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Résumé Naissances évitées par la méthode de régulation menstruelle : une application de la théorie des processus de renouvellement R.G. Potter et J.A. Fortney La méthode de "régulation menstruelle" consiste à pratiquer, dès qu'un retard de règles est constaté (moins de deux semaines après la date normale), une aspiration utérine. Les particularités de cette méthode sont les suivantes : tout d 'abord, l'aspiration peut être pratiquée inutilement, car il n 'est pas possible de savoir avec certitude au moment de l'aspiration si la femme est effectivement enceinte ; en deuxième lieu, la méthode contribue à raccourcir le "temps-mort" associé à toute grossesse, puisque celle-ci est interrompue très tôt. Enfin, la méthode n 'est pas efficace à 100%. Dans cet article, on compare le devenir de trois cohortes : une cohorte "de contrôle" de femmes pratiquant la contraception avec une efficacité déterminée, sur chaque intervalle entre naissances ; une cohorte ayant, de plus, recours si nécessaire à la régulation menstruelle une fois seulement sur chaque intervalle ; une cohorte recourant chaque fois que nécessaire à l'aspiration (et pratiquant toujours la même contraception). Chacune des cohortes est supposée homogène, c'est-à-dire que les diverses probabilités (fécondabilité résiduelle, probabilité qu'un cycle ovulaire dure n jours, etc.) s'appliquent également à toutes les femmes de la cohorte, et ne varient pas dans le temps. Le nombre de naissances évitées (B) est égal au rapport de l'intervalle moyen entre aspiration (^ln) et de l'intervalle moyen entre naissances en l'absence d'aspiration fM44A Les formules I et II en donnent deux expressions, qui permettent de discuter l'influence des divers paramètres en jeu. La section suivante est consacrée à l'estimation des paramètres. En particulier, le tableau 1 reproduit les résultats de diverses enquêtes, relatifs au délai entre la date attendue pour les règles et le moment où l'aspiration est demandée (de 8 à 11 jours le plus souvent). Le tableau 2 donne une répartition du délai entre la demande d'aspiration et le retour des règles, pour des femmes dont le test de grossesse s 'était révélé négatif. Les résultats montrent d'abord que le nombre de naissances évitées par extraction utile augmente avec l'efficacité de la contraception, c'est-à-dire quand diminue la fécondabilité résiduelle (tableau 3). Mais la proportion des interventions utiles (femme effectivement enceinte) est d'autant plus faible que l'aspiration est faite précocement (tableaux 4 et 5), si bien que le nombre de naissances évitées par extraction diminue fortement avec le délai z (tableaux 4, 6 et 7). Les annexes 1 et 2 donnent le détail des calculs.

With increasing girl&rsquo ; s enrolment in schools, school preparedness to ensure a menstrual friendly environment is crucial. The study aimed to conduct a systematic review regarding the existing evidence on menstrual hygiene management (MHM) across schools in India. It further aimed to highlight the actions that have been taken by the government to improve the MHM situation in India. We conducted the systematic literature search using PubMed, EMBASE, and Web of Science for searching the peer-reviewed articles and Google Scholar for anecdotal reports published from inception until 30 October 2019. Of 1125 publications retrieved through the search, 183 papers were included in this review, using a priori created data-extraction form. Meta-analysis was used to estimate the pooled prevalence (PP) of MHM practices in schools. Less than half of the girls were aware of menstruation before menarche (PP 0.45, 0.39 to 0.51, I2 = 100.0%, n = 122). Teachers were a less common source of information about menstruation to girls (PP 0.07, 0.05 to 0.08, I2 = 100.0%, n = 86). Separate toilets for girls were present in around half of the schools (PP 0.56, 0.42 to 0.75, I2 100.0%, n = 11). MHM in schools should be strengthened with convergence between various departments for explicit implementation of guidelines.

With increasing girls' enrolment in schools, school preparedness to ensure a menstrual friendly environment is crucial. The study aimed to conduct a systematic review regarding the existing evidence on menstrual hygiene management (MHM) across schools in India. It further aimed to highlight the actions that have been taken by the government to improve the MHM situation in India. We conducted the systematic literature search using PubMed, EMBASE, and Web of Science for searching the peer-reviewed articles and Google Scholar for anecdotal reports published from inception until 30 October 2019. Of 1125 publications retrieved through the search, 183 papers were included in this review, using a priori created data-extraction form. Meta-analysis was used to estimate the pooled prevalence (PP) of MHM practices in schools. Less than half of the girls were aware of menstruation before menarche (PP 0.45, 0.39 to 0.51, I(2) = 100.0%, n = 122). Teachers were a less common source of information about menstruation to girls (PP 0.07, 0.05 to 0.08, I(2) = 100.0%, n = 86). Separate toilets for girls were present in around half of the schools (PP 0.56, 0.42 to 0.75, I(2) 100.0%, n = 11). MHM in schools should be strengthened with convergence between various departments for explicit implementation of guidelines.

This volume offers feminist perspectives on the social, cultural and medical aspects of women as sexual beings and of their fertility, pregnancy and child bearing. It serves as a companion to "Advances in Gender Research volume 7, Gender perspectives on Health and Medicine: Key Themes". As in the previous volume, the authors critique and transcend conventional biomedical approaches to the subject matter. The seven essays raise questions about control and agency asking who decides if, when and how fertility should be controlled and the circumstances under which child birth takes place. They address decision-making on multiple levels from the individual to the national and transnational and grapple with such controversial matters as genital cutting, self-help menstrual extraction and direct-entry midwifery. They interrogate the policies and practices of states and transnational agencies that have a bearing on sexuality and reproductive health, the ways in which womens genitalia have been objectified and manipulated by practices that purport to be both traditional and modern, and the motivations of those who provide alternative forms of fertility control and birthing methods. The intended audience is the social science community, especially those who are interested in the study of gender, sexuality and reproductive health, medicine and alternative medicine, and the areas where these interface.

A survey of plants used for the treatment of menstrual disorders and after-child birth problems was conducted in Abeokuta South Local Government. Hundred (100) questionnaires were administered using multi stage sampling method on traditional herbal practitioners. Ethnobotanical information such as, plants and plant parts used, methods of extraction used and mode of administration of the herbal preparations of these plants were requested. Also, phytochemical contents of the most frequently mentioned plants were determined. Data were subjected to Analysis of variance (ANOVA) with probability set at p<0.05 and descriptive statistics. Results revealed that a total of fifty-six (56) plants belonging to 37 families were mentioned. The most frequently mentioned families are Euphorbiaceae, Leguminoceae, Anacardiaceae, Apocynaceae, Araceae and Combretaceae. Sesamum indicum, Dioclea sarmentosa, Clausena anisata, Anogeissus leiocarpus, Alafia barteri, Tetrapleura tetraptera, Daniella oliveri, Lannea egregia and Alstonia boonei were the most frequently mentioned plants used in the treatment of menstrual disorders and after-childbirth problems. Leaves (34%), fruits (7%), flowers (3%), tubers (2%), stem-barks (28%), seeds (11%) , roots and barks (2%) and roots (13%) were the plants reported being used for the remedy of these disorders. Decoction (54%), squeezing (9%), grinding/squeezing (14%), paste (4%), exudation (4%), cooking (4%), soaking/ decoction/infusion (4%), and heating to ashes (4%) were the methods of extracting the bioactive principles of the plants using water (79%) as major solvent. Significant difference (P < 0.05) was observed in the quantities of tannins recorded in the leaves of Sesamun indicum, Dioclea sarmentosa, Clausena anisata, Anogeissus leiocarpus and Alafia barteri. Similar observations were found in the quantities of saponnins, alkaloids, flavonoids and phenol. Highest values of tannins (0.32mg/g), saponnins (1.07mg/g), alkaloids (5.16mg/g), flavonoids (3.12mg/g) and phenol (0.09 mg/g) were determined in the leaves of Clausena anisata, Sesanum indicum, Dioclea sarmentosa and Alafia barteri. Across the roots of these plants, similar amount of tannins and saponnins were quantified. This observation varied significantly when compared with alkaloids, flavonoids and phenol quantified in the roots of plants. Highest tannins (1.67mg/g) and saponnins (3.33 mg/g) were recorded in the roots of Dioclea sarmentosa, alkaloids (4.33 mg/g) and flavonoid (6.33 mg/g) in Anogeissus leiocarpus while phenol (1.33 mg/g) was recorded in roots of Sesanum indicum. Key words: Menstrual Disorders, Childbirth Problems, phytochemical contents, Traditional practitioners, Indigenous plants

Dieser Beitrag greift Missverständnisse gegenüber der Frauengesundheitsbewegung innerhalb von Erinnerungskultur auf. Ziele von gynäkologischer Selbstuntersuchung (Self-Help) scheinen im feministischen Diskurs, aber auch in der Geschlechterforschung jüngerer Zeit als unpolitische Übung gesundheitlicher Selbstbildung fehlgedeutet zu werden. Um dies als geschichtliches Missverständnis zu markieren, erscheint es vielversprechend, historische Dokumente der Neuen Frauenbewegung mit späteren aktivistischen Zeugnissen zu verbinden. In einem derartigen Fokus wird es möglich, Hinweise auf politische Gehalte in feministischen Publikationen retrospektiv zu entziffern. Aspekte menstrueller Extraktion, die jene Praktik als Ersttrimester-Abtreibungen - und somit als strafrechtlich untersagte Handlungen - nachvollziehbar machen würden, sind besonders in den frühen Jahren der Neuen Frauenbewegung von Aktivistinnen in schriftlichen Dokumenten dezidiert ausgelassen worden. Das Wissen zu dieser Technik als feministischer Selbsthilfeansatz, um frühe Schwangerschaften abzubrechen, wurde in Selbsthilfe-Workshops geteilt und der vorliegende Beitrag zeigt, wie es sich international jenseits von Publikationen in der Vertraulichkeit feministischer Netzwerke verbreiten konnte. Gynäkologische Selbsthilfe wird dabei als politische Aktionsform verdeutlicht, um zu fragen, ob feministische Erinnerungskultur dieses Politikum durch eine verengte eigene Perspektive aus dem Blick verloren hat.

A fracture, being an acquired rupture or break of the bone, is a significant and debilitating injury commonly seen among athletes and military personnel. Stress fractures, which have a repetitive stress aetiology, are highly prevalent among military populations, especially those undergoing training. The primary aim of this review is to identify non-modifiable risk factors for stress fractures in military personnel undergoing training. A systematic search was conducted of three major databases to identify studies that explored risk factors for stress fractures in military trainees. Critical appraisal, data extraction, and a narrative synthesis were conducted. Sixteen articles met the eligibility criteria for the study. Key non-modifiable risk factors identified were prior stress fracture and menstrual dysfunction, while advancing age and race other than black race may be a risk factor. To reduce the incidence of stress fractures in military trainees, mitigating modifiable risk factors among individuals with non-modifiable risk factors (e.g., optimising conditioning for older trainees) or better accommodating non-modifiable factors (for example, extending training periods and reducing intensity to facilitate recovery and adaptation) are suggested, with focus on groups at increased risk identified in this review.

A fracture, being an acquired rupture or break of the bone, is a significant and debilitating injury commonly seen among athletes and military personnel. Stress fractures, which have a repetitive stress aetiology, are highly prevalent among military populations, especially those undergoing training. The primary aim of this review is to identify non-modifiable risk factors for stress fractures in military personnel undergoing training. A systematic search was conducted of three major databases to identify studies that explored risk factors for stress fractures in military trainees. Critical appraisal, data extraction, and a narrative synthesis were conducted. Sixteen articles met the eligibility criteria for the study. Key non-modifiable risk factors identified were prior stress fracture and menstrual dysfunction, while advancing age and race other than black race may be a risk factor. To reduce the incidence of stress fractures in military trainees, mitigating modifiable risk factors among individuals with non-modifiable risk factors (e.g., optimising conditioning for older trainees) or better accommodating non-modifiable factors (for example, extending training periods and reducing intensity to facilitate recovery and adaptation) are suggested, with focus on groups at increased risk identified in this review.

The aim of this thesis was to study - from different perspectives - adolescent pregnancy and parenthood in Swaziland. The specific objectives were to: i) explore maternity care practices and support for adolescent mothers during their stay in the maternity unit; ii) study the postpartum support to adolescent mothers and their newborns at home by families, communities and health professionals; iii) explore adolescents' views regarding risky sexual behaviour; iv) explore adolescent boys' views on adolescent pregnancy and parenthood; v) explore health care staff provision of adolescent sexual and reproductive health care services in Swaziland. Qualitative and quantitative studies were carried out in four regions in Swaziland. Observations and checklists were used to assess the maternity care practices and semi-structured interviews were held with adolescents during their stay in the maternity ward (I). Seven days after delivery adolescent mothers were visited and interviewed in their homes (II). Twenty -four Focus Group Discussions (FGDs) with adolescent girls and boys (III) and further six FGDs with Swazi adolescent boys were conducted (IV). Questionnaires were distributed to health care staff in eleven health facilities in two regions in Swaziland. Statistical software was used for analysis of quantitative data (I, II, V) and content analysis was used for analysis of qualitative data (II, III, IV). Although the pregnant adolescents perceived that they were met in a welcoming manner by the midwives, the findings from the physical examination were poorly explained to them. None of the 33 adolescents were encouraged to bring a social support person with them during labour. All the girls were admitted and started with an uneventful labour, 12 (36%) had normal deliveries; nine 11 (35%) had an episiotomy, one (2%) was delivered by vacuum extraction and nine (27%) had a lower segment caesarean section performed, Seventeen (71%) adolescent mothers started breastfeeding their babies within one hour after birth and 7 (29%) started after two hours. Most of the adolescents were told to come back for postnatal check up (I). All adolescents were aware that missing a menstrual period was indicative of pregnancy and 30 (97%) were aware of different contraceptive methods but had not used any. They had got information about contraceptives from their peers. Twenty-five (81%) did not want the pregnancy and 15 (48%) had to drop out-of-school. Twenty-six (84%) first informed the partner about the pregnancy and none initially told their parents for fear of being scolded, beaten or chased away from home. Four (13%) had been scolded by midwives. Twenty-four (77%) had been abandoned by their partners after the birth of the baby, 15 (48%) had support from their parents, 14 (45%) from other relatives and 19 (61%) were satisfied with the support they received from their parents and other relatives (II). Age at first intercourse, peer pressure and trust in the relationship were found to be important factors in decisionmaking for risky sexual behaviours. Participants thought that the ideal age for starting sexual activity was 16 for girls and 17 years for boys. The majority believed that condom use implies a lack of trust in a partner and that condoms should be used when people have extra marital sex e.g. with prostitutes and casual partners, infected with STI and that condom use is un-pleasurable and artificial. There were generally negative attitudes to condom use. Adolescents were influenced by their peers to engage in sexual activity and the majority agreed that sex with multiple partners was common among them (III). Boys wanted to test what it meant to have sex. The boys commonly denied the pregnancy, feared that their parents would chase them away from home and that their peers would laugh at them if they had impregnated a girl. The boys believed that unfaithfulness was common in both sexes and thus could not trust the girls. Boys were aware that adolescent mothers and their babies faced serious health and social problems. The boys asked for better sexual and reproductive health (SRH) education and lacked communication about sexuality with adults. The boys requested the Government to provide jobs for them (IV). Most common services that were provided were regarding STIs/HIV/AIDS, pre-and post-test counselling and testing on HIV, contraceptives and condom use. Half of the nurses/midwives had no continued education and lacked supervision on ASRH care. The majority had unresolved moral doubts, negative attitudes, values and ethical dilemmas towards abortion care between the law, which is against abortion, and the reality of the adolescents' situation. Forty-four participants wanted to be trained on post abortion care while eight on how to perforin abortions (V). Implications for practice: The quality of maternity care for adolescents needs attention and evidence based practices. Provision of social support should be followed, including contraceptive counselling for both girls and boys to prevent STIs/HIV and unplanned pregnancies. Nursing, midwifery curricula should integrate comprehensive ASRH. There is need for political support for the ASRH programme in Swaziland.