(1/152) Intrauterine donor insemination in single women and lesbian couples: a comparative study of pregnancy rates.
The outcome of intrauterine donor insemination (IUI-DI) with frozen spermatozoa was analysed retrospectively in 675 cycles in single women (n = 122; 536 cycles) and lesbian (n = 35; 139 cycles) couples. The lesbian patients were younger at the initiation of treatment (mean 34.5 years; range 26-44) than the single women (mean 38.5; range 29-47) (P = 0.005). Clinical pregnancy rate was 36% in single women and 57% in lesbians (P < 0.05), the cumulative pregnancy rate after six cycles being 47% and 70% respectively, although the outcome was similar when related to age. The miscarriage rate was higher (35%) in single women than in lesbians (15%; P < 0.05), the rate being independent of maternal age. There were no apparent differences seen between the two groups with respect to the possible effect of parity, duration of infertility, causes of infertility and type of treatment at initiation of treatment; the sole exception was that the age of lesbian women was statistically significantly younger than that of single women (P < 0.005). When corrected for age, the pregnancy rates and complications were lower and higher respectively in single women but these differences did not reach statistical significance. However, the disparity between the treatment outcomes of single women and lesbian patients of similar ages may also reflect the fact that single women are likely to have failed to conceive for a period of time prior to referral to a specialist centre for treatment. (+info)
(2/152) Prevalence of sleep disturbance and hypnotic medication use in relation to sociodemographic factors in the general Japanese adult population.
This study was the first nationwide population-based study to estimate the prevalence rates of sleep disturbance and hypnotic medication use in the general Japanese adult population. In 1997, 2,800 Japanese adults aged 20 years and over were randomly selected from the 1995 Census and 1,871 were examined using the Pittsburgh Sleep Quality Index. The respective estimated overall prevalences of insomnia (INS), difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), poor perceived quality of sleep (PQS) and hypnotic medication use (HMU) were 17.3%, 8.6%, 12.9%, 17.8%, and 3.5% in males and 21.5%, 12.6%, 16.2%, 20.2% and 5.4% in females. Among males, DIS (OR = 2.76) and PQS (OR = 2.12) were associated with never having married. DMS was associated with being 60 years and older (OR = 2.68) or divorced/separated (OR = 3.74). Among females, DMS was associated with being widowed (OR = 1.65), unemployed (OR = 1.60), 40 to 59 years old (OR = 0.57) or never having married (OR = 0.39). DIS was associated with being widowed (OR = 1.67) or unemployed (OR = 1.58). HMU was associated with advancing age (OR = 8.26-10.7), being widowed (OR = 2.12) or never having married (OR = 2.84). PQS was associated with advancing age (OR = 0.63-0.50). Our study showed sleep disturbance and hypnotic medication use were prevalent among Japanese adults and some sociodemographic factors contributed to them. (+info)
(3/152) Living arrangements affect dietary quality for U.S. adults aged 50 years and older: NHANES III 1988-1994.
The number and proportion of older U.S. adults who live alone have increased dramatically in the past three decades, and there is concern that these individuals may have particularly poor dietary quality. We examined the association of four living arrangements (living with a spouse only, with a spouse plus someone else, with someone other than a spouse or living alone) with dietary quality (the number of low nutrients out of a possible 15, with low defined as <67% of the recommended dietary allowance) among 6525 U.S. adults aged 50-64 y and those >/=65 y in the third National Health and Nutrition Examination Survey (NHANES III 1988-1994). Among non-Hispanic Caucasian adults, those who lived with a spouse only had better dietary quality, with significant differences ranging from 0.8 to 1.5 fewer low nutrients compared with those with other living arrangements. Effects of living arrangements on dietary quality were also seen among non-Hispanic African-Americans, Mexican-Americans, and those of "other" races, but differences were significant only for African-American men aged >65 y living with a spouse plus others (1.6 additional low nutrients compared with those living with a spouse only). Energy intake was strongly associated with dietary quality, but did not account for the associations between living arrangements and dietary quality. Although middle-aged and older adults with living arrangements other than living with a spouse only (including those living alone) tended to have poorer dietary quality, the effects varied substantially across age, gender and ethnic categories. (+info)
(4/152) A minimum income for healthy living.
BACKGROUND: Half a century of research has provided consensual evidence of major personal requisites of adult health in nutrition, physical activity and psychosocial relations. Their minimal money costs, together with those of a home and other basic necessities, indicate disposable income that is now essential for health. METHODS: In a first application we identified such representative minimal costs for healthy, single, working men aged 18-30, in the UK. Costs were derived from ad hoc survey, relevant figures in the national Family Expenditure Survey, and by pragmatic decision for the few minor items where survey data were not available. RESULTS: Minimum costs were assessed at 131.86 pound sterling per week (UK April 1999 prices). Component costs, especially those of housing (which represents around 40% of this total), depend on region and on several assumptions. By varying these a range of totals from 106.47 pound sterling to 163.86 pound sterling per week was detailed. These figures compare, 1999, with the new UK national minimum wage, after statutory deductions, of pound 105.84 at 18-21 years and 121.12 pound sterling at 22+ years for a 38 hour working week. Corresponding basic social security rates are 40.70 pound sterling to 51.40 pound sterling per week. INTERPRETATION: Accumulating science means that absolute standards of living, "poverty", minimal official incomes and the like, can now be assessed by objective measurement of the personal capacity to meet the costs of major requisites of healthy living. A realistic assessment of these costs is presented as an impetus to public discussion. It is a historical role of public health as social medicine to lead in public advocacy of such a national agenda. (+info)
(5/152) Comprehensive family planning services to an urban black community.
A three year experience. (+info)
(6/152) Primary health care services for single homeless people: defects and opportunities.
BACKGROUND: An innovative residential centre in west London during 1997-1998 helped older rough sleepers leave the streets and resettle in conventional homes. Many clients presented with multiple physical illnesses complicated by chronicity and poor management. The centre initially experienced difficulties in obtaining health care for the residents, briefly relied on an A&E department for treatment of serious and minor ailments, and latterly was served by a GP practice supported by special funding. OBJECTIVE: The aims of this study were to describe the problems of providing at short notice primary health care services to a high-need group, and the prospective opportunities for the delivery of the required care. METHOD: A monitoring study collected routine operational data, life histories from 88 residents using a semi-structured questionnaire and information from 61 residents about their contacts with GPs before residence in the centre. Interviews were also conducted with the centre's staff, a Health Authority officer and a GP who treated the residents. RESULTS: The medical care of the residents was a major concern. Many had physical illnesses yet three-fifths had not seen a GP for more than 5 years. Many were not registered, even among those who recently had become homeless. It was difficult to organize the residents' medical care and to access special funding at short notice. When funding was secured, there were difficulties in contracting the service. CONCLUSION: Current registration and commissioning procedures are ill fitted to provide primary care services to a high-needs group at short notice. Primary Care Groups, special funding and contractual arrangements provide opportunities for GPs and primary health care workers to provide an improved service to marginalized and special needs groups. The responsibility to identify and respond to exceptional needs should be clearly defined and allocated. (+info)
(7/152) Trends in pregnancy rates for the United States, 1976-97: an update.
OBJECTIVES: This report presents detailed pregnancy rates for 1996 and 1997 to update a recently published comprehensive report on pregnancies and pregnancy rates for U.S. women. METHODS: Tabular and graphic data on pregnancy rates by age, race, and Hispanic origin, and by marital status are presented and described. RESULTS: In 1997 an estimated 6.19 million pregnancies resulted in 3.88 million live births, 1.33 million induced abortions, and 0.98 million fetal losses. The 1997 pregnancy rate of 103.7 pregnancies per 1,000 women aged 15-44 years is the lowest recorded since 1976 (102.7), the first year for which a consistent series of national pregnancy rates is available. The 1997 rate was 10 percent lower than the peak rate in 1990 (115.6). The teenage pregnancy rate dropped steadily through 1997, falling to a record low of 94.3 pregnancies per 1,000 teenagers 15-19 years, 19 percent below the 1990 level (116.3). Rates for younger teenagers declined more than for older teenagers. (+info)
(8/152) Breast cancer rates in populations of single women.
The well known associations of breast cancer with fertility patterns and diet are interdependent and it is difficult to estimate the extent to which breast cancer is related to diet. This was attempted by analysing breast cancer rates in populations of single (never married) women for which the contribution of childbearing would be small. Age specific breast cancer rates for single women showed the same variation by country, social class, urban-rural area and with time, as did the corresponding rates for married women, suggesting that common or related factors determined breast cancer rates in single and married women. Also, dietary correlations of breast cancer rates at 55-64 years, around 1960, were not sifnificantly different for single women and the general female population. This supported the view that the dietary associations with breast cancer, observed in larger studies of general female populations, did not arise indirectly from an association with childbearing rates. It was pointed our that the positive association of breast cancer with sugar, observed for single and for all women, was accopanied by a negative association with starch. These opposite associations with two forms of varbohydrate seemed inconsistent on general nutritional grounds and could be explained as arising indirectly to the association of breast cancer with affluence. Otherwise, it would seem necessary to establish a nutritional difference between starch and sugar, which could reasonably influence breast cancer rates, before the association was accepted as indicating cause. (+info)