Previous reproductive history and post-natal family planning among HIV-infected women in Ukraine

BACKGROUND: Ukraine has the highest antenatal HIV prevalence in Europe. The national prevention of mother-to-child transmission (MTCT) programme has reduced the MTCT rate, but less attention has been given to the prevention of unintended pregnancy among HIV-positive women. Our objectives were to describe the reproductive health, condom use and family planning (FP) practices of HIV-positive childbearing Ukrainian women and to identify factors associated with different methods of post-natal contraception. METHODS: HIV-infected childbearing women, diagnosed before or during pregnancy, were enrolled prospectively in a post-natal cohort study in four regional HIV/AIDS centres in Ukraine from December 2007. Logistic regression models were used to identify factors associated with post-natal FP practices. RESULTS: Data were available for 371 women enrolled by March 2009; 82% (n = 303) were married or cohabiting, 27% (97 of 363) reported a current HIV-negative sexual partner and 69% were diagnosed with HIV during their most recent pregnancy. Overall, 21% (75 of 349) of women were not using contraception post-natally (of whom 80% reported no current sexual activity), 50% (174 of 349) used condoms, 20% (74 of 349) relied solely/partially on coitus interruptus and 4% used hormonal methods or intrauterine device. Among married/cohabiting women, consistent use of condoms in the previous pregnancy [AOR 1.96 (95%CI 1.06–3.62)], having an HIV-positive partner [AOR 0.42 (0.20–0.87)], current sexual activity [AOR 4.53 (1.19–17.3)] and study site were significantly associated with post-natal condom use; 16% of those with HIV-negative partners did not use condoms. Risk factors for non-use of FP were lack of affordability [AOR 6.34 (1.73–23.2)] and inconsistent use of condoms in the previous pregnancy [AOR 7.25 (1.41–37.2)]. CONCLUSIONS: More than 40% of HIV-positive women in this population are at risk of unintended pregnancy and the one in six women in HIV-discordant couples not using barrier methods risk transmitting HIV to their partners. Our study results are limited by the observational nature of the data and the potential for both measured and unmeasured confounding

Sexually transmitted diseases and gynecologic symptoms and signs in women with a history of induced abortion

PIP: This study examines the relationship between a history of induced abortion and current or previous sexually transmitted diseases (STDs) and other gynecologic symptoms. Study participants consisted of a cohort of women attending 2 family planning and 1 youth clinic; 192 were admitted with history of induced abortion and 804 women served as controls. A structured interview to obtain data on previous genital infections and gynecologic symptoms was conducted and gynecologic examination was performed. Various types of STDs and gynecologic symptoms were diagnosed including chlamydial infection, gonorrhea, genital herpes, genital warts, cervical human papillomavirus infection, bacterial vaginosis, candidiasis, and bacterial vaginosis. The study found a high frequency of gynecologic symptoms in women with history of induced abortion such as abnormal vaginal discharges, pruritus, genital malodor, deep dyspareunia and urinary symptoms. Moreover, a history of gonorrhea, genital chlamydial infection, genital warts, and genital herpes were 1.5-5 times more common among women who experienced induced abortion. As a consequence of the 3-fold increase in the history of STDs, the study found a 4-fold increase of a history of pelvic inflammatory disease in women with induced abortion history. Considering these findings, women attending clinics for induced abortions could be a good target population for STD information programs and campaigns

Objective structured practical exam from discipline «Ukrainian language as foreign»: trying the implementation of european experience in the ukrainian educational process

У праці запропоновано й детально описано експериментальну станцію об’єктивного структурованого клінічного іспиту (ОСКІ) з дисципліни «Українська мова як іноземна». Наголошено на практиці такого тестування фахових медичних компетентностей і за кордоном, і в Україні. Проаналізовано теоретичний доробок, присвячений проблемам ОСПІ й ОСКІ. Зауважено про доцільність впровадження об’єктивних структурованих атестацій студентів-медиків на неклінічних кафедрах вищих навчальних медичних установ. Дефіновано об’єктивно структурований практичний іспит із дисципліни «Українська мова як іноземна». З’ясовано суть і механізм проведення об’єктивно структурованого практичного та клінічного іспитів. Детально описано роль ОСКІ в системі оцінювання в медичній освіті. Представлено й проаналізовано експериментальну станцію об’єктивного структурованого практичного іспиту з обраної засвоюваної студентами теми («Медична карта стаціонарного хворого. Паспортна частина», ІІІ курс, медичний факультет). Акцентовано на тому, що розробленою спеціальною методикою можна послуговуватися під час перевірки рівня засвоєння студентами знань, опанування ними базових фахових навичок із неклінічних дисциплін. Пропоноване дослідження виконано в межах антропоцентичної наукової парадигми. Базовий – загальнолінгвістичний метод наукового опису. У праці використано описово-аналітичний метод і метод порівняння, а також елементи методу кількісних підрахунків. Апельовано й до спеціальних лінгвістичних методів і прийомів, зокрема дискурс-аналізу.High quality higher education is a solid basis of individual and public intellectual property. It is also an integrated part of standard of living and citizens’ welfare. Finally, the mission of higher education is to offer competitive priority to its receivers now and in the future. So, we need to pay our attention on the quality of education. This article focuses on the health care system. This system of our modern society is very important because the existence and further development of the state institute as a whole is impossible without the full and harmonious functioning of the health care system. The authors focus their attention on the monitoring of students’ knowledge and their speaking skills. The article is devoted to the problem of using the Objective Structured Practical Examination (OSPE) at a medical universitу, especially at the non-clinical departments of higher educational establishments. The experimental Stations of the Objective Structured Clinical Examination (OSCI) of the discipline «Ukrainian as a Foreign Language» has been proposed and described in details. The practice of such testing of professional medical competencies have been emphasized. Problems of research OSPI and OSKI have been analyzed. The importance of using the Objective Structured Clinical Examinations has been noted and proved. This article pays our attention on the fact, that the Objective Structured Clinical Examination (OSCE) is a test of skills, behaviour, attitudes and application of knowledge, which has been an integral part of medical and dental curricula since late 1970s. As a procedural exam, it has been successfully supplementing other outcome-oriented assessment methods in order to measure students’ preparedness to practice. In addition to making a judgement about competence, the aim of assessment is to guide future learning and shape values. The essence and mechanism of objectively structured practical and clinical examinations have been clarified. The role and importance of using OSCI at the higher educational establishments, especially universities offer varying levels of healthcare services, have been described and proved. An experimental station of an objective structured practical examination («Medical card of a hospital patient. Passport part», III course, medical faculty) has been presented and analyzed in details. In addition, the real possibility of using the Objective Structured Practical Examination (OSPE) can be used for checking of students’ language knowledge and their speaking skills. Thus, it was concluded that there are some differences between the Objective Structured Practical Examination (OSPE) and the Objective Structured Clinical Examination (OSCI). The research has been presented within the anthropocentric scientific paradigm. Main descriptive-analytical methods, general-linguistic methods of scientific description, modern methods of comparison have been used. It has been appealed to special linguistic methods and techniques, including discourse analysis