BackgroundDelayed childbearing in European countries has resulted in an increase in the number of women having children later in life. Thus more women face the problem of age-related infertility and cannot achieve their desired number of children. Childbearing postponement is one of the main reasons for the increasing use of assisted reproductive technology (ART) and conversely, the latter may be one of the factors contributing to the rise in female childbearing age. The research goal of our article is to evaluate the demographic importance of ART increased use and to examine its impact on both the fertility rate and birth timing.MethodsComparative analysis based on demographic and ART data collected by the European IVF-monitoring (EIM) Consortium for the European Society of Human Reproduction and Embryology (ESHRE).ResultsMost countries with a higher total fertility rate (TFR) also registered a higher number of treatment cycles per 1 million women of reproductive age. Despite the positive relationship between the postponement rate and the demand for ART among women aged 35 and older, the highest share of children born after ART was not found in countries characterized by a “delayed” fertility schedule. Instead, the highest proportion of ART births was found in countries with fertility schedules concentrated on women aged between 25 and 34. Accordingly, the effective use of ART can be expected in populations with a less advanced postponement rate.ConclusionsART can have a demographic relevancy when women take advantage of it earlier rather than later in life. Furthermore it is suggested that the use of ART at a younger age increases women’s chance of achieving their reproductive goals and reduces the risk of age-related infertility and failed ART. Based on a demographic approach, reproductive health policy may become an integral part of policies supporting early childbearing: it may keep women from delaying too long having children and increase the chance of diagnosing potential reproductive health problems requiring a timely ART application.

The paper provides a comparative analysis of childcare and leave policies in four Central European countries. The rst part considers developments in policy since the 1960s, including the rst extended leave scheme introduced in Hungary in 1967 and the changes that have taken place since the end of the communist regimes. Although the transition process during the 1990s had many similarities, the emergence of national, cultural and religious identities contributed to some diversi cation of policies. After certain divergent trends, the Czech Republic and Hungary converged again towards the end of the 1990s, as both countries returned to a pro-natalist approach. Slovakia has retained a balance between pro-natalist and pro-traditional approaches. Poland had less generous policies before 1989: the subsequent political resurgence of Catholicism has accentuated the speci city of that country's policies. The second part discusses major issues arising in the post-1990 period: population policy and fertility; women's employment and the gap between rights and practices in the division of household work; and the speci c situation in the Czech Republic. KEY WORDS Parental leave; maternity leave; childcare; Central EuropeRESUMEN El articulo aporta un aná lisis comparativo de las polṍticas del cuidado infantil y permiso laboral (baja por maternidad/paternidad) en los cuatro paṍses centroeuropeos. La primera parte considera el desarrollo de la polṍtica desde los 1960s, incluida la primera esquema de permiso prolongado introducido en Hungrṍa en 1967 y los cambios desde el n de los gobiernos comunistas. Aunque habṍa muchas semejanzas, la aparición de identidades nacionales, culturales y religiosas contribuyó a una diversi cación en la polṍtica. Después de ciertas tendencias divergentes, la Repú blica Checa y Hungrṍa convergieron hacia el n de los 90s, como ambos paṍses volvieron al planteamiento pro-natalidad. Eslovaquia ha guardado un equilibrio entre enfoques pro-natalidad y pro-tradicional. Polonia tenṍa polṍticas menos generosos antes de 1989: el posterior resurgimiento del catolicismo ha subrayado la especi cidad de las polṍticas del paṍs. La segunda parte discute cuestiones que surgieron después de 1990: la polṍtica de población y la fertilidad, el empleo de mujeres y la distancia entre derechos y practicas en la división de tareas domesticas, y la situación especi ca en la Repú blica Checa.

Comorbid psychopathology, including self-harm and suicidal behavior, is often found in patients with eating disorders. To better understand the reasons for high comorbid psychopathology among eating disorders, self-harm, and suicidal behavior, we examined this comorbidity in female patients hospitalized with eating disorders. In a sample of 47 girls admitted for anorexia nervosa, atypical anorexia nervosa, and bulimia nervosa, 72% had depressive symptoms, 11% had obsessive-compulsive symptoms, 9% had anxiety disorder, 23% had substance abuse, and 57% had disharmonious personality development. Suicidal behavior was present in 60% of patients and self-harm in 49%. Association was found between self-harm and suicidality. In all, 68% of girls with eating disorders had a positive score in the Children’s Depression Inventory questionnaire and 62% of them in the Child Adolescent Suicidal Potential Index questionnaire. Clinical examination of girls with eating disorders should focus on identifying the risk of suicidal behavior and self-harm.

BackgroundThe marked increase in autism spectrum disorders (ASD) prevalence has stimulated worldwide interest in exploring broader circumstances of care of autistic children, including the role of socioeconomic status (SES) and family information on autism.MethodsOur sample comprised of 160 children who participated in a diagnostic examination focused on autism, and their parents who completed a simple descriptive questionnaire focusing on the family situation as well as family self-education about autism. The diagnosis of ASD was confirmed in 120 children (75% of the sample; 94 boys, 26 girls) with mean age 6.2±2.7 years (median 5.3, range 2.2–17.2 years). In 71 autistic patients (59.2%), a diagnosis of mental retardation was also established.ResultsThe age at diagnosis of ASD correlated negatively with maternal (P=0.014) and paternal (P=0.002) ages at the time of birth of the ASD child as well as with paternal (P=0.002) and maternal (P=0.050) education. The age at diagnosis of ASD did not correlate with family SES. Mothers were significantly more active in seeking information on autism than fathers or both parents equally (80 vs 9 vs 28 cases, respectively; P<0.001). The mean number of information sources on autism was 3.5±1.8 with a range 0–9. The mean number of resources did not differ among the three SES groups (3.50 vs 3.49 vs 4.25, respectively; P=0.704). The mean number of sources did not correlate with the age at diagnosis of ASD. The most often used sources were the Internet (81.7%), followed by psychologists (48.3%), books (46.7%), and child and adolescent psychiatrists (43.3%).ConclusionAn earlier diagnosis of ASD is associated with higher parental age at birth and higher parental education but not with family SES or number of family information sources.

Eating disorders frequently occur in conjunction with autism spectrum disorders, posing diagnostic and therapeutic difficulties. The comorbidity of anorexia nervosa and Asperger syndrome is a significant clinical complication and has been associated with a poorer prognosis. The authors are presenting the cases of an eleven-year-old girl and a five-and-a-half-year-old girl with comorbid eating disorders and Asperger syndrome.