Social Context of Child Development

PEDIATRICS ◽  
1981 ◽  
Vol 68 (5) ◽  
pp. 705-712
Author(s):  
Leon Eisenberg

Theories of child development, no less than the ways in which children develop, are influenced by social context. This thesis is illustrated by examples drawn from three areas relevant to pediatrics. First, given the data demonstrating that fewer biologic and social hazards result from first trimester abortion than from carrying an unwanted pregnancy to term, the current controversy about abortion can only be understood in relation to concerns about contemporary patterns of sexual behavior, contraceptive use, and preferred family size. Second, now that the majority of mothers are employed in the work force, stress on the importance of "bonding" in early infancy, on the basis of dubious evidence, leads to unwarranted implications for social policy. Third, in contrast to the traditional American belief in public schools as instruments for the democratization of our society, public education is now being assailed as useless (and thus undeserving of funding) despite data indicating that schools make a difference to both academic and behavioral outcomes. In these controversies, differing value commitments lead to the choice of different data sets to justify a priori conclusions. Social theories are, by their very nature, value-laden but they can nonetheless be effective guides to action if those values are made explicit.

2018 ◽  
Vol 16 (3) ◽  
pp. 269-273 ◽  
Author(s):  
Deepak Shrestha ◽  
Shreyashi Aryal ◽  
Binita Sharma

Background: With the legalization of medical abortion in Nepal, mifepristone-misoprostol combination via different routes has been widely used for early abortion. This study aims to evaluate the efficacy and acceptability of 200 milligrams mifepristone orally followed by 800 micrograms sublingual misoprostol in outpatient setting.Methods: It was an open-label prospective study conducted in outpatient department of a tertiary hospital over a period of 13 months. Clients upto nine weeks of pregnancy were enrolled. 200 milligrams of mifepristone orally followed by 800 micrograms of misoprostol sublingually 36 to 48 hours later were prescribed. They were followed up in 14 days sonologically or verbally through telephone. Side effects and satisfaction to the regimen were assessed through acceptability questionnaire. Mann-Whitney U test was used for analyzing categorical data.Results: A total of 47 clients were enrolled. The mean age and gestational age were 29.38 years (SD+5.914) and 6.2 weeks (SD+1.28) respectively. The commonest indications for termination were completed family and unwanted pregnancy (40.4% each). The average duration of bleeding was 5.76 days (SD +3.61). Abdominal cramping was the most common side effect (95.7%). The least acceptable parameter was the bleeding time (80.9%). For 97.9% clients, the adverse effects were acceptable. The overall success rate of the regimen was 87.2%.Conclusions: With a comparable success rate to vaginal use, home based sublingual use of misoprostol in low resource settings offers an acceptable and cost effective alternative for medical abortion upto nine weeks of pregnancy. Lesser gestational age is a useful predictor for successful abortion.


2013 ◽  
Vol 10 (3) ◽  
pp. 8-13
Author(s):  
Shyam Thapa ◽  
S Neupane ◽  
I Basnett ◽  
E Read

Background  The use of abortion services at the Maternity Hospital clinic, the largest public sector abortion clinic in Nepal, has risen over the years. Whether the profile of the clients, reasons for abortion, and contraceptive use have changed are not known and need to be investigated. Objectives This paper evaluates changes between 2005 and 2010 in the socio-demographic profile of abortion users, reasons for seeking abortion, and contraceptive use of two cohorts of women who had first-trimester abortion at the Maternity Hospital. Methods We used data from two similar surveys conducted in 2005 and 2010 among 672 and 392 women, respectively, who obtained first-trimester surgical abortion in a large public sector clinic. We analyzed trend data in service utilization and carried out a cost analysis.  Results The number of women having abortions has steadily increased over the years, and cumulatively about 19,800 women have received services. The profile of the clients at this clinic has remained essentially the same between 2005 and 2010. The typical users of abortion services at the clinic were 27 years old with two living children, mostly married, with the majority not wanting to have more children. About half of them used a contraceptive method—mostly condoms, withdrawal, the pill and rhythm—in the month of unintended pregnancy, suggesting failures with these methods. Health concerns, dislike of available methods, and perceived low risk of pregnancy were common reasons for not using a contraceptive method. Conclusion Despite increases in the number of clients, the socio-demographic profile of the abortion clients has remained similar over the years. The linkage between the abortion and family planning clinics needs to be strengthened. Kathmandu University Medical Journal | VOL.10 | NO. 3 | ISSUE 39 | JUL- SEP 2012 | Page 8-13 DOI: http://dx.doi.org/10.3126/kumj.v10i3.8010


2012 ◽  
Vol 45 (2) ◽  
pp. 205-215 ◽  
Author(s):  
RAJESH KUMAR ◽  
A. J. FRANCIS ZAVIER ◽  
SHVETA KALYANWALA ◽  
SHIREEN J. JEJEEBHOY

SummaryMany abortion seekers in India attempt to induce abortion on their own, by accessing oral medication/preparations from a chemist without a prescription or from an unauthorized provider, and present at registered facilities if these attempts fail. However, little is known about those whose efforts fail or the ways in which programmes and policies may address the needs of such women. This paper explores the experiences of women whose efforts failed, including their socio-demographic profile, the preparations they used, and the extent to which they experienced serious complications, delayed seeking care from an authorized provider, or delayed abortion until the second trimester of pregnancy. Data come from a larger study assessing the feasibility of the provision of medical abortion by non-physicians; a total of 3394 women who sought medical abortion from selected clinical settings in Bihar and Jharkhand between 2008 and 2010 constitute the sample. Prior to visiting the clinic, nearly a third of these women (31%) had made at least one unsuccessful attempt to terminate the unwanted pregnancy by using a range of oral medications/preparations available over-the-counter in medical shops. Logistic regression analysis suggests that educated women (OR 1.6–1.7), those from urban areas (OR 6.2) and those from Bihar (OR 1.6) were significantly more likely than women with no education, rural women and those from Jharkhand to have used such medication. Also notable is that the average gestational age of women who had made a previous attempt to terminate their pregnancy was almost identical to that of women who had not done so when they presented at the registered facility. These findings may inform policies and programmes that seek to identify and reduce the potential risks associated with unauthorized abortion-seeking practices, and highlight the need to fully inform women, chemists and providers about oral medications, what works and what does not, and how effective medication must be taken.


2018 ◽  
Vol 16 (3) ◽  
pp. 269-273 ◽  
Author(s):  
Deepak Shrestha ◽  
Shreyashi Aryal ◽  
Binita Sharma

Background:With the legalization of medical abortion in Nepal, mifepristone-misoprostol combination via different routes has been widely used for early abortion. This study aims to evaluate the efficacy and acceptability of 200 milligrams mifepristone orally followed by 800 micrograms sublingual misoprostol in outpatient setting.Methods: It was an open-label prospective study conducted in outpatient department of a tertiary hospital over a period of 13 months. Clients upto nine weeks of pregnancy were enrolled. 200 milligrams of mifepristone orally followed by 800 micrograms of misoprostol sublingually 36 to 48 hours later were prescribed. They were followed up in 14 days sonologically or verbally through telephone. Side effects and satisfaction to the regimen were assessed through acceptability questionnaire. Mann-Whitney U test was used for analyzing categorical data.Results: A total of 47 clients were enrolled. The mean age and gestational age were 29.38 years (SD+5.914) and 6.2 weeks (SD+1.28) respectively. The commonest indications for termination were completed family and unwanted pregnancy (40.4% each). The average duration of bleeding was 5.76 days (SD +3.61). Abdominal cramping was the most common side effect (95.7%). The least acceptable parameter was the bleeding time (80.9%). For 97.9% clients, the adverse effects were acceptable. The overall success rate of the regimen was 87.2%. Conclusions: With a comparable success rate to vaginal use, home based sublingual use of misoprostol in low resource settings offers an acceptable and cost effective alternative for medical abortion upto nine weeks of pregnancy. Lesser gestational age is a useful predictor for successful abortion. Keywords: abortion; mifepristone; misoprostol; sublingual; termination.


2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Luciana Pietro ◽  
Fátima Bottcher-Luiz ◽  
Lício Augusto Velloso ◽  
Joseane Morari ◽  
Marcelo Nomura ◽  
...  

Abstract Blastocyst implantation and neoplastic invasion have some common properties related to tissue invasion, mediated by various cytokines. Aim To compare the expression of IL-6, STAT-3 and telomerase in material of abortions in the first trimester of pregnancy, at term placentas and in choriocarcinomas. Methods Immunohistochemical reactions were performed on formalin fixed and included in paraffin samples from 3 groups: abortions, normal at term placentas and choriocarcinomas. Western Blot and Real-Time PCR assays were performed on fresh material from BeWo cell line and in primary culture cells of normal placenta. Results Immunohistochemical reactions: IL-6 expression was moderate in the first trimester abortion samples and high in at term placentas and choriocarcinomas. STAT-3 was strongly positive in all groups. Telomerase expression was absent in normal at term placentas but was increased in BeWo cells. Conclusion IL-6 and STAT-3 are present in the invasion process of the normal placental development and they are maintained during the malignant transformation to choriocarcinoma. The intense telomerase expression observed in BeWo cells was strongly associated with the malignant phenotype, confirming it as a good marker for cell transformation and tumor progression.


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