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The purpose of this study is to determine the prevalence of risky sexual activities among adolescents within the context of other behavioural factors that contribute to compromised health outcomes, for both sexes, those who initiated sexual activity at an early age were more likely to engage in a variety of significant risks behaviours factor. Possibility engaging in sexual activity is associated with age, low academic performance, substance abuse, violence, depression, and suicidal tendencies. The more regular occurrence of these risk factors, the higher the chances of engaging in sexual activity. The aim of various examining is to find efforts on how specific ways of conceptualizing to reduce multiple risk factors and to determine how adolescents’ views on reproductive issues influence may develop sexual initiation and patterns of behaviour in sexual activity over the time. KEYWORD: Adolescent, Healthy, Sexual Activity, Therapy, Emotional, Multiple Risk

OBJECTIVE Adolescent and young women (10-24 years old) are a neglected group in humanitarian settings and their sexual and reproductive health (SRH) needs are habitually ignored. Our study aims to assess main SRH issues affecting migrant Venezuelan adolescents and young women in Boa Vista, Roraima at the northwestern border of Venezuela-Brazil. METHODS A cross-sectional study with a self-responded questionnaire with information about SRH was conducted in 153 Venezuelan adolescent and young migrant women at Boa Vista, from January 18 to 23, 2021. A descriptive analysis was performed. RESULTS Mean age was 17.7 years and two-thirds were under 20 years old. The majority (84%) were living on the streets. Most of them (54%) reported that they had at least one previous childbirth, 10% were pregnant at the time of the interview, 30% of them were not attending prenatal care. The main SRH concern was contraception (35%); however, 75% of those interviewed who went to a healthcare service were unable to obtain the method of their choice and for 91% no other contraceptive was offered. CONCLUSION Migrant Venezuelan adolescents and young women in Boa Vista have their SRH needs overlooked. Efforts to address these SRH needs, especially during the pandemic, require urgent attention.

The study examines how doctors in interwar Czechoslovakia intervened in reproductive issues and related areas of life in an attempt to combat the declining birthrate, a trend that was considered a threat to society. Inspired by Foucault’s concept of medicalization and biopower, through the analysis of medical literature and articles from the press in the interwar period, I will demonstrate how Czechoslovak doctors, not only but especially under the influence of eugenics, foregrounded the categories of health and sickness in order to assert definitions of “correct” forms of reproduction while attempting to stigmatize and discourage forms of reproduction that they considered detrimental to the health of society or the nation. The aim of the study is not only to expand the body of knowledge about the activities and attitudes of Czechoslovak doctors in the interwar period but also to call attention to the still current topic of the political background of reproductive policy Studie zkoumá, jak lékaři v meziválečném Československu zasahovali do oblasti reprodukce a souvisejících oblastí, ve snaze bojovat s klesající porodností, tedy trendem, který byl považován za jednu z hrozeb tehdejší společnosti. Inspirována Foucaultovými koncepty medikalizace a biomoc, se prostřednictvím analýzy lékařské literatury a tisku z meziválečného období, pokusím ukázat, jak českoslovenští lékaři (nejen, ale především) pod vlivem eugeniky, usilovali o prosazení „správných“ forem reprodukce a stigmatizaci a těch forem reprodukce, které považovali za škodlivé zdraví společnosti nebo národa, a to prostřednictvím zdůrazňování kategorie zdraví a nemoci. Cílem studia není pouze rozšíření znalostí o činnosti a postojích československých lékařů v meziválečném období, ale také upozornit na stále aktuální téma politického pozadí reprodukční politiky.

A pesquisa tem como objetivo correlacionar com os padrões de autoestima e fatores associados em gestantes de alto risco em uma maternidade de referência na cidade do Recife, Pernambuco, Brasil. Trata-se de um estudo descritivo, transversal, com abordagem quantitativa. A população amostral incluiu 112 mulheres, gestantes, adultas. Na coleta de dados foi utilizado um formulário adaptado da versão no Brasil da Escala de Autoestima de Rosenberg (EAR), acrescido de questões socioeconômicas, obstétricas e reprodutivas. Observou-se que escolaridade foi í única variável com associação significativa com autoestima (p < 0,05) e para a referida variável se destaca que o percentual com autoestima insatisfatória reduziu com o grau de escolaridade, sendo 96,0% entre as que tinham até fundamental incompleto, 75,0% entre as que ensino fundamental e 61,0% entre as que tinham ensino médio/superior. Reconhece-se que as maternidades funcionam muitas vezes como porta de acesso para identificação e acolhimento dessas gestantes sendo necessária a atualização/capacitação dos profissionais de saúde para o atendimento adequado e direcionado, uma vez que poucas mulheres têm acesso í avaliação de seu estado emocional durante a gestação.

Systemic sclerosis (SSc) is a rare systemic autoimmune disease that can influence reproductive health. SSc has a strong female predominance, and the disease onset can occur during fertility age in almost 50% of patients. Preconception counseling, adjustment of treatment, and close surveillance during pregnancy by a multidisciplinary team, are key points to minimize fetal and maternal risks and favor successful pregnancy outcomes. The rates of spontaneous pregnancy losses are comparable to those of the general obstetric population, except for patients with diffuse cutaneous SSc and severe internal organ involvement who may carry a higher risk of abortion. Preterm birth can frequently occur in women with SSc, as it happens in other rheumatic diseases. Overall disease activity generally remains stable during pregnancy, but particular attention should be paid to women with major organ disease, such as renal and cardiopulmonary involvement. Women with such severe involvement should be thoroughly informed about the risks during pregnancy and possibly discouraged from getting pregnant. A high frequency of sexual dysfunction has been described among SSc patients, both in females and in males, and pathogenic mechanisms of SSc may play a fundamental role in determining this impairment. Fertility is overall normal in SSc women, while no studies in the literature have investigated fertility in SSc male patients. Nevertheless, some considerations regarding the impact of some immunosuppressive drugs should be done with male patients, referring to the knowledge gained in other rheumatic diseases.

The concern about the offspring’s health is one of the reasons for a reduced family size of women with rheumatic diseases (RD). Increased risk of autoimmune diseases (AD) and neurodevelopmental disorders (ND) has been reported in children born to patients with RD. Within a nationwide survey about reproductive issues of women with RD, we aimed at exploring the long-term outcome of their children. By surveying 398 patients who received their diagnosis of RD during childbearing age (before the age of 45), information about the offspring were obtained from 230 women who declared to have had children. A total of 148 (64.3%) patients were affected by connective tissue diseases (CTD) and 82 (35.7%) by chronic arthritis. Data on 299 children (156 males, 52.1%; mean age at the time of interview 17.1 ± 9.7 years) were collected. Twelve children (4.0%), who were born to patients with CTD in 75% of the cases, were affected by AD (8 cases of celiac disease). Eleven children had a certified diagnosis of ND (3.6%; 6 cases of learning disabilities); 9 of them were born to mothers with CTD (5 after maternal diagnosis). No association was found between ND and prenatal exposure to either maternal autoantibodies or anti-rheumatic drugs. Absolute numbers of offspring affected by AD and ND were low in a multicentre cohort of Italian women with RD. This information can be helpful for the counselling about reproductive issues, as the health outcomes of the offspring might not be an issue which discourage women with RD from having children.

This thesis explores attitudes towards different forms of reproductive rights in Europe, both variation in such attitudes and what factors can help us explain this variation. The gender and politics literature has begun disaggregating women’s issues into sub- categories. Due to the varied nature of the reproductive issues, I argue needs this important sub-category needs to be disaggregated further. One important reproductive issue is abortion, and the relevant factors for explaining variation in individual attitudes are well-established. In comparison, much less is known about what explains variation in attitudes toward assisted reproductive technology (ART), which is an emerging issue in the field of reproductive rights. Drawing on explanations identified for abortion attitudes, I rely on party explanations and cultural and religious explanations to explain individual attitudes towards ART. Employing the most comprehensive survey data available (European Values Study), I test what country-level explanations account for variation in aggregated attitudes toward assisted insemination (AI) and in vitro fertilization (IVF) compared to abortion in Europe. I find that political orientation has a relatively little explanatory power for AI/IVF and abortion attitudes, while religiosity is a substantial predictor of negative attitudes towards AI/IVF and abortion. I draw on data from the EVS as well as the Norwegian National Election Study (NNES), which includes variables on both surrogacy and abortion attitudes, to disaggregate attitudes towards reproductive rights further. The results suggest Christian Democratic Party support and religiosity are strong predictors of negative attitudes toward AI/IVF, surrogacy and abortion. My findings point to the importance of disaggregating the sub-category of reproductive issues even further, as the explanatory power of political orientation and religiosity differ between AI/IVF and abortion attitudes, as well as AI/IVF and surrogacy attitudes.

This chapter addresses phenomena seen in children that represent departure from a gender essentialist viewpoint. This is the idea that normal people can be categorized as male or female, and that social behavior should ordinarily follow from biological sex. Gender essentialism is integral to most traditional religious and philosophical systems, but is now almost excluded from many academic and professional forums. This chapter discusses gender incongruity, and disorders of sexual differentiation, as examples of challenges to the gender essentialist viewpoint.

Tissue engineering is an innovative approach to develop allogeneic tissues and organs. The uterus is a very sensitive and complex organ, which requires refined techniques to properly regenerate and even, to rebuild itself. Many therapies were developed in 20th century to solve reproductive issues related to uterus failure and, more recently, tissue engineering techniques provided a significant evolution in this issue. Herein we aim to provide a broad overview and highlights of the general concepts involved in bioengineering to reconstruct the uterus and its tissues, focusing on strategies for tissue repair, production of uterine scaffolds, biomaterials and reproductive animal models, highlighting the most recent and effective tissue engineering protocols in literature and their application in regenerative medicine. In addition, we provide a discussion about what was achieved in uterine tissue engineering, the main limitations, the challenges to overcome, and future perspectives in this research field. Impact Statement This review presents the applications of tissue engineering in uterine reconstruction and in regenerative therapies of uterine wall injuries.

Reproductive problems in dairy animals emerged as prime concern for farmers due to their significant effect on the profitability and sustainability of dairy ventures in India. The present study was undertaken to assess the major reproductive problems of dairy animals as well as to develop and validate the extension strategies for managing reproductive problems. A total of 60 respondents from three villages viz Dilawara, Chundipur and Dhakwada of Karnal district were selected through simple random sampling. Data were gathered through structured interview schedule from dairy farmers who had at least one milch animal. Study revealed that repeat breeding, anestrous, retention of fetal membrane and prolapse were the major reproductive problems of dairy animals as perceived by 46.67, 36.67, 28.33 and 26.67 per cent of respondents respectively. Among 14 selected extension strategies, development and demonstration of video on specific reproductive issues with Rank Based Quotient (RBQ) value of 81.19 and preparation of extension literature with RBQ value of 72.38 were found to be the two best strategies for faster dissemination of information onmanagement of reproductive problems. The mean knowledge gain was found to be 10.75 per cent, 13.28 per cent and 15.23 per cent after exposure to different treatments i.e. booklet, video and both (video+booklet) respectively in the studyvillages. This explains the effectiveness of extension strategies and warrants the extension personnel to contextualise and deploy appropriate combinations of different extension strategies in order toimprove the information delivery system.

Objective Sexual and reproductive health rights are the rights of all people regardless of their age, sex and other characteristics to make choices about their own sexuality and reproductive issues. However, little is known about the knowledge and attitude towards SRH rights in Ethiopia. Therefore, this study aimed to assess knowledge and attitude towards SRH rights and associated factors among Adet Tana Haik college students in northwest Ethiopia. Results Overall, about 59.6% students were knowledgeable and more than half (53.4%) had favorable attitude towards SRH rights. In this study, students attending third-year class (AOR = 2.20;95% CI 1.29, 3.33), discussion with parents (AOR = 3.35;95% CI 1.61, 6.96), respondent’s mothers attended secondary/above school (AOR = 3.01; 95% CI 1.28, 7.13), participation in RH clubs (AOR = 1.72; 95% CI 1.09, 2.70) and favorable attitude towards SRH rights (AOR = 2.41; 95% CI 1.56, 3.74) were significantly associated with knowledge of participants. On the other hand, knowledge of students (AOR = 2.33; 95% CI 1.36, 7.07), participation in RH clubs (AOR = 1.41;95% CI 1.09, 2.20) and discussion with parents (AOR = 2.50; 95% CI 1.15, 5.47) were the predictors for the attitude of students towards SRH rights. Hence, strengthening women’s education, encouraging discussions with parents and participation in RH clubs may improve the knowledge and attitude of students towards SRH rights. Electronic supplementary material The online version of this article (10.1186/s13104-019-4116-4) contains supplementary material, which is available to authorized users.

Montmorillonite clay due to its abundance and environmental friendliness, has several industrial applications among which is the adsorption of mycotoxins in foods and feeds as binding agents. Fungal species from the genus Fusarium produce zearalenone (ZEA); an oestrogenic compound, which has been implicated in hormonal and reproductive issues for both animal and man. In this study, various nanoformulations from montmorillonite clay and Cymbopogon citratus (lemongrass) extracts were developed for the decontamination of ZEA in millet. The various formulations developed included montmorillonite clay and essential oil of Cymbopogon citratus (Mont-LGEO), montmorillonite clay mixed with C. citratus (lemongrass) powder (Mont-LGP) and montmorillonite clay washed with 1 mM NaCl (Mont-Na). Unmodified montmorillonite clay (Mont) and C. citratus (lemongrass powder) (LGP) served as the negative controls for the treatment. Each of the formulations was exposed to millet grains at concentrations of 8 and 12% and stored for 4 weeks. All the formulations were effective in the decontamination of ZEA in millet after 4 weeks with LGP exposed at 12% recording the highest reduction of 98.3% while the second most effective formulation, Mont-LGP exposed at 12% showed a 66% reduction of ZEA in millet (p = 0.05).

Direct oral anticoagulants (DOACs) are replacing warfarin and other vitamin K antagonists for a wide range of indications. Advantages of DOAC therapy are fewer food and drug interactions and fixed dosing without routine laboratory monitoring, making DOACs the perfect choice especially for younger patients, in whom the main indication for anticoagulation is prevention and treatment of venous thromboembolism (VTE). Although DOACs are safer and much more convenient than other anticoagulant alternatives, their profile may have drawbacks, especially for younger female patients in whom reproductive issues need special considerations. These may include the issue of heavy menstrual bleeding (HMB) during anticoagulant therapy, the embryotoxicity risk from inadvertent DOAC exposure during pregnancy, and the prevention or planning of pregnancies during DOAC therapy. This review summarizes the most relevant evidence in this increasingly important field of women’s health.

Background: Reproductive issues as related to congenital heart disease (CHD) such as recurrence risk in offspring, safety of hormonal birth control, and safety of pregnancy for mother and baby must be discussed in the clinic and at home. Providers can ensure correct information to assist the adolescent in making informed decisions about reproductive health and allow the parent to provide proper support and guidance to the adolescent. The level to which these conversations occur is unknown. Methods: A survey distributed to female adolescent/mother dyads assessed …

Multiple sclerosis is a chronic disease that may lead to different types of symptoms and disabilities. with the better quality of life and decreased disability due to early diagnosis and the availability of disease-modifying therapies (DMTs), the treating physician is increasingly asked to counsel patients on its effects on fertility and reproduction. In particular, reproductive issues are still scarcely studied and discussed in men. Among the still open questions are the following: (a) Does multiple sclerosis cause infertility per sè? (b) Is multiple sclerosis correlated with conditions that increase the risk of infertility? (c) Do DMTs or other therapies for multiple sclerosis impact gonadal function in men? The aim of this review is to provide an overview on the available literature data about the reproductive issues unique to men with multiple sclerosis, underlining the numerous areas where evidence is lacking and, therefore, the priorities for future research.

The majority of the over one billion people with disabilities (PWDs) around the world face challenges related to sexual and reproductive health (SRH) information. The main causes are cultural, legal, political and social practices that continue to marginalize people with disabilities when it comes to sexual and reproductive health. Literature shows that societies do not approve for PWDs to engage in sexual and reproductive issues. PWDs were regarded as people without sexual feelings. Women with disabilities were sterilized without their consent. PWDs were seen as people who cannot make decisions when it comes to sexual and reproductive rights. PWDs are also systemically denied the opportunity to access SRH information. Social media is providing alternative sources of information and learning platforms to women with disabilities. The chapter will also discuss how women with disabilities are benefitting from social media platforms in the area of SRH.

Endometriosis affects a great proportion of women during their reproductive years and may impair female fertility in several ways. Ovarian endometrioma (OE) is the most frequent phenotype and growing evidence suggest an endometrioma-mediated damage to the ovary, ovarian reserve and oocyte quality. Traditionally, surgery has been the first-line treatment in cases of OE. Great advances in assisted reproduction and fertility preservation techniques opened new possibilities towards a more conservative approach. Herein we discuss multiple mechanisms responsible for the deterioration of the reproductive capacity in cases of OE as well as the pros and cons of different treatment options. The management of endometrioma-related subfertility remains controversial and it will depend on patient's intentions and priorities. In the "internet era" patients tend to be hyper-informed and more participative, but they are often misguided and misinformed. Thus, doctors should be able to convert these individuals into well-informed patients in order to facilitate the process of shared decision making, which is extremely relevant in the context of OEs.

Background: This study investigates the knowledge, attitudes, and practices (KAP) concerning reproductive health (RH) and sexuality among in- and out-of-school adolescents in the Cordillera Administrative Region (CAR), Philippines. Methods: Using a quantitative, cross-sectional approach, this study examined 739 in- and out-of-school adolescents who were recruited through snowball and simple random sampling. Results: Statistically significant differences were noted in the knowledge, attitudes, and practices regarding sexuality based on age. Age was associated with knowledge, attitudes, and practices concerning RH. Educational attainment toward sexuality also caused statistically significant changes in knowledge, attitudes, and practices. The KAP regarding sexuality and sex only showed statistically significant differences in attitudes and RH and sex to attitudes. Schooling produced statistically significant differences in knowledge, attitudes, and practices regarding sexuality; for RH, statistically significant differences were found only in knowledge and attitudes. Conclusion: The results can inform educational campaign development, which can be used when devising appropriate behavioral change materials suitable for and responsive to the needs and demands of the CAR adolescents.

Despite its strong affirmation on the international scene, reproductive liberty has not been very successful in realizing reproductive rights under European human rights law. The aim of this article is to examine two possible argumentative avenues for reframing reproductive rights, the market and the health frameworks. The authors argue that those approaches to reproductive issues enrich reproductive rights and should be better considered by the European Court of Human Rights in order to frame a European concept of reproductive rights. Despite its strong affirmation on the international scene, reproductive liberty has not been very successful in realising reproductive rights under European human rights law. The aim of this article is to examine two possible argumentative avenues for reframing reproductive rights, the market and the health frameworks. The authors argue that those approaches to reproductive issues enrich reproductive rights and should be better considered by the European Court of Human Rights in order to frame a European concept of reproductive rights.

Administrative databases, registers, and other sources of big data can be interesting sources to address important research questions on reproduction in women with rheumatic diseases. There are many different types of administrative datasets worldwide, and it is important to understand the type of data present and unavailable in each dataset, validity and potential misclassification of data, and the ability to link maternal data with infant data. This article discusses the advantages and methodologic issues associated with administrative database use for the conduct of observational studies on reproductive issues in women with rheumatic diseases.

The female upper genital tract (UGT) hosts important reproductive organs including the cervix, uterus, fallopian tubes, and ovaries. Several pathologies affect these organ systems such as infections, reproductive issues, structural abnormalities, cancer, and inflammatory diseases that could have significant impact on women's overall health. Effective disease management is constrained by the multifaceted nature of the UGT, complex anatomy and a dynamic physiological environment. Development of drug delivery strategies that can overcome mucosal and safety barriers are needed for effective disease management. This review introduces the anatomy, physiology, and mucosal properties of the UGT and describes drug delivery barriers, advances in drug delivery technologies, and opportunities available for new technologies that target the UGT.

The election of Donald Trump to the presidency came as a severe and unexpected shock to the already beleaguered pro-choice movement in the US. This article will review what the president-elect said during the campaign about abortion and what his administration is likely to do after his inauguration.

Objective The reproductive choices of women affected by rheumatic diseases (RD) can be influenced by several factors, including the quality of physician-patient communication. We conducted a survey on reproductive issues aiming at exploring the unmet needs of women with RD during childbearing age. Methods We administered 65 multiple-choice and 12 open-answer questions about pregnancy counselling, contraception, use of drugs during pregnancy and other women reproductive issues to 477 consecutive women with RD aged 18–55 years followed-up in 24 rheumatology centres in Italy. Analysis was restricted to 398 patients who received their diagnosis of RD before the age of 45. According to the RD diagnosis, patients were subdivided into 2 groups: connective tissue diseases (n = 249) and chronic arthritis (n = 149). Results At the time of interview, women in both groups had a mean age of 40 years. Nearly one third of patients in each group declared not to have received any counselling about either pregnancy desire nor contraception. A smaller family size than desired was reported by nearly 37% of patients, because of concerns related to maternal disease in one fourth of the cases. A “Disease Knowledge Index” (DKI) was created to investigate the degree of patients’ information about the implications of their RD on reproductive issues. Having received counselling was associated with higher DKI values and with a positive impact on family planning. Conclusion Italian women of childbearing age affected by RD reported several unmet needs in their knowledge about reproductive issues. Strategies are needed to implement and facilitate physician-patient communication.

This article provides a review of the available data on reproductive issues that arise in patients with multiple sclerosis (MS).Recent findings have replicated earlier findings that pregnancy and possibly breast-feeding bring about a favorable immunomodulatory effect in patients with MS. Use of disease-modifying therapies prior to pregnancy may further decrease a patient's risk for postpartum disease activity.The annualized relapse rate in MS decreases during pregnancy, with a nadir in the third trimester, and rebounds significantly in the 3-month postpartum period. Exclusive breast-feeding may exert a beneficial effect in decreasing the postpartum risk for relapse. Certain assisted reproductive technology methods are thought to increase the risk for relapse. Disease-modifying therapies are generally discontinued during pregnancy and lactation with a few exceptions. The pregnancy course is usually routine without significant obstetric complications, and babies, although slightly smaller, are typically healthy.

Ultrasonography is used by bovine practitioners more for reproductive issues than as a diagnostic test for medical and surgical diseases. This article reviews the specific challenges and standards concerning reporting of studies on diagnostic accuracy of ultrasound in cattle for nonreproductive issues. Specific biases and applicability concerns in studies reporting ultrasonography as a diagnostic test are also reviewed. Better understanding of these challenges will help the practitioner to interpret and apply (or not) diagnostic accuracy study results depending on the field context. Examples of application of sensitivity and specificity results in a clinical context are given using the Bayes theorem.

Young peoples' need for sexual counselling is well documented, and both website and hotline based services have been established as means of health promotion in this field. Such measures are, however, rarely evaluated, so this article offers data from the world's presumably oldest sexuality helpline aimed at young people. With an observation time of two decades and a total of 42,325 questions asked, the study provides a unique glance into the sexual landscapes of Danish youth. It shows an overall male predominance among callers and reveals that the counselling themes change over time and differ between both age groups and genders. The article suggests that telephone counselling - although more resource demanding than on-line alternatives - provides a secure, anonymous and dialogue-based arena for discussing delicate sexual issues and therefore may constitute a viable supplement to web based media for young people with the need to talk rather than just chat.

The presence of pollutants in water makes the environment toxic to all living biota and affect s reproduction in fish . One of such pollutants is e ndosulfan , which is an off-patent organochlorine insecticide, widely used in various agricultural activities. Endosulfan is extremely toxic to fish and all other aquatic organisms, showing a range of chronic effects, including genotoxicity, and reproductive issues . Therefore , the aim of the research was to find the effect of endosulfan on c GnRH, sGnRH, GtH-I and GtH-II gene expression in male hard-lipped barb fish . These fish were kept in aquarium containing several levels of endosulfan (0 mg/L [control]; 0.88 mg/L [low level]; 1.76 mg/L [medium level]; and 2.64 mg/L [high] level) for 60 days. The effects of endosulfan on GnRH performance on the fish were evaluated by the expressions of these genes; cGnRH-II, sGnRH, GtH -I , and GtH-II . In the 8th week, there was a decrease in the expression of all the four genes in fish with high dose of endosulfan compared with the control group (P < 0.05). These findings showed that endosulfan in hibits the expression of c GnRH, sGnRH, GtH -I and GtH-II genes in male hard-lipped barb.

Summary Multiple Sclerosis (MS) is a chronic demyelinating disease where nerve cells are stripped from their protective layers and ultimately stripping the person from his neurological functions. Patients will face multitude constraints in order to adapt his living conditions, miserable in most cases. Many ethical challenges orbit around patients with MS (PwMS). These challenges include the complexity of the relationship between the patients and the physician, and between the patient and the members of the family and/or the caregiver; other challenges involve reproductive issues, justice in healthcare, concerns about drug clinical trials and placebo arms and end of life and palliative care issues. This review highlighted many of the ethical concerns that could be faced while dealing with PwMS and exposing recent publications in this regard. This article also has a pedagogical aim towards physicians and caregivers, for a better ethical management in MS.

Michigan attorney general Dana Nessel has filed a lawsuit against more than a dozen chemical businesses that make or historicallymade per- and polyfluoroalkyl substances (PFAS) in the state. The suit alleges that 3M, DuPont, Chemours, Archroma, Arkema, and others knowingly and recklessly manufactured, distributed, and disposed of PFAS materials, resulting in the contamination of the state’s natural resources and drinking water. The chemicals have been linked to cancer, reproductive issues, and other health problems. The suit asks the companies to stop selling PFAS and compensate the state for investigation, monitoring, and cleanup.

For decades, women have undergone breast implant surgery either for health or aesthetic reasons. Some adverse effects have made their history full of events, showing the complex factors involved in the interaction of the device with the human body. Understanding the adverse outcomes is a key factor to improve the breast implants. This will help to increase the safety of the procedure. It is also important to stress some new concerns as well as the lack of evidence of involvement on specific long-term health outcomes in women with silicone gel breast implants, such as cancer; connective tissue, rheumatologic, and autoimmune diseases; neurologic diseases; reproductive issues, including lactation; offspring issues; and mental health issues. The development of the National Breast Implant Registry (NBIR), since 2012 by the American Society of Plastic Surgeons in collaboration with the FDA was a huge step to understand these issues. In this database, it is possible to collect and tracks important information on patients and devices, maximizing data extraction from clinical cohorts and directing more meaningful analyses. Researchers could finally obtain clarification of the long-term health outcomes of silicone gel breast implants.

Infertility is a prevalent public health issue that affects approximately one-in-six couples in the United States. Male reproductive issues contribute to about half of infertility cases. Thus a thorough evaluation of the male partner is a critical part of the work up of an infertile couple. This includes a detailed history, physical exam, laboratory evaluation, and semen analysis. Treatment includes medical and surgical therapies.

The medical as well as societal developments in reproductive medicine and respectively artificial reproductive technologies have challenged lawmakers, courts, politicians, medical experts and society itself over the last decades. Challenges can be seen in cross-border reproductive care, equal access to reproductive care, social freezing, disposal of embryos, multiple implantation, homosexual parenthood or surrogacy. Since different regulatory regimes have been enacted throughout Europe (e.g. liberal system in Spain, restrictive system in Austria) to accommodate, limit and regulate reproductive issues, we are analysing the question, if reproductive medicine should be harmonized within Europe. Therefore we are not only discussing already existing approaches e.g. self-regulation, or minimal standards of safety and quality, but we are also scrutinizing the role of high courts, such as the European Court of Human Rights (ECHR) and international declarations and conventions. Concluding we are briefly sketching aspects of a proposal for a potential harmonisation of reproductive medicine in Europe.

Montmorillonite clay due to its abundance and environmental friendliness has several industrial applications among which are the adsorption of mycotoxins in foods and feed. The mycotoxin; zearalenone (ZEA) is oestrogenic and has been implicated in hormonal and reproductive issues for both man and animals. Thus, nanoformulations from Montmorillonite clay and Cymbopogoncitratus (lemongrass) extracts were developed for the reduction of the toxin in millet. The various formulations include: Montmorillonite clay to which extract of Cymbopogoncitratus(lemon grass essential oil)has been incorporated (Mont-LGEO), Montmorillonite clay mixed with C. citratus(lemon grass)powder (Mont-LGP) and Montmorillonite clay washed with NaCl (Mont-Na). Pure Montmorillonite clay (Mont) and C. citratus (lemon grass) powder (LGP) served as the controls for the treatment. Each of these compositions were applied to millet samples at a concentration of 8 % and 12% and stored for 4 weeks. XRD patterns for compositions containing Montmorillonite clay revealed major peaks at 2-Theta value of 20.06° representing Montmorillonite and 26.56° and 68.53°representing quartz. The level of ZEA in all treated samples was quantified after 4 weeks using the Liquid Chromatography tandem mass spectrophotometer LC-MS/MS. All the compositions were effective in the decontamination of zearalenone. Furthermore, C. citratus powder was the most effective in the decontamination of zearalenone in the cereal after 4 weeks.

Complete androgen insensitivity syndrome is a rare condition, wherein a genetic male is phenotypically female and is raised as a female. Treatement requires timely gonadectomy, need for long term hormonal replaceent therapy, psycological and genetic counseling. The type, dose, duration of hrt is not well studied. Reproductive issues also need to be addressed in these young woman. We report here a case of complete androgen insensitivity which posed a quandary for management of long term bone health. Review of literature for management is discussed. These cases are best managed by a multi-disciplenary team comprising of gynecologist, geneticist, endocrinologist and clinical psycologist or psychiatrist.

Abstract Brazilian Pentecostals are establishing new transnational Christian connections in Africa. Focusing on Mozambique, this paper examines the specific logic of cultural mixing that is emerging in the South-South contact of African and Brazilian Pentecostals. This South-South connection is based on a particular framing of the transatlantic history in Afro-Brazilian concepts of evil, such as macumba and feitiçaria. The South-South transnational features of Afro-Brazilian Pentecostalism enhance a need to spiritually scrutinize, combat and transcend aspects of ‘African culture’ in the reproductive sphere of marriage, sexuality, family, money and work. Upwardly mobile Mozambican women, who are conquering new cultural positions, are finding this South-South transnational Pentecostal space attractive. Afro-Brazilian Pentecostalism and upwardly mobile women find and reinforce each other in their capacities to challenge and move frontiers in the national sphere around reproductive issues. However, the powerful atmosphere of conquest that South-South Pentecostalism consequently creates has to be carefully manoeuvred by the women to not let their accusations of feitiçaria rise against themselves.

Since the first Pharmacopoeia under the title "De Materia Medica," the importance of the utilization of plants and herbs has been an invaluable medicinal tool successfully employed for strengthening the immune system for combating a number of diseases in general, or assisting fertility and reproductive issues in particular. The beneficial use of herbal extracts, constituting the basis of modern medicines, is lately under the shadow of Codex Alimentarius that threatens, if not properly applied, serious immunity features rendering the host defenseless for intercepting harmful invaders, one of which is the mesenchymal endometriotic stem cell causing endometriosis.

Background: Although concern about future fertility for adolescents and young adults (AYAs) with cancer is high, referrals to reproductive endocrinologists (REI) are low. Oncology nurses are well positioned to facilitate these referrals but may lack the knowledge and training. This report describes a learning activity in the Educating Nurses about Reproductive Issues in Cancer Healthcare (ENRICH) program whereby oncology nurses interviewed REIs. Method: Participants were instructed to conduct an interview with an REI using a semistructured guide and provided a written report of the discussion. We examined responses to each question using qualitative content analysis. Results: Seventy-seven participants across 15 states provided a summary. Learner summaries highlighted four themes related to FP, including Cost, Time, Lack of Information or Referrals, and Learning About Available Options. Conclusion: Oncology nurses have an opportunity for a partnership to ensure that concerns about fertility among AYA patients are addressed. J Contin Educ Nurs . 2016;47(8):376–384.

Cystic fibrosis (CF) is a life-limiting autosomal recessive disorder affecting ~1 in 2500–4000 Caucasians. As most CF patients have no family history of the disorder, carrier screening for CF has the potential to prospectively identify couples at risk of conceiving an affected child. At-risk couples may consequently choose to act on the provided information and take steps to avoid the birth of a child with CF. Although carrier screening is widely believed to enhance reproductive autonomy of prospective parents, the practice also raises important ethical questions. A written questionnaire was administered to adult patients and parents of children with CF with the aim to explore participants’ attitudes toward CF carrier screening and related reproductive issues. The study population was recruited from a CF patient registry in Belgium and comprised 111 participants (64 parents, 47 patients aged 16 or older). We found that more than 80% of all participants were in favor of preconception carrier screening for CF. However, some were concerned over potential negative consequences of population-wide CF carrier screening. Regarding future reproductive intentions, 43% of the participants indicated a desire to have children. Among these, preimplantation genetic diagnosis was found to be the most preferred reproductive option, closely followed by spontaneous pregnancy and prenatal diagnosis. Although the findings of our study suggest that patients and parents of children with CF support a population-based carrier screening program for CF, they also highlight some issues deserving particular attention when implementing such a program.

This chapter aims to offer an introduction for the management of the ethically controversial issues arising from the relationships between reproductive choices and genetic testing. In particular, three main ethical issues recurrent within this debate are presented and analysed. First of all, it is shown that reproductive choices can be different number choices, meaning that the reproductive decision will change the number of individuals eventually born, or same number choices, meaning that the reproductive decision will not change the number of individuals eventually born. Secondly, considerations pertaining to the quality of life and welfare of the future children are introduced as having a pivotal role in the assessment of controversial reproductive issues. Finally, the principle of procreative beneficence is presented.

Many women would prefer to view pregnancy as a natural part of life rather than as a medical condition. When faced with underlying disorders that require treatment, or frequent complications as a result of such conditions, this can pose both a physical and an emotional challenge. Furthermore, clinical experience has shown that many but not all women give higher priority to the health of their unborn child than to themselves (Bates et al. 2012). As clinicians it is therefore important to consider benefits and risks of treatments carefully for both mother and child and use the best available evidence to guide patient care.

SHROUDED GENDER AND REPRODUCTIVE ISSUES IN CHILD WELFARE AND PROTECTION PROCEEDINGSThis commentary examines the case of Haringey London Borough Council v C (a child), E and another (referred subsequently in this article as the Haringey LBC case). The case focused on child protection issues under the Children Act 1989 (the 1989 Act) arising from a UK charity’s claims that it could provide infertile couples with miracle babies through supernatural means.

Objectives Marfan syndrome (MFS) is an autosomal dominant connective tissue disorder with manifestations mainly involving the skeletal, ocular, and cardiovascular systems. The phenotypic variability observed in MFS makes genetic counselling difficult. Prenatal diagnosis (PND) and preimplantation genetic diagnosis are technically feasible when a causal mutation is identified, but both raise many ethical questions in this condition. Little is known about opinions and practices in such reproductive issues in MFS. The goal of this study was to report on patients' points of view and geneticists' standard practices. Methods Two different questionnaires were produced. Results Fifty geneticists filled in the questionnaire. Twenty-two per cent thought that PND was acceptable, 72% debatable and 6% not acceptable. Preimplantation genetic diagnosis was more often reported acceptable (34% of answers). Results varied according to the physician's experience with the disease. Fifty-four answers were collected for patients' questionnaires. Most of them (74%) were favourable to the development of prenatal testing, and believed that the choice should be given to parents. However, only a minority would opt for prenatal diagnosis for themselves. Conclusion This study showed that the majority of patients were in favour of PND and that opinions among practitioners varied widely, but that overall, practitioners favoured a systematic multidisciplinary evaluation of the couple's request. © 2012 John Wiley & Sons, Ltd.

Mullerian duct anomalies represent a heterogenous group of congenital malformations resulting from abnormal formation or incomplete fusion of Mullerian ducts. Most cases present at puberty or early adulthood with primary amenorrhea or fertility problems although many are asymptomatic and remain undiagnosed. The reported frequency of these anomalies varies, consequent mainly to the inaccuracy of diagnostic methods used and the lack of a uniform classification system. The actual reproductive impact of each anomaly continues to remain ill defined. In addition, radiologic and endoscopic advances appear to have increased the number of unnecessary surgical corrections for these defects. This article attempts to review the reproductive impact of various Mullerian anomalies in a simplified manner. (J GYNECOL SURG 28:127)