“… I would have left that man long time ago but, …” exploring circumstances of and motivators for repeat adolescent birth in Eastern Uganda

Background First birth before 18 years has declined in Uganda unlike repeat adolescent birth (=second or more births before age 20 years). We explored the circumstances of and motivators for repeat adolescent birth in Eastern Uganda. Methods Between January and March 2020, we conducted a qualitative study involving 70 individual in-depth interviews with purposively selected respondents - 20-25-year-old women with and without repeat adolescent birth, their partners, and parents, in the communities of Teso sub-region. We conducted latent content analysis. Results Four major themes emerged: poverty, vulnerability, domestic violence, and demotivators. Sub-themes identified under poverty were: “limited provisions”, “peasantry”, “large families”, “dropping out of school”, “alcohol abuse”, and “broken family structure”. Vulnerability included “marital entrapment” and “partner coercion”. Demotivators included: “abandonment”, “stern warning”, “objection to marriage”, and “empowerment”. Extreme poverty resulted in inadequate provision of basic needs leading to unprotected sexual activity in a bid to secure financial support. Following the first birth, more than three quarters of the women with repeat adolescent birth reported increased economic distress that forced them to remain in unwanted marriage/union, often characterized by partner coercion, despite wanting to delay that repeat birth. Women without repeat adolescent birth avoided a second birth by empowerment through: an economic activity, contraception use, and resumption of schooling. Conclusion Repeat adolescent birth in Uganda is premised around attempts to address the economic distress precipitated by first birth. Many women want to delay that repeat birth but the challenges robbed them of their reproductive autonomy. Beyond efforts to prevent first birth, programs need to address economic empowerment, ensure contraceptive access, and school re-integration for adolescent mothers in order to prevent shortly-spaced repeat births.

Genetics of Ayurveda in Infertility

Introduction: Infertility is the clinical entity where couple fail to conceive even after one year of regular unprotected sexual activity. Many factors are responsible for infertility like ovulation defects, spermatogenic failure, parental age, obesity, anatomical defects, infections, also with specific karyotype and genotype. Materials and Methods: Data was collected from Classical references and modern textual references are collected to show how Ayurveda explains beautifully about the infertility, genetic cause for it. Results: Effort are made to explain genetic theory according to Ayurveda in the context of Infertility Discussion: To have a healthy individual constitution impact of certain factors are very essential, which includes healthy reproductive organs of both male and female, healthy sperm and ovum, dietic regimen, Prakruti of couple, seasonal effect, Panchamahabhoota and Shadbhavas. Impact of Doshas on these will have vital role in formation of genetic code and reproductive capacity of individual. Hence all the above factors may be said as factors responsible for genetic modification influencing the fertility in Ayurveda. This knowledge is highly essential and need of the day for welfare of better society with good progeny through means of Ayurveda.

Atypical dimensions of caregiver–adolescent interaction in an economically disadvantaged sample

The Goal-Corrected Partnership Adolescent Coding System (GPACS) has shown promise in assessing a secure as well as three atypical patterns of parent–adolescent interaction during a conflict discussion. The current study of 186 economically disadvantaged families examines the degree to which four GPACS patterns: secure/collaborative, hostile/punitive, role confused, and disoriented, prospectively predict adolescents’ social competence and maladaptive behavior (internalizing, externalizing, and risk behaviors) at age 15 years after controlling for these social behaviors at age 13 years and contemporaneous GPACS scores. Adolescents from secure/collaborative dyads at age 13 were more likely to have a secure state of mind in the Adult Attachment Interview at age 15 and showed higher levels of teachers’ ratings of empathy and lower levels of teachers’ ratings of externalizing behaviors at age 15 years. Adolescents in disoriented dyads showed higher levels of teacher-rated internalizing problems, while male adolescents in role confused dyads reported higher levels of involvement in risk behaviors, including unprotected sexual activity and substance use problems.

Risky Business

Purpose The purpose of this article is to review risk behaviors and their health consequences in adolescents with type 1 diabetes. The existing literature on common risk behaviors in adolescents is examined, with a focus on illicit drug use, alcohol use, smoking, unprotected sexual activity, and disordered eating behaviors. Conclusions A review of the literature highlights the lack of studies of risk behaviors in this population. Much of what is known comes from studies with adolescents in the general population or from studies of adults with type 1 diabetes. Known risk and protective factors for risk behaviors and health outcomes are noted. Based on these findings, suggestions are provided for diabetes educators and health care providers to assess for and prevent risk behaviors in adolescents with type 1 diabetes. Directions for future research in this population are indicated, including the need to develop and test standardized prevention programs.

School-Based Condom Availability Programs

The repercussions of sexual activity among teens continue to be a significant issue in the United States. Detrimental consequences to unprotected sexual activity among teens include unintended pregnancy and acquiring a sexually transmitted disease (STD) or human immunodeficiency virus (HIV). It is estimated that each year approximately 3 million teens acquire an STD and 860,000 become pregnant. A variety of programs have been implemented in school systems in an attempt to reduce the STDs, HIV, and pregnancy among teens. One program is the distribution of condoms in the school. There are many factors that the school nurse must consider in the development of a school-based condom disbursement program. This article addresses school-based condom availability programs as well as issues for the school nurse to consider when implementing such a program.

Pelvic Inflammatory Disease and Involuntary Infertility: Prospective Pilot Observations

Objective: We prospectively evaluated the rate of adverse reproductive outcomes following pelvic inflammatory disease (PID) in a small cohort of American women.Methods: We enrolled 28 patients having either salpingitis confirmed by laparoscopy or endometritis confirmed by endometrial biopsy. The follow-up was maintained by clinic visits and telephone contact.Results: A median of 15.4 months of follow-up was accomplished for 82.1% of these women. Fifty-two percent (13/25) had unprotected sexual activity without conception for at least 6 months. Fully 55.6% (10/18) of the cohort were involuntarily infertile after at least 1 year of follow-up.Conclusion: In the first prospective cohort study of the reproductive outcomes of American women having had PID, high rates of infertility at 1 year of follow-up were experienced by these women.