This study is concerned with the pre-marital environmental factors that might influence the declining birth rate among college women. There have been some studies made on this subject, but none of them has taken into consideration so many variables, to the writer's knowledge, as are recognized in this survey.

Introduction. Research on teen childbearing has consistently noted that unfavorable socioeconomic conditions experienced at the community and family levels underpin disparities in teen birth rates. However, rather than examining socioeconomic factors alone, community-level differences in teen births could be measured by examining in tandem, the intersection between sociodemographic deprivation and health professional shortage areas (HPSA). Objectives. To examine the differences in teen birth rates by sociodemographic deprivation and HPSA in rural and urban counties of the United States. Methods. Results. Of the 3,136 counties, 78.7% of rural counties were in the highest category of socio-demographic deprivation compared to about 21.1% of urban counties. 76.0% of rural counties were categorized as having shortages of primary care, dental, and mental health providers, compared to 24.0% of urban counties. Rural counties had an additional 7.4 births per 1,000 females aged 15-19 years (p <0.0001) when compared to urban counties. The highest level of sociodemographic deprivation had a strong positive association with teen birth rates (β = 17.46; SE = 0.53; p < 0.0001). Rural counties with the whole designation of a health professional shortage increased county-level teen births by 7.18 births per 1,000 females aged 15-19 years (p <0.0001), compared to urban counties with no designation. Rural counties with higher levels of sociodemographic deprivation and a designation of health professional shortages in at least one area had significantly higher teen births than their urban counterparts (p <0.0001). Conclusions. Rural communities across different levels of deprivation and HPSA designated categories continue to have disproportionately greater teen birth rates. While these findings reveal the unique characteristics of sociodemographic and HPSA as a useful social determinant of teen birth, rural communities showed inherent vulnerabilities that contribute to poorer teen birth outcomes. Future research should examine the extent to which access to contraceptive services differs among rural and urban communities and the role of rural safety net providers in the provision of these services.

This dissertation" Specialized education in the field of practitioners for children and adolescents in the Czech Republic " focuses on the development of specialized postgraduate medical uducation in the context of social change in the Czech Republic after 1989 and their impact on staffing in the field of health care practitioners for children and adolescents . The first part describes the theoretical and factual basis , which is closely related to the issues . These concepts explained the functioning and development of the health system, providing primary care by practitioners for children and adolescents, impact of transformation of the labor market and human resources in health care and human rights in health care. To analyze the empirical part of the thesis i used the method of historical institutional analysis. I explained formal and informal relationships in time cohorts between major actors and their influence in shaping the institutional framework of specialized education of physicians over time, especially in the legislative documents. Attention is paid especially to organization and financing of specialist medical education in the field of practitioner for children and adolescens, aging of population present practitioners, and their generational replacement in the context of demographic...