCCAM) (1 December 2010), ClinicalTrials.gov (December 2010) and Current Controlled Trials (1 December 2010), searched the reference lists of selected studies and contacted professionals and authors in the field. Randomized controlled trials, involving pregnant women of any age at any time from conception to one month after birth, comparing mind-body interventions with a control group. Mind-body interventions include: autogenic training, biofeedback, hypnotherapy, imagery, meditation, prayer, auto-suggestion, tai-chi and yoga. Control group includes: standard care, other pharmacological or non-pharmacological interventions, other types of mind-body interventions or no treatment at all. Three review authors independently assessed trials for inclusion all assessed risk of bias for each included study. We extracted data independently using an agreed form and checked it for accuracy. We included eight trials (556 participants), evaluating hypnotherapy (one trial), imagery (five trials), autogenic training (one trial) and yoga (one trial). Due to the small number of studies per intervention and to the diversity of outcome measurements, we performed no meta

  20. Optimizing weight gain in pregnancy to prevent obesity in women and children.

    Science.gov (United States)

    Herring, S J; Rose, M Z; Skouteris, H; Oken, E

    2012-03-01

    Pregnancy is now considered to be an important risk factor for new or persistent obesity among women during the childbearing years. High gestational weight gain is the strongest predictor of maternal overweight or obesity following pregnancy. A growing body of evidence also suggests that both high and low gestational weight gains are independently associated with an increased risk of childhood obesity, suggesting that influences occurring very early in life are contributing to obesity onset. In response to these data, the US Institute of Medicine (IOM) revised gestational weight gain guidelines in 2009 for the first time in nearly two decades. However, less than one third of pregnant women achieve guideline-recommended gains, with the majority gaining above IOM recommended levels. To date, interventions to optimize pregnancy weight gains have had mixed success. In this paper, we summarize the evidence from human and animal studies linking over-nutrition and under-nutrition in pregnancy to maternal and child obesity. In addition, we discuss published trials and ongoing interventions to achieve appropriate gestational weight gain as a strategy for obesity prevention in women and their children.

  1. Using Evidence-Based Parenting Programs to Advance CDC Efforts in Child Maltreatment Prevention. Research Brief

    Science.gov (United States)

    Valle, Linda Anne; Whitaker, Daniel J.; Lutzker, John R.; Filene, Jill H.; Wyatt, Jennifer M.; Cephas, Kendell C.; Hoover, D. Michele

    2004-01-01

    The Centers for Disease Control and Prevention (CDC) recognize child maltreatment as a serious public health problem with extensive short- and long-term health effects. In addition to the immediate physical and emotional effects of maltreatment, children who have experienced abuse and neglect are at increased risk of adverse health effects and…

  2. Recurrent Issues in Efforts to Prevent Homicidal Youth Violence in Schools: Expert Opinions

    Science.gov (United States)

    Dill, Karen E.; Redding, Richard E.; Smith, Peter K.; Surette, Ray; Cornell, Dewey G.

    2011-01-01

    Developmental research on social influences on adolescents can guide practices aimed to prevent homicidal youth violence. School shootings have repeatedly raised questions about the contributory role of bullying and entertainment violence, how news media publicity might produce copycat crimes, and whether stiffer criminal sanctions might have a…

  3. Engaging pregnant and parenting teens: early challenges and lessons learned from the Evaluation of Adolescent Pregnancy Prevention Approaches.

    Science.gov (United States)

    Asheer, Subuhi; Berger, Amanda; Meckstroth, Alicia; Kisker, Ellen; Keating, Betsy

    2014-03-01

    This article draws on data from the ongoing federal Evaluation of Adolescent Pregnancy Prevention Approaches to discuss the early implementation experiences of two new and innovative programs intended to delay rapid repeat pregnancy among teen mothers: (1) AIM 4 Teen Moms, in Los Angeles County, California; and (2) Teen Options to Prevent Pregnancy (T.O.P.P.), in Columbus, Ohio. Program staff report common challenges in working with teen mothers, particularly concerning recruitment and retention, staff capacity and training, barriers to participation, and participants' overarching service needs. Lessons learned in addressing these challenges provide useful guidance to program developers, providers, policy makers, and stakeholders working with similar populations.

  4. Text Messaging to Improve Preventive Health Attitudes and Behaviors During Pregnancy: A Prospective Cohort Analysis.

    Science.gov (United States)

    Moniz, Michelle H; Meyn, Leslie A; Beigi, Richard H

    2015-01-01

    To delineate the effects of text messages sent to pregnant women to promote preventive health beliefs and behaviors. A prospective cohort analysis was performed among women who participated in a randomized, controlled trial aimed at improving preventive health. Participants (158 pregnant women enrolled from 2010-2012) received 12 weekly text messages encouraging preventive health behaviors (tobacco cessation, condom use for disease prevention, nutrition optimization, seat belt use, breastfeeding). Pre- and postintervention surveys assessed preventive health beliefs and practices. At follow-up, participants agreed that receiving text messages changed their beliefs about targeted preventive health behaviors: smoking (50%), sexually transmitted disease prevention (72%), prenatal vitamins (83%), seat belt use (68%), nutritious foods (84%), and breastfeeding (68%). Many participants reported more frequent engagement in target behaviors at follow-up than at baseline: decreased tobacco use (among 41% of smokers), more consistent condom use (among 7% of sexually active participants), more prenatal vitamin intake (32%), more frequent seatbelt use (32%), more frequent healthy food intake (41%), and intention to breastfeed longer (21%). Pregnant women receiving text messages promoting preventive health reported improvements in targeted beliefs and behaviors, suggesting that text messaging may be used for health promotion during pregnancy.

  5. Pregnancy, STDS, and AIDS prevention: evaluation of New Image Teen Theatre.

    Science.gov (United States)

    Hillman, E; Hovell, M F; Williams, L; Hofstetter, R; Burdyshaw, C; Rugg, D; Atkins, C; Elder, J; Blumberg, E

    1991-01-01

    New Image Teen Theatre combines peer education and theatre in an informative and entertaining package. This study was undertaken to assess the effectiveness of New Image Teen Theatre on altering teenagers' attitudes, knowledge, and intentions regarding sexual behavior. A total of 143 adolescents between the ages of 13 and 19 viewed the performance. The performance focused on the prevention of pregnancy, AIDS, and STDs and included content aimed at increasing communication. Teen participants completed pretest and posttest questionnaires. Almost half of the adolescents reported having engaged in sexual intercourse. About one third of the sexually active reported never using birth control, and only 21% reported consistent use of condoms. These results confirm adolescents' risk for pregnancy, STDs, and AIDS in particular. Following the performance, the teens reported significantly more willingness to discuss sexual issues with others, significantly greater intention to use birth control (for sexually active teens), and demonstrated significantly greater sexual knowledge. Furthermore, they indicated that they had experienced more positive emotions than negative emotions while viewing the production. Results suggest that theatre education may set the stage for more comprehensive interventions designed to prevent pregnancy, STDs, and AIDS.

  6. Awareness of prevention of teenage pregnancy amongst secondary school learners in Makhado municipality.

    Science.gov (United States)

    Maxwell, Giliana M; Radzilani-Makatu, Makondelele; Takalani, James F

    2016-04-01

    Sexuality plays a very significant role in the lives of both boys and girls. It is, therefore, considered important for schools to recognise and accept sexuality as part of the development process of the child. Professor Kader Asmal (previous South African Minister of Education) suggested that the earlier the school begins to teach learners about sexuality, the better because they can be easily misled by their peers if proper guidance regarding their sexuality is not given. The current study was conducted to assess the awareness of teenagers on the prevention of teenage pregnancy (TP) in six secondary school learners situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province. The study was conducted at six secondary schools situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province in 2014. A quantitative descriptive survey study was conducted where data were collected, using self-administered questionnaires, from 381 systematically sampled participants from six secondary schools situated in the Soutpansberg-West circuit, Makhado Municipality in Limpopo province. Data were analysed descriptively using the Statistical Package for the Social Sciences (SPSS) software, version 22.0. Necessary approval procedures and ethical clearance were obtained prior to data collection. Ninety-four percent of participants agreed that TP can be prevented through abstaining from sex, whilst 65% of participants agreed that TP could be prevented by using contraceptives such as pills and injections. Eighty-three percent of participants agreed that T Pcould be prevented through the use of condoms. Seventy-four percent participants disagreed that bathing after sex prevents teenage pregnancies. Furthermore, 28% participants agreed that TP can be prevented by oral sex. The conclusion drawn was that learners are aware of the measures for preventing TP.

  7. Pregnancy

    DEFF Research Database (Denmark)

    Palmer, Keith T; Bonzini, Matteo; Bonde, Jens Peter Ellekilde;

    2013-01-01

    Most pregnant women are exposed to some physical activity at work. This Concise Guidance is aimed at doctors advising healthy women with uncomplicated singleton pregnancies about the risks arising from five common workplace exposures (prolonged working hours, shift work, lifting, standing and heavy...... physical workload). The adverse outcomes considered are: miscarriage, preterm delivery, small for gestational age, low birth weight, pre-eclampsia and gestational hypertension. Systematic review of the literature indicates that these exposures are unlikely to carry much of an increased risk for any...... on pregnancy. Moreover, moderate physical exercise is thought to be healthy in pregnancy and most pregnant women undertake some physical work at home. The guidelines provide risk estimates and advice on counselling....

  8. Undue inducement, or unfair exclusion: considering a case study of pregnancy in an HIV prevention trial.

    Science.gov (United States)

    Haire, Bridget G; Folayan, Morenike Oluwatoyin

    2017-07-24

    In their recent paper' Undue inducement: a case study in CAPRISA 008', Mngadi et al conclude that a participant in an HIV prevention study who deliberately concealed her pregnancy was not'unduly induced' to participate by the offer of an experimental product. This paper argues that while the authors' conclusion is sound, the framing of this case study is consistent with the preoccupation in research ethics with the concept of undue inducement, coupled with a highly risk-averse attitude to pregnancy (regardless of whether those risks may be willingly assumed by pregnant women themselves). We suggest that the critical research ethics question raised by Mngadi et al's case study is not 'undue inducement', but the exclusion of pregnant women from research studies where the risks are acceptable to the potential participant, and benefits likely. We also suggest that current regulatory paradigms regarding pregnancy are both overly paternalistic and value the fetus over the mother. In order to ensure timely provision of new HIV prevention agents, we argue that there is a need for expeditious testing of proven effective agents in pregnancy, with due consideration given to situations where preliminary efficacy data exist but fall short of licensure standards. This requires a paradigm shift from researchers, funders, regulators and ethical review bodies towards practices that critically examine the legitimacy of the exclusion of pregnant women on a study-by-study basis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Behavioral Interventions for Preventing Sexually Transmitted Infections and Unintended Pregnancies: An Overview of Systematic Reviews.

    Science.gov (United States)

    Macaya Pascual, A; Ferreres Riera, J R; Campoy Sánchez, A

    2016-05-01

    Countless sex education programs have been implemented worldwide in recent decades, but epidemiological data show no improvement in rates of sexually transmitted infections or unintended pregnancies. To summarize the evidence from higher-quality systematic reviews on the efficacy of behavioral interventions for the prevention of sexually transmitted infections and unintended pregnancies. We conducted an overview of reviews by selecting systematic reviews that met minimum quality criteria in terms of the design of the studies reviewed. We compared the results obtained when the effects of interventions were assessed on the basis of objective criteria (biological data) to those obtained when outcomes were assessed on the basis of subjective criteria (self-reports). The results of Cochrane and non-Cochrane reviews were also compared. We identified 55 systematic reviews. No overall effect on the sexual behavior of program participants was observed in 72.5% of the reviews that used objective criteria and in 48.1% of the reviews based on subjective criteria. In the Cochrane reviews, no evidence of an overall effect was observed in 86% of reviews based on objective variables and in 70.5% of those based on subjective variables. There is no evidence that behavioral interventions modify rates of sexually transmitted infections (including human immunodeficiency virus infections) or unintended pregnancies, particularly when effects are assessed using objective, biological data. Primary prevention strategies for sexually transmitted infections and unintended pregnancies need to be re-evaluated. Copyright © 2015 AEDV. Published by Elsevier España, S.L.U. All rights reserved.

  10. Possibilities in Anaemia Prevention during Pregnancy through the Basic Health Care System

    Directory of Open Access Journals (Sweden)

    Karácsony Ilona

    2015-05-01

    Full Text Available In case of pregnancies, one of the most common pathological conditions in internal medicine is aneamia with iron-deficiency. Furthermore, iron deficiency may also affect the mother and the fetus negatively. We wanted to find out which group of expectant mothers are mostly affected, which factors influence the development of aneamia. It was also observable in the case of those living at higher living standards that they take fetus-protecting vitamins with a significantly higher frequency before the pregnancy than those living at lower living standards. According to our research data, 67% of the sample developed aneamia. In our research the risk group consisted of young, vegetarian expectant mothers with low education and the multiparas. After conception, the timing of gynaecological consultation was appropriate and the majority of the sample had a clear idea of the ways of preventing aneamia. However, prevention was only realized in practice - based on the criteria - only with a frequency of 12%. It would be important to consciously plan pregnancy. After taking expectant mothers into care, they should - as soon as possible - be screened for the deficiency and in need, supplements should be started. Risk groups should be given greater attention. In their case, a routine supplement of iron would be desirable even before the development of a deficiency. During pregnancy care, awareness must be raised and an iron-rich diet should be established at the beginning. Beyond these, general practitioner, health visitors have the opportunity - through the close relationship with the expectant mothers - to control laboratory tests, provide appropriate information, recommend vitamin preparations as well as check taken medications.

  11. Interventions to prevent adverse fetal programming due to maternal obesity during pregnancy.

    Science.gov (United States)

    Nathanielsz, Peter W; Ford, Stephen P; Long, Nathan M; Vega, Claudia C; Reyes-Castro, Luis A; Zambrano, Elena

    2013-10-01

    Maternal obesity is a global epidemic affecting both developed and developing countries. Human and animal studies indicate that maternal obesity adversely programs the development of offspring, predisposing them to chronic diseases later in life. Several mechanisms act together to produce these adverse health effects. There is a consequent need for effective interventions that can be used in the management of human pregnancy to prevent these outcomes. The present review analyzes the dietary and exercise intervention studies performed to date in both altricial and precocial animals, rats and sheep, with the aim of preventing adverse offspring outcomes. The results of these interventions present exciting opportunities to prevent, at least in part, adverse metabolic and other outcomes in obese mothers and their offspring.

  12. Use of psychotropic medication among inpatients during focused efforts in prevention of coercion and restraint

    DEFF Research Database (Denmark)

    Højlund, Mikkel; Høgh, Lene; Munk-Jørgensen, Povl

    and reduced life expectancy. The aim of this study is therefore to quantify the use of psychotropic medication when implementing interventions to reduce coercion and restraint. Methods: Cohort study on patients in risk of agitation and coercion in a psychiatric ward operating without physical restraint......Objective: Department of Psychiatry in Aabenraa participates in a national Danish project supporting efforts to reduce coercion and restraint in psychiatry. Antipsychotic and anxiolytic medicine is widely used among agitated patients, but is also known to contribute to cardio-vascular disease...... the project period. Results: Data collection is carried out during autumn of 2016 and preliminary results will be presented at the meeting in Gothenburg. Conclusions: Data from this study will provide new information to the evaluation of initiatives towards reduction of restraint in psychiatry. It will also...

  13. Pregnancy

    Science.gov (United States)

    ... occur between 34 and 36 weeks—these are late-preterm births. 5 Infants born in the 37th and 38th ... NICHD News and Spotlights Common tests for preterm birth not useful for ... in treating mildly low thyroid function in pregnancy, NIH Network study finds ...

  14. Retaining clients in an outcome monitoring evaluation study: HIV prevention efforts in community settings.

    Science.gov (United States)

    Smith, Bryce D; Kalayil, Elizabeth J; Patel-Larson, Alpa; Chen, Brenda; Vaughan, Marla

    2012-02-01

    The Centers for Disease Control and Prevention (CDC), Division of HIV/AIDS Prevention (DHAP) conducted outcome monitoring studies on evidence-based interventions (EBIs) provided by CDC-funded community-based organizations (CBOs). Critical to the success of outcome monitoring was the ability of CBOs to recruit and retain clients in evaluation studies. Two EBIs, Video Opportunities for Innovative Condom Education and Safer Sex (VOICES/VOCES) and Healthy Relationships, were evaluated using repeated measure studies, which require robust follow-up retention rates to increase the validity and usefulness of the findings. The retention rates were high for both VOICES/VOCES CBOs (95.8% at 30 days and 91.1% at 120 days), and Healthy Relationships CBOs (89.5% at 90 days and 83.5% at 180 days). This paper presents an overview of the retention of clients, challenges to follow-up, and strategies developed by CBOs to achieve high retention rates. These strategies and rates are discussed within the context of the CBOs' target populations and communities. Published by Elsevier Ltd.

  15. Economic evaluation of a comprehensive teenage pregnancy prevention program: pilot program.

    Science.gov (United States)

    Rosenthal, Marjorie S; Ross, Joseph S; Bilodeau, Roseanne; Richter, Rosemary S; Palley, Jane E; Bradley, Elizabeth H

    2009-12-01

    Previous research has suggested that comprehensive teenage pregnancy prevention programs that address sexual education and life skills development and provide academic support are effective in reducing births among enrolled teenagers. However, there have been limited data on the costs and cost effectiveness of such programs. The study used a community-based participatory research approach to develop estimates of the cost-benefit of the Pathways/Senderos Center, a comprehensive neighborhood-based program to prevent unintended pregnancies and promote positive development for adolescents. Using data from 1997-2003, an in-time intervention analysis was conducted to determine program cost-benefit while teenagers were enrolled; an extrapolation analysis was then used to estimate accrued economic benefits and cost-benefit up to age 30 years. The program operating costs totaled $3,228,152.59 and reduced the teenage childbearing rate from 94.10 to 40.00 per 1000 teenage girls, averting $52,297.84 in total societal costs, with an economic benefit to society from program participation of $2,673,153.11. Therefore, total costs to society exceeded economic benefits by $559,677.05, or $1599.08 per adolescent per year. In an extrapolation analysis, benefits to society exceed costs by $10,474.77 per adolescent per year by age 30 years on average, with social benefits outweighing total social costs by age 20.1 years. This comprehensive teenage pregnancy prevention program is estimated to provide societal economic benefits once participants are young adults, suggesting the need to expand beyond pilot demonstrations and evaluate the long-range cost effectiveness of similarly comprehensive programs when they are implemented more widely in high-risk neighborhoods.

  16. Prevention and promotion is the cornerstone in the effort to erradicate cholera in primary care

    Directory of Open Access Journals (Sweden)

    Yurieth Gallardo

    2013-10-01

    Full Text Available Introduction. Cholera has accompanied mankind since time immemorial with historical records from China, India and ancient Greece. However, registers are available only since 1817, when the first documented pandemic emerged in Asia and spread to Turkey and Arab countries. Since then, eight episodes of cholera pandemic have occurred in the world. Objective. To inform the scientific community about the epidemiological situation in the province of Granma, Cuba, at the cross-sectional period of July 2012 and the prevention and health promotion measures that were introduced in the first level of care for cases of diarrhea caused by Vibrio cholerae. These measures were implemented in the territory with an intersectoral approach, resulting in the adoption of healthy lifestyles by the general population. Conclusion. Basic sanitation activities were undertaken to slow the spread of the disease, complemented by suggestions to the medical community about the importance of epidemiological surveillance to detect reemergence.

  17. The difference transport makes to child mortality and preventive healthcare efforts: Riders for Health.

    Science.gov (United States)

    Coleman, Barry J; Howard, Emma; Jenkinson, Astrid

    2011-02-01

    The 20th and 21st century witnessed the development of many sophisticated vaccinations and other key preventive health interventions, and yet child mortality in sub-Saharan Africa remains unacceptably high. One of the barriers identified to reducing child mortality in rural regions of Africa is distance and lack of transportation. In order to address this, a growing charitable organisation, Riders for Health (http://www.riders.org) has developed a reliable and cost-effective system for managing vehicles used in all types of healthcare delivery. The system intends to ensure that the delivery of health interventions is never undermined by failing vehicles no matter how harsh the terrain. The system provides reliable transport in direct support of partner healthcare goals and, in so doing, maintains a supply of appropriately managed vehicles, particularly motorcycles. Thereby health workers are empowered, their productivity and coverage enhanced and the efficiency of health interventions they promote maximised.

  18. Community-based health efforts for the prevention of falls in the elderly

    Directory of Open Access Journals (Sweden)

    Alan Hanley

    2010-12-01

    Full Text Available Alan Hanley1, Carmel Silke2, John Murphy31Department of Medicine, Letterkenny General Hospital, Letterkenny, Co Donegal, Ireland; 2Department of Rheumatology, Our Lady's Hospital Manorhamilton, Manorhamilton, Co Leitrim, Ireland; 3Department of Medicine, Castlebar, Co Mayo, IrelandAbstract: Falls are a major public health problem in the elderly population. The associated health care cost is great. It has therefore become an important public health matter to evaluate those interventions that might be effective in reducing the risk of falls. Risk factors that predict an increased risk of falling are described. We discuss interventions that can be employed in the community to reduce the risk of falls and associated injuries by discipline, including physiotherapy, occupational therapy, and physician-led interventions. We also discuss the cost-effectiveness of such interventions.Keywords: fall, fracture, prevention, public health

  19. From mission to measures: performance measure development for a Teen Pregnancy Prevention Program.

    Science.gov (United States)

    Farb, Amy Feldman; Burrus, Barri; Wallace, Ina F; Wilson, Ellen K; Peele, John E

    2014-03-01

    The Office of Adolescent Health (OAH) sought to create a comprehensive set of performance measures to capture the performance of the Teen Pregnancy Prevention (TPP) program. This performance measurement system needed to provide measures that could be used internally (by both OAH and the TPP grantees) for management and program improvement as well as externally to communicate the program's progress to other interested stakeholders and Congress. This article describes the selected measures and outlines the considerations behind the TPP measurement development process. Issues faced, challenges encountered, and lessons learned have broad applicability for other federal agencies and, specifically, for TPP programs interested in assessing their own performance and progress.

  20. Optimizing Prevention of HIV and Unplanned Pregnancy in Discordant African Couples.

    Science.gov (United States)

    Wall, Kristin M; Kilembe, William; Vwalika, Bellington; Haddad, Lisa B; Khu, Naw Htee; Brill, Ilene; Onwubiko, Udodirim; Chomba, Elwyn; Tichacek, Amanda; Allen, Susan

    2017-08-01

    Dual method use, which combines condoms with a more effective modern contraceptive to optimize prevention of HIV and unplanned pregnancy, is underutilized in high-risk heterosexual couples. Heterosexual HIV-discordant Zambian couples were enrolled from couples' voluntary HIV counseling and testing services into an open cohort with 3-monthly follow-up (1994-2012). Relative to dual method use, defined as consistent condom use plus modern contraception, we examine predictors of (1) condom-only use (suboptimal pregnancy prevention) or (2) modern contraceptive use with inconsistent condom use (effective pregnancy prevention and suboptimal HIV prevention). Among 3,049 couples, dual method use occurred in 28% of intervals in M+F- and 23% in M-F+, p < 0.01; condom-only use in 56% in M+F- and 61% in M-F+, p < 0.01; and modern contraceptive use with inconsistent condom use in 16% regardless of serostatus. Predictors (p < 0.05) of condom-only use included the man being HIV+ (adjusted hazard ratio, aHR = 1.15); baseline oral contraceptive pill (aHR = 0.76), injectable (aHR = 0.48), or implant (aHR = 0.60) use; woman's age (aHR = 1.04 per 5 years) and lifetime number of sex partners (aHR = 1.01); postpartum periods (aHR = 1.25); and HIV stage of the index partner III/IV versus I (aHR = 1.10). Predictors (p < 0.05) of modern contraceptive use with inconsistent condom use included woman's age (aHR = 0.94 per 5 years) and HIV+ male circumcision (aHR = 1.51), while time-varying implant use was associated with more consistent condom use (aHR = 0.80). Three-quarters of follow-up intervals did not include dual method use. This highlights the need for counseling to reduce unintended pregnancy and HIV transmission and enable safer conception.

  1. Efficacy of malaria prevention during pregnancy in an area of low and unstable transmission

    DEFF Research Database (Denmark)

    Ndyomugyenyi, Richard; Clarke, Siân E; Hutchison, Coll L.

    2011-01-01

    was 15.0%, 14.7% and 6.5%, respectively. Maternal and fetal outcomes were generally remarkably similar across all intervention groups (P>0.05 for all outcomes examined). A marginal difference in maternal haemoglobin was observed in the dual intervention group (12.57g/dl) compared with the IPTp and ITN...... services was observed. With ITNs offering a number of advantages over IPTp, yet showing comparable efficacy, we discuss why ITNs could be an appropriate preventive strategy for malaria control during pregnancy in areas of low and unstable transmission....

  2. Adaptation Guidance for Evidence-Based Teen Pregnancy and STI/HIV Prevention Curricula: From Development to Practice

    Science.gov (United States)

    Rolleri, Lori A.; Fuller, Taleria R.; Firpo-Triplett, Regina; Lesesne, Catherine A.; Moore, Claire; Leeks, Kimberly D.

    2014-01-01

    Evidence-based interventions (EBIs) are effective in preventing adolescent pregnancy and sexually transmitted infections; however, prevention practitioners are challenged when selecting and adapting the most appropriate programs. While there are existing adaptation frameworks, there is little practical guidance in applying research in the field.…

  3. Adaptation Guidance for Evidence-Based Teen Pregnancy and STI/HIV Prevention Curricula: From Development to Practice

    Science.gov (United States)

    Rolleri, Lori A.; Fuller, Taleria R.; Firpo-Triplett, Regina; Lesesne, Catherine A.; Moore, Claire; Leeks, Kimberly D.

    2014-01-01

    Evidence-based interventions (EBIs) are effective in preventing adolescent pregnancy and sexually transmitted infections; however, prevention practitioners are challenged when selecting and adapting the most appropriate programs. While there are existing adaptation frameworks, there is little practical guidance in applying research in the field.…

  4. Hyperbaric index in the primary prevention of hypertensive complications in high-risk pregnancy.

    Science.gov (United States)

    Otero González, Alfonso; Uribe Moya, Silvia; Arenas Moncaleano, Ivan Gilberto; Borrajo Prol, María Paz; García García, María Jesús; López Sánchez, Luis

    2015-01-01

    Preeclampsia (PE) is a major cause of fetal morbidity and mortality. In the Western World, PE affects 2-7% of pregnancies and is responsible for 50,000 deaths annually. Early detection is a priority as it can change the clinical course, but there are no biomarkers or instrumental methods with high sensitivity and specificity. Only the hyperbaric index has a sensitivity and specificity of 99% for early identification of pregnant women at risk of developing PE, but its use is not widespread. To assess the usefulness of the hyperbaric index in the primary prevention of hypertensive pregnancy complications in a public healthcare area. This is a retrospective study of pregnancies that occurred in our area during the period 2007-2012 (N=11,784). The diagnosis was established by the hyperbaric index and pregnant women at risk were treated with ASA at night. In pregnant patients referred to the nephrology clinic (38.2%), diagnosed as high-risk for PE, and treated with 100mg ASA/night (from week 17), the incidence of PE episodes was reduced by 96.94. Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  5. Aquatic Activities During Pregnancy Prevent Excessive Maternal Weight Gain and Preserve Birth Weight.

    Science.gov (United States)

    Bacchi, Mariano; Mottola, Michelle F; Perales, Maria; Refoyo, Ignacio; Barakat, Ruben

    2017-01-01

    The aim of the present study was to examine the influence of a supervised and regular program of aquatic activities throughout gestation on maternal weight gain and birth weight. A randomized clinical trial. Instituto de Obstetricia, Ginecología y Fertilidad Ghisoni (Buenos Aires, Argentina). One hundred eleven pregnant women were analyzed (31.6 ± 3.8 years). All women had uncomplicated and singleton pregnancies; 49 were allocated to the exercise group (EG) and 62 to the control group (CG). The intervention program consisted of 3 weekly sessions of aerobic and resistance aquatic activities from weeks 10 to 12 until weeks 38 to 39 of gestation. Maternal weight gain, birth weight, and other maternal and fetal outcomes were obtained by hospital records. Student unpaired t test and χ(2) test were used; P values ≤.05 indicated statistical significance. Cohen's d was used to determinate the effect size. There was a higher percentage of women with excessive maternal weight gain in the CG (45.2%; n = 28) than in the EG (24.5%; n = 12; odds ratio = 0.39; 95% confidence interval: 0.17-0.89; P = .02). Birth weight and other pregnancy outcomes showed no differences between groups. Three weekly sessions of water activities throughout pregnancy prevents excessive maternal weight gain and preserves birth weight. The clinicaltrial.gov identifier: NCT 02602106.

  6. Development and Predictive Effects of Eating Disorder Risk Factors during Adolescence: Implications for Prevention Efforts

    Science.gov (United States)

    Rohde, Paul; Stice, Eric; Marti, C. Nathan

    2014-01-01

    Objective Although several prospective studies have identified factors that increase risk for eating disorders, little is known about when these risk factors emerge and escalate, or when they begin to predict future eating disorder onset. The objective of this report was to address these key research gaps. Method Data were examined from a prospective study of 496 community female adolescents (M = 13.5, SD = 0.7 at baseline) who completed eight annual assessments of potential risk factors and eating disorders from preadolescence to young adulthood. Results Three variables exhibited positive linear increases: Perceived pressure to be thin, thin-ideal internalization and body dissatisfaction; three were best characterized as quadratic effects: dieting (essentially little change); negative affectivity (overall decrease), and BMI (overall increase). Elevated body dissatisfaction at ages 13, 14, 15, and 16 predicted DSM-5 eating disorders onset in the 4 year period after each assessment, but the predictive effects of other risk factors were largely confined to age 14; BMI did not predict eating disorders at any age. Discussion The results imply that these risk factors are present by early adolescence, though eating disorders tend to emerge in late adolescence and early adulthood. These findings emphasize the need for efficacious eating disorder prevention programs for early adolescent girls, perhaps targeting 14 year olds, when risk factors appear to be most predictive. In early adolescence, it might be fruitful to target girls with body dissatisfaction, as this was the most consistent predictor of early eating disorder onset in this study. PMID:24599841

  7. Understanding social and sexual networks of sexual minority men and transgender women in Guatemala city to improve HIV prevention efforts.

    Science.gov (United States)

    Tucker, C; Arandi, C Galindo; Bolaños, J Herbert; Paz-Bailey, G; Barrington, C

    2014-11-01

    Sexual minority men and transgender women are disproportionately affected by HIV in Guatemala. Innovative prevention strategies are urgently needed to address these disparities. While social network approaches are frequently used to reach sexual minorities, little is known about the unique network characteristics among sub-groups. We conducted in-depth qualitative interviews with 13 gay-identifying men, eight non-gay-identifying men who have sex with men (MSM) and eight transgender women in Guatemala City. Using narrative and thematic coding procedures, we identified distinct patterns in the size, composition, and overlap between social and sexual networks across groups. Gay-identifying men had the largest, most supportive social networks, predominantly comprising family. For both non-gay-identifying MSM and transgender women, friends and sex clients provided more support. Transgender women reported the smallest social networks, least social support, and the most discrimination. HIV prevention efforts should be tailored to the specific sexual minority population and engage with strong ties.

  8. Engaging Minority Youth in Diabetes Prevention Efforts Through a Participatory, Spoken-Word Social Marketing Campaign.

    Science.gov (United States)

    Rogers, Elizabeth A; Fine, Sarah C; Handley, Margaret A; Davis, Hodari B; Kass, James; Schillinger, Dean

    2017-07-01

    To examine the reach, efficacy, and adoption of The Bigger Picture, a type 2 diabetes (T2DM) social marketing campaign that uses spoken-word public service announcements (PSAs) to teach youth about socioenvironmental conditions influencing T2DM risk. A nonexperimental pilot dissemination evaluation through high school assemblies and a Web-based platform were used. The study took place in San Francisco Bay Area high schools during 2013. In the study, 885 students were sampled from 13 high schools. A 1-hour assembly provided data, poet performances, video PSAs, and Web-based platform information. A Web-based platform featured the campaign Web site and social media. Student surveys preassembly and postassembly (knowledge, attitudes), assembly observations, school demographics, counts of Web-based utilization, and adoption were measured. Descriptive statistics, McNemar's χ(2) test, and mixed modeling accounting for clustering were used to analyze data. The campaign included 23 youth poet-created PSAs. It reached >2400 students (93% self-identified non-white) through school assemblies and has garnered >1,000,000 views of Web-based video PSAs. School participants demonstrated increased short-term knowledge of T2DM as preventable, with risk driven by socioenvironmental factors (34% preassembly identified environmental causes as influencing T2DM risk compared to 83% postassembly), and perceived greater personal salience of T2DM risk reduction (p < .001 for all). The campaign has been adopted by regional public health departments. The Bigger Picture campaign showed its potential for reaching and engaging diverse youth. Campaign messaging is being adopted by stakeholders.

  9. High-sodium intake prevents pregnancy-induced decrease of blood pressure in the rat.

    Science.gov (United States)

    Beauséjour, Annie; Auger, Karine; St-Louis, Jean; Brochu, Michéle

    2003-07-01

    Despite an increase of circulatory volume and of renin-angiotensin-aldosterone system (RAAS) activity, pregnancy is paradoxically accompanied by a decrease in blood pressure. We have reported that the decrease in blood pressure was maintained in pregnant rats despite overactivation of RAAS following reduction in sodium intake. The purpose of this study was to evaluate the impact of the opposite condition, e.g., decreased activation of RAAS during pregnancy in the rat. To do so, 0.9% or 1.8% NaCl in drinking water was given to nonpregnant and pregnant Sprague-Dawley rats for 7 days (last week of gestation). Increased sodium intakes (between 10- and 20-fold) produced reduction of plasma renin activity and aldosterone in both nonpregnant and pregnant rats. Systolic blood pressure was not affected in nonpregnant rats. However, in pregnant rats, 0.9% sodium supplement prevented the decreased blood pressure. Moreover, an increase of systolic blood pressure was obtained in pregnant rats receiving 1.8% NaCl. The 0.9% sodium supplement did not affect plasma and fetal parameters. However, 1.8% NaCl supplement has larger effects during gestation as shown by increased plasma sodium concentration, hematocrit level, negative water balance, proteinuria, and intrauterine growth restriction. With both sodium supplements, decreased AT1 mRNA levels in the kidney and in the placenta were observed. Our results showed that a high-sodium intake prevents the pregnancy-induced decrease of blood pressure in rats. Nonpregnant rats were able to maintain homeostasis but not the pregnant ones in response to sodium load. Furthermore, pregnant rats on a high-sodium intake (1.8% NaCl) showed some physiological responses that resemble manifestations observed in preeclampsia.

  10. Prevention

    DEFF Research Database (Denmark)

    Halken, S; Høst, A

    2001-01-01

    , breastfeeding should be encouraged for 4-6 months. In high-risk infants a documented extensively hydrolysed formula is recommended if exclusive breastfeeding is not possible for the first 4 months of life. There is no evidence for preventive dietary intervention neither during pregnancy nor lactation....... Preventive dietary restrictions after the age of 4-6 months are not scientifically documented....

  11. The substance and sources of young children's healthy eating and physical activity knowledge: implications for obesity prevention efforts.

    Science.gov (United States)

    Lanigan, J D

    2011-05-01

    The prevalence of overweight among young children is increasing at an alarming rate. Global efforts to address the issue can benefit from understanding how young children's experiences across multiple contexts shape their perspectives of healthy weight. This qualitative study examines the substance and sources of young American children's knowledge related to healthy eating, physical activity and media practices. Role play and semi-structured interviews were conducted in child-care settings with 81 children aged 3-5 who represented diverse socio-economic statuses and ethnic backgrounds. Children demonstrated better understanding of the benefits of healthy eating compared with physical activity. Snacks and beverages consumed outside mealtime were less likely to be healthy even among the 40% of children who demonstrated an understanding of healthy nutrition. The majority of children's leisure activity selections involved media and minimally active pursuits. Three quarters of the children were unable to articulate reasons for healthy choices or identify the sources of their health understandings. The media was listed as source of health information more frequently than adults. Obesity prevention efforts targeting young children need to use consistent messaging across all contexts in which children develop in order to increase their understanding that physical activity and eating choices support health. Efforts need to counter inaccurate information and address the rationale for health practices. Key gaps in young children's understanding include: the importance of drinking water, that snacks are part of nutritional intake and the benefits of engaging in physical activities. © 2011 Blackwell Publishing Ltd.

  12. High-risk behaviors among adult men and women in Botswana: Implications for HIV/AIDS prevention efforts

    Science.gov (United States)

    Keetile, Mpho

    2014-01-01

    Abstract The government of Botswana has been spending a lot of money in the prevention, treatment, care and support for HIV/AIDS patient for decades. This paper uses data from the third Botswana AIDS Impact Survey (BAIS III) to explore high-risk behaviors of adults and how they affect government efforts to stop the spread of HIV/AIDS. The objective of this paper is to fill in the gap on the assessment of high-risk behaviors associated with HIV/AIDS and their implications on HIV/AIDS prevention efforts. A nationally representative sample of 10,159 men and women aged 20–64 years who had successfully completed the BAIS III individual questionnaire were used in the study. Both descriptive and binary logistic regression analyses were used for analysis. Crude odds ratios were obtained from gross effects model while adjusted odds ratios (AOR) were obtained from the net effects model. Statistically significant association was observed between multiple current partners and alcohol consumption (AOR = 1.5), drug abuse (AOR = 1.7), transactional sex (AOR = 2.6) and intergenerational sex (AOR = 1.07). Furthermore, statistically significant association was seen for inconsistent condom use and having tested for HIV (AOR = 1.5). These results show a worrying tendency that despite government's efforts to stop the spread of HIV/AIDS, adults in Botswana continue to indulge in high-risk behaviors. Therefore, any programs and policies on HIV/AIDS should first target these high-risk behaviors. PMID:25293869

  13. High-risk behaviors among adult men and women in Botswana: implications for HIV/AIDS prevention efforts.

    Science.gov (United States)

    Keetile, Mpho

    2014-01-01

    The government of Botswana has been spending a lot of money in the prevention, treatment, care and support for HIV/AIDS patient for decades. This paper uses data from the third Botswana AIDS Impact Survey (BAIS III) to explore high-risk behaviors of adults and how they affect government efforts to stop the spread of HIV/AIDS. The objective of this paper is to fill in the gap on the assessment of high-risk behaviors associated with HIV/AIDS and their implications on HIV/AIDS prevention efforts. A nationally representative sample of 10,159 men and women aged 20-64 years who had successfully completed the BAIS III individual questionnaire were used in the study. Both descriptive and binary logistic regression analyses were used for analysis. Crude odds ratios were obtained from gross effects model while adjusted odds ratios (AOR) were obtained from the net effects model. Statistically significant association was observed between multiple current partners and alcohol consumption (AOR = 1.5), drug abuse (AOR = 1.7), transactional sex (AOR = 2.6) and intergenerational sex (AOR = 1.07). Furthermore, statistically significant association was seen for inconsistent condom use and having tested for HIV (AOR = 1.5). These results show a worrying tendency that despite government's efforts to stop the spread of HIV/AIDS, adults in Botswana continue to indulge in high-risk behaviors. Therefore, any programs and policies on HIV/AIDS should first target these high-risk behaviors.

  14. Smoking during Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  15. Cystic Fibrosis and Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  16. Pregnancy Complications: Chlamydia

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  17. Pregnancy Complications: Syphilis

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  18. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  19. Abuse during Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  20. Radiation and Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  1. Mercury and Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  2. Pregnancy Complications: Gonorrhea

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  3. Alcohol during Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  4. Pregnancy Complications: Salmonellosis

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  5. Pregnancy Complications: Genital Herpes

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  6. Street Drugs and Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  7. Pregnancy week by week

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  8. Getting Fit Before Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  9. Heroin and Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  10. Prescription Opioids during Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  11. Weight Gain during Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  12. Cravings during Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  13. Effectiveness of peer education interventions for HIV prevention, adolescent pregnancy prevention and sexual health promotion for young people: a systematic review of European studies.

    Science.gov (United States)

    Tolli, M V

    2012-10-01

    Peer education remains a popular strategy for health promotion and prevention, but evidence of its effectiveness is still limited. This article presents a systematic review of peer education interventions in the European Union that were published between January 1999 and May 2010. The objective of the review is to determine the effectiveness of peer education programs for human immunodeficiency virus (HIV) prevention, adolescent pregnancy prevention and promotion of sexual health among young people. Standardized methods of searching and data extraction were utilized and five studies were identified. Although a few statistically significant and non-significant changes were observed in the studies, it is concluded that, overall, when compared to standard practice or no intervention, there is no clear evidence of the effectiveness of peer education concerning HIV prevention, adolescent pregnancy prevention and sexual health promotion for young people in the member countries of the European Union. Further research is needed to determine factors that contribute to program effectiveness.

  14. Women’s perception of accuracy of ultrasound dating in late pregnancy: a challenge to prevention of prolonged pregnancy in a resource-poor Nigerian setting

    Directory of Open Access Journals (Sweden)

    Ugwu EO

    2014-02-01

    Full Text Available Emmanuel O Ugwu,1 Godwin U Odoh,1 Cyril C Dim,1 Samuel N Obi,1 Euzebus C Ezugwu,1 Innocent I Okafor21Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria; 2Department of Obstetrics and Gynaecology, Enugu State University Teaching Hospital, Parklane, Enugu, NigeriaBackground: Expected date of delivery (EDD is estimated from the last menstrual period (LMP or ultrasound scan. Conflicts between these estimates especially on the part of the physician and his/her patient could pose a challenge to prevention of prolonged pregnancy. The objective of this study was to determine the perception and acceptability of menstrual dating (EDD derived from LMP with regard to timing of labor induction for postdatism by pregnant women who have a late pregnancy (≥23 weeks’ gestation ultrasound scan.Methods: This cross-sectional study included 443 consecutive pregnant women receiving antenatal care at two tertiary health institutions in Enugu, Nigeria, from January 1, 2013 to March 31, 2013.Results: The mean age of the women was 27.9±2.41 (range 17–45 years. Most ultrasound scans (90.8%, 357/389 were carried out in late pregnancy, and 41.9% (167/389 were self-referred. The majority of the respondents (51.7%, 229/443 did not accept induction of labor for postdatism at a certain menstrual dating-derived gestational age of 40 weeks plus 10 days if the late pregnancy ultrasound scan dating was less. Predictors of this poor attitude to timing of induction of labor for postdatism included low educational level, low social class, and poor knowledge of the limitations of ultrasound scan dating in late pregnancy (P<0.05.Conclusion: The worrisome confidence in ultrasound scan dating is a challenge to the prevention of prolonged pregnancy and its complications in our environment. Antenatal health education should discourage self-referral for ultrasound scan dating and emphasize its limitations in late pregnancy

  15. Folic acid supplementation in pregnancy to prevent preterm birth: a systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Saccone, Gabriele; Berghella, Vincenzo

    2016-04-01

    Folic acid (FA) may have a role in the prevention of pregnancy complications. However, the efficacy of FA supplementation in reducing the risk of preterm birth (PTB) is still unclear. The aim of this systematic review with meta-analysis was to evaluate the efficacy of folic acid supplementation during pregnancy to prevent preterm birth (PTB). The research protocol was designed a priori, defining methods for searching the literature in electronic databases, including and examining articles, and extracting and analyzing data. We included all randomized trials (RCTs) of asymptomatic singleton gestations without prior PTB who were randomized to prophylactic treatment with either FA supplementation or control (placebo or no treatment). The primary outcome was the incidence of PTB pregnancy does not prevent PTB <37 weeks. Daily FA supplementation remains the most important intervention to reduce the risk of neural tube defects.

  16. Enhancing teen pregnancy prevention in local communities: capacity building using the interactive systems framework.

    Science.gov (United States)

    Duffy, Jennifer L; Prince, Mary Severson; Johnson, Erin E; Alton, Forrest L; Flynn, Shannon; Faye, Amy Mattison; Padgett, Polly Edwards; Rollison, Chris; Becker, Dana; Hinzey, Angela L

    2012-12-01

    Getting To Outcomes (GTO), an innovative framework for planning, implementing, evaluating, and sustaining interventions has been shown to be effective in helping community-based organizations (CBOs) introduce science-based approaches into their prevention work. However, the Interactive Systems Framework (ISF) suggests that adopting innovations like GTO requires a significant amount of capacity building through training and technical assistance (T/TA). In this study, 11 CBOs and three schools in South Carolina entered into a 3 year program of intense and proactive T/TA based on the ISF to learn how to apply an adaptation of GTO (Promoting Science-Based Approaches-Getting To Outcomes, PSBA-GTO) to their teen pregnancy prevention programs. Using semi-structured interviews, the partnering organizations were assessed at three points in time, pre-T/TA, 12 months, and post T/TA (30 months) for their performance of the steps of GTO in their work. The seven organizations which participated in T/TA until the end of the project received an average of 76 h of TA and 112 h of training per organization. Interview results showed increased performance of all 10 steps of PSBA-GTO by these organizations when conducting their teen pregnancy programs. These results suggest targeted and proactive T/TA can successfully bridge the gap between research and practice by using a three part delivery system, as prescribed in the ISF, which relies on an intermediary prevention support system to ensure accurate and effective translation of research to the everyday work of community-based practitioners.

  17. THE ROLE OF NUTRITION IN CARIES PREVENTION AND MAINTENANCE OF ORAL HEALTH DURING PREGNANCY.

    Science.gov (United States)

    Jevtić, Marija; Pantelinaci, Jelena; Jovanović Ilić, Tatjana; Petrović, Vasa; Grgić, Olja; Blazić, Larisa

    2015-01-01

    Pregnancy may pose an increased risk for the development of caries and other oral health problems. Continuous screening of oral health status, implementing appropriate preventive measures (particularly oral hygiene, healthy diet plans and education) is of paramount importance not only for oral health but also for the general health status of the future mother and her offspring. EFFECTS OF FOOD ON CARIES DEVELOPMENT: Caries prevention through healthy diet implicates the reduction in frequency and amount of intake of cariogenic food, above all ofrefined carbohydrates, i.e. sugars and sweets. Foods known to have caries-prophylactic effects should predominate in healthy diet plans. They mainly include solid foods, which have mechanical effects on teeth cleaning, as well as foods providing sufficient amounts of vitamins (A, C, D) and a variety of elements and compounds (calcium, phosphates, fluorides) favoring the preservation and remineralization of tooth structures. EDUCATION OF PREGNANT WOMEN ON HEALHY DEIT: In accomplishing these goals, education and direct positive communication between the educator and the pregnant woman play a crucial role. Educative approach is always individual and determined by the patient's specific cultural and socioeconomic features and status, as well as her habits, motivation and willingness to accept relevant recommendations. Accomplishing the aforementioned goals requires the appropriate organization and professional competence within the preventive dental service and its close cooperation with the relevant medical institutions and social support in the framework of public health protection. Preserving of oral health during pregnancy is predominantly influenced by the following factors: 1) healthy diet, 2) oral hygiene, 3) patients' education, 4) regular control of oral health, 5) appropriate organization of dental services and 6) community engagement.

  18. Molar Pregnancy

    Science.gov (United States)

    ... may check for other medical problems, including: Preeclampsia Hyperthyroidism Anemia A molar pregnancy can't continue as a normal viable pregnancy. To prevent complications, the molar tissue must be removed. Treatment usually consists of one or more of the ...

  19. Prevention of unintended pregnancy and HIV/STIs among Latinos in rural communities: perspectives of health care providers.

    Science.gov (United States)

    Branch, Meredith; Harvey, S Marie; Zukoski, Ann P; Warren, Jocelyn

    2010-08-01

    Latino women in the United States are disproportionately at risk for unintended pregnancy, HIV, and sexually transmitted infections (STIs). We conducted nine focus groups with health care practitioners who provide reproductive health care to Latinos in rural areas of the Northwest. From the practitioner perspective, we explored barriers and facilitators to the acquisition and use of contraceptives and to the prevention of HIV/STIs among rural Latinos. Suggestions for improving reproductive health care included Spanish-language resources/materials and convenient contraceptive methods. Findings provide context to the complex issues related to unintended pregnancy and disease prevention among Latinos residing in rural communities.

  20. Effectiveness of the delivery of interventions to prevent malaria in pregnancy in Kenya.

    Science.gov (United States)

    Dellicour, Stephanie; Hill, Jenny; Bruce, Jane; Ouma, Peter; Marwanga, Doris; Otieno, Peter; Desai, Meghna; Hamel, Mary J; Kariuki, Simon; Webster, Jayne

    2016-04-18

    Coverage with malaria in pregnancy interventions remains unacceptably low. Implementation research is needed to identify and quantify the bottlenecks for the delivery and use of these life-saving interventions through antenatal clinics (ANC). A cross-sectional study was carried out in ANC across nine health facilities in western Kenya. Data were collected for an individual ANC visit through structured observations and exit interviews with the same ANC clients. The cumulative and intermediate systems effectiveness for the delivery of intermittent preventive treatment (IPTp) and insecticide-treated nets (ITNs) to eligible pregnant women on this one specific visit to ANC were estimated. Overall the ANC systems effectiveness for delivering malaria in pregnancy interventions was suboptimal. Only 40 and 53 % of eligible women received IPTp by directly observed therapy as per policy in hospitals and health centres/dispensaries respectively. The overall systems effectiveness for the receipt of IPTp disregarding directly observed therapy was 62 and 72 % for hospitals and lower level health facilities, respectively. The overall systems effectiveness for ITNs for first ANC visit was 63 and 67 % for hospitals and lower level facilities, respectively. This study found that delivery of IPTp and ITNs through ANC was ineffective and more so for higher-level facilities. This illustrates missed opportunities and provider level bottlenecks to the scale up and use of interventions to control malaria in pregnancy delivered through ANC. The high level of clustering within health facilities suggest that future studies should assess the feasibility of implementing interventions to improve systems effectiveness tailored to the health facility level.

  1. Being targeted: Young women's experience of being identified for a teenage pregnancy prevention programme.

    Science.gov (United States)

    Sorhaindo, Annik; Bonell, Chris; Fletcher, Adam; Jessiman, Patricia; Keogh, Peter; Mitchell, Kirstin

    2016-06-01

    Research on the unintended consequences of targeting 'high-risk' young people for health interventions is limited. Using qualitative data from an evaluation of the Teens & Toddlers Pregnancy Prevention programme, we explored how young women experienced being identified as at risk for teenage pregnancy to understand the processes via which unintended consequences may occur. Schools' lack of transparency regarding the targeting strategy and criteria led to feelings of confusion and mistrust among some young women. Black and minority ethnic young women perceived that the assessment of their risk was based on stereotyping. Others felt their outgoing character was misinterpreted as signifying risk. To manage these imposed labels, stigma and reputational risks, young women responded to being targeted by adopting strategies, such as distancing, silence and refusal. To limit harmful consequences, programmes could involve prospective participants in determining their need for intervention or introduce programmes for young people at all levels of risk. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  2. Mexican adolescents’ goals as determinants in the prevention of early pregnancies

    Directory of Open Access Journals (Sweden)

    Erika E Atienzo

    2014-05-01

    Full Text Available Objective. This study aims to explore adolescents’ intentions related to the early formation of a family. Materials and methods. We administered a survey to students in eight schools in Morelos and Mexico City, in 2010. We analyzed intentions of marrying or having a child and fitted an exploratory path model to assess predictors of the intentions of having a child before the age of 20 (n=2974. Results. Around 77% of adolescents expect to have their first child at 20 years or later; 21% show ambivalence or incongruence regarding this, whereas 2% expect to have a child before the age of 20. Parents’ expectations for their child’s education influence the importance that adolescents give to education. The latter promotes the idea of postponing childbearing until 20 years or later (β=0.13. Conclusions. In order to prevent early pregnancies, interventions and programs should encourage the construction of personal and professional goals.

  3. School-based interventions for preventing Hiv, sexually transmitted infections, and pregnancy in adolescents

    Science.gov (United States)

    Mason-Jones, Amanda J; Sinclair, David; Mathews, Catherine; Kagee, Ashraf; Hillman, Alex; Lombard, Carl

    2016-01-01

    Background School-based sexual and reproductive health programmes are widely accepted as an approach to reducing high-risk sexual behaviour among adolescents. Many studies and systematic reviews have concentrated on measuring effects on knowledge or self-reported behaviour rather than biological outcomes, such as pregnancy or prevalence of sexually transmitted infections (STIs). Objectives To evaluate the effects of school-based sexual and reproductive health programmes on sexually transmitted infections (such as HIV, herpes simplex virus, and syphilis), and pregnancy among adolescents. Search methods We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for published peer-reviewed journal articles; and ClinicalTrials.gov and the World Health Organization's (WHO) International Clinical Trials Registry Platform for prospective trials; AIDS Educaton and Global Information System (AEGIS) and National Library of Medicine (NLM) gateway for conference presentations; and the Centers for Disease Control and Prevention (CDC), UNAIDS, the WHO and the National Health Service (NHS) centre for Reviews and Dissemination (CRD) websites from 1990 to 7 April 2016. We handsearched the reference lists of all relevant papers. Selection criteria We included randomized controlled trials (RCTs), both individually randomized and cluster-randomized, that evaluated school-based programmes aimed at improving the sexual and reproductive health of adolescents. Data collection and analysis Two review authors independently assessed trials for inclusion, evaluated risk of bias, and extracted data. When appropriate, we obtained summary measures of treatment effect through a random-effects meta-analysis and we reported them using risk ratios (RR) with 95% confidence intervals (CIs). We assessed the certainty of the evidence using the GRADE approach. Main results We included eight cluster-RCTs that enrolled 55,157 participants. Five trials were conducted in

  4. Decline of placental malaria in southern Ghana after the implementation of intermittent preventive treatment in pregnancy

    Directory of Open Access Journals (Sweden)

    Eggelte Teunis A

    2007-11-01

    Full Text Available Abstract Background Intermittent preventive treatment in pregnancy with sulphadoxine-pyrimethamine (IPTp-SP has been adopted as policy by many countries in sub-Saharan Africa. However, data on the post-implementation effectiveness of this measure are scarce. Methods Clinical and parasitological parameters were assessed among women delivering at a district hospital in rural southern Ghana in the year 2000 when pyrimethamine chemoprophylaxis was recommended (n = 839 and in 2006 (n = 226, approximately one year after the implementation of IPTp-SP. Examinations were performed in an identical manner in 2000 and 2006 including the detection of placental Plasmodium falciparum infection by microscopy, histidine-rich protein 2, and PCR. Results In 2006, 77% of the women reported to have taken IPTp-SP at least once (26%, twice; 24%, thrice. In 2006 as compared to 2000, placental P. falciparum infection was reduced by 43–57% (P P = 0.0009, and median birth weight was 130 g higher (P = 0.02. In 2006, likewise, women who had taken ≥ 1 dose of IPTp-SP revealed less infection and anaemia and their children tended to have higher birth weights as compared to women who had not used IPTp-SP. However, placental P. falciparum infection was still observed in 11% (microscopy to 26% (PCR of those women who had taken three doses of IPTp-SP. Conclusion In southern Ghana, placental malaria and maternal anaemia have declined substantially and birth weight has increased after the implementation of IPTp-SP. Likely, these effects can further be increased by improving IPTp-SP coverage and adherence. However, the remnant prevalence of infection in women having taken three doses of IPTp-SP suggests that additional antimalarial measures are needed to prevent malaria in pregnancy in this region.

  5. Why do we report suicides and how can we facilitate suicide prevention efforts? Perspectives of Hong Kong media professionals.

    Science.gov (United States)

    Cheng, Qijin; Fu, King-wa; Caine, Eric; Yip, Paul S F

    2014-01-01

    The Hong Kong news media report suicide-related events more frequently and sensationally than Western countries. Little is known about Hong Kong media professionals' experiences and thoughts about such reporting. To understand Hong Kong media professionals' experiences and perceptions of suicide reporting and whether the news media can be better engaged into suicide prevention. We conducted three focus groups of journalists from both the Cantonese and English language news media. Data were analyzed using grounded theory methods. We discerned three rationales from participants regarding their intense coverage of suicide-related events: (1) satisfying commercial competitiveness, (2) addressing social problems, and (3) responding to readers' interests. The first rationale was a dominant and vigorous motivating factor, and often influenced suicide reporting among local Cantonese media. Media professionals recommended engagement strategies targeted at frontline journalists, media managers, and general media consumers. We see potential to involve news media professionals in Hong Kong as working partners in suicide prevention. To succeed, this effort requires engagement in a proactive, consistent, and sustained fashion.

  6. Breast cancer prevention: lessons to be learned from mechanisms of early pregnancy-mediated breast cancer protection.

    Science.gov (United States)

    Meier-Abt, Fabienne; Bentires-Alj, Mohamed; Rochlitz, Christoph

    2015-03-01

    Pregnancy at early, but not late age, has a strong and life-long protective effect against breast cancer. The expected overall increase in breast cancer incidence demands the development of a pharmaceutical mimicry of early-age pregnancy-mediated protection. Recently, converging results from rodent models and women on molecular and cellular mechanisms underlying the protective effect of early-age pregnancy have opened the door for translational studies on pharmacologic prevention against breast cancer. In particular, alterations in Wnt and TGFβ signaling in mammary stem/progenitor cells reveal new potential targets for preventive interventions, and thus might help to significantly reduce the incidence of breast cancer in the future. ©2015 American Association for Cancer Research.

  7. [To the question of rational nutrition, micronutrient status correction, prevention and treatment of iron deficiency in pregnancy].

    Science.gov (United States)

    Tayupova, I M

    2015-01-01

    In the article the features of healthy nutrition in pregnant women suffering from iron deficiency has been discussed. The criteria for diagnosis of anemia during pregnancy, the stage of the disease development, the specifics of iron deficiency during gestation, the need in this trace element in pregnant women have been defined. The necessity of an adequate selection of a balanced diet during pregnancy complicated with anemia has been based. Iron content in food products along with the extent of absorption depending upon the origin of the product have been considered. The compounds that contribute to a better absorption of iron, as well as medicinal substances that prevent its absorption have been presented. Special attention is paid to the questions of preventative measures in preventing anemia in pregnant women. In addition to a balanced diet and iron preparations for treatment and prevention of anemia, the appointment of vitamin-mineral supplements and specialized foods for pregnant enriched with micronutrients has been substantiated.

  8. Assessing Capacity to Promote Science-Based Programs: A Key Informant Study of State Teen Pregnancy Prevention Organizations

    Science.gov (United States)

    Saunders, Edward; Sabri, Bushra; Huberman, Barbara; Klaus, T. W.; Davis, Laura

    2011-01-01

    The purpose of this qualitative study was to identify significant external and internal challenges that state organization leaders face in promoting science-based teen pregnancy prevention programs within their states. The state organization administrators were chosen because their organizations were funded by the U.S. Centers for Disease Control…

  9. A Participatory Action Research Approach to Developing Youth-Friendly Strategies for the Prevention of Teenage Pregnancy

    Science.gov (United States)

    Wood, Lesley; Hendricks, Farah

    2017-01-01

    Teenage pregnancy among school-going youth is a concern worldwide, but in socially-economically challenged environments it is a result of, and contributory factor to, a complex web of social injustice. In South Africa, most of the school-based prevention interventions to date have been adult-designed and imparted, with the voice of the target…

  10. Project Taking Charge: Six-/Month Follow-Up of a Pregnancy Prevention Program for Early Adolescents.

    Science.gov (United States)

    Jorgensen, Stephen R.; And Others

    1993-01-01

    Conducted six-month follow-up study to evaluate effectiveness of Project Taking Charge, abstinence-based program to delay sexual intercourse and prevent teenage pregnancy. Findings from adolescents at two sites revealed that many knowledge gains found at posttest were retained at follow-up. Program participants were less likely than comparison…

  11. Short-Term Impact of Safer Choices: A Multicomponent, School-Based HIV, Other STD, and Pregnancy Prevention Program.

    Science.gov (United States)

    Coyle, Karin; Basen-Engquist, Karen; Kirby, Douglas; Parcel, Guy; Banspach, Stephen; Harrist, Ronald; Baumler, Elizabeth; Weil, Marsha

    1999-01-01

    Evaluated the effectiveness of the first year of "Safer Choices," a two-year, multicomponent HIV, STD, and pregnancy-prevention program for high school students based on social theory. Student self-report surveys indicated that "Safer Choices" succeeded in reducing selected risk behaviors and in enhancing selected protective…

  12. Communication between Asian American Adolescents and Health Care Providers about Sexual Activity, Sexually Transmitted Infections, and Pregnancy Prevention

    Science.gov (United States)

    Zhao, Jessie; Lau, May; Vermette, David; Liang, David; Flores, Glenn

    2017-01-01

    Asian American adolescents have been reported to have the lowest amount of communication with health care providers regarding sexual health topics (sexual activity, contraception, sexually transmitted infections, and pregnancy prevention). This study identified Asian American adolescents' attitudes/beliefs regarding how health care providers can…

  13. A Participatory Action Research Approach to Developing Youth-Friendly Strategies for the Prevention of Teenage Pregnancy

    Science.gov (United States)

    Wood, Lesley; Hendricks, Farah

    2017-01-01

    Teenage pregnancy among school-going youth is a concern worldwide, but in socially-economically challenged environments it is a result of, and contributory factor to, a complex web of social injustice. In South Africa, most of the school-based prevention interventions to date have been adult-designed and imparted, with the voice of the target…

  14. Young Women's Lived Experience of Participating in a Positive Youth Development Programme: The "Teens & Toddlers" Pregnancy Prevention Intervention

    Science.gov (United States)

    Sorhaindo, Annik; Mitchell, Kirstin; Fletcher, Adam; Jessiman, Patricia; Keogh, Peter; Bonell, Chris

    2016-01-01

    Purpose: Evaluation of the Teens & Toddlers (T&T) positive youth development (PYD) and teenage pregnancy prevention programme suggested that the intervention had minimal effectiveness partly due to its unclear theory of change. The purpose of this paper is to examine the lived experiences of young women participating in the programme to…

  15. Assessing the availability of the teratogenic drug isotretinoin outside the pregnancy prevention programme : a survey of e-pharmacies

    NARCIS (Netherlands)

    Lagan, Briege M.; Dolk, Helen; White, Bronagh; Uges, Donald R. A.; Sinclair, M.

    2014-01-01

    PurposeThe increase in online purchasing of medications raises safety concerns regarding teratogenic drugs. The use of the teratogenic drug isotretinoin' for women of childbearing age requires strict adherence to the Pregnancy Prevention Programme (PPP), a risk minimisation measure imposed on prescr

  16. A new strategy and its effect on adherence to intermittent preventive treatment of malaria in pregnancy in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K; Yanow, Stephanie; Birungi, Josephine;

    2013-01-01

    Few women in Uganda access intermittent preventive treatment of malaria in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP). Previous studies have shown that high costs, frequent stock-out of drugs, supplies and poor quality of care are the greatest hindrance for women to access health services...

  17. Recurrent thrombosis prevention with intravenous immunoglobulin and hydroxychloroquine during pregnancy in a patient with history of catastrophic antiphospholipid syndrome and pregnancy loss.

    Science.gov (United States)

    Mar, Nataliya; Kosowicz, Rebecca; Hook, Karen

    2014-01-01

    We report a case of a 36-year old patient with prior history of thrombosis in a setting of antiphospholipid antibody syndrome (APS) as well as pregnancy-associated catastrophic antiphospholipid syndrome (CAPS), resulting in multi-organ infarction and pregnancy loss. The episode of CAPS occurred while she was receiving antepartum low-dose aspirin and therapeutic-dose enoxaparin. This patient presented again at 6 weeks gestation and ultrasounds were consistent with fetal growth restriction, concerning for placental insufficiency and thrombosis. This time, hydroxychloroquine and monthly intravenous immunoglobulin (IVIG) infusions were added to her prophylaxis regimen, resulting in a successful delivery. Platelet count and antiphospholipid antibody titers were routinely monitored throughout pregnancy as markers of disease activity for APS. Current thromboprophylaxis guidelines do not address therapeutic options to prevent further pregnancy morbidity in women who develop recurrent episodes of thrombosis or CAPS despite receiving adequate anti-thrombotic treatment. Use of hydroxychloroquine and IVIG has been associated with good outcomes in this subset of patients.

  18. Assessing School-Based Gang Prevention Efforts in Urban Centers: Are These Programs Reaching Those Students Who May Benefit the Most?

    Science.gov (United States)

    Rodriguez, Hector

    2009-01-01

    In recent years, schools have become a focal point for general delinquency and gang prevention programs for a variety of reasons. One premise behind this approach is that schools can serve as ideal settings for providing delinquency and intervention services because youths spend so much time there. School-based gang prevention efforts are supposed…

  19. 75 FR 77645 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Pregnancy...

    Science.gov (United States)

    2010-12-13

    ... Control Special Emphasis Panel (SEP): Pregnancy Risk Assessment Monitoring System (PRAMS), DP11-001 Panel..., discussion, and evaluation of ``Pregnancy Risk Assessment Monitoring System (PRAMS), DP11-001 Panel...

  20. Influence of regularity of checkups during pregnancy on prevalence of asymptomatic bacteriuria and maternal behaviors regarding urinary infection prevention.

    Science.gov (United States)

    Babic, U; Opric, D; Perovic, M; Dmitrovic, A; MihailoviC, S; Kocijancic, D; Radakovic, J; Dugalic, M Gojnic

    2015-01-01

    T0 investigate how the regularity of checkups in pregnancy influences maternal behavior regarding habits in prevention of urinary tract infection (UTI), the level of information, and finally the prevalence of asymptomatic bacteriuria (AB). This study included 223 women with regular and 220 women with irregular checkups in pregnancy were given the questionnaire on the following issues: frequency of sexual intercourses during pregnancy, the regularity of bathing and changing of underwear, the direction of washing the genital region after urinating, the regularity of antenatal visits to gynecologist, and the subjective experience concerning the quality of the information received by the healthcare provider. AB was present significantly more frequent in group of participants with irregular controls during pregnancy compared to group with regular checkups in pregnancy. The prevalence of AB was higher in those women who had irregular prenatal checkups. Maternal behaviors related with the risk of urinary infections are more frequent among women with irregular prenatal care. Results of the present study emphasize the importance of regular prenatal care in AB prevention.

  1. The Process of Prevention and Treatment for Pregnancy Gingivitis%妊娠期龈炎的防治进展

    Institute of Scientific and Technical Information of China (English)

    吴家嘉; 何显科

    2014-01-01

    妊娠期龈炎是妊娠期发病率极高的疾病之一,不但影响妊娠期妇女的身心健康,同时也可能对胎儿的生长发育造成影响,甚至导致妊娠不良结局。对妊娠期龈炎的控制,预防是关键、治疗是补充。本文着重从妊娠期龈炎的预防和治疗两方面对相关资料进行综述。%Pregnancy gingivitis is one of the high incidence diseases during pregnancy, it not only affects the physical and mental health of pregnant women, but also may affect the fetal development growth, even leads to adverse pregnancy outcomes. For the controlling of pregnancy gingivitis, pre-vention is the key, treatment is supplement. This article would focus on the two aspects of prevention and treatment of pregnancy gingivitis to make a review.

  2. Interventions for preventing and treating low-back and pelvic pain during pregnancy.

    Science.gov (United States)

    Liddle, Sarah D; Pennick, Victoria

    2015-09-30

    More than two-thirds of pregnant women experience low-back pain and almost one-fifth experience pelvic pain. The two conditions may occur separately or together (low-back and pelvic pain) and typically increase with advancing pregnancy, interfering with work, daily activities and sleep. To update the evidence assessing the effects of any intervention used to prevent and treat low-back pain, pelvic pain or both during pregnancy. We searched the Cochrane Pregnancy and Childbirth (to 19 January 2015), and the Cochrane Back Review Groups' (to 19 January 2015) Trials Registers, identified relevant studies and reviews and checked their reference lists. Randomised controlled trials (RCTs) of any treatment, or combination of treatments, to prevent or reduce the incidence or severity of low-back pain, pelvic pain or both, related functional disability, sick leave and adverse effects during pregnancy. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We included 34 RCTs examining 5121 pregnant women, aged 16 to 45 years and, when reported, from 12 to 38 weeks' gestation. Fifteen RCTs examined women with low-back pain (participants = 1847); six examined pelvic pain (participants = 889); and 13 examined women with both low-back and pelvic pain (participants = 2385). Two studies also investigated low-back pain prevention and four, low-back and pelvic pain prevention. Diagnoses ranged from self-reported symptoms to clinicians' interpretation of specific tests. All interventions were added to usual prenatal care and, unless noted, were compared with usual prenatal care. The quality of the evidence ranged from moderate to low, raising concerns about the confidence we could put in the estimates of effect. For low-back painResults from meta-analyses provided low-quality evidence (study design limitations, inconsistency) that any land-based exercise significantly reduced pain (standardised mean difference

  3. Can a health coaching intervention delivered during pregnancy help prevent excessive gestational weight gain?

    Science.gov (United States)

    Hill, Briony; Skouteris, Helen; Fuller-Tyszkiewicz, Matthew; McPhie, Skye

    2016-10-01

    This study evaluated: (1) the efficacy of a health coaching (HC) intervention designed to prevent excessive gestational weight gain (GWG); and (2) whether there were improved psychological, motivational, and behavioural outcomes for women in the HC intervention compared to a "usual care" control group. In this quasi-experimental study, 267 pregnant women ≤18 weeks gestation were recruited between August 2011 and June 2013 from two hospital antenatal clinics in Melbourne, Australia. Intervention women received four individual HC and two group HC/educational sessions informed by theories of behaviour change. Women completed questionnaires assessing psychological, motivational and behavioural outcomes at 16-18 (baseline) and 33 (post-intervention) weeks gestation. Weight measures were collected. Compared to usual care, the intervention did not limit GWG or prevent excessive GWG. However, HC women reported greater use of active coping skills post-intervention. Despite lack of success of the HC intervention, given the risks associated with excessive weight gain in pregnancy, health professionals should continue to recommend appropriate GWG.

  4. Changing the policy for intermittent preventive treatment with sulfadoxine-pyrimethamine during pregnancy in Malawi.

    Science.gov (United States)

    Mwendera, Chikondi A; de Jager, Christiaan; Longwe, Herbert; Phiri, Kamija; Hongoro, Charles; Mutero, Clifford M

    2017-02-20

    The growing resistance of Plasmodium falciparum to sulfadoxine-pyrimethamine (SP) treatment for uncomplicated malaria led to a recommendation by the World Health Organization for the use of artemisinin-based combination therapy. Inevitably, concerns were also raised surrounding the use of SP for intermittent prevention treatment of malaria during pregnancy (IPTp) amidst the lack of alternative drugs. Malawi was the first country to adopt intermittent prevention treatment with SP in 1993, and updated in 2013. This case study examines the policy updating process and the contribution of research and key stakeholders to this process. The findings support the development of a malaria research-to-policy framework in Malawi. Documents and evidence published from 1993 to 2012 were systematically reviewed in addition to key informant interviews. The online search identified 170 potential publications, of which eight from Malawi met the inclusion criteria. Two published studies from Malawi were instrumental in the WHO policy recommendation which in turn led to the updating of national policies. The updated policy indicates that more than two SP doses, as informed by research, overcome the challenges of the first policy of two SP doses only because of ineffectiveness by P. falciparum resistance and the global lack of replacement drugs to SP for IPTp. International WHO recommendations facilitated a smooth policy change driven by motivated local leadership with technical and financial support from development partners. Policy development and implementation should include key stakeholders and use local malaria research in a research-to-policy framework.

  5. Condom Availability in Schools: A Practical Approach to the Prevention of Sexually Transmitted Infection/HIV and Unintended Pregnancy.

    Science.gov (United States)

    2017-06-01

    Adolescents and young adults are highly impacted by sexually transmitted infections (STIs) and unplanned pregnancy in the United States and globally. Consistent and correct use of male latex condoms is associated with protection against both STIs and pregnancy. Providing adolescents and young adults with access to free condoms in schools may increase the use of condoms by improving condom availability, eliminating cost, and decreasing embarrassment associated with purchasing condoms. Studies demonstrate that condom availability in schools is associated with the increased use of condoms and improved overall sexual health. The Society for Adolescent Health and Medicine encourages schools to make condoms available to students as part of efforts to decrease rates of STIs and unplanned pregnancy in adolescents and young adults. The Society for Adolescent Health and Medicine also encourages health care providers to advocate for and support the availability of condoms in local schools. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  6. Lifestyle INtervention for Diabetes prevention After pregnancy (LINDA-Brasil): study protocol for a multicenter randomized controlled trial.

    Science.gov (United States)

    Schmidt, Maria Inês; Duncan, Bruce B; Castilhos, Cristina; Wendland, Eliana Márcia; Hallal, Pedro C; Schaan, Beatriz D'Agord; Drehmer, Michele; Costa e Forti, Adriana; Façanha, Cristina; Nunes, Maria Angélica

    2016-03-30

    Gestational diabetes mellitus (GDM), a hyperglycemic state detected during pregnancy, is an established risk factor for diabetes. However, treatment during pregnancy in and of itself is not able to eliminate this risk, and a considerable fraction of women with GDM will develop frank diabetes in the decade following pregnancy. Our aim is to conduct a multicenter randomized controlled trial to investigate the effectiveness of a lifestyle intervention program implemented after a pregnancy complicated by GDM in delaying or preventing the development of type 2 diabetes. Women aged 18 or older identified as having recent GDM are recruited and followed by telephone to assess eligibility for the trial. To be eligible, women must have used insulin during pregnancy or present intermediate hyperglycemia postpartum. Women are encouraged to enter the trial as early as 10 weeks, and are permitted to do so up to 2 years after a pregnancy with GDM. An estimated 740 women will be randomized to either conventional care or to coach-based interventions focused on breastfeeding, weight loss, healthy eating, and increased physical activity, and predominantly delivered by telephone. Women are followed annually to detect new onset diabetes, the primary outcome, and additional secondary outcomes which include reversion to normoglycemia, weight loss, physical activity and fitness, and insulin resistance. Though previous studies have demonstrated that type 2 diabetes can be delayed or prevented, no study has yet demonstrated the feasibility and effectiveness of similar interventions implemented in the postpartum period for women with recent GDM. If shown to be successful, this approach could become an important means of preventing diabetes in primary care settings. ClinicalTrials.gov Identifier: NCT02327286; Registered 23 December 2014.

  7. A comparative analysis of predictors of teenage pregnancy and its prevention in a rural town in Western Nigeria

    Directory of Open Access Journals (Sweden)

    Amoran Olorunfemi E

    2012-07-01

    Full Text Available Abstract Introduction Teenagers younger than 15 are five times more likely to die during pregnancy or childbirth than women in their twenties and mortality rates for their infants are higher as well. This study was therefore designed to determine the recent prevalence and identify factors associated with teenage pregnancy in a rural town in Nigeria. Methods This study is an analytical comparative cross-sectional study. A total sample of all pregnant women attending the primary health care in Sagamu local government area, Ogun State within a 2 months period were recruited into the study. Results A total of 225 pregnant women were recruited into the study. The prevalence of teenage pregnancy was 22.9%. Teenagers [48.2%] reported more unwanted pregnancy when compared with the older age group [13.6%] [OR = 5.91, C.I = 2.83-12.43]. About half 33 [41.1%] of the teenage pregnant women and 28.6% of the older pregnant women did not know how to correctly use condom to prevent pregnancy [OR = 0.57, C.I = 0.29-1.13]. Predictors of teenage pregnancy were low social class (OR = 2.25, C.I = 1.31-3.85], Religion (OR = 0.44, C.I = 0.21-0.91], being a student (OR = 3.27, C.I = 1.02-10.46 and having a white collar job (OR = 0.09, C.I = 0.01-0.81. Conclusion The study concludes that employment in an established organization (white collar job is highly protective against teenage pregnancy while students are becoming increasingly prone to early pregnancy. Government should structure employment in low income countries in such a way as to give a quota to adolescents who are unable to continue their education.

  8. A comparative analysis of predictors of teenage pregnancy and its prevention in a rural town in Western Nigeria.

    Science.gov (United States)

    Amoran, Olorunfemi E

    2012-07-30

    Teenagers younger than 15 are five times more likely to die during pregnancy or childbirth than women in their twenties and mortality rates for their infants are higher as well. This study was therefore designed to determine the recent prevalence and identify factors associated with teenage pregnancy in a rural town in Nigeria. This study is an analytical comparative cross-sectional study. A total sample of all pregnant women attending the primary health care in Sagamu local government area, Ogun State within a 2 months period were recruited into the study. A total of 225 pregnant women were recruited into the study. The prevalence of teenage pregnancy was 22.9%. Teenagers [48.2%] reported more unwanted pregnancy when compared with the older age group [13.6%] [OR = 5.91, C.I = 2.83-12.43]. About half 33 [41.1%] of the teenage pregnant women and 28.6% of the older pregnant women did not know how to correctly use condom to prevent pregnancy [OR = 0.57, C.I = 0.29-1.13]. Predictors of teenage pregnancy were low social class (OR = 2.25, C.I = 1.31-3.85], Religion (OR = 0.44, C.I = 0.21-0.91], being a student (OR = 3.27, C.I = 1.02-10.46) and having a white collar job (OR = 0.09, C.I = 0.01-0.81). The study concludes that employment in an established organization (white collar job) is highly protective against teenage pregnancy while students are becoming increasingly prone to early pregnancy. Government should structure employment in low income countries in such a way as to give a quota to adolescents who are unable to continue their education.

  9. Primary prevention of hemoglobinopathies by prenatal diagnosis and selective pregnancy termination in a Muslim country: Oman

    Directory of Open Access Journals (Sweden)

    Suha Mustafa Hassan

    2014-11-01

    Full Text Available Hemoglobinopathies (HBP are the most common genetic disorder in Oman and are in need of prevention programs due to the high incidence of β-thalassemia major and sickle cell disease. Prenatal diagnosis (PD and selective pregnancy termination is shown to be the most effective prevention tool for the control of HBP. However, PD is not available in Oman thus far because abortion is subject to religious, cultural and ethical issues. We have examined the attitude of a number of Omani HBP carrier couples towards prenatal diagnosis and selective abortion. We have interviewed 35 couples at risk visiting the main premarital clinic in Muscat between Jan 2011 and Jan 2012. Couples were interviewed using a pre-structured questionnaire. The majority would have accepted prenatal diagnosis (94% if the service would be available in the country but pregnancy termination was greatly influenced by religious values. 血红蛋白病(HBP)是一种在阿曼最常见的遗传性疾病,由于其高发的B型地中海贫血症及镰状细胞症,相关的预防措施对于这一国家来说,相当重要。产前诊断(PD)和选择性终止妊娠被证实是针对管控血红蛋白病(HBP)的最有效方法。然而,由于受到宗教、文化和伦理抵制堕胎的影响,产前诊断(PD)并不能在该国得以应用。我们对该国一部分血红蛋白病患夫妇做了一项关于产前诊断的意向调查。2011年一月至2012年一月,我们在马斯喀特(阿曼首都)的一家婚前诊所对35对夫妇做了相关的采访调查。调查的问卷是事先设置好的。大部分(94%)夫妇表示接受产前诊断如果相应的措施能得到广泛的普及,但是他们对于选择性终止妊娠的态度受到了其宗教价值观的极大影响。

  10. Timing of intermittent preventive treatment for malaria during pregnancy and the implications of current policy on early uptake in north-east Tanzania

    Directory of Open Access Journals (Sweden)

    Chambo Pili

    2008-05-01

    Full Text Available Abstract Background Intermittent preventive treatment (IPTp is efficacious in reducing the adverse outcomes associated with pregnancy-associated malaria, however uptake of the recommended two doses is low in Tanzania, and little is known of the timepoint during pregnancy at which it is delivered. This study investigated the timing of delivery of IPTp to pregnant women attending antenatal clinics (ANC, and the potential determinants of timely uptake. Methods Structured interviews were conducted with staff and pregnant women at antenatal clinics in northeast Tanzania, and antenatal consultations were observed. Facility-based and individual factors were analysed for any correlation with timing of IPTp uptake. Results Almost half the women interviewed first attended ANC during or before the fourth month of gestation, however 86% of these early attendees did not receive IPTp on their first visit. The timing of IPTp delivery complied closely with the national guidelines which stipulate giving the first dose at 20–24 weeks gestation. Uptake of at least one dose of IPTp among women who had reached this gestation age was 67%, although this varied considerably between clinics. At one facility, IPTp was not delivered because SP was out of stock. Conclusion Early uptake of IPTp was found to be hampered by factors external to health worker performance or women's individual preferences. These include insufficient drug stocks and an apparent lack of information to health workers on the reasoning for continued use of SP for IPTp when it has been replaced as a first-line treatment. In addition, an unexpectedly high proportion of women attend antenatal clinics before 20 weeks of pregnancy. While current policy denies the use of IPTp at this time, there is emerging, but incomplete, evidence that malaria in early pregnancy may contribute considerably to the burden of pregnancy-related malaria. Current policy may thus result in a missed opportunity for maximising

  11. Current considerations on teenage pregnancy

    Directory of Open Access Journals (Sweden)

    Camila Cristina Manfré

    2011-03-01

    Full Text Available Teenage pregnancy has acquired significant proportions. It is estimated that 20 to 25% of all pregnant women in Brazil are teenagers. The present study, through an analysis of the current literature, examines the main aspects involving pregnancy during adolescence, along with its consequences on the life of young mothers, their children and social environment. We conclude that the efforts of health care professionals, parents and educators are crucial to increase awareness of adolescent sexuality. The application of this knowledge is a way to prevent teen pregnancy, thus avoiding the harmful effects on young mothers and their children.

  12. Progestogens to prevent preterm birth in twin pregnancies: an individual participant data meta-analysis of randomized trials

    Directory of Open Access Journals (Sweden)

    Schuit Ewoud

    2012-03-01

    Full Text Available Abstract Background Preterm birth is the principal factor contributing to adverse outcomes in multiple pregnancies. Randomized controlled trials of progestogens to prevent preterm birth in twin pregnancies have shown no clear benefits. However, individual studies have not had sufficient power to evaluate potential benefits in women at particular high risk of early delivery (for example, women with a previous preterm birth or short cervix or to determine adverse effects for rare outcomes such as intrauterine death. Methods/design We propose an individual participant data meta-analysis of high quality randomized, double-blind, placebo-controlled trials of progestogen treatment in women with a twin pregnancy. The primary outcome will be adverse perinatal outcome (a composite measure of perinatal mortality and significant neonatal morbidity. Missing data will be imputed within each original study, before data of the individual studies are pooled. The effects of 17-hydroxyprogesterone caproate or vaginal progesterone treatment in women with twin pregnancies will be estimated by means of a random effects log-binomial model. Analyses will be adjusted for variables used in stratified randomization as appropriate. Pre-specified subgroup analysis will be performed to explore the effect of progestogen treatment in high-risk groups. Discussion Combining individual patient data from different randomized trials has potential to provide valuable, clinically useful information regarding the benefits and potential harms of progestogens in women with twin pregnancy overall and in relevant subgroups.

  13. Organization and staffing barriers to parent involvement in teen pregnancy prevention programs: challenges for community partnerships.

    Science.gov (United States)

    Flores, Janet E; Montgomery, Susanne; Lee, Jerry W

    2005-09-01

    To evaluate parent involvement in a Southern California teen pregnancy prevention community partnership project. Researchers expected to find parent and family-related participation barriers similar to those described in the family support literature, which they could address with program modifications. Three phases of qualitative evaluation occurred: key informant interviews and focus groups with youth and parents; focus groups with service providers; and key informant interviews with service providers, their supervisor, and the collaborative coordinator. Theory-based, open-ended question guides directed the interviews and focus groups, and transcriptions were coded and themed using grounded theory methods. Parents and youth sought ways to improve connections and communication with each other, and parents welcomed parenting education from the project. Unexpectedly, the major obstacles to parent participation identified in this project were largely organizational, and included the assignment of parent involvement tasks to agencies lacking capacities to work effectively with parents, inadequate administrative support for staff, and the absence of an effective system for communicating concerns and resolving conflicts among collaborative partners. Youth serving agencies may not be the best partners to implement effective parent involvement or family support interventions. Collaborative leadership must identify appropriate partners, engender their cooperation, and support their staff to further the overall goals of the collaborative.

  14. Melatonin prevents neural tube defects in the offspring of diabetic pregnancy.

    Science.gov (United States)

    Liu, Shangming; Guo, Yuji; Yuan, Qiuhuan; Pan, Yan; Wang, Liyan; Liu, Qian; Wang, Fuwu; Wang, Jingjing; Hao, Aijun

    2015-11-01

    Melatonin, an endogenous neurohormone secreted by the pineal gland, has a variety of physiological functions and neuroprotective effects. However, its protective role on the neural tube defects (NTDs) was not very clear. The aim of this study was to investigate the effects of melatonin on the incidence of NTDs (including anencephaly, encephalocele, and spina bifida) of offspring from diabetic pregnant mice as well as its underlying mechanisms. Pregnant mice were given 10 mg/kg melatonin by daily i.p. injection from embryonic day (E) 0.5 until being killed on E11.5. Here, we showed that melatonin decreased the NTDs (especially exencephaly) rate of embryos exposed to maternal diabetes. Melatonin stimulated proliferation of neural stem cells (NSCs) under hyperglycemic condition through the extracellular regulated protein kinases (ERK) pathway. Furthermore, as a direct free radical scavenger, melatonin decreased apoptosis of NSCs exposed to hyperglycemia. In the light of these findings, it suggests that melatonin supplementation may play an important role in the prevention of neural malformations in diabetic pregnancy.

  15. Extended Foster Care for Transition-Age Youth: An Opportunity for Pregnancy Prevention and Parenting Support.

    Science.gov (United States)

    Putnam-Hornstein, Emily; Hammond, Ivy; Eastman, Andrea Lane; McCroskey, Jacquelyn; Webster, Daniel

    2016-04-01

    This analysis examined California county birth rate variations among girls in foster care. The objective was to generate data to assess potential intervention points tied to federal legislation extending foster care beyond age 18 years. Child protection records for all adolescent girls in foster care at age 17 years between 2003 and 2007 (N = 20,222) were linked to vital birth records through 2011. The cumulative percentage of girls who had given birth by age 21 years was calculated by county and race/ethnicity. One in three (35.2%) adolescent girls in foster care had given birth at least once before age 21 years. Although significant birth rate variations emerged, even at the low end of the county range, more than one in four girls had given birth by age 21 years. Child welfare systems are now charged with coordinating transitional services for foster youth beyond age 18 years. Extended foster care provides new opportunities for pregnancy prevention work and targeted parenting support. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  16. Malaria in Pregnancy

    Directory of Open Access Journals (Sweden)

    E E Okpere

    2010-01-01

    Full Text Available Malaria remains one of the highest contributors to the precarious maternal mortality figures in sub-Saharan Africa. At least 6 million women worldwide are at risk of malaria infection in pregnancy. Malaria contributes to at least 10, 000 maternal deaths and to at least 200, 000 newborn deaths annually. Malaria is a contributor or aetiologic factor in pregnancy complications including anaemia, spontaneous abortion, prematurity and stillbirths. Pregnancy results in increased incidence and severity of malaria. Cerebral malaria, acute renal failure and severe anaemia, rare complications in adults living in malaria endemic areas, may complicate malaria in pregnancy. Research implicate reduced maternal immunity from increased steroid levels in pregnancy, increased attractiveness of pregnant women to mosquito bites and increased adherence of parasitized erythrocytes to Chondroitin sulphate A expressed in the placentae. This is worse in the first and second pregnancies. With infection with the Human Immunodeficiency Virus [HIV], the effects of malaria in pregnancy are even worse. Over the decades, there have been concerted worldwide collaborative efforts, spearheaded by the World Health Organization [WHO] and including governments and allied agencies to tackle the scourge of malaria in pregnancy. The main thrusts of such efforts have been: to increase the use of insecticide treated mosquito bed nets [ITN]; intermittent preventive treatment of malaria [IPT]; and adequate case treatment of acute malaria attacks in pregnancy. While for IPT, Sulfadoxine-Pyrimethamine [SP] combination has been proven to be of benefit in preventing acute and latent malaria in pregnancy and its associated complications, the WHO has introduced the use of Artemisinin-Combination Therapy [ACT] for the first-line treatment of uncomplicated malaria in pregnancy, the need to confirm malaria before treatment and the enforcement of completion of therapy once started. The Roll Back

  17. Lack of Thromboxane Synthase Prevents Hypertension and Fetal Growth Restriction after High Salt Treatment during Pregnancy.

    Directory of Open Access Journals (Sweden)

    Chen-Hsueh Pai

    Full Text Available Preeclampsia (PE is a potentially fatal pregnancy-related hypertensive disorder characterized by poor placenta development that can cause fetal growth restriction. PE-associated pathologies, including thrombosis, hypertension, and impaired placental development, may result from imbalances between thromboxane A2 (TXA2 and prostacyclin. Low-dose aspirin, which selectively inhibits TXA2 production, is used to prevent high-risk PE. However, the role of TXA2 in aspirin-mediated protective effects in women with PE is not understood fully. In this study, we examined the role of prostanoids in PE using human samples and an induced PE mouse model. We demonstrated that the administration of salted drinking water (2.7% NaCl to wild-type mice resulted in elevated placental TXA2 synthase (TXAS and plasma TXA2, but not prostacyclin, levels, which was also found in our clinical PE placenta samples. The high salt-treated wild-type pregnant mice had shown unchanged maternal body weight, hypertension (MAP increase 15 mmHg, and decreased pup weight (~50% and size (~24%, but these adverse effects were ameliorated in TXAS knockout (KO mice. Moreover, increased expression of interleukin-1β and downstream phosphorylated-p38-mitogen-activated protein kinase were concordant with apoptosis induction in the placentas of salt water-treated wild-type mice. These alterations were not observed in TXAS KO mice. Together, our data suggest that TXA2 depletion has anti-PE effects due to the prevention of hypertension and placental damage through downregulation of the interleukin-1β pathway.

  18. Lack of Thromboxane Synthase Prevents Hypertension and Fetal Growth Restriction after High Salt Treatment during Pregnancy.

    Science.gov (United States)

    Pai, Chen-Hsueh; Yen, Ching-Tzu; Chen, Chie-Pein; Yu, I-Shing; Lin, Shu-Wha; Lin, Shu-Rung

    2016-01-01

    Preeclampsia (PE) is a potentially fatal pregnancy-related hypertensive disorder characterized by poor placenta development that can cause fetal growth restriction. PE-associated pathologies, including thrombosis, hypertension, and impaired placental development, may result from imbalances between thromboxane A2 (TXA2) and prostacyclin. Low-dose aspirin, which selectively inhibits TXA2 production, is used to prevent high-risk PE. However, the role of TXA2 in aspirin-mediated protective effects in women with PE is not understood fully. In this study, we examined the role of prostanoids in PE using human samples and an induced PE mouse model. We demonstrated that the administration of salted drinking water (2.7% NaCl) to wild-type mice resulted in elevated placental TXA2 synthase (TXAS) and plasma TXA2, but not prostacyclin, levels, which was also found in our clinical PE placenta samples. The high salt-treated wild-type pregnant mice had shown unchanged maternal body weight, hypertension (MAP increase 15 mmHg), and decreased pup weight (~50%) and size (~24%), but these adverse effects were ameliorated in TXAS knockout (KO) mice. Moreover, increased expression of interleukin-1β and downstream phosphorylated-p38-mitogen-activated protein kinase were concordant with apoptosis induction in the placentas of salt water-treated wild-type mice. These alterations were not observed in TXAS KO mice. Together, our data suggest that TXA2 depletion has anti-PE effects due to the prevention of hypertension and placental damage through downregulation of the interleukin-1β pathway.

  19. [Sexual responsibility: a key concept in the prevention of AIDS, abortion and adolescent pregnancies].

    Science.gov (United States)

    Luco, A

    1992-01-01

    Worldwide, approximately 300,000 people have AIDS, and there are 50-100 infections for each case. Responsible sexual behavior is crucial for prevention, since sexual transmission is the principal route of contracting AIDS. The major causes of maternal mortality in the 15-39 year age group in Latin America are complications from induced abortion which is also responsible for 40% of global maternal mortality, i.e., 200,000 women die because of induced abortion complications out of 500,000 women who succumb to pregnancy- and birth-related caused annually. In the 1980s 38% of deaths in Chile were related to abortion of women who died in reproductive age. In developing countries almost 50% of hospital admissions occur because of abortion sequelae. Infant mortality is higher in 20-year old mothers giving birth compared with the 20-29 age group. 40,000 children are born/year in Chile to mothers 20. In 1980 these births made up 16.7% of all births. 45% of births of mothers 20 are illegitimate. These young mothers are often unprepared for the parental role: 80% of children hospitalized for malnutrition were children of adolescent mothers according to a survey. The Catholic Church's view opposing contraceptives and sexuality outside of marriage conflicts with contemporary opinion backed by mass media favoring sexuality as leading to personal enrichment and advocating contraception. More than 60% of boys and more than 30% of girls start sexual relations 20. Young people do not use contraceptives because of misinformation, difficulty in getting appropriate information, and male machismo. AIDS prevention mandate sex education stressing responsible sexuality with abstinence, condom use, and monogamy.

  20. Course Of Pregnancy, Delivery And Health State Of Newborns After Preventive Treatment Of Gestosis In Pregnant Women Of Risk Group

    Directory of Open Access Journals (Sweden)

    N.I. Zryachkin

    2009-12-01

    Full Text Available The research objective is to decrease the frequency of perinatal complications in mother, fetus and newborn. Methodology used is prospective study. Course of pregnancy, delivery, postnatal period and neonatal period has been studied at 50 women and children (the basic group, at 80 women and children (group of comparison. The state of mi-crocirculation was studied at the I- II trimesters of pregnancy before and after treatment by means of biomicroscopy of vessels of eye conjunctiva by slit lamp with computer data processing. Homocysteine was studied at the I- II trimesters of pregnancy before and after treatment, and children of The control group consisted of 63 pregnant women without complicated anamnesis and with somatic status who gave birth to 63 children. At the I trimester of pregnancy in risk groups of development of gestosis hyperhomocysteinemia, preclinical disturbances of processes of microcirculation were observed. The method of preventive treatment of gestosis in the basic group included anticoagulant - Vessl Due F, vitamin E, essenciale H, folic acid, vitamin B6, vitamin B12. The preventive treatment was directed on stabilization of function of vessel endothelium, improvement of processes of microcirculation leading to decrease in frequency and severity of gestosis, perinatal complications in mother and newborn

  1. Prevention of pregnancy complications in iran following implementing a national educational program.

    OpenAIRE

    Maryam Moghani Lankarani; Nasrin Changizi; Mohammadreza Rasouli; Mohammad Amir AmirKhani; Shervin Assari(Psychiatry Dept., Center for Research on Ethnicity, Culture and Health, University of Michigan, Ann Arbor, MI USA)

    2014-01-01

    Objective: To determine the impact of a national intervention program on some pregnancy complications in Iran. Materials and methods: This multicenter study was conducted in governmental sector in 14 provinces in Iran between 2003 and 2005. Intervention included education of all maternal health care providers including gynecologists, general physicians, and midwifes in the governmental sector. Time interval between the pre- (of 3,978 and 3,958 pregnancies) and post- (3,958 pregnancies) measur...

  2. Hormonal prevention of breast cancer: Mimicking the protective effect of pregnancy

    OpenAIRE

    1999-01-01

    Full term pregnancy early in life is the most effective natural protection against breast cancer in women. Rats treated with chemical carcinogen are similarly protected by a previous pregnancy from mammary carcinogenesis. Proliferation and differentiation of the mammary gland does not explain this phenomenon, as shown by the relative ineffectiveness of perphenazine, a potent mitogenic and differentiating agent. Here, we show that short term treatment of nulliparous rats with pregnancy levels ...

  3. "Welfare queens" and "teen moms": how the social construction of fertile women impacts unintended pregnancy prevention policy in the United States.

    Science.gov (United States)

    James, E Angel; Rashid, Moira

    2013-01-01

    In the United States, unintended pregnancy is a serious health, social, and economic concern. However, the existing prevention policies have proven ineffective at decreasing the rate of unintended pregnancy at a national level. This lack of effective national prevention policy is better understood when viewed through the lens of a policy theory that incorporates an understanding of social construction and its effects on policy development. Through the application of one such policy theory, this article explores how the social construction of fertile women in the United States affects previous and recently enacted unintended pregnancy prevention policies.

  4. Herpes simplex virus infection in pregnancy and in neonate: status of art of epidemiology, diagnosis, therapy and prevention

    Directory of Open Access Journals (Sweden)

    Barucca Valentina

    2009-04-01

    Full Text Available Abstract Herpes simplex virus (HSV infection is one of the most common viral sexually transmitted diseases worldwide. The first time infection of the mother may lead to severe illness in pregnancy and may be associated with virus transmission from mother to foetus/newborn. Since the incidence of this sexually transmitted infection continues to rise and because the greatest incidence of herpes simplex virus infections occur in women of reproductive age, the risk of maternal transmission of the virus to the foetus or neonate has become a major health concern. On these purposes the Authors of this review looked for the medical literature and pertinent publications to define the status of art regarding the epidemiology, the diagnosis, the therapy and the prevention of HSV in pregnant women and neonate. Special emphasis is placed upon the importance of genital herpes simplex virus infection in pregnancy and on the its prevention to avoid neonatal HSV infections.

  5. Lack of knowledge of HIV status a major barrier to HIV prevention, care and treatment efforts in Kenya: results from a nationally representative study.

    Directory of Open Access Journals (Sweden)

    Peter Cherutich

    Full Text Available BACKGROUND: We analyzed HIV testing rates, prevalence of undiagnosed HIV, and predictors of testing in the Kenya AIDS Indicator Survey (KAIS 2007. METHODS: KAIS was a nationally representative sero-survey that included demographic and behavioral indicators and testing for HIV, HSV-2, syphilis, and CD4 cell counts in the population aged 15-64 years. We used gender-specific multivariable regression models to identify factors independently associated with HIV testing in sexually active persons. RESULTS: Of 19,840 eligible persons, 80% consented to interviews and blood specimen collection. National HIV prevalence was 7.1% (95% CI 6.5-7.7. Among ever sexually active persons, 27.4% (95% CI 25.6-29.2 of men and 44.2% (95% CI 42.5-46.0 of women reported previous HIV testing. Among HIV-infected persons, 83.6% (95% CI 76.2-91.0 were unaware of their HIV infection. Among sexually active women aged 15-49 years, 48.7% (95% CI 46.8-50.6 had their last HIV test during antenatal care (ANC. In multivariable analyses, the adjusted odds ratio (AOR for ever HIV testing in women ≥35 versus 15-19 years was 0.2 (95% CI: 0.1-0.3; p<0.0001. Other independent associations with ever HIV testing included urban residence (AOR 1.6, 95% CI: 1.2-2.0; p = 0.0005, women only, highest wealth index versus the four lower quintiles combined (AOR 1.8, 95% CI: 1.3-2.5; p = 0.0006, men only, and an increasing testing trend with higher levels of education. Missed opportunities for testing were identified during general or pregnancy-specific contacts with health facilities; 89% of adults said they would participate in home-based HIV testing. CONCLUSIONS: The vast majority of HIV-infected persons in Kenya are unaware of their HIV status, posing a major barrier to HIV prevention, care and treatment efforts. New approaches to HIV testing provision and education, including home-based testing, may increase coverage. Targeted interventions should involve sexually active men, sexually

  6. Conducting rigorous research with subgroups of at-risk youth: lessons learned from a teen pregnancy prevention project in Alaska

    OpenAIRE

    Hohman-Billmeier, Kathryn; Nye, Margaret; Martin, Stephanie

    2016-01-01

    In 2010, Alaska Department of Health and Social Services (DHSS) received federal funding to test an evidence-based teen pregnancy prevention program. The grant required a major modification to an existing program and a randomized control trial (RCT) to test its effectiveness. As the major modifications, Alaska used peer educators instead of adults to deliver the program to youth aged 14–19 instead of the original curriculum intended age range of 12–14. Cultural and approach adaptations were i...

  7. Community-based distribution of sulfadoxine-pyrimethamine for intermittent preventive treatment of malaria during pregnancy improved coverage but reduced antenatal attendance in southern Malawi

    NARCIS (Netherlands)

    K.P. Msyamboza; E.J. Savage; P.N. Kazembe; S. Gies; G. Kalanda; U. D'Alessandro; B.J. Brabin

    2009-01-01

    To evaluate the impact of a 2-year programme for community-based delivery of sulfadoxine-pyremethamine (SP) on intermittent preventive treatment during pregnancy coverage, antenatal clinic attendance and pregnancy outcome. Fourteen intervention and 12 control villages in the catchment areas of Chikw

  8. Pregnancy prevents hypertensive remodeling and decreases myogenic reactivity in posterior cerebral arteries from Dahl salt-sensitive rats : a role in eclampsia?

    NARCIS (Netherlands)

    Aukes, Annet M.; Vitullo, Lisa; Zeeman, Gerda G.; Cipolla, Marilyn J.

    2007-01-01

    Previous studies have demonstrated that pregnancy prevents protective hypertension-induced remodeling of cerebral arteries using nitric oxide synthase (NOS) inhibition to raise mean arterial pressure (MAP). In the present study, we investigated whether this effect of pregnancy was specific to NOS in

  9. Intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy: provider knowledge and acceptability.

    Directory of Open Access Journals (Sweden)

    Lucy Smith Paintain

    Full Text Available Malaria in pregnancy (MiP is associated with increased risks of maternal and foetal complications. The WHO recommends a package of interventions including intermittent preventive treatment (IPT with sulphadoxine-pyrimethamine (SP, insecticide-treated nets and effective case management. However, with increasing SP resistance, the effectiveness of SP-IPT has been questioned. Intermittent screening and treatment (IST has recently been shown in Ghana to be as efficacious as SP-IPT. This study investigates two important requirements for effective delivery of IST and SP-IPT: antenatal care (ANC provider knowledge, and acceptance of the different strategies. Structured interviews with 134 ANC providers at 67 public health facilities in Ashanti Region, Ghana collected information on knowledge of the risks and preventative and curative interventions against MiP. Composite indicators of knowledge of SP-IPT, and case management of MiP were developed. Log binomial regression of predictors of provider knowledge was explored. Qualitative data were collected through in-depth interviews with fourteen ANC providers with some knowledge of IST to gain an indication of the factors influencing acceptance of the IST approach. 88.1% of providers knew all elements of the SP-IPT policy, compared to 20.1% and 41.8% who knew the treatment policy for malaria in the first or second/third trimesters, respectively. Workshop attendance was a univariate predictor of each knowledge indicator. Qualitative findings suggest preference for prevention over cure, and increased workload may be barriers to IST implementation. However, a change in strategy in the face of SP resistance is likely to be supported; health of pregnant women is a strong motivation for ANC provider practice. If IST was to be introduced as part of routine ANC activities, attention would need to be given to improving the knowledge and practices of ANC staff in relation to appropriate treatment of MiP. Health

  10. Culturally Responsive Adolescent Pregnancy and Sexually Transmitted Infection Prevention Program for Middle School Students in Hawai‘i

    Science.gov (United States)

    Barker, Linda Toms; Chan, Vincent; Eucogco, Jasmine

    2016-01-01

    Objectives. To evaluate the effectiveness of Pono Choices, a culturally responsive adolescent pregnancy and sexually transmitted infection (STI) prevention program targeting middle school youths in Hawai‘i. Methods. We conducted a cluster randomized controlled trial with the school as the unit of random assignment over 3 semesters between 2012 and 2013. The sample consisted of 36 middle schools and 2203 students. We administered student surveys to collect baseline outcomes, student demographic data, and outcomes at 12 months after baseline. Results. We found statistically significant effects for the knowledge assessment, which focused on basic understanding of adolescent pregnancy and STI prevention. The average percentage of correct responses was 73.6 for the treatment group and 60.4 for the control group (P < .001). We did not find statistically significant effects on behavioral outcomes (initiation of sexual activity or engagement in high-risk sexual behavior) or on other nonbehavioral outcomes (attitudes, skills, intentions). Conclusions. Pono Choices had a statistically significant impact on knowledge of adolescent pregnancy and STI prevention among middle school students at 12 months after baseline, though it did not lead to detectable changes in behavioral outcomes within the 1-year observation period. These results call for an exploration of longer-term outcomes to assess effects on knowledge retention and behavioral changes. PMID:27689477

  11. A Measure for Evaluating the Effectiveness of Teen Pregnancy Prevention Programs.

    Science.gov (United States)

    Somers, Cheryl L.; Johnson, Stephanie A.; Sawilowksy, Shlomo S.

    2002-01-01

    The Teen Attitude Pregnancy Scale (TAPS) was developed to measure teen attitudes and intentions regarding teenage pregnancy. The model demonstrated good internal consistency and concurrent validity for the samples in this study. Analysis revealed evidence of validity for this model. (JDM)

  12. Baby Think It Over: Using Role-Play To Prevent Teen Pregnancy.

    Science.gov (United States)

    Out, Jennifer W.; Lafreniere, Kathryn D.

    2001-01-01

    Examined the effectiveness of Baby Think It Over (BTIO), an infant simulation program that seeks to modify attitudes toward teen pregnancy and teen parenting. After experiencing BTIO, teens in the intervention group were more likely to accurately access their personal risk for an unplanned pregnancy than were teens in the comparison group. (Author)

  13. An Evaluation of a School-Based Teenage Pregnancy Prevention Program Using a Logic Model Framework

    Science.gov (United States)

    Hulton, Linda J.

    2007-01-01

    Teenage pregnancy and the subsequent social morbidities associated with unintended pregnancies are complex issues facing school nurses in their daily work. In contemporary practice, school nurses are being held to higher standards of accountability and being asked to demonstrate the effective outcomes of their interventions. The purpose of this…

  14. What Can Be Done to Prevent Smoking in Pregnancy? A Literature Review

    Science.gov (United States)

    Bull, Leona

    2003-01-01

    Smoking in pregnancy is a serious health risk to mother and baby that is associated with premature birth, low birth weight and respiratory disorders. Recently it has become apparent that smoking in pregnancy can have long-term consequences for the child, including learning difficulties, elevated risk of diabetes, obesity and asthma. Over the past…

  15. An Evaluation of a School-Based Teenage Pregnancy Prevention Program Using a Logic Model Framework

    Science.gov (United States)

    Hulton, Linda J.

    2007-01-01

    Teenage pregnancy and the subsequent social morbidities associated with unintended pregnancies are complex issues facing school nurses in their daily work. In contemporary practice, school nurses are being held to higher standards of accountability and being asked to demonstrate the effective outcomes of their interventions. The purpose of this…

  16. Teen Pregnancy Prevention Program Recommendations from Urban and Reservation Northern Plains American Indian Community Members

    Science.gov (United States)

    McMahon, Tracey R.; Hanson, Jessica D.; Griese, Emily R.; Kenyon, DenYelle Baete

    2015-01-01

    Despite declines over the past few decades, the United States has one of the highest rates of teen pregnancy compared to other industrialized nations. American Indian youth have experienced higher rates of teen pregnancy compared to the overall population for decades. Although it's known that community and cultural adaptation enhance program…

  17. Teen Pregnancy Prevention Program Recommendations from Urban and Reservation Northern Plains American Indian Community Members

    Science.gov (United States)

    McMahon, Tracey R.; Hanson, Jessica D.; Griese, Emily R.; Kenyon, DenYelle Baete

    2015-01-01

    Despite declines over the past few decades, the United States has one of the highest rates of teen pregnancy compared to other industrialized nations. American Indian youth have experienced higher rates of teen pregnancy compared to the overall population for decades. Although it's known that community and cultural adaptation enhance program…

  18. Reproductive health in eight navies: a comparative report on education, prevention services, and policies on pregnancy, maternity/paternity leaves, and childcare.

    Science.gov (United States)

    Fjord, Lakshmi; Ames, Genevieve

    2009-03-01

    As occupational cultures, navies are remarkable for an ability to achieve far-reaching cultural and behavioral effects by both sweeping and incremental policy changes. Therefore, navy policies for reproductive health education and services, childcare, and maternity and paternity leaves have potential to be at the vanguard of gender parity efforts to successfully integrate women into once male-only occupations. This article provides summaries of reproductive health education programs, pregnancy prevention services, and policies currently in effect in eight navies where women work alongside male peers as sailors and officers. Our objective is to bring together comparative data that is hard to find by other means, which may prove useful to researchers, policy-makers, and naval personnel. Project methodology involved questionnaires sent to naval attaches stationed in embassies in Washington, DC, who referred sections to their appropriate departments. The results are quotations from completed questionnaires and policies sent from the navies of Germany, Latvia, the Netherlands, Norway, South Africa, Spain, the United Kingdom, and the United States. Policies under review include sexual conduct, pregnancy, and maternity and paternity leaves. We also report the latest available statistical data regarding women in these navies, such as numbers of women, percentages of navy women vs. total military women, and dates of women's inclusion as naval personnel.

  19. Flares of systemic lupus erythematosus during pregnancy and the puerperium: prevention, diagnosis and management.

    Science.gov (United States)

    Stojan, George; Baer, Alan N

    2012-07-01

    Systemic lupus erythematosus is a systemic autoimmune disease that primarily affects women in their reproductive age years. Pregnancy in systemic lupus erythematosus now has favorable outcomes for the majority of women. However, flares of disease activity, preeclampsia, fetal loss, intrauterine growth retardation and preterm birth are established risks of such pregnancies. Active lupus nephritis at the time of conception poses the greatest risk for disease flares and poor obstetric outcomes. Patients should delay conception until their lupus has been in remission for at least 6 months. In addition, certain lupus medications are potentially teratogenic and need to be stopped before conception. The signs and symptoms of a lupus flare may mimic those of normal pregnancy, impeding its recognition during pregnancy. Hydroxychloroquine, low-dose prednisone, pulse intravenous methylprednisolone and azathioprine are commonly used to treat lupus flares during pregnancy.

  20. Cervical pessary placement for prevention of preterm birth in unselected twin pregnancies: a randomized controlled trial.

    Science.gov (United States)

    Nicolaides, Kypros H; Syngelaki, Argyro; Poon, Liona C; de Paco Matallana, Catalina; Plasencia, Walter; Molina, Francisca S; Picciarelli, Gemma; Tul, Natasa; Celik, Ebru; Lau, Tze Kin; Conturso, Roberto

    2016-01-01

    Preterm birth is the leading cause of neonatal death and handicap in survivors. Although twins are found in 1.5% of pregnancies they account for about 25% of preterm births. Randomized controlled trials in singleton pregnancies reported that the prophylactic use of progestogens, cervical cerclage and cervical pessary reduce significantly the rate of early preterm birth. In twin pregnancies, progestogens and cervical cerclage have been shown to be ineffective in reducing preterm birth. The objective of this study was to test the hypothesis that the insertion of a cervical pessary in twin pregnancies would reduce the rate of spontaneous early preterm birth. This was a multicenter, randomized controlled trial in unselected twin pregnancies of cervical pessary placement from 20(+0)-24(+6) weeks' gestation until elective removal or delivery vs. expectant management. Primary outcome was spontaneous birth control groups in rates of spontaneous birth birth. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Cervical pessary in the prevention of preterm births in multiple pregnancies with a short cervix: PRISMA compliant systematic review and meta-analysis.

    Science.gov (United States)

    Thangatorai, Ramesh; Lim, Fang Chan; Nalliah, Sivalingam

    2017-05-07

    Preterm births occur frequently in multiple pregnancies with a short cervix. The cervical pessary is a potential intervention for prevention of preterm births. To assess the effectiveness of cervical pessary in the prevention of preterm births in multiple pregnancies with a short cervix (data showed no benefit of using cervical pessary in the prevention of preterm births, birth weights less than 1500 g, less than 2500 g, adverse neonatal events and fetal/neonatal deaths in twin pregnancies with a short cervix. We are unable to show benefit of using cervical pessary in preventing preterm births in twin pregnancies with a short cervix. However, as cervical pessary is a reasonable intervention, there is a need for more randomized controlled trials in this area.

  2. [Consensus statement on monitoring of HIV: pregnancy, birth, and prevention of mother-to-child transmission].

    Science.gov (United States)

    Polo Rodríguez, Rosa; Muñoz Galligo, Eloy; Iribarren, José Antonio; Domingo Pedrol, Pere; Leyes García, María; Maiques Montesinos, Vicente; Miralles Martín, Pilar; Noguera Julian, Antoni; Ocampo Hernández, Antonio; Péres Bares, María Lourdes; López Rojano, Marta; Suy Franch, Anna; Viñuela Beneitez, María Carmen; González Tomé, María Isabel

    2014-05-01

    The main objective in the management of HIV-infected pregnant women is prevention of mother-to-child transmission; therefore, it is essential to provide universal antiretroviral treatment, regardless of CD4 count. All pregnant women must receive adequate information and undergo HIV serology testing at the first visit. We assembled a panel of experts appointed by the Secretariat of the National AIDS Plan (SPNS) and the other participating Scientific Societies, which included internal medicine physicians with expertise in the field of HIV infection, gynecologists, pediatricians and psychologists. Four panel members acted as coordinators. Scientific information was reviewed in publications and conference reports up to November 2012. In keeping with the criteria of the Infectious Diseases Society of America, 2levels of evidence were applied to support the proposed recommendations: the strength of the recommendation according to expert opinion (A, B, C), and the level of empirical evidence (I, II, III). This approach has already been used in previous documents from SPNS. The aim of this paper was to review current scientific knowledge, and, accordingly, develop a set of recommendations regarding antiretroviral therapy (ART), regarding the health of the mother, and from the perspective of minimizing mother-to-child transmission (MTCT), also taking into account the rest of the health care of pregnant women with HIV infection. We also discuss and evaluate other strategies to reduce the MTCT (elective Cesarean, child's treatment…), and different aspects of the topic (ARV regimens, their toxicity, monitoring during pregnancy and postpartum, etc.). Copyright © 2013 Elsevier España, S.L. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  3. Prevention of thrombosis in pregnancy: how practical are consensus derived clinical practice guidelines?

    LENUS (Irish Health Repository)

    Hayes-Ryan, D

    2012-11-01

    Thromboembolic disease (TED) has, for many years, consistently been identified as one of the leading causes of direct maternal mortality. In November 2009, the RCOG published a guideline on the prevention of TED that has been rapidly adopted by hospital trusts in the UK. The aim of our study was to determine the number and profile of women in our population that would require treatment with low molecular weight heparin (LMWH) and the cost implications of such treatment if these guidelines were implemented. A retrospective review of the first 100 women who delivered at the Coombe Women & Infants University Hospital (CWIUH) in 2010 was conducted and risk stratification applied at the relevant time points. A total of 51% were deemed to be at intermediate or high risk of TED at some point during pregnancy. In 35 of the 51 women (70%), this risk was attributable to factors such as age>35 years, parity≥3, BMI>30 kg\\/m2 or cigarette smoking. In our obstetric population, the percentage of women with these risk factors was: 25.5%, 8.5%, 19% and 16.7%, respectively. Implementation of this guideline would increase the hospital annual expenditure on LMWH by a factor of 17. The strategy of attributing risk by accumulating factors that individually have a low risk of TED and are prevalent in the population needs to be re-visited. The cost of implementation of these guidelines is not inconsiderable in the absence of data to indicate that clinical outcome is improved with their implementation.

  4. The Heart-Placenta Axis in the First Month of Pregnancy: Induction and Prevention of Cardiovascular Birth Defects

    Directory of Open Access Journals (Sweden)

    Kersti K. Linask

    2013-01-01

    Full Text Available Extrapolating from animal studies to human pregnancy, our studies showed that folate (FA deficiency as well as one-time exposure to environmental factors in the first two to three weeks of human gestation can result in severe congenital heart defects (CHDs. Considering that approximately 49% of pregnancies are unplanned, this period of pregnancy can be considered high-risk for cardiac, as well as for neural, birth defects, as the woman usually is not aware of her pregnancy and may not yet be taking precautionary actions to protect the developing embryo. Using avian and mouse vertebrate models, we demonstrated that FA supplementation prevents CHD induced by alcohol, lithium, or elevation of the metabolite homocysteine, a marker for FA deficiency. All three factors affected the important Wnt signaling pathway by suppressing Wnt-mediated gene expression in the heart fields, resulting in a delay of cardiomyocyte migration, cardiomyogenesis, and CHD. Optimal protection of cardiogenesis was observed to occur with FA supplementation provided upon morning after conception and at higher doses than the presently available in prenatal vitamin supplementation. Our studies demonstrate pathways and cell processes that are involved with protection of one-carbon metabolism during heart development.

  5. Efforts and Programs of the Department of Defense Relating to the Prevention, Mitigation, and Treatment of Blast Injuries

    Science.gov (United States)

    2007-01-01

    Regeneration of Orthopedic Tissues for Military Applications: This project tests LifeCell’s hybrid ACL ( anterior cruciate ligament ) graft using a...of prosthetic technology and improvement in occupational and physical therapies . These efforts will leverage the three DoD Amputee Centers as...events. Extremity • Rehabilitation – Therapy : Conduct more physical and occupational therapy research. Efforts and Programs of the Department of

  6. School-based interventions for preventing HIV, sexually transmitted infections, and pregnancy in adolescents.

    Science.gov (United States)

    Mason-Jones, Amanda J; Sinclair, David; Mathews, Catherine; Kagee, Ashraf; Hillman, Alex; Lombard, Carl

    2016-11-08

    School-based sexual and reproductive health programmes are widely accepted as an approach to reducing high-risk sexual behaviour among adolescents. Many studies and systematic reviews have concentrated on measuring effects on knowledge or self-reported behaviour rather than biological outcomes, such as pregnancy or prevalence of sexually transmitted infections (STIs). To evaluate the effects of school-based sexual and reproductive health programmes on sexually transmitted infections (such as HIV, herpes simplex virus, and syphilis), and pregnancy among adolescents. We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for published peer-reviewed journal articles; and ClinicalTrials.gov and the World Health Organization's (WHO) International Clinical Trials Registry Platform for prospective trials; AIDS Educaton and Global Information System (AEGIS) and National Library of Medicine (NLM) gateway for conference presentations; and the Centers for Disease Control and Prevention (CDC), UNAIDS, the WHO and the National Health Service (NHS) centre for Reviews and Dissemination (CRD) websites from 1990 to 7 April 2016. We handsearched the reference lists of all relevant papers. We included randomized controlled trials (RCTs), both individually randomized and cluster-randomized, that evaluated school-based programmes aimed at improving the sexual and reproductive health of adolescents. Two review authors independently assessed trials for inclusion, evaluated risk of bias, and extracted data. When appropriate, we obtained summary measures of treatment effect through a random-effects meta-analysis and we reported them using risk ratios (RR) with 95% confidence intervals (CIs). We assessed the certainty of the evidence using the GRADE approach. We included eight cluster-RCTs that enrolled 55,157 participants. Five trials were conducted in sub-Saharan Africa (Malawi, South Africa, Tanzania, Zimbabwe, and Kenya), one in Latin America

  7. 76 FR 5379 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Pregnancy...

    Science.gov (United States)

    2011-01-31

    ... Control Special Emphasis Panel (SEP): Pregnancy Risk Assessment Monitoring System (PRAMS), DP11-001 Panels... Be Discussed: The meeting will include the initial review, discussion, and evaluation of...

  8. Taking a Teen Pregnancy Prevention Program to the Home: The AIM 4 Teen Moms Experience.

    OpenAIRE

    Subuhi Asheer; Ellen Kisker

    2014-01-01

    This report discusses findings from the first 18 months of a program implementation evaluation of AIM 4 Teen Moms, a teen pregnancy intervention designed to delay rapid repeat pregnancies among parenting teen mothers in Los Angeles. The program is delivered primarily in participants' homes. The report describes the program's development and design, recruiting approach, facilitators' training in and delivery of the program, and youth engagement and response, concluding with lessons for future ...

  9. Optimizing weight gain in pregnancy to prevent obesity in women and children

    OpenAIRE

    Herring, Sharon J.; Rose, Marisa Z.; Skouteris, Helen; Oken, Emily

    2011-01-01

    Pregnancy is now considered to be an important risk factor for new or persistent obesity among women during the childbearing years. High gestational weight gain is the strongest predictor of maternal overweight or obesity following pregnancy. A growing body of evidence also suggests that both high and low gestational weight gains are independently associated with an increased risk of childhood obesity, suggesting that influences occurring very early in life are contributing to obesity onset. ...

  10. Prevention, management and extent of adverse pregnancy outcomes in women with hereditary antithrombin deficiency.

    Science.gov (United States)

    Rogenhofer, Nina; Bohlmann, Michael K; Beuter-Winkler, Petra; Würfel, Wolfgang; Rank, Andreas; Thaler, Christian J; Toth, Bettina

    2014-03-01

    Antithrombin (AT) deficiency is a rare hereditary thrombophilia with a mean prevalence of 0.02 % in the general population, associated with a more than ten-fold increased risk of venous thromboembolism (VTE). Within this multicenter retrospective clinical analysis, female patients with inherited AT deficiency were evaluated concerning the type of inheritance and extent of AT deficiency, medical treatment during pregnancy and postpartally, VTE risk as well as maternal and neonatal outcome. Statistical analysis was performed with SPPS for Windows (19.0). A total of 18 pregnancies in 7 patients were evaluated, including 11 healthy newborns ≥37th gestational weeks (gw), one small for gestational age premature infant (25th gw), two late-pregnancy losses (21st and 28th gw) and four early miscarriages. Despite low molecular weight heparin (LMWH) administration, three VTE occurred during pregnancy and one postpartally. Several adverse pregnancy outcomes occurred including fetal and neonatal death, as well as severe maternal neurologic disorders occurred. Patients with substitution of AT during pregnancy in addition to LMWH showed the best maternal and neonatal outcome. Close monitoring with appropriate anticoagulant treatment including surveillance of AT levels might help to optimize maternal and fetal outcome in patients with hereditary AT deficiency.

  11. Prevention of unintended pregnancy and use of contraception-important factors for preconception care.

    Science.gov (United States)

    Kallner, Helena Kopp; Danielsson, Kristina Gemzell

    2016-09-20

    Preservation of fertility and optimizing health before pregnancy is becoming increasingly important in societies where childbirth often is postponed. Research shows that as women postpone childbirth they achieve higher levels of education and higher incomes. This leads to advantages for their children and for society. However, as women postpone childbearing they are at risk for contracting conditions which may affect fertility and/or pregnancies, pregnancy outcome, and the newborn child. Preconception counseling is therefore becoming increasingly important. Women are often unaware of the added health benefits of contraception and have the right to be well informed so they can make decisions to fulfill their reproductive desires. Contraception can reduce the risk of unintended pregnancies, ectopic and molar pregnancies, and sexually transmitted infections. In addition, hormonal contraceptives reduce the risk of some types of cancer, dysmenorrhea, heavy menstrual bleeding, and anemia and are a treatment for endometriosis. Contraception should increasingly be looked upon as a means of preserving fertility and optimizing health status before a planned pregnancy. Thus, effective contraception can provide women with a possibility of achieving their long-term reproductive goals, although childbearing is actually postponed. The most effective contraceptive methods are the long-acting reversible contraceptives, which have been shown to be highly effective especially in young women who have difficulties with adherence to user-dependent methods. Therefore, these methods should increasingly be promoted in all age groups.

  12. Prevention of pregnancy complications in iran following implementing a national educational program.

    Directory of Open Access Journals (Sweden)

    Maryam Moghani Lankarani

    2014-09-01

    Full Text Available To determine the impact of a national intervention program on some pregnancy complications in Iran.This multicenter study was conducted in governmental sector in 14 provinces in Iran between 2003 and 2005. Intervention included education of all maternal health care providers including gynecologists, general physicians, and midwifes in the governmental sector. Time interval between the pre- (of 3,978 and 3,958 pregnancies and post- (3,958 pregnancies measurements were 18 months. Self reported data on pregnancy complications were registered. Interviews were conducted by trained personnel. Participants were interviewed when admitted for delivery or at the time attending for vaccination of their 2 month infants.The following pregnancy complications were reduced significantly as compared to before intervention: 1 bleeding or spotting, 2 urinary tract complications, 3 blurred vision and severe headache, 4 premature labor pain, 5 anemia, 6 severe vomiting, 7 inappropriate weight gain, 8 endometritis, 9 urinary incontinence, 10 breast abscess or mastitis, 11 wound infection, and 12 bleeding was significantly reduced after intervention, compared to before intervention. Premature rupture of membrane showed a significant increase. These complications did not show a significant change: 1 hypertension, 2 fever and chills, 3 convulsion, shock, and loss of consciousness, and 4 obstetric fistula.National programs may be proved to be largely effective by decreasing some of the pregnancy complications in developing countries.

  13. The Association Between Reported Venlafaxine Use in Early Pregnancy and Birth Defects, National Birth Defects Prevention Study, 1997–2007

    Science.gov (United States)

    Polen, Kara ND; Rasmussen, Sonja A; Riehle-Colarusso, Tiffany; Reefhuis, Jennita

    2015-01-01

    Background Few epidemiologic studies have investigated the use of venlafaxine (Effexor®), an antidepressant used to treat major depression and anxiety disorders in adults, during pregnancy. Our objective was to determine whether use of venlafaxine during pregnancy is associated with specific birth defects. Methods We used data from the National Birth Defects Prevention Study (NBDPS), a population-based, case-control study in the United States. Our analysis included mothers with pregnancies affected by one of 30 selected birth defects (cases) and babies without birth defects (controls) with estimated dates of delivery between 1997–2007. Exposure was any reported use of venlafaxine from one month preconception through the third month of pregnancy. We calculated adjusted odds ratios (aORs) and 95% Fisher’s Exact confidence intervals (CIs) for 24 birth defect groups for which at least 400 case mothers were interviewed. Our adjusted analyses controlled for maternal age and race-ethnicity. Results Among the 27,045 NBDPS participants who met inclusion criteria, 0.17% (14/8,002) of control mothers and 0.40% (77/19,043) of case mothers reported any use of venlafaxine from one month preconception through the third month of pregnancy. Statistically significant associations were found for anencephaly, atrial septal defect (ASD) secundum or ASD not otherwise specified, coarctation of the aorta, cleft palate, and gastroschisis. Conclusions Our data suggest associations between periconceptional use of venlafaxine and some birth defects. However, sample sizes were small, confidence intervals were wide, and additional studies are needed to confirm these results. PMID:23281074

  14. Contraception and unwanted pregnancy.

    Science.gov (United States)

    Adler, N E

    1984-01-01

    marriage, 5) immediately following geographical mobility, 6) immediately following a pregnancy, 7) toward the end of the reproductive period, and 8) during menopause. Several researchers investigated the factors which play a role in contraceptive decision making. All the options available to those who experienced unwanted pregnancies entailed some degree of pain. Women who chose abortion, compared to those who had term pregnancies tended to suffer less serious, longterm consequences. Most abortion patients suffered only mild or temporary stress. Abortion patients who had more serious reactions tended to be young, single, Catholid, and socially immature. Individuals who a history of psychological problems, had negative relationships with their mothers, felt ambivalent about the abortion, or felt pressured to have an abortion were also more likely to experience psychological disturbances at some point following abortion. Most studies of unwanted pregnancy were retrospective, correlational, and based on small samples. Many were based on self-selected samples. Several social factors hinder efforts to investigate this sensitive social problem. As a result, intervention strategies, designed to prevent unwanted pregnancy, are frequently based on inadequate research. Efforts must be made to increase research on unwanted pregnancy and to utilize this research to develop effective preventive strategies.

  15. Pregnancy incidence and risk factors among women participating in vaginal microbicide trials for HIV prevention: systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Alfred Musekiwa

    Full Text Available INTRODUCTION: Pregnancy is contraindicated in vaginal microbicide trials for the prevention of HIV infection in women due to the unknown maternal and fetal safety of the microbicides. Women who become pregnant are taken off the microbicide during pregnancy period but this result in reduction of the power of the trials. Strategies to reduce the pregnancy rates require an understanding of the incidence and associated risk factors of pregnancy in microbicide trials. This systematic review estimates the overall incidence rate of pregnancy in microbicide trials and describes the associated risk factors. METHODS: A comprehensive literature search was carried out to identify eligible studies from electronic databases and other sources. Two review authors independently selected studies and extracted relevant data from included studies. Meta-analysis of incidence rates of pregnancy was carried out and risk factors of pregnancy were reported narratively. RESULTS: Fifteen studies reporting data from 10 microbicide trials (N=27,384 participants were included. A total of 4,107 participants (15.0% fell pregnant and a meta-analysis of incidence rates of pregnancy from 8 microbicide trials (N=25,551 yielded an overall incidence rate of 23.37 (95%CI: 17.78 to 28.96 pregnancies per 100 woman-years. However, significant heterogeneity was detected. Hormonal injectable, intra-uterine device (IUD or implants or sterilization, older age, more years of education and condom use were associated with lower pregnancy. On the other hand, living with a man, history of pregnancy, self and partner desire for future baby, oral contraceptive use, increased number of unprotected sexual acts and inconsistent use of condoms were associated with higher pregnancy. CONCLUSIONS: The incidence rate of pregnancy in microbicide trials is high and strategies for its reduction are urgently required in order to improve the sample size and power of these trials.

  16. Prevention and management of malaria during pregnancy: findings from a comparative qualitative study in Ghana, Kenya and Malawi.

    Science.gov (United States)

    Pell, Christopher; Meñaca, Arantza; Afrah, Nana A; Manda-Taylor, Lucinda; Chatio, Samuel; Were, Florence; Hodgson, Abraham; Hamel, Mary J; Kalilani, Linda; Tagbor, Harry; Pool, Robert

    2013-11-20

    In endemic regions of sub-Saharan Africa, malaria during pregnancy (MiP) is a major preventable cause of maternal and infant morbidity and mortality. Current recommended MiP prevention and control includes intermittent preventive treatment (IPTp), distribution of insecticide-treated bed nets (ITNs) and appropriate case management. This article explores the social and cultural context to the uptake of these interventions at four sites across Africa. A comparative qualitative study was conducted at four sites in three countries: Ghana, Malawi and Kenya. Individual and group interviews were conducted with pregnant women, their relatives, opinion leaders, other community members and health providers. Observations, which focused on behaviours linked to MiP prevention and treatment, were also undertaken at health facilities and in local communities. ITNs were generally recognized as important for malaria prevention. However, their availability and use differed across the sites. In Malawi and Kenya, ITNs were sought-after items, but there were complaints about availability. In central Ghana, women saved ITNs until the birth of the child and they were used seasonally in northern Ghana. In Kenya and central Ghana, pregnant women did not associate IPTp with malaria, whereas, in Malawi and northern Ghana, IPTp was linked to malaria, but not always with prevention. Although IPTp adherence was common at all sites, whether delivered with directly observed treatment or not, a few women did not comply with IPTp often citing previous side effects. Although generally viewed as positive, experiences of malaria testing varied across the four sites: treatment was sometimes administered in spite of a negative diagnosis in Ghana (observed) and Malawi (reported). Despite generally following the advice of healthcare staff, particularly in Kenya, personal experience, and the availability and accessibility of medication--including anti-malarials--influenced MiP treatment. Although ITNs were

  17. High rates of parasite recrudescence following intermittent preventive treatment with sulphadoxine-pyrimethamine during pregnancy in Benin

    DEFF Research Database (Denmark)

    Moussiliou, Azizath; Sissinto-Savi De Tove, Yolande; Doritchamou, Justin;

    2013-01-01

    BACKGROUND: Despite widespread parasite resistance to sulphadoxine-pyrimethamine (SP) its use for intermittent preventative treatment during pregnancy remains the policy in Benin and throughout most of sub-Saharan Africa. METHODS: In a prospective study, 982 pregnant women were recruited in Benin...... the persistence of parasites and malaria consequences, were investigated. Recurrent parasites were genotyped to identify recrudescences from re-infections. RESULTS: The prevalence of pfdhfr/pfdhps quadruple mutants (triple pfdhfr + single pfdhps) was consistently above 80% while quintuple and sextuple mutants...

  18. Efforts and Programs of the Department of Defense Relating to the Prevention, Mitigation, and Treatment of Blast Injuries

    Science.gov (United States)

    2008-10-01

    and devising innovative strategies for improved pain management.  Reset. Advancing tissue engineering and prosthetics; improving recovery of... pain and anxiety after trauma also may protect against PTSD. These findings can be implemented in practice now, at little cost, and with minimal...years, the AFIRM team will focus its efforts on five clinical areas: (1) burn repair, (2) wound healing without scarring, (3) craniofacial reconstruction

  19. Treatment and prevention of malaria in pregnancy in the private health sector in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K; Buregyeya, Esther; Rutebemberwa, Elizeus

    2016-01-01

    the factors that most influenced correct treatment of fever in pregnancy. CONCLUSION: Treatment of fever during pregnancy was poor in this study setting. These data highlight the need to develop interventions to improve patient safety and quality of care for pregnant women in the private health sector...... or private clinic. Data was collected using a structured questionnaire targeting one provider who was found on duty in each selected private health facility and consented to the study. The main variables were: provider characteristics, previous training received, type of drugs stocked, treatment...

  20. Teenage Pregnancy.

    Science.gov (United States)

    McClellan, Mary C.

    1987-01-01

    Reviews the problems of teenage pregnancy, including the costs to society, the challenge to educators, and the types of preventive programs developing across the country. Programs dealing strictly with reproduction and contraception are the least effective deterrents to teenage pregnancy. (MD)

  1. Teenage Pregnancy.

    Science.gov (United States)

    McClellan, Mary C.

    1987-01-01

    Reviews the problems of teenage pregnancy, including the costs to society, the challenge to educators, and the types of preventive programs developing across the country. Programs dealing strictly with reproduction and contraception are the least effective deterrents to teenage pregnancy. (MD)

  2. 76 FR 4703 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Pregnancy...

    Science.gov (United States)

    2011-01-26

    ... HUMAN SERVICES Centers for Disease Control and Prevention Disease, Disability, and Injury Prevention and..., Scientific Review Officer, CDC, National Center for Chronic Disease Prevention and Health Promotion, Office... and Prevention and the Agency for Toxic Substances and Disease Registry. Dated: January 20,...

  3. The acceptability of intermittent screening and treatment versus intermittent preventive treatment during pregnancy: results from a qualitative study in Northern Ghana

    NARCIS (Netherlands)

    Pell, C.; Meñaca, A.; Chatio, S.; Hodgson, A.; Tagbor, H.; Pool, R.

    2014-01-01

    Background: Affecting mother and child, malaria during pregnancy (MiP) provokes a double morbidity and mortality burden. Within a package of interventions to prevent MiP in endemic areas, the WHO currently recommends intermittent preventive treatment (IPTp). Concerns about anti-malarial resistance h

  4. A Community Needs Index for Adolescent Pregnancy Prevention Program Planning: Application of Spatial Generalized Linear Mixed Models.

    Science.gov (United States)

    Johnson, Glen D; Mesler, Kristine; Kacica, Marilyn A

    2017-02-06

    Objective The objective is to estimate community needs with respect to risky adolescent sexual behavior in a way that is risk-adjusted for multiple community factors. Methods Generalized linear mixed modeling was applied for estimating teen pregnancy and sexually transmitted disease (STD) incidence by postal ZIP code in New York State, in a way that adjusts for other community covariables and residual spatial autocorrelation. A community needs index was then obtained by summing the risk-adjusted estimates of pregnancy and STD cases. Results Poisson regression with a spatial random effect was chosen among competing modeling approaches. Both the risk-adjusted caseloads and rates were computed for ZIP codes, which allowed risk-based prioritization to help guide funding decisions for a comprehensive adolescent pregnancy prevention program. Conclusions This approach provides quantitative evidence of community needs with respect to risky adolescent sexual behavior, while adjusting for other community-level variables and stabilizing estimates in areas with small populations. Therefore, it was well accepted by the affected groups and proved valuable for program planning. This methodology may also prove valuable for follow up program evaluation. Current research is directed towards further improving the statistical modeling approach and applying to different health and behavioral outcomes, along with different predictor variables.

  5. Malaria prevention and treatment in pregnancy: survey of current practice among private medical practitioners in Lagos, Nigeria.

    Science.gov (United States)

    Rabiu, Kabiru Afolarin; Davies, Nosimot Omolola; Nzeribe-Abangwu, Ugochi O; Adewunmi, Adeniyi Abiodun; Akinlusi, Fatimat Motunrayo; Akinola, Oluwarotimi Ireti; Ogundele, Sunday O

    2015-01-01

    We studied the practice of malaria prevention and treatment in pregnancy of 394 private medical practitioners in Lagos State, Nigeria using a self-administered pre-tested structured questionnaire. Only 39 (9.9%) respondents had correct knowledge of the World Health Organization (WHO) strategies. Malaria prophylaxis in pregnancy was offered by 336 (85.3%), but only 98 (24.9%) had correct knowledge of recommended chemoprophylaxis. Of these, 68 (17.3%) had correct knowledge of first trimester treatment, while only 41 (10.4%) had knowledge of second and third trimester treatment. Only 64 (16.2%) of respondents routinely recommended use of insecticide-treated bed nets. The most common anti-malarial drug prescribed for chemoprophylaxis was pyrimethamine (43.7%); chloroquine was the most common anti-malarial prescribed for both first trimester treatment (81.5%) and second and third trimester treatment (55.3%). The study showed that private medical practitioners have poor knowledge of malaria prophylaxis and treatment in pregnancy, and the practice of most do not conform to recommended guidelines.

  6. The First Four Years: A Synopsis of the Global Effort. Department of Defense HIV/AIDS Prevention Program (DHAPP)

    Science.gov (United States)

    2005-06-01

    innovative part of the training materials developed for GPS peer educators was a flip chart that was designed to elucidate the audience’s knowledge...integrated into the official police uniform. The condom wallet and peer educator flip chart have since been widely replicated prevention products in

  7. Suicide Risk Protocols: Addressing the Needs of High Risk Youths Identified through Suicide Prevention Efforts and in Clinical Settings

    Science.gov (United States)

    Heilbron, Nicole; Goldston, David; Walrath, Christine; Rodi, Michael; McKeon, Richard

    2013-01-01

    Several agencies have emphasized the importance of establishing clear protocols or procedures to address the needs of youths who are identified as suicidal through suicide prevention programs or in emergency department settings. What constitutes optimal guidelines for developing and implementing such protocols, however, is unclear. At the request…

  8. The potential role of HPV vaccination in the prevention of infectious complications of pregnancy

    DEFF Research Database (Denmark)

    Bonde, Ulla; Jøergensen, Jan Stener; Mogensen, Ole

    2014-01-01

    outcomes of pregnancy. HPV may contribute to infertility and may increase the risk of miscarriage. Recent studies indicate a significant rate of vertical transmission of HPV between mother and child but whether the mode of delivery makes a difference to the risk of transmission remains unknown. HPV...

  9. Possibilities in Anaemia Prevention during Pregnancy through the Basic Health Care System

    Science.gov (United States)

    Karácsony, Ilona; Albrecht, Hanna; Brantmüller, Éva

    2015-01-01

    In case of pregnancies, one of the most common pathological conditions in internal medicine is aneamia with iron-deficiency. Furthermore, iron deficiency may also affect the mother and the fetus negatively. We wanted to find out which group of expectant mothers are mostly affected, which factors influence the development of aneamia. It was also…

  10. Classroom Goal Structures and HIV and Pregnancy Prevention Education in Rural High School Health Classrooms

    Science.gov (United States)

    Anderman, Eric M.; Cupp, Pamela K.; Lane, Derek R.; Zimmerman, Rick; Gray, DeLeon L.; O'Connell, Ann

    2011-01-01

    Over 5,000 adolescents enrolled in required rural high school health courses reported their perceptions of mastery and extrinsic goal structures in their health classrooms. Data were collected from all students at three time points (prior to HIV and pregnancy instruction, 3 months after instruction, and 1 year after instruction). Results indicated…

  11. Possibilities in Anaemia Prevention during Pregnancy through the Basic Health Care System

    Science.gov (United States)

    Karácsony, Ilona; Albrecht, Hanna; Brantmüller, Éva

    2015-01-01

    In case of pregnancies, one of the most common pathological conditions in internal medicine is aneamia with iron-deficiency. Furthermore, iron deficiency may also affect the mother and the fetus negatively. We wanted to find out which group of expectant mothers are mostly affected, which factors influence the development of aneamia. It was also…

  12. Docosahexaenoic Acid Supplementation during Pregnancy: A Potential Tool to Prevent Membrane Rupture and Preterm Labor

    Directory of Open Access Journals (Sweden)

    Emanuela Pietrantoni

    2014-05-01

    Full Text Available Polyunsaturated fatty acids (PUFAs are required to maintain the fluidity, permeability and integrity of cell membranes. Maternal dietary supplementation with ω-3 PUFAs during pregnancy has beneficial effects, including increased gestational length and reduced risk of pregnancy complications. Significant amounts of ω-3 docosahexaenoic acid (DHA are transferred from maternal to fetal blood, hence ensuring high levels of DHA in the placenta and fetal bloodstream and tissues. Fetal DHA demand increases exponentially with gestational age, especially in the third trimester, due to fetal development. According to the World Health Organization (WHO and the Food and Agriculture Organization of the United Nations (FAO, a daily intake of DHA is recommended during pregnancy. Omega-3 PUFAs are involved in several anti-inflammatory, pro-resolving and anti-oxidative pathways. Several placental disorders, such as intrauterine growth restriction, premature rupture of membranes (PROM and preterm-PROM (pPROM, are associated with placental inflammation and oxidative stress. This pilot study reports on a preliminary evaluation of the significance of the daily DHA administration on PROM and pPROM events in healthy pregnant women. Further extensive clinical trials will be necessary to fully elucidate the correlation between DHA administration during pregnancy and PROM/pPROM occurrence, which is related in turn to gestational duration and overall fetal health.

  13. Patterns of condom use among students at historically Black colleges and universities: implications for HIV prevention efforts among college-age young adults.

    Science.gov (United States)

    El Bcheraoui, Charbel; Sutton, Madeline Y; Hardnett, Felicia P; Jones, Sandra B

    2013-01-01

    Over 1.1 million Americans are living with human immunodeficiency virus (HIV), and African-American youth and young adults are disproportionately affected. Condoms are the most effective prevention tool, yet data regarding condom use patterns for African-American college youth are lacking. To inform and strengthen HIV prevention strategies with African-American college-age youth, we surveyed students attending 24 historically Black colleges and universities regarding condom use patterns. Students were administered anonymous questionnaires online to explore knowledge, attitudes, and practices related to condom use during last sexual intercourse (LSI). Among 824 sexually active respondents (51.8% female, median age 20 years, 90.6% heterosexuals), 526 (63.8%) reported condom use during LSI. Students who used condoms for disease prevention, whose mothers completed high school or had some college education or completed college were more likely to have used a condom during LSI. Spontaneity of sexual encounters, not feeling at risk of HIV, and partner-related perceptions were associated with condom non-use during LSI (pcollege youth sample did not use a condom during LSI and may benefit from increased condom education efforts. These efforts should highlight condoms' effectiveness in protection from HIV. Future HIV education and prevention strategies with similar groups of young adults should explore the implications of maternal education, clarify perceptions of HIV risk, and consider strategies that increase consistent condom use to interrupt sexual transmission of HIV.

  14. German Tobacco Industry’s Successful Efforts to Maintain Scientific and Political Respectability to Prevent Regulation of Secondhand Smoke

    OpenAIRE

    Bornhäuser, Annette; McCarthy,, Jennifer; Glantz, Stanton A. Ph.D.

    2006-01-01

    EXECUTIVE SUMMARY Germany is one of the few industrialized nations in which the tobacco industry remains a legitimate force in business, government, science and society at large. Though Germany has been an international leader in environmental protection, the German tobacco industry has been successful in preventing the translation of knowledge of the dangers of pollution from secondhand smoke into effective public health policy through a carefully planned collaboration w...

  15. A Qualitative Study of Acculturation and Diabetes Risk among Urban, Immigrant Latinas: Implications for Diabetes Prevention Efforts

    Science.gov (United States)

    O’Brien, Matthew J.; Shuman, Sara J.; Barrios, Dulce M.; Alos, Victor A.; Whitaker, Robert C.

    2014-01-01

    Purpose The purpose of this qualitative study was to understand how acculturation influences diabetes risk among urban, immigrant Latinas (Hispanic women). Methods Five focus groups were conducted with 26 urban, immigrant Latinas who were at high clinical risk for developing diabetes. The focus group sessions were audiotaped and transcribed verbatim. The authors independently analyzed transcripts using an inductive method of open coding, and themes were established by consensus among authors. Results All of the participants were foreign-born and had low levels of acculturation. During the acculturation process, they noted changes in their lifestyle behaviors and the family context in which those behaviors are shaped. They reported that since living in the U.S., their improved economic circumstances led to increased consumption of less healthy foods and beverages and a more sedentary lifestyle. They also described changing family roles and responsibilities, including working outside the home, which constrained healthy food choices. However, they perceived that their position of influence within the family offered opportunities to help family members prevent diabetes. Conclusions Lifestyle interventions to prevent diabetes in Latinas should address their acculturation experiences, which impact family functioning and health behaviors related to diabetes risk. For example, given the perceived link between Latinas’ improved economic circumstances and their diabetes risk, prevention programs should incorporate strategies to help Latinas avoid adopting less healthy lifestyle behaviors that become affordable during the acculturation process. PMID:24872386

  16. Antenatal interventions for preventing the transmission of cytomegalovirus (CMV) from the mother to fetus during pregnancy and adverse outcomes in the congenitally infected infant.

    LENUS (Irish Health Repository)

    McCarthy, Fergus P

    2012-01-31

    BACKGROUND: Cytomegalovirus (CMV) is a herpesvirus and the most common cause of congenital infection in developed countries. Congenital CMV infection can have devastating consequences to the fetus. The high incidence and the serious morbidity associated with congenital CMV infection emphasise the need for effective interventions to prevent the antenatal transmission of CMV infection. OBJECTIVES: The aim of this review was to assess the benefits and harms of interventions used during pregnancy to prevent mother to fetus transmission of CMV infection. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group\\'s Trials Register (31 December 2010). SELECTION CRITERIA: All randomised controlled trials (RCTs) and quasi RCTs investigating antenatal interventions for preventing the transmission of CMV from the mother to fetus during pregnancy and adverse outcomes in the congenitally infected infant. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies for inclusion. MAIN RESULTS: We identified six studies from the search. None of these studies met the pre-defined criteria for inclusion in this review. AUTHORS\\' CONCLUSIONS: To date, no RCTs are available that examine antenatal interventions for preventing the transmission of CMV from the infected mother to fetus during pregnancy and adverse outcomes in the congenitally infected infant. Further research is needed to assess the efficacy of interventions aimed at preventing the transmission of CMV from the mother to fetus during pregnancy including a long-term follow-up of exposed infants and a cost effective analysis.

  17. Rapid Antiretroviral Therapy Initiation for Women in an HIV-1 Prevention Clinical Trial Experiencing Primary HIV-1 Infection during Pregnancy or Breastfeeding.

    Directory of Open Access Journals (Sweden)

    Susan Morrison

    Full Text Available During an HIV-1 prevention clinical trial in East Africa, we observed 16 cases of primary HIV-1 infection in women coincident with pregnancy or breastfeeding. Nine of eleven pregnant women initiated rapid combination antiretroviral therapy (ART, despite having CD4 counts exceeding national criteria for ART initiation; breastfeeding women initiated ART or replacement feeding. Rapid ART initiation during primary HIV-1 infection during pregnancy and breastfeeding is feasible in this setting.

  18. Do screening-preventative interventions in asymptomatic pregnancies reduce the risk of preterm delivery--a critical appraisal of the literature.

    Science.gov (United States)

    Varma, Rajesh; Gupta, Janesh K; James, David K; Kilby, Mark D

    2006-08-01

    Recent research has suggested that women who experience preterm delivery (PTD) may be identified earlier in pregnancy and before onset of symptoms. Interventions commenced at this earlier asymptomatic stage may offer an opportunity to prevent PTD or lengthen gestation sufficiently to reduce adverse perinatal outcome. Our objective was to examine the evidence that supports or refutes this approach to preventing PTD. We therefore conducted a systematic search and critical appraisal of the identified literature. We found evidence that introducing screening-preventative strategies for asymptomatic pregnancies may reduce the rate of PTD. Evidence for screening and selective treatment exists for: asymptomatic bacteriuria; bacterial vaginosis in low-risk population groups; elective cervical cerclage in high-risk pregnancies; indicated cervical cerclage in women with short cervical length on ultrasound; prophylactic progesterone supplementation in high-risk pregnancies, and smoking cessation. However, for most other strategies, such as increased antenatal attendance, or routine administration of prophylactic micronutrients, the evidence is inconsistent and conflicting. Information on neonatal outcomes apart from PTD (such as serious neonatal morbidity and mortality) was found to be lacking in most studies. It was therefore not possible to establish whether preventing PTD or prolonging gestation would correlate to improved perinatal outcome, and this lessened the potential clinical usefulness of any proposed preventative strategy. No studies were found that evaluated the effectiveness of combining screening-preventative strategies. The review concludes with a suggested an antenatal management plan designed to prevent PTD based on current practice and the evidence presented in this article.

  19. Implementation lessons: the importance of assessing organizational "fit" and external factors when implementing evidence-based teen pregnancy prevention programs.

    Science.gov (United States)

    Demby, Hilary; Gregory, Alethia; Broussard, Marsha; Dickherber, Jennifer; Atkins, Shantice; Jenner, Lynne W

    2014-03-01

    In recent years, the demand for evidence-based teen pregnancy prevention programs has increased, but practitioners often struggle to replicate and implement them as designed in real-world community settings. The purpose of this article is to describe the barriers and facilitators encountered during pilot year attempts to implement an evidence-based teen pregnancy prevention program within three types of organizations: (1) small community-based organizations; (2) a school-based organization; and (3) a large decentralized city-sponsored summer youth program. We frame our discussion of these experiences within the context of a systemic, multilevel framework for implementation consisting of (1) core implementation components; (2) organizational components; and (3) external factors. This article explores the organizational and external implementation factors we experienced during the implementation process, describes our lessons learned throughout this process, and offers strategies for other practitioners to proactively address these factors from the start of program planning. These findings may provide useful insight for other organizations looking to implement multi-session, group-level interventions with fidelity.

  20. Multidisciplinary management of ornithine transcarbamylase (OTC) deficiency in pregnancy: essential to prevent hyperammonemic complications.

    Science.gov (United States)

    Lamb, Stephanie; Aye, Christina Yi Ling; Murphy, Elaine; Mackillop, Lucy

    2013-01-02

    Ornithine transcarbamylase (OTC) deficiency is the most common inborn error in the metabolism of the urea cycle with an incidence of 1 in 14,000 live births. Pregnancy can trigger potentially fatal hyperammonemic crises. We report a successful pregnancy in a 29-year-old primiparous patient with a known diagnosis of OTC deficiency since infancy. Hyperammonemic complications were avoided due to careful multidisciplinary management which included a detailed antenatal, intrapartum and postnatal plan. Management principles include avoidance of triggers, a low-protein diet and medications which promote the removal of nitrogen by alternative pathways. Triggers include metabolic stress such as febrile illness, particularly gastroenteritis, fasting and any protein loading. In our case the patient, in addition to a restricted protein intake, was prescribed sodium benzoate 4 g four times a day, sodium phenylbutyrate 2 g four times a day and arginine 500 mg four times a day to aid excretion of ammonia and reduce flux through the urea cycle.

  1. Classroom Goal Structures and HIV/Pregnancy Prevention Education in Rural High School Health Classrooms

    OpenAIRE

    Anderman, Eric M.; CUPP, PAMELA K.; Lane, Derek R.; Zimmerman, Rick; Gray, DeLeon L.; O'Connell, Ann

    2011-01-01

    Over 5,000 adolescents enrolled in required rural high school health courses reported their perceptions of mastery and extrinsic goal structures in their health classrooms. Data were collected from all students at three time points (prior to HIV/pregnancy instruction, three months after instruction, and one year after instruction). Results indicated that classroom goal structures were related to both proximal and distal knowledge, attitudes, intentions, and efficacy beliefs. Results in partic...

  2. Systematic review of clinical trials on dietary interventions to prevent excessive weight gain during pregnancy among normal weight, overweight and obese women

    DEFF Research Database (Denmark)

    Tanentsapf, Ida; Heitmann, Berit L; Adegboye, Amanda R A

    2011-01-01

    Excessive weight gain during pregnancy and subsequent postpartum weight retention may contribute to the epidemic of obesity among women of childbearing age. Preventing excessive gestational weight gain (GWG) to optimize maternal, fetal and infant wellbeing is therefore of great importance. A number...... of dietary interventions in this area has been conducted with inconsistent results, which has made it difficult to identify effective strategies to prevent excessive weight gain during pregnancy among normal weight, overweight and obese women. The primary objective of this review was to evaluate the effect...

  3. Estradiol valerate and dienogest: a novel four-phasic oral contraceptive pill effective for pregnancy prevention and treatment of heavy menstrual bleeding.

    Science.gov (United States)

    Micks, Elizabeth; Jensen, Jeffrey T

    2011-09-01

    Estradiol valerate and dienogest have been combined to create a novel four-phasic oral contraceptive pill effective for both pregnancy prevention and treatment of heavy menstrual bleeding. This formulation represents the only oral contraceptive pill available in the USA containing an estrogen component that is biologically active as the endogenous estrogen 17β-estradiol. This medication was developed out of efforts to replace the most common estrogen in contraceptive pills, ethinyl estradiol, which is known to be a potent inducer of hepatic protein synthesis. Estradiol valerate has been available since the 1970s in oral and injectable forms indicated for the treatment of menopausal climacteric symptoms. Dienogest has been used in other oral contraceptive pills for over 10 years. Previous attempts to develop an oral contraceptive pill with natural estradiol or estradiol valerate were unsuccessful due to poor cycle control. A novel dynamic-dosing regimen was devised to improve the bleeding pattern. This medication has been shown in several clinical trials to have good contraceptive efficacy and cycle control. Recent studies have also demonstrated that this medication is effective for the treatment of heavy menstrual bleeding. However, compared with other oral contraceptive pills, this medication is associated with a higher frequency of absent withdrawal bleeding. Furthermore, the dynamic dosing regimen requires relatively complex instructions for users who miss pills.

  4. Impact of Sulfadoxine-Pyrimethamine resistance on effectiveness of intermittent preventive therapy for malaria in pregnancy at clearing infections and preventing low birth weight

    DEFF Research Database (Denmark)

    Desai, Meghna; Gutman, Julie; Taylor, Steve M.

    2016-01-01

    BACKGROUND: Owing to increasing sulfadoxine-pyrimethamine (SP) resistance in sub-Saharan Africa, monitoring the effectiveness of intermittent preventive therapy in pregnancy (IPTp) with SP is crucial. METHODS: Between 2009 and 2013, both the efficacy of IPTp-SP at clearing existing peripheral....... An individual-level prospective pooled analysis was conducted. RESULTS: Among 1222 parasitemic pregnant women, overall polymerase chain reaction-uncorrected and -corrected failure rates by day 42 were 21.3% and 10.0%, respectively (39.7% and 21.1% in high-resistance areas; 4.9% and 1.1% in low-resistance areas......). Median time to recurrence decreased with increasing prevalence of Pfdhps-K540E. Among 6099 women at delivery, IPTp-SP was associated with a 22% reduction in the risk of LBW (prevalence ratio [PR], 0.78; 95% confidence interval [CI], .69-.88; P

  5. Efficacy of infant simulator programmes to prevent teenage pregnancy: a school-based cluster randomised controlled trial in Western Australia.

    Science.gov (United States)

    Brinkman, Sally A; Johnson, Sarah E; Codde, James P; Hart, Michael B; Straton, Judith A; Mittinty, Murthy N; Silburn, Sven R

    2016-11-05

    Infant simulator-based programmes, which aim to prevent teenage pregnancy, are used in high-income as well as low-income and middle-income countries but, despite growing popularity, no published evidence exists of their long-term effect. The aim of this trial was to investigate the effect of such a programme, the Virtual Infant Parenting (VIP) programme, on pregnancy outcomes of birth and induced abortion in Australia. In this school-based pragmatic cluster randomised controlled trial, eligible schools in Perth, Western Australia, were enrolled and randomised 1:1 to the intervention and control groups. Randomisation using a table of random numbers without blocking, stratification, or matching was done by a researcher who was masked to the identity of the schools. Between 2003 and 2006, the VIP programme was administered to girls aged 13-15 years in the intervention schools, while girls of the same age in the control schools received the standard health education curriculum. Participants were followed until they reached 20 years of age via data linkage to hospital medical and abortion clinic records. The primary endpoint was the occurrence of pregnancy during the teenage years. Binomial and Cox proportional hazards regression was used to test for differences in pregnancy rates between study groups. This study is registered as an international randomised controlled trial, number ISRCTN24952438. 57 (86%) of 66 eligible schools were enrolled into the trial and randomly assigned 1:1 to the intervention (28 schools) or the control group (29 schools). Then, between Feb 1, 2003, and May 31, 2006, 1267 girls in the intervention schools received the VIP programme while 1567 girls in the control schools received the standard health education curriculum. Compared with girls in the control group, a higher proportion of girls in the intervention group recorded at least one birth (97 [8%] of 1267 in the intervention group vs 67 [4%] of 1567 in the control group) or at least one

  6. Classroom Goal Structures and HIV/Pregnancy Prevention Education in Rural High School Health Classrooms.

    Science.gov (United States)

    Anderman, Eric M; Cupp, Pamela K; Lane, Derek R; Zimmerman, Rick; Gray, DeLeon L; O'Connell, Ann

    2011-12-01

    Over 5,000 adolescents enrolled in required rural high school health courses reported their perceptions of mastery and extrinsic goal structures in their health classrooms. Data were collected from all students at three time points (prior to HIV/pregnancy instruction, three months after instruction, and one year after instruction). Results indicated that classroom goal structures were related to both proximal and distal knowledge, attitudes, intentions, and efficacy beliefs. Results in particular indicate that the perception of a mastery goal structure in health education classrooms fosters knowledge, improved attitudes, enhanced efficacy beliefs, and lower intentions to have sexual intercourse.

  7. Preventing rapid repeat pregnancy and promoting positive parenting among young mothers in foster care.

    Science.gov (United States)

    Finigan-Carr, Nadine M; Murray, Kantahyanee W; O'Connor, Julia M; Rushovich, Berenice R; Dixon, Desyree A; Barth, Richard P

    2015-01-01

    Young mothers in foster care face considerable challenges above and beyond that of their non-foster care peers. Child welfare workers have few resources to guide them in the selection of evidence-informed programs, models, and strategies that address the unique risk factors and needs of youth in foster care who are at risk for rapid repeat pregnancy and inadequate parenting practices. Workers need knowledge of the evidence about which programs are most likely to improve key health and well-being outcomes. The article assesses the evidence-based programs identified and yields a list that reflects the best evidence for efficacy and effectiveness.

  8. Immunity, infectious diseases and the knowledge of 100 Latvian pregnant women of the impact of infectious diseases on the pregnancy and its prevention

    Directory of Open Access Journals (Sweden)

    Anna Abramova

    2015-08-01

    Full Text Available Infection diseases may adversely affect the pregnancy, lead to the development of foetal abnormalities, foetal death, congenital infections and preterm birth. Infection is possible in antenatal, postnatal and intranatal way. CMV, adenovirus, enterovirus are the most common viruses which are found during the examination of amniotic fluid. Hundred Latvian pregnant women were offered to fill in the questionnaire with the help of which it will be possible to study their knowledge on infectious diseases during pregnancy and preventive options. The obtained data were compared with foreign literature and foreign studies. Respondents' age was from 19 to 43 years. Only 65% of women are aware that the risk of contracting infectious diseases during pregnancy is higher. Only 7% of women know about all possible ways of infection during pregnancy. 68% of women note that bacterial vaginosis may harm foetus and adversely affect pregnancy. Compared to the study conducted in Japan, Latvian pregnant women know about toxoplasmosis 4% more often than in Japan. Knowledge of pregnant women about the impact of infectious diseases on the foetus and pregnancy, potential infection and prevention ways is insufficient. Women want to know and receive understandable information from health care professionals. [Int J Reprod Contracept Obstet Gynecol 2015; 4(4.000: 954-958

  9. An examination of participants who develop an eating disorder despite completing an eating disorder prevention program: implications for improving the yield of prevention efforts.

    Science.gov (United States)

    Horney, Audra C; Stice, Eric; Rohde, Paul

    2015-05-01

    Numerous trials provide support for the Body Project, an eating disorder prevention program wherein young women with body image concerns critique the thin ideal. Despite medium to large effects, some participants subsequently develop an eating disorder, suggesting that intervention or recruitment procedures could be improved. This study investigated baseline and acute intervention predictors of DSM-5 eating disorder development during a 3-year follow-up among Body Project participants. Combined data from two trials compare participants who experienced eating disorder onset during follow-up (n = 20) to those who did not (n = 216). Participants who did versus did not develop an eating disorder started the intervention with higher eating disorder symptoms (η (2) = 0.08), negative affect (η (2) = 0.06), thin-ideal internalization (η (2) = 0.02), and body dissatisfaction (η (2) = 0.02); the same baseline predictors of eating disorder onset emerged in controls. Attenuated pre-post reductions in eating disorder symptoms (η (2) = 0.01) predicted eating disorder onset but not after controlling for baseline levels. Given that Body Project and control participants who later developed an eating disorder started with initial elevations in risk factors and eating disorder symptoms, it might be useful to develop a more intensive variant of this program for those exhibiting greater risk at baseline and to deliver the prevention program earlier to prevent initial escalation of risk. The fact that nonresponders also showed greater negative affect and eating disorder symptoms suggests that it might be useful to add activities to improve affect and increase dissonance about disordered eating.

  10. Tracking the evolution of HIV/AIDS in China from 1989-2009 to inform future prevention and control efforts.

    Directory of Open Access Journals (Sweden)

    Zhongwei Jia

    Full Text Available BACKGROUND: To determine policy implications, this analysis tracks the evolution of HIV/AIDS infection across China to understand current trends and potential risk factors. METHODS AND PRINCIPAL FINDINGS: A retrospective study with spatial analytical model and multilevel spatial models was conducted among 326,157 HIV/AIDS cases reported from 1989-2009. The results indicate that the distribution of HIV/AIDS was clustered at the county level with different directional distributions across China from 2003 to 2009. Compared to 2003, by 2009 there was a 122% increase in HIV cases among rural residents, 294% increase among urban residents, 211% increase among migrants, and 237% increase among permanent residents. The overall proportion of HIV by different routes of transmission showed dramatic changes with a 504% increase in sexual transmission of HIV, 90% decrease in blood/plasma transmission, and 35% decrease in injecting drug user transmission. Sexual transmission was the major transmission route among women (44% and the elderly (59% in men, 44% in women as well as among permanent (36% and urban residents (33%. Among those <65 years old, women increased more than men, but among those ≥ 65 years, men increased more than women. Migrants contributed to the variance of HIV infection between counties but not within counties. The length of highway and urbanization combined with illiteracy were risk factors for HIV/AIDS. CONCLUSIONS/SIGNIFICANCE: Rates of HIV/AIDS among permanent urban residents, particularly women and elderly men, have increased significantly in recent years. To prevent HIV from spreading further among the general population, additional attention should be paid to these populations as well as to migrants.

  11. Foods to Avoid or Limit during Pregnancy

    Science.gov (United States)

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce ...

  12. [Smoking and pregnancy (psychosocial aspects of the prevention of damage caused by nicotine) (author's transl)].

    Science.gov (United States)

    Wenderlein, J M

    1977-10-01

    The literature on the detrimental effects of smoking on pregnancy is indeed extensive. Despite the hazard of a significantly increased perinatal mortality, especially on account of prematurity with low birth weight of the infants, no wellaimed campaign has been conducted so far which would aim at enlightening pregnant women about the dangers involved in smoking. A study conducted with a group of 425 women treated in our outpatient department is analyzed to determine the audience for an informative brochure on smoking, and also to find out the most effective way in which this brochure should be presented and worded. Every third young woman up to 25 years of age is a regular smoker (p less than 0,0001). There is a significantly higher incidence of smokers among unmarried women than among married ones. (p less than 0.05). Career women and employees were found to smoke twice as often than those not gainfully employed (p less than 0.01). Women without children, too, smoked twices as often as women with two and more children (p less than 0.05). Furthermore, women with an IQ above 100 smoked cigarettes twice as often than women with an IQ up to 100. Two out of 12 psychometrically studied personality traits bore a significant relationship to smoking. These results agree with perinatologic literature and are discussed under the aspect of effective information on the hazards of smoking during pregnancy.

  13. Endocrine Disruptors and Pregnancy: Knowledge, Attitudes and Prevention Behaviors of French Women.

    Science.gov (United States)

    Rouillon, Steeve; Deshayes-Morgand, Chloé; Enjalbert, Line; Rabouan, Sylvie; Hardouin, Jean-Benoit; Migeot, Virginie; Albouy-Llaty, Marion

    2017-09-06

    Endocrine disrupting chemicals (EDC) are environmental exposure factors that are rarely reported in clinical practice, particularly during pregnancy. This study aimed to describe women's knowledge, attitudes and behaviors towards EDC exposure. A study was conducted in the French Department of Vienne between 2014 and 2016 and comprised semi-structured interviews with pregnant women, a focus group of professionals in perinatology and environmental health, and the administration of a psychosocial questionnaire comprising scores in 300 pregnant or in postpartum period women. The mean score of knowledge was 42.9 ± 9.8 out of 100 (from 13.5 to 75.7). Exposure attitude was determined by risk perception. Mean level of cues to action to reduce their EDC exposure was estimated at 56.9 ± 22.5 out of 100 (from 0 to 100). Anxiety was significantly increased after the questionnaire. Anxiety about EDC was associated with a high score of knowledge (OR = 2.30, 95% CI (1.12-4.71)) and with no pregnancy anxiety (OR = 0.57, 95% CI (0.34-0.95)). Our findings suggest that healthcare providers should consider pregnant women's knowledge and perceptions, possibilities of action, and be careful not to increase their anxiety when advising them about EDC and environmental exposure.

  14. Maternal anemia in pregnancy: assessing the effect of routine preventive measures in a malaria-endemic area.

    Science.gov (United States)

    Ouédraogo, Smaïla; Koura, Ghislain K; Bodeau-Livinec, Florence; Accrombessi, Manfred M K; Massougbodji, Achille; Cot, Michel

    2013-02-01

    We investigated the effectiveness of routine preventive measures for anemia in Beninese pregnant women during pregnancy. Anemia (hemoglobin < 110 g/L) was common: 68.3% at first antenatal visit (ANV1), 64.7% at second antenatal visit (ANV2), and 40.6% at delivery. Parasitic infections and nutritional deficiencies were the most preventable causes. After intermittent preventive treatment (IPTp) and antihelminthic treatments, malaria prevalence decreased from 15.1% (ANV1) to 4.0% (ANV2) and increased again to 9.6% at delivery. Helminth infections dropped from 11.1% (ANV1) to 7.2% (ANV2) and 2.4% at delivery. Malaria was associated with lower mean hemoglobin on ANV1 and delivery, and iron deficiency was associated with lower mean hemoglobin on ANV1 and ANV2. IPTp and antihelminthic treatments were efficacious to clear parasitic infections and improve hematologic status, whereas the effectiveness of daily iron and folic acid supplements to correct iron and folate deficiencies and decrease anemia was less marked, possibly because of lack of compliance.

  15. Office of Adolescent Health medical accuracy review process--helping ensure the medical accuracy of Teen Pregnancy Prevention Program materials.

    Science.gov (United States)

    Jensen, Jo Anne G; Moreno, Elizabeth L; Rice, Tara M

    2014-03-01

    The Office of Adolescent Health (OAH) developed a systematic approach to review for medical accuracy the educational materials proposed for use in Teen Pregnancy Prevention (TPP) programs. This process is also used by the Administration on Children, Youth, and Families (ACYF) for review of materials used in the Personal Responsibility Education Innovative Strategies (PREIS) Program. This article describes the review process, explaining the methodology, the team implementing the reviews, and the process for distributing review findings and implementing changes. Provided also is the definition of "medically accurate and complete" as used in the programs, and a description of what constitutes "complete" information when discussing sexually transmitted infections and birth control methods. The article is of interest to program providers, curriculum developers and purveyors, and those who are interested in providing medically accurate and complete information to adolescents.

  16. Practical experience from the Office of Adolescent Health's large scale implementation of an evidence-based Teen Pregnancy Prevention Program.

    Science.gov (United States)

    Margolis, Amy Lynn; Roper, Allison Yvonne

    2014-03-01

    After 3 years of experience overseeing the implementation and evaluation of evidence-based teen pregnancy prevention programs in a diversity of populations and settings across the country, the Office of Adolescent Health (OAH) has learned numerous lessons through practical application and new experiences. These lessons and experiences are applicable to those working to implement evidence-based programs on a large scale. The lessons described in this paper focus on what it means for a program to be implementation ready, the role of the program developer in replicating evidence-based programs, the importance of a planning period to ensure quality implementation, the need to define and measure fidelity, and the conditions necessary to support rigorous grantee-level evaluation.

  17. Empowering adolescent girls in Sub-Saharan Africa to prevent unintended pregnancy and HIV: A critical research gap.

    Science.gov (United States)

    Phillips, Sharon J; Mbizvo, Michael T

    2016-01-01

    The need to prevent early pregnancy and HIV among adolescent girls in Sub-Saharan Africa has been recognized increasingly over recent years. Although extensive work has been done to determine appropriate interventions for girls in high-income countries, very little evidence is available to guide programmatic interventions in Sub-Saharan Africa. The available evidence has been equivocal regarding improved outcomes. While knowledge and self-reported behaviors frequently change with interventions, including those performed at the community level, educational programs, and direct contraceptive provision, downstream outcomes rarely reflect a significant effect of the interventions; however, provision of financial or other interventions to incentivize continued school enrollment are a promising development. We suggest directions for future research to fill this critical gap in the literature. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  18. Maternal Creatine Supplementation during Pregnancy Prevents Long-Term Changes in Diaphragm Muscle Structure and Function after Birth Asphyxia.

    Directory of Open Access Journals (Sweden)

    Domenic A LaRosa

    Full Text Available Using a model of birth asphyxia, we previously reported significant structural and functional deficits in the diaphragm muscle in spiny mice, deficits that are prevented by supplementing the maternal diet with 5% creatine from mid-pregnancy. The long-term effects of this exposure are unknown. Pregnant spiny mice were fed control or 5% creatine-supplemented diet for the second half of pregnancy, and fetuses were delivered by caesarean section with or without 7.5 min of in-utero asphyxia. Surviving pups were raised by a cross-foster dam until 33±2 days of age when they were euthanized to obtain the diaphragm muscle for ex-vivo study of twitch tension and muscle fatigue, and for structural and enzymatic analyses. Functional analysis of the diaphragm revealed no differences in single twitch contractile parameters between any groups. However, muscle fatigue, induced by stimulation of diaphragm strips with a train of pulses (330 ms train/sec, 40 Hz for 300 sec, was significantly greater for asphyxia pups compared with controls (p<0.05, and this did not occur in diaphragms of creatine + asphyxia pups. Birth asphyxia resulted in a significant increase in the proportion of glycolytic, fast-twitch fibres and a reduction in oxidative capacity of Type I and IIb fibres in male offspring, as well as reduced cross-sectional area of all muscle fibre types (Type I, IIa, IIb/d in both males and females at 33 days of age. None of these changes were observed in creatine + asphyxia animals. Thus, the changes in diaphragm fatigue and structure induced by birth asphyxia persist long-term but are prevented by maternal creatine supplementation.

  19. Pilot Study to Evaluate Compliance and Tolerability of Cranberry Capsules in Pregnancy for the Prevention of Asymptomatic Bacteriuria

    Science.gov (United States)

    Rumney, Pamela J.; Hindra, Sasha; Guzman, Lizette; Le, Jennifer; Nageotte, Michael

    2015-01-01

    Abstract Objectives: To evaluate the compliance with and tolerability of daily cranberry capsule ingestion for asymptomatic bacteriuria (ASB) prevention in pregnancy. Design: A total of 49 pregnant women from two sites were randomly assigned to cranberry or matching placebo, two doses daily, at gestational ages less than 16 weeks. Patients were followed monthly for urinary tract infection until delivery. Up to seven monthly visits were scheduled for each patient. Delivery data were evaluated. Results: Of 38 evaluable patients, the mean compliance rate over the study period was 82% (range, 20%–100%). This compliance rate and the 74% of patients achieving good (≥75%) compliance were similar between those who received cranberry capsules and placebo. Compliance evaluation revealed that most patients stopped capsule consumption after 34–38 weeks of participation. Multivariate logistic regression and longitudinal analysis showed a significant interaction time effect with cranberry treatment. However, cranberry consumption was not a significant predictor of gastrointestinal intolerance or study withdrawal. Although 30% of patients withdrew for various reasons, only 1 withdrew because of intolerance to the cranberry capsules. Loss to follow-up was mostly due to provider change (9 of 49 [18%]) and therapy disinterest (4 of 49 [8%]). Seven cases of ASB occurred in 5 patients: 2 of 24 (8%) in the cranberry group and 3 of 25 (12%) in the placebo group. No cases of cystitis or pyelonephritis were observed. Conclusion: One third of pregnant women could not complete the study protocol for various reasons. Compliance with and tolerability of cranberry capsule ingestion appear good; these capsules provide a potentially effective means to prevent ASB in pregnancy. Further studies with large samples are necessary to confirm the findings. PMID:26535612

  20. Smoking, HIV, and risk of pregnancy loss.

    Science.gov (United States)

    Westreich, Daniel; Cates, Jordan; Cohen, Mardge; Weber, Kathleen M; Seidman, Dominika; Cropsey, Karen; Wright, Rodney; Milam, Joel; Young, Mary A; Mehta, C Christina; Gustafson, Deborah R; Golub, Elizabeth T; Fischl, Margaret A; Adimora, Adaora A

    2017-02-20

    Cigarette smoking during pregnancy increases risks of poor pregnancy outcomes including miscarriage and stillbirth (pregnancy loss), but the effect of smoking on pregnancy loss among HIV-infected women has not been explored. Here, investigated the impact of smoking on risk of pregnancy loss among HIV-positive and HIV-negative women, and estimated the potential impact of realistic smoking cessation interventions on risk of pregnancy loss among HIV-positive women. We analyzed pregnancy outcomes in HIV-positive and HIV-negative participants in the Women's Interagency HIV Study between 1994 and 2014. We estimated effects of current smoking at or immediately before pregnancy on pregnancy loss; we controlled for confounding using regression approaches, and estimated potential impact of realistic smoking cessation interventions using a semiparametric g-formula approach. Analysis examined 1033 pregnancies among 659 women. The effect of smoking on pregnancy loss differed dramatically by HIV status: adjusted for confounding, the risk difference comparing current smokers to current nonsmokers was 19.2% (95% confidence limit 10.9-27.5%) in HIV-positive women and 9.7% (95% confidence limit 0.0-19.4%) in HIV-negative women. These results were robust to sensitivity analyses. We estimated that we would need to offer a realistic smoking cessation intervention to 36 women to prevent one pregnancy loss. Smoking is a highly prevalent exposure with important consequences for pregnancy in HIV-positive pregnant women in the United States, even in the presence of potent highly active antiretroviral therapy. This evidence supports greater efforts to promote smoking cessation interventions among HIV-positive women, especially those who desire to become pregnant.

  1. Smoking, HIV, and risk of pregnancy loss

    Science.gov (United States)

    Westreich, Daniel; Cates, Jordan; Cohen, Mardge; Weber, Kathleen M.; Seidman, Dominika; Cropsey, Karen; Wright, Rodney; Milam, Joel; Young, Mary A.; Mehta, C. Christina; Gustafson, Deborah R.; Golub, Elizabeth T.; Fischl, Margaret A.; Adimora, Adaora A.

    2017-01-01

    Objective: Cigarette smoking during pregnancy increases risks of poor pregnancy outcomes including miscarriage and stillbirth (pregnancy loss), but the effect of smoking on pregnancy loss among HIV-infected women has not been explored. Here, investigated the impact of smoking on risk of pregnancy loss among HIV-positive and HIV-negative women, and estimated the potential impact of realistic smoking cessation interventions on risk of pregnancy loss among HIV-positive women. Design: We analyzed pregnancy outcomes in HIV-positive and HIV-negative participants in the Women's Interagency HIV Study between 1994 and 2014. Methods: We estimated effects of current smoking at or immediately before pregnancy on pregnancy loss; we controlled for confounding using regression approaches, and estimated potential impact of realistic smoking cessation interventions using a semiparametric g-formula approach. Results: Analysis examined 1033 pregnancies among 659 women. The effect of smoking on pregnancy loss differed dramatically by HIV status: adjusted for confounding, the risk difference comparing current smokers to current nonsmokers was 19.2% (95% confidence limit 10.9–27.5%) in HIV-positive women and 9.7% (95% confidence limit 0.0–19.4%) in HIV-negative women. These results were robust to sensitivity analyses. We estimated that we would need to offer a realistic smoking cessation intervention to 36 women to prevent one pregnancy loss. Conclusion: Smoking is a highly prevalent exposure with important consequences for pregnancy in HIV-positive pregnant women in the United States, even in the presence of potent highly active antiretroviral therapy. This evidence supports greater efforts to promote smoking cessation interventions among HIV-positive women, especially those who desire to become pregnant. PMID:27902507

  2. Insights in public health: Building support for an evidence-based teen pregnancy and sexually transmitted infection prevention program adapted for foster youth.

    Science.gov (United States)

    Smith, Tamara; Clark, Judith F; Nigg, Claudio R

    2015-01-01

    Hawai'i Youth Services Network (HYSN) was founded in 1980 and is incorporated as a 501(c) (3) organization. HYSN plays a key role in the planning, creation, and funding of local youth services. One of HYSN's focuses is teen pregnancy and sexually transmitted infections (STI) prevention among foster youth. Foster youth are at a greater risk for teen pregnancy and STI due to a variety of complex factors including instability, trauma, and emancipation from the foster care system. This article highlights how HYSN is leveraging both federal and local funding, as well as other resources, in order to implement an evidence-based teen pregnancy and STI prevention program adapted for foster youth.

  3. Effect of information education and communication (IEC) programme on knowledge of pregnant mothers regarding prevention and management of warning signs during pregnancy.

    Science.gov (United States)

    Takoo, Sarla; Chhugani, Manju; Sharma, Veena

    2013-01-01

    The present study was conducted to evaluate the effectiveness of an Information, Education and Communication (IEC) programme on knowledge of pregnant mothers regarding prevention and management of warning signs during pregnancy in a selected health care setting at New Delhi. An evaluative research approach with one group pre-test and post-test design was adopted for the present study. A structured interview schedule was prepared. Purposive non-probability sampling technique was employed to interview 30 pregnant mothers who attended antenatal clinic. Data gathered was analysed and interpreted using both descriptive and inferential statistics. The study revealed that there was maximum knowledge deficit regarding warning signs of pregnancy. IEC programme was effective in enhancing the knowledge of pregnant mothers on prevention and management of warning signs during pregnancy.

  4. Intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy: a randomised controlled non-inferiority trial.

    Directory of Open Access Journals (Sweden)

    Harry Tagbor

    Full Text Available BACKGROUND: The effectiveness of intermittent preventive treatment of malaria in pregnancy (IPTp may be compromised by the spread of resistance to sulphadoxine/pyrimethamine (SP across Africa. But little information exists on alternative drugs for IPTp or alternative strategies for the prevention of malaria in pregnancy. Therefore, we have investigated whether screening with a rapid diagnostic test and treatment of those who are positive (IST at routine antenatal clinic attendances is as effective and as safe as SP-IPTp in pregnant women. METHODS AND FINDINGS: During antenatal clinic sessions in six health facilities in Ghana held between March 2007 and September 2007, 3333 pregnant women who satisfied inclusion criteria were randomised into three intervention arms (1 standard SP-IPTp, (2 IST and treatment with SP or (3 IST and treatment with amodiaquine+artesunate (AQ+AS. All women received a long-lasting insecticide treated net. Study women had a maximum of three scheduled follow-up visits following enrollment. Haemoglobin concentration and peripheral parasitaemia were assessed between 36 and 40 weeks of gestation. Birth weight was measured at delivery or within 72 hours for babies delivered at home. Parasite prevalence at enrollment in primigravidae and in multigravidae was 29.6% and 10.2% respectively. At 36-40 weeks of gestation the prevalence of asymptomatic parasitaemia was 12.1% in study women overall and was very similar in all treatment groups. The risk of third trimester severe anaemia or low birth weight did not differ significantly between the three treatment groups regardless of gravidity. IST with AQ+AS or SP was not inferior to SP-IPTp in reducing the risk of low birth weight (RD  =  -1.17[95%CI; -4.39-1.02] for IST-SP vs. SP-IPTp and RD = 0.78[95%CI; -2.11-3.68] for IST-AQAS vs. SP-IPTp; third trimester severe anaemia (RD = 0.29[95%CI; -0.69-1.30] for IST-SP vs. SP-IPTp and RD  =  -0.36[95%CI;-1.12-0.44] for IST-AQAS vs

  5. Anemia and Pregnancy

    Science.gov (United States)

    ... Advocacy Toolkit Home For Patients Blood Disorders Anemia Anemia and Pregnancy Your body goes through significant changes ... becoming anemic. back to top Is Pregnancy-Related Anemia Preventable? Good nutrition is the best way to ...

  6. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... at risk? Zika virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how ... inspired by stories from the families at the heart of our mission or share your own story ...

  7. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... defects, premature birth and infant mortality. Solving premature birth Featured articles Accomplishments and lessons learned since the ... and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce your ...

  8. Blood Clotting and Pregnancy

    Medline Plus

    Full Text Available ... harming your baby. Jump To: Am I at Risk? The risk of developing a blood clot during pregnancy is ... prevent blood clots during pregnancy: Be aware of risk factors. Know your family history. Make sure your ...

  9. Arabin cervical pessary to prevent preterm birth in twin pregnancies with short cervix.

    Science.gov (United States)

    Di Tommaso, Mariarosaria; Seravalli, Viola; Arduino, Silvana; Bossotti, Carlotta; Sisti, Giovanni; Todros, Tullia

    2016-08-01

    A retrospective study was conducted to evaluate the effect of Arabin cervical pessary in twin pregnancies with cervical length (CL)  <25 mm between 21 and 31 weeks. Forty patients receiving pessary were matched with 40 controls without pessary. They were matched for gestational age (GA) at admission and CL. GA at delivery, delivery before 36, 34 and 32 weeks, latency between detection of short cervix and delivery, and duration of hospital admission were compared between groups. Women with the pessary delivered at higher GA compared to controls (35 vs. 33 weeks, p = 0.02). Cervical pessary significantly reduced the incidence of delivery  <36 and  < 34 weeks (p < 0.05), but not before 32 weeks. Interval between detection of short cervix and delivery was longer in the pessary group and duration of hospital admission was shorter (p = 0.03) compared to women without pessary.

  10. Prevention and treatment of venous thromboembolism in pregnancy in patients with hereditary antithrombin deficiency

    Directory of Open Access Journals (Sweden)

    James AH

    2013-05-01

    Full Text Available Andra H James,1 Barbara A Konkle,2,3 Kenneth A Bauer4 1Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, Virginia, 2Puget Sound Blood Center, Seattle, Washington, 3Department of Medicine, University of Washington, Seattle, Washington, 4Department of Medicine, Beth Israel Deaconess Medical Center and VA Boston Healthcare System, Harvard Medical School, Boston, Massachusetts, USA Objective: The aims of the study reported here were to provide data from six pregnant subjects who were enrolled in a clinical trial of antithrombin (AT concentrate, discuss other published case series and case reports, and provide general guidance for the use of AT concentrate for inherited AT deficiency in pregnancy. Methods: In the late 1980s, 31 AT-deficient subjects were enrolled in a prospective treatment trial of the plasma-derived AT concentrate Thrombate III®. Herein, newly available treatment data about the six pregnant subjects in the trial is tabulated and summarized. Results: All six experienced venous thromboembolism (VTE during pregnancy, were dosed according to a weight-based protocol, and were treated concomitantly with anticoagulation. Loading doses of AT concentrate of 54–62 units/kg were followed by maintenance doses of 50%–100% of the loading dose for 3–10 days. At the time of labor, loading doses of 46–50 units/kg were followed by maintenance doses of 50%–75% of the loading dose for 5–7 days. None of the six experienced recurrent thrombosis while receiving treatment with AT concentrate. Conclusion: Currently we suggest that women with AT deficiency who are pregnant or postpartum and have a personal history of VTE or current VTE receive AT concentrates. Keywords: thrombophilia, thrombosis, plasma-derived concentrate, labor, delivery, heparin.

  11. Herpes simplex virus infection during pregnancy.

    Science.gov (United States)

    Stephenson-Famy, Alyssa; Gardella, Carolyn

    2014-12-01

    Genital herpes in pregnancy continues to cause significant maternal morbidity, with an increasing number of infections being due to oral-labial transmission of herpes simplex virus (HSV)-1. Near delivery, primary infections with HSV-1 or HSV-2 carry the highest risk of neonatal herpes infection, which is a rare but potentially devastating disease for otherwise healthy newborns. Prevention efforts have been limited by lack of an effective intervention for preventing primary infections and the unclear role of routine serologic testing.

  12. Systematic review of sexual risk among pregnant and mothering teens in the USA: pregnancy as an opportunity for integrated prevention of STD and repeat pregnancy.

    Science.gov (United States)

    Meade, Christina S; Ickovics, Jeannette R

    2005-02-01

    Behaviors that lead to teen pregnancy also place young women at risk for STDs and repeat pregnancy. Compared to the broad literature on adolescent sexual risk behavior, our understanding of sexual risk in pregnant/mothering teens lags far behind. Primary objectives of this systematic review (1981-2003) of pregnant/mothering teens were to: (1) document rates of STD, repeat pregnancy, condom use, and contraception; (2) identify correlates of these biological and behavioral outcomes; (3) review sexual risk reduction interventions; and (4) discuss directions for future research and implications for clinical care. Fifty-one studies met inclusion criteria. Rates of STD and repeat pregnancy were high, with the majority of teens engaging in unprotected sex during and after pregnancy. An Ecological Model of Sexual Risk, based on Bronfenbrenner's (1989) Ecological Systems Theory, was proposed to organize findings on correlates of sexual risk. Improvements in research, including integration of outcomes and risk factors, stronger methodologies, and standardized assessments, are essential. Results suggest that teen pregnancy is a marker for future sexual risk behavior and adverse outcomes, and that pregnant/mothering teens need hybrid interventions promoting dual use of condoms and hormonal contraception. Pregnancy may provide a critical "window of opportunity" for sexual risk reduction.

  13. Enhancement of "Reducing the Risk" for the 21st Century: Improvement to a Curriculum Developed to Prevent Teen Pregnancy and STI Transmission

    Science.gov (United States)

    Langley, Cheri; Barbee, Anita P.; Antle, Becky; Christensen, Dana; Archuleta, Adrian; Sar, Bibhuti K.; Karam, Eli; van Zyl, Riaan; Cunningham, Michael R.; Borders, Kevin

    2015-01-01

    To ensure that "Reducing the Risk," a successful teen pregnancy prevention education curriculum, remains relevant for today's youth, covers all information youth need to know in order to make better choices, and is delivered in a standardized way, adaptations were made and enhancements were added. This article describes results of a…

  14. Isotretinoin use and compliance with the Dutch Pregnancy Prevention Programme: a retrospective cohort study in females of reproductive age using pharmacy dispensing data.

    NARCIS (Netherlands)

    Teichert, M.; Visser, L.E.; Dufour, M.; Rodenburg, E.; Straus, S.M.; Smet, P.A.G.M. de; Stricker, B.H.C.

    2010-01-01

    BACKGROUND: Isotretinoin is very effective in the treatment of severe acne. However, because of the teratogenic properties of this agent an isotretinoin Pregnancy Prevention Programme (PPP) was implemented in the Netherlands to guarantee that treatment is contraindicated in women of reproductive age

  15. Peer education: The effects on knowledge of pregnancy related malaria and preventive practices in women of reproductive age in Edo State, Nigeria

    NARCIS (Netherlands)

    Mens, P.F.; Scheelbeek, P.F.D.; Al Atabbi, H.; Enato, E.F.O.

    2011-01-01

    Background: There is limited uptake of measures to prevent malaria by pregnant women in Nigeria which is often related to the lack of knowledge on Malaria in Pregnancy (MIP) and its effects on mother and foetus. This study, explored peer to peer education as a tool in raising knowledge of MIP among

  16. Peer education: The effects on knowledge of pregnancy related malaria and preventive practices in women of reproductive age in Edo State, Nigeria

    NARCIS (Netherlands)

    P.F. Mens; P.F.D. Scheelbeek; H. Al Atabbi; E.F.O. Enato

    2011-01-01

    Background: There is limited uptake of measures to prevent malaria by pregnant women in Nigeria which is often related to the lack of knowledge on Malaria in Pregnancy (MIP) and its effects on mother and foetus. This study, explored peer to peer education as a tool in raising knowledge of MIP among

  17. Intermittent preventive sulfadoxine-pyrimethamine treatment of primigravidae reduces levels of plasma immunoglobulin G, which protects against pregnancy-associated Plasmodium falciparum malaria

    DEFF Research Database (Denmark)

    Staalsoe, Trine; Shulman, Caroline E; Dorman, Edgar K;

    2004-01-01

    Pregnancy-associated malaria (PAM) is an important cause of maternal and neonatal suffering. It is caused by Plasmodium falciparum capable of inhabiting the placenta through expression of particular variant surface antigens (VSA) with affinity for proteoglycans such as chondroitin sulfate A....... Protective immunity to PAM develops following exposure to parasites inhabiting the placenta, and primigravidae are therefore particularly susceptible to PAM. The adverse consequences of PAM in primigravidae are preventable by intermittent preventive treatment (IPTp), where women are given antimalarials...

  18. Chromosomal abnormalities in azoospermic and non-azoospermic infertile men: numbers needed to be screened to prevent adverse pregnancy outcomes.

    Science.gov (United States)

    Dul, E C; van Echten-Arends, J; Groen, H; Dijkhuizen, T; Land, J A; van Ravenswaaij-Arts, C M A

    2012-09-01

    How many infertile men who wish to conceive need to be screened for chromosomal abnormalities to prevent one miscarriage or the birth of one child with congenital anomalies (CAs)? In azoospermic men, the prevalence of chromosomal abnormalities is 15.2% and the number needed to be screened (NNS; minimum-maximum estimate) for a miscarriage is 80-88 and for a child with CAs is 790-3951. The prevalence of chromosomal abnormalities in non-azoospermic men is 2.3% and the NNS are 315-347 and 2543-12 723, respectively. Guidelines advise the screening of infertile men for chromosomal abnormalities to prevent miscarriages and children with congenital abnormalities, but no studies have been published on the effectiveness of this screening strategy. Retrospective cohort study of 1223 infertile men between 1994 and 2007. Men with azoospermia and men eligible for ICSI treatment visiting a university hospital fertility clinic in The Netherlands who underwent chromosomal analysis between 1994 and 2007 were identified retrospectively in a registry. Only cases of which at least one sperm analysis was available were included. Data were collected by chart review, with a follow-up of pregnancies and their outcomes until 2010. The chromosomal abnormalities were categorized according to their risk of unbalanced offspring, i.e. miscarriage and/or child with CAs. Multi-level analysis was used to estimate the impact of chromosomal abnormalities on the outcome of pregnancies in the different subgroups of our cohort. NNS for miscarriages and children with CAs were calculated based on data from our cohort and data published in the literature. A chromosomal abnormality was found in 12 of 79 men with azoospermia (15.2%) and in 26 of 1144 non-azoospermic men (2.3%). The chromosomal abnormalities were categorized based on the literature, into abnormalities with and abnormalities without increased risk for miscarriage and/or child with CAs. In our study group, there was no statistically significant

  19. Evaluating HIV prevention efforts using semiparametric regression models: results from a large cohort of women participating in an HIV prevention trial from KwaZulu-Natal, South Africa

    Directory of Open Access Journals (Sweden)

    Gita Ramjee

    2013-11-01

    Full Text Available Objective: To describe and quantify the differences in risk behaviours, HIV prevalence and incidence rates by birth cohorts among a group of women in Durban, South Africa. Methods: Cross-sectional and prospective cohort analyses were conducted for women who consented to be screened and enrolled in an HIV prevention trial. Demographic and sexual behaviours were described by five-year birth cohorts. Semiparametric regression models were used to investigate the bivariate associations between these factors and the birth cohorts. HIV seroconversion rates were also estimated by birth cohorts. Results: The prevalence of HIV-1 infection at the screening visit was lowest (20.0% among the oldest (born before 1960 cohorts, while the highest prevalence was observed among those born between 1975 and 79. Level of education increased across the birth cohorts while the median age at first sexual experience declined among those born after 1975 compared to those born before 1975. Only 33.03% of the oldest group reported ever using a condom while engaging in vaginal sex compared to 73.68% in the youngest group; however, HIV and other sexually transmitted infection (STI incidence rates were significantly higher among younger women compared to older women. Conclusions: These findings clearly suggest that demographic and sexual risk behaviours are differentially related to the birth cohorts. Significantly high HIV and STI incidence rates were observed among the younger group. Although the level of education increased, early age at sexual debut was more common among the younger group. The continuing increase in HIV and STI incidence rates among the later cohorts suggests that the future trajectory of the epidemic will be dependent on the infection patterns in younger birth cohorts.

  20. Aligning HIV/AIDS communication with the oral tradition of Africans: a theory-based content analysis of songs' potential in prevention efforts.

    Science.gov (United States)

    Bekalu, Mesfin Awoke; Eggermont, Steven

    2015-01-01

    Despite a growing recognition of songs as a useful HIV/AIDS campaign strategy, little research has investigated their potential and/or actual impact. In this study, through a theory-based content analysis, we have assessed the prevention domains covered and the health-relevant constructs promoted by 23 AIDS songs widely used to aid prevention efforts in Ethiopia. To identify the health-relevant constructs and reveal their potential to facilitate or inhibit positive changes, the Extended Parallel Process Model (EPPM) has been used. The findings revealed that the songs cover most of the prevention domains that constitute the current agenda of behavior change communication in Sub-Saharan Africa. However, although all the EPPM variables have been found in almost every song, there were significantly more efficacy messages than threat messages. This suggests that although the songs may lead to positive changes in HIV/AIDS-related outcomes among audiences who have already perceived the threat posed by HIV/AIDS, they are less likely to motivate and thereby generate responses from audiences who have less or no threat perceptions. It is argued that given their potential as a culturally appropriate strategy in Sub-Saharan Africa where oral channels of communication play significant roles, songs could be harnessed for better outcomes through a theory-based design.

  1. User and Provider Acceptability of Intermittent Screening and Treatment and Intermittent Preventive Treatment with Dihydroartemisinin-Piperaquine to Prevent Malaria in Pregnancy in Western Kenya.

    Science.gov (United States)

    Hill, Jenny; Hoyt, Jenna; Achieng, Florence; Ouma, Peter; L'lanziva, Anne; Kariuki, Simon; Desai, Meghna; Webster, Jayne

    2016-01-01

    The World Health Organization recommends intermittent preventive treatment in pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP) alongside long-lasting insecticide-treated nets (LLIN) and case management for reducing the risks associated with malaria in pregnancy in areas of moderate-to-high transmission in sub-Saharan Africa. Due to increasing Plasmodium falciparum resistance to SP, the search for alternative drugs or strategies to control malaria in pregnancy is a priority. We assessed the acceptability among pregnant women and health providers of intermittent screening and treatment (ISTp) and IPTp with dihydroartemisinin-piperaquine (DP) as alternative strategies in the context of an un-blinded clinical trial. Qualitative data were collected through ten focus group discussions with women participating in a randomized controlled trial to evaluate ISTp or IPTp with DP (multi-day regimen) versus IPTp with SP (single dose) in western Kenya. Individual in-depth interviews were conducted with 26 health providers working in the trial facilities and trial staff. Women appreciated the advantages of being tested with a rapid diagnostic test (RDT) at every ANC visit (although a few women disliked finger pricks) and accepted that they would not receive any antimalarial when tested RDT-negative. There were differences in women's experiences of the efficacy of antimalarials between the trial arms, with more women in the IPTp-SP arm reporting they had experienced malaria episodes. Side effects were experienced among women taking DP and SP. Although women and trial staff reported adherence to the full DP regimen within the trial, health providers were not confident that women would adhere to multi-day regimens in non-trial settings. Health providers recognized the advantages of ISTp in reducing unnecessary exposure to drugs, but lacked confidence in the reliability of RDTs compared to microscopy. Our findings indicate that, within a trial context, ISTp-DP and IPTp-DP were

  2. The impact of intermittent preventive treatment with sulfadoxine-pyrimethamine on the prevalence of malaria parasitaemia in pregnancy.

    Science.gov (United States)

    Umeh, Uchenna Anthony; Obi, Samuel N; Onah, Hyacinth E; Ugwu, Emmanuel Onyebuchi V; Ajah, Leonard Ogbonna; Umeh, Chioma Roseline; Okafor, Innocent Igwebuike

    2012-07-01

    The Roll Back Malaria initiatives were introduced to ensure that 60% of pregnant women receive intermittent preventive anti-malarial treatment by the end of 2005 in an attempt to halve the mortality from malaria by 2010. Our aim was to determine the prevalence of asymptomatic malaria parasitaemia in pregnant women on intermittent preventive treatment (IPT) with sulfadoxine-pyrimethamine (SP) compared with a control group. This comparative study involved testing the peripheral blood of pregnant women on IPT with SP and a control group that did not receive SP for the malaria parasite upon registration and at 34 weeks gestational age. The levels of parasitaemia in the intervention group upon registration (4.9%) and at 34 weeks (63.9%) were not significantly different (P > 0.05) from that of the control group (10%) and at 34 weeks gestation (68.3%). IPT with SP during pregnancy did not significantly reduce the prevalence of the malaria parasitaemia among the pregnant women in our environment.

  3. Intermittent preventive treatment of malaria in pregnancy with mefloquine in HIV-negative women: a multicentre randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Raquel González

    2014-09-01

    Full Text Available Intermittent preventive treatment in pregnancy (IPTp with sulfadoxine-pyrimethamine (SP is recommended by WHO to prevent malaria in African pregnant women. The spread of SP parasite resistance has raised concerns regarding long-term use for IPT. Mefloquine (MQ is the most promising of available alternatives to SP based on safety profile, long half-life, and high efficacy in Africa. We evaluated the safety and efficacy of MQ for IPTp compared to those of SP in HIV-negative women.A total of 4,749 pregnant women were enrolled in an open-label randomized clinical trial conducted in Benin, Gabon, Mozambique, and Tanzania comparing two-dose MQ or SP for IPTp and MQ tolerability of two different regimens. The study arms were: (1 SP, (2 single dose MQ (15 mg/kg, and (3 split-dose MQ in the context of long lasting insecticide treated nets. There was no difference on low birth weight prevalence (primary study outcome between groups (360/2,778 [13.0%] for MQ group and 177/1,398 (12.7% for SP group; risk ratio [RR], 1.02 (95% CI 0.86-1.22; p=0.80 in the ITT analysis. Women receiving MQ had reduced risks of parasitemia (63/1,372 [4.6%] in the SP group and 88/2,737 [3.2%] in the MQ group; RR, 0.70 [95% CI 0.51-0.96]; p=0.03 and anemia at delivery (609/1,380 [44.1%] in the SP group and 1,110/2743 [40.5%] in the MQ group; RR, 0.92 [95% CI 0.85-0.99]; p=0.03, and reduced incidence of clinical malaria (96/551.8 malaria episodes person/year [PYAR] in the SP group and 130/1,103.2 episodes PYAR in the MQ group; RR, 0.67 [95% CI 0.52-0.88]; p=0.004 and all-cause outpatient attendances during pregnancy (850/557.8 outpatients visits PYAR in the SP group and 1,480/1,110.1 visits PYAR in the MQ group; RR, 0.86 [0.78-0.95]; p=0.003. There were no differences in the prevalence of placental infection and adverse pregnancy outcomes between groups. Tolerability was poorer in the two MQ groups compared to SP. The most frequently reported related adverse events were dizziness

  4. Treatment of asymptomatic vaginal candidiasis in pregnancy to prevent preterm birth: an open-label pilot randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Rickard Kristen

    2011-03-01

    Full Text Available Abstract Background Although the connection between ascending infection and preterm birth is undisputed, research focused on finding effective treatments has been disappointing. However evidence that eradication of Candida in pregnancy may reduce the risk of preterm birth is emerging. We conducted a pilot study to assess the feasibility of conducting a large randomized controlled trial to determine whether treatment of asymptomatic candidiasis in early pregnancy reduces the incidence of preterm birth. Methods We used a prospective, randomized, open-label, blinded-endpoint (PROBE study design. Pregnant women presenting at Candida were randomized to 6-days of clotrimazole vaginal pessaries (100mg or usual care (screening result is not revealed, no treatment. The primary outcomes were the rate of asymptomatic vaginal candidiasis, participation and follow-up. The proposed primary trial outcome of spontaneous preterm birth Results Of 779 women approached, 500 (64% participated in candidiasis screening, and 98 (19.6% had asymptomatic vaginal candidiasis and were randomized to clotrimazole or usual care. Women were not inconvenienced by participation in the study, laboratory testing and medication dispensing were problem-free, and the follow-up rate was 99%. There was a tendency towards a reduction in spontaneous preterm birth among women with asymptomatic candidiasis who were treated with clotrimazole RR = 0.33, 95%CI 0.04-3.03. Conclusions A large, adequately powered, randomized trial of clotrimazole to prevent preterm birth in women with asymptomatic candidiasis is both feasible and warranted. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR: ACTRN12609001052224

  5. Preparing towards Preventing and Containing an Ebola Virus Disease Outbreak: What Socio-cultural Practices May Affect Containment Efforts in Ghana?

    Directory of Open Access Journals (Sweden)

    Philip Baba Adongo

    2016-07-01

    Full Text Available Ebola Virus Disease (EVD is a condition with high fatality. Though the disease is deadly, taking precautions to reduce contact with infected people and their secretions can prevent cross- infection. In the 2014 EVD outbreak, socio-cultural factors were identified to be responsible for the spread of the disease in the three most affected countries in West Africa. In this light, we undertook this study to identify socio-cultural factors that may influence the prevention and containment of EVD in Ghana and ways to address such practices.We conducted a descriptive qualitative study in five regions in Ghana. Twenty-five focus group discussions (5 in each region with community members (4 in each region and nurses (1 in each region were conducted. In addition, forty (40 in-depth interviews were conducted with various stakeholders and opinion leaders; eight in each region. All interviews were recorded using a digital voice recorder and transcribed. With the aid of Nvivo 10 for windows, we analyzed the data using framework analysis.We found that socio-cultural practices, such as care of the body of dead and burial practices, widowhood rites and anointing children with water used to rinse the dead, were common. These practices require individuals coming into direct contact with either the dead or items used to take care of the dead. Social norms also require frequent handshakes in all social gatherings such as funeral, and religious congregations. We also found that self-medication (using herbs and orthodox medications was a common practice. People use both biomedical and non-orthodox health outlets either simultaneously or in sequence in times of ill-health.The study concludes that high risk socio-cultural practices were common among Ghanaians and generally perceived as indispensable. These high risk practices may hinder containment efforts in the event of an outbreak. Community leaders should be engaged in any social mobilization to modify these

  6. “THE BOYS GET THE PLEASURE THE GIRLS GET THE PAIN" : The views of teenage girls in Kenya concerning the causes and prevention of teenage pregnancy

    OpenAIRE

    Matheka, Robert

    2012-01-01

    The purpose of this study was to find out teenagers’ views concerning the causes and prevention of teenage pregnancy in Nguluni located in Kenya. The aim was to get important information that can be used by partners and stakeholders who have a role in reducing teenage pregnancy. This study was qualitative through participation of 40 female students aged 13-16 from a local mixed day high school. Narrative study was used to collect data where participants wrote essays. Data was analysed by cont...

  7. Engineering a segmented dual-reservoir polyurethane intravaginal ring for simultaneous prevention of HIV transmission and unwanted pregnancy.

    Directory of Open Access Journals (Sweden)

    Justin T Clark

    Full Text Available The HIV/AIDS pandemic and its impact on women prompt the investigation of prevention strategies to interrupt sexual transmission of HIV. Long-acting drug delivery systems that simultaneously protect womenfrom sexual transmission of HIV and unwanted pregnancy could be important tools in combating the pandemic. We describe the design, in silico, in vitro and in vivo evaluation of a dual-reservoir intravaginal ring that delivers the HIV-1 reverse transcriptase inhibitor tenofovir and the contraceptive levonorgestrel for 90 days. Two polyether urethanes with two different hard segment volume fractions were used to make coaxial extruded reservoir segments with a 100 µm thick rate controlling membrane and a diameter of 5.5 mm that contain 1.3 wt% levonorgestrel. A new mechanistic diffusion model accurately described the levonorgestrel burst release in early time points and pseudo-steady state behavior at later time points. As previously described, tenofovir was formulated as a glycerol paste and filled into a hydrophilic polyurethane, hollow tube reservoir that was melt-sealed by induction welding. These tenofovir-eluting segments and 2 cm long coaxially extruded levonorgestrel eluting segments were joined by induction welding to form rings that released an average of 7.5 mg tenofovir and 21 µg levonorgestrel per day in vitro for 90 days. Levonorgestrel segments placed intravaginally in rabbits resulted in sustained, dose-dependent levels of levonorgestrel in plasma and cervical tissue for 90 days. Polyurethane caps placed between segments successfully prevented diffusion of levonorgestrel into the tenofovir-releasing segment during storage.Hydrated rings endured between 152 N and 354 N tensile load before failure during uniaxial extension testing. In summary, this system represents a significant advance in vaginal drug delivery technology, and is the first in a new class of long-acting multipurpose prevention drug delivery systems.

  8. Engineering a segmented dual-reservoir polyurethane intravaginal ring for simultaneous prevention of HIV transmission and unwanted pregnancy.

    Science.gov (United States)

    Clark, Justin T; Clark, Meredith R; Shelke, Namdev B; Johnson, Todd J; Smith, Eric M; Andreasen, Andrew K; Nebeker, Joel S; Fabian, Judit; Friend, David R; Kiser, Patrick F

    2014-01-01

    The HIV/AIDS pandemic and its impact on women prompt the investigation of prevention strategies to interrupt sexual transmission of HIV. Long-acting drug delivery systems that simultaneously protect womenfrom sexual transmission of HIV and unwanted pregnancy could be important tools in combating the pandemic. We describe the design, in silico, in vitro and in vivo evaluation of a dual-reservoir intravaginal ring that delivers the HIV-1 reverse transcriptase inhibitor tenofovir and the contraceptive levonorgestrel for 90 days. Two polyether urethanes with two different hard segment volume fractions were used to make coaxial extruded reservoir segments with a 100 µm thick rate controlling membrane and a diameter of 5.5 mm that contain 1.3 wt% levonorgestrel. A new mechanistic diffusion model accurately described the levonorgestrel burst release in early time points and pseudo-steady state behavior at later time points. As previously described, tenofovir was formulated as a glycerol paste and filled into a hydrophilic polyurethane, hollow tube reservoir that was melt-sealed by induction welding. These tenofovir-eluting segments and 2 cm long coaxially extruded levonorgestrel eluting segments were joined by induction welding to form rings that released an average of 7.5 mg tenofovir and 21 µg levonorgestrel per day in vitro for 90 days. Levonorgestrel segments placed intravaginally in rabbits resulted in sustained, dose-dependent levels of levonorgestrel in plasma and cervical tissue for 90 days. Polyurethane caps placed between segments successfully prevented diffusion of levonorgestrel into the tenofovir-releasing segment during storage.Hydrated rings endured between 152 N and 354 N tensile load before failure during uniaxial extension testing. In summary, this system represents a significant advance in vaginal drug delivery technology, and is the first in a new class of long-acting multipurpose prevention drug delivery systems.

  9. Mental effort

    NARCIS (Netherlands)

    Kirschner, Paul A.; Kirschner, Femke

    2013-01-01

    Kirschner, P. A., & Kirschner, F. (2012). Mental effort. In N. Seel (Ed.), Encyclopedia of the sciences of learning, Volume 5 (pp. 2182-2184). New York, NY: Springer. doi:10.1007/978-1-4419-1428-6_226

  10. Preventing cardiovascular disease after hypertensive disorders of pregnancy: Searching for the how and when.

    Science.gov (United States)

    Groenhof, T Katrien J; van Rijn, Bas B; Franx, Arie; Roeters van Lennep, Jeanine E; Bots, Michiel L; Lely, A Titia

    2017-01-01

    Background Women with a history of a hypertensive disorder during pregnancy (HDP) have an increased risk of cardiovascular events. Guidelines recommend assessment of cardiovascular risk factors in these women later in life, but provide limited advice on how this follow-up should be organized. Design Systematic review and meta-regression analysis. Methods The aim of our study was to provide an overview of existing knowledge on the changes over time in three major modifiable components of cardiovascular risk assessment after HDP: blood pressure, glucose homeostasis and lipid levels. Data from 44 studies and up to 6904 women with a history of a HDP were compared with risk factor levels reported for women of corresponding age in the National Health And Nutrition Examination Survey, Estudio Epidemiólogico de la Insuficiencia Renal en España and Hong Kong cohorts ( N = 27,803). Results Compared with the reference cohort, women with a HDP presented with higher mean blood pressure. Hypertension was present in a higher rate among women with a previous HDP from 15 years postpartum onwards. At 15 years postpartum (±age 45), one in five women with a history of a HDP suffer from hypertension. No differences in glucose homeostasis parameters or lipid levels were observed. Conclusions Based on our analysis, it is not possible to point out a time point to commence screening for cardiovascular risk factors in women after a HDP. We recommend redirection of future research towards the development of a stepwise approach identifying the women with the highest cardiovascular risk.

  11. Economic evaluation of an alternative drug to sulfadoxine-pyrimethamine as intermittent preventive treatment of malaria in pregnancy.

    Directory of Open Access Journals (Sweden)

    Elisa Sicuri

    Full Text Available Intermittent preventive treatment in pregnancy (IPTp with sulfadoxine-pyrimethamine (SP is recommended in HIV-negative women to avert malaria, while this relies on cotrimoxazole prophylaxis (CTXp in HIV-positive women. Alternative antimalarials are required in areas where parasite resistance to antifolate drugs is high. The cost-effectiveness of IPTp with alternative drugs is needed to inform policy.The cost-effectiveness of 2-dose IPTp-mefloquine (MQ was compared with IPTp-SP in HIV-negative women (Benin, Gabon, Mozambique and Tanzania. In HIV-positive women the cost-effectiveness of 3-dose IPTp-MQ added to CTXp was compared with CTXp alone (Kenya, Mozambique and Tanzania. The outcomes used were maternal clinical malaria, anaemia at delivery and non-obstetric hospital admissions. The poor tolerability to MQ was included as the value of women's loss of working days. Incremental cost-effectiveness ratios (ICERs were calculated and threshold analysis undertaken.For HIV-negative women, the ICER for IPTp-MQ versus IPTp-SP was 136.30 US$ (2012 US$ (95%CI 131.41; 141.18 per disability-adjusted life-year (DALY averted, or 237.78 US$ (95%CI 230.99; 244.57, depending on whether estimates from Gabon were included or not. For HIV-positive women, the ICER per DALY averted for IPTp-MQ added to CTXp, versus CTXp alone was 6.96 US$ (95%CI 4.22; 9.70. In HIV-negative women, moderate shifts of variables such as malaria incidence, drug cost, and IPTp efficacy increased the ICERs above the cost-effectiveness threshold. In HIV-positive women the intervention remained cost-effective for a substantial (up to 21 times increase in cost per tablet.Addition of IPTp with an effective antimalarial to CTXp was very cost-effective in HIV-positive women. IPTp with an efficacious antimalarial was more cost-effective than IPTp-SP in HIV-negative women. However, the poor tolerability of MQ does not favour its use as IPTp. Regardless of HIV status, prevention of malaria in

  12. Bidirectional links between HIV and intimate partner violence in pregnancy: implications for prevention of mother-to-child transmission

    Directory of Open Access Journals (Sweden)

    Abigail M Hatcher

    2014-11-01

    Full Text Available Introduction: Prevention of mother-to-child transmission (PMTCT has the potential to eliminate new HIV infections among infants. Yet in many parts of sub-Saharan Africa, PMTCT coverage remains low, leading to unacceptably high rates of morbidity among mothers and new infections among infants. Intimate partner violence (IPV may be a structural driver of poor PMTCT uptake, but has received little attention in the literature to date. Methods: We conducted qualitative research in three Johannesburg antenatal clinics to understand the links between IPV and HIV-related health of pregnant women. We held focus group discussions with pregnant women (n=13 alongside qualitative interviews with health care providers (n=10, district health managers (n=10 and pregnant abused women (n=5. Data were analysed in Nvivo10 using a team-based approach to thematic coding. Findings: We found qualitative evidence of strong bidirectional links between IPV and HIV among pregnant women. HIV diagnosis during pregnancy, and subsequent partner disclosure, were noted as a common trigger of IPV. Disclosure leads to violence because it causes relationship conflict, usually related to perceived infidelity and the notion that women are “bringing” the disease into the relationship. IPV worsened HIV-related health through poor PMTCT adherence, since taking medication or accessing health services might unintentionally alert male partners of the women's HIV status. IPV also impacted on HIV-related health via mental health, as women described feeling depressed and anxious due to the violence. IPV led to secondary HIV risk as women experienced forced sex, often with little power to negotiate condom use. Pregnant women described staying silent about condom negotiation in order to stay physically safe during pregnancy. Conclusions: IPV is a crucial issue in the lives of pregnant women and has bidirectional links with HIV-related health. IPV may worsen access to PMTCT and secondary

  13. Signos Vitales-Prevención de embarazos en adolescentes (Preventing Teen Pregnancy)

    Centers for Disease Control (CDC) Podcasts

    2015-04-07

    Este podcast se basa en la edición de abril del 2015 del informe Signos Vitales de los CDC. En los Estados Unidos ha descendido la tasa de nacimientos en adolescentes, sin embargo, en el 2013 nacieron más de 273 000 bebés de madres adolescentes de entre 15 y 19 años. Infórmese sobre los tipos de anticonceptivos más eficaces.  Created: 4/7/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/7/2015.

  14. Effort to Enhance Early Detection for Vulnerable Pregnancy by Midwives Through Complete Fulfillment of Maternal and Child Health (MCH Bookin Bangkalan East Java Year 2013

    Directory of Open Access Journals (Sweden)

    Ristrini Ristrini

    2015-03-01

    Kesehatan Kabupaten Bangkalan agar memberikan penghargaan bagi bidan yang berprestasi.Kata kunci:Kelengkapan Pengisian Buku KIA, Deteksi Dini Risiko Tinggi, Ibu Hamil ABSTRACTBackground:MCH book is a tool for early detection for vulnerable gravida. Meanwhile, the utilization of MCH book was still low. The target achieved for early detection was 12% out of 20% from 2011 to 2012. Based on SDKI 2012 duka, the average maternal mortality rate reached 359 per 100.000 live births, increased significantly from the data of SDKI 2007 which reached 228 per 100.000 live births. Methods:This study was observational with cross sectional design. Both quantitative and qualitative data were collected. Secondary data were collected by the availability of MCH book, midwives training, supervisions, and complete fulfillment of MCH book. Populations in Puskesmas Kedundung and Puskesmas Geger Bangkalan District. The samples were midwives with more than one year working and graduated from DIII (diploma. The complete fulfillment of MCH book was identified from family identity, delivery preparation, gravida medical record, antenatal medical record, postnatal medical record, KMS (Booklet to Infant Nutritional Status Detection, Neonatus medical record, infant medical record, vitamin A supplementary. Result: The complete fulfillments were in Puskesmas Geger 0.66 (category: good 0.51–1.00 and Puskesmas Kedundung 0.35 (category: low 0.00–0.50. Midwives’ Motivations were low (50.0% and midwives workload were high (66.7% at Puskesmas Geger. Midwives were highly motivated (66.7% and their workloads are fair. Recomendation: make group of work and allocate the job description properly to assist midwives workload. In addition, health office of Bangkalan should give reward to those who do the work excellently.Key words:complete fulfilment of MCH book, early detection of highrisk pregnancy, pregnant women

  15. Stop or go? Preventive cognitive therapy with guided tapering of antidepressants during pregnancy: study protocol of a pragmatic multicentre non-inferiority randomized controlled trial.

    Science.gov (United States)

    Molenaar, Nina M; Brouwer, Marlies E; Bockting, Claudi L H; Bonsel, Gouke J; van der Veere, Christine N; Torij, Hanneke W; Hoogendijk, Witte J G; Duvekot, Johannes J; Burger, Huibert; Lambregtse-van den Berg, Mijke P

    2016-03-18

    Approximately 6.2 % of women in the USA and 3.7 % of women in the UK, use Selective Serotonin Reuptake Inhibitors (SSRIs) during their pregnancies because of depression and/or anxiety. In the Netherlands, this prevalence is around 2 %. Nonetheless, SSRI use during pregnancy is still controversial. On the one hand SSRIs may be toxic to the intrauterine developing child, while on the other hand relapse or recurrence of depression during pregnancy poses risks for both mother and child. Among patients and professionals there is an urgent need for evidence from randomized studies to make rational decisions regarding continuation or tapering of SSRIs during pregnancy. At present, no such studies exist. 'Stop or Go' is a pragmatic multicentre randomized non-inferiority trial among 200 pregnant women with a gestational age of less than 16 weeks who use SSRIs without clinically relevant depressive symptoms. Women allocated to the intervention group will receive preventive cognitive therapy with gradual, guided discontinuation of SSRIs under medical management (STOP). Women in the control group will continue the use of SSRIs (GO). Primary outcome will be the (cumulative) incidence of relapse or recurrence of maternal depressive disorder (as assessed by the Structured Clinical Interview for DSM disorders) during pregnancy and up to three months postpartum. Secondary outcomes will be child outcome (neonatal outcomes and psychomotor and behavioural outcomes up to 24 months postpartum), and health-care costs. Total study duration for participants will be therefore be 30 months. We specified a non-inferiority margin of 15 % difference in relapse risk. This study is the first to investigate the effect of guided tapering of SSRIs with preventive cognitive therapy from early pregnancy onwards as compared to continuation of SSRIs during pregnancy. We will study the effects on both mother and child with a pragmatic approach. Additionally, the study examines cost effectiveness. If non

  16. 异位妊娠发生的相关因素及预防%Study on relative factors and prevention of ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    谢秀媚

    2012-01-01

    目的 探讨分析引发异位妊娠的相关因素及预防措施.方法 随机抽取2009年1月~2011年1月某院妇产科诊治的100例异位妊娠患者的临床资料,同时随机抽取同期100例正常妊娠者的临床资料,对引发异位妊娠的相关因素资料进行单因素分析与Logistic回归分析.结果 Logistic回归模型分析显示引发异位妊娠的主要因素有口服紧急避孕药史、IUD、妇科炎症史、腹部手术史和孕产次.结论 异位妊娠是由一种或多种因素综合作用的结果,与多种因素有关,应采取措施,防患于未然.%OBJECTIVE To study the related factors and prevention measures of ectopic pregnancy. METHODS A randomized selection for clinical materials of 100 cases of ectopic pregnancy patients in obstetrics and gynecology department from January 2010 to January 2011. At the same time, randomly selected the clinical materials of 100 cases of normal pregnancy. The related factors of causing ectopic pregnancy were analyzed by single factor analysis and Logistic regression analysis. RESULTS Logistic regression model analysis showed that causes of ectopic pregnancy were the oral history of emergency contraception, IUD, gynecological inflammation history, abdominal surgeries and production time with child. CONCLUSION Ectopic pregnancy is caused by one or more related factors, it should take measures to prevent it.

  17. Effortful echolalia.

    Science.gov (United States)

    Hadano, K; Nakamura, H; Hamanaka, T

    1998-02-01

    We report three cases of effortful echolalia in patients with cerebral infarction. The clinical picture of speech disturbance is associated with Type 1 Transcortical Motor Aphasia (TCMA, Goldstein, 1915). The patients always spoke nonfluently with loss of speech initiative, dysarthria, dysprosody, agrammatism, and increased effort and were unable to repeat sentences longer than those containing four or six words. In conversation, they first repeated a few words spoken to them, and then produced self initiated speech. The initial repetition as well as the subsequent self initiated speech, which were realized equally laboriously, can be regarded as mitigated echolalia (Pick, 1924). They were always aware of their own echolalia and tried to control it without effect. These cases demonstrate that neither the ability to repeat nor fluent speech are always necessary for echolalia. The possibility that a lesion in the left medial frontal lobe, including the supplementary motor area, plays an important role in effortful echolalia is discussed.

  18. 妊娠高血压疾病产前预测及预防%Prediction and Prevention in Prenatal Hypertension of Pregnancy Disease

    Institute of Scientific and Technical Information of China (English)

    吴淑荣

    2015-01-01

    Objective To investigate the risk factors and preventions of hypertension of pregnancy disease. Methods 30 cases of hypertension of pregnancy had predicted the risk factors,in order to be avoided the happening of the disease and prevented the complications. Results Total 30 patients were analyzed, 9 cases were adopt artificial midwifery,21 cases were adopt cesarean section. Conclusion The effective prevention and treatment intervention are given in early pregnancy,in order to prevent the happening of the complications caused by disease.%目的:探讨妊娠期高血压疾病有关的危险因素及预防。方法对妊娠期高血压疾病患者30例进行高危因素预测,避免疾病的发生及预防疾病所致并发症的发生。结果30例患者,生产时行人工助产9例,剖宫产21例。结论早期妊娠时需发挥有效的预防和治疗干预,清楚了解疾病的病因并避免疾病的发生。

  19. Local illness concepts and their relevance for the prevention and control of malaria during pregnancy in Ghana, Kenya and Malawi: findings from a comparative qualitative study.

    Science.gov (United States)

    Menaca, Arantza; Pell, Christopher; Manda-Taylor, Lucinda; Chatio, Samuel; Afrah, Nana A; Were, Florence; Hodgson, Abraham; Ouma, Peter; Kalilani, Linda; Tagbor, Harry; Pool, Robert

    2013-07-22

    In sub-Saharan Africa, the burden of morbidity and mortality linked to malaria during pregnancy (MiP) is significant and compounded by its unclear symptoms and links with other health problems during pregnancy. Mindful of the biomedical and social complexity of MiP, this article explores and compares local understandings of MiP and their links with other pregnancy-related health problems. A comparative qualitative study was undertaken at four sites in three countries: Ghana, Malawi and Kenya. Individual and group interviews were conducted with pregnant women, their relatives, opinion leaders, other community members and health providers. MiP-related behaviours were also observed at health facilities and in local communities. Across the four sites, local malaria concepts overlapped with biomedically defined malaria. In terms of symptoms, at-risk groups, outcomes and aetiology of malaria during pregnancy, this overlap was however both site-specific and partial. Moreover, the local malaria concepts were not monolithic and their descriptions varied amongst respondents. The symptoms of pregnancy and malaria also overlapped but, for respondents, symptom severity was the distinguishing factor. Malaria was generally, though not universally, perceived as serious for pregnant women. Miscarriage was the most widely known outcome, and links with anaemia, low birth weight and congenital malaria were mentioned. Nonetheless, amongst many potential causes of miscarriage, malaria was not recognized as the most important, but rather interacted with other pregnancy-related problems. Given the overlap of common pregnancy problems with the symptoms of malaria, and the limited association of malaria with its main outcomes, a comprehensive antenatal care programme is the most appropriate strategy for the provision of health education, prevention and treatment for MiP. Variations in locally shared understandings of MiP must however be taken into account when designing and promoting Mi

  20. Messages on pregnancy and family planning that providers give women living with HIV in the context of a Positive Health, Dignity, and Prevention intervention in Mozambique

    Directory of Open Access Journals (Sweden)

    Hilliard S

    2014-12-01

    Full Text Available Starr Hilliard, Sarah A Gutin, Carol Dawson Rose Department of Community Health Systems, School of Nursing, University of California at San Francisco, San Francisco, CA, USA Background: Family planning is an important HIV prevention tool for women living with HIV (WLHIV. In Mozambique, the prevalence of HIV among women of reproductive age is 13.1% and the average fertility rate is high. However, family planning and reproductive health for WLHIV are under-addressed in Mozambique. This study explores provider descriptions of reproductive health messages in order to identify possible barriers and facilitators to successfully addressing family planning and pregnancy concerns of WLHIV. Methods: In 2006, a Positive Health, Dignity, and Prevention program was introduced in Mozambique focused on training health care providers to work with patients to reduce their transmission risks. Providers received training on multiple components, including family planning and prevention of mother-to-child transmission (PMTCT. In-depth interviews were conducted with 31 providers who participated in the training in five rural clinics in three provinces. Data were analyzed using qualitative content analysis. Results: Analysis showed that providers' clinical messages on family planning, pregnancy, and PMTCT for WLHIV could be arranged along a continuum. Provider statements ranged from saying that WLHIV should not become pregnant and condoms are the only valid form of family planning for WLHIV, to suggesting that WLHIV can have safe pregnancies. Conclusion: These data indicate that many providers continue to believe that WLHIV should not have children and this represents a challenge for integrating family planning into the care of WLHIV. Also, not offering WLHIV a full selection of family planning methods severely limits their ability to protect themselves from unintended pregnancies and to fully exercise their reproductive rights. Responding to the reproductive health

  1. Sexual Behavior and Vaginal Practices During Pregnancy and Postpartum: Implications for HIV Prevention Strategies.

    Science.gov (United States)

    Kinuthia, John; Richardson, Barbra A; Drake, Alison L; Matemo, Daniel; Unger, Jennifer A; McClelland, Raymond S; John-Stewart, Grace

    2017-02-01

    Understanding sexual behaviors and vaginal practices of pregnant and breastfeeding women in sub-Saharan Africa is critical to inform HIV prevention strategies during these periods. HIV-uninfected women presenting for antenatal care in western Kenya were enrolled and followed through 36 weeks postpartum. Sexual behavior and vaginal practices were ascertained by structured questionnaires. Logistic regression was used to assess correlates of unprotected sex, vaginal washing, and vaginal drying. Among 1252 women enrolled, 78.4% were married (of whom 15.1% were in polygamous unions), 1.4% had a known HIV-infected partner, and 33.6% had a partner of unknown HIV status. At enrollment, 58.5% reported sex in the past month (94.3% unprotected) and 4.5% reported forced sex. Odds of unprotected sex at enrollment was >11-fold higher in married than in unmarried women (P < 0.001) and lower among women who reported partners of unknown HIV status or HIV-infected compared with HIV-uninfected partners. Median time to postpartum resumption of sex was 7 weeks (interquartile range 4-12). Prevalence of unprotected sex in the past week increased from 6.6% to 60.0% between 2 and 36 weeks postpartum (P < 0.001). Vaginal washing was reported by 60.1% of women at enrollment and prevalence remained stable postpartum; vaginal drying was reported by 17.9% at enrollment and decreased to 6.1% at 36 weeks postpartum (P < 0.001). Vaginal washing and drying were associated with forced sex. High rates of unknown partner HIV status, polygamy, and less frequent condom use among pregnant/postpartum women underscore the need for female-controlled HIV prevention interventions. Vaginal washing and drying may present challenges to microbicide use.

  2. Rh(O)D immune globulin products for prevention of alloimmunization during pregnancy.

    Science.gov (United States)

    Aitken, Samuel L; Tichy, Eric M

    2015-02-15

    The pharmacologic properties of Rhesus (Rh) immune globulin (RhIG) and clinical data on its effectiveness in preventing Rh-antigen alloimmunization in pregnant women are reviewed. RhIG is a human plasma derivative that targets red blood cells (RBCs) positive for Rh(O) antigen (also called D antigen). In the United States and other countries, the widespread use of RhIG has markedly reduced the occurrence of hemolytic disease of the fetus and newborn (HDFN), a devastating condition caused by D-antigen sensitization of a pregnant woman via exposure to fetal RBCs (usually during detachment of the placenta in labor) that results in a maternal immune response leading to severe hemolysis in the fetus. Routine administration of RhIG at 26-30 weeks' gestation and again within 72 hours of delivery has been shown to be highly effective in preventing maternal Rh alloimmunization, with very low rates of D-antigen sensitization (in the range of 0-2.2%) reported in multiple studies of at-risk women. The four RhIG products currently available in the United States have common clinical indications but differ in certain attributes. Pharmacists can play an important role in guiding other clinicians on the rationale for the use of RhIG, important differences between products, and appropriate timing of RhIG therapy. Routine administration of RhIG to women at risk for Rh alloimmunization is clinically effective and has made HDFN a rare clinical event. The available RhIG products are not the same and should be carefully reviewed to ensure that they are administered safely. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  3. Preventive and Therapeutic Role of Dietary Inositol Supplementation in Periconceptional Period and During Pregnancy: A Summary of Evidences and Future Applications.

    Science.gov (United States)

    Noventa, Marco; Vitagliano, Amerigo; Quaranta, Michela; Borgato, Shara; Abdulrahim, Baydaa; Gizzo, Salvatore

    2016-03-01

    Although inositol dietary deficiency in the general population has not been demonstrated at the serum level, several findings are emerging regarding the impact of inositol supplementation in periconceptional period and in early phases of pregnancy. We are aimed to summarize all experimental (murine in vivo and in vitro murine embryo studies) and clinical (human) evidences regarding the role of inositol in the prevention and treatment of folate-resistant embryo neural tube defects (FR-NTDs) and gestational diabetes mellitus (GDM). We also collected all information regarding the effect that inositol supplementation may have in the metabolic reassessment of early and late pregnancy in order to draw evidence-based conclusions and suggest further studies defining the potential therapeutic role of this molecule in human reproduction. The systematic review of literature clearly showed that inositol supplementation in preconceptional period and in early phase of pregnancy reduces the risk of developing GDM in patients at increased risk. Furthermore, continued intake during pregnancy improves the metabolic status of affected patients, but further studies are needed to confirm this end point. All women at risk of FR-NTDs assuming inositol from the periconceptional period until late pregnancy are reported to have healthy newborns without any significant complications linked to inositol supplementation.

  4. Reuse of single-dose nevirapine in subsequent pregnancies for the prevention of mother-to-child HIV transmission in Lusaka, Zambia: A cohort study

    Directory of Open Access Journals (Sweden)

    Sinkala Moses

    2008-12-01

    Full Text Available Abstract Background Single-dose nevirapine (SDNVP for the prevention of mother-to-child HIV transmission (PMTCT results in the selection of resistance mutants among HIV-infected mothers. The effects of these mutations on the efficacy of SDNVP use in a subsequent pregnancy are not well understood. Methods We compared risks of perinatal HIV transmission between multiparous women who had previously received a dose of SDNVP (exposed and those that had not (unexposed and who were given SDNVP for the index pregnancy within a PMTCT clinical study. We also compared transmission risks among exposed and unexposed women who had two consecutive pregnancies within the trial. Logistic regression modeling was used to adjust for possible confounders. Results Transmission risks did not differ between 59 SDNVP-exposed and 782 unexposed women in unadjusted analysis or after adjustment for viral load and disease stage (adjusted odds ratio 0.6, 95% confidence interval [CI] 0.2 to 2.0. Among 43 women who had two consecutive pregnancies during the study, transmission risks were 7% (95% CI 1% to 19% at both the first (unexposed and second (exposed delivery. The results were unchanged, if infant death was included as an outcome. Conclusion These data suggest that the efficacy of SDNVP may not be diminished when reused in subsequent pregnancies.

  5. Increased doses of vaginal progesterone for the prevention of preterm birth in twin pregnancies: a randomised controlled double-blind multicentre trial.

    Science.gov (United States)

    Serra, V; Perales, A; Meseguer, J; Parrilla, J J; Lara, C; Bellver, J; Grifol, R; Alcover, I; Sala, M; Martínez-Escoriza, J C; Pellicer, A

    2013-01-01

    Previous trials have shown little benefit for preventing preterm birth in twin pregnancies using 90-200 mg of daily vaginal natural progesterone. Higher doses have not been tested. Our aim was to determine the efficacy and safety of two different daily doses of vaginal natural progesterone (200 and 400 mg), compared with placebo, for preventing preterm birth in unselected twin pregnancies. Randomised controlled double-blind multicentre trial (1:1:1). The study was carried out in five university centres from Valencia, Murcia and Alicante (Spain). Women with dichorionic diamniotic twin pregnancies. The women self-inserted two vaginal pessaries daily, containing placebo (n = 96), 200 mg of natural progesterone (n = 97) or 400 mg of natural progesterone (n = 97), from 20 to 34 weeks of gestation or delivery. Randomisation was performed by an external centre. Data were analysed on an intention-to-treat basis. Preterm birth rate. The baseline characteristics for placebo and progesterone groups were similar. Comparison of the three groups and analysis of progesterone-treated versus untreated women showed similar pregnancy and neonatal outcomes. The proportion of preterm and very preterm births, low birthweight, perinatal mortality and neonatal morbidity showed no differences between the three groups. Similar results were also obtained when comparing the 200- versus 400-mg progesterone groups. No serious adverse effects were encountered. Vaginal progesterone therapy was generally well tolerated, but failed to prevent preterm births in unselected dichorionic diamniotic twin pregnancies. The 400-mg progesterone dose offered no advantages over the 200-mg regimen. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

  6. Urinary Tract Infection as a Preventable Cause of Pregnancy Complications: Opportunities, Challenges, and a Global Call to Action

    OpenAIRE

    Gilbert, Nicole M.; O'Brien, Valerie P.; Hultgren, Scott; Macones, George; Lewis, Warren G.; Lewis, Amanda L.

    2013-01-01

    The urinary tract is a common site of infection in humans. During pregnancy, urinary tract infection (UTI) is associated with increased risks of maternal and neonatal morbidity and mortality, even when the infection is asymptomatic. By mapping available rates of UTI in pregnancy across different populations, we emphasize this as a problem of global significance. Many countries with high rates of preterm birth and neonatal mortality also have rates of UTI in pregnancy that exceed rates seen in...

  7. [RELEVANT PRINCIPLES IN THE DIAGNOSIS, TREATMENT, AND PREVENTION OF TOXOPLASMOSIS DURING PREGNANCY].

    Science.gov (United States)

    Merzlova, N B; Serova, I A; Yagodina, A Yu

    2015-01-01

    A retrospective survey of the prevalence of TORCH infections among pregnant women was performed in the perinatal center, M. A. Tverye Military Sanitary Unit Nine (Perm), in June 2010 to December 2013. The survey covered 2060 women: they were all examined for cytomegalovirus, herpes simplex virus, and Toxoplasma. Antibodies to Toxoplasma gondii were detected in 28.68% (591/2060); 98.62% were found to have antibodies to herpes simplex; antibodies to cytomegalovirus were identified in 87.13% (1795/2060). Acute maternal toxoplasmosis was diagnosed by seroconversion or determination of IgM anti-Toxoplasma gondii antibodies, in the presence of a low avidity index and a four-fold increase in antibody titers, by simultaneously studying paired serum samples obtained at a 2-week interval. To confirm fetal infection, amniotic fluid PCR examination should be performed after 18 weeks' gestation. No consensus of opinion as to the principles of treatment for toxoplasmosis in pregnant women makes relevant the long-term results of antibacterial and antiprotozoal treatment cycles varying in duration and intensity. The prevention of acute toxoplasmosis in pregnant women ensures the principle of a mother's personal responsibility for infection safety of a newborn infant, which is informationally provided in health and safety fundamentals course and pregravid preparation schools.

  8. Adolescent pregnancy and contraception.

    Science.gov (United States)

    Dalby, Jessica; Hayon, Ronni; Carlson, Jensena

    2014-09-01

    7% of US teen women became pregnant in 2008, totaling 750,000 pregnancies nationwide. For women ages 15 to 19, 82% of pregnancies are unintended. Adolescents have a disproportionate risk of medical complications in pregnancy. Furthermore, adolescent parents and their infants both tend to suffer poor psychosocial outcomes. Preventing unintended and adolescent pregnancies are key public health objectives for Healthy People 2020. Screening for sexual activity and pregnancy risk should be a routine part of all adolescent visits. Proven reductions in unintended pregnancy in teens are attained by providing access to contraception at no cost and promoting the most-effective methods.

  9. Multiple Pregnancy

    Science.gov (United States)

    ... Education & Events Advocacy For Patients About ACOG Multiple Pregnancy Home For Patients Search FAQs Multiple Pregnancy Page ... Multiple Pregnancy FAQ188, July 2015 PDF Format Multiple Pregnancy Pregnancy How does multiple pregnancy occur? What are ...

  10. Pregnancy Complications

    Science.gov (United States)

    ... To receive Pregnancy email updates Enter email Submit Pregnancy complications Complications of pregnancy are health problems that ... pregnancy. Expand all | Collapse all Health problems before pregnancy Before pregnancy, make sure to talk to your ...

  11. Cost-effectiveness of antiviral therapy during late pregnancy to prevent perinatal transmission of hepatitis B virus

    Directory of Open Access Journals (Sweden)

    Wenjun Wang

    2016-03-01

    Full Text Available Background. Hepatitis B virus (HBV infections are perinatally transmitted from chronically infected mothers. Supplemental antiviral therapy during late pregnancy with lamivudine (LAM, telbivudine (LdT, or tenofovir (TDF can substantially reduce perinatal HBV transmission compared to postnatal immunoprophylaxis (IP alone. However, the cost-effectiveness of these measures is not clear. Aim. This study evaluated the cost-effectiveness from a societal perspective of supplemental antiviral agents for preventing perinatal HBV transmission in mothers with high viral load (>6 log10 copies/mL. Methods. A systematic review and network meta-analysis were performed for the risk of perinatal HBV transmission with antiviral therapies. A decision analysis was conducted to evaluate the clinical and economic outcomes in China of four competing strategies: postnatal IP alone (strategy IP, or in combination with perinatal LAM (strategy LAM + IP, LdT (strategy LdT + IP, or TDF (strategy TDF + IP. Antiviral treatments were administered from week 28 of gestation to 4 weeks after birth. Outcomes included treatment-related costs, number of infections, and quality-adjusted life years (QALYs. One- and two-way sensitivity analyses were performed to identify influential clinical and cost-related variables. Probabilistic sensitivity analyses were used to estimate the probabilities of being cost-effective for each strategy. Results. LdT + IP and TDF + IP averted the most infections and HBV-related deaths, and gained the most QALYs. IP and TDF + IP were dominated as they resulted in less or equal QALYs with higher associated costs. LdT + IP had an incremental $2,891 per QALY gained (95% CI [$932–$20,372] compared to LAM + IP (GDP per capita for China in 2013 was $6,800. One-way sensitivity analyses showed that the cost-effectiveness of LdT + IP was only sensitive to the relative risk of HBV transmission comparing LdT + IP with LAM + IP. Probabilistic sensitivity analyses

  12. Teen Pregnancy

    Centers for Disease Control (CDC) Podcasts

    2014-04-16

    In this podcast, Dr. Tom Frieden, CDC Director, discusses the issue of teen pregnancy and some strategies to address it.  Created: 4/16/2014 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 4/16/2014.

  13. The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, human immunodeficiency virus, and sexually transmitted infections: two systematic reviews for the Guide to Community Preventive Services.

    Science.gov (United States)

    Chin, Helen B; Sipe, Theresa Ann; Elder, Randy; Mercer, Shawna L; Chattopadhyay, Sajal K; Jacob, Verughese; Wethington, Holly R; Kirby, Doug; Elliston, Donna B; Griffith, Matt; Chuke, Stella O; Briss, Susan C; Ericksen, Irene; Galbraith, Jennifer S; Herbst, Jeffrey H; Johnson, Robert L; Kraft, Joan M; Noar, Seth M; Romero, Lisa M; Santelli, John

    2012-03-01

    Adolescent pregnancy, HIV, and other sexually transmitted infections (STIs) are major public health problems in the U.S. Implementing group-based interventions that address the sexual behavior of adolescents may reduce the incidence of pregnancy, HIV, and other STIs in this group. Methods for conducting systematic reviews from the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness of two strategies for group-based behavioral interventions for adolescents: (1) comprehensive risk reduction and (2) abstinence education on preventing pregnancy, HIV, and other STIs. Effectiveness of these interventions was determined by reductions in sexual risk behaviors, pregnancy, HIV, and other STIs and increases in protective sexual behaviors. The literature search identified 6579 citations for comprehensive risk reduction and abstinence education. Of these, 66 studies of comprehensive risk reduction and 23 studies of abstinence education assessed the effects of group-based interventions that address the sexual behavior of adolescents, and were included in the respective reviews. Meta-analyses were conducted for each strategy on the seven key outcomes identified by the coordination team-current sexual activity; frequency of sexual activity; number of sex partners; frequency of unprotected sexual activity; use of protection (condoms and/or hormonal contraception); pregnancy; and STIs. The results of these meta-analyses for comprehensive risk reduction showed favorable effects for all of the outcomes reviewed. For abstinence education, the meta-analysis showed a small number of studies, with inconsistent findings across studies that varied by study design and follow-up time, leading to considerable uncertainty around effect estimates. Based on these findings, group-based comprehensive risk reduction was found to be an effective strategy to reduce adolescent pregnancy, HIV, and STIs. No conclusions could be drawn on the

  14. Helping Clinicians Prevent Pregnancy among Sexually Active Adolescents: U.S. Medical Eligibility Criteria for Contraceptive Use and U.S. Selected Practice Recommendations for Contraceptive Use.

    Science.gov (United States)

    Godfrey, Emily M

    2015-08-01

    The United States has made substantial progress in reducing teenage birth rates in recent decades, but rates remain high. Teen pregnancy can increase the risk of poor health outcomes and lead to decreased educational attainment, increased poverty, and welfare use, as well as increased cost to taxpayers. One of the most effective ways to prevent teenage pregnancy is through the use of effective birth control methods. The Centers for Disease Control (CDC) and Prevention has made the prevention of teenage pregnancy 1 of its 10 winnable battles. The CDC has released 2 evidence-based clinical guideline documents regarding contraceptive use for adolescents and adults. The first guideline, US Medical Eligibility Criteria for Contraceptive Use, 2010, helps clinicians recognize when a contraceptive method may not be safe to use for a particular adolescent but also when not to withhold a contraceptive method that is safe to use. The second document, US Selected Practice Recommendations for Contraceptive Use, 2013, provides guidance for how to use contraceptive methods safely and effectively once they are deemed safe. Health care providers are encouraged to use these documents to provide safe and effective contraceptive care to patients seeking family planning, including adolescents.

  15. A new strategy and its effect on adherence to intermittent preventive treatment of malaria in pregnancy in Uganda.

    Science.gov (United States)

    Mbonye, Anthony K; Yanow, Stephanie; Birungi, Josephine; Magnussen, Pascal

    2013-09-21

    Few women in Uganda access intermittent preventive treatment of malaria in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP). Previous studies have shown that high costs, frequent stock-out of drugs, supplies and poor quality of care are the greatest hindrance for women to access health services. In order to increase adherence to IPTp, we conceptualised an intervention that offset delivery care costs through providing a mama kit, created awareness on health benefits of IPTp and built trust between the provider and the client. The new strategy was conceived along four constructs namely: 1) creating awareness by training midwives to explain the benefits of SP and the importance of adhering to the two doses of SP as IPTp to all pregnant women who attended ANC and consented to the study. Midwives were trained for two days in customer care and to provide a friendly environment. The pregnant women were also informed of the benefits of attending ANC and delivering at health facilities. 2) Each woman was promised a mama kit during ANC; 3) trust was built by showing the mama kit to each woman and branding it with her name; 4) keeping the promise by providing the mama kit when women came to deliver. The strategy to increase adherence to two doses of SP and encourage women to deliver at health facilities was implemented at two health facilities in Mukono district (Kawolo hospital and Mukono health centre IV). The inclusion criteria were women who: i) consented to the study and ii) were in the second trimester of pregnancy. All pregnant women in the second trimester (4-6 months gestation) who attended ANC and consented to participate in the study were informed of the benefits of SP, the importance of delivering at health facilities, were advised to attend the scheduled visits, promised a mama kit and ensured the kit was available at delivery. The primary outcome was the proportion of pregnant women adhering to a two dose SP regimen. A total of 2,276 women received the first

  16. Prevention of Defective Placentation and Pregnancy Loss by Blocking Innate Immune Pathways in a Syngeneic Model of Placental Insufficiency.

    Science.gov (United States)

    Gelber, Shari E; Brent, Elyssa; Redecha, Patricia; Perino, Giorgio; Tomlinson, Stephen; Davisson, Robin L; Salmon, Jane E

    2015-08-01

    Defective placentation and subsequent placental insufficiency lead to maternal and fetal adverse pregnancy outcome, but their pathologic mechanisms are unclear, and treatment remains elusive. The mildly hypertensive BPH/5 mouse recapitulates many features of human adverse pregnancy outcome, with pregnancies characterized by fetal loss, growth restriction, abnormal placental development, and defects in maternal decidual arteries. Using this model, we show that recruitment of neutrophils triggered by complement activation at the maternal/fetal interface leads to elevation in local TNF-α levels, reduction of the essential angiogenic factor vascular endothelial growth factor, and, ultimately, abnormal placentation and fetal death. Blockade of complement with inhibitors specifically targeted to sites of complement activation, depletion of neutrophils, or blockade of TNF-α improves spiral artery remodeling and rescues pregnancies. These data underscore the importance of innate immune system activation in the pathogenesis of placental insufficiency and identify novel methods for treatment of pregnancy loss mediated by abnormal placentation.

  17. Interventions to Prevent Unintended and Repeat Pregnancy Among Young People in Low- and Middle-Income Countries: A Systematic Review of the Published and Gray Literature.

    Science.gov (United States)

    Hindin, Michelle J; Kalamar, Amanda M; Thompson, Terri-Ann; Upadhyay, Ushma D

    2016-09-01

    Adolescent pregnancy, particularly unintended pregnancy, can have lasting social, economic, and health outcomes. The objective of this review is to identify high-quality interventions and evaluations to decrease unintended and repeat pregnancy among young people in low- and middle-income countries. PubMed, Embase, PsycInfo, Cinahl Plus, Popline, and the Cochrane Databases were searched for all languages for articles published through November 2015. Gray literature was searched by hand. Reference tracing was utilized, as well as unpacking systematic reviews. Selected articles were those that were evaluated as having high-quality interventions and evaluations using standardized scoring. Twenty-one high-quality interventions and evaluations were abstracted. Nine reported statistically significant declines in pregnancy rates (five cash transfer programs, one education curriculum, two life-skills curricula, and a provision of contraception intervention), seven reported increases in contraceptive use (three provision of contraception interventions, two life-skills curricula, a peer education program, and a mass media campaign), two reported decreases in sexual activity (a cash transfer program and an education and life-skills curriculum), and two reported an increase in age of sexual debut (both cash transfer programs). The selected high quality, effective interventions included in this review can inform researchers, donors, and policy makers about where to make strategic investments to decrease unintended pregnancy during young adulthood. Additionally, this review can assist with avoiding investments in interventions that failed to produce significant impact on the intended outcomes. The diversity of successful high-quality interventions, implemented in a range of venues, with a diversity of young people, suggests that there are multiple strategies that can work to prevent unintended pregnancy.

  18. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce your risk of ... Make United States a Leader in Preterm Birth Prevention March of Dimes Names 13-Year Old Boy ...

  19. Exercise during Pregnancy

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  20. Conducting rigorous research with subgroups of at-risk youth: lessons learned from a teen pregnancy prevention project in Alaska.

    Science.gov (United States)

    Hohman-Billmeier, Kathryn; Nye, Margaret; Martin, Stephanie

    2016-01-01

    In 2010, Alaska Department of Health and Social Services (DHSS) received federal funding to test an evidence-based teen pregnancy prevention program. The grant required a major modification to an existing program and a randomized control trial (RCT) to test its effectiveness. As the major modifications, Alaska used peer educators instead of adults to deliver the program to youth aged 14-19 instead of the original curriculum intended age range of 12-14. Cultural and approach adaptations were included as well. After 4 years of implementation and data collection, the sample was too small to provide statistically significant results. The lack of findings gave no information about the modification, nor any explanation of how the curriculum was received, or reasons for the small sample. This paper reports on a case study follow-up to the RCT to better understand outcome and implementation results. For this study, researchers reviewed project documents and interviewed peer educators, state and local staff, and evaluators. Three themes emerged from the data: (a) the professional growth of peer educators and development of peer education, (b) difficulties resulting from curriculum content, especially for subpopulations of sexually active youth, youth identified as lesbian, gay, bisexual, transgender, queer, intersex and/or asexual, pregnant, and parenting youth and (c) the appropriateness of an RCT with subpopulations of at-risk youth. Three recommendations emerged from the case study. First, including as many stakeholders as possible in the program and evaluation design phases is essential, and must be supported by appropriate funding streams and training. Second, there must be recognition of the multiple small subpopulations found in Alaska when adapting programs designed for a larger and more homogeneous population. Third, RCTs may not be appropriate for all population subgroups.

  1. Conducting rigorous research with subgroups of at-risk youth: lessons learned from a teen pregnancy prevention project in Alaska

    Directory of Open Access Journals (Sweden)

    Kathryn Hohman-Billmeier

    2016-12-01

    Full Text Available In 2010, Alaska Department of Health and Social Services (DHSS received federal funding to test an evidence-based teen pregnancy prevention program. The grant required a major modification to an existing program and a randomized control trial (RCT to test its effectiveness. As the major modifications, Alaska used peer educators instead of adults to deliver the program to youth aged 14–19 instead of the original curriculum intended age range of 12–14. Cultural and approach adaptations were included as well. After 4 years of implementation and data collection, the sample was too small to provide statistically significant results. The lack of findings gave no information about the modification, nor any explanation of how the curriculum was received, or reasons for the small sample. This paper reports on a case study follow-up to the RCT to better understand outcome and implementation results. For this study, researchers reviewed project documents and interviewed peer educators, state and local staff, and evaluators. Three themes emerged from the data: (a the professional growth of peer educators and development of peer education, (b difficulties resulting from curriculum content, especially for subpopulations of sexually active youth, youth identified as lesbian, gay, bisexual, transgender, queer, intersex and/or asexual, pregnant, and parenting youth and (c the appropriateness of an RCT with subpopulations of at-risk youth. Three recommendations emerged from the case study. First, including as many stakeholders as possible in the program and evaluation design phases is essential, and must be supported by appropriate funding streams and training. Second, there must be recognition of the multiple small subpopulations found in Alaska when adapting programs designed for a larger and more homogeneous population. Third, RCTs may not be appropriate for all population subgroups.

  2. Feasibility of a controlled trial aiming to prevent excessive pregnancy-related weight gain in primary health care

    Directory of Open Access Journals (Sweden)

    Weiderpass Elisabete

    2008-08-01

    Full Text Available Abstract Background Excessive gestational weight gain and postpartum weight retention may predispose women to long-term overweight and other health problems. Intervention studies aiming at preventing excessive pregnancy-related weight gain are needed. The feasibility of implementing such a study protocol in primary health care setting was evaluated in this pilot study. Methods A non-randomized controlled trial was conducted in three intervention and three control maternity and child health clinics in primary health care in Finland. Altogether, 132 pregnant and 92 postpartum women and 23 public health nurses (PHN participated in the study. The intervention consisted of individual counselling on physical activity and diet at five routine visits to a PHN and of an option for supervised group exercise until 37 weeks' gestation or ten months postpartum. The control clinics continued their usual care. The components of the feasibility evaluation were 1 recruitment and participation, 2 completion of data collection, 3 realization of the intervention and 4 the public health nurses' experiences. Results 1 The recruitment rate was slower than expected and the recruitment period had to be prolonged from the initially planned three months to six months. The average participation rate of eligible women at study enrolment was 77% and the drop-out rate 15%. 2 In total, 99% of the data on weight, physical activity and diet and 96% of the blood samples were obtained. 3 In the intervention clinics, 98% of the counselling sessions were realized, their contents and average durations were as intended, 87% of participants regularly completed the weekly records for physical activity and diet, and the average participation percentage in the group exercise sessions was 45%. 4 The PHNs regarded the extra training as a major advantage and the high additional workload as a disadvantage of the study. Conclusion The study protocol was mostly feasible to implement, which

  3. Moving beyond quantity of participation in process evaluation of an intervention to prevent excessive pregnancy weight gain

    Directory of Open Access Journals (Sweden)

    Paul Keriann H

    2013-02-01

    Full Text Available Abstract Background Few lifestyle interventions have successfully prevented excessive gestational weight gain. Understanding the program processes through which successful interventions achieve outcomes is important for the design of effective programs. The objective of this study was to evaluate the effect of the quantity and quality of participation in a healthy lifestyle intervention on risk of excessive gestational weight gain. Findings Pregnant women (N = 179 received five newsletters about weight, nutrition, and exercise plus postcards on which they were asked to set related goals and return to investigators. The quantity of participation (dose was defined as low for returning few or some vs. high for many postcards (N = 89, 49.7%. Quality of participation was low for setting few vs. high for some or many appropriate goals (N = 92, 51.4%. Fisher’s exact tests and multivariate logistic regression were used to analyze the effect of participation variables on the proportion with excessive weight gain. Quantity and quality of participation alone were each not significantly associated with excessive gestational weight gain, while quality of participation among those with high-levels of participation approached significance (p = 0.07. The odds of gaining excessively was decreased when women had both a high quantity and quality of participation (OR = 0.04, 95% CI = 0.005, 0.30. Conclusions Both quantity and quality of participation are important program process measures in evaluations of lifestyle interventions to promote healthy weight gain during pregnancy.

  4. Estimated impact on birth weight of scaling up intermittent preventive treatment of malaria in pregnancy given sulphadoxine-pyrimethamine resistance in Africa: A mathematical model

    Science.gov (United States)

    Floyd, Jessica; ter Kuile, Feiko; Cairns, Matt

    2017-01-01

    Background Malaria transmission has declined substantially in the 21st century, but pregnant women in areas of sustained transmission still require protection to prevent the adverse pregnancy and birth outcomes associated with malaria in pregnancy (MiP). A recent call to action has been issued to address the continuing low coverage of intermittent preventive treatment of malaria in pregnancy (IPTp). This call has, however, been questioned by some, in part due to concerns about resistance to sulphadoxine-pyrimethamine (SP), the only drug currently recommended for IPTp. Methods and findings Using an existing mathematical model of MiP, we combined estimates of the changing endemicity of malaria across Africa with maps of SP resistance mutations and current coverage of antenatal access and IPTp with SP (IPTp-SP) across Africa. Using estimates of the relationship between SP resistance mutations and the parasitological efficacy of SP during pregnancy, we estimated the varying impact of IPTp-SP across Africa and the incremental value of enhancing IPTp-SP uptake to match current antenatal care (ANC) coverage. The risks of MiP and malaria-attributable low birthweight (mLBW) in unprotected pregnancies (i.e., those not using insecticide-treated nets [ITNs]) leading to live births fell by 37% (33%–41% 95% credible interval [crI]) and 31% (27%–34% 95% crI), respectively, from 2000 to 2015 across endemic areas in sub-Saharan Africa. However, these gains are fragile, and coverage is far from optimal. In 2015, 9.5 million (8.3 million–10.4 million 95% crI) of 30.6 million pregnancies in these areas would still have been infected with Plasmodium falciparum without intervention, leading to 750,000 (390,000–1.1 million 95% crI) mLBW deliveries. In all, 6.6 million (5.6 million–7.3 million 95% crI) of these 9.5 million (69.3%) pregnancies at risk of infection (and 53.4% [16.3 million/30.6 million] of all pregnancies) occurred in settings with near-perfect SP curative

  5. Estimated impact on birth weight of scaling up intermittent preventive treatment of malaria in pregnancy given sulphadoxine-pyrimethamine resistance in Africa: A mathematical model.

    Directory of Open Access Journals (Sweden)

    Patrick G T Walker

    2017-02-01

    Full Text Available Malaria transmission has declined substantially in the 21st century, but pregnant women in areas of sustained transmission still require protection to prevent the adverse pregnancy and birth outcomes associated with malaria in pregnancy (MiP. A recent call to action has been issued to address the continuing low coverage of intermittent preventive treatment of malaria in pregnancy (IPTp. This call has, however, been questioned by some, in part due to concerns about resistance to sulphadoxine-pyrimethamine (SP, the only drug currently recommended for IPTp.Using an existing mathematical model of MiP, we combined estimates of the changing endemicity of malaria across Africa with maps of SP resistance mutations and current coverage of antenatal access and IPTp with SP (IPTp-SP across Africa. Using estimates of the relationship between SP resistance mutations and the parasitological efficacy of SP during pregnancy, we estimated the varying impact of IPTp-SP across Africa and the incremental value of enhancing IPTp-SP uptake to match current antenatal care (ANC coverage. The risks of MiP and malaria-attributable low birthweight (mLBW in unprotected pregnancies (i.e., those not using insecticide-treated nets [ITNs] leading to live births fell by 37% (33%-41% 95% credible interval [crI] and 31% (27%-34% 95% crI, respectively, from 2000 to 2015 across endemic areas in sub-Saharan Africa. However, these gains are fragile, and coverage is far from optimal. In 2015, 9.5 million (8.3 million-10.4 million 95% crI of 30.6 million pregnancies in these areas would still have been infected with Plasmodium falciparum without intervention, leading to 750,000 (390,000-1.1 million 95% crI mLBW deliveries. In all, 6.6 million (5.6 million-7.3 million 95% crI of these 9.5 million (69.3% pregnancies at risk of infection (and 53.4% [16.3 million/30.6 million] of all pregnancies occurred in settings with near-perfect SP curative efficacy (>99% based on the most recent

  6. Estimated impact on birth weight of scaling up intermittent preventive treatment of malaria in pregnancy given sulphadoxine-pyrimethamine resistance in Africa: A mathematical model.

    Science.gov (United States)

    Walker, Patrick G T; Floyd, Jessica; Ter Kuile, Feiko; Cairns, Matt

    2017-02-01

    Malaria transmission has declined substantially in the 21st century, but pregnant women in areas of sustained transmission still require protection to prevent the adverse pregnancy and birth outcomes associated with malaria in pregnancy (MiP). A recent call to action has been issued to address the continuing low coverage of intermittent preventive treatment of malaria in pregnancy (IPTp). This call has, however, been questioned by some, in part due to concerns about resistance to sulphadoxine-pyrimethamine (SP), the only drug currently recommended for IPTp. Using an existing mathematical model of MiP, we combined estimates of the changing endemicity of malaria across Africa with maps of SP resistance mutations and current coverage of antenatal access and IPTp with SP (IPTp-SP) across Africa. Using estimates of the relationship between SP resistance mutations and the parasitological efficacy of SP during pregnancy, we estimated the varying impact of IPTp-SP across Africa and the incremental value of enhancing IPTp-SP uptake to match current antenatal care (ANC) coverage. The risks of MiP and malaria-attributable low birthweight (mLBW) in unprotected pregnancies (i.e., those not using insecticide-treated nets [ITNs]) leading to live births fell by 37% (33%-41% 95% credible interval [crI]) and 31% (27%-34% 95% crI), respectively, from 2000 to 2015 across endemic areas in sub-Saharan Africa. However, these gains are fragile, and coverage is far from optimal. In 2015, 9.5 million (8.3 million-10.4 million 95% crI) of 30.6 million pregnancies in these areas would still have been infected with Plasmodium falciparum without intervention, leading to 750,000 (390,000-1.1 million 95% crI) mLBW deliveries. In all, 6.6 million (5.6 million-7.3 million 95% crI) of these 9.5 million (69.3%) pregnancies at risk of infection (and 53.4% [16.3 million/30.6 million] of all pregnancies) occurred in settings with near-perfect SP curative efficacy (>99%) based on the most recent

  7. Malaria risk factors in women on intermittent preventive treatment at delivery and their effects on pregnancy outcome in Sanaga-Maritime, Cameroon.

    Directory of Open Access Journals (Sweden)

    Calvin Tonga

    Full Text Available Malaria is known to have a negative impact on pregnant women and their foetuses. The efficacy of Sulfadoxine-Pyrimethamine (SP used for intermittent preventive treatment (IPT is being threatened by increasing levels of resistance. This study assessed malaria risk factors in women on intermittent preventive treatment with SP (IPTp-SP at delivery and their effects on pregnancy outcome in Sanaga-Maritime Division, Cameroon. Socio-economic and obstetrical data of mothers and neonate birth weights were documented. Peripheral blood from 201 mothers and newborns as well as placental and cord blood were used to prepare thick and thin blood films. Maternal haemoglobin concentration was measured. The overall malaria parasite prevalence was 22.9% and 6.0% in mothers and newborns respectively. Monthly income lower than 28000 FCFA and young age were significantly associated with higher prevalence of placental malaria infection (p = 0.0048 and p = 0.019 respectively. Maternal infection significantly increased the risk of infection in newborns (OR = 48.4; p<0.0001. Haemoglobin concentration and birth weight were lower in infected mothers, although not significant. HIV infection was recorded in 6.0% of mothers and increased by 5-folds the risk of malaria parasite infection (OR = 5.38, p = 0.007. Attendance at antenatal clinic and level of education significantly influenced the utilisation of IPTp-SP (p<0.0001 and p = 0.018 respectively. Use of SP and mosquito net resulted in improved pregnancy outcome especially in primiparous, though the difference was not significant. Malaria infection in pregnancy is common and increases the risk of neonatal malaria infection. Preventive strategies are poorly implemented and their utilization has overall reasonable effect on malaria infection and pregnancy outcome.

  8. Preventing smoking during pregnancy: the importance of maternal knowledge of the health hazards and of the treatment options available

    Directory of Open Access Journals (Sweden)

    André Luís Bertani

    2015-04-01

    Full Text Available OBJECTIVE: To examine the pattern of tobacco use and knowledge about tobacco-related diseases, as well as to identify popular types of electronic media, in pregnant women, in order to improve strategies for the prevention or cessation of smoking among such women. METHODS: A cross-sectional study involving 61 pregnant women, seen at primary care clinics and at a university hospital, in the city of Botucatu, Brazil. For all subjects, we applied the Hospital Anxiety and Depression Scale. For subjects with a history of smoking, we also applied the Fagerström Test for Nicotine Dependence, and we evaluated the level of motivation to quit smoking among the current smokers. RESULTS: Of the 61 pregnant women evaluated, 25 (40.9% were smokers (mean age, 26.4 ± 7.4 years, 24 (39.3% were former smokers (26.4 ± 8.3 years, and 12 (19.8% were never-smokers (25.1 ± 7.2 years. Thirty-nine women (63.9% reported exposure to passive smoking. Of the 49 smokers/former smokers, 13 (26.5% were aware of the pulmonary consequences of smoking; only 2 (4.1% were aware of the cardiovascular risks; 23 (46.9% believed that smoking does not harm the fetus or newborn infant; 21 (42.9% drank alcohol during pregnancy; 18 (36.7% reported increased cigarette consumption when drinking; 25 (51.0% had smoked flavored cigarettes; and 12 (24.5% had smoked a narghile. Among the 61 pregnant women evaluated, television was the most widely available and favorite form of electronic media (in 85.2%, as well as being the form most preferred (by 49.2%. CONCLUSIONS: Among pregnant women, active smoking, passive smoking, and alternative forms of tobacco consumption appear to be highly prevalent, and such women seem to possess little knowledge about the consequences of tobacco use. Educational programs that include information about the consequences of all forms of tobacco use, employing new and effective formats tailored to this particular population, should be developed, in order to promote

  9. Preventing smoking during pregnancy: the importance of maternal knowledge of the health hazards and of the treatment options available.

    Science.gov (United States)

    Bertani, André Luís; Garcia, Thais; Tanni, Suzana Erico; Godoy, Irma

    2015-01-01

    To examine the pattern of tobacco use and knowledge about tobacco-related diseases, as well as to identify popular types of electronic media, in pregnant women, in order to improve strategies for the prevention or cessation of smoking among such women. A cross-sectional study involving 61 pregnant women, seen at primary care clinics and at a university hospital, in the city of Botucatu, Brazil. For all subjects, we applied the Hospital Anxiety and Depression Scale. For subjects with a history of smoking, we also applied the Fagerström Test for Nicotine Dependence, and we evaluated the level of motivation to quit smoking among the current smokers. Of the 61 pregnant women evaluated, 25 (40.9%) were smokers (mean age, 26.4 ± 7.4 years), 24 (39.3%) were former smokers (26.4 ± 8.3 years), and 12 (19.8%) were never-smokers (25.1 ± 7.2 years). Thirty-nine women (63.9%) reported exposure to passive smoking. Of the 49 smokers/former smokers, 13 (26.5%) were aware of the pulmonary consequences of smoking; only 2 (4.1%) were aware of the cardiovascular risks; 23 (46.9%) believed that smoking does not harm the fetus or newborn infant; 21 (42.9%) drank alcohol during pregnancy; 18 (36.7%) reported increased cigarette consumption when drinking; 25 (51.0%) had smoked flavored cigarettes; and 12 (24.5%) had smoked a narghile. Among the 61 pregnant women evaluated, television was the most widely available and favorite form of electronic media (in 85.2%), as well as being the form most preferred (by 49.2%). Among pregnant women, active smoking, passive smoking, and alternative forms of tobacco consumption appear to be highly prevalent, and such women seem to possess little knowledge about the consequences of tobacco use. Educational programs that include information about the consequences of all forms of tobacco use, employing new and effective formats tailored to this particular population, should be developed, in order to promote smoking prevention and cessation among

  10. Adherence to intermittent preventive treatment for malaria with sulphadoxine-pyrimethamine and outcome of pregnancy among parturients in South East Nigeria

    Directory of Open Access Journals (Sweden)

    Onyebuchi AK

    2014-04-01

    Full Text Available Azubike Kanario Onyebuchi,1 Lucky Osaheni Lawani,2 Chukwuemeka Anthony Iyoke,3 Chukwudi Robinson Onoh,1 Nwabunike Ekene Okeke4 1Department of Obstetrics and Gynecology, Federal Teaching Hospital, Abakaliki, Nigeria; 2School of Postgraduate Studies, Department of Community Medicine, University of Nigeria; 3Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Enugu, Nigeria; 4Department of Obstetrics and Gynecology, Mile Four Catholic Hospital, Abakaliki, Nigeria Background: Intermittent preventive treatment of malaria for pregnant women (IPTp is a very important strategy for the control of malaria in pregnancy in malaria-endemic tropical countries, where mosquito bites easily occur during evening outdoor activities. Issues related to provision, cost, and acceptability may affect the use of IPTp in some developing countries. The aim of the study was to assess the uptake and adherence to sulphadoxine-pyrimethamine-based intermittent preventive treatment of malaria during pregnancy and the relationship of IPTp use to pregnancy outcomes in two major obstetric centers in South East Nigeria. Methods: This was a prospective descriptive study involving women who received antenatal and delivery services. All recruited women were followed-up from booking until delivery, and statistical analysis was done with Epi Info version 7. Results: A total of 516 parturients were studied. The mean gestational age at booking was 21.8±6.9 weeks while the mean number of antenatal visits throughout the pregnancy was 5.5±3.1. The rate of uptake of at least one dose of prescribed IPTp was 72.1% (367/516. Of the 367 who took prescribed IPTp, adherence to second doses of IPTp was 59.7% (219/367, and only 4.9% (18/367 took a third dose. Clinical malaria occurred in 85% (127/149 of women who did not receive IPTp at all compared to 20.5% of those who received at least one dose of IPTp. All those who had clinical malaria despite IPTp had only one

  11. The clinical profile of women with stable ischaemic heart disease in Spain. More effort is needed in secondary prevention. SIRENA study.

    Science.gov (United States)

    Gámez, J M; Ripoll, T; Barrios, V; Anguita, M; Pedreira, M; Madariaga, I

    2016-01-01

    Cardiovascular diseases are the leading cause of death for women, especially ischaemic heart disease, which is still considered a man's disease. In Spain, there are various registries on ischaemic heart disease, although none are exclusively for women. The objectives of the SIRENA study were to describe the clinical profile of women with ischaemic heart disease treated in cardiology consultations, to estimate its prevalence of cardiovascular risk factors and understand its clinical management. A multicentre observational study was conducted with a sample of 631 women with stable ischaemic heart disease, consecutively included during cardiology consultations. Forty-one researchers from all over Spain participated in the study. The mean age was 68.5 years. The clinical presentation was in the form of acute coronary syndrome in up to 67.2% of the patients. The prevalence of cardiovascular risk factors was high (77.7% of the patients had hypertension, 40.7% had diabetes and 68% had dyslipidaemia), with 30.7% having uncontrolled hypertension, 78.4% having LDL-cholesterol levels higher than 70mg/dL and 49.2% having HbA1c levels greater than 7%. The considerable majority of the patients underwent optimal medical treatment with antiplatelet agents, beta-blockers, renin-angiotensin-aldosterone system blockers and hypolipidaemic agents. Coronary angiography was performed for 88.3% of the patients, and 63.4% underwent percutaneous coronary intervention. Women with stable ischaemic heart disease in Spain initially present some form of acute coronary syndrome and a high prevalence of inadequately controlled cardiovascular risk factors, despite undergoing optimal medical therapy. A high percentage of these women undergo coronary revascularisation. Increased efforts are required for secondary prevention in women with stable ischaemic heart disease. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  12. Insecticide-treated nets for the prevention of malaria in pregnancy: a systematic review of randomised controlled trials.

    Directory of Open Access Journals (Sweden)

    Carol Gamble

    2007-03-01

    Full Text Available BACKGROUND: Protection from malaria with insecticide-treated bednets (ITNs during pregnancy is widely advocated, but evidence of benefit has been inconsistent. We undertook a systematic review of randomised trials. METHODS AND FINDINGS: Three cluster-randomised and two individually randomised trials met the inclusion criteria; four from Africa (n = 6,418 and one from Thailand (n = 223. In Africa, ITNs compared to no nets increased mean birth weight by 55 g (95% confidence interval [CI] 21-88, reduced low birth weight by 23% (relative risk [RR] 0.77, 95% CI 0.61-0.98, and reduced miscarriages/stillbirths by 33% (RR 0.67, 0.47-0.97 in the first few pregnancies. Placental parasitaemia was reduced by 23% in all gravidae (RR 0.77, 0.66-0.90. The effects were apparent in the cluster-randomised trials and the one individually randomised trial in Africa. The trial in Thailand, which randomised individuals to ITNs or untreated nets, showed reductions in anaemia and fetal loss in all gravidae, but not reductions in clinical malaria or low birth weight. CONCLUSIONS: ITNs used throughout pregnancy or from mid-pregnancy onwards have a beneficial impact on pregnancy outcome in malaria-endemic Africa in the first few pregnancies. The potential impact of ITNs in pregnant women and their newborns in malaria regions outside Africa requires further research.

  13. Teen Pregnancy Prevention.

    OpenAIRE

    Rebecca A. Maynard; Amy Johnson

    2001-01-01

    Reports on the national evaluation of Title V abstinence education programs, focusing on 1) the need for scientifically rigorous research to improve future policies and practices, 2) ways in which federal support for abstinence education has changed local approaches to reducing teen sexual activity, and 3) what the national evaluation will contribute to the knowledge base.

  14. Teen Pregnancy Prevention

    OpenAIRE

    Melissa Schettini Kearney

    2001-01-01

    Reports on the national evaluation of Title V abstinence education programs, focusing on 1) the need for scientifically rigorous research to improve future policies and practices, 2) ways in which federal support for abstinence education has changed local approaches to reducing teen sexual activity, and 3) what the national evaluation will contribute to the knowledge base.

  15. Prevent Infections in Pregnancy

    Science.gov (United States)

    ... parasite. Learn more about toxoplasmosis . Stay away from wild or pet rodents and their droppings. Have a pest control professional get rid of pests in or around your home. If you have a pet rodent, like a hamster or guinea pig, have someone else care for it until after ...

  16. A community-based delivery system of intermittent preventive treatment of malaria in pregnancy and its effect on use of essential maternity care at health units in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K; Bygbjerg, I C; Magnussen, Pascal

    2007-01-01

    Community delivery of intermittent preventive treatment of malaria in pregnancy (IPTp) is one potential option that could mitigate malaria in pregnancy. However, there is concern that this approach may lead to complacency among women with low access to essential care at health units. A non...... approaches. Data on care-seeking practices before and after the intervention were collected. The majority of women with the new approaches accessed IPTp in the second trimester and adhered to two doses of sulfadoxine/pyrimethamine (SP) (1404/2081; 67.5%). Antenatal care (four recommended visits) increased...... from 3.4% (27/805) to 56.8% (558/983) (Pcare for malaria at health units increased from 16.7% (128/767) to 36.0% (146/405) (P

  17. ACE2 activation by xanthenone prevents leptin-induced increases in blood pressure and proteinuria during pregnancy in Sprague-Dawley rats.

    Science.gov (United States)

    Ibrahim, Hisham Saleh; Froemming, Gabrielle Ruth Anisah; Omar, Effat; Singh, Harbindar Jeet

    2014-11-01

    This study investigates the effect of ACE2 activation on leptin-induced changes in systolic blood pressure (SBP), proteinuria, endothelial activation and ACE2 expression during pregnancy in Sprague-Dawley rats. Pregnant rats were given subcutaneous injection of either saline, or leptin, or leptin plus xanthenone (ACE2 activator), or xanthenone (XTN) alone. SBP, serum ACE, ACE2, endothelin-1, E-selectin and ICAM-1 levels were estimated; also their gene expressions were determined in the kidney and aorta respectively. Compared to control, SBP was higher in the leptin-only treated group (Pleptin-only treated rats (Pleptin-only treated rats when compared to controls (Pleptin administration during pregnancy significantly increases SBP, proteinuria, endothelial activation, but decreases ACE2 level and expression. These effects are prevented by concurrent administration of xanthenone.

  18. Supply-related drivers of staff motivation for providing intermittent preventive treatment of malaria during pregnancy in Tanzania: evidence from two rural districts

    Directory of Open Access Journals (Sweden)

    Mubyazi Godfrey M

    2012-02-01

    Full Text Available Abstract Background Since its introduction in the national antenatal care (ANC system in Tanzania in 2001, little evidence is documented regarding the motivation and performance of health workers (HWs in the provision of intermittent preventive treatment of malaria during pregnancy (IPTp services in the national ANC clinics and the implications such motivation and performance might have had on HWs and services' compliance with the recommended IPTp delivery guidelines. This paper describes the supply-related drivers of motivation and performance of HWs in administering IPTp doses among other ANC services delivered in public and private health facilities (HFs in Tanzania, using a case study of Mkuranga and Mufindi districts. Methods Interviews were conducted with 78 HWs participating in the delivery of ANC services in private and public HFs and were supplemented by personal communications with the members of the district council health management team. The research instrument used in the data collection process contained a mixture of closed and open-ended questions. Some of the open-ended questions had to be coded in the form that allowed their analysis quantitatively. Results In both districts, respondents acknowledged IPTp as an essential intervention, but expressed dissatisfaction with their working environments constraining their performance, including health facility (HF unit understaffing; unsystematic and unfriendly supervision by CHMT members; limited opportunities for HW career development; and poor (HF infrastructure and staff houses. Data also suggest that poor working conditions negatively affect health workers' motivation to perform for ANC (including IPTp services. Similarities and differences were noted in terms of motivational factors for ANC service delivery between the HWs employed in private HFs and those in public HFs: those in private facilities were more comfortable with staff residential houses, HF buildings, equipment

  19. A randomized clinical trial of exercise during pregnancy to prevent gestational diabetes mellitus and improve pregnancy outcome in overweight and obese pregnant women.

    Science.gov (United States)

    Wang, Chen; Wei, Yumei; Zhang, Xiaoming; Zhang, Yue; Xu, Qianqian; Sun, Yiying; Su, Shiping; Zhang, Li; Liu, Chunhong; Feng, Yaru; Shou, Chong; Guelfi, Kym J; Newnham, John P; Yang, Huixia

    2017-04-01

    Obesity and being overweight are becoming epidemic, and indeed, the proportion of such women of reproductive age has increased in recent times. Being overweight or obese prior to pregnancy is a risk factor for gestational diabetes mellitus, and increases the risk of adverse pregnancy outcome for both mothers and their offspring. Furthermore, the combination of gestational diabetes mellitus with obesity/overweight status may increase the risk of adverse pregnancy outcome attributable to either factor alone. Regular exercise has the potential to reduce the risk of developing gestational diabetes mellitus and can be used during pregnancy; however, its efficacy remain controversial. At present, most exercise training interventions are implemented on Caucasian women and in the second trimester, and there is a paucity of studies focusing on overweight/obese pregnant women. We sought to test the efficacy of regular exercise in early pregnancy to prevent gestational diabetes mellitus in Chinese overweight/obese pregnant women. This was a prospective randomized clinical trial in which nonsmoking women age >18 years with a singleton pregnancy who met the criteria for overweight/obese status (body mass index 24≤28 kg/m(2)) and had an uncomplicated pregnancy at exercise or a control group. Patients did not have contraindications to physical activity. Patients allocated to the exercise group were assigned to exercise 3 times per week (at least 30 min/session with a rating of perceived exertion between 12-14) via a cycling program begun within 3 days of randomization until 37 weeks of gestation. Those in the control group continued their usual daily activities. Both groups received standard prenatal care, albeit without special dietary recommendations. The primary outcome was incidence of gestational diabetes mellitus. From December 2014 through July 2016, 300 singleton women at 10 weeks' gestational age and with a mean prepregnancy body mass index of 26.78 ± 2.75 kg/m(2

  20. Sub-optimal delivery of intermittent preventive treatment for malaria in pregnancy in Nigeria: influence of provider factors

    Directory of Open Access Journals (Sweden)

    Onoka Chima A

    2012-09-01

    Full Text Available Abstract Background The level of access to intermittent preventive treatment for malaria in pregnancy (IPTp in Nigeria is still low despite relatively high antenatal care coverage in the study area. This paper presents information on provider factors that affect the delivery of IPTp in Nigeria. Methods Data were collected from heads of maternal health units of 28 public and six private health facilities offering antenatal care (ANC services in two districts in Enugu State, south-east Nigeria. Provider knowledge of guidelines for IPTp was assessed with regard to four components: the drug used for IPTp, time of first dose administration, of second dose administration, and the strategy for sulphadoxine-pyrimethamine (SP administration (directly observed treatment, DOT. Provider practices regarding IPTp and facility-related factors that may explain observations such as availability of SP and water were also examined. Results Only five (14.7% of all 34 providers had correct knowledge of all four recommendations for provision of IPTp. None of them was a private provider. DOT strategy was practiced in only one and six private and public providers respectively. Overall, 22 providers supplied women with SP in the facility and women were allowed to take it at home. The most common reason for doing so amongst public providers was that women were required to come for antenatal care on empty stomachs to enhance the validity of manual fundal height estimation. Two private providers did not think it was necessary to use the DOT strategy because they assumed that women would take their drugs at home. Availability of SP and water in the facility, and concerns about side effects were not considered impediments to delivery of IPTp. Conclusion There was low level of knowledge of the guidelines for implementation of IPTp by all providers, especially those in the private sector. This had negative effects such as non-practice of DOT strategy by most of the providers

  1. Preventing unintended pregnancies and improving contraceptive use among young adult women in a rural, Midwestern state: health promotion implications.

    Science.gov (United States)

    Campo, Shelly; Askelson, Natoshia M; Spies, Erica L; Losch, Mary

    2010-05-01

    Despite high rates of unintended pregnancy among women aged 18 to 30 years, little research has been conducted to understand the factors associated with their contraceptive use. Eighteen focus groups were conducted with young adult women (N = 106) who were mostly white, non-Hispanic. Results suggested that contraceptive use was negatively affected by low contraceptive knowledge; use of alcohol; a lack of planning for sex; a misperception of the likelihood of pregnancy; forgetting to use contraceptives; and concerns about side effects, cost, and confidentiality. Women liked the peace of mind that using contraceptives gave them and the benefits of regular periods from some hormonal methods. Implications for reducing unintended pregnancies through interventions are offered.

  2. Teen pregnancy: an update.

    Science.gov (United States)

    McCracken, Katherine A; Loveless, Meredith

    2014-10-01

    To provide clinicians with a review of recent research and clinically applicable tools regarding teen pregnancy. Teen pregnancy rates have declined but still remain a significant problem in the USA. Teen pregnancy prevention was identified by Centers for Disease Control and Prevention as one of its top six priorities, which is increasing research and intervention data. Long-acting contraceptive methods are acceptable to teens and have been shown to reduce teen birth rates. Pregnant teens need special attention to counseling on pregnancy options and reducing risk during pregnancy with regular prenatal care. Postpartum teens should be encouraged and supported to breastfeed, monitored for depression, and have access to reliable contraception to avoid repeat undesired pregnancy. This review highlights important issues for all providers caring for female adolescents and those who may encounter teen pregnancy. Foremost prevention of teen pregnancy by comprehensive sexual education and access to contraception is the priority. Educating patients and healthcare providers about safety and efficacy of long-acting reversible contraception is a good step to reducing undesired teen pregnancies. Rates of postpartum depression are greater in adolescents than in adults, and adolescent mothers need to be screened and monitored for depression. Strategies to avoid another undesired pregnancy shortly after delivery should be implemented.

  3. Pregnant adolescent self-care in the prevention of risk factors of Hypertensive Disorders in Pregnancy (HDP - doi:10.5020/18061230.2007.p173

    Directory of Open Access Journals (Sweden)

    Zélia Maria de Sousa Araújo Santos

    2012-01-01

    Full Text Available Adolescent pregnancy is considered a problem for public health, due to the high mortality related to hypertensive disorders in pregnancy – HDP. This was a descriptive study with the aim of analyzing the pregnant adolescent self-care in the prevention of HDP risk factors. It was carried out in the Nucleus of Integrated Medical Attention – NAMI, in Fortaleza – Ceará, with twenty women from the Dendê Community, taken care of in the prenatal ambulatory of that institution, during the months of September and October, 2005. The data were collected by means of interview. The pregnant adolescents informed precarious socio-economic conditions, low schooling and other risk factors for HDP, beyond the age: black color, familiar history, arterial hypertension (AH, diabetes mellitus, renal illness and emotional conflicts. The knowledge on the prevention of risk factors was restricted to five (25% pregnant adolescents; however it was reduced to fragmented information, and the preventive behaviors related to feeding habit, smoke and alcoholism cessation, and physical exercise. Therefore, it was evidenced among the adolescents the unsatisfactory exercise of self-care activities, aiming at preventing HDP risk factors; that beyond the age, they presented other predisposing factors to this disorders; that they were susceptible to preventive behaviors and/or control, as in the case of chronic-degenerative illnesses – AH and diabetes mellitus. Probably, this behavior was associated to the elementary and fragmented knowledge, and the absence or the deficiency of family participation in health promotion actions, mainly in those inherent to the prenatal follow-up.

  4. Estimating HIV Incidence during Pregnancy and Knowledge of Prevention of Mother-to-Child Transmission with an Ad Hoc Analysis of Potential Cofactors

    Directory of Open Access Journals (Sweden)

    Thomas Obinchemti Egbe

    2016-01-01

    Full Text Available Background. We determined the incidence of HIV seroconversion during the second and third trimesters of pregnancy and ad hoc potential cofactors associated with HIV seroconversion after having an HIV-negative result antenatally. We also studied knowledge of PMTCT among pregnant women in seven health facilities in Fako Division, South West Region, Cameroon. Method. During the period between September 12 and December 4, 2011, we recruited a cohort of 477 HIV-negative pregnant women by cluster sampling. Data collection was with a pretested interviewer-administered questionnaire. Sociodemographic information, knowledge of PMTCT, and methods of HIV prevention were obtained from the study population and we did Voluntary Counselling and Testing (VCT for HIV. Results. The incidence rate of HIV seroconversion during pregnancy was 6.8/100 woman-years. Ninety percent of the participants did not use condoms throughout pregnancy but had a good knowledge of PMTCT of HIV. Only 31.9% of participants knew their HIV status before the booking visit and 33% did not know the HIV status of their partners. Conclusion. The incidence rate of HIV seroconversion in the Fako Division, Cameroon, was 6.8/100 woman-years. No risk factors associated with HIV seroconversion were identified among the study participants because of lack of power to do so.

  5. Clusters of Factors Identify A High Prevalence of Pregnancy Involvement Among US Adolescent Males.

    Science.gov (United States)

    Lau, May; Lin, Hua; Flores, Glenn

    2015-08-01

    The study purpose was to use recursive partitioning analysis (RPA) to identify factors that, when clustered, are associated with a high prevalence of pregnancy involvement among US adolescent males. The National Survey of Family Growth is a nationally representative survey of individuals 15-44 years old. RPA was done for the 2002 and 2006-2010 cycles to identify factors which, when combined, identify adolescent males with the highest prevalence of pregnancy involvement. Pregnancy-involvement prevalence among adolescent males was 6 %. Two clusters of adolescent males have the highest pregnancy-involvement prevalence, at 84-87 %. In RPA, the highest pregnancy-involvement prevalence (87 %) was seen in adolescent males who ever HIV tested, had >4 lifetime sexual partners, reported less than an almost certain chance of feeling less physical pleasure with condom use, had an educational attainment of 4 lifetime sexual partners, reported less than an almost certain chance of feeling less physical pleasure with condom use, had an educational attainment ≥11th grade, were >17 years old, and had their first contraceptive education ≥10th grade, had a pregnancy-involvement prevalence of 84 %. Pregnancy-prevention efforts among adolescent males who have been involved in a pregnancy may need to target risk factors identified in clusters with the highest pregnancy prevalence to prevent subsequent pregnancies in these adolescent males and improve their future outcomes.

  6. Other Considerations for Pregnancy and Breast Cancer

    Science.gov (United States)

    ... Cancer Patient Breast Cancer Patient Breast Cancer Treatment Male Breast Cancer Treatment Breast Cancer Treatment & Pregnancy Breast Cancer Prevention Breast Cancer Screening Health Professional Breast Cancer Treatment Male ... Treatment Breast Cancer Treatment & Pregnancy Breast Cancer Prevention ...

  7. All4You! A Randomized Trial of an HIV, Other STDs, and Pregnancy Prevention Intervention for Alternative School Students

    Science.gov (United States)

    Coyle, Karin K.; Kirby, Douglas B.; Robin, Leah E.; Banspach, Stephen W.; Baumler, Elizabeth; Glassman, Jill R.

    2006-01-01

    This study evaluated All4You!, a theoretically based curriculum designed to reduce sexual risk behaviors associated with HIV, other STDs, and unintended pregnancy among students in alternative schools. The study featured a randomized controlled trial involving 24 community day schools in northern California. A cohort of 988 students was assessed…

  8. The GIG: An Innovative Intervention To Prevent Adolescent Pregnancy and Sexually Transmitted Infection in a Latino Community.

    Science.gov (United States)

    de Anda, Diane

    2002-01-01

    In Los Angeles County, the GIG intervention offers education to adolescents about pregnancy and sexually transmitted infections at a social event geared to the youth culture. Pre- and posttests completed by 609 Latino adolescents indicated an increase in knowledge and attitude changes. Use of peer educators was an important component of program…

  9. Effects of a Teen Pregnancy Prevention Program on Teens' Attitudes toward Sexuality: A Latent Trait Modeling Approach

    Science.gov (United States)

    Thomas, Charles L.; Dimitrov, Dimiter M.

    2007-01-01

    The purpose of this study was to examine the effects of program interventions in a school-based teen pregnancy program on hypothesized constructs underlying teens' attitudes toward sexuality. An important task related to this purpose was the validation of the constructs and their stability from pre- to postintervention measures. Data from 1,136…

  10. Efficacy of malaria prevention during pregnancy in an area of low and unstable transmission: an individually-randomised placebo-controlled trial using intermittent preventive treatment and insecticide-treated nets in the Kabale Highlands, southwestern Uganda.

    Science.gov (United States)

    Ndyomugyenyi, Richard; Clarke, Siân E; Hutchison, Coll L; Hansen, Kristian Schultz; Magnussen, Pascal

    2011-11-01

    Intermittent preventive treatment of malaria during pregnancy (IPTp) and insecticide-treated nets (ITN) are recommended malaria interventions during pregnancy; however, there is limited information on their efficacy in areas of low malaria transmission in sub-Saharan Africa. An individually-randomised placebo-controlled trial involving 5775 women of all parities examined the effect of IPTp, ITNs alone, or ITNs used in combination with IPTp on maternal anaemia and low birth weight (LBW) in a highland area of southwestern Uganda. The overall prevalence of malaria infection, maternal anaemia and LBW was 15.0%, 14.7% and 6.5%, respectively. Maternal and fetal outcomes were generally remarkably similar across all intervention groups (P>0.05 for all outcomes examined). A marginal difference in maternal haemoglobin was observed in the dual intervention group (12.57g/dl) compared with the IPTp and ITN alone groups (12.40g/dl and 12.44g/dl, respectively; P=0.04), but this was too slight to be of clinical importance. In conclusion, none of the preventive strategies was found to be superior to the others, and no substantial additional benefit to providing both IPTp and ITNs during routine antenatal services was observed. With ITNs offering a number of advantages over IPTp, yet showing comparable efficacy, we discuss why ITNs could be an appropriate preventive strategy for malaria control during pregnancy in areas of low and unstable transmission. Copyright © 2011 Royal Society of Tropical Medicine and Hygiene. All rights reserved.

  11. A non-inferiority, individually randomized trial of intermittent screening and treatment versus intermittent preventive treatment in the control of malaria in pregnancy

    DEFF Research Database (Denmark)

    Tagbor, Harry; Cairns, Matthew; Bojang, Kalifa

    2015-01-01

    BACKGROUND: The efficacy of intermittent preventive treatment for malaria with sulfadoxine-pyrimethamine (IPTp-SP) in pregnancy is threatened in parts of Africa by the emergence and spread of resistance to SP. Intermittent screening with a rapid diagnostic test (RDT) and treatment of positive women...... (ISTp) is an alternative approach. METHODS AND FINDINGS: An open, individually randomized, non-inferiority trial of IPTp-SP versus ISTp was conducted in 5,354 primi- or secundigravidae in four West African countries with a low prevalence of resistance to SP (The Gambia, Mali, Burkina Faso and Ghana......-AL performed as well as IPTp-SP. In the absence of an effective alternative medication to SP for IPTp, ISTp-AL is a potential alternative to IPTp in areas where SP resistance is high. It may also have a role in areas where malaria transmission is low and for the prevention of malaria in HIV positive women...

  12. Ambivalence and Pregnancy: Adolescents' Attitudes, Contraceptive Use and Pregnancy

    National Research Council Canada - National Science Library

    Hannah Brückner; Anne Martin; Peter S. Bearman

    2004-01-01

    CONTEXT: It is often argued that adolescents who become pregnant do not sufficiently appreciate the negative consequences, and that prevention programs should target participants' attitudes toward pregnancy. METHODS...

  13. Anti-bacterial activity of intermittent preventive treatment of malaria in pregnancy: comparative in vitro study of sulphadoxine-pyrimethamine, mefloquine, and azithromycin

    Directory of Open Access Journals (Sweden)

    Mombo-Ngoma Ghyslain

    2010-10-01

    Full Text Available Abstract Background Intermittent preventive treatment of malaria with sulphadoxine-pyrimethamine (SP is recommended for the prevention of malaria in pregnancy in sub-Saharan Africa. Increasing drug resistance necessitates the urgent evaluation of alternative drugs. Currently, the most promising candidates in clinical development are mefloquine and azithromycin. Besides the anti-malarial activity, SP is also a potent antibiotic and incurs significant anti-microbial activity when given as IPTp - though systematic clinical evaluation of this action is still lacking. Methods In this study, the intrinsic anti-bacterial activity of mefloquine and azithromycin was assessed in comparison to sulphadoxine-pyrimethamine against bacterial pathogens with clinical importance in pregnancy in a standard microdilution assay. Results SP was highly active against Staphylococcus aureus and Streptococcus pneumoniae. All tested Gram-positive bacteria, except Enterococcus faecalis, were sensitive to azithromycin. Additionally, azithromycin was active against Neisseria gonorrhoeae. Mefloquine showed good activity against pneumococci but lower in vitro action against all other tested pathogens. Conclusion These data indicate important differences in the spectrum of anti-bacterial activity for the evaluated anti-malarial drugs. Given the large scale use of IPTp in Africa, the need for prospective clinical trials evaluating the impact of antibiotic activity of anti-malarials on maternal and foetal health and on the risk of promoting specific drug resistance of bacterial pathogens is discussed.

  14. Examination of the Relationship between Psychosocial Mediators and Intervention Effects in It’s Your Game: An Effective HIV/STI/Pregnancy Prevention Intervention for Middle School Students

    Directory of Open Access Journals (Sweden)

    Elizabeth Baumler

    2012-01-01

    Full Text Available A set of mediation analyses were carried out in this study using data from It’s Your Game. . .Keep It Real (IYG, a successful HIV/STI/pregnancy prevention program. The IYG study evaluated a skill and normbased. HIV/STI/pregnancy prevention program that was implemented from 2004 to 2007 among 907 urban low-income middle school youth in Houston, TX, USA. Analyses were carried out to investigate the degree to which a set of proposed psychosocial measures of behavioral knowledge, perceived self-efficacy, behavioral, and normative beliefs, and perceived risky situations, all targeted by the intervention, mediated the intervention’s effectiveness in reducing initiation of sex. The mediation process was assessed by examining the significance and size of the estimated effects from the mediating pathways. The findings from this study provide evidence that the majority of the psychosocial mediators targeted by the IYG intervention are indeed related to the desired behavior and provide evidence that the conceptual theory underlying the targeted psychosocial mediators in the intervention is appropriate. Two of the psychosocial mediators significantly mediated the intervention effect, knowledge of STI signs and symptoms and refusal self-efficacy. This study suggests that the underlying causal mechanisms of action of these interventions are complex and warrant further analyses.

  15. Long-term outcome of a randomized controlled universal prevention trial through a positive parenting program: is it worth the effort?

    OpenAIRE

    2010-01-01

    Abstract Background Approximately 20% of children experience internalizing or externalizing DSM-IV-TR disorders. This prevalence rate cannot be reduced through treatment only. Effective preventive interventions are therefore urgently needed. The aim of the current investigation is to evaluate the two-year efficacy of the group Triple P parenting program administered universally for the prevention of child behavior problems. Methods Based on their respective preschool, N = 280 families were ra...

  16. Long-term outcome of a randomized controlled universal prevention trial through a positive parenting program: is it worth the effort?

    OpenAIRE

    2010-01-01

    Background Approximately 20% of children experience internalizing or externalizing DSM-IV-TR disorders. This prevalence rate cannot be reduced through treatment only. Effective preventive interventions are therefore urgently needed. The aim of the current investigation is to evaluate the two-year efficacy of the group Triple P parenting program administered universally for the prevention of child behavior problems. Methods Based on their respective preschool, N = 280 families were randomly as...

  17. Long-term outcome of a randomized controlled universal prevention trial through a positive parenting program: is it worth the effort?

    OpenAIRE

    2010-01-01

    Background Approximately 20% of children experience internalizing or externalizing DSM-IV-TR disorders. This prevalence rate cannot be reduced through treatment only. Effective preventive interventions are therefore urgently needed. The aim of the current investigation is to evaluate the two-year efficacy of the group Triple P parenting program administered universally for the prevention of child behavior problems. Methods Based on their respective preschool, N = 280 families were randomly a...

  18. Pregnancy Tests

    Science.gov (United States)

    ... Us Home A-Z Health Topics Pregnancy tests Pregnancy tests > A-Z Health Topics Pregnancy test fact ... To receive Publications email updates Enter email Submit Pregnancy tests If you think you may be pregnant , ...

  19. Ultrasound pregnancy

    Science.gov (United States)

    Pregnancy sonogram; Obstetric ultrasonography; Obstetric sonogram; Ultrasound - pregnancy; IUGR - ultrasound; Intrauterine growth - ultrasound; Polyhydramnios - ultrasound; Oligohydramnios - ultrasound; ...

  20. Urinary tract infection as a preventable cause of pregnancy complications: opportunities, challenges, and a global call to action.

    Science.gov (United States)

    Gilbert, Nicole M; O'Brien, Valerie P; Hultgren, Scott; Macones, George; Lewis, Warren G; Lewis, Amanda L

    2013-09-01

    The urinary tract is a common site of infection in humans. During pregnancy, urinary tract infection (UTI) is associated with increased risks of maternal and neonatal morbidity and mortality, even when the infection is asymptomatic. By mapping available rates of UTI in pregnancy across different populations, we emphasize this as a problem of global significance. Many countries with high rates of preterm birth and neonatal mortality also have rates of UTI in pregnancy that exceed rates seen in more developed countries. A global analysis of the etiologies of UTI revealed familiar culprits as well as emerging threats. Screening and treatment of UTI have improved birth outcomes in several more developed countries and would likely improve maternal and neonatal health worldwide. However, challenges of implementation in resource-poor settings must be overcome. We review the nature of the barriers occurring at each step of the screening and treatment pipeline and highlight steps necessary to overcome these obstacles. It is our hope that the information compiled here will increase awareness of the global significance of UTI in maternal and neonatal health and embolden governments, nongovernmental organizations, and researchers to do their part to make urine screening and UTI treatment a reality for all pregnant women.

  1. Intervención psicoeducativa tutorial en la prevención del embarazo precoz / Tutorial psycho-educative intervention for preventing pregnancy in teenagers

    Directory of Open Access Journals (Sweden)

    Ubillús, S. P

    2016-01-01

    integral system of prevention of adolescent’s pregnancy contributing to the reduction of early pregnancy. It emphasizes the tutorial character on the basis of human rights, gender equality and education of values. The general layout constitutes a framework for sexual education of adolescents by means of tutors and suited to students’ needs contributing to early pregnancy prevention.

  2. Exercise during Pregnancy

    Medline Plus

    Full Text Available ... Preterm labor and premature birth: Are you at risk? Zika virus and pregnancy Folic acid Medicine safety ... defects prevention Learn how to help reduce your risk of some birth defects by getting a preconception ...

  3. Pregnancy - health risks

    Science.gov (United States)

    ... provider before trying to get pregnant. Seeing a prenatal provider before trying to get pregnant or early in the pregnancy can help prevent, or detect and control health risks to the mother and unborn baby ...

  4. Hypertensive Emergencies in Pregnancy.

    Science.gov (United States)

    Olson-Chen, Courtney; Seligman, Neil S

    2016-01-01

    The prevalence of hypertensive disorders in pregnancy is increasing. The etiology and pathophysiology of hypertensive disorders in pregnancy remain poorly understood. Hypertensive disorders are a major cause of maternal and perinatal morbidity and mortality. Treatment of hypertension decreases the incidence of severe hypertension, but it does not impact rates of preeclampsia or other pregnancy complications. Several antihypertensive medications are commonly used in pregnancy, although there is a lack of randomized controlled trials. Severe hypertension should be treated immediately to prevent maternal end-organ damage. Appropriate antepartum, intrapartum, and postpartum management is important in caring for patients with hypertensive disorders.

  5. Prevention

    Science.gov (United States)

    ... Error processing SSI file About Heart Disease & Stroke Prevention Heart disease and stroke are an epidemic in ... secondhand smoke. Barriers to Effective Heart Disease & Stroke Prevention Many people with key risk factors for heart ...

  6. Control beliefs are related to smoking prevention in prenatal care.

    Science.gov (United States)

    Lemola, Sakari; Meyer-Leu, Yvonne; Samochowiec, Jakub; Grob, Alexander

    2013-10-01

    Smoking during pregnancy is one of the most important avoidable health risks for the unborn child. Gynaecologists and midwives play a fundamental role in the prevention of smoking during pregnancy. However, a large number of health care practitioners still do not address smoking in pregnant patients. We examined whether gynaecologists and midwives engage in screening and counselling of pregnant women and conducting interventions to prevent smoking during pregnancy. Further, we examined the role of gynaecologists' and midwives' control beliefs. Control beliefs involve efficacy expectations--the practitioner's confidence in his capacity to conduct prevention efforts adequately--and outcome expectations--the practitioner's expectation that such prevention efforts are successful in general. A total of 486 gynaecologists and 366 midwives completed a questionnaire on screening of smoking, counselling and other interventions they conduct to prevent smoking during pregnancy. Moreover, gynaecologists and midwives rated their control beliefs regarding their influence on pregnant patients' smoking habits. The majority of gynaecologists and midwives reported screening all pregnant patients regarding smoking, explaining the risks and recommending smoking cessation. By contrast, only a minority engages in more extensive prevention efforts. Strong control beliefs were predictive of a higher likelihood of screening and counselling, as well as of engaging in more extensive interventions. The findings point to the importance of strengthening gynaecologists' and midwives' control beliefs by professional education and training on smoking prevention. © 2012 John Wiley & Sons Ltd.

  7. Relationships between the Family Environment and School-Based Obesity Prevention Efforts: Can School Programs Help Adolescents Who Are Most in Need?

    Science.gov (United States)

    Bauer, K. W.; Neumark-Sztainer, D.; Hannan, P. J.; Fulkerson, J. A.; Story, M.

    2011-01-01

    Identifying factors that contribute to students' behavior and weight improvements during school-based obesity prevention interventions is critical for the development of effective programs. The current study aims to determine whether the support and resources that adolescent girls received from their families were associated with improvements in…

  8. Prevention of Mother-to-Child Transmission of HIV in Option B+ Era: Uptake and Adherence During Pregnancy in Western Uganda.

    Science.gov (United States)

    Schnack, Alexandra; Rempis, Eva; Decker, Sarah; Braun, Vera; Rubaihayo, John; Busingye, Priscilla; Tumwesigye, Nazarius Mbona; Harms, Gundel; Theuring, Stefanie

    2016-03-01

    Since 2012, lifelong antiretroviral therapy for all HIV-positive pregnant women ("Option B+") is recommended by WHO for the prevention of mother-to-child transmission of HIV (PMTCT). Many sub-Saharan African countries have since introduced this regimen, but to date, longer-term outcome evaluations are scarce. We conducted an observational study in Fort Portal Municipality, Uganda, to describe uptake and adherence of Option B+ during pregnancy. HIV-positive women approaching antenatal care (ANC) services in two hospitals were enrolled and followed-up at monthly routine ANC visits until delivery. At each visit, next to sociodemographic and clinical data, we assessed drug adherence through pill counts. In total, 124 HIV-positive pregnant women were enrolled in our study; from these, 80.8% had not been aware of their positive serostatus before. Forty-five PMTCT clients (36.3%) never returned to ANC after their first visit. Protective factors (p < 0.05) for immediate loss to care included previous HIV status knowledge, status disclosure before or at first ANC visit, and tertiary education. Among those clients starting Option B+, the median adherence during pregnancy was 95.7% pill intake. Rather low adherence (<80%) was observed in 21.1% of clients, while more than half achieved an adherence level of ≥95%, with 40.8% of all clients being 100% adherent. The cohort's median adherence remained stable throughout the course of pregnancy. Healthcare providers should place high emphasis on individual PMTCT counseling at first ANC encounter, and pay special attention to those women previously unaware of their HIV status. However, after initial uptake, high adherence seems to be feasible for Option B+.

  9. Is a 6-week supervised pelvic floor muscle exercise program effective in preventing stress urinary incontinence in late pregnancy in primigravid women?: a randomized controlled trial.

    Science.gov (United States)

    Sangsawang, Bussara; Sangsawang, Nucharee

    2016-02-01

    The study investigated the effect of a 6-week supervised pelvic floor muscle exercise (PFME) program to prevent stress urinary incontinence (SUI) at 38 weeks' gestation. We conducted a randomized controlled trial into two arms design: one intervention group and one control group, using the randomly computer-generated numbers. A research assistant, who was not involved with care of the participants, randomly drawn up and opened the envelope for each participant to allocate into the intervention group and the control group. The investigators could not be blinded to allocation. Seventy primigravid women who had continent with gestational ages of 20-30 weeks were randomly assigned to participate in the intervention (n=35) and control groups (n=35). The intervention was a supervised 6-week PFME program with verbal instruction and a handbook, three training sessions of 45 min with the main researcher (at 1st, 3rd and 5th week of the program) and self-daily training at home for an overall period of 6 weeks. The control condition was the PFME and the stop test had been trained by the main researcher to all of the participants in the intervention group. The primary outcome was self-reported of SUI, and the secondary outcome was the severity of SUI in pregnant women which comprises of frequency, volume of urine leakage and score of perceived severity of SUI in late pregnancy at 38th weeks of pregnancy. Statistical analysis was performed using Chi-square test, Independent-sample t-test, and Mann-Whitney U-test. Significance P-value was pregnancy. The women who performed PFME program under the training sessions once every two weeks found that the program demands less time, incurs lower costs and possibly offers more motivation to exercise. This 6-week supervised PFME program may be suitable in real clinical situation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Barriers and Facilitators for the Use of a Medical Mobile App to Prevent Work-Related Risks in Pregnancy: A Qualitative Analysis.

    Science.gov (United States)

    Velu, Adeline V; van Beukering, Monique Dm; Schaafsma, Frederieke G; Frings-Dresen, Monique Hw; Mol, Ben Wj; van der Post, Joris Am; Kok, Marjolein

    2017-08-22

    The number of women participating in the labor market in Europe has increased over the last several decades. At the same time, there is growing evidence that certain conditions of employment during pregnancy may have a negative influence on pregnancy outcomes. In order to better inform pregnant women, we aim to develop an app to help assess the health risk as a result of personal and work-related factors and provide personal advice for these women and their health care providers. The aim of this study was to compose a thematic overview of the perceived facilitators and barriers according to pregnant women, medical professionals, and employers for the use of a mobile app in obstetrical care to prevent occupational-related pregnancy complications. Two multidisciplinary focus group meetings with in total 14 participants were conducted with pregnant women, occupational physicians, general practitioners, midwives, obstetricians, and representatives of trade unions and employer organizations. Transcripts were analyzed by qualitatively coding procedures and constant comparative methods. We identified 24 potential facilitators and 12 potential barriers for the use of the app in 4 categories: content of the app, the app as a mean to provide information, ease of use, and external factors. The 3 main facilitators identified were the need for a good interaction between the app and the user, apps were viewed as a more practical source of information, and the information should be understandable, according to the existing guidelines, and well-dosed. The 2 main barriers for use were extensive battery and memory use of the smartphone and sending frequent push notifications. The results of this study are important considerations in the developing process of a medical app implementing a guideline or evidence-based information in practice.

  11. Intermittent Preventive Treatment of Malaria in Pregnancy with Mefloquine in HIV-Negative Women: A Multicentre Randomized Controlled Trial.

    OpenAIRE

    Raquel González; Ghyslain Mombo-Ngoma; Smaïla Ouédraogo; Kakolwa, Mwaka A.; Salim Abdulla; Manfred Accrombessi; Aponte, John J.; Daisy Akerey-Diop; Arti Basra; Valérie Briand; Meskure Capan; Michel Cot; Kabanywanyi, Abdunoor M; Christian Kleine; Peter G Kremsner

    2014-01-01

    Editors' Summary Background Half the world's population is at risk of malaria, a mosquito-borne parasitic disease that kills about 600,000 people every year. Most of these deaths occur among young children in sub-Saharan Africa but pregnant women and their unborn children living in Africa are also very vulnerable to malaria. Infection with malaria during pregnancy can cause severe maternal anemia (reduced red blood cell numbers), stillbirths, and pre-term and low-birthweight babies, and is re...

  12. Venous thromboembolism and pregnancy

    Directory of Open Access Journals (Sweden)

    Maristella D’Uva

    2010-03-01

    Full Text Available Maristella D’Uva1, Pierpaolo Di Micco2, Ida Strina1, Giuseppe De Placido1Department of Obstetrics and Gynecology and Human Reproduction, “Federico II” University of Naples, Naples, Italy; 2Internal Medicine Division, Buonconsiglio Fatebenefratelli Hospital of Naples, Naples, ItalyAbstract: In recent decades, the association between a hypercoagulable state and its causes and adverse pregnancy outcome, in particular recurrent pregnancy loss (RPL has been studied extensively. Although the first studies were focused only on the association between thrombophilia and RPL, subsequent studies underlined also a potential role of antithrombotic treatment to prevent vascular complication such as venous thromboembolism (VTE during pregnancy. Thromboprophylaxis should be considered also for pregnant subjects carriers of molecular thrombophilia or that previously experienced VTE, in order to prevent VTE during pregnancy, while antithrombotic treatment for VTE should be performed during all pregnant periods.Keywords: thrombophilia, venous thromboembolism, recurrent pregnancy loss, factor V Leiden

  13. Hormones in pregnancy

    Directory of Open Access Journals (Sweden)

    Pratap Kumar

    2012-01-01

    Full Text Available The endocrinology of human pregnancy involves endocrine and metabolic changes that result from physiological alterations at the boundary between mother and fetus. Progesterone and oestrogen have a great role along with other hormones. The controversies of use of progestogen and others are discussed in this chapter. Progesterone has been shown to stimulate the secretion of Th2 and reduces the secretion of Th1 cytokines which maintains pregnancy. Supportive care in early pregnancy is associated with a significant beneficial effect on pregnancy outcome. Prophylactic hormonal supplementation can be recommended for all assisted reproduction techniques cycles. Preterm labor can be prevented by the use of progestogen. The route of administration plays an important role in the drug′s safety and efficacy profile in different trimesters of pregnancy. Thyroid disorders have a great impact on pregnancy outcome and needs to be monitored and treated accordingly. Method of locating review: Pubmed, scopus

  14. [Pregnancy in Gaucher disease].

    Science.gov (United States)

    Boufettal, H; Quessar, A; Jeddaoui, Z; Mahdoui, S; Noun, M; Hermas, S; Samouh, N

    2014-05-01

    Gaucher disease is a lysosomal storage disorder due to deficiency of glucocerebrosidase. The association with pregnancy exposes the worsening of the disease and complications of pregnancy and puerperium. We report a case of pregnancy in a woman of 35 years, suffering from Gaucher disease type 1. Pregnancy had a favorable outcome. Complications occurred. They were kept under control. The outcome was favorable. The authors discuss the evolution of the disease during pregnancy and management of complications. They can occur during pregnancy, post-partum and breastfeeding. Support begins with preconception consultation. It involves finding and correcting the biological problems and deficiencies, and management of complications. Genetic counseling is important, it helps prevent inbreeding. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  15. Management of cancer in pregnancy.

    Science.gov (United States)

    Amant, Frédéric; Han, Sileny N; Gziri, Mina Mhallem; Vandenbroucke, Tineke; Verheecke, Magali; Van Calsteren, Kristel

    2015-07-01

    A multidisciplinary discussion is necessary to tackle a complex and infrequent medical problem such as cancer occurring during pregnancy. Pregnancy does not predispose to cancer, but cancers occurring in women of reproductive age are encountered during pregnancy. Ultrasonography and magnetic resonance imaging are the preferred staging examinations, but also a sentinel node staging procedure is possible during pregnancy. Standard cancer treatment is aimed for. Operations can safely be performed during pregnancy, but surgery of genital cancers can be challenging. The observation that chemotherapy administered during the second or third trimester of pregnancy, that is, after the period of organogenesis, has little effect on the long-term outcome of children adds to the therapeutic armamentarium during pregnancy. Cancer treatment during pregnancy adds in the continuation of the pregnancy and the prevention of prematurity.

  16. Winning the Hearts and Minds: Improving U.S. Counter-Radicalization Efforts Through a Study of the United Kingdoms Prevent Strategy

    Science.gov (United States)

    2015-03-01

    travel through air and sea, thus providing a wealth of targets to international terrorists. One key difference between the two 68Thomas Joscelyn...need to be effective from the Internet at their leisure . And, finally, today’s terrorist may be those individuals who have grown up in the very... traveling or resident overseas. It is these connections that highlight the key fact that PREVENT work in the United Kingdom is often dependent on

  17. Progestogens and Pregnancy

    Directory of Open Access Journals (Sweden)

    Schindler AE

    2015-01-01

    Full Text Available Based upon the intensive research by E. Diczfalusy and his scholars with the concept of the “feto-placental-unit”, the development of diagnostic procedures by hormone measurements in pregnancy, therapeutic and preventive effects of the use of progestogens (progesterone, dydrogesterone, 17-alpha-hydroxyprogesterone caproate were developed and are at present to be further evaluated in order to be used for prevention and treatment of pregnancy disorders such as threatened miscarriage, recurrent (habitual miscarriage, preterm labor and preeclampsia (hypertension in pregnancy.

  18. Making Pono Choices: a collaborative approach to developing a culturally responsive teen pregnancy and sexually transmitted infections prevention curriculum in Hawai'i.

    Science.gov (United States)

    Manaseri, Holly; Uehara, Denise; Roberts, Kelly

    2014-12-01

    The overall extent of evidence-based culturally responsive health education programs targeting ethnic minority groups in Hawai'i is limited. The few that do exist were adapted from models developed with other majority ethnic groups in mind and may not always be appropriate for Native Hawaiian or Pacific Islander youth (Okamoto et al. in J Alcohol Drug Educ 54(1):56-75, 2010; Helm and Baker in J Ethn Cult Divers Soc Work 20(2):131-149, 2011; Po'a-Kekuawela et al. in J Ethn Cult Divers Soc Work 18(3):242-258, 2009). The need for a culturally responsive, evidence-based health curriculum is clear considering the large disparities reported among Hawaiian youth in health, academic achievement, and other identified risk factors. School-based health interventions are an opportunity not only to improve the physical well being of students, but also to increase their ability to learn and succeed in school. The University of Hawai'i at Manoa-Center on Disability Studies (UH-CDS) received a highly competitive grant from the US Office of Adolescent Health to develop a teen pregnancy and sexually transmitted infection (STI) prevention curriculum for Hawai'i middle school youth. The authors will detail a collaborative process that led to a culturally responsive sexual health curriculum for middle school youth designed to meet the rigorous standards of an evidenced-based review and more importantly reduce teen pregnancies and STI transmission.

  19. Supplementation with vitamins C and E during pregnancy for the prevention of preeclampsia and other adverse maternal and perinatal outcomes: a systematic review and metaanalysis.

    Science.gov (United States)

    Conde-Agudelo, Agustín; Romero, Roberto; Kusanovic, Juan Pedro; Hassan, Sonia S

    2011-06-01

    To determine whether supplementation with vitamins C and E during pregnancy reduces the risk of preeclampsia and other adverse maternal and perinatal outcomes. Systematic review and metaanalysis of randomized controlled trials. Nine trials involving a total of 19,810 women were included. Overall, there were no significant differences between the vitamin and placebo groups in the risk of preeclampsia (9.6% vs 9.6%; relative risk, 1.00, 95% confidence interval, 0.92-1.09). Similar results were obtained when subgroup analyses were restricted to women at high risk or low/moderate risk for preeclampsia. Women supplemented with vitamins C and E were at increased risk of developing gestational hypertension and premature rupture of membranes, and decreased risk of abruptio placentae. There were no significant differences between the vitamin and placebo groups in the risk of other adverse maternal or fetal/perinatal outcomes. Supplementation with vitamins C and E during pregnancy does not prevent preeclampsia. Published by Mosby, Inc.

  20. Feasibility and Initial Efficacy Evaluation of a Community-Based Cognitive-Behavioral Lifestyle Intervention to Prevent Excessive Weight Gain During Pregnancy in Latina Women.

    Science.gov (United States)

    Gesell, Sabina B; Katula, Jeffrey A; Strickland, Carmen; Vitolins, Mara Z

    2015-08-01

    About 48 % of US women gain more weight during pregnancy than recommended by the Institute of Medicine (IOM). Excessive gestational weight gain is a major risk factor for obesity in both women and offspring over their lifetimes, and should be avoided. This study was designed to test the feasibility and initial efficacy of a prenatal behavioral intervention in a sample of low-income, predominantly Latina women. The intervention was delivered in groups of 8-10 women in a community recreation center, and structured to reduce the proportion of women who gained weight in excess of IOM guidelines. Recruitment targets were met in 3 months: 135 pregnant women (>10 and lifestyle intervention during pregnancy was feasible in a hard-to-reach, high-risk population of low-income Latina women, and showed efficacy in preventing excessive gestational weight gain. Due to frequently changing work schedules, strategies are needed to either increase attendance at group sessions (e.g., within a group prenatal care format) or to build core skills necessary for behavior change through other modalities.