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This study describes birth-related practices and their determinants among women in the Jumla district of Nepal. Data were derived from a household survey in 1996. Of 939 married women of reproductive age, 657 who had given birth to their last child during the previous five years were included in the analysis. Qualitative information was further obtained from traditional birth attendants (TBAs), mothers-in-law, community leaders and pregnant women. High-risk practices were common and related to local custom and lack of knowledge on the importance of cleanliness. Husband's level of education greater than fifth grade significantly reduced the high-risk practices in all stages of childbirth, independent of other socio-economic, biological and village variables. [ABSTRACT FROM AUTHOR]

. Linear penetration, number of penetrating spermatozoa and their motility were studied in 400 semen samples using a capillary tube method and with cervical mucus as a test medium. A close correlation was found between these parameters. All three showed a high correlation with a proposed 'penetration score'. Of the semen properties routinely tested sperm motility showed the highest correlation with the penetration parameters. [ABSTRACT FROM AUTHOR]

Semen samples were examined from 51 fertile men, and from the male partners in 283 infertile marriages. In addition to routine analysis, they were tested for sperm penetration through ovulatory cervical mucus, using the method of Kremer with slight modifications. Comparison of the 2 groups in regard to semen properties showed statistically significant differences between the means for density, percentage of living, motile and abnormal spermatozoa, for motility degree, and for sperm penetration. No significant difference between the means was found for volume, content of fructose and acid phosphatase in the seminal plasma. In the entire series a moderate correlation was found between sperm penetration and percentage of motile spermatozoa, motility degree, density, percentage of living and percentage of abnormal spermatozoa. A low correlation was found between sperm penetration and volume, content of fructose or acid phosphatase in seminal plasma. The variance of sperm penetration due to regression of the other semen properties was only 43%. Sperm penetration had the highest discriminant function coefficient of the tested semen properties. Semen samples from fertile men had high penetration values although other semen properties were sometimes pathological. The sperm penetration test is a most valuable supplement to routine semen analysis for male fertility estimation. [ABSTRACT FROM AUTHOR]

. Fertility, pre-freeze and post-thaw sperm motility, penetration ability and duration of motility in cervical mucus of spermatozoa were studied in 7 heterologous insemination donors and in 4 men in connection with homologous inseminations. No conception occurred after 50 heterologous and 15 homologous inseminations using semen preserved at-196°C. The post-thaw motility, penetration ability and duration of motility in cervical mucus of spermatozoa were reduced by the freeze-preservation procedure. The fertilizing capacity of freeze-pre-served semen was more reduced than expected from the post-thaw sperm motility and penetration ability. The semen quality was of significant importance for the post-thaw sperm motility and penetration ability. [ABSTRACT FROM AUTHOR]

Seminal properties in relation to fertility were studied in 14 semen donors, used for heterologous inseminations in 178 women. There were 100 conceptions. Fertility of the donors was statistically significantly related to the in vitro penetration and duration of motility of spermatozoa in cervical mucus. [ABSTRACT FROM AUTHOR]

. The seminal properties and female fertility factors were studied in 45 couples where homologous in- seminations were performed. For 10 couples (group I) normal coitus was impossible. In this group there were 8 normal pregnancies and 1 miscarriage. For 35 couples (group 11) the postcoital test showed persistently reduced penetration because of poor semen quality or hostility of the cervical mucus. In this group there were 10 concep tions, 4 normal pregnancies and 6 miscarriages. The semen quality was a more important prognostic than pathological findings in the women. In vitro sperm penetration of cervical mucus seemed to be the best criterion for judging the prognosis. Homologous insemination can be of value in the treatment of infertility, but careful selection of patients is needed. [ABSTRACT FROM AUTHOR]

The sperm penetration test introduced by Kremer was studied, using cervical mucus as the test medium and human semen samples with varying properties. The spermatozoa from semen samples of good quality penetrated rapidly, to more than 30 mm within one hour. Spermatozoa from semen samples of poor quality penetrated slowly and a maximum penetration of less than 20 mm was noted. Capillary tube size, incubation temperature, and the amount of mucus protruding from the capillary tube, had no appreciable influence on the results. Reproducibility was good. Storage of the cervical mucus at + 4°C or - 20°C for 3 weeks did not influence its suitability as a test medium. The test is easy to perform and well suited for routine semen analysis. [ABSTRACT FROM AUTHOR]

Jet-washing of the uterine cavity for cytological examination has been performed in 200 patients. The results were compared with the histological diagnoses obtained by curettage. In 24 patients with endometrial carcinoma, both methods showed one specimen to be 'not adequate' while the other showed malignancy. A combination of jet-wash and curettage gave a diagnosis in 96% of patients while curettage alone gave a diagnosis in 82%, and cytology alone in 90%. The method is simple and may be of special value in postmenopausal patients. [ABSTRACT FROM PUBLISHER]

Despite growing recognition of the importance of applying a systems lens to action on obesity, there has only been limited analysis of the extent to which this lens has actually been applied. The CO-CREATE project used a youth-led participatory action research approach to generate policy ideas towards the reduction of adolescent overweight and obesity across Europe. In order to assess the extent to which these youth-generated policy ideas take a systems approach, we analyzed them using the Intervention Level Framework (ILF). The ILF ascribes actions to one of five system levels, from Structural Elements, the least engaged with system change, up to Paradigm, which is the system's deepest held beliefs and thus the most difficult level at which to intervene. Of the 106 policy ideas generated by young people during the CO-CREATE project, 91 (86%) were categorized at the level of Structural Elements. This emphasis on operational rather than systems level responses echoes findings from a previous study on obesity strategies. Analyzing the distribution of systems level responses using the ILF has the potential to support more effective action on obesity by allowing identification of opportunities to strengthen systems level responses overall., (© 2023 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.)

The United Nations Convention on the Rights of the Child emphasizes the importance of allowing children and adolescents to influence decisions that are important to them following their age and maturity. This paper explores the principles, practices, and implications around using parental versus child/adolescent consent when participating in social science research and policy development. Experiences from two studies are presented: The Confronting Obesity: Co-creating policy with youth (CO-CREATE) and the Health Behaviour in School-aged Children (HBSC) study, a World Health Organization (WHO) Collaborative Cross-National study. Although parental consent may be an important gatekeeper for protecting children and adolescents from potentially harmful research participation, it may also be considered an obstacle to the empowerment of children and adolescents in case they want to share their views and experiences directly. This paper argues that evaluation of possible harm should be left to ethics committees and that, if no harm related to the research participation processes is identified and the project has a clear perspective on collaborating with the target group, adolescents from the age of 12 years should be granted the legal capacity to give consent to participate in the research project. Collaboration with adolescents in the development of the research project is encouraged., (© 2023 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.)

Objective: The aim of the present study was to evaluate the effects of fetal gender on serum human chorionic gonadotropin (hCG) and testosterone in normotensive and preeclamptic pregnancies., Methods: The study consisted of 137 women with singleton pregnancies in the third trimester. Seventy-three pregnancies were uncomplicated; among those were 35 male and 38 female fetuses. Sixty-four pregnancies were complicated by preeclampsia; among those were 33 male and 31 female fetuses. Human chorionic gonadotropin and total testosterone were measured in maternal peripheral blood., Results: In male-bearing pregnancies, maternal hCG and testosterone serum levels were significantly higher in preeclamptic than normotensive mothers (P <.001). In female-bearing pregnancies, testosterone levels were significantly higher in preeclamptic than normotensive mothers (P <.001), whereas the hCG levels were not significantly different. Male-bearing preeclamptic women had significantly higher testosterone levels than female-bearing preeclamptic women (P <.02), whereas the hCG levels were not significantly different. In uncomplicated pregnancies the hCG levels were significantly higher in female-bearing than in male-bearing mothers (P <.005), whereas the testosterone levels were not significantly different., Conclusion: In preeclamptic pregnancies with male fetuses, the maternal serum hCG levels were significantly higher than in uncomplicated pregnancies. Total testosterone levels were significantly higher in pregnancies with either gender and significantly higher in male-bearing than in female-bearing pregnancies. This may indicate an androgen influence on the pathophysiologic mechanism of preeclampsia.

Background: Our aim was to investigate associations between maternal characteristics, with emphasis on hematological status, and risk of low birth weight and preterm delivery among pregnant Nepali women., Methods: In a case-control study, 1400 pregnant women attending Patan Hospital, Kathmandu, Nepal for antenatal care and delivery in the period 1994 to 1996 were included. Women with twin pregnancies (n=15) and those delivering infants with congenital malformations (n=13) were excluded from the study. Maternal characteristics including hematocrit values were recorded at the first antenatal visit. Main outcome measures included birth weight, gestation at delivery, Apgar score, mode of delivery, and perinatal death. Linear and logistic regression models were used to analyze data., Results: Severe anemia (hematocrit < or =24%) was associated with a significantly increased risk of low birth weight (<2500 g) and preterm delivery (<37 weeks gestation). High hematocrit values (> or =40%) did not increase the risk of low birth weight or preterm delivery. The risk of low Apgar score or operative deliveries was significantly increased in women with severe anemia in the first trimester. Teenagers, women with short height or low body mass index, and those belonging to the ethnic group Brahmins, had significantly higher risks of delivering low birth weight infants., Conclusions: Severe maternal anemia, particularly in the first trimester, was significantly associated with adverse pregnancy outcome. Low maternal age, height or body mass index also increased the risk of low birth weight. Improvements in the nutritional status of young Nepali women could contribute to improved health among their infants.

This article outlines a community-based retrospective study in a remote area of Nepal and describes local birth practices and their impact on infant mortality. Data collection was carried out in two steps, a household survey from September to October 1996 and a qualitative research phase. Data collected include socio-economic background, reproductive history, birth practices and child survival. Among 3007 live-born children, 660 (22%) died before their first birthday. In keeping with local customs, approximately half of the children were delivered in an animal shed and the other half in the home. Children born in an animal shed were at significantly higher risk of dying than were those born in the home even after adjusting for socio-economic status and biological variables. The association was stronger in the neonatal period (OR = 2.8, 95% CI 1.9-4.1) than during the post-neonatal period (OR= 1.3, 95% CI 1.02-1.6). The preparation of the delivery place was inadequate and thereby facilitated infection of both the newborn and the mother. Traditional norms and animal-shed delivery practices are common in the Jumla community. The reasons addressed for giving birth in the animal shed included (1) Household Deity's anger if delivery takes place in the home and (2) easy to clean the shed following the birth.