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By: Connie Watkins Bales, PhD

• Professor in Medicine
• Senior Fellow in the Center for the Study of Aging and Human Development

https://medicine.duke.edu/faculty/connie-watkins-bales-phd

Prenatal methylmercury exposure from ocean fish consumption in the Seychelles child development study breast cancer 24 buy dostinex with a mastercard. The most common form of prenatal exposure is maternal fish consumption womens health ukiah ca order genuine dostinex on line, but whether such exposure harms the fetus is unknown menstruation tissue purchase dostinex 0.5mg overnight delivery. We aimed to identify adverse neurodevelopmental effects in a fish-consuming population. Fish in Seychelles contain much the same concentrations of MeHg as commercial ocean fish elsewhere. Prenatal MeHg exposure was determined from maternal hair growing during pregnancy. We assessed neurocognitive, language, memory, motor, perceptual-motor, and behavioural functions in children at age 9 years. The association between prenatal MeHg exposure and the primary endpoints was investigated with multiple linear regression with adjustment for covariates that affect child development. Covariates affecting child development were appropriately associated with endpoints. Interpretation: these data do not support the hypothesis that there is a neurodevelopmental risk from prenatal MeHg exposure resulting solely from ocean fish consumption. Impact of prenatal chlorpyrifos exposure on neurodevelopment in the first 3 years of life among inner-city children. Effects of in utero exposure to polychlorinated biphenyls and related contaminants on cognitive functioning in young children. These effects cannot be attributed to a broad range of potential confounding variables, the impact of which was evaluated statistically. The data demonstrate the continuation of a toxic impact received in utero and observed initially during infancy on a dimension of cognitive functioning fundamental to learning. Manganese, monoamine metabolite levels at birth, and child psychomotor development. Several studies have demonstrated neurobehavioral impairment related to manganese (Mn) exposure in the workplace. Exposure to high doses of manganese is associated with irreversible neurodegenerative disorders resembling idiopathic Parkinson disease. Although there is a risk of Mn accumulation in the foetus during pregnancy, little information exists about developmental effects of environmental low-level exposure in human. For this reason, we conducted a prospective epidemiological study in 247 healthy pregnant women and their babies to determine the long-term effect of in utero Mn levels on child�s psychomotor development. Concurrently, we examined the relationship between Mn tissue levels at delivery and foetal plasma monoamine metabolites. Of the newborns, 195 were examined at 9 months, 126 at 3 years and 100 at 6 years. After adjustment for potential confounding co-factors (child�s gender, mother�s educational level), negative relationships were observed between cord blood Mn levels and several psychomotor sub-scales at age of 3 years: �attention� (partial r= 0. These results suggest that environmental Mn exposure in utero could affect early psychomotor development. Autism spectrum disorders in relation to distribution of hazardous air pollutants in the San Francisco Bay area. Because concentrations of many of these were highly correlated, we combined the chemicals into mechanistic and structural groups, calculating summary index scores. The individual compounds that contributed most to these associations included mercury, cadmium, nickel, trichloroethylene, and vinyl chloride. Conclusions: Our results suggest a potential association between autism and estimated metal concentrations, and possibly solvents, in ambient air around the birth residence, requiring confirmation and more refined exposure assessment in future studies. Results show that prenatal exposures at the levels recently encountered have implications for school performance. Effect of prenatal exposure to airborne polycyclic aromatic hydrocarbons on neurodevelopment in the first 3 years of life among inner-city children. The odds of cognitive developmental delay were also significantly greater for children with high prenatal exposure (odds ratio = 2.

Sommer women's health center worcester ma purchase dostinex 0.25 mg amex, Marni breast cancer ribbon tattoo discount dostinex 0.5mg otc, �Putting Menstrual Hygiene Management into the School Water and Sanitation Agenda� zeid women's health clinic generic dostinex 0.5mg fast delivery, Waterlines, vol. Crofts, Tracey, and Julie Fisher, �Menstrual Hygiene in Ugandan Schools: An investigation of low-cost sanitary pads�, Journal of Water, Sanitation, and Hygiene for Development, vol. The majority of women in the study (78%) had positive attitudes towards menstruation, viewing it as a natural event that can be anticipated and predicted. However, many of the women (51�58%) perceived it as debilitating and bothersome to everyday living. Menstruation was perceived by women as impacting on participation and performance in higher education, suggesting that the provision of tertiary education for previously disadvantaged groups needs to consider the needs of women who experience difficulty managing menstruation. The provision of material resources, education in self-care strategies and distribution of information to normalise menstruation may assist the adverse impact of menstruation on their higher education experience. Introduction Menarche, the first menstrual period, typically occurs between the ages of 12 and 15 and is a critical milestone in the transition to young adulthood (Nagar & Aimol, 2010; McMahon et al. However, it remains largely under-researched in developing world contexts and there is a significant need to understand present-day experiences of menstruation, particularly among young women living in societies in transition such as South Africa. Studies among Western women have shown that their attitudes are generally negative and that menstruation is largely experienced as shameful, debilitating and disruptive of activities and social interactions (Chrisler, Marvan, Gorman, & Rossini, 2015). In developing world contexts, however, women�s experience of menstruation and the impact of sociocultural and demographic factors on their attitudes towards menstruation remain largely under-researched. Women�s attitudes towards menstruation are complex and need to be explored in the context of their lived experiences (Chothe et al. The present study University of the Western Cape Research Repository apadmana@uwc. Overall, these studies reported that young South African women experience menstruation as stigmatising and view themselves as being �debased� by it. Nevertheless, there is limited information regarding South African women�s attitudes towards menstruation and the extent to which it impacts on their daily lives and educational experiences. Studies from a number of African countries, including Kenya (Jewitt & Ryley, 2014), Tanzania (Kirk & Sommer, 2006), Malawi (Grant, Lloyd & Mensch, 2010) and Ghana (Sommer, Ackatia-Armah, Connolly, & Smiles, 2015) have reported that young women appraise menstruation as the most significant social stressor and barrier to schooling. International studies on the menstrual-related experiences of young women attending college in Britain (Anastasakis, Kingman, Lee, Economides, & Kadir, 2008), Japan (Yamamoto, Okazaki, Sakamoto, & Funatsu, 2009), India (Sharma, Malhotra, Taneja, & Saha, 2008; Singh, Kiran, Singh, Nel, Singh, & Tiwari, 2008) and Turkey (Pinar, Colak & Oksuz, 2011) have corroborated this. Menstrual related physical symptoms and psychological distress was experienced by women as hindering their full participation in university life. Furthermore, poverty and limited access to resources often mean that girls and women living in these contexts cannot afford sanitary products, leading to missed classes or dropping out of school (Kirk & Sommer, 2006). In the South African context, this may also be true for girls and women from historically disadvantaged communities, particularly those living in informal settlements and other low socio-economic areas, owing to their limited access to resources needed to manage menstruation. In terms of the existing literature, five attitudinal related dimensions regarding menstruation have been identified, namely menstruation as �a debilitating event�, �a bothersome event�, �a natural event�, �an event that can be predicted and anticipated� and �denial of the effect of menstruation� (Brooks-Gunn & Ruble, 1980; 1986). The extent to which the menstrual experiences of young women attending university in transitional societies such as South Africa correspond to the existing literature is unclear. How do young South African women in higher education characterise their experience of menstruation How do the attitudes towards menstruation held by young South African students vary in terms of demographics How do South African students perceive menstruation as impacting on their attendance and performance at university Method Participants and setting A total of 255 women enrolled for undergraduate studies at a historically disadvantaged South African university participated in the study. Most participants lived in a household where their primary caregiver was employed (71. Biographical and social context variables Participants self-reported on personal demographics. They also self reported on socio-contextual variables such as whether menstruation was freely spoken about in their family, who they felt most comfortable speaking to about menstruation, whether they experienced financial difficulties purchasing sanitary products, and whether they had ever been absent from university due to menstruation. Procedure Ethical approval for the study was granted by the University of the Western Cape through the Department of Psychology.

In addition to xanax menopause symptoms order 0.5 mg dostinex fast delivery the advantages mentioned in the opening paragraph of this chapter menopause type 8 order generic dostinex pills, it helps to breast cancer yeti buy dostinex line determine if the research hypotheses are appropriate, if any ethical issues have been overlooked, to re-formulate ambiguous questions, to determine the how long it would take participants to complete the questionnaire, and to determine if participants understood the instructions (Siniscalco & Auriat, 2005). After the pilot study was conducted, the questionnaires were reviewed and the necessary amendments were made. Although no items were eliminated completely from the original questionnaire, demographic factors were removed as it became clear after conducting the pilot study that they would not yield any relevant information. An example of such demographical information is that of professional rank of teachers. Specifics, such as the wording and clarity of questions on the questionnaires, were restructured before being finalised. Participants in the pilot study expressed some difficulties regarding the wording of certain items and consequently the researcher made amendments to the final questionnaire. For example, the statement: �learners with dyslexia usually experience difficulties with language skills such as spelling and writing� was amended for the purposes of clarity, to read �learners with dyslexia usually experience difficulties with language skills such as spelling� and �learners with dyslexia usually experience difficulties with language skills such as writing� respectively. A few participants stated that they could not respond to the original statement as they agreed with the first concept but disagreed with the latter notion or vice versa. Separating the statements made it easier for the respondents to focus on the two distinct issues at hand. Summary In this chapter the researcher discussed the research design, ethical considerations, specifics of the questionnaire, reliability and validity, and the pilot study of the present study. In Chapter 6 details of the sample (including the sampling technique), the procedure used to collect data and a brief data analysis summary are provided. Sample According to Durrheim (2006), it is generally impossible and/or impractical to study all the cases in a population, and therefore a sample that represents the population is selected for study. The population studied in this research was teachers in mainstream high schools in the Western Cape region (N=7995), and the sample was drawn from this population (Department of Basic Education, 2012). Teachers at all 16 schools were invited to participate in the study but only 194 agreed and therefore received the questionnaire. Since 133 teachers completed and returned the questionnaire, the study had a response rate of 69%. A broad category of non-probability sampling, called purposive sampling was used in this study. Purposive sampling involves selecting participants who are typical of the population to be studied (Van Vuuren & Maree, 1999). Purposive sampling was deemed the most appropriate sampling technique for this study since participants were selected because of the particular criterion, namely teachers in a mainstream high school. This kind of sampling is also known as judgement sampling, where the researcher makes a judgement about the characteristics of the sample and selects them according to that judgement (Van Vuuren & Maree, 1999). Generalisation is limited in that the findings may not be transferable to larger populations. However, it can be generalised to the specific population from which the sample was drawn. They overcome this limitation through the use of content/face validity (Johnson, 2009). Although generalisation of findings based on non-random samples is limited, a description of the phenomenon can be achieved (Van Vuuren & Maree, 1999). The strength of purposive sampling is that it is often used in social science research and is very strong in quality assurance (Fridah, 2002). The sample for the study consisted of 133 teachers, the majority of which were female (N=100, i. The gender split in this study is a fairly accurate reflection of the gender split in the Western Cape Education Department, where the majority (66%) of teachers are female (Department of Basic Education, 2012). This is again a fair reflection of the home language demographics in the Western Cape, where almost half (48%) of the people in the province speak Afrikaans (South Africa. It is interesting to note that although the majority of teachers reported that their home language was Afrikaans, they also reported that their main language of teaching was English. This finding is in line with trends in recent years where more parents are opting to place their children in English medium classes even when they speak another language at home. Participants who completed their teaching qualification at Stellenbosch University comprised the largest group (N=61, i.

By convention menstrual vitamins purchase dostinex online pills, any new vaginal carcinoma developing at least 5 years after cervical cancer is considered a new primary lesion womens health keene nh order dostinex 0.5mg online. For women who had a cervical or vulvar neoplasm menstrual workout dostinex 0.5mg without a prescription, the Pap test is an important part of routine follow up with each physician visit, because these patients are at an increased lifetime risk for developing vaginal cancer. It is recommended that Pap test surveillance for vaginal cancer be performed yearly after the patient has completed surveillance for cancer of the cervix or vulva. If the patient has a history of cervical dysplasia or cervical cancer, yearly screening is recommended. When adjusted for age and prior cervical disease, the incidence of vaginal cancer is not increased in women who had hysterectomy for benign disease (213). Because primary vaginal tumors tend to be multicentric, the entire vaginal mucosa should be considered at risk. Therefore, in addition to screening cytology, careful bimanual examination of the entire vagina and vulva is recommended for women at high risk. Symptoms Painless vaginal bleeding and discharge are the most common symptoms of vaginal cancer. With more advanced tumors, urinary retention, bladder spasm, hematuria, and frequency of urination may occur. In a large series, 14% were asymptomatic and diagnosis was made by routine examination or abnormal cytology (206). Tumors developing on the posterior vaginal wall may produce rectal symptoms, such as tenesmus, constipation, or blood in the stool. Diagnosis the diagnostic workup includes a complete history and physical examination, careful speculum examination and palpation of the vagina, and bimanual pelvic and rectal examinations. It is important to rotate the speculum to obtain a careful view of the entire vagina because posterior wall lesions frequently occur and may be overlooked. In early squamous cell lesions, the diagnosis is often suggested by an abnormal Pap test result; however, this is not true for clear cell adenocarcinomas, which are characterized by submucosal growth. In these cases, the diagnosis is suggested by cytologic findings in only 33% of cases. Visually suspicious areas in the vagina should be evaluated with a targeted biopsy using the same instruments as those used for cervical biopsies. Careful palpation of the vagina may be helpful in detecting submucosal irregularities. The most common site of vaginal cancer is in the upper one-third of the vagina on the posterior wall. The developing tumor may be missed during initial inspection because of obscured visualization caused by the blades of the speculum (214). Colposcopy is valuable in evaluating patients with abnormal Pap test results, unexplained vaginal bleeding, or ulcerated erythematous patches in the upper vagina. A colposcopically targeted biopsy may not allow a definitive diagnosis, and a partial vaginectomy may be necessary to determine invasion. Occult invasive carcinoma may be detected by such an excision, particularly in patients who have a history of prior hysterectomy in whom the vaginal vault closure may bury some of the vaginal epithelium at risk for cancer (215). Pathology Cancer of the vagina spreads most often by direct extension into the pelvic soft tissues and adjacent organs. Metastases to the pelvic and para-aortic lymph nodes may occur in advanced disease. Lesions in the lower one-third of the vagina may spread directly to the inguinal femoral lymph nodes and the pelvic nodes (216). Hematogenous dissemination to the lungs, liver, or bone may occur as a late phenomenon. Squamous cell carcinomas are the most common form of vaginal cancer, occurring in 80% to 90% of cases. These tumors most commonly occur in the upper one-third, posterior wall of the vagina.

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