Bulletin of the Pan American Health Organization
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Bull Pan Am Health Organ · Jan 1993
Comparative StudyFamily planning issues relating to maternal and infant mortality in the United States.
Both maternal and infant death rates in the United States are much higher than in many developed countries. The interrelationships between abortions and maternal and infant mortality have been analyzed on the basis of data from the 1970s and 1980s. The legalization of abortions in 1973 resulted in a marked increase in legal abortions and marked reductions in maternal and infant mortality over the course of the 1970s. ⋯ Comparisons with findings in Sweden reveal that the rates of unplanned pregnancy, abortion, and infant mortality were all much higher in the United States than in Sweden. The differences are attributed to better contraceptive services, which were made available free or very inexpensively in Sweden. Also, the frequency of low weight births was much lower in Sweden.
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Bull Pan Am Health Organ · Jan 1993
Comparative StudyMaternal mortality in Latin American urban areas: the case of São Paulo, Brazil.
This article describes maternal mortality trends in São Paulo, Brazil, from 1960 through 1990. In so doing, it compares mortality rates derived from death certificate data with rates suggested by three independent surveys conducted in the city of São Paulo in 1962-1963, 1974-1975, and 1986. In general, these data indicate that a substantial share of all maternal deaths in the city have been ascribed to other causes on death certificates, that prevailing maternal mortality levels are far higher than those found in the urban areas of most developed countries, and that in recent years levels of maternal mortality in the city have been rising. Various measures are suggested for improving the accuracy of available data and reducing the maternal mortality they describe.
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Bull Pan Am Health Organ · Jan 1991
A program for prevention and control of epidemic dengue and dengue hemorrhagic fever in Puerto Rico and the U.S. Virgin Islands.
The ongoing resurgence of Aedes aegypti in the Americas--abetted by poor mosquito control, urbanization, and increased air travel--has led to dengue hyperendemicity, more frequent dengue epidemics, and the emergence of dengue hemorrhagic fever (DHF). This article describes a program developed to cope with this situation that emphasizes disease prevention rather than general mosquito control measures.
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Bull Pan Am Health Organ · Jan 1990
ReviewThe relationship of autonomy and integrity in medical ethics.
The emergence of autonomy as a sociopolitical, legal, and moral concept has profoundly influenced medical ethics. It has shifted the center of decision-making from the physician to the patient and reoriented the whole physician-patient relationship toward a relationship more open, more honest, and more respectful of the dignity of the person of the patient. ⋯ As a foundation for medical relationships, the concept of integrity is richer, more fundamental, and more closely tied to what it is to be a whole human person. So, for reasons outlined in this article, we should deepen our grasp of the notion that autonomy depends upon preserving the integrity of persons and that both integrity of persons and autonomy depend on the physician.