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1

Pakistan: contraceptive prevalence rate up.  

PubMed

Pakistan's low sociodemographic profile has changed dramatically since the 1994 International Conference on Population and Development, said the Minister for Population Welfare and Science and Technology, HE Begum Sayda Abida Hussain, during her statement at the Forum. Based on the population census of 1998, Pakistan has an annual population growth rate of 2.3%, she said. The decline may be attributed to changes in married patterns and a rapid reduction in marital fertility, she added. The contraceptive prevalence rate has gone up from only 2% in the early 1990s to about 27% in 1998. Meeting the demand for reproductive health services, reducing maternal, infant and child mortality, and promoting gender equality are high priorities for her government, she informed the participants in the Forum. In line with this priority, the Government of Pakistan has developed a new population and development policy and is working to improve the education and status of women, lower fertility, increase contraceptive prevalence, and reduce infant and maternal mortality, she told the meeting. Pakistan is expanding reproductive health services in the rural and urban areas through community-based organizations, she said. Some 50,000 women workers now provide counseling and other services to women at their doorstep. Before concluding her address, she called on donors' increased support for ICPD implementation. "The full implementation of the ICPD agenda requires resources that are beyond the capacity of a developing country like Pakistan," she said. PMID:12157873

1999-09-01

2

Effect of village midwife program on contraceptive prevalence and method choice in indonesia.  

PubMed

Indonesia established its Village Midwife Program in 1989 to combat high rates of maternal mortality. The program's goals were to address gaps in access to reproductive health care for rural women, increase access to and use of family planning services, and broaden the mix of available contraceptive methods. In this study, we use longitudinal data from the Indonesia Family Life Survey to examine the program's effect on contraceptive practice. We find that the program did not affect overall contraceptive prevalence but did affect method choice. Over time, for women using contraceptives, midwives were associated with increased odds of injectable contraceptive use and decreased odds of oral contraceptive and implant use. Although the Indonesian government had hoped that the Village Midwife Program would channel women into using longer-lasting methods, the women's "switching behavior" indicates that the program succeeded in providing additional outlets for and promoting the use of injectable contraceptives. PMID:24323659

Weaver, Emily H; Frankenberg, Elizabeth; Fried, Bruce J; Thomas, Duncan; Wheeler, Stephanie B; Paul, John E

2013-12-01

3

Prevalence of gonorrhoea among women using various methods of contraception.  

PubMed

Among 2,005 women attending a contraceptive clinic 9-3 per cent. were found to have gonorrhoea. When these women were classified according to the method of contraception used at the time of their initial visit to the clinic, the following prevalence of gonorrhoea was observed: oral contraceptives 11-5 per cent., intrauterine contraceptive devices 9-9 per cent., barrier methods (condom-diaphragm-foam) 4-2 per cent. These differences are statistically significant. The authors suggest that the additional protective advantage of barrier methods should be considered when the physician and patient are selecting appropriate methods of contraception. PMID:811317

Berger, G S; Keith, L; Moss, W

1975-10-01

4

Prevalence of gonorrhoea among women using various methods of contraception.  

PubMed Central

Among 2,005 women attending a contraceptive clinic 9-3 per cent. were found to have gonorrhoea. When these women were classified according to the method of contraception used at the time of their initial visit to the clinic, the following prevalence of gonorrhoea was observed: oral contraceptives 11-5 per cent., intrauterine contraceptive devices 9-9 per cent., barrier methods (condom-diaphragm-foam) 4-2 per cent. These differences are statistically significant. The authors suggest that the additional protective advantage of barrier methods should be considered when the physician and patient are selecting appropriate methods of contraception.

Berger, G S; Keith, L; Moss, W

1975-01-01

5

Community-based incentives: increasing contraceptive prevalence and economic opportunity.  

PubMed

This article describes the implementation of a project in rural Thailand that used loan incentives for promoting small-scale income-generating activities and contraception practice. The project was initiated by the non-governmental Population and Community Development Association. Quarterly bonuses to a village fund are tied to the village's contraceptive prevalence rate, loan applications to individuals are prioritized according to applicant family planning (FP) practice, and members receive fund shares according to FP method used, e.g. 80 shares for a vasectom, 20 for an IUD. FP practice was monitored and the loan fund administered by trained loan fund officers from the community. The proiject was evaluated using 6 project villages and 3 controls with no loan fund. 3 of the experimental villages's loan funds were managed by female committees and benefits were available to all women regardless of marital status. The other funds were male/female managed and available only to married reproductive age couples. The proportion of women practising FP increased form 46% to 75% in 2 years, as opposed to from 51% to 57% in the contrrol villages. Pregnancy rates declined sharply. The strongest mechanism forFP use seems to have been the village-level incentive. Loan officers were able to motivate villagers to use FP. Women's status appears to have improved in the villages with female-administered funds. By encoraging capital investment, the fund appears to have gbreatly improved farm profits, and the loan repayment rate was almost 100%. The program attempted to avoid coersion, and did not compete with other loan programs. It appears helpful to emphasize training officers. Futre programs can tie incentives to pregnancy rates to deemphasize modern contraception. Services being promoted must be accessible and socially acceptable. PMID:12268013

Weeden, D; Bennett, A; Lauro, D; Viravaidya, M; Techo, W

1986-09-01

6

Effect of contraceptives on the prevalence of vaginal colonization with Candida species in Edo State, Nigeria.  

PubMed

High vaginal swabs (HVS) obtained from 500 volunteers in Edo State, Nigeria which comprised 394 contraceptive users and 106 non-contraceptive users were screened for the prevalence of Candida species using standard procedures. Results revealed the isolation of Candida species in 246 of volunteers. These included Candida albicans 174 (38.4%), Candida pseudotropicalis 20 (4%), Candida stellatoidea 15 (3%), Candida krusei nine (1.8%), Candida guilliermondii 12 (2.4%), Candida tropicalis 11 (2.2%) and Candida glabrata five (1%). Of the 394 contraceptive users, 203 (51.5%) had Candida species isolated from them compared to 43 (40.6%) from 106 non-contraceptive users. There was significant relationship (P<0.001) between the type of contraceptive used and the prevalence of vaginal colonization. Age and marital status of the volunteers sampled had significant relationship (P<0.001) with the prevalence of vaginal colonization. Results have revealed an association between use of contraceptive and the prevalence of vaginal colonization in our environment. PMID:15496123

Enweani, I B; Gugnani, H C; Okobia, R; Ojo, S B

2001-12-01

7

The World Fertility Survey and Contraceptive Prevalence Surveys: a comparison of substantive results.  

PubMed

This paper deals with the findings of the World Fertility Survey (WFS) and Contraceptive Prevalence Surveys (CPSs) in five areas of common interest: fertility, contraceptive use, measuring the effect of the availability of contraceptives on levels of use, the unmet need for family planning services, and breastfeeding. The comparisons have several implications for those designing surveys of fertility and family planning in developing countries, among them, that women should be asked for the dates of at least their last two births (not just the last birth as in the CPSs) in order to ensure accurate estimates of fertility and duration of breastfeeding. PMID:6701950

Anderson, J E; Cleland, J G

1984-01-01

8

ORAL CONTRACEPTIVES DECREASE THE PREVALENCE OF OVARIAN CANCER IN THE HEN  

PubMed Central

Ovarian cancer is the leading cause of reproductive cancer death in U.S. women. This high mortality rate is due to the lack of early detection methods and ineffectiveness of therapy for advanced disease. Until more effective screening methods and therapies are developed, chemoprevention strategies are warranted. The hen has a high spontaneous prevalence of ovarian cancer and has been used as a model for studying ovarian cancer chemoprevention. In this study, we used the hen to determine the effect of progestin alone, estrogen alone, or progestin and estrogen in combination (as found in oral contraceptives) on ovarian cancer prevalence. We found that treatment with progestin alone and in combination with estrogen decreased the prevalence of ovarian cancer. A significant risk reduction of 91% was observed in the group treated with progestin alone (risk ratio 0.0909: 95% confidence interval 0.0117-0.704) and an 81% reduction was observed in the group treated with progestin plus estrogen (risk ratio 0.1916: 95% confidence interval 0.043-0.864). Egg production was also significantly reduced in these treatment groups compared to control. We found no effect of progestin, either alone or in combination with estrogen, on apoptosis or proliferation in the ovary, indicating that this is not the likely mechanism responsible for the protective effect of progestin in the hen. Our results support the use of oral contraceptives to prevent ovarian cancer and suggest that ovulation is related to the risk of ovarian cancer in hens and that other factors, such as hormones, more than likely modify this risk.

Trevino, Lindsey S.; Buckles, Elizabeth L.; Johnson, Patricia A.

2011-01-01

9

Effects of the Philippine family planning outreach project on contraceptive prevalence: a multivariate analysis.  

PubMed

The 1980 Community Outreach Survey was used to assess the impact of the Outreach Project involving 2600 community workers on contraceptive prevalence. The primary measure was clinical prevalence (numerator limited to use of clinical methods--pills, IUD, and sterilization; the denominator was married women aged 15-44). The 46 socioeconomic (SES) and program input variables that appeared to be most closely correlated with contraceptive prevalence were subject to multivariate analysis on a stepwise basis. Of these 5 out of 7 SES variables accounted for 26.9% of the variance in clinical prevalence (household SES 22%, education of head of household 3%). 10 program variables (apart from specific Outreach Project variables) accounted for less than 4%. 12 Outreach Project variables accounted for a further 11.9% of the total variance or 17.2% of the residual variance. The most influential Outreach Project variables were whether the supply point officer was currently using a clinical method and the amount of personal contact with couples. The Outreach Project variables with no appreciable independent effect included mass media inputs, background characteristics of workers, and job satisfaction of the workers. Overall, the multivariate analysis demonstrated that the Outreach Project has affected contraceptive prevalence in the rural areas of the Philippines not reached by clinic-based operations. PMID:7348467

Laing, J E

1981-11-01

10

Prevalent and Incident Bacterial Vaginosis Are Associated with Sexual and Contraceptive Behaviours in Young Australian Women  

PubMed Central

Background To determine prevalence and incidence of bacterial vaginosis (BV) and risk factors in young sexually-active Australian women. Methods 1093 women aged 16–25 years were recruited from primary-care clinics. Participants completed 3-monthly questionnaires and self-collected vaginal smears 6-monthly for 12-months. The primary endpoint was a Nugent Score?=?7–10 (BV) and the secondary endpoint was a NS?=?4–10 (abnormal flora [AF]). BV and AF prevalence estimates and 95% confidence intervals (95%CI) were derived, and adjusted odds ratios (AOR) calculated to explore epidemiological associations with prevalent BV and AF. Proportional-hazards regression models were used to examine factors associated with incident BV and AF. Results At baseline 129 women had BV [11.8% (95%CI: 9.4–14.2)] and 188 AF (17.2%; 15.1–19.5). Prevalent BV was associated with having a recent female partner [AOR?=?2.1; 1.0–4.4] and lack of tertiary-education [AOR?=?1.9; 1.2–3.0]; use of an oestrogen-containing contraceptive (OCC) was associated with reduced risk [AOR?=?0.6; 0.4–0.9]. Prevalent AF was associated with the same factors, and additionally with >5 male partners (MSP) in 12-months [AOR?=?1.8; 1.2–2.5)], and detection of C.trachomatis or M.genitalium [AOR?=?2.1; 1.0–4.5]. There were 82 cases of incident BV (9.4%;7.7–11.7/100 person-years) and 129 with incident AF (14.8%; 12.5–17.6/100 person-years). Incident BV and AF were associated with a new MSP [adjusted rate ratio (ARR)?=?1.5; 1.1–2.2 and ARR?=?1.5; 1.1–2.0], respectively. OCC-use was associated with reduced risk of incident AF [ARR?=?0.7; 0.5–1.0]. Conclusion This paper presents BV and AF prevalence and incidence estimates from a large prospective cohort of young Australian women predominantly recruited from primary-care clinics. These data support the concept that sexual activity is strongly associated with the development of BV and AF and that use of an OCC is associated with reduced risk.

Fairley, Christopher K.; Chen, Marcus Y.; Tabrizi, Sepehr N.; Donovan, Basil; Kaldor, John M.; McNamee, Kathryn; Urban, Eve; Walker, Sandra; Currie, Marian; Birden, Hudson; Bowden, Francis; Garland, Suzanne; Pirotta, Marie; Gurrin, Lyle; Hocking, Jane S.

2013-01-01

11

Is it Really Safe Sex? Analyzing the Causal Link between Contraceptive Usage and Crime Rates  

Microsoft Academic Search

This research investigates the possibility of a causal link between contraceptive use in the 1970s and the decline of crime rates observed during the 1990s. A theoretical framework is adopted in which individual contraceptive use reflects a decision to delay parenthood until a family network can be established. This decision, in turn, increases the costs associated with criminal behavior, decreasing

Nicholas J. Hill

2007-01-01

12

Contraceptive Failure Rates of Etonogestrel Subdermal Implants in Overweight and Obese Women  

PubMed Central

Objective To estimate the contraceptive failure rates of the etonogestrel subdermal contraceptive implant in overweight and obese women, and compare failure rates to women of normal weight and women using intrauterine devices (IUDs). Methods The Contraceptive CHOICE Project is a large prospective cohort study designed to promote the use of long-acting reversible contraceptive methods to reduce unintended pregnancies in the St. Louis region. Participants are provided reversible contraception of their choice at no cost. We collected baseline height and weight of each participant. During each survey, participants were asked about missed menses and possible pregnancies. Any participant who suspected a pregnancy was asked to come in for urine pregnancy testing. Analysis includes the first 8,445 participants enrolled in CHOICE of which 1,168 chose the implant and 4,200 chose the IUD. Student’s t-test, ?2 test, and Kaplan-Meier survival curves were used to perform statistical analyses to estimate failure rates in overweight and obese women using the implant and IUDs. Results Of the women choosing the implant, 28% were overweight and 35% were obese. Of the women who chose an IUD, 27% were overweight and 35% were obese. The 3-year cumulative failure rates for implant and IUD users were less than 1 per 100 women-years and did not vary by body mass index (BMI). Conclusion We found no decrease in the effectiveness of the implant in overweight or obese women. The implant may be offered as a first-line contraceptive method to any woman seeking a reversible, and reliable birth control method.

Xu, Hanna; Wade, Jennifer A.; Peipert, Jeffrey F.; Zhao, Qiuhong; Madden, Tessa; Secura, Gina M.

2014-01-01

13

Continuation rates of the subdermal contraceptive Implanon(®) and associated influencing factors.  

PubMed

OBJECTIVES To investigate the continuation rates of the etonogestrel subdermal contraceptive implant among well-informed women, and the reasons for early discontinuation. STUDY DESIGN Retrospective consecutive cohort design. METHODS Women who had the implant inserted between 1 January 2006 and 1 January 2010 at the Atrium Medical Centre, the Netherlands were followed up for at least three years. The dates of insertion and removal were recorded, as were the reasons for removal. Statistical analysis was performed using the independent samples t-test and the Pearson alpha correlation test. RESULTS The implant was inserted in 230 women. Follow-up was possible in 214 women, with an average age of 26.7 years. Most of them were nulliparous and the majority had used a combined oral contraceptive, Implanon®, or Mirena® previously. The mean overall continuation period was 23.5 months (95% confidence interval: 21.7-25.3), with a median of 25 months. The continuation rate after 12 months was 72%; after 24 months, 53%; and after 36 months, 25%, with all women concerned having a new implant placed. The previously used contraceptive method Implanon® was associated with the highest continuation rates. An erratic bleeding pattern was the main reason for early removal. CONCLUSIONS Despite adequate counselling before insertion, the continuation rate of the etonogestrel implant was rather low compared to those reported by other investigators. The main reason for discontinuation was an irregular bleeding pattern. PMID:24329119

Teunissen, Anna Maria; Grimm, Bernd; Roumen, Frans J M E

2014-02-01

14

[Contraception in immigrant women: Influence of sociocultural aspects on the choice of contraceptive method].  

PubMed

There are currently 6 million immigrants living in Spain. Half of them are women, the majority of whom are of childbearing age. These women, who suffer high rates of induced abortion, form a special group who require a special approach to their reproductive health. In order to study the use of contraceptive methods in this population, a review was made of 1100 clinical histories from our Sexual Health and Reproduction Clinic. Latin American women were the most prevalent group who came to seek information about contraception, followed by Eastern Europeans and Moroccans. Fewer Asian and Sub-Saharan women sought these services. The contraceptives most frequently used were the intrauterine device (used mostly by Latin American and Eastern European women), and combined oral contraception, most used by Moroccan women. It is important to advise the immigrant women about contraceptive methods, taking into account their preferences, in order to improve adherence to the method. PMID:23583187

Paraíso Torras, B; Maldonado Del Valle, M D; López Muñoz, A; Cañete Palomo, M L

2013-01-01

15

Improving access to emergency contraception under the Scottish Sexual Health Strategy: can rates of unintended pregnancy be reduced?  

PubMed

Unintended pregnancy is a global sexual health problem. Outcomes of unintended pregnancy include unwanted childbirth and abortion, which may be associated with negative physical and psychosocial health implications for women. In Scotland, the Scottish Sexual Health Strategy has the stated goal of improving the sexual health of the people of Scotland. One aim of the Strategy is to reduce rates of unintended pregnancy and one policy designed to achieve this is 'widening access to emergency contraception'. This paper examines the success of this policy with reference to the implicit link it makes between expanding access to emergency contraception and increasing its effective use, aiming thereby to reduce rates of unintended pregnancy. Since there is evidence that previous policies and strategies expanding access to emergency contraception have failed to reduce such rates, alternative approaches to achieve a reduction in unintended pregnancies are discussed. PMID:24007249

McGowan, James G

2013-09-01

16

Contraceptive procedures.  

PubMed

Although most women desire to control the size and spacing of their family, the rate of unintended pregnancy in the United States remains high, with approximately half of all pregnancies being unintended. Reducing unintended pregnancy is a national public health goal, and the increased use of long-acting reversible contraceptives (LARCs) (intrauterine devices and implants) can help meet this goal. LARCs are among the most effective forms of contraception available. There are few contraindications to their use, and insertion and removal are straightforward procedures that are well tolerated in the outpatient office setting. PMID:24286997

Beasley, Anitra; Schutt-Ainé, Ann

2013-12-01

17

Emergency contraception  

MedlinePLUS

Morning-after pill; Postcoital contraception; Birth control - emergency; Plan B ... prevents pregnancy in the same way as regular birth control pills. TYPES OF EMERGENCY CONTRACEPTION Two emergency contraceptive ...

18

Male contraception  

PubMed Central

Contraception is an accepted route for the control of population explosion in the world. Traditionally hormonal contraceptive methods have focused on women. Male contraception by means of hormonal and non hormonal methods is an attractive alternative. Hormonal methods of contraception using testosterone have shown good results. Non hormonal reversible methods of male contraception like reversible inhibition of sperm under guidanceare very promising. In this article we have reviewed the current available options for male contraception.

Mathew, Vivek; Bantwal, Ganapathi

2012-01-01

19

[Contraceptive methods].  

PubMed

Interest in contraceptive devices has increased in recent years due to their safety and protection offered against venereal disease. Use of the devices prevents sperm from entering the uterine canal. Failure of a device is usually caused either because the contraceptive outside the uterus is wrongly positioned or because not enough active spermicidal ingredients were released before ejaculation. Mass production of condoms was made possible through utilization of latex rubber. Different color and shape alternatives have made condom usage more popular in developing countries. The diaphragm and its variation, the cervical cap, are treated with spermicide and then placed inside the vagina. Correct size of the contraceptive is an important consideration. Spermicides consist of active substances that kill sperm, as well as a carrier substance such as foam, ointment and jelly. The newest preventive device is the contraceptive sponge, which can stay in place for up to 36 hours. IN vitro studies show that effectiveness of condoms is 0.5-2.0 (Pearl's index). Combination use of diaphragm and spermicide yields a protection rate of 2-20 (life-table index), and spermicides 0.3-30.0. Risks associated with these methods include local irritation. It was believed that some spermicides increased rats of miscarriage, Down's Syndrome and other chromosomal abnormalities, as well as limb anomalies. Diaphragm use increases potential for urinary tract infections. Toxic shock may occur with some users of sponge and diaphragm. All the mentioned contraceptives protect from infection, and are most suitable for people who cannot tolerate hormonal preparations or IUD's, who are in a casual sexual relationship or nursing mothers or youth. PMID:3331144

Toivonen, J

1987-01-01

20

Hormonal Contraceptives and Adherence  

Microsoft Academic Search

\\u000a Hormonal contraceptives are among the most widely used reversible methods of preventing pregnancy. In 2002, oral contraceptive\\u000a pills (OCPs) were the most popular contraceptive method, used by 11.6 million women in the USA [1]. Unfortunately, for methods\\u000a such as OCPs, which depend on adherence in order to be effective, there is a large difference in failure rates between perfect\\u000a use

Jeanette R. Chin; Geeta K. Swamy; Serina E. Floyd; Lori A. Bastian

21

[Social marketers' lack of success in using CSM discipline to harness commercial resources and increase contraceptive prevalence].  

PubMed

Social marketers have certainly shown that the CSM discipline can quickly and cost-effectively harness commercial resources to increase contraceptive prevalence. But why hasn't the social marketing idea caught on in more countries? According to Social Marketing Forum, only a tiny number of countries have active programs after more than a decade of effort. The most likely reason for this lack of success is doubt and fear on the part of both developing countries' officials and donor agencies about allowing marketing enthusiasts--with our very noticeable advertising methods--to join the family planning fight. And what has our answer been? Usually, a head-on retort such as, "But look at all the condoms we've sold]" And that gets us nowhere, because the successful peddling of 1 not-so-impressive method doesn't begin to balance the fears of a possible backlash that brash condom promotions could bring down on official heads. The lesson we should be learning is that social marketers possess to narrow an outlook and promote a small range of products that don't enthuse decisionmakers. Hence, we are often perceived as condom salesmen--and not much more. What should we be doing? We should be selling the idea of using private sector experience to assist national development. That means social development, particularly improved health, family planning and women's education. These 3 activities have proven effective in reducing fertility and would add up to a marketing opportunity--a longterm challenge that should enthuse dicisionmakers, private sector entrepreneurs and donor agencies alike. Further, our model--the commercial sector--is renowned for branching out and secceeding in a broad range of endeavors. As an example, Procter and Gamble uses separate divisions to market different products. Initiatives already exist in many countries to harness the private sector as a development tool. Social marketers should be leading the initiative--and benefitting from it, too. PMID:12266330

Davies, J

1984-01-01

22

[Male contraception].  

PubMed

Contraception allows within a heterosexual couple to have a more fulfilling as possible sexuality while protecting against the occurrence of unintended pregnancy. In a majority of couples, contraception is assumed by women. Currently, male contraceptive methods most commonly used are the male condom and vasectomy. Many other strategies, including hormonal contraceptive regimens, have been proposed and evaluated. The purpose of this review is to present an overview of the various current and future male contraceptive methods. PMID:24412108

Robin, Geoffroy; Marcelli, François; Rigot, Jean-Marc

2014-02-01

23

Unintended Pregnancy and Contraception Among Active Duty Servicewomen and Veterans  

PubMed Central

The number of women of childbearing age who are active duty service members or veterans of the U.S. military is increasing. These women may seek reproductive health care at medical facilities operated by the military, in the civilian sector or through the Department of Veterans Affairs. This article reviews the current data on unintended pregnancy and prevalence of and barriers to contraceptive use among active duty and veteran women. Active duty servicewomen have high rates of unintended pregnancy and low contraceptive use which may be due to official prohibition of sexual activity in the military, logistic difficulties faced by deployed women and limited patient and provider knowledge of available contraceptives. In comparison, little is known about rates of unintended pregnancy and contraceptive use among women veterans. Based on this review, research recommendations to address these issues are provided.

Goyal, Vinita; Borrero, Sonya; Schwarz, Eleanor Bimla

2012-01-01

24

Emergency Contraception  

MedlinePLUS

... emergency contraceptive pills. If you are pregnant, have breast cancer, or have had blood clots, you should not use emergency contraceptive pills. Talk with your doctor about whether emergency ...

25

Prevalency rate and personality comparisons of bulimic and normal adolescents.  

PubMed

This study was designed to examine (1) the prevalency rate of bulimia in high school students and (2) the personality characteristics of bulimic students when compared with a matched control group using the MMPI. The Bulimia Test and the Eating Disorder Inventory were used to screen for the disorder, followed by clinical interviews. A prevalency rate of 5.8% was established. A significant discriminate function was found using the Pa, Hy, Mf, and Sc scales to discriminate bulimics from controls. PMID:2376210

Dacey, C M; Nelson, W M; Aikman, K G

1990-01-01

26

Obesity and hormonal contraceptive efficacy  

PubMed Central

Obesity is a major public health concern affecting an increasing proportion of reproductive-aged women. Avoiding unintended pregnancy is of major importance, given the increased risks associated with pregnancy, but obesity may affect the efficacy of hormonal contraceptives by altering how these drugs are absorbed, distributed, metabolized or eliminated. Limited data suggest that long-acting, reversible contraceptives maintain excellent efficacy in obese women. Some studies demonstrating altered pharmacokinetic parameters and increased failure rates with combined oral contraceptives, the contraceptive patch and emergency contraceptive pills suggest decreased efficacy of these methods. It is unclear whether bariatric surgery affects hormonal contraceptive efficacy. Obese women should be offered the full range of contraceptive options, with counseling that balances the risks and benefits of each method, including the risk of unintended pregnancy.

Robinson, Jennifer A; Burke, Anne E

2014-01-01

27

Prevalence Rates of Mental Disorders in Chilean Prisons  

PubMed Central

Objective High rates of mental disorders have been reported for prison populations worldwide, particularly in low- and middle-income countries (LMICs). The present study aimed to establish prevalence rates of mental disorders in Chilean prisoners. Method A nationwide random sample of 1008 prisoners was assessed in 7 penal institutions throughout Chile. Twelve-month prevalence rates were established using the Composite International Diagnostic Interview (CIDI) and compared to the prevalence rates previously published for the general population. Results Prevalence rates were 12.2% (95% CI, 10.2-14.1) for any substance use disorder, 8.3% (6.6-10.0) for anxiety disorders, 8.1% (6.5-9.8) for affective disorders, 5.7% (4.4-7.1) for intermittent explosive disorders, 2.2% (1.4-3.2) for ADHD of the adult, and 0.8% (0.3-1.3) for non-affective psychoses. Significantly higher prevalence rates among prisoners as compared to the general population in Chile were seen for major depression (6.1% vs. 3.7% males, Z=2.58, p<0.05) and illicit drug use (3.3% vs. 0.6% males with drug abuse, Z=2.04, p<0.05; 2.6% vs. 0.1% females with drug abuse, Z=5.36, p<0.001; 3.4% vs. 1.1% males with drug dependence, Z=3.70; p<0.001). Dysthymia (6.5% vs. 15.6%, Z=-2.39, p<0.05), simple (3.3% vs. 11.5%, Z=-3.13, p<0.001) and social phobias (3.9% vs. 9.7%, Z=2.38, p<0.05) were significantly less frequent in the female prison population than in the general population. One-year prevalence rates of alcohol abuse (2.3% vs. 3.9%; Z=-2.04; p<0.05) and dependence (2.7% vs. 8.2%; Z=-5.24; p<0.001) were less prevalent in the male prison population than in the general population. Conclusions Service provision for prison populations in Chile should acknowledge high rates of depression and illicit drug use. Overall prevalence rates are lower than reported in other LMICs. Previous research in prison populations in LMICs might have overestimated prevalence rates of mental disorders.

Mundt, Adrian P.; Alvarado, Ruben; Fritsch, Rosemarie; Poblete, Catalina; Villagra, Carolina; Kastner, Sinja; Priebe, Stefan

2013-01-01

28

Unresolved issues in contraceptive health policy.  

PubMed

The year 2000 marked the fortieth anniversary of the oral contraceptive known as the "pill." Despite the availability of the pill, and other contraceptives, many unresolved issues remain. Concerns with contraceptive side effects, high use-failure rates, and high rates of both unintended pregnancies and abortions indicate a need for improved contraceptive choices. Experts have called for a second contraceptive revolution that would bring radically new contraceptive products to the market. Unfortunately, this second revolution has not occurred, and contraceptive research has been virtually abandoned by most major pharmaceutical firms. We suggest that inclusion of contraceptives within the 1983 Orphan Drug Act and U.S. federal legislation known as the Food and Drug Administration (FDA) defense could provide the economic incentives needed to spark the second contraceptive revolution. PMID:12487700

Reaves, Natalie D

2002-12-01

29

Contraception Update  

Microsoft Academic Search

A discussion of contraceptive options would not be complete without reviewing the population that needs contraception. In\\u000a the United States, 48% of the 6.3 million pregnancies that occur annually are unplanned. Approximately 50% of these unplanned\\u000a pregnancies occur among the small percentage of women at risk for pregnancy who do not use contraception. There are approximately\\u000a 60 million women in

Amitasrigowri S. Murthy; Bryna Harwood

30

Population and antenatal-based HIV prevalence estimates in a high contracepting female population in rural South Africa  

Microsoft Academic Search

BACKGROUND: To present and compare population-based and antenatal-care (ANC) sentinel surveillance HIV prevalence estimates among women in a rural South African population where both provision of ANC services and family planning is prevalent and fertility is declining. With a need, in such settings, to understand how to appropriately adjust ANC sentinel surveillance estimates to represent HIV prevalence in general populations,

Brian D Rice; Jörg Bätzing-Feigenbaum; Victoria Hosegood; Frank Tanser; Caterina Hill; Till Barnighausen; Kobus Herbst; Tanya Welz; Marie-Louise Newell

2007-01-01

31

Adolescent contraception.  

PubMed

Sexual health for adolescents is based on three components: recognizing sexual rights, sexuality education and counseling, and confidential high-quality services. Contraception needs to include prevention of both STIs and pregnancy. The main options for adolescents are condoms backed-up by emergency contraception; and hormonal contraceptives in a longer, mutually monogamous relationship. Condoms and hormonal contraception together can be well recommended for adolescents. Condom use should not be stopped before it is reasonably certain that the partner is STI-negative. Other alternatives can be considered in special cases. Improved contraceptive methods do not automatically lead to reduced numbers of adolescent abortions. The prevention of unintended adolescent pregnancies requires four elements: a desire to use protection, a good contraceptive method, ability to obtain the contraceptive method, and ability to use it. All these components are important, and if one is missing contraception will fail. In the developed countries, we have good contraceptive methods, but improvements are still needed in the other components. When adolescent sexuality is not condemned but sexuality education and sexual health services instead are provided, it is possible to profoundly improve adolescent sexual health with comparatively small costs. Each year new groups of young people mature, requiring new efforts. PMID:22846536

Apter, Dan

2012-01-01

32

The geography of HIV/AIDS prevalence rates in Botswana  

PubMed Central

Background Botswana has the second-highest human immunodeficiency virus (HIV) infection rate in the world, with one in three adults infected. However, there is significant geographic variation at the district level and HIV prevalence is heterogeneous with the highest prevalence recorded in Selebi-Phikwe and North East. There is a lack of age-and location-adjusted prevalence maps that could be used for targeting HIV educational programs and efficient allocation of resources to higher risk groups. Methods We used a nationally representative household survey to investigate and explain district level inequalities in HIV rates. A Bayesian geoadditive mixed model based on Markov Chain Monte Carlo techniques was applied to map the geographic distribution of HIV prevalence in the 26 districts, accounting simultaneously for individual, household, and area factors using the 2008 Botswana HIV Impact Survey. Results Overall, HIV prevalence was 17.6%, which was higher among females (20.4%) than males (14.3%). HIV prevalence was higher in cities and towns (20.3%) than in urban villages and rural areas (16.6% and 16.9%, respectively). We also observed an inverse U-shape association between age and prevalence of HIV, which had a different pattern in males and females. HIV prevalence was lowest among those aged 24 years or less and HIV affected over a third of those aged 25–35 years, before reaching a peak among the 36–49-year age group, after which the rate of HIV infection decreased by more than half among those aged 50 years and over. In a multivariate analysis, there was a statistically significant higher likelihood of HIV among females compared with males, and in clerical workers compared with professionals. The district-specific net spatial effects of HIV indicated a significantly higher HIV rate of 66% (posterior odds ratio of 1.66) in the northeast districts (Selebi-Phikwe, Sowa, and Francistown) and a reduced rate of 27% (posterior odds ratio of 0.73) in Kgalagadi North and Kweneng West districts. Conclusion This study showed a clear geographic distribution of the HIV epidemic, with the highest prevalence in the east-central districts. This study provides age- and location-adjusted prevalence maps that could be used for the targeting of HIV educational programs and efficient allocation of resources to higher risk groups. There is need for further research to determine the social, cultural, economic, behavioral, and other distal factors that might explain the high infection rates in some of the high-risk areas in Botswana.

Kandala, Ngianga-Bakwin; Campbell, Eugene K; Rakgoasi, Serai Dan; Madi-Segwagwe, Banyana C; Fako, Thabo T

2012-01-01

33

Contraceptive Equity  

PubMed Central

The Equity in Prescription Insurance and Contraceptive Coverage Act, introduced in Congress in 1997 and still unpassed, seeks to redress health insurers’ failure to pay for birth control as they pay for other prescription drugs, most paradoxically Viagra. In 1936 the International Workers Order (IWO), a fraternal society, became the first insurer to include contraception in its benefits package. A forerunner in the movement for prepaid medical care, the IWO offered its members primary care and contraceptive services for annual flat fees. Founded at a time when the legal status of contraception was in flux, the IWO’s Birth Control Center was the only such clinic to operate on an insurance system. Recent state laws and judicial actions have revived the IWO’s groundbreaking view of contraception as a basic preventive service deserving of insurance coverage.

Temkin, Elizabeth

2007-01-01

34

Unexpectedly low prevalence rates of IBS among adult Israeli Jews.  

PubMed

The irritable bowel syndrome (IBS) and other functional bowel disorders (FBDs) are common functional gastrointestinal disorders. The prevalence of IBS using Rome II criteria is generally lower than with previous criteria. The aim of this study was to determine the prevalence of IBS and other FBDs in the adult Israeli Jewish population, which has not been surveyed to date. A telephone survey was conducted on a representative sample of the study population provided by the Israel Ministry of the Interior. IBS and other FBDs were diagnosed by Rome II criteria. The study population was 981 individuals and the overall response rate was 54%. The mean age was 45.0 years and 55% were females. In all, 2.9% had IBS (females: 3.7%, males: 1.8%, P = 0.08). The rate increased to 4.1% when the Rome II diagnostic criteria were amended to include some chronic alternators who are not picked up by the original scoring system. Approximately 26% of the respondents had a functional lower gastrointestinal (GI) disorder (females: 32.1%, males: 17.7%, P < 0.0001). Prevalence rates for IBS among Israeli Jewish adults are lower than rates reported from most countries, despite the high level of stress resulting from Israel's geopolitical circumstances. Possible reasons for this low prevalence are discussed. PMID:15787941

Sperber, A D; Shvartzman, P; Friger, M; Fich, A

2005-04-01

35

The impact of hormonal contraceptives on blood pressure, urinary albumin excretion and glomerular filtration rate  

PubMed Central

Aim In short-term studies, hormonal contraceptives (HC) have been suggested to induce a rise in blood pressure (BP) and urinary albumin excretion (UAE), while the effect of HC in renal function (GFR) is still under debate. Data on long-term and withdrawal effects of HC use on these outcomes are, however, not available. We therefore studied whether the start and cessation of HC induce changes in BP, UAE and GFR. Methods We used data from the PREVEND Study, a prospective cohort of subjects aged 28–75 years. Eligible were women aged ? 45 years with complete clinical and pharmacy data on baseline and follow-up screening (4 years later). Multivariate regression analysis was used to estimate the effects of HC on BP, UAE and GFR in those who started (n = 73), stopped (n = 117) or continued (n = 183) with those who never used HC (n = 286) as the reference group. Results BP increased among starters and fell in stoppers. These changes compared with never-users were statistically significant, even after adjustment for relevant variables. UAE increased by 14.2% in starters (P = 0.074) and fell by 10.6% in stoppers (P = 0.021), while GFR fell by 6.3% in starters (P < 0.001) and did not change in stoppers. The effects of stopping HC on UAE and GFR were significantly different compared with changes among never-users, even after adjustment for other variables (P = 0.023 and 0.036, respectively). Conclusions The start of HC was independently associated with worsening of BP, UAE and GFR, while stopping HC use resulted in an improvement. These data suggest that long-term HC use (aged 28–45 years) may be deleterious from the cardiovascular and renal point of view, but stopping may result in correction of these effects.

Atthobari, Jarir; Gansevoort, Ron T; Visser, Sipke T; de Jong, Paul E; de Jong-van den Berg, Lolkje T W

2007-01-01

36

Effect of ?-dose rate and total dose interrelation on the polymeric hydrogel: A novel injectable male contraceptive  

NASA Astrophysics Data System (ADS)

Functional necessity to use a particular range of dose rate and total dose of ?-initiated polymerization to manufacture a novel polymeric hydrogel RISUG ® (reversible inhibition of sperm under guidance) made of styrene maleic anhydride (SMA) dissolved in dimethyl sulphoxide (DMSO), for its broad biomedical application explores new dimension of research. The present work involves 16 irradiated samples. They were tested by fourier transform infrared spectroscopy, matrix assisted laser desorption/ionization-TOF, field emission scanning electron microscopy, high resolution transmission electron microscopy, etc. to see the interrelation effect of gamma dose rates (8.25, 17.29, 20.01 and 25.00 Gy/min) and four sets of doses (1.8, 2.0, 2.2 and 2.4 kGy) on the molecular weight, molecular weight distribution and porosity analysis of the biopolymeric drug RISUG ®. The results of randomized experiment indicated that a range of 18-24 Gy/min ?-dose rate and 2.0-2.4 kGy ?-total doses is suitable for the desirable in vivo performance of the contraceptive copolymer.

Jha, Pradeep K.; Jha, Rakhi; Gupta, B. L.; Guha, Sujoy K.

2010-05-01

37

[Contraceptive compliance - why is contraceptive failure still so frequent?].  

PubMed

Contraceptive compliance is defined as the correct use (according to the method specific prescriptions given by a medical professional and/or in written form as patient information leaflet) of a contraceptive method. Non-compliance describes a mismatch between the real behaviour of a user and the correct or ideal behaviour. There are various indicators that in general contraceptive compliance is far from ideal. Many studies report a rate of unintended pregnancies of 50%, half of them terminating in abortion. The abortion rate remains high even in countries with availability of advanced contraceptive technology. Especially with hormonal contraception and barrier methods the gap between correct and real use is large. Discontinuation rates per year reach up to 50%. Reasons for Non Compliance are (a) Lack of motivation to prevent a pregnancy due to ambivalence regarding the wish for a child as well as sexual and relationship issues (b) Cognitive factors (False information, misconceptions, irrational fears) (c) Difficult or lacking access to contraceptive methods (d) Behavioral errors and mistakes (Forgetting, loosing etc.) and (e) Side effects of the methods used. Three strategies to improve compliance can be distinguished: (a) Improving counselling; (b) Developing contraceptive methods which demand a low level of compliant behaviour by the user; (c) Improving quality of life of users by minimizing the negative side effects and maximizing the non contraceptive health benefits. PMID:19180434

Bitzer, Johannes

2009-02-01

38

Emergency Contraception  

MedlinePLUS

... provider after using emergency contraception pills? • Can I get pregnant later in my menstrual cycle after I have ... pregnancy if you are already pregnant. Can I get pregnant later in my menstrual cycle after I have ...

39

Spousal discordance on fertility preference and its effect on contraceptive practice among married couples in Jimma zone, Ethiopia  

PubMed Central

Objectives To assess spousal agreement levels regarding fertility preference and spousal communication, and to look at how it affects contraceptive use by couples. Methods We conducted a cross-sectional study to collect quantitative data from March to May 2010 in Jimma zone, Ethiopia, using a multistage sampling design covering six districts. In each of the 811 couples included in the survey, both spouses were interviewed. Concordance between the husband and wife was assessed using different statistics and tests including concordance rates, ANOVA, Cohen’s ? and McNemar’s test for paired samples. Multivariate analysis was computed to ascertain factors associated with contraceptive use. Results Over half of the couples wanted more children and 27.8% of the spouses differed about the desire for more children. In terms of sex preference, there was a 48.7% discord in couples who wanted to have more children. At large, spousal concordance on the importance of family planning was positive. However, it was the husband’s favourable attitude towards family planning that determined a couple’s use of contraception. Overall, contraceptive prevalence was 42.9%. Among the groups with the highest level of contraceptive users, were couples where the husband does not want any more children. Spousal communication about the decision to use contraception showed a positive association with a couple’s contraceptive prevalence. Conclusions Family planning programs aiming to increase contraceptive uptake could benefit from findings on spousal agreement regarding fertility desire, because the characteristics of each spouse influences the couple’s fertility level. Disparities between husband and wife about the desire for more children sustain the need for male consideration while analysing the unmet need for contraception. Moreover, men play a significant role in the decision making concerning contraceptive use. Accordingly, involving men in family planning programs could increase a couple’s contraceptive practice in the future.

2014-01-01

40

Menstrual irregularity and compliance in contraception: comparison between oral contraceptives and etonogestrel contraceptive implant  

Microsoft Academic Search

We study the relation between menstrual irregularity and continuation rates from women who use oral contraceptive pill and those with subdermal progesterone implant. We made a retrospective comparative study, in private medical practice, of 117 women who are users of oral contraceptives with 30 ?g of ethinyl estradiol (EE; Group A, n=64) and 20 ?g EE (Group B, n=37), and

Alexandra Bermúdez; Mario Muñiz; Luis Ruvalcaba; Julio Chanona; Melecio Beltrán; Silvio Cuneo

2004-01-01

41

Prevalence of Increased Albumin Excretion Rate in Young Saudi Adults  

Microsoft Academic Search

Introduction: Albuminuria is an important risk predictor of chronic kidney disease and cardiovascular disease. In this study, we aim to evaluate the prevalence of increased urinary albumin excretion (UAE) rate amongst a subgroup of young Saudi army\\/navy recruits. Methods: 2,000 Saudi military recruits were tested for microalbuminuria by dipstick and 24-hour urine collection for quantitative evaluation. Results: In the whole

H. Abo-Zenah; A. El-Benayan; A. M. El Nahas

2008-01-01

42

Population Matters Policy Brief: Improvements in Contraception Are Reducing Historically High Abortion Rates in Russia.  

National Technical Information Service (NTIS)

Like many Communist or post-Communist nations, Russia has one of the highest abortion rates in the world. These rates have created a legacy of significant medical problems. Complications from abortion are the cause of more than one in four maternal deaths...

2001-01-01

43

Lifetime Prevalence Rates of Sleep Paralysis: A Systematic Review  

PubMed Central

Objective To determine lifetime prevalence rates of sleep paralysis. Data Sources Keyword term searches using “sleep paralysis”, “isolated sleep paralysis”, or “parasomnia not otherwise specified” were conducted using MEDLINE (1950-present) and PsychINFO (1872-present). English and Spanish language abstracts were reviewed, as were reference lists of identified articles. Study Selection Thirty five studies that reported lifetime sleep paralysis rates and described both the assessment procedures and sample utilized were selected. Data Extraction Weighted percentages were calculated for each study and, when possible, for each reported subsample. Data Synthesis Aggregating across studies (total N = 36533), 7.6% of the general population, 28.3% of students, and 31.9% of psychiatric patients experienced at least one episode of sleep paralysis. Of the psychiatric patients with panic disorder, 34.6% reported lifetime sleep paralysis. Results also suggested that minorities experience lifetime sleep paralysis at higher rates than Caucasians. Conclusions Sleep paralysis is relatively common in the general population and more frequent in students and psychiatric patients. Given these prevalence rates, sleep paralysis should be assessed more regularly and uniformly in order to determine its impact on individual functioning and better articulate its relation to psychiatric and other medical conditions.

Barber, Jacques P.

2011-01-01

44

Contraceptive Failures in Overweight and Obese Combined Hormonal Contraceptive Users  

PubMed Central

Objective To estimate weather contraceptive failure rates among combined oral contraceptive pill, patch, and vaginal ring users was associated with increasing body mass index (BMI). Methods Females enrolled in a large contraceptive study offering the reversible method of their choice at no cost, were followed for 2 to 3 years. We compared the failure rates (pregnancy) among users of the oral contraceptive pill (OCP), transdermal patch, and contraceptive vaginal ring stratified by BMI. Results Among the 7,486 participants available for this analysis, 1,523 chose OCPs, patch, or ring at enrollment. Of the 334 unintended pregnancies, 128 were found to be a result of pill, patch, or ring failure. Three-year failure rates were not different across BMI categories (BMI <25: 8.44% (95% CI 6.1, 11.5), BMI 25–30: 11.03% (95% CI 7.5, 16.0), BMI >30: 8.92% (95% CI 7.6, 11.5). Increasing parity (HR: 3.06, CI 1.31–7.18), and history of a previous unintended pregnancy (HR: 2.82, CI: 1.63–4.87), but not BMI, were significant risk factors for unintended pregnancy. Conclusion Overweight and obese females do not appear to be at increased risk for contraceptive failure when using the contraceptive pill, patch, or vaginal ring.

McNicholas, Colleen; Zhao, Qiuhong; Secura, Gina; Allsworth, Jenifer E.; Madden, Tessa; Peipert, Jeffrey F.

2014-01-01

45

Prevalence of Rate-Dependent Behaviors in Cardiac Muscle  

NASA Astrophysics Data System (ADS)

We explore the rate-dependent dynamic response of periodically paced bullfrog (Rana catesbeiana) cardiac muscle. Alternans (2:2 behavior) occur in 35% of animals and 2:1<-->1:1 bistability in 74% of animals. In addition, we observe 2:2<-->2:1 bistablility. We discuss the implications of these results for two map-based models of cardiac dynamics. The high prevalence of bistability suggests that this dynamical behavior must be accounted for in the design of closed-loop feedback protocols to stabilize cardiac dynamics.

Hall, G. Martin; Bahar, Sonya; Gauthier, Daniel J.

1999-04-01

46

[Male contraception].  

PubMed

Various methods of contraception in men are reviewed. One of the methods of contraception is the use of hormonal agents (estrogens, androgens, antiandrogens, progestins, or their combinations), which block spermatogenesis. More advantageous is the use of nonhormonal agents (alpha-chlorhydrine, 6-chloro-6-deoxyglucose, salsosulfapyridine), which act on the process of sperm maturation in the epididymis. Plant extracts show marked contraceptive activity in men. The preparation gossypol isolated from cotton seeds and roots was found to inhibit male fertility. Various isomers of gossypol decreased sperm mobility by inhibiting the mitochondrial respiratory chain. Major side-effect of gossypol was hepatotoxicity. Glycosides isolated from the herb Tripterigium Wilfordii (TW) were found to have the antifertility activity. The antifertility effect of TW glycosides was dose- dependent: large doses were shown to inhibit spermatogenesis, while small doses were found to decrease sperm motility and viability. TW glycosides were free of toxic side-effects. Another approach to regulation of male fertility is the use of surgical methods of contraception including vasectomy. Development of less invasive and reversible surgical methods showed effectiveness of subcutaneous occlusion of vas deferens with various chemical substances (calcium chloride, p-butyl-2-cyanoacrylate). The best results were achieved with high molecular weight medical polyurethane. PMID:2042728

Khomasuridze, A G; Marshaniia, Z S

1991-01-01

47

[Contraception in adolescents].  

PubMed

The proportion of women aged 15-19 in Colombia who are mothers declined from 14% in 1985 to 10% in 1990, but the actual number of cases increased due to population growth. Some 1,780,000 adolescents who have had children or are pregnant require family planning services. An additional, unknown number of adolescent pregnancies are terminated by abortion. It is estimated that 95% of adolescent pregnancies diagnosed or followed by PROFAMILIA's center for young people were unwanted. Reasons for making family planning services available to adolescents include the ever young age at initiation of sexual activity, the very low rates of contraceptive usage among sexually active adolescents, the lack of information of adolescents concerning reproduction and contraception, and their fear and guilt surrounding their sexual activity and contraceptive usage. Obstetrical services appear reluctant to furnish adolescent mothers with information on contraception, and the pharmacists and their employees who provide such information may not be aware of contraindications for this age group or whether adolescents are adequately instructed in use of the method. The rising age at marriage increases the span of time that adolescents are at risk of unwanted pregnancy. Adolescents who are well informed about sexuality and contraception and trained in decision making, self-esteem, and responsible parenthood are likely to postpone sexual activity. Information on contraception and family planning services needs to be made available to adolescents in a way that will actually motivate use. Information on sex and contraception should be made available at puberty and should include the form of use, contraindications, and advantages and disadvantages of all methods appropriate to adolescents. Orientation and assistance in selecting the best method should be individually tailored and should be provided in schools or other places accessible to young people, in a language they can understand. Rhythm and withdrawal are relatively ineffective for inexperienced adolescents and should be replaced by more effective methods. Abstinence should be promoted, especially among the youngest adolescents. Young people should be shown that abstinence is not abnormal and does not imply homosexuality, and that other avenues of sexual expression are available. Condoms and spermicides are the ideal methods for adolescents because of their availability, low cost, absence of side effects, and protection against sexually transmitted disease. Promotion of condom and spermicide use requires combatting some misconceptions about sex and contraception, such as that relations should not be planned or that the genitals should not be touched. PMID:12286386

1992-12-01

48

Contraceptive practice in the Philippines.  

PubMed

Contraceptive use increased substantially in the Philippines from 1983 to 1986. Prevalence increased 32.1% in 1983, 45.7% in 1986. Increase in use was among married women in Northern Mindanao, Central Visayas, Southern Tagalog, Bicol, and Western Mindanao. Prevalence remained unchanged in Southern Mindanao. During this period, modern contraceptive methods also increased with more women opting to use the pill, IUD, injectables, and sterilization. In most areas in the Philippines, contraceptive use escalated with the more traditional methods like rhythm and withdrawal. Modern family planning increased most in urban areas such as Northern and Western Mindanao. Age also played a significant part in the study. Women aged 20-24 increased usage between 1983 and 1986. A more substantial increase was noticed in the 25-49 year old group, and the highest increase came from married women aged 30-34, with at least 3-4 children, during 1983. This figure shifted in 1986 with contraceptive use becoming more pronounced among 35-39 year olds. Modern methods declined at the 40-44 age bracket due to low fecundity. Throughout the country, modern contraceptive methods were more widely practiced by working women and was defined occupationally. Women in production, labor, and service occupations displayed a low level of modern usage, while those women in professional, administrative, and technical positions were more likely to use modern methods. PMID:12343038

1989-01-01

49

Modern contraceptive utilization among female ART attendees in health facilities of Gimbie town, West Ethiopia  

PubMed Central

Background In many areas of the world where HIV prevalence is high, rates of unintended pregnancy have also been shown to be high. Of all pregnancies worldwide in 2008, 41% were reported as unintended and approximately 50% of these ended in abortion. To address these problems family planning is the best solution. Therefore, the purpose of the study was to assess modern contraceptive use among females on ART in health facilities of Gimbie town, Western Ethiopia. Methods A facility based cross-sectional study was conducted in Gimbie town, western Ethiopia from December 2012 to January 2013. HIV infected women of reproductive age group (15-49 years) who came for ART care follow up during the data collection period were included in the study. Data was collected using an interviewer administered questionnaire. Binary logistic regression and multivariate analysis were employed using SPSS version 17. Results Three hundred ninety five women on ART have participated in the study. More than half, 224 (56.7%), of the respondents were using modern contraceptive, of whom 67 (30%) use dual contraceptive method. Having information on modern contraception is positively associated with modern contraceptive use with (AOR=6.3, 95% CI (1.67, 24.1)) and respondents who have family size ?4 were 50% less contraceptive users than those who have family size >4 (AOR=0.51, 95% CI (0.27, 0.96)). Conclusion In this study contraceptive use among HIV positive women is better than the general population. However, use of dual methods, long acting and permanent method of contraceptives were found to be low. Continuous and targeted information provision on modern contraceptive should be done.

2014-01-01

50

Contraceptive Options for Perimenopausal Women.  

PubMed

A number of safe and effective contraceptive choices exist for the perimenopausal woman. With increasing experience, we have learned that hormonal methods are safer than initially thought, particularly with the lower-dose formulations currently prescribed. Furthermore, the pill offers many noncontraceptive health benefits. And while progestins, in contraceptive doses, have a slight adverse impact on the lipoprotein profile, there has been no parallel increase in clinical cardiovascular disease. Since elimination of the Dalkon shield, the IUD has been recognized as a very safe and effective method of contraception; the risk of associated infection seems primarily related to the insertion procedure. Barrier methods provide somewhat reliable contraception, with varying degrees of added protection against STD. The decreased fertility rate among perimenopausal women allows some latitude when contraceptive methods with suboptimal efficacies are selected; however, unintended pregnancy is a significant problem for women older than 40 years, should it occur. Surgical sterilization remains the most popular form of contraception among perimenopausal-aged couples. Natural family planning techniques are safe and somewhat underutilized. All women should be counseled about the availability of postcoital contraceptive methods. PMID:9746640

Plourd

1996-09-01

51

Does the number of raters influence the pressure ulcer prevalence rate?  

Microsoft Academic Search

We analyzed data from pressure ulcer prevalence studies conducted in nursing homes between 2004 and 2006 concerning differences in the observed pressure ulcer prevalence rates while looking into the number of nurses conducting skin inspections (one or two). Results of the analysis revealed that the number of raters did not influence the observed pressure ulcer prevalence rate. Adequate preparation and

Jan Kottner; Antje Tannen; Ruud Halfens; Theo Dassen

2009-01-01

52

Egyptian contraception.  

PubMed

Dr. Margaret Jackson recently visited Yugoslavia and Egypt on behalf of the IPPF. She supplies the following notes for the Bulletin on her impressions of the contraceptive programme in Egypt: Dr. Mazhar was appointed about a year ago to organize and coordinate the Government family planning programme in Egypt. Because of the urgency of getting the programme under way, and in order to run the service as economically as possible, Dr Mazhar decided to use the existing health centres. Fortunately these are widely distributed throughout the habitable part of Egypt, concentrated mainly in the most thickly populated areas. Although these centres are not always adequate for use in the programme they are gradually being improved. Of the newer methods, oral contraceptives were the first to be used extensively in Egypt; they are well accepted by many women. IUDs have been successfully fitted by some Egyptian doctors for a number of years (e.g. by the late Dr. M.K.A. Razzak, and more recently by Dr M.I. Ragab), but this method has not been used on a large scale. Now the Government plan to include IUDs in the family planning programme; and Dr Mazhar is determined to keep the fitting of these devices in the hands of the gynaecologists. It has been decreed that all those holding gynaecological qualifications shall spend a given number of hours a week in government service helping with the IUD programme. Whether this will work smoothly is still uncertain, but the idea is fundamentally sound. PMID:12332034

1967-01-01

53

Adolescents and oral contraceptives.  

PubMed

Oral contraceptive (OC) options for adolescents are provides. Clarification for those desiring a birth control method is necessary and the benefits of decreased acne and dysmenorrhea with low dose OCs should be stressed along with the importance of compliance. A community effort is suggested to communicate the sexual and contraceptive alternatives, including abstinence and outercourse (sexual stimulation to orgasm without intercourse). Attention is given to concerns associated with teenage sexual activity, prevention of adolescent pregnancy, contraceptive options for the adolescent patient, adolescent attitudes toward birth control OCs, management of the adolescent OC user, manipulation of steroid components of OCs to respond to adolescent concerns, and other hormonal contraceptive options such as minipills or abstinence. The text is supplemented with tables: the % of US women by single years of age for 1971, 1976, 1979, and 1982; comparative pregnancy and abortion rates for the US and 5 other countries; federal cost for teen childbearing; adolescent nonhormonal contraceptive methods (advantages, disadvantages, and retail cost); checklist to identify those at risk for noncompliance with OCs; hormonal side effects of OCs; risks from OCs to adolescents; and benefits of OCs. Concern about adolescent pregnancy dates back to Aristotle. A modern profile shows girls form single-parent families are sexually active at an earlier age, adolescent mothers produce offspring who repeat the cycle, victims of sexual abuse are more likely to be sexually active, and teenagers in foster care are 4 times more likely to be sexually active and 8 times more likely to become pregnant. Prevention involves a multifaceted approach. OCs are the most appropriate contraceptive choice for adolescents. Frequency of intercourse is closely associated with OC use after approximately 15 months of unprotected sexual activity. At risk for noncompliance variables are scales of personality development (autonomy, self-esteem, locus of control), life expectations (marriage, college, career), dating behavior, age at 1st intercourse, perceived risk for becoming pregnant, personal attributes (sex, birth control, acquisition of birth control, pregnancy, parents' and peers' feelings toward sex and birth control), and previous experiences with birth control. PMID:1679420

Sanfilippo, J S

1991-01-01

54

A systematic review of effectiveness and safety of different regimens of levonorgestrel oral tablets for emergency contraception  

PubMed Central

Background Unintended pregnancy is a complex phenomenon which raise to take an emergency decision. Low contraceptive prevalence and high user failure rates are the leading causes of this unexpected situation. High user failure rates suggest the vital role of emergency contraception to prevent unplanned pregnancy. Levonorgestrel - a commonly used progestin for emergency contraception. However, little is known about its pharmacokinetics and optimal dose for use. Hence, there is a need to conduct a systematic review of the available evidences. Methods Randomized, double-blind trials were sought, evaluating healthy women with regular menstrual cycles, who requested emergency contraception within 72 h of unprotected coitus, to one of three regimens: 1.5 mg single dose levonorgestrel, two doses of 0.75 mg levonorgestrel given 12 h apart or two doses of 0.75 mg levonorgestrel given 24 h apart. The primary outcome was unintended pregnancy; other outcomes were side-effects and timing of next menstruation. Results Every trial under consideration successfully established the contraceptive effectiveness of levonorgestrel for preventing unintended pregnancy. Moreover, a single dose of levonorgestrel 1.5 mg for emergency contraception supports its safety and efficacy profile. If two doses of levonorgestrel 0.75 mg are intended for administration, the second dose can positively be taken 12–24 h after the first dose without compromising its contraceptive efficacy. The main side effect was frequent menstrual irregularities. No serious adverse events were reported. Conclusions The review shows that, emergency contraceptive regimen of single-dose levonorgestrel is not inferior in efficacy to the two-dose regimen. All the regimens studied were very efficacious for emergency contraception and prevented a high proportion of pregnancies if taken within 72 h of unprotected coitus. Single levonorgestrel dose (1.5 mg) can substitute two 0.75 mg doses 12 or 24 h apart. With either regimen, the earlier the treatment is given, the more effective it seems to be.

2014-01-01

55

Liability concerns in contraceptive research and development  

Microsoft Academic Search

The history of liability claims in the US against contraceptive products is among the issues that discourage manufacturers from investing in discovery and development in this field. Other factors are the high cost of new drug development, elevated insurance rates for contraceptives, and the desire to avoid controversy that can disturb corporate tranquility. General features of the American legal system

S. J Segal

1999-01-01

56

Advance Provision of Emergency Contraception for Adolescents  

ERIC Educational Resources Information Center

Emergency contraception is most effective at preventing unintended pregnancy when taken as early as possible following unprotected sexual intercourse. Advance provision of this medication supports more timely and effective use. In the midst of rising teen pregnancy rates, current policies often limit access to emergency contraception for…

Adamji, Jehan-Marie; Swartwout, Kathryn

2010-01-01

57

La contraception des adolescentes en France en 2007  

Microsoft Academic Search

The two main objectives of adolescence contraception are the eviction of involuntary pregnancies and the prevention of sexually transmitted infections. In France, in spite of our rich contraceptive arsenal and a widely spread information, the rate of voluntary termination of pregnancy keeps growing among the teenagers population — and this, probably because the gap between theoretical effectiveness and practice of contraception

G. Robin; P. Massart; B. Letombe

2007-01-01

58

Is postpartum contraceptive advice given antenatally of value?  

Microsoft Academic Search

In response to the concept that a good postpartum program should begin prenatally, this study was designed to determine whether the provision of expert contraceptive counseling during the antenatal period would have an impact on contraceptive uptake, patterns of contraceptive usage, and pregnancy rates during the first year after childbirth. Over 500 women attending antenatal clinics in each of three

K. B. Smith; Z. M. van der Spuy; L. Cheng; R. Elton; A. F. Glasier

2002-01-01

59

Hormonal Approaches to Male contraception  

PubMed Central

Purpose of review Condoms and vasectomy are male controlled family planning methods but suffer from limitations in compliance (condoms) and limited reversibility (vasectomy); thus many couples desire other options. Hormonal male contraceptive methods have undergone extensive clinical trials in healthy men and shown to be efficacious, reversible and appear to be safe. Recent Findings The success rate of male hormonal contraception using injectable testosterone alone is high and comparable to methods for women. Addition of progestins to androgens improved the rate of suppression of spermatogenesis. Supported by government or non-government organizations, current studies aim to find the best combination of testosterone and progestins for effective spermatogenesis suppression and to explore other delivery methods for these hormones. Translation of these advances to widespread use in the developed world will need the manufacturing and marketing skills of the pharmaceutical industry. Availability of male contraceptives to the developing world may require commitments of governmental and non-governmental agencies. In a time when imbalance of basic resources and population needs are obvious, this may prove to be a very wise investment. Summary Male hormonal contraception is efficacious, reversible and safe for the target population of younger men in stable relationships. Suppression of spermatogenesis is achieved with a combination of an androgen and a progestin. Partnership with industry will accelerate the marketing of a male hormonal contraceptive. Research is ongoing on selective androgen and progesterone receptor modulators that suppress spermatogenesis, minimize potential adverse events while retaining the androgenic actions.

Wang, Christina; Swerdloff, Ronald S.

2010-01-01

60

Reported prevalence of urinary incontinence in women in a general practice  

Microsoft Academic Search

To determine the prevalence of urinary incontinence and other urinary symptoms a questionnaire was sent to all women aged 25 and over and to women under 21 taking oral contraceptives registered with a rural practice (n=937); the questionnaire was completed by 833 women (89%). The overall prevalence of urinary incontinence was 41% (343\\/833); rates were lower in nulliparous and postmenopausal

Jacqueline V Jolleys

1988-01-01

61

Political constraints on contraceptive development in the United States.  

PubMed

In the US there is a great need for new contraceptives because the current available choices are too limited. Many groups of women, teenagers, women over 40 and lactating mothers have even greater need because of their special requirement. There are 6 million annual pregnancies in the US, 50% of them are unintended. This is the highest percentage of unintended pregnancies in the developed world with Canada having only 39%, the UK 32%, and the Netherlands 17%. 46% of women can expect to have at least 1 unintended pregnancy in their lifetime. Almost half of these unintended pregnancies end in abortion. Of those seeking abortion, 26% are under 20 and 81% are under 30. 69% are white and 82% are single. 49% of these women reported not using contraception when they conceived. Even when a woman uses contraceptives she is still exposed to the risk of contraceptive failure. These failure rates vary from 5-30% for the pill to spermicides. Over a 10-year period the rate climbs to 25-50% for the pill or the IUD. In the US, contraceptives are the most expensive with the pill selling for 60 times what is costs for similar formulations in other countries. Norplant and IUDs, the most reliable reversible methods cost hundreds of dollars and thus make them unavailable for teenagers and poor women who need them most. The primary benefit of increased contraceptive prevalence (CP) is a reduction in the number of unwanted pregnancies and thus abortions. The CP rate for married women of reproductive age in the us is 66%, compared to 73% in Canada, 83% in the UK, 78% in Sweden, and 72% in the Netherlands. The reason new methods are not being developed are multiple: fear of product liability litigation; fear of poor product sales due to public fear; regulation and market pressures that simply do not make them profitable. It can take 12 years and $200 million to develop a new drug and US patents only last 17 years. Thus in order to make a profit the company must have a high rate of sales. Changes in the approval process and financial incentives similar to those for orphan drugs could bring new methods to market. PMID:1944616

Smith, J B; Potts, D M; Fortney, J A

1991-10-01

62

Disparities in prevalence rates for lung, colorectal, breast, and prostate cancers in Medicaid.  

PubMed Central

BACKGROUND: Given previous reports of variations in prevalence of cancer in low-income individuals, we sought to determine if disparities in cancer prevalence existed in a similarly-insured Medicaid population. METHODS: Using Maryland Medicaid administrative claims data, prevalence rates of lung, colorectal, breast, and prostate cancers were calculated for Maryland Medicaid recipients who were continuously eligible during the period from January 1, 2000 to December 31, 2000. Chi-squared tests were used to test the differences across subgroups. Cancer prevalence data were age-adjusted using Maryland Medicaid enrollees as the standard population. RESULTS: The care prevalence rates for lung, colorectal, breast, and prostate cancers were 75/10,000, 63/10,000, 92/10,000, and 45/10,000, respectively. These rates were 1.2 to 5.2 times those reported at the national level. Generally, higher cancer prevalence rates in certain racial groups in Maryland Medicaid were consistent with previous studies. Regional differences in cancer prevalence existed for each cancer studied. CONCLUSIONS: Limiting our study sample to a population of uniformly low socioeconomic individuals did not eliminate the disparity in prevalence rates between blacks and whites. Different patterns of racial disparity across regions reported by previous researchers might be due to small area variation in addition to socioeconomic status.

Mullins, C. Daniel; Cooke, Jesse L.; Wang, Junling; Shaya, Fadia T.; Hsu, Doren Van; Brooks, Sandra

2004-01-01

63

How a Married Woman`s Characteristics Affect her Contraceptive Behavior?  

NASA Astrophysics Data System (ADS)

In Pakistan, population growth rate is 2.2% and Total Fertility Rate (TFR) is as high as 5.4. It is the result of low Contraceptive Prevalence Rate (CPR) of only 28%. Due to low CPR, women have high rate of unwanted births in Pakistan. In this study using probit estimation on primary data, we have analyzed the woman=s characteristics responsible for low contraceptive prevalence among married women in urban areas of Punjab (Pakistan). For the purpose one thousand married women in the age group of 15-49 years, who were not currently pregnant were interviewed from urban areas of Bahawalpur and Lahore. The individual characteristics of married women were focused, although household characteristics, socio-economic conditions of the community where woman is living, religious and cultural factors are also important. It is found that age of woman, education of woman, woman`s status, her economic activity, income level and age at marriage were found major determinants of contraceptive prevalence in women. The policies towards the education of women, status of women, labor force participation of women and legal interventions towards the increase in marriage age are stressed to increase the CPR.

Khan, Rana Ejaz Ali; Khan, Tasnim

64

STD and contraception in adolescents.  

PubMed Central

The prevalence of sexually transmitted diseases (STDs) in adolescents is poorly documented, as published studies consider single diseases or subgroups of adolescents. To obtain a broader view we examined STDs in unselected adolescent boys and girls at two contrasting genitourinary medicine (GUM) clinics, a large one at St Thomas's Hospital in inner London, which serves commuters and an inner city population, the other a smaller one at Swansea in south Wales, which serves a mixed urban and rural population. Contraception was also assessed in the girls. The STDs in adolescents were compared with the total diagnoses in patients of all ages attending the two GUM clinics, and with total diagnoses in all patients attending GUM clinics in England and Wales. The most striking finding was that all adolescents had at least one infection, whereas 18% of diagnoses in patients of all ages were of no infection. This contrasts with results of previous studies of selected groups, which suggested that the prevalence of STDs is similar in adults and adolescents. The percentages of infections, other than herpes at both clinics and trichomoniasis at Swansea, were higher in adolescents than in patients of all ages. High incidences of pelvic inflammatory disease in London and genital warts at Swansea suggest future problems. Only 66% of adolescent girls practised contraception, and only 8% stated that condoms were used. All people caring for adolescents should consider whether they are sexually active and, if they are, whether they need contraceptive advice or referral to a GUM clinic.

Thin, R N; Whatley, J D; Blackwell, A L

1989-01-01

65

Explanatory model to describe school district prevalence rates for mental retardation and learning disabilities.  

PubMed

Data reports from South Carolina's 92 independent school districts were used to calculate prevalence rates of mental retardation and learning disabilities among school-age children. These prevalence rates were 41.66/1,000 children enrolled for mental retardation and 33.21/1,000 children enrolled for learning disabilities. The 1980-1981 school year was selected because this was the last year in which disaggregated reports were submitted for placement in educable mental handicap (EMH), trainable mental handicap (TMH), and profound mental handicap (PMH) programs. Exploratory factor analysis and multiple regression analysis were used to explain school district prevalence rates of categorization of children into programs for mental retardation and learning disabilities. Results show that community SES and tax inputs explain 39% of the variation in prevalence rates and that these factors affect rates indirectly. PMID:7803034

McDermott, S

1994-09-01

66

Vaginal contraceptives still evolving.  

PubMed

The effort to develop vaginal contraceptives began in the distant past and is still underway today. 1000 years ago, South American Indians inserted into the vagina bark strips impregnated with quinine. In medieval times women used vaginal inserts of cloth soaked in honey or vinegar. Quinine pessaries were introduced into Europe in the late 1800s, and in the early 1900s investigators began to study the effects of various chemicals on sperm motility. Following World War II, surfactant spermicides which disrupt the sperm membrane were developed and marketed. Many of these preparations contained nonoxynol-9. Currently, the D-isomer of propranolol is being examined as a spermicidal contraceptive, and several bacteriocides, e.g., benzalkonium and chlorhexidine, are being developed as spermicides which reduce the penetrability of cervical mucus. Other chemicals being investigated act by inhibiting the acrosome reaction. Advantages of vaginal contraceptives are that they are inexpensive, reversible, and relatively safe and easy to use. Generally they require no medical intervention or supervision. In addition, spermicides may kill or inhibit the growth of organisms responsible for sexually transmitted diseases. Disadvantages of spermicides are that they are generally less effective than many other methods, some interfere with sexual spontaneity, they may cause local irritations, and some women find them messy to use. Recently, concerns were expressed about the possible teratogenic effects of sperimicides. Most of these concerns proved to be unfounded. Given the many new avenues of research, the major disadvantage of sperimicides, i.e., their high failure rates, may be minimized in the near future. PMID:12340621

Pearson, R M

1986-01-01

67

[Male contraception in 1987].  

PubMed

Male contraception apart from vasectomy and the condom is still in a virtually experimental stage. An acceptable male method must not interfere with sexual function and must meet the same demands for safety, simplicity, efficacy and reversibility as female methods. Condoms are the oldest and most effective reversible male method. Vasectomy is a simple and safe procedure, popular in some countries. Its biggest drawback is its uncertain reversibility even after successful reanastomosis. Hormonal approaches to male contraception are based on use of steroid or peptide compounds to inhibit production of the gonadotropins luteinizing hormone (LH) and follicle stimulating hormone (FSH) by the pituitary, resulting in azoospermia. The actual development of such methods has been confounded by imperfect knowledge of the hormonal mechanisms regulating spermatogenesis. The method requires 2 months to become effective because the process of human spermatogenesis is so lengthy. Rates of azoospermia greater than 70-80% have never been achieved. Among substances used, testosterone enanthate is unacceptable because of irregular efficacy and secondary effects inherent in the doses of androgens. Several progestins have been studied in combination with injectable, implanted, or percutaneous androgen therapy. Azoospermia is not usually achieved and secondary effects are significant. Medroxyprogesterone acetate has given more promising results in limited trials. Cyproterone acetate and danazol, a synthetic analog of 17 alpha ethinyl testosterone, are powerful but have significant side effects. The expectation that superanalogs to gonadotropin releasing hormone (GnRH) would provide a male hormonal method has thus far not been met. GnRH agonists have never yet produced a durable azoospermia in human males, even with continuous perfusion of elevated doses. It has recently been shown that the required androgen substitution interferes with achievement of azoospermia. GnRH antagonists appear more promising, but the androgen substitution poses a similar problem to that encountered with GnRH agonists. The first human trials are now underway. The hormonal approach may ultimately provide an interesting choice for individuals able to have regular spermograms, but does not appear feasible on a wide scale. A direct approach to male contraception at the level of the epididymis or testicles is theoretically interesting because of the rapidity of the effect. Gossypol, a phenolic compound extracted from cotton oil or seeds, provides extreme oligospermia in 99.9% of users, but the effect has been irreversible in a nonnegligible proportion of men using it for more than 2 years. Other compounds tested have been too toxic for clinical use. Immunological approaches pose major theoretical problems and all developments remain experimental. A better knowledge of the physiology of spermatogenesis and of the control of sperm movement will be required for development of a satisfactory male contraceptive method. PMID:3310192

Silvestre, L; Varin, C; Bouchard, P

1987-09-21

68

Prevalence Rates of Attention Deficit/Hyperactivity Disorder in a School Sample of Venezuelan Children  

ERIC Educational Resources Information Center

A total of 1,535 4-12 year-old children were screened with the Conners' rating scales, followed by diagnostic confirmation by the diagnostic interview schedule for children-IV-parent version. The prevalence of ADHD was estimated to be 10.03%, and only 3.9% of children had received medication for the treatment of ADHD symptoms. Prevalence rates and…

Montiel, Cecilia; Pena, Joaquin A.; Montiel-Barbero, Isabel; Polanczyk, Guilherme

2008-01-01

69

Improving the uptake of long acting reversible contraception: a review.  

PubMed

Across the world rates of unintended pregnancy are high. Unintended pregnancy not only results in substantial costs to health services, it can lead to personal distress for women experiencing this. Whilst a large number of unintended pregnancies occur in those not using any method of contraception, a proportion occur in women using a contraceptive method incorrectly or inconsistently. Long acting reversible methods of contraception such as the IUD, IUS, contraceptive implant and contraceptive injectables are the most effective methods of contraception. In spite of this, they are under-utilized by women in developed countries. Educating women and health professionals, and dispelling myths about these methods may improve their acceptability. Furthermore, facilitating uptake by ensuring that a range of contraceptive providers are trained and able to provide to women without undue delay, particularly in the immediate post abortion and postpartum period, may also be effective strategies to improve uptake, and prevent more unintended pregnancies. PMID:23689167

Michie, L; Cameron, S T

2013-06-01

70

Socioeconomic Correlates of Contraceptive Use among the Ethnic Tribal Women of Bangladesh: Does Sex Preference Matter?  

PubMed Central

Objective To examine the relationship between socioeconomic factors affecting contraceptive use among tribal women of Bangladesh with focusing on son preference over daughter. Materials and methods The study used data gathered through a cross sectional survey on four tribal communities resided in the Rangamati Hill District of the Chittagong Hill Tracts, Bangladesh. A multistage random sampling procedure was applied to collect data from 865 currently married women of whom 806 women were currently married, non-pregnant and had at least one living child, which are the basis of this study. The information was recorded in a pre-structured questionnaire. Simple cross tabulation, chi-square tests and logistic regression analyses were performed to analyzing data. Results The contraceptive prevalence rate among the study tribal women was 73%. The multivariate analyses yielded quantitatively important and reliable estimates of likelihood of contraceptive use. Findings revealed that after controlling for other variables, the likelihood of contraceptive use was found not to be significant among women with at least one son than those who had only daughters, indicating no preference of son over daughter. Multivariate logistic regression analysis suggests that home visitations by family planning workers, tribal identity, place of residence, husband's education, and type of family, television ownership, electricity connection in the household and number of times married are important determinants of any contraceptive method use among the tribal women. Conclusion The contraceptive use rate among the disadvantaged tribal women was more than that of the national level. Door-step delivery services of modern methods should be reached and available targeting the poor and remote zones.

Hassan, Che Hashim

2013-01-01

71

[Resistance and compliance to contraception in adolescents].  

PubMed

Although inadequate information on sex and contraception is frequently believed to account for contraceptive failure in adolescents, other factors including resistence to contraception or poor compliance with method requirements have been invoked to explain contraceptive failures in well-informed adolescents. Sexual relations are beginning at ever-younger ages in France; a 1980 survey indicated that 50% had their 1st sexual relations before age 17. Sexual activity is sporadic and irregular but usually occurs with the same partner. At least 50% of 1st sexual relations are unprotected by contraception, and half of adolescent pregnancies occur in the 1st 6th months of sexual activity. 6-12 months pass on average before sexually active adolescents begin to use contraception. Rates of pregnancy and abortion have increased especially among adolescents under 16, and in 1979 almost 20% of all abortions were in women under 20 years old. In 1980, only 20% of adolescents used contraception, with 17.3% using oral contraceptives. Few statistics exist on the complex phenomenon of conscious or subconscious contraceptive resistence in adolescence, and clinical experience serves as a better guide. A frequent attitude among adolescents is that sexual relations should be spontaneous and romantic, traits viewed as incompatible with contraception. "Magical thinking", failure to appreciate the real risk of pregnancy, and dissociation of sex and pregnancy are common. Adolescents who doubt their fecundity may engage in unprotected relations to reassure themselves, while some seeking to assert their femininity may use pills although they have no need for contraception. Guilt and ambivalence may be unconscious motivations for poor contraceptive use. Young girls in cold, uncaring, neglectful, or conflict-ridden homes may seek affection from a sexual partner and wish to have a baby to demonstrate their attachment. Such situations often lead to well-accepted pregnancies and may also demonstrate a desire for self-affirmation, a search for identity, and a reliving of the mother's own childhood. Very young girls especially may be reluctant to discuss contraception for fear of displeasing their partners or losing their love. Fear of gynecological examinations, distrust of both the side effects of pills and the efficacy of all other contraceptive methods, and rebellion against the adult world are additional reasons for nonuse of contraception. Fears on the part of the mother or resentment of the daughter's maturity and sexuality or other feelings may impede communication and hence acquisition and use of contraception. Resistence by adults in general to expressions of sexuality among adolescents may prevent physicians from prescribing pills and educators from providing information on sex and contraception. Compliance with contraception appears to be a multidimensional phenomenon with 3 principal domaines: individual characteristics, the environment, and the availability of contraception. Unfavorable social situations and young age at initiation of sexual activity are unfavorable to compliance, while a well-defined identity, autonomy, and sense of responsability are favorable. The most important environmental factor is a supportive family, while the type of method appears to be less significant. Careful and sympathetic reception of the adolescent and good follow-up by the health worker can boost compliance. PMID:12267710

Pichot, F; Dayan-lintzer, M

1985-10-01

72

Combined oral contraceptives: health benefits beyond contraception.  

PubMed

It has been recognized for over 50 years that combined oral contraceptives (COCs) are also capable of offering health benefits beyond contraception through the treatment and prevention of several gynaecological and medical disorders. During the last years a constant attention was given to the adverse effects of COCs, whereas their non-contraceptive benefits were underestimated. To date, most women are still unaware of the therapeutic uses of hormonal contraceptives, while on the contrary there is an extensive and constantly increasing of these non-contraceptive health benefits. This review summarizes the conditions of special interest for physicians, including dysmenorrhoea, menorrhagia, hyperandrogenism (acne, hirsutism, polycystic ovary syndrome), functional ovarian cysts, endometriosis, premenstrual syndrome, myomas, pelvic inflammatory disease, bone mineral density, benign breast disease and endometrial/ovarian and colorectal cancer. The benefits of COCs in rheumatoid arthritis, multiple sclerosis, menstrual migraine and in perimenopause have also been treated for more comprehensive information. Using COCs specifically for non-contraceptive indications is still outside the product licence in the majority of cases. We strongly believe that these aspects are not of minor relevance and they deserve a special consideration by health providers and by the mass media, which have the main responsibility in the diffusion of scientific information. Thus, counseling and education are necessary to help women make well-informed health-care decisions and it is also crucial to increase awareness among general practitioners and gynaecologists. PMID:25056245

Caserta, D; Ralli, E; Matteucci, E; Bordi, G; Mallozzi, M; Moscarini, M

2014-09-01

73

Reversible Contraception Update: The Importance of Long-Acting Reversible Contraception  

PubMed Central

The past several years have seen an expansion in contraception options. Emerging data support the use of long-acting reversible contraception (LARC) such as the intrauterine device and subdermal implant as the most effective methods of contraception with the highest continuation rates and very high levels of patient satisfaction. In addition, the appropriate target population for the use of the intrauterine device now includes nulliparous women and adolescents. When a patient considers initiating a new contraceptive method, it is important to consider the characteristics of each method, including the side effects, effectiveness, and patient acceptability. Additionally, medical comorbidities must also be evaluated prior to choosing a method. In this article, we provide a brief overview of available reversible contraceptive methods, with an emphasis on LARC.

Mestad, Renee E.; Kenerson, Jessica; Peipert, Jeffrey F.

2011-01-01

74

Luteinizing hormone--releasing hormone agonists: a quick reference for prevalence rates of potential adverse effects.  

PubMed

Men with prostate cancer (PCa) frequently undergo androgen deprivation therapy (ADT), typically in the form of a depot injection of luteinizing hormone-releasing hormone agonists (LHRHa). LHRHa are associated with many adverse effects (eg, hot flashes, sexual dysfunction, loss of muscle mass, osteopenia, metabolic syndrome), which drastically impact patient quality of life. This literature review, which includes a comprehensive table documenting prevalence rates, provides a quick reference for health care professionals involved in the care of men undergoing ADT with LHRHa. Primary sources were acquired from PubMed using the search terms "androgen deprivation therapy" and each potentially adverse effect (eg, "androgen deprivation therapy and hot flashes"). Commonly cited review articles were also examined for citations of original studies containing prevalence rates. More than 270 articles were reviewed. In contrast to many existing reviews, rates are cited exclusively from original sources. The prevalence rates, obtained from original sources, suggest that more than half of documented adverse effects are experienced by as many as 40% or more of patients. A critique of the literature is also provided. Although there is a vast literature of both original and review articles on specific adverse effects of LHRHa, the quality of research on prevalence rates for some adverse effects is subpar. Many review articles contain inaccuracies and do not cite original sources. The table of prevalence rates will serve as a quick reference for health care providers when counseling patients and will aid in the development of evidence-based patient education materials. PMID:23891497

Walker, Lauren M; Tran, Susan; Robinson, John W

2013-12-01

75

Male Hormonal Contraception  

Microsoft Academic Search

\\u000a The principle of hormonal male contraception based on suppression of gonadotropins and spermatogenesis has been established\\u000a over the last three decades. All hormonal male contraceptives use testosterone, but only in East Asian men can testosterone\\u000a alone suppress spermatogenesis to a level compatible with contraceptive protection. In Caucasians, additional agents are required\\u000a of which progestins are favored. Current clinical trials concentrate

E. Nieschlag

76

Committee opinion no. 539: adolescents and long-acting reversible contraception: implants and intrauterine devices.  

PubMed

Long-acting reversible contraception (LARC)—intrauterine devices and the contraceptive implant—are safe and appropriate contraceptive methods for most women and adolescents. The LARC methods are top-tier contraceptives based on effectiveness, with pregnancy rates of less than 1% per year for perfect use and typical use. These contraceptives have the highest rates of satisfaction and continuation of all reversible contraceptives. Adolescents are at high risk of unintended pregnancy and may benefit from increased access to LARC methods. PMID:22996129

2012-10-01

77

Contraception and antiepileptic drugs.  

PubMed

Epilepsy is a neurologic condition that affects women and women's choices in many areas of their lives. Some antiepileptic drugs (AEDs) used in the treatment of epilepsy can interact with hormonal contraceptives. The result can be decreased effectiveness in the contraceptive with the possibility of unintended pregnancy, or decreased effectiveness of the AED that can result in seizure activity. This article provides information about concurrent AED and contraceptive use to assist health care providers in guiding women with epilepsy to make the best contraceptive choices based on their reproductive life plans. PMID:22587648

Guillemette, Taasha; Yount, Susan M

2012-01-01

78

Prevalence rates and socioeconomic characteristics of post-partum depression in Hungary  

Microsoft Academic Search

The rapid socioeconomic transition in post-communist Hungary adversely affected the overall morbidity and mortality rates in the 1990s. Prevalence data on depressive disorders from the region are still scarce, however. This study reports the findings of the first epidemiological survey, using the Edinburgh Postnatal Depression Scale (EPDS) and the Beck Depression Inventory (BDI), on the prevalence of post-partum depression and

Emese Nagy; Peter Molnar; Attila Pal; Hajnalka Orvos

2011-01-01

79

Lifetime sexual assault prevalence rates and reporting practices in an emergency department population  

Microsoft Academic Search

Study Objective: Studies suggest significant rates of female sexual assault (SA); the majority of SAs remain unreported, and few victims receive medical care. The purpose of this study was to determine lifetime prevalence rates of SA in an emergency department population and to assess reporting patterns to police, physicians, and social service agencies. Methods: A verbally administered survey was given

Kim M. Feldhaus; Debra Houry; Robin Kaminsky

2000-01-01

80

Urgent need for contraceptive education and services in Chinese unmarried undergraduates: a multi-campus survey.  

PubMed

In order to ascertain prevalence rate of premarital sexual intercourse, unintended pregnancy and abortion, and evaluate associated factors of unintended pregnancy among undergraduates from all over China, the representative sample of unmarried undergraduates was obtained by using a multi-stage, stratified, probability cluster design, and data were collected by using a survey questionnaire. 62 326 available responders were gained. 11.6% of them acknowledged having experiences of premarital sexual intercourse (standardized prevalence rate of sexual intercourse was 13.8%). 31.5% of students active in premarital sex acknowledged undergoing unintended pregnancy. 76.2% of pregnant students selected abortion to end it. Of students active in premarital sex, 46.2% used contraception at the first sexual intercourse, 28.2% replied "always" using contraception in sexual intercourse. The rate of using condoms, oral contraceptives (OCs), and withdrawal among students who had used contraception was 52.0%, 31.0%, and 27.2% respectively. "No preparation for sex" (40.3%), "pleasure decrement" (32.1%), "won't-be-pregnancy in occasional sexual intercourse" (30.2%) were their common excuses for using no contraception. The identified risk factors for unintended pregnancy among students active in premarital sex by multivariate analysis were as follows: having no steady lover [having no steady lover vs having a steady lover: odds ratio (OR), 1.875; 95% confidence interval (CI), 1.629-2.158], unaware of the course of conception (unaware vs aware: OR, 2.023; 95% CI, 1.811-2.260), considering abortion not endanger women's physical and mental health (no endangerment vs endangerment: OR, 2.659; 95% CI, 2.265-3.121), nonuse of contraception (never use vs always use: OR, 1.682; 95% CI, 1.295-2.185). Medical students were not less likely to experience an unintended pregnancy than nonmedical students (OR, 1.111; 95% CI, 0.906-1.287). The substantial proportion of unintended pregnancy among undergraduates indicates a need for convenient and targeted contraceptive education and services. PMID:21823000

Zhou, Yuanzhong; Xiong, Jinwen; Li, Jie; Huang, Shiyun; Shang, Xuejun; Liu, Guohui; Zhang, Meimei; Yin, Pin; Wei, Sheng; Xiong, Chengliang

2011-08-01

81

The trend of pressure ulcer prevalence rates in German hospitals: Results of seven cross-sectional studies  

Microsoft Academic Search

Pressure ulcer prevalence rates provide useful information about the magnitude of this health problem. Only limited information on pressure ulcers in Germany was available before 2001. The purpose of this study was to compare results of seven pressure ulcer prevalence surveys which were conducted annually between 2001 and 2007 and to explore whether pressure ulcer prevalence rates decreased. The second

Jan Kottner; Doris Wilborn; Theo Dassen; Nils Lahmann

2009-01-01

82

Advance provision of emergency contraception for adolescents.  

PubMed

Emergency contraception is most effective at preventing unintended pregnancy when taken as early as possible following unprotected sexual intercourse. Advance provision of this medication supports more timely and effective use. In the midst of rising teen pregnancy rates, current policies often limit access to emergency contraception for adolescents. A literature search identified three recent experimental studies of advance provision for adolescents. This article reviews those studies and finds strong support for advance provision for adolescents. Usage of emergency contraception increased with advance provision and there was no increase in negative sexual behaviors or decrease in usage of other contraceptive forms. Implications of these findings for school nurses and school-based health center staff are also discussed. PMID:20693415

Adamji, Jehan-Marie; Swartwout, Kathryn

2010-12-01

83

Modeling white-tailed deer Odocoileus virginianus population control by contraception  

Microsoft Academic Search

Large populations of white-tailed deer Odocoileus virginianus present conservation problems in suburban landscapes because of limited population control options. We used the GAPPS II modeling system to simulate temporal effects of contraception on deer population control and the interaction between contraception and uncertain immigration rates. Contraception rates less than 50% of female deer curbed population growth with a long (30

Steven W. Seagle; John D. Close

1996-01-01

84

Determinants of contraceptive method choice in an industrial city of India.  

PubMed

This study examines the determinants of contraceptive method choice in Jamshedpur, an industrial city in Bihar State, one of the few areas in India that enjoys a "cafeteria approach" to family planning method selection. While contraceptive prevalence in India is about 35%, Jamshedpur has a prevalence rate close to 60%. One of Jamshedpur's special programs is the Tata Iron and Steel Company (TISCO) Family Welfare Programme, which provides an array of services to both employees and nonemployees. In 1983, TISCO commissioned the International Institute for Populations Studies (IIPS) to evaluate its programs. Based on the findings of an IIPS survey of 2376 currently married women between the ages of 15-44, this study attempts to identify determinants of contraceptive method choice. For its analysis, the study used a multinomial method choice. For its analysis, the study used a multinomial logit regression, a model appropriate for studying the relationships between a number of covariates and a dependent variable (the contraceptive method used) that has more than 2 possible outcomes (female sterilization, male sterilization, condom, female temporary method, natural methods, or no method). The survey examined the following covariates: religion/caste, mother tongue, husband's occupation, place of employment, age at consummation of marriage, husband's education, wife's education, marriage duration, survival status of last child, number and sex of living children, and attitude variables. The study found that religion, mother tongue, and educational levels are important determinants of acceptance and method choice. The number of children -- especially sons -- also affected contraceptive use, rising as family size increases. The study revealed that the Jamshedpur population did exercise choice in clear patterns when the choices were made available. PMID:12284858

Bhende, A A; Choe, M K; Rele, J R; Palmore, J A

1991-09-01

85

Posttraumatic stress symptoms in Navy personnel: prevalence rates among recruits in basic training.  

PubMed

Individuals in the military are often required to endure high levels of stress as a result of demanding operational requirements or deployments. Individuals who enter the military with pre-existing mental health problems such as posttraumatic stress disorder (PTSD) are likely to be at heightened risk of adverse reactions to military stressors. The present study documents the prevalence of PTSD symptoms among new Navy recruits and compares the prevalence of PTSD symptomology among recruits to prevalence rates that have been reported for comparable civilian populations. Results suggest that 15 percent of new Navy recruits are experiencing measurable symptoms of posttraumatic stress. Prevalence of these symptoms among Navy recruits is comparable to that among civilian adolescent and young adult populations. PMID:17292582

Stander, Valerie A; Merrill, Lex L; Thomsen, Cynthia J; Milner, Joel S

2007-01-01

86

High prevalence rates of diabetes and hypertension among refugee psychiatric patients.  

PubMed

There is increasing evidence that immigrants and traumatized individuals have elevated prevalence of medical disease. This study focuses on 459 Vietnamese, Cambodian, Somali, and Bosnian refugee psychiatric patients to determine the prevalence of hypertension and diabetes. The prevalence of hypertension was 42% and of diabetes was 15.5%. This was significantly higher than the US norms, especially in the groups younger than 65. Diabetes and hypertension were higher in the high-trauma versus low-trauma groups. However, in the subsample with body mass index (BMI) measurements subjected to logistic regression, only BMI was related to diabetes, and BMI and age were related to hypertension. Immigrant status, presence of psychiatric disorder, history of psychological trauma, and obesity probably all contributed to the high prevalence rate. With 2.5 million refugees in the country, there is a strong public health concern for cardiovascular disease in this group. PMID:18277218

Kinzie, John David; Riley, Crystal; McFarland, Bentson; Hayes, Meg; Boehnlein, James; Leung, Paul; Adams, Greg

2008-02-01

87

Home pregnancy testing kits: prevalence of use, false-negative rates, and compliance with instructions.  

PubMed Central

This study investigated the prevalence of home pregnancy kit use, incidence of false-negative results, and compliance with testing procedures. Among 144 pregnant women, identified through three health care settings, prevalence of test-kit use was 28.5 per cent. The false-negative rate was 24.3 per cent. Total compliance with instructions was reported by only 32 per cent of users. Women testing less than nine days after menstrual period was due had false-negative rates of 33 per cent contrasted with 21 per cent for those testing after the nine days.

Valanis, B G; Perlman, C S

1982-01-01

88

Preventing Unintended Pregnancies by Providing No-Cost Contraception  

PubMed Central

OBJECTIVE To promote the use of long-acting reversible contraceptive methods (LARC) (intrauterine devices and implants) and provide contraception at no cost to a large cohort of participants in an effort to reduce unintended pregnancies in our region. METHODS We enrolled 9,256 adolescents and women at risk for unintended pregnancy into the Contraceptive CHOICE Project, a prospective cohort study of adolescents and women desiring reversible contraceptive methods. Participants were recruited from the two abortion facilities in the St. Louis region and through provider referral, advertisements, and word of mouth. Contraceptive counseling included all reversible methods, but emphasized the superior effectiveness of LARC methods (IUDs and implants). All participants received the reversible contraceptive method of their choice at no cost. We analyzed abortion rates, the percentage of abortions that are repeat abortions, and teenage births. RESULTS We observed a significant reduction in the percentage of abortions that are repeat abortions in the St. Louis region compared to Kansas City and nonmetropolitan Missouri (P < 0.001). Abortion rates of the CHOICE cohort were less than half the regional and national rates (P < 0.001). The rate of teenage birth within the CHOICE cohort was 6.3 per 1,000, compared to the U.S. rate of 34.1 per 1,000. CONCLUSION We noted a clinically and statistically significant reduction in abortion rates, repeat abortions, and teenage birth rates. Unintended pregnancies may be reduced by providing no-cost contraception and promoting the most effective contraceptive methods.

Peipert, Jeffrey F.; Madden, Tessa; Allsworth, Jenifer E.; Secura, Gina M.

2014-01-01

89

Does Multimorbidity Influence the Occurrence Rates of Chronic Conditions? A Claims Data Based Comparison of Expected and Observed Prevalence Rates  

PubMed Central

Objective Multimorbidity is a complex phenomenon with an almost endless number of possible disease combinations with unclear implications. One important aspect in analyzing the clustering of diseases is to distinguish between random coexistence and statistical dependency. We developed a model to account for random coexistence based on stochastic distribution. We analyzed if the number of diseases of the patients influences the occurrence rates of chronic conditions. Methods We analyzed claims data of 121,389 persons aged 65+ using a list of 46 chronic conditions. Expected prevalences were simulated by drawing without replacement from all observed diseases using observed overall prevalences as initial probability weights. To determine if a disease occurs more or less frequently than expected by chance we calculated observed-minus-expected deltas for each disease. We defined clinical relevance as |delta| ? 5.0%. 18 conditions were excluded because of a prevalence < 5.0%. Results We found that (1) two chronic conditions (e.g. hypertension) were more frequent than expected in patients with a low number of comorbidities; (2) four conditions (e.g. renal insufficiency) were more frequent in patients with many comorbidities; (3) six conditions (e.g. cancer) were less frequent with many comorbidities; and (4) 16 conditions had an average course of prevalences. Conclusion A growing extent of multimorbidity goes along with a rapid growth of prevalences. This is for the largest part merely a stochastic effect. If we account for this effect we find that only few diseases deviate from the expected prevalence curves. Causes for these deviations are discussed. Our approach also has methodological implications: Naive analyses of multimorbidity might easily be affected by bias, because the prevalence of all chronic conditions necessarily increases with a growing extent of multimorbidity. We should therefore always examine and discuss the stochastic interrelations between the chronic conditions we analyze.

Schafer, Ingmar

2012-01-01

90

Hormonal contraception and lactation.  

PubMed

Hormonal contraceptive measures can be used immediately postpartum if the patient so desires. Progestin-only contraceptives are preferable to estrogen-containing methods if initiated during the first six months after delivery. Progestin only contraceptives do not appear to affect milk volume, composition, or to cause deleterious effects in the infant. Ideally for women who desire a form of contraception in addition to lactation-induced amenorrhea, progestin-only methods should be started at six weeks postpartum if the woman is fully breastfeeding. Since contraception protection is provided by lactation amenorrhea, the six week delay will decrease infant exposure to exogenous hormones and decrease the incidence of irregular postpartum bleeding. Milk volume may decrease with the use of estrogen; however, no detrimental effects have been shown on infant growth or development. For women who are planning to gradually wean their infant, use of COCs may provide an easier transition to bottle-feeding. COCs should be used with caution by women who are not able to obtain supplemental milk. A decrease in milk volume can lead to earlier discontinuation of the hormonal contraceptive in an attempt to increase milk quantity. Supplementation is often needed, and then the woman ovulates again, possibly resulting in an unintended pregnancy. Many women are motivated immediately postpartum to accept contraception. For other women, lack of access to health care may provide barriers in obtaining adequate contraception later. In either case, there are adequate data to show no detriments of starting progestin-only contraceptives within days of delivery. Therefore, the best method for the patient should be employed to ensure adequate contraception while preserving optimal lactation. PMID:9025449

Kelsey, J J

1996-12-01

91

Does current contraceptive choice correspond with user satisfaction?  

PubMed

A contraceptive method that suits an individual's needs may be more consistently used leading to greater user satisfaction. We therefore wanted to investigate whether a woman's current contraceptive choice corresponded with qualities identified by women as important. An anonymous survey was completed by women in their reproductive years, living in the North East of England, before seeing a healthcare professional. A total of 177 English-speaking women, who were sexually active and of reproductive age, completed questionnaires giving a response rate of 54%. A correlation was found between the current contraceptive used and the previously stated qualities felt to be important when choosing a method (p = 0.034, ?(2)-test). Similarly, a relationship was found between the current contraceptive method and reasons stated against choosing a contraceptive (p = 0.002, ?(2)-test). Overall, British women are generally satisfied with their chosen contraceptive method. PMID:22296430

Rosales, C; Mansour, D; Cox, M A A

2012-02-01

92

FastStats: Contraceptive Use  

MedlinePLUS

... Contraceptive Use Data are for the U.S. Contraceptive methods Leading contraceptive method among women aged 15-29: Pill Percent of ... table 1 [PDF - 443 KB] More data Contraceptive Methods Women Have Ever Used: United States, 1982–2010 [ ...

93

One-Year Prevalence Rates of Major Depressive Disorder in First-Year University Students  

ERIC Educational Resources Information Center

First-year university students may be more at risk for experiencing Major Depressive Disorder (MDD) than the general population given associated risk factors of this age range. A two-phase procedure was used to estimate the one-year prevalence rate of MDD and comorbid Major Anxiety Disorders among first-year university students at a small Canadian…

Price, E. Lisa; McLeod, Peter J.; Gleich, Stephen S.; Hand, Denise

2006-01-01

94

Perceived Prevalence of Teasing and Bullying Predicts High School Dropout Rates  

ERIC Educational Resources Information Center

This prospective study of 276 Virginia public high schools found that the prevalence of teasing and bullying (PTB) as perceived by both 9th-grade students and teachers was predictive of dropout rates for this cohort 4 years later. Negative binomial regression indicated that one standard deviation increases in student- and teacher-reported PTB were…

Cornell, Dewey; Gregory, Anne; Huang, Francis; Fan, Xitao

2013-01-01

95

Prevalence rates of obsessive-compulsive symptoms and psychiatric comorbidity among adolescents in Iran.  

PubMed

Recent epidemiological studies show that obsessive-compulsive disorder (OCD) and its comorbidity with psychiatric problems is more prevalent among children and adolescents than was previously believed. The primary aim of the current study is to investigate the point-prevalence rate of obsessive compulsive symptoms in a sample of adolescent high school student in Iran. A two-stage epidemiological study was carried out through a clustered random sampling method. All participants went through a two-stage assessment procedure, in the first screening phase, the Maudsley Obsessive-Compulsive Inventory (MOCI) was administered to 909 randomly selected students (in the age range 14-18 years). Participants were considered possible sub-clinical or clinical OCD cases, if they obtained a score of MOCI?15. In the second stage, the Symptoms Checklist -90-revised (SCL-90-R) was administered to student who fulfilled the screening criteria. The prevalence of OC symptoms was found to be 11.2 percent for the total sample. The most prevalent comorbid conditions were depression and anxiety with prevalence rates of 91.2 and 78.4 percent respectively. Gender, age, birth-order, parent's education and family income had no statistically significant association with OC symptoms. Further research in this area is warranted in order to establish a set of comprehensive global assessment and measurement tools, which would allow cross-cultural studies in the field of OCD. PMID:22071645

Shams, Giti; Foroughi, Elham; Esmaili, Yaghoob; Amini, Homayoon; Ebrahimkhani, Narges

2011-01-01

96

Contraception and headache.  

PubMed

Most women have used at least 1 method of contraception during their reproductive years, with the majority favoring combined oral contraceptives. Women are often concerned about the safety of their method of choice and also ask about likely effects on their pre-existing headache or migraine and restrictions on using their headache medication. While there should be no restriction to the use of combined hormonal contraceptives by women with migraine without aura, the balance of risks vs benefits for women with aura are debatable. Migraine with aura, but not migraine without aura, is associated with a twofold increased risk of ischemic stroke, although the absolute risk is very low in healthy, nonsmoking women. Although ethinylestradiol has been associated with increased risk of ischemic stroke, the risk is dose-dependent. Low-dose pills currently used are considerably safer than pills containing higher doses of ethinylestradiol but they are not risk-free. This review examines the evidence available regarding the effect that different methods of contraception have on headache and migraine and identifies strategies available to minimize risk and to manage specific triggers such as estrogen "withdrawal" headache and migraine associated with combined hormonal contraceptives. The independent risks of ischemic stroke associated with migraine and with hormonal contraceptives are reviewed, and guidelines for use of contraception by women with migraine are discussed in light of the current evidence. PMID:23432442

MacGregor, E Anne

2013-02-01

97

Reaching the poor through community-based distributors of contraceptives: experiences from Muheza district, Tanzania.  

PubMed

Community based distribution (CBD) programmes were introduced as a strategy to ensure access of contraceptives to the needy. The strategy is reported to increase contraceptive knowledge and use. Although CBD agents have the advantage of reaching the poor in rural areas, wealth gap does exist even in these settings. The objective of this study was to determine access to information and modern contraceptives services among people of different wealth status in a rural setting in Muheza, Tanzania. This cross-sectional study was conducted following a six year project in promotion of contraceptive using community-based agents. The study area was stratified into three socio-geographical strata from which one village was randomly selected. Through house-to-house visits, interviews were conducted using structured questionnaires until the required sample size was obtained. A community-led wealth ranking criteria was developed through consensus and used to classify respondents into wealth categories. A total of 1,420 respondents were interviewed. Contraceptive Prevalence Rate (CPR) for modern methods was 32.2%; injectables accounted for half (50.8%) followed by pills (32.7%). CBD agents accounted for one-third (34.3%) of the contraceptive use. There was no difference in the access to information (P=0.44) and to contraceptives (P=0.83) between the poorer and the less poor. Half of the respondents (49.4%; 214/431) reported paying for services, with no difference between the less poor and the poorer (P=0.75). Respondents receiving services from health facilities were more likely to pay for services (61.3%) compared to CBD agents (25.0%). However, the level of satisfaction was high (approximately 70%) in both health facilities and CBD agents. This study has shown that people in the rural settings of Muheza district were able to access information and contraceptives from CBD agents and health facilities, regardless of their wealth status. There is however, need to address the issue of informal payments lest it deters people in need from accessing the services. PMID:24409640

Simba, Daudi; Schuemer, Cordula; Forrester, Kate; Hiza, Merriment

2011-01-01

98

Oral contraception: a review.  

PubMed

This review of the development of oral contraceptives (OCs) begins with a summary of research between 1920 and 1950 that led to the first highly effective, orally active progestogen for human use. Enovid by Searle, the first marketed OC, began being distributed in 1960; it was combination of 9.85 mg of norethynodrel and .150 mg of mestranol. Research on combination norethynodrel-containing products revealed that the dosage was too high. Discussion focuses on preparations containing norethisterone, norethisterone acetate, medroxyprogesterone diacetate, norgestrel, other Norgestrel products available outside the US, progestogen, as well as the sequentials and the multiphasics. The active phase of clinical development was during 1950s and 1960s. The Food and Drug Administration (FDA) had an active role in regulating OCs; OCs with more than .05 mg of estrogen were removed from the market; FDA permitted ethinyl estradiol as a substitute for mestranol. Pregnancy rates appear lower in clinical trials than among the general population. 3% during the first year is considered more characteristics of the failure rate among the general population. It appears that intermenstrual bleeding (IMB) has decreased as doses have been decreased, but strict comparison between studies and over time is not possible. There is valid documentation of the rate of IMB with low-dose OCs, or of differences between new OC users and prior OC users, or of the impact of the strength of OC components. PMID:1687400

Edgren, R A

1991-01-01

99

Assessing sexual aggression: Addressing the gap between rape victimization and perpetration prevalence rates  

Microsoft Academic Search

Obtaining consistent and accurate rates of women's sexual assault experiences and men's history of sexual aggression has proved difficult and rates vary tremendously throughout the literature [Koss, M.P. (1993a). Detecting the scope of rape: A review of prevalence research methods. Journal of Interpersonal Violence, 8 (2), 198–222].It has been suggested that methodological factors influence the detection of women's sexual assault

Elizabeth D. Kolivas; Alan M. Gross

2007-01-01

100

Factors Associated with the Differences in Migraine Prevalence Rates between Spanish Regions  

PubMed Central

We have analyzed the relation of prevalence rates in Spanish regions with a series of human, environmental, and ecological factors. We find that the variability in migraine rates found between Spanish regions may be explained by interregional differences in the percentage of daily smokers, percentage of alcohol consumers, percentage of population presenting physical and/or psychological life-limiting conditions, percentage of population engaging in physical exercise, minimum absolute temperatures per year, number of days under 0°C per year, and altitude.

Matias-Guiu, Jorge; Fernandez, Cristina; Porta-Etessam, Jesus; Mateos, Valentin; Diaz-Insa, Samuel

2014-01-01

101

The contraceptive implant.  

PubMed

Contraceptive implants provide long-acting, highly effective reversible contraception. Currently, the only subdermal implant available to women in the United States is the single rod etonogestrel implant, Implanon (N.V. Organon, Oss, the Netherlands) approved by the Food and Drug Administration in July 2006. Implanon is currently approved for 3 years of use, provides excellent efficacy throughout its use, and is easy to insert and remove. Similar to other progestin-only contraceptives, Implanon can cause irregular vaginal bleeding. Implanon has been shown to be safe to use during lactation, may improve dysmenorrhea, and does not significantly affect bone mineral density, lipid profile, or liver enzymes. PMID:17982333

Hohmann, Heather; Creinin, Mitchell D

2007-12-01

102

Contraception matters: indicators of poor usage of contraception in sexually active women attending family planning clinics in Victoria, Australia  

PubMed Central

Background Unintended pregnancy (mistimed or unwanted) remains an important health issue for women. The purpose of this study was to determine the prevalence of and factors associated with risk of unintended pregnancy in a sample of Victorian women attending family planning clinics. Methods This cross-sectional survey of three Family Planning Victoria Clinics from April to July 2011 recruited women aged 16-50 years with a male sexual partner in the last 3 months, and not intending to conceive. The questionnaire asked about contraceptive behaviours and important factors that influence contraception use (identified from a systematic literature review). Univariate analysis was calculated for the variables of interest for associations with contraceptive use. An overall multivariate model for being at risk for unintended pregnancy (due to inconsistent or ineffective contraceptive use or non-use) was calculated through backward elimination with statistical significance set at <0.05. Results 1006 surveys were analyzed with 96% of women reporting contraception use in the last 3 months. 37% of women were at risk for unintended pregnancy due to imperfect use (61% inconsistent users; 31% ineffective methods) or never using contraception (8%). On multivariate analysis, women at risk for unintended pregnancy compared with women not at risk were <25 years old (OR 1.8, 95% CI 1.2-2.7); had no university/postgraduate degree (OR 1.7, 95% CI 1.2-2.4); and had >1 partner in the last 3 months (OR 3.2, 95% CI 2.3-4.6). These women were dissatisfied with current contraception (OR 2.5, 95% 1.8-3.5); felt “vulnerable” to pregnancy (OR 2.1, 95% CI 1.6-3.0); were not confident in contraceptive knowledge (OR 2.6, 95% CI 1.5-4.8); were unable to stop to use contraception when aroused (OR 2.1, 95% CI 1.5-2.9) but were comfortable in speaking to a doctor about contraception (OR 2.3, 95% CI 1.1-4.1). Conclusion Despite reported high contraceptive usage, nearly 40% of women were at risk for unintended pregnancy primarily due to inconsistent contraceptive use and use of ineffective contraception. Strategies for improving consistency of effective contraception use or greater emphasis on long-acting contraception may be needed for certain subpopulations at higher risk for unintended pregnancy.

2012-01-01

103

Clinical experience and acceptability of the etonogestrel subdermal contraceptive implant  

Microsoft Academic Search

Objective: To evaluate efficacy, adverse effects, and user continuation rate of an etonogestrel subdermal single-rod contraceptive implant. Methods: A total of 417 healthy volunteers of childbearing age were included in this multicenter trial. After implant insertion, the women were followed up during the 3 years of contraceptive action. At each visit, clinical findings, side effects, and bleeding patterns were recorded.

J. B. Otero Flores; M. Lozano Balderas; M. Cortés Bonilla; L. Vázquez-Estrada

2005-01-01

104

Evaluative Indices Assigned to Contraceptive Methods by University Undergraduates  

ERIC Educational Resources Information Center

Background: Preordinate attitudes and beliefs about contraception may influence acceptance or rejection of a particular method. Purpose: We examined the attitudes about contraception methods held by undergraduate students (N=792) at two large southeastern universities in the United States. Methods: Twelve methods were rated on 40 semantic…

McDermott, Robert J.; Malo, Teri L.; Dodd, Virginia J.; Daley, Ellen M.; Mayer, Alyssa B.

2011-01-01

105

National prevalence rates of bully victimization among students with disabilities in the United States.  

PubMed

This study examined the prevalence rates of bully victimization and risk for repeated victimization among students with disabilities using the Special Education Elementary Longitudinal Study and the National Longitudinal Transition Study-2 longitudinal datasets. Results revealed that a prevalence rate ranging from 24.5% in elementary school to 34.1% in middle school. This is one to one and a half times the national average for students without disabilities. The rate of bully victimization was highest for students with emotional disturbance across school levels. Findings from this study also indicated that students with disabilities who were bullied once were at high risk of being bullied repeatedly. Elementary and middle school students with autism and high school students with orthopedic impairments were at the greatest risk of experiencing repeated victimization. Implications of the findings are discussed. PMID:23294235

Blake, Jamilia J; Lund, Emily M; Zhou, Qiong; Kwok, Oi-Man; Benz, Michael R

2012-12-01

106

Prevalence of human endogenous retroviral element associates with Hodgkin's lymphoma incidence rates?  

PubMed Central

Human endogenous retrovirus-H (HERV-H) is implicated in leukaemias and lymphomas, but the precise molecular mechanism underlying HERV-mediated carcinogenesis remains unknown. We determined the prevalence of HERV-H in a cross-section of the Singapore population and explored the relationship between HERV-H positivity and incidence rates for Hodgkin's lymphoma in three major ethnic groups of Singapore. We observed that Malays were 1.11 times likely (95% CI=1.05–1.17; P<0.01), and Indians 1.12 times likely (95% CI=1.07–1.18; P<0.01) to be HERV-H positive when compared to Chinese. Interestingly, the incidence rates of Hodgkin's lymphoma for the three races positively correlated to the respective prevalence rate for HERV-H positivity (r=0.9921 for male; r=0.9801 for female), suggesting that viral inheritance in human may predispose certain racial origin unfavourably to malignancy.

Woo, Wee Hong; Shen, Liang; Leong, Sai Mun; Koay, Evelyn Siew-Chuan

2013-01-01

107

Reducing pressure ulcer prevalence rates in the long-term acute care setting.  

PubMed

Information about pressure ulcer prevalence, prevention, and optimal management strategies in the long-term acute care hospital (LTACH) setting is sparse. Although care processes in other patient care settings have been reported to affect pressure ulcer prevalence rates, the effect of such programs in the LTACH is unknown. To reduce perceived above-average pressure ulcer prevalence rates and improve care processes, a 108-bed LTACH used a failure mode and effects analysis to identify and address high-priority areas for improvement. Areas in need of improvement included a lack of 1) wound care professionals, 2) methods to consistently document prevention and wound data, and 3) an interdisciplinary wound care team approach, as well as a faulty electronic medical record. While prevalence data were collected, policies and procedures based on several published guidelines were developed and incorporated into the pressure ulcer plan of care by the newly established wound care team. Improved assessment and documentation methods, enhanced staff education, revised electronic records, wound care product reviews, and a facility-wide commitment to improved care resulted in a reduction of facility-acquired pressure ulcer prevalence from 41% at baseline to an average of 4.2% during the following 12 months as well as fewer missing electronic record data (<1% of charts had missing data). These study results suggest that staff education, better documentation, and a dedicated wound care team improves care practices and reduces pressure ulcer prevalence in the LTACH. Studies to increase knowledge about the LTACH patient population and their unique needs and risk profiles are needed. PMID:19387096

Milne, Catherine T; Trigilia, Donna; Houle, Tracy L; Delong, Sandra; Rosenblum, David

2009-04-01

108

Epilepsy and Oral Contraception  

PubMed Central

A controlled cross-over trial in 20 epileptic women, receiving regular anticonvulsant therapy showed that an oral contraceptive with a low oestrogen/ progestogen content had no significant effect on the average frequency of fits compared with identical dummy tablets.

Espir, Michael; Walker, M. E.; Lawson, June P.

1969-01-01

109

[Immuno-contraceptive vaccines].  

PubMed

Results of studies on birth control vaccines accomplished by many research groups within the WHO Special Programe of Research, Development and Research Training in Human Reproduction has been reviewed. The mostly investigated contraceptive vaccines contain human chorionic gonadotropin, and therefore structure, biological role and immunogenicity of the hormone were presented. Also, vaccines obtained on the basis of subunit beta of the human chorionic gonadotropin, its heterodimer with subunit beta of ovine lutropin or C-terminal peptide of beta subunit were described. Results of two phases of clinical trials with immuno-contraceptive vaccines were presented. The use of contraceptive vaccines for treatment of some trophoblastic tumors and the idea of using contraceptive recombinant vaccines were also mentioned. PMID:8657642

Kochanowska, I E; Szewczuk, A

1995-01-01

110

Unintended Pregnancy Prevention: Contraception  

MedlinePLUS

... a decision. The risk of pregnancy after vasectomy. Obstetrics and Gynecology. 2004 ;103:848–850. A comparison of women’s regret following vasectomy versus tubal sterilization. Obstetrics and Gynecology. 2002 ;99:1073–1079. Contraceptive sterilization ...

111

Attitude toward contraception and abortion among Cura?ao women. Ineffective contraception due to limited sexual education?  

PubMed Central

Background In Curaçao is a high incidence of unintended pregnancies and induced abortions. Most of the induced abortions in Curaçao are on request of the woman and performed by general practitioners. In Curaçao, induced abortion is strictly prohibited, but since 1999 there has been a policy of connivance. We present data on the relevance of economic and socio-cultural factors for the high abortion-rates and the ineffective use of contraception. Methods Structured interviews to investigate knowledge and attitudes toward sexuality, contraception and abortion and reasons for ineffective use of contraceptives among women, visiting general practitioners. Results Of 158 women, 146 (92%) participated and 82% reported that their education on sexuality and about contraception was of good quality. However 'knowledge of reliable contraceptive methods' appeared to be - in almost 50% of the cases - false information, misjudgements or erroneous views on the chance of getting pregnant using coitus interruptus and about the reliability and health effects of oral contraceptive pills. Almost half of the interviewed women had incorrect or no knowledge about reliability of condom use and IUD. 42% of the respondents risked by their behavior an unplanned pregnancy. Most respondents considered abortion as an emergency procedure, not as contraception. Almost two third experienced emotional, physical or social problems after the abortion. Conclusions Respondents had a negative attitude toward reliable contraceptives due to socio-cultural determined ideas about health consequences and limited sexual education. Main economic factors were costs of contraceptive methods, because most health insurances in Curaçao do not cover contraceptives. To improve the effective use of reliable contraceptives, more adequate information should be given, targeting the wrong beliefs and false information. The government should encourage health insurance companies to reimburse contraceptives. Furthermore, improvement of counseling during the abortion procedure is important.

2011-01-01

112

Protrhombotic effects of contraceptives.  

PubMed

The use of oral contraceptives first became widespread some 40 years ago, and reports of an excess risk of cardiovascular disease among women who used these agents soon followed. Few drugs have been the object of such intensive epidemiological research, the outcome of which has provided clinicians with detailed information about risks not only of specific thrombotic diseases but also important non-contraceptive benefits from the pill. Recently, oral contraceptives have been classified by some according to "generation" (first, second, third, and most recently, fourth generation): first-generation formulations containing lynestrenol or norethindrone, second-generation formulations containing levonorgestrel, third-generation formulations containing desogestrel or gestodene, and oral contraceptives containing an estrogen and other progestagens (cyproterone or norgestimate) or a progestagen alone. The results of several study was that the use of the older high-dose oral contraceptives increased the risk of cardiovascular disease by modifying the Low-density lipoprotein and High-Density lipoprotein cholesterol level, increasing triglyceride serum level, reducing glucose tolerance, raising blood pressure, and promoting clotting mechanisms. In this review we investigate the mechanism of the oral contraceptives and performed a risk assessment of every generation. PMID:20858187

Fazio, Giovanni; Ferrara, Filippo; Barbaro, Giuseppe; Alessandro, Gullotti; Ferrro, Giovanni; Novo, Giuseppina; Novo, Salvatore

2010-01-01

113

Male contraception: history and development.  

PubMed

Although the twentieth century has seen great strides in the development of female contraception, not a single new agent has been introduced as an approved method for common use for male contraception. Condoms (considered uncomfortable by some) and vasectomy (a permanent invasive procedure) are the only options provided to men, leaving an undue burden on women to bear contraceptive responsibility. Significant developments have, however, been made with regard to hormonal and nonhormonal contraception, and minor, reversible, procedural contraception. This article reviews the currently available, soon to be available, and theoretically possible methods of male contraception. PMID:24286773

Kogan, Paul; Wald, Moshe

2014-02-01

114

Contraception in Wisconsin: a review.  

PubMed

The Contraceptive Equality Mandate took effect in Wisconsin on January 1, 2010. This mandate from the Wisconsin Office of the Commissioner of Insurance requires all insurance companies in the state of Wisconsin to cover all types of contraception, making Wisconsin the 28th state to do so. This article reviews the literature related to several types of contraception including Implanon (a newly available implantable contraception), drospirenone-containing oral contraceptive pills, and intrauterine devices. We also review evidence regarding depot medroxyprogesterone acetate and bone mineral density, and new cycling regimens for oral contraceptive pills. PMID:21287884

Schrager, Sarina; Paddock, Elizabeth; Dalby, Jessica; Knudsen, Lara

2010-12-01

115

Contraceptive choice and acceptability: the future for STI risk in Kelantan, Malaysia.  

PubMed

More than 150 million women become pregnant in developing countries annually and an estimated 287,000 die from pregnancy-related causes. Contraception is vital to prevent unnecessary maternal deaths, as well as sexually transmitted infections. The objective of this study was to investigate preferred contraceptive methods and the factors that influence contraceptive choice among women in Kelantan, Malaysia. A cross-sectional study using interview-based questionnaires was conducted, during July and August 2009, in local family planning clinics in Kelantan. The questionnaire was administered to adult women (age 20-50). Prevalence of unplanned pregnancies was high (48%). Contraceptive preference was Depo contraceptive injection (32%), oral contraceptive pills (27%), intrauterine devices (15%) and contraceptive implants (12%); 9% used condoms. Only 2% used contraception to protect against sexually transmitted infections or HIV/AIDS. Younger women (OR 0.90; 95% CI 0.807-0.993) were more likely to use contraception. In conclusion, non-interrupted contraceptive methods were preferred. More than 60% would stop using contraception if it interrupted intercourse. From both a public health and infectious disease perspective, this is extremely worrying. PMID:23970646

Shiely, Frances; Saifuddin, Mohammed Syafiek

2014-03-01

116

Air pollution, weather, and associated risk factors related to asthma prevalence and attack rate  

Microsoft Academic Search

Asthma is an important public health challenge. The objective of this research was to investigate the relationship of air pollution and weather to adolescent asthma prevalence and attack rate. A 6-month mass screening asthma study was conducted from October 1995 to March 1996 in Taiwan. The study population included junior high school students from throughout the country (1,139,452 students). Eighty-nine

Wen-Chao Ho; William R. Hartley; Leann Myers; Meng-Hung Lin; Yu-Sheng Lin; Chih-Hui Lien; Ruey-Shiung Lin

2007-01-01

117

Prevalence rates of helmet use among motorcycle riders in a developed region in China.  

PubMed

This study aimed to determine the prevalence rates of helmet use, and of correct helmet use (chinstrap firmly fastened) among motorcycle riders and their passengers in Zhongshan, Guangdong Province, China. A cross-sectional survey involving direct observation of motorcycle riders was conducted at 20 randomly selected intersections. A total of 13,410 motorcycles were observed during a 10-day period in February 2009. The overall prevalence of helmet use was 72.6% (95% CI: 71.8-73.3%) among drivers and 34.1% (95% CI: 32.7-35.5%) among pillion passengers. The prevalence of correct use was 43.2% (95% CI: 42.4-44.0%) and 20.9% (95% CI: 19.8-22.1%) for drivers and passengers respectively. The helmet wearing rate on city streets was almost 95%, however city riders were more likely than rural riders to wear non-motorcycle helmets while riding. In multivariate analyses, factors associated with increased helmet use included riding on city streets, male gender, being a driver, carrying less passengers and riding a registered motorcycle. The results indicated enforcement and education activities need to be strengthened with respect to both helmet use and helmet quality, especially in rural areas, in order to improve wearing rates. PMID:21094316

Xuequn, Yu; Ke, Liang; Ivers, Rebecca; Du, Wei; Senserrick, Teresa

2011-01-01

118

Adolescents and contraceptive advice.  

PubMed

In the Scandinavian countries there is no age limit for adolescents' access to contraceptive advice. Denmark deems it important to avoid barriers which prevent young girls from seeking contraceptive advice. Offering easy access to counseling is preferable to adolescent girls having unwanted pregnancies. In Denmark there is no age limit for adolescent girls to see their general practitioner (GP) for instruction in the use contraceptive methods. Without parental consent all can receive such counseling. In addition, the GP is obliged to observe professional secrecy at counseling, hence parents cannot request any information from the GP. There must be exceptionally serious reasons for breaking this professional secrecy. Thus a young woman should not refrain from seeking advice out of fear that her parents will know about her intimate life, and that she protects herself against unwanted pregnancy. It is not desirable to fix any age limit for adolescents' right to seek this advice because it concerns the adolescents' actual sex life. After the introduction of free abortion, many quite young girls sought abortion. The objective is to bolster the development that all children receive the requisite sex education at school, as well as to ensure that there is easy access to information on contraceptive methods. The GP's counseling is provided free of charge. A number of contraceptive clinics are available all over the country to provide alternative contraceptive counseling in case a young woman does not want to consult her GP because perchance the GP is her family doctor. Denmark as well as the other Scandinavian countries characteristically give high priority to promoting and improving the access to information and counseling on contraceptive methods by avoiding all economical, geographical, ethical, or emotional barriers. PMID:12222237

Sondergaard, M

1993-06-01

119

High Lifetime Pregnancy and Low Contraceptive Usage Among Sex Workers Who Use Drugs- An Unmet Reproductive Health Need  

PubMed Central

Background The objective of this study was to describe levels of pregnancy and contraceptive usage among a cohort of street-based female sex workers (FSWs) in Vancouver. Methods The study sample was obtained from a community-based prospective cohort study (2006-2008) of 211 women in street-based sex work who use drugs, 176 of whom had reported at least one prior pregnancy. Descriptive statistics were used to estimate lifetime pregnancy prevalence, pregnancy outcomes (miscarriage, abortion, adoption, child apprehension, child custody), and contraceptive usage. In secondary analyses, associations between contraceptive usage, individual and interpersonal risk factors and high number of lifetime pregnancies (defined as greater than the sample mean of 4) were examined. Results Among our sample, 84% reported a prior pregnancy, with a mean of 4 lifetime pregnancies (median = 3; IQR: 2-5). The median age of women reporting 5+ pregnancies was 38 years old [interquartile range (IQR): 25.0-39.0] compared to 34 years [IQR: 25.0-39.0] among women reporting 4 or fewer prior pregnancies. 45% were Caucasian and 47% were of Aboriginal ancestry. We observed high rates of previous abortion (median = 1;IQR:1-3), apprehension (median = 2; IQR:1-4) and adoption (median = 1; IQR:1-2) among FSWs who reported prior pregnancy. The use of hormonal and insertive contraceptives was limited. In bivariate analysis, tubal ligation (OR = 2.49; [95%CI = 1.14-5.45]), and permanent contraceptives (e.g., tubal ligation and hysterectomy) (OR = 2.76; [95%CI = 1.36-5.59]) were both significantly associated with having five or more pregnancies. Conclusion These findings demonstrate high levels of unwanted pregnancy in the context of low utilization of effective contraceptives and suggest a need to improve the accessibility and utilization of reproductive health services, including family planning, which are appropriately targeted and tailored for FSWs in Vancouver.

2011-01-01

120

[Vaginal contraception. Pt. 1 (author's transl)].  

PubMed

Vaginal contraception is enjoying a revival among women who fear the side effects of the pill or of the IUD. Vaginal contraception by vaginal diaphragm or by cervical cap is totally reversible and never causes complications; there may be short term reversible side effects with the diaphragm, such as cystitis, uretritis, and hemorroids; no side effects are associated with the use of cervical caps. Vaginal contraception has the added advantage of exercising a notable prophylactic actions on the diffusion of verereal diseases and of other vaginal infections such as trichomoniasis and candidosis. It is also possible that vaginal contraception offers protection against cervical neoplasia. Failure rate of diaphragm use is an average 10/100 women years, and for the cervical cap it is about 7.6/100 women years, when both devices are properly used. Vaginal contraception needs to be used in conjunction with spermicidal agents. Spermicidal agents can be used alone and can be very effective; they are, however, not well accepted by most couples, who resent the interruption of the sexual act. Two experimental models of vaginal sponge are now under study; vaginal sponges can be left in place for some time, and insertion is very easy. PMID:12336893

Keith, L; Berger, G S; Jackson, M

1981-04-01

121

HIV infection and contraceptive need among female Ethiopian voluntary HIV counseling and testing clients  

Microsoft Academic Search

Despite political endorsement of voluntary HIV counseling and testing (VCT), and family planning integration in Ethiopia, little is known about the reproductive health needs of VCT clients. We estimated contraceptive prevalence and need among 646 Ethiopian female VCT clients. We compared socio-demographic characteristics of contracepting VCT clients to those with unmet need and examined how these characteristics are associated with

H. Bradley; A. Tsui; A. Kidanu; D. Gillespie

2010-01-01

122

Contraception with Chlormadinone Acetate in Woman with Previous Contraceptive Jaundice  

PubMed Central

The oral contraceptive chlormadinone acetate has been given for eight months to a woman who had developed jaundice during four pregnancies, and twice while taking a combined contraceptive pill. No side-effects or changes in liver function were observed. This is further evidence that progestogens used for contraception, and in particular those derived from hydroxyprogesterone, are less hepatotoxic than the oestrogenic components.

Thompson, R. P. H.; Williams, Roger

1970-01-01

123

Introducing new contraceptives.  

PubMed

At this time, private research efforts to discover new contraceptives are threatened. Drug companies, particularly in the US, have reduced their interest in contraceptive development due to concern over the rising cost of product liability insurance, the cost of lawsuits in defense of liability claims, and the fear of extremely high awards by juries in product liability cases. The current form of private-public collaboration, now threatened by the liability crisis, works under a few simple principles of agreement. Private industry agrees to supply its patented chemical compounds for assessment as contraceptive agents, to be willing to enter into negotiations with public sector organizations to develop the contraceptive drugs if initial tests warrant it, and to release compounds to another company if the patent-holder declines to proceed with contraceptive development. The public-sector program agrees to fund the studies, keep the industry informed, and maintain confidentiality. When the technology is discovered by the public sector and is of potential interest to private industry, the collaboration involves other issues. The public agency agrees to supply manufacturing know-how and all biological and clinical information, to license under applicable patents, and to permit cross reference to regulatory agency filings. Private industry agrees to use its best efforts to bring the product to market, to manufacture the product at reduced cost for public sector use, or to provide know-how for others to do so. It also agrees to assume product liability and to grant the public sector agency licenses to any patented improvement in its product. Contraceptive research both within and outside the US is feeling the effects of the US litigious atmosphere. Companies from abroad now wish to steer clear of contraceptive research, even though these companies would be prepared to meet the requirements of the Food and Drug Administration. Contraceptives, considered to be high risk targets for lawsuits, are receiving little of the research budgets of pharmaceutical companies. Opposition anti-abortion forces also has had an effect. When the Population Council received new drug approval for the Copper-T-200, it was the 1st time the FDA had issued approval to a noncommercial sponsor. This unprecedented event established a new phase in the cooperative efforts between industry and the nonprofit sector to develop contraceptive products. It showed that given adequate funding, nonprofit agencies can carry out full product development, including the initial regulatory agency clearances. PMID:12341234

Segal, S J; Coutinho, E

1986-12-01

124

Contraception in perimenopause.  

PubMed

Women in their forties are still potentially fertile, and pregnancy in this age group is attended with increased maternal mortality, spontaneous abortion, fetal anomalies and perinatal mortality. Contraception for women in this age group has special risks and benefits; both should be balanced to choose between the different options available. Recent epidemiological and clinical pharmacology studies have indicated the safety of extending the use of combined oral contraceptives (COCs) beyond the age of 35 years and up to menopause. Women who have reasons for avoiding COCs can use progestogen-only contraceptives like pills, depot injectables and implants. Implant combines high efficacy and long-term effect. Both copper-releasing and levonorgestrel-releasing intrauterine contraceptive device (LNG-IUD) combine the advantages of high efficacy and long-term effect. The reduced fecundity above the age of forty can allow extending the use beyond the accepted term, and up to one or two years beyond the menopause without the need for replacement. The levonorgestrel IUD has the advantage of reducing the amount of menstrual bleeding. The condom has the added benefit of protection against sexual transmitted diseases (STDs). Male or female sterilization is an excellent contraceptive option, provided that this approach is culturally acceptable and available at reasonable cost and low risk. PMID:12929981

Taneepanichskul, Surasak; Dusitsin, Nikorn

2003-06-01

125

Directive counseling on long-acting contraception.  

PubMed Central

National rates of unintended births are a major public health concern. The availability of highly effective long-acting contraceptives has prompted some public officials to promote the coercive use of these methods to reduce such problems as intergenerational poverty and child abuse. Broad-brush public policies that require long-term contraceptive use are unethical. However, persuasion to use these methods can be appropriate. One place for exerting ethically justified influence is in family planning counseling. The dominant nondirective counseling model, which excludes the possibility of vigorous persuasion, is overly rigid. Family planning professionals should develop practice protocols that permit and guide the exercise of directive counseling to use long-acting contraception.

Moskowitz, E; Jennings, B

1996-01-01

126

Delivering non-hormonal contraceptives to men: advances and obstacles  

PubMed Central

There have been major advances in male contraceptive research during the past two decades. However, for a contraceptive to be used by men, its safety requires more stringent scrutiny than therapeutic compounds for treatment of illnesses because the contraceptives will be used by healthy individuals for an extended period of time, perhaps decades. A wide margin is therefore required between the effective dose range and doses that cause toxicity. It might be preferable that a male contraceptive, in particular a non-hormone-based compound, is delivered specifically and/or directly to the testis and has a rapid metabolic clearance rate, reducing the length of exposure in the liver and kidney. In this article, we highlight the latest developments regarding contraceptive delivery to men and with the aim of providing useful information for investigators in future studies.

Mruk, Dolores D.; Cheng, C. Yan

2014-01-01

127

Abortion and contraception: attitudes of South african university students.  

PubMed

Despite the availability of contraception, the rates of abortion among young women in South Africa continue to increase. We designed a study to examine young people's attitudes about abortion and contraception. One hundred and eighty-eight South African university students (97 females and 91 males) completed the survey. While we found moral objections to abortion for the sample as a whole, females showed stronger support for availability of abortion and women's autonomy compared with males. The respondents acknowledged the importance of contraception at a personal and general level, but more than 40% of them believed that women who use contraception are promiscuous. Females expressed difficulty with usage more frequently than males and indicated that they would not consider sexual intercourse if contraception were not available. For health care workers involved in counseling young people about their sexual and reproductive choices, the challenge lies in promoting a culture of equal rights and respect for women's reproductive freedom. PMID:19418325

Patel, Cynthia J; Kooverjee, Trisha

2009-06-01

128

Disturbances of motor unit rate modulation are prevalent in muscles of spastic-paretic stroke survivors.  

PubMed

Stroke survivors often exhibit abnormally low motor unit firing rates during voluntary muscle activation. Our purpose was to assess the prevalence of saturation in motor unit firing rates in the spastic-paretic biceps brachii muscle of stroke survivors. To achieve this objective, we recorded the incidence and duration of impaired lower- and higher-threshold motor unit firing rate modulation in spastic-paretic, contralateral, and healthy control muscle during increases in isometric force generated by the elbow flexor muscles. Impaired firing was considered to have occurred when firing rate became constant (i.e., saturated), despite increasing force. The duration of impaired firing rate modulation in the lower-threshold unit was longer for spastic-paretic (3.9 ± 2.2 s) than for contralateral (1.4 ± 0.9 s; P < 0.001) and control (1.1 ± 1.0 s; P = 0.005) muscles. The duration of impaired firing rate modulation in the higher-threshold unit was also longer for the spastic-paretic (1.7 ± 1.6 s) than contralateral (0.3 ± 0.3 s; P = 0.007) and control (0.1 ± 0.2 s; P = 0.009) muscles. This impaired firing rate of the lower-threshold unit arose, despite an increase in the overall descending command, as shown by the recruitment of the higher-threshold unit during the time that the lower-threshold unit was saturating, and by the continuous increase in averages of the rectified EMG of the biceps brachii muscle throughout the rising phase of the contraction. These results suggest that impairments in firing rate modulation are prevalent in motor units of spastic-paretic muscle, even when the overall descending command to the muscle is increasing. PMID:24572092

Mottram, C J; Heckman, C J; Powers, R K; Rymer, W Z; Suresh, N L

2014-05-15

129

Contraception and gynaecological care.  

PubMed

Hormonal contraception, through suppression of ovarian activity or endometrial proliferation, can be used to treat and prevent a range of gynaecological disorders. There is evidence to support the effectiveness of the levonorgestrel intra-uterine system (LNG-IUS), combined oral contraceptive pill (COC) and progestogen-only injectable depot-medroxyprogesterone acetate for treating heavy menstrual bleeding and dysmenorrhoea. COCs are also an effective treatment for acne and hirsuitism, and may lessen the symptoms of premenstrual syndrome. There is good evidence that COCs can significantly reduce the risk of both ovarian and endometrial cancer. There is also some evidence that COCs may prevent ovarian cysts, endometrial hyperplasia and fibroids. The LNG-IUS may be used as endometrial protection in women using hormone replacement therapy or tamoxifen. This chapter will deal with the evidence for both treatment and prevention of a range of gynaecological disorders of different hormonal contraceptive methods. PMID:19147411

Cameron, Sharon

2009-04-01

130

Contraception in the future.  

PubMed

A recent meeting at the Royal Society in London to consider future developments in contraception stressed 4 areas of concern. 1) Fertility regulation needs 3 broad stimuli: constant or increased motivation, better delivery systems, and technological improvements. Recognition of the need to regulate fertility varies among societies. 2) Although the risks of the pill must not be minimized, it still offers the most unusual combination of safety, efficiency, and reliability; IUDs have been improved; the use of sterilization has increased; and the demand for abortion world-wide is growing. 3) To develop new methods of contraception, considerable scientific study has yet to be done, especially in learning about the fundamental physiological systems involved in human conception. 4) Serious attention should be given the adverse relationship between the needs of poor, developing countries and the multinational corporations that produce contraceptives, in the main, for affluent users. PMID:12334211

1976-03-01

131

Differences in the Nonuse of any Contraception and Use of Specific Contraceptive Methods in HIV Positive and HIV Negative Rwandan Women  

PubMed Central

Contraception can reduce the dual burden of high fertility and high HIV prevalence in sub-Sahara Africa, but significant barriers remain regarding access and use. We describe factors associated with nonuse of contraception and with use of specific contraceptive methods in HIV positive and HIV negative Rwandan women. Data from 395 HIV-positive and 76 HIV-negative women who desired no pregnancy in the previous 6 months were analyzed using univariate and multivariate logistic regression models to identify clinical and demographic characteristics that predict contraceptive use. Differences in contraceptive methods used were dependent on marital/partner status, partner's knowledge of a woman's HIV status, and age. Overall, condoms, abstinence, and hormonal methods were the most used, though differences existed by HIV status. Less than 10% of women both HIV+ and HIV? used no contraception. Important differences exist between HIV-positive and HIV-negative women with regard to contraceptive method use that should be addressed by interventions seeking to improve contraceptive prevalence.

Adedimeji, Adebola A.; Hoover, Donald R.; Shi, Qiuhu; Cohen, Mardge H.; Gard, Tracy; Anastos, Kathryn

2012-01-01

132

Condom and oral contraceptive use and risk of cervical intraepithelial neoplasia in Australian women  

PubMed Central

Objective To assess the association between condom use and oral contraceptive consumption and the risk of cervical intraepithelial neoplasia (CIN). Methods A cross-sectional study was conducted in Perth clinics. A total of 348 women responded to the structured questionnaire. Information sought included demographic and lifestyle characteristics such as the use of condom for contraception, consumption of oral contraceptive, and duration of oral contraceptive usage. Crude and adjusted odds ratio (OR) and associated 95% confidence interval (CI) were calculated using unconditional logistic regression models and reported as estimates of the relative risk. Results The prevalence of CIN was found to be 15.8%. The duration of oral contraceptive consumption among women with abnormal Papanicolaou (Pap) smear result indicating CIN was significantly shorter than those without abnormal Pap smear result (mean±SD, 5.6±5.2 years vs. 8.2±7.6 years; p=0.002). Comparing to ?3 years usage, prolonged consumption of oral contraceptive for ?10 years reduced the risk of CIN (p=0.012). However, use of condom for contraception might not be associated with a reduced risk of CIN after accounting for the effects of confounding factors (adjusted OR, 0.52; 95% CI, 0.05 to 5.11; p=0.577). Conclusion Use of oral contraceptives, but not condoms, for contraception appeared to be inversely associated with CIN. Prolonged use of oral contraceptive demonstrated its benefits of reducing the risk of CIN.

Lee, Andy H.; Colville, Linda; Xu, Daniel; Binns, Colin W.

2014-01-01

133

Will the use of different prevalence rates influence the development of a primary prevention programme for low-back problems?  

Microsoft Academic Search

To determine relations to low-back problems (LBP), different prevalence rates are used. The disadvantage of using different selection criteria is that studies are not comparable, except where they provide the same results. The present aim was to establish whether different prevalence selection criteria lead to different answers on a newly formed set of questionnaires. Since this set is new, reliability

E. Zinzen; D. Caboor; M. Verlinden; E. Cattrysse; W. Duquet; P. Van Roy; Jan Pieter Clarys

2000-01-01

134

Changes in Yearly Birth Prevalence Rates of Children with Down Syndrome in the Period 1986-2007 in the Netherlands  

ERIC Educational Resources Information Center

Background: The Netherlands are lacking reliable national empirical data in relation to the development of birth prevalence of Down syndrome. Our study aims at assessing valid national live birth prevalence rates for the period 1986-2007. Method: On the basis of the annual child/adult ratio of Down syndrome diagnoses in five out of the eight Dutch…

de Graaf, G.; Haveman, M.; Hochstenbach, R.; Engelen, J.; Gerssen-Schoorl, K.; Poddighe, P.; Smeets, D.; van Hove, G.

2011-01-01

135

International variation in reported livebirth prevalence rates of Down syndrome, adjusted for maternal age  

PubMed Central

Reported livebirth prevalence of Down syndrome (DS) may be affected by the maternal age distribution of the population, completeness of ascertainment, accuracy of diagnosis, extent of selective prenatal termination of affected pregnancies, and as yet unidentified genetic and environmental factors. To search for evidence of the latter, we reviewed all published reports in which it was possible to adjust both for effects of maternal age and for selective termination (where relevant).?We constructed indices that allowed direct comparisons of prevalence rates after standardising for maternal age. Reference rates were derived from studies previously identified as having near complete ascertainment. An index value significantly different from 1 may result from random fluctuations, as well as from variations in the factors listed above. We found 49 population groups for which an index could be calculated. Methodological descriptions suggested that low values could often be attributed to underascertainment. A possible exception concerned African-American groups, though even among these most acceptable studies were compatible with an index value of 1. As we have reported elsewhere, there was also a suggestive increase in rates among US residents of Mexican or Central American origin. Nevertheless, our results suggest that "real" variation between population groups reported to date probably amounts to no more than ±25%. However, reliable data in many human populations are lacking including, surprisingly, some jurisdictions with relatively advanced health care systems. We suggest that future reports of DS livebirth prevalence should routinely present data that allow calculation of an index standardised for maternal age and adjusted for elective prenatal terminations.???Keywords: Down syndrome; prenatal diagnosis; maternal age standardisation; epidemiology

Carothers, A.; Hecht, C.; Hook, E.

1999-01-01

136

Prevalence rate of supernumerary teeth among non-syndromic South Indian population: An analysis  

PubMed Central

Aim: Supernumerary teeth are considered as one of the most significant dental anomalies during the primary and early mixed dentition stage. The main objective of the study was to determine the prevalence rate of supernumerary teeth in the patients who reported to the Department of Oral Medicine and Radiology and to study the associated clinical complications. Materials and Methods: A longitudinal observational study was conducted of 2216 patients for a period of 4 months with the documentation of demographic data, the presence of supernumerary teeth, their location, and associated complications such as mechanical trauma, dental caries, and associated pathology. Results: The study recorded 27 supernumerary teeth from the examined 2216 patients. This yields a prevalence of 1.2%, with greater frequency in males which was 1.49% and in females the frequency was 0.85%. The greatest proportion of supernumerary teeth was found in the maxillary anterior region (77.8%). Out of this, 85.7% were classified as mesiodens based on their location. The displacement of adjacent teeth was the most common finding, followed by dental caries. Conclusion: The prevalence of supernumerary teeth in this study was 1.2% which is in agreement with that reported in similar studies and the maxillary mesiodens was the most common location. Displacement of adjacent teeth was the most common finding.

Mahabob, M. Nazargi; Anbuselvan, G. J.; Kumar, B. Senthil; Raja, S.; Kothari, Sucitha

2012-01-01

137

Personal stigma in schizophrenia spectrum disorders: a systematic review of prevalence rates, correlates, impact and interventions  

PubMed Central

A systematic electronic PubMed, Medline and Web of Science database search was conducted regarding the prevalence, correlates, and effects of personal stigma (i.e., perceived and experienced stigmatization and self-stigma) in patients with schizophrenia spectrum disorders. Of 54 studies (n=5,871), published from 1994 to 2011, 23 (42.6%) reported on prevalence rates, and 44 (81.5%) reported on correlates and/or consequences of perceived or experienced stigmatization or self-stigma. Only two specific personal stigma intervention studies were found. On average, 64.5% (range: 45.0–80.0%) of patients perceived stigma, 55.9% (range: 22.5–96.0%) actually experienced stigma, and 49.2% (range: 27.9–77.0%) reported alienation (shame) as the most common aspect of self-stigma. While socio-demographic variables were only marginally associated with stigma, psychosocial variables, especially lower quality of life, showed overall significant correlations, and illness-related factors showed heterogeneous associations, except for social anxiety that was unequivocally associated with personal stigma. The prevalence and impact of personal stigma on individual outcomes among schizophrenia spectrum disorder patients are well characterized, yet measures and methods differ significantly. By contrast, research regarding the evolution of personal stigma through the illness course and, particularly, specific intervention studies, which should be conducted utilizing standardized methods and outcomes, are sorely lacking.

Gerlinger, Gabriel; Hauser, Marta; De Hert, Marc; Lacluyse, Kathleen; Wampers, Martien; Correll, Christoph U

2013-01-01

138

Personal stigma in schizophrenia spectrum disorders: a systematic review of prevalence rates, correlates, impact and interventions.  

PubMed

A systematic electronic PubMed, Medline and Web of Science database search was conducted regarding the prevalence, correlates, and effects of personal stigma (i.e., perceived and experienced stigmatization and self-stigma) in patients with schizophrenia spectrum disorders. Of 54 studies (n=5,871), published from 1994 to 2011, 23 (42.6%) reported on prevalence rates, and 44 (81.5%) reported on correlates and/or consequences of perceived or experienced stigmatization or self-stigma. Only two specific personal stigma intervention studies were found. On average, 64.5% (range: 45.0-80.0%) of patients perceived stigma, 55.9% (range: 22.5-96.0%) actually experienced stigma, and 49.2% (range: 27.9-77.0%) reported alienation (shame) as the most common aspect of self-stigma. While socio-demographic variables were only marginally associated with stigma, psychosocial variables, especially lower quality of life, showed overall significant correlations, and illness-related factors showed heterogeneous associations, except for social anxiety that was unequivocally associated with personal stigma. The prevalence and impact of personal stigma on individual outcomes among schizophrenia spectrum disorder patients are well characterized, yet measures and methods differ significantly. By contrast, research regarding the evolution of personal stigma through the illness course and, particularly, specific intervention studies, which should be conducted utilizing standardized methods and outcomes, are sorely lacking. PMID:23737425

Gerlinger, Gabriel; Hauser, Marta; De Hert, Marc; Lacluyse, Kathleen; Wampers, Martien; Correll, Christoph U

2013-06-01

139

The copper intrauterine device for emergency contraception: an opportunity to provide the optimal emergency contraception method and transition to highly effective contraception.  

PubMed

Worldwide, 40% of all pregnancies are unintended. Widespread, over-the-counter availability of oral emergency contraception (EC) has not reduced unintended pregnancy rates. The EC visit presents an opportunity to initiate a highly effective method of contraception in a population at high risk of unintended pregnancy who are actively seeking to avoid pregnancy. The copper intrauterine device (IUD), the most effective method of EC, continues to provide contraception as effective as sterilization for up to 12 years, and it should be offered as the first-line method of EC wherever possible. Increased demand for and supply of the copper IUD for EC may have an important role in reducing rates of unintended pregnancy. The EC visit should include access to the copper IUD as optimal care but should ideally include access to all highly effective methods of contraception. PMID:23895075

Dermish, Amna I; Turok, David K

2013-07-01

140

Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) normative elevation rates: comparisons with epidemiological prevalence rates.  

PubMed

Odland, Berthelson, Sharma, Martin, and Mittenberg ( 2013 ) caution that clinically elevated scale scores produced by members of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008 /2011) normative sample raise concerns about the potential for false positive findings of psychopathology. However, the MMPI-2-RF normative sample is intended to represent the general population of the United States, 26.2% of which met criteria for a Diagnostic and Statistical Manual-IV (APA, 1994 ) disorder in a 12-month period (Kessler, Chiu, Demler, & Walters, 2005 ). In the current study we compare scale elevation rates in the MMPI-2-RF normative sample to prevalence rates of mental disorders primarily drawn from the National Comorbidity Study Replication (Kessler et al., 2005 ). Our objective was to evaluate MMPI-2-RF elevation rates in an epidemiological context. Results indicate that MMPI-2-RF scale elevation rates were generally consistent with epidemiological data when examined in the context of standard interpretation guidelines for the inventory. We also reiterate Ben-Porath and Tellegen's (2008/2011) caution that MMPI-2-RF scale elevations alone are not sufficient to indicate the presence of psychiatric disorder. Rather they are best viewed as indications of the need to evaluate the individual for possible disorder(s). Implications of these results, limitations of this study, and future directions in research are discussed. PMID:23957313

Tarescavage, Anthony M; Marek, Ryan J; Finn, Jacob A; Hicks, Adam; Rapier, Jessica L; Ben-Porath, Yossef S

2013-01-01

141

Prevalence of human endogenous retroviral element associates with Hodgkin's lymphoma incidence rates.  

PubMed

Human endogenous retrovirus-H (HERV-H) is implicated in leukaemias and lymphomas, but the precise molecular mechanism underlying HERV-mediated carcinogenesis remains unknown. We determined the prevalence of HERV-H in a cross-section of the Singapore population and explored the relationship between HERV-H positivity and incidence rates for Hodgkin's lymphoma in three major ethnic groups of Singapore. We observed that Malays were 1.11 times likely (95% CI=1.05-1.17; P<0.01), and Indians 1.12 times likely (95% CI=1.07-1.18; P<0.01) to be HERV-H positive when compared to Chinese. Interestingly, the incidence rates of Hodgkin's lymphoma for the three races positively correlated to the respective prevalence rate for HERV-H positivity (r=0.9921 for male; r=0.9801 for female), suggesting that viral inheritance in human may predispose certain racial origin unfavourably to malignancy. PMID:24596672

Woo, Wee Hong; Shen, Liang; Leong, Sai Mun; Koay, Evelyn Siew-Chuan

2014-01-01

142

Current status of contraceptive vaginal rings.  

PubMed

Contraceptive vaginal rings (CVR) offer a new, effective contraceptive option, expanding the available choices of hormonal contraception. Various ring prototypes have been evaluated: progestin-only rings and combined progestin-estrogen rings, as well as different combination of progestins and estrogens. The progestin-only ring is intended for continuous use, whereas the combined ring has been designed for cyclic 3-week in/1-week out use, although several studies have explored alternative schemes of extended use. However, only two ring designs have reached the market: NuvaRing, a 1-month combined ring that releases etonogestrel and ethinylestradiol, and Progering, a 3-month progesterone-releasing ring for use in lactating women. A one year Nestorone/ethinyl estradiol CVR is approaching the final stages of development, as the Population Council is preparing to submit a new drug application to the Food and Drug Administration. The main advantages of CVRs are their effectiveness (similar or slightly better than the pill), ease of use without the need of remembering a daily routine, user ability to control initiation and discontinuation, nearly constant release rate allowing for lower doses, greater bioavailability and good cycle control with the combined ring, in comparison with oral contraceptives. Current prototypes in development include rings releasing progesterone receptor modulators, which would provide estrogen-free contraception, as well as combined rings releasing estradiol, instead of ethinyl-estradiol, providing a safer profile. Furthermore, intensive efforts towards developing dual protection rings, providing both contraception and protection against reproductive tract infections, offer hope that this greatly needed technology will soon undergo clinical testing and will be in the hands of women worldwide in the near future. PMID:23040125

Brache, Vivian; Payán, Luis José; Faundes, Aníbal

2013-03-01

143

Nomegestrol acetate-17b-estradiol for oral contraception  

PubMed Central

Oral contraceptives remain a popular method of contraception over 50 years after their introduction. While safe and effective for many women, the failure rate of oral contraception is about 8%. Concerns about the risk of venous thromboembolism continue to drive the search for the safest oral contraceptive formulations. The oral contraceptive NOMAC-E2 contains nomegestrol acetate (NOMAC) 2.5 mg + 17b-estradiol (E2) 1.5 mg. The approved dosing regimen is 24 days of active hormone, followed by a 4-day hormone-free interval. NOMAC is a progestin derived from testosterone, which has high bioavailability, rapid absorption, and a long half-life. Estradiol, though it has a lower bioavailability, has been successfully combined with NOMAC in a monophasic oral contraceptive. Two recently published randomized controlled trials demonstrate that NOMAC-E2 is an effective contraceptive, with a Pearl Index less than one pregnancy per 100 woman-years. The bleeding pattern on NOMAC-E2 is characterized by fewer bleeding/spotting days, shorter withdrawal bleeds, and a higher incidence of amenorrhea than the comparator oral contraceptive containing drospirenone and ethinyl estradiol. The adverse event profile appears to be acceptable. Few severe adverse events were reported in the randomized controlled trials. The most common adverse events were irregular bleeding, acne, and weight gain. Preliminary studies suggest that NOMAC-E2 does not seem to have negative effects on hemostatic and metabolic parameters. While no one oral contraceptive formulation is likely to be the optimum choice for all women, NOMAC-E2 is a formulation with effectiveness comparable with that of other oral contraceptives, and a reassuring safety profile.

Burke, Anne

2013-01-01

144

Nomegestrol acetate-17b-estradiol for oral contraception.  

PubMed

Oral contraceptives remain a popular method of contraception over 50 years after their introduction. While safe and effective for many women, the failure rate of oral contraception is about 8%. Concerns about the risk of venous thromboembolism continue to drive the search for the safest oral contraceptive formulations. The oral contraceptive NOMAC-E2 contains nomegestrol acetate (NOMAC) 2.5 mg + 17b-estradiol (E2) 1.5 mg. The approved dosing regimen is 24 days of active hormone, followed by a 4-day hormone-free interval. NOMAC is a progestin derived from testosterone, which has high bioavailability, rapid absorption, and a long half-life. Estradiol, though it has a lower bioavailability, has been successfully combined with NOMAC in a monophasic oral contraceptive. Two recently published randomized controlled trials demonstrate that NOMAC-E2 is an effective contraceptive, with a Pearl Index less than one pregnancy per 100 woman-years. The bleeding pattern on NOMAC-E2 is characterized by fewer bleeding/spotting days, shorter withdrawal bleeds, and a higher incidence of amenorrhea than the comparator oral contraceptive containing drospirenone and ethinyl estradiol. The adverse event profile appears to be acceptable. Few severe adverse events were reported in the randomized controlled trials. The most common adverse events were irregular bleeding, acne, and weight gain. Preliminary studies suggest that NOMAC-E2 does not seem to have negative effects on hemostatic and metabolic parameters. While no one oral contraceptive formulation is likely to be the optimum choice for all women, NOMAC-E2 is a formulation with effectiveness comparable with that of other oral contraceptives, and a reassuring safety profile. PMID:23836965

Burke, Anne

2013-01-01

145

An "Imperfect" Contraceptive Society: Fertility and Contraception in Italy  

PubMed Central

Italy represents an unexpected and in some ways paradoxical outcome in terms of fertility control: a drop to one of the lowest birth rates in the world has been accompanied by the preponderant use of “traditional” methods despite the availability of “modern” contraception. Using data from 349 interviews conducted in 2005–2006 in four Italian cities, we argue that Italian women achieve “unplanned” AND desired conceptions through the use of withdrawal and natural methods. While data from other countries reveal similar notions of ambivalence surrounding pregnancy intentions and contraceptive use, Italy stands out for the surprising correlation between highly “managing” the conditions under which children are born and the socially commended approach of “letting births happen”. Such results suggest the need to rethink theoretical understandings of low fertility. Through the use of non-technological methods individuals manipulate culturally produced norms and beliefs about the appropriate moment to have a child; simultaneously, their actions are embedded in larger cultural, economic, and political processes.

Gribaldo, Alessandra; Judd, Maya D.; Kertzer, David I.

2013-01-01

146

Funding of Contraceptive Research  

Microsoft Academic Search

This paper presents data on financial support of the reproductive sciences and contraceptive development assembled in the course of a two-year review of research funding by an international group of scientists and scientific administrators. Until the mid-1960s, research in reproduction was supported primarily by university budgets, philanthropic funds, and pharmaceutical firms. This research received only an insignificant share of the

O. Harkavy; F. S. Jaffe; Marjorie A. Koblinsky; S. J. Segal

1976-01-01

147

Religious aspects of contraception  

Microsoft Academic Search

After an introduction recounting the pronatalist views of the world's religions, the article goes on to explore each of the major religions, Judaism, Christianity, Islam, Hinduism, Sikhism and Buddhism and their belief systems in relation to contraception and abortion. This is followed by a discussion of the practical consequences of these beliefs and of the role of the professional in

Elphis Christopher

2006-01-01

148

Food allergies in developing and emerging economies: need for comprehensive data on prevalence rates  

PubMed Central

Although much is known today about the prevalence of food allergy in the developed world, there are serious knowledge gaps about the prevalence rates of food allergy in developing countries. Food allergy affects up to 6% of children and 4% of adults. Symptoms include urticaria, gastrointestinal distress, failure to thrive, anaphylaxis and even death. There are over 170 foods known to provoke allergic reactions. Of these, the most common foods responsible for inducing 90% of reported allergic reactions are peanuts, milk, eggs, wheat, nuts (e.g., hazelnuts, walnuts, almonds, cashews, pecans, etc.), soybeans, fish, crustaceans and shellfish. Current assumptions are that prevalence rates are lower in developing countries and emerging economies such as China, Brazil and India which raises questions about potential health impacts should the assumptions not be supported by evidence. As the health and social burden of food allergy can be significant, national and international efforts focusing on food security, food safety, food quality and dietary diversity need to pay special attention to the role of food allergy in order to avoid marginalization of sub-populations in the community. More importantly, as the major food sources used in international food aid programs are frequently priority allergens (e.g., peanut, milk, eggs, soybean, fish, wheat), and due to the similarities between food allergy and some malnutrition symptoms, it will be increasingly important to understand and assess the interplay between food allergy and nutrition in order to protect and identify appropriate sources of foods for sensitized sub-populations especially in economically disadvantaged countries and communities.

2012-01-01

149

Prevalence Rates of Gambling Problems in Montreal, Canada: A Look at Old Adults and the Role of Passion  

Microsoft Academic Search

The purpose of the present research was to determine the prevalence rate of gambling problems in senior citizens (55 years\\u000a and older). A community-dwelling sample composed of 810 old adults living in the greater Montreal area in the Province of\\u000a Quebec completed the Revised South Oaks Gambling Screen (SOGS-R). Results revealed that the 12-month prevalence rate was 1.2%\\u000a for pathological gambling

Frédérick Philippe; Robert J. Vallerand

2007-01-01

150

Dimensions of the contraceptive attributes questionnaire.  

PubMed

Principal components factor analyses with orthogonal rotation were performed on Importance, Sponge Agreement, Pill Agreement, and Diaphragm Agreement scales on the Contraceptive Attributes Questionnaire (CAQ) to ascertain reliability and validity. Specifically, the intent was to measure whether the scales included more than 1 dimension. Internal consistency of the factors was also measured with Cronbach's alpha for each of the factors in each of the Importance and Agreement factors. Data were obtained from a US national telephone survey of 1187 sexually active women 15-44 years. 385 were currently using the contraceptive sponge, 407 women who had formerly used the sponge, and 396 who had never used the sponge and were using other forms of contraception. 91.9% were white, 5.8% were black, and 1.4% were of Hispanic origin. 75.9% were employed outside the household. 61.4% were currently married, 25.2% were never married, and 13.4% were widowed or divorced. The instrument was designed to measure the subjective importance of specific attributed that contraceptive methods may have (Importance) and the perceived characteristics of specific contraceptive methods (Agreement). Importance is measured by the respondent's rating on a 5-point scale of how important each of 18 attributes was in selecting a birth control method. Agreement was determined by asking how much one agrees that the 18 attributes describes each of 3 methods: the pill, the sponge, and the diaphragm (14 attributes). The model of contraceptive decision making assumes that choice of a specific method is a function of value, importance, and likelihood. The attributes were based on 2 other sources, and pretesting reduces 63 items down to 18. The results yielded ratings of agreement for all 3 methods on convenience and absence of health problems and side effects attributes. For vaginal methods only, the attribute of greatest importance was convenience. The conclusion is that the subscales have reasonable internal consistency. In the comparison of women who used different methods, there were differences by user status on the ratings of the Importance and Agreement attributes for all 3 methods. Sponge users emphasized obtaining contraceptives without consulting medical staff. Pill users were concerned with the reputation of the method and convenience of use. Diaphragm users related to the reputation and familiarity with the method. Limitations were built into the sample which was not randomly selected, predominately white, and may reflect more innovative users. Items also were all stated in the positive. The CAQ would be useful is determining the characteristics of methods of importance to her and her perceptions of methods. Future research might examine different populations and compare positive and negative items. PMID:12344926

Beckman, L J; Harvey, S M; Murray, J

1992-06-01

151

Non-contraceptive benefits and risks of contraception.  

PubMed

Contraception is primarily used to prevent pregnancy. However, a user should be aware of both the possible non-contraceptive benefits she/he may experience and any potential risks to her/his health. These issues should be discussed as fully as possible, using current, evidence-based information prior to commencing a method. Some methods may be prescribed solely for their non-contraceptive benefits for a woman who does not require it for contraception. Potential risks to a woman's health may make certain methods unacceptable if concurrent medical problems or lifestyle issues exist. This chapter discusses the main non-contraceptive benefits and risks for each contraceptive method in turn. PMID:19196552

Haider, Zara; D'Souza, Rachel

2009-04-01

152

Chlamydia trachomatis and oral contraceptive use: a quantitative review.  

PubMed Central

OBJECTIVES--Chlamydia trachomatis is now recognised as a major sexually transmitted disease; oral contraceptive use is rapidly increasing particularly in developing countries. There are thus important public health implications of the many reports that isolation of C trachomatis is more frequent among users of oral contraceptives. The aim of this analysis was to assess the strength and consistency of this association by summarising published studies between 1972 and 1990. DESIGN--Studies identified were grouped according to whether they were prospective or case-control studies. Data were extracted and pooled estimates of the unadjusted odds ratios were made for all studies, as well as for sub-groups defined by an index of study quality, background prevalence of C trachomatis, and the contraceptive comparison being made. LOCATION--Studies in the analysis were mainly conducted in Europe and North America; the meta-analysis was done at the Harvard School of Public Health, Boston, MA, USA. RESULTS--The pooled estimated unadjusted odds ratio for 29 case-control studies examined was 1.93 (95% CI, 1.77-2.11), indicating an almost twofold increased risk of chlamydial infection for oral contraceptive users. Neither study quality nor prevalence of C trachomatis modified this risk. When compared to the use of barrier contraceptives, however, the risk of infection for women using oral contraceptives increased to 2.91 (95% CI, 1.86-4.55). The pooled estimated protective effect of barrier methods in these studies was 0.34 (95% CI, 0.22-0.54). CONCLUSIONS--Cross-study comparisons of the relationship between oral contraceptive use and chlamydial infection are limited by the design and analysis of many component studies which did not control for confounding factors such as sexual behaviour and age. The almost twofold risk of increased chlamydial infection for oral contraceptive users, supported by the findings of two prospective studies, however, points to the importance of considering the risks and benefits of oral contraceptive use in women who are likely to be exposed to C trachomatis and other STDs. The protective effect of barrier methods emphasizes the continued need for promoting barrier methods of contraception.

Cottingham, J; Hunter, D

1992-01-01

153

[Emergency oral contraception policy: the Peruvian experience].  

PubMed

Emergency oral contraception is part of the sexual and reproductive rights of women. In 2001, this health policy was incorporated into the Rules of the National Family Planning Program of the Ministry of Health, primarily to prevent unwanted pregnancy and its serious consequences, induced abortion and the high associated maternal mortality rate, which are major public health problems. Scientific research has confirmed that the main mechanism of action of levonorgestrel, component of emergency oral contraception (EOC) is to inhibit or delay ovulation, preventing fertilization of the egg; additionally, it increases the thickening of the cervical mucus, making the sperm migration more difficult. No study has found endometrial abnormalities that may interfere with the implantation of the fertilized egg or embryo development of an implanted egg. However, despite the support of medical science and legal backing, the EOC is available only to users with economic resources, but its use has not been fully implemented in public sector services, due to obstacles created by groups opposed to contraception under claim of an alleged abortive effect that has already been ruled out scientifically. This article describes the administrative experience and legal confrontations between groups of power that prevent the proper implementation of an emergency contraception policy in Peru. PMID:24100827

Pretell-Zárate, Eduardo A

2013-07-01

154

The effect of joint contraceptive decisions on the use of Injectables, Long-Acting and Permanent Methods (ILAPMs) among married female (15-49) contraceptive users in Zambia: a cross-sectional study  

PubMed Central

Background Zambia’s fertility rate and unmet need for family planning are still high. This is in spite of the progress reported from 1992 to 2007 of the increase in contraceptive prevalence rate from 15% to 41% and use of modern methods of family planning from 9% to 33%. However, partner disapproval of family planning has been cited by many women in many countries including Zambia. Given the effectiveness of long-acting and permanent methods of family planning (ILAPMs) in fertility regulation, this paper sought to examine the relationship between contraceptive decision-making and use of ILAPMs among married women in Zambia. Methods This paper uses data from the 2007 Zambia Demographic and Health Survey. The analysis is based on married women (15–49) who reported using a method of family planning at the time of the survey. Out of the 7,146 women interviewed, only 1,630 women were valid for this analysis. Cross-tabulations and binary logistic regressions with Chi-square were used to analyse associations and the predictors of use of ILAPMs of contraception, respectively. A confidence interval of .95 was used in determining relationships between independent and dependent variables. Results Two thirds of women made joint decisions regarding contraception and 29% of the women were using ILAPMs. Women who made joint contraceptive decisions are significantly more likely to use ILAPMs than women who did not involve their husband in contraceptive decisions. However, the most significant predictor is the wealth index. Women from rich households are more likely to use ILAPMs than women from medium rich and poor households. Results also show that women of North Western ethnicities and those from Region 3 had higher odds of using ILAPMs than Tonga women and women from Region 2, respectively. Conclusion Joint contraceptive decision-making between spouses is key to use of ILAPMs in Zambia. Our findings have also shown that the wealth index is actually the strongest factor determining use of these methods. As such, family planning programmes directed at increasing use of LAPMs ought to not only encourage spousal communication but should also consider rolling out interventions that incorporate economic empowerment.

2014-01-01

155

Prevalence and incidence rates of pressure ulcers in an Emergency Department.  

PubMed

Older patients represent an increasing population in emergency department (ED) with underlying diseases and longer ED length of stay, which are potential risk factors of pressure ulcers (PUs). The aim of the study was to determine the prevalence and incidence rates of PUs in an Emergency Department and to analyse variables related to PUs occurrence. The study was carried out in the Emergency Department of Bordeaux (France), and included 602 patients from 1 to 15 June 2010. All the potential body sites of pressure were examined at admission and discharge for all the patients by trained nurses. Comorbidity score, list of treatment, length of stay (hours), PUs (including stage I) and C-reactive protein (CRP) level were systematically recorded. A total of 47 (7·8%) patients had prevalent PUs at admission and 74 (12·3%) at discharge. The cumulative incidence was 4·9% and the incidence density was 5·4 per 1000 patients per hour. In multivariate analysis, higher comorbidities (OR 1·3; P = 0·014) and CRP levels (OR 1·005; P = 0·017) were both independent risk factors for developing PU. In conclusion, these data show that even a very short stay to the ED is sufficient to induce PUs especially stage I. PMID:23043304

Dugaret, Elodie; Videau, Marie-Neige; Faure, Isabelle; Gabinski, Claude; Bourdel-Marchasson, Isabelle; Salles, Nathalie

2014-08-01

156

Letter: Sequential oral contraceptives.  

PubMed

Lyon, Silverberg, and Makowski published papers showing that young women taking long-term sequential oral contraceptives, especially Oracon, may develop adenocarcinoma of the endometrium. Other reports have shown that sequentials may cause adenomatous hyperplasia accompanied by severe degrees of anaplasia. All patients studied were asymptomatic, and the majority were oligomenorrheic prior to using sequentials. Patients who choose to continue with these agents should be closely observed and subjected to office endometrial aspirations at 6-month intervals. If adenomatous hyperplasia is diagnosed, patients should be encouraged to use nonsteroid forms of contraception. Repeat aspiration should be performed in 3-6 months; the patients should keep basal body temperature records. If situation persists and the adenomatous hyperplasia persists for 3-6 months, oral or parenteral progesterone therapy is indicated. It is believed that progestins will reverse the adenomatous hyperplasia. If it does not revert to secretory endometrium and severe, atypical adenomatous hyperplasia is found, hysterectomy may be indicated. PMID:1254031

Lyon, F A

1976-03-01

157

Hormonal contraceptive use and risk of HIV-1 disease progression  

PubMed Central

Background For HIV-1 infected women, hormonal contraception prevents unintended pregnancy, excess maternal morbidity, and vertical HIV-1 transmission. Hormonal contraceptives are widely used but their effects on HIV-1 disease progression are unclear. Methods In a prospective study among 2269 chronically HIV-1 infected women from 7 countries in East and southern Africa and with enrollment CD4 counts ?250 cells/mm3, we compared rates of HIV-1 disease progression among those using and not using hormonal contraception (i.e. oral or injectable methods). The primary outcome was a composite endpoint of CD4 decline to <200 cells/mm3, initiation of antiretroviral therapy, or death. Results 372 women experienced HIV-1 disease progression during 3242 years of follow up (incidence rate=11.5 events per 100 person-years). Rates of HIV-1 disease progression among women who were currently using and not using hormonal contraception were 8.54 and 12.31 per 100 person-years, respectively (adjusted hazard ratio [HR] 0.74, 95% CI 0.56–0.98, p=0.04). Rates were 8.58 and 8.39 per 100 person-years for the subsets using injectable and oral contraception (adjusted HR=0.72, p=0.04 for injectable users and adjusted HR=0.83, p=0.5 for oral users compared to women not using hormonal contraception). Sensitivity analyses assessing enrollment or cumulative contraceptive use during the study demonstrated risk estimates closer to 1.0 with no evidence for accelerated disease progression. Conclusions Among African women with chronic HIV-1 infection, use of hormonal contraception was not associated with deleterious consequences for HIV-1 disease progression.

Heffron, Renee; Mugo, Nelly; Ngure, Kenneth; Celum, Connie; Donnell, Deborah; Were, Edwin; Rees, Helen; Kiarie, James; Baeten, Jared M.

2013-01-01

158

Foie et contraception orale  

Microsoft Academic Search

\\u000a La contraception orale (CO) est utilisée par plus de 100 millions de femmes [1]. La teneur en éthinylestradiol, initialement de 150 ?g au début des années 1960 a rapidement été réduite en raison des complications\\u000a cardiaques et thrombo-emboliques pour atteindre 15 à 20 ?g dans les pilules de dernière génération, et une pilule combinée\\u000a associant un progestatif de synthèse à

A. Mallat

159

La contraception masculine  

Microsoft Academic Search

Resume  Des méthodes de contraception masculine sont actuellement utilisables, en particulier les méthodes mécaniques comme le préservatif,\\u000a dont le taux d’échec est important, ou la vasectomie qui présente un caractère irréversible. De plus, ces méthodes ne sont\\u000a pas acceptées par tous les couples.\\u000a \\u000a Les méthodes hormonales sont basées sur la suppression réversible de la sécrétion des gonadotrophines (LH et FSH) et

Clément Jimenez

2004-01-01

160

Cervical carcinogenesis and contraception.  

PubMed

Cytologic evaluation of cervical smears has been carried out in 3,374 women who used different modes of contraception (Lippes loop, copper T200, copper T220, copper devices containing higher copper content than the copper T200, CuT380 Ag, levonorgestrel IUD, injections of noresthisterone oenanthate, and subdermal implants of levonorgestrel) under the Contraceptive Testing Programme of Indian Council of Medical Research for periods ranging from 6 months to 15 yr. While no case of severe dysplasia or malignancy was noticed with any type of contraceptive, 113 dysplastic smears (99 mild and 14 moderate) were encountered on follow-up, giving an incidence of 3.3%, which was statistically insignificant compared with the pretreatment incidence of 1.4% (47 of 3,374). The highest incidence of dysplasia was seen with devices containing a high copper content (9.2%), followed by CuT200 (6.1%) and levonorgestrel implants (4.2%), and was lowest with Lippes loop (1.8%), injection of noresthisterone oenanthate (1.7%), and CuT380 Ag (1.5%), but statistics higher than the pretreatment incidence of 1.4% were seen only with CuT200 and devices containing high copper content. Retrogression of dysplasia was seen in 85 of the 94 posttreatment dysplasia cases and in all 47 pretreatment dysplasia cases, whereas in the remaining nine posttreatment cases of dysplasia the lesion persisted for 6-12 mo, necessitating discontinuation of contraception. The accumulated follow-up data indicate that the CuT380 Ag device is a promising IUD for the future in view of its low incidence of dysplasia determined during its use up to 5 yr. However, more prolonged follow-up in larger numbers of subjects is required to confirm its innocuousness on long-term retention. PMID:1935511

Misra, J S; Engineer, A D; Das, K; Tandon, P

1991-01-01

161

Status of Contraceptive Vaccines  

PubMed Central

Problem This is a review of antisperm contraceptive vaccines (CV), and synthesis of human scFv antibodies that can be used as immunocontraceptives. Method of study Various methods of proteomics and genomics, peptide synthesis, phage display technology, and antibody engineering were used to obtain multi-epitope vaccines and human scFv antibodies from immunoinfertile and vasectomized men. The present review primarily focuses on the effect of multi-epitope vaccines and Izumo on fertility and synthesis and characterization of sperm specific human scFv antibodies. Results The immunization with Izumo peptides causes a contraceptive effect in female mice. The efficacy is enhanced by combination vaccination, including peptides based on other sperm antigens. Using phage display technology, we were able to synthesize at least four novel scFv antibodies with unique complimentarity determining regions (CDRs) that reacted with specific fertility-related sperm antigens. These antibodies inhibited human sperm function in vitro, and their immunocontraceptive effect in vivo is currently being investigated. Conclusions The multi-epitope vaccines may provide an efficacious and viable approach to contraception. The human scFv antibodies, if they block fertility in vivo, may provide unique and novel immunocontraceptives, the first of its kind for human use. The multi-epitope CV and preformed engineered antibodies of defined specificity may obliterate the concern related to inter-individual variability of the immune response.

Naz, Rajesh K.

2008-01-01

162

Ethinylestradiol/dienogest in oral contraception.  

PubMed

The low-dose combined oral contraceptive of ethinylestradiol 30 microg and dienogest 2 mg was launched in Germany in 1995, and is now the most commonly prescribed oral contraceptive in this country. Dienogest is a novel 19-nortestosterone-derived progestin with a unique pharmacokinetic and pharmacological profile, including antiandrogenic properties. Clinical studies have demonstrated that ethinylestradiol/dienogest is a reliable ovulation inhibitor with high contraceptive efficacy that is comparable with other combined oral contraceptives. It also provides effective cycle control, with reduced intensity and duration of menstrual bleeding, and improves dysmenorrhoea. The combination of ethinylestradiol and dienogest reduces serum androgen levels, and increases the levels of thyroid hormones; however, although thyroid hormone levels increase, there is no increased activity due to increases in transporter protein. Like other low-dose oral contraceptives, ethinylestradiol/dienogest has only minor influences on lipid and carbohydrate metabolism, adrenal hormones and blood pressure parameters, and appears to have a balanced effect on the haemostatic system. Ethinylestradiol/dienogest also has beneficial effects on hair and skin; a number of studies have reported decreased hair and skin greasiness, and improvements in acne vulgaris following treatment with ethinylestradiol/dienogest. After discontinuation of ethinylestradiol/dienogest, there may be a small delay in conception during the first three cycles, but there is no subsequent impairment of fertility. Furthermore, the duration of use of ethinylestradiol/dienogest does not seem to influence the rate of conception or time to conception. Ethinylestradiol/dienogest is well tolerated; adverse reactions associated with treatment include breast pain, headache and nausea/vomiting. These adverse reactions are rare and decrease in incidence over time. PMID:20394455

Pérez-Campos, Ezequiel F

2010-04-16

163

Estimation of the prevalence and rate of acute transfusion reactions occurring in Windhoek, Namibia  

PubMed Central

Background Acute transfusion reactions are probably common in sub-Saharan Africa, but transfusion reaction surveillance systems have not been widely established. In 2008, the Blood Transfusion Service of Namibia implemented a national acute transfusion reaction surveillance system, but substantial under-reporting was suspected. We estimated the actual prevalence and rate of acute transfusion reactions occurring in Windhoek, Namibia. Methods The percentage of transfusion events resulting in a reported acute transfusion reaction was calculated. Actual percentage and rates of acute transfusion reactions per 1,000 transfused units were estimated by reviewing patients’ records from six hospitals, which transfuse >99% of all blood in Windhoek. Patients’ records for 1,162 transfusion events occurring between 1st January – 31st December 2011 were randomly selected. Clinical and demographic information were abstracted and Centers for Disease Control and Prevention National Healthcare Safety Network criteria were applied to categorize acute transfusion reactions1. Results From January 1 – December 31, 2011, there were 3,697 transfusion events (involving 10,338 blood units) in the selected hospitals. Eight (0.2%) acute transfusion reactions were reported to the surveillance system. Of the 1,162 transfusion events selected, medical records for 785 transfusion events were analysed, and 28 acute transfusion reactions were detected, of which only one had also been reported to the surveillance system. An estimated 3.4% (95% confidence interval [CI]: 2.3–4.4) of transfusion events in Windhoek resulted in an acute transfusion reaction, with an estimated rate of 11.5 (95% CI: 7.6–14.5) acute transfusion reactions per 1,000 transfused units. Conclusion The estimated actual rate of acute transfusion reactions is higher than the rate reported to the national haemovigilance system. Improved surveillance and interventions to reduce transfusion-related morbidity and mortality are required in Namibia.

Meza, Benjamin P.L.; Lohrke, Britta; Wilkinson, Robert; Pitman, John P.; Shiraishi, Ray W.; Bock, Naomi; Lowrance, David W.; Kuehnert, Matthew J.; Mataranyika, Mary; Basavaraju, Sridhar V.

2014-01-01

164

Efficacy of a combined contraceptive regimen consisting of condoms and emergency contraception pills  

PubMed Central

Background To evaluate and compare the effectiveness of the combined regimen (consisting of condoms and emergency contraception pills (ECP)) and using condoms only for the purpose of preventing pregnancy. Methods One-thousand-five-hundred-and-sixty-two (1,562) couples as volunteers enrolled at nine centers in Shanghai. Eight-hundred-and-twelve (812) were randomized to use male condoms and ECP (i.e., Levonorgestrel) as a back-up to condoms (the intervention group) and 750 to use male condoms only(the control group), according to their working unit. Participants were visited at admission and at the end of 1, 3, 6, 9, and 12 months. The cumulative life table rates were calculated for pregnancy and other reasons for discontinuation. Result The gross cumulative life table rates showed that the cumulative discontinuation rates for all reasons during the year of follow-up in the condoms plus emergency contraception group and the condoms only group were 7.76?±?0.94 and 6.61?±?0.91, respectively, per 100 women (?2?=?0.41, p?=?0.5227). The cumulative gross pregnancy rate of the condoms plus emergency contraception group and the condoms only group were 2.17?±?0.52 and 1.25?±?0.41, respectively, per 100 women (?2?=?1.93, p?=?0.1645). The Pearl Index in the condoms plus emergency contraception group and the condoms only group were 2.21% and 1.26%, respectively. Conclusion Male condoms remain a highly effective contraceptive method for a period of one year while consistently and correctly used. In addition, the lowest pregnancy rate followed from perfect use condom.

2014-01-01

165

Phase of oral contraceptive cycle and endurance capacity of rowers.  

PubMed

Eight female rowers (M age = 21.0 yr., SD = 2.8), using a monophasic oral-contraceptive pill, performed a 1-hr. rowing ergometer test (intensity: 70% VO2max) during the active-pill and non active-pill phases of the oral contraceptive cycle. No significant differences were found in mean energy expenditure, oxygen consumption, respiratory exchange ratio, and heart rate during the endurance test at the two phases of the oral contraceptive cycle. Mean energy expenditure rate, carbohydrate energy expenditure, lipid energy expenditure, and blood lactate during the test were not statistically significantly different among the cycle phases. In conclusion, there was no observed difference in substrate oxidation and blood lactate level during endurance rowing at different phases of the oral contraceptive cycle in these endurance-trained rowers. Endurance-trained female athletes on oral contraceptives should not worry about the possible differences in substrate oxidation during everyday training at different phases of the oral contraceptive cycle. PMID:22403922

Vaiksaar, Sille; Jürimäe, Jaak; Mäestu, Jarek; Purge, Priit; Kalytka, Svetlana; Shakhlina, Larissa; Jürimäe, Toivo

2011-12-01

166

Age- and sex-standardised prevalence rates of fatigue in a large hospital-based sample of cancer patients  

PubMed Central

Background: The aim of this longitudinal study was to determine age- and sex-standardised prevalence rates of cancer-related fatigue in different groups of patients. Methods: This was a prospective study in a cohort of N=1494 cancer patients investigating fatigue at three time points t1–t3 (t1: admission to hospital, t2: discharge, t3: half a year after t1). Fatigue was measured with the Multidimensional Fatigue Inventory. Age- and sex-adjusted norms were derived from a representative community sample of N=2037, using a cutoff at the 75th percentile. Results: At admission to the hospital, 32% of the patients were classified as fatigued. At discharge, the overall prevalence rate was 40%, and at half a year after t1, prevalence was 34%. Fatigue prevalence rates differed according to tumour stage, site, age, and sex of the patients. Conclusion: The prevalence rates provided by this study can be used for the planning of research and clinical routine.

Singer, S; Kuhnt, S; Zwerenz, R; Eckert, K; Hofmeister, D; Dietz, A; Giesinger, J; Hauss, J; Papsdorf, K; Briest, S; Brown, A

2011-01-01

167

Oral Contraceptives and Cancer Risk  

MedlinePLUS

... benefits associated with oral contraception. American Journal of Obstetrics and Gynecology 2004; 190(4 Suppl):S5–22. [ ... oral contraceptive use and risk of ovarian cancer. Obstetrics and Gynecology 1992; 80(4):708–714. [PubMed ...

168

Differences in prevalence rates of PTSD in various European countries explained by war exposure, other trauma and cultural value orientation  

PubMed Central

Background Guided by previous explorations of historical and cultural influences on the occurrence of PTSD, the aim of the present study was to investigate the contributions of war victimisation (in particular, World War II) and other civil trauma on the prevalence of PTSD, as mediated by cultural value orientation. Secondary data analysis was performed for 12 European countries using data, including PTSD prevalence and number of war victims, crime victims, and natural disaster victims, from different sources. Ten single value orientations, as well as value aggregates for traditional and modern factors, were investigated. Results Whilst differences in PTSD prevalence were strongly associated with war victim rates, associations, albeit weaker, were also found between crime victims and PTSD. When cultural value orientations, such as stimulation and conformity as representatives of modern and traditional values, were included in the multivariate predictions of PTSD prevalence, an average of approximately 80% of PTSD variance could be explained by the model, independent of the type of trauma exposure. Conclusion The results suggest that the aftermath of war contributes to current PTSD prevalence, which may be explained by the high proportion of the older population who directly or indirectly experienced traumatic war experiences. Additional findings for other types of civil trauma point towards an interaction between value orientation and country-specific trauma rates. Particularly, being personally oriented towards stimulation appears to interact with differences in trauma prevalence. Thus, cultural value orientation might be viewed not only as an individual intrinsic process but also as a compensatory strategy after trauma exposure.

2014-01-01

169

Colonic Crohn's disease and use of oral contraception.  

PubMed Central

The prevalence of use of oral contraception before the onset of disease was established in 100 consecutive women attending follow up clinics for inflammatory bowel disease. A significant excess of women with Crohn's disease confined to the colon had taken oral contraceptives in the year before developing symptoms (10/16 (63%] compared with women with small-intestinal Crohn's disease (12/49 (24%); p less than 0.02) and women with ulcerative colitis (3/35 (9%); p less than 0.0005). When the patient groups were matched for age and year of onset of disease usage of oral contraception before the onset of disease was still more common among women with isolated colonic Crohn's disease (9/12, 75%) than among those with ulcerative colitis (2/12 (17%); p less than 0.02) and was also more common than would be expected from reported figures for oral contraception in England and Wales (31.4% of women aged under 41; p less than 0.005). A survey of current patient records showed that isolated colonic disease was at least twice as common among women with Crohn's disease (63/218, 29%) compared with men (25/181, 14%; p less than 0.001). These data support the suggestion made previously that oral contraceptives may predispose to a colitis that resembles colonic Crohn's disease.

Rhodes, J M; Cockel, R; Allan, R N; Hawker, P C; Dawson, J; Elias, E

1984-01-01

170

Contraception masculine hormonale  

Microsoft Academic Search

Resume  Les méthodes de contraception hormonale, qui visent toutes à la suppression des gonadotrophines, peuvent être classées en\\u000a 2 catégories, selon qu’elles font appel aux dérivés des stéroïdes ou aux analogues du GnRH. L’administration de testostérone\\u000a à doses supra-physiologiques a une action supressive de la spermatogenèse connue depuis longtemps. Elle a été testée dans\\u000a une étude multicentrique par l’OMS sur 271

J. F. Guerin

1996-01-01

171

Association between the Delta Estimated Glomerular Filtration Rate and the Prevalence of Monoclonal Gammopathy of Undetermined Significance in Korean Males  

PubMed Central

Background. We investigated the association between the reduction in the estimated glomerular filtration rate (eGFR) and the prevalence of monoclonal gammopathy of undetermined significance (MGUS) in Korean males. Methods. We enrolled 723 healthy Korean males. Serum creatinine concentration, serum electrophoresis, serum immunofixation, and the serum free light chain assay were performed. We calculated delta eGFR per year (?eGFR/yr). The prevalence of MGUS was compared based on the ?eGFR/yr and age group. Results. Thirteen (1.8%) of 723 participants exhibited the monoclonal band on serum immunofixation. Prevalence of MGUS by age group was 0.00% (0/172 for 40 years), 1.63% (6/367 for 60 years), and 3.80% (7/184 for >60 years). The median decrease in ?eGFR/yr was 5.3%. The prevalence of MGUS in participants in their 50s with >5.3% decline in ?eGFR/yr was significantly higher than those with <5.3% decrease in ?eGFR/yr (3.16% versus 0.00%; P = 0.049). The prevalence of MGUS in participants in their 50s with >5.3% decrease in ?eGFR/yr was similar to that of healthy males in their 60s. Conclusion. Using the rate of reduction in ?eGFR/yr in healthy Korean males who had their serum creatinine level checked regularly may increase the MGUS detection rate in clinical practice.

Chun, Sail; Min, Won-Ki

2014-01-01

172

Condom practices of urban teens using Norplant contraceptive implants, oral contraceptives, and condoms for contraception  

Microsoft Academic Search

Objectives: The availability of long-acting hormonal birth control methods has created new contraceptive options for adolescents. The purpose of this study was to determine whether teens initiating these methods use condoms less frequently than teens using oral contraceptive pills or condoms alone and may therefore be at an increased risk of acquiring sexually transmitted infections. Study Design: To investigate ongoing

Philip D. Darney; Lisa S. Callegari; Allison Swift; Elizabeth S. Atkinson; Anne M. Robert

1999-01-01

173

Examining the efficacy, safety, and patient acceptability of the etonogestrel implantable contraceptive  

PubMed Central

Contraceptive implants provide long-acting, highly effective reversible contraception. The etonogestrel implant (ENG implant) is a single rod implant that offers three years of efficacy. The ENG implant was designed to provide contraceptive efficacy by inhibiting ovulation and Pearl Index scores reported for this method are similar to other long-acting reversible contraception as well as similar to sterilization. The implant has been shown to be safe during breast feeding and may improve symptoms of dysmenorrhea and endometriosis. Irregular bleeding patterns can be expected with the device’s use and should be addressed in order to decrease rates of discontinuation.

Hohmann, Heather

2009-01-01

174

Examining the efficacy, safety, and patient acceptability of the etonogestrel implantable contraceptive.  

PubMed

Contraceptive implants provide long-acting, highly effective reversible contraception. The etonogestrel implant (ENG implant) is a single rod implant that offers three years of efficacy. The ENG implant was designed to provide contraceptive efficacy by inhibiting ovulation and Pearl Index scores reported for this method are similar to other long-acting reversible contraception as well as similar to sterilization. The implant has been shown to be safe during breast feeding and may improve symptoms of dysmenorrhea and endometriosis. Irregular bleeding patterns can be expected with the device's use and should be addressed in order to decrease rates of discontinuation. PMID:19936163

Hohmann, Heather

2009-01-01

175

Liability concerns in contraceptive research and development.  

PubMed

The history of liability claims in the US against contraceptive products is among the issues that discourage manufacturers from investing in discovery and development in this field. Other factors are the high cost of new drug development, elevated insurance rates for contraceptives, and the desire to avoid controversy that can disturb corporate tranquility. General features of the American legal system influence the large number and cost of product liability claims in the US compared to Europe. These differences pertain to issues such as the role of judges, how lawyers receive their compensation, and the use of expert scientific testimony. The history of litigation in the US against pharmaceutical products and devices pertaining to women's health suggests that interventions that involve the reproductive system are held to different standards or elicit different emotional responses than other pharmaceutical products or devices. PMID:10661751

Segal, S J

1999-12-01

176

The effects of contraception on female poverty.  

PubMed

Poverty rates are particularly high among households headed by single women, and childbirth is often the event preceding these households' poverty spells. This paper examines the relationship between legal access to the birth control pill and female poverty. We rely on exogenous cross-state variation in the year in which oral contraception became legally available to young, single women. Using census data from 1960 to 1990, we find that having legal access to the birth control pill by age 20 significantly reduces the probability that a woman is subsequently in poverty. We estimate that early legal access to oral contraception reduces female poverty by 0.5 percentage points, even when controlling for completed education, employment status, and household composition. PMID:24988652

Browne, Stephanie P; LaLumia, Sara

2014-01-01

177

Does ethnicity matter in male hormonal contraceptive efficacy?  

PubMed Central

The development of male hormonal contraception has progressed significantly during the last three decades. The ultimate goal is to produce an effective, safe and reversible male method of contraception that are within reach of and can be used by all men globally. This review aims to outline the recent developments in male hormonal contraception with special emphasis on how ethnicity influences acceptability, extent of sperm suppression, and rate of recovery of spermatogenesis. Baseline differences in testicular histomorphology and testosterone metabolism between East Asian and Caucasian men have been reported, but whether this contributes significantly to varying degrees of sperm suppression in response to exogenous testosterone therapy is less known. Testosterone alone male hormonal contraceptive regimens are effective and applicable for East Asian men, and less so for Caucasians. Combinations of progestins with androgens are sufficient to optimize effectiveness of suppression and applicability to all ethnicities. New compounds such as steroidal or non-steroidal selective androgen receptor modulators with dual androgenic and progestational activities are potential compounds for further development as male hormonal contraceptive methods. At the present time, combined androgen and progestin contraceptive regimens appear to be effective, safe, reversible and convenient to use for all men with ethnic, cultural and environmental differences. Further refinements on the hormonal agent, methods of delivery, and dose optimization of the androgen relative to the progestin are necessary. This goal mandates further investment and large clinical trials in multiethnic populations to better define safety and efficacy.

Ilani, Niloufar; Liu, Peter Y; Swerdloff, Ronald S; Wang, Christina

2011-01-01

178

[Historical survey of modern reversible contraceptive methods].  

PubMed

Because of contraception, pregnancy need not be viewed by women as punishment for sexual activity but as a planned and desired event. Most of the contraceptive methods used in developing countries at present were introduced during the 1960s, but use of contraception has a long history and some methods date back to antiquity. Contraceptive pills were already used around 2000 BC in the form of mercury and arsenic tablets. Their effectiveness was questionable. The role of hormones in human reproduction began to be understood only in the early 1900s. The discovery of progesterone in a Mexican iguana in the 1940s permitted production of progesterone on a large scale. Estrogens had been identified around 1930. Human trials of a contraceptive pill beginning in 1956 in Puerto Rico demonstrated that progestins could prevent pregnancy by suppressing ovulation. Later on, estrogen was added to reduce menstrual irregularities. The 1st generation of combined oral contraceptives contained very high levels of hormones associated with high rates of side effects. Numerous formulations with lower hormonal contents became available beginning around 1970 and constitute the principal formulations in use today. A number of long acting hormonal methods based on progestins have been developed, including injectables, some IUDs and vaginal rings, and implants. The 1st commercially available injectable, norethisterone enanthate, did not acquire the wide distribution of medroxyprogesterone acetate, sold as Depo Provera and used to treat various pathological conditions as well as for contraception. The 1st true IUDs were small stones placed within the uteri of camels by nomads to prevent pregnancy during long caravans. An IUD was developed in 1909 by Richter, and the 2 most widely used models before 1960 were the Grafenberg and Ota silver rings. Use of the 2 rings became rare for medical reasons after 1935 despite their efficacy. Safe plastic IUDs which appeared beginning in the early 1960s were flexible and capable of returning to their original shape after insertion. The Lippes loop was the 1st highly successful IUD. Bioactive IUDs containing copper were developed in the 1970s. Research is underway to develop IUDs which will resist expulsion, reduce bleeding, be more appropriate for multiparas, and last longer. IUDs are used to treat intrauterine adhesions as well as for contraception. A gummy substance used to block the cervix was described in Egypt in 1850 BC. Japanese and Chinese prostitutes of antiquity placed oiled bamboo paper at the cervical opening for contraception. Diaphragms and cervical caps were developed in the 19th century in Germany. Large scale production became possible after 1880 with the development of better, more durable, and cheaper rubber. An Egyptian writing in 3500 BC began the study of spermicides. Numerous substances such as lemon juice and honey have been placed in the vagina to avoid pregnancy. Such substances are available to all women and some were reasonably effective. Current research is directed toward development of spermicides which will also prevent sexually transmitted diseases. The 1st condoms were made of animal skins by an English physician to prevent transmission of venereal diseases. Rubber condoms appeared in the early 20th century and are widely utilized in some family planning programs. Pregnancy vaccines and a reversible hormonal method for men are among methods under development. PMID:12268230

Mbabajende, V

1986-04-01

179

Hair loss and contraceptives.  

PubMed

In a review of the relationship of hair loss to oral contraceptive (OC) use, several studies are examined. The effect of pregnancy on hair loss has been substantiated. After the 3rd month of pregnancy the proportion of follicles in active growth rises. Increased shedding follows childbirth due to the delayed physiological passage of some follicles into the resting phase, blood loss, and sometimes anticoagulants. In contraceptive studies it can be shown that in 1/2 of the patients there was a temporary increase in the proportion of resting during early treatment but that pretreatment status was regained in 6 months. In 11 patients in this study who showed high pretreatment levels of resting follicles, the proportion of actively growing follicles actually increased with OCs. The incidence of diffuse alopecia in women between 1952 and 1971 has remained unchanged although OC use has increased. This suggests the effect of OCs on alopecia is insignificant. There may be a causal relationship between stopping estrogen and hair loss. However, it may be possible that genetically suseptible women might be affected by OCs. In patients where hair loss is accompanied by seborrhea or where there is hirsuitism it is suggested that the pill be discontinued. PMID:4736624

1973-06-01

180

Counseling and management of patients requesting subcutaneous contraceptive implants: proposal for a decisional algorithm.  

PubMed

Abstract Despite the easy access to contraception today, the rate of unintended pregnancies is still high because of scarce education among women on the methods available and of non-adherence to indications or discontinuation of the contraceptive method chosen. Adherence to contraception can be implemented through counseling programs intended to provide potential users with information regarding all contraceptive options available and to address women's concerns in line with their lifestyle, health status, family planning, and expectations. In here, we evaluate a multi-step decisional path in contraceptive counseling, with specific focus on potential users of long-acting release contraception etonorgestrel. We propose an algorithm about the management of possible issues associated with the use of subcutaneous contraceptive implant, with a special focus on eventual changes in bleeding patterns. We hope our experience may help out health-care providers (HCPs) to provide a brief but comprehensive counseling in family planning, including non-oral routes of contraceptive hormones. Indeed, we believe that a shared and informed contraceptive choice is essential to overcome eventual side-effects and to improve compliance, rate of continuation and satisfaction, especially with novel routes of administration. PMID:24720344

Guida, Maurizio; Visconti, Federica; Cibarelli, Francesca; Granozio, Giovanni; Troisi, Jacopo; Martini, Ellis; Nappi, Rossella

2014-07-01

181

Male and Female Recipients of Unwanted Sexual Contact in a College Student Sample: Prevalence Rates, Alcohol Use, and Depression Symptoms  

Microsoft Academic Search

It is typically assumed that acquaintance rapeand other forms of unwanted sexual contact involve malesas perpetrators and females as victims. The currentstudyinvestigated prevalence rates of experiencing as well as instigating sexual coercion, force,and other types of unwanted sexual contact for both menand women in a college Greek system. 165 men and 131women (82% Caucasian) completed 2 gender neutral measures of

Mary E. Larimer; Amy R. Lydum; Britt K. Anderson; Aaron P. Turner

1999-01-01

182

Facet Joint Pain in Chronic Spinal Pain: An Evaluation of Prevalence and False-positive Rate of Diagnostic Blocks  

Microsoft Academic Search

Study Design: A retrospective review. Objectives: Evaluation of the prevalence of facet or zygapophy- sial joint pain in chronic spinal pain of cervical, thoracic, and lumbar origin by using controlled, comparative local anesthetic blocks and evaluation of false-positive rates of single blocks in the diagnosis of chronic spinal pain of facet joint origin. Summary of Background Data: Facet or zygapophysial

Rajeev Manchukonda; Kavita N. Manchikanti; Kimberly A. Cash; Vidyasagar Pampati; Laxmaiah Manchikanti

2007-01-01

183

Construction Industry Apprentices' Substance Use: A Survey of Prevalence Rates, Reasons for Use, and Regional and Age Differences  

ERIC Educational Resources Information Center

Prevalence rates and reasons for substance use were studied in a sample of 172 male construction industry apprentices who had a mean age of 20 years. Results were compared with those of men in similar age groups in Victoria, and regional and age differences were explored. Findings indicate that more metropolitan apprentices had experimented with…

du Plessis, Karin; Corney, Tim

2011-01-01

184

A systematic review of college student-athlete drinking: Prevalence rates, sport-related factors, and interventions  

Microsoft Academic Search

Alcohol use among college students has become a considerable public health problem. Among this group, intercollegiate athletes are at a particularly high risk for excessive alcohol consumption and resulting negative alcohol-related consequences. The purpose of our review was to systematically examine three main issues related to alcohol consumption among intercollegiate athletes: (a) the prevalence rates and alcohol consumption patterns of

Matthew P. Martens; Kristen Dams-O'Connor; Niels C. Beck

2006-01-01

185

Insertion and 3-year follow-up experience of 372 etonogestrel subdermal contraceptive implants by family physicians in Granada, Spain  

Microsoft Academic Search

BackgroundUser profile, continuation rate, reasons for discontinuation, problems during insertion and removal, and effectiveness of an etonogestrel subdermal contraceptive implant (ESCI) were assessed.

Lorenzo Arribas-Mir; Dolores Rueda-Lozano; María Agrela-Cardona; Tania Cedeño-Benavides; Carmen Olvera-Porcel; Aurora Bueno-Cavanillas

2009-01-01

186

Prevalence rates of Giardia and Cryptosporidium among diarrheic patients in the Philippines.  

PubMed

The prevalence of Giardia and Cryptosporidium among 3,456 diarrheic patients corrected from May 2004 to May 2005 in the Philippines was determined. Of 133 (3.8%) positive samples, 69 (2.0%) were positive for Giardia and 67 (1.9%) for Cryptosporidium. Three samples had co-infection with Giardia and Cryptosporidium. Luzon had the highest positive samples (5.0%) followed by Mindanao (4.9%), then Visayas (2.2%). Giardia was most prevalent in Mindanao (3.6%) while Cryptosporidium was most prevalent in Luzon (3.1%). The prevalence of Giardia (2.0%) among pediatric patients (0-18 years) did not significantly differ from that (1.9%) among adults (> 18 years old). However, for Cryptosporidium, the prevalence (2.9%) among pediatric patients was significantly higher compared to that (0.2%) among adult patients. In the pediatric population, the highest percentage of patients with Giardia was the 5-9 year old age group, while that of Cryptosporidium was in the 0-4 year old group. The prevalence of Giardia, but not Cryptosporidium, was significantly higher in male than female adults. Seasonality had a distinct peak in September with Cryptosporidium more prevalent in the rainy (2.6%) than dry season (0.9%). PMID:19062686

Natividad, Filipinas F; Buerano, Corazon C; Lago, Catherine B; Mapua, Cynthia A; de Guzman, Blanquita B; Seraspe, Ebonia B; Samentar, Lorena P; Endo, Takuro

2008-11-01

187

Etonogestrel implant (Implanon) for contraception.  

PubMed

Levonorgestrel 38 mg subdermal implant (Norplant), intended to provide contraception for 5 years, was withdrawn in the UK in 1999 due to unwanted effects (menstrual disturbances) and difficulties in removing the device. Since then, [symbol: see text]etonogestrel implant (Implanon-Organon), another progestogen--only subdermal contraceptive device, has become available in the UK. The manufacturer claims that etonogestrel implant provides contraception for up to 3 years and is easy to insert and remove. Here, we consider the place of etonogestrel implant. PMID:11526801

2001-08-01

188

Noncontraceptive uses of hormonal contraception.  

PubMed

Hormonal contraceptives are not only effective methods of birth control but also are effective at treating and/or preventing a variety of gynecologic and general disorders. Hormonal contraceptives can decrease the severity of acne, correct menstrual irregularities, treat endometriosis-associated pain, decrease bleeding associated with uterine myomas, decrease pain associated with menstrual periods, moderate symptoms associated with premenstrual syndrome, reduce menstrual migraine frequency, and increase bone mineral density as well as decrease the risk of specific cancers such as endometrial and ovarian cancer. Women need to receive this information to guide them in their decisions regarding choice of contraception as well as treatment options for gynecologic disorders. PMID:22060223

King, Joyce

2011-01-01

189

Oral Contraceptives and Breast Cancer: Safety of Oral Contraception.  

National Technical Information Service (NTIS)

Oral contraceptives and the revised testing procedures that are being recommended for determining toxicity and carcinogenicity characteristics, with particular emphasis on breast cancer, are discussed. Required testing procedures for both laboratory anima...

R. A. Edgren

1991-01-01

190

[Adolescents and contraception today].  

PubMed

Between 1960-80, the adolescent population increased significantly. The concept of adolescence changes from 1 period to another and is difficult to delimit precisely. There are 4 main tasks of adolescence: 1) affective emancipation from parents and adults in general 2) acquisition of economic independence 3) psychosexual differentiation and 4) establishment of self-identity. Adverse economic conditions tend to retard the process and postpone entrance into active life and confrontation with reality. Adolescents of today tend to suffer a profound malaise and to live from day to day with little enthusiasm for the future. The circle of friends assumes greater and greater importance in the face of the breakup of families. Adolescents' sexuality is affected by the same tendencies as the rest of their experience. The age at 1st intercourse is dropping steadily. Usually sexual activity is hidden from the parents because of their probable disapproval. Society presents contradictory messages, promoting sexual pleasure but condemning it in the young. Most adolescents live in a sort of serial monogamy in which relations may be intensely felt and couples may be together a year or more on average. Characteristics of adolescent sexual relationships are the tendency of complete sexual relations not to occur immediately, sporadic and unplanned nature, and reduced number of partners. Adolescents frequently fail to use contraception when they become sexually active because they do not believe they can become pregnant. To assist the adolescent in using contraception, it is necessary to know whether she is seeking a method on her own account or was sent by someone else, what the partner thinks about contraception, how often sexual relations occur, and whether a method has been used in the past. The choice should be made by the patient. Pills are the preferred method, followed by IUDs and spermicides. Condoms, although they protect against sexually transmitted diseases, are poorly adapted to adolescent psychology because they require forethought and a wait. Follow-up should be arranged before the adolescent leavs the family planning center in order to encourage and facilitate regular usage by the client. PMID:6553985

Faugier, C

1983-05-01

191

Peri-Abortion Contraceptive Choices of Migrant Chinese Women: A Retrospective Review of Medical Records  

Microsoft Academic Search

BackgroundMigrant Asian women reportedly have low levels of contraceptive use and high rates of abortion in New Zealand. Chinese make up the largest proportion of migrant Asian in New Zealand. This study aimed to describe the contraceptive choices of Chinese women seeking abortion; to examine method choice in relation to demographic characteristics (including length of stay) and to determine whether

Sally B. Rose; Zhang Wei; Annette J. Cooper; Beverley A. Lawton

2012-01-01

192

Using Pharmacies in Washington State To Expand Access to Emergency Contraception  

Microsoft Academic Search

women's awareness and use of emergency contraception by utilizing pharmacists to increase its availability. We also discuss the impact that their expanded role is having on access to emergency contraception, and thereby the potential impact of the pro- gram on rates of unintended pregnancy.

Elisa S. Wells; Jane Hutchings; Jacqueline S. Gardner; Jennifer L. Winkler; Timothy S. Fuller; Don Downing; Rod Shafer

193

Contraceptive Use Patterns across Teens' Sexual Relationships. Fact Sheet. Publication #2008-07  

ERIC Educational Resources Information Center

Teens typically fail to use contraceptives consistently, which contributes to high rates of unintended pregnancy and sexually transmitted infections (STIs) among this age group. Existing research has focused primarily on how teens' own characteristics are related to contraceptive use, but has paid less attention to how the characteristics of…

Holcombe, Emily; Carrier, David; Manlove, Jennifer; Ryan, Suzanne

2008-01-01

194

Contraceptive practices and attitudes among immigrant and nonimmigrant women in Canada  

PubMed Central

Abstract Objective To compare experiences, attitudes, and beliefs of immigrant and nonimmigrant women presenting for abortion with regard to contraception, and to identify difficulties involved in accessing contraception in Canada. Design A survey of immigrant and nonimmigrant women asking about women’s experiences with and attitudes toward contraceptives and any barriers to contraceptive access they have encountered. Demographic data including ethnicity, country of origin, and length of residence in Canada were collected. Setting Two urban abortion clinics. Participants Women presenting for first-trimester abortion. Main outcome measures Type of contraception used when the unwanted pregnancy was conceived, attitudes to contraceptives, and barriers to access of contraceptives. Results A total of 999 women completed questionnaires during the study period (75.9% response rate); 466 of them (46.6%) were born in Canada. Immigrant women presenting for abortion were less likely to be using hormonal contraception when they got pregnant (12.5% vs 23.5%, P < .001) and had more negative attitudes toward hormonal contraception (62.6% vs 51.6%, P < .003). They reported having more difficulties accessing contraception before the abortion (24.8% vs 15.3%, P < .001) than nonimmigrant women did. About half of all the women expressed fear about intrauterine device use. The longer immigrant women had lived in Canada, the more likely they were to have similar responses to those of Canadian-born women. Conclusion The information provided by this study might be valuable for family doctors and other clinicians to improve contraceptive information resources for immigrants to address existing knowledge gaps and other culturally relevant concerns. As about half of all women presenting for abortion expressed negative attitudes toward the more effective methods of contraception, it is important that family doctors educate all women at risk for unintended pregnancies.

Wiebe, Ellen

2013-01-01

195

Prevalence of respiratory diseases and their association with growth rate and space in randomly selected swine herds.  

PubMed Central

The prevalence and extent of respiratory tract lesions were measured in 1425 pigs from 27 randomly selected herds in the summer of 1982 and winter of 1983. About 75% of pigs had lesions of enzootic pneumonia, approximately 60% had atrophic rhinitis and approximately 11% had pleuropneumonia and/or pleuritis. Individual pig growth rate was recorded on two of the farms, and it was found that the correlations between growth rate and severity of enzootic pneumonia lesions were positive on one farm and negative on the other. Negative correlations between severity of turbinate atrophy and growth rate existed in one of the two herds. Extent of pneumonia and severity of turbinate atrophy were poorly related in individual pigs but herd averages were moderately and positively correlated. Prevalence of diffuse pleuritis and of pleuropneumonia were positively related, as were the extent of pneumonia and prevalence of localized pleuritis. Prevalence of pleuropneumonia was strongly correlated with increased days-to-market. A method of estimating the average days-to-market using weekly herd data (inventory) was developed.

Wilson, M R; Takov, R; Friendship, R M; Martin, S W; McMillan, I; Hacker, R R; Swaminathan, S

1986-01-01

196

Nomegestrol acetate/estradiol: in oral contraception.  

PubMed

Nomegestrol acetate/estradiol is a combined oral contraceptive with approval in many countries. This fixed-dose combination tablet contains nomegestrol acetate, a highly selective progestogen, and estradiol, a natural estrogen. It is the first monophasic combined oral contraceptive to contain estradiol, and is taken in 28-day cycles, consisting of 24 active therapy days with 4 placebo days (i.e. 24/4-day cycles). In two large, 1-year, randomized, open-label, multicentre, phase III trials in healthy adult women (aged 18-50 years), nomegestrol acetate/estradiol was at least as effective as drospirenone/ethinylestradiol as contraceptive therapy, as the pregnancy rates in women aged 18-35 years (primary efficacy population) in terms of the Pearl Index (primary endpoint) were numerically lower with nomegestrol acetate/estradiol, although the between-group difference was not statistically significant. In both trials, nomegestrol acetate/estradiol was given in a 24/4-day cycle, and drospirenone/ethinylestradiol was given in a 21/7-day cycle. The criteria for using condoms in case of forgotten doses were less stringent in the nomegestrol acetate/estradiol group than in the drospirenone/ethinylestradiol group. Nomegestrol acetate/estradiol therapy for up to 1 year was generally well tolerated in healthy adult women, with an acceptable tolerability profile in line with that expected for a combined oral contraceptive. The most commonly reported adverse events were acne and abnormal withdrawal bleeding (most often shorter, lighter or absent periods). Overall, compared with drospirenone/ethinylestradiol, nomegestrol acetate/estradiol appeared to be associated with less favourable acne-related outcomes, and shorter, lighter or absent periods. PMID:22950535

Yang, Lily P H; Plosker, Greg L

2012-10-01

197

Non-contraceptive benefits of oral hormonal contraceptives.  

PubMed

It is becoming evident that oral hormonal contraceptives-besides being well established contraceptives-seem to become important medications for many functional or organic disturbances. So far, clinical effectiveness has been shown for treatment as well as prevention of menstrual bleeding disorders and menstrual-related pain symptoms. Also this is true for premenstrual syndrome (PMS) and premenstrual disphoric disorder (PMDD). Particular oral contraceptives (OCs) containing anti-androgenic progestogens were shown to be effective medications for treatment of androgenisation symptoms (seborrhea, acne, hirsutism, alopecia). Through perfect suppression of the hypothalamic-pituitary-ovarian axis OCs have proven to be effective in elimination of persistent follicular cysts. Endometriosis/adenomyosis related pain symptoms are well handled similar to other drugs like Gonadotropine Releasing Hormone agonists but are less expensive, with less side effects, and possibility to be used for longer periods of time. This is also true for myoma. Pelvic inflammatory disease, rheumatoid arthritis, menstrual migraine, and onset of multiple sclerosis are prevented or delayed. Bone density is preserved and asthma symptoms improved. Endometrial hyperplasia and benign breast disease can be controlled. There is definitely a significant impact on risk reduction regarding endometrial, ovarian, and colon cancers. In conclusion, it needs to be recognized that oral combined hormonal contraceptives (estrogen/ progestogen combination) are - besides being reliable forms of contraception - are cost-effective medications for many medical disorders in women. Therefore, these contraceptives drugs are important for female and global health and should be used in clinical practice. PMID:23853619

Schindler, Adolf E

2013-01-01

198

Non-use of contraception: determinants among Ugandan university students  

PubMed Central

Background In Uganda, adolescent pregnancy often results in adverse maternal and neonatal health outcomes. In this context, low use of contraception and high rates of maternal mortality rate make preventing unwanted pregnancies critical. Objective The objective was to determine the relationship between non-use of contraception and socio-demographic factors, alcohol consumption, and types of partner(s) among Ugandan university students. Design In 2010, 1,954 students at Mbarara University of Science and Technology in southwestern Uganda participated in a cross-sectional study whereby a self-administered questionnaire was used to assess socio-demographic factors, alcohol consumption, and sexual behaviour including the use of contraceptives. Multivariable logistic regression was used for the analysis and data were stratified by sex. Results 1,179 students (60.3% of the study population) reported that they were sexually active. Of these, 199 (18.6%) did not use contraception in their last sexual encounter. Students currently not in a relationship had higher odds of non-use of contraception (odds ratio 1.8, 95% confidence interval 1.2–2.7). The association remained statistically significant for both males and females after controlling for age, sexual debut, area of growing up, and educational level of the household head. Socio-demographic determinants of age (22 or younger), early sexual debut (at age 16 years or earlier), and a rural background were significant for males but not for females. A synergistic effect between not currently being in a relationship and early sexual debut were also observed to have an effect on the non-use of contraception. Conclusion Non-use of contraception among Ugandan university students differs for males and females, possibly due to gendered power relations. Sexual and reproductive health policies and programmes should be designed to take these differences into account.

Mehra, Devika; Agardh, Anette; Petterson, Karen Odberg; Ostergren, Per-Olof

2012-01-01

199

Contraception for adolescents with lupus  

PubMed Central

Sexually active adolescents, including young women with lupus, are at high risk for unplanned pregnancy. Unplanned pregnancy among teens with lupus is associated with an elevated risk of poor maternal and fetal outcomes. The provision of effective contraception is a crucial element of care for a sexually-active young woman with lupus. Unfortunately, providers may be hesitant to prescribe contraception to this group due to concerns about increasing the risk of lupus complications. This article reviews the risks and benefits of currently-available contraceptives for young women with lupus. Providers are encouraged to consider long-term, highly-effective contraception, such as implantables and intrauterine devices, for appropriately selected adolescents with lupus.

2010-01-01

200

Diagnostic Prevalence Rates from Early to Mid-Adolescence among Indigenous Adolescents: First Results from a Longitudinal Study  

PubMed Central

Objective Investigate change in prevalence rates for mental and substance abuse disorders between early and mid-adolescence among a cohort of Indigenous adolescents. Method The data are from a lagged, sequential study of 651 Indigenous adolescents from a single culture in the northern Midwest United States and Canada. At Waves 1 (ages 10 – 12 years) and 4 (ages 13 – 15 years), one adult caretaker and one tribally enrolled adolescent completed a computer-assisted personal interview that included DISC-R assessment for 11 diagnoses. Multivariate analyses investigate effects of Wave 1 adolescent diagnosis and Wave 1 biological mother diagnosis (University of Michigan Composite International Diagnostic Interview) on Wave 4 diagnostic outcomes. Results The findings show a increase in prevalence rates for substance abuse disorders (SUDs) and conduct disorders (CD) between ages 10 – 12 years and 13 – 15 years among Indigenous adolescents, with these disorders affecting more than one-fourth of the children. The rate of lifetime CD is about twice those expected in general population studies (23.4% vs. 5–10%) and rate of lifetime SUD (27.2%) is three times that reported in the 2004 National Survey on Drug Use and Health (9.4%) for individuals 12 years or older. Prevalence rates for any single mental or substance use disorder (44.8 lifetime) for the 13 – 15 year olds are similar to the lifetime prevalence rates reported in the National Comorbidity Survey-Replication (46.4%) for individuals 18 years and older. Conclusions A mental health crisis exists on the Indigenous reservations and reserves that participated in this study. Current service systems are overwhelmed and unable to meet the demands.

Whitbeck, Les B.; Yu, ManSoo; Johnson, Kurt D.; Hoyt, Dan R.; Walls, Melissa L.

2008-01-01

201

Male contraceptive formulation comprising norethisterone  

US Patent & Trademark Office Database

A formulation for male contraception comprising a progestin possessing both estrogenic and androgenic properties is remarkably effective for spermatogenesis suppression in males. The progestin Norethisterone (NET), particularly its derivatives Norethisterone acetate and Norethisterone enanthate in sufficient doses induce oligozoospermia or azoospermia in males. Formulations further comprising an androgen, such as a testosterone derivative such as a testosterone ester, particularly testosterone undecanoate, are especially effective male contraceptive formulations.

2006-04-11

202

Molecular approaches to contraceptive development  

Microsoft Academic Search

The next generation of contraceptives will be based on the identification of novel molecules essential for reproductive processes\\u000a and will rely on the refinement of older as well as newer technologies. Functional analysis of naturally occurring reproductive\\u000a genetic disorders and creation of mice null for specific genes would greatly assist in the choice of genetic targets for contraceptive\\u000a development. Structure-based

Usha Natraj

2001-01-01

203

Ulipristal acetate in emergency contraception.  

PubMed

Despite the widespread availability of highly effective methods of contraception, unintended pregnancy is common. Unplanned pregnancies have been linked to a range of health, social and economic consequences. Emergency contraception reduces risk of pregnancy after unprotected intercourse, and represents an opportunity to decrease number of unplanned pregnancies and abortions. Emergency contraception pills (ECP) prevent pregnancy by delaying or inhibiting ovulation, without interfering with post fertilization events. If pregnancy has already occurred, ECPs will not be effective, therefore ECPs are not abortificants. Ulipristal acetate (17alpha-acetoxy-11beta-(4N-N,N-dymethilaminophenyl)-19-norpregna--4,9-diene-3,20-dione) is the first drug that was specifically developed and licensed for use as an emergency contraceptive. It is an orally active, synthetic, selective progesterone modulator that acts by binding with high affinity to the human progesterone receptor where it has both antagonist and partial agonist effects. It is a new molecular entity and the first compound in a new pharmacological class defined by the pristal stem. Up on the superior clinical efficacy evidence, UPA has been quickly recognized as the most effective emergency contraceptive pill, and recently recommended as the first prescription choice for all women regardless of the age and timing after intercourse. This article provides literature review of UPA and its role in emergency contraception. PMID:24851646

Goldstajn, Marina Sprem; Baldani, Dinka Pavici?; Skrgati?, Lana; Radakovi?, Branko; Vrbi?, Hrvoje; Cani?, Tomislav

2014-03-01

204

Sexual Initiation, Contraceptive Use, and Pregnancy Among Young Adolescents  

PubMed Central

OBJECTIVE: To present new data on sexual initiation, contraceptive use, and pregnancy among US adolescents aged 10 to 19, and to compare the youngest adolescents’ behaviors with those of older adolescents. METHODS: Using nationally representative data from several rounds of the National Survey of Family Growth, we performed event history (ie, survival) analyses to examine timing of sexual initiation and contraceptive use. We calculated adolescent pregnancy rates by single year of age using data from the National Center for Health Statistics, the Guttmacher Institute, and the US Census Bureau. RESULTS: Sexual activity is and has long been rare among those 12 and younger; most is nonconsensual. By contrast, most older teens (aged 17–19) are sexually active. Approximately 30% of those aged 15 to 16 have had sex. Pregnancy rates among the youngest teens are exceedingly low, for example, ?1 per 10?000 girls aged 12. Contraceptive uptake among girls as young as 15 is similar to that of their older counterparts, whereas girls who start having sex at 14 or younger are less likely to have used a method at first sex and take longer to begin using contraception. CONCLUSIONS: Sexual activity and pregnancy are rare among the youngest adolescents, whose behavior represents a different public health concern than the broader issue of pregnancies to older teens. Health professionals can improve outcomes for teenagers by recognizing the higher likelihood of nonconsensual sex among younger teens and by teaching and making contraceptive methods available to teen patients before they become sexually active.

Philbin, Jesse M.

2013-01-01

205

COMBINING PREVALENCE AND MORTALITY RISK RATES: THE CASE OF CIGARETTE SMOKING*  

PubMed Central

Cigarette smoking is a particularly pernicious behavior because of its high prevalence and mortality risk. We use the powerful methodology of life tables with covariates and employ the National Health Interview Survey-Multiple Cause of Death file to illuminate the interrelations of smoking with other risk factors, and with the combined influences of smoking prevalence and population size on smoking-attributable mortality. We find that the smoking-mortality gap is only modestly affected by other risk factors and excess deaths due to smoking among U.S. adults in the year 2000 were as great as 340,000. Better knowledge of the prevalence and mortality risk associated with cigarette smoking statuses enhances the future health and longevity prospects of the U.S. population.

Rogers, Richard G.; Hummer, Robert A.; Krueger, Patrick M.; Pampel, Fred C.

2011-01-01

206

Menstrual Cycle Phase and Duration of Oral Contraception Intake Affect Olfactory Perception  

PubMed Central

Although a significant impact of cycle phase on olfactory thresholds has been shown in females, limited data exist regarding discrimination and identification. Therefore, we investigated a broader range of olfactory performance and analyzed the impact of cycle phase and oral contraception. We measured 80 healthy Caucasians, including 20 females taking oral contraceptives and 40 females without oral contraception who were further divided into follicular and luteal phase. Olfactory performance of all participants was assessed twice using the “Sniffin’ Sticks” battery and intensity and pleasantness ratings of n-butanol were collected. Data analysis revealed that females outperformed males in odor discrimination and odor identification. In the luteal phase, higher thresholds and higher intensity ratings for n-butanol emerged. Duration of oral contraception correlated positively with olfactory performance pointing to better performance with longer intake. Hence, our data show that odor performance is affected by menstrual cycle phase and duration of oral contraception intake and thus can be modulated by hormonal changes.

Derntl, Birgit; Schopf, Veronika

2013-01-01

207

Diagnosis and Prevalence of Uterine Leiomyomata in Female Chimpanzees (Pan troglodytes)  

PubMed Central

Uterine leiomyomata are common, affecting 70–80% of women between 30 and 50 years of age. Leiomyomata have been reported for a variety of primate species, although prevalence rates and treatments have not been widely reported. The prevalence, diagnosis, and treatment of uterine leiomyomata in the Alamogordo Primate Facility and the Keeling Center for Comparative Medicine and Research were examined. Uterine leiomyomata were diagnosed in 28.4% of chimpanzees with an average age at diagnosis of 30.4±8.0 years. Advanced age (>30 years) was related to an increase in leiomyomata and use of hormonal contraception was related to a decrease in leiomyomata. As the captive chimpanzee population ages, the incidence of leiomyomata among female chimpanzees will likely increase. The introduction of progesterone-based contraception for non-breeding research and zoological chimpanzees may reduce the development of leiomyomata. Finally, all chimpanzee facilities should institute aggressive screening programs and carefully consider treatment plans.

Videan, EN; Satterfield, WC; Buchal, S; Lammey, ML

2011-01-01

208

Vaginal contraceptive activity of a chelated vanadocene.  

PubMed

Bis(cyclopentadienyl) complexes of vanadium (IV) or vanadocenes are rapid and potent inhibitors of human sperm motility with potential as a new class of contraceptive agents. This study sought to determine the vaginal contraceptive activity of vanadocene dithiocarbamate (VDDTC), a stable vanadocene (IV)-chelated complex, using the standard rabbit model as well as the domestic pig as a physiologically relevant animal model for contraception. In experiment I, ovulating New Zealand White does in subgroups of eight were artificially inseminated (AI) with semen mixed with VDDTC (0.01-1 mM) or vehicle. In experiment II, ovulating does in subgroups of 18 were AI at 5 and 60 min after intravaginal application of a gel with and without 0.1% VDDTC or 2% nonoxynol-9 (N-9) (Gynol II, Ortho Pharmaceutical, Raritan, NJ), and allowed to complete term pregnancy. In experiment III, seven sexually mature Duroc gilts in standing estrus were AI with and without intravaginal application of 0.1% VDDTC gel microemulsion. Exposure of rabbit semen to VDDTC at the time of artificial insemination resulted in a dose-dependent reduction in fertility. Exposure of semen to 1 mM VDDTC led to complete inhibition of fertility as assessed by the number of embryos (control 49/94 vs. VDDTC-treated 0/117, p<.0001) or the percent embryos (52% vs. 0%, respectively) based on number of embryos to corpora lutea. Intravaginal administration of 0.1% VDDTC gel microemulsion or Gynol II prior to artificial insemination significantly inhibited term pregnancy rates (88% and 62% inhibition, respectively) when compared to control gel alone. Vanadocene dithiocarbamate gel microemulsion provided 80% inhibition of fertility even when insemination was delayed until 60 min after intravaginal application of VDDTC gel microemulsion. Rabbits that delivered litters despite intravaginal exposure of semen to VDDTC via gel microemulsion had healthy offsprings with no apparent perinatal repercussions. In domestic pigs, intravaginal applications of 0.1% VDDTC gel microemulsion prior to artificial insemination led to complete inhibition of fertility as assessed by the number of embryos (control 29/52 vs. VDDTC-treated 0/44, p<.0001) or the percent embryos (56% vs. 0%, respectively) based on the number of embryos to corpora lutea. These results suggest that VDDTC is a potent contraceptive agent in vivo. Intravaginal use of VDDTC via a gel microemulsion has clinical potential as a safe alternative to currently used detergent-type contraceptives. PMID:16022855

D'Cruz, Osmond J; Uckun, Fatih M

2005-08-01

209

Evaluation of pressure ulcer prevalence rates for hospice patients post-implementation of pressure ulcer protocols  

Microsoft Academic Search

Hospice patients may be particularly at risk for pressure ulcer development due to several factors. Identifying populations at risk for pressure ulcer development, such as hospice patients, and providing prevention and risk protocols for these populations can substantially reduce the prevalence and incidence of pressure ulcers. However, are hospice patients prone for skin break-down despite prevention and treatment efforts? This

Darlene S. Hanson; Diane Langemo; Bette Olson; Susan Hunter; Christine Burd

1994-01-01

210

Estimating HIV prevalence from surveys with low individual consent rates: annealing individual and pooled samples  

PubMed Central

Many HIV prevalence surveys are plagued by the problem that a sizeable number of surveyed individuals do not consent to contribute blood samples for testing. One can ignore this problem, as is often done, but the resultant bias can be of sufficient magnitude to invalidate the results of the survey, especially if the number of non-responders is high and the reason for refusing to participate is related to the individual’s HIV status. One reason for refusing to participate may be for reasons of privacy. For those individuals, we suggest offering the option of being tested in a pool. This form of testing is less certain than individual testing, but, if it convinces more people to submit to testing, it should reduce the potential for bias and give a cleaner answer to the question of prevalence. This paper explores the logistics of implementing a combined individual and pooled testing approach and evaluates the analytical advantages to such a combined testing strategy. We quantify improvements in a prevalence estimator based on this combined testing strategy, relative to an individual testing only approach and a pooled testing only approach. Minimizing non-response is key for reducing bias, and, if pooled testing assuages privacy concerns, offering a pooled testing strategy has the potential to substantially improve HIV prevalence estimates.

2013-01-01

211

Family size, sex composition of children and contraceptive use: a case study of Kerala.  

PubMed

With the sudden decline of fertility it was particularly interesting to examine the situation in Kerala, regarding parental sex preference in formulating family planning policies for the rest of India with high fertility and son preference. The 1980 Kerala Fertility Survey included nearly 3000 households with about 2700 ever married women in reproductive age. Maternity history and fertility regulation data were collected. Data from 2500 currently married women were used, cross-classified by the number of male and female living children and contraceptive use status. A multiplicative model was used to study various interaction effects and to construct standardized rates of contraceptive use. Measures adjusted for both male and female composition and differential use of contraceptives among male-female combinations were obtained by the model to avoid arbitrariness in choosing rates and to preclude objections raised in previous research on Arnold's index. The model was generalized to facilitate simultaneous effects of the number of male and female children and family size on contraceptive use. Initial analysis showed that the effect of sex preference on contraceptive acceptance was rather negligible. However, there was a significant male-female interaction effect on contraceptive use. Contraception was high when the family size was large, with children of the same sex. With the effect of family size removed, the contraceptive use rate seemed to be in the inverse direction of the number of male or female children. This was possibly the result of two factors: 1) high contraception rate with large families of the same sex, and 2) low use of contraception among large families with a high number of children of both sexes. The Kerala situation partly supports McClelland's theory that couples already having proportionally more daughters may terminate fertility earlier. In Kerala such termination also occurs when couples have proportionally more sons, and family size also plays an important role in fertility cessation. PMID:12345254

Suchindran, C M; Ramakumar, R; Sathi Devi, K

1993-01-01

212

Television and contraception.  

PubMed

This article consists of excerpts from a speach made on October 19th at the 1986 annual meeting of the Association of Planned Parenthood Professionals by Dr. Luella Klein, President of the American College of Obstetricians and Gynecologists (ACOG) between 1984-85. The speaker described the reaction of US television network to the ACOG's request that the networks air a public service announcement encouraging responsible sexual behavior among the nation's young people. In 1984 the ACOG initiated a public information program aimed at reducing the high number of unwanted births among young people. The ACOG with the help of an advertising agency developed a 27-second public service announcement stressing responsible parenthood and informing young people that they could write or call for further information. A booklet, entitled "Facts," was prepared for distribution to those who inquired. It advised young people to consider postponing sexual intercourse but to use the most effective methods of contraception if they decided to be sexually active. Oral contraceptives for females and condoms for males were recommended as the most effective methods. When the 3 major television networks, i.e., the American Broadcasting Company (ABC), the National Broadcasting Company (NBC), and the Columbia Broadcasting System (CBS), were requested to carry the announcement, all 3 networks claimed the announcement was too controversial to air. These same networks do not hesitate to show blatant, irresponsible sexual behavior repeatedly during their entertainment programming, and commercials with sexual innuendos are routinely accepted for airing by the networks. In July, 1986, the ACOG called a news conference in New York City to inform the news media about the rejection of the announcement by the networks. The conference stimulated considerable interest, and the story was carried by many newspapers and by radio and television news programs. Many of the news accounts of the story contained the public service announcement itself. As a result, young people began calling and writing for the booklet. Editorials critical of the networks' handling of the ACOG request appeared in numerous publications. The author then wrote to the presidents of each network asking them to reconsider the ACOG request. The presidents of ABC and CBS flatly rejected the request, but the president of NBC agreed to meet with the ACOG to work out an acceptable announcement. The networks must be encouraged to promote a more responsible and realistic image of sexual behavior than the image currently being conveyed in television programs and ads. PMID:12340617

Klein, L

1986-01-01

213

Effect of agricultural activities on prevalence rates, and clinical and presumptive malaria episodes in central Côte d’Ivoire  

Microsoft Academic Search

Agricultural activities, among other factors, can influence the transmission of malaria. In two villages of central Côte d’Ivoire (Tiémélékro and Zatta) with distinctively different agro-ecological characteristics, we assessed Plasmodium prevalence rates, fever and clinically confirmed malaria episodes among children aged 15 years and below by means of repeated cross-sectional surveys. Additionally, presumptive malaria cases were monitored in dispensaries for a

Benjamin G. Koudou; Yao Tano; Jennifer Keiser; Penelope Vounatsou; Olivier Girardin; Kouassi Klero; Mamadou Koné; Eliézer K. N’Goran; Guéladio Cissé; Marcel Tanner; Jürg Utzinger

2009-01-01

214

Prevalence rates of respiratory symptoms in Italian general population samples, exposed to different levels of air pollution  

Microsoft Academic Search

To assess the relationships between prevalence rates of respiratory symptoms and air pollution, two epidemiological surveys were conducted. Two general population samples living in different parts of North Italy were included: (1) the rural unpolluted area of the Po River Delta (PRD)(n = 3,289, age 8-64 y), before activation of a large oil-burning thermoelectricpower plant; and (2) the urban area

G. Viegi; P. Paoletti; M. Velluntini; E. Diviggiano; L. Carrozzi; C. Di Pede; C. Giuntini; M. D. Lebowitz

2008-01-01

215

Psychiatric Comorbidity in Women With Binge Eating Disorder Prevalence Rates From a Non-Treatment-Seeking Sample  

Microsoft Academic Search

This study provides estimates of comorbid psychiatric disorders in women with binge eating disorder (BED). Sixty-one BED and 60 control participants, who were recruited from the community, completed the Structured Clinical Interview for DSM—III—R Axis I and Axis II disorders and self-report measures of eating and general psychiatric symptomatology. Regarding psychiatric diagnoses, women with BED had higher lifetime prevalence rates

Christy F. Telch

2000-01-01

216

Effects of Contraceptive Education on Adolescent Male Contraceptive Behavior and Attitudes.  

ERIC Educational Resources Information Center

The relationship between contraceptive education and teenage male contraceptive behavior was investigated. Findings indicated that brief or moderately in-depth contraceptive education had little effect on contraceptive behavior. The teenage pregnancy and other sex-related problems may make parents and schools more amenable to comprehensive…

Taylor, Mary E.; And Others

1989-01-01

217

[Cancer of the cervix, papillomavirus, contraception and tobacco].  

PubMed

This survey started in May 1989 and deals with 2,436 patients treated by 10 gynecologists from the Brussels region. In addition to routine cytological analysis in cervical smears, an additional test for Human Papilloma Virus (HPV 16, 18 and 33) was advised for these women. Gynecologists filled in a questionnaire about these patients. In cases with benign cytology, virus prevalence was 2 times greater in woman who took contraceptive pills, over at least 6 months, than in each of the other groups using either diaphragm or male condoms or no contraception, or at menopausal age. It was strange to find that viral prevalence varied according to the pill trade mark, but not according to the pill hormonal content. No confounding factor in population recruitment could be detected. In contrast to viral infection, prevalence of cancer lesions was not increased in the oral contraception group. Squamous intraepithelial lesions of Low Grade and High Grade (SIL LG and HG) were on the contrary 2 times less frequent in women taking the pill, with or without HPV infection. During follow-up of 223 women, the same HPV genotype persisted in SIL lesions but it disappeared within 4 to 8 weeks in 68% of normal cervical smears. However, beyond this period, the proportion of women with persisting virus remained nearly constant, indicating that a subgroup may be less able to mount a defence against the infection. Risk factor of cigarette smoking for SIL LG or HG was 1.6 in women with HPV and 4.0 in those with no virus. This factor was 3.3 in women with oral contraception and 4.5 in the other group. PMID:8228010

Thiry, L; Vokaer, R; Detremmerie, O; De Schepper, N; Herzog, A; Bollen, A

1993-01-01

218

Factors Affecting Contraceptive Use in Peninsular Malaysia.  

National Technical Information Service (NTIS)

The extent of contraceptive use among Malaysian women is encouraging and indicates a growing awareness of the benefits of family planning. This is the conclusion of the study on the determinants of contraceptive use in Peninsular Malaysia. The report incl...

T. N. Peng I. Abdurahman

1981-01-01

219

The Evolution of a Contraception Program  

ERIC Educational Resources Information Center

This article describes the Contraception Counseling and Education Clinic and describes how the program evolved from providing just contraception education to one that included sex therapy and counseling. (PD)

Packard, Rose Ann

1974-01-01

220

Contraception and Birth Control: Other FAQs  

MedlinePLUS

... methods with your sexual partner. What are the health risks and side effects associated with contraception? Different forms of contraception carry different health risks and side effects, and some of them are ...

221

Male contraception: another holy grail.  

PubMed

The idea that men should participate in family planning by playing an active role in contraception has become more acceptable in recent years. Up to the present the condom and vasectomy have been the main methods of male contraception. There have been and continue to be efforts to develop an acceptable hormonal contraceptive involving testosterone (T) suppression. However the off target affects, delivery of the analogs and the need for T replacement have proven difficult obstacles to this technology. Research into the development of non-hormonal contraception for men is progressing in several laboratories and this will be the subject of the present review. A number of promising targets for the male pill are being investigated. These involve disruption of spermatogenesis by compromising the integrity of the germinal epithelium, interfering with sperm production at the level of meiosis, attacking specific sperm proteins to disrupt fertilizing ability, or interfering with the assembly of seminal fluid components required by ejaculated sperm for acquisition of motility. Blocking contractility of the vas deferens smooth muscle vasculature to prevent ejaculation is a unique approach that prevents sperm from reaching the egg. We shall note the lack of interest by big pharma with most of the support for male contraception provided by the NIH. PMID:24368213

Murdoch, Fern E; Goldberg, Erwin

2014-01-15

222

Two problems in oral contraception: arteriosclerotic cardiopathy and drug interactions.  

PubMed

The Authors examine two aspects of oral contraception: the risk of arteriosclerotic cardiopathy and the interaction with other drugs. The former is rather limited but increases significantly when other arteriosclerotic risk factors, first and foremost smoke, are present. The dose of both the estrogenic and the progestinic components also influences the risk. The Authors examine the most recent information on the interference of some drugs with the contraceptive effectiveness of synthetic, especially low-dose, estroprogestinics, which is mediated by changes of the intestinal absorption or metabolic clearance rate. Finally, they analyse the interference of contraceptive steroids with the kinetics of other drugs and, consequently, with the intensity of therapeutical and side effects. PMID:7160061

Onnis, A; Grella, P V; Di Lenardo, L

1982-01-01

223

Contraception among bankers in an urban community in Lagos state, Nigeria  

PubMed Central

Introduction Contraception means procedures employed to interfere at one stage or the other with the normal sequence of events in the process of reproduction leading to a failure in conception. It means voluntary techniques adopted to achieve birth control. Its use remains sensitive worldwide. Within the same society, contraception varies amongst people of different socio-cultural, educational, religious, or occupational affiliations. It also varies between urban and rural settlements. Some contraceptive techniques also prevent sexually transmitted infections (STIs). The prevalence of STIs also varies with these same factors. There is very limited literature on contraception exclusively amongst bankers. We sought to investigate the level of awareness and practice of contraception amongst bankers in an urban society in Lagos State, Nigeria. Methods In this descriptive cross-sectional study, 200 self-administered structured questionnaires were retrieved from bankers from 5 banks selected by simple random sampling in Surulere Local Government Area of Lagos State, Nigeria. Data was subsequently statistically analyzed using SPSS. Results The age range was 21-45 years, mean28.8±1.4 years, 51.7% were males (72% single, 27% married, 1% separated) and 48.3% were females (52.4% single, 47.6% married). All (100%) respondents were aware of contraception, 93.3% males and 91.7% females were sexually active, 88.9% males and 84.5% females believe contraception is useful. Most (71.4%) respondents practice contraception, males (81%) being more than females (61.1%), p < 0.05. More (71.4%) females and fewer (37.8%) males believe that contraception prevents pregnancy but not STIs, 28.6% of females and 46.6% of males believe it prevents both pregnancy and STIs, whereas 14% of males and no female believe contraception prevents STIs but not pregnancy. Conclusion The awareness of and practice of contraception was very high among the bankers but more male bankers practice contraception whereas more female bankers perceive contraceptives to be for the married only.

Meka, Ijeoma Angela; Okwara, Emmanuel Chidiebere; Meka, Anthony Obiamaka

2013-01-01

224

Doubled prevalence rates of ANCA-associated vasculitides and giant cell arteritis between 1994 and 2006 in northern Germany.  

PubMed

Objectives. The aim of this study was to investigate the period prevalences of ANCA-associated vasculitides (AAV), including granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), eosinophilic GPA (EGPA)/Churg-Strauss and GCA, in an urban and rural population in northern Germany in 2006 and to compare the data with our previous study performed in 1994. Methods. We identified of all patients with AAV or GCA via questionnaires to all hospital departments, physicians, health insurance providers, pension funds, reference laboratories for autoimmune diseases and death registries in Luebeck (city) and the rural region of Segeberg (population 468 962) between January and December 2006. The type of vasculitis, gender, year of birth, postal code and death were documented and re-evaluated. Results. One-hundred and fifty patients were identified, indicating a prevalence of 320 per million inhabitants for the complete catchment area (95% CI 285, 355). GCA was more prevalent than AAV: 171 (146, 197) vs 149 (126, 174). GCA and AAV have almost doubled since 1994. GCA increased from 240 (164, 315) to 440 (399, 481) per million in the population ?50 years of age and AAV increased from 74 to 149 cases per million. GCA and AAV were more prevalent in the urban compared with the rural region. Conclusion. The prevalence rates of AAV and GCA almost doubled from 1994 to 2006 for this region with a stable population and using an identical study design. Increased awareness has led to an earlier diagnosis of systemic vasculitis and improved activity-adapted treatment mostly based on randomized controlled trials has led to longer survival. Aspects such as environmental factors and exposure to certain substances need further research. PMID:24425780

Herlyn, Karen; Buckert, Frederike; Gross, Wolfgang L; Reinhold-Keller, Eva

2014-05-01

225

Contraception: mise au point et nouveautés  

Microsoft Academic Search

History of contraception is one of the most important medical and social progress in terms of individual liberty. However access to contraception is still a public health concern. Over 80 million of unintended pregnancies occur every year in the world resulting in 45 million of abortion and 70 000 female deaths. In France, 75 % of women use a contraception,

C. Gallo; S. Christin-Maitre

2007-01-01

226

The Contraception Counseling and Education Clinic.  

ERIC Educational Resources Information Center

This report is a detailed summary of how the contraception counseling and education clinic at Berkeley operates. The clinic is a broad-based contraception service within the student health service, designed to meet the specific needs of college students. It offers contraception education service, and devices, venereal disease screening,…

California Univ., Berkeley.

227

Clinical trials in male hormonal contraception  

Microsoft Academic Search

Research has established the principle of hormonal male contraception based on suppression of gonadotropins and spermatogenesis. All hormonal male contraceptives use testosterone, but only in East Asian men can testosterone alone suppress spermatogenesis to a level compatible with contraceptive protection. In Caucasians, additional agents are required of which progestins are favored. Clinical trials concentrate on testosterone combined with norethisterone, desogestrel,

Eberhard Nieschlag

2010-01-01

228

Rethinking Mandatory HIV Testing During Pregnancy in Areas With High HIV Prevalence Rates: Ethical and Policy Issues  

PubMed Central

We analyzed the ethical and policy issues surrounding mandatory HIV testing of pregnant women in areas with high HIV prevalence rates. Through this analysis, we seek to demonstrate that a mandatory approach to testing and treatment has the potential to significantly reduce perinatal transmission of HIV and defend the view that mandatory testing is morally required if a number of conditions can be met. If such programs are to be introduced, continuing medical care, including highly active antiretroviral therapy, must be provided and pregnant women must have reasonable alternatives to compulsory testing and treatment. We propose that a liberal regime entailing abortion rights up to the point of fetal viability would satisfy these requirements. Pilot studies in the high-prevalence region of southern African countries should investigate the feasibility of this approach.

Schuklenk, Udo; Kleinsmidt, Anita

2007-01-01

229

Rethinking mandatory HIV testing during pregnancy in areas with high HIV prevalence rates: ethical and policy issues.  

PubMed

We analyzed the ethical and policy issues surrounding mandatory HIV testing of pregnant women in areas with high HIV prevalence rates. Through this analysis, we seek to demonstrate that a mandatory approach to testing and treatment has the potential to significantly reduce perinatal transmission of HIV and defend the view that mandatory testing is morally required if a number of conditions can be met. If such programs are to be introduced, continuing medical care, including highly active antiretroviral therapy, must be provided and pregnant women must have reasonable alternatives to compulsory testing and treatment. We propose that a liberal regime entailing abortion rights up to the point of fetal viability would satisfy these requirements. Pilot studies in the high-prevalence region of southern African countries should investigate the feasibility of this approach. PMID:17538051

Schuklenk, Udo; Kleinsmidt, Anita

2007-07-01

230

Opposing views on contraceptives presented.  

PubMed

This article presents two opposing views on the importance of artificial contraceptives. It is noted that in the April 19 issue of the Manila Bulletin, Ms. Ethel Soliven wrote in her column that the position of the Catholic Church on artificial contraceptives is standing in the way of success of the Philippine family planning campaign. To this effect, Sister Mary Pilar Versoza of the Religious of the Good Shepherd, sent a letter of rebuttal saying that the church has never been remiss in emphasizing the true meaning of sexual act, love and relationship, marriage, and family responsibilities. Sister Pilar contended that ligation and condoms do not solve husbands¿ selfishness. In response, Soliven argued in another issue of the Manila Bulletin that she believes in the need to provide access to artificial contraceptives. Soliven asserted that destitute couples who cannot provide their families with even the barest necessities of life should be provided with the means with which to prevent unwanted pregnancies. PMID:12322661

231

[Ictus, pregnancy and contraception].  

PubMed

Ictus is a severe complication of pregnancy and the puerperium and a significant cause of maternal mortality. The risk of ictus increases by 3-13 times during pregnancy because of a tendency toward hypercoagulability, hemodynamic alterations related to increased blood volume, and severe arterial hypertension. This work outlines the incidence, etiology, diagnosis, and treatment of ischemic cerebrovascular pathology, cerebral venous thrombosis, and hemorrhagic cerebrovascular pathology occurring during pregnancy. Risk factors are indicated. The role of oral contraceptives (OCs) as a risk factor for cerebrovascular pathology is then discussed. Various prospective and retrospective studies to establish the causal or casual relationship between OC use and ictus have been published since 1962. Two important studies published in 1969 found a statistically significant increased relative risk of ischemic cerebrovascular accident in OC users. The Collaborative Group for the Study of Stroke in Young Women included hemorrhagic ictus in a retrospective study for the first time in 1973, finding that the risk of thrombotic and hemorrhagic cerebrovascular accident was significantly greater in OC users. In 1975, using the same sample, the group found a positive relation between increased blood pressure and risk of ischemic and hemorrhagic events in OC users. The largest prospective study, begun by the Royal College of General Practitioners in England in 1968, found an increased risk of mortality from circulatory diseases in OC users, with mortality risks for coronary ischemia and subarachnoid hemorrhage statistically significant. The study found that the use of OCs increased the risk of fatal subarachnoid hemorrhage, especially in women over 35 who smoked. Other prospective studies found an increased incidence of nonfatal cerebrovascular accident, with relative risks for all cerebrovascular accidents ranging from 5 to 6.5. A recent continuation of the Royal College Study found that patients using OCs had a relative risk for cerebrovascular accidents of 1.5. The risk was increased at higher doses and for some specific progestins. PMID:7497275

Pareja, A; Láinez, J M

1995-01-01

232

Epilepsy in a population of 6000 re-examined: secular trends in first attendance rates, prevalence, and prognosis.  

PubMed Central

It is important to document changes in the vital statistics of epilepsy in the general population so that the success or failure of prevention and treatment can be assessed and health provisions planned. A population of 6000 persons was studied 10 years apart to determine secular trends in the prevalence and prognosis of epilepsy. The lifetime prevalence of all patients with one or more afebrile seizures was 20.3/1000 (95% CI 16.9-24.3) in 1983 and 21.0/1000 (95% CI 17.6-25.1) in 1993. The prevalence of active epilepsy was 5.3/1000 (95% CI 3.6-7.5) in 1983 and 4.3 (95% CI 2.8-6.3) in 1993. To assess trends in incidence rates the annual first attendance rates were measured from 1964 to 1993. Annual first attendance rates in children (age < 20 years) have declined from 152.4/100,000 (90% CI 106.0-212.9) in the years 1974-83, to 60.9/100,000 (90% CI 33.0-103.3) in the years from 1984-93, suggesting that the incidence of epilepsy in children is falling. Also noteworthy was the first attendance rates for epilepsy in elderly people (61-80 years) in the years 1984-93, of 82.0 (90% CI 38.5-154.0), higher than in any other age group. This increase in the number of elderly patients with epilepsy is important, and has health planning implications, especially with the overall increase in the total elderly population. There was, however, no evidence that prognosis has significantly altered in the past 40 years.

Cockerell, O C; Eckle, I; Goodridge, D M; Sander, J W; Shorvon, S D

1995-01-01

233

Actual and Counterfactual Smoking Prevalence Rates in the US population via Micro-simulation  

PubMed Central

The Smoking History Generator (SHG) developed by the National Cancer Institute simulates individual life/smoking histories that serve as inputs for the Cancer Intervention and Surveillance Modeling Network (CISNET) lung cancer models. In this chapter, we review the SHG inputs, describe its outputs, and outline the methodology behind it. As example, we use the SHG to simulate individual life histories for individuals born between 1890 and 1984 for each of the CISNET smoking scenarios and use those simulated histories to compute the corresponding smoking prevalence over the period 1975–2000.

Jeon, Jihyoun; Meza, Rafael; Krapcho, Martin; Clarke, Lauren; Byrne, Jeff; Levy, David T.

2012-01-01

234

Geographical variation and factors influencing modern contraceptive use among married women in Ethiopia: evidence from a national population based survey  

PubMed Central

Background Modern contraceptive use persists to be low in most African countries where fertility, population growth, and unmet need for family planning are high. Though there is an evidence of increased overall contraceptive prevalence, a substantial effort remains behind in Ethiopia. This study aimed to identify factors associated with modern contraceptive use and to examine its geographical variations among 15–49 married women in Ethiopia. Methods We conducted secondary analysis of 10,204 reproductive age women included in the 2011 Ethiopia Demographic and Health Survey (DHS). The survey sample was designed to provide national, urban/rural, and regional representative estimates for key health and demographic indicators. The sample was selected using a two-stage stratified sampling process. Bivariate and multivariate logistic regressions were applied to determine the prevalence of modern contraceptive use and associated factors in Ethiopia. Results Being wealthy, more educated, being employed, higher number of living children, being in a monogamous relationship, attending community conversation, being visited by health worker at home strongly predicted use of modern contraception. While living in rural areas, older age, being in polygamous relationship, and witnessing one’s own child’s death were found negatively influence modern contraceptive use. The spatial analysis of contraceptive use revealed that the central and southwestern parts of the country had higher prevalence of modern contraceptive use than that of the eastern and western parts. Conclusion The findings indicate significant socio-economic, urban–rural and regional variation in modern contraceptive use among reproductive age women in Ethiopia. Strengthening community conversation programs and female education should be given top priority.

2013-01-01

235

Continuation of Reversible Contraception in Teenagers and Young Women  

PubMed Central

Objective To examine the effect of age on continuation rates of reversible contraceptive methods among teenagers and young women aged 14–19 years and women aged 20–25 years, compared to women older than 25 years of age. Methods We analyzed data from 7,472 participants enrolled in the Contraceptive CHOICE Project, a prospective cohort study of women offered no-cost contraception. Our primary objective was to compare 12-month continuation rates between teenagers and women aged 14–19, 20–25, and 26 years and older. We collected data about method continuation from telephone surveys and chart review. We used Kaplan-Meier survival curves to estimate continuation and Cox proportional hazard models to examine the risk of contraceptive method discontinuation. Results Twelve-month continuation of long-acting reversible contraceptive (LARC) methods was over 75% for all age groups. Teenagers and young women aged 14–19 years using LARC methods had slightly lower continuation rates (81%) than older women (85–86%), but this did not reach statistical or clinical significance. Compared to women older than 25 years of age, teenagers and women aged 14–19 years had lower continuation rates for non-LARC methods (44% v. 53%; HRadj1.32, 95% CI 1.02–1.73). The teenagers and young women aged 14–19 years were less likely to be satisfied with non-LARC methods (42% v. 51%; RRadj 0.80, 95% CI 0.65–0.98), but not LARC methods (75% v. 83%; RR 0.94, 95% CI 0.88–1.01) when compared to women over 25 years of age; however, the differences were small. Conclusion Teenagers and young women have high rates of LARC method continuation.

Rosenstock, Jessica R.; Peipert, Jeffrey F.; Madden, Tessa; Zhao, Qiuhong; Secura, Gina M.

2014-01-01

236

Recurrent paroxysmal positional vertigo related to oral contraceptive treatment.  

PubMed

Benign paroxysmal positional vertigo (BPPV) is a high-prevalence vestibular end-organ disorder caused by the detachment of utricular otoconia which float in the posterior or lateral semicircular canal. In the majority of cases the etiology of BPPV is unknown and it may follow viral infection, vascular disorders or head trauma. BPPV may be recurrent, with some authors demonstrating a correlation between recurrence and female gender. We report herein on ten cases (out of 289 diagnoses of BPPV) of recurrent idiopathic BPPV, occurring in healthy women receiving oral contraceptive treatment, which ceased after treatment suspension. It has been hypothesized that the impaired water and electrolyte balance, the variations of endolymphatic pH and the impairment of glucose or lipid metabolism induced by oral contraceptive treatment may cause otoconial degeneration and subsequent otoconia detachment and BPPV. The rarity of the finding (10/289) could account for the poor attention paid to the hormonal pathogenesis of BPPV. PMID:16522527

Giacomini, Pier Giorgio; Napolitano, Bianca; Alessandrini, Marco; Di Girolamo, Stefano; Magrini, Antonio

2006-01-01

237

Pelvic Examinations and Access to Oral Hormonal Contraception  

PubMed Central

OBJECTIVE Requiring a pelvic examination before prescribing oral contraception poses an unnecessary barrier to contraceptive access. Medical guidelines have outlined the safety of oral contraception provision without a pelvic examination, yet little is known about the practices of clinicians providing reproductive health care. Our purpose was to investigate clinicians? requirements for pelvic examination and what may account for practice differences. METHODS We administered a mailed survey to a national probability sample of obstetrician–gynecologists (ob-gyns), family medicine physicians, and advanced practice nurses specializing in obstetrics and gynecology and women?s health or family medicine in 2008–2009 (N = 1,196), with a response rate of 65.3% RESULTS Nearly one third of ob-gyns and family medicine physicians reported always requiring a pelvic examination when prescribing oral contraception (ob-gyns 29%; family medicine 33%). A higher proportion of advanced practice nurses in primary care (45%) and a markedly lower percentage of advanced practice nurses in reproductive health (17%) reported always requiring the examination. In adjusted analyses, older clinicians were more likely to require the pelvic examination (odds ratio [OR] 1.03, P<.01) and clinicians serving a higher proportion of Medicaid patients more likely (OR 1.62, P<.05). Providers in private practice were more than twice as likely as those working in family-planning or community clinics to require pelvic examinations (OR 2.30, P<.01). CONCLUSION One third of clinicians we surveyed require pelvic examinations before provision of oral contraceptives, despite guidelines indicating they are unnecessary and research suggesting they can pose a barrier to contraceptive access.

Henderson, Jillian T.; Sawaya, George F.; Blum, Maya; Stratton, Laura; Harper, Cynthia C.

2013-01-01

238

Flea species infesting dogs in Florida and Bartonella spp. prevalence rates.  

PubMed

Several Bartonella spp. associated with fleas can induce a variety of clinical syndromes in both dogs and humans. However, few studies have investigated the prevalence of Bartonella in the blood of dogs and their fleas. The objectives of this study were to determine the genera of fleas infesting shelter dogs in Florida, the prevalence of Bartonella spp. within the fleas, and the prevalence of Bartonella spp. within the blood of healthy dogs from which the fleas were collected. Fleas, serum, and EDTA-anti-coagulated whole blood were collected from 80 healthy dogs, and total DNA was extracted for PCR amplification of Bartonella spp. The genera of fleas infesting 43 of the dogs were determined phenotypically. PCR amplicons from blood and flea pools were sequenced to confirm the Bartonella species. Amplicons for which sequencing revealed homology to Bartonella vinsonii subsp. berkhoffii (Bvb) underwent specific genotyping by targeting the 16S-23S intergenic spacer region. A total of 220 fleas were collected from 80 dogs and pooled by genus (43 dogs) and flea species. Bartonella spp. DNA was amplified from 14 of 80 dog blood samples (17.5%) and from 9 of 80 pooled fleas (11.3%). B. vinsonii subsp. berkhoffii DNA was amplified from nine dogs and five of the flea pools. Bartonella rochalimae (Br) DNA was amplified from six dogs and two flea pools. One of 14 dogs was co-infected with Bvb and Br. The dog was infested with Pulex spp. fleas containing Br DNA and a single Ctenocephalides felis flea. Of the Bvb bacteremic dogs, five and four were infected with genotypes II and I, respectively. Of the Bvb PCR positive flea pools, three were Bvb genotype II and two were Bvb genotype I. Amplification of Bvb DNA from Pulex spp. collected from domestic dogs, suggests that Pulex fleas may be a vector for dogs and a source for zoonotic transfer of this pathogen from dogs to people. The findings of this study provide evidence to support the hypothesis that flea-infested dogs may be a reservoir host for Bvb and Br and that ectoparasite control is an important component of shelter intake protocols. PMID:24268654

Yore, K; DiGangi, B; Brewer, M; Balakrishnan, N; Breitschwerdt, E B; Lappin, M

2014-01-31

239

Combined role of reduced estimated glomerular filtration rate and microalbuminuria on the prevalence of peripheral arterial disease.  

PubMed

Chronic kidney disease (CKD), defined by either microalbuminuria (MA) or a reduced estimated glomerular filtration rate (eGFR), is associated with an increased risk of peripheral arterial disease (PAD). The presence of both abnormalities might identify a subgroup of adults at particularly high risk of PAD. Accordingly, we sought to evaluate the combined effect of a reduced eGFR and MA on the prevalence of PAD among United States adults. United States adults >or=40 years old (n = 6,951) participating in the 1999 to 2004 National Health and Nutrition Examination Survey were cross-classified into 4 groups according to the presence or absence of MA (urinary albumin/creatinine ratio >or=30 mg/g) and reduced eGFR (<60 mL/min/1.73 m(2)). PAD was defined as an ankle-brachial index of <0.9. The prevalence of PAD among adults without MA or a reduced eGFR was 3.6% compared to 9.7%, 14.8%, and 25.4% among adults with MA alone, reduced eGFR alone, and both reduced eGFR and MA, respectively. After multivariate adjustment, the odds ratio for prevalent PAD associated with MA alone, reduced eGFR alone, and both reduced eGFR and MA compared to those without MA or reduced eGFR was 1.72 (95% confidence interval 1.16 to 2.55), 1.58 (95% confidence interval 1.09 to 2.29), and 2.26 (95% confidence interval 1.30 to 3.94), respectively. In conclusion, the coexistence of MA and reduced eGFR was associated with a high prevalence of PAD and might be useful in identifying patients with vascular disease. PMID:19892066

Baber, Usman; Mann, Devin; Shimbo, Daichi; Woodward, Mark; Olin, Jeffrey W; Muntner, Paul

2009-11-15

240

Contraception and the Adolescent Diabetic.  

ERIC Educational Resources Information Center

Data from a study of 11 teenage diabetics suggests that pregnancy among adolescent diabetics is more frequent than among the general population, at a time when diabetic control is poor because of psychosocial factors associated with adolescence. Current recommendations regarding contraception for diabetic women, focusing on barrier methods, are…

Fennoy, Ilene

1989-01-01

241

Contraception in ethnic minority groups in Bedford.  

PubMed

As an aid to health visitors who must provide advice on family planning, this article discusses the cultural and religious backgrounds of Italians, West Indians, Bengalis, and Punjabis as they affect family size and family planning, and describes a survey of the contraceptive practices of 100 mothers from these groups in Bedford. Family planning advice is provided to all mothers by doctors and health visitors, and services are available at family planning clinics or through general practitioners. Most of the Italians in Bedford originated in southern Italy. Traditional family life and strict morality remain strong, and Roman Catholic attitudes toward childbearing and birth control are influential. There are trends toward greater fertility decision making by couples, however. West Indians are characterized by a high illegitimacy rate, unstable unions, and early sexual experience, but their birthrate has fallen since their initial immigration to Britain. Among Bengalis, childbearing is the only means of prestige for women and sons are regarded as a source of security. Contraceptives are approved by the Islam religion but are seen as a threat to the traditional power structure of the male-dominated family. Punjabis, at one time a peasant group, are tending to become craftsmen with better education and the nuclear family is more common. Hinduism stresses early marriage and having many sons, but among Sikhs women may work outside the home and exercise great influence in family affairs. 10 West Indian, 9 Bengali, 44 Italian, and 37 Punjabi women having babies since June 1979 were selected from the birth record books of 3 health visitors in Bedford. There was no control group, and a true comparison was not possible. Average age and parity were 24 and 1.7 for West Indians, 27 and 4.4 for Bengalis, 26 and 1.8 for Italians, and 26 and 2.3 for Punjabis. 4 of 10 West Indians were unmarried, but there were no unmarried Asian mothers and only 1 Italian. Most women went to general practitioners rather than Area Health Authority family planning clinics. Oral contraceptives were the most popular method in all groups. No Muslims used sterilization as a contraceptive method but several Sikhs did so. The Bengalis, who had the highest number of pregnancies, also had the highest percentage of unemployed husbands, were 1 of the newest immigrant groups in Bedford, and had the worst housing conditions and most language problems. PMID:6922111

Beard, P

1982-08-01

242

Metabolic effects of contraceptive steroids.  

PubMed

Estrogen and progestins have been used by millions of women as effective combined contraceptives. The safety of hormonal contraceptives has been documented by years of follow-up and serious adverse events that may be related to their use are rare in the young population exposed to these agents. The balance between the benefits and the risks of contraceptive steroids is generally positive in particular when comparing to the risks of pregnancy and especially in women with risk factors. The metabolic changes induced by the synthetic steroids used in contraception, such as lipoprotein changes, insulin response to glucose, and coagulation factors have been considered as potential markers of cardiovascular and venous risk. Observations of these effects have led to modifications of the composition of hormonal contraceptive in order to minimize these changes and hence potentially decrease the risks. The synthetic estrogen Ethinyl-Estradiol (EE) exerts a stronger effect that natural estradiol (E2) on hepatic metabolism including estrogen-dependent markers such as liver proteins. This stronger hepatic impact of EE has been related to its 17?-ethinyl group which prevents the inactivation of the molecule and results in a more pronounced hepatic effect of EE as compared to estradiol. Due to its strong activity, administering EE via a non-oral route does not prevent its impact on liver proteins. In order to circumvent the metabolic changes induced by EE, newer products using more natural compounds such as estradiol (E2) and estradiol valerate (E2V) have been introduced. The synthetic progestins used for contraception are structurally related either to testosterone (T) (estranes and gonanes) or to progesterone (pregnanes and 19-norpregnanes). Several new progestins have been designed to bind more specifically to the progesterone receptor and to minimize side-effects related to androgenic, estrogenic or glucocorticoid receptor interactions. Dienogest (DNG), and drospirenone (DRSP) and the 19-norpregnanes including Nestorone® (NES), nomegestrol acetate (NOMAc) and trimegestone (TMG) have been combined with estrogen either EE or E2 or estradiol valerate (E2V). Risks and benefits of the newer progestins used in contraception depend upon the type of molecular structure, the type and dose of estrogen associated in a combination and the route of administration. The lower metabolic impact of estradiol-based combinations may result in an improved safety profile, but large surveillance studies are warranted to confirm this plausible hypothesis. So far, the contraindications and warnings for use of current COCs also apply to the estradiol-based COCs. PMID:21538049

Sitruk-Ware, Regine; Nath, Anita

2011-06-01

243

Cholesterol content of menstrual discharge. Influence of contraceptives.  

PubMed

An investigation was undertaken to study the cholesterol content of menstrual discharge and to establish its relationship to the cyclic acti vities of the endometrium. The effects that an oral contraceptive and IUD might have on cholesterol concentration in menstrual discharge and blood serum were also investigated. A total of 38 subjects were used. 9 were taking the oral contraceptive, Ortho-Novum; 4 were fitted with an IUD; and the remaining 25 were used as controls. Blood and menstrual discharges were collected and tested. Blood serum levels for all groups were constant during the menstrual cycle. It was found that the concentrations of cholesterol in the menstrual discharge samples of each group were significantly lower than the corresponding values in blood serum. The cholesterol levels in the menstrual discharge of the control and IUD groups were in the same narrow range and did not vary with the day of the cycle. The values for the oral contraceptives users also did not vary significantly with the day of the cycle, but they were signific antly lower than for levels obtained for the other 2 groups. The total excretion rate of cholesterol was highest for the IUD group, while the oral contraceptive users showed a significantly lowered rate of excretion than either the control or IUD group. The high excretion pattern shown by the IUD group is a reflection of these women's heavier flow. PMID:5742478

DeMeere, L J; Gilbreath, E B; Pattison, D S

1968-11-01

244

Common mental disorders among HIV-infected individuals in South Africa: prevalence, predictors, and validation of brief psychiatric rating scales.  

PubMed

Despite the high prevalence of both mental disorders and HIV infection in much of sub-Saharan Africa, little is known about the occurrence of mental health disorders among HIV-infected individuals. We conducted a cross-sectional study among individuals enrolled into HIV care and treatment services near Cape Town, South Africa. Psychiatric diagnoses were measured using the Mini-International Neuropsychiatric Interview (MINI) administered by trained research nurses. In addition, all participants were administered brief rating scales for depression (the Center for Epidemiological Studies Depression Scale [CES-D]), posttraumatic stress disorder (PTSD), the Harvard Trauma Questionnaire (HTQ), and alcohol dependence/abuse (the Alcohol Use Disorders Identification Test [AUDIT]). The median age among the 465 participants was 33 years and 75% were female; 48% were receiving antiretroviral therapy. Overall, the prevalence of depression, PTSD and alcohol dependence/abuse was 14% (n = 62), 5% (n = 24), and 7% (n = 35), respectively. In multivariate analysis, the prevalence of all disorders was significantly higher among individuals who spoke Afrikaans compared to Xhosa. While the AUDIT showed excellent sensitivity and specificity in detecting MINI-defined dependence/abuse (area under the receiver-operating characteristic curve, 0.96), the HTQ and CES-D had lower performance characteristics in detecting PTSD (0.74) and depression (0.76), respectively. These data demonstrate high levels of depression, PTSD and alcohol dependence/abuse among HIV-infected individuals in this setting. Additional research is required to refine these rating scales for maximum applicability in cross-cultural populations. More generally, HIV care and treatment services represent an important venue to identify and manage individuals with common mental disorders in resource-limited settings. PMID:18260806

Myer, Landon; Smit, Joalida; Roux, Liezel Le; Parker, Siraaj; Stein, Dan J; Seedat, Soraya

2008-02-01

245

Does contraceptive treatment in wildlife result in side effects? A review of quantitative and anecdotal evidence.  

PubMed

The efficacy of contraceptive treatments has been extensively tested, and several formulations are effective at reducing fertility in a range of species. However, these formulations should minimally impact the behavior of individuals and populations before a contraceptive is used for population manipulation, but these effects have received less attention. Potential side effects have been identified theoretically and we reviewed published studies that have investigated side effects on behavior and physiology of individuals or population-level effects, which provided mixed results. Physiological side effects were most prevalent. Most studies reported a lack of secondary effects, but were usually based on qualitative data or anecdotes. A meta-analysis on quantitative studies of side effects showed that secondary effects consistently occur across all categories and all contraceptive types. This contrasts with the qualitative studies, suggesting that anecdotal reports are insufficient to investigate secondary impacts of contraceptive treatment. We conclude that more research is needed to address fundamental questions about secondary effects of contraceptive treatment and experiments are fundamental to conclusions. In addition, researchers are missing a vital opportunity to use contraceptives as an experimental tool to test the influence of reproduction, sex and fertility on the behavior of wildlife species. PMID:19656957

Gray, Meeghan E; Cameron, Elissa Z

2010-01-01

246

Examining the prevalence rate of Pediculus capitis infestation according to sex and social factors in primary school children  

PubMed Central

Objective To determine the prevalence rate of head louse infestation among elementary students, and examine the associated factors with infection in the city of Aran and Bidgol. Methods A total of 19 boys' and girls' primary schools were selected by multistage, systematic random sampling. Overall, 3?590 students were examined for head lice infestation in urban areas of Aran and Bidgol during 2008. The diagnosis was based on live louse or nit on the scalp of students. The students were screened by standard questionnaire and demographic data in addition to related information were obtained by interview and observation. The data were analyzed by SPSS software using chi-square and Fisher's exact tests. Results The mean age of students was (8.68±1.58) years ranging between 6-12 years. The total prevalence of head louse infestation was 0.47%. This rate was 0.42% and 0.05% in female and male, respectively. There was a significant association between pediculosis and sex, father's job, mother's education, access to bathroom in home, prior infection, drug use and nationality, respectively (P<0.05). Conclusions The results showed that pediculosis was not a major health priority among primary school in city of Aran and Bidgol. However, enhancing the knowledge of students about head lice infestation and the existence of health teachers in schools can play a significant role in disease control.

Doroodgar, Abbas; Sadr, Fakhraddin; Doroodgar, Masoud; Doroodgar, Moein; Sayyah, Mansour

2014-01-01

247

Do women and men consider abortion as an alternative to contraception in the United States? An exploratory study  

Microsoft Academic Search

The USA, a country with widespread access to the full range of modern methods of contraception, continues to have one of the highest abortion rates among developed countries. Forty-nine per cent of women reported ever experiencing an unintended pregnancy in 2001; 48% of these conceptions occurred during a month that contraception was used. We explored the extent to which people

Ann M. Moore; Susheela Singh; Akinrinola Bankole

2011-01-01

248

A randomized trial of the intrauterine contraceptive device vs hormonal contraception in women who are infected with the human immunodeficiency virus  

PubMed Central

OBJECTIVE The purpose of this study was to determine whether the intrauterine contraceptive device (IUD) is effective and safe among women who are infected with the human immunodeficiency virus (HIV). STUDY DESIGN We randomly assigned 599 postpartum, HIV-infected women in Zambia to receive either a copper IUD or hormonal contraception and followed them for at least 2 years. RESULTS Women who were assigned randomly to hormonal contraception were more likely to become pregnant than those who were assigned randomly to receive an IUD (rate, 4.6/100 vs 2.0/100 woman-years; hazards ratio, 2.4; 95% CI, 1.3–4.7). One woman who was assigned to the IUD experienced pelvic inflammatory disease (crude rate, 0.16/100 woman-years; 95% CI, 0.004–868); there was no pelvic inflammatory disease among those women who were assigned to hormonal contraception. Clinical disease progression (death or CD4+ lymphocyte count dropping below 200 cells/?L) was more common in women who were allocated to hormonal contraception (13.2/100 woman-years) than in women who were allocated to the IUD (8.6/100 woman-years; hazard ratio, 1.5; 95% CI, 1.04–2.1). CONCLUSION The IUD is effective and safe in HIV-infected women. The unexpected observation that hormonal contraception was associated with more rapid HIV disease progression requires urgent further study.

Stringer, Elizabeth M.; Kaseba, Christine; Levy, Jens; Sinkala, Moses; Goldenberg, Robert L.; Chi, Benjamin H.; Matongo, Inutu; Vermund, Sten H.; Mwanahamuntu, Mulindi; Stringer, Jeffrey S. A.

2009-01-01

249

Contraception-related venous thromboembolism in adolescents.  

PubMed

Venous thromboembolism (VTE) is a rare but serious complication of combined hormonal contraception. While the absolute risk of VTE is low in adolescents, thrombotic events in contraception users younger than the age of 20 years account for 5 to 10% of total contraception-related VTE events in population studies, because of the high frequency of contraception use in adolescents. An increased risk of VTE exists not only with oral contraceptives, but also the contraceptive patch and vaginal ring. Most adolescents who experience contraception-related VTE have additional transient or inherited thrombotic risk factors at the time of VTE. Although the presence of inherited thrombophilia impacts the risk of contraception-related VTE, thrombophilia screening before contraception prescribing should be targeted only to high-risk populations. Pediatric institutions, caregivers, and young women need to be aware of the risk of VTE with estrogen-containing contraception, and maintain a high index of suspicion for this complication in women using these agents. PMID:24356931

O'Brien, Sarah H

2014-02-01

250

Emergency contraception in Wisconsin: a review.  

PubMed

Emergency contraception is used to prevent pregnancy in the event of unprotected sexual intercourse. The most common methods of emergency contraception are combination and progestin-only oral contraceptive pills. They are effective, safe, and have few side effects. Most physicians are aware of emergency contraception, yet it is not widely prescribed or used. The American Medical Association and the American College of Obstetricians and Gynecologists recommend providing information and access to emergency contraceptive pills at routine gynecologic visits. Evidence has shown that women provided with advance supplies of emergency contraceptive pills were more likely to use them. There is no evidence of increased sexual risk-taking behavior or reduction in use of regular birth control methods. It is estimated that with wider use of emergency contraceptive, nearly half of unplanned pregnancies and abortions could be prevented. Access and knowledge of emergency contraception are the biggest barriers to use. Many emergency departments in Wisconsin do not prescribe emergency contraception, making access for women in rural areas difficult. By increasing use of emergency contraceptive pills by improving access and improving patient knowledge, unplanned pregnancies and abortions may be reduced. PMID:16933412

Sabo, Laura; Schrager, Sarina

2006-07-01

251

Unmet need for contraception among HIV-positive women in Lesotho and implications for mother-to-child transmission.  

PubMed

In Lesotho, the risk of mother-to-child-transmission (MTCT) of HIV is substantial; women of childbearing age have a high HIV prevalence rate (26.4%), low knowledge of HIV status and a total fertility rate of 3.5 births per woman. An effective means of preventing MTCT is to reduce unwanted fertility. This paper examines the unmet need for contraception to limit and space births among HIV-positive women in Lesotho aged 15-49 years, using the 2004 Lesotho Demographic and Health Survey. HIV-positive women have their need for contraception unmet in almost one-third of cases, and multivariate analysis reveals this unmet need is most likely amongst the poor and amongst those not approving of family planning. Urgent action is needed to lower the level of unmet need and reduce MTCT. A constructive strategy is to improve access to family planning for all women in Lesotho, irrespective of HIV status, and, more specifically, integrate family planning with MTCT prevention and voluntary counselling and testing services. PMID:18847526

Adair, Timothy

2009-03-01

252

Pregnancy Ambivalence and Contraceptive Use Among Young Adults in the United States  

PubMed Central

CONTEXT Pregnancy ambivalence, or conflicted desire about having a baby, has been associated with decreased contraceptive use and unintended pregnancy. However, prior studies have neither included men nor focused on young adults, even though people in their 20s have the highest rates of unintended pregnancy. METHODS Nationally representative data from 2008–2009 were used to examine pregnancy ambivalence and its association with contraceptive practices among 774 respondents who were 18–29 years old and in current sexual relationships. Bivariate and multivariate analyses assessed relationships between pregnancy ambivalence, contraceptive use, gender and other social, demographic and psychosocial variables. RESULTS Forty-five percent of respondents exhibited pregnancy ambivalence. The proportion was higher among men than among women (53% vs. 36%), and the diference remained significant in the multivariate analysis (odds ratio, 2.9). Ambivalence was associated with lowered likelihood of contraceptive use, but this relationship was statistically significant only for men: Compared with men with clear intentions to avoid pregnancy, ambivalent men were less likely to have used any method of contraception in the last month (0.4). CONCLUSIONS The association between men’s pregnancy ambivalence and contraceptive practices suggests that women should not remain the sole targets of pregnancy prevention programs. Further research should explore whether clinical interventions that assess and address pregnancy ambivalence for both women and men could lead to improved contraceptive counseling and use.

Higgins, Jenny A.; Popkin, Ronna A.; Santelli, John S.

2013-01-01

253

Long acting contraception provision by rural primary care physicians.  

PubMed

Abstract Objectives: Unplanned pregnancy is a public health problem in the United States, including in rural areas. Primary care physicians are the main providers of health care to women in rural areas and are uniquely positioned to help reduce unplanned pregnancy in rural women. This study documents provision of contraception by rural primary care physicians, focusing on the most effective, long acting methods, intrauterine devices (IUDs) and contraceptive implants. Methods: We surveyed all primary care physicians practicing in rural areas of Illinois and Wisconsin. Bivariate analysis was performed using chi squared and Fisher's exact test, and multivariable analysis was performed with logistic regression to determine factors associated with provision. Results: The response rate was 862 out of 2312 physicians (37%). Nine percent of respondents place implants and 35% place IUDs. Eighty-seven percent of physicians had not had training in implant placement, and 41% had not had training in IUD placement. In multivariable analysis, factors associated with placement of long acting contraception include provision of maternity care, and female gender of the physician. The most common reasons for not providing the methods were lack of training and perceived low demand from patients. Conclusions: Many rural primary care providers do not place long acting contraceptive devices due to lack of training. Female physicians and those providing maternity care are the most likely to place these devices. Increased training for primary care physicians both during and after residency would help increase access to these options for women in rural areas. PMID:24443930

Lunde, Britt; Smith, Paul; Grewal, Manpreet; Kumaraswami, Tara; Cowett, Allison; Harwood, Bryna

2014-06-01

254

Elevated rates of current PTSD among Hispanic veterans in the NVVRS: true prevalence or methodological artifact?  

PubMed

The elevated rate of current posttraumatic stress disorder (PTSD) among Hispanic Vietnam veterans has been attributed to culturally based expressiveness that inflates symptom self-reports. To investigate this possibility, the authors conducted three hypothesis-driven analyses with National Vietnam Veterans Readjustment Study (NVVRS) data from the Structured Clinical Interview for DSM-III-R (SCID-) diagnosed subsample of male Vietnam Theater veterans (N = 260). First, persistence of the Hispanic elevation after adjusting for war-zone stress exposure initially suggested the effect of greater expressiveness. Second, symptom-based analyses isolated this effect to the self-report Mississippi Scale for Combat-Related PTSD and not to the clinician-rated SCID interview. Third, objective measures of functioning did not reveal a unique Hispanic pattern of lower impairment associated with current PTSD. These tests suggest that greater Hispanic expressiveness does not account for the Hispanic elevation in current PTSD in the NVVRS SCID-diagnosed subsample. PMID:18404629

Lewis-Fernández, Roberto; Turner, J Blake; Marshall, Randall; Turse, Nicholas; Neria, Yuval; Dohrenwend, Bruce P

2008-04-01

255

[Health risks of oral contraceptives].  

PubMed

Oral contraceptives (OC) are either composed of a combination of an estrogen derivative (usually ethinly estradiol) and a progestogen, or they contain a progestogen only. OC are characterized by a high effectiveness and have a low failure rate if taken correctly. Most women tolerate OC relatively well, but adverse effects do occur which are driven by the estrogen dose as well as by the type of progestogen. The most frequently reported adverse effects are nausea or vomiting, breast tenderness, headache or inbalanced mood, but these unwanted side effects are often transient. The fear of weight gain of many OC users is not necessarily supported by data from studies which report relatively little differences in body mass index on average during OC use. Nevertheless, substantial weight gain can occur in individual women. The widely discussed fear of breast cancer is also not justified, and the risk of developing ovarian or endometrial cancer is reduced for women who use OC on a regular basis. Venous thromboembolism (VTE) is the adverse effect with the greatest potential for serious harm if pulmonary embolism develops. This rare, but potentially dangerous adverse effect of OC has been discussed emotionally for many years and keeps attracting a lot of public interest. VTE is rare in young women, but the VTE risk is increased two- to sixfold for OC users as compared to non-users. The VTE risk increases with increasing estrogen dose, is highest in the first year of use, and is higher for OC from the third generation (containing desogestrel, gestodene or norgestimate) than for OC from the second generation (containing levonorgestrel) or than for the progestogen-only pill. According to most studies, OC containing the progestogens drospirenone or cyproterone acetate are similar with regard to VTE risks than OC from the third generation. Individual genetic susceptibility affecting the clotting system plays a major role in the risk of developing VTE in combination with OC, and smoking is also an important contributing factor to an increased VTE risk for women using OC. It is important that doctors and pharmacists inform new users of OC about potential health risks of OC use, and that the personal and family history of previous health risks is assessed thoroughly in order to rule out that important and relevant contraindications are present when a women starts taking OC. PMID:21656494

Meier, Christoph R

2011-06-01

256

Recent innovations in oral contraception.  

PubMed

Traditional forms of oral contraception contain 21 days of hormone-containing pills and 7 days of placebo during the hormone-free interval (HFI). Since 2003, the Food and Drug Administration has approved 24/4, 84/7, and 365-day regimens. These regimens shorten the HFI in an attempt to decrease bleeding and menstrual-associated side effects. Safety and efficacy of these regimens is comparable with traditional 21/7 dosing. Extended regimens are associated with high patient satisfaction. Bleeding patterns are similar or shorter in women using extended regimens, along with improvement in menstrual symptoms. One of the new formulations contains the new progestin drospirenone, which has antimineralocorticoid and antiandrogenic properties. This review summarizes the data about new formulations of oral contraception available in the United Sates and also provides a summary of the current literature on drospirenone. PMID:20391327

Cremer, Miriam; Phan-Weston, Scarlett; Jacobs, Adam

2010-03-01

257

Receiving voluntary family planning services has no relationship with the paradoxical situation of high use of contraceptives and abortion in Vietnam: a cross-sectional study  

PubMed Central

Background Vietnam shows a paradoxical situation where high contraceptive prevalence goes together with high abortion rates. This study examined the associations between self-reports of having received voluntary family planning (VFP) services and induced abortions. Methods A cross sectional survey was conducted in Thai Nguyen province, covering a total of 1281 women. Data were derived from a sample of 935 married women aged 18–49?years who were ever-users (93.5%) and current users of contraceptives (84%), and had completed birth histories. The dependent variables were the likelihood of having an induced abortion and repeated (two or more) induced abortions. The main independent variable was having received the three VFP dimensions (counselling, broader information, and access to availability). The association was examined using multivariate logistic regressions, taking into account women’s socio-demographic characteristics. Results The overall induced abortion percentage was 19.4 per 100 pregnancies. None of the three VFP dimensions was significantly associated with the odds of having an induced abortion or having repeated induced abortions. Mother’s age of 35 or older, having more than three living children, and ever used female contraception methods significantly doubled or more the odds of having an induced abortion and significantly tripled the odds of having repeated abortions. Conclusions Results indicate that women receiving VFP services were not less likely to have induced abortions. The provision of family planning counselling, information on contraceptive method mix, and management skills to ensure availability, are in need of reinforcement in a new set of policy and program strategies in the future.

2012-01-01

258

Pharmacologic Development of Male Hormonal Contraceptive Agents  

PubMed Central

The world population continues to increase dramatically despite the existence of contraceptive technology. The use of male hormonal contraception may help in preventing unintended pregnancies and managing future population growth. Male hormonal contraception relies on the administration of exogenous hormones to suppress spermatogenesis. Clinical trials have tested several regimens using testosterone, alone or in combination with a progestin. These regimens were shown to be >90% effective in preventing conception and were not associated with serious adverse events.

Roth, MY; Amory, JK

2011-01-01

259

Sex Education, Contraceptive and Reproductive Knowledge, and Contraceptive Use among Black Adolescent Females  

Microsoft Academic Search

This study examined sources of sex education for Black adolescent females and assessed relationships among sex education, knowledge about contraception and reproduction, and contraceptive use. The majority of adolescents reported having discussions with parents and having formal instruction regarding pregnancy, the menstrual cycle, and contraception. Neither parental discussion nor formal instruction on pregnancy and the menstrual cycle was related to

Diane Scott-Jones; Sherry L. Turner

1988-01-01

260

Communication about Contraception and Knowledge of Oral Contraceptives amongst Norwegian High School Students.  

ERIC Educational Resources Information Center

Examines communication about contraception and specific knowledge of oral contraceptives (OCs) in a sample of Norwegian high school students. More females than males discussed contraception at least monthly. Discussions were predominantly held with peers and not adults. Females were far more knowledgeable about OCs than males. The most significant…

Hansen, Thomas; Skjeldestad, Finn Egil

2003-01-01

261

Pharmacological Approaches to Male Contraception  

Microsoft Academic Search

\\u000a Alternatives to suppressing spermatogenesis by exogenous hormones for male contraception (see Chap. 29) include chemical approaches\\u000a to destroy pituitary gona-totrophes, immunological targeting of the hypothalamic GnRH, physically damaging the testis by local\\u000a heating and ultrasound application or administering toxicants that compromise Sertoli cell or germ cell function (Page et\\u000a al. 2008). They all lead to the same end result of

Trevor G. Cooper; Ching-Hei Yeung

262

Adolescent cognitive and contraceptive behaviors.  

PubMed

Sexually active teenage girls tend to wait at least a year before commencing contraceptive use, but half of all adolescent pregnancies occur within 6 months of the onset of sexual activity. To promote contraceptive use among adolescents and prevent unwanted pregnancy, an understanding of adolescent cognitive development is necessary. It has been suggested that many teenagers become pregnant not as a result of a lack of information, but because they lack the cognitive and behavioral skills needed to use the information. The major cognitive task in adolescence--formal operational thinking--involves the ability to analyze situations and hypothesize outcomes. According to Paiget, the capacity to imagine the future and act accordingly begins to emerge at about 11 years of age. However, many teenagers fail to develop this ability to think beyond the present and remain immersed in sexual fantasies when it comes to the area of sexuality. Since they are unable to conceptualize pregnancy and childbearing, they fail to use contraception. Moreover, adolescents commonly believe that they are not at risk of pregnancy the 1st few times they have sexual intercourse and are generally immune from the negative consequences of personal actions. Group discussions and role playing appear to be particularly effective tools to help adolescents speculate on the possible results of engaging in various sexual behaviors and stimulate cognitive development to advance from a concrete to a formal operational level. PMID:3649684

Yoos, L

1987-01-01

263

Reconciling disparate prevalence rates of PTSD in large samples of US male Vietnam veterans and their controls  

Microsoft Academic Search

BACKGROUND: Two large independent studies funded by the US government have assessed the impact of the Vietnam War on the prevalence of PTSD in US veterans. The National Vietnam Veterans Readjustment Study (NVVRS) estimated the current PTSD prevalence to be 15.2% while the Vietnam Experience Study (VES) estimated the prevalence to be 2.2%. We compared alternative criteria for estimating the

William W Thompson; Irving I Gottesman; Christine Zalewski

2006-01-01

264

New progestin oral contraceptives and the female condom.  

PubMed

Recent advances in contraceptive technology offer US adolescent females the potential to reduce their risk of unwanted pregnancy and sexually transmitted diseases (STDs) without unacceptable side effects. Newly developed oral contraceptives that contain the progestins desogestrel or norgestimate (Desogen, Ortho-Cept, Ortho-Cyclen, and Ortho Tri-Cyclen) have fewer metabolic and androgen-related side effects yet maintain the progestational suppression of ovulation and the endometrium. The failure rate for these progestin pills is under 1%. A Sunday start regimen may be most appropriate for adolescents who have intercourse on weekends. To avoid discontinuation, adolescents should be counseled that breakthrough bleeding may occur for the first three cycles. Also recommended for use by adolescents is the new female condom--the only female-controlled method that confers protection against both pregnancy and STDs. With careful, consistent use, the female condom has a failure rate of 2.6% in the first six months. PMID:7596650

Gold, M A

1995-04-01

265

Prevalence rates of male and female sexual violence perpetrators in a national sample of adolescents.  

PubMed

IMPORTANCE Sexual violence can emerge in adolescence, yet little is known about youth perpetrators-especially those not involved with the criminal justice system. OBJECTIVE To report national estimates of adolescent sexual violence perpetration and details of the perpetrator experience. DESIGN, SETTING, AND PARTICIPANTS Data were collected online in 2010 (wave 4) and 2011 (wave 5) in the national Growing Up With Media study. Participants included 1058 youths aged 14 to 21 years who at baseline read English, lived in the household at least 50% of the time, and had used the Internet in the last 6 months. Recruitment was balanced on youths' biological sex and age. MAIN OUTCOMES AND MEASURES Forced sexual contact, coercive sex, attempted rape, and completed rape. RESULTS Nearly 1 in 10 youths (9%) reported some type of sexual violence perpetration in their lifetime; 4% (10 females and 39 males) reported attempted or completed rape. Sixteen years old was the mode age of first sexual perpetration (n?=?18 [40%]). Perpetrators reported greater exposure to violent X-rated content. Almost all perpetrators (98%) who reported age at first perpetration to be 15 years or younger were male, with similar but attenuated results among those who began at ages 16 or 17 years (90%). It is not until ages 18 or 19 years that males (52%) and females (48%) are relatively equally represented as perpetrators. Perhaps related to age at first perpetration, females were more likely to perpetrate against older victims, and males were more likely to perpetrate against younger victims. Youths who started perpetrating earlier were more likely than older youths to get in trouble with caregivers; youths starting older were more likely to indicate that no one found out about the perpetration. CONCLUSIONS AND RELEVANCE Sexual violence perpetration appears to emerge earlier for males than females, perhaps suggesting different developmental trajectories. Links between perpetration and violent sexual media are apparent, suggesting a need to monitor adolescents' consumption of this material. Victim blaming appears to be common, whereas experiencing consequences does not. There is therefore urgent need for school programs that encourage bystander intervention as well as implementation of policies that could enhance the likelihood that perpetrators are identified. PMID:24100409

Ybarra, Michele L; Mitchell, Kimberly J

2013-12-01

266

Reconciling disparate prevalence rates of PTSD in large samples of US male Vietnam veterans and their controls  

PubMed Central

Background Two large independent studies funded by the US government have assessed the impact of the Vietnam War on the prevalence of PTSD in US veterans. The National Vietnam Veterans Readjustment Study (NVVRS) estimated the current PTSD prevalence to be 15.2% while the Vietnam Experience Study (VES) estimated the prevalence to be 2.2%. We compared alternative criteria for estimating the prevalence of PTSD using the NVVRS and VES public use data sets collected more than 10 years after the United States withdrew troops from Vietnam. Methods We applied uniform diagnostic procedures to the male veterans from the NVVRS and VES to estimate PTSD prevalences based on varying criteria including one-month and lifetime prevalence estimates, combat and non-combat prevalence estimates, and prevalence estimates using both single and multiple indicator models. Results Using a narrow and specific set of criteria, we derived current prevalence estimates for combat-related PTSD of 2.5% and 2.9% for the VES and the NVVRS, respectively. Using a more broad and sensitive set of criteria, we derived current prevalence estimates for combat-related PTSD of 12.2% and 15.8% for the VES and NVVRS, respectively. Conclusion When comparable methods were applied to available data we reconciled disparate results and estimated similar current prevalences for both narrow and broad definitions of combat-related diagnoses of PTSD.

Thompson, William W; Gottesman, Irving I; Zalewski, Christine

2006-01-01

267

Prevalence of poor self-rated health and associated risk factors among older adults in Cali, Colombia  

PubMed Central

Introduction: Self-rated health (SRH) has beeen considered an important marker of quality of life and an independent predictor of mortality in older adults. Objective: To determine the prevalence of poor SRH and identify risk factors associated with poor SRH among older adults residing in the Commune 18 of the city of Cali, Colombia, in 2009. Methods: A population-based cross-sectional study with a single-stage cluster sampling design. Sample included 314 persons aged 60 and older. The dependent variable, SRH was dichotomized into good (excellent, very good, good) and poor (fair, poor). Independent variables were sociodemographic, biological, mental, functional and geriatric syndromes. Logistic regression was used for multivariate statistical modeling. Results: Overall, 40.1% reported poor SRH (women 42.9%, men 35.0%). Factors independently associated with poor SRH were diabetes mellitus, depression, fear of falling and frailty syndrome (frail and pre-frail vs. non-frail). Widowed men reported poorer health than married men while other marital status (single/separated/divorced) was associated with better self-rated health in women. Conclusion: Potential modifiable factors such as depression and frailty syndrome are important determinants for poor SRH in Colombian older adults.

Zapata-Ossa, Helmer de J; Cubides-Munevar, Angela M; Curcio, Carmen L; Villegas, Juan de D; Reyes-Ortiz, Carlos A

2013-01-01

268

Prevalence rates of respiratory symptoms in Italian general population samples exposed to different levels of air pollution  

SciTech Connect

The authors surveyed two general population samples aged 8 to 64 living in the unpolluted, rural area of the Po Delta (northern Italy) and in the urban area of Pisa (central Italy). Each subject filled out a standardized interviewer-administered questionnaire. The Pisa sample was divided into three groups according to their residence in the urban-suburban areas and to outdoor air pollution exposure (automobile exhaust only or industrial fumes as well). Significantly higher prevalence rates of all the respiratory symptoms and diseases were found in Pisa compared with the Po Delta. Current smoking was more frequent in the rural area, but the urban smokers had a higher lifetime cigarette consumption. Childhood respiratory trouble and recurrent respiratory illnesses were evenly distributed. Exposure to parental smoking in childhood and lower educational level were more frequent in Po Delta, whereas familial history of respiratory/allergic disorders and work and indoor exposures were more often reported in the city. Multiple logistic regression models estimating independently the role of the various risk factors showed significant odds ratios associated with residence in Pisa for all the symptoms but chronic phlegm. The conclusion, these preliminary analyses indicate an urban factor related to the rates of respiratory symptoms and diseases in Italy in the 1980s.

Viegi, G. (Univ. of Pisa (Italy) Univ. of Arizona, Tucson (United States)); Paoletti, P.; Carrozzi, L.; Vellutini, M.; Diviggiano, E.; Pistelli, G.; Giutini, G. (Univ. of Pisa (Italy)); Di Pede, C. (Univ. of Arizona, Tucson (United States) Occupational Medicine Service, Toscana (Italy)); Lebowitz, M.D. (Univ. of Arizona, Tucson (United States))

1991-08-01

269

La contraception de l'adolescente  

PubMed Central

Approximately one-half of all female adolescents are sexually active. Family physicians whose patients include female adolescents must be able to provide them with information and advice about contraception. In this article, adolescent contraception is examined in detail and a number of strategies for achieving optimum compliance are presented.

Pinsonneault, Odette

1991-01-01

270

Religious and Cultural Influences on Contraception  

Microsoft Academic Search

Objective: To elucidate the religious and cultural influences that may affect the acceptance and use of various methods of contraception, including emergency contraception. Methods: Literature searches were conducted to identify religious teachings related to family, sexual relations, and family planning for Christianity, Judaism, Islam, Hinduism, Buddhism, and Chinese religious traditions. Religious scholars from each of the major religions were consulted

Amirrtha Srikanthan; Robert L. Reid

271

Efficacy and Safety of Long-Acting Reversible Contraception  

PubMed Central

Long-acting reversible contraception (LARC) includes intrauterine devices (IUDs) and the subdermal implant. These methods are the most effective reversible methods of contraception, and have the additional advantages of being long-lasting, convenient, well liked by users and cost effective. Compared with other user-dependent methods that increase the risk of noncompliance-related method failure, LARC methods can bring ‘typical use’ failure rates more in line with ‘perfect use’ failure rates. LARC methods are ‘forgettable’; they are not dependent on compliance with a pill-taking regimen, remembering to change a patch or ring, or coming back to the clinician for an injection. LARC method failure rates rival that of tubal sterilization at <1% for IUDs and the subdermal implant. For these reasons, we believe that IUDs and implants should be offered as first-line contraception for most women. This article provides a review of the LARC methods that are currently available in the US, including their effectiveness, advantages, disadvantages and contraindications. Additionally, we dispel myths and misconceptions regarding IUDs, and address the barriers to LARC use.

Stoddard, Amy; McNicholas, Colleen; Peipert, Jeffrey F.

2013-01-01

272

Prospects for increased contraceptive pill use in Japan.  

PubMed

Although oral contraceptives are not commercially available in Japan, a low-dose contraceptive pill is expected to become available soon. The current rate of pill use is less than 1 percent, but recent survey data indicate that about 10 percent of currently married women of reproductive age intend to use the pill when it comes on the market. Those who favor the pill do so because it is highly effective in preventing unwanted pregnancies, and because it reduces the need for abortions. Many other women report uncertainty about the pill because of concern about side effects. Given that Japan has a contraceptive failure rate of about 25 percent, with 29 percent of women having had at least one abortion, many women who do not yet favor the pill may shift to it once the low-dose pill comes on the market and they are reassured about its safety. Thus, the rate of pill use is likely to rise well above 10 percent. PMID:1792677

Ogawa, N; Retherford, R D

1991-01-01

273

Why women don't use contraception.  

PubMed

Subjective and objective factors relating to why women do not use and continue to use contraception are examined. The information presented is based on 2 samples of women: 1736 women who presented at the Fertility Control Clinic (Australia) between July 1973 and February 1974; and 233 women who came to the Clinic in July and August 1974. The information about each woman includes social factors such as age, marital status, religion, education, occupation and place of residence, contraceptive history, reason for seeking abortion, information about sexual experience, and an assessment of why the woman was not using effective contraception. Culturally conditioned feelings of guilt about sexual activity and the belief that adults condemn pre-marital sex makes it very difficult for a young woman to get up the courage to request contraception. A total of 12% of 1 Clinic sample were either too afraid to see a doctor for contraception or did see a doctor and were refused contraception. A very significant factor preventing good contraceptive use at the beginning of sexual experience is the unplanned nature of the experience. 75% of the teenagers in the 1st sample failed to initiate adequate contraception because they were poorly informed, unsure of their sexual role, or deterred by their doctor. Ignorance of the need for contraception and the methods available is clearly an objective inhibition to their use, but the reason for the ignorance may be bound up with subjective factors such as guilt about sex and subsequent ambivalence toward learning about it. Reasons for failure to continue to use contraception include the following: for some, the risk of producing an unwanted pregnancy adds flavor to the sexual act; some women rationalize their sexual activity, and this usually leads to discontinuation of contraceptive use; failure to change the contraceptive when needs change; the need to prove fertility; fear of adverse side-effects; failure to anticipate coitus; prohibition of the prescription of contraceptives in new residential area; and incorrect information. Available evidence supports the proposition that making the facilities available will greatly reduce the incidence of poor or neglected contraception. PMID:12263457

Wainer, J

1981-04-01

274

Oral contraceptives. Who, which, when, and why?  

PubMed

The risks of oral contraceptives are very small, and they cluster in a subset of users, although warning signs of cardiovascular complications must be heeded. The best choice of an oral contraceptive is one with an estrogen content of 30 to 35 micrograms. A greater (50 micrograms) content may be necessary if breakthrough bleeding or amenorrhea persists beyond a few treatment cycles. The starting date for the pill can be up to the sixth day of the cycle. Noncontraceptive benefits of the pill may include a protective effect against endometrial and ovarian malignancy, benign breast disease, and infection of the upper genital tract. Both the contraceptive and noncontraceptive benefits of low-dose combination oral contraceptives are desirable. They far outweigh the risks in women who require a high-efficacy, reversible contraceptive and who have no significant contraindication to use of the pill. PMID:3628138

Marut, E L

1987-09-15

275

Intrauterine contraceptive devices in diabetic women.  

PubMed

11 of 30 (36.6%) insulin-dependent diabetic women fitted with intrauterine contraceptive devices (IUCDs) became pregnant within 1 year, whereas the pregnancy rate for non-diabetic women fitted with the same types of IUCD by the same consultant gynaecologists over a similar time period was 4 per 100 women years (4%). As soon as the high risk was recognised, devices were removed (2 from diabetic women who were pregnant and 19 from non-pregnant diabetic women), and patients were advised about other methods of contraception. The IUCDs were examined in a scanning electron microscope with X-ray microprobe analysis to measure the amount of copper eroded from the wire, the extent of the encrustation (if any) deposited on the wire, and the composition of the deposit, and the data were compared with those for 111 devices removed from non-diabetic women, 40% of the IUCDs from diabetic women had sulphur and chloride in the deposit, compared with 15.3% of IUCDs from normal women, and fewer IUCDs from diabetic women had calcareous deposits. In devices from normal women, erosion and deposition seemed to occur independently, but in IUCDs from diabetic women, there was high erosion, there were also large deposits, and where there was little deposit, the erosion was slight. 7 of 14 IUCDs taken from normal women who had become pregnant with an IUCD in situ had a high sulphur plus chloride deposit; none of these IUCDs had a predominantly calcareous deposit compared with 19.8% of the IUCDs from non-pregnant normal women. The evidence militates against the insertion of IUCDs in diabetic patients and indicated that, even in non-diabetic women, there may be small groups for whom the risk of becoming pregnant is very high. PMID:6120391

Gosden, C; Steel, J; Ross, A; Springbett, A

1982-03-01

276

State-of-the-art of non-hormonal methods of contraception: II. Chemical barrier contraceptives.  

PubMed

Chemical contraceptives mainly known as spermicides are one of the oldest types of contraceptives. The industrial revolution facilitated new developments, and they became a leading and widespread method. However, their use declined in the second half of the 20th century, and came under focus again only with the upsurge of sexually transmitted infections (STIs). The effectiveness of spermicides depends on the users' compliance and pregnancy rates vary widely: from 6/100 woman-year (with perfect use) to 26/100 woman-year (with typical use). Preparations consist of two components: an excipient (foam, cream, jelly, soluble film, suppository or tablet); and a chemical agent with spermicidal properties (acidic compound, microbicidal agent, detergent). The most widely used active agent has been the surface active (detergent) nonoxynol-9 (N-9). Based on their mode of action (surfactant effect of detergents, enzymatic action of microbicides on cell metabolism) spermicides were thought to provide protection against STIs including HIV. Recent studies have, however, shown that detergents may actually increase the risk. Because of this, there is an urgent need for a suitable non-detergent spermicide, and research should focus on developing new compounds to replace N-9 and other agents having similar undesired effects. This paper reviews the latest studies reporting results on these recent developments. PMID:20055729

Batár, István

2010-04-01

277

The Male Role in Contraception: Implications for Health Education.  

ERIC Educational Resources Information Center

Many males still perceive contraception as a woman's responsibility. This paper describes male contraceptives and their effectiveness and draws implications for school and community health education professionals. More equitable sharing of the responsibility for contraception might result in more effective contraception. (PP)

Chng, Chwee Lye

1983-01-01

278

Males and Morals: Teenage Contraceptive Behavior Amid the Double Standard  

ERIC Educational Resources Information Center

This paper reviews literature on teenage contraceptive behavior and teenage contraceptive decision making. The paper describes the persistence of a sexual double standard in terms of moral motivation to use contraception and in terms of the relative lack of communication about contraception among young partners. (Author)

Scales, Peter

1977-01-01

279

The Contraceptive Needs for STD Protection among Women in Jail  

ERIC Educational Resources Information Center

We assessed the contraceptive needs of women in jails and their sexually transmitted disease (STD) history and risk to determine effective contraceptive methods for this population. A survey of demographics, sexual health, contraceptive use, and preferred method of contraception was completed by participants recruited at jails in a medium-sized…

Oswalt, Krista; Hale, Galen J.; Cropsey, Karen L.; Villalobos, Gabriella C.; Ivey, Sara E.; Matthews, Catherine A.

2010-01-01

280

The role of health literacy and numeracy in contraceptive decision-making for urban Chicago women.  

PubMed

Low functional health literacy and numeracy have known associations with poor health outcomes, yet little work has investigated these markers of health disparity in a family planning population. We used an in-depth qualitative process and 2 literacy and numeracy assessment tools, the REALM-7 and the Schwartz numeracy scale, to assess the role of literacy and numeracy in contraceptive decision-making in an urban Chicago population. Brief surveys and semi-structured interviews were conducted with 30 postpartum women who had received Medicaid-funded care at an obstetrics clinic in an academic medical center. In-person one-on-one interviews were then reviewed for themes using an iterative process. Qualitative analysis techniques identifying emergent themes were applied to interview data. Literacy and numeracy were assessed using REALM-7 and a validated 3-question numeracy scale. In this cohort of African American (63 %) and Hispanic (37 %) women (median age 26), 73 % had unplanned pregnancies. Although health literacy rates on the REALM-7 were adequate, numeracy scores were low. Low literacy and numeracy scores were associated with interview reports of poor contraceptive knowledge and difficulty with contraceptive use. Low health literacy and numeracy may play an important role in contraception decision-making in this low-income, minority population of women. We recommend further study of literacy and numeracy in a family planning population. Comprehensive contraception education and communication around the contraceptive decision-making process should take place at literacy and numeracy levels appropriate to each individual. PMID:24105614

Yee, Lynn M; Simon, Melissa A

2014-04-01

281

A review of the use of progestogen-only minipills for contraception during lactation.  

PubMed

Progestogen-only minipills and other systems for releasing low doses of progestogens alone are widely used for contraception in breast-feeding women around the world. There is good evidence to confirm their acceptability and their lack of effect on milk production, neonatal growth and early development. In contrast, combined oral contraceptives frequently decrease milk production, and may produce minor changes in milk composition. However, even combined oral contraceptives do not appear to produce adverse effects on neonatal well-being and development, although minor reductions in initial growth rate may sometimes occur. Progestogen-only methods may also produce subtle changes in milk composition, although less than combined oral contraceptives. Steroids are transferred from plasma into milk in small quantities, but the amounts are usually very low or insufficient to allow detection in the infants using present-day assays. There has been theoretical concern that these tiny amounts of steroids might affect neonatal reproductive development, but this appears to be unwarranted. Progestogen-only methods are being widely used for post-partum contraception, and they appear to have particular advantages in this situation. They also have few disadvantages; a theoretical concern about a possible effect on later reproductive or sexual development has no evidence to support it. The present licensing situation in Australia, which lists lactation as a relative contraindication to progestogen-only contraceptive use, causes real concern to potential users and appears to lead to frequent errors in compliance. PMID:1947224

Fraser, I S

1991-01-01

282

Combined hormonal contraceptives and venous thromboembolism: putting the risks into perspective.  

PubMed

To date, 13 studies have provided data on the risk of venous thromboembolism associated with combined oral contraceptives containing drospirenone or the norelgestromin-containing contraceptive patch. The studies varied in their conclusions about whether these methods are associated with higher risks than combined oral contraceptives containing other progestins: the primary reported measures of association (adjusted odds ratios, incidence rate ratios, or hazard ratios) ranged from 0.9 to 3.3. All of the studies had weaknesses in population selection, data validity or completeness, or analysis that may have led to biased or spurious findings. Venous thromboembolism is rare; if the contraceptive methods of interest do confer a higher risk of thromboembolism, only an additional 5-10 per 10,000 users per year would be affected. The important message for patients, clinicians, and policy makers is that the benefits of all contraceptive methods markedly outweigh their risks, primarily because they prevent pregnancy, an inherently hazardous condition. Product labels for hormonal contraceptives should emphasize their substantial health benefits and established safety. PMID:22525916

Raymond, Elizabeth G; Burke, Anne E; Espey, Eve

2012-05-01

283

Prevalence of antibodies to herpes simplex virus types 1 and 2 in pregnant women, and estimated rates of infection.  

PubMed Central

There has been a recent increase in notifications of genital herpes but it is not known whether this has been reflected in the pregnant population. We have therefore carried out a study to determine the prevalence of herpes simplex antibodies in pregnant women and to estimate the incidence of primary infection. Sera were collected from 3533 women at antenatal clinics and tested for total antibodies to herpes simples virus (HSV), and if positive, for specific antibodies to HSV-2. Estimates of HSV-1 seroprevalence were derived from the HSV-2 seronegative population. HSV-1 seroprevalence was nearly 100% in black women born in Africa or the Caribbean and 60-80% in white, Asian and UK born black women. It was lower in women in non-manual employment. HSV-2 seroprevalence was related to age, rising from 0 at age 16 to 40% at age 35 in black women, and to about 10% in Asian and white women. The estimated incidence of primary HSV-2 infection during pregnancy, per 1000 pregnancies, was about 2.4 in Asian women, 5 in white women, and 20 in black women. Estimates of the incidence of neonatal infection were derived from these figures and compared to the nationally reported rates.

Ades, A E; Peckham, C S; Dale, G E; Best, J M; Jeansson, S

1989-01-01

284

Lactational amenorrhea method as a contraceptive strategy in Niger.  

PubMed

If used properly, the lactational amenorrhea method (LAM) can be a valuable family planning tool, particularly in low-income countries; however, the degree to which LAM is used correctly and characteristics associated with its use have not been well documented. We therefore sought to use nationally representative data from Niger, where fertility rates are high and women may have limited access to alternative contraceptive methods, to describe the proportion of women who use LAM correctly and the characteristics associated with LAM use. We utilized cross-sectional data from the 2006 Niger Demographic Health Survey. Our sample included all sexually active, non-pregnant, breastfeeding women using some form of contraception (N = 673, unweighted). We used weighted frequencies to describe the correct use of LAM and logistic regression models to describe women who chose LAM for contraception. Among our sample, 52% reported LAM as their primary method of contraception, but only 21% of the women who reported using LAM used it correctly. Women who reported using LAM were more likely to live in certain regions of the country, to have no formal education, and to have delivered their most recent baby at home. They were also less likely to have discussed family planning at a health facility or with their husband/partner in the past year. Results indicated that few women in Niger who reported using LAM used it correctly. Our findings reinforce the need to address this knowledge gap, especially given Niger's high fertility rate, and may inform efforts to improve family planning in Niger and in other low-income countries. PMID:22688540

Sipsma, Heather L; Bradley, Elizabeth H; Chen, Peggy G

2013-05-01

285

High Prevalence of Metabolic Syndrome in First-Degree Male Relatives of Women with Polycystic Ovary Syndrome Is Related to High Rates of Obesity  

PubMed Central

Context: Women with polycystic ovary syndrome (PCOS) have twice the risk for metabolic syndrome (MetS) compared to women from the general population. Mothers and sisters of affected women also have an increased prevalence of MetS. Objective: The aim of the study was to determine the prevalence of MetS in fathers and brothers of women with PCOS compared to men from the general population. Design and Setting: We conducted a cross-sectional observational study at academic medical centers. Participants: A total of 211 fathers and 58 brothers of women with PCOS were studied and compared to 1153 and 582 Third National Health and Nutrition Survey (NHANES III) men of similar age and race/ethnicity, respectively. Main Outcome Measure: We measured MetS prevalence. Results: The prevalence of MetS was increased in fathers (42 vs. 32%; P = 0.006) and brothers (22 vs. 9%; P = 0.001) compared to NHANES III men. Fathers and brothers had higher body mass index (BMI) than NHANES III men (P < 0.0001). MetS rates were similar in fathers and brothers compared to NHANES III groups after adjusting for BMI. Total testosterone was inversely related to MetS in both fathers and brothers, but this relationship was also accounted for by the higher BMI in male relatives. Conclusion: Male relatives of women with PCOS had increased prevalence rates of MetS and obesity compared to the general U.S. male population from NHANES III. In contrast to women with PCOS and their female relatives, the higher prevalence of MetS in male relatives was accounted for by elevated BMI. These findings suggest that the high rates of MetS in male relatives of women with PCOS are related to higher rates of obesity than the general population.

Coviello, Andrea D.; Sam, Susan; Legro, Richard S.; Dunaif, Andrea

2009-01-01

286

Should oral contraceptives be available without prescription?  

PubMed Central

In this paper, it is argued that oral contraceptives should be available without prescription. Prescription status entails heavy costs, including the dollar, time, and psychological costs of visiting a physician to obtain a prescription, the financial and human costs of unintended pregnancies that result from the obstacle to access caused by medicalization of oral contraceptives, and administrative costs to the health care system. After a review and evaluation of the reasons for strict medical control of oral contraceptives in the United States, safety concerns anticipated in response to the proposal discussed here are addressed. Also, concerns that prescription status is necessary for efficacious use are evaluated. It is concluded that neither safety nor efficacy considerations justify prescription status for oral contraceptives. Revised package design and patient labeling could allow women to screen themselves for contraindications, to educate themselves about danger signs, and to use oral contraceptives safely and successfully. Several alternatives to providing oral contraceptives by prescription with current package design and labeling and selling them over the counter are suggested; the proposals discussed would make these safe and effective contraceptives easier to obtain and to use.

Trussell, J; Stewart, F; Potts, M; Guest, F; Ellertson, C

1993-01-01

287

Lifestyle factors, hormonal contraceptives and premenstrual symptoms: The UK Southampton Women's Survey  

PubMed Central

Objective To estimate the prevalence of premenstrual symptoms in women from the general population in Southampton, UK, and examine their association with lifestyle factors and contraceptive usage. Design Cross-sectional survey. Setting The City of Southampton, UK. Population 974 women aged 20-34 years (53% of the 1,841 women invited to participate). Methods Interviews, questionnaires and completion of a prospective six-week menstrual symptom diary recording on a daily basis the presence and severity of eleven common premenstrual symptoms. Main outcome measures Premenstrual symptoms were identified from the diaries by two clinicians who reviewed them independently using a pre-defined algorithm to assess the onset and decline of symptoms in relation to the start of menstruation. Results 24% of the women were considered to have premenstrual symptoms (95% confidence interval [CI] 21% to 27%). Women were less likely to have symptoms if they had higher levels of educational attainment and suffered less from stress. No associations were found between premenstrual symptoms and diet, alcohol or strenuous exercise, nor after adjustment for other factors, with age, smoking or body mass index. Use of any form of hormonal contraceptives was associated with a lower prevalence of premenstrual symptoms (prevalence ratio 0.66 (95%CI:0.52 to 0.84)). Conclusions Premenstrual symptoms were common in this cohort. Use of hormonal contraceptive methods was associated with a lower prevalence of these symptoms.

Sadler, Carrie; Smith, Helen; Hammond, Julia; Bayly, Rosie; Borland, Sharon; Panay, Nick; Crook, David; Inskip, Hazel

2011-01-01

288

Risk of non-fatal venous thromboembolism in women using oral contraceptives containing drospirenone compared with women using oral contraceptives containing levonorgestrel: case-control study using United States claims data  

PubMed Central

Objective To compare the risk of non-fatal venous thromboembolism in women receiving oral contraceptives containing drospirenone with that in women receiving oral contraceptives containing levonorgestrel. Design Nested case-control and cohort study. Setting The study was based on information from PharMetrics, a United States based company that collects information on claims paid by managed care plans. Participants The study encompassed all women aged 15 to 44 years who received an oral contraceptive containing either drospirenone or levonorgestrel after 1 January 2002. Cases were women with current use of a study oral contraceptive and a diagnosis of venous thromboembolism in the absence of identifiable clinical risk factors (idiopathic venous thromboembolism). Up to four controls were matched to each case by age and calendar time. Main outcome measures Odds ratios comparing the risk of non-fatal venous thromboembolism in users of the two contraceptives; incidence rates and rate ratios of non-fatal venous thromboembolism for users of each of the study contraceptives. Results 186 newly diagnosed, idiopathic cases of venous thromboembolism were identified in the study population and matched with 681 controls. In the case-control analysis, the conditional odds ratio for venous thromboembolism comparing use of oral contraceptives containing drospirenone with use of those containing levonorgestrel was 2.3 (95% confidence interval 1.6 to 3.2). The incidence rates for venous thromboembolism in the study population were 30.8 (95% confidence interval 25.6 to 36.8) per 100?000 woman years among users of oral contraceptives containing drospirenone and 12.5 (9.61 to 15.9) per 100?000 woman years among users of oral contraceptives containing levonorgestrel. The age adjusted incidence rate ratio for venous thromboembolism for current use of oral contraceptives containing drospirenone compared with those containing levonorgestrel was 2.8 (2.1 to 3.8). Conclusions The risk of non-fatal venous thromboembolism among users of oral contraceptives containing drospirenone seems to be around twice that of users of oral contraceptives containing levonorgestrel, after the effects of potential confounders and prescribing biases have been taken into account.

2011-01-01

289

Contraceptive failure in the United States  

PubMed Central

This review provides an update of previous estimates of first-year probabilities of contraceptive failure for all methods of contraception available in the United States. Estimates are provided of probabilities of failure during typical use (which includes both incorrect and inconsistent use) and during perfect use (correct and consistent use). The difference between these two probabilities reveals the consequences of imperfect use; it depends both on how unforgiving of imperfect use a method is and on how hard it is to use that method perfectly. These revisions reflect new research on contraceptive failure both during perfect use and during typical use.

Trussell, James

2013-01-01

290

CONTRACEPTION TECHNOLOGY: PAST, PRESENT AND FUTURE  

PubMed Central

Steady progress in contraception research has been achieved over the past 50 years. Hormonal and non-hormonal modern contraceptives have improved women’s lives by reducing different health conditions that contributed to considerable morbidity. However the contraceptives available today are not suitable to all users and the need to expand contraceptive choices still exists. Novel products such as new implants, contraceptive vaginal rings, transdermal patches and newer combinations of oral contraceptives have recently been introduced in family planning programs and hormonal contraception is widely used for spacing and limiting births. Concerns over the adverse effects of hormonal contraceptives have led to research and development of new combinations with improved metabolic profile. Recent developments include use of natural compounds such as estradiol (E2) and estradiol valerate (E2V) with the hope to decrease thrombotic risk, in combination with newer progestins derived from the progesterone structure or from spirolactone, in order to avoid the androgenic effects. Progesterone antagonists and progesterone receptor modulators are highly effective in blocking ovulation and preventing follicular rupture and are undergoing investigations in the form of oral pills and in semi long-acting delivery systems. Future developments also include the combination of a contraceptive with an antiretroviral agent for dual contraception and protection against sexually transmitted diseases, to be used before intercourse or on demand, as well as for continuous use in dual-protection rings. Alhough clinical trials of male contraception have reflected promising results, limited involvement of industry in that area of research has decreased the likelihood of having a male method available in the current decade. Development of non-hormonal methods are still at an early stage of research, with the identification of specific targets within the reproductive system in ovaries and testes, as well as interactions between spermatozoa and ova. It is hoped that the introduction of new methods with additional health benefits would help women and couples with unmet needs to obtain access to a wider range of contraceptives with improved acceptability.

Sitruk-Ware, Regine; Nath, Anita; Mishell, Daniel R.

2012-01-01

291

Students' Perceptions of Contraceptives in University of Ghana  

PubMed Central

Objective This study sought to explore University of Ghana Business School diploma student's knowledge of contraceptives, types of contraceptives, attitudes towards contraceptive users, preference for contraceptives, benefits, and side-effects of contraceptives. Materials and methods Data was conducted with three sets of focus group discussions. Participants were systematically sampled from accounting and public administration departments. Results Findings showed that students had little knowledge of contraceptives. The male and female condoms were the main contraceptive types reported out of the many modern and traditional methods of contraceptives. The main benefits of contraceptives were; ability to protect against STIs, abortions, unwanted pregnancy and psychological trauma. Whilst most respondents preferred future use of pills, side-effects of contraceptives were mostly reported for condoms than other contraceptive methods. Results showed that participants had bad attitudes towards unmarried contraceptive users. Conclusion Generally, our findings show that detailed knowledge about contraceptives is low. There is a little gap of information on contraception knowledge, timing, and contraceptive types among university diploma students. Reproductive and maternal services should be available and accessible for tertiary students.

Kayi, Esinam Afi

2013-01-01

292

The DSM-IV Rates of Child and Adolescent Disorders in Puerto Rico: Prevalence, Correlates, Service Use, and the Effects of Impairment  

Microsoft Academic Search

to 6.9% when a measure of global impairment was added to that definition. The most prevalent disorders were at- tention-deficit\\/hyperactivity disorder (8.0%) and oppo- sitional defiant disorder (5.5%). Children in urban set- tings had higher rates than those in rural regions. Older age was related to higher rates of major depression and social phobia, and younger age was related to

Glorisa Canino; Patrick E. Shrout; Maritza Rubio-Stipec; Hector R. Bird; Milagros Bravo; Rafael Ramirez; Ligia Chavez; Margarita Alegria; Ann Hohmann; Julio Ribera; Pedro Garcia; Alfonso Martinez-Taboas

2004-01-01

293

Substance Use and Other Mental Health Disorders Among Veterans Returning to the Inner City: Prevalence, Correlates, and Rates of Unmet Treatment Need  

PubMed Central

Estimates of substance use and other mental health disorders of veterans (N = 269) who returned to predominantly low-income minority New York City neighborhoods between 2009 and 2012 are presented. Although prevalences of posttraumatic stress disorder, traumatic brain injury, and depression clustered around 20%, the estimated prevalence rates of alcohol use disorder, drug use disorder, and substance use disorder were 28%, 18%, and 32%, respectively. Only about 40% of veterans with any diagnosed disorder received some form of treatment. For alcohol use disorder, the estimate of unmet treatment need was 84%, which is particularly worrisome given that excessive alcohol use was the greatest substance use problem.

Vazan, Peter; Golub, Andrew; Bennett, Alex S.

2013-01-01

294

An all time low utilization of intrauterine contraceptive device as a birth spacing method- a qualitative descriptive study in district Rawalpindi, Pakistan  

PubMed Central

Background Pakistan was among the leading countries in south Asia which started the family planning program in late 50s, forecasting the need to control the population. Despite this early intervention, fertility rate has declined but slower in Pakistan as compared to most other Asian countries. Pakistan has almost a stagnant contraceptive prevalence rate for more than a decade now, perhaps owing to the inadequate performance of the family planning programs. The provision and use of long term contraceptives such as IUCD has always been low (around 2%) and associated with numerous issues. Married women who want to wait before having another child, or end childbearing altogether, are not using any long term method of contraception. Methodology A descriptive qualitative study was conducted from May to July 2012, to explore and understand the perceptions of women regarding the use of IUCDs and to understand the challenges/issues at the service provider’s end. Six FGDs with community women and 12 in-depth interviews were conducted with family planning providers. The data was analyzed using the Qualitative Content Analysis approach. Results The study revealed that the family planning clients are reluctant to use IUCDs because of a number of myths and misconceptions associated with the method. They have reservations about the provider’s capability and quality of care at the facility. Private health providers are not motivated and are reluctant to provide the IUCDs because of inadequate counseling skills, lack of competence and improper supporting infrastructure. Government programs either do not have enough supplies or trained staff to promote the IUCD utilization. Conclusion Besides a well-designed community awareness campaign, providers’ communication and counseling skills have to be enhanced, as these are major contributing factors in IUCD acceptance. Ongoing training of all family planning service providers in IUCD insertion is very important, along with strengthening of their services.

2013-01-01

295

Barriers to use of modern contraceptives among women in an inner city area of Osogbo metropolis, Osun state, Nigeria  

PubMed Central

Objectives To determine the knowledge and attitudes on modern contraceptive use of women living in an inner city area of Osogbo. Materials and methods Three hundred and fifty nine women of childbearing age were studied utilizing a community-based, descriptive, cross-sectional study design. A multistage random sampling technique was used in recruiting respondents to the study. A four-part questionnaire was applied dually, by interviewers and by respondents’ self administration, and the data was analyzed using the SPSS software version 17.0. Results The mean age of respondents was 28.6 ± 6.65 years. The majority (90.3%) of respondents were aware of modern methods of family planning (FP), 76.0% claimed awareness of where to obtain FP services, and 74.9% knew of at least five methods. However, only 30.6% had ever used contraceptives, while only 13.1% were current users. The most frequently used method was the male condom. The commonly perceived barriers accounting for low use of FP methods were fear of perceived side effects (44.0%), ignorance (32.6%), misinformation (25.1%), superstition (22.0%), and culture (20.3%). Some reasons were proffered for respondents’ nonuse of modern contraception. Predictors of use of modern contraceptives include the awareness of a place of FP service provision, respondents’ approval of the use of contraceptives, higher education status, and being married. Conclusion Most of the barriers reported appeared preventable and removable and may be responsible for the reported low point prevalence of use of contraceptives. It is recommended that community-based behavioral-change communication programs be instituted, aimed at improving the perceptions of women with respect to bridging knowledge gaps about contraceptive methods and to changing deep-seated negative beliefs related to contraceptive use in Nigeria.

Asekun-Olarinmoye, EO; Adebimpe, WO; Bamidele, JO; Odu, OO; Asekun-Olarinmoye, IO; Ojofeitimi, EO

2013-01-01

296

Higher risk of venous thrombosis associated with drospirenone-containing oral contraceptives: a population-based cohort study  

PubMed Central

Background: Combined oral contraceptives are a common method of contraception, but they carry a risk of venous and arterial thrombosis. We assessed whether use of drospirenone was associated with an increase in thrombotic risk relative to third-generation combined oral contraceptives. Methods: Using computerized records of the largest health care provider in Israel, we identified all women aged 12 to 50 years for whom combined oral contraceptives had been dispensed between Jan. 1, 2002, and Dec. 31, 2008. We followed the cohort until 2009. We used Poisson regression models to estimate the crude and adjusted rate ratios for risk factors for venous thrombotic events (specifically deep vein thrombosis and pulmonary embolism) and arterial thromboic events (specifically transient ischemic attack and cerebrovascular accident). We performed multivariable analyses to compare types of contraceptives, with adjustment for the various risk factors. Results: We identified a total of 1017 (0.24%) venous and arterial thrombotic events among 431 223 use episodes during 819 749 woman-years of follow-up (6.33 venous events and 6.10 arterial events per 10 000 woman-years). In a multivariable model, use of drospirenone carried an increased risk of venous thrombotic events, relative to both third-generation combined oral contraceptives (rate ratio [RR] 1.43, 95% confidence interval [CI] 1.15–1.78) and second-generation combined oral contraceptives (RR 1.65, 95% CI 1.02–2.65). There was no increase in the risk of arterial thrombosis with drospirenone. Interpretation: Use of drospirenone-containing oral contraceptives was associated with an increased risk of deep vein thrombosis and pulmonary embolism, but not transient ischemic attack or cerebrovascular attack, relative to second- and third-generation combined oral contraceptives.

Gronich, Naomi; Lavi, Idit; Rennert, Gad

2011-01-01

297

Depo-Provera: An Injectable Contraceptive  

MedlinePLUS

... Contraceptive What is Depo-Provera? Depo-Provera (medroxyprogesterone acetate) is an injectable medicine (a “shot”) that prevents ... can cause you to lose some of the calcium that is stored in your bones. The longer ...

298

Emergency contraception - a human rights issue.  

PubMed

Emergency contraception is the only resource that women can use to avoid becoming pregnant after having sexual intercourse without contraceptive protection. It could be a powerful means to prevent unwanted pregnancies and their devastating consequences for women's health, social wellbeing and life project, and for the unwanted child, if all people had ample access to good quality information, education and services for sexual and reproductive health. In spite of the preventive medicine value of emergency contraception, conservative sectors oppose its availability, appealing to moral values that are not universally shared in pluralistic societies. Excluding the only contraceptive that can be used after intercourse because some consider the mechanism of action to be unacceptable would mean restricting the right of choice of others, and imposing one particular belief or set of values on all members of the community, thus violating the freedom of conscience. Authorities have a moral obligation to protect human rights. PMID:16480928

Croxatto, Horacio B; Fernández, Soledad Díaz

2006-06-01

299

Contraception épididymaire: état des recherches et perspectives  

Microsoft Academic Search

Resume  Le développement de nouvelles stratégies contraceptives est un enjeu économique important. L'épididyme, siège de la maturation\\u000a post-testiculaire des spermatozoïdes est depuis peu sous les feux de la recherche comme un organe cible pour le développement\\u000a de nouvelles approches contraceptives chez les mammifères. En effet, cet organe dans lequel transitent et sont stockés les\\u000a permatozoïdes (chez la plupart des mammifères) est,

Joël R. Drevet

2004-01-01

300

Contraception and HIV infection in women  

PubMed Central

BACKGROUND More than 15 million women, many of reproductive age, were infected with human immunodeficiency virus (HIV) at the end of 2007. As the HIV epidemic evolves, heterosexual intercourse is increasingly risky: the risk of infection in exposed young women is 4- to 7-fold higher than in young men and nearly half a million newborns annually have HIV. This review aims to show the effect of contraceptive choices on risk of HIV and on the course of disease in women with HIV. METHODS Relevant citations were selected by agreement between the authors after a search of MEDLINE using the terms HIV/AIDS and contraception. RESULTS Risk of transmission of HIV varies from 1 in 200 to 1 in 10 000 coital incidents, depending in part on the integrity of the vaginal epithelium. Consistent use of male condoms has been proven to reduce horizontal transmission of HIV by 80% among HIV-serodiscordant couples. Hormonal contraception may increase the risk of HIV acquisition in high-risk women such as commercial sex workers, but not in women at low risk of HIV. While hormonal contraception did not affect progression of disease in two cohort studies involving 370 women, in a randomized trial among women not receiving antiretroviral medication, clinical disease accelerated in the oral contraception group (13.2/100 woman-years) compared with the copper intrauterine devices group (8.6/100 woman-years; hazard ratio, 1.5; 95% confidence interval, 1.04–2.1). Hormonal contraception does not interfere with antiviral drug effectiveness. CONCLUSIONS All the available reversible contraceptive methods can generally be used by women at risk of HIV infection and by HIV-infected women. Further studies are needed to investigate the safety and efficiency of hormonal contraception in women living with HIV/AIDS.

Heikinheimo, Oskari; Lahteenmaki, Pekka

2009-01-01

301

The role of the social network in contraceptive decision-making among young, African American and Latina women  

PubMed Central

Purpose Understanding reasons for contraception decisions is critical to improving our ability to reduce rates of unintended pregnancies. We used an in-depth qualitative approach to examine the contraceptive decision-making process, with special attention to the role of the social network, among a group of young, postpartum urban minority women. Methods Brief surveys and semi-structured interviews were conducted with 30 consenting postpartum women. In-person one-on-one interviews were then reviewed for themes using an iterative process. Qualitative analysis techniques identifying emergent themes were applied to interview data. Results In this cohort of African American (63%) and Hispanic (37%) women (median age 26), 73% had unplanned pregnancies. The social network, including friends, mothers, and partners, were key sources of contraception myths, misconceptions, and vicarious experiences. Women also utilized media, including the internet, as an additional source of information. Information relayed by the social network had a direct influence on contraceptive decisions for many women. Conclusions The experiences and opinions of the social network influence contraceptive decisions in this population of young, minority women. The social network, including friends, family members, and media sources, are a key source of contraceptive information for many women. Comprehensive contraception counseling should explore the experiences and opinions of the patient’s social network to the extent possible.

Yee, Lynn M.; Simon, Melissa

2010-01-01

302

Contraception in HIV-positive female adolescents  

PubMed Central

Sexual behavior of HIV-positive youths, whether infected perinatally, through risky behavior or other ways, is not substantially different from that of HIV-uninfected peers. Because of highly active antiretroviral therapy, increasing number of children, infected perinatally, are surviving into adolescence and are becoming sexually active and need reproductive health services. The objective of this article is to review the methods of contraception appropriate for HIV-positive adolescents with a special focus on hormonal contraceptives. Delaying the start of sexual life and the use of two methods thereafter, one of which is the male condom and the other a highly effective contraceptive method such as hormonal contraception or an intrauterine device, is currently the most effective option for those who desire simultaneous protection from both pregnancy and sexually transmitted diseases. Health care providers should be aware of the possible pharmacokinetic interactions between hormonal contraception and antiretrovirals. There is an urgent need for more information regarding metabolic outcomes of hormonal contraceptives, especially the effect of injectable progestins on bone metabolism, in HIV-positive adolescent girls.

2011-01-01

303

Systemic photosensitivity due to a contraceptive patch.  

PubMed

Hormonal contraceptives are a known but rarely reported cause of photosensitivity. A 35-year-old female developed several episodes of a prurigionous papulovesicular eruption located on sun-exposed areas that resolved without scarring in days. She had been using a transdermal contraceptive (EVRA: norelgestromin and ethinyloestradiol) for 3 years, and once it was stopped, the patient became asymptomatic. She had another episode after the use of oral contraceptives (YAZ: ethinyloestradiol and drospirenone). The biopsy of the lesions showed a spongiotic dermatitis. Minimal erythema dose was diminished when the patient was using EVRA and YAZ and became normal when they were withdrawn. Phototesting with UVA, photopatch testing and blood porphyrins were normal. Antinuclear antibodies were 1/80 initially and were 1/320 6 months later. Anti-deoxyribonucleic acid antibodies, extractable nuclear antigens, anti Ro and Anti La were negative and no systemic symptoms had developed. When all hormonal contraceptives were stopped, the patient became asymptomatic. We report a case of systemic photosensitivity induced by the contraceptive patch. To the best of our knowledge, no other cases induced by transdermal contraceptives have been reported previously. PMID:20626825

Gómez-Bernal, Silvia; Loureiro, Manuel; Rodríguez-Granados, María Teresa; Toribio, Jaime

2010-08-01

304

High prevalence rate of left superior vena cava determined by echocardiography in patients with congenital heart disease in Saudi Arabia  

PubMed Central

Background Persistent left superior vena cava (LSVC) is one of the common anomalies of the systemic veins. Its prevalence is 0.1–0.3% in the general population and is more common with congenital heart disease (CHD). The importance of detecting persistent LSVC prior to cardiac surgery is paramount for systemic veins cannulations. Aim The aim was to evaluate the prevalence of persistent LSVC in patients with CHD in Saudi Arabia. Methods All patients referred to our institution had echocardiography. All complete studies were reviewed for the presence of persistent LSVC. A computerized database was created including the demographic data, CHD diagnoses, and the presence of persistent LSVC. Results A total of 2,042 were examined with an age range of 1 day to 16 years. The complete echocardiographic studies were 1,832 (90%) of whom 738 (40%) patients had CHD. The prevalence of persistent LSVC in patients with CHD was 7.8% (OR 9.26, 95% CI 4.7–18.2, p<0.001). The most common cardiac defect associated with persistent LSVC was complete atrioventricular septal defect (AVSD); all patients with AVSD had Down syndrome. The total number of patients with AVSD was 41, and persistent LSVC was found in 11 (26%) of them (odds ratio 5.1, 95% CI 2.4–10.8, p<0.001). Conclusions The prevalence of persistent LSVC in the current population is almost double the reported prevalence obtained using the same echocardiographic screening tool.

Eldin, Ghada Shiekh; El-Segaier, Milad; Galal, Mohammed Omer

2013-01-01

305

Reimbursement of hormonal contraceptives and the frequency of induced abortion among teenagers in Sweden  

PubMed Central

Background Reduction in costs of hormonal contraceptives is often proposed to reduce rates of induced abortion among young women. This study investigates the relationship between rates of induced abortion and reimbursement of dispensed hormonal contraceptives among young women in Sweden. Comparisons are made with the Nordic countries Finland, Norway and Denmark. Methods Official statistics on induced abortion and numbers of prescribed and dispensed hormonal contraceptives presented as “Defined Daily Dose/thousand women” (DDD/T) aged 15-19 years were compiled and related to levels of reimbursement in all Swedish counties by using public official data. The Swedish numbers of induced abortion were compared to those of Finland, Norway and Denmark. The main outcome measure was rates of induced abortion and DDD/T. Results No correlation was observed between rates of abortion and reimbursement among Swedish counties. Nor was any correlation found between sales of hormonal contraceptives and the rates of abortion. In a Nordic perspective, Finland and Denmark, which have no reimbursement at all, and Norway all have lower rates of induced abortion than Sweden. Conclusions Reimbursement does not seem to be enough in order to reduce rates of induced abortion. Evidently, other factors such as attitudes, education, religion, tradition or cultural differences in each of Swedish counties as well as in the Nordic countries may be of importance. A more innovative approach is needed in order to facilitate safe sex and to protect young women from unwanted pregnancies.

2014-01-01

306

Contraceptive methods and the risk of Chlamydia trachomatis infection in young women.  

PubMed

To evaluate the relation between contraceptive methods and cervical Chlamydia trachomatis infection, the authors studied a population-based sample of 1,779 nonpregnant women aged 15-34 years who underwent cell culture diagnostic testing for the detection of C. trachomatis at a health maintenance organization. Barrier contraceptive method users were classified as those who reported using one of the following methods at time of testing: condom, diaphragm, cervical cap, spermicidal sponge, foam, or vaginal spermicidal suppositories. Barrier methods were associated with a reduction in the risk of chlamydial infection in women aged 25 years or older when compared with all other women in the same age category (adjusted prevalence odds ratio = 0.15, 95% confidence interval (CI) 0.04-0.66). When compared with only noncontracepting women, the adjusted prevalence odds ratio was 0.34 (95% CI 0.06-1.99). The protective effect of barrier methods was not evident in women younger than age 25 years. Oral contraceptive use was not associated with the risk of C. trachomatis infection using either referent group; the adjusted prevalence odds ratio was 0.99 (95% CI 0.57-1.73) compared with all other women, and 0.88 (95% CI 0.44-1.79) compared with noncontracepting women. These findings suggest that present patterns of use of barrier methods differ by age and afford only selective protection against cervical C. trachomatis infections. PMID:7572949

Park, B J; Stergachis, A; Scholes, D; Heidrich, F E; Holmes, K K; Stamm, W E

1995-10-01

307

Women's experience with postpartum intrauterine contraceptive device use in India  

PubMed Central

Background Postpartum intrauterine contraceptive devices (PPIUCD) are increasingly included in many national postpartum family planning (PPFP) programs, but satisfaction of women who have adopted PPIUCD and complication rates need further characterization. Our specific aims were to describe women who accepted PPIUCD, their experience and satisfaction with their choice, and complication of expulsion or infection. Methods We studied 2,733 married women, aged 15–49 years, who received PPIUCD in sixteen health facilities, located in eight states and the national capital territory of India, at the time of IUCD insertion and six weeks later. The satisfaction of women who received IUCD during the postpartum period and problems and complications following insertion were assessed using standardized questionnaires. Results Mean (SD) age of women accepting PPIUCD was 24 (4) years. Over half of women had parity of one, and nearly one-quarter had no formal schooling. Nearly all women (99.6%) reported that they were satisfied with IUCD at the time of insertion and 92% reported satisfaction at the six-week follow-up visit. The rate of expulsion of IUCD was 3.6% by six weeks of follow-up. There were large variations in rates of problems and complications that were largely attributable to the individual hospitals implementing the study. Conclusions Women who receive PPIUCD show a high level of satisfaction with this choice of contraception, and the rates of expulsion were low enough such that the benefits of contraceptive protection outweigh the potential inconvenience of needing to return for care for that subset of women.

2014-01-01

308

Knowledge, Perceptions, and Motivations for Contraception: Influence on Teens' Contraceptive Consistency  

ERIC Educational Resources Information Center

Using data from the National Longitudinal Study of Adolescent Health, the authors examine the association between contraceptive use patterns in teens' first sexual relationships and their knowledge of, perceptions of, and motivations for contraception and pregnancy prevention. Results from logistic regression analyses show that knowledge,…

Ryan, Suzanne; Franzetta, Kerry; Manlove, Jennifer

2007-01-01

309

Oral contraceptives, other methods of contraception, and risk reduction for ovarian cancer.  

PubMed

Oral contraceptives reduce the risk of ovarian cancer, but the impact of other methods of contraception has not been fully explored. This population-based, case-control study involved women 20-69 years of age who had ever had intercourse. We compared cases with a recent diagnosis of ovarian cancer (N = 727) with community controls (N = 1,360). All methods of contraception evaluated were associated with a reduced risk for ovarian cancer. After adjustment for age, race, pregnancies, and family history of ovarian cancer, the odds ratios for ever-use of each method as compared with never-use were: oral contraceptives for contraception, 0.6 (95% confidence interval = 0.5-0.8); intrauterine device, 0.8 (95% confidence interval = 0.6-1.0); barrier methods, 0.8 (95% confidence interval = 0.6-0.9); tubal ligation, 0.5 (95% confidence interval 0.4-0.7); and vasectomy, 0.8 (95% confidence interval = 0.6-1.1). Nulligravid women were not protected by any of these contraceptive methods. Multigravid women, however, were protected by all methods. We conclude that various methods of contraception reduce ovarian cancer risk. This effect does not appear to result from contraceptive use being a nonspecific marker of fertility. The results imply mechanisms other than hormonal or ovulatory by which ovarian cancer risk is reduced. PMID:11337604

Ness, R B; Grisso, J A; Vergona, R; Klapper, J; Morgan, M; Wheeler, J E

2001-05-01

310

The effectiveness of postcoital hormonal contraception.  

PubMed

The authors of a literature review of 10 studies on the efficacy of postcoital hormonal contraception (PCHC) contend that the studies' failure rates were too low because they divided the number of observed pregnancies by total number of women treated with PCHC. They claim that the only significant measure of efficacy is proportionate reduction in pregnancies caused by PCHC. Further, they examined the number of observed pregnancies and expected pregnancies if the women had not used PCHC. 2 different methods to estimate expected number of pregnancies resulted in 2 sets of failure rates for combined estrogen preparations (CEP): 4.2-100% and 5.9-44.4%. 2 other professionals find their use of Tietze's pregnancy risk estimates inapplicable, because women who use PCHC do not experience uniform distribution of unprotected intercourse across the cycle but rather near midcycle. Thus, their assumption of 2-4% risk of pregnancy per single unprotected act of intercourse biases the results. These professionals consider that the way to compare results from different studies is to use expected number of pregnancies estimated by corresponding the cycle day of intercourse with cycle day specific conception rates to obtain the only significant estimates of PCHC efficacy. Yet this methodology was applied in only 4 of the 10 studies examined by the authors of the literature review. Further, 1 study used a high-dose estrogen and 3 used a CEP preparation. Effectiveness rates were 84% for the high-dose estrogen and a mean of 76% for the 3 CEP studies. Further, there were 3 other CEP studies published after the literature review which had used the appropriate methodology. The weighted average of the 5 literature review CEP studies and these 3 studies is 74.%. Even though PCHC is not perfectly effective, it does adequately protect against unintended pregnancy. RU-486 is more effective than CEPs, but until it is available in the US, the best means of preventing unplanned pregnancies after intercourse is PCHC. PMID:1483529

Trussell, J; Stewart, F

1992-01-01

311

Prevention of infection in voluntary surgical contraception.  

PubMed

The prevention of infections requires serious attention from personnel of voluntary surgical contraception programs. Preoperative antisepsis of the skin, use of careful surgical handwashing, sterilization of high-level disinfection of surgical equipment, and meticulous surgical technique are essential to prevent the occurrence of all types of infection. Screening clients for pre-existing infection, especially tubal infection, is important. Preferred antiseptics for both the surgical scrub and skin preparation of the patient are iodophors such as Betadine and chlorhexidine preparation such as Hibitane. Also effective are hexochlorophene (e.g., pHisoHex) for the surgical scrub and tincture of iodine for the operative site. Thorough cleaning and steam autoclaving to sterilize heat stable items and glutaraldehyde soaking to disinfect laparoscopes have become accepted standards. Small incisions, careful nontraumatic tissue handling, and excellent hemostasis all contribute to reduce infection risks. If unsuspected active pelvic infection is encountered at the time of minilaparotomy or laparoscopy, the tubes should not be occluded. Clients undergoing surgical sterilization should be instructed in how to care for their incision, what side effects to expect, when to resume normal activity, and what to do if complications develop. Clients must understand the importance of seeking immediate medical care if the incision becomes inflamed or tender, if there is bleeding, or if fever develops. Good follow up and reporting of infections will also produce data that can identify programs with excessive rates of poststerilization infection so that remedial measures can be taken. PMID:12341653

Porter, C W

1987-03-01

312

Designed Chemical Intervention with Thiols for Prophylactic Contraception  

PubMed Central

Unlike somatic cells, sperm have several-fold more available-thiols that are susceptible to redox-active agents. The present study explains the mechanism behind the instant sperm-immobilizing and trichomonacidal activities of pyrrolidinium pyrrolidine-1-carbodithioate (PPC), a novel thiol agent rationally created for prophylactic contraception by minor chemical modifications of some known thiol drugs. PPC, and its three derivatives (with potential active-site blocked by alkylation), were synthesized and evaluated against live human sperm and metronidazole-susceptible and resistant Trichomonas vaginalis, in vitro. Sperm hexokinase activity was evaluated by coupled enzyme assay. PPC irreversibly immobilized 100% human sperm in ?30 seconds and totally eliminated Trichomonas vaginalis more efficiently than nonoxynol-9 and metronidazole. It significantly inhibited (P<0.001) thiol-sensitive sperm hexokinase. However, the molecule completely lost all its biological activities once its thiol group was blocked by alkylation. PPC was subsequently formulated into a mucoadhesive vaginal film using GRaS excipients and evaluated for spermicidal and microbicidal activities (in vitro), and contraceptive efficacy in rabbits. PPC remained fully active in quick-dissolving, mucoadhesive vaginal-film formulation, and these PPC-films significantly reduced pregnancy and fertility rates in rabbits. The films released ?90% of PPC in simulated vaginal fluid (pH 4.2) at 37°C in 5 minutes, in vitro. We have thus discovered a common target (reactive thiols) on chiefly-anaerobic, redox-sensitive cells like sperm and Trichomonas, which is susceptible to designed chemical interference for prophylactic contraception. The active thiol in PPC inactivates sperm and Trichomonas via interference with crucial sulfhydryl-disulfide based reactions, e.g. hexokinase activation in human sperm. In comparison to non-specific surfactant action of OTC spermicide nonoxynol-9, the action of thiol-active PPC is apparently much more specific, potent and safe. PPC presents a proof-of-concept for prophylactic contraception via manipulation of thiols in vagina for selective targeting of sperm and Trichomonas, and qualifies as a promising lead for the development of dually protective vaginal-contraceptive.

Jain, Ashish; Verma, Vikas; Sharma, Vikas; Kushwaha, Bhavana; Lal, Nand; Kumar, Lalit; Rawat, Tara; Dwivedi, Anil K.; Maikhuri, Jagdamba P.; Sharma, Vishnu L.; Gupta, Gopal

2013-01-01

313

Family planning and contraceptive decision-making by economically disadvantaged, African-American women  

PubMed Central

Background Significant racial disparities exist in the US unplanned pregnancy rate. We conducted a qualitative study using the theory of planned behavior as a framework to describe how low-income, African-American women approach family planning. Study Design Structured focus groups were held with adult, low-income, non-pregnant, African-American women in Connecticut. Data were collected using a standardized discussion guide, and audio-taped and transcribed. Four, independent researchers coded the transcripts using the constant comparative method. Codes were organized into over-arching themes. Results Contraceptive knowledge was limited with formal education often occurring after sexual debut. Attitudes about contraception were overtly negative with method effectiveness being judged by the experience of side effects. Family and friends strongly influence contraceptive decisions while male partners are primarily seen as a barrier. Contraceptive pills are perceived as readily accessible although compliance is considered a barrier. Conclusions Contraception education should occur before sexual debut, should involve trusted family and community members, and should positively frame issues in terms of achieving life goals.

Hodgson, Eric J.; Collier, Charlene; Hayes, Laura; Curry, Leslie; Fraenkel, Liana

2013-01-01

314

Adolescents, contraception, and confidentiality: a national survey of obstetrician-gynecologists  

PubMed Central

Background Given recent legislative efforts to require parental notification for the provision of reproductive health care to minors, we sought to assess how ob/gyns respond to requests for confidential contraceptive services. Study Design Mailed survey of 1800 U.S. Obstetrician-Gynecologists, utilizing a vignette where a 17-year-old college freshman requests birth control pills and does not want her parents to know. Criterion variables were the likelihood of: encouraging her to abstain from sexual activity until she is older; persuading her to involve her parents in this decision; and prescribing contraceptives without notifying her parents. Covariates included physicians’ religious, demographic, and clinical characteristics. Results Response rate 66%. Most (94%) would provide contraceptives without notifying her parents. Half (47%) would encourage her to involve a parent, and half (54%) would advise abstinence until she is older. Physicians who frequently attend religious services were more likely to encourage her to involve her parents (OR 1.9), and to abstain from sex until she is older (OR 4.4), but equally likely to provide the contraceptives. Conclusions Most obstetrician-gynecologists will provide adolescents with contraceptives without notifying their parents.

Lawrence, Ryan E; Rasinski, Kenneth A.; Yoon, John D; Curlin, Farr A

2011-01-01

315

The contribution of school-level factors to contraceptive use among adolescents in New York city public high schools  

NASA Astrophysics Data System (ADS)

Every year approximately 17,000 adolescents ages 15-19 become pregnant in New York City. Most of these pregnancies are unintended and only a small percent of adolescents use effective contraception, with wide disparities by race/ethnicity and poverty level. While many studies have identified factors associated with contraceptive use, most research has focused on individual level factors, with little attention to the contribution of the school environment to sexual risk behavior and contraceptive use. This study investigates the effect of school-level factors on contraceptive use among adolescents in NYC public high schools before and after controlling for individual-level factors, and whether this effect varies with race/ethnicity. Using a cross-sectional design, the NYC Youth Risk Behavior Survey (YRBS) individual-level datasets for 2007, 2009 and 2011 were linked to a school-level dataset. Variables were selected based on empirical findings on factors associated with sexual behaviors, including contraceptive use, by adolescents. The analytic sample included all YRBS respondents aged 14 or older who reported having sexual intercourse in the past three months and had complete responses to the YRBS questions on contraceptive use at last sex (N=8,054). The chi square test of significance was used to evaluate significant associations between independent variables and contraceptive use in bivariate analyses; variables with a p value < 0.1 were included in the multivariable analyses. Binary and multinomial logistic regression analyses were conducted to estimate the strength of the associations of school-level factors with contraceptive use among sexually active adolescents. Findings included that use of any contraception and/or hormonal contraception at last sexual intercourse was associated with attending schools with a higher six-year graduation rate, higher percent of students strongly agreeing they were safe in their classrooms, higher percent of teachers at the school for over two years, and having a School-Based Health Center (SBHC) in the building. No known study has examined the contribution of school-level effects to contraceptive use in a dataset linking YRBS and school-level datasets. Implications of research findings are that schools providing a supportive, engaging and safe environment can protect students from sexual risk behaviors and increase contraceptive use among sexually active adolescents.

Kaplan, Deborah L.

316

Action against contraceptive implant threatened.  

PubMed

Norplant provides contraception over a five-year period through the gradual subcutaneous release of the progestogen levonorgestrel. It has been on the US market since 1991 and available in Great Britain since 1993. Already the subject of group legal actions in several US states, Norplant may soon be the target of lawyers in Britain for litigation. The lawyers allege that insertion of the implant under the skin of the upper arm by untrained doctors has led to painful and difficult removals and left women with scarred arms. Moreover, insufficient warning has been given about possible side effects such as mood swings and continuous vaginal bleeding. Hoechst Roussel, marketer of the implant in Britain, however, argues that only doctors trained in Norplant insertion and removal should attempt either procedure. Removal will be problematic only if preceded by a problem insertion. Hoechst Roussel recently advised gynecologists, in writing, not to attempt to extract the implant unless they are trained in the removal technique. By British law, the application of a drug product once approved for general release to general practitioners and family planning doctors cannot be restricted by a pharmaceutical company. PMID:7647639

Dyer, C

1995-08-19

317

Factors predicting mood changes in oral contraceptive pill users  

PubMed Central

Background Over 100 million women worldwide are using oral contraceptives pills (OCP) and mood changes were being as the primary reason for OCP discontinuation. The purpose of this study was to determine the prevalence and predicting factors of mood changes in oral contraceptive pills users. Methods This was a cross-sectional study of 500 women aged 15–49 years old using low dose (LD) pills attending family planning centers in Ahwaz, Iran. Data were collected via face-to-face interviews using a structured questionnaire including items on demographic, self-efficacy and mood change. Both univarate and multiple logistic regression analyses were performed to assess the relationship between reported mood change and the independent variables. Results In all 406 women reported that they did experience OCP side effects. Of these, 37.7% of women (n =153) reported mood changes due to OCP use. The results of multiple logistic regression revealed that place of living (OR =2.57, 95% CI?=?1.06-6.20, p =0.03), not receiving information on OCP side effects (OR =1.80, 95% CI?=?1.15-2.80, p =0.009), and lower self-efficacy (OR?=?0.87, 95% CI?=?0.80-0.94, p =0.001) were significant predictors of mood changes. Conclusion The findings from this study indicated that the prevalence of reported mood changes due to OCP use among Iranian women appeared to be consistent with other studies. In addition the findings showed that receiving information on OCP side effects from health care workers and self-efficacy were important predicting factors for mood changes. Indeed implementing educational programs and improving self-efficacy among women are recommended.

2013-01-01

318

Prevention of unintended pregnancy: a focus on long-acting reversible contraception.  

PubMed

This article summarizes the literature regarding the epidemiology and prevention of unintended pregnancy in the United States. Because of the Affordable Care Act and its accompanying contraceptive provision, there is a need for more primary care clinicians to provide family planning services. Office-based interventions to incorporate family planning services in primary care are presented, including clinical tools and electronic health record use. Special attention is paid to long-acting reversible contraceptive methods (the subdermal implant and intrauterine devices); these highly effective and safe methods have the greatest potential to decrease the rate of unintended pregnancy, but have been underused. PMID:24830607

Pickle, Sarah; Wu, Justine; Burbank-Schmitt, Edith

2014-06-01

319

Variations in use of cardiology services in a health authority: comparison of coronary artery revascularisation rates with prevalence of angina and coronary mortality.  

PubMed Central

OBJECTIVE: To explore the relation between rates of coronary artery revascularisation and prevalence of angina to assess whether use of health services reflects need. DESIGN: Prevalence of angina symptoms determined by postal questionnaire on 16750 subjects (18 to 94 years). Comparison of data on use of coronary artery revascularisation with prevalence of symptoms and mortality from coronary heart disease. SETTING: Health authority with population of 530000. SUBJECTS: Patients admitted to hospital for coronary heart disease; patients who died; and patients undergoing angiography, angioplasty, or coronary artery bypass graft. Cohort of 491 people with symptoms from survey. MAIN OUTCOME MEASURES: Pearson's product moment correlation coefficients for relation between variables. RESULTS: Overall, 4.0% (95% confidence interval 3.7% to 4.4%) of subjects had symptoms. Prevalences varied widely between electoral wards and were positively associated with Townsend score (r = 0.79; P < 0.001), as was mortality, but the correlation between admission rates and Townsend score was less clear (r = 0.47; P < 0.01). Revascularisation rate and Townsend score were not associated. The ratio of revascularisation to number experiencing symptoms was inversely related to Townsend score (r = 0.67; P < 0.001). The most deprived wards had only about half the number of revascularisations per head of population with angina than did the more affluent wards. In affluent wards 11% (13/116) of those with symptoms had coronary angiograms compared with only 4% (9/216) in poorer wards (chi 2 = 4.96; P = 0.026). Townsend score also inversely correlated with revascularisations per premature death from coronary heart disease (r = 0.55; P < 0.01) and revascularisations per admission for myocardial infarction (r = 0.47; P < 0.01). CONCLUSION: The use of interventional cardiology services is not commensurate with need, thus exhibiting the inverse care law.

Payne, N.; Saul, C.

1997-01-01

320

Contraceptive methods available to patients of office-based physicians and title X clinics --- United States, 2009-2010.  

PubMed

Unintended pregnancies, which accounted for an estimated 49% of all pregnancies in the United States in 2001, more often are associated with adverse outcomes for both mother and child than are intended pregnancies. In 2008, an estimated 36 million U.S. women of reproductive age were in need of family planning services because they were sexually active, able to get pregnant, and not trying to get pregnant; this represented a 6% increase from year 2000 estimates. To assess the provision of various reversible contraceptive methods by U.S family planning providers, CDC mailed a survey on contraceptive provision to random samples of 2,000 office-based physicians and 2,000 federally funded Title X clinics. This report summarizes those results, which indicated that a greater proportion of Title X clinic providers than office-based physicians offered on-site availability of a number of methods, including injectable depot medroxyprogesterone acetate (DMPA) (96.6% versus 60.9%) and combined oral contraceptive pills (92.1% versus 48.8%). However, a greater proportion of office-based physicians than Title X clinic providers reported on-site availability of the levonorgestrel-releasing intrauterine device (LNG-IUD) (56.4% versus 46.6%). Less than maximal use of long-acting, reversible contraceptive methods (LARCs), including IUDs and contraceptive implants, might be a contributing factor to high unintended pregnancy rates in the United States. Improving contraceptive delivery by increasing on-site availability in physicians' offices and clinics of a range of contraceptive methods, including LARCs, might increase contraceptive use and reduce rates of unintended pregnancy. PMID:21228760

2011-01-14

321

Pregnancy, Contraception and Emergency Contraception: The Language of Urban Adolescent Young Women  

PubMed Central

Study Objective We sought to characterize how a group of urban adolescent females understands the domains of pregnancy, contraception and emergency contraception (EC). Design We utilized the research strategy of freelisting as part of an in-depth interview study. Setting and Participants Urban adolescent females presenting to a Pediatric Emergency Department. Participants were enrolled using a purposive sampling strategy if they were Black, English-speaking females ages 15 through 19 years old who resided in one of 11 zip codes surrounding the hospital. Main Outcome Measure Smith’s saliency score. Freelists were analyzed for the entire sample as well as for subgroups. Results Thirty adolescents completed the interview. We found that this group of adolescents uses different words to characterize the domains of pregnancy, contraception and EC. The only overlapping salient term was “abortion,” which appeared in the overall lists for pregnancy and EC and in the younger group’s list for contraception. In addition, lack of knowledge was cited as an important factor related to contraception. Conclusions Adolescent patients may not understand the concepts of contraception and EC fully. Providers should consider the potential need to provide an explanation for terms used, and should consider explicitly differentiating between routine forms of contraception and EC, as well as between EC and abortion.

Mollen, Cynthia J.; Fernando, Melissa; Hayes, Katie L.; Barg, Frances K.

2012-01-01

322

Contraceptive implants: long acting and provider dependent contraception raises concerns about freedom of choice.  

PubMed Central

David Bromham's editorial on contraceptive implants ignores the wider issues to voice concern that trial by media could limit contraceptive choice by jeopardising research into new methods. However, it is more beneficial to the public for points of conflict to be debated openly. Furthermore, the impetus for research into new contraceptive technology is driven by profit and political motives and is only marginally affected by the media. Implanted contraceptives may increase the choice of contraceptive methods, but they put control of fertility increasingly into the hands of the medical profession. Herein lies their greatest problem: their potential to increase providers' control over clients' choice. There is the danger that certain groups of women may be targeted for their use: in the United States the coercive use of Norplant for mothers receiving welfare benefit has been suggested. Long acting contraceptives are a contraceptive of choice only when they are available without pressure, as part of a wider menu; when instant removal on request is guaranteed; and when there is an open and free flow of information and opinions between users, health professionals, and special interest groups. Images p1394-a

Thompson, M. S.

1996-01-01

323

Asymptomatic bacteriuria: prevalence rates of causal microorganisms, etiology of infection in different patient populations, and recent advances in molecular detection.  

PubMed

Bacteriuria, or the presence of bacteria in urine, is associated with both asymptomatic and symptomatic urinary tract infection and underpins much of the dynamic of microbial colonization of the urinary tract. The prevalence of bacteriuria in dissimilar patient groups such as healthy adults, institutionalized elderly, pregnant women, and immune-compromised patients varies widely. In addition, assessing the importance of 'significant bacteriuria' in infected individuals represents a diagnostic challenge, partly due to various causal microorganisms, and requires careful consideration of the distinct etiologies of bacteriuria in different populations and circumstances. Recent molecular discoveries have revealed how some bacterial traits can enable organisms to grow in human urine, which, as a fitness adaptation, is likely to influence the progression of bacteriuria in some individuals. In this review, we comprehensively analyze currently available data on the prevalence of causal organisms with a focus on asymptomatic bacteriuria in dissimilar populations. We evaluate recent advances in the molecular detection of bacteriuria from a diagnostic viewpoint and briefly discuss the potential benefits and some of the challenges of these approaches. Overall, this review provides an update on the comparative prevalence and etiology of bacteriuria from both microbiological and clinical perspectives. PMID:23808987

Ipe, Deepak S; Sundac, Lana; Benjamin, William H; Moore, Kate H; Ulett, Glen C

2013-09-01

324

Over-the-counter access to emergency contraception without age restriction: an opinion of the Women's Health Practice and Research Network of the American College of Clinical Pharmacy.  

PubMed

Family planning remains a high priority area for the United States, with goals to increase the proportion of pregnancies that are intended, reduce pregnancy rates among adolescents, and increase contraceptive use prioritized in the Healthy People 2020 objectives. Contraception intended for use after unprotected intercourse, known as emergency contraception, remains underutilized. Levonorgestrel is one method of oral emergency contraception, which prevents fertilization and does not disrupt an already established pregnancy; thus, timing of administration is critical. Despite data demonstrating safety and efficacy, evidence-based decision making has been overshadowed by politically charged actions involving levonorgestrel emergency contraception for over a decade. The Women's Health Practice and Research Network of the American College of Clinical Pharmacy supports expanded access to levonorgestrel emergency contraception and removal of barriers such as age restrictions on the nonprescription drug product. Pharmacists remain a key provider of emergency contraceptive services and can help ensure timely access. In states where direct pharmacy access to emergency contraception is available, pharmacists are encouraged to participate. Education, research, and advocacy are other important responsibilities for pharmacists in this arena. PMID:23450827

Rafie, Sally; McIntosh, Jennifer; Gardner, Debra K; Gawronski, Kristen M; Karaoui, Lamis R; Koepf, Erin R; Lehman, Katherine Joy; McBane, Sarah; Patel-Shori, Nima M

2013-05-01

325

Taking the Initiative: A Green Light for Contraceptive Responsibility?  

ERIC Educational Resources Information Center

One explanation for the lack of contraception use among adolescents is that young women may feel embarrassment or rejection by their partners if they initiate the use of contraception. To explore young adults' reactions to contraceptive use, 160 college students evaluated a description of an unmarried young couple which varied the length of time…

Phillis, Diane E.; Allgeier, Elizabeth Rice

326

Having a Say Matters: Influence of Decision-Making Power on Contraceptive Use among Nigerian Women Ages 35-49 Years  

PubMed Central

Background Research suggests that women of reproductive age who are involved in household decision-making are more likely than those who are not involved to be able to control their fertility. Little is known, however, about this relationship among women at the upper end of the reproductive spectrum. The aim of this study was to determine the association between household decision-making power and modern contraceptive use among Nigerian women ages 35–49 years. Methods A descriptive, cross-sectional study involving a secondary analysis of data from the Nigerian 2008 Demographic and Health Survey was conducted among women ages 35–49 years who were considered to be in need of contraception. The outcome was modern contraceptive use while the main independent variable was a woman's household decision-making power score, constructed using principal component analysis. Multivariate logistic regression was performed to determine whether the women's household decision-making power score, categorized into tertiles, was independently associated with modern contraceptive use. Data were weighted and adjusted for the complex survey design. Results Prevalence of modern contraceptive use among Nigerian women deemed to be in need of contraception in this study was 18.7%. Multivariate logistic regression showed that women's decision-making power remained statistically significantly associated with modern contraceptive use, even after adjusting for age, education, religion, polygyny, parity, wealth and domicile. Women who were in the highest decision-making power tertile had more than one and a half times the odds of using modern contraception compared with women in the lowest tertile [Adjusted Odds Ratio?=?1.70; 95% Confidence Interval?=?1.31–2.21, p<0.001]. Significance Older Nigerian women who are involved in making household decisions are also able to make decisions related to their fertility. Programs in Nigeria focused on increasing modern contraceptive use should include strategies to increase women's status through encouraging more visible involvement in decision-making across different spheres of their lives.

OlaOlorun, Funmilola M.; Hindin, Michelle J.

2014-01-01

327

Benefit-risk assessment of the levonorgestrel intrauterine system in contraception.  

PubMed

The levonorgestrel-releasing intrauterine system (IUS) is a long-acting, fully reversible method of contraception. It is one of the most effective forms of contraception available, and combines the advantages of both hormonal and intrauterine contraception. The levonorgestrel-releasing IUS also gives the users many non-contraceptive benefits: the amount of menstrual bleeding and the number of days of menstrual bleeding are reduced, which makes it suitable for the treatment of menorrhagia (heavy menstrual blood loss). Dysmenorrhoea (painful menstruation) and premenstrual symptoms are also relieved. In addition, the levonorgestrel-releasing IUS provides protection for the endometrium during hormone replacement therapy. The local release of levonorgestrel into the uterine cavity results in a strong uniform suppression of the endometrial epithelium as the epithelium becomes insensitive to estradiol released from the ovaries. This accounts for the reduction in menstrual blood loss. All possible patterns of bleeding are seen among users of the levonorgestrel-releasing IUS; however, most of the women who experience total amenorrhoea continue to ovulate. The first months of use are often characterised by irregular, scanty bleeding, which in most cases resolves spontaneously. The menstrual pattern and fertility return to normal soon after the levonorgestrel-releasing IUS is removed. The contraceptive efficacy is high with 5-year failure rates of 0.5-1.1 per 100 users. The absolute number of ectopic pregnancies is low, as is the rate per 1000 users. The levonorgestrel-releasing IUS is equally effective in all age groups and the bodyweight of the user is not associated with failure of the method. In Western cultures continuance rates among users of the levonorgestrel-releasing IUS are comparable with those of other long-term methods of contraception. Premature removal of the device is most often associated with heavy menstrual bleeding and pain, as with other long-term methods of contraception, and is most common in the youngest age group. When adequately counselled about the benign nature of oligo- or amenorrhoea, most women are very willing to accept life without menstruation. The risk of premature removal can be markedly diminished with good pre-insertion counselling, which also markedly increases user satisfaction. User satisfaction is strongly associated with the information given at the time of the levonorgestrel-releasing IUS insertion. Thus, the benefits of the levonorgestrel-releasing IUS make it a very suitable method of contraception for most women. PMID:15588115

Backman, Tiina

2004-01-01

328

Companies commit to emergency contraception -- have you?  

PubMed

Despite the efforts of the medical community, as well as promotional efforts by pharmaceutical companies, relatively few women in the US have heard of emergency contraceptives (ECs). Gynetics, marketer of Preven, plans to file a new drug application for a levonorgestrel EC by the end of 1999, with an anticipated approval in the second half of 2000. Women's Capital Corp., marketer of Plan B, is also aiming for a national commercial launch of its product. According to a recently published acceptability study, women will use ECs when they are made available. A survey among 235 women at 13 Kaiser Permanente medical offices in San Diego, California, regarding their experiences with ECs showed that 91% were satisfied with ECs, and 97% said they would use ECs for emergencies only--dispelling fears that women would forego use of ongoing contraception. About 70% of the women who participated in the study were using a contraceptive method when they requested ECs. PMID:12295558

1999-12-01

329

Consuming contraceptive control: gendered distinctions in web-based contraceptive advertising.  

PubMed

There are over a hundred contraceptives currently on the market in the USA. In this paper, we present a discourse analysis of the stand-alone websites for 43 contraceptives in an effort to understand what contraceptive manufacturers are selling consumers along with their products. Manufacturers tailor marketing messages to promote conventional sex and gender norms using a scientific discourse. In particular, these products appropriate feminist ideals about independence and bodily integrity and promise consumers control and choice over procreation and sexual health, while existing within a larger context of medical surveillance in a patriarchal and capitalist culture. PMID:20552472

Medley-Rath, Stephanie R; Simonds, Wendy

2010-10-01

330

New progestagens for contraceptive use.  

PubMed

The progestins have different pharmacologic properties depending upon the parent molecule, usually testosterone or progesterone (P), from which they are derived. Very small structural changes in the parent molecule may induce considerable differences in the activity of the derivative. In hormonal contraceptives, progestins represent the major agent designed for suppressing ovulation and are used in combination with estrogen (E) usually ethinyl-estradiol (EE). The development of new generations of progestins with improved selectivity profiles has been a great challenge. Steroidal and nonsteroidal progesterone receptor (PR) agonists have been synthesized as well, although the latter are still in a very early stage of development. Several new progestins, have been synthesized in the last two decades. These include dienogest (DNG), drospirenone (DRSP), Nestorone (NES), nomegestrol acetate (NOMAc) and trimegestone (TMG). These new progestins have been designed to have no androgenic or estrogenic actions and to be closer in activity to the physiological hormone P. DRSP differs from the classic progestins as it is derived from spirolactone. It is essentially an antimineralocorticoid steroid with no androgenic effect but a partial antiandrogenic effect. The antiovulatory potency of the different progestins varies. TMG and NES are the most potent progestins synthesized to date, followed by two of the older progestins, keto-desogestrel (keto-DSG) and levonorgestrel (LNG). The new molecules TMG, DRSP and DNG also have antiandrogenic activity. Striking differences exist regarding the side effects among the progestins and the combination with EE leads to other reactions related to the E itself and whether the associated progestin counterbalances, more or less, the estrogenic action. The 19-norprogesterone molecules and the new molecules DRSP and DNG are not androgenic and, therefore, have no negative effect on the lipid profile. Given their pharmacological properties, it is likely that the new progestins may have neutral effects on metabolic or vascular risks. However, this hypothesis must be confirmed in large clinical trials. PMID:16291771

Sitruk-Ware, Regine

2006-01-01

331

Vector-borne disease surveillance in puerto rico: pathogen prevalence rates in canines ? Implications for public health and the u.s. Military ? Applying the one health concept.  

PubMed

Vector-borne diseases (VBDs) make up a large number of emerging infectious and zoonotic diseases. Vectors such as ticks, fleas, and mosquitoes parasitize dogs, thus making canine populations adequate reservoirs for infectious disease and zoonoses. The U.S. military deploys its personnel and Military Working Dogs (MWDs) throughout the world with possible risk of exposure to VBDs. Canine VBDs continue to have veterinary and public health significance for the host nations as well as for deployed U.S. personnel and MWDs. Thus, ongoing and consistent disease surveillance is an essential component to preserve health. The purpose of this study was to survey dogs from multiple cities and varying regions throughout Puerto Rico to determine the prevalence of ehrlichiosis (Ehrlichia canis), anaplasmosis (Anaplasma phagocytophilum), Lyme disease (Borrelia burgdorferi), and heartworm disease (Dirofilaria immitis) from May to July 2012. Canine blood samples (1?3 ml) from the cities of San Juan (n = 629), Guaynabo (n = 50), Ponce (n = 20) and Vieques Island (n = 53) were obtained and tested on-site using an IDEXX SNAP? 4Dx? (enzyme-linked immunosorbent assay) test kit. Prevalence for single or multiple disease status was calculated for each site. The overall period prevalence of VBD in Puerto Rico in the shelter population was 57.7% (71/123). In Guaynabo, the VBD prevalence was 30% (15/50); 2 (13%) of these positive dogs had VBD co-infection. In the coastal port city of Ponce, it was 60% (12/20); 6 (50%) dogs were infected by two or more VBDs. On Vieques Island, it was 83% (44/53); 27 (61%) dogs were coinfected. Conversely, samples collected at the Fort Buchanan Veterinary Clinic in the capitol city of San Juan resulted in a VBD prevalence of 8.9% (56/629). Lyme disease was not detected in any sample. This study showed the presence of D. immitis, E. canis, and A. phagocytophilum in all four sites of Puerto Rico, emphasizing the value of surveillance for VBDs to determine disease prevalence, complete risk assessments, and impleme t timely preventive medicine and other preventive measures. The lower VBD prevalence rate in the canine samples from Fort Buchanan demonstrates the value of responsible pet ownership and importance of preventive medicine and public health. PMID:23817880

McCown, Michael E; Opel, Taylor; Grzeszak, Benjamin

2013-01-01

332

Contraception, punishment and women who use drugs  

PubMed Central

Background In light of the recent debate on the use of financial incentives to promote long-acting contraception and sterilisation among women who use illicit drugs we discuss attitudes to contraception, pregnancy and parenting among Australian women who inject drugs. Methods Qualitative interviews were conducted with 90 women of reproductive age about contraceptive use, preferences, reproductive histories, attitudes to and experiences of parenting. All women were either currently, or had previously injected drugs. The in-depth, semi-structured interviews were compared and contrasted for themes relating to drug use, contraception, pregnancy and parenting. Results Participants aspired to control their fertility, expressed individual contraceptive preferences and concerns for their children (both born and unborn). Most had tried a number of contraceptive methods interspersed by periods of non-use related to experiences of side-effects, being single or abstinent, believing that they were infertile and trying to conceive. Attitudes varied from woman to woman and in the same individual over their life course. Some believed that they were not likely to be capable, but most aspired to be successful mothers. Conclusions Women’s drug use should not automatically be associated with an inability to make informed health care choices or to care for children. Evidence suggests that women who use drugs do not need to be paid to limit or end their fertility. Rather, programs that aim to reduce barriers to obtaining free, non-discriminating reproductive advice and parenting assistance would better utilise women’s agency to improve their own reproductive health.

2014-01-01

333

Oral contraceptives in polycystic ovary syndrome.  

PubMed

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of women of reproductive age and combined oral contraceptives (OCs) are often the first-line treatment of the syndrome by improving hyperandrogenism and regulating menstrual cycles. Oral contraceptives have some cardiovascular and metabolic effects that varies among different formulations depending upon the dose and type of the both estrogen and progestin components. These cardiometabolic effects of OCs raise some concerns about their long-term use in PCOS, but available data suggest that the benefits outweigh the risks. More studies are needed to clarify the safety of long-term use of OCs in PCOS. PMID:25003228

Helvaci, N; Yildiz, B O

2014-09-01

334

Contraceptive use among clients of the Atlanta Feminist Women's Health Center at three to five weeks post-abortion.  

PubMed

Little is known about women's contraceptive use and sexual activity in the immediate post-abortion period although effective contraceptive use is paramount during this time because fertility returns almost immediately. This study sought to learn more about women's contraceptive use and sexual behaviors to inform abortion providers and help them serve their clients better, potentially leading to a decline in the rates of unintended pregnancy and repeat abortion. Abortion clients of an Atlanta, GA clinic were surveyed over the telephone 3-5 weeks post-abortion. Background information was collected from clinic medical charts. Simple and stratified frequencies and logistic regression were used to describe women's sexual activity and contraceptive use in the immediate post-abortion period and to determine if variables known at the time of the abortion could predict contraceptive use 3-5 weeks post-abortion. 54.2% (n = 39) of women had engaged in sexual intercourse in the immediate post-abortion period. Of these, 30.8% (n = 12) were not using a contraceptive method or were not using it effectively. Women who said they did not want or need information about birth control on their medical history form were less likely to be using contraception 3-5 weeks post abortion. Emphasizing the rapid return of fertility and risk of conception in pre-abortion counseling sessions could prevent future unintended pregnancies among abortion clients. Further research could explore the interaction between a willingness to talk about contraceptive methods at the time of abortion and method use post-abortion. PMID:20602161

Moslin, Trisha A; Rochat, Roger W

2011-08-01

335

Dispensation of emergency contraceptive pills in Michigan Title X clinics.  

PubMed Central

OBJECTIVES: Emergency contraceptive pill dispensation was estimated in Michigan Title X family planning programs. METHODS: Logistic regression and tobit estimation models were used to predict whether and to what extent emergency contraceptive pills are dispensed. RESULTS: Of the 53 programs studies, 32 dispensed emergency contraceptive pills, averaging fewer than one client per month. Total dispensation was skewed toward a few programs, and the contribution of health departments to this total was small. Emergency contraceptive pill services appeared to be randomly distributed across programs, although most dispenser reported having provided the pills for less than 12 months. CONCLUSIONS: Recent policy advances should lead to more consistent emergency contraceptive pill dispensation in Title X programs.

Brown, J W; Boulton, M L

1998-01-01

336

Norplant contraceptive maker accused of profiteering on drug.  

PubMed

Family planning groups and a lawmaker accused a US drug company yesterday of profiteering on Norplant, the implantable, 5-year contraceptive. The company said its $365 product is cheaper than birth-control pills. But Rep. Ron Wyden said Norplant was developed with extensive government support and sells for $23 in some Third World countries. He said its cost to Wyeth-Ayerst laboratories may be as little as $16. About 875,000 US women have had 6 match-sized hormone-dispensing rubber capsules implanted in their upper arms since 1990. Dr. Amy Pollack of the Association of Reproductive Health Professionals said 56% of the 6 million pregnancies in the US each year are unwanted. She said 1.7 million pregnancies occur among women using contraceptives. The failure rate is less than 4 per 10,000 with Norplant compared with 3 per 100 women on the pill, she said. Dr. Marc W. Deitch, Wyeth's medical director, said the company made a risky decision to bring Norplant to market in collaboration with the nonprofit Population Council. The implant costs women 20 cents a day over its 5-year life, said Dr. Deitch. The $365 cost is significantly less than the $1481 they would pay over 5 years for birth-control pills, $762 for a diaphragm and $590 for shots of Depo Provera, he said. Male condoms cost $312 and an IUD $176. Family planning advocates challenged Dr. Deitch's math. Judith DeSarno, president of the National Family Planning and Reproductive Health Association, said federally funded clinics pay only $60 for a 5-year supply of oral contraceptives. Women also must pay doctor fees--usually from $150 to $200--for inserting Norplant and eventually removing it from their upper arms. PMID:12287220

1993-11-11

337

Oral contraceptives and the risk of gallbladder disease: a comparative safety study  

PubMed Central

Background Recent concerns have been raised about the risk of gallbladder disease associated with the use of drospirenone, a fourth-generation progestin used in oral contraceptives. We conducted a study to determine the magnitude of this risk compared with other formulations of oral contraceptives. Methods We conducted a retrospective cohort study using the IMS LifeLink Health Plan Claims Database. We included women who were using an oral contraceptive containing ethinyl estradiol combined with a progestin during 1997–2009. To be eligible, women had to have been taking the oral contraceptive continuously for at least six months. We computed adjusted rate ratios (RRs) for gallbladder disease using a Cox proportional hazards model. In the primary analysis, gallbladder disease was defined as cholecystectomy; in a secondary analysis, it was defined as hospital admission secondary to gallbladder disease. Results We included 2 721 014 women in the cohort, 27 087 of whom underwent surgical or laparoscopic cholecystectomy during the follow-up period. Compared with levonorgestrel, an older second-generation progestin, a small, statistically significant increase in the risk of gallbladder disease was associated with desogestrel (adjusted RR 1.05, 95% confidence interval [CI] 1.01–1.09), drospirenone (adjusted RR 1.20, 95% CI 1.16–1.26) and norethindrone (adjusted RR 1.10, 95% CI 1.06–1.14). No statistically significant increase in risk was associated with the other formulations of oral contraceptive (ethynodiol diacetate, norgestrel and norgestimate). Interpretation In a large cohort of women using oral contraceptives, we found a small, statistically significant increase in the risk of gallbladder disease associated with desogestrel, drospirenone and norethindrone compared with levonorgestrel. However, the small effect sizes compounded with the possibility of residual biases in this observational study make it unlikely that these differences are clinically significant.

Etminan, Mahyar; Delaney, Joseph A.C.; Bressler, Brian; Brophy, James M.

2011-01-01

338

New approaches to male non-hormonal contraception  

PubMed Central

A non-hormonal male contraceptive is a contraceptive that does not involve the administration of hormones or hormone blockers. This review will focus on the use of lonidamine derivatives and inhibitors of retinoic acid biosynthesis and function as approaches to male non-hormonal contraception. Two current lonidamine derivatives, Adjudin and H2-gamendazole, are in development as male contraceptives. These potent anti-spermatogenic compounds impair the integrity of the apical ectoplasmic specialization, resulting in premature spermiation and infertility. Another approach to male contraceptive development is the inhibition of retinoic acid in the testes, as retinoic acid signaling is necessary for spermatogenesis. The administration of the retinoic acid receptor antagonist BMS-189453 reversibly inhibits spermatogenesis in mice. Similarly, oral dosing of WIN 18,446, which inhibits testicular retinoic acid biosynthesis, effectively contracepts rabbits. Hopefully, one of these approaches to non-hormonal male contraception will prove to be safe and effective in future clinical trials.

Nya-Ngatchou, Jean-Jacques; Amory, John K.

2012-01-01

339

Employment status and the prevalence of poor self-rated health. Findings from UK individual-level repeated cross-sectional data from 1978 to 2004  

PubMed Central

Objectives To assess, using individual level data, how the proportion of people in different employment statuses may have played a role in the prevalence of poor self-rated health from 1978 to 2004 as there have been major changes in employment patterns in advanced market democracies and employment is an important correlate of health. Design Individual-level analysis of repeated cross-sectional surveys. Setting UK. Participants 125?125 men and 139?535 women of working age (25–59). Outcome measure Self-rated general health. Results Compared to 1978 there was evidence of higher levels of poor health in the subsequent years. For example, in 2004, the prevalence of poor health was 2.8 (95% CI 1.7 to 3.9) and 1.3 (0.1 to 2.5) percentage points higher than 1978 for men and women, respectively, after adjusting for age. After additional adjustment for socio-economic characteristics, annual differences compared to 1978 increased (5.4 (4.2 to 6.5) and 4.4 (3.2 to 5.6) for men and women in 2004). Further adjustment for employment status, however, attenuated the annual differences in poor health (0.7 (?0.3 to 1.7) for men and 1.5 (0.3 to 2.6) for women in 2004). Conclusions These results suggest that the proportion of people in different employment statuses, particularly the proportion in sickness- or disability-related economic inactivity, could play an important role in the prevalence of poor self-rated health in the UK. Whether decreasing economic inactivity would enhance population health is an open question that needs further investigation. Trial registration This observational study was not registered.

Popham, Frank; Gray, Linsay; Bambra, Clare

2012-01-01

340

Differential effect of wealth quintile on modern contraceptive use and fertility: evidence from Malawian women  

PubMed Central

Background High fertility and wide inequality in wealth distribution are phenomenal problems in sub-Saharan Africa. Modern Contraceptives (MC) are useful for limiting fertility, but are not always easily accessible in Malawi. This study examines the gap in MC use and fertility between women in the richest and poorest Wealth Quintile (WQ). Methods The study was cross-sectional in design and utilized Malawi DHS dataset, 2010. It focused on women of reproductive age. The dependent variables are ever and current use of MC. Chi-square and multinomial logistic regression were used for the analysis. Results Mean children ever born by women in the poorest and richest WQs were 3.94?±?2.7 and 2.82?±?2.3 respectively (p?rate (Adj.TFR) was higher among women in the poorest (Adj.TFR?=?7.60) WQ than the richest (Adj.TFR?=?4.45). The prevalence of ever use of MC was higher among women in the richest WQ (82.4%) than the poorest (66.8%) (p?contraceptive use between women in the poorest and richest WQ in Malawi.

2014-01-01

341

Progress and prospects in male hormonal contraception  

PubMed Central

Purpose of review Testosterone functions as a contraceptive by suppressing the secretion of luteinizing hormone and follicle-stimulating hormone from the pituitary. Low concentrations of these hormones deprive the testes of the signals required for spermatogenesis and results in markedly decreased sperm concentrations and effective contraception in a majority of men. Male hormonal contraception is well tolerated and acceptable to most men. Unfortunately, testosterone-alone regimens fail to completely suppress spermatogenesis in all men, meaning that in some the potential for fertility remains. Recent findings Because of this, novel combinations of testosterone and progestins, which synergistically suppress gonadotropins, have been studied. Two recently published testosterone/progestin trials are particularly noteworthy. In the first, a long-acting injectable testosterone ester, testosterone decanoate, was combined with etonogestrel implants and resulted in 80–90% of subjects achieving a fewer than 1 million sperm per milliliter. In the second, a daily testosterone gel was combined with 3-monthly injections of depot medroxyprogesterone acetate producing similar results. Summary Testosterone-based hormone combinations are able to reversibly suppress human spermatogenesis; however, a uniformly effective regimen has remained elusive. Nevertheless, improvements, such as the use of injectable testosterone undecanoate, may lead to a safe, reversible and effective male contraceptive.

Amory, John K.

2009-01-01

342

Contraception and Abortion: American Catholic Responses  

Microsoft Academic Search

The struggle within Roman Catholicism over contraception, and the struggle which is likely to arise over abortion, reflect a mixture of theological and social change. The challenge to papal authority inherent in the dissent from Pope Paul's encyclical on birth control is bound to have pro found ramifications in the church. At the same time, however, the fact of Catholic

Daniel Callahan

1970-01-01

343

Parental Involvement and Young Women's Contraceptive Use  

ERIC Educational Resources Information Center

Young adult women in the United States tend to delay family formation, pursue higher education and professional jobs, and become sexually active before marriage. Using effective contraception is the best way to ensure that nonmarital parenthood does not disrupt educational and career plans. Because parental involvement in education shapes…

Frisco, Michelle L.

2005-01-01

344

Impact of oral contraceptive on bone metabolism.  

PubMed

Oral contraceptives are used by numerous women very often throughout a prolonged period of time and more and more and more frequently early in life, within the first reproductive years. According to the close relationship between estrogen and bone metabolism, the question of the impact of combined oral contraceptive (COC) on bone needs to be addressed. During adulthood, most studies have reported that COC, even those containing a low dose of ethinyl-estradiol had neutral or possibly beneficial effect on bone health. Use of COC within the perimenopausal years prevents the activation of bone metabolism and the decrease in bone mass. In adolescent girls, the skeletal effect of COC is of greater concern. Recent data suggest that the oral contraception may impede the development of peak bone mass, particularly when started within the teen years. Initiation of COC within the first 3 years after menarche would be a strong determinant of bone mass acquisition impairment. Whether this bone impact is also dependent on the dose of ethinyl-estradiol has not been fully elucidated. To date epidemiological studies did not report association between use of combined oral contraceptive and the risk of fracture. PMID:23384745

Trémollieres, Florence

2013-02-01

345

Association Between Tampon Use and Choosing the Contraceptive Vaginal Ring  

PubMed Central

Objective To estimate whether tampon users are more likely to select the contraceptive vaginal ring than combined oral contraceptive pills (OCPs). Methods The Contraceptive Choice Project is a longitudinal study of 10,000 St. Louis-area women promoting the use of long-acting, reversible methods of contraception and evaluating user continuation and satisfaction for all reversible methods. We performed univariable and multivariable analyses of the 311 women who were asked about tampon use at the time of enrollment and who chose the contraceptive vaginal ring or OCPs to assess the association of tampon use and choice of combined hormonal method. Results Among contraceptive vaginal ring and OCP users, 247 (79%) reported using tampons. Contraceptive vaginal ring users were not significantly different than OCP users in terms of age, race or ethnicity, marital status, insurance, BMI, and parity. Adjusted analysis indicates tampon users were more likely to choose the contraceptive vaginal ring instead of OCPs (adjusted RR=1.34; 95%CI: 1.01–1.78). Women with previous contraceptive vaginal ring experience were also more likely to choose the contraceptive vaginal ring (adjusted RR=1.96; 95%CI: 1.6–2.4). Recent OCP use did not influence method choice. Conclusion In our baseline analysis of the Contraceptive Choice Project, tampon users were more likely to choose the contraceptive vaginal ring than OCPs. Use of tampons could be considered an indicator for the initial acceptability of the contraceptive vaginal ring, but all women should be offered the contraceptive vaginal ring regardless of experience with tampon use.

Tepe, Melissa; Mestad, Renee; Secura, Gina; Allsworth, Jenifer E.; Madden, Tessa; Peipert, Jeffrey F.

2011-01-01

346

Satisfaction and compliance in hormonal contraception: the result of a multicentre clinical study on women's experience with the ethinylestradiol/norelgestromin contraceptive patch in Italy  

PubMed Central

Background For many women finding the right contraceptive method can be challenging and consistent and correct use over a lifetime is difficult. Even remembering to take a birth control pill every day can be a challenge. The primary objective of this study was to evaluate women's experience with a weekly ethinylestradiol/norelgestromin contraceptive patch (EE/NGMN patch), given new technologies recently developed in hormonal contraception to increase women's options in avoiding daily dosing. Methods In 24 Italian sites, 207 women received the EE/NGMN patch for up to 6 cycles. At study end, overall satisfaction and preference, as well as compliance, efficacy and safety, were evaluated. Results 175 women (84.5%) completed the study. The overall satisfaction rate was 88%; convenience and once-a-week frequency of the patch were especially appreciated. At baseline, 82 women (39.4%) were using a contraceptive method, mainly oral contraceptives and barrier methods, but only 45.1% were very satisfied/satisfied; after 6 months with the patch, 86.3% of this subset was very satisfied/satisfied. Considering the method used in the 3 months before the study entry, 78.1% strongly preferred/preferred the patch, for convenience (53.9%), ease of use/simplicity (28.9%), fewer (9.2%) and less severe (2.6%) side effects. Compliance was very high: 1034/1110 cycles (93.2%) were completed with perfect compliance and the mean subject's compliance score was 90%. One on-therapy pregnancy occurred. The patch was safe and well tolerated: adverse events frequency was low, with predominantly single reports of each event. Most of them started and subsided during cycle 1. Conclusion This study demonstrated that the EE/NGMN patch is associated with high satisfaction levels and excellent compliance. At study end, the majority of women indicated that they would continue using the patch.

Crosignani, Pier Giorgio; Nappi, Carmine; Ronsini, Salvatore; Bruni, Vincenzina; Marelli, Silvia; Sonnino, Davide

2009-01-01

347

The Prevalence of Drug Abuse in the Army: A Comparison of Urinalysis and Survey Rates. Technical Report 75-17.  

ERIC Educational Resources Information Center

This report describes part of the research conducted under Work Unit MODE, which examined methodological approaches in acquiring valid research data pertinent to critical social problems. It describes a study in which rates of nontherapeutic drug use obtained by a random urine screening program among Army personnel were compared with rates

Reaser, Joel M.; And Others

348

Contraceptive Hormone Use and Cardiovascular Disease  

PubMed Central

Contraceptive hormones, most commonly prescribed as oral contraceptives (OC), are a widely utilized method to prevent ovulation, implantation and therefore pregnancy. The Women’s Health Initiative demonstrated cardiovascular risk linked to menopausal hormone therapy among women without pre-existing cardiovascular disease, prompting review of the safety, efficacy and side effects of other forms of hormone therapy. A variety of basic science, animal and human data suggest that contraceptive hormones have anti-atheromatous effects, however relatively less is known regarding the impact on atherosclerosis, thrombosis, vasomotion and arrhythmogenesis. Newer generation OC formulations currently in use indicate no increased myocardial infarction (MI) risk for current users, but a persistent increased risk of venous thrombo-embolism (VTE). There are no cardiovascular data available for the newest generation contraceptive hormone formulations, including those that contain newer progestins that lower blood pressure, as well as the non-oral routes (topical and vaginal). Current guidelines indicate that, as with all medication, contraceptive hormones should be selected and initiated by weighing risks and benefits for the individual patient. Women 35 years and older should be assessed for cardiovascular risk factors including hypertension, smoking, diabetes, nephropathy and other vascular diseases including migraines, prior to use. Existing data are mixed with regard to possible protection from OC for atherosclerosis and cardiovascular events; longer-term cardiovascular follow-up of menopausal women with regard to prior OC use, including subgroup information regarding adequacy of ovulatory cycling, the presence of hyperandrogenic conditions, and the presence of prothrombotic genetic disorders is needed to address this important issue.

Shufelt, Chrisandra L.; Noel Bairey Merz, C.

2009-01-01

349

Modelling strategic interventions in a population with a total fertility rate of 8.3: a cross-sectional study of Idjwi Island, DRC  

PubMed Central

Background Idjwi, an island of approximately 220,000 people, is located in eastern DRC and functions semi-autonomously under the governance of two kings (mwamis). At more than 8 live births per woman, Idjwi has one of the highest total fertility rates (TFRs) in the world. Rapid population growth has led to widespread environmental degradation and food insecurity. Meanwhile family planning services are largely unavailable. Methods At the invitation of local leaders, we conducted a representative survey of 2,078 households in accordance with MEASURE DHS protocols, and performed ethnographic interviews and focus groups with key informants and vulnerable subpopulations. Modelling proximate determinates of fertility, we evaluated how the introduction of contraceptives and/or extended periods of breastfeeding could reduce the TFR. Results Over half of all women reported an unmet need for spacing or limiting births, and nearly 70% named a specific modern method of contraception they would prefer to use; pills (25.4%) and injectables (26.5%) were most desired. We predicted that an increased length of breastfeeding (from 10 to 21 months) or an increase in contraceptive prevalence (from 1% to 30%), or a combination of both could reduce TFR on Idjwi to 6, the average desired number of children. Increasing contraceptive prevalence to 15% could reduce unmet need for contraception by 8%. Conclusions To meet women’s need and desire for fertility control, we recommend adding family planning services at health centers with NGO support, pursuing a community health worker program, promoting extended breastfeeding, and implementing programs to end sexual- and gender-based violence toward women.

2012-01-01

350

Popular Contraceptive Methods in Women Aged 35 Years and Older Attending Health Centers of 4 Cities in Khuzestan Province, Iran  

PubMed Central

Background The prevalence of unintended pregnancy and associated risks are higher in late reproductive years. Limited studies have focused on contraceptive choices in these women. The aim of the study was to identify contraceptive choices and their related factors in women 35 years or older attending health centers of Khuzestan province. Objectives Additionally, several line of evidence indicated relationship between increasing maternal age and poor pregnancy outcomes (1, 2). Pregnancies above the age of 35 are accompanied with more risks for complication related to pregnancy as compared to younger women (3-5). Risk of spontaneous abortion is 74.4% in mothers aged 45 years or more. Patients and Methods In a cross-sectional study 1584 women aged 35 years and older attending public health centers of four cities of Khuzestan were studied. We used an interviewer-administered questionnaire for data collection. Women investigators were recruited for interview and filling the questionnaire. Participants were assured of the confidentiality of their responses. Results The mean age of women was 39.8 ± 4.2 years. The most popular contraceptive methods used in this age group were oral contraceptive pills (31.4%), condom (28.1%), and tubal ligation (14.8%). Less effective contraceptive methods were used in 41.5% of women. Significant associations were found between the use of effective methods and literacy of husband (OR = 0.80, 95% CI: 0.75, 0.91), city of residence (OR = 0, 92, 95%CI: 0.87-0.97), women age (OR = 0.97, 95% CI; 0.94-0.99), and women education (OR = 0.87, 95%CI: 0.76-0.99) (P < 0.01). Conclusions In spite of risk of pregnancy and unintended pregnancy in this age group, about a half of them used less effective contraceptive methods, hence family planning education, and counseling to older women should be a priority in health centers.

Nouhjah, Sedighe; Amiri, Elham; Khodai, Azim; Yazdanpanah, Azar; Nadi Baghu, Maryam

2013-01-01

351

Diagnostic Prevalence Rates from Early to Mid-Adolescence among Indigenous Adolescents: First Results from a Longitudinal Study  

ERIC Educational Resources Information Center

The study investigates change in occurrences for mental and substance abuse children between early and mid-adolescence among a group of indigenous adolescents. Findings show a dramatic increase in occurrence rates for substance abuse disorder and conduct disorder, and a mental health crisis on indigenous reservations and reserves indicating a need…

Whitbeck, Les B.; Yu, Mansoo; Johnson, Kurt D.; Hoyt, Dan R.; Walls, Melissa L.

2008-01-01

352

New York City Physicians' Views of Providing Long-Acting Reversible Contraception to Adolescents  

PubMed Central

PURPOSE Although the US adolescent pregnancy rate is high, use of the most effective reversible contraceptives—intrauterine devices (IUDs) and implantable contraception—is low. Increasing use of long-acting reversible contraception (LARC) could decrease adolescent pregnancy rates. We explored New York City primary care physicians’ experiences, attitudes, and beliefs about counseling and provision of LARC to adolescents. METHODS We conducted in-depth telephone interviews with 28 family physicians, pediatricians, and obstetrician-gynecologists using an interview guide based on an implementation science theoretical framework. After an iterative coding and analytic process, findings were interpreted using the capability (knowledge and skills), opportunity (environmental factors), and motivation (attitudes and beliefs) conceptual model of behavior change. RESULTS Enablers to IUD counseling and provision include knowledge that nulliparous adolescents are appropriate IUD candidates (capability) and opportunity factors, such as (1) a clinical environment supportive of adolescent contraception, (2) IUD availability in clinic, and (3) the ability to insert IUDs or easy access to an someone who can. Factors enabling motivation include belief in the overall positive consequences of IUD use; this is particularly influenced by a physicians’ perception of adolescents’ risk of pregnancy and sexually transmitted disease. Physicians rarely counsel about implantable contraception because of knowledge gaps (capability) and limited access to the device (opportunity). CONCLUSION Knowledge, skills, clinical environment, and physician attitudes, all influence the likelihood a physician will counsel or insert LARC for adolescents. Interventions to increase adolescents’ access to LARC in primary care must be tailored to individual clinical practice sites and practicing physicians, the methods must be made more affordable, and residency programs should offer up-to-date, evidence-based teaching.

Rubin, Susan E.; Davis, Katie; McKee, M. Diane

2013-01-01

353

Contraceptive options for women with a history of solid-organ transplantation.  

PubMed

Women of reproductive age who have received a solid-organ transplant are at risk for unplanned pregnancy. Fertility can return as soon as 1 month after transplantation, and the baseline unplanned pregnancy rate in the United States is approximately 50%. Pregnancy, although not absolutely contraindicated in this population, carries risk greater than the general population and should be timed with regard to medication regimen and organ function. The Centers for Disease Control categorizes every form of contraception as Category 2-benefits outweigh risks-in women with an uncomplicated transplantation. There is a large range of contraceptive options, varying in drug formulation, route of delivery, and discrepancy between "perfect" and "typical" use. Long-acting reversible contraceptive methods include intrauterine devices (IUDs) and subdermal implants and show great promise for women with solid-organ transplant. These methods have excellent efficacy, eliminate user error, and, in the case of IUDs, have extremely low or no systemic drug absorption. Providers have historical concerns regarding the association of IUD and infection; however, modern studies have shown their safety in both immunocompetent and immunocompromised patients. Women with a history of solid-organ transplantation can be safely offered a wide range of contraceptive options to suit their individualized needs. PMID:23358183

Krajewski, Colleen M; Geetha, Duvuru; Gomez-Lobo, Veronica

2013-05-27

354

Immediate vs. delayed insertion of intrauterine contraception after second trimester abortion: study protocol for a randomized controlled trial  

PubMed Central

Background We describe the rationale and protocol for a randomized controlled trial (RCT) to assess whether intrauterine contraception placed immediately after a second trimester abortion will result in fewer pregnancies than current recommended practice of intended placement at 4 weeks post-abortion. Decision analysis suggests the novel strategy could substantially reduce subsequent unintended pregnancies and abortions. This paper highlights considerations of design, implementation and evaluation of a trial expected to provide rigorous evidence for appropriate insertion timing and health economics of intrauterine contraception after second trimester abortion. Methods/Design Consenting women choosing to use intrauterine contraception after abortion for a pregnancy of 12 to 24 weeks will be randomized to insertion timing groups either immediately (experimental intervention) or four weeks (recommended care) post abortion. Primary outcome measure is pregnancy rate at one year. Secondary outcomes include: cumulative pregnancy rates over five year follow-up period, comprehensive health economic analyses comparing immediate and delayed insertion groups, and device retention rates, complication rates (infection, expulsion) and, contraceptive method satisfaction. Web-based Contraception Satisfaction Questionnaires, clinical records and British Columbia linked health databases will be used to assess primary and secondary outcomes. Enrolment at all clinics in the province performing second trimester abortions began in May 2010 and is expected to complete in late 2011. Data on one year outcomes will be available for analysis in 2014. Discussion The RCT design combined with access to clinical records at all provincial abortion clinics, and to information in provincial single-payer linked administrative health databases, birth registry and hospital records, offers a unique opportunity to evaluate such an approach by determining pregnancy rate at one through five years among enrolled women. We highlight considerations of design, implementation and evaluation of a trial expected to provide rigorous evidence for appropriate insertion timing and health economics of intrauterine contraception after second trimester abortion. Trial registration Current Controlled Trials ISRCTN19506752

2011-01-01

355

A comparative study on attitude of contraceptive methods users towards common contraceptive methods  

PubMed Central

BACKGROUND: Family planning is a method of thinking and a life style which is chosen voluntarily and according to the attitudes and responsible determination of the couples in order to promote the hygiene and convenience of the family. This study aimed to identify and compare the attitudes of the users of common contraceptive methods with regard to each method separately. METHODS: The descriptive study was conducted in 2010. The study samples included 378 women using common contraceptive methods as LD pills, IUD (intrauterine devices), condom, withdrawal, tubectomy (females sterilization) and vasectomy as well as withdrawal method. The samples were selected through systemic random sampling from 9 health care centers. The data collection tool was a researcher-made. In order to determine the validity and reliability of the questionnaires, the content validity and Cronbach's alpha correlation coefficient methods were used. In order to analyze the data, the descriptive and inferential statistical methods (ANOVA) were used. RESULTS: Mean score of attitude regarding different contraceptive methods in the group who were users of the same method was above the users of all the methods; however, total attitude score toward the contraceptive methods was approximately similar to each other in all the groups and there was no significant difference among the different groups. CONCLUSIONS: The findings of this study showed that attitude is an important factor in choosing the contraceptive methods; therefore, this issue should to be taken into account by the family planning planners and consultants.

Ehsanpour, Soheila; Mohammadifard, Maedeh; Shahidi, Shahla; Nekouyi, Nafise Sadat

2010-01-01

356

Divergence between the high rate of p53 mutations in skin carcinomas and the low prevalence of anti-p53 antibodies  

PubMed Central

Circulating anti-p53 antibodies have been described and used as tumoural markers in patients with various cancers and strongly correlate with the p53 mutated status of the tumours. No study has yet looked at the prevalence of such antibodies in skin carcinoma patients although these tumours have been shown to be frequently p53 mutated. Most skin carcinoma can be diagnosed by examination or biopsy, but aggressive, recurrent and/or non-surgical cases' follow up would be helped by a biological marker of residual disease. We performed a prospective study looking at the prevalence of anti-p53 antibodies using an ELISA technique in a series of 105 skin carcinoma patients in comparison with a sex-?and age-matched control skin carcinoma-free group (n = 130). Additionally, p53 accumulation was studied by immunohistochemistry to confirm p53 protein altered expression in a sample of tumours. Anti-p53 antibodies were detected in 2.9% of the cases, with a higher prevalence in patients suffering from the more aggressive squamous cell type (SCC) of skin carcinoma (8%) than for the more common and slowly growing basal cell carcinoma type or BCC (1.5%). p53 protein stabilization could be confirmed in 80% of tumours studied by IHC. This low level of anti-p53 antibody detection contrasts with the high rate of p53 mutations reported in these tumours. This observation shows that the anti-p53 humoral response is a complex and tissue-specific mechanism. © 2001 Cancer Research Campaign http://www.bjcancer.com

Moch, C; Moysan, A; Lubin, R; Salmoniere, P de La; Soufir, N; Galisson, F; Vilmer, C; Venutolo, E; Pelletier, F Le; Janin, A; Basset-Seguin, N

2001-01-01

357

Effects of Administration of Fostamatinib on Blood Concentrations of an Oral Contraceptive in Healthy Female Subjects  

ClinicalTrials.gov

Scientific Terminology Rheumatoid Arthritis, Healthy Female Volunteers, Pharmacokinetics, Oral Contraceptive, Drug-drug Interaction; Laymen Terminology Level of Oral Contraceptive in Blood, Oral Contraceptive, Rheumatoid Arthritis, Drug -Drug Interaction

2012-02-17

358

Hormonal Contraception and HIV-1 Infection: Medroxyprogesterone Acetate Suppresses Innate and Adaptive Immune Mechanisms  

PubMed Central

Recent observational studies indicate an association between the use of hormonal contraceptives and acquisition and transmission of HIV-1. The biological and immunological mechanisms underlying the observed association are unknown. Depot medroxyprogesterone acetate (DMPA) is a progestin-only injectable contraceptive that is commonly used in regions with high HIV-1 prevalence. Here we show that medroxyprogesterone acetate (MPA) suppresses the production of key regulators of cellular and humoral immunity involved in orchestrating the immune response to invading pathogens. MPA inhibited the production of interferon (IFN)-?, IL-2, IL-4, IL-6, IL-12, TNF?, macrophage inflammatory protein-1? (MIP-1?), and other cytokines and chemokines by peripheral blood cells and activated T cells and reduced the production of IFN? and TNF? by plasmacytoid dendritic cells in response to Toll-like receptor-7, -8, and -9 ligands. Women using DMPA displayed lower levels of IFN? in plasma and genital secretions compared with controls with no hormonal contraception. In addition, MPA prevented the down-regulation of HIV-1 coreceptors CXCR4 and CCR5 on the surface of T cells after activation and increased HIV-1 replication in activated peripheral blood mononuclear cell cultures. The presented results suggest that MPA suppresses both innate and adaptive arms of the immune system resulting in a reduction of host resistance to invading pathogens.

Huijbregts, Richard P. H.; Helton, E. Scott; Michel, Katherine G.; Sabbaj, Steffanie; Richter, Holly E.; Goepfert, Paul A.

2013-01-01

359

Contraceptive decision-making in military women.  

PubMed

The purpose of this study was to explore the experiences of women in the military related to the prevention of pregnancy. Ten single women, ages 19 to 24, volunteered to be participants. They were interviewed over a 12-week period in a private setting at a military clinic. The results of the study were that their decision to use contraception was influenced by their personal goals, family values, perceived support system, and effectiveness of the birth control. These women used contraceptive methods that they felt were right for them. The conclusion of the study was that women in active military duty are in need of reproductive health education, career counseling, and support. Nurses are in a good position to provide these needed services. PMID:17595410

Chung-Park, Min S

2007-07-01

360

Cost savings from emergency contraceptive pills in canada  

Microsoft Academic Search

Objective: To estimate cost savings from emergency contraceptive pills in Canada.Methods: We modeled cost savings when a single emergency contraceptive treatment was provided after unprotected intercourse and when women were provided emergency contraceptive pills in advance.Results: Each dollar spent on a single treatment saved $1.19–$2.35 (in Canadian currency), depending on the regimen and on assumptions about savings from costs avoided

James Trussell; Ellen Wiebe; Tara Shochet; Édith Guilbert

2001-01-01

361

DEVELOPMENT OF DIAZACON™ AS AN AVIAN CONTRACEPTIVE  

Microsoft Academic Search

Due to increasing human-wildlife conflicts with birds and growing opposition to lethal techniques, nonlethal methods need to be developed to help manage bird populations. DiazaCon™ is a promising oral contraceptive that acts by directly inhibiting the conversion of desmosterol to cholesterol. Because cholesterol is essential for the production of the steroid reproductive hormones testosterone, progesterone, and estradiol, DiazaCon™ also indirectly

CHRISTI A. YODER; KIMBERLY S. BYNUM; LOWELL A. MILLER

362

Contraceptive options for the gestational diabetic woman.  

PubMed

Of the contraceptive choices open to a post-partum woman with gestational diabetes, this discussion concentrates on low-dose oral contraceptives. Although gestational diabetes usually clears at delivery, 75% of these women will go on to developed impaired glucose tolerance or overt diabetes, especially if they are obese or if their glucose level had been high. Many elect permanent sterilization, but those requiring reversible contraception usually choose the IUD or the pill. IUDs carry a high risk of infection and are less effective in diabetics. The author compared a low-dose combined pill with 400 mcg norethindrone and 35 mcg ethinyl estradiol (Ovcon 35), and a pill containing levonorgestrel (Triphasil), to barrier contraception in 230 women with recent gestational diabetes. After 6-13 months of use 11-17% of each group had impaired glucose tolerance, and 15-20% of each group had diabetes (n.s.). Insulin levels rose from 28.5 mIU/mL to 59.7 in controls, 32.0 to 71.8 in Ovcon 35 users, and from 40.2 to 85.1 in Triphasil users (p0.05). HDL values rose significantly in the group taking Ovcon, and LDL values fell significantly in all 3 groups. These low-dose pills can be used safely in postpartum gestational diabetic women, as long as they do not smoke, are encouraged to lose weight, and have no sign of cardiovascular disease as evidenced by albuminuria and an ophthalmoscopic exam. PMID:1679421

Shoupe, D; Bopp, B

1991-01-01

363

Prevalence and Correlates of Poor Self-Rated Health in the United States: The National Elder Mistreatment Study  

PubMed Central

Objectives Despite its subjective nature, self report of health status is strongly correlated with long term physical morbidity and mortality. Among the most reliable predictors of self-reported poor health is older age. In younger adult populations, a second reliable predictor of reported poor health is the experience of domestic and other interpersonal violence. However, very little research exits on the connection between elder mistreatment and self reports of poor health. The aim of the present study was to examine the level of, and correlates for, poor self-rated health in a community sample of older adults with particular emphasis on elder mistreatment history, demographics, and social dependency variables. Design Random Digit Dialing telephone survey methodology. Setting A national representative phone survey of non-institutionalized U.S. household population. Participants 5,777 U.S. adults, aged 60 and older. Measurements Individuals participated in a structured interview assessing elder mistreatment history, demographics, and social dependency variables. Results Poor self-rated health was endorsed by 22.3% of the sample. Final multivariable logistic regression models showed that poor self-rated health was associated with unemployment, marital status, low income, low social support, use of social services, needing help in activities of daily living, and being bothered by emotional problems. Exploratory analyses revealed a mediational role of emotional symptoms in the association between physical maltreatment and poor health. Conclusions Results suggest that poor health is common among older adults. This study also identified correlates of poor health that may be useful in identification of those in need of intervention.

Amstadter, Ananda B.; Begle, Angela Moreland; Cisler, Josh M.; Hernandez, Melba A.; Muzzy, Wendy; Acierno, Ron

2010-01-01

364

Contraceptive vaccines for wildlife: a review.  

PubMed

Wildlife, free-ranging and captive, poses and causes serious population problems not unlike those encountered with human overpopulation. Traditional lethal control programs, however, are not always legal, wise, safe, or publicly acceptable; thus, alternative approaches are necessary. Immunocontraception of free-ranging wildlife has reached the management level, with success across a large variety of species. Thus far, the immunocontraceptive research and management applications emphasis have been centered on porcine zona pellucida and gonadotropin-releasing hormone vaccines. Contraceptive success has been achieved in more than 85 different wildlife species, at the level of both the individual animal and the population. At the population management level with free-ranging species, the primary focus has been on wild horses, urban deer, bison, and African elephants. The challenges in the development and application of vaccine-based wildlife contraceptives are diverse and include differences in efficacy across species, safety of vaccines during pregnancy, the development of novel delivery systems for wild and wary free-ranging animals, and the constraints of certain non-contraceptive effects, such as effects on behavior. Beyond the constraints imposed by the public and a host of regulatory concerns, there exists a real limitation for funding of well-designed programs that apply this type of fertility control. PMID:21501279

Kirkpatrick, Jay F; Lyda, Robin O; Frank, Kimberly M

2011-07-01

365

Unmet need for contraception: issues and challenges.  

PubMed

Unmet need for contraception has been a central indicator for monitoring the progress of family planning programs for 25 years. The purpose of this article is to provide a broad context for the more focused contributions that follow in this special issue. The validity and measurement of the concept of unmet need are discussed. We then present regional trends among married women since 1970. Major reductions in unmet need have been achieved, with the clear exception of sub-Saharan Africa. Less success can be claimed in addressing the needs of sexually active unmarried women, who contribute nearly 20 percent to overall unmet need in developing countries. Prominent reasons for unmet need in settings where contraceptive uptake is low include social resistance and insufficient information concerning methods. As contraceptive use increases, the importance of these reasons wanes, but concerns regarding side effects and health impact remain a barrier, and discontinued users now constitute a large proportion of those with unmet need. Drawing on these reasons, we outline measures to further reduce unmet need. PMID:24931071

Cleland, John; Harbison, Sarah; Shah, Iqbal H

2014-06-01

366

The contraceptive practice of one thousand abortion patients.  

PubMed

This is a report on the contraceptive practice of 1000 cases who attended the Parkview clinic for termination of pregnancy. Fifty percent were not using any method of contraception at the time of conception. The principal reasons for non-use were dissatisfaction with previous methods and risk taking behaviour. Fifty percent became pregnant while using contraception, and in 20 percent methods which are generally regarded as reliable had been used. Fourteen percent were using the pill at the time of failure and this group is studied in greater detail. Improvements in contraceptive practice are suggested. PMID:6962387

Sparrow, M J

1982-12-22

367

Unintended pregnancy and subsequent use of modern contraceptive among slum and non-slum women in Nairobi, Kenya  

PubMed Central

Background In spite of major gains in contraceptive prevalence over the last few decades, many women in most parts of the developing world who would like to delay or avoid pregnancy do not use any method of contraception. This paper seeks to: a) examine whether experiencing an unintended pregnancy is associated with future use of contraception controlling for a number factors including poverty at the household and community levels; and b) investigate the mechanisms through which experiencing an unintended pregnancy leads to uptake of contraception. Methods Quantitative and qualitative data from a cross-sectional research project conducted in 2009/10 in two slum settlements and two non-slum settings of Nairobi, Kenya are used. The quantitative component of the project was based on a random sample of 1,259 women aged 15–49 years. Logistic regression models were used to assess the effect of unintended pregnancy on future contraceptive use. The qualitative component of the project successfully interviewed a total of 80 women randomly selected from survey participants who had reported having at least one unintended pregnancy. Results Women whose last pregnancy was unintended were more likely to be using a modern method of contraception, compared to their peers whose last pregnancy was intended, especially among the wealthier group as shown in the interaction model. Among poor women, unintended pregnancy was not associated with subsequent use of contraception. The qualitative investigation with women who had an unplanned pregnancy reveals that experiencing an unintended pregnancy seems to have served as a “wake-up call”, resulting in greater attention to personal risks, including increased interest in pregnancy prevention. For some women, unintended pregnancy was a consequence of strong opposition by their partners to family planning, while others reported they started using contraceptives following their unintended pregnancy, but discontinued after experiencing side effects. Conclusion This study provides quantitative and qualitative evidence that women who have had an unintended pregnancy are “ready for change”. Family planning programs may use the contacts with antenatal, delivery and post-delivery care system as an opportunity to identify women whose pregnancy is unplanned, and target them with information and services.

2014-01-01

368

Intentions to use contraceptives in Pakistan: implications for behavior change campaigns  

PubMed Central

Background Since 1990-91, traditional method use has increased at a faster rate in Pakistan than modern method use. The importance of hormonal methods or the IUD has diminished and that of traditional methods has increased in the method mix. There is a need to identify factors motivating and deterring the adoption of specific family planning methods among married men and women in Pakistan. Methods In addition to social and demographic characteristics of respondents, a representative household survey collected information on psychological correlates of family planning behavior from 1,788 non-pregnant wives and 1,805 husbands with not-pregnant wives. Males and females were from separate households. Principal components analysis was conducted to identify the underlying constructs that were important for each gender. Multinomial logistic regression analysis was conducted to determine the correlates of male and female intentions to use contraceptive methods. Results Amongst women, the perception that her in-laws support family planning use was the strongest determinant of her intentions to use contraceptive methods. A woman's belief in the importance of spacing children and her perception that a choice of methods and facilities with competent staff were available were also powerful drivers of her intentions to use contraceptive methods. The strongest obstacle to a woman's forming an intention to use contraceptive methods was her belief that family planning decisions were made by the husband and fertility was determined by God's will. Fears that family planning would harm a woman's womb lowered a woman's intentions to use methods requiring procedures, such as the IUD and female sterilization. The perception that a responsible, caring, husband uses family planning to improve the standard of living of his family and to protect his wife's health was the most important determinant of a man's intention to use condoms. A husband's lack of self-efficacy in being able to discuss family planning with his wife was the strongest driver of the intention to use withdrawal. A man's fear that contraceptives would make a woman sterile and harm her womb lowered his intention to use modern contraceptive methods. Conclusions These findings highlight the importance of having secondary target audiences such as mothers-in-law and husbands in family planning behavior change campaigns implemented in Pakistan. Campaigns that stress the importance of child spacing are likely to have an impact. Client perceptions of the quality of care are important determinants of intentions to use contraceptive methods in Pakistan. Client concerns that the IUD and sterilization procedures might harm a woman's womb and cause sterility should be addressed. The findings suggest that there is a need to assess the actual quality of service delivery in Pakistan.

2010-01-01

369

Risk of Breast Cancer in Relation to the Use of Injectable Progestogen Contraceptives and Combined Estrogen\\/Progestogen Contraceptives  

Microsoft Academic Search

Recent studies have suggested that progestogen-only contraceptives and combined estrogen\\/progestogen oral contraceptives (COCs) may increase the risk of breast cancer among women less than 35 years of age or among recent users. The authors conducted a case-control study, in which cases of breast cancer (n = 419) and controls (n = 1,625) hospitalized for conditions unrelated to contraceptive use were

Samuel Shapiro; Lynn Rosenberg; Margaret Hoffman; Hanneke Truter; Diane Cooper; Sowmya Rao; David Dent; Anne Gudgeon; Jakobus van Zyl; Judith Katzenellenbogen; Ross Bailie

370

Prevalence rate of thyroid diseases among autopsy cases of the atomic bomb survivors in Hiroshima, 1951-1985  

SciTech Connect

To examine the radiogenic risk of latent thyroid cancer, thyroid adenoma, colloid/adenomatous goiter and chronic thyroiditis, the date for 3821 subjects collected in the course of autopsies of atomic bomb survivors in Hiroshima from 1951 to 1985 by the Radiation Effects Research Foundation (RERF) were analyzed using a logistic model. About 80% of the autopsies were performed at RERF and the remainder at local hospitals. The frequencies of the above diseases were not associated with whether the underlying cause of death was cancer. However, note that our results may be influenced by potentially biasing factors associated with autopsy selection. The relative frequency of latent thyroid cancer (greatest dimension {le}1.5 cm but detectable on a routine microscopic slide of the thyroid gland) increased as the radiation dose increased and was about 1.4-fold greater at 1 Gy than in the 0-Gy dose group. The relative occurrence of thyroid adenoma also increased as radiation dose increased, and was about 1.5-fold greater at 1 Gy than in the 0-Gy dose group. Sex, age at the time of the bombing or period of observation did not significantly modify the radiogenic risks for thyroid adenoma or latent thyroid cancer. No statistically significant association was found between radiation exposure and the rates of colloid/adenomatous goiter and chronic thyroiditis. The possible late effect of atomic bomb radiation on the frequency of benign thyroid diseases is discussed on the basis of these data. 38 refs., 2 figs., 5 tabs.

Yoshimoto, Yasuhiko; Ezaki, Haruo [Radiation Effects Research Foundation, Hiroshima (Japan); Etoh, Ryozo [Fukuyama Hospital, Kagoshima (Japan); Hiraoka, Toshio [Kawaishi Hospital, Hiroshima (Japan); Akiba, Suminori [Kagoshima Univ. (Japan)

1995-03-01

371

[Changes in functional status of patients at initial admission to a psychogeriatric nursing home and at point-prevalence rate].  

PubMed

During a period of 15 years (1973-1987) the dependency of 902 patients on first admission to a psychogeriatric nursing home has been registered by means of the Beoordelingsschaal voor Oudere Patiënten (BOP, i.e. Behavioural Rating Scale for Elderly Patients). Besides, age, sex, marital status and place of residence before admission were registered. During the research period the proportion of severely disabled patients decreased systematically. The proportion of patients directly admitted from their homes increased. Furthermore, we found an increase of the proportion of married patients. These results are compatible with a greater accessibility of the nursing home, since the availability of nursing home beds in the region has grown significantly. Though the proportion of patients who were severely disabled on first admission, decreased, the experienced burden of care for in-patients has strongly increased. Since 1973 not only the dependency of in-patients increased, but also the need for a higher quality of care. We assume that the burden of care giving has increased due to these factors, but not to changed characteristics of patients on first admission. PMID:2349622

van Loo, E H; Roelofs, C A; Diesfeldt, H F

1990-04-01

372

Minimal stimulation IVF using clomiphene citrate and oral contraceptive pill pretreatment for LH suppression  

Microsoft Academic Search

Objective: To determine if oral contraceptive pill (OC) pre-treatment prior to minimal stimulation IVF using clomiphene citrate (CC) would make the procedure easier to perform by preventing the LH surge and result in pregnancy rates (PRs) comparable to stimulated IVF.Design: Prospective cohort study.Setting: Private tertiary infertility center.Patient(s): Thirty-two women with tubal or pelvic adhesive disease as the cause of their

Emmett F Branigan; M. Antoinette Estes

2000-01-01

373

Acceptance of long-acting reversible contraceptive methods by adolescent participants in the Contraceptive CHOICE Project  

PubMed Central

Background Adolescent women have a high risk of unintended pregnancy. Currently, there are little data about their choice to initiate long-acting reversible contraception (LARC). Study Design We evaluated the association of age and preference for a LARC vs. a non-LARC method among adolescent participants in the Contraceptive CHOICE Project, comparing those aged 14–17 years to adolescents aged 18–20 years. We then analyzed the association between age and choice of the implant vs. the intrauterine device (IUD) among adolescents. Results Of the 5086 women enrolled, 70% (n=3557) of participants chose a LARC method. Among adolescents aged 14–20 years, 69% of 14–17-year-olds chose LARC, while 61% of 18–20-year-olds chose LARC (relative risk 1.16, 95% confidence interval 1.03–1.30). Among adolescents choosing a LARC method, 63% (n=93/148) of the 14–17-year-olds chose the implant, whereas 71% (n=364/510) of the 18–20-year-olds chose the IUD. Conclusion Long-acting reversible contraception use is clearly acceptable and common among adolescents enrolled in the Contraceptive CHOICE Project, with the younger group being most interested in the implant.

Mestad, Renee; Secura, Gina; Allsworth, Jenifer E; Madden, Tessa; Zhao, Qiuhong; Peipert, Jeffrey F

2012-01-01

374

Oral Contraceptives and Breast Cancer: Modeling Risks and Benefits of Oral Contraceptives.  

National Technical Information Service (NTIS)

Recently, a great deal of attention has been focused on the relationship between oral contraceptive use and the risk of breast cancer. The approach of most studies to evaluate this relationship has been to estimate the increased incidence of breast cancer...

J. A. Fortney

1991-01-01

375

Agreement between patient-reported and provider-reported choice of contraceptive method among family planning patients in New York City: implications for public health  

PubMed Central

National data on choice of contraceptive method and subsequent use are critical for monitoring progress toward meeting public health goals in reducing unintended pregnancy in the US. Yet few studies have focused on the reliability of clinically-reported or patient-reported measures of choice of contraceptive method for the range of available contraceptive methods. Among 1,844 women receiving reproductive health care at two federally funded centers in New York City, choice of contraceptive method at the end of the visit from two data sources was compared, ie, patient self-report, and provider-report as recorded in the clinical-administrative database. Agreement between the two data sources was assessed for the sample. Sociodemographic predictors of agreement were assessed using logistic regression. Agreement between the data sources was also assessed on a method-by-method basis using positive specific agreement. Participants were predominantly Latina (69%), foreign-born (76%), and low-income (99% with incomes <200% federal poverty level). Agreement of patient-reported and provider-reported contraceptive choice was highest for hormonal methods (positive specific agreement 94.0%) and intrauterine devices (89.9%), and lowest for condoms (53.5%). In the logistic regression model, agreement was lower among teens aged 16–19 years compared with women aged 25+ years (odds ratio 0.74; 95% confidence interval 0.55–0.99). Because teens are more likely to rely on condoms, the logistic regression model was repeated, adjusting for provider report of condom choice; after adjustment, no sociodemographic differences in agreement were observed. National data sources or studies relying on provider-reported method choice to derive estimates of contraceptive prevalence may overestimate choice of condoms. Our findings raise the question of whether condom choice can be accurately assessed by a single open-ended measure of choice of contraceptive method.

Ventura, Alicia; Garbers, Samantha; Meserve, Allison; Chiasson, Mary Ann

2013-01-01

376

College Students' Knowledge, Attitudes, and Behaviors regarding Sex and Contraceptives  

ERIC Educational Resources Information Center

This study examined gender differences in college students' knowledge, attitudes, and sexual behaviors of 1,004 predominantly heterosexual students. Results indicated that students had limited knowledge about contraceptives and sexually transmitted infections (STIs). Females had a more positive view about contraceptives and males had more…

Toews, Michelle L.; Yazedjian, Ani

2012-01-01

377

Benefits and Risks of Third-Generation Oral Contraceptives  

PubMed Central

OBJECTIVE To evaluate the risks and benefits of third-generation oral contraceptives. DATA SOURCES A medlinesearch was done for English language articles published from 1985 through 1998 relating to the side-effect profile of third-generation oral contraceptives or their association with cardiovascular or thromboembolic disease. All articles containing original data were included. DATA SYNTHESIS The risk of venous thromboembolism appears to be 1.5- to 2.7-fold greater in users of third-generation, compared with second-generation, oral contraceptives. Compared with nonusers, women who use third-generation oral contraceptives may have a 4.8- to 9.4-fold greater risk of venous thromboembolism. Users of third-generation oral contraceptives do not appear to have an increased risk of myocardial infarction compared with nonusers and may have risk of myocardial infarction of 0.26 to 0.7 compared with second-generation users. Whether third-generation oral contraceptives are associated with a decreased stroke risk is still not clear. CONCLUSIONS Although third-generation oral contraceptives most likely increase a user's risk of venous thromboembolism, their improved side-effect profile and their possible decreased association with myocardial infarction and stroke may make them a useful new class of oral contraceptives for most women except those at increased risk of venous thrombosis.

LeBlanc, Erin S; Laws, Ami

1999-01-01

378

Evaluation of a Computerized Contraceptive Decision Aid for Adolescent Patients.  

ERIC Educational Resources Information Center

Discusses a computer-based contraceptive decision aid used with adolescent female family planning clinic patients (N=949). Results show improved short-term knowledge of and confidence in oral contraceptive (OC) efficacy. Higher OC knowledge after one year and fewer pregnancies were seen in one group. Findings suggest the usefulness of informatics…

Chewning, Betty; Mosena, Pat; Wilson, Dale; Erdman, Harold; Potthoff, Sandra; Murphy, Anita; Kuhnen, Kathleen Kennedy

1999-01-01

379

Pharmacy Access to Emergency Contraception in Rural and Frontier Communities  

ERIC Educational Resources Information Center

Context: Timely access to emergency contraception (EC) has emerged as a major public health effort in the prevention of unintended pregnancies. The recent FDA decision to allow over-the-counter availability of emergency contraception for adult women presents important rural health implications. American women, especially those living in rural and…

Bigbee, Jeri L.; Abood, Richard; Landau, Sharon Cohen; Maderas, Nicole Monastersky; Foster, Diana Greene; Ravnan, Susan

2007-01-01

380

[Blockade of calcium channels - a perspectiveof male contraception?].  

PubMed

Besides condoms and vasectomy with their own limitations, no other reliable methods of contraception are available to men. Ion channels play a key role in maturation, capacitation and acrosome reaction of sperms. Blockade of calcium channels with pharmacological inhibitors or compounds isolated from plant extracts might be suggested as one of promising mechanisms of future male contraceptives. PMID:23710989

Driák, D; Svandová, I

2013-04-01

381

Premarital Contraceptives Usage among Male and Female Adolescents.  

ERIC Educational Resources Information Center

Variables important in predicting female contraception usage were found to be those which involved dyadic commitment, conditions of love, self-esteem, and father's occupation (social class). The best predictors of male contraception usage involved experience in dating and internalization of role models via mother's and father's permissiveness.…

Hornick, Joesph P.; And Others

1979-01-01

382

Contraceptive Counseling and Use among Women with Poorer Health  

PubMed Central

Background To explore associations between health status, contraceptive counseling and contraceptive use. Methods Women aged 18–50 visiting one of 4 primary care clinics were invited to complete surveys after their visit. Perceived health status was measured using a 5-point scale. Among those considered at risk of unintended pregnancy, logistic regression was used to investigate associations between health status and contraceptive counseling and use. Findings Women reporting poorer health had decreased odds of receiving some contraceptive counseling at their visit (aOR=0.62, CI=0.39, 0.97) and using some contraception at last intercourse (aOR=0.63, CI=0.41, 0.97) compared to women reporting better health. However, among women with poorer health, receipt of counseling about hormonal contraception was associated with increased odds of using hormonal methods (aOR=8.22, CI=1.77, 38.19). Only 7% of women in poorer health received counseling on highly effective reversible contraception. Conclusions Women in poorer health may be at risk of adverse reproductive health outcomes and should receive counseling on safe hormonal and highly effective reversible contraceptives.

Lee, Jessica K.; Parisi, Sara M.; Schwarz, Eleanor Bimla

2013-01-01

383

Hormonal Contraceptive Use and Breast Cancer in Thai Women  

PubMed Central

Background Breast cancer is the most common cancer in women worldwide. We investigated the association of hormonal contraceptive use and breast cancer in Thai women. Methods A cohort study was conducted in Khon Kaen, Thai