Voluntary Interruption Research Articles

Voluntary interruption of pregnancy in Colombia: Contributions to the debate from public mental health

Voluntary interruption of pregnancy in Colombia: Contributions to the debate from public mental health

Salud Sexual: La gran olvidada del ámbito educativo

Introduction: Sexual education is a priority in the psychosocial development of people and there is a significant deficit both in the school and the Institutes and Universities, in the informative-preventive field, as in sexual counseling and in the intervention of Clinical Sexology and / or Sexual Medicine that are taught, already as indispensable subjects in the Faculties of Medicine of Europe, USA, Canada and Latin America. In Spain we have more than a decade with a Master of Sexology that is taught at universities (Almeria, Health Sciences (UAL, Seville, Extremadura) Other University as Camilo Jose Cela, (at the INCISEX, the Institute of Sexological Sciences ) has been teaching sexology for more than 4 decades, and today sex education occupies spaces in many schools and in many families.The physical and emotional need to touch us, to give us pleasure and intimacy, accompanies us from birth to We die, to all people, sexuality is reworked throughout a life.Objective: To value sexual education in our area. Method: Analysis of rights and duties in education applied to the sexual field in our country. The OMS. defines Sexual Health in 1975. The W.A.S. in the XIII World Congress of Sexology, (29.06.1997 establishes the Universal Declaration of Sexual Rights or Declaration of Valencia) and updates them in 2014.Results: There has been an increase in Spanish legislation in the field of sex education, however, an important deficit is still detected that logically limits the formation and development of people. For a National Sexual Health Plan, and implementation of the March 2010 Law. Organic Law 2/2010, of arch 3, on sexual and reproductive health and the voluntary interruption of pregnancy. https://www.boe.es/buscar/pdf/2010/BOE-A-2010-3514- consolidado.pdfConclusions: Sexual education should be increased in schools, institutes and universities that facilitate the personal development of all people, from infancy to old age.

Investigation on silent bacterial infections in specimens from pregnant women affected by spontaneous miscarriage.

Miscarriage is one of the main complications occurring in pregnancy. The association between adverse pregnancy outcomes and silent bacterial infections has been poorly investigated. Ureaplasma parvum and urealiticum, Mycoplasma genitalium and hominis and Chlamydia trachomatis DNA sequences have been investigated by polymerase chain reaction (PCR) methods in chorionic villi tissues and peripheral blood mononuclear cells (PBMCs) from females with spontaneous abortion (SA, n = 100) and females who underwent voluntary interruption of pregnancy (VI, n = 100). U. parvum DNA was detected in 14% and 15% of SA and VI, respectively, with a mean of bacterial DNA load of 1.3 × 10-1 copy/cell in SA and 2.8 × 10 -3 copy/cell in VI; U. urealiticum DNA was detected in 3% and 2% of SA and VI specimens, respectively, with a mean DNA load of 3.3 × 10-3 copy/cell in SA and 1.6 × 10-3 copy/cell in VI; M. hominis DNA was detected in 5% of SA specimens with a DNA load of 1.3 × 10-4 copy/cell and in 6% of VI specimens with a DNA load of 1.4 × 10-4 copy/cell; C. trachomatis DNA was detected in 3% of SA specimens with a DNA load of 1.5 × 10-4 copy/cell and in 4% of VI specimens with a mean DNA load of 1.4 × 10-4 copy/cell. In PBMCs from the SA and VI groups, Ureaplasma spp, Mycoplasma spp and C. trachomatis DNAs were detected with a prevalence of 1%-3%. Bacteria were investigated, for the first time, by quantitative real-time PCR (qPCR) in chorionic villi tissues and PBMCs from women affected by SA and VI. These data may help to understand the role and our knowledge of the silent infections in SA.

Posttraumatic Stress Disorder as a Significant Correlate of Voluntary Antiretroviral Treatment Interruption in Adult HIV-Infected Patients Followed up in French Hospitals: Data From the ANRS-VESPA2 National Survey.

Although antiretroviral treatment (ART) no longer requires 100% adherence, voluntary treatment interruption (VTI) still may have a negative impact on virologic success. Previous studies have shown that posttraumatic stress disorder (PTSD) is more prevalent in HIV-infected patients than in the general population. However, no study has yet investigated the relationship between PTSD and VTI. We analyzed this relationship using data from a French national survey representative of HIV-infected adults followed up in hospitals. A total of 3,022 HIV-infected adults participated in the ANRS-VESPA2 survey (April 2011-January 2012) and answered a face-to-face questionnaire that included the Composite International Diagnostic Interview Short-Form to diagnose PTSD and assess sociobehavioral variables such as VTI. Multivariable logistic regression models were used to study the relationship between PTSD and VTI. Among the 2,768 ART-treated participants with available data for both PTSD screening and ART interruption (study sample), prevalence of PTSD was 13.3%, and 7.2% of individuals reported VTI during the previous month. After adjustment for being a female Sub-Saharan African immigrant and reporting harmful alcohol consumption (Alcohol Use Disorders Identification Test score ≥ 8), lifetime PTSD was found to be independently associated with VTI (adjusted odds ratio [95% CI] = 1.64 [1.07-2.53], P = .025). PTSD is highly prevalent in HIV-infected patients followed up in French hospitals and is a significant predictor of VTI. PTSD is a psychiatric disorder that is still underdiagnosed and undertreated in many countries despite its negative consequences on health behaviors. As there is evidence of effective treatment for PTSD, HIV care providers need to be trained in screening for this disorder.

Las ambivalencias de la interrupción voluntaria del embarazo

La interrupción voluntaria del embarazo es una opción con la que cuenta la mujer, si una vez embarazada se ve inmersa en alguna causal que le facilite terminar, de manera consciente, la gestación en curso. Si la mujer ejecuta los requisitos para las circunstancias en que se puede solicitar la interrupción voluntaria del embarazo, esta debe contar con la asesoría en opciones de terminación de la gestación; con lo cual se le ratifican sus derechos a la autonomía y la autodeterminación reproductiva. No obstante, también se le debe informar que aun estando inmersa en alguna causal puede optar por continuar con la gestación y asumir la crianza o dar el producto del embarazo en adopción.

Estado actual de la salud afectivo-sexual de las personas con diversidad funcional en españa.

El objetivo de este estudio es aportar conocimiento sobre el estado actual de la Salud Afectivo Sexual de las personas con Diversidad Funcional (PDF) en el territorio español a partir de las consultas a la Asesoria de ANSSYD. Para ello se realiza un diseño cuantitativo descriptivo transversal, donde los sujetos de estudio sonPDF, familiares y profesionales que contactan con la asesoría. Los datos se obtienena partir de las consultas realizadas via online, telefónica durante 6 años. (Octubre de 2012 a Octubre de 2017).Para el registro de los datos se ha utilizado el paquete Microsofot Office 2010. Resultados: Se atienden 1856 consultas de familiares, cuidadores y PDF, centrando sus dudas en las siguientes variables: Embarazo, desconocimiento sobre sexualidad, disfunciones sexuales, coito, orientación sexual, juguetes eróticos, asistencia sexual (AS), desconocimiento de las funciones del AS equiparándolo a terapia. En referencia a las consultas planteadas por profesionales se recogen 1758 consultas centrando sus dudas en las siguientes variables: anticoncepción, desconocimiento y dudas sobre sexualidad en PDF, Masturbación, coito, orientación sexual, juguetes eróticos, asistencia sexual (AS), fantasías y Derechos sexuales y Reproductivos de las PDF Conclusiones: Es patente el aumento de consultas recibidas en la Asesoría que se centran en intereses informativos sobre sexualidad que no han sido cubiertos por los profesionales a su servicio. La falta de desarrollo de la Ley Orgánica 2/2010 de 3 de Marzo de Salud Sexual y Reproductiva e interrupción voluntaria del embarazo tiene como consecuencia el incumplimiento de la misma con las consecuencias de falta de formación e información . La escasez de formación en sexualidad y más concretamente de sexualidad y diversidad funcional en los profesionales para afrontar las necesidades de las PDF y la carencia de programas y materiales educativos adaptados a las necesidades especiales de las PDF, dificulta el aprendizaje a este colectivo, a sus familias y a los profesionales en relación a la sexualidad, impidiendo a estas personas el empoderamiento a través de ella. Han de tomarse medidas urgentes por parte de las Administraciones, de los Ministerios de Educación y Sanidad y de los profesionales que ostentan cargos de gestión, para que en el siglo XXI los problemas de visualización y de reconocimiento de la afectividad y sexualidad en las PDF dejen de producirse.

Managing fertile women under lithium treatment: the challenge of a Teratology Information Service.

The objective of the present study is to review the literature regarding the management of fertile patients under lithium treatment for bipolar disorder and to report the experience of our Teratology Information Service over the past thirteen years in managing women treated with lithium during preconception, pregnancy and breastfeeding. This research focuses on a selective review of the literature and a retrospective survey has been carried out on fertile women under lithium treatment who called our service at A. Gemelli University Hospital in Rome from May 2002 to December 2015. A total of 140 women under lithium treatment called our TIS. A complete follow-up has been performed on 34 patients: 29 called during pregnancy and 5 called during preconception. None of the patients called during breastfeeding, while half of the patients were taking concomitant drugs during pregnancy. One major cardiac malformation (hypoplastic left heart syndrome) has been reported. No minor malformations have been detected. Twenty-one patients delivered a living child, with one premature neonate. Two patients underwent voluntary interruption of pregnancy and six patients had early spontaneous abortion. In one patient, intrauterine growth retardation occurred, but with no adverse neonatal outcomes. Four neonates experienced transient respiratory distress at birth. Two children developed mild to severe language delay, but normal motor development. Lithium treatment in fertile women is a very delicate topic, where risks and benefits of discontinuing therapy when women plan to become pregnant should be accurately evaluated. Thorough peri-conceptional counselling is crucial for the outcome of pregnancy and for maternal health status during preconception, gestation and breastfeeding.

Direct evidence of viral infection and mitochondrial alterations in the brain of fetuses at high risk for schizophrenia

There is increasing evidences that favor the prenatal beginning of schizophrenia. These evidences point toward intrauterine environmental factors that act specifically during the second pregnancy trimester producing a direct damage of the brain of the fetus. The current available technology doesn't allow observing what is happening at cellular level since the human brain is not exposed to a direct analysis in that stage of the life in subjects at high risk of developing schizophrenia. Methods. In 1977 we began a direct electron microscopic research of the brain of fetuses at high risk from schizophrenic mothers in order to finding differences at cellular level in relation to controls.A study of the gametes or the amniotic fluid cells in women at risk of having a schizophrenic offspring is considered. Of being observed the same alterations that those observed previously in the cells of the brain of the studied foetuses, it would intend to these women in risk of having a schizophrenia descendant, previous information of the results, the voluntary medical interruption of the pregnancy or an early anti HSV1 viral treatment as preventive measure of the later development of the illness. Schizophrenia is a severe neurodevelopmental disorder with genetic and environmental etiologies. Prenatal viral/bacterial infections and inflammation play major roles in the genesis of schizophrenia.

Progressive Uruguay: Between Sovereignty and Biocontrol

Since having carried out a long ethnographic research process with extremely poor drug users, I outline the paths of treatment provided by different Uruguayan State sectors to citizens who are marginally situated: extremely impoverished, imprisoned or problematic drug users. On the one hand, Uruguay is a country considered liberal and progressive, during the last years laws that regulate the access to cannabis, same-sex marriage and voluntary interruption of pregnancy have been passed. On the other hand, the country has a tutelary and watchful facet that demands obedience from subjects in order to actually habilitate their exercise of some rights and the access to care. Likewise other countries do, the Uruguayan State debates whether to submit to sovereignty threats, or to the practicing of contemporary forms of biopower control.

Large scale good quality mesenchymal stem cell production: Indonesian experience

There is increasing evidences that favor the prenatal beginning of schizophrenia. These evidences point toward intrauterine environmental factors that act specifically during the second pregnancy trimester producing a direct damage of the brain of the fetus. The current available technology doesn't allow observing what is happening at cellular level since the human brain is not exposed to a direct analysis in that stage of the life in subjects at high risk of developing schizophrenia. Methods. In 1977 we began a direct electron microscopic research of the brain of fetuses at high risk from schizophrenic mothers in order to finding differences at cellular level in relation to controls.A study of the gametes or the amniotic fluid cells in women at risk of having a schizophrenic offspring is considered. Of being observed the same alterations that those observed previously in the cells of the brain of the studied foetuses, it would intend to these women in risk of having a schizophrenia descendant, previous information of the results, the voluntary medical interruption of the pregnancy or an early anti HSV1 viral treatment as preventive measure of the later development of the illness. Schizophrenia is a severe neurodevelopmental disorder with genetic and environmental etiologies. Prenatal viral/bacterial infections and inflammation play major roles in the genesis of schizophrenia.

Knowledge and practice of Togolese women concerning cervical cancer.

To identify the determinants of the knowledge and practice of Togolese women concerning cervical cancer. This cross-sectional study with a descriptive and analytical focus took place in Togo during the four-month period from May to August 2016 and surveyed women aged 18 to 60 living in the Lomé municipal area for at least 12 months. Sampling of the intervention zones was based on reasoned choice depending on the availability of health structures in the area. Once in the field, the health centers were taken as landmarks, and the individual living closest to the center was the first to be surveyed. The snowball technique was adopted. All data were entered and analyzed by Epi Info version 7.2 and Excel 2016. Bivariate (chi-2) and multivariate (logistic regression) analyses were performed to study potential associations between different variables. We interviewed 207 women, whose mean age was 31.7 years (±10.7). Of the 65.5% (95% CI = 58.6-72.0) of respondents who had heard of cervical cancer, 2.9% (95% CI = 0.6-5.2) knew HPV infection is a risk factor. Of the 70 women seeing a gynecologist-obstetrician, only 23.2% (95% CI = 13.0-34.9) had been screened for cervical cancer. More than half of our respondents had a history (96.1%) of voluntary interruption of pregnancy, or miscarriage, infection and gynecological and obstetric surgery. The proportion of women with both an obstetric history and screening was 9.7% (95% CI = 6.0-14.5). The leading reason for not being screened among our respondents was a fear of pelvic examination (frequency: 11.9%, 95% CI = 7.2-16.5). Women seeing a gynecologist and/or with a high educational level are more likely to be informed about cervical cancer and have a greater likelihood of screening.

“Eu Fiz um Aborto”: Os Blogues como Espaços de Manifesto

Resumo Neste artigo, procuramos refletir sobre a experiência da interrupção voluntária da gestação das mulheres no Brasil e o modo como essa experiência se relaciona com os direitos sexuais e reprodutivos das mulheres. Para isso, realizamos uma pesquisa no espaço virtual, que foi utilizado como meio documental para a obtenção de relatos de mulheres que passaram pela experiência do aborto. Ao costurar os fragmentos dessas histórias, construímos saberes sobre a experiência de abortar, a qual, segundo a nossa leitura, pode ser dividida em três momentos temporais: momento da decisão pelo aborto; momento após a decisão e momento de cuidado. As mulheres, ao contarem suas histórias reprodutivas, falam de todas as mulheres, do tornar-se mulher no contexto histórico, social e cultural em que vivemos.

Health care students at an Argentinean school of medicine: are they well prepared to provide quality sexual and reproductive health services?

Objectives: The aim of our study was to assess what students of the University of Buenos Aires School of Medicine learn about sexual and reproductive health (SRH) and rights, focusing particularly on their knowledge of accessibility to contraception and abortion legislation. Methods: In this cross-sectional study, self-administered, anonymous questionnaires were administered to 760 first year students and to 695 final year students from different fields of study (medicine, midwifery, nursing, radiology, nutrition, speech therapy and physiotherapy) between 2011 and 2013. Students’ knowledge of SRH was measured according to six variables: contraceptive methods, accessibility to contraception, emergency contraception, legislation on surgical contraception, legislation on voluntary interruption of pregnancy, and HIV transmission and prevention. Their level of knowledge was categorised as low, basic, medium or high, according to their responses. Results: We observed higher levels of knowledge in final year students compared with first year students. Those with basic level knowledge or higher were doubled in most of the variables. However, when analysed in detail per field of study, the differences were not so marked. It is important that medical, midwifery and nursing students receive formal education in SRH topics. Conclusions: Our investigation revealed important deficiencies in knowledge in core topics of SRH care among soon-to-be health care providers that could represent serious barriers to health and rights for the Argentinean population in the near future. Thus, there is an urgent need to improve the teaching of SRH care.

A simple model of HIV epidemic in Italy: The role of the antiretroviral treatment.

In the present paper we propose a simple time-varying ODE model to describe the evolution of HIV epidemic in Italy. The model considers a single population of susceptibles, without distinction of high-risk groups within the general population, and accounts for the presence of immigration and emigration, modelling their effects on both the general demography and the dynamics of the infected subpopulations. To represent the intra-host disease progression, the untreated infected population is distributed over four compartments in cascade according to the CD4 counts. A further compartment is added to represent infected people under antiretroviral therapy. The per capita exit rate from treatment, due to voluntary interruption or failure of therapy, is assumed variable with time. The values of the model parameters not reported in the literature are assessed by fitting available epidemiological data over the decade 2003÷2012. Predictions until year 2025 are computed, enlightening the impact on the public health of the early initiation of the antiretroviral therapy. The benefits of this change in the treatment eligibility consist in reducing the HIV incidence rate, the rate of new AIDS cases, and the rate of death from AIDS. Analytical results about properties of the model in its time-invariant form are provided, in particular the global stability of the equilibrium points is established either in the absence and in the presence of infected among immigrants.

A Survey on Data Mining Technologies for Decision Support System of Maternal Care Domain

Data mining is becoming gradually popular and vital to healthcare organizations, finding useful patterns in complex data, transforming it into beneficial information for decision making. The latest statistics of WHO and UNICEF show that annually approximately 55,000 women die due to preventable pregnancy-related causes in India. Therefore, the current focus of health care researchers is to promote the use of e-health technology in developing countries. There have been many studies that apply data mining methods to recognize solutions for health care limitations in obstetrics and maternal care domain. Some of those studies included high risk pregnancy, prediction of preeclampsia, Identification of obstetric risk factors, discovering the risk factors of preterm birth, and predicting risk pregnancy in women performing voluntary interruption of pregnancy. This paper provides a survey and analysis of data mining methods that have been applied to maternal care domain.

Interrupciones voluntarias del embarazo en adolescentes del medio rural: evolución desde 2008

ObjectiveThe incidence of voluntary pregnancy interruption (VPI) is an important indicator, first of unwanted pregnancies, and secondly the effectiveness of Family Planning Clinics. We attempt to determine the adolescent voluntary pregnancy interruption rate in our area and compare it with that found in previous years. MethodA cross-sectional and multicentre study was conducted using data from VPI requests collected in the Primary Care Health District of Estepa, over two different periods, both 21 months, separated by six years (Between May 2006 and January 2008, and from October 2012 to June 2014). The variables collected included locality of origin, and date and place of birth. ResultsThere were 67 VPI requests in the first period, of which 25.37% were foreigners. Although the number of VPI is smaller (60) in the second period, there is an increase in the percentage of foreigners who request it, 36.66%). If we take the age limit of being adolescent as under 21 years, in the first period studied there were 33 women who applied VPI (50.76% of VPI processed), of whom 9 were under 19, and 15.15% were foreigners. In the second period, PVI was requested by 20 adolescents (33.3% of VPI processed), of whom 13 were under 19 years old, and 35% were foreigners. ConclusionsThe prevalence of VPI requests in all the age groups and adolescents is much lower than that observed in the rest of Spain. We observed a significant increase in adolescent VPI requests compared with previous years, and it is particularly significant in foreign adolescents.

Obstetrician-gynecologist's attitudes toward legal and voluntary interruption of pregnancy

Objective In 2006, Colombia decriminalized legal and voluntary interruption of pregnancy (LVIP) in situations in which: the mother's life or health is in danger, fetal life-threatening malformations exist, or when the pregnancy is the result of rape, non-consensual artificial insemination, or incest. Difficulties reported in the introduction of this practice are related to the attitudes of doctors. Obstetricians usually are the doctors who attend these cases; an assessment of their attitudes regarding this situation was performed. Method Qualitative and quantitative. Self-administered anonymous questionnaires were applied to obstetricians who work in Bucaramanga on January 30th, 2012. Subsequently, semi-structured interviews were performed to a sub-sample of that population. Results Important deficits in the knowledge of legislation regarding LVIP and conscientious objection were found. Life-threatening for mother, and fetal life-threatening malformations were the most accepted items and the most likely to be practiced. The item "pregnancy secondary to rape" although accepted, was the most objected to for reasons of conscience. Conclusion The inclusion of gestational age as a regulatory criterion for LVIP was suggested by the interviewees. The joint effect of the findings mentioned above, and both administrative and logistic difficulties in the Colombian health system constitute barriers for patients in cases of LVIP.

Report of the procedure of voluntary interruption of pregnancy at a university hospital in Uruguay.

ABSTRACTOBJECTIVE To describe the constitution and operation of a voluntary interruption of pregnancy team of a university hospital, from the outlook of the mental health team.METHODS In this case study, the following aspects were analyzed: 1) historical background; 2) implementation of Law 18,897 of October 22, 2012; and 3) functioning of the program at the Hospital de Clínicas of the Facultad de Medicina (Universidad de la República, Uruguay), taking into account three dimensions: structure, process, and results.RESULTS Between December 2012 and November 2013, a total of 6,676 voluntary interruptions of pregnancy were reported in Uruguay; out of these, 80 were conducted at the Hospital de Clínicas. The patients’ demographic data agreed with those reported at the national level: Of the total patients, 81.0% were aged over 19 years; 6.2% decided to continue with the pregnancy; and only 70.0% attended the subsequent control and received advice on contraception.CONCLUSIONS In its implementation year in Uruguay, we can assess the experience as positive from the point of view of women’s health. Our experience as a mental health team at the Hospital de Clínicas, inserted into the multidisciplinary voluntary interruption of pregnancy team, is in the process of assessment and reformulation of practices.

Voluntary pregnancy interruption, listening to the psychologist

Professional support from a psychologist can enable women who wish to, to understand the personal motives for their choice to abort.

The First Preliminary Reference of the French Constitutional Court to the CJEU:Révolution de Palaisor Revolution in French Constitutional Law?

A preliminary reference on the part of the Constitutional Council was, in several respects, not to be expected. It was debatable whether it would consider itself as a “court or tribunal” within the meaning of Article 267 of the Treaty on the Functioning of the European Union (TFEU) and, therefore, whether it would refer a case to the European Court of Justice (CJEU) at all. The French constitutional court could also have resorted to theacte clairdoctrine so as to escape from their obligation to ask for the interpretive guidance of the CJEU. However, the main reason why a reference was not awaited by legal actors lies in the limited jurisdiction of the Constitutional Council. Until the introduction in 2008 of the so-called QPC, that is,question prioritaire de constitutionnalité(the Priority Preliminary Reference mechanism on issues of constitutionality), theConseil constitutionnelhad a very limited jurisdiction compared to its European counterparts. Its main mission was to assess the conformity of parliamentary bills and treaties with the Constitution and only with the Constitution. Its review could only take placeex ante, between the adoption and the promulgation of a text. By opening the way to anex postreview of statutes with regard to the rights and freedoms guaranteed by the Constitution, the QPC brought about a major change in the French adjudication system: statutes are no longer immune from constitutional challenge once they are in force. However, treaties and other international or European commitments are no parameters of constitutional review. TheConseil constitutionnelmade this clear in 1975 and never seriously changed track, despite minor qualifications to the rule. In their seminalIVGruling on the Voluntary Interruption of Pregnancy Act, they held that it was not up to them to review the compatibility of bills with treaties, in spite of Article 55 of the Constitution. Consequently, the task of the constitutional judges does not go beyond the assessment of laws with regard to the Constitution. This is the main reason that explains why, on the face of it, theConseil constitutionnelwas unlikely to refer a case to the CJEU. Why would it seek the interpretation or ask for the review of a European text if this text is immaterial for it and if the yardstick of its examination is the Constitution and only the Constitution? Yet, it happened. For the first time, theConseilreferred a case to the CJEU on 4 April 2013. Although this is undoubtedly a major legal breakthrough, we will see in due course that this is probably more arévolution de palaisthan a true revolution in French constitutional law.