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Legal Status at the Federal Level of Assisted Human Reproduction in Canada

May 19, 2015 Comments off

Legal Status at the Federal Level of Assisted Human Reproduction in Canada
Source: Library of Parliament

The world’s first “test-tube baby,” the result of fertilizing a human ovum in vitro and transferring the resulting embryo to a woman’s uterus, was born in England in 1978. This achievement followed decades of clinical and laboratory research. It also catalyzed interest in a new area of medical ethics as multiple technological advances, along with their implications for genetics, posed new ethical questions and responsibilities.

This paper provides an overview of the many steps that the Canadian federal government has taken to establish a legislative and regulatory framework for reproductive technologies and related research. This background includes a description of the Royal Commission on New Reproductive Technologies, early attempts at legislation and a discussion of the Assisted Human Reproduction Act, in force since 2004, including its list of prohibited activities. The constitutional challenge to the legislation that was brought by the Attorney General of Quebec and ultimately heard by the Supreme Court of Canada is reviewed. Finally, the federal government’s response to the Supreme Court decision in the form of amendments to the Act is summarized. This paper does not examine how activities related to assisted human reproduction may be regulated by the provinces.

Perspectives on Sexual Health and Function of Recent Male Combat Veterans of Iraq and Afghanistan

May 15, 2015 Comments off

Perspectives on Sexual Health and Function of Recent Male Combat Veterans of Iraq and Afghanistan
Source: Sexual Medicine

Background
U.S. veterans of recent wars in Iraq and Afghanistan may be at greater risk for sexual dysfunction due to injuries, mental health conditions, medications used to treat those conditions, and psychosocial factors.

Objective
To explore the perceptions of recent Veterans about sexual health and dysfunction, contributing factors, its impact and solutions.

Design
Qualitative study.

Participants
Eight men who screened positive for sexual dysfunction at initial presentation to a postdeployment clinic at a Veterans Affairs medical center.

Approach
Patients who screened positive for sexual dysfunction and indicated an interest in participating were contacted and scheduled for an in-person private interview with a researcher. Interviews were semistructured, utilizing open-ended and follow-up probe questions to elicit the individual’s perspective about sexual dysfunction and its cause, impact and solutions. Interviews were recorded, transcribed and analyzed for themes.

Key Results
These heterosexual men discussed a range of sexual dysfunction in their activities including lack of desire, erectile dysfunction, delayed orgasm, premature ejaculation, and distraction. They also discussed the importance of setting or context and changes over time to their sexual health and function. The men shared their ideas about contributory factors, including normal aging, medication side effects, injury and a possible role for combat deployment more generally. Reported solutions for sexual dysfunction included medications, herbal remedies, and new positions and approaches to sexual activity. Participants reported discussing sexual dysfunction with their health-care providers and what was helpful. Finally, the men expressed in their own words the significant impact of sexual dysfunction on their self-perception, their partners, and their relationships.

Conclusions
Sexual dysfunction in recent combat veterans can have important negative effects on their health and relationships. Our findings elucidate perceived contributory factors and preferred solutions, which can be applied by health-care providers to improve the management of sexual dysfunction in these patients.

New Study Examines Human Services for Low-Income and At-Risk LGBT Populations

May 8, 2015 Comments off

New Study Examines Human Services for Low-Income and At-Risk LGBT Populations
Source: Williams Institute (UCLA School of Law) and Mathematica

Despite social and legal progress for lesbian, gay, bisexual, and transgender (LGBT) people in the United States, much about low-income and at-risk LGBT individuals and their participation in federal human service programs remains unknown. In fact, data suggest LGBT people may be disproportionately at risk of poor outcomes related to economic security and social well-being, compared to the general population.

To address this knowledge gap, Mathematica, in partnership with the Williams Institute at UCLA School of Law, conducted an assessment for the U.S. Department of Health and Human Services, Administration for Children and Families (ACF), Office of Planning, Research & Evaluation. The project aims to help identify the current knowledge base and priorities for future research and, ultimately, strengthen services for low-income and at-risk LGBT people.

A report and related issue brief look at LGBT populations’ characteristics and interactions with human services and identify data gaps. The project focused on (1) income support and self-sufficiency programs for low-income families, (2) child welfare programs, and (3) programs for youth—especially services funded by ACF (assistance for runaway and homeless youth, and sexual health education for adolescents). Three additional briefs delve into recommendations for future research in these key

State of the World’s Mothers: The Urban Disadvantage

May 6, 2015 Comments off

State of the World’s Mothers: The Urban Disadvantage
Source: Save the Children

The findings are clear. One of the worst places in the world to be a mother is in an urban slum. The 16th annual State of the World’s Mothers report delves into a comparison of the health disparities between wealthy and poor women and children living in cities around the world. In 2015 more than half of the world’s population lives in cities. Unfortunately, a growing proportion of child deaths are occurring within these cities in urban slums.

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Stressful Life Events Experienced by Women in the Year Before Their Infants’ Births — United States, 2000–2010

May 4, 2015 Comments off

Stressful Life Events Experienced by Women in the Year Before Their Infants’ Births — United States, 2000–2010
Source: Morbidity and Mortality Weekly Report (CDC)

Epidemiologic studies suggest that prenatal stress is associated with preterm birth, low birth weight (1–3), and peripartum anxiety and depressive symptoms (4). The most recent population-based study, assessing trends in stress experienced in the year before an infant’s birth, used 1990–1995 data from 11 states participating in the Pregnancy Risk Assessment Monitoring System (PRAMS) (5). That study found that 64% of women surveyed reported experiencing at least one stressful life event (SLE), although the prevalence declined slightly over the study period. PRAMS data for 2000–2010 were used to examine more recent trends and to determine if the prevalence of SLEs has continued to decrease in the past decade. Additionally, 2010 data were used to determine the extent that maternal demographics and state of residence are associated with SLEs. This report describes the results of those analyses, which found that most women in the sample reported experiencing ≥1 SLEs in the year before their infant’s birth, although the prevalence of experiencing SLEs decreased during 2000–2010. In 2010, based on data from 27 states, 70.2% of women reported ≥1 SLEs. The mean number of SLEs was 1.81, ranging from 1.41 in New York City to 2.26 in Oklahoma. SLEs were most frequently financial. Prevalence of SLEs varied by PRAMS reporting site and maternal demographics. Younger, less educated, unmarried, and Medicaid-covered women had the highest prevalence of SLEs. Public health practitioners and clinicians can use the information on trends and risk factors for SLEs to determine the likelihood that pregnant women might benefit from screening for stressors during pregnancy.

Policy Basics: Special Supplemental Nutrition Program for Women, Infants, and Children

May 4, 2015 Comments off

Policy Basics: Special Supplemental Nutrition Program for Women, Infants, and Children
Source: Center on Budget and Policy Priorities

The Special Supplemental Nutrition Program for Women, Infants, and Children, popularly known as WIC, provides nutritious foods, counseling on healthy eating, breastfeeding support, and health care referrals to more than 8 million low-income women, infants, and children at nutritional risk.

Infants and very young children can face lifelong cognitive and health consequences if they don’t get adequate nourishment. WIC aims to ensure that pregnant women get the foods they need to deliver healthy babies and that those babies are well-nourished as they grow into toddlers.

An extensive body of research over the last few decades shows that WIC works. WIC participation contributes to healthier births, more nutritious diets, improved infant feeding practices, less anemia, and more preventive health care.

Mathematica Conducts First Study of WIC Agencies’ Breastfeeding Policies and Practices

May 2, 2015 Comments off

Mathematica Conducts First Study of WIC Agencies’ Breastfeeding Policies and Practices
Source: Mathematica Policy Research

The psychological, economic, and overall health benefits of breastfeeding, for both infants and mothers, are well documented. However, many barriers to breastfeeding exist, including cultural norms, lack of family support, employment and lack of health services, particularly among disadvantaged and low-income populations. In an effort to overcome those barriers, breastfeeding promotion and support is a core component of the nutrition services provided by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) to low-income women and children up to five years of age.

A new In Focus and Research Recap video from Mathematica Policy Research’s WIC Breastfeeding Policy Inventory Study (WIC BPI) for the U.S. Department of Agriculture, Food and Nutrition Service, shed light on the comprehensive range of policies and practices that WIC agencies use to promote breastfeeding. The first study to examine WIC agencies’ breastfeeding policies, the WIC BPI surveyed 90 state-level agencies and nearly 1,800 local WIC agencies.

Mathematica found the following:

+ Nearly 80 percent of local WIC agencies had at least one staff member with a breastfeeding credential.
+ Two-thirds of local WIC agencies operated a peer counseling program to provide breastfeeding support. Peer counseling has been shown to be one of the most successful approaches to encourage mothers to breastfeed.
+ Nearly all local agencies collected information about WIC participants’ breastfeeding initiation, duration, and exclusivity, but only about half collected information about intensity.

The WIC BPI lays the groundwork for future research on how agencies’ breastfeeding policies and practices evolve over time and which practices are associated with better breastfeeding rates for different populations. Helping the USDA understand WIC agencies’ currently breastfeeding measurement capabilities can contribute to the design of future breastfeeding reporting systems.

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