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Washington, D.C., Pan American Health Organization, 1985. 172 p. (PAHO Scientific Publication 492.)At present, aging is the most salient change affecting global population structure, mainly due to a marked decline in fertility rates. The Pan American Health Organization Secretariat organized a Briefing on Health Care for the Elderly in October 1984. Its purpose was to enable planners and decision-makers from health and planning ministries to exchange information on their health care programs for the elderly. This volume publishes some of the most relevant papers delivered at that meeting. The papers are organized into the following sections: 1) the present situation, 2) services for the elderly, 3) psychosocial and economic implications of aging, 4) training issues, 5) research and planning issues, and 6) governmental and nongovernmental policies and programs.
Contraception. 1984 Dec; 30(6):505-22.The World Health Organization (WHO) conducted a randomized comparative trail of th effects of hormonal contrception on milk volume and infant growth. The 341 study participants, drawn from 3 obstetric centers in Hungary and Thailand, were 20-35 years of age with 2-4 live births and previous successful experience with breastfeeding. Subjects who chose oral contraception (OC) were randomly allocated to a combined preparation containing 150 mcg levonorgestrel and 30 mcg ethinyl estradiol (N=86) or to a progestin-only minipill containing 75 mcg dl-norgestrel (N=8). 59 Thai women receiving 150 mg depot medroxyprogesterone (DPMA) intramuscularly every 3 months were also studied. An additional 111 women who were using nonhormonal methods of contraception or no contraception served as controls. Milk volume was determined by breast pump expression. No significant differences in average milk volume were noted between treatment groups at the 6 week baseline visit. However, between the 6th and 24th weeks, average milk volume in the combined OC group declined by 41.9%, which was significantly greater than the declines of 12.0% noted in the progestin-only group, 6.1% among DMPA users, and 16.7% among controls. The lower expressed milk volume among combined OC users did not impair infant growth. No significant differences were observed between treatment groups in terms of average infant body weight or rate or weight gain. Users of combined OCs may have compensated for their decreased milk volume by providing more extensive supplementary feeding or more prolonged suckling episodes. These results suggest that the estrogen content of combined OCs adversely affects the capacity of the breast to produce milk; thus, family planning programs should make nonestrogen-containing methods available to breastfeeding mothers. Although no effects on infant growth were noted in this study, the possibility of such efects cannot be excluded in populations where infant growth largely depends on the adequacy of unsupplemente d lactation.
METHODS AND FINDINGS IN EXPERIMENTAL AND CLINICAL PHARMACOLOGY. 1992 May; 14(4):289-95.UNICEF promotes the use of a very effective, inexpensive treatment of dehydration in developing countries: oral rehydration therapy (ORT), which is oral administration of a solution with equimolar concentrations of sodium and glucose (osmolality of about 300 mosmol). The solution is isotonic with respect to total body water when it reaches the small intestine. It expands the extracellular fluid without changing serum osmolality, thus, brain edema does not occur. Further, metabolic degradation of glucose eventually releases free water. On the other hand, intravenous rehydration with saline solution can be lethal, causing excess free water to expand shrunken cells and, thereby, causing brain swelling, rupture of blood vessels and hemorrhage. Yet, physicians and other health workers in developed countries have been quite sow to accept ORT. Leading conditions of dehydration include insensible loss of water and heat through evaporation from the respiratory tract and skin (common in dry air, hot environment, and fever), sensible loss of water and heat through perspiration (common in hot, humid environment and with warm and absorbent clothing), and irritation of the intestinal mucosa by allergies, infections, toxins, and intolerance to some nutrients, resulting in diarrhea. Diarrhea is indeed the main cause of dehydration. Other causes of dehydration are: failure of the hypothalamus to secrete antidiuretic hormone (ADH), kidney unresponsiveness to ADH, diabetes mellitus, protein-rich nutrition, catabolic states, and brush-border lactase after weaning. Physiological changes in dehydration consist of rigidity of the connective tissue (vascular system and lungs) and intracellular fluid loss to the extracellular spaces, resulting in dry mucous membranes, shrunken muscle cells in the lips and the tongue, soft eyes, and adverse effects to the central nervous system. Children become dehydrated more readily than adults, but they tolerate it better.
New York, New York, Population Council, . , 88,  p.This annual report of the Population Council for 1986 is divided into 3 sections covering 3 divisions: the Center for Biomedical Research, the Center for Policy Studies and International Programs, and Program Support and Services, which includes the Office of Communications. The introductory part of the report includes a listing of the board of trustees, and a summary message from the president, George Zeidenstein, at his 10th anniversary. The Center for Biomedical Research conducts practical research for actual development of contraceptives and supports basic research on topics in reproductive physiology. Examples of current projects are subdermal implants, contraceptive rings, progestin-releasing IUDs, and antifertility vaccines. The Center for Policy Studies has a Director and 11 associate staff doing research on population issues and related communication activities; supports research in Third World institutions through the International Research Awards Program on the Determinants of Fertility in Developing countries; participates in the Demographic and Health Surveys project; and publishes the Population and Development Review. The International Programs section worked principally on introducing Norplant implants worldwide, enhancing women's participation in development programs, and incorporating demographic factors into the development process. The program has regional offices in Bangkok, Cairo, and Mexico City, and its sub-Saharan African program, managed from the New York office. The Office of Communications provides population information to professionals worldwide, and publishes the Population and Development Review and Studies in Family Planning, as well as fact books, handbooks, and the Annual Report. Each subsection concludes with a listing of publications by staff and fellows. The report ends with financial statements and complete lists of fellowships, awards, contracts, publications, and staff.
Bangkok, Thailand, Unesco Principal Regional Office for Asia and the Pacific, 1991. , 100 p. (Population Education Programme Service)The UNESCO training manual for secondary school teachers or other family life educators is a revised version of Adolescent Education. This volume is Module 1, Physical Aspects. The other modules comprising the package are Module 2, Social Aspects; Module 3, Sex Roles; and Module 4, Sexually Transmitted Diseases. Materials are based on the Population Education Clearing House collection, and have been adapted for use in Asian and Pacific areas, even though attitudes vary widely among countries. Physical aspects deals with male and female reproductive systems, including physical, emotional, and psychological changes that occur during puberty and the physiological processes of human conception. The 1st chapter is concerned with providing a conceptual framework for understanding the adolescent education program and a short bibliography. The Module is comprised of 7 lessons and each may have a set of objectives, time required, materials needed, procedure, comments and considerations, information sheet, and suggested activities. Lesson 1.1 deals with the female reproductive system and external genitalia and male reproductive system and bullbourethral glands and penis. Lesson 1.2 is concerned with ovulation and menstruation. Lessons 1.3 is on the physical, emotional, and psychological changes during puberty. Lesson 1.4 relates to the body clock, which tells the physical signs of reproductive maturity. Lesson 1.5 entails looking at myself as I see my body. Lesson 1.6 is on conception. Lesson 1.7 provides the necessary information on pregnancy and essential needs. The time required for each lesson ranges from 40-80 minutes. Worksheets provide detailed pictures to augment the information sheets. An example of the information sheet for the male body clock is as follows: Puberty is described, and 8 sequential changes are outlined. Puberty is defined as beginning between 10-11 years and proceeding at a variable rate of change. The changes are growth of testes and scrotum, straight pubic hairs, 1st ejaculation, growth spurt, voice change, underarm and coarser body hair, oil and sweat glands activated, and facial hair (beard).
MIDWIVES CHRONICLE. 1985 Jul; 98(1170):200-1.At the April meeting of the World Health Organization (WHO), experts in occupational health concluded that there is no evidence to justify the exclusion of women from any type of employment. Yet, they simultaneously underscored the need for conditions in places of work to be adapted to women, and in particular to those women employed in manual work, whether agriculture or manufacture. This was WHO's 1st meeting on the subject of health and the working woman. According to the experts, anatomical and physiological differences between men and women should not limit job opportunities. As more and more women enter the work force, machines need to be redesigned to take into account the characteristics of working women. In industries where strength is a requirement, e.g., mining, a certain level of body strength and size should be established and applied to both sexes. Also recommended were measures to protect women of childbearing age, who form the majority of women in the work force, against the hazards of chemicals -- gases, lead, solder fumes, sterilizing agents, pesticides -- and other threats to health deriving from the work places. Chemicals or ionizing radiation absorbed into the body could lead to mutagenicity, not only of women but also of men. In cases where a woman has conceived, mutagenicity could mean fetal death, or, where damage is done to sperm or ovum, lead to congenital malformation and to leukemia in newborns. Solvents so absorbed could appear in breast milk, thus poisoning the baby. Ionizing radiation, used in several industrial operations, also has been linked to breast cancer. As women increasingly take jobs that once used to be done solely by men, more needs to be known about the hazards of their health and of the psychosocial implications of long working hours. The following were included among recommendations made to increase knowledge and to protect health: that epidemiological studies be conducted in the risk of working women as well as more research on the effects of chemicals on pregnant workers; that working women be allowed to breastfeed children for at least 6 months at facilities set up at work places; and that information and health education programs be carried out to alert women against occupational health hazards.
Mothers and Children. 1985 Nov-Dec; 5(1):5, 7.Currently standards from industrialized countries are used to assess the growth patterns of breastfed infants in developing countries. Infant growth faltering is interpreted as an indicator of insufficient lactational capacity on the mother's part. 2 recent articles suggest the need for a critical reappraisal of current growth standards and their use for evaluating the adequacy of infant feeding practices. The most commonly used standards to evaluate infant growth are derived from the US National Center for Health Statistics based on anthropometric data collected in the US population 3-month intervals up to the age of 3. During this period, infant feeding practices varied greatly. Many babies were bottle-fed and given supplemental feedings early in life. No large sample of exclusively breastfed infants has been studied from birth on, and thus a standard for breastfed infants is not available. A study of fully breastfed infants was done in England and suggests that there are differences in growth rates. Among a population of 48 exclusively breastfed boys and girls, for the 1st 3 to 4 months of life, growth of breastfed infants was greater than National Center for Health Statistics Standards, while after 4 months growth velocity decelerated more quickly than the standard. The growth of infants studied in Kenya, New Guinea and the Gambia appears to falter at 2-3 months of age using the NCHS standard. Findings suggest that current FAO/WHO recommended energy intakes may be excessive. Recent studies in the US support this assertion. The adequacy of the milk production for the infants in this US study done in Texas was illustrated by their growth rates. Length for age percentiles were higher than the NCHS standards throughout the study though at birth they did not differ significantly. 1 reason these breastfed infants were able to maintain growth despite less than recommended energy intakes is that the ratio of weight gain/100 calories of milk consumed was 10-30% higher among the breastfed infants compared to formula fed infants, suggesting a more efficient use of breastmilk than formula. There is a need for studies of exclusively breastfed infants with larger samples to determine what growth pattern should be considered the norm.
In: World Health Organization. Manual of the international statistical classification of diseases, injuries, and causes of death. Vol. 1. Geneva, Switzerland, WHO, 1977. 761-8.This presentation defines live birth, fetal death, causes of death, underlying causes of death, birthweight and low birthweigth, gestational age, preterm, term, postterm, and maternal mortality. It makes recommendations regarding the following: responsibility for medical certification of cause of death; form of medical certificate of cause of death; confidentiality of medical information; selection of the cause for mortality tabulation; use of the International Classification of Diseases; perinatal mortality statistics; maternal mortality statistics, statistical tables; and tabulation of causes of death. Medical certification of cause of death should normally be the responsibility of the attending phsician. In the statistical use of the medical certificate of cause of death and other medical records, administrative procedures should provide such safeguards as are necessary to preserve the confidential nature of the information given by the position. It is recommended that national perinatal statistics should include all fetuses and infants delivered weight at least 500 gm (or, when birthweight is unavailable, the corresponding gestational age--22 weeks--or body length (25 cm crown heel), whether alive or dead). The maternal mortality rate, the direct obstetric death rate, and the indirect obstetric death rate should be expressed as rates per 1000 livebirths. The degree of detail in cross classification by cause, sex, age, and area of territory will depend partly on the purpose and range of the statistics and partly on the practical limits as regards the size of the tables. The patterns listed, designed to promote international comparability, consist of standard ways of expressing various characteristics.
World Health Organization Technical Report Series.. 1965; 22.Add to my documents.