Background: Despite increased recognition of the need for sexual and reproductive health and rights in humanitarian settings, evidence focusing on mainstreaming reproductive health services such as maternal, neonatal ...Background: Despite increased recognition of the need for sexual and reproductive health and rights in humanitarian settings, evidence focusing on mainstreaming reproductive health services such as maternal, neonatal mortality, human immunodeficiency virus transmission and unsafe abortion still remains inadequate. The ability to understand the magnitude of the needs and highlight existing gaps is supported by improved data which is critical to informing effective policies, programming and funding decisions. The purpose of this report is to present the results of a research prioritization exercise on sexual and reproductive health and rights services in humanitarian settings for the WHO Africa region for the next three years. Methods: We adapted the Child Health and Nutrition Research Initiative method in three phases. Experts from the region participated in an online survey to identify key areas for research in sexual and reproductive health and rights. To identify potential areas for research, the experts ensured answerability, effectiveness, deliverability, equity and potential impact of the questions. The research areas they identified were reviewed by World Health Organization technical team from headquarters. In a meeting of 67 participants, the questions were subjected to further review and analysis. Using a modified for scoring criteria, the questions were scored and ranked to provide the top ten priority questions to address sexual and reproductive health and rights services in humanitarian settings. Results: A list of 21 priority research questions on sexual and reproductive health and rights services in humanitarian settings were scored and ranked. Top ten priorities research questions were identified. Those that scored highly by scoring 30 points out of the possible maximum of 30 include: “determining the prevalence and associated factors of unwanted pregnancies and abortions performed in emergency and humanitarian settings”, “evidence on gender-based violence in humanitarian situations and its associated factors” and “defining an optimal model for coordinating sexual and reproductive health and rights interventions and responses in crisis situations”. Conclusions: Top ten research priorities in sexual and reproductive health and rights services in humanitarian settings were identified. The priority research areas have the potential to identify the best areas for programming of services in humanitarian settings. It is our hope that the identified research areas will be prioritized to support programming of services in humanitarian settings based on scientific evidence.展开更多
Background: The use of mobile phones continues to rise rapidly in the provision of health related services. Many countries have adopted the use of mobiles to provide sexual and reproductive health and rights and espec...Background: The use of mobile phones continues to rise rapidly in the provision of health related services. Many countries have adopted the use of mobiles to provide sexual and reproductive health and rights and especially among the adolescents where specific messages are tailored for various audiences with specific messages. The purpose of this paper is to present the results of a research priority setting exercise on mHealth and innovative strategies. Methods: We adapted Child Health and Nutrition Research Initiative methodology to identify and set research priorities on mHealth and innovative strategies that respond to sexual and reproductive health and rights services. General potential research questions were gathered online from multiple stakeholders in the region and sent for consolidation consolidated to technical experts in World Health Organization headquarters. The second phase involved a meeting with experts to review and thematically analyze the questions list of 33 questions producing a list of 22 research questions. The questions were scored against a six point criteria and ranked accordingly. Ten top priority research questions were identified. Results: Lists of 33 priority research questions for mHealth and innovative strategies were proposed for discussions by 67 stakeholders. The questions were reviewed, scored and ranked in a technical meeting by experts. The highest ranking questions at 87% include evaluation of mHealth for data management and sexual and reproductive health and rights decision making, assessment of innovative local financing techniques to support community based sexual reproductive health and rights and evaluation of the role of mobile technologies in referral and counter referral. Conclusions: Information and communication technology is developing drastically and has a great potential in improving health especially in sexual and reproductive health and rights service delivery. This potential must be demonstrated with more relevant and quality research on mHealth and innovative strategies priorities identified.展开更多
Background: Many policy makers deliberating on comprehensive sexual and reproductive health and rights services need reliable evidence to make choices that benefit women, adolescents, children and the wider society. W...Background: Many policy makers deliberating on comprehensive sexual and reproductive health and rights services need reliable evidence to make choices that benefit women, adolescents, children and the wider society. While universal health coverage discourse provides an opportunity to expand access through evidence based interventions, many gaps exist. Research prioritization has proved to be very helpful in identifying relevant areas especially in constrained resource settings. The purpose of this paper is to present the results of the World Health Organization Africa Region research prioritization for sexual and reproductive health and rights. These priorities hope to guide the region for the next three years. Methods: We used the Child Health and Nutrition Research Initiative approach to identify priority questions among many potential areas for research prioritization on sexual and reproductive health and rights. The implementation process was organized in three phases. The first phase involved sending out an online survey to various experts with experience in sexual and reproductive health rights. These questions were received by a technical team from World Health Organization headquarters for review. 634 questions were identified for potential research and grouped into 12 themes. The second phase involved experts who reviewed the questions. The team merged questions with duplications, removed the questions that were out of scope and finally refined the wordings. In the final phase, experts worked in groups to score and rank top ten priority questions for each of the 12 thematic areas. Results: A list of 120 priority questions for sexual and reproductive health and rights were prioritized by 67 participants drawn from 16 organizations. Most of the priority research questions (45%) focused on the theme of gender-based violence, 35% prioritized services in sexual and reproductive health and rights in humanitarian settings while 15% prioritized preventing unsafe abortion. 5% of the participants prioritized cervical cancer prevalence, prevention and treatment as a thematic area out of the questions in the top 20 research priority questions. Conclusions: Key priority research questions in sexual and reproductive health and rights were identified around five themes. The priority list will be of significance to World Health Organization regional Office for Africa and her stakeholders for the next three years.展开更多
Objective:To determine the effects of textile dyeing industrial wastewater on the hematological parameters and reproductive health including histoarchitecture of male gonad(testes)of mice.Methods:Twenty-four Swiss alb...Objective:To determine the effects of textile dyeing industrial wastewater on the hematological parameters and reproductive health including histoarchitecture of male gonad(testes)of mice.Methods:Twenty-four Swiss albino mice at 4-weeks old were divided into four groups(n=6 per group).Mice of group 1 supplied with normal drinking water were served as the control group.Mice of group 2,3 and 4 were supplied normal drinking water mixed with textile dyeing wastewater at 5%,10% and 20% concentration,respectively.After completing 24 weeks of treatment,different hematological profile,weight of testes,gonadosomatic index(GSI),sperm concentration and morphology were measured.Moreover,histopathological changes in testes were examined.Results:Hematocrit value and hemoglobin concentrations were decreased in all groups of wastewater-treated mice compared to the control group.Likewise,weight of testes,GSI and sperm concentration were decreased significantly in wastewater-treated mice in comparison to the control group.The percentage of morphologically healthy epididymal sperm was significantly reduced in wastewater-treated mice.Histopathological examination revealed degenerative changes in seminiferous tubules,a smaller number of spermatogenic cells,elongation of seminiferous tubules and degenerative changes of seminiferous tubules in wastewater-treated mice.Conclusions:Textile dyeing wastewater has harmful effects on hematological profile and reproductive health of male mice.展开更多
Stromal vascular fraction(SVF)is a complex mixture derived from adipose tissue,consisting of a variety of cells.Due to its potential for tissue repair,immunomod-ulation,and support of angiogenesis,SVF represents a pro...Stromal vascular fraction(SVF)is a complex mixture derived from adipose tissue,consisting of a variety of cells.Due to its potential for tissue repair,immunomod-ulation,and support of angiogenesis,SVF represents a promising frontier in regenerative medicine and offers potential therapy for a range of disease condi-tions.In this article,we delve into the mechanisms through which SVF exerts its effects and explore its potential applications in treating both male and female reproductive disorders,including erectile dysfunction,testicular injury,stress urinary incontinence and intrauterine adhesion.展开更多
As global greenhouse gases continue rising,the urgency of more ambitious action is clearer than ever before.China is the world’s biggest emitter of greenhouse gases and one of the countries affected most by climate c...As global greenhouse gases continue rising,the urgency of more ambitious action is clearer than ever before.China is the world’s biggest emitter of greenhouse gases and one of the countries affected most by climate change.The evidence about the impacts of climate change on the environment and human health may encourage China to take more decisive action to mitigate greenhouse gas emissions and adapt to climate impacts.展开更多
Objective:The aim of this study was to investigate the health expectations(HEs)in patients with diabetes and the factors affecting it using an integrative systematic review.Methods:A comprehensive literature search wa...Objective:The aim of this study was to investigate the health expectations(HEs)in patients with diabetes and the factors affecting it using an integrative systematic review.Methods:A comprehensive literature search was conducted in databases including PubMed,Scopus,Science Direct,Google Scholar,ProQuest,CINAHL,SID,Iran Doc,and Magiran without time limitation using related keywords.The systematic literature search was performed using a guide provided by York University.Results:From a total of 1883 articles,17 of them finally met the eligibility criteria.According to the findings of this study,HE of diabetic patients was included in four categories:“dynamism,”“consequentialism,”“comprehensive care,”and“access to facilities.”Also,these expectations can be influenced by various factors,including“developments in societies,”“changing the conditions of health care systems,”and“individual factors.”Conclusions:Health professionals should pay attention to the expectations of diabetic patients who are involved in complex disease conditions and consider meeting them as a key factor in providing patient-centered care,improving health outcomes,and patient satisfaction.展开更多
Objective The study aim was to investigate the effects of exposure to multiple environmental organic pollutants on cardiopulmonary health with a focus on the potential mediating role of oxidative stress.Methods A repe...Objective The study aim was to investigate the effects of exposure to multiple environmental organic pollutants on cardiopulmonary health with a focus on the potential mediating role of oxidative stress.Methods A repeated-measures randomized crossover study involving healthy college students in Beijing was conducted. Biological samples, including morning urine and venous blood, were collected to measure concentrations of 29 typical organic pollutants, including hydroxy polycyclic aromatic hydrocarbons(OH-PAHs), bisphenol A and its substitutes, phthalates and their metabolites, parabens,and five biomarkers of oxidative stress. Health assessments included blood pressure measurements and lung function indicators.Results Urinary concentrations of 2-hydroxyphenanthrene(2-OH-PHE)(β = 4.35% [95% confidence interval(CI): 0.85%, 7.97%]), 3-hydroxyphenanthrene(β = 3.44% [95% CI: 0.19%, 6.79%]), and 4-hydroxyphenanthrene(4-OH-PHE)(β = 5.78% [95% CI: 1.27%, 10.5%]) were significantly and positively associated with systolic blood pressure. Exposures to 1-hydroxypyrene(1-OH-PYR)(β = 3.05% [95% CI:-4.66%,-1.41%]), 2-OH-PHE(β = 2.68% [95% CI:-4%,-1.34%]), and 4-OH-PHE(β = 3% [95% CI:-4.68%,-1.29%]) were negatively associated with the ratio of forced expiratory volume in the first second to forced vital capacity. These findings highlight the adverse effects of exposure to multiple pollutants on cardiopulmonary health. Biomarkers of oxidative stress, including 8-hydroxy-2'-deoxyguanosine and extracellular superoxide dismutase, mediated the effects of multiple OH-PAHs on blood pressure and lung function.Conclusion Exposure to multiple organic pollutants can adversely affect cardiopulmonary health.Oxidative stress is a key mediator of the effects of OH-PAHs on blood pressure and lung function.展开更多
Polycyclic aromatic hydrocarbons(PAHs)are a typical class of persistent organic pollutants that is ubiquitous worldwide.Previous animal studies suggested that PAHs had adverse effects on female reproduction.However,th...Polycyclic aromatic hydrocarbons(PAHs)are a typical class of persistent organic pollutants that is ubiquitous worldwide.Previous animal studies suggested that PAHs had adverse effects on female reproduction.However,the human data regarding relationship of PAHs exposure with women reproductive health,such as ovarian dysfunction,are scarce.In this case-control study,the associations of serum levels of PAHs with the risk of premature ovarian failure(POF)and reproductive hormones in Chinese women were investigated,with recruiting 157 POF patients and 217 healthy women.The serum levels of 12 types of PAHs,as well as reproductive hormones,including follicle-stimulating hormone,luteinizing hormone and anti-mullerian hormone,were determined.In the logistic regression models,most individual PAH congeners showed significantly positive correlations with the risk of POF(p<0.05),except for fluorine and pyrene.Benzo(a)pyrene(BaP),as the most carcinogenic PAH congener,was observed to be significantly positively associated with the risk of POF.After adjustment for age,body mass index,educational levels and household income,per one-unit increase in the log-transformed BaP concentration was significantly correlated with 2.191-fold increased risk of POF(OR=2.191,95%CI:1.634-2.938,p<0.05).To the best of our knowledge,this is the first study to report an association between internal exposure levels of PAHs and the increased risk of POF in women.展开更多
In this study, we aimed to determine the effects of hepatitis B virus （HBV） infection on sperm quality and the outcome of assisted reproductive technology （ART）. A total of 916 men （457 HBV-positive and 459 HBV-n...In this study, we aimed to determine the effects of hepatitis B virus （HBV） infection on sperm quality and the outcome of assisted reproductive technology （ART）. A total of 916 men （457 HBV-positive and 459 HBV-negative） seeking fertility assistance from January 2008 to December 2009 at the Women＇s Hospital in the School of Medicine at Zhejiang University were analysed for semen parameters. Couples in which the men were hepatitis B surface antigen （HBsAg）-seropositive were categorized as HBV-positive and included 587 in vitrofertilisation （IVF） and 325 intracytoplasmic sperm injection （ICSI） cycles from January 2004 to December 2009; negative controls were matched for female age, date of ova retrieval, ART approach used （IVF or ICSI） and randomized in a ratio of 1：1 according to the ART treatment cycles （587 for IVF and 325 for ICSI）. HBV-infected men exhibited lower semen volume, lower total sperm count as well as poor sperm motility and morphology （P〈O.05） when compared to control individuals. Rates of two-pronuclear （2PN） fertilisation, high-grade embryo acquisition, implantation and clinical pregnancy were also lower among HBV-positive patients compared to those of HBV-negative patients after ICSI and embryo transfer （P〈0.05）; IVF outcomes were similar between the two groups （P〉0.05）. Logistic regression analysis showed that HBV infection independently contributed to increased rates of asthenozoospermia and oligozoospermia/azoospermia （P〈0.05） as well as decreased rates of implantation and clinical pregnancy in ICSI cycles （P〈0.05）. Our results suggest that HBV infection in men is associated with poor sperm quality and worse ICSI and embryo transfer outcomes but does not affect the outcome of IVF and embryo transfer.展开更多
Objective To examine the influence of China＇s economic reforms on population health and regional mortality rates.Methods Longitudinal study measuring the mortality trends and their regional variations.Using data from...Objective To examine the influence of China＇s economic reforms on population health and regional mortality rates.Methods Longitudinal study measuring the mortality trends and their regional variations.Using data from the three most recent national censuses,we used the model life table to adjust the mortality levels within the population for each census,and to calculate life expectancy.We then examined the variation in patterns of mortality and population health by economic status,region and gender from 1980-2000.Results Life expectancy varied with economic status,province,and gender.Results showed that,although life expectancy in China had increased overall since the early 1980s,regional differences became more pronounced.Life expectancy for populations who live in the eastern coastal provinces are greater than those in the western regions.Conclusion Differences in life expectancy are primarily related to differences in regional economic development,which in turn exacerbate regional health inequalities.Therefore,it is necessary to improve economic development in less developed regions and to improve health policies and the public health system that address the needs of everyone.展开更多
The discovery of artemisinin is significant because not only it is an innovative new drug,but also its treatment of malaria has saved millions of lives worldwide,especially in(tropical)developing countries.The 2015 No...The discovery of artemisinin is significant because not only it is an innovative new drug,but also its treatment of malaria has saved millions of lives worldwide,especially in(tropical)developing countries.The 2015 Nobel Prize in Physiology or Medicine was awarded to Professor Tu You-You,a scientist from China,who made this seminal discovery.Malaria is one of the most prevalent展开更多
Objectives 1） To explore the relationship between RTIs and mental status of Naxi women; 2） to compare the differences of depression ＆ anxiety between Naxi women who have and not have RTIs; and 3） to put forward so...Objectives 1） To explore the relationship between RTIs and mental status of Naxi women; 2） to compare the differences of depression ＆ anxiety between Naxi women who have and not have RTIs; and 3） to put forward some suggestions for improving Naxi women＇s reproductive health in psychological point of view. Methods A cross-sectional survey was adopted, 280 married Naxi female volunteers who aged above 20 years old were selected by cluster random sampling from the two selected villages of Lugufu Township of Yanyuan county in Sichuan. Two self-reporting scales, CES-D and SAS were used for assessment of depression and anxiety of the subjects. Results The facts of mental status of Sichuan Naxi women brook no optimism. Among 280 Naxi reproductive age women who were investigated in current study, only 74 （26.4%） have no depression symptoms, and 116 （41.4%） have no anxiety symptoms. For the study population, the average total scores （TS） of CES-D was 20.1, and the average total index scores （TIS） of SAS was 50.2, and both of them were above a minimum value doubted to have symptoms. There were big differences of both average TS of CES-D and TIS of SAS between Naxi women who have and not have RTIs. Further analysis revealed that RTI was a main risk factor influencing women＇s mental status （OR = 16. 043 for depression, and OR = 12.954 for anxiety）. In addition, Naxi women＇s depression and anxiety were related to order births （≤2, OR=3.149, 95% CI： 1.228, 8.076）, sex debut was younger （≤17, OR=3.043, 95% CI： 1.895, 4.884）, and multiple pregnancy （≥ 3, OR=2.728, 95% CI： 1.990, 4.173）, etc. Conclusion For improving Naxi women＇s mental status, a pressing matter of the moment is for local medical persons to gain the knowledge about mental health and the diagnosis and treatment levels of psychological disorders. At the same time, pssychological counselling should become a main activity of reproductive health services.展开更多
Invasive genetic screening of pre-implantation embryos via biopsied trophectoderm(TE)cells has been in use for more than 20 years,while its benefits in selecting euploid embryos remain controversial.Recent advances in...Invasive genetic screening of pre-implantation embryos via biopsied trophectoderm(TE)cells has been in use for more than 20 years,while its benefits in selecting euploid embryos remain controversial.Recent advances in the ability to process embryonic cell-free DNA(cfDNA)from blastocoel fluid(BF)and spent culture media(SCM)of blastocysts in a manner similar to that of a biopsied TE sample provide a potential alternative holding great promise for obtaining cytogenetic information of the embryos without intrusive biopsy of traditional biopsy-based pre-implantation genetic testing(PGT).Several studies have reported even higher diagnostic accuracy in non-invasive PGT(ni-PGT)than conventional PGT.However,there are still several technical challenges to be overcome before ni-PGT can be accepted as a reliable genomic information source of embryo.In this review,we have summarized the emergence and current state of ni-PGT,and discussed our own perspectives on their limitations and future prospect.There is still a long way to go before truly wide clinical application of ni-PGT.展开更多
Background: Infertility is a unique medical challenge that can have health behavioral consequence on infertile women including lack of self-esteem, depression, anxiety, fertility problem in infertile couples. The aim ...Background: Infertility is a unique medical challenge that can have health behavioral consequence on infertile women including lack of self-esteem, depression, anxiety, fertility problem in infertile couples. The aim of this study was to evaluate correlation between self-efficacy and health behaviors scales in infertile women. Methods: A cross sectional study was conducted on 89 infertile women with mild to moderate depression (Beck scores 10 - 47) who were recruited from Fatemeh Zahra Infertility and Reproductive Health Research Center. All participants completed Self-efficacy Inventory (ISE) and other health behavioral scales (e.g., the Beck Depression Inventory (BDI), Cattle Anxiety Scale (CAS), Fertility Problem Infertility (FPI), and GHQ). Pearson correlation coefficient and Spearman rho correlation coefficient were used to analyze the data. Variables were included in the study if they had a p-value展开更多
Background: Ministry of Health, Government of India developed the Adolescent Reproductive and Sexual Health (ARSH) strategy and operationalized adolescent health services up to district and sub-district hospital level...Background: Ministry of Health, Government of India developed the Adolescent Reproductive and Sexual Health (ARSH) strategy and operationalized adolescent health services up to district and sub-district hospital level. Objectives: To operationalize adolescent health services at primary health care level in a block of Maharashtra;assess impact of need based interventions on quality of services;and understand potential for scalability in the state. Methods: Adolescent and Youth friendly centers were established at primary health care settings and interventions such as health system strengthening, sensitizing gatekeepers, involving Accredited Social Health Activist (ASHAs), developing inter and intra-sectoral linkages, improving monitoring and evaluation were tested. Results: Over a period of 2009-2014, there was a steady increase in the number of clients attending the Adolescent and Youth Friendly Health Centers (A&YFHCs). Attitude of providers to address adolescents’ needs improved significantly. Successful interventions were networking with schools, colleges and Non Government Organization (NGOs), linkages with HIV program and Integrated Child Development Services (ICDS), and involvement of ASHAs. Conclusions: The study demonstrates that although health system has the primary responsibility of addressing health issues among adolescents;it has limitations in terms of its reach to adolescents and generating demand for services. There is a need to network with education sector, ICDS, NGOs working for adolescent health and development to work as a team and address the multifaceted needs of the adolescents. Such a strategy will be crucial while implementing the recently launched Rashtriya Kishor Swasthya Karyakram— the new national adolescent health programme in India.展开更多
Objective:To identify factors that determine the uptake of in-vitro fertilization(IVF),and to determine the predicting effect of the identified factors on the uptake of IVF among couples attending fertility clinic at ...Objective:To identify factors that determine the uptake of in-vitro fertilization(IVF),and to determine the predicting effect of the identified factors on the uptake of IVF among couples attending fertility clinic at a tertiary health institution in Benin City,Nigeria.Methods:This study adopted a cross-sectional descriptive design.A self-structured questionnaire tested was validated and administered to 250 couples who attended fertility clinic.Data were collected from March 2021 to June 2021 and were analyzed using the Statistical Package for Social Science(SPSS)version 21.Data were presented and interpreted using descriptive statistics and inferential statistics such as Chi-square,univariate statistics and multivariate logistic regression analysis.Results:Among 250 couples,154(61.6%)were willing to adopt IVF.The multivariate logistic regression analysis showed that catholic religion[odds ratio(OR)0.21,95%confident interval(CI)0.54-0.73],family income(OR 1.50,95%CI 1.10-2.00)and age(OR 1.04,95%CI 1.01-1.10)were the major factors that determined the uptake of IVF,with P-value of<0.001,0.018 and 0.031,respectively.Conclusions:The uptake of IVF could be sustained or improved on,if the government should improve on the cost of living for families,and religious leaders need to be encouraged to pass on the information about IVF to their members to be well guided about the possibilities of IVF.展开更多
To understand the HIV/IDS knowledge level and its influential factors among reproductive men in China so as to provide scientific evidence for preventive measures. Methods Cross-sectional survey, system random sample ...To understand the HIV/IDS knowledge level and its influential factors among reproductive men in China so as to provide scientific evidence for preventive measures. Methods Cross-sectional survey, system random sample and constructed questionnaire were used in this study. There were 1 285 male subjects who had filled in anon）,mous questionnaires. Results There were significant differences on the HIV/IDS knowledge level in different counties and different demographic characteristic people. Major inJluential factors inchtded area, urban/rural, marriage, educational level, age, consultation about HIV/AIDS. Conclusion It is necessary to strengthen the training of HIV/AIDS knowledge among reproductive men.展开更多
Objective To systematic review and analyze the practices and effects of integrating post-abortion family planning （PAFP） services into existing health system worldwide in order to inform the future interventions to ...Objective To systematic review and analyze the practices and effects of integrating post-abortion family planning （PAFP） services into existing health system worldwide in order to inform the future interventions to deliver PAFP in China. Methods A systematic search for relevant published and unpublished literature was conducted. Based on a set of criteria, citation and full text were screened, related data were extracted. Findings of included studies were reviewed and analyzed using a textual narrative approach to synthesis. Results A total of 28 studies were included in the synthesis. The studies were published between 1995 and 2008 and covered 20 countries. Some countries were in the stage of piloting post-abortion care （PAC）/PAFP intervention, while others were either from piloting to scaling up or examined how well a pilot PAC/PAFP intervention and resulting improvements were able to be maintained over the long term in the same intervention site. Most studies examined initiatives that were implemented at public sectors from tertiary, secondary to primary health facilities, while a few were imple- mented at private sectors. Efforts of integrating PAFP into existing health system from health system perspectives such as funding the programs, training of trainer （TOT） training or on the job training of physicians and mid-level service provider, expan- sion the range of contraceptive methods available including a few free distribution of contraceptives, improving data collection including cost analysis in a few countries,service guidelines provided to health professionals, supportive supervision at program sites to ensure quality of care, and leadership from government to strengthen PAC/ PAFP service by revising or developing a new national policy. Effects of those intervention programs included that 2 studies decreased abortion rates, 7 studies improved modern contraceptive use, 1 study improved women＇s knowledge on sexual ＆ reproductive health, and 5 studies reported women＇s high satisfaction rate with receiving PAC/PAFP services. Conclusion Each study was conducted within a cultural legal social and religious framework. There might be no single set of best practices that can be put forward as a model to integrate PAFP into existing health system in China. These areas should be taken into account in our future intervention including government＇s optimization and complement to the regulations related to abortion, contraception and PAFP, capacity building for service provider, continuous efforts to improve the quality of PAFP service, and accessibility of multiple contraceptive methods for married as well as unmarried youth.展开更多
文摘Background: Despite increased recognition of the need for sexual and reproductive health and rights in humanitarian settings, evidence focusing on mainstreaming reproductive health services such as maternal, neonatal mortality, human immunodeficiency virus transmission and unsafe abortion still remains inadequate. The ability to understand the magnitude of the needs and highlight existing gaps is supported by improved data which is critical to informing effective policies, programming and funding decisions. The purpose of this report is to present the results of a research prioritization exercise on sexual and reproductive health and rights services in humanitarian settings for the WHO Africa region for the next three years. Methods: We adapted the Child Health and Nutrition Research Initiative method in three phases. Experts from the region participated in an online survey to identify key areas for research in sexual and reproductive health and rights. To identify potential areas for research, the experts ensured answerability, effectiveness, deliverability, equity and potential impact of the questions. The research areas they identified were reviewed by World Health Organization technical team from headquarters. In a meeting of 67 participants, the questions were subjected to further review and analysis. Using a modified for scoring criteria, the questions were scored and ranked to provide the top ten priority questions to address sexual and reproductive health and rights services in humanitarian settings. Results: A list of 21 priority research questions on sexual and reproductive health and rights services in humanitarian settings were scored and ranked. Top ten priorities research questions were identified. Those that scored highly by scoring 30 points out of the possible maximum of 30 include: “determining the prevalence and associated factors of unwanted pregnancies and abortions performed in emergency and humanitarian settings”, “evidence on gender-based violence in humanitarian situations and its associated factors” and “defining an optimal model for coordinating sexual and reproductive health and rights interventions and responses in crisis situations”. Conclusions: Top ten research priorities in sexual and reproductive health and rights services in humanitarian settings were identified. The priority research areas have the potential to identify the best areas for programming of services in humanitarian settings. It is our hope that the identified research areas will be prioritized to support programming of services in humanitarian settings based on scientific evidence.
文摘Background: The use of mobile phones continues to rise rapidly in the provision of health related services. Many countries have adopted the use of mobiles to provide sexual and reproductive health and rights and especially among the adolescents where specific messages are tailored for various audiences with specific messages. The purpose of this paper is to present the results of a research priority setting exercise on mHealth and innovative strategies. Methods: We adapted Child Health and Nutrition Research Initiative methodology to identify and set research priorities on mHealth and innovative strategies that respond to sexual and reproductive health and rights services. General potential research questions were gathered online from multiple stakeholders in the region and sent for consolidation consolidated to technical experts in World Health Organization headquarters. The second phase involved a meeting with experts to review and thematically analyze the questions list of 33 questions producing a list of 22 research questions. The questions were scored against a six point criteria and ranked accordingly. Ten top priority research questions were identified. Results: Lists of 33 priority research questions for mHealth and innovative strategies were proposed for discussions by 67 stakeholders. The questions were reviewed, scored and ranked in a technical meeting by experts. The highest ranking questions at 87% include evaluation of mHealth for data management and sexual and reproductive health and rights decision making, assessment of innovative local financing techniques to support community based sexual reproductive health and rights and evaluation of the role of mobile technologies in referral and counter referral. Conclusions: Information and communication technology is developing drastically and has a great potential in improving health especially in sexual and reproductive health and rights service delivery. This potential must be demonstrated with more relevant and quality research on mHealth and innovative strategies priorities identified.
文摘Background: Many policy makers deliberating on comprehensive sexual and reproductive health and rights services need reliable evidence to make choices that benefit women, adolescents, children and the wider society. While universal health coverage discourse provides an opportunity to expand access through evidence based interventions, many gaps exist. Research prioritization has proved to be very helpful in identifying relevant areas especially in constrained resource settings. The purpose of this paper is to present the results of the World Health Organization Africa Region research prioritization for sexual and reproductive health and rights. These priorities hope to guide the region for the next three years. Methods: We used the Child Health and Nutrition Research Initiative approach to identify priority questions among many potential areas for research prioritization on sexual and reproductive health and rights. The implementation process was organized in three phases. The first phase involved sending out an online survey to various experts with experience in sexual and reproductive health rights. These questions were received by a technical team from World Health Organization headquarters for review. 634 questions were identified for potential research and grouped into 12 themes. The second phase involved experts who reviewed the questions. The team merged questions with duplications, removed the questions that were out of scope and finally refined the wordings. In the final phase, experts worked in groups to score and rank top ten priority questions for each of the 12 thematic areas. Results: A list of 120 priority questions for sexual and reproductive health and rights were prioritized by 67 participants drawn from 16 organizations. Most of the priority research questions (45%) focused on the theme of gender-based violence, 35% prioritized services in sexual and reproductive health and rights in humanitarian settings while 15% prioritized preventing unsafe abortion. 5% of the participants prioritized cervical cancer prevalence, prevention and treatment as a thematic area out of the questions in the top 20 research priority questions. Conclusions: Key priority research questions in sexual and reproductive health and rights were identified around five themes. The priority list will be of significance to World Health Organization regional Office for Africa and her stakeholders for the next three years.
基金funded by the Ministry of Science and Technology of the Government of People’s Republic of Bangladesh(163-BS/2020-2021).
文摘Objective:To determine the effects of textile dyeing industrial wastewater on the hematological parameters and reproductive health including histoarchitecture of male gonad(testes)of mice.Methods:Twenty-four Swiss albino mice at 4-weeks old were divided into four groups(n=6 per group).Mice of group 1 supplied with normal drinking water were served as the control group.Mice of group 2,3 and 4 were supplied normal drinking water mixed with textile dyeing wastewater at 5%,10% and 20% concentration,respectively.After completing 24 weeks of treatment,different hematological profile,weight of testes,gonadosomatic index(GSI),sperm concentration and morphology were measured.Moreover,histopathological changes in testes were examined.Results:Hematocrit value and hemoglobin concentrations were decreased in all groups of wastewater-treated mice compared to the control group.Likewise,weight of testes,GSI and sperm concentration were decreased significantly in wastewater-treated mice in comparison to the control group.The percentage of morphologically healthy epididymal sperm was significantly reduced in wastewater-treated mice.Histopathological examination revealed degenerative changes in seminiferous tubules,a smaller number of spermatogenic cells,elongation of seminiferous tubules and degenerative changes of seminiferous tubules in wastewater-treated mice.Conclusions:Textile dyeing wastewater has harmful effects on hematological profile and reproductive health of male mice.
文摘Stromal vascular fraction(SVF)is a complex mixture derived from adipose tissue,consisting of a variety of cells.Due to its potential for tissue repair,immunomod-ulation,and support of angiogenesis,SVF represents a promising frontier in regenerative medicine and offers potential therapy for a range of disease condi-tions.In this article,we delve into the mechanisms through which SVF exerts its effects and explore its potential applications in treating both male and female reproductive disorders,including erectile dysfunction,testicular injury,stress urinary incontinence and intrauterine adhesion.
基金supported by the National Natural Science Foundation of China(No.82025030,No.72394404)the National Key Research and Development Program of China(No.2022YFC3702700)the National Research Program for Key Issues in Air Pollution Control of China(No.DQGG0401).
文摘As global greenhouse gases continue rising,the urgency of more ambitious action is clearer than ever before.China is the world’s biggest emitter of greenhouse gases and one of the countries affected most by climate change.The evidence about the impacts of climate change on the environment and human health may encourage China to take more decisive action to mitigate greenhouse gas emissions and adapt to climate impacts.
基金supported by Tehran University of Medical Sciences,Tehran,Iran(no.9711199007).
文摘Objective:The aim of this study was to investigate the health expectations(HEs)in patients with diabetes and the factors affecting it using an integrative systematic review.Methods:A comprehensive literature search was conducted in databases including PubMed,Scopus,Science Direct,Google Scholar,ProQuest,CINAHL,SID,Iran Doc,and Magiran without time limitation using related keywords.The systematic literature search was performed using a guide provided by York University.Results:From a total of 1883 articles,17 of them finally met the eligibility criteria.According to the findings of this study,HE of diabetic patients was included in four categories:“dynamism,”“consequentialism,”“comprehensive care,”and“access to facilities.”Also,these expectations can be influenced by various factors,including“developments in societies,”“changing the conditions of health care systems,”and“individual factors.”Conclusions:Health professionals should pay attention to the expectations of diabetic patients who are involved in complex disease conditions and consider meeting them as a key factor in providing patient-centered care,improving health outcomes,and patient satisfaction.
基金supported by the National Key Research&Development Program of the Ministry of Science and Technology of China(2022YFE0134900,2023YFC3708305,2023YFC3708302)Strategy Priority Research Program(Category B)of the Chinese Academy of Sciences(No.XDB0750300)National Natural Science Foundation of China(Grant No.42477455,42077390).
文摘Objective The study aim was to investigate the effects of exposure to multiple environmental organic pollutants on cardiopulmonary health with a focus on the potential mediating role of oxidative stress.Methods A repeated-measures randomized crossover study involving healthy college students in Beijing was conducted. Biological samples, including morning urine and venous blood, were collected to measure concentrations of 29 typical organic pollutants, including hydroxy polycyclic aromatic hydrocarbons(OH-PAHs), bisphenol A and its substitutes, phthalates and their metabolites, parabens,and five biomarkers of oxidative stress. Health assessments included blood pressure measurements and lung function indicators.Results Urinary concentrations of 2-hydroxyphenanthrene(2-OH-PHE)(β = 4.35% [95% confidence interval(CI): 0.85%, 7.97%]), 3-hydroxyphenanthrene(β = 3.44% [95% CI: 0.19%, 6.79%]), and 4-hydroxyphenanthrene(4-OH-PHE)(β = 5.78% [95% CI: 1.27%, 10.5%]) were significantly and positively associated with systolic blood pressure. Exposures to 1-hydroxypyrene(1-OH-PYR)(β = 3.05% [95% CI:-4.66%,-1.41%]), 2-OH-PHE(β = 2.68% [95% CI:-4%,-1.34%]), and 4-OH-PHE(β = 3% [95% CI:-4.68%,-1.29%]) were negatively associated with the ratio of forced expiratory volume in the first second to forced vital capacity. These findings highlight the adverse effects of exposure to multiple pollutants on cardiopulmonary health. Biomarkers of oxidative stress, including 8-hydroxy-2'-deoxyguanosine and extracellular superoxide dismutase, mediated the effects of multiple OH-PAHs on blood pressure and lung function.Conclusion Exposure to multiple organic pollutants can adversely affect cardiopulmonary health.Oxidative stress is a key mediator of the effects of OH-PAHs on blood pressure and lung function.
基金supported by Zhejiang Provincial Natural Science of Foundation of China(No.LQ20B070005)the Fundamental Research Funds for the Central Universities(Nos.2019FZJD007 and 2019QNA6008)+1 种基金the National Natural Science Foundation of China(Nos.21876151 and 81703236)Project for Zhejiang Medical Technology Program(Nos.2018KY437,2016KYA049 and WKJ-ZJ-1621)
文摘Polycyclic aromatic hydrocarbons(PAHs)are a typical class of persistent organic pollutants that is ubiquitous worldwide.Previous animal studies suggested that PAHs had adverse effects on female reproduction.However,the human data regarding relationship of PAHs exposure with women reproductive health,such as ovarian dysfunction,are scarce.In this case-control study,the associations of serum levels of PAHs with the risk of premature ovarian failure(POF)and reproductive hormones in Chinese women were investigated,with recruiting 157 POF patients and 217 healthy women.The serum levels of 12 types of PAHs,as well as reproductive hormones,including follicle-stimulating hormone,luteinizing hormone and anti-mullerian hormone,were determined.In the logistic regression models,most individual PAH congeners showed significantly positive correlations with the risk of POF(p<0.05),except for fluorine and pyrene.Benzo(a)pyrene(BaP),as the most carcinogenic PAH congener,was observed to be significantly positively associated with the risk of POF.After adjustment for age,body mass index,educational levels and household income,per one-unit increase in the log-transformed BaP concentration was significantly correlated with 2.191-fold increased risk of POF(OR=2.191,95%CI:1.634-2.938,p<0.05).To the best of our knowledge,this is the first study to report an association between internal exposure levels of PAHs and the increased risk of POF in women.
基金This work was supported by a grant from the Natural Science Foundation of Zhejiang Province, China （Y206148）. The authors gratefully acknowledge the members of the Department of Reproductive Endocrinology in the Women＇s Hospital at Zhejiang University for their continued assistance.
文摘In this study, we aimed to determine the effects of hepatitis B virus （HBV） infection on sperm quality and the outcome of assisted reproductive technology （ART）. A total of 916 men （457 HBV-positive and 459 HBV-negative） seeking fertility assistance from January 2008 to December 2009 at the Women＇s Hospital in the School of Medicine at Zhejiang University were analysed for semen parameters. Couples in which the men were hepatitis B surface antigen （HBsAg）-seropositive were categorized as HBV-positive and included 587 in vitrofertilisation （IVF） and 325 intracytoplasmic sperm injection （ICSI） cycles from January 2004 to December 2009; negative controls were matched for female age, date of ova retrieval, ART approach used （IVF or ICSI） and randomized in a ratio of 1：1 according to the ART treatment cycles （587 for IVF and 325 for ICSI）. HBV-infected men exhibited lower semen volume, lower total sperm count as well as poor sperm motility and morphology （P〈O.05） when compared to control individuals. Rates of two-pronuclear （2PN） fertilisation, high-grade embryo acquisition, implantation and clinical pregnancy were also lower among HBV-positive patients compared to those of HBV-negative patients after ICSI and embryo transfer （P〈0.05）; IVF outcomes were similar between the two groups （P〉0.05）. Logistic regression analysis showed that HBV infection independently contributed to increased rates of asthenozoospermia and oligozoospermia/azoospermia （P〈0.05） as well as decreased rates of implantation and clinical pregnancy in ICSI cycles （P〈0.05）. Our results suggest that HBV infection in men is associated with poor sperm quality and worse ICSI and embryo transfer outcomes but does not affect the outcome of IVF and embryo transfer.
基金supported by funding from National "973" project on Population and Health (No.2007CB5119001)National Yang Zi Scholar Program, 211 and 985 projects of Peking University (No.20020903)
文摘Objective To examine the influence of China＇s economic reforms on population health and regional mortality rates.Methods Longitudinal study measuring the mortality trends and their regional variations.Using data from the three most recent national censuses,we used the model life table to adjust the mortality levels within the population for each census,and to calculate life expectancy.We then examined the variation in patterns of mortality and population health by economic status,region and gender from 1980-2000.Results Life expectancy varied with economic status,province,and gender.Results showed that,although life expectancy in China had increased overall since the early 1980s,regional differences became more pronounced.Life expectancy for populations who live in the eastern coastal provinces are greater than those in the western regions.Conclusion Differences in life expectancy are primarily related to differences in regional economic development,which in turn exacerbate regional health inequalities.Therefore,it is necessary to improve economic development in less developed regions and to improve health policies and the public health system that address the needs of everyone.
文摘The discovery of artemisinin is significant because not only it is an innovative new drug,but also its treatment of malaria has saved millions of lives worldwide,especially in(tropical)developing countries.The 2015 Nobel Prize in Physiology or Medicine was awarded to Professor Tu You-You,a scientist from China,who made this seminal discovery.Malaria is one of the most prevalent
文摘Objectives 1） To explore the relationship between RTIs and mental status of Naxi women; 2） to compare the differences of depression ＆ anxiety between Naxi women who have and not have RTIs; and 3） to put forward some suggestions for improving Naxi women＇s reproductive health in psychological point of view. Methods A cross-sectional survey was adopted, 280 married Naxi female volunteers who aged above 20 years old were selected by cluster random sampling from the two selected villages of Lugufu Township of Yanyuan county in Sichuan. Two self-reporting scales, CES-D and SAS were used for assessment of depression and anxiety of the subjects. Results The facts of mental status of Sichuan Naxi women brook no optimism. Among 280 Naxi reproductive age women who were investigated in current study, only 74 （26.4%） have no depression symptoms, and 116 （41.4%） have no anxiety symptoms. For the study population, the average total scores （TS） of CES-D was 20.1, and the average total index scores （TIS） of SAS was 50.2, and both of them were above a minimum value doubted to have symptoms. There were big differences of both average TS of CES-D and TIS of SAS between Naxi women who have and not have RTIs. Further analysis revealed that RTI was a main risk factor influencing women＇s mental status （OR = 16. 043 for depression, and OR = 12.954 for anxiety）. In addition, Naxi women＇s depression and anxiety were related to order births （≤2, OR=3.149, 95% CI： 1.228, 8.076）, sex debut was younger （≤17, OR=3.043, 95% CI： 1.895, 4.884）, and multiple pregnancy （≥ 3, OR=2.728, 95% CI： 1.990, 4.173）, etc. Conclusion For improving Naxi women＇s mental status, a pressing matter of the moment is for local medical persons to gain the knowledge about mental health and the diagnosis and treatment levels of psychological disorders. At the same time, pssychological counselling should become a main activity of reproductive health services.
基金We thank professors Cynthia Casson Morton and Yiping Shen from Harvard Medical School and professor Sharon YC Ruan from Hong Kong Polytechnic University for revising the manuscript.This work was supported by the National Key Research and Development Program of China(2018YFC1005003)the National Natural Science Foundation of China(81974224,81771535)+2 种基金the Natural Science Foundation of Zhejiang Province(LZ18H040001,LQ19H040007)Zhejiang Provincial Key Medical Technology Program(WKJ-ZJ-1826)Zhejiang University Education Foundation Global Partnership Fund.The authors declared no conflict of interest.
文摘Invasive genetic screening of pre-implantation embryos via biopsied trophectoderm(TE)cells has been in use for more than 20 years,while its benefits in selecting euploid embryos remain controversial.Recent advances in the ability to process embryonic cell-free DNA(cfDNA)from blastocoel fluid(BF)and spent culture media(SCM)of blastocysts in a manner similar to that of a biopsied TE sample provide a potential alternative holding great promise for obtaining cytogenetic information of the embryos without intrusive biopsy of traditional biopsy-based pre-implantation genetic testing(PGT).Several studies have reported even higher diagnostic accuracy in non-invasive PGT(ni-PGT)than conventional PGT.However,there are still several technical challenges to be overcome before ni-PGT can be accepted as a reliable genomic information source of embryo.In this review,we have summarized the emergence and current state of ni-PGT,and discussed our own perspectives on their limitations and future prospect.There is still a long way to go before truly wide clinical application of ni-PGT.
文摘Background: Infertility is a unique medical challenge that can have health behavioral consequence on infertile women including lack of self-esteem, depression, anxiety, fertility problem in infertile couples. The aim of this study was to evaluate correlation between self-efficacy and health behaviors scales in infertile women. Methods: A cross sectional study was conducted on 89 infertile women with mild to moderate depression (Beck scores 10 - 47) who were recruited from Fatemeh Zahra Infertility and Reproductive Health Research Center. All participants completed Self-efficacy Inventory (ISE) and other health behavioral scales (e.g., the Beck Depression Inventory (BDI), Cattle Anxiety Scale (CAS), Fertility Problem Infertility (FPI), and GHQ). Pearson correlation coefficient and Spearman rho correlation coefficient were used to analyze the data. Variables were included in the study if they had a p-value
文摘Background: Ministry of Health, Government of India developed the Adolescent Reproductive and Sexual Health (ARSH) strategy and operationalized adolescent health services up to district and sub-district hospital level. Objectives: To operationalize adolescent health services at primary health care level in a block of Maharashtra;assess impact of need based interventions on quality of services;and understand potential for scalability in the state. Methods: Adolescent and Youth friendly centers were established at primary health care settings and interventions such as health system strengthening, sensitizing gatekeepers, involving Accredited Social Health Activist (ASHAs), developing inter and intra-sectoral linkages, improving monitoring and evaluation were tested. Results: Over a period of 2009-2014, there was a steady increase in the number of clients attending the Adolescent and Youth Friendly Health Centers (A&YFHCs). Attitude of providers to address adolescents’ needs improved significantly. Successful interventions were networking with schools, colleges and Non Government Organization (NGOs), linkages with HIV program and Integrated Child Development Services (ICDS), and involvement of ASHAs. Conclusions: The study demonstrates that although health system has the primary responsibility of addressing health issues among adolescents;it has limitations in terms of its reach to adolescents and generating demand for services. There is a need to network with education sector, ICDS, NGOs working for adolescent health and development to work as a team and address the multifaceted needs of the adolescents. Such a strategy will be crucial while implementing the recently launched Rashtriya Kishor Swasthya Karyakram— the new national adolescent health programme in India.
文摘Objective:To identify factors that determine the uptake of in-vitro fertilization(IVF),and to determine the predicting effect of the identified factors on the uptake of IVF among couples attending fertility clinic at a tertiary health institution in Benin City,Nigeria.Methods:This study adopted a cross-sectional descriptive design.A self-structured questionnaire tested was validated and administered to 250 couples who attended fertility clinic.Data were collected from March 2021 to June 2021 and were analyzed using the Statistical Package for Social Science(SPSS)version 21.Data were presented and interpreted using descriptive statistics and inferential statistics such as Chi-square,univariate statistics and multivariate logistic regression analysis.Results:Among 250 couples,154(61.6%)were willing to adopt IVF.The multivariate logistic regression analysis showed that catholic religion[odds ratio(OR)0.21,95%confident interval(CI)0.54-0.73],family income(OR 1.50,95%CI 1.10-2.00)and age(OR 1.04,95%CI 1.01-1.10)were the major factors that determined the uptake of IVF,with P-value of<0.001,0.018 and 0.031,respectively.Conclusions:The uptake of IVF could be sustained or improved on,if the government should improve on the cost of living for families,and religious leaders need to be encouraged to pass on the information about IVF to their members to be well guided about the possibilities of IVF.
文摘To understand the HIV/IDS knowledge level and its influential factors among reproductive men in China so as to provide scientific evidence for preventive measures. Methods Cross-sectional survey, system random sample and constructed questionnaire were used in this study. There were 1 285 male subjects who had filled in anon）,mous questionnaires. Results There were significant differences on the HIV/IDS knowledge level in different counties and different demographic characteristic people. Major inJluential factors inchtded area, urban/rural, marriage, educational level, age, consultation about HIV/AIDS. Conclusion It is necessary to strengthen the training of HIV/AIDS knowledge among reproductive men.
基金funded by the European Commission’s Seventh Framework Program[FP7/2007-2013]under grant agreement No.282490
文摘Objective To systematic review and analyze the practices and effects of integrating post-abortion family planning （PAFP） services into existing health system worldwide in order to inform the future interventions to deliver PAFP in China. Methods A systematic search for relevant published and unpublished literature was conducted. Based on a set of criteria, citation and full text were screened, related data were extracted. Findings of included studies were reviewed and analyzed using a textual narrative approach to synthesis. Results A total of 28 studies were included in the synthesis. The studies were published between 1995 and 2008 and covered 20 countries. Some countries were in the stage of piloting post-abortion care （PAC）/PAFP intervention, while others were either from piloting to scaling up or examined how well a pilot PAC/PAFP intervention and resulting improvements were able to be maintained over the long term in the same intervention site. Most studies examined initiatives that were implemented at public sectors from tertiary, secondary to primary health facilities, while a few were imple- mented at private sectors. Efforts of integrating PAFP into existing health system from health system perspectives such as funding the programs, training of trainer （TOT） training or on the job training of physicians and mid-level service provider, expan- sion the range of contraceptive methods available including a few free distribution of contraceptives, improving data collection including cost analysis in a few countries,service guidelines provided to health professionals, supportive supervision at program sites to ensure quality of care, and leadership from government to strengthen PAC/ PAFP service by revising or developing a new national policy. Effects of those intervention programs included that 2 studies decreased abortion rates, 7 studies improved modern contraceptive use, 1 study improved women＇s knowledge on sexual ＆ reproductive health, and 5 studies reported women＇s high satisfaction rate with receiving PAC/PAFP services. Conclusion Each study was conducted within a cultural legal social and religious framework. There might be no single set of best practices that can be put forward as a model to integrate PAFP into existing health system in China. These areas should be taken into account in our future intervention including government＇s optimization and complement to the regulations related to abortion, contraception and PAFP, capacity building for service provider, continuous efforts to improve the quality of PAFP service, and accessibility of multiple contraceptive methods for married as well as unmarried youth.
