RESUMO
BACKGROUND: The prospective, observational XANTUS study demonstrated low rates of stroke and major bleeding in real-world rivaroxaban-treated patients with non-valvular atrial fibrillation (NVAF) from Western Europe, Canada and Israel. XANTUS-EL is a component of the overall XANTUS programme and enrolled patients with NVAF treated with rivaroxaban from Eastern Europe, the Middle East and Africa (EEMEA) and Latin America. METHODS: Patients with NVAF starting rivaroxaban for stroke prevention were consecutively recruited and followed for 1â¯year, at approximately 3-month intervals, or for ≥30â¯days after permanent rivaroxaban discontinuation. Primary outcomes were major bleeding, adverse events (AEs), serious AEs and all-cause mortality. Secondary outcomes included stroke, non-central nervous system systemic embolism (non-CNS SE), transient ischaemic attack (TIA), myocardial infarction (MI) and non-major bleeding. All major outcomes were centrally adjudicated. RESULTS: Overall, 2064 patients were enrolled; mean age⯱â¯standard deviation was 67.1⯱â¯11.32â¯years; 49.3% were male. Co-morbidities included heart failure (30.9%), hypertension (84.2%), diabetes mellitus (26.5%), prior stroke/non-CNS SE/TIA (16.2%) and prior MI (10.7%). Mean CHADS2, CHA2DS2-VASc and HAS-BLED scores were 2.0, 3.6 and 1.6, respectively. Treatment-emergent event rates were (events/100 patient-years, [95% confidence interval]): major bleeding 0.9 (0.5-1.4); all-cause mortality 1.7 (1.2-2.4); stroke/non-CNS SE 0.7 (0.4-1.2); any AE 18.1 (16.2-20.1) and any serious AE 8.3 (7.0-9.7). One-year treatment persistence was 81.9%. CONCLUSIONS: XANTUS-EL confirmed low stroke and major bleeding rates in patients with NVAF from EEMEA and Latin America. The population was younger but with more heart failure and hypertension than XANTUS; stroke/SE rate was similar but major bleeding lower.
RESUMO
BACKGROUND: Efavirenz-based antiretroviral therapy (ART) regimens are preferred for treatment of adult HIV-positive patients co-infected with tuberculosis (HIV/TB). Few studies have compared outcomes among HIV/TB patients treated with efavirenz or non-efavirenz containing regimens. METHODS: HIV-positive patients aged ≥16 years with a diagnosis of tuberculosis recruited to the TB:HIV study between Jan 1, 2011, and Dec 31, 2013 in 19 countries in Eastern Europe (EE), Western Europe (WE), and Latin America (LA) who received ART concomitantly with TB treatment were included. Patients either received efavirenz-containing ART starting between 15 days prior to, during, or within 90 days after starting tuberculosis treatment, (efavirenz group), or other ART regimens (non-efavirenz group). Patients who started ART more than 90 days after initiation of TB treatment, or who experienced ART interruption of more than 15 days during TB treatment were excluded. We describe rates and factors associated with death, virological suppression, and loss to follow up at 12 months using univariate, multivariate Cox, and marginal structural models to compare the two groups of patients. RESULTS: Of 965 patients (647 receiving efavirenz-containing ART, and 318 a non-efavirenz regimen) 50% were from EE, 28% from WE, and 22% from LA. Among those not receiving efavirenz-containing ART, regimens mainly contained a ritonavir-boosted protease inhibitor (57%), or raltegravir (22%). At 12 months 1.4% of patients in WE had died, compared to 20% in EE: rates of virological suppression ranged from 21% in EE to 61% in WE. After adjusting for potential confounders, rates of death (adjusted Hazard Ratio; aHR, 95%CI: 1.13, 0.72-1.78), virological suppression (aHR, 95%CI: 0.97, 0.76-1.22), and loss to follow up (aHR, 95%CI: 1.17, 0.81-1.67), were similar in patients treated with efavirenz and non-efavirenz containing ART regimens. CONCLUSION: In this large, prospective cohort, the response to ART varied significantly across geographical regions, whereas the ART regimen (efavirenz or non-efavirenz containing) did not impact on the proportion of patients who were virologically-suppressed, lost to follow up or dead at 12 months.
Assuntos
Antirretrovirais/uso terapêutico , Antituberculosos/uso terapêutico , Infecções por HIV/tratamento farmacológico , Tuberculose/tratamento farmacológico , Adulto , Alcinos , Benzoxazinas/uso terapêutico , Ciclopropanos , Europa (Continente) , Europa Oriental , Feminino , Infecções por HIV/complicações , Infecções por HIV/mortalidade , Humanos , América Latina , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Taxa de Sobrevida , Resultado do Tratamento , Tuberculose/complicaçõesRESUMO
PIP: At February's Cairo+5 proceedings at the Hague, the Center for Reproductive Law and Policy (CRLP) called a press conference to discuss changes in abortion laws around the world since the International Conference on Population and Development in Cairo in 1994. According to the director of CRLP's International Program, 9 countries have modified their abortion laws since Cairo. Of those, 7 liberalized their laws, while Poland and El Salvador further restricted legislation. The CRLP supports the liberalization of abortion laws for all women in all countries. Abortion law has been liberalized in South Africa since Cairo, with the enactment in 1997 of the Termination of Pregnancy Act. In contrast, however, anti-choice groups in Poland successfully challenged the legality of abortion in 1996 by declaring it against the Polish Constitution. Abortion is prohibited in Chile in all circumstances, even to save the life of the woman. However, despite the illegality of abortion in that country, half of all pregnancies in Chile end in abortion. Unsafe abortion contributes to the 50% maternal mortality rate in Nepal. Abortion in the country is punishable by a 20-year prison sentence, regardless of the age of the woman.^ieng
Assuntos
Aborto Induzido , Legislação como Assunto , África , África Subsaariana , África Austral , América , Ásia , América Central , Chile , Países Desenvolvidos , Países em Desenvolvimento , El Salvador , Europa (Continente) , Europa Oriental , Serviços de Planejamento Familiar , América Latina , Nepal , América do Norte , Polônia , África do Sul , América do SulRESUMO
The Inter-Health Programme was launched in 1986 by WHO, with the collaboration of a coordination centre (National Public Health Institute, Finland) to control and prevent chronic noncommunicable diseases (CNCDs) among adults. Programmes for action were organized based on the concept that most major CNCDs share common risk factors and that those that are lifestyle related are modifiable through efficient interventions using multifactorial strategies involving community participation and behaviour changes carried out at the primary health care level. Twelve countries from all WHO Regions have joined the programme. A baseline survey was undertaken in all countries with a common protocol, following the criteria and methods employed in the MONICA Project. Altogether 36815 men and women aged 35-64 years were included in the present analysis from the following Inter-Health countries: Chile, China, Cyprus, Finland, Lithuanian SSR, Malta, Mauritius, Russian SFSR, United Republic of Tanzania, and USA. In addition to individual country analysis, centralized analysis was carried out at the Finnish National Public Health Institute and the Department of Community Health, Kuopio University, Finland. Reported here are the mean values of blood pressure, body mass index, and serum total cholesterol as well as specific prevalences of smoking, hypertension, obesity, and hypercholesterolaemia.
PIP: The Inter-Health Program was launched in 1986 by the World Health Organization (WHO) with the collaboration of Finland's National Public Health Institute to control and prevent chronic noncommunicable diseases (CNCDs) among adults. The program consists of interventions designed to modify the levels of the major risk factors of CNCDs in the community through an integrated, community-oriented approach to health promotion and maintenance. 12 countries from all WHO regions have joined the program. The effects of intervention activities were measured by examining changes in the status of risk factors in populations before and after a given intervention. A baseline survey was conducted in all of the Inter-Health countries with a common protocol to identify the relevant risk factors. 36,815 men and women aged 35-64 from Chile, China, Cyprus, Finland, Lithuania, Malta, Mauritius, Russia, Tanzania, and the US were surveyed. This paper reports the mean values of blood pressure, body mass index, and serum total cholesterol as well as specific prevalences of smoking, hypertension, obesity, and hypercholesterolemia.
Assuntos
Doença Crônica/epidemiologia , Inquéritos Epidemiológicos , Adulto , Estudos Transversais , Países Desenvolvidos , Países em Desenvolvimento , Feminino , Indicadores Básicos de Saúde , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Organização Mundial da SaúdeRESUMO
Reported is a study of live, cold-adapted (CA) reassortant mono-, di-, and trivalent influenza type A and B vaccines in a series of controlled clinical and epidemiological investigations involving nearly 130 000 children aged 3-15 years. The results of clinical, immunological, and morbidity investigations of the vaccinees and a control group over 6-months' follow-up indicated that the vaccines were completely attenuated by the children. Transient febrile reactions occurred in < 1% of the children after vaccination, including double seronegative individuals with low antibody titres. The type A reisolates examined were genetically stable. The reassortants did not suppress each other after simultaneous inoculation of children and stimulated antibody response to influenza virus strains A1, A3, and B. The incidence of influenza-like diseases was approximately 30-40% lower among the vaccinated group than among the control group. The study demonstrates, for the first time, the efficacy of CA vaccine against infections caused by influenza B virus.
PIP: Considerable progress has been made in recent years in developing live, attenuated influenza vaccines, with most attention having been directed to the development of cold-adapted (CA), attenuated reassortant vaccines. Such vaccines are widely used in the Russian Federation to immunize children. Findings are reported from a study of live, CA reassortant mono-, di-, and trivalent influenza type A and B vaccines in a series of controlled clinical and epidemiological investigations involving almost 130,000 children aged 3-15 years. Clinical, immunological, and morbidity investigations of the vaccinated children and a control group over a six-month follow-up period indicate that the vaccines were completely attenuated by the children. Transient febrile reactions occurred in less than 1% of the children after vaccination, including double seronegative individuals with low antibody titres. The type A reisolates examined were genetically stable. Furthermore, the reassortants did not suppress each other after simultaneous inoculation of children and stimulated antibody response to influenza virus strains A1, A3, and B. The incidence of influenza-like diseases was approximately 30-40% lower among the vaccinated group than among the control group. It is noted that this study demonstrates, for the first time, the efficacy of CA vaccine against infections caused by influenza B virus.
Assuntos
Vacinas contra Influenza/administração & dosagem , Adolescente , Criança , Pré-Escolar , Cuba/epidemiologia , Surtos de Doenças , Métodos Epidemiológicos , Humanos , Imunoglobulina E/isolamento & purificação , Vacinas contra Influenza/efeitos adversos , Vacinas contra Influenza/imunologia , Influenza Humana/epidemiologia , Ativação Linfocitária , Radioimunoensaio , U.R.S.S./epidemiologiaRESUMO
PIP: Tourists traveling internationally lower their inhibitions and take greater risks than they would typically in their home cultures. Loneliness, boredom, and a sense of freedom contribute to this behavioral change. Some tourists travel internationally in search of sexual gratification. This motivation may be actively conscious or subconscious to the traveler. Billed as romantic with great natural beauty, Thailand, the Philippines, Brazil, the Dominican Republic, and Kenya are popular destinations of tourists seeking sex. The Netherlands and countries in eastern Europe are also popular. With most initial cases of HIV infection in Europe having histories of international travel, mass tourism is a major factor in the international transmission of AIDS. While abroad, tourists have sex with casual partners, sex workers, and/or other tourists. Far from all tourists, however, carry and consistently use condoms with these partners. One study found female and non white travelers to be less likely than Whites and males to carry condoms. The risk of HIV infection increases in circumstances where condoms are not readily available in the host country and/or are of poor quality. Regarding actual condom use, a study found only 34% of sex tourists from Switzerland to consistently use condoms while abroad. 28% of men in an STD clinic in Melbourne, Australia, reported consistent condom use in sexual relations while traveling in Asia; STDs were identified in 73% of men examined. The few studies of tourists suggest that a significant proportion engage in risky behavior while traveling. HIV prevalence is rapidly increasing in countries known as destinations for sex tourism. High infection rates are especially evident among teenage sex workers in Thailand. Simply documenting the prevalence of risky behavior among sex tourists will not suffice. More research is needed on travelers and AIDS with particular attention upon the motivating factors supporting persistent high-risk behavior.^ieng
Assuntos
Síndrome da Imunodeficiência Adquirida , Atitude , Preservativos , Comportamento Contraceptivo , Cultura , Estudos de Avaliação como Assunto , Infecções por HIV , Atividades de Lazer , Psicologia , Fatores de Risco , Comportamento Sexual , África , África Subsaariana , África Oriental , América , Ásia , Sudeste Asiático , Comportamento , Biologia , Brasil , Região do Caribe , Anticoncepção , Demografia , Países Desenvolvidos , Países em Desenvolvimento , Doença , República Dominicana , Inglaterra , Europa (Continente) , Europa Oriental , Serviços de Planejamento Familiar , Quênia , América Latina , Países Baixos , América do Norte , Filipinas , População , Características da População , América do Sul , Suíça , Tailândia , Reino Unido , VirosesRESUMO
"This...paper seeks to discern the current situation in East-West migration, including migratory movements within, and towards East Europe, and its possible trends beyond 1993. In so doing it takes into account some of the major policy and operational measures which are being taken or are contemplated by the governments of East and West Europe." Consideration is given to the determinants of East-West migration, sources of possible future migratory pressures, the impact of the formation of the European Community on migratory flows, and movements to and within Eastern Europe.
Assuntos
Emigração e Imigração , Política , Política Pública , Demografia , Países Desenvolvidos , Europa (Continente) , Europa Oriental , União Europeia , Organizações , População , Dinâmica PopulacionalRESUMO
PIP: The Bongaarts model quantifies intermediate variables that have a direct impact on fertility and it is related to the classical analytic framework of intermediate fertility variables (IFVs) introduced by Davis and Blake. The model requires data on age-specific proportions of women currently married, age-specific fertility rates (ASFRs), estimates of postpartum infecundability, and proportion of women currently using effective contraceptive methods. Horne, El-Khorazaty, and Suchindran (1990) developed a childbearing model estimating projected ages at 1st and last birth (AFB, ALB) and the reproductive life span (RLS), making use of only ASFRs available from either vital statistics or sample surveys. The correspondence between Bongaarts-type indices of marriage, contraception, and infecundability and the childbearing indices is discussed. Data on both fertility-inhibiting and childbearing indices were available for 225 subpopulations. Application 1: Characterization of the fertility-inhibiting indices by the childbearing indices. Contraceptive practice is the major fertility-inhibiting factor among women who stop childbearing before age 35 years, but for those women who stop reproducing in their late thirties, long duration of breastfeeding is. Application 2: Decomposition of fertility decline by the childbearing indices. For societies with a low TFR of only 2 births, contraceptive use plays the major role in achieving this low fertility level, regardless of age at 1st birth, and age at last birth not exceeding 35 years. Application 3: Annual fertility-inhibiting indices using ASFRs. In Kuwait the TFR declined from 4.7 births in the early 1960s to well below 2 births in the late 1970s and 1980s owing to direct government support to family planning programs. The correspondence model, using only macro-level vital statistics data, can predict indirectly fertility-inhibiting indices on an annual basis for countries lacking the micro-level data necessary for estimating those indices directly.^ieng
Assuntos
Coeficiente de Natalidade , Anticoncepção , Países em Desenvolvimento , Serviços de Planejamento Familiar , Fertilidade , Casamento , Modelos Teóricos , América , Ásia , Ásia Ocidental , Região do Caribe , Cuba , Demografia , Países Desenvolvidos , Europa (Continente) , Europa Oriental , Kuweit , América Latina , Oriente Médio , América do Norte , População , Dinâmica Populacional , Pesquisa , RomêniaRESUMO
PIP: The Congress Workshop on People and Protected Areas convened to discuss the need to combine modern science and traditional knowledge to effect sustainable development among indigenous peoples in the world. The founder of the Fundacion Pro-Sierra Nevada de Santa Marta talked about development of training programs for displaced farmers and rehabilitation of Indian lands and villages in the Sierra Nevada of northern Colombia. The 3 indigenous peoples (Kogi, Arsario, and Arhuaco Indians) have only recently regained title to their forebears' lands. In fact, in 1990, the government of Colombia gave about 25% of the country back to indigenous populations. The forebears of the Kogi, Arsario, and Arhuaco Indians constructed great stone cities and advanced systems of agriculture, terracing, and irrigation. The Indians have lived under the Law of the Mother for thousands of years. This code dictates human behavior so that humans are in unity with plant and animal cycles, star movements, climatic phenomena, and the sacred geography of the coastal mountains. They are so much an integral part of their ecosystem that they even limit their population size. Now they resurrect villages in 2 national parks and indigenous reservations. Farmers who colonized the area since the 1960s must now leave the reserves and begin anew in nearby buffer zones. Here they learn revitalized agricultural techniques to abandon their illegal marijuana, cocaine, and poppy farming. At the workshop, participants also learned about conservation activities of the Imgrauen in the Banc d'Arguin National Park in Mauritania who continue to use dolphins to catch mullet. In India, the Bisnoi people living in the Rajasthan desert have established their own unofficial protected areas to keep the fragile ecosystem. Other examples were in Niger and Central Europe. The workshop participants agreed that recognition of land tenure and intellectual property rights were high priorities.^ieng
Assuntos
Agricultura , Comportamento , Congressos como Assunto , Conservação dos Recursos Naturais , Economia , Educação , Etnicidade , Indígenas Sul-Americanos , Densidade Demográfica , Fatores Socioeconômicos , África , África Subsaariana , África do Norte , África Ocidental , América , Ásia , Colômbia , Cultura , Demografia , Países Desenvolvidos , Países em Desenvolvimento , Meio Ambiente , Europa (Continente) , Europa Oriental , Índia , América Latina , Mauritânia , Oriente Médio , Níger , População , Características da População , Dinâmica Populacional , América do SulRESUMO
PIP: The author describes a set of principles concerning census procedures agreed to by the countries of the Council for Mutual Economic Assistance. These include an agreement to conduct a decennial census at the end of each decade and close to the beginning of a year, and an agreed number of minimum and optimum components. Dates of future censuses include: Poland, 1988; USSR, 1989; Mongolia, 1989; Viet Nam, 1989; Romania, 1990; Hungary, 1990; Cuba, 1990; Czechoslovakia, 1990; German Democratic Republic, 1991; Yugoslavia, 1991; and Bulgaria, 2000.^ieng
Assuntos
Censos , Cooperação Internacional , América , Ásia , Sudeste Asiático , Bulgária , Região do Caribe , Cuba , Tchecoslováquia , Países Desenvolvidos , Países em Desenvolvimento , Europa (Continente) , Europa Oriental , Ásia Oriental , Alemanha Oriental , Hungria , América Latina , Mongólia , América do Norte , Polônia , Características da População , Pesquisa , Romênia , U.R.S.S. , Vietnã , IugosláviaRESUMO
PIP: This article presents current estimates of the number, rate, and proportion of abortions for all countries which make such data available. 76% of the world's population lives in countries where induced abortion is legal at least for health reasons. Abortion is legal in almost all developed countries. Most developing countries have some laws against abortion, but it is permitted at least for health reasons in the countries of 67% of the developing world's population. The other 33%--over 1 billion persons--reside mainly in subSaharan Africa, Latin America, and the most orthodox Muslim countries. By the beginning of the 20th century, abortion had been made illegal in most of the world, with rules in Africa, Asia, and Latin America similar to those in Europe and North America. Abortion legislation began to change first in a few industrialized countries prior to World War II and in Japan in 1948. Socialist European countries made abortion legal in the first trimester in the 1950s, and most of the industrialized world followed suit in the 1960s and 1970s. The worldwide trend toward relaxed abortion restrictions continues today, with governments giving varying reasons for the changes. Nearly 33 million legal abortions are estimated to be performed annually in the world, with 14 million of them in China and 11 million in the USSR. The estimated total rises to 40-60 million when illegal abortions added. On a worldwide basis some 37-55 abortions are estimated to occur for each 1000 women aged 15-44 years. There are probably 24-32 abortions per 100 pregnancies. The USSR has the highest abortion rate among developed countries, 181/1000 women aged 15-44, followed by Rumania with 91/1000, many of them illegal. The large number of abortions in some countries is due to scarcity of modern contraception. Among developing countries, China apparently has the highest rate, 62/1000 women aged 15-44. Cuba's rate is 59/1000. It is very difficult to calculate abortion rates in countries where the procedure is illegal. On the basis of hospital reports and other fragmentary information, the true rate appears to be relatively high in Latin America and the Far East. The abortion rate for Latin America in the mid-1970s was estimated at 65/1000 fertile aged women, and rates were believed to be higher in urban areas. Sub-Saharan Africa, where women desire very large families, apparently had the lowest rates. Up to 68% of pregnancies in the USSR, 57% in Rumania, and 55% in Japan may end in abortion. The proportion in developing countries ranged from 8% in Vietnam to 43% in China. Women undergoing abortion in developed countries tend to be young, childless, and single, while those in developing countries tend to be older, high parity, and married. Abortion mortality is still high in countries where large numbers of illegal abortions are performed by unqualified personnel, as in many parts of Latin America.^ieng
Assuntos
Aspirantes a Aborto , Aborto Criminoso , Aborto Induzido , Aborto Legal , Países Desenvolvidos , Países em Desenvolvimento , Estudos de Avaliação como Assunto , Serviços de Planejamento Familiar , Legislação como Assunto , Política , Projetos de Pesquisa , Pesquisa , África , África Subsaariana , América , Ásia , Sudeste Asiático , Região do Caribe , América Central , Anticoncepção , Cuba , Europa (Continente) , Europa Oriental , Ásia Oriental , Japão , América Latina , América do Norte , Romênia , América do Sul , U.R.S.S. , VietnãRESUMO
PIP: To facilitate understanding of the consumer market potential of today's world, "International Demographics" clusters the world's 150 largest countries based on their demographic and socioeconomic characteristics. The names of the 5 clusters--The Dependents, The Seekers, The Climbers, The Ultimate Consumers, and The Rocking Chairs--help identify the kind of consumer markets the countries represent. The 150 countries included in this 1987 volume are considered potential markets and are organized by cluster. All data cited are the most current numbers available, and all population estimates are the latest projections by the Center for International Research, US Census Bureau. Population trends of the next 14 years will change existing markets, and open new markets. However, due to rapid population growth in the poorest of the world economy, the Dependent countries, only intensified efforts on the part of the countries themselves and increased assistance from the international development community can pull these countries up. The sheer size of the market in Seeker and Climber countries is sufficient to indicate increased consumer demand. Add to that increasing income, the predominance of youth, and the ongoing rural-to-urban shift, and it is clear that demand will center on consumer durables for beginning families as the large proportions of youth will center on consumer durables for beginning families as the large proportions of youth enter their prime spending years of 15-64. Construction, sanitation, power, telecommunications, and transport are expected to boom as youth add pressure to urban job markets and housing. Slowed or stagnated growth in the rapidly aging Ultimate Consumer and Rocking Chair countries tells a different story. Some Rocking Chair countries such as West Germany already are experiencing natural decrease. Market growth in the Ultimate Consumer and Rocking Chair countries is geared to the increasingly sophisticated tastes and needs of the elderly rather than to an increase in numbers. 4 demographic factors help identify market potential--the average annual population growth rate, the average number of lifetime births per woman, the status of women, and urbanization. Countries not currently considered good potential markets are growing very rapidly at an average population growth rate of 2.5% or more and will continue to do so. The status of women is low, and the urban population is concentrated in 1 city. countries with good market potential are growing more slowly, at a rate of 1.5-2.5% a year. Fertility is under control, the status of women is improving, and urbanization is spread throughout the country.^ieng
Assuntos
Demografia , Economia , Dinâmica Populacional , Crescimento Demográfico , População , Planejamento Social , África , Distribuição por Idade , Fatores Etários , América , Ásia , Coeficiente de Natalidade , América Central , Países Desenvolvidos , Países em Desenvolvimento , Emigração e Imigração , Europa (Continente) , Europa Oriental , Mortalidade Infantil , América Latina , Mortalidade , América do Norte , Ilhas do Pacífico , Paridade , Características da População , Projetos de Pesquisa , Países Escandinavos e Nórdicos , Classe Social , Fatores Socioeconômicos , América do Sul , U.R.S.S. , Urbanização , Direitos da MulherAssuntos
Aculturação , Idioma , Religião , Migrantes , América , Argentina , Comunicação , Demografia , Países Desenvolvidos , Países em Desenvolvimento , Emigração e Imigração , Europa (Continente) , Europa Oriental , Alemanha Oriental , Alemanha Ocidental , América Latina , População , Dinâmica Populacional , Mudança Social , América do Sul , U.R.S.S.RESUMO
PIP: This discussion considers the issue of reporductive rights in the countries of Mexico, Nigeria, Iraq, India, Germany, China, Colombia, Poland, Italy, Egypt, and Ireland. In Mexico abortion is illegal, but an estimated 3 million illegal abortions are performed yearly. Complications from these abortions send 600,000 women to Mexican hospitals each year. The Mexican government, concerned about overpopulation, appears to be moving toward a liberalization of its abortion policy. Birth control is available, often without a prescription, in pharmacies, public health agencies, and some hotels. In Nigeria if a pregnant women goes abroad she must take a medical test upon returning to prove she has remained pregnant during the trip. Underground abortionists cater especially to unmarried teenagers. Women in Nigeria obtain birth control with the written permission of their husbands. Elective abortion is illegal in Iraq. Theoretically, contraception is available to all without a doctor's prescription, but in actuality, only married women buy contraceptives which are often simply not in stock in pharmacies and stores. Elective abortion is legal in India where the government has launched an agressive family planning compaign. India's family planners have had to work against religious prohibitions against abortion. Germany has zero population growth and the lowest birthrate in the world. Birth control is available to all, both by prescription and over the counter. Abortion became legal in 1978. In China "one couple one child" is the favorite slogan and the eventual goal of an aggressive family planning campaign inaugurated in 1979. The Chinese hope this policy will reduce population growth to 5% by 1985 and allow the country to achieve zero population growth by the end of the century. To this end, the Chinese government has launched a massive public education program encouraging late marriages and the use of contraception. Abortions, sterilizations, and contraceptive devices are available free at pharmacies or the workplace. In Colombia abortion is illegal; contraceptives are available to married women by prescription. Since 1960 Polish women have had the right to abortion once they have made an "oral declaration" establishing the need for one. Birth control is freely available. Abortion is legal in Italy during the 1st trimester for women 18 or older and for women under 18 with parental permission for medical, economic, social, family, or psychological reasons. Nontherapeutic abortion is illegal in Egypt, but birth control is available to all without a prescription and is increasingly used among urban, educated Egyptians. In Ireland birth control is available only by prescription and only to married women. A constitutuional amendment bans abortion.^ieng
Assuntos
Aborto Induzido , Atenção à Saúde , Serviços de Planejamento Familiar , Planejamento em Saúde , Acessibilidade aos Serviços de Saúde , Administração de Serviços de Saúde , Direitos Humanos , Legislação como Assunto , Marketing de Serviços de Saúde , Organização e Administração , Política , África , África Subsaariana , África do Norte , África Ocidental , América , Ásia , Ásia Ocidental , América Central , China , Colômbia , Anticoncepção , Países Desenvolvidos , Países em Desenvolvimento , Economia , Egito , Europa (Continente) , Europa Oriental , Ásia Oriental , Alemanha Ocidental , Saúde , Índia , Iraque , Irlanda , Itália , América Latina , México , Oriente Médio , Nigéria , América do Norte , Polônia , América do SulRESUMO
PIP: A method for evaluating the quality of census or survey data is outlined. The method is based on a model developed in 1961 by Hansen, Hurvitz, and Bershad. The use of the present model for comparisons of data quality among countries is described and evaluated. Applications to data from Cuba, Spain, Hungary, and the United States are included. (summary in ENG, RUS)^ieng
Assuntos
Censos , Coleta de Dados , Estudos de Avaliação como Assunto , Modelos Teóricos , Características da População , Reprodutibilidade dos Testes , Projetos de Pesquisa , Pesquisa , América , Região do Caribe , Cuba , Europa (Continente) , Europa Oriental , Hungria , América Latina , América do Norte , Estudos de Amostragem , Espanha , Estados UnidosRESUMO
For 20 years, female sterilization has been increasing in popularity as a contraceptive method in Costa Rica. However, contraceptive sterilization has never been allowed explicitly under Costa Rican law. In 1976 the Costa Rican National Assembly instituted more stringent guidelines regarding medical sterilizations in order to eliminate contraceptive sterilizations, which had been occurring under relatively loose interpretations of national policy. Data from the 1976 National Fertility Survey and the 1981 Contraceptive Prevalence Survey indicate that the change in policy had only a short-term effect. Period sterilization rates fell substantially after 1976 but rebounded considerably by 1980, and the estimate of the proportion of married women who will ultimately be sterilized was approximately .5 for the periods both before and after 1976.
PIP: There has been a rapid decline in fertility in Costa Rica in the past 2 decades as a result of dramatic increases in the use of contraceptives, female sterilization being one of the most popular. The objection of certain groups to contraceptive sterilization was responsible for a change in procedures designed to eliminate sterilization for contraceptive purposes. However the enforcement of this policy has had little or no long term effect since medical versus contraceptive indications for the procedure cannot be defined precisely, and surgical sterilization for medical reasons is an important part of any modern health program for women. Other examples of government effort to eliminate access to certain forms of contraception or to reverse fertility declines, especially Eastern European countries such as limiting the availability of abortion, have had only very short-lived impact on birth rates. Romania provides the most striking example. In 1966, before stringent regulations in regard to abortion went into effect, the abortion ratio per 1000 live births was 3050; in 1967 it was 333, when abortion was legally limited to women over 45; or women having 4 or more children; or with specific medical indications. But the ratio increased to a level close to 1000 by 1972; abortions were being performed more frequently on the grounds of adverse mental health consequences, which were classified as a medical indication. The general conclusion from the cases cited in this paper is that once low fertility norms are widely accepted in a society that is accustomed to access to the effective contraception needed to fulfill those norms, the ability of a government to restrict access to certain methods of contraception is substantially limited. Studies of family planning in developing countries show that the task of initiating a fertility decline is very difficult as high fertility norms are deeply integrated into social systems and not easy to dislodge. However, once low fertility norms and associated behavior are firmly established, they are equally difficult to dislodge.
Assuntos
Política Pública , Esterilização Tubária/tendências , Adolescente , Adulto , Fatores Etários , Costa Rica , Estudos Transversais , Feminino , Humanos , Casamento , Pessoa de Meia-Idade , Gravidez , Romênia , Fatores de TempoRESUMO
PIP: The attempt is made in this discussion to describe and draw lessons from the treatment of behavioral demographic variables in the Bachue demo-economic models constructed for the Philippines, Kenya, Brazil and Yugoslavia. Focus is on certain theoretical, technical and practical problems encountered in inserting demographic variables in the system as a whole; how they have been measured in the various applications of the Bachue models, how they are behaviorally explained and linked to the other elements in the system, the data sources used, and some issues of econometric estimates and modelling. 8 issues are dealt with: population accounting and lag structure; fertility; mortality; migration; nuptiality; household formation; schooling; and labor force participation. In each case model structure, dependent and explanatory variables, and empirical strategy are discussed. Summary tables compare the approaches of the different models. The specifics of each country situation rule out the identification of the best solution. Some suggestions regarding more promising approaches are included with respect to choice of variables and the estimation of behavioral models. The endogenous nature of certain demographic elements of a demo-economic model are clear, but construction of the Bachue models has shown that there are no exact rules valid for all cases. There is considerable variety in the way characteristics of the population have been represented in the various applications.^ieng
Assuntos
Computadores , Demografia , Economia , Modelos Econômicos , Modelos Teóricos , Fatores Socioeconômicos , Estatística como Assunto , África , África Subsaariana , África Oriental , América , Ásia , Sudeste Asiático , Brasil , Países Desenvolvidos , Países em Desenvolvimento , Educação , Processamento Eletrônico de Dados , Emigração e Imigração , Emprego , Europa (Continente) , Europa Oriental , Características da Família , Fertilidade , Quênia , América Latina , Casamento , Idade Materna , Mortalidade , Filipinas , População , Características da População , Pesquisa , Classe Social , América do Sul , IugosláviaRESUMO
This Bulletin examines the evidence that the world's fertility has declined in recent years, the factors that appear to have accounted for the decline, and the implications for fertility and population growth rates to the end of the century. On the basis of a compilation of estimates available for all nations of the world, the authors derive estimates which indicate that the world's total fertility rate dropped from 4.6 to 4.1 births per woman between 1968 and 1975, thanks largely to an earlier and more rapid and universal decline in the fertility of less developed countries (LDCs) than had been anticipated. Statistical analysis of available data suggests that the socioeconomic progress made by LDCs in this period was not great enough to account for more than a proportion of the fertility decline and that organized family planning programs were a major contributing factor. The authors' projections, which are compared to similar projections from the World Bank, the United Nations, and the U.S. Bureau of the Census, indicate that, by the year 2000, less than 1/5 of the world's population will be in the "red danger" circle of explosive population growth (2.1% or more annually); most LDCs will be in a phase of fertility decline; and many of them -- along with most now developed countries -- will be at or near replacement level of fertility. The authors warn that "our optimistic prediction is premised upon a big IF -- if (organized) family planning (in LDCs) continues. It remains imperative that all of the developed nations of the world continue their contribution to this program undiminished."
Assuntos
Coeficiente de Natalidade , Países em Desenvolvimento , Estudos de Avaliação como Assunto , Planejamento em Saúde , Crescimento Demográfico , Avaliação de Programas e Projetos de Saúde , Fatores Socioeconômicos , Estatística como Assunto , África , Fatores Etários , Ásia , Sudeste Asiático , Ásia Ocidental , Região do Caribe , América Central , Demografia , Economia , Europa (Continente) , Europa Oriental , Serviços de Planejamento Familiar , Fertilidade , América Latina , América do Norte , Ilhas do Pacífico , Aceitação pelo Paciente de Cuidados de Saúde , População , Controle da População , Dinâmica Populacional , Análise de Regressão , História Reprodutiva , Pesquisa , América do Sul , U.R.S.S.RESUMO
PIP: Recent evidence from the U.S. and from other selected countries is examined on parent sex preferences for their children and how strongly these are held. This involves the significance of these preferences, the social and economic conditions that foster different types of preferences, and how different individuals and societies deal with them. The traditional preference for boys appears to remain nearly universal, which runs contrary to the ideal of "every child a wanted child," and also presents an obstacle to desired declines in fertility in developing countries where sons are still perceived as needed for economic and emotional security. This tendency has been turned around in Japan, Singapore, Hong Kong, and the U.S., where small families are now the ideal. 3 basic approaches to the scientific selection of sex-specific sperm for preselection, the timing of sexual intercourse, the separation of male- and female-bearing sperm followed by artificial insemination, and selective abortion after fetal sex determination indicate that an effective and practical method of sex control is still further off than predicted.^ieng
Assuntos
Pesquisa , Sexo , Fatores Socioeconômicos , África , Argentina , Ásia , Sudeste Asiático , Ásia Ocidental , Bangladesh , Comportamento , Coeficiente de Natalidade , Chile , China , Demografia , Economia , Europa (Continente) , Europa Oriental , Ásia Oriental , Hong Kong , Hungria , Índia , Israel , Japão , Coreia (Geográfico) , América Latina , Malásia , Mortalidade , Nigéria , América do Norte , Núcleo Familiar , Psicologia , Pré-Seleção do Sexo , Valores Sociais , América do Sul , Taiwan , Fatores de Tempo , Estados UnidosRESUMO
PIP: Recent developments in the tobacco industry in several countries are described: 1) in the USSR the policy is not to encourage smoking but to produce pleasant cigarettes which are as harmless as possible; 2) in the US, a survey shows that in 1975 not more than 12.4% of men over age 21 smoked a pipe; 3) in Britain a new cigarette tax structure will cripple the cigarette industry's coupon scheme of which manufacturers make great use to secure brand loyalty; 4) in the Philippines a proposal to print a health warning on cigarette packets and in advertisements might affect cigarette and tobacco taxes, which contribute 47% of government income; 5) in the Netherlands health warnings will be printed on cigarette packs, 6) in Austria there has been an increase of 4.2% in cigarette smoking since late 1975; 7) in Poland anti-smoking officials have proposed that the name of the popular "Sport" cigarette be changed; 8) in Indonesia there has been a recovery in kretek sales; 9) in Denmark cigarette consumption increased 6% from 1974; and 10) in western Europe it has been shown that up to 99% of grocery stores in Ireland sell tobacco products, 91% in Britain, 30% in Austria, 17% in Spain, and 7% in Italy.^ieng