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Backgroud: Despite the advancements in the rights of persons with disabilities in Western countries, the motherhood of women with intellectual disabilities remains scarcely visible. The approval of the Convention on the Rights of Persons with Disabilities (2006) and its subsequent ratification by the Spanish Government (2008) recalls the obligation to fulfil the rights of persons with disabilities to found a family (art. 23) and to choose who they want to live with (art. 19). While the importance of this legislation is undeniable, the personal experiences of women with intellectual disabilities still demand effective changes. Methods: This article reports the results of a study entitled "Subjectivities and motherhood in women with intellectual disabilities. Reflections in dialogue through an inclusive research project." In this study, we delved into the stories of 13 women, aged between 24 and 72, to learn about their motherhood experiences (before, during and after making the decision of being mothers) and to identify the barriers and supports encountered. Methods for data collection included individual semi-structured interviews, discussion groups and other narrative and visual resources (images and biograms). Findings: This study explores in depth the obstacles identified by the participating mothers, which have been organised around six themes: (1) information and guidance on sexuality and family planning, (2) assistance of health services, (3) employment and housing situation, (4) child custody, (5) raising children, and (6) informal support. The participants encountered difficulties in all the above fields related to contextual factors. In other words, these barriers do not derive from individual issues centred on their disability, but from factors that often do not depend on mothers with intellectual disabilities, such as deprivation of socio-educational opportunities. Conclusions: Our results show the nuanced ways in which these mothers were immersed in a social system that questions them as 'good mothers' and violates their rights. As we discussed, the participants' desires and decisions to engage and/or continue with motherhood constitute an exercise of resistance to this system.

Most studies of sex education center on local Anglo-Euro-American contexts, tracing the origin of sex education to a coordinated response to the spread of venereal diseases. These neglect the circumstances in which sex education developed in the developing world between the 1950s and 1980s: a growing collective anxiety about rising birth rates that culminated in the adoption of population control measures. This paper examines the "glocal" history of population-centered sex education in the developing world in the 1960s and 1970s, through the case study of Singapore. Examining the emergence of the first sex education curriculum in post-independence Singapore between 1966 and 1973, I argue that population-centered sex education that emerged in Singapore was intimately connected with global population politics. Analysis of how the policy was formulated shows that the Singapore state reacted to both domestic and global concerns. In connecting local developments to global contexts, this paper gestures toward the possibilities of studying the global history of population-centered sex education.

This study aimed to determine the effectiveness of two simulation types used for family planning consultation of midwifery students and to compare these methods. This study was conducted at a university in Kastamonu, Turkey, in 2020-2021. The sample of the study was 90 midwifery students. The family planning skill training and communication skills of the students were evaluated by watching the video recordings in the virtual patient simulation (VPS) and under the supervision of the instructor in the peer simulation (PS). In each instructional environment, the students' satisfactions were evaluated. Students' Knowledge scores of family planning increased after web-based training (38.3%; 67.9%) The mean scores for communication skills (VPS = 72.1; PS = 63.7) were found higher in VPS and family planning counseling skills (VPS = 66.5; PS = 77.6) were found in PS (p < 0.01). As the education environments were getting more like the reality, the students' not to used communication skills effectively and stress levels were found higher. VSP and PS are thought to be effective development of students' competency. The use of different simulation types can be integrated into midwifery education and contribute to the development of students' knowledge, skills, and communication levels.

Women seeking higher education frequently do so during peak childbearing years and women with higher levels of education are more likely to postpone motherhood until a later age. Fertility rate, defined as the average number of children born to a woman over her lifetime, has decreased globally. The decrease in birthrate has been partially attributed to women seeking educational opportunities. Understanding the experience of students in this realm would allow higher education institutions to better support students who are (or wish to be) mothers. Unfortunately, there is a paucity of research examining graduate women and the factors involved in their consideration of having a child while in school. We seek to fill this gap by examining the impact of fertility concerns (FC) and importance of on-time degree completion (DC) on the probability of having a biological child in graduate school (PC) among 469 female graduate psychology students in the USA. We found higher FC was associated with higher PC. In contrast, higher DC was associated with lower PC. Furthermore, FC had a significant unique relation to PC after accounting for the contribution of DC. We discuss how institutions and programs may help support and empower female graduate students by implementing educational policies and procedures that are supportive of graduate student mothers. This is particularly important because a large proportion of women pursue advanced degrees, and this number is projected to increase.

This study aimed to assess the fertility knowledge of Japanese education undergraduates who plan to become schoolteachers and examine related factors. A cross-sectional questionnaire survey was conducted with 252 first-year education undergraduates at a Japanese university. The Cardiff Fertility Knowledge Scale (CFKS) was used to measure fertility knowledge, and other items inquiring about basic reproductive knowledge were included. We assessed the relationship between fertility knowledge and gender and the experience of future life planning, among other factors. We found that fertility knowledge varied. Participants possessed a relatively good knowledge of the relationships between fertility and female ageing, and smoking, but limited knowledge about the effect of sexually transmitted infections on fertility. Male participants answered more correctly than female participants (p < 0.01) regarding 'sperm production'; however, female respondents answered more accurately than male respondents (p < 0.01) regarding 'timing of menopause. In Japan, the national curriculum standard for upper secondary schools was revised in 2018, and fertility was added to the Health and Physical Education curriculum. The study results suggested that it is important to include fertility in a sex education teaching curriculum for education undergraduates to enable them to deliver fertility education as teachers in the future.

Reproductive interconception care provided at maternal postpartum visits may help reduce unintended pregnancies and elongate birth intervals for women experiencing homelessness. To improve interconception care uptake, this qualitative study aimed to identify barriers and facilitators to reproductive interconception care from the perspectives of women who were recently pregnant and homeless. A semi-structured interview guide and demographic survey were developed based on epidemiological findings, Information-Motivation-Behavioral Skill framework components, and a review by community health workers for content validity. After conducting 12 interviews with women recently pregnant and homeless in a local continuum of care in 2022, audio-recorded interviews were transcribed, iteratively coded using a priori and emerging codes, and thematically analyzed. Key themes were identified to determine implications and next steps to improving reproductive interconception care uptake. Interrelated themes focused on information (e.g., knowledge and misconceptions about pregnancy, birth intervals, contraception), motivation (e.g., attitudes about interconception care experiences, perinatal social influences), behavioral skills (e.g., objective ability to obtain interconception care and perceived self-efficacy related to attending maternal postpartum visits and increasing birth intervals), and macro-level factors (e.g., obtaining housing, contextualizing socioeconomic factors, navigating COVID-19). The findings suggest the need for flexible, streamlined, and personalized interconception care delivery that acknowledges pressing housing and relationship considerations and supports women's autonomy. Improvements to reproductive interconception care may reduce future unintended pregnancies, increase birth intervals, and improve birth outcomes among women experiencing homelessness.

Waiting rooms provide an ideal location to disseminate health information. In this mixed-methods study, we evaluated waiting room-based health education talks at two clinics in the Dominican Republic and explored recommendations for implementing this intervention in similar settings. The talks addressed noncommunicable diseases, sexually transmitted infections, family planning and gender-based violence. We conducted pre- and posttests to assess attendees' change in knowledge and conducted semi-structured interviews with a subset of them. We conducted a semi-structured focus group with educators. Analyses included Wilcox Signed Rank Tests and McNemar tests for pre- and posttests, conventional content analysis for individual interviews and transcript coding for the focus group. Patient participants were 69.3% female aged 39.6 years (SD = 13.5) on average at one clinic (n = 127) and 100% female aged 17.4 (SD = 1.3) on average at the second clinic (n = 24). Focus group participants (n = 5) had 4.8 years (SD = 3.3) of health educator experience on average. Pre- and posttests showed significant improvement (P < 0.05) across all talks. Qualitative interviews emphasized engaging, clear and brief content delivery with visual aids. The focus group highlighted the importance of patient-centered design with culturally concordant delivery and identified implementation challenges. Findings demonstrate that waiting room-based education talks improve knowledge and provide suggestions for similar interventions.

Objective: Community college students engage in more risky sexual behavior compared to their four-year counterparts, yet have access to fewer reproductive health services. The study's purpose was to examine whether California Community College student health centers' participation in Family PACT, a state publicly-funded family planning program, increased reproductive health services to community colleges students. Participants: California community college student health centers. Methods: Bivariate analyses of student health centers with and without Family PACT participation and qualitative analysis of five participating campuses. Results: Among the 60 colleges in the study, 25 student health centers participated in the Family PACT program. Family PACT campuses reported greater provision of sexual and reproductive health services and higher levels of staffing and revenue. Conclusions: Key benefits of Family PACT participation among community colleges include expansion of sexual and reproductive health services to an underserved population and increased student health centers' financial sustainability.

Monitoring, evaluation, and research activities generate important data, but they often fail to change policies or programs. In addition, local program staff and partners often feel disconnected from these activities, which undermines their ownership of data and results. To bridge the gaps between monitoring, evaluation, and research and to give them a common purpose through locally owned, actionable learning, we developed an integrated Monitoring, Evaluation, Research, Learning, and Adapting (MERLA) framework. Implemented and refined in over 20 countries, the framework integrates data-gathering methodologies with collaborative techniques for translating evidence into knowledge that influences program practice and government policy. In this publication, we describe the MERLA framework and present two case studies demonstrating how its application enables learning and adaptation led by in-country teams.

This descriptive study examines the reproductive health awareness of 100 randomly selected college students in selected private colleges in Olongapo City. The survey covered six basic and common reproductive health issues: maternal and child health, family planning, promotion of breastfeeding, adolescent reproductive health, prevention and management of abortion, prevention and management of reproductive tract infections. The data were subjected using weighted mean, and Pearson -r. The following information was generated: student-respondents were aware of the six basic and common reproductive health issues. On the sources of students' information, which included socio-economic conditions, status of women, social and gender issues, culture and psycho-social issues, the respondents perceived all of these factors as important. The correlational analysis also revealed a moderate to strong relationship values in all six health issues. The sources of students' information significantly affected the levels of awareness in the different issues about reproductive health. Moreover, the sources of reproductive health information come from the following according as ranked by the respondents: parents, nurse/doctor, television, friends, and the internet.

Objective: Rising incidence of acquired multidrug-resistant tuberculosis (MDR-TB) in South Africa suggests low knowledge and implementation of infection prevention and control strategies in household and congregate settings. This study contributes to the under-researched area of non-biomedical responses to sub-adherence to treatment. Design: The study utilises a quasi-ethnographic qualitative case study of 10 women aged 18 to 34 years to understand their treatment adherence behaviours through the lens of their sex, gender, age, cultural beliefs and socio-economic status. Setting: This study investigated reasons for young women's sub-optimal adherence to treatment for acquired MDR-TB in eThekwini Metro, KwaZulu-Natal province, South Africa, which records high burdens of tuberculosis (TB), MDR-TB and HIV. Methods: Primary data were collected from 20 participants who were selected through criterion, purposive and snowball sampling. Data were gathered through focus group discussions with women being treated for transmitted MDR-TB and key informant interviews with their family members, health workers and KwaZulu-Natal Provincial Department of Health personnel. Results: Anti-MDR-TB treatment affects women's sexuality, intimate relationships, family planning intentions and reproductive health. Some vulnerable women struggle to persevere on noxious and lengthy treatment regimes that affect their reproductive and psychological health. Women may skip doses or abandon treatment when high pill burdens and adverse events make intimate and sexual relations with male partners, on whom they may depend for their livelihoods, difficult. Conclusion: It is important to consider the effects of lengthy treatment on young people's social and sexual lives and self-esteem when (re)designing MDR-TB counselling approaches. This paper advances an evidence-based treatment education and counselling strategy to contribute to improving MDR-TB treatment adherence and success.

Background: People with disability have the same sexual and reproductive health needs and rights as people without disability, yet experience considerable barriers in accessing information and services. The Reproductive and Family Health Association of Fiji, Family Planning Australia, and disability stakeholders implemented a comprehensive sexuality education (CSE) disability inclusion project to increase access for students with disability to age-appropriate sexuality education. Method: A train the trainer model was utilised, whereby staff and disability stakeholders undertook competency-based training on delivering sexuality education to teachers and people with disability, then trained and supported teachers working in special disability schools to provide sexuality education to students. An evaluation explored the acceptability and effectiveness of the project, utilising baseline and endline surveys and interviews. Findings: From 2016 to 2018, the CSE disability project reached teachers and students in nine special disability schools in Fiji. At project completion, teachers reported increased confidence overall in teaching about sexuality and relationships, and students demonstrated increased knowledge regarding puberty and body changes. Interview findings suggested the project contributed to overcoming silence and stigma for people with disability and promoting safety for young people. Conclusion: Age- and developmentally appropriate sexuality education for people with disability is essential for equipping them with necessary knowledge and skills. The CSE disability project utilised a collaborative, capacity building approach to co-design and implement sexuality education in special disability schools in Fiji. With commitment from stakeholders, this could be sustained and expanded to support students with disability in achieving optimal sexual and reproductive health.

This study was carried out to investigate family dynamics and parenting problems of secondary school students in Uyo Metropolis of Akwa Ibom State. Three research questions and three null hypotheses were formulated to guide the study. The survey design was adopted for the study. The population of 7412 students (2016/2017 academic session) with a sample of 200 students selected from 4 public secondary schools within the study area. A researcher -- made questionnaire called "Family Dynamics and Parenting Problems of Secondary School Students Questionnaire (FDPPSSQ)" was used to elicit data from respondents. The research instrument has a 4-point rating scale. The Pearson Product Moment (PPM) Correlation Coefficient of 0.87 ascertained the reliability of instrument for use in the study. After the administration, scoring and collation of the instrument, the data obtained were subjected to Independent t-test. All the null hypotheses were tested at 0.05 level of significance. Based on the result of this study, it is concluded that Secondary School students' in Uyo Metropolis Area differ significantly in terms of parenting problem based on parent-child relationship, parent level of education and family size of students. It is recommended that Seminars, workshops, and symposia on family size should be organized for parents. This will make them aware of family size as it influences secondary school students, thus parents will also control the family size through birth control mechanisms.

The provision of comprehensive sexuality education (CSE) accords opportunities for scientifically accurate information about sexual and reproductive health (SRH). We used a mixed-methods study to characterise adolescent SRH knowledge, attitudes and service utilisation experiences in the context of CSE implementation in Zambia. In-school young people aged 12-24 years (N = 1,612) in the North-Western Province were randomly surveyed. A 29-item index was constructed to measure alignment of knowledge, attitudes and values (KAV) with the CSE curriculum. Logistic regression, stratifying by sexual debut status, modelled associations of past-year HIV counselling and testing and family planning service access, respectively, with CSE-KAV index scores. Focus group discussions further explored perceptions of and experiences accessing SRH services. Despite moderate SRH knowledge and acceptability of SRH services, fewer than half of sexually experienced young people reported accessing SRH services. Among sexually experienced youth, neither HIV testing nor family planning service utilisation in the previous year were associated with higher CSE-KAV index scores. Salient barriers to SRH service uptake included limited perceived benefits, unsupportive household and community environments, and negative interactions with health providers. To increase accessibility and uptake of youth SRH services, linking school-based CSE to SRH services is recommended.

The rapid increase in human population is one of the underlying factors driving the ecological crisis. Despite efforts on the part of educators to raise awareness of environmental issues, the ecological impact of a burgeoning population -- and the ethical implications of having children -- remains an unbroachable topic. Nevertheless, the increase in human numbers is central to questions of sustainability: How can a species expect to survive in a finite terrestrial environment without limits to its population? Since most of the world's ecological impact can be traced to capitalist-industrial- consumer societies in over-developed nations, the middle and upper classes in rich countries must weigh the ecological consequences of their family-planning decisions. In this paper, I argue that educational programs that are concerned with environmental ethics should have students examine the assumptions and implications of having children. I consider the risks associated with this proposal and respond to a series of possible objections. This paper does not advocate coercive measures for population control, but rather enjoins a pedagogical responsibility to view having children as an act with ecological consequences, an act that must be subject to careful examination.

Systems thinking is needed due to the growing complexity of the problems faced family planning field workers in the external environment that is constantly changing. System thinking ability could not be separated from efforts to develop learning for the workers, both learning at the individual, group, or organization level. The design of the study was quantitative study using cross-sectional study. There is a relationship between the scale of field worker's system thinking with the learning environment at organization level (p 0.017

Prior research studies suggest that maternal polyunsaturated fatty acids could have protective effects on neurodevelopmental outcomes. The objective of this study was to examine associations between maternal polyunsaturated fatty acid intake during pregnancy and risk for autism spectrum disorder and other non-typical development in a prospective cohort. Eligible women already had a child with autism spectrum disorder and were planning a pregnancy or were pregnant with another child. Children were clinically assessed longitudinally and diagnosed at 36 months. Maternal polyunsaturated fatty acid intake during pregnancy was estimated using food frequency questionnaires. Maternal third-trimester plasma polyunsaturated fatty acid concentration was measured by gas chromatography. In all, 258 mother-child pairs were included. Mothers consuming more total omega-3 in the second half of pregnancy were 40% less likely to have children with autism spectrum disorder (relative risk = 0.6, 95% confidence interval: 0.3-0.98). No significant associations were observed between maternal third-trimester plasma polyunsaturated fatty acid subtype concentrations and risk of autism spectrum disorder. However, higher plasma eicosapentaenoic acid and docosahexaenoic acid concentrations were associated with lower non-typical development risk (relative risk ranging from 0.47 to 0.88). This study provides suggestive evidence of associations between risk of autism spectrum disorder in the children and maternal omega-3 intake in late pregnancy but not with third-trimester plasma polyunsaturated fatty acids. Further research is needed to evaluate these potential relationships.

This study investigated the structural relationships between Korean mothers' marital conflict, social support, value of children, and follow-up childbirth plan. It also examined the mediating influence of social support and value of children on these relationships. A structural equation model analysis was performed on 1,285 mothers' survey responses from the 2015 Korean Children Panel Study. The results showed that, first, marital conflict directly influenced social support and value of children. Second, social support and value of children directly affected follow-up childbirth plan. Third, marital conflict not only directly influenced follow-up childbirth plan, but also indirectly affected it through social support and value of children. This study concludes with a discussion of the implications of the influence of marital conflict on follow-up childbirth plan mediated by social support and value of children.

Breastfeeding duration has been linked to maternal and child health. Current-status (or interval-censored) data offers a more reliable measure of duration and cessation of breastfeeding than approaches that rely on recall, due to high percentage of 'heaping'. The present study explores the determinants of breastfeeding termination within the first three years of life in Bangladesh using the Cox proportional hazards model. Data were drawn from two rounds of the Bangladesh Demographic and Health Surveys 2011 and 2014. Results showed that secondary or higher educated mothers (hazard ratio, [HR] 1.7), mothers from wealthier families (HR 1.4), and relatively over-nourished mothers (HR 1.2) were at higher risk of breastfeeding termination. Breastfeeding termination was also associated with contraceptive use, exposure to family planning programme in media and place of residence. Pooled data also suggests that early breastfeeding termination is increasing in Bangladesh. The findings have implications for policy makers in shaping public information campaigns on breastfeeding.

Few studies have examined the relationships between intimate partner violence (IPV) and the sexual and reproductive health outcomes of women in sub-Saharan countries in general and Ghana specifically. This study began to fill the gap by investigating whether individual- and community-level IPV influenced unwanted pregnancy and pregnancy loss among women in Ghana. Nationally representative cross-sectional data were collected from 2,289 ever-married women, and multilevel modeling was used to estimate individual- and community-level effects. At the individual level, IPV was significantly associated with unwanted pregnancy and pregnancy loss. Women with experience of both physical and sexual violence were more likely to have reported an unwanted pregnancy and a pregnancy loss. However, only those experiencing sexual violence reported unwanted pregnancies. Similarly, community-level IPV was associated with sexual health outcomes. Respondents in communities with higher levels of sexual violence were significantly more likely to have had unwanted pregnancies. The findings corroborate calls for policy makers to consider IPV a reproductive health issue. They also emphasize the need to move beyond individual-level interventions to consider structural and community contexts when addressing the sexual and reproductive health outcomes of women in Ghana.

Education is viewed as a tool for change. Globally, efforts are geared toward enhancing the educational process of students' academic achievement in secondary schools. However, there is gap associated with differences in the students' attributes, and the desire for parents to provide better educational opportunities to their children. To achieve the goal of this research, students from Katsina State Science and Technical Education Board (STEB) were purposively selected for the study. Random sampling technique was used to select 300 students from six secondary schools. Primary data were collected using a structured questionnaire designed to address the specific objectives of the study. Cramer's V and stepwise regression model were used as tool of analyses to achieve the stated objectives of the study. Age of students was found statistically related to students' academic achievement using Cramer's V. The regression model has an R2 (0.915) implying that 92% of the total variations in students' academic achievement was accounted for by the independent variables. The F statistic was also reliably fit and statistically significant at p = 0.001 confidence level. Of the nineteen variables, nine were statistically significant and show effect on students' academic achievement. The significant variables that were positively related to academic achievement are: parent education, parent occupation, family feeding, provision of resource materials, visits to schools, provision of pocket money, and residential type. Family type and age category of parents had negative effects on students' academic achievement. We recommend for an intensified public enlightenment and awareness campaign on family planning and child spacing as well as dilution of family resources to counter the effect of family type being a risk factor.

Children who are healthy early in life--from conception to age five--not only grow up to be healthier adults, they are also better educated, earn more, and contribute more to the economy. The United States lags behind other advanced countries in early childhood health, threatening both the health of future generations and the nation's long-term economic viability. Moreover, unhealthy childhoods are not evenly distributed. An accounting of early childhood health in the United States reveals stark inequalities along racial/ethnic and socioeconomic lines. Because of the strong connection between early health and adult outcomes, early childhood offers a critical window to improve disadvantaged children's life chances through evidence-based interventions and thereby to reduce inequality. Restricting her review to studies that can plausibly show causation, Maya Rossin-Slater examines the evidence behind a variety of programs and policies that target any of three groups: women at risk of getting pregnant, pregnant women, or children through age five. She finds that some programs and policies have failed to show consistent results. But the good news is that others are quite effective at improving early childhood health. The most successful include the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), universal immunization, and high-quality, center-based early childhood care and education. Economic analyses reveal that these programs' benefits outweigh their costs, suggesting that public spending to support them is more than justified.

Young African American and Latina women aged 15 to 24 are more likely to adopt short-acting forms of contraception over long-acting reversible contraception. Mobile applications and other forms of digital media may be useful for providing adolescents with information about sexual and reproductive health both inside and outside of the health care setting. The miPlan app was designed in accordance with principles of user experience design, and its content was informed by the theory of planned behavior and the transtheoretical model of behavior change. A university-based design team engaged young African American and Latina women to inform app development and provide input on app design, conducting multiple rounds of usability testing. Researchers then evaluated the acceptability of the miPlan app in family planning clinics among African American and Latina women aged 15 to 24. Participants rated the app highly acceptable, finding it both easy to use and highly informative. We demonstrate that mobile applications designed in conjunction with user populations may be effective at providing health information due to users' ability to identify with them and their accessibility.

More children than ever before are conceived with the use of assisted reproductive technologies and many are raised in families that are structurally different from most. Research on the experiences of children growing up in diverse families has shown that children may face disapproval, a lack of understanding, and in some cases, bullying by those outside of their home environment, including from their peers at school This study evaluated the use of theatrical performance and post-performance discussions as a method of informing young people about different families. Findings indicated that performance was an effective and engaging learning tool, as it presented first-hand experiences of family diversity. Post-performance discussions were important in enabling young people to improve their understanding of different methods of Assisted Reproductive Technologies and diverse family forms. Young people were found to value engagement activities that are unbiased, interactive, and do not make them feel awkward or uncomfortable.

The purpose of this study was to develop a valid and reliable scale measuring the Indonesians' scientific habits of mind (SHOM) levels via the SSIs in context. The sample of the study consisted of 658 Indonesian people (aged 18-68 years; 385 females and 273 males; mean age: 35.5) randomly drawn from 3 districts of Special Region of Yogyakarta, Indonesia. To ensure content validity, the researchers matched SHOM (mistrust of arguments from authority, open-mindedness, scepticism, rationality, objectivity, suspension of belief, and curiosity) with the SSIs in the Indonesian context. A group of experts and a pilot study with 10 lay people ensured face validity. Concurrent validity was verified via independent samples t-test. To confirm convergent and discriminant validity, confirmatory factor analysis, and reliability values were calculated. Because the final version (33 items) of the SHOM scale has high validity in content, face, convergent, discriminant, and concurrent, it provides valid conclusions based on the theoretical constructs for the sub-scales. This suggests that the SHOM scale may be adapted or improved for SSIs in different contexts.

Frank Furstenberg examines how the newly extended timetable for entering adulthood is affecting, and being affected by, the institution of the Western, particularly the American, family. He reviews a growing body of research on the family life of young adults and their parents and draws out important policy implications of the new schedule for the passage to adulthood. Today, says Furstenberg, home-leaving, marriage, and the onset of childbearing take place much later in the life span than they did during the period after World War II. After the disappearance of America's well-paying unskilled and semi-skilled manufacturing jobs during the 1960s, youth from all economic strata began remaining in school longer and marrying and starting their own families later. Increasing numbers of lower-income women did not marry at all but chose, instead, non-marital parenthood--often turning to their natal families for economic and social support, rather than to their partners. As the period of young adults' dependence on their families grew longer, the financial and emotional burden of parenthood grew heavier. Today, regardless of their income level, U.S. parents provide roughly the same proportion of their earnings to support their young adult children. Unlike many nations in Europe, the United States, with its relatively underdeveloped welfare system, does not invest heavily in education, health care, and job benefits for young adults. It relies, instead, on families' investments in their own adult children. But as the transition to adulthood becomes more protracted, the increasing family burden may prove costly to society as a whole. Young adults themselves may begin to regard childbearing as more onerous and less rewarding. The need to provide greater support for children for longer periods may discourage couples from having additional children or having children at all. Such decisions could lead to lower total fertility, ultimately reduce the workforce, and further aggravate the problem of providing both for increasing numbers of the elderly and for the young. U.S. policy makers must realize the importance of reinforcing the family nest and helping reduce the large and competing demands that are being placed on today's parents. (Contains 4 figures and 73 endnotes.)

Objective: Men's engagement in family planning has become part of the global health agenda; however, little is known about the training manuals health practitioners' use and how these manuals describe and explain men's roles within a family planning context. Design: To further understand engagement, this paper examines how training manuals written for health practitioners describe and define men's participation within family planning. Setting: The training manuals were written for UK health practitioners and covered men's contributions to family planning. Method: Discourse analysis was used to examine the three training manuals focused upon. Results: Three main discourses were identified: 'contraception is a woman's responsibility', 'men disengage with health practitioners' and 'men are biologically predisposed to avoid sexual responsibility'. Conclusion: Together, these three discourses function to marginalise men in family planning, constructing them as detached accessories that lack the ability to engage.

Parent involvement is a predictor of postsecondary education and employment outcomes, but rigorous measures of parent involvement for youth with disabilities are lacking. Hirano, Garbacz, Shanley, and Rowe adapted scales based on Hoover-Dempsey and Sandler model of parent involvement for use with parents of youth with disabilities aged 14 to 23. This study assessed the psychometric properties of the Motivators of Parent Involvement (MPI) scales. A confirmatory factor analysis tested an 11-factor model, three parent involvement factors, and eight motivators of involvement factors for parents of transition-age youth (ages 14-25) with disabilities. Using a sample of 288 parents and caregivers, the model was determined to have acceptable fit. The MPI can be used to assess motivators of parent involvement and guide interventions.

Background: Following the occurrence of natural or man-made disaster, relief worker priorities include providing water, food, shelter, and immunizations for displaced persons. Like these essential initiatives, reproductive health education and services must also be incorporated into recovery efforts. Purpose: This study examined reproductive health care indicators, including the key areas of HIV/AIDS and other sexually transmitted infection (STI) transmission, family planning and pregnancy-related health services, and selected reproductive health education knowledge among refugees and internally displaced persons residing in southern Belize following Hurricane Mitch's assault on the region in 1998. In addition, the occurrence of gender-based violence was measured. Methods: Internally displaced persons and refugee men and women were interviewed about prenatal care and delivery services, family planning knowledge and utilization, HIV/AIDS and other STI transmission knowledge, and sexual violence. Results: Numerous misconceptions about HIV/AIDS and other STIs existed. Most persons had never used any family planning method. Oral contraceptive use declined as length of stay at refugee camps increased. Most women were able to access prenatal services. Violence against women, including sexual violence, was reported. Discussion: Better access to medical services and education about reproductive health issues are needed following disasters. Translation to Health Education Practice: Health educators can contribute to relief efforts. Moreover, other relief workers should be equipped with skills and knowledge to help meet the reproductive health needs of disaster victims. (Contains 3 tables.)

Disparities in cervical cancer and human papillomavirus (HPV) vaccination persist among Vietnamese and Latina women. Through a partnership with Planned Parenthood of Orange and San Bernardino Counties (PPOSBC) in Southern California, we conducted in-depth interviews with young adult Latina (n = 24) and Vietnamese (n = 24) women, and PPOSBC staff (n = 2). We purposively sampled vaccinated women to elicit HPV vaccine decision narratives to uncover rich data on motivators, cultural values, and implicit vaccine attitudes. Unvaccinated women were interviewed to identify barriers. Women were also asked to discuss their observations of men's HPV vaccine attitudes. Narrative engagement theory guided the study privileging the meaning women ascribed to their experiences and conversations related to vaccine decision making. Vaccine decision narratives included (a) mother-daughter narratives, (b) practitioner recommendation of HPV vaccination, (c) independence narratives among Vietnamese women, (d) HPV (un)awareness narratives, and (d) school exposure to HPV knowledge. Barriers to vaccinating included trust in partner HPV status, and family silence and stigma about sexual health. Participants conveyed the importance of including messages aimed at reaching men. Practitioners described insurance barriers to offering same day vaccination at PPOSBC health center visits. Narrative communication theory and methodology address health equity by privileging how Vietnamese and Latina women ascribe meaning to their lived experiences and conversations about HPV vaccination. Identifying authentic and relatable vaccine decision narratives will be necessary to effectively engage Vietnamese and Latina women. These findings will guide the process of adapting an existing National Cancer Institute research-tested HPV vaccine intervention.

Although a genetic evaluation can identify the etiology in 15-30% of individuals with autism spectrum disorder, several studies show an underuse of genetic services by affected families. We have explored the access to genetic services and perception of genetics and recurrence risk in parents of autistic children in Spain. Despite the high interest in genetics, our results show a remarkable underutilization of genetic services, with only 30% of families having visited a genetic service and 13% of patients having undergone the recommended genetic test. This poor service provision influenced recurrence risk perception and had a great impact on family planning. The National Health System should ensure their access to genetic services allowing them to take informed decisions with precise information.

Northern Thailand is home to many hill tribes, who have lived for hundreds of years as subsistence farmers or nomadic hunters. In the 1940s, communist insurgencies drove many hill tribes from China, Burma, and other nations south into northern Thailand. Uprooted from their native lands, the hill tribes left behind ties to economic resources and, to compensate, many turned to the growth of the opium poppy as a cash crop. The growth and sale of opium endangered their lives and those of the citizens of the surrounding countries, and slash and burn farming methods resulted in environmental degradation. In 1969, the Thai government formed the Royal Projects to address this situation. The Royal Project Foundation then expanded its development efforts with the establishment of the Education and Social Development Projects (ESDPs), which seek to implement sustainable social services within the villages, and have been largely successful in hill tribe villages. The authors' research assessed the current status of the ESDPs, the causes of the program's successes and failures, and the needs of the villagers of Doi Ang Khang. The authors' study is concerned primarily with the Lahu and Palong tribes of Doi Ang Khang, which reside in the villages of Khob Dong and Nor Lae, respectively. The aim of their evaluation was to develop an understanding of why the Khob Dong village had not achieved a high level of success from the ESDPs and to recommend strategies for improving future development projects. (Contains 1 table.)

The world has a population of 6 billion. India alone has a population of 1 billion. This is despite the fact that India was the first country in the world to have a population policy. It is important to understand the factors that led to this population explosion and the complex links between population growth rates and levels of development. Indeed, many feel that the family planning program shows little evidence of concern for the poor women it is supposed to serve. India was one of the first nations to officially launch a family planning program. A modest beginning was made in 1952 and IUCD (intrauterine contraceptive device) was initiated in 1965. About 100 million married women throughout the developing world have an unmet need for family planning. About one-third of these women, an estimated 31 million, live in India. Unmet need for family planning is estimated to affect 16 percent of married couples in India. This paper gives a historical perspective of India's Family Welfare Program focusing on the role played by IUCD. The Program has gone through various revamps shifting its initial target oriented approach to a more client centered approach. The National Population Policy 2000 resets the objectives of the program given the scale and diversity of India's population making it pro-poor, pro-women and pro-nature. However, poverty, illiteracy, and a shortage of resources remain the main barriers to the promotion and wider acceptance of family planning.