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  1. 1

    The breastmilk controversy.

    Panos Institute

    WORLDAIDS. 1992 Jan; (19):11.

    In 1991, researchers followed 212 mothers and infants who tested HIV-1 negative at delivery in Rwanda. Later 8 infants tested HIV positive. Both the infants and mothers became infected simultaneously. They ruled out other routes of infection and concluded that the colostrum and breast milk were possibly the route of infection for 4 infants and positively the route for 4 infants. They postulated that when one 1st becomes infected with HIV, one may have high levels of HIV in the blood and thus be more infectious in the time period between 1st contracting HIV and development of HIV antibodies. All the mothers were vulnerable to sexual exploitation because they were either unmarried or widowed or had absent husbands and unstable sexual partnerships. Thus the risk factor of economic and social instability enhanced their vulnerability to exposure to HIV. The researchers suggested that heal professionals should counsel HIV negative mothers who are at high risk about the possibility of transmitting HIV via breast milk if they happen to seroconvert. In some developing countries like Rwanda, no alternatives to breast feeding exist so the researchers advocated intervention studies to assess the efficacy and feasibility of alternative nutritional practices, such as wet nursing, for mothers at high risk of acquiring HIV after delivery. They did not conclude that already HIV infected mothers should not breast feed since research had not yet proved that infants acquire HIV from breast milk of infected mothers. In fact, other research showed that HIV positive infants who are breast fed live longer than bottle fed HIV infants. After publication of this study, WHO continued its commitment to promote, protect, and support breast feeding no matter what the HIV prevalence of a country is.
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  2. 2

    Marriage and divorce in Australia.

    Mcdonald PF

    In: United Nations [UN]. Economic and Social Commission for Asia and the Pacific [ESCAP]. Population of Australia. Vol. 1. New York, New York, UN, 1982. 183-98. (Country Monograph Series No. 9; ST/ESCAP/210)

    Australian marriage patterns in the late 19th century reflected those found among the English middle class, with a high proportion of males never marrying and late ages at 1st marriage. However, the attainment of the fertility transition in the 1930s stimulated a greater willingness to marry, even under adverse economic circumstances. A dramatic decline in age at marriage accompanied World War II. This decline, which continued throughout the 1950s and 60s, was further stimulated in the late 1960s by widespread use of oral contraceptives. Effective birth control allowed women to marry at a young age but delay childbearing until their careers had become established. The 1970s, however, were marked by the collapse of the early marriage pattern. The economic insecurity of that period led to a more conservative approach to the decision to marry, with postponement until economic security or psychological preparedness had been attained. These patterns have been noted across geographic, ethnic, religious and class groupings. Divorce reached high levels in 1947, as a result of the disruption caused by World War II, but then declined. The Family Law Act of 1975, which liberalized divorce requirements, led to an upsurge in the divorce rate in the 1970s. By 1980, there were 11.7 divorces/1000 married women. The increase in divorce is not just occurring among the younger generation of married women, but equally affects marriages that took place during the 1950s and 60s. There are an average of 2 children in divorces taking place among parents. 10% of ever-married women and 4% of ever-married men are widowed by the age of 50 years. By age 70, 40% of women and 11% of men are widowers. Although there has been little systematic study of remarriage, rates appear to be higher among younger men and women. Rates of remarriage seem to be higher after widowhood for men than women. Research should be directed to the question of whether the more cautious approach to marriage emerging in recent years achieves better quality marriages. Attention should also be given to trends in the proportion of men and women never marrying.
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