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1

Association of programmatic factors with low contraceptive prevalence rates in a rural area of Bangladesh  

PubMed Central

Objective The study was conducted to identify selected programmatic factors relating to low contraceptive-use in a low-performing rural sub-district in Sylhet division of Bangladesh. Methods A cross-sectional survey was carried out among 6983 currently-married women of reproductive age (MWRA) (15–49 years). To estimate the association between current contraceptive-use and other selected factors, multivariate analyse were performed, estimating the crude and adjusted odds ratios (OR), including 95% confidence intervals (CI). Results The use of health facility by the MWRA in the last three months, distance from the residence to the nearest health facility, and contact with field workers in the last six months was significantly associated with contraceptive prevalence rate (CPR). There were potential differences regarding CPR, sources of contraceptive supply and Family Welfare Assistant (FWA) visit between hard to reach and non-hard to reach unions of Nabiganj sub-district. Conclusion Strategies should be devised to increase the accessibility of MWRA to contraceptive methods by increased partnership with non-public sector and increased contacts with outreach workers through introducing community volunteers, and mobile phones help lines, by organizing frequent satellite clinics (SCs) and making community clinics (CCs) functional. Innovative strategies should be piloted for improving use of contraception in such hard to reach and low performing locality. PMID:23782912

2013-01-01

2

Contraception  

Microsoft Academic Search

The United States has the highest rate of teen pregnancy in the Western world. Although abstinence may be the ideal solution for the prevention of this problem, one half of adolescents in the United States are sexually active. This article reviews the epidemiology of contraception among adolescents, barriers to effective use of contraception, and ways to improve efficacy. Major methods

Paula K. Braverman; Victor C. Strasburger

1993-01-01

3

Estimating the contribution of a service delivery organisation to the national modern contraceptive prevalence rate: Marie Stopes International's Impact 2 model  

PubMed Central

Background Individual family planning service delivery organisations currently rely on service provision data and couple-years of protection as health impact measures. Due to the substitution effect and the continuation of users of long-term methods, these metrics cannot estimate an organisation's contribution to the national modern contraceptive prevalence rate (CPR), the standard metric for measuring family planning programme impacts. Increasing CPR is essential for addressing the unmet need for family planning, a recognized global health priority. Current health impact estimation models cannot isolate the impact of an organisation in these efforts. Marie Stopes International designed the Impact 2 model to measure an organisation's contribution to increases in national CPR, as well as resulting health and demographic impacts. This paper aims to describe the methodology for modelling increasing national-level CPR as well as to discuss its benefits and limitations. Methods Impact 2 converts service provision data into estimates of the number of family planning users, accounting for continuation among users of long-term methods and addressing the challenges of converting commodity distribution data of short-term methods into user numbers. These estimates, combined with the client profile and data on the organisation's previous year's CPR contribution, enable Impact 2 to estimate which clients maintain an organisation's baseline contribution, which ones fulfil population growth offsets, and ultimately, which ones increase CPR. Results Illustrative results from Marie Stopes Madagascar show how Impact 2 can be used to estimate an organisation's contribution to national changes in the CPR. Conclusions Impact 2 is a useful tool for service delivery organisations to move beyond cruder output measures to a better understanding of their role in meeting the global unmet need for family planning. By considering health impact from the perspective of an individual organisation, Impact 2 addresses gaps not met by other models for family planning service outcomes. Further, the model helps organisations improve service delivery by demonstrating that increases in the national CPR are not simply about expanding user numbers; rather, the type of user (e.g. adopters, provider changers) must be considered. Impact 2 can be downloaded at http://www.mariestopes.org/impact-2. PMID:23902699

2013-01-01

4

On the determination of contraceptive prevalence using health care utilization data.  

PubMed

A potential application of health care utilization databases is in the determination of contraceptive prevalence. A model linking specific factors concerning the utilization of modern methods of family planning has been developed to estimate contraceptive prevalence by age group for Saskatchewan. The limitations of these estimations of contraceptive prevalence are discussed. PMID:9179107

Edouard, L

1997-04-01

5

Contraceptive prevalence, reproductive health and our common future.  

PubMed

The 1980s will go into history as a decade of lost opportunities to increase contraceptive prevalence and improve reproductive health worldwide. As the decade closes, 500 million couples still have no access to fertility regulation, there are 30-50 million induced abortions each year, 15 million infant and child deaths (30% of all deaths worldwide), an estimated 250 million new cases of sexually transmitted diseases and 60-80 million infertile couples. One of the major problems is that many policy makers are still unimpressed with the global demographic reality. World population was less than 300 million 1991 years ago. It took some 1500 years to double this number by the time of the voyages of Columbus to America. The first billion was reached at the beginning of the last century and the second in the lifetime of the author, in 1927. Then it took less than 50 years to double this number to 4 billion by 1976. Global population is 5.3 billion today. In view of such figures, it is understandable that, historically, it was this demographic concern that in the 1960s persuaded many governments to support family planning programmes. During the subsequent decades, it was gradually recognized by developing country governments that family planning lowers infant, child and maternal mortality and morbidity and reduces the number of illegal abortions and their health hazards. Today, 52 developing country governments support family planning programmes for the demographic rationale, but 65 for the reproductive health and human rights rationale. Where do we go from here? That will mainly depend on the number of years it will take to reach replacement level of fertility (around 2.1 children per couple) worldwide. If the level is reached in 2010 (the low projection of the United Nations), global population will stabilize by the end of the 21st century at 8 billion; if it is reached in 2035 (medium projection), population will stabilize around 10 billion; however, if it is reached only in 2065 (high projection), the global population in 2100 will consist of more than 14 billion people, with major consequences on every walk of life. To restrict the final population to 10 billion, contraceptive prevalence must increase from 51% to 58% of married women of reproductive age before the year 2000 and to 71% by 2020, implying an increase from the present 350 million users to 500 and 800 million, respectively.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:2036793

Diczfalusy, E

1991-03-01

6

Provision of long-acting reversible contraception in HIV-prevalent countries: results from nationally representative surveys in southern Africa  

PubMed Central

Objective To analyse the current provision of long-acting reversible contraception (LARC) and clinician training needs in HIV-prevalent settings. Design Nationally representative survey of clinicians. Setting HIV-prevalent settings in South Africa and Zimbabwe. Population Clinicians in South Africa and Zimbabwe. Methods Nationally representative surveys of clinicians were conducted in South Africa and Zimbabwe (n = 1444) to assess current clinical practice in the provision of LARC in HIV-prevalent settings. Multivariable logistic regression was used to analyse contraceptive provision and clinician training needs. Main outcome measure Multivariable logistic regression of contraceptive provision and clinician training needs. Results Provision of the most effective reversible contraceptives is limited: only 14% of clinicians provide copper intrauterine devices (IUDs), 4% levonorgestrel-releasing IUDs and 16% contraceptive implants. Clinicians’ perceptions of patient eligibility for IUD use were overly restrictive, especially related to HIV risks. Less than 5% reported that IUDs were appropriate for women at high risk of HIV or for HIV-positive women, contrary to evidence-based guidelines. Only 15% viewed implants as appropriate for women at risk of HIV. Most clinicians (82%), however, felt that IUDs were underused by patients, and over half desired additional training on LARC methods. Logistic regression analysis showed that LARC provision was largely restricted to physicians, hospital settings and urban areas. Results also showed that clinicians in rural areas and clinics, including nurses, were especially interested in training. Conclusions Clinician competency in LARC provision is important in southern Africa, given the low use of methods and high rates of unintended pregnancy among HIV-positive and at-risk women. Despite low provision, clinician interest is high, suggesting the need for increased evidence-based training in LARC to reduce unintended pregnancy and associated morbidities. PMID:23721413

Morse, J; Chipato, T; Blanchard, K; Nhemachena, T; Ramjee, G; McCulloch, C; Blum, M; Saleeby, E; Harper, CC

2013-01-01

7

Rheumatoid factor (antigammaglobulin) in women: effects of oral contraceptives use of its prevalence.  

PubMed

A total of 14,856 women, including 921 pregnant subjects, were tested for rheumatoid factor; 4,562 were using oral contraceptives at the time of testing. The prevalence of rheumatoid factor increased directly with age. The age-adjusted prevalence of rheumatoid factor was lower in oral contraceptive users than in nonusers but this difference was not statistically significant. Rheumatoid factor remained positive in 39% of subjects undergoing retesting after an average interval of 16 months. Those women with higher titers of rheumatoid factor were more likely to remain positive (81%). Of the women having positive tests, 5.4% were identified as having rheumatoid disease. PMID:59601

Sponzilli, E E; Ramcharan, S; Wingerd, J

1976-01-01

8

The link between oral contraceptive use and prevalence in autism spectrum disorder.  

PubMed

Autism spectrum disorder (ASD) is a group of developmental disabilities that include full syndrome autism, Asperger's syndrome, and other pervasive developmental disorders. The identified prevalence of ASD has increased in a short time period across multiple studies causing some to conclude that it has reached epidemic proportions in the U.S. Many possible explanations for the rise in numbers of individuals diagnosed with ASD have been offered and yet, causes and contributing factors for ASD are inadequately understood. Current evidence suggests that both genetics and environment play a part in causing ASD. One possible risk factor for the increase in prevalence has been profoundly overlooked in the existing biomedical and epidemiologic literature. As the prevalence of ASD has risen in the last sixty years, so has the prevalence of the usage of the oral contraceptives and other modern hormonal delivery methods. In 1960 about one million American women were using oral contraceptives, today close to 11 million women in the U.S. use oral contraceptives. Eighty-two percent of sexually active women in the U.S. have used oral contraceptives at some point during their reproductive years. Thus, the growth in use of progesterone/estrogen-based contraceptives in the United State has reached near-ubiquitous levels among women in the child-bearing age range. The suppression of ovulation produced by estrogen-progesterone is an indisputable abnormality. It is logical to consider the outcome of the ovum that would have been normally released from the ovary during ovulation. To date there is no comprehensive research into the potential neurodevelopmental effects of oral contraceptive use on progeny. The issue has been only sparsely considered in the biomedical literature. This article hypothesizes that the compounds, estrogen and progesterone, used in oral contraceptives modify the condition of the oocyte and give rise to a potent risk factor that helps explain the recent increase in the prevalence of ASD's. This hypothesis does not propose to delineate the cause of autism. Rather, it attempts to explain the recent dramatic increase in prevalence and point the way for further study that will lead to causal examination. PMID:25459142

Strifert, Kim

2014-12-01

9

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. PMID:23472099

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

10

High prevalence of insulin resistance assessed by the glucose clamp technique in hormonal and non-hormonal contraceptive users.  

PubMed

Objective To assess the prevalence of insulin resistance (IR) and associated factors in contraceptive users. Methods A total of 47 women 18 to 40 years of age with a body mass index (kg/m(2)) < 30, fasting glucose levels < 100 mg/dl and 2-hour glucose level < 140 mg/dl after a 75-g oral glucose load were submitted to a hyperinsulinemic-euglycemic clamp. The women were distributed in tertiles regarding M-values. The analysed variables were use of combined hormonal/non-hormonal contraception, duration of use, body composition, lipid profile, glucose levels and blood pressure. Results IR was detected in 19% of the participants. The women with low M-values presented significantly higher body fat mass, waist-to-hip ratio, fasting insulin, HOMA-IR and were nulligravida, showed > 1 year of contraceptive use and higher triglyceride levels. IR was more frequent among combined oral contraceptive users, however no association was observed after regression analysis. Conclusions The prevalence of IR was high among healthy women attending a family planning clinic independent of the contraceptive method used with possible long-term negative consequences regarding their metabolic and cardiovascular health. Although an association between hormonal contraception and IR could not be found this needs further research. Family planning professionals should be proactive counselling healthy women about the importance of healthy habits. PMID:25328007

Melhado-Kimura, Vaneska; Alegre, Sarah Monte; Pavin, Elizabeth João; Dos Santos, Priscilla de Nazaré Silva; Bahamondes, Luis; Fernandes, Arlete

2015-04-01

11

Prevalence and Factors Associated with Sexually Transmitted Infections among HIV Positive Women Opting for Intrauterine Contraception  

PubMed Central

Background Women living with HIV/AIDS (WLHA) are a high risk group for sexually transmitted infections (STIs). However, the majority of women with STIs are asymptomatic. Data on prevalence of STIs among WLHA in Uganda are limited. The objective of the study was to determine prevalence and factors associated with STIs among WLHA opting for intrauterine contraceptive device (IUD). Methods Three hundred fifty one WLHA deemed free of STIs using a syndromic logarithm were enrolled into the study. Endo-cervical swabs were taken before IUD insertion and PCR test for Nisseria gonorrhea (NG), Trichomonas vaginalis (TV) and Chlamydia trachomatis (CT) infections conducted. Results Participants’ mean age was 29.4 ± 6.2 years, 83% were under 35years, 50% had secondary education and 73% were married. The majority (69%) had disclosed their HIV sero status to their spouses, 82% used Cotrimoxazole prophylaxis, 70% were on antiretroviral therapy, 90% had CD4 count greater than 350, about 60% reported condoms use and 70% were of parity 2-4. Over 50% of the participants’ spouses were older than 35 years and 72% had attained secondary education. STIs prevalence was 11.1%, (95% CI 7.8-14.4) and individual prevalence for TV, NG, and CT was 5.9%, 5.4% and 0.9% respectively. Factors independently associated with STI were having primary or less education (OR= 2.3, 95% CI: 1.09 - 4.85) having a spouse of primary or less education (OR= 3.3, 95% CI: 1.6 - 6.78) and muslim faith (OR= 0.2, 95% CI: 0.04 - 0.78). Conclusion STI prevalence was 11.1%. TV and NG were the commonest STIs in this population. Having primary or less education for both participant and spouse was associated with increased risk while being of muslim faith was associated with reduced risk of STI. PMID:25859659

2015-01-01

12

Implantable contraceptives for women: effectiveness, discontinuation rates, return of fertility, and outcome of pregnancies  

Microsoft Academic Search

Progestogen-only contraceptive implants are highly effective. In most studies, 5-year cumulative pregnancy rates are less than 1.5\\/100 women for Norplant and Norplant II. No study has yet reported any failures with Implanon. Weight over 70 kg and age at insertion under 25 years both increase the failure rate of Norplant and Norplant II; however, data are as yet lacking for

Anna Glasier

2002-01-01

13

Association between long-acting reversible contraceptive use, teenage pregnancy, and abortion rates in England  

PubMed Central

Background Since the late 1990s, the British government has launched major strategies to address high teenage pregnancy and abortion rates in England. These have focused in part on improving access to contraception through national campaigns. This study assessed teenage pregnancy and abortion rate trends since 1998 and possible associations with usage of long-acting reversible contraceptives (LARCs). Methods Teenage conception rates and age-specific abortion rates were obtained from the Office for National Statistics and the Department of Health. LARC usage data was obtained for Depo-Provera, Implanon/Nexplanon, intrauterine devices, Mirena, and Noristerat from the IMS British Pharmaceutical Index, IMS Hospital Pharmacy Audit, IMS Disease Analyzer, and KT-31 reports. Through linear regression methods, changes in conception and abortion-related outcomes during 1998–2011 and the associations with LARC usage were assessed. Results Conception rates for girls younger than 18 years of age decreased significantly between 1998–2011, from 46.6 to 30.7 per 1,000 girls. A statistically significant association was observed between this decrease and increased LARC usage (P=0.0024) in this population. Abortion rates among females aged <18 years or aged 18–19 years decreased between 1998–2011, and their associations with increased LARC usage were statistically significant (P=0.0029 and P=0.0479, respectively). The pattern in older women was complex; abortion rates in women aged 20–24 years or 25–34 years increased slightly from 1998 to 2011, with stabilization during 2007–2011. Conclusion Increased LARC usage in England was significantly associated with decreased teenage pregnancy rates and abortion rates in females aged <20 years. Government strategies appears to have a positive impact on these outcomes; however, abortion rates among women over 20 years of age remain an issue. PMID:25473316

Connolly, Anne; Pietri, Guilhem; Yu, Jingbo; Humphreys, Samantha

2014-01-01

14

Effects of putative male pheromones on female ratings of male attractiveness: Influence of oral contraceptives and the menstrual cycle  

Microsoft Academic Search

Previous research has revealed that natural and synthetic pheromones can enhance ratings of opposite sex attractiveness. The present study investi- gated the effects of exposure to male axillary secretions on female ratings of the sexual attractiveness of male stimuli. Thirty-two female undergradu- ates, half of whom were contraceptive pill users, rated male vignette char- acters and photographs of male faces

Frances Thorne; Nick Neave; Andrew Scholey; Mark Moss; Bernhard Fink

15

Male contraception.  

PubMed

With the powerful tools of molecular investigation, the last decade has witnessed the most remarkable scientific advance in our history, yet no new leads for male contraception have been forthcoming. All the likely methods of male contraception discussed above were derived from relatively 'old' physiological principles or serendipitous observations. The increasing gap between fundamental research (in the control of mammalian spermatogenesis) and the lack of clinical application are a testament to the low public funding priority afforded to male reproduction and the unwillingness of the pharmaceutical industry to invest in male reproductive research and development. Yet amidst such an unfavourable setting and with very limited support, it is heartening to note that the prospects of introducing a new systemic method for male contraception into the market by the end of this millenium has been greatly enhanced. Thus the results of recent studies have confirmed the contraceptive efficacy of sex steroid-induced oligozoospermia and unexpectedly revealed an ethnically distinct pattern of susceptibility to the hormonal suppression of spermatogenesis. Thus, Asian men are more responsive than are caucasian, and long-acting testosterone esters now being tested in that most densely populated part of the world may well hasten the large-scale application of this method. This is probably the most effective way to correct the misconceptions that men are unwilling or disinterested in sharing in family planning options with their partners. Together with the increased acceptance of novel non-surgical and reversible methods of vas deferens occlusion and the availability of improved non-latex condoms, the currently unfulfilled contraceptive needs of millions of men can be increasingly met in future years. The consequent increase in overall contraceptive prevalence could well make the telling difference between demographic catastrophe and maintaining good quality existence. Politicians, scientists and industrialists need to wake up to their responsibilities and the opportunities offered by this untapped resource and market potential. PMID:8736719

Wu, F C

1996-04-01

16

Contraception for adolescents.  

PubMed

Contraception is a pillar in reducing adolescent pregnancy rates. The American Academy of Pediatrics recommends that pediatricians develop a working knowledge of contraception to help adolescents reduce risks of and negative health consequences related to unintended pregnancy. Over the past 10 years, a number of new contraceptive methods have become available to adolescents, newer guidance has been issued on existing contraceptive methods, and the evidence base for contraception for special populations (adolescents who have disabilities, are obese, are recipients of solid organ transplants, or are HIV infected) has expanded. The Academy has addressed contraception since 1980, and this policy statement updates the 2007 statement on contraception and adolescents. It provides the pediatrician with a description and rationale for best practices in counseling and prescribing contraception for adolescents. It is supported by an accompanying technical report. PMID:25266430

2014-10-01

17

Plan A: postabortion contraception.  

PubMed

More than 1 million abortions are performed annually in the United States. Women presenting for abortion care are often motivated by the pregnancy to use effective contraception; they are also at high risk for repeat unintended pregnancy. For these reasons, abortion represents an optimal time to initiate effective contraception. There is strong evidence that most methods of contraception, including intrauterine devices and the contraceptive implant, should be initiated at the time of the abortion procedure. Most women ovulate within the first month after an abortion. If provision of contraception is delayed, women are less likely to use effective contraception and more likely to have a repeat unintended pregnancy. Although some methods of permanent contraception can be safely performed at the time of abortion, federal and state laws often restrict these procedures being performed concurrently. Contraceptive counseling and provision at the time of abortion are important strategies to decrease rates of unintended pregnancy. PMID:25254920

Micks, Elizabeth; Prager, Sarah

2014-12-01

18

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

19

Prevalence of pregnancy experiences and contraceptive knowledge among single adults in a low socio-economic suburban community in Kuala Lumpur, Malaysia  

PubMed Central

Background This study aimed to investigate the prevalence of pregnancy experience and its association with contraceptive knowledge among single adults in a low socio-economic suburban community in Kuala Lumpur, Malaysia. Methods A cross-sectional survey was conducted in 2012 among the Kerinchi suburban community. Of the total 3,716 individuals surveyed, young single adults between 18 and 35 years old were questioned with regard to their experience with unplanned pregnancy before marriage. Contraceptive knowledge was assessed by a series of questions on identification of method types and the affectivity of condoms for the prevention of sexually transmitted diseases. Results A total of 226 female and 257 male participants completed the survey. In total, eight female (3.5%) participants reported experience with an unplanned pregnancy before marriage, and five male (1.9 %) participants had the experience of impregnating their partners. The participants had a mean total score of 3.15 (SD = 1.55) for contraceptive knowledge out of a possible maximum score of five. Female participants who had experienced an unplanned pregnancy had a significantly lower contraceptive knowledge score (2.10 ± 1.48) than who had never experienced pregnancy (3.30 ± 1.35), p<0.05. Likewise, male participants who had experienced impregnating their partners had a significantly lower contraceptive knowledge score (1.60 ± 1.50) than those who did not have such experience (3.02 ± 1.59), p<0.05. Conclusion The results showed evidence of premarital unplanned pregnancy among this suburban community. The low level of contraceptive knowledge found in this study indicates the need for educational strategies designed to improve contraceptive knowledge. PMID:25438066

2014-01-01

20

Emergency Contraception  

MedlinePLUS

... have used emergency contraception pills? • How is the copper intrauterine device (IUD) used as emergency contraception? • Glossary ... your next menstrual period starts. How is the copper intrauterine device (IUD) used as emergency contraception? The ...

21

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. PMID:23226635

Mathew, Vivek; Bantwal, Ganapathi

2012-01-01

22

[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

23

Long-term contraceptives.  

PubMed

To avoid unintended pregnancy, women in the UK need to consistently use reliable contraception for over 30 years. The long-acting reversible contraceptive methods compromise the progestogen-only implant, the progestogen-only injectable contraceptive, the copper-bearing intra-uterine device and the levonorgestrel-releasing intra-uterine system. These methods of contraception are highly reliable in pregnancy prevention, and are amongst the medically safest methods for users. Despite this, these long-acting methods are used by less than 10% of the UK population. National guidance has advised that increasing uptake of these long-acting methods will reduce the unplanned pregnancy rate. In addition, these methods are more cost effective than the oral contraceptive even at 1 year of use. Obstetricians and gynaecologists frequently come into contact with women requiring contraceptive advice, and should have a sound knowledge of the long-acting methods. PMID:20558111

Brown, Audrey

2010-10-01

24

Contraception in the perimenopause.  

PubMed

Pregnancy in women aged 40 and above is frequently unplanned and the legal abortion rate is high in this age group. Contraception and fertility are shrouded in popular mythology and many women do not appreciate either their risk of conception or the range of methods available to prevent conception. Either hormonal or non-hormonal methods of contraception may be appropriate. PMID:2059771

Hollingworth, B A; Guillebaud, J

1991-04-01

25

Continuation rates of oral hormonal contraceptives in a cohort of first-time users: a population-based registry study, Sweden 2005–2010  

PubMed Central

Objective To investigate if continuation rates in first-time users of oral hormonal contraceptives differed between different formulations and to measure if the rates were related to the prescribing categories, that is, physicians and midwives. Design A longitudinal national population-based registry study. Setting The Swedish prescribed drug register. Participants All women born between 1977 and 1994 defined as first-time users of hormonal contraceptives from 2007 to 2009 (n=226?211). Main outcome measures A tendency to switch the type of hormonal contraceptive within 6?months use and repeated dispensation identical to the first were estimated as percentages and relative risks (RRs). Physicians’ and midwives’ prescription patterns concerning the women's continuation rates of oral hormonal contraceptive type. Results In Sweden, there were 782?375 women born between 1977 and 1994 at the time of the study. Of these, 226?211 women were identified as first-time users of hormonal contraceptives. Ethinylestradiol+levonorgestrel, desogestrel-only and ethinylestradiol+drospirenone were the hormonal contraceptives most commonly dispensed to first-time users at rates of 43.3%, 24.4% and 11.1%, respectively. The overall rate of switching contraceptive types in the first 6?months was 11.3%, which was highest for desogestrel-only (14.3%) and lowest for ethinylestradiol+drospirenone (6.6%). The switching rate for all three products was highest in the 16-year to 19-year age group. Having a repeated dispensation identical to the initial dispensation was highest for users of ethinylestradiol either combined with levonorgestrel or drospirenone, 81.4% and 81.2%, respectively, whereas this rate for the initial desogestrel-only users was 71.5%. The RR of switching of contraceptive type within the first 6?months was 1.35 (95% CI 1.32 to 1.39) for desogestrel-only and 0.63 (0.59 to 0.66) for ethinylestradiol+drospirenone compared with ethinylestradiol+levonorgestrel as the reference category. There were no differences in the women's continuation rates depending on the prescriber categories. Conclusions Desogestrel-only users conferred the highest switcher rate to another hormonal contraceptive within a 6-month period. Users of ethinylestradiol+levonorgestrel were more prone to switch to another product within 6?months than women using ethinylestradiol+drospirenone. These findings may be of clinical importance when tailoring hormonal contraceptives on an individual basis. PMID:24141970

Josefsson, Ann; Wiréhn, Ann-Britt; Lindberg, Malou; Foldemo, Anniqa; Brynhildsen, Jan

2013-01-01

26

Emergency Contraception  

MedlinePLUS

... available: emergency contraceptive pills and the copper-containing intrauterine device (IUD). Emergency contraceptive pills include the following: A pill that contains levonorgestrel (some brand names: My Way, Next Choice, Plan ...

27

Contraceptive Development.  

ERIC Educational Resources Information Center

This report provides an overview of research activities and needs in the area of contraceptive development. In a review of the present state, discussions are offered on the effectiveness and drawbacks of oral contraceptives, intrauterine devices, barrier methods, natural family planning, and sterilization. Methods of contraception that are in the…

Troen, Philip; And Others

28

Emergency contraception.  

PubMed

Emergency contraception is the only form of contraception where implementation can occur after sexual relations or forced intercourse. Hormonal methods can be administered up to 72h after unprotected intercourse. Emergency contraception is safe, legal, and simple to administer. Widespread availability could dramatically decrease the number of unwanted pregnancies. PMID:7893964

Barnhart, K T; Sondheimer, S J

1994-12-01

29

Unmet contraceptive needs among refugees  

PubMed Central

Abstract Objective To describe what women of reproductive age who received primary care at a refugee health clinic were using for contraception upon arrival to the clinic, and to quantify the unmet contraceptive needs within that population. Design Retrospective chart review. Setting Crossroads Clinic in downtown Toronto, Ont. Participants Women of reproductive age (15 to 49 years) who first presented for care between December 1, 2011, and December 1, 2012. To be included, a woman had to have had 2 or more clinic visits or an annual health examination. Exclusion criteria for the contraception prevalence calculation were female sexual partner, menopause, hysterectomy, pregnancy, or trying to conceive. Main outcome measures Contraception use prevalence was measured, as was unmet contraceptive need, which was calculated using a modified version of the World Health Organization’s definition: the number of women with an unmet need was expressed as a percentage of women of reproductive age who were married or in a union, or who were sexually active. Results Overall, 52 women met the criteria for inclusion in the contraceptive prevalence calculation. Of these, 16 women (30.8%) did not use any form of contraception. Twelve women were pregnant at some point in the year and stated the pregnancy was unwanted or mistimed. An additional 14 women were not using contraception but had no intention of becoming pregnant within the next 2 years. There were no women with postpartum amenorrhea not using contraception and who had wanted to delay or prevent their previous pregnancy. In total, 97 women were married or in a union, or were sexually active. Unmet need was calculated as follows: (12 + 14 + 0)/97 = 26.8%. Conclusion There was a high unmet contraceptive need in the refugee population in our study. All women of reproductive age should be screened for contraceptive need when first seeking medical care in Canada. PMID:25642489

Aptekman, Marina; Rashid, Meb; Wright, Vanessa; Dunn, Sheila

2014-01-01

30

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. PMID:24007251

Robinson, Jennifer A; Burke, Anne E

2014-01-01

31

Intrauterine contraception.  

PubMed

Essential facts Intrauterine contraception (IUC) methods are long-acting reversible contraceptives with licensed durations of use lasting between three and ten years. They include copper intrauterine devices (Cu-IUD), which are non-hormonal, and levonorgestrel intrauterine systems (LNG-IUS), which release levonorgestrel. They are suitable for most women, including those who have not been pregnant. PMID:25315545

2014-10-21

32

Contraceptive Evaluation.  

ERIC Educational Resources Information Center

The objective of research in contraceptive evaluation is to improve the ability of individuals to choose contraceptive methods best suited to their needs and circumstances and to provide information that will lead to the development of safer and more effective methods. There are usually three considerations in judging the importance of a method of…

Hulka, Barbara S.; And Others

33

Emergency Contraception  

Microsoft Academic Search

mergency contraception is used after unprotected intercourse or a contraceptive acci- dent to prevent unwanted pregnancy. It is thought to work by stopping or delaying ovulation or preventing implantation if fertilization has already taken place. Hormonal methods, mifepristone, and intrauterine device insertion are among the methods used worldwide. Combination estrogen-progestin birth control pills are the most commonly used form of

Caroline Wellbery

2000-01-01

34

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. PMID:17761562

Temkin, Elizabeth

2007-01-01

35

[Extended cycle oral contraceptives].  

PubMed

Oral contraceptive pills are conventionally prescribed in a manner that causes monthly withdrawal uterine bleeding (lunar month). The reasons for this are historical without an inherent medical need. According to our literature search, there are patients' demands for less frequent menstrual cycles. We have learned from patients who were given the pill continuously for long periods due to medical or social indications that continuous administration of the contraceptive pill is feasible and safe. In the current review, the authors have searched the literature regarding extended cycle oral contraception for periods of time up to one year. This way of administration of the pill is not compromising the efficacy of pregnancy prevention, nor is it detrimental in terms of cardiovascular and hemostatic complications or endometrial malignancy. It is known that there is a slightly increased risk of breast cancer in users of oral contraceptives up to 10 years, regardless of the mode of administration. From a few studies of hormone replacement therapy in postmenopausal women, there is concern that continuous treatment may be deleterious, while sequential is not. Extended cycle contraceptive treatment has a few side effects, mainly increased breakthrough bleeding but decreased withdrawal bleeding. Other side effects were less prevalent than in conventional administration. PMID:17990394

Geist, Ruth; Beyth, Yoram

2007-10-01

36

Helicobacter pylori in sleeve gastrectomies: prevalence and rate of complications.  

PubMed

HELICOBACTER PYLORI IN SLEEVE GASTRECTOMIES: Prevalence & Rate of Complications. Prevalence of Helicobacter pylori has not been established in sleeve gastrectomy specimens and yet initial observations indicate that it is significant. The aim is to determine prevalence of Helicobacter pylori and correlate with rate of post-operative complications. A total of 89 Sleeve gastrectomies were identified. Pathology reports and slides were re-examined. Warthin Starry special stain and clinical history were obtained. 38 cases were Helicobacter pylori positive (44%). 33 (39%) cases initially reported negative for Helicobacter pylori on routine hematoxylin and eosin stained slide; were positive when Warthin starry stain was employed. The presence of neutrophils in tissue was strongly associated with presence of Helicobacter pylori on Warthin stain (p<0.001). Post-operative complications were observed in 8 patients (9%). Complications were not significantly associated with Warthin-Starry special stain status (p=0.98). PMID:23386918

Albawardi, Alia; Almarzooqi, Saeeda; Torab, Fawaz Chikh

2013-01-01

37

Helicobacter pylori in sleeve gastrectomies: prevalence and rate of complications  

PubMed Central

Helicobacter pylori in Sleeve gastrectomies: Prevalence & Rate of Complications. Prevalence of Helicobacter pylori has not been established in sleeve gastrectomy specimens and yet initial observations indicate that it is significant. The aim is to determine prevalence of Helicobacter pylori and correlate with rate of post-operative complications. A total of 89 Sleeve gastrectomies were identified. Pathology reports and slides were re-examined. Warthin Starry special stain and clinical history were obtained. 38 cases were Helicobacter pylori positive (44%). 33 (39%) cases initially reported negative for Helicobacter pylori on routine hematoxylin and eosin stained slide; were positive when Warthin starry stain was employed. The presence of neutrophils in tissue was strongly associated with presence of Helicobacter pylori on Warthin stain (p<0.001). Post-operative complications were observed in 8 patients (9%). Complications were not significantly associated with Warthin-Starry special stain status (p=0.98). PMID:23386918

Albawardi, Alia; Almarzooqi, Saeeda; Torab, Fawaz Chikh

2013-01-01

38

College Students' Perceived Disease Risk versus Actual Prevalence Rates  

ERIC Educational Resources Information Center

Objective: To compare college students' perceived disease risk with disease prevalence rates. Methods: Data were analyzed from 625 college students collected with an Internet-based survey. Paired t-tests were used to separately compare participants' perceived 10-year and lifetime disease risk for 4 diseases: heart disease, cancer, diabetes, and…

Smith, Matthew Lee; Dickerson, Justin B.; Sosa, Erica T.; McKyer, E. Lisako J.; Ory, Marcia G.

2012-01-01

39

[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

40

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. PMID:24708827

2014-01-01

41

Emergency contraception.  

PubMed

There have been numerous attempts to control fertility after unprotected sexual intercourse (UPSI). From very bizarre methods like the vaginal application of Coca Cola to the more serious attempts using calcium antagonists influencing fertility parameters in sperm to hormonal methods or intrauterine devices. So far, hormonal methods preventing or delaying ovulation have proved to be the most popular starting with the combination of ethinyl estradiol and levonorgestrel (LNG), known as the Yuzpe regimen. The first dose had to be taken within 72 hours of UPSI, a second one 12 hours later. Later on, LNG alone, at first in a regimen similar to the Yuzpe method (2?×?0.75?mg 12 hours apart) showed to be more successful, eventually resulting in the development of a 1.5?mg LNG pill that combined good efficacy with a high ease of use. Several efficacious and easy to use methods for emergency contraception (EC) are available on the market today with the most widely spread being LNG in a single dose of 1.5?mg (given as one tablet of 1.5?mg or 2 tablets of 0.75?mg each) for administration up to 3 days (according to WHO up to 5 days) after UPSI. Its limitations are the non-optimal efficacy which is decreasing the later the drug is taken and the fact that it is only approved for up to 72 hours after UPSI. This regimen has no effect on the endometrium, corpus luteum function and implantation, is not abortive and don't harm the fetus if accidentally taken in early pregnancy. It has no impact on the rate of ectopic pregnancies. It has become the standard method used up to this day in most countries. Since the mid 1970s copper IUDs have been used for EC, which show a high efficacy. Their disadvantages lie in the fact that EC is considered an off label use for most IUDs (not for the GynFix copper IUD in the European Union) and that they might not be acceptable for every patient. Furthermore IUD-insertion is an invasive procedure and it is required trained providers and sterilized facilities. Mifepristone in the dosages of 10 or 25?mg is used with good results as an emergency contraceptive in China for up to 120 hours after UPSI, but has never received any significant consideration in Western countries. While high doses of mifepristone has an effect on endometrial receptivity and will inhibit ovulation if given in the follicular phase and prevent implantation if given in the early luteal phase, low doses such as 10?mg has no impact on the endometrium. Mifepristone does not increase the rate of ectopic pregnancies. The most recent development is the approval of the selective progesterone receptor modulator ulipristal acetate (UPA) in the dosage of 30?mg for EC up to 5 days after UPSI, combining the safe and easy application of the single dose LNG pill with an even higher efficacy. It has shown to be more efficacious than LNG and can be used for up to 120 hours after UPSI; the difference in efficacy is highest for 0-24 hours, followed by 0-72 hours following UPSI. No VTE has been reported following UPA-administration or any progesterone receptor modulator. No effect on endometrium, corpus luteum function and implantation has been observed with doses used for EC. Independent of the substance it should be noted that, if there is a choice, the intake of an oral emergency contraceptive pill should happen as soon as possible after the risk situation. A pre-existing pregnancy must be excluded. Possible contraindications and drug interactions must be considered according to the individual special product informations. PMID:23437846

Gemzell-Danielsson, Kristina; Rabe, Thomas; Cheng, Linan

2013-03-01

42

Emergency contraception.  

PubMed

This review will focus on the available methods for emergency contraception (EC), efficacy, side effects and mechanisms of action. Copper intrauterine device (IUD) has been shown to be the most effective method for EC which can be continually used for regular contraception. However, this possibility is seldom used and may be little known. Among the hormonal EC methods 1.5 mg levonorgestrel is the most widely used EC pill while the more recently developed Ulipristal acetate (UPA) has been shown to be the most effective option. This is probably due to a more pronounced prevention of follicular rupture compared with other hormonal EC methods. Knowledge is needed to better advise lactating women and obese women on optimal EC method. Furthermore a possible interaction of UPA with regular hormonal contraception and possibilities for "bridging" from EC to regular contraception needs to be explored. To increase efficacy future studies should focus on EC methods that target the endometrium. PMID:23384749

Lalitkumar, P G L; Berger, Cecilia; Gemzell-Danielsson, Kristina

2013-02-01

43

Emergency contraception  

MedlinePLUS

... that is used contains a small amount of copper. Your doctor can remove it after your next period. You may also choose to leave it in place to provide ongoing birth control. MORE ABOUT EMERGENCY CONTRACEPTIVE PILLS Women of any ...

44

Contraception for adolescents.  

PubMed

In the contraceptive clinic of the Margaret Sanger Research Bureau, about 3000 patients are served each year, with at least 15% under 18. Of those attending the Teen Center as of 1972, aged 17 and younger, 15% used the diaphragm, 26% the IUD, 43% oral contraceptives, 10% foam or condom, and 5% a long-acting injectable. The Teen Center's program is limited to 200 girls, and along with contraceptive services, provides peer group discussions which help the girls decide which contraceptive to choose. Girls choose the diaphragm mostly when intercourse does not occur frequently. The IUD is best for those who fear the possibility of forgetting to use contraception. Although the IUD is not ideal for nulliparous women, gentle and slow insertion techniques reduce unpleasant symptoms. The girl who wishes to run no pregnancy risk whatsoever, who is not fearful of side effects, who has no strong feelings about ingesting chemicals, who is confident of not forgetting to take the pill regularly, and who desires the convenience of routine is most likely to select the oral contraceptive. The risks of the effect of oral contraceptives on the growing body are countered by the greater potential harmful effects of pregnancy producing much higher estrogen levels than caused by the pill. Because of the different needs of teenagers, they are seen every 3 months. Since the clinic's beginning in February 1971, about 8% have dropped from the program; 12 girls became pregnant and 9 had subsequent abortions. The low dropout rate is attributed to the teenagers' perception that the staff accepts and cares about them. PMID:4805712

Lane, M E

1973-01-01

45

Barriers to Sustained Use of Contraception in Nepal: Quality of Care, Socioeconomic Status, and Method-Related Factors  

Microsoft Academic Search

Owing to previously limited data availability, low contraceptive prevalence, and predominance of permanent method use in Nepal, there have been few studies of contraceptive-use dynamics. The aim of this article is to examine contraceptive use dynamics in Nepal in light of the country's ongoing fertility transition and change in contraceptive method-mix. Drawing on the 2003 Contraceptive Acceptance and Use Patterns

Bina Gubhaju

2009-01-01

46

Adolescents and emergency contraception  

Microsoft Academic Search

The United States has a high rate of teen pregnancies. The Food and Drug Administration recently approved hormonal emergency contraception (EC), which can be used after unprotected intercourse to reduce the likelihood that a pregnancy will occur. Several pill regimens that are now available by prescription only are safe and effective if used within 72 hours of unprotected intercourse. However,

Carol F. Roye; Jennifer R. M. Johnsen

2002-01-01

47

Contraceptive use dynamics of Asian women in Britain.  

PubMed

In-depth interviews were conducted with married Asian women from Indian, Pakistani and Bangladeshi backgrounds, to investigate patterns of contraceptive use and influences on contraceptive decision making. The results show two distinctively different contraceptive 'lifecycles'. Non-professional women typically have little knowledge about contraception until after their marriage or first birth. Their patterns of contraceptive behaviour show low levels of contraceptive use until after their first birth, when condom use is most prevalent. Non-professional women are influenced by their extended family, religion and cultural expectations on their fertility and family planning decisions. Professional women show an entirely different pattern of contraceptive behaviour. They are more likely to have knowledge about contraception before marriage, use some method of contraception throughout their childbearing years (typically the pill) and cite personal, practical or economic considerations in their fertility decisions rather than religious, cultural or extended family influences. PMID:10581881

Hennink, M; Diamond, I; Cooper, P

1999-10-01

48

Emergency contraception with a Copper IUD or oral levonorgestrel: an observational study of 1-year pregnancy rates  

PubMed Central

Objective We investigated the one-year pregnancy rates for emergency contraception (EC) users who selected the copper T380 IUD or oral levonorgestrel (LNG) for EC. Study Design This prospective study followed women for 1 year after choosing either the copper T380 IUD or oral LNG for EC. The study was powered to detect a 6% difference in pregnancy rates within the year after presenting for EC. Results Of the 542 women who presented for EC, agreed to participate in the trial, and meet inclusion criteria, 215 (40%) chose the copper IUD and 327 (60%) chose oral LNG. In the IUD group, 127 (59%) were nulligravid. IUD insertion failed in 42 women (19%). The 1-year follow-up rate was 443/542 (82%); 64% of IUD users contacted at 1 year still had their IUDs in place. The 1-year cumulative pregnancy rate in women choosing the IUD was 6.5% vs. 12.2% in those choosing oral LNG (HR= 0.53, 95% CI: 0.29–0.97, p=0.041). By type of EC method actually received, corresponding values were 5.2% for copper IUD users vs. 12.3% for oral LNG users, HR 0.42 (95% CI: 0.20–0.85, p= 0.017). A multivariable logistic regression model controlling for demographic variables demonstrates that women who chose the IUD for EC had fewer pregnancies in the following year than those who chose oral LNG (HR 0.50, 95% CI: 0.26–0.96, p=0.037). Conclusion One year after presenting for EC women choosing the copper IUD for EC were half as likely to have a pregnancy compared to those choosing oral LNG. PMID:24332433

Turok, David K.; Jacobson, Janet C.; Dermish, Amna I.; Simonsen, Sara E.; Gurtcheff, Shawn; McFadden, Molly; Murphy, Patricia A.

2014-01-01

49

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. PMID:21571556

Barber, Jacques P.

2011-01-01

50

A three-year comparative study of continuation rates, bleeding patterns and satisfaction in Australian women using a subdermal contraceptive implant or progestogen releasing-intrauterine system.  

PubMed

BACKGROUND Long-acting reversible contraceptive methods (LARCs) are safe, highly effective, readily reversible, and require no action on the part of the user following insertion. Early discontinuation may put women at increased risk of unintended pregnancy. METHODS Following insertion of a progestogen-only subdermal implant or intrauterine system (IUS) at Family Planning NSW, women 18 years and older completed a questionnaire about their choice. At 6 weeks, 6, 12, 24 and 36 months by telephone or online they completed a questionnaire about bleeding patterns, side effects, satisfaction, and reasons for discontinuation. RESULTS Two hundred IUS users and 149 implant users were enrolled. The former were generally older, married or in a de-facto relationship, and had children. Forty-seven percent of implant users discontinued within three years compared to 27% of IUS users (p = 0.002). In the first two years amenorrhoea was more frequent in implant users. Frequent bleeding/spotting was more prevalent in the first year of IUS use but over time was twice as prevalent in implant users. Infrequent bleeding/spotting was more common in IUS users. CONCLUSION Both devices are highly effective and acceptable cost-effective methods. While LARCs should be promoted to women of all ages seeking contraception, early discontinuation due to unacceptable bleeding highlights the need for pre-insertion counselling. PMID:24229367

Weisberg, Edith; Bateson, Deborah; McGeechan, Kevin; Mohapatra, Lita

2014-02-01

51

Emergency contraception.  

PubMed

This review summarises the development of emergency contraception (EC) methods, and provides an overview on the currently available options of EC which are effective and safe back-up methods in case of non-use or failure of the regular contraception. The copper intrauterine contraceptive device is currently the most effective method. In most countries, a single dose of levonorgestrel 1.5 mg is the first-line hormonal EC given within 72 h of unprotected intercourse. The oral anti-progestogens such as mifepristone and ulipristal acetate are promising alternatives with better efficacies and a wider treatment window of up to 120 h post coitus, probably resulting from more diverse ancillary mechanisms of actions. Education on EC should be part of any contraceptive counselling. Improving access to EC by providing it over the counter or in advance would not promote its abuse nor encourage risky sexual behaviours, but may further facilitate the timely use so as to achieve the best efficacy. PMID:24898437

Li, Hang-Wun Raymond; Lo, Sue Seen Tsing; Ho, Pak-Chung

2014-08-01

52

Emergency Contraception  

MedlinePLUS

... pregnancy and STDs. If a girl has been forced to have unwanted sex, she should see a doctor right away to ... It is also available to teens who are forced to have unprotected sex. Emergency contraception is not recommended for girls who ...

53

Contraception for adolescents.  

PubMed

CME EDUCATIONAL OBJECTIVES: 1.Identify and explain the four currently available methods of emergency contraception.2.Discuss the risk and benefits of intrauterine devices as a first-line option for contraception in adolescents.3.Review strategies for explaining the most common contraceptive methods to an adolescent. The US has the highest pregnancy rate of any industrialized nation, approximately twice that of Canada, four times that of France, and eight times that of Japan or Italy.1 In recent years, the rate has declined, partially due to delayed coitarche (age of onset of vaginal sexual intercourse) but mainly due to greater use of contraception.2 Per the 2011 Youth Risk Behavior Survey (a national survey of about 15,000 youth in schools), 33% of high school freshmen, 44% of sophomores, 53% of juniors, and 63% of seniors have had vaginal sexual intercourse. To prevent unplanned and unwanted teenage pregnancies, which have negative consequences on a teenager's health and future, pediatricians must be able to provide birth control or at least know where to refer their patients in need. PMID:23379400

Yen, Sophia; Martin, Susanne

2013-02-01

54

[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

55

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

56

Preventing Repeat Teen Pregnancy: Postpartum Depot Medroxyprogesterone Acetate, Oral Contraceptive Pills, or the Patch?  

Microsoft Academic Search

Study ObjectiveTo prospectively evaluate the repeat teen pregnancy rates, within one year of delivery, among adolescents who choose the contraceptive patch (Ortho Evra) versus oral contraceptive pills (OCP) versus Depot Medroxyprogesterone Acetate (Depo Provera, DMPA) for postpartum contraception.

Andrea Ries Thurman; Natalie Hammond; Helen E. Brown; Mary Ellen Roddy

2007-01-01

57

Impact of Social Franchising on Contraceptive Use When Complemented by Vouchers: A Quasi-Experimental Study in Rural Pakistan  

PubMed Central

Background Pakistan has had a low contraceptive prevalence rate for the last two decades; with preference for natural birth spacing methods and condoms. Family planning services offered by the public sector have never fulfilled the demand for contraception, particularly in rural areas. In the private sector, cost is a major constraint. In 2008, Marie Stopes Society – a local NGO started a social franchise programme along with a free voucher scheme to promote uptake of IUCDs amongst the poor. This paper evaluates the effectiveness of this approach, which is designed to increase modern long term contraceptive awareness and use in rural areas of Pakistan. Methodology We used a quasi-experimental study design with controls, selecting one intervention district and one control district from the Sindh and Punjab provinces. In each district, we chose a total of four service providers. A baseline survey was carried out among 4,992 married women of reproductive age (MWRA) in February 2009. Eighteen months after the start of intervention, an independent endline survey was conducted among 4,003 women. We used multilevel logistic regression for analysis using Stata 11. Results Social franchising used alongside free vouchers for long term contraceptive choices significantly increased the awareness of modern contraception. Awareness increased by 5% in the intervention district. Similarly, the ever use of modern contraceptive increased by 28.5%, and the overall contraceptive prevalence rate increased by 19.6%. A significant change (11.1%) was recorded in the uptake of IUCDs, which were being promoted with vouchers. Conclusion Family planning franchise model promotes awareness and uptake of contraceptives. Moreover, supplemented with vouchers, it may enhance the use of IUCDs, which have a significant cost attached. Our research also supports a multi-pronged approach- generating demand through counselling, overcoming financial constraints by offering vouchers, training, accreditation and branding of the service providers, and ensuring uninterrupted contraceptive supplies. PMID:24069287

Khurram Azmat, Syed; Tasneem Shaikh, Babar; Hameed, Waqas; Mustafa, Ghulam; Hussain, Wajahat; Asghar, Jamshaid; Ishaque, Muhammad; Ahmed, Aftab; Bilgrami, Mohsina

2013-01-01

58

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. PMID:24731751

2014-01-01

59

Emergency contraception: clinical outcomes.  

PubMed

Emergency contraception (EC) is widely used to prevent unwanted pregnancy. This review considers the safety and efficacy of three commonly used methods -- levonorgestrel (LNG-EC), ulipristal acetate (UPA) and the copper intrauterine device. All are extremely safe, and side effects are minimal. Concerns about increased risks of ectopic pregnancy after EC use have proved unfounded, and possible teratogenic effects seem unlikely. Although the true effectiveness of EC is impossible to estimate, recent research suggests that LNG-EC prevents around 50% of expected pregnancies in women using the method within 72 h of intercourse, whereas UPA appeared to prevent almost two thirds of pregnancies. Emergency intrauterine device insertion probably prevents over 95% of pregnancies. However, although improved accessibility of EC has clearly led to increased use, it does not appear to have had any public health benefit in reducing unintended pregnancy rates. Most of the data on sexual behavior following improved access to EC do not show any detrimental effect on subsequent use of other more effective methods of contraception or on the incidence of unintended pregnancy or sexually transmitted infection. However, unless these other methods of contraception are also made easily available from pharmacies, improved access to EC risks unlinking its use with use of subsequent ongoing contraception. PMID:23040128

Glasier, Anna

2013-03-01

60

Contraception and Birth Control  

MedlinePLUS

... Trials Resources and Publications En Español Contraception and Birth Control: Condition Information Skip sharing on social media ... Contraception is the prevention of pregnancy. Contraception, or birth control, also allows couples to plan the timing ...

61

Evidence from peninsular Malaysia of breastfeeding as a contraceptive method.  

PubMed

This report examines Malaysian women's perceptions of the contraceptive effect of breastfeeding, the determinants of their perceptions, and any effect these perceptions might have on nursing duration and contraceptive use. The report also considers whether women are consciously replacing breastfeeding with modern contraceptive methods. Data from the 1976 Malaysian Family Life Survey are analyzed, and the author concludes that Malaysian women do perceive that breastfeeding has a contraceptive effect, but that this perception is not universal. Ethnicity and desire for a particular family size are the most significant determinants of this perception. Finally, Malaysian women's recognition of the contraceptive effect of nursing does not influence either the duration of their breastfeeding or their adoption of contraception. Malaysian women may not be abandoning breastfeeding to adopt contraception. More probably, breastfeeding declines and contraceptive prevalence increases with modernization. PMID:1293861

Rao, S R

1992-01-01

62

Contraceptive Use and Pregnancy Outcomes among Opioid Drug-Using Women: A Retrospective Cohort Study  

PubMed Central

Objective The contraceptive needs of illicit opioid users differ from non-drug users but are poorly understood. The aim of this study was to describe contraceptive use and pregnancy outcomes in opioid-using women, and to examine their association with a range of risk factors. Method This retrospective cohort study used UK general practice records, Treatment Outcomes Profile and National Drug Treatment Monitoring System data, and a nested data validation exercise. A cohort of 376 women aged 20–61 years were in active treatment for opioid addiction in October 2010 at two specialised primary care practices in North-East England. Outcomes were age-adjusted prevalence estimates for contraceptive use and pregnancy outcomes in users of illicit opioids. The association between lifestyle-related risk factors and contraception was explored. Results Drug-using women made lower use of planned (non-condom) contraception (24% vs 50%, p<0.001), had more frequent pregnancy terminations (0.46 vs. 0.025, p = 0.004) and higher annual incidence of chlamydia (1.1% vs. 0.33%, p<0.001), when compared with age-matched population data. Specifically, there was low use of oral contraceptives (4% vs. 25%, p<0.001), IUCD (1% vs. 6%, p<0.001), and sterilisation (7% vs. 6%, p = 0.053), but higher rates of injectable contraceptives (6% vs. 3%, p = 0.003). A total of 64% of children aged <16 years born to this group did not live with their mother. No individual risk factor (such as sex-working) significantly explained the lower use or type of non-condom contraception. Conclusions This is the first study to describe planned contraceptive use among drug-users, as well as the association with a range of risk factors and pregnancy outcomes. The low uptake of planned contraception, set against high rates of terminations and sexually transmitted disease demonstrates the urgent clinical need to improve contraceptive services, informed by qualitative work to explore the values and beliefs influencing low contraceptive uptake. PMID:25739018

Cornford, Charles S.; Close, Helen J.; Bray, Roz; Beere, Deborah; Mason, James M.

2015-01-01

63

[Acceptance and use of contraceptive methods in Rwanda in 1991].  

PubMed

In Rwanda in 1991, ONAPO had 89,491 new acceptors of family planning. The increase in new acceptors peaked in 1983 (227.33%) and bottomed out in 1991 (8.54%). During 1981-1991, the most accepted method was injectables followed by oral contraceptives (OCs). In 1991, new acceptors of barrier methods increased 82.91%. IUD acceptance had stagnated since 1985. The number of social/health settings dispensing contraceptives increased each year (18 in 1981 to 316 in 1991). During 1981-1991, 49 secondary family planning posts became functional to facilitate accessibility to family planning services. The number of new acceptors in July was two times more numerous than the monthly mean of new acceptors recruited in 1991. The districts of Byumba, Kigali, and Ruhengeri recruited more than 45% of registered new acceptors in 1991. Cyangugu district and Kigali city were in last place in terms of size of new acceptors. Gisenyi and Kibungo districts had no implant acceptors. Cyangugu, Gitarama, Kibuye, and Kigali districts had no vasectomy acceptors. Gitarama had the biggest proportion of OC acceptors, even bigger than that for injectables. Contraceptive use increased each year. Ruhengeri district had the largest number of contraceptive users (19,319) followed by Byumba and Kigali districts (17,876 and 16,220, respectively). More than 60% of contraceptive users depended on injectables. IUD use was rare, except in Kigali city (8.3%). OC use and injectable use were used equally in Kigali city (31.7% and 33.3%, respectively). Overall, OCs and injectables were used by 87.8% of contraceptive users. December was the worst method in terms of contraceptive use. In December 1991, the national contraceptive prevalence rate was 12.6%, lower than the 1991 goal of 15%. At the beginning of 1991, Kigali City had a rate higher than the objective. Between January and December, Kigali City's rate increased from 19.7% to 21.7%. Byumba district had the best performance (15.4% in January to 14.6% in December). PMID:12290185

Butera, B

1992-04-01

64

Gambling disorder: estimated prevalence rates and risk factors in Macao.  

PubMed

An excessive, problematic gambling pattern has been regarded as a mental disorder in the Diagnostic and Statistical Manual for Mental Disorders (DSM) for more than 3 decades (American Psychiatric Association [APA], 1980). In this study, its latest prevalence in Macao (one of very few cities with legalized gambling in China and the Far East) was estimated with 2 major changes in the diagnostic criteria, suggested by the 5th edition of DSM (APA, 2013): (a) removing the "Illegal Act" criterion, and (b) lowering the threshold for diagnosis. A random, representative sample of 1,018 Macao residents was surveyed with a phone poll design in January 2013. After the 2 changes were adopted, the present study showed that the estimated prevalence rate of gambling disorder was 2.1% of the Macao adult population. Moreover, the present findings also provided empirical support to the application of these 2 recommended changes when assessing symptoms of gambling disorder among Chinese community adults. Personal risk factors of gambling disorder, namely being male, having low education, a preference for casino gambling, as well as high materialism, were identified. PMID:25134026

Wu, Anise M S; Lai, Mark H C; Tong, Kwok-Kit

2014-12-01

65

Contraception and society.  

PubMed

When an idea meets the exigencies of an epoch, it becomes stronger than any form of political power and it becomes the common property of humankind. Such an idea was the development of contraceptives. In retrospect, the invention of contraceptives was as fundamental for the evolution of humankind as the invention of the wheel; today more than 550 million couples are using contraceptive methods. The large-scale use of contraceptives triggered the most powerful social revolutions of a century in reproductive health and gender equity, and substantially contributed to an unparalleled demographic change, characterized by a rapid aging of populations. One of the important reasons for population aging is a significant decline in fertility rates, resulting in gradually changing population structures with fewer and fewer children and more and more elderly persons. The causes underlying these demographic changes are complex and manifold; they reflect major societal changes of historical dimensions. Many of our institutions cater increasingly for a population structure that no longer exists. There is therefore an increasing need for institutional reforms in social security, health care, housing and education. In addition, several surveys conducted in the developed world have indicated an erosion of confidence in our basic institutions, e.g. courts and justice, the Church and Parliament. Whereas modem sociologists are concerned about an increase in crime, decrease in trust and depleted social capital, one can also observe an accelerated perception of our global destiny and a re-awakening of the moral impulse with a strong demand for increased transparency in public affairs. Also, various global communities have assumed a growing importance. It can be predicted that international professional communities, such as the European Society of Contraception, will play an increasingly important future role in influencing policies in general and health policies in particular. because of their profound commitment to the improvement of the human condition by the judicious use of new scientific information. PMID:12648291

Diczfalusy, E

2002-12-01

66

Emergency contraception: separating fact from fiction.  

PubMed

Rates of unintended pregnancy and abortion are high, yet many doctors do not feel comfortable discussing emergency contraception with patients, even in cases of sexual assault. Since the approval of ulipristal acetate (ella) for emergency contraception, there has been even more confusion and controversy. This article reviews various emergency contraceptive options, their efficacy, and special considerations for use, and will attempt to clarify myths surrounding this topic. PMID:23125326

Batur, Pelin

2012-11-01

67

Bipolar disorder and comorbid alcoholism: prevalence rate and treatment considerations.  

PubMed

Classic Kraepelian observations and contemporary epidemiological studies have noted a high prevalence rate between bipolar disorder and alcoholism. The extent to which these two illnesses are comorbid (i.e., two distinct disease processes each with an independent course of illness), genetically linked, or different phenotypic expressions of bipolar illness itself continues to be investigated. It is increasingly clear that co-occurring alcohol abuse or dependence in bipolar disorder phenomenologically changes the illness presentation with higher rates of mixed or dysphoric mania, rapid cycling, increased symptom severity, and higher levels of novelty seeking, suicidality, aggressivity, and impulsivity. It is very encouraging that interest and efforts at evaluating pharmacotherapeutic compounds has substantially increased over the past few years in this difficult-to-treat patient population. This article will review the clinical studies that have evaluated the effectiveness of conventional mood stabilizers (lithium, carbamazepine, divalproex, and atypical antipsychotics) in the treatment of alcohol withdrawal and relapse prevention in patients with alcoholism and in the treatment of bipolar disorder with comorbid alcoholism. A number of add-on, adjunctive medications, such as naltrexone, acamprosate, topiramate, and the atypical antipsychotics quetiapine and clozapine, may be candidates for further testing. PMID:17156154

Frye, Mark A; Salloum, Ihsan M

2006-12-01

68

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. PMID:24708837

2014-01-01

69

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

70

Prevalence and incidence rates of chronic inflammatory demyelinating polyneuropathy in the Japanese population  

Microsoft Academic Search

Objective and methods:To characterise the epidemiological features of chronic inflammatory demyelinating polyneuropathy (CIDP) in the Japanese population, this study performed a nationwide assessment of the prevalence and incidence rates in Japan.Results:The prevalence rate per 100 000 was 1.61 in the total population; 2.01 in males and 1.23 in females. The age dependent prevalence rates were 0.23 in juveniles (55 years).

M Iijima; H Koike; N Hattori; A Tamakoshi; M Katsuno; F Tanaka; M Yamamoto; K Arimura; G Sobue

2008-01-01

71

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

72

Emergency contraception  

PubMed Central

Emergency contraception (EC) is an effective way to prevent an unintended or unplanned pregnancy. EC is available in two forms in Canada: a progestin-only method and a combined hormonal method, also known as the Yuzpe regimen. EC has been proven to be most effective within 72 h and up to 120 h after unprotected sexual intercourse. To date, the progestin-only method is the preferred method of EC recommended to teens because it is known for higher efficacy and fewer side effects, and is, therefore, more widely accepted over the combined method. Teens should also be counselled that the progestin-only method is widely available without a doctor’s prescription across Canada. PMID:21731419

Katzman, DK; Taddeo, D

2010-01-01

73

Contraceptive method-mix and family planning program in Vietnam.  

PubMed

In Vietnam between 1989 and 1993, the modern contraceptive prevalence rate stopped at 38%. In 1984, the government implemented economic renovation (Doi Moi). This closed agricultural cooperatives which had supported commune health centers. Health workers received either low or no wages, resulting in low morale, absenteeism, and moving to the private sector or agriculture. Most women began using the IUD because it was low cost and easy to monitor, provided long-term protection against pregnancy, and there was a limited supply of oral contraceptives (OCs) and condoms. Condom use fell from 13% in 1984 to 1.4% in 1993. More than 80% of contraceptive users used the IUD. The IUD is not appropriate for many women because of health problems: 60-70% of pregnant women and 80% of parturient women have anemia, 40-60% of women have reproductive tract infections, and sexually transmitted diseases are rising. Vietnam's Prime Minister and the Communist Party are committed to expanding the range of the contraceptive method-mix and choice. Limited method choice is especially a problem in rural areas. It increases the abortion rate. About 38% of abortions supplant modern and traditional family planning methods. Improper counseling, insufficient knowledge, and low promotion of OCs account for the low use of OCs. Inferior quality, aversion by couples, and inaccessibility in most rural areas limit condom use. Women's fear and husband's objection outweigh the government's promotion of sterilization. Providers have limited comprehensive accurate and current knowledge of contraceptives. Health service facilities are concentrated in urban and semiurban areas. The quality of care in rural areas, where there is no clean water supply, is inferior. An annual target used to forecast contraceptive needs risks contraceptive stocks expiring during storage and/or disruptions in supply of users. Consecutive actions to eliminate constraints to use of other methods, developing a community level service delivery system to provide a wide range of methods, and developing specific service delivery systems for specific methods are optional strategies to expand method choice in Vietnam. PMID:12288574

Hardjanti, K

1995-01-01

74

Determinants of modern contraceptive utilization among married women of reproductive age group in North Shoa Zone, Amhara Region, Ethiopia  

PubMed Central

Background Ethiopia is the second most populous country in Africa with high fertility and fast population growth rate. It is also one of the countries with high maternal and child mortality rate in sub-Saharan Africa Family planning is a crucial strategy to halt the fast population growth, to reduce child mortality and improve maternal health (Millennium Development Goal 4 and 5). Therefore, this study aimed to assess the prevalence and determinants of modern contraceptive utilization among married women of reproductive age group. Methods A community based cross-sectional study was conducted from August 15 to September 1, 2010 among married women aged 15–49 years in Debre Birhan District. Multistage sampling technique was used to select a total of 851 study participants. A pre-tested structured questionnaire was used for gathering data. Bivariate and multivariate logistic regression analyses were performed using SPSS version 16.0 statistical package. Results Modern contraceptive prevalence rate among currently married women was 46.9%. Injectable contraceptives were the most frequently used methods (62.9%), followed by intrauterine device (16.8%), pills (14%), norplant (4.3%), male condom (1.2%) and female sterilization (0.8%). Multiple logistic regression model revealed that the need for more children (AOR 9.27, 95% CI 5.43-15.84), husband approve (AOR 2.82, 95% CI 1.67-4.80), couple’s discussion about family planning issues (AOR 7.32, 95% CI 3.60-14.86). Similarly, monthly family income and number of living children were significantly associated with the use of modern contraceptives. Conclusion Modern contraceptive use was high in the district. Couple’s discussion and husband approval of contraceptives use were significantly associated with the use of modern contraceptives. Therefore, district health office and concerned stakeholders should focus on couples to encourage communication and male involvement for family planning. PMID:24490810

2014-01-01

75

Contraception and hormonal management in the perimenopause.  

PubMed

This literature review focuses on contraception in perimenopausal women. As women age, their fecundity decreases but does not disappear until menopause. After age 40, 75% of pregnancies are unplanned and may result in profound physical and emotional impact. Clinical evaluation must be relied on to diagnose menopause, since hormonal levels fluctuate widely. Until menopause is confirmed, some potential for pregnancy remains; at age 45, women's sterility rate is 55%. Older gravidas experience higher rates of diabetes, hypertension, and death. Many safe and effective contraceptive options are available to perimenopausal women. In addition to preventing an unplanned and higher-risk pregnancy, perimenopausal contraception may improve abnormal uterine bleeding, hot flashes, and menstrual migraines. Long-acting reversible contraceptives, including the levonorgestrel intrauterine system (LNG-IUS), the etonogestrel subdermal implant (ESI), and the copper intrauterine device (Cu-IUD), provide high efficacy without estrogen. LNG-IUS markedly decreases menorrhagia commonly seen in perimenopause. Both ESI and LNG-IUS provide endometrial protection for women using estrogen for vasomotor symptoms. Women without cardiovascular risk factors can safely use combined hormonal contraception. The CDC's Medical Eligibility Criteria for Contraceptive Use informs choices for women with comorbidities. No medical contraindications exist for levonorgestrel emergency-contraceptive pills, though obesity does decrease efficacy. In contrast, the Cu-IUD provides reliable emergency and ongoing contraception regardless of body mass index (BMI). PMID:24773233

Long, Margaret E; Faubion, Stephanie S; MacLaughlin, Kathy L; Pruthi, Sandhya; Casey, Petra M

2015-01-01

76

National Prevalence Rates of Bully Victimization among Students with Disabilities in the United States  

ERIC Educational Resources Information Center

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…

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

2012-01-01

77

Access to modern contraception.  

PubMed

Access to modern contraception has become a recognized human right, improving the health and well-being of women, families and societies worldwide. However, contraceptive access remains uneven. Irregular contraceptive supply, limited numbers of service delivery points and specific geographic, economic, informational, psychosocial and administrative barriers (including medical barriers) undermine access in many settings. Widening the range of providers enabled to offer contraception can improve contraceptive access, particularly where resources are most scarce. International efforts to remove medical barriers include the World Health Organization's Medical Eligibility Criteria. Based on the best available evidence, these criteria provide guidance for weighing the risks and benefits of contraceptive choice among women with specific clinical conditions. Clinical job aids can also improve access. More research is needed to further elucidate the pathways for expanding contraceptive access. Further progress in removing medical barriers will depend on systems for improving provider education and promoting evidence-based contraceptive service delivery. PMID:16443395

Welsh, Michael J; Stanback, John; Shelton, James

2006-06-01

78

Unintended Pregnancy Prevention: Contraception  

MedlinePLUS

... types of emergency contraceptive pills available in the United States. Some emergency contraceptive pills are available over the ... to learn more: Poststerilization regret: findings from the United States Collaborative Review of Sterilization. Obstet Gynecol . 1999;93: ...

79

Contraception for adolescents.  

PubMed

A working knowledge of contraception will assist the pediatrician in both sexual health promotion as well as treatment of common adolescent gynecologic problems. Best practices in adolescent anticipatory guidance and screening include a sexual health history, screening for pregnancy and sexually transmitted infections, counseling, and if indicated, providing access to contraceptives. Pediatricians' long-term relationships with adolescents and families allow them to help promote healthy sexual decision-making, including abstinence and contraceptive use. Additionally, medical indications for contraception, such as acne, dysmenorrhea, and heavy menstrual bleeding, are frequently uncovered during adolescent visits. This technical report provides an evidence base for the accompanying policy statement and addresses key aspects of adolescent contraceptive use, including the following: (1) sexual history taking, confidentiality, and counseling; (2) adolescent data on the use and side effects of newer contraceptive methods; (3) new data on older contraceptive methods; and (4) evidence supporting the use of contraceptives in adolescent patients with complex medical conditions. PMID:25266435

Ott, Mary A; Sucato, Gina S

2014-10-01

80

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

81

The prevalence rates of pathological gambling: A look at methods  

Microsoft Academic Search

Planning the gambling environment requires protection of the public's health, safety and welfare. Whereas most public gaming provisions and statutes address the public's fears of organized crime as well as some welfare needs, rarely do they safeguard the public's health regarding the spread of the mental disease known as pathological gambling. Measurement of the prevalence and incidence of this disease

Robert P. Culleton

1989-01-01

82

Menstrual Concerns and Intrauterine Contraception Among Adolescent Bariatric Surgery Patients  

PubMed Central

Abstract Objective Adolescent obesity has dramatically increased in recent decades, and along with that so have other medical comorbidities, such as hypertension, diabetes, hyperlipidemia, nonalcoholic steatohepatitis, polycystic ovary syndrome (PCOS), and pseudotumor cerebri. Obesity and related comorbidites may be contraindications to hormonal contraception, making contraception counseling of morbidly obese adolescents more challenging. Obese adolescent females seeking bariatric surgery need effective contraception in the postoperative period. This study is designed to determine the acceptance rate of the levonorgestrel-releasing intrauterine device (IUD) and describe common menstrual problems in obese adolescent bariatric surgery patients. Methods This is a historic cohort study of adolescent females who underwent bariatric surgery over a 2-year period at a tertiary referral center for pediatric obesity. Data were systematically abstracted. The percent of patients with menstrual problems and the acceptance rate for the levonorgestrel-releasing IUD were determined. Results Twenty-five adolescents met inclusion criteria. The mean age was 17.4 years (standard deviation [SD] 2.6), and the mean body mass index (BMI) was 51.4 (SD 6.3) kg/m2. Eighty-four percent were white. Twenty-eight percent had menorrhagia, 32% had oligomenorrhea, 40% had dysmenorrhea, and 36% had PCOS. Ninety-two percent (23 of 25) underwent IUD placement. Conclusions There was a high prevalence of menstrual problems among this sample of severely obese adolescent females. The majority accepted the IUD, indicating it is a viable option among this population. PMID:21413894

Miller, Rachel J.; Inge, Thomas H.

2011-01-01

83

Associations between national gambling policies and disordered gambling prevalence rates within Europe.  

PubMed

Policymakers and other interested stakeholders currently are seeking information about the comparative effectiveness of different regulatory approaches to minimising gambling-related harm. This study responds to this research gap by exploring associations between gambling policies and disordered gambling prevalence rates. We gathered information about gambling policies for thirty European jurisdictions and past-year prevalence rates for disordered gambling for twelve of these jurisdictions. We present policy trends and prevalence rates and then describe the level of association between policy and prevalence. We observe one statistically significant association between policy and prevalence: rates of sub-clinical (i.e., Level 2) disordered gambling were higher within environments that mandated less strict regulation of advertising for online gambling. Finally, we discuss the implications of our research in the context of the current process regarding the pan-European regulation of gambling. Our findings do not offer evidence for certain assumptions made in the past by the European judiciary. PMID:24370209

Planzer, Simon; Gray, Heather M; Shaffer, Howard J

2014-01-01

84

Contraceptive revolution.  

PubMed

Global population will increase by almost 1 billion people in the 1990s, the largest 10-year increase ever recorded. In 1994 alone, population will surpass 5.7 billion. The prospect of double-digit billions of people is worrisome, especially since these numbers may affect global warming, supplies of fresh water, destruction of rain forests, industrial pollution, and sustainable development. Yet, many indicators of quality of life show that people enjoy a better quality of life today than they did 100 years ago. Between India's independence and now, life expectancy increased by 20 years, infant mortality decreased 2-fold, literacy increased, and the food supply stabilized. Even though India's population has almost tripled since 1947, its economy increased rapidly and is 1 of the world's top 10 economies. University enrollment stands at 4.5 million. Agricultural production has exceeded demand. India represents the potential for human achievement through technological advancement and social organization. If the world's first national family planning program had been more successful when it began in 1952 in an India of 350 million people, India's population would be around 500 million instead of the expected 1 billion in 2000. All countries need to achieve a sustainable balance between human numbers and needs and natural resources. Family planning is an essential, cost-effective part of any development strategy. Family planning use has reduced fertility from 6 to 3.6 in developing countries. In 1965, only 8% used contraception, while more than 50% use it now. The most remarkable family planning/fertility reduction successes are Bangladesh, Brazil, Colombia, Indonesia, Mexico, and Thailand. Sufficient investment in family planning is needed if significant declines in fertility are to occur. More than 90% of the developing world's people are in countries with official family planning programs. Cost-effective assistance by donors and developing countries implementing their own sustainable development policies should curb population growth. PMID:12345685

Segal, S J

1994-06-01

85

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. PMID:2788122

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

1989-01-01

86

Contraceptive use in Canada, 1984.  

PubMed

Canada's first national fertility survey, carried out by telephone in 1984, found that 68 percent of all women aged 18-49-73 percent of currently married women, 69 percent of the previously married women and 57 percent of single women--are practicing contraception. Overall, the most widely used method of birth control in Canada is sterilization (male and female), which is relied on by almost 60 percent of all married users and 66 percent of previously married users. Among single women, the preferred method is the pill, chosen by seven out of 10 of such users. Among all women, the major determinant of method choice is age: The pill is overwhelmingly chosen by women under 25, and sterilization, by those 30 and over. While the IUD and the condom are used by roughly 10-14 percent of women in their 20s who practice contraception, these methods decline in importance with increasing age. Highly educated women are less likely than those with little education to elect sterilization, and more likely to rely on barrier methods. Differences in contraceptive prevalence and patterns of use between Catholics and Protestants have all but disappeared in Canada, but church attendance and country of birth appear to exert a modest influence on method choice. As might be anticipated, women whose family size is complete have considerably higher levels of contraceptive use than those who expect to have more children. The survey reveals no difference in contraceptive use between Quebec women and those in the rest of Canada, thus confirming both the accuracy of earlier Quebec studies showing extremely high levels of sterilization and the applicability of these findings to all other Canadian women.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3842662

Balakrishnan, T R; Krotki, K; Lapierre-Adamcyk, E

1985-01-01

87

Copper Intrauterine Device for Emergency Contraception: Clinical Practice Among Contraceptive Providers  

PubMed Central

Objective The copper intrauterine device (IUD) is the most effective emergency contraceptive available but is largely ignored in clinical practice. We examined clinicians’ recommendation of the copper IUD for emergency contraception in a setting with few cost obstacles. Methods We conducted a survey among clinicians (n=1,246; response rate 65%) in a California State family planning program, where U.S. Food and Drug Administration-approved contraceptives are available at no cost to low-income women. We used multivariable logistic regression to measure the association of intrauterine contraceptive training and evidence-based knowledge with having recommended the copper IUD for emergency contraception. Results The large majority of clinicians (85%) never recommended the copper IUD for emergency contraception, and most (93%) required two or more visits for an IUD insertion. Multivariable analyses showed insertion skills were associated with having recommended the copper IUD for emergency contraception, but the most significant factor was evidence-based knowledge of patient selection for IUD use. Clinicians who viewed a wide range of patients as IUD candidates were twice as likely to have recommended the copper IUD for emergency contraception. While over 93% of obstetrician–gynecologists were skilled in inserting the copper IUD, they were no more likely to have recommended it for emergency contraception than other physicians or advance practice clinicians. Conclusion Recommendation of the copper IUD for emergency contraception is rare, despite its high efficacy and long-lasting contraceptive benefits. Recommendation would require clinic flow and scheduling adjustments to allow same-day IUD insertions. Patient-centered and high-quality care for emergency contraception should include a discussion of the most effective method. PMID:22270272

Harper, Cynthia C.; Speidel, J. Joseph; Drey, Eleanor A.; Trussell, James; Blum, Maya; Darney, Philip D.

2011-01-01

88

Bias From Using Occupational Smoking Prevalence to Adjust Occupational Incidence Cohort Lung Cancer Mortality Rates  

PubMed Central

Objective: To describe how smoking correction factors based on comparing worker smoking prevalence with population smoking prevalence are biased if applied to an occupational incidence cohort. Methods: Relative rates of smoking for shorter-tenure workers derived from occupational cohort lung cancer studies were applied to incidence and prevalence population tenure distributions to calculate relative smoking estimates. Results: High smoking rates in short-tenure workers have little effect on prevalent worker rates (relative smoking estimates, 1.04 and 1.02) and much larger effect in occupational incidence populations (relative smoking estimates, 1.58 and 1.21), which have a much higher proportion of short tenure-workers. Conclusions: Smoking correction estimates derived from surveys of smoking habits in prevalent workers may introduce bias when applied to incidence workers because of very different proportions of short-tenure workers (length-time biased sampling). PMID:25427172

Roth, H. Daniel

2015-01-01

89

Screening of registered leprosy cases and its effects on prevalence rate.  

PubMed

Prevalence rates of leprosy in 6 endemic districts in Andhra Pradesh, India with a population of 168.71 lakhs (1981 census) were studied before and after screening of registered cases. The screening was carried out as part of multidrug treatment project implementation. After such screening a sharp fall in the registered prevalence rate, by 26.2% on the average, was observed in all the districts. About 34.8% of the total cases were declared as Released from control. The implication of these findings regarding registered cases fit for such release and the overall registered prevalence rates in the country must be kept in mind. PMID:2212732

Rao, P S; Sirumban, P

1990-01-01

90

HIV Prevalence Rates among Injection Drug Users in 96 Large US Metropolitan Areas, 1992–2002  

PubMed Central

This research presents estimates of HIV prevalence rates among injection drug users (IDUs) in large US metropolitan statistical areas (MSAs) during 1992–2002. Trend data on HIV prevalence rates in geographic areas over time are important for research on determinants of changes in HIV among IDUs. Such data also provide a foundation for the design and implementation of structural interventions for preventing the spread of HIV among IDUs. Our estimates of HIV prevalence rates among IDUs in 96 US MSAs during 1992–2002 are derived from four independent sets of data: (1) research-based HIV prevalence rate estimates; (2) Centers for Disease Control and Prevention Voluntary HIV Counseling and Testing data (CDC CTS); (3) data on the number of people living with AIDS compiled by the CDC (PLWAs); and (4) estimates of HIV prevalence in the US. From these, we calculated two independent sets of estimates: (1) calculating CTS-based Method (CBM) using regression adjustments to CDC CTS; and (2) calculating the PLWA-based Method (PBM) by taking the ratio of the number of injectors living with HIV to the numbers of injectors living in the MSA. We take the mean of CBM and PBM to calculate over all HIV prevalence rates for 1992–2002. We evaluated trends in IDU HIV prevalence rates by calculating estimated annual percentage changes (EAPCs) for each MSA. During 1992–2002, HIV prevalence rates declined in 85 (88.5%) of the 96 MSAs, with EAPCs ranging from ?12.9% to ?2.1% (mean EAPC?=??6.5%; p?prevalence rate declined from 11.2% in 1992 to 6.2 in 2002 (EAPC, ?6.4%; p?prevalence rate declined from 8.1% to 4.4% (EAPC, ?6.5%; p?prevalence rate across the 11 years declined from 43.5% to 22.8% (EAPC, ?6.7%; p?prevalence rates may reflect high continuing mortality among infected IDUs, as well as primary HIV prevention for non-infected IDUs and self-protection efforts by them. These results warrant further research into the population dynamics of disease progression, access to health services, and the effects of HIV prevention interventions for IDUs. Electronic supplementary material The online version of this article doi:10.1007/s11524-008-9328-1 contains supplementary material, which is available to authorized users. PMID:19015995

Lieb, Spencer; Cleland, Charles M.; Cooper, Hannah; Brady, Joanne E.; Friedman, Samuel R.

2008-01-01

91

Contraception and abortion in Romania.  

PubMed

After the downfall of the Ceausescu regime in December, 1989, the new Government of Romania abolished the law that prohibited abortions on request. Subsequently, the rate of legally induced abortions increased significantly while the rate of maternal mortality declined dramatically. Despite the large number of women who request induced abortions, most women and gynaecologists say that they would prefer to prevent unwanted pregnancies through the use of modern contraception. In this paper we examine factors that contribute to the disparity between women's desire to use modern contraception to prevent unwanted pregnancies and their practice of having induced abortions to prevent unwanted births. The results show that women (and suggest that men) need a wide choice of dependably available high-quality contraceptives; they need to be able to obtain information, counselling, and methods from a wide range of sources/health-care providers; both women's and men's perceptions about, and use of, modern contraception could be positively affected through sexual education started in secondary school; and, to reduce repeat abortions, women's post-abortion family-planning needs must not be neglected. PMID:8096575

Johnson, B R; Horga, M; Andronache, L

1993-04-01

92

Serbian gynaecologists' views on contraception and abortion.  

PubMed

Objectives To examine Serbian gynaecologists' attitudes and practices related to contraception and abortion, as the principal alternative to contraception. Methods A self-reported questionnaire was administered to a convenience sample of gynaecologists attending educational meetings of a medical society from October 2012 to October 2013. The data gathered were assessed by means of univariate and multivariate analyses. Results Almost half of the respondents had ethical objections and would refuse to provide certain contraceptives to patients. Two thirds of the gynaecologists (63%) considered fertility awareness methods to be a poor option for most women. Twenty-three percent objected to abortion. Those who objected to contraceptives were less likely to object to abortions (OR: 0.422). This attitude was more prevalent in Southern and Eastern Serbia, where gynaecologists were more likely to object (OR: 4.892) and to refuse to prescribe contraceptives (OR: 4.161), but less likely to object to abortion (OR: 0.278) than in other regions. Conclusions A large proportion of Serbian gynaecologists objected to some contraceptive methods and were more in favour of abortions, especially in the least developed regions. PMID:25431888

Milosavljevic, Jelena; Krajnovic, Dusanka; Bogavac-Stanojevic, Natasa; Mitrovic-Jovanovic, Ana

2015-04-01

93

Contraceptive practice in china: 1970-2004.  

PubMed

Using large-scale data from the national conventional statistics and nationally representative sample surveys, the current study aims to assess the level, mode, and determinants of modern contraceptive use from 1970 to 2004 among married couples aged 20 to 49 years in China. A relatively stable Chinese mode of contraception has been established and maintained since the 1980s, characterized by prominent, long-acting contraceptive use and the highest overall prevalence in the world during the past 3 decades. In recent years, the composition of contraceptive use has changed, characterized by the increasing use of the intrauterine device and short-acting methods and a drastic decrease in male and female sterilization. However, the dominance of the long-acting methods has not undergone substantial change. The results from a multinomial logit model employed in this study indicate that family planning policy and socioeconomic and demographic factors jointly influence contraceptive choice. In particular, contraceptive choice is closely associated with the strength of family planning policy in China. PMID:23695542

Wang, Cuntong

2015-03-01

94

High HIV Prevalence and Diagnosis Rates in New York City Black Men  

Microsoft Academic Search

We sought to identify population and subpopulation disparities in rates of HIV diagnosis and prevalence among black males\\u000a 13 years and older in New York City. We used population-based data from the New York City HIV\\/AIDS surveillance registry and\\u000a US Census 2000 to calculate HIV prevalence in 2006 and HIV diagnosis rates in 2007. Black males were the largest demographic\\u000a group

Ellen W. WiewelDavid; David B. Hanna; Elizabeth M. Begier; Lucia V. Torian

2011-01-01

95

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. PMID:24971107

Hassan, Che Hashim

2013-01-01

96

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. PMID:19641264

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

2011-01-01

97

Oral Contraceptive Pill and PCOS  

MedlinePLUS

PCOS: The Oral Contraceptive Pill Posted under Health Guides . Updated 25 February 2014. +Related Content Key Facts ... of oral contraceptive pills for young women with PCOS? Regular and Lighter Periods: Oral contraceptive pills can ...

98

The impact of high-flux dialysis on mortality rates in incident and prevalent hemodialysis patients  

PubMed Central

Background/Aims The effect of high-flux (HF) dialysis on mortality rates could vary with the duration of dialysis. We evaluated the effects of HF dialysis on mortality rates in incident and prevalent hemodialysis (HD) patients. Methods Incident and prevalent HD patients were selected from the Clinical Research Center registry for end-stage renal disease (ESRD), a Korean prospective observational cohort study. Incident HD patients were defined as newly diagnosed ESRD patients initiating HD. Prevalent HD patients were defined as patients who had been receiving HD for > 3 months. The primary outcome measure was all-cause mortality. Results This study included 1,165 incident and 1,641 prevalent HD patients. Following a median 24 months of follow-up, the mortality rates of the HF and low-flux (LF) groups did not significantly differ in the incident patients (hazard ratio [HR], 1.046; 95% confidence interval [CI], 0.592 to 1.847; p = 0.878). In the prevalent patients, HF dialysis was associated with decreased mortality compared with LF dialysis (HR, 0.606; 95% CI, 0.416 to 0.885; p = 0.009). Conclusions HF dialysis was associated with a decreased mortality rate in prevalent HD patients, but not in incident HD patients. PMID:25378976

Kim, Hyung Wook; Kim, Su-Hyun; Kim, Young Ok; Jin, Dong Chan; Song, Ho Chul; Choi, Euy Jin; Kim, Yong-Lim; Kim, Yon-Su; Kang, Shin-Wook; Kim, Nam-Ho; Yang, Chul Woo

2014-01-01

99

Single Estimated Glomerular Filtration Rate and Albuminuria Measurement Substantially Overestimates Prevalence of Chronic Kidney Disease  

Microsoft Academic Search

Background\\/Aims: Guidelines require repeatedly diminished estimated glomerular filtration rate (eGFR) and\\/or albuminuria to diagnose chronic kidney disease (CKD), and advise screening only in select populations. Many estimates of CKD prevalence have used single measurements. This longitudinal study assessed eGFR and albuminuria reproducibility, and impact on estimate of CKD prevalence, in factory workers. Methods: A total of 512 white workers in

M. J. Bottomley; A. Kalachik; C. Mevada; M. O. Brook; T. James; P. N. Harden

2011-01-01

100

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

101

Changes in Contraceptive Use in Bulgaria, 1995-2000  

PubMed Central

Comparison of results from national surveys conducted in Bulgaria in 1995 and 2000 reveal little overall change in use of modern contraceptives. Dramatic increases occurred, however, among women younger than 25 who entered their reproductive period after the end of the state socialist period. This finding suggests that contraceptive gains in the country will come largely as a cohort-replacement process. From these data, no separate program impact appears for special clinics established to provide direct, subsidized delivery of modern contraceptives to women in selected cities. The special clinics opened in cities where contraceptive use was already above the national average. During these five years, other cities lacking special clinics managed to gain in prevalence of modern contraceptive use, leaving a relatively homogenous urban-rural difference in levels of use throughout the country. PMID:11831051

Carlson, Elwood; Lamb, Vicki

2009-01-01

102

History of contraception  

Microsoft Academic Search

Attempts to control fertility have always depended on social factors as much as on research and religious beliefs have played a large part in the provision or prohibition of contraception. Before the 20th century most references to contraception were linked to illicit sexual relations. It was not until the early 20th century that birth control became available for married couples.The

Carol A Quarini

2005-01-01

103

[Changes in Upper Gastrointestinal Diseases according to Improvement of Helicobacter pylori Prevalence Rate in Korea].  

PubMed

Helicobacter pylori can cause variety of upper gastrointestinal disorders such as peptic ulcer, mucosa associated lymphoid tissue (MALT)-lymphoma, and gastric cancer. The prevalence of H. pylori infection has significantly decreased in Korea since 1998 owing to active eradication of H. pylori. Along with its decrease, the prevalence of peptic ulcer has also decreased. However, the mean age of gastric ulcer increased and this is considered to be due to increase in NSAID prescription. Gastric cancer is one of the leading causes of cancer deaths in Korea and Japan, and IARC/WHO has classified H. pylori as class one carcinogen of gastric cancer. Despite the decreasing prevalence of H. pylori infection, the total number of gastric cancer in Korea has continuously increased from 2006 to 2011. Nevertheless, the 5 year survival rate of gastric cancer patients significantly increased from 42.8% in 1993 to 67% in 2010. This increase in survival rate seems to be mainly due to early detection of gastric cancer and endoscopic mucosal dissection treatment. Based on? these findings, the prevalence of peptic ulcer is expected to decrease even more with H. pylori eradication therapy and NSAID will become the main cause of peptic ulcer. Although the prevalence of gastric cancer has not changed along with decreased the prevalence of H. pylori, gastric cancer is expected to decrease in the long run with the help of eradication therapy and endoscopic treatment of precancerous lesions. PMID:25896153

Park, Soo Heon

2015-03-25

104

The 1998 Canadian Contraception Study.  

ERIC Educational Resources Information Center

Describes the 1998 Canadian Contraception Study, a mailed survey which asked women about contraceptive practices past, present, and future (including use of oral contraceptives, condoms, and sterilization); familiarity with and opinion about different contraception methods; and general sexual and reproductive health. The paper also examines…

Fisher, William A.; Boroditsky, Richard; Bridges, Martha L.

1999-01-01

105

Recent advances in hormonal contraception  

PubMed Central

This report reviews some of the new studies regarding new hormonal contraceptive formulations (e.g., Yaz, Qlaira®, extended-cycle or continuous combined contraceptives, subcutaneous depot medroxyprogesterone acetate, and ulipristal acetate as an emergency contraceptive). Recent data on the relationship between hormonal contraceptive use and bone health are also reviewed. PMID:21173872

Li, HW Raymond

2010-01-01

106

Recent advances in hormonal contraception.  

PubMed

This report reviews some of the new studies regarding new hormonal contraceptive formulations (e.g., Yaz, Qlaira(®), extended-cycle or continuous combined contraceptives, subcutaneous depot medroxyprogesterone acetate, and ulipristal acetate as an emergency contraceptive). Recent data on the relationship between hormonal contraceptive use and bone health are also reviewed. PMID:21173872

Li, Hw Raymond; Anderson, Richard A

2010-01-01

107

Contraceptive development: why the snail's pace?  

PubMed

Current contraceptive methods are not well-suited to many Americans. More safe and effective methods would be desirable. A report, "Developing New Contraceptives: Obstacles and Opportunities" was released in January 1990. It summarized 2 years of data collection by the Committee on Contraceptive Development which includes pharmaceutical company executives, physicians, reproductive biologists, public health, legal, and public policy experts, demographers, and economists. Barrier facing the development of new methods in the US were analyzed and ways to speed up research suggested. Particularly ill served are teenagers, young mothers, and comparatively older couples. The health risks of pregnancy, delivery, and labor "may be underrated." The pill is now the most common form of contraception in the US, followed by female sterilization, condoms, and vasectomy. 95% of women, aged 15-44, who have ever had intercourse, have used 1 or more contraceptive methods. Contraceptive discontinuation and failure rates are high, too. No fundamentally new contraceptives have been approved for use since the IUD and the pill in the 60s. Modifications of existing methods are in clinical trials. Obstacles cited were attitudes of the public, federal regulations and product liability, and the organization of and resources available for research. Public attitudes are very conservative. There is no great demand for more products. Since the 1960s, only 1 large pharmaceutical company (Ortho Pharmaceutical Corp.) is still involved in contraceptive research. Activity by small firms, nonprofit organizations, and universities has increased. Federal research funding in reproductive biology has only increased modestly since the mid 1970s. Private foundation support has dramatically declined. The time involved in the great costs of data required for Food and Drug Administration (FDA) approval have reduced research incentives. The average time it takes to get FDA approval has increased in the past 20 years. Weighing the risks and benefits of contraceptives is different from doing that with other drugs, yet FDA procedures do not allow for this. Product liability laws are different in each of the 50 states. Contraceptive development was greatly damaged by the mid 1980s insurance crisis. The committee recommended that the FDA put more importance on the effectiveness and convenience of new contraceptives. A comprehensive postmarketing surveillance system should be set up, and congress should pass a federal products liability law. PMID:2379571

Kaeser, L

1990-01-01

108

Menstrual nirvana: amenorrhea through the use of continuous oral contraceptives.  

PubMed

Medically induced amenorrhea has been used successfully in women who have medical conditions that worsen during menstruation. Menstrual suppression through the use of continuous oral contraceptives has been proven to be safe, effective, and extremely acceptable to women. Women without medical indications for menstrual suppression may find medically induced amenorrhea to be a significant improvement in their quality of life. Greater satisfaction with use of oral contraception may encourage compliance and increase the prevalence of pill-related health benefits. PMID:12429077

Edelman, Alison

2002-12-01

109

Future contraceptive methods.  

PubMed

Contraceptive development in the US over the past two decades has been seriously hampered by regulatory issues, political pressures, and legal concerns. Researchers primarily outside of the US, however, are continuing to work on improving existing methods and developing new ones. In particular, AIDS has renewed interest in barrier methods to prevent the transmission of HIV, the underlying agent of AIDS. Female-controlled barrier methods and agents with virucidal and microbicidal properties are sorely needed. This article provides an overview of some contraceptive methods on the market in other countries, but not available in the US, modifications to existing methods which are under investigation, and new methods of contraception on the horizon. After the opening section on the climate for contraceptive development, the paper examines contraception for female use under the following headings: hormonal implants; biodegradable implants; biodegradable norethindrone pellets; biodegradable injectable norethindrone microspheres; transdermal contraceptives; vaginal rings; injectables; IUDs; female barrier methods such as spermicides, the PROTECTAID sponge, disposable diaphragms, and Lea's Shield and FemCap; and permanent chemical and reversible forms of sterilization. For men, testosterone injections, progestin-androgen combinations, peptide hormones, polyurethane and Kraton condoms of comparatively more headroom, permanent and reversible sterilization, drugs and plant compounds, nifedipine, and contraceptive vaccines are considered. PMID:12345631

1994-09-01

110

Contraceptive choice for young people  

Microsoft Academic Search

Background and methodologyGiving young women access to newer contraceptives such as the combined contraceptive patch, combined contraceptive vaginal ring and single-rod implant may help reduce teenage pregnancies. However, little is known about young people's attitudes towards these contraceptives. This cross-sectional survey, using a self-completion questionnaire, aimed to explore young people's attitudes towards these contraceptives in order to develop understanding of

Rebecca Say; Diana Mansour

2009-01-01

111

[Contraception in the future].  

PubMed

In the last decade, global use of contraceptive methods has increased. About 50% of couples of childbearing age use a modern contraceptive method. This evolution and a positive change in attitude towards male contraception has encouraged research in fertility regulation to enlarge and to improve acceptance of the contraceptive mix. Current injectable contraceptives interfere with the menstrual cycle. Research is exploring ways to minimize such secondary effects by reducing the total hormone dose and by changing the way the active product is delivered (e.g., microspheres). An injectable prototype is an analogue of levonorgestrel (HRP 002). A new IUD is made of leather suspended by a nylon suture which has been inserted into the uterine muscle. RU-486, often used to interrupt early pregnancy, is being tested as an oral contraceptive (OC). It inhibits secretion of gonadotropins and ovulation. It holds promise as an OC with no estrogen component. Since it also inhibits endometrial development and thus prevents implantation, it may someday be used for emergency contraception (i.e., postcoital contraception). New contraceptive implants under study include Norplant RII (2 rods of levonorgestrel lasting for 3 years), Implanon (desogestrel), and Capranor (biodegradable implant lasting 2 years). The female condom consists of a flexible polyurethane sheath with a flexible ring at each end. It has the potential to protect against sexually transmitted diseases since it covers the labial lips and is impermeable to HIV. France and Switzerland have both approved its use. It will enter the UK market at the end of the year. Approval for marketing has been sought in the US. PMID:7974827

Hamzaoui, R; Boukhris, M

1994-02-01

112

Contraception for midlife women.  

PubMed

Women wish to continue to be sexually active long after their desire to bear children. The risks associated with unintended pregnancy easily can be avoided by providing women with information about, and access to, contraceptives that are safe and effective. Because fertility naturally declines with age, different contraceptives may be more suitable for women toward the end of their reproductive years than were appropriate at periods of peak fertility. This article discusses the risks and benefits of various contraceptives for midlife women and the implications of this information on nursing practice. PMID:1596431

Root, W B

1992-01-01

113

Prevalence rates and odds ratios of shoulder-neck diseases in different occupational groups  

Microsoft Academic Search

The aim of the present study was to evaluate the association and impact of occupational exposure and diseases of the shoulder and neck. Prevalence rates, odds ratios, aetiological fractions, and their confidence intervals were computed for pooled and non-pooled data of previous published reports. By comparison with office workers and farmers, dentists had an increased odds ratio for cervical spondylosis

M Hagberg; D H Wegman

1987-01-01

114

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

115

Exploring the crime of identity theft: Prevalence, clearance rates, and victim\\/offender characteristics  

Microsoft Academic Search

Although the crime of identity theft has garnered a great deal of media attention, relatively little empirical research existed on the prevalence of the crime, its clearance rate by arrest, or the demographic characteristics of the victims and the identifiable offenders. The purpose of this article is to expand the knowledge of this growing crime. Using data from a large

Stuart F. H. Allison; Amie M. Schuck; Kim Michelle Lersch

2005-01-01

116

Prevalence Rates of Depression, Anxiety, and Somatization among Rural Southwestern Native American Children.  

ERIC Educational Resources Information Center

Internalizing symptoms, which include anxiety and depression, may be the most common pattern of psychopathology found in children. However, the knowledge base targeting internalizing symptomology in Native American children of the Southwest is surprisingly limited. This paper reports on a study of prevalence rates of internalizing disorders among…

Morris, Carolyn T.; Morris, Christopher; Crowley, Susan L.

117

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

118

Depression and anxiety in patients with hepatitis C: prevalence detection rates and risk factors  

Microsoft Academic Search

Abstract Objective: We examined,a group of patients awaiting interferon treatment for hepatitis C to estimate the prevalence and detection rates of and risk factors for mood,disorders. Methods: The Structured Clinical Interview for DSM-IV Axis I Disorders: Clinician Version was used to detect psychiatric disorder. Self- completion instruments were used to rate symptom severity, subjective cognitive function, work and social adjustment,

Jeannette Golden; M. r. c. psych; Anne Marie O'dwyer; Ronan M. Conroy; St James's Hospital

119

Estimating the Prevalence and Awareness Rates of Hypertension in Africa: A Systematic Analysis  

PubMed Central

Background The burden of hypertension is high in Africa, and due to rapid population growth and ageing, the exact burden on the continent is still far from being known. We aimed to estimate the prevalence and awareness rates of hypertension in Africa based on the cut off “?140/90 mm Hg”. Methods We conducted a systematic search of Medline, EMBASE and Global Health. Search date was set from January 1980 to December 2013. We included population-based studies on hypertension, conducted among people aged ?15 years and providing numerical estimates on the prevalence of hypertension in Africa. Overall pooled prevalence of hypertension in mixed, rural and urban settings in Africa were estimated from reported crude prevalence rates. A meta-regression epidemiological modelling, using United Nations population demographics for the years 1990, 2000, 2010 and 2030, was applied to determine the prevalence rates and number of cases of hypertension in Africa separately for these four years. Results Our search returned 7680 publications, 92 of which met the selection criteria. The overall pooled prevalence of hypertension in Africa was 19.7% in 1990, 27.4% in 2000 and 30.8% in 2010, each with a pooled awareness rate (expressed as percentage of hypertensive cases) of 16.9%, 29.2% and 33.7%, respectively. From the modelling, over 54.6 million cases of hypertension were estimated in 1990, 92.3 million cases in 2000, 130.2 million cases in 2010, and a projected increase to 216.8 million cases of hypertension by 2030; each with an age-adjusted prevalence of 19.1% (13.9, 25.5), 24.3% (23.3, 31.6), 25.9% (23.5, 34.0), and 25.3% (24.3, 39.7), respectively. Conclusion Our findings suggest the prevalence of hypertension is increasing in Africa, and many hypertensive individuals are not aware of their condition. We hope this research will prompt appropriate policy response towards improving the awareness, control and overall management of hypertension in Africa. PMID:25090232

Adeloye, Davies; Basquill, Catriona

2014-01-01

120

Contraceptive discontinuation and switching among couples receiving integrated HIV and family planning services in Lusaka, Zambia  

PubMed Central

Objective To describe predictors of contraceptive method discontinuation and switching behaviors among HIV positive couples receiving couples' voluntary HIV counseling and testing services in Lusaka, Zambia. Design Couples were randomized in a factorial design to two family planning educational intervention videos, received comprehensive family planning services, and were assessed every 3-months for contraceptive initiation, discontinuation and switching. Methods We modeled factors associated with contraceptive method upgrading and downgrading via multivariate Andersen-Gill models. Results Most women continued the initial method selected after randomization. The highest rates of discontinuation/switching were observed for injectable contraceptive and intrauterine device users. Time to discontinuing the more effective contraceptive methods or downgrading to oral contraceptives or condoms was associated with the women's younger age, desire for more children within the next year, heavy menstrual bleeding, bleeding between periods, and cystitis/dysuria. Health concerns among women about contraceptive implants and male partners not wanting more children were associated with upgrading from oral contraceptives or condoms. HIV status of the woman or the couple was not predictive of switching or stopping. Conclusions We found complicated patterns of contraceptive use. The predictors of contraception switching indicate that interventions targeted to younger couples that address common contraception-related misconceptions could improve effective family planning utilization. We recommend these findings be used to increase the uptake and continuation of contraception, especially long acting reversible contraceptive (LARC) methods, and that fertility-goal based, LARC-focused family planning be offered as an integral part of HIV prevention services. PMID:24088689

Haddad, Lisa; Wall, Kristin M; Vwalika, Bellington; Htee Khu, Naw; Brill, Ilene; Kilembe, William; Stephenson, Rob; Chomba, Elwyn; Vwalika, Cheswa; Tichacek, Amanda; Allen, Susan

2014-01-01

121

History of oral contraception.  

PubMed

On the 50th birthday of the pill, it is appropriate to recall the milestones which have led to its development and evolution during the last five decades. The main contraceptive effect of the pill being inhibition of ovulation, it may be called a small miracle that this drug was developed long before the complex regulation of ovulation and the menstrual cycle was elucidated. Another stumbling block on its way was the hostile climate with regard to contraception that prevailed at the time. Animal experiments on the effect of sex steroids on ovulation, and the synthesis of sex steroids and orally active analogues were the necessary preliminaries. We owe the development of oral contraceptives to a handful of persons: two determined feminists, Margaret Sanger and Katherine McCormick; a biologist, Gregory Pincus; and a gynaecologist, John Rock. Soon after the introduction of the first pills, some nasty and life-threatening side effects emerged, which were due to the high doses of sex steroids. This led to the development of new preparations with reduced oestrogen content, progestins with more specific action, and alternative administration routes. Almost every decade we have witnessed a breakthrough in oral contraception. Social and moral objections to birth control have gradually disappeared and, notwithstanding some pill scares, oral contraceptives are now one of the most used methods of contraception. Finally, all's well that ends well: recent reports have substantiated the multiple noncontraceptive health benefits paving the way for a bright future for this 50-year-old product. PMID:21091163

Dhont, Marc

2010-12-01

122

Twenty-Four–Month Continuation of Reversible Contraception  

PubMed Central

Objective To estimate 24-month continuation rates of all reversible contraceptive methods for women enrolled in the Contraceptive CHOICE Project. Methods We analyzed 24-month data from the 9,256 participants enrolled in the Contraceptive CHOICE Project, a prospective observational cohort study that provides no-cost contraception to women in the St. Louis region. The project promoted the use of long-acting reversible contraception (LARC; intrauterine devices (IUDs) and implants) in an effort to reduce the rates of unintended pregnancy. This analysis includes participants who received their baseline contraceptive method within 3 months of enrollment and who completed a 24-month follow-up survey (n=6,153). Results Twenty-four month continuation rates for LARC and non-LARC methods were 77% and 41%, respectively. Continuation rates for the levonorgestrel and the copper IUDs were similar (79% versus 77%), whereas the implant continuation rate was significantly lower (69%, p<0.001) compared to IUDs at 24 months. There was no statistically significant difference in 24-month continuation rates among the four non-LARC methods (oral contraceptive pill 43%, patch 40%, ring 41%, depot medroxyprogesterone acetate (DMPA) 38%, p=0.72). Participants who chose a LARC method at enrollment were at significantly lower risk of contraceptive method discontinuation (adjusted hazard ratio=0.29, 95% confidence interval 0.26, 0.32) compared with women who selected a non-LARC method. Conclusion IUDs and the implant have the highest rates of continuation at 24-months. Given their effectiveness and high continuation rates, IUDs and implants should be first-line contraceptive options and shorter-acting methods such as OCPs, patch, ring, and DMPA should be second tier. PMID:24104781

O’Neil, Micaela E.; Peipert, Jeffrey F.; Zhao, Qiuhong; Madden, Tessa; Secura, Gina

2014-01-01

123

A Continuation of the Paradigm Wars? Prevalence Rates of Methodological Approaches across the Social/Behavioral Sciences  

ERIC Educational Resources Information Center

A new line of research has emerged that examines the prevalence rates of mixed methods within disciplines in the social/behavioral sciences. Research presented in this article is unique in that it examines prevalence rates across multiple disciplines using an established cross-disciplinary classification scheme. Results indicate that there are…

Alise, Mark A.; Teddlie, Charles

2010-01-01

124

Ortho Evra, a new contraceptive patch.  

PubMed

Ortho Evra is the first transdermal patch approved for the prevention of pregnancy. Comparative trials have shown that Ortho Evra has efficacy similar to the oral contraceptives Mercilon (not available in the United States) and Triphasil for the prevention of pregnancy when used as directed. Adverse effects with Ortho Evra are similar to those reported with combined oral contraceptives, with the exceptions of mild-to-moderate application-site reactions and an increased frequency of breast symptoms. The most commonly reported adverse reactions were breast symptoms, headache, application-site reactions, nausea and vomiting, dysmenorrhea, and abdominal pain. Approximately 5% of study subjects had at least one patch that did not stay attached to their skin, and about 2% of women withdrew from clinical trials due to irritation from the patch. In clinical studies, the patch appeared to be less effective in women weighing more than 90 kg than in women with lower body weights. More research is needed on the relationship between body weight and contraceptive patch efficacy. In two clinical trials, compliance was greater with the patch than with oral contraceptives. Whether this will result in reduced pregnancy rates in general use is unknown. Additional studies are warranted to determine if the patch offers any significant efficacy or safety advantages over current methods of hormonal contraception. PMID:12680477

Sicat, Brigitte L

2003-04-01

125

Depression and anxiety in prostate cancer: a systematic review and meta-analysis of prevalence rates  

PubMed Central

Objectives To systematically review the literature pertaining to the prevalence of depression and anxiety in patients with prostate cancer as a function of treatment stage. Design Systematic review and meta-analysis. Participants 4494 patients with prostate cancer from primary research investigations. Primary outcome measure The prevalence of clinical depression and anxiety in patients with prostate cancer as a function of treatment stage. Results We identified 27 full journal articles that met the inclusion criteria for entry into the meta-analysis resulting in a pooled sample size of 4494 patients. The meta-analysis of prevalence rates identified pretreatment, on-treatment and post-treatment depression prevalences of 17.27% (95% CI 15.06% to 19.72%), 14.70% (95% CI 11.92% to 17.99%) and 18.44% (95% CI 15.18% to 22.22%), respectively. Pretreatment, on-treatment and post-treatment anxiety prevalences were 27.04% (95% CI 24.26% to 30.01%), 15.09% (95% CI 12.15% to 18.60%) and 18.49% (95% CI 13.81% to 24.31%), respectively. Conclusions Our findings suggest that the prevalence of depression and anxiety in men with prostate cancer, across the treatment spectrum, is relatively high. In light of the growing emphasis placed on cancer survivorship, we consider that further research within this area is warranted to ensure that psychological distress in patients with prostate cancer is not underdiagnosed and undertreated. PMID:24625637

Watts, Sam; Leydon, Geraldine; Birch, Brian; Prescott, Philip; Lai, Lily; Eardley, Susan; Lewith, George

2014-01-01

126

Progestin-Only Oral Contraceptives  

MedlinePLUS

... Progestin-only oral contraceptives are a very effective method of birth control, but they do not prevent ... oral contraceptives on another day, use a backup method of birth control (such as a condom and/ ...

127

Recent advances in contraception  

PubMed Central

Focusing on intrauterine contraceptives (IUC), contraceptive implants, and emergency contraceptives, we review recent advances in contraceptive development and discuss progress in policies to improve access to the most effective methods. We report on the shift in practice towards routinely providing IUCs and implants to young and nulliparous women, prompted in part by the reduced diameter of the insertion tube for the Mirena IUC and the development of a smaller IUC called Skyla. Additionally, we describe the new SCu300A intrauterine ball and the development of an implant called Nexplanon, which comes with a preloaded inserter. We also discuss the efficacy of ulipristal acetate versus levonorgestrel for emergency contraception, especially for women who weigh more than 75 kg. Finally, in light of the increasing interest in providing IUCs and implants to women in the immediate postpartum and post-abortion periods, we consider the rationale for this change in practice and review the progress that has been made so far in the United States. PMID:25580267

Trussell, James

2014-01-01

128

Emergency contraception: a review.  

PubMed

Emergency contraceptives (EC) are forms of contraception that women can use after intercourse to prevent pregnancy. EC use is safe for women of all ages, and there are no medical contraindications to its use. There are two types of emergency contraceptive pills currently available: ulipristal acetate (UPA) and levonorgestrel. UPA is the most effective oral option for EC. In the United States, levonorgestrel containing ECPs are available without prescription to women and men without age restrictions. However, the more effective UPA pills require a prescription. ECPs do not cause abortion or harm an established pregnancy. Placement of a copper intrauterine device (IUD) is more effective EC than either UPA or levonorgestrel, and requires a timely visit with a trained clinician. EC pills are less effective for women who are overweight or obese, therefore such women should be offered a copper IUD or ulipristal rather than levonorgestrel pills. Any woman requesting EC after unprotected intercourse should be offered treatment within 120 hours of intercourse, as should all women who are victims of sexual assault. Women requesting EC should be offered information and services for ongoing contraception. Although levonorgestrel EC is now available over-the-counter, ongoing need exists to educate women about emergency contraception to encourage prompt use of EC when it is needed. PMID:25313947

Corbelli, J; Bimla Schwarz, E

2014-12-01

129

Recent advances in contraception.  

PubMed

Focusing on intrauterine contraceptives (IUC), contraceptive implants, and emergency contraceptives, we review recent advances in contraceptive development and discuss progress in policies to improve access to the most effective methods. We report on the shift in practice towards routinely providing IUCs and implants to young and nulliparous women, prompted in part by the reduced diameter of the insertion tube for the Mirena IUC and the development of a smaller IUC called Skyla. Additionally, we describe the new SCu300A intrauterine ball and the development of an implant called Nexplanon, which comes with a preloaded inserter. We also discuss the efficacy of ulipristal acetate versus levonorgestrel for emergency contraception, especially for women who weigh more than 75 kg. Finally, in light of the increasing interest in providing IUCs and implants to women in the immediate postpartum and post-abortion periods, we consider the rationale for this change in practice and review the progress that has been made so far in the United States. PMID:25580267

Aiken, Abigail R A; Trussell, James

2014-01-01

130

Screening for alcohol use disorders in a genitourinary medicine and contraception clinic: a service evaluation.  

PubMed

Summary National Institute for Health and Clinical Excellence guidance advises that all patients routinely undergo alcohol screening. Our service evaluation in a sexual health clinic assessed the acceptability of alcohol screening, the prevalence of hazardous drinking and the uptake of referral to a specialist alcohol service. Three services were evaluated: a genitourinary medicine service, a contraception service and an integrated sexual health service. AUDIT was used to screen 276 patients; those scoring ?8 were classified as hazardous drinkers. Screening uptake was 58% overall, 58% for the contraception service, 71% for the genitourinary medicine service and 100% for the integrated sexual health service. Overall, 28% had AUDIT scores ?8. Hazardous drinking rates were higher in the genitourinary medicine (32%) and integrated sexual health services (52%) compared to the contraception service (21%); 7% of hazardous drinkers accepted referral. High rates of hazardous drinking were identified within all three groups, but uptake of referral was low. Alternative strategies to specialist alcohol service referral are discussed. PMID:24501232

Thorley, Nicola L; Kumar, Vinod; Nightingale, Peter; Radcliffe, Keith

2014-10-01

131

FastStats: Contraceptive Use  

MedlinePLUS

... Share Compartir 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 [ ...

132

Adolescent Religiosity and Contraceptive Usage.  

ERIC Educational Resources Information Center

Examined contraceptive use by never married, sexually experienced female adolescents (N=224). Found birth control pills to be the single most popular method of contraception. Subjects who reported regularly attending religious services were less likely to have used an effective, medical method of contraception than those who rarely attended…

Studer, Marlena; Thornton, Arland

1987-01-01

133

Reproductive and Contraceptive Knowledge, Contraceptive Self-Efficacy, and Contraceptive Behavior among Teenage Women.  

ERIC Educational Resources Information Center

Investigates the relationships among teenage women's Contraceptive Self-Efficacy (CSE), reproductive and contraceptive knowledge (RCK), and contraceptive behavior. No significant relationships existed between RCK and behavior. However, CSE explained variance in RCK, while other measures uncovered common areas of misinformation that influence…

Levinson, Ruth Andrea

1995-01-01

134

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

135

Crime and violence in Brazil: Systematic review of time trends, prevalence rates and risk factors?  

PubMed Central

Between 1980 and 2010 there were 1 million homicides in Brazil. Dramatic increases in homicide rates followed rises in inequality, more young men in the population, greater availability of firearms, and increased drug use. Nevertheless, disarmament legislation may have helped reduce homicide rates in recent years. Despite its very high rate of lethal violence, Brazil appears to have similar levels of general criminal victimization as several other Latin American and North American countries. Brazil has lower rates of drug use compared to other countries such as the United States, but the prevalence of youth drug use in Brazil has increased substantially in recent years. Since 1990, the growth of the Brazilian prison population has been enormous, resulting in the fourth largest prison population in the world. Through a systematic review of the literature, we identified 10 studies assessing the prevalence of self-reported offending in Brazil and 9 studies examining risk factors. Levels of self-reported offending seem quite high among school students in Brazil. Individual and family-level risk factors identified in Brazil are very similar to those found in high-income countries. PMID:24027422

Murray, Joseph; Cerqueira, Daniel Ricardo de Castro; Kahn, Tulio

2013-01-01

136

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. PMID:23836965

Burke, Anne

2013-01-01

137

Kenya: many women know about contraceptives, but few use them.  

PubMed

The 1989 Kenya Demographic and Health Survey found women to be well informed about contraceptive methods, yet Kenya's population growth rate is higher than India's where contraceptive knowledge is less universal. 89% of women surveyed in Kenya knew of at least 1 modern method. Contraceptives are, however, used less than one would expect given such high levels of contraceptive awareness and knowledge. A study of contraceptive use dynamics was, therefore, conducted different districts. A total 982 currently or ever-married women were interviewed. 81% knew of at least 1 method; with highest awareness of the oral pill at 71.4%, and lowest for traditional methods at 3%. Health workers and friends were identified as the most important information sources. While a full 51% were pregnant at the time of the study, only 34% had ever used contraceptives. Those opting to use selected contraceptives did do on the basis of perceived ease and safety, as well as from health worker recommendations. Most acceptors began with a contraceptive method shortly after bearing the 1st child. While varied reasons were cited for switching methods, unavailability of the 1st was the most common. Non-users offered a range of reasons including health problems, ignorance, personal and familial opposition, religion, and fatalism, among others. Steps suggested to increase the use of modern contraceptives include providing better and more education, improving living standards, information/education/communication targeted to illiterate women in rural areas, improving contraceptive supply and service quality, and providing better advice to clients regarding method suitability. PMID:12284508

1991-01-01

138

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

139

Estimating Prevalence of Injecting Drug Users and As-sociated Death Rates in England Using Regional Data  

E-print Network

the prevalence of current injecting drug users (IDUs) of opiates and/or crack cocaine in EnglandEstimating Prevalence of Injecting Drug Users and As- sociated Death Rates in England Using of Strathclyde, Glasgow, UK. Gordon Hay Centre for Drug Misuse Research, University of Glasgow, Glasgow, UK

King, Ruth

140

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. PMID:25045191

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

2013-01-01

141

Update on emergency contraception.  

PubMed

Emergency contraception is a woman's last chance to prevent unintended pregnancy. Ulipristal acetate, a selective progesterone receptor modulator, when taken as a single 30 mg dose, is a new, safe and effective emergency contraceptive that can be used from the first day and up to 5 days following unprotected intercourse. The older progesterone-only emergency contraceptive, levonorgestrel, is taken as two 0.75 mg pills 12 hours apart (Next Choice(®); Watson Pharmaceuticals Inc., Morristown, NJ, USA) or a single 1.5 mg pill (Plan B One-Step™; Watson Pharmaceuticals Inc.), and is approved for only 72 hours after unprotected intercourse. During clinical development, ulipristal acetate has been shown to be more effective than levonorgestrel in delaying or inhibiting ovulation. A recent meta-analysis of two randomized clinical trials showed ulipristal acetate to have a pregnancy risk 42% lower than levonorgestrel up to 72 hours and 65% lower in the first 24 hours following unprotected intercourse. Moreover, when taken beyond 72 hours, significantly more pregnancies were prevented with ulipristal acetate than with levonorgestrel. Side effects are mild and similar to those seen with levonorgestrel. Ulipristal acetate was approved for emergency contraception by the US Food and Drug Administration in August 2010, and has been launched in the USA as ella(®) (Watson Pharmaceuticals Inc.) since December 1, 2010. Ella is prescription only and is priced comparable to Plan B One-Step. PMID:21153722

Fine, Paul M

2011-02-01

142

POLICY STATEMENT CONTRACEPTIVE USE  

E-print Network

acceptable contraceptives, may be found at the IRB web site. The FDA uses five categories, designated as A, B of fetal abnormalities if administered during the first (second, third, or all) trimester(s) of pregnancy rule out the possibility of harm, however, (name of drug) should be used during pregnancy only

143

Update in Contraception  

Microsoft Academic Search

ifty percent of all pregnancies in the United States are unintended. Sixty percent of these unplanned pregnancies occur in woman using some contraceptive method.1 These statistics demonstrate that although numerous methods of con- traception are available, many women either are not finding a reliable method that suits their lifestyle or are not adhering to their current birth control method. Researchers

Jennifer Tassa Bhojwani; Michelle L. Matthews

144

CUP: contraceptive users pamphlet.  

PubMed

This pamphlet, edited by an ad hoc committee of several consultants, scientists, theologians, public health and family planning directors, and an international attorney, covers the following topics: contra-conception; choices of contraceptives; contraceptive package information; copper IUDs; pelvic inflammatory disease (PID); sexually transmitted diseases; and acquired immunodeficiency syndrome. It includes a questionnaire for sexually transmitted diseases (STDs). Professor Joseph Goldzieher describes the "Contra-Conception" database as "a synthesis of up-to-date literature and contemporary guidelines, designed to provide ready access for practicing physicians and medical students." It contains data on several types of hormonal contraception. "Contra-Conceptions" is designed to allow the physician to set his or her own pace when working with the computer, and no previous computer experience is required. 1 of the program's many innovative features is the patient-profiling/decisionmaking section which can be used in the doctor's office to help decide what type of hormonal contraceptive is appropriate for a particular patient. The program permits the doctor to evaluate the significance of patient variables such as parity, smoking, menstrual difficulties and helps the doctor to identify the risks and benefits of the various methods and, ultimately, to make a balanced decision in the context of the most recent data. Contraceptive drugs and devices should include detailed information on the following: description of formula or device; indication, usage, and contraindications, clinical pharmacology and toxicology; dose-related risk; pregnancies per 100 women year; and detailed warning. The sequence of major pathophysiological reactions associated with copper IUDs is identified as are special problems of pelvic infections in users of copper IUDs. Those women who use oral contraceptives (OCs) or a barrier method of contraception or whose partners use a condom have a lower frequency of PID than women not employing any protection. It is well established that copper IUDs cause different types and different degrees of PID. Women using copper IUDs are more at risk for pelvic infection. There is a higher frequency of salpingitis and PID when copper IUDs are employed especially when the population is nulligravidas under the age of 25. The pamphlet lists criteria for the diagnosis of salpingo-oophoritis and actue salpingitis. PMID:12267728

1986-02-01

145

Preventing Unintended Pregnancies and Improving Contraceptive Use Among Young Adult Women in a Rural, Midwestern State: Health Promotion Implications  

Microsoft Academic Search

Despite high rates of unintended pregnancy among women aged 18 to 30 years, little research has been conducted to understand the factors associated with their contraceptive use. Eighteen focus groups were conducted with young adult women (N = 106) who were mostly white, non-Hispanic. Results suggested that contraceptive use was negatively affected by low contraceptive knowledge; use of alcohol; a

Shelly Campo; Natoshia M. Askelson; Erica L. Spies; Mary Losch

2010-01-01

146

Explaining Recent Declines in Adolescent Pregnancy in the United States: The Contribution of Abstinence and Improved Contraceptive Use  

Microsoft Academic Search

Objectives. We explored the relative contributions of declining sexual activity and improved contraceptive use to the recent decline in adolescent pregnancy rates in the United States. Methods. We used data from 1995 and 2002 for women 15 to 19 years of age to develop 2 indexes: the contraceptive risk index, summarizing the overall effec- tiveness of contraceptive use among sexually

John S. Santelli; Laura Duberstein Lindberg; Lawrence B. Finer; Susheela Singh

2007-01-01

147

Oral contraceptives, sociocultural beliefs and psychiatric symptoms  

Microsoft Academic Search

The occurence of psychiatric symptoms as detected by the General Health Questionnaire was examined in three groups of Moslem women. Those who used oral contraceptives were compared to those who used local contraceptives and those using no contraceptives in relation to their beliefs about prohibition of contraception by the Islamic religious code and\\/or about possible health hazards of contraception. Those

M. Fakhr El-Islam; Taha H. Malasi; Sanaa I. Abu-Dagga

1988-01-01

148

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

149

Contraception: traditional and religious attitudes.  

PubMed

Humans have tried to control fertility for centuries. Primitive, preliterate societies practiced infanticide and abortion. When primitive women understood the advantages of conception control, they tried, when possible, to use contraception. In the 4th century B.C., Plato and Aristotle advocated a one-child family. Greek medical literature reported a hollow tube inserted through the cervix into the uterus and a potion as contraceptives. Islamic physicians had much knowledge about conception control. The attitudes toward contraception. In the 5th century B.C., Saint Augustine condemned contraception, even among married couples. The condom emerged in the early modern period. Yet, they were usually worn to protect against disease, e.g., bilharzia in Egypt and syphilis in Europe. The cervical cap and the diaphragm are examples of occlusive pessaries. By 1880, contraceptives and spermicides were advertised. In 1928, the IUD joined the existing contraceptives. Today we have combined oral contraceptives. Judaic law requires husbands to fulfill their wives sexual needs, separate from their duty to procreate. It also calls men, not women, to procreate and forbids men from masturbating, thus Judaic law does not forbid women from practicing contraception. The Roman Catholic church forbids contraceptive use because it is a sin against nature. Some Protestant denominations have allowed contraceptive use. Islamic law states that children are gifts from Allah. Some Moslems believe that they must have many children, but Allah and the Prophet state that children have rights to education and future security. These rights allow couples to prevent pregnancy. Neither Hinduism nor Buddhism prohibit contraceptive use. Differences in husband-wife communication, sex roles, access to contraceptives, and traditional family values will have more of an effect on contraceptive use and fertility than theological barriers or the social class of religious groups. PMID:8365507

Schenker, J G; Rabenou, V

1993-04-01

150

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. PMID:23256652

2012-01-01

151

Report calls for new revolution in contraceptive technology.  

PubMed

In response to the high rates of contraceptive failure and abortion in the US, members of an Institute of Medicine (National Academy of Sciences) panel called for a "second contraceptive revolution." Since oral contraceptives were introduced in the early 1960s, social, legal, and financial barriers have stalled any further development of new methods. Most research activity has focused on modifying existing hormonal methods rather than creating new technology. Essential is stronger collaboration between government, industry, private insurers, and the public. Product liability concerns have been a major obstacle, in the US more than in other countries. Thus, the panel called for a statute that would protect manufacturers from certain lawsuits if their contraceptives had been approved by the US Food and Drug Administration. Given the pharmaceutical industry's insistence on clearer drug regulatory protocol as a condition of contraceptive development, the panel recommended immediate guidelines for high-priority areas such as spermicides and vaginal microbicides. To spread the legal and financial risks associated with the development of anti- and post-implantation methods such as RU-486, the panel urged that small biotech firms form partnerships with nonprofit organizations and large pharmaceutical companies. Another option for new contraceptive development is a global contraceptive commodity program or multilateral purchasing pool, in which competing manufacturers would be eligible for volume purchases of their products by the sponsoring agencies. PMID:12291557

Durbin, S

1996-09-01

152

Update on emergency contraception.  

PubMed

Emergency contraception (EC) is any method used after sexual intercourse to prevent pregnancy. This article provides an overview of the history of EC methods and describes the current availability of oral and intrauterine EC. Oral forms include the Yuzpe regimen (combining ethinyl estradiol and levonorgestrel), levonorgestrel-only pills, and ulipristal acetate, which is a new emergency contraceptive drug recently approved by the US Food and Drug Administration. The copper T-380A intrauterine device can also be used for EC. Information about dosing, timing, access, and other considerations in the provision of EC is covered. Clinicians should be aware of all available options in order to counsel women in need of EC appropriately. PMID:23050729

Murphy, Patricia Aikins

2012-01-01

153

Oral contraceptive use and psychiatric disorders in a nationally representative sample of women.  

PubMed

The purpose of this study is to examine the association between oral contraceptive use (any current use, duration, and type) and major depressive disorder (MDD), generalized anxiety disorder (GAD), and panic disorder (PD) in a nationally representative sample of women in the USA. Data were drawn from 1,105 women aged 20-39 in the National Health and Nutrition Examination Surveys from 1999 to 2004. The associations between self-reported use of oral contraceptives in the past year and DSM-IV diagnosed and subthreshold MDD, GAD, and PD in the past year were assessed comparing oral contraceptive users to all non-users, former users, and former long-term users. Women using oral contraceptives had a lower past-year prevalence of all disorders assessed, other than subthreshold MDD. When adjusted for confounders, women using oral contraceptives in the past year had significantly lower odds of subthreshold PD, compared to former users (odds ratio (OR)?=?0.34, 95 % CI 0.14-0.84). Effects estimates were strongest for monophasic (versus multiphasic) oral contraceptive users. Hormonal contraceptive use was associated with reduced risk of subthreshold PD. A potential mental health benefit of hormonal contraceptives has substantial public health implications; prospective longitudinal studies are needed to confirm whether hormonal contraceptive use improves mental health. PMID:25113319

Cheslack-Postava, Keely; Keyes, Katherine M; Lowe, Sarah R; Koenen, Karestan C

2015-02-01

154

Adolescent Contraceptive Method Choices  

Microsoft Academic Search

This article analyzes determinants of contraceptive method choices among adolescent women in the United States. By using data\\u000a from the 1982 National Survey of Family Growth, we examine factors that differentiate users of various methods early in the\\u000a sexual careers of teenaged women. We find that patterns of method choice not only vary by race and region within the United

Joan R. Kahn; Ronald R. Rindfuss; David K. Guilkey

1990-01-01

155

History (of oral contraceptives).  

PubMed

This article summarizes the interest and research in oral contraceptives, with particular attention given to recent discoveries in the field. Development of the present day pill was impossible until scientific discoveries of female ovarian hormones during pregnancy. Scientific work in the 1920s identified the 2 hormones, estrogen and progesterone, and scientists showed that use of the 2 together influenced ovulation and eased dysmenorrhea. It was not until 1944 that a scientist produced progesterone from a plant steroid; today synthetic steroids are available. Margaret Sanger, a pioneer in the American Family Planning Movement, financed and encouraged early human volunteer trials and later clinical trials with contraceptive pills. By 1957, the pills were approved by the FDA for use in treating menstrual disorders. In January 1962, they were released on the market as contraceptives. By 1976-77, the pill was used by 80-100 million women around the world. A dated table summarizes the information in the article in a timetable fashion. PMID:12308937

1978-02-01

156

Advances in male hormonal contraception  

PubMed Central

Contraception is a basic human right for its role on health, quality of life and wellbeing of the woman and of the society as a whole. Since the introduction of female hormonal contraception the responsibility of family planning has always been with women. Currently there are only a few contraceptive methods available for men, but recently, men have become more interested in supporting their partners actively. Over the last few decades different trials have been performed providing important advances in the development of a safe and effective hormonal contraceptive for men. This paper summarizes some of the most recent trials. PMID:25673544

Antonietta, Costantino; Giulia, Gava; Marta, Berra; Cristina, Meriggiola Maria

2014-01-01

157

The Impact of Height during Childhood on the National Prevalence Rates of Overweight  

PubMed Central

Background It is known that height and body mass index (BMI) are correlated in childhood. However, its impact on the (trend of) national prevalence rates of overweight and obesity has never been investigated. The aim of our study is to investigate the relation between height and national prevalence rates of overweight and obesity in childhood between 1980, 1997, and 2009, and to calculate which fixed value of p (2.0,2.1, …,3.0) in kg/mp during childhood is most accurate in predicting adult overweight. Methods and findings Cross-sectional growth data of children from three Dutch nationwide surveys in 1980, 1997, and 2009, and longitudinal data from the Terneuzen Birth Cohort and the Harpenden Growth Study were used. Relative risks (RR) and 95% confidence intervals (CI) were calculated. Our study showed that tall (>1 standard deviation (SD)) girls aged 5.0–13.9 y were more often overweight (RR?=?3.5,95%CI:2.8–4.4) and obese (RR?=?3.9,95%CI:2.1–7.4) than short girls (prevalence rates of overweight and obesity than their shorter peers. We suggest taking into account the impact of height when evaluating trends and variations of BMI distributions in childhood, and to use BMI to predict adult overweight. PMID:24465694

van Dommelen, Paula; de Kroon, Marlou L. A.; Cameron, Noël; Schönbeck, Yvonne; van Buuren, Stef

2014-01-01

158

Substances used and prevalence rates of pharmacological cognitive enhancement among healthy subjects.  

PubMed

Pharmacological "cognitive enhancement" (CE) is defined as the use of any psychoactive drug with the purpose of enhancing cognition, e.g. regarding attention, concentration or memory by healthy subjects. Substances commonly used as CE drugs can be categorized into three groups of drugs: (1) over-the-counter (OTC) drugs such as coffee, caffeinated drinks/energy drinks, caffeine tablets or Ginkgo biloba; (2) drugs being approved for the treatment of certain disorders and being misused for CE: drugs to treat attention-deficit/hyperactivity disorder (ADHD) such as the stimulants methylphenidate (MPH, e.g. Ritalin(®)) or amphetamines (AMPH, e.g. Attentin(®) or Adderall(®)), to treat sleep disorders such as modafinil or to treat Alzheimer's disease such as acetylcholinesterase inhibitors; (3) illicit drugs such as illicit AMPH, e.g. "speed", ecstasy, methamphetamine (crystal meth) or others. Evidence from randomized placebo-controlled trials shows that the abovementioned substances have limited pro-cognitive effects as demonstrated, e.g. regarding increased attention, increased cognitive speed or shortening of reaction times, but on the same time poses considerable safety risks on the consumers. Prevalence rates for the use of CE drugs among healthy subjects show a broad range from less than 1 % up to more than 20 %. The range in prevalence rates estimates results from several factors which are chosen differently in the available survey studies: type of subjects (students, pupils, special professions, etc.), degree of anonymity in the survey (online, face-to-face, etc.), definition of CE and substances used/misused for CE, which are assessed (OTC drugs, prescription, illicit drugs) as well as time periods of use (e.g. ever, during the past year/month/week, etc.). A clear and comprehensive picture of the drugs used for CE by healthy subjects and their adverse events and safety risks as well as comprehensive and comparable international data on the prevalence rates of CE among healthy subjects are of paramount importance for informing policy makers and healthcare professionals about CE. PMID:25214391

Franke, Andreas G; Bagusat, Christiana; Rust, Sebastian; Engel, Alice; Lieb, Klaus

2014-11-01

159

The impact on fertility of contraceptive failure in China in the 1980s.  

PubMed

Contraceptive failure was an important determinant of fertility in China in the 1980s. Based on the data from the China Two-per-Thousand Fertility Survey, this study shows that about 7% of the general fertility rate of currently married women aged 15-49 for a 12-month period is attributed to contraceptive failure, mainly due to the high failure rate associated with IUD use. A number of demographic characteristics are associated with contraceptive use, and with contraceptive failure and its outcome. Relevant socioeconomic differentials are also identified. PMID:7650045

Wang, D; Diamond, I

1995-07-01

160

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

PubMed

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 the associated risk factors in Hungary. A total of 1030 mothers who delivered their babies between May and July 1999 in 16 counties in Hungary were screened for depressive symptoms 3-26 weeks post-partum. The survey found that 10.81% of the sample was above the cut-off score of 13, and the EPDS detected post-partum depressive symptoms with 76% (95% confidence interval (CI)=60.5-87.1) sensitivity and 92% (95% CI=90.5-94.1) specificity. In addition, 24 socio-demographic, socio-psychiatric data and personal and obstetric variables were surveyed. Results of a hierarchical logistic regression analysis showed that depression of the mother during pregnancy was the strongest predictor of depressive symptoms post-partum. Depression before pregnancy, housing conditions, marital relationship status and family history of alcohol problems were also identified as predictors for post-partum depressive symptoms. PMID:20965093

Nagy, Emese; Molnar, Peter; Pal, Attila; Orvos, Hajnalka

2011-01-30

161

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. PMID:24725355

2014-01-01

162

Mirena ® (Levonorgestrel intrauterine system): A successful novel drug delivery option in contraception  

Microsoft Academic Search

This manuscript serves as a review of Mirena®, the levonorgestrel intrauterine system (LNG IUS) as a very successful drug delivery system. The LNG IUS has a very high contraceptive efficacy rate, and low rates of patient discontinuation. In addition to its contraceptive benefits, most users experience a decrease in menstrual bleeding over the 5 years of use. LNG IUS has also

Susan Rose; Angela Chaudhari; C. Matthew Peterson

2009-01-01

163

The levonorgestrel intrauterine system in contraception  

Microsoft Academic Search

The levonorgestrel intrauterine system (LNG IUS) releases 20 ?g\\/24 h of levonorgestrel from a polymer cylinder mounted on a T-shaped frame and covered with a release rate-controlling membrane. It is approved for 5-year use. The most outstanding features of LNG IUS are its high contraceptive efficacy and reduction of menstrual blood flow. No single mode of action can account for

Pekka Lähteenmäki; Ilkka Rauramo; Tiina Backman

2000-01-01

164

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. PMID:24333079

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

165

Contraception for adolescents with lupus  

Microsoft Academic Search

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

Melissa S Tesher; Amy Whitaker; Melissa Gilliam; Linda Wagner-Weiner; Karen B Onel

2010-01-01

166

Contraceptive sponge patient insert warns of TSS.  

PubMed

The Today contraceptive sponge patient insert is being revised to reflect concerns about the possible relationship between toxic shock syndrome (TSS) and the vaginal contraceptive sponge. The sponge was first marketed over-the-counter in June 1983. It is made of polyurethane impregnated with the spermicide nonoxynol-9 and is intended to provide 24 hours of contraception. At the time of approval, the Food and Drug Administration (FDA) required a patient insert containing a warning that clinical trials had not been large enough to assess the risk of TSS, and that users should seek medical care if they developed the listed symptoms of TSS. In February 1984, 4 cases of confirmed TSS were reported to be associated with sponge use. Of these, 2 occurred in women who had difficulty removing the product, 1 occurred in a woman 37 days postpartum, and 1 occurred in a woman who had left the sponge in place for 5 days. All were nonmenstruating white women, 20-29 years of age. As of July 1, 1984 there had been 4 additional confirmed nonmenstruating cases of TSS with the contraceptive sponge. The manufacturer of the sponge, VLI Corporation, added a warning in February on the outside packaging and in the patient insert. It advises the user to consult her physician or clinic immediately if she experiences 2 or more of the warning signs of TSS, to remove the sponge within the specified time limit, and to consult one's physician or clinic before using this product after childbirth, miscarriage, or abortion. The data should be regarded as preliminary, but the rate of TSS in nonmenstruating women using the contraceptive sponge is estimated to be less than that in menstruating women using tampons but more than the background rate for nonmenstruating women. TSS patients should be managed as those suffering from other forms of shock. Large volumes of fluid and supportive care should be used as needed. A vaginal examination should be performed with removal of any tampon or vaginal contraceptive. There is no evidence that antibiotics are effective in treating active TSS cases, but beta-lactamase-resistant antistaphylococcal antibiotics seem to be effective in preventing recurrences. PMID:6479516

1984-08-01

167

Sexual and Reproductive Health Knowledge, Contraception Uptake, and Factors Associated with Unmet Need for Modern Contraception among Adolescent Female Sex Workers in China  

PubMed Central

Objective In China, policy and social taboo prevent unmarried adolescents from accessing sexual and reproductive health (SRH) services. Research is needed to determine the SRH needs of highly disadvantaged groups, such as adolescent female sex workers (FSWs). This study describes SRH knowledge, contraception use, pregnancy, and factors associated with unmet need for modern contraception among adolescent FSWs in Kunming, China. Methods A cross-sectional study using a one-stage cluster sampling method was employed to recruit adolescents aged 15 to 20 years, and who self-reported having received money or gifts in exchange for sex in the past 6 months. A semi-structured questionnaire was administered by trained peer educators or health workers. Multivariable logistic regression was conducted to determine correlates of low knowledge and unmet need for modern contraception. Results SRH knowledge was poor among the 310 adolescents surveyed; only 39% had heard of any long-acting reversible contraception (implant, injection or IUD). Despite 98% reporting not wanting to get pregnant, just 43% reported consistent condom use and 28% currently used another form of modern contraception. Unmet need for modern contraception was found in 35% of adolescents, and was associated with having a current non-paying partner, regular alcohol use, and having poorer SRH knowledge. Past abortion was common (136, 44%). In the past year, 76% had reported a contraception consultation but only 27% reported ever receiving SRH information from a health service. Conclusions This study demonstrated a low level of SRH knowledge, a high unmet need for modern contraception and a high prevalence of unintended pregnancy among adolescent FSWs in Kunming. Most girls relied on condoms, emergency contraception, or traditional methods, putting them at risk of unwanted pregnancy. This study identifies an urgent need for Chinese adolescent FSWs to be able to access quality SRH information and effective modern contraception. PMID:25625194

Lim, Megan S. C.; Zhang, Xu-Dong; Kennedy, Elissa; Li, Yan; Yang, Yin; Li, Lin; Li, Yun-Xia; Temmerman, Marleen; Luchters, Stanley

2015-01-01

168

Mapping the serological prevalence rate of west nile fever in equids, Tunisia.  

PubMed

West Nile fever (WNF) is a viral disease of wild birds transmitted by mosquitoes. Humans and equids can also be affected and suffer from meningoencephalitis. In Tunisia, two outbreaks of WNF occurred in humans in 1997 and 2003; sporadic cases were reported on several other years. Small-scale serological surveys revealed the presence of antibodies against WN virus (WNV) in equid sera. However, clinical cases were never reported in equids, although their population is abundant in Tunisia. This study was achieved to characterize the nationwide serological status of WNV in Tunisian equids. In total, 1189 sera were collected in 2009 during a cross-sectional survey. Sera were tested for IgG antibodies, using ELISA and microneutralization tests. The estimated overall seroprevalence rate was 28%, 95% confidence interval [22; 34]. The highest rates were observed (i) in the north-eastern governorates (Jendouba, 74%), (ii) on the eastern coast (Monastir, 64%) and (iii) in the lowlands of Chott El Jerid and Chott el Gharsa (Kebili, 58%; Tozeur, 52%). Environmental risk factors were assessed, including various indicators of wetlands, wild avifauna, night temperature and chlorophyllous activity (normalized difference vegetation index: NDVI). Multimodel inference showed that lower distance to ornithological sites and wetlands, lower night-time temperature, and higher NDVI in late spring and late fall were associated with higher serological prevalence rate. The model-predicted nationwide map of WNF seroprevalence rate in Tunisian equids highlighted different areas with high seroprevalence probability. These findings are discussed in the perspective of implementing a better WNF surveillance system in Tunisia. This system might rely on (i) a longitudinal survey of sentinel birds in high-risk areas and time periods for WNV transmission, (ii) investigations of bird die-offs and (iii) syndromic surveillance of equine meningoencephalitis. PMID:23906318

Bargaoui, R; Lecollinet, S; Lancelot, R

2015-02-01

169

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

170

Pharmacokinetic and pharmacodynamic drug interactions between antiretrovirals and oral contraceptives.  

PubMed

More than 50 % of women living with HIV in low- and middle-income countries are of reproductive age, but there are limitations to the administration of oral contraception for HIV-infected women receiving antiretroviral therapy due to drug-drug interactions caused by metabolism via the cytochrome P450 isoenzymes and glucuronidation. However, with the development of newer antiretrovirals that use alternative metabolic pathways, options for contraception in HIV-positive women are increasing. This paper aims to review the literature on the pharmacokinetics and pharmacodynamics of oral hormonal contraceptives when given with antiretroviral agents, including those currently used in developed countries, older ones that might still be used in salvage regimens, or those used in resource-limited settings, as well as newer drugs. Nucleos(t)ide reverse transcriptase inhibitors (NRTIs), the usual backbone to most combined antiretroviral treatments (cARTs) are characterised by a low potential for drug-drug interactions with oral contraceptives. On the other hand non-NRTIs (NNRTIs) and protease inhibitors (PIs) may interact with oral contraceptives. Of the NNRTIs, efavirenz and nevirapine have been demonstrated to cause drug-drug interactions; however, etravirine and rilpivirine appear safe to use without dose adjustment. PIs boosted with ritonavir are not recommended to be used with oral contraceptives, with the exception of boosted atazanavir which should be used with doses of at least 35 µg of estrogen. Maraviroc, an entry inhibitor, is safe for co-administration with oral contraceptives, as are the integrase inhibitors (INIs) raltegravir and dolutegravir. However, the INI elvitegravir, which is given in combination with cobicistat, requires a dose of estrogen of at least 30 µg. Despite the growing evidence in this field, data are still lacking in terms of large cohort studies, randomised trials and correlations to real clinical outcomes, such as pregnancy rates, in women on antiretrovirals and hormonal contraception. PMID:25331712

Tittle, Victoria; Bull, Lauren; Boffito, Marta; Nwokolo, Nneka

2015-01-01

171

A Qualitative Analysis of Long-Acting Reversible Contraception.  

PubMed

Increasing access to long-acting reversible contraception (LARC), including the intrauterine device and the implant is a public health and clinical imperative to reduce rates of unintended pregnancy. In 2012, the American College of Obstetricians and Gynecologists recommended these methods for all women, including adolescents. Little research explores why young women reject these safe, effective contraceptive methods. A total of 53 women aged 18-24 years completed in-depth interviews. Analytical techniques from the grounded theory approach were used to identify patterns and themes across the data. Participants initiated hormonal contraception for "the pill's" beneficial side effects and believed a myth of perfect use, which constructed a false choice of LARC methods. Barriers to LARC options included access, medical resistance, and cost. Participants described a sense of unease about methods perceived as "alien." These women underestimated the risks of oral contraceptive pills and overestimated the risks of long-acting reversible contraception, including infertility. The myth of perfect use emerged as participants wanted to be in control by taking "the pill" every day; however, many described imperfect adherence. Findings include strategies for public health professionals and health care providers to distribute satisfactory and effective contraception for young women. Effective health communication campaigns will emphasize the desirable side effects, safety and increased effectiveness of LARC methods. PMID:25424456

Sundstrom, Beth; Baker-Whitcomb, Annalise; DeMaria, Andrea L

2014-11-26

172

Abortion and contraceptive failure.  

PubMed

Persona, marketed by Unipath, is a new method of natural family planning which has been on the market since 1996. It works by measuring the hormone levels in a woman's urine and letting her know when she is not fertile and may have sex without using a barrier method of contraception. The British Pregnancy Advisory Service (BPAS) found that their surveyed clients who reported using Persona had 188 abortions in 3 months and concluded that there was a need for better information and more advice for couples who plan to use the method. The other major non-NHS abortion provider, Marie Stopes International, reported similar findings, with about 60 women per month visiting their clinics for abortions after having used the method. The BPAS survey also showed that 43% of the women who had an abortion after using Persona were aged 24 years or younger even though Persona is intended for use by women aged 25-40 years in stable relationships. A similar proportion also reported having sex on days when the method told them that they were most fertile. These latter women were not asked if they used another method of contraception on fertile days. An additional 13% reported ignoring the instructions to wait for 3 natural periods after terminating pill use before beginning to use Persona. PMID:12321444

1998-01-01

173

Vaccination for contraception.  

PubMed

Vaccination for birth control has several advantages over currently available methods of family planning and should prove an attractive addition to the contraceptive armamentarium both in developing countries and in a developed country such as Australia. Concerns have been voiced by consumer health advocates that vaccines, like other long acting contraceptive methods, may be abused by health authorities in developing countries and by their use in vulnerable groups such as aborigines in our own country. These concerns need to be recognised and addressed. More difficult to accommodate are the anxieties expressed by feminist groups about the 'loss of control' and 'lack of body awareness' inherent in a method, such as a vaccine, that is relatively easily administered and has no overt side effects. There is no evidence that these concerns are shared by women in general. The antifertility vaccine that will most likely be applied first in family planning programmes is one directed against the pregnancy hormone hCG. A WHO vaccine directed against the C-terminal peptide of beta-hCG provokes a specific and safe immune response and will enter Phase 2 trials in Sweden this year. Subsequent developments with this vaccine will include the replacement of the current emulsion vehicle by a delivery system based on biodegradeable microspheres which will give a more sustained antigen release and duration of effectiveness. PMID:7848209

Jones, W R

1994-06-01

174

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. PMID:24895568

Chun, Sail; Min, Won-Ki

2014-01-01

175

Low rate of total hip replacement as reflected by a low prevalence of hip osteoarthritis in South Korea  

PubMed Central

Summary Objective We attempted to estimate the rate of total hip replacement (THR) using a national database and the prevalence of hip osteoarthritis (OA) from the reading of intravenous pyelograms (IVPs) in a Korean population. Materials Reimbursement records from all hospitals in South Korea were extracted from the Health Insurance Review Agency (HIRA) database. Records with both the procedure code corresponding to THR and containing the diagnosis code for hip OA were selected. We estimated the age- and sex-specific rates of THR from 2002 to 2006. Hip joints from 580 subjects older than 70 years old who underwent an IVP were assessed for the presence of OA. Results The rate of THR increased with age, reaching a peak over the age of 65–69 years, with the age-standardized risk ratios in women vs men of approximately 1.5. Although the rate of THR increased over the 5-year study period, it was significantly lower than that of total knee replacement (TKR) in Korean population (THR vs TKR 1:15.9). The prevalence of hip OA in the IVP cohort was 1.2% (1.7% for men and 0.7% for women). Conclusion The rate of THR was significantly lower than that of TKR in Korean population. Hip OA prevalence among the IVP subjects was 1.2%. Further studies on factors that account for the low prevalence of hip OA among Asians need to be conducted. PMID:18558502

Kim, H. A.; Koh, S. H.; Lee, B.; Kim, I. J.; Seo, Y. I.; Song, Y. W.; Hunter, D. J.; Zhang, Y.

2015-01-01

176

Ulipristal acetate: contraceptive or contragestive?  

PubMed

Ulipristal acetate is the first selective progesterone receptor modulator approved for postcoital contraception in the US. It appears to be significantly more effective in inhibition of ovulation than other forms of emergency contraception. However, ulipristal acetate is structurally similar to mifepristone, and several lines of evidence suggest that a postfertilization mechanism of action is also operative. This mechanism of action is considered to be contragestive versus contraceptive. Ulipristal acetate administration is contraindicated in a known or suspected pregnancy; however, it could quite possibly be used as an effective abortifacient. Health-care providers should inform patients of the possibility of both mechanisms of action with use of this drug. PMID:21666088

Keenan, Jeffrey A

2011-06-01

177

Prevalence of Suicidal Ideation, Attempts, and Completed Suicide Rate in Chinese Aging Populations: A Systematic Review  

PubMed Central

Background As one of the leading causes of death around the world, suicide is a global public health threat. Due to the paucity of systematic studies, there exist vast variations in suicide ideation, attempts and suicide rates between various regions of Chinese aging communities. Objectives Our systematic study aims to 1) identify studies describing the epidemiology of suicidal ideation, suicide attempts and behaviors among global Chinese communities; 2) conduct systematic review of suicide prevalence; 3) provide cross-cultural insights on this public health issue in the diverse Chinese elderly in China, Hong Kong, Taiwan, Asian societies and Western countries. Data sources Using the PRISMA statement, we performed systematic review including studies describing suicidal ideation, attempts, and behavior among Chinese older adults in different communities. Literature searches were conducted by using both medical and social science data bases in English and Chinese. Results Forty-nine studies met inclusion criteria. Whereas suicide in Chinese aging population is a multifaceted issue, culturally appropriate and inter-disciplinary approach to improve the quality of life for the Chinese older adults is critical. Conclusions Future research is needed to explore the risk and protective factors associated with suicidal thoughts, attempts and behaviors in representative Chinese aging populations. PMID:23791030

Simon, Melissa; Chang, E-Shien; Zeng, Ping; Dong, XinQi

2013-01-01

178

Change rates and prevalence of a dichotomous variable: simulations and applications.  

PubMed

A common modelling approach in public health and epidemiology divides the population under study into compartments containing persons that share the same status. Here we consider a three-state model with the compartments: A, B and Dead. States A and B may be the states of any dichotomous variable, for example, Healthy and Ill, respectively. The transitions between the states are described by change rates, which depend on calendar time and on age. So far, a rigorous mathematical calculation of the prevalence of property B has been difficult, which has limited the use of the model in epidemiology and public health. We develop a partial differential equation (PDE) that simplifies the use of the three-state model. To demonstrate the validity of the PDE, it is applied to two simulation studies, one about a hypothetical chronic disease and one about dementia in Germany. In two further applications, the PDE may provide insights into smoking behaviour of males in Germany and the knowledge about the ovulatory cycle in Egyptian women. PMID:25749133

Brinks, Ralph; Landwehr, Sandra

2015-01-01

179

Change Rates and Prevalence of a Dichotomous Variable: Simulations and Applications  

PubMed Central

A common modelling approach in public health and epidemiology divides the population under study into compartments containing persons that share the same status. Here we consider a three-state model with the compartments: A, B and Dead. States A and B may be the states of any dichotomous variable, for example, Healthy and Ill, respectively. The transitions between the states are described by change rates, which depend on calendar time and on age. So far, a rigorous mathematical calculation of the prevalence of property B has been difficult, which has limited the use of the model in epidemiology and public health. We develop a partial differential equation (PDE) that simplifies the use of the three-state model. To demonstrate the validity of the PDE, it is applied to two simulation studies, one about a hypothetical chronic disease and one about dementia in Germany. In two further applications, the PDE may provide insights into smoking behaviour of males in Germany and the knowledge about the ovulatory cycle in Egyptian women. PMID:25749133

Brinks, Ralph; Landwehr, Sandra

2015-01-01

180

[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

181

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

182

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

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

Seafood consumption, the DHA content of mothers’ milk and prevalence rates of postpartum depression: a cross-national, ecological analysis  

Microsoft Academic Search

Background: Mothers selectively transfer docosahexaenoic acid (DHA) to their fetuses to support optimal neurological development during pregnancy. Without sufficient dietary intake, mothers become depleted of DHA and may increase their risk of suffering major depressive symptoms in the postpartum period. We postulated that the DHA content of mothers’ milk and seafood consumption would both predict prevalence rates of postpartum depression

Joseph R. Hibbeln

2002-01-01

186

Ectopic Pregnancy and Emergency Contraceptive Pills: A Systematic Review  

PubMed Central

Objective To evaluate the existing data to estimate the rate of ectopic pregnancy among emergency contraceptive pill treatment failures. Data Sources Our initial reference list was generated from a 2008 Cochrane review of emergency contraception. In August 2009, we searched Biosys Previews, the Cochrane Database of Systematic Reviews, Medline, Global Health Database, Health Source: Popline, and Wanfang Data (a Chinese database). Methods of Study Selection This study included data from 136 studies which followed a defined population of women treated one time with emergency contraceptive pills (either mifepristone or levonorgestrel), and in which the number and location of pregnancies were ascertained. Results Data from each article were abstracted independently by two reviewers. In the studies of mifepristone, 3 out of 494 (0.6%) pregnancies were ectopic; in the levonorgestrel studies, 3 out of 307 (1%) were ectopic. Conclusion The rate of ectopic pregnancy when treatment with emergency contraceptive pills fails does not exceed the rate observed in the general population. Since emergency contraceptive pills are effective in lowering the risk of pregnancy, their use should reduce the chance that an act of intercourse will result in ectopic pregnancy. PMID:20502299

Cleland, Kelly; Raymond, Elizabeth; Trussell, James; Cheng, Linan; Zhu, Haoping

2014-01-01

187

Non-Contraceptive Benefits of Oral Hormonal Contraceptives  

PubMed Central

Abstract 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

2012-01-01

188

Knowledge, attitude and practice of emergency contraceptive among women who seek abortion care at Jimma University specialized hospital, southwest Ethiopia  

PubMed Central

Background In Ethiopia maternal mortality rate is very high more than one in five women die from pregnancy or pregnancy related causes. The use of contraceptives to prevent unwanted pregnancies and unsafe abortion is an important strategy to minimize maternal mortality rate. Among various forms of contraception, emergency contraceptives are the only one that can be used after sexual intercourse offering chance to prevent unwanted pregnancy. The aim of this study was to assess the knowledge, attitude and practice of emergency contraceptive among women who seek abortion care at Jimma University specialized hospital (JUSH). Methods Institution base cross-sectional study on knowledge, attitude and practice of emergency contraceptive was conducted at JUSH from April to June, 2011Data was collected using structured questionnaire and analyzed using SPSS version 17.0. Results In this study 89 women were interviewed. More than half of them (48) were from urban area and 41 were from rural area.46 (51.7%) of them were single. Of all the respondents only nine women had awareness about emergency contraceptive. Seven of the women mentioned pills as emergency contraception and only two of them mentioned both pills and injectable as emergency contraception. All of them have positive attitude towards emergency contraception but none of them have ever used emergency contraceptives. Conclusion and recommendation The finding revealed pregnancy among women of 15-19 years was very common. The knowledge and practice of emergency contraception is very low. But there is high positive attitude towards emergency contraceptives. Since there is much deficit on knowledge of women on emergency contraceptives, in addition to making them accessible; programs targeted at promotion and education of emergency contraceptives is helpful to prevent unwanted pregnancy. PMID:22410271

2012-01-01

189

Effect of contraceptives on the skin.  

PubMed

Combined oral contraceptives (COCs) affect the skin 3 different ways. They decrease the amount of androgenic hormones produced in the ovaries and adrenal gland. They also limit the quantity of biologically active circulating testosterone. Finally, estrogen markedly decreases oil production in the sebaceous glands. Physicians should prescribe to women with acne a COC that is low in progestogen and high in estrogen. A biphasic pill with no more than 500 mcg norethisterone/day meets these requirements. If a woman is taking systemic antibiotics to treat acne, however, the physician should prescribe a biphasic pill containing 50 mcg ethinyl estradiol. Even though many believe that using COCs causes hair loss, there is little evidence to support it. Nevertheless, if a woman has indeed experienced hair loss, she should take a COC with a high estrogen to progestogen ratio. As in some pregnant women, cholasma may occur in women taking COCs when not protected from sunlight. Physicians need to prescribe the lowest possible dose of hormones in these women and counsel them to shield their face from sunlight. To err on the side of safety, women who have had a malignant melanoma should not use a hormonal contraceptive. In addition, women who have experienced many bouts of skin candidiasis should use an alternative contraceptive. Other skin disorders that they have been found to be more prevalent in women taking COCs include erythema nodosum, accelerated systemic lupus erythematosus, porphyria cutanea tarda, herpes gestationis, spider naevus, and telangiectasia. There also exists an association between dermatitis and barrier methods and spermicides. Some articles have suggested that copper containing IUDs have also cause a variety of skin disorders. PMID:3240155

1988-10-01

190

Emerging options for emergency contraception.  

PubMed

Emergency post-coital contraception (EC) is an effective method of preventing pregnancy when used appropriately. EC has been available since the 1970s, and its availability and use have become widespread. Options for EC are broad and include the copper intrauterine device (IUD) and emergency contraceptive pills such as levonorgestrel, ulipristal acetate, combined oral contraceptive pills (Yuzpe method), and less commonly, mifepristone. Some options are available over-the-counter, while others require provider prescription or placement. There are no absolute contraindications to the use of emergency contraceptive pills, with the exception of ulipristal acetate and mifepristone. This article reviews the mechanisms of action, efficacy, safety, side effects, clinical considerations, and patient preferences with respect to EC usage. The decision of which regimen to use is influenced by local availability, cost, and patient preference. PMID:24453516

Koyama, Atsuko; Hagopian, Laura; Linden, Judith

2013-02-18

191

Emerging Options for Emergency Contraception  

PubMed Central

Emergency post-coital contraception (EC) is an effective method of preventing pregnancy when used appropriately. EC has been available since the 1970s, and its availability and use have become widespread. Options for EC are broad and include the copper intrauterine device (IUD) and emergency contraceptive pills such as levonorgestrel, ulipristal acetate, combined oral contraceptive pills (Yuzpe method), and less commonly, mifepristone. Some options are available over-the-counter, while others require provider prescription or placement. There are no absolute contraindications to the use of emergency contraceptive pills, with the exception of ulipristal acetate and mifepristone. This article reviews the mechanisms of action, efficacy, safety, side effects, clinical considerations, and patient preferences with respect to EC usage. The decision of which regimen to use is influenced by local availability, cost, and patient preference. PMID:24453516

Koyama, Atsuko; Hagopian, Laura; Linden, Judith

2013-01-01

192

Variation in postpartum contraceptive method use: Results from the Pregnancy Risk Assessment Monitoring System (PRAMS)  

PubMed Central

Objective The National Survey of Family Growth has been a primary data source for trends in US women’s contraceptive use. However, national-level data may mask differences in contraceptive practice resulting from variation in local policies and norms. Study Design We used the Pregnancy Risk Assessment Monitoring System), a survey of women who are 2–4 months postpartum. Information on women’s current method was available for 18 reporting areas from 2000–2009. Using the two most recent years of data, we computed the weighted proportion of women using specific contraceptive methods according to payment for delivery (Medicaid or private insurance) and examined differences across states. We used log binomial regression to assess trends in method use in 8 areas with consecutive years of data. Results Across states, there was a wide range of use of female sterilization (7.0–22.6%) and long-acting reversible contraception (LARC; 1.9–25.5%). Other methods, like vasectomy and the patch/ring, had a narrower range of use. Women with Medicaid-paid deliveries were more likely to report female sterilization, LARC and injectables as their method compared to women with private insurance. LARC use increased ?18% per year, while use of injectables and oral contraceptives declined by 2.5%–10.6% annually. Conclusions The correlation in method-specific prevalence within states suggests shared social and medical norms, while the larger variation across states may reflect both differences in norms and access to contraception for low-income women. Surveys of postpartum women, who are beginning a new segment of contraceptive use, may better capture emerging trends in US contraceptive method mix. Implications There is considerable variation in contraceptive method use across states, which may result from differences in state policies and funding for family planning services, local medical norms surrounding contraceptive practice, and women’s and couples’ demand or preference for different methods. PMID:24237967

White, Kari; Potter, Joseph E.; Hopkins, Kristine; Grossman, Daniel

2013-01-01

193

Ulipristal acetate for emergency contraception.  

PubMed

Ulipristal acetate is a progesterone receptor modulator. As an emergency contraceptive, a 30-mg micronized formulation is effective for use up to 120 h from unprotected sexual intercourse. Ulipristal acetate acts as an antagonist of the progesterone receptor at the transcriptional level and a competitive antagonist of glucocorticoid receptor function. In contrast to other contraceptives, it has little effect on sex hormone-binding globulin. Although a single small study demonstrated some potential endometrial effects after ulipristal acetate administration, the clinical relevance of these findings is unclear. The incidence of adverse events in clinical trials for emergency contraception has typically been minimal, with one study showing a higher than expected incidence of nausea upon ulipristal acetate use. Ulipristal acetate, like other emergency contraceptive products, can lengthen the time to the next expected menstruation. Ulipristal acetate may have several advantages over currently approved emergency contraceptives. When compared to levonorgestrel, ulipristal acetate maintains its efficacy for a full 120 h, whereas levonorgestrel formulations have declining efficacy over that time frame. Moreover, although the copper intrauterine device (IUD) is highly effective as an emergency contraceptive, accessibility is an issue since the IUD requires a skilled provider for insertion. PMID:20967297

Russo, J A; Creinin, M D

2010-09-01

194

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

195

Role of the levonorgestrel intrauterine system in effective contraception.  

PubMed

Norgestrel, a synthetic progestin chemically derived from 19-nortestosterone, is six times more potent than progesterone, with variable binding affinity to various steroid receptors. The levonorgestrel-releasing intrauterine system (LNG IUS) provides a long-acting, highly effective, and reversible form of contraception, with a pearl index of 0.18 per 100 women-years. The locally released hormone leads to endometrial concentrations that are 200-800 times those found after daily oral use and a plasma level that is lower than that with other forms of levonorgestrel-containing contraception. The contraceptive effect of the LNG IUS is achieved mainly through its local suppressive effect on the endometrium, leading to endometrial thinning, glandular atrophy, and stromal decidualization without affecting ovulation. The LNG IUS is generally well tolerated. The main side effects are related to its androgenic activity, which is usually mild and transient, resolving after the first few months. Menstrual abnormalities are also common but well tolerated, and even become desirable (eg, amenorrhea, hypomenorrhea, and oligomenorrhea) with proper counseling of the patient during the choice of the method of contraception. The satisfaction rates after 3 years of insertion are high, reaching between 77% and 94%. The local effect of the LNG IUS on the endometrium and low rates of systemic adverse effects have led to its use in other conditions rather than contraception, as for the treatment of endometrial hyperplasia, benign menorrhagia, endometriosis, adenomyosis, and uterine fibroids. PMID:23990713

Attia, Abdelhamid M; Ibrahim, Magdy M; Abou-Setta, Ahmed M

2013-01-01

196

Role of the levonorgestrel intrauterine system in effective contraception  

PubMed Central

Norgestrel, a synthetic progestin chemically derived from 19-nortestosterone, is six times more potent than progesterone, with variable binding affinity to various steroid receptors. The levonorgestrel-releasing intrauterine system (LNG IUS) provides a long-acting, highly effective, and reversible form of contraception, with a pearl index of 0.18 per 100 women-years. The locally released hormone leads to endometrial concentrations that are 200–800 times those found after daily oral use and a plasma level that is lower than that with other forms of levonorgestrel-containing contraception. The contraceptive effect of the LNG IUS is achieved mainly through its local suppressive effect on the endometrium, leading to endometrial thinning, glandular atrophy, and stromal decidualization without affecting ovulation. The LNG IUS is generally well tolerated. The main side effects are related to its androgenic activity, which is usually mild and transient, resolving after the first few months. Menstrual abnormalities are also common but well tolerated, and even become desirable (eg, amenorrhea, hypomenorrhea, and oligomenorrhea) with proper counseling of the patient during the choice of the method of contraception. The satisfaction rates after 3 years of insertion are high, reaching between 77% and 94%. The local effect of the LNG IUS on the endometrium and low rates of systemic adverse effects have led to its use in other conditions rather than contraception, as for the treatment of endometrial hyperplasia, benign menorrhagia, endometriosis, adenomyosis, and uterine fibroids. PMID:23990713

Attia, Abdelhamid M; Ibrahim, Magdy M; Abou-Setta, Ahmed M

2013-01-01

197

DHCR7 mutation carrier rates and prevalence of the RSH/Smith-Lemli-Opitz syndrome: where are the patients?  

PubMed

RSH/Smith-Lemli-Opitz (SLOS) is an inborn error of metabolism with protean manifestations. Its exact incidence and prevalence are not known; however, the carrier rate for the most frequently occurring mutation, the null mutation IVS8-1G > C, is approximately 1 in 100 for the Caucasian population in North America (1%) and possibly as high as 1 in 50 to 1 in 30 in Central European populations (2-3.3%). Based on the allele frequencies and the proportion of this mutation observed in various patient populations, the expected incidence of RSH/SLOS in those populations was calculated and reported to be between 1 in 1,590 and 1 in 17,000. However, around the world the observed prevalence and incidence are much lower than those calculated from the individual mutation carrier rates observed in any given population. The discrepancy between the expected incidence and prevalence can be explained only in part by the neonatal and infancy deaths of the most severely affected children with RSH/SLOS and the under ascertainment of mild and atypical cases at the mild end of the spectrum. RSH/SLOS may be responsible for a high number of miscarriages. Recent observations estimate the prevalence of SLOS at 16 weeks of gestation as similar to that observed at birth (approximately 1 in 60,000) suggesting that either reduced fertility of carrier couples or losses of affected embryos or fetuses in the first trimester play a significant role in reducing the second trimester prevalence of RSH/SLOS. It is possible that the estimates of carrier rates based on population screening for the most commonly occurring mutations may not reflect the true carrier rates in the population. In order to reconcile the above-mentioned paradoxes, we propose a model based on a higher than observed carrier frequency of the most common mutation and on very high fetal loss of homozygotes for that mutation. PMID:16906538

Nowaczyk, Ma?gorzata J M; Waye, John S; Douketis, James D

2006-10-01

198

The Prevalence Rate of Helicobacter pylori Infection in, Chronic Otitis Media With Effusion Patients  

PubMed Central

Background: Otitis media with effusion (OME) is a common disease in children. Viral or bacterial infections, allergy, adenoids, functional abnormalities of the Eustachian tube, and gastroesophageal reflux might have a possible role in the pathogenesis of OME. However, the exact pathogenesis of OME is still unsettled. Objectives: The purpose of this study was to compare Helicobacter pylori prevalence rates in the nasopharynx of pediatric patients with and without OME. Patients and Methods: Eighty-four patients (50 males and 34 females) who were subjected to adenoidectomy and myringotomy were included in the study group. Ninety-one patients (48 males and 43 females) who had only adenoidectomy were selected as the control group. Detection of H. pylori was done by polymerase chain reaction (PCR). Results: Adenoid samples were positive for H. pylori in 21 (25%) patients in study group and 18 (19.8%) patients in control group. In the study group, 36 (42.8%) effusion samples (otitis media) of the patients were positive for H. pylori. In an analysis that compared H. pylori–negative and –positive children, the odds ratio (OR) for the occurrence of H. pylori was 1.35 (95% CI, 0.66 - 2.71). The association of age with H. pylori positivity decreased for 1-5 years age group, (1.09; 95% CI, 0.39 – 3.05) but increased for the 6-10 years group (OR, 1.48; 95% CI, 0.61–3.58). Furthermore, the association of sex with H. pylori positivity decreased for the male group (OR, 1.21; 95% CI, 0.50 – 2.91), but increased in the female group (OR, 1.44; 95% CI, 0.51–0.4.05). Conclusions: Heavy colonization of H. pylori in adenoid tissue and middle ear might have a role in pathogenesis of this infection. For OME cases resistant to medical treatment, it might be meaningful to evaluate the patient for H. pylori. PMID:25147680

Saki, Nader; Samarbaf Zadeh, Ali Reza; Sheikhpour Jonaky, Reza; Noori, Seyed Mahdi; Kayedani, Gholam Abbas; Nikakhlagh, Soheila

2014-01-01

199

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. PMID:24972489

2014-01-01

200

Contraceptive practices and pregnancy intendedness among pregnant adolescents  

PubMed Central

Background Adolescent pregnancy is a major health problem in many developing countries. Objective To assess contraceptive practices and pregnancy intendedness in pregnant adolescents. Materials and methods This study was prospectively conducted from September 2013 to June 2014. All consecutively pregnant women between 15 and 19 years old attending the Antenatal Clinic at Srinagarind Hospital and the Khon Kaen Branch of the Planned Parenthood Association of Thailand were invited for participation. Face-to-face interviews by trained interviewers using standardized questionnaires were carried out. Logistic regression was used to determine an adjusted odds ratio (aOR) and 95% confidence interval (CI) of independent predictors. Results Two hundred participants were enrolled. Mean age was 17.2 years. One hundred and eighteen (59.0%) were currently in school. Seventy-five (37.5%) participants had never used any contraceptive methods. Of the 125 participants who had ever used contraception, regular use of contraceptives was reported in only 21 participants (16.8%). Only two participants (1.0%) had ever used an intrauterine device or implant. Participants’ age was a significant independent factor associated with non-use of contraceptives (aOR, 6.42; 95% CI, 2.94–14.04). Of the 200 participants, 132 (66.0%) declared that the pregnancy was unintended. Significant independent factors predicting unintended pregnancy were educational status (aOR, 6.17; 95% CI, 3.27–13.75) and participants’ age (aOR, 5.76; 95% CI, 2.42–13.70). Conclusion Non-use and use of contraceptive methods with high failure rates were major reasons leading to adolescent pregnancies. Participants’ age was an independent factor predicting non-use of contraceptives. Educational status and age of the participants were significant factors predicting unintended pregnancy.

Lanjakornsiripan, Wakul; Amnatbuddee, Siriruthai; Seejorn, Kanok; Werawatakul, Yuthapong; Kleebkaow, Pilaiwan; Komwilaisak, Ratana; Luanratanakorn, Sanguanchoke

2015-01-01

201

High Rates of Pregnancy among Vocational School Students: Results of Audio Computer-Assisted Self-Interview Survey in Chiang Rai, Thailand.  

ERIC Educational Resources Information Center

Examined prevalence of and factors associated with pregnancy and abortion among vocation school students in northern Thailand. Age, current contraceptive use, early initiation of sexual intercourse, alcohol and drug use, and sexual coercion were associated with self or partner pregnancy. High rates of pregnancy and abortion indicate the need for…

Manopaiboon, Chomnad; Kilmarx, Peter H.; van Griensven, Frits; Chaikummao, Supaporn; Jeeyapant, Supaporn; Limpakarnjanarat, Khanchi; Uthaiworavit, Wat

2003-01-01

202

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

203

Contraceptive use by Iranian women with hypertension, diabetes or obesity.  

PubMed

Women with chronic medical conditions require careful contraceptive management. The aim of this cross-sectional study in Tehran was to determine the pattern of contraception use by women with diabetes, hypertension or obesity. A sample of 264 women aged 18-53 years old was recruited; 81 (30.7%) had diabetes type 2,100 (37.9%) were obese/overweight (BMI > 25 kg/m2) and 83 (31.5%) had hypertension. Across all 3 groups, the rate of use of contraceptive methods was significantly different before and after diagnosis. Before diagnosis of disease the most common method was hormonal contraception in all women (55.0%, 71.6% and 78.3% of diabetic, overweight and hypertensive women respectively), whereas after diagnosis coital withdrawal was the most common method in diabetic and obese/overweight women (41.2% and 28.0% respectively) and almost the most common method for hypertensive women (35.4%). Use of safe and modern methods of contraception in women with certain chronic medical conditions was low and needs more attention. PMID:24975309

Nojomi, M; Morrovatdar, N; Davoudi, F; Hosseini, S

2013-07-01

204

Contraception and Birth Control: Other FAQs  

MedlinePLUS

... Trials Resources and Publications En Español Contraception and Birth Control: Other FAQs Skip sharing on social media ... choose a method of contraception? The choice of birth control depends on many factors. Before deciding on ...

205

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

206

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

207

Hypertension in the United States workforce: differences in prevalence and treatment rates among blue- and white- collar workers  

Microsoft Academic Search

Although hypertension is a major risk factor for cardiovascular disease, with associated high costs for employers and employees alike, little is known about its prevalence, both diagnosed and undiagnosed, or treatment rates among blue- and white-collar workers in the United States workforce. The third National Health and Nutrition Examination Survey (NHANES III)(1988-1994) provides a unique opportunity to describe national hypertension

Margaret McDonald; Robin P. Hertz; Alan N. Unger; Christine L. Baker

2002-01-01

208

Emergency contraception review: evidence-based recommendations for clinicians.  

PubMed

Several options for emergency contraception are available in the United States. This article describes each method, including efficacy, mode of action, safety, side effect profile, and availability. The most effective emergency contraceptive is the copper intrauterine device (IUD), followed by ulipristal acetate and levonorgestrel pills. Levonorgestrel is available for sale without restrictions, whereas ulipristal acetate is available with prescription only, and the copper IUD must be inserted by a clinician. Although EC pills have not been shown to reduce pregnancy or abortion rates at the population level, they are an important option for individual women seeking to prevent pregnancy after sex. PMID:25254919

Cleland, Kelly; Raymond, Elizabeth G; Westley, Elizabeth; Trussell, James

2014-12-01

209

Preliminary Evaluation of Four Oral Contraceptives Containing only Progestogens  

PubMed Central

One hundred and seventy-five women took part in a comparative clinical trial of four progestogen-only oral contraceptives and were followed for either a year or until treatment was discontinued. Megestrol acetate 0·25 mg. was found to be a very ineffective contraceptive, 21 out of 43 women becoming pregnant. One, three, and four pregnancies occurred during treatment with norethisterone acetate 0·3 mg., norgestrel 0·05 mg., and chlormadinone 0·5 mg., respectively, corresponding to pregnancy rates of 4, 9, and 12 per 100 woman-years of use. All three effective progestogens were very much less acceptable than modern low-dose combined oral contraceptives. Discontinuation of treatment for medical reasons (particularly menstrual disturbances) during the course of only one year affected 24% receiving norethisterone acetate, 38% receiving norgestrel, and 46% receiving chlormadinone. PMID:4182352

Mears, Eleanor; Vessey, M. P.; Andolšek, Lidija; Oven, Antonija

1969-01-01

210

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

211

Emergency contraception. Widely available and effective but disappointing as a public health intervention: a review.  

PubMed

Emergency contraception (EC) prevents pregnancy after unprotected sex or contraceptive failure. Use of EC has increased markedly in countries where a product is available over the counter, yet barriers to availability and use remain. Although effective in clinical trials, it has not yet been possible to show a public health benefit of EC in terms of reduction of unintended pregnancy rates. Selective progesterone receptor modulators developed as emergency contraceptives offer better effectiveness than levonorgestrel, but still EC is less effective than use of ongoing regular contraception. Methods which inhibit ovulation whenever they are taken or which act after ovulation to prevent implantation and strategies to increase the uptake of effective ongoing contraception after EC use would prevent more pregnancies. PMID:25678571

2015-04-01

212

What influences adolescents' contraceptive decision-making? A meta-ethnography.  

PubMed

Increased access to and use of contraception has contributed significantly to the decline in teen birth rates since 1991, yet many teens use contraception inconsistently or not at all. This meta-ethnography was conducted to identify the factors that influence adolescents' contraceptive decision-making. Fourteen qualitative studies were examined using G. W. Noblit and R. D. Hare's (1988) meta-ethnographic approach. Three themes of self, partner and family were found to influence contraceptive decision-making in both positive and negative ways. Assisting adolescents to maximize positive and reduce negative influences regarding contraceptive decision-making has the potential to assist teens to more effectively avoid unintended pregnancy and sexually transmitted infections. PMID:24880101

Daley, Alison Moriarty

2014-01-01

213

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. PMID:23446064

2013-01-01

214

Prevalence Rates and Demographic Characteristics Associated with Depression in Pregnancy and the Postpartum.  

ERIC Educational Resources Information Center

Examined prevalence of depression in 360 women during pregnancy and after delivery. At both assessments, approximately 25 percent reported elevated levels of depressive symptomatology. Ten percent met diagnostic criteria for depression during pregnancy; 6.8 percent were depressed postpartum. One-half of postpartum depression cases were new onset.…

Gotlib, Ian H.; And Others

1989-01-01

215

Teen contraception: A review of perspectives on compliance  

Microsoft Academic Search

National attention has been drawn to the near epidemic rates of teen-age pregnancy in this country, with greater psychological understanding of this problem cited as a research need. This paper reviews available literature on teen contraceptive compliance with particular focus on the development of self-regulation. In this first section, programs designed to enhance teens' choice and use of birth control

J. Gayle Beck; Dana K. Davies

1987-01-01

216

Young women's experiences of side-effects from contraceptive implants: a challenge to bodily control.  

PubMed

In the UK, long-acting reversible contraceptives have been welcomed by sexual health policy-makers and many practitioners as a particularly effective way of preventing unintended pregnancy, especially teenage conception. However, little is known about women's individual experiences of these forms of contraception beyond limited data on retention rates and reasons for discontinuation. The main aims of this research were to gain a fuller understanding of why some young women have their implants removed, and what may help them maintain this method of contraception if they wish to do so. The contraceptive choices of 20 young women (aged 16-22) who had chosen the implant, and later discontinued it, were examined. They had experienced unacceptable side effects that they attributed to the implant, and interpreted as a threat to their bodily control, which they were not prepared to tolerate. These feelings were exacerbated if they then encountered delays after requesting removal. Although they remained concerned to avoid unintended pregnancy, they generally moved to a less reliable form of contraception following implant removal and felt discouraged from trying other long-acting contraception. We suggest that principles of contraceptive choice should include facilitating the discontinuation of unsatisfactory methods; implant removal should therefore be readily available when requested, regardless of the length of time the implant has been in place. Long-acting forms of contraception do not suit all women, and will not obviate the need for other forms of reproductive control, including legal abortion. PMID:23684202

Hoggart, Lesley; Newton, Victoria Louise

2013-05-01

217

Testing mechanisms of the dilution effect: deer mice encounter rates, Sin Nombre virus prevalence and species diversity.  

PubMed

Species diversity has been shown to decrease prevalence of disease in a variety of host-pathogen systems, in a phenomenon termed the Dilution Effect. Several mechanisms have been proposed by which diversity may decrease prevalence, though few have been tested in natural host-pathogen systems. We investigated the mechanisms by which diversity influenced the prevalence of Sin Nombre virus (SNV), a directly transmitted virus in deer mice (Peromyscus maniculatus). We monitored both intra and interspecific encounters of deer mice using foraging arenas at five sites in the Great Basin Desert with disparate levels of species diversity to examine two potential mechanisms which may contribute to the dilution of SNV prevalence: (1) reduced frequency of encounters between deer mice, or (2) reduced duration of contacts between deer mice. We also investigated the relationship between deer mouse density and these mechanisms, as density is often predicted to influence both inter and intraspecific encounters. Results of our study indicate that frequency of intraspecific interactions between deer mice was reduced with increased diversity. Species diversity did not impact average duration of encounters. Density was correlated with absolute, but not relative rates of encounters between deer mice, suggesting that encounters may be influenced by factors other than density. Our study indicates that species diversity influences the dynamics of SNV by reducing encounters between deer mice in a trade-off between intra and interspecific interactions. PMID:19495881

Clay, Christine A; Lehmer, Erin M; St Jeor, Stephen; Dearing, M Denise

2009-06-01

218

Mathematical models of wildlife management by contraception  

Microsoft Academic Search

Because of some disadvantages with traditional culling by baiting or trapping for population control, contraception is being considered again by many wildlife managers. Mathematical analysis is necessary for practical use of contraception in wildlife management. In this paper, we have proposed several steady-state models of contraception and simple culling. Major conclusions are drawn from theoretical analysis. (1) In the absence

Zhibin Zhang

2000-01-01

219

Contraception in the Adolescent: An Update  

Microsoft Academic Search

ABSTRACT. Contraception remains an important part of national efforts to reduce adolescent pregnancy in the United States. A number of safe and effective contracep- tive methods are available for our youth, including ab- stinence, barrier methods, oral contraceptives, Depo- Provera, and Norplant. Research over the past few decades has resulted in a variety of oral contraceptives with reduced amounts of

Donald E. Greydanus; Dilip R. Patel; Mary Ellen Rimsza

2009-01-01

220

Emergency contraception: an updated review.  

PubMed

Emergency contraception is a common practice now. Many categories of drugs are marketed with modifications in dosage, in combination and even in the timing of administration. Recent re-analysis suggests that there is still no uniformity of opinion on the actual mechanism of action and this has often fueled the ethical controversy. This review analyzes the most common emergency contraception drugs: levonorgestrel, mifepristone and ulipristal acetate about their action underlining that the hormonal products, when used in emergency contraception, play different roles depending on the phase of the menstrual cycle during which they are administered.This review aims to examine rigorously the most accredited literature to verify if a evidence-based uniformity of opinions has been achieved about the biological effects of hormones administered after the sexual intercourse. PMID:23905038

Guida, M; Marra, M L; Palatucci, V; Pascale, R; Visconti, F; Zullo, F

2011-09-01

221

Emergency Contraception: An Updated Review  

PubMed Central

Summary Emergency contraception is a common practice now. Many categories of drugs are marketed with modifications in dosage, in combination and even in the timing of administration. Recent re-analysis suggests that there is still no uniformity of opinion on the actual mechanism of action and this has often fueled the ethical controversy. This review analyzes the most common emergency contraception drugs: levonorgestrel, mifepristone and ulipristal acetate about their action underlining that the hormonal products, when used in emergency contraception, play different roles depending on the phase of the menstrual cycle during which they are administered.This review aims to examine rigorously the most accredited literature to verify if a evidence-based uniformity of opinions has been achieved about the biological effects of hormones administered after the sexual intercourse. PMID:23905038

Guida, M.; Marra, M.L.; Palatucci, V.; Pascale, R.; Visconti, F.; Zullo, F.

2011-01-01

222

Developments in male contraception.  

PubMed

Relevant research efforts in male contraception involve: 1) hormonal approaches to block sperm production by inhibiting the hypothalamic-pituitary-gonadal axis, 2) disruption of sperm production by drugs that act directly on the testes, 3) interruption of sperm transport, and 4) alteration of secretions of the accessory sex glands and their subsequent effect on the spermatozoa. Both agonistic and antagonistic synthetic analogs of the hypothalamic gonadotropin releasing hormone (GnRH) factor cost too much and lack an effective mode of administration. Recent studies indicate that over 90% of Chinese and Indonesian men can develop complete azoospermia following either a testosterone or a progestin and an androgen combination treatment. Vaccines that utilize GnRH and follicle stimulating hormone as the active antigens have been introduced in clinical studies in the US and India. Drugs such as sulfasalazine, pyrimethamine, nitrofurane, and bis(di-chloracytal) diamines reduce male fertility but side effects make them unacceptable. Dinitropyrroles, halopropanedils, chlorosugars, and indazole carboxylic acids have been tried in laboratory animals. Gossypol rendered men infertile in large-scale clinical studies conducted in China but synthesis of safer analogs has not succeeded. Extracts of another plant, tripterigium wilfordii, are used in China as a popular herbal medicine. Vasectomy has improved with no-scalpel vasectomy and by the novel technique of blocking the vas with cured in situ polymeric plugs. Preliminary data suggest that men prefer condoms made from polyurethane as opposed to latex rubber increasingly used to protect against AIDs and sexually transmitted diseases. The antifungal agents, imidazoles, have spermicidal activity and synthetic variants may reduce undesirable side effects. Research on male-oriented methods has intensified during the last 10-15 years, but a new product is not likely to appear in the next 5-10 years. PMID:12286189

Bialy, G; Alexander, N J

1992-01-01

223

Current Opinion of Obstetricians on the Prescription of Emergency Contraception: A German-American Comparison  

PubMed Central

Background: There are no current studies on the opinions of obstetricians and gynaecologists in Germany about emergency contraception (or post-coital contraception, morning-after pill). The opinions of a large group of physicians were collected using of a questionnaire and compared with the results of an American survey (n?=?1154). Methods: A two-part questionnaire was used – part 1: sociodemographic data, part 2: 4 scenarios to illustrate the possible advantages and disadvantages of free access to emergency contraception as well as 4 indications and situations for which emergency contraception can be prescribed. Results: The response rate was 91.7?% (165/180 questionnaires). 63.9?% (103/161) of the German responding physicians were of the opinion that women with access to emergency contraception experienced unwanted pregnancies less frequently than those without access. Merely 26.2?% of the responding physicians supported the prescription-free availability of emergency contraception in apothecaries. The German-American comparison ultimately revealed only a few major differences, e.g., in answers to the question whether or not access to emergency contraception could reduce the number of unwanted pregnancies (89 vs. 64?%). Conclusions: The high rejection rate of free access to emergency contraception of almost 70?% in our surveyed group supports the current position published by the German Society for Gynaecology and Obstetrics (Deutsche Gesellschaft für Gynäkologie und Geburtshilfe) and the German Professional Union of Gynaecologists (deutscher Berufsverband der Frauenärzte). Since other medical organisations, e.g., WHO, supported the prescription-free access to levonorgestrel formulations as emergency contraception a few years ago, it would be interesting to ask a larger sample of German gynaecologists and obstetricians about their opinions on emergency contraception. PMID:25258456

David, M.; Berends, L.; Bartley, J.

2012-01-01

224

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. PMID:24067083

2013-01-01

225

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. PMID:17538051

Schuklenk, Udo; Kleinsmidt, Anita

2007-01-01

226

The outcome of the primary vascular access and its translation into prevalent access use rates in chronic haemodialysis patients  

PubMed Central

Background The American Fistula First Breakthrough Initiative currently aims for a 66% arterio-venous fistula (AVF) rate, while in the UK, best practice tariffs target AVF and arterio-venous graft (AVG) rates of 85%. The present study aims to assess whether these goals can be achieved. Methods We conducted a retrospective cohort study on patients who initiated haemodialysis from 1995 to 2006. Outcomes were the final failure-free survival of the first permanent access and the type of second access created. Prevalent use rates for the access types were calculated on the 1st January of each year for the second half of the study period. Results Two hundred and eleven out of 246 patients (86%) received an AVF, 16 (6%) an AVG and 19 (8%) a permanent catheter (PC) as the first permanent access. Eighty-six (35%) patients had final failure of the primary access. One- and 3-year final failure-free survival rates were 73 and 65% for AVF compared with 40 and 20% for AVG and 62 and 0% for PC, respectively. In patients with primary AVF, female sex {hazard ratio (HR) 2.20 [confidence interval (CI) 1.29–3.73]} and vascular disease [HR 2.24 (CI 1.26–3.97)] were associated with a poorer outcome. A similar trend was observed for autoimmune disease [HR 2.14 (CI 0.99–4.65)]. As second accesses AVF, AVG and PC were created in 47% (n = 40), 38% (n = 33) and 15% (n = 13). The median prevalent use rate was 80.5% for AVF, 14% for AVG and 5.5% for PC. Conclusions The vascular access targets set by initiatives from the USA and UK are feasible in unselected haemodialysis patients. High primary AVF rates, the superior survival rates of AVFs even in patient groups at higher risk of access failure and the high rate of creation of secondary AVFs contributed to these promising results.

Praehauser, Claudia; Breidthardt, Tobias; Moser-Bucher, Cora Nina; Wolff, Thomas; Baechler, Katrin; Eugster, Thomas; Dickenmann, Michael; Gurke, Lorenz; Mayr, Michael

2012-01-01

227

Coping with contraception: cognitive and behavioral methods with adolescents.  

PubMed

Teenagers' sporadic use or nonuse of contraception is 1 explanation for the high rates of unwanted pregnancies in the US. Past efforts have had limited impact as they focused on simply providing adolescents with information and increased access to birth control. The argument here points to specific cognitive and behavioral skills, which adolescents lack, and which are required for effective contraception. Previous research documents an increase in teenagers' use of contraception following a skills-training program presented in intensive small-group format. The present study evaluates cognitive and behavioral skills training methods implemented with large groups (n=120), in the natural environment. The subjects are male and female students of a middle class suburban public high school. Training in this preventive approach stresses verbal and nonverbal components of effective interpersonal communication--approach, refusal and request responses--as important behavioral skills. Cognitive skills training emphasizes the application of facts about reproduction and contraception to make optimal decisions in situations involving sexual activity. Leaders help the subjects relate abstract facts and observable risks to their own life circumstances and choices. Additional skills practice involves the completion of written assignments outside the group setting. At the end of the 2-week training period, the students are evaluated along 4 measures: a knowledge inventory, a contraceptive attitudes and intentions inventory, and a videotaped performance test. Analyses of findings support the feasibility of large-group procedures for helping adolescents cope with sexuality and contraception. Future investigations are needed to replicate the present research as are longitudinal follow-up data to assess the long-term effects of this treatment approach. PMID:12265688

Gilchrist, L D; Schinke, S P

1983-01-01

228

Prevalence and Prognostic Significance of Long QT Interval among Patients with Chest Pain: Selecting an Optimum QT Rate Correction Formula  

PubMed Central

Background Little is known about the prevalence and prognostic significance of long QT interval among patients with chest pain during the acute phase of suspected cardiovascular injury. Objectives Our aim was to investigate the prevalence and prognostic significance of long QT interval among patients presenting to the emergency department (ED) with chest pain using an optimum QT rate correction formula. Methods We performed secondary analysis on data obtained from the IMMEDIATE AIM trial (N, 145). Data included 24-hour 12-lead Holter electrocardiographic recordings that were stored for offline computer analysis. The QT interval was measured automatically and rate corrected using seven QTc formulas including subject specific correction. The formula with the closer to zero absolute mean QTc/RR correlation was considered the most accurate. Results Linear and logarithmic subject specific QT rate correction outperformed other QTc formulas and resulted in the closest to zero absolute mean QTc/RR correlations (mean ± SD; 0.003 ± 0.002; 0.017 ± 0.016; respectively). These two formulas produced adequate correction in 100% of study participants. Other formulas (Bazett’s, Fridericia’s, Framingham, and Study specific) resulted in inadequate correction in 47.6 to 95.2% of study participants. Using the optimum QTc formula, linear subject specific, the prevalence of long QTc interval was 14.5%. The QTc interval did not predict mortality or hospital admission at short and long term follow-up. Only the QT/RR slope predicted mortality at 7 year follow-up (odds ratio, 2.01; 95% CI, 1.02 to 3.96; p < 0.05). Conclusions Adequate QT rate correction can only be performed using subject specific correction. Long QT interval is not uncommon among patients presenting to the ED with chest pain. PMID:23597403

Hasanien, Amer A.; Drew, Barbara J.; Howie-Esquivel, Jill; Fung, Gordon; Harris, Patricia

2013-01-01

229

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

230

JAMA Patient Page: Oral Contraceptives  

MedlinePLUS

... is 0.1%. However, in the real world, accounting for missed days of use, the chance of pregnancy is about 8% per year. Side Effects Side effects of oral contraceptives vary depending on the pills’ hormone levels and types. Some include vaginal spotting and abnormal ...

231

How Effective Is Male Contraception?  

MedlinePLUS

... Mechanisms Active Funding Opportunity Announcements, notices & mechanisms Small Business Programs Grant Programs for Small Businesses Peer Review ... Infertility? How Can Male Infertility Be Treated? NICHD Research Information ... Page Content Not all contraceptive methods are appropriate for all situations, and individuals should ...

232

Contraception in the prepill era.  

PubMed

Although medical history has documented the desire to control fertility since ancient times, safe and effective contraception did not exist until this century and has not been equally available to all people. Strong moral sentiments, economic and social class factors, religious beliefs, familial and gender relations, and political as well as legal constraints have often limited the ability of physicians in favor of contraception to provide advice and methods of birth control to their patients. By the early 1900s, a constellation of factors--in particular, the large influx of poor immigrants, and feminist groups advocating women's rights--helped to move forward a birth-control movement in this country and abroad. In the early 20th century, Margaret Sanger became one of the most avid proponents of contraception in the United States. By 1950, she and Katharine McCormick had contracted with biologist Gregory Pincus to develop an effective birth control pill. A collaborative effort by Pincus and other researchers led to trials of the pill in Puerto Rico, Haiti, and Mexico between 1956 and 1957, which provided the basis for an application to the Food and Drug Administration for approval of the first oral contraceptive. PMID:10342089

Connell, E B

1999-01-01

233

Contraception in the prepill era  

Microsoft Academic Search

Although medical history has documented the desire to control fertility since ancient times, safe and effective contraception did not exist until this century and has not been equally available to all people. Strong moral sentiments, economic and social class factors, religious beliefs, familial and gender relations, and political as well as legal constraints have often limited the ability of physicians

Elizabeth B Connell

1999-01-01

234

Contraceptive knowledge, contraceptive use, and self-esteem among Navy personnel.  

PubMed

This study evaluated the sexual knowledge (including contraceptive and reproductive knowledge), contraceptive use, and self-esteem among a sample of 158 male and female United States Navy sailors assigned to Navy ships. In spite of the fact that men and women viewed themselves as relatively knowledgeable with respect to contraception, results showed substantial knowledge deficits. Women demonstrated significantly greater sexual knowledge than men, and contraceptive/ reproductive knowledge was highly correlated with self-reported use of contraceptives. Finally, self-esteem was highly correlated with sexual knowledge and certain contraceptive use behaviors. PMID:9110557

Gallagher, C K; Lall, R; Johnson, W B

1997-04-01

235

Socio-economic and cultural differentials in contraceptive usage among Ghanaian women.  

PubMed

Data from the Ghana Fertility Survey of 2001 married women in 1979-1980 were subjected to logistic regression to determine the factors influencing contraceptive use. In this Ghanaian sample only 22 women and no men were sterilized, 11% used an efficient contraceptive method and 8% were using an inefficient method. The most prevalent methods were abstinence by 6% and pill by 5%. The variables analyzed were birth cohort, age at 1st marriage, education, occupation, religion, ethnicity, rural/urban residence, northern/southern residence and number of children desired number of living children. All these factors were dichotomized, e.g., cohort: born before or after 1950. Factors positively significant for contraceptive use were younger women (20% more likely), married at age 20 or older (82% more), education (150% for any method, 67% for an efficient method), professional occupations, protestants, urban residence, southern residence, desire fewer children. Factors negatively associated with contraception were agricultural work (50% as likely), non-Christian religion, both traditional and Moslems (75%), desiring more children and living in the north. Unexpectedly, living in the northern undeveloped region was strongly linked with use of an efficient contraceptive. A factor without significant effect was ethnicity, Akan or non-Akan. These results were discussed with a general review of the literature on determinants of contraceptive use. PMID:12284022

Oheneba-sakyi, Y

1990-01-01

236

The Prevalence, Rate of Progression, and Treatment of Elbow Flexion Contracture in Children with Brachial Plexus Birth Palsy  

PubMed Central

Background: Elbow flexion contracture is a well-known complication of brachial plexus birth palsy that adversely affects upper-extremity function. The prevalence, risk factors, and rate of progression of elbow flexion contracture associated with brachial plexus birth palsy have not been established, and the effectiveness of nonoperative treatment involving nighttime splinting or serial casting has not been well studied. Methods: The medical records of 319 patients with brachial plexus birth palsy who had been seen at our institution between 1992 and 2009 were retrospectively reviewed to identify patients with an elbow flexion contracture (?10°). The chi-square test for trend and the Kaplan-Meier estimator were used to evaluate risk factors for contracture, including age, sex, and the extent of brachial plexus involvement. Longitudinal models were used to estimate the rate of contracture progression and the effectiveness of nonoperative treatment. Results: An elbow flexion contracture was present in 48% (152) of the patients with brachial plexus birth palsy. The median age of onset was 5.1 years (range, 0.25 to 14.8 years). The contracture was ?30° in 36% (fifty-four) of these 152 patients and was accompanied by a documented radial head dislocation in 6% (nine). The prevalence of contracture increased with increasing age (p < 0.001) but was not significantly associated with sex or with the extent of brachial plexus involvement. The magnitude of the contracture increased by 4.4% per year before treatment (p < 0.01). The magnitude of the contracture decreased by 31% when casting was performed (p < 0.01) but thereafter increased again at the same rate of 4.4% per year. The magnitude of the contracture did not improve when splinting was performed but the rate of increase thereafter decreased to <0.1% per year (p = 0.04). Conclusions: The prevalence of elbow flexion contracture in children with brachial plexus birth palsy may be greater than clinicians perceive. The prevalence increased with patient age but was not significantly affected by sex or by the extent of brachial plexus involvement. Serial casting may initially improve severe contractures, whereas nighttime splinting may prevent further progression of milder contractures. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. PMID:22398733

Sheffler, Lindsey C.; Lattanza, Lisa; Hagar, Yolanda; Bagley, Anita; James, Michelle A.

2012-01-01

237

Quality, mainstream services with proactive and targeted outreach: A model of contraceptive service provision for young people  

Microsoft Academic Search

IntroductionHigh teenage pregnancy rates in the UK reflect low levels of contraceptive use. Young people have a negative perception of contraceptive services and experience significant practical barriers to their use. Dedicated young people's services are considered an effective way to improve access. However it is costly to provide two parallel services (one for older and one for young clients) and

Paula Baraitser; Rachael Fettiplace; Frances Dolan; Helen Massil; Sarah Cowley

2002-01-01

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

Emergency contraception - Potential for women's health  

PubMed Central

Emergency contraception (EC) is a safe and effective method which is used to prevent unwanted pregnancy after unprotected sexual intercourse. Many of the unwanted pregnancies end in unsafe abortions. The search for an ideal contraceptive, which does not interfere with spontaneity or pleasure of the sexual act, yet effectively controls the fertility, is still continuing. Numerous contraceptive techniques are available, yet contraceptive coverage continues to be poor in India. Thus, even when not planning for a pregnancy, exposure to unprotected sex takes place often, necessitating the use of emergency contraception. This need may also arise due to failure of contraceptive method being used (condom rupture, diaphragm slippage, forgotten oral pills) or following sexual assault. Emergency contraception is an intervention that can prevent a large number of unwanted pregnancies resulting from failure of regular contraception or unplanned sexual activity, which in turn helps in reducing the maternal mortality and morbidity due to unsafe abortions. However, a concern has been expressed regarding repeated and indiscriminate usage of e-pill, currently the rational use of emergency contraception is being promoted as it is expected to make a significant dent in reducing the number of unwanted pregnancies and unsafe abortions. In fact, since the introduction of emergency contraception, the contribution of unsafe abortion towards maternal mortality has declined from 13 to 8 per cent. PMID:25673542

Mittal, Suneeta

2014-01-01

240

Contraceptive choices--turning back the clock.  

PubMed

Contraceptive choices are being reduced rather than being expanded in many parts of the world, particularly in Western countries. Although this paper presents an Australian perspective, the concerns are shared by family planners in other countries. The reasons for this are multiple and complex and often interrelated but ultimately depend on commercial considerations. The community expectation is that an ideal contraceptive can and does exist, but the media sensationalization of contraceptive problems has given many contraceptive methods a poor image. Contraceptive availability is also affected by liability issues, which have increased the cost of product liability insurance, and medical liability insurance of health professionals, increasing both the cost of contraceptives to the individual and the availability of services such as IUD insertions and sterilization, as practitioners withdraw their services, due to cost of insurance. The cost of marketing a new contraceptive from the time the idea is first developed until it is approved for marketing also deters manufacturers from developing new contraceptives. Delays in drug evaluation procedures in many countries deters companies with already well established contraceptives from marketing them in such countries. The effect of political stands by radical feminists or consumer groups, also effect both the image and the availability of contraceptives, as can be seen with the saga of Depo-Provera, RU486 and intrauterine devices. Similarly, the moral perceptions of anti-abortion groups and health care providers is also a threat to fertility control services. Possible solutions to some of these problems are offered in the paper. PMID:1950710

Weisberg, E

1991-01-01

241

Contraceptive Options and Their Associated Estrogenic Environmental Loads: Relationships and Trade-Offs  

PubMed Central

This work explores the relationships between a user's choice of a given contraceptive option and the load of steroidal estrogens that can be associated with that choice. Family planning data for the USA served as a basis for the analysis. The results showed that collectively the use of contraception in the USA conservatively averts the release of approximately 4.8 tonnes of estradiol equivalents to the environment. 35% of the estrogenic load released over the course of all experienced pregnancies events and 34% the estrogenic load represented by all resultant legacies are a result of contraception failure and the non-use of contraception. A scenario analysis conducted to explore the impacts of discontinuing the use of ethinylestradiol-based oral contraceptives revealed that this would not only result in a 1.7-fold increase in the estrogenic loading of the users, but the users would also be expected to experience undesired family planning outcomes at a rate that is 3.3 times higher. Additional scenario analyses in which ethinylestradiol-based oral contraceptive users were modeled as having switched entirely to the use of male condoms, diaphragms or copper IUDs suggested that whether a higher or lower estrogenic load can be associated with the switching population depends on the typical failure rates of the options adopted following discontinuation. And, finally, it was estimated that, in the USA, at most 13% of the annual estrogenic load can be averted by fully meeting the contraceptive needs of the population. Therefore, while the issue of estrogen impacts on the environment cannot be addressed solely by meeting the population's contraceptive needs, a significant fraction of the estrogenic mass released to environment can be averted by improving the level with which their contraceptive needs are met. PMID:24670973

Khan, Usman; Nicell, Jim A.

2014-01-01

242

Contraceptive options and their associated estrogenic environmental loads: relationships and trade-offs.  

PubMed

This work explores the relationships between a user's choice of a given contraceptive option and the load of steroidal estrogens that can be associated with that choice. Family planning data for the USA served as a basis for the analysis. The results showed that collectively the use of contraception in the USA conservatively averts the release of approximately 4.8 tonnes of estradiol equivalents to the environment. 35% of the estrogenic load released over the course of all experienced pregnancies events and 34% the estrogenic load represented by all resultant legacies are a result of contraception failure and the non-use of contraception. A scenario analysis conducted to explore the impacts of discontinuing the use of ethinylestradiol-based oral contraceptives revealed that this would not only result in a 1.7-fold increase in the estrogenic loading of the users, but the users would also be expected to experience undesired family planning outcomes at a rate that is 3.3 times higher. Additional scenario analyses in which ethinylestradiol-based oral contraceptive users were modeled as having switched entirely to the use of male condoms, diaphragms or copper IUDs suggested that whether a higher or lower estrogenic load can be associated with the switching population depends on the typical failure rates of the options adopted following discontinuation. And, finally, it was estimated that, in the USA, at most 13% of the annual estrogenic load can be averted by fully meeting the contraceptive needs of the population. Therefore, while the issue of estrogen impacts on the environment cannot be addressed solely by meeting the population's contraceptive needs, a significant fraction of the estrogenic mass released to environment can be averted by improving the level with which their contraceptive needs are met. PMID:24670973

Khan, Usman; Nicell, Jim A

2014-01-01

243

Do the emotional side-effects of hormonal contraceptives come from pharmacologic or psychological mechanisms?  

PubMed

Hormonal preparations have become one of the most popular methods used for controlling fertility. The literature over the last 40 years continues to reveal how their numerous side effects negatively impact many users and even society at large. Three large cohort trials were the first to demonstrate, on a grand scale, certain emotional and behavioral associations with contraceptive use. Current contraceptive use was associated with an increase rate in depression, divorce, tranquilizer use, sexual dysfunction, and suicide and other violent and accidental deaths. Despite the advent of more "user friendly" contraceptives, the discontinuation rate secondary to side effects has changed little through the years. While in rare cases hormonal preparations can be deadly to the user, there is substantial evidence that their negative effect issues more from their emotional and behavioral properties. This paper reviews the results of over seven studies which further characterize these prominent associations, particularly with hormonal contraception, in an attempt to demonstrate their association with the intrinsic pharmacologic properties of hormonal preparations. Hormonal contraceptive users, in contrast with non users, were found to have higher rates of depression, anxiety, fatigue, neurotic symptoms, sexual disturbances, compulsion, anger, and negative menstrual effects. The question of whether the association of these maladies is directly due to the effect of taking exogenous hormones versus the psychological impact of the contraceptive behavior itself had yet to be studied. Seven small randomized-controlled trials were found in a review of the literature which studied this hypothesis in a direct way. They do not support the origination of these side effects being from the pharmacological properties of hormones. No association was found between hormone levels and emotional functioning in females. Psychiatric evaluations among IUD and oral contraceptive pill (OCP) users reveal no significant differences. Women who were given an OCP placebo experienced a similar side effect profile of OCP users. Different hormonal concentrations and combinations made no significant difference in the side effect profile. A study of women who were given either "weak female hormones" or a placebo failed to duplicate the side effect profile found in all of the other studies where the hormones were labeled as contraceptives. The evidence suggests that most of the side effects of hormonal contraception are a result of a psychological response to the practice of contraception. More study is warranted to further understand this psychological phenomenon, especially now that an effective non-contraceptive method of fertility regulation and more reliable psychological instruments are available. Furthermore, it is reasonable to hypothesize, given the present data, that contraceptive activity itself is inherently damaging to women. PMID:15236788

Robinson, Stephen A; Dowell, Matt; Pedulla, Dominic; McCauley, Larry

2004-01-01

244

Reasons for pregnancy termination: negligence or failure of contraception?  

PubMed

Interviews with 200 abortion seekers at a Finnish hospital revealed a high incidence of contraceptive failure. Although 93% claimed to have adequate knowledge about contraception, only 23 women (11.5%) were using a reliable method (pill or IUD) at the time of conception. 126 (63%) were relying on a less safe method (e.g., condoms, spermicides, rhythm) and 51 (25.5%) were not using any form of fertility control. 9 of the 16 pill users admitted irregular use; another 3 experienced vomiting or diarrhea at the time of conception, which may have compromised the method's effectiveness. Of the 116 condom users, 89 reported that the condom had broken or slipped off during intercourse or that use had been irregular. Concern about side effects was the most frequently cited reason for not using the pill or IUD; in many other cases, women had been advised by their physician to take a break from use of these methods. Overall, contraceptive failure was considered to have occurred in 43 cases (21.5%); the methods involved were IUD (7 cases), pill (4 cases), condoms (27 cases), and spermicides (5 cases). Recommended to reduce the high rate of contraceptive failure are counseling on proper method use and the alleviation of concern about side effects associated with the most effective methods. PMID:8533567

Savonius, H; Pakarinen, P; Sjöberg, L; Kajanoja, P

1995-11-01

245

'Stratified Contraception': Emergency Contraceptive Pills and Women's Differential Experiences in Contemporary India.  

PubMed

Available without prescriptions in India since 2005, emergency contraceptive pills (ECPs) and their advertisements have provided women with increased contraceptive options and a vocabulary to talk about their reproductive lives. I draw on long-term fieldwork with women in urban India about ECPs, demonstrating a new form of 'stratified contraception' enabled by these pills and their advertisements. I posit that there are within India spaces that replicate the luxuries and privileges of the global North. These material conditions, I suggest, are replicated when it comes to contraception as there are hubs of women consumers of contraception and contraceptive advertising that participate in an 'imagined cosmopolitanism' within the global South in close proximity to 'contraceptive ghettos.' Moving beyond simplistic binaries, I outline three major stratifications along which women experience this medical technology and outline the implications for women and their contraceptive choices when notions of northern privilege exist in the 'South.' PMID:24901232

Sheoran, Nayantara

2014-06-01

246

[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

247

CONTRACEPTION FOR BREAST-FEEDING WOMEN  

E-print Network

This guideline should be used in conjunction with the detailed Clinical Guidelines, Section A 9 Contraception guidelines that contain information regarding individual contraception methods. KEY POINTS 1. All postnatal women should be offered counselling regarding contraception prior to discharge. 2. Postnatal women should be advised of available services to provide contraception counselling, provision of services, and how to access appointments. These include general practitioner services, community Family Planning Services, and the Family Planning Clinic at KEMH. 3. Women who are not breastfeeding should be advised to use contraception within 4 weeks of birth should they wish to avoid risk of pregnancy. 1 4. All methods of contraception are considered suitable for women who are not breastfeeding 2 as long as there are no contraindications for that method.

Authorised Ogccu

2001-01-01

248

Revisiting a pilot survey involving contraception and teenage pregnancy in Ayrshire and Arran  

Microsoft Academic Search

ContextHow to respond to the challenge of reducing unplanned pregnancy rates in Ayrshire and Arran.Objectives(1) To improve understanding of the educational needs of 11-15-year-olds regarding contraception which could be used to inform planning of future sex education in schools in Ayrshire and Arran. (2) To put this in context by reviewing contraceptive usage amongst 14-16-year-old pregnant teenagers.Design(1) A questionnaire given

Susu Salihi; Denise W Brown; Elaine Melrose; Sheila Merchant

2002-01-01

249

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

250

HEALTH MATTERS Frequently Asked Questions About the Contraceptive Patch  

E-print Network

. The contraceptive patch may protect against some cancers and breast disease. Who should not use the contraceptive contraceptives is always safer than childbirth or abortion. Serious risks are increased if you smoke cigarettes

Yener, Aylin

251

Update on hormonal contraception and bone density  

Microsoft Academic Search

Combination hormonal contraception and progestin-only contraception (including depot medroxyprogesterone acetate [DMPA]) are\\u000a effective and convenient forms of reversible contraception that millions of women use worldwide. In recent years, observations\\u000a of reduced bone mineral density in current users of these methods have led to concerns that this hormone-induced bone loss\\u000a might translate into long-term increased fracture risk. Special focus has been

Michelle M. Isley; Andrew M. Kaunitz

2011-01-01

252

Contraception technology: past, present and future.  

PubMed

Steady progress in contraception research has been achieved over the past 50 years. Hormonal and nonhormonal 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 and estradiol valerate 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. Although 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 nonhormonal methods is 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. PMID:22995540

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

2013-03-01

253

Contraceptive use in women with bacterial vaginosis  

Microsoft Academic Search

The aim of the study was to investigate if bacterial vaginosis (BV) is associated with use of specific contraceptives. Women at family planning and youth clinics (n = 956), among whom 131 had BV, were subjects for structured in-depth interviews including current and previous contraceptive use. Variables measuring sexual risk-taking were ascertained. Current users of contraceptives were compared with non-users.

Marina Shoubnikova; Dan Hellberg; Staffan Nilsson; Per-Anders Mårdh

1997-01-01

254

Trends in the Prevalence Rates and Numbers of Blind and Visually Impaired Schoolchildren.  

ERIC Educational Resources Information Center

This paper draws on primary and secondary data sources to document an increasing number of visually handicapped children. The paper discusses socioeconomic trends, increased rates of handicapping conditions in general, increased number of legally blind schoolchildren, and evidence of an increase in retinopathy of prematurity. (JDD)

Kirchner, C.

1990-01-01

255

Gender differences in drunk driving prevalence rates and trends: a 20-year assessment using multiple sources of evidence.  

PubMed

This research tracked women's and men's drunk driving rates and the DUI sex ratio in the United States from 1982-2004 using three diverse sources of evidence. Sex-specific prevalence estimates and the sex ratio are derived from official arrest statistics from the Federal Bureau of Investigation, self-reports from the Centers for Disease Control and Prevention, and traffic fatality data from the National Highway and Transportation Safety Administration. Drunk driving trends were analyzed using Augmented Dickey Fuller time series techniques. Female DUI arrest rates increased whereas male rates declined then stabilized, producing a significantly narrower sex ratio. According to self-report and traffic data, women's and men's drunk driving rates declined and the gender gap was unchanged. Women's overrepresentation in arrests relative to their share of offending began in the 1990s and accelerated in 2000. Women's arrest gains, contrasted with no systematic change in DUI behavior, and the timing of this shift suggest an increased vulnerability to arrest. More stringent laws and enforcement directed at less intoxicated offenders may inadvertently target female offending patterns. PMID:18499352

Schwartz, Jennifer

2008-09-01

256

Antidepressant treatment of premature ejaculation: discontinuation rates and prevalence of side effects for dapoxetine and paroxetine in a naturalistic setting.  

PubMed

The present study aimed to investigate prevalence of and reasons for selective serotonin reuptake inhibitor (SSRI) discontinuation, and compare the two most common SSRIs used in premature ejaculation (PE) treatment, in naturalistic settings (that is, outside clinical trials). The sample consisted of 132 Finnish men with a mean age of 42.5 years (s.d.=10.6) who had received medical treatment for lifelong PE. The men were enlisted for the study after identifying individuals from the third author's (a physician specializing in sexual medicine) patient registry. Participants responded to a secure, online questionnaire. PE treatment-related side effects of, and discontinuation rates for, different SSRIs were retrospectively self-reported. Treatment efficacy and happiness with treatment were retrospectively self-assessed. Discontinuation rates were uniformly high, ranging from 28.8 to 70.6% between different SSRIs. Dapoxetine was associated with the highest dropout rates (70.6%), and paroxetine the lowest, discontinuation rates. Limited efficacy and side effects were the most common reasons for discontinuation. Paroxetine was more effective and better tolerated than dapoxetine. A considerable number of patients chose to spontaneously discontinue treatment, especially so in the case of dapoxetine, corroborating recent studies conducted in naturalistic settings. Further research efforts are necessary to develop new and improve existing PE treatment alternatives.International Journal of Impotence Research advance online publication, 20 November 2014; doi:10.1038/ijir.2014.37. PMID:25410962

Jern, P; Johansson, A; Piha, J; Westberg, L; Santtila, P

2014-11-20

257

Review of the combined contraceptive vaginal ring, NuvaRing®  

PubMed Central

The purpose of this review was to test contraceptive efficacy, cycle control, tolerability, and acceptability as found in the non-comparative studies with NuvaRing® by those found in the randomized trials comparing NuvaRing and combined oral contraceptives (COCs). All large non-comparative studies and all relevant randomized controlled trials (RCTs) between NuvaRing and a COC up to and including December 2006 were analyzed. Two large multi-center registration studies, 1 large daily clinical practice study, and 6 RCTs comparing NuvaRing and a COC were identified. The findings in the non-comparative studies were confirmed in the RCTs. Contraceptive efficacy was high showing no significant differences in comparison with the COC; cycle control was good and consistently better than that of the COC; compliance was high and comparable with that of the pill; the incidence of adverse events such as breast tenderness, headache, and nausea was low, but not lower than with the COC despite a halving of the systemic exposure to ethinyl estradiol (EE) with NuvaRing compared with a 30-?g EE-containing COC; the incidence of local and ring-related events was low but higher than with the COC, leading to higher discontinuation rates among NuvaRing users; acceptability was high and comparable between both contraceptives, resulting in a global improvement of sexual function with both methods. After study completion, women using NuvaRing were more likely to continue with their method than women using a COC. The good results with respect to contraceptive efficacy, cycle control, tolerability, and acceptability as achieved with NuvaRing in the large non-comparative registration studies were confirmed in the RCTs comparing NuvaRing with different COCs. PMID:18728840

Roumen, Frans JME

2008-01-01

258

Elevated Rates of Current PTSD Among Hispanic Veterans in the NVVRS: True Prevalence or Methodological Artifact?  

PubMed Central

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.

2015-01-01

259

Glomerular filtration rate and prevalence of chronic kidney disease in Wilms’ tumour survivors  

Microsoft Academic Search

Glomerular filtration rate (GFR) was evaluated in 32 Wilms' tumour survivors (WTs) in a cross-sectional study using 99 Tc-diethylene triamine pentaacetic acid (99 Tc-DTPA) clearance, the Schwartz formula, the new Schwartz equation for chronic kidney disease (CKD), cystatin C serum concentration and the Filler formula. Kidney damage was established by beta-2-microglobulin (B-2-M) and albumin urine excretion, urine sediment and ultrasound

Joanna Stefanowicz; Mateusz Kosiak; Grzegorz Romanowicz; Rados?aw Owczuk; El?bieta Adamkiewicz-Dro?y?ska; Anna Balcerska

2011-01-01

260

Counseling adolescents about contraception: towards the development of an evidence-based protocol for contraceptive counselors.  

PubMed

Research on contraceptive counseling of adolescents in clinics and service delivery settings is considered. The provider context as well as the developmental context of adolescence is characterized and their implications for contraceptive counseling are explicated. After reviewing research on the effectiveness of contraceptive counseling, it was concluded there is little empirical evidence to support the efficacy of current practices considered as a totality. Twelve principles for effective contraceptive counseling were then derived as a basis for building an evidence-based contraceptive counseling protocol for adolescents. PMID:23535060

Jaccard, James; Levitz, Nicole

2013-04-01

261

[Biology - contraception - adolescence. From the physiology of puberty to the possible physiopathology of contraception in the formative years].  

PubMed

Because of the increasingly early age at which adolescents initiate sexual activity, their need for contraception has increased. A contraceptive suited to the needs of adolescents must be effective and well tolerated, with quick and perfect reversibility and no effects on the ongoing maturation process. Adolescents in general do not seek information on contraception as frequently as on abortion. Withdrawal and the various forms of rhythm involve no side effects but their use demands a high level of motivation ill suited to the episodic sex lives of adolescents, and their failure rate is high. Spermicides are seldom utilized by adolescents because of their inconvenience and the anatomical knowledge required. Their efficacy is incomplete and little is known about their possible side effects. Condoms are available without prescription, effective against pregnancy and sexually transmitted diseases, and free of side effects. Their main drawback is the need for male participation. The diaphragm is effective and free of side effects. It offers protection against sexually transmitted diseases and allows ovarian maturation. Its disadvantages are the need to be fitted and the inconvenience of use. IUDs are contraindicated for nulliparas but may be used if hormonal contraception is also contraindicated and all other methods are refused. Hormonal contraception for males is still in the experimental stage. The minipill, with its small dose of synthetic progestagen, is suited for use by adolescents because it does not inhibit ovulation, but the need to take a pill at the same time every day may not be compatible with the habits or life style of young girls. Sequential pills are not totally effective and may involve a risk of endometrial cancer. Highly effective combined pills are available at various dose levels. Higher dose classic combined pills have the advantage for adolescents of continued protection in case of forgetting. Prescriptions may be changed to smaller doses when the habit of taking them regularly is developed. PMID:6921157

Lonchambon, P; Plat, P

1982-06-01

262

Contraceptive use in women under 20 years of age: A study in Iran.  

PubMed

Contraception methods are one of the most important factors in population control. A choice of the safe and effective methods available to adolescents may guarantee their safety. The purpose of the present study was to evaluate the rate and kind of contraceptive methods used by women under 20 years of age and finding the related demographic factors. A total of 500 women who finished the study were evaluated regarding the rate of contraceptive use, which method was used and the probable demographic-related factors. More than half (51.6%) of the women used contraception. The most common method was breast-feeding (27.1%), although only 2.8% had enough knowledge about breast-feeding as a contraceptive method. Other common methods used were IUD (intrauterine device) (24.8%) and the withdrawal method (24.8%). The usage of contraception was directly related to the number of pregnancies, the age of marriage and the woman's age at first pregnancy. It related indirectly to the level of education, the number of brothers and sisters and size of the family, socioeconomic status, the age of the mother when married and the age of menarche. PMID:24911985

Shahpoorian, F; Kashanian, M; Shakhan, Z; Sheikhansari, N

2014-10-01

263

Research Gaps in Defining the Biological Link between HIV Risk and Hormonal Contraception  

PubMed Central

Epidemiologic data suggest an association between depot medroxyprogesterone acetate (DMPA), a progesterone-based hormonal contraceptive, and increased risk of HIV acquisition and transmission. DMPA is highly effective and is among the most commonly used form of hormonal contraception in areas of high HIV prevalence. Thus, defining the biological mechanisms that contribute to the potential negative synergy between DMPA and HIV is key and may facilitate the identification of alternative contraceptive strategies. Proposed mechanisms include thinning or disruption of the cervicovaginal epithelial barrier, induction of mucosal inflammation, interference with innate and adaptive soluble and cellular immune responses, and/or alterations in the vaginal microbiome. DMPA may also indirectly increase the risk of HIV by promoting genital herpes or other sexually transmitted infections. However, there is a paucity of rigorous in vitro, animal model and clinical data to support these potential mechanisms highlighting the need for future research. PMID:24548147

Murphy, Kerry; Irvin, Susan C.; Herold, Betsy C.

2014-01-01

264

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

265

Women's use of contraception in rural India  

Microsoft Academic Search

This paper examines the determinants of contraceptive use among married women in four villages in rural West Bengal, India. It uses primary quantitative data obtained from a survey of 600 women and qualitative data derived from ethnographic methods. Bi- and multi-variate analyses demonstrate that the factors that most influence a woman's use of contraception include her age, the number of

Elizabeth Chacko

2001-01-01

266

Understanding Adolescent Contraceptive Choice: An Empirical Test.  

ERIC Educational Resources Information Center

Research using expectancy models has shown contraceptive choice among adults to be a rational process in that intentions and behaviors reflect an individual's beliefs, values, attitudes, and perceptions of social norms. This study examined whether such an approach could accurately represent adolescents' contraceptive decision-making. It used the…

Adler, Nancy E.; And Others

267

Predictors of contraceptive use by adolescent mothers  

Microsoft Academic Search

This study examines the differences between adolescents who do versus those who do not use contraceptives after the birth of their first child. The sample consists of 89 low-income mothers in the state of Indiana. A discriminant function analysis is used to determine if the adolescents' home environment, financial resources, self-esteem, or future orientation discriminates between contracepting and noncontracepting adolescents.

Joan A. Jurich; Teresa Hughes

1991-01-01

268

A review of "once-a-month" combined injectable contraceptives.  

PubMed

The once-a-month combined progestogen and estrogen injectables were developed to overcome menstrual irregularity, a major reason for discontinuation of progestogen-only contraceptives. About 2 million women have already used the combined once-a-month injectables, particularly in Latin America and China. The currently available once-a-month combined injectable contraceptives are Chinese Injectable No. 1 (17 alpha-hydroxyprogesterone caproate, estradiol valerate), another formulation marketed under various brand names in Latin America (dihydroxyprogesterone acetophenide, estradiol enanthate), Cyclofem (medroxyprogesterone acetate [MPA], estradiol cypionate), Mesigyna (norethisterone enanthate, estradiol valerate), and Mego-E (megestrol acetate, 17 beta-estradiol). Cyclofem and Mesigyna are very effective at preventing pregnancy (1-year rate, 99.8-99.6%). The rate for the dihydroxyprogesterone acetophenide/estradiol enanthate formulation is 100%, while that for Chinese Injectable No. 1 is 94%. Even though menstrual disturbances occur less often in once-a-month injectable users, they are the leading medical reason for discontinuation. At 1 year of use, about 70% of Cyclofem and Mesigyna users have regular bleeding patterns compared to 8% of Depo-Provera users. None of the Cyclofem and Mesigyna studies have found them to induce any adverse or clinically relevant metabolic changes. Once-a-month combined estrogen and progestogen injectables do not cause any significant delay in return to ovulation, but researchers should collect more data on conception rates for women who discontinue for planned pregnancy and those who discontinue for bleeding disorders and amenorrhea. Research into service delivery of these injectables is needed to assess managerial requirements or adaptations that would be required should there be more wide scale introduction of a contraceptive into both public and private sectors. Age, contraceptive history, learning about injectables and husbands' attitude, and knowing another user's satisfaction with the service appear to be important determinants of acceptability of once-a-month injectables. PMID:12290848

Newton, J R; D'arcangues, C; Hall, P E

1994-01-01

269

Social Transmission and the Spread of Modern Contraception in Rural Ethiopia  

PubMed Central

Socio-economic development has proven to be insufficient to explain the time and pace of the human demographic transition. Shifts to low fertility norms have thus been thought to result from social diffusion, yet to date, micro-level studies are limited and are often unable to disentangle the effect of social transmission from that of extrinsic factors. We used data which included the first ever use of modern contraception among a population of over 900 women in four villages in rural Ethiopia, where contraceptive prevalence is still low (<20%). We investigated whether the time of adoption of modern contraception is predicted by (i) the proportion of ever-users/non ever-users within both women and their husbands' friendships networks and (ii) the geographic distance to contraceptive ever-users. Using a model comparison approach, we found that individual socio-demographic characteristics (e.g. parity, education) and a religious norm are the most likely explanatory factors of temporal and spatial patterns of contraceptive uptake, while the role of person-to-person contact through either friendship or spatial networks remains marginal. Our study has broad implications for understanding the processes that initiate transitions to low fertility and the uptake of birth control technologies in the developing world. PMID:21799882

Alvergne, Alexandra; Gibson, Mhairi A.; Gurmu, Eshetu; Mace, Ruth

2011-01-01

270

Safety, efficacy and patient acceptability of the contraceptive and non-contraceptive uses of the LNG-IUS  

PubMed Central

Intrauterine devices (IUDs) provide highly effective, long-term, safe, reversible contraception, and are the most widely used reversible contraceptive method worldwide. The levonorgestrel-releasing intrauterine system (LNG-IUS) is a T-shaped IUD with a steroid reservoir containing 52 mg of levonorgestrel that is released at an initial rate of 20 ?g daily. It is highly effective, with a typical-use first year pregnancy rate of 0.1% – similar to surgical tubal occlusion. It is approved for 5 years of contraceptive use, and there is evidence that it can be effective for up to 7 years of continuous use. After removal, there is rapid return to fertility, with 1-year life-table pregnancy rates of 89 per 100 for women less than 30 years of age. Most users experience a dramatic reduction in menstrual bleeding, and about 15% to 20% of women become amenorrheic 1 year after insertion. The device’s strong local effects on the endometrium benefit women with various benign gynecological conditions such as menorrhagia, dysmenorrhea, leiomyomata, adenomyosis, and endometriosis. There is also evidence to support its role in endometrial protection during postmenopausal estrogen replacement therapy, and in the treatment of endometrial hyperplasia. PMID:21072274

Bednarek, Paula H; Jensen, Jeffrey T

2010-01-01

271

Shedding Rates and SeroPrevalence of Brucella melitensis in Lactating Goats of Shahrekord, Iran  

PubMed Central

Background: Brucellosis remains a major worldwide zoonosis. Caprine brucellosis is a significant problem for both public health and animal production. Brucella melitensis causes disease in goats, sheep, humans, and occasionally cattle. Transmission is by ingestion or contact with infected materials, vaginal discharge, or milk. Objectives: The current study aimed to determine the rate of B. melitensis seropositives and its probable shedding in lactating goats from flocks in Shahrekord district, Iran. Materials and Methods: In the current study, 1080 samples of milk, blood and vaginal swabs of 360 lactating goats (three samples from each animal) were randomly collected from 12 flocks in Shahrekord district. Serums from blood samples were examined by Rose Bengal plate (RBT) test and the titre of positives determined by tube agglutination test (TAT). Vaginal swab and milk (cream and sediment) samples were cultured on Brucella agar. Brucella spp. suspected pure cultures were incubated in the same conditions and then examined by Modified Zeil-Nelson (MZN) staining, oxidase and catalase tests. Positive isolates were examined by PCR. Results: Out of 360 serum samples, 50 (13.9%) were positive by RBT, and six (1/66%) were positive by TAT. Culturing of milk and vaginal samples lead to isolation of 12 (3.33%) and 10 (2.77%) Brucella spp. suspected colonies, respectively. The PCR examinations of these isolates showed that ten (2.77%) milk and 6 vaginal swab samples (1.66%) belonged to B. melitensis species. Eight goats (2.22%) had positive results in RBT, culture and PCR examinations, simultaneously. Conclusions: The regional distribution of caprine brucellosis and shedding of B. melitensis through vaginal secretions and milk secretions of lactating goats indicated that 50% and 83.33% of the goat flocks contained vaginal and milk shedders, respectively. PMID:25147691

Ebrahimi, Azizollah; Milan, Jalal Sheykh kanluye; Mahzoonieh, Mohamad Reza; Khaksar, Khadijeh

2014-01-01

272

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

273

Antimicrobial resistance status and prevalence rates of extended spectrum beta-lactamase producers isolated from a mixed human population  

PubMed Central

Owing to the increasing epidemiological and therapeutic challenges associated with infections due to ESBL producers, ESBL prevalence rate among some bacteria isolates from healthy and non-healthy human population in a metropolitan Nigerian setting was evaluated. A total of one hundred and forty-five (145) bacteria strains were isolated from a total of four hundred and sixty (460) samples collected from urine, wound, throat and anal swabs of 220 healthy volunteers in the community and from 240 patients in 2 secondary and 2 tertiary hospitals (altogether, 4) in Enugu metropolis. The presumptive confirmatory test used for ESBL detection was the Double Disc Synergy Test (DDST) method. Conjugation and plasmid curing studies were also done for resistance factor determination. Of the 145 isolates, 20 were ESBL producers with 35% of these ESBL producers being of community origin and 65% from hospitals. This translates to 4.8% and 9% incidences (comparably higher than established prevalence of 4.4% and 7.5 respectively) for community and hospital infections respectively. The ESBL isolates showed high resistance to tetracycline, gentamicin, pefloxacin, ceftriaxone, cefuroxime, ciprofloxacin and Augmentin® (Amoxicilin and clavulanic acid combination). Conjugation studies for Resistance plasmid transfer showed non-transference of resistance determinants between the ESBL transconjugants and recipient strains. Correspondingly, the plasmid curing studies revealed that the acridine orange could not effect a cure on the isolates as they still retained high resistance to the antibiotics after the treatment. This study confirms the growing incidences/pool of ESBL strains in Nigeria and call for widespread and continuous monitoring towards an effective management of the potential therapeutic hurdle posed by this trend. PMID:21619555

Afunwa, Ruth A.; Odimegwu, Damian C.; Iroha, Romanus I.; Esimone, Charles O.

2011-01-01

274

Teen contraception: a review of perspectives on compliance.  

PubMed

National attention has been drawn to the near epidemic rates of teen-age pregnancy in this country, with greater psychological understanding of this problem cited as a research need. This paper reviews available literature on teen contraceptive compliance with particular focus on the development of self-regulation. In this first section, programs designed to enhance teens' choice and use of birth control are reviewed, with specific attention given to emerging issues and methodological concerns. In the second section, studies that examine factors predictive of contraceptive use in teen-age girls are discussed. This literature is grouped according to three conceptual systems: medical perspectives, behavioral theory, and self-regulation and self-control approaches. A summary is presented, specifying ways in which conceptually based research findings can assist in program development to address the problem of teen pregnancy. PMID:3314791

Beck, J G; Davies, D K

1987-08-01

275

Oral contraceptive containing natural estradiol for premenopausal women.  

PubMed

An open multicenter trial was performed in six centers in Finland to study the efficacy, safety and acceptability of a new biphasic oral contraceptive pill containing natural estradiol and cyproterone acetate. The participants were 288 women with a mean age of 39.3 +/- 3.4 years (range 30-49) who were willing to use the new pill as their only contraceptive method. In total, 23% of the women were smokers. The cumulative experience was 2800 treatment cycles during the first year. The net 12-month continuation rate was 63%. One pregnancy occurred in a woman who lost 5 tablets in the second treatment cycle, which gives a 12-month cumulative pregnancy rate of 0.4%. Serum progesterone values, determined twice during the third treatment cycle, showed ovulation inhibition in 95% of women. There were no serious side effects. Intermenstrual bleeding was recorded by 35.5% and 24.5% of women at 3 and 12 months, respectively. The bleedings became scantier in most women and dysmenorrhoea disappeared. No changes were observed in total and high density lipoprotein cholesterol concentrations after 1 year. With the exception of intermenstrual spotting, the efficacy, safety and acceptability of the new pill was almost as good as that of the modern low dose oral contraceptives. This is the first pill containing natural estradiol that has gained clinical acceptance and which can also be prescribed for smokers over 35 years old until the climacteric. PMID:7731379

Hirvonen, E; Allonen, H; Anttila, M; Kulmala, Y; Ranta, T; Rautiainen, H; Sipilä, P; Ylöstalo, P

1995-01-01

276

The efficacy of intrauterine devices for emergency contraception: a systematic review of 35 years of experience  

PubMed Central

BACKGROUND Intrauterine devices (IUDs) have been studied for use for emergency contraception for at least 35 years. IUDs are safe and highly effective for emergency contraception and regular contraception, and are extremely cost-effective as an ongoing method. The objective of this study was to evaluate the existing data to estimate the efficacy of IUDs for emergency contraception. METHODS The reference list for this study was generated from hand searching the reference lists of relevant articles and our own article archives, and electronic searches of several databases: Medline, Global Health, Clinicaltrials.gov, Popline, Wanfang Data (Chinese) and Weipu Data (Chinese). We included studies published in English or Chinese, with a defined population of women who presented for emergency contraception and were provided with an IUD, and in which the number of pregnancies was ascertained and loss to follow-up was clearly defined. Data from each article were abstracted independently by two reviewers. RESULTS The 42 studies (of 274 retrieved) that met our inclusion criteria were conducted in six countries between 1979 and 2011 and included eight different types of IUD and 7034 women. The maximum timeframe from intercourse to insertion of the IUD ranged from 2 days to 10 or more days; the majority of insertions (74% of studies) occurred within 5 days of intercourse. The pregnancy rate (excluding one outlier study) was 0.09%. CONCLUSIONS IUDs are a highly effective method of contraception after unprotected intercourse. Because they are safe for the majority of women, highly effective and cost-effective when left in place as ongoing contraception, whenever clinically feasible IUDs should be included in the range of emergency contraception options offered to patients presenting after unprotected intercourse. This review is limited by the fact that the original studies did not provide sufficient data on the delay between intercourse and insertion of the IUD, parity, cycle day of intercourse or IUD type to allow analysis by any of these variables. PMID:22570193

Cleland, Kelly; Zhu, Haoping; Goldstuck, Norman; Cheng, Linan; Trussell, James

2012-01-01

277

Psychological distress and post-abortion contraceptive method effectiveness level chosen at an urban clinic  

PubMed Central

Objective We investigated whether more psychological distress before an abortion is associated with the effectiveness of contraception selected (low, moderate, or high effectiveness) at an abortion clinic visit. Method Using data from 253 women attending an urban abortion clinic that primarily serves low-income women, we tested the association between pre-abortion psychological distress and the effectiveness level of post-abortion contraceptive choice. Based on typical use failure rates, we classified effectiveness of contraceptive choice into three levels—low, moderate, and high effectiveness. We measured psychological distress with four validated measures of depressive, anxious, and stress symptoms, and negative affect, as well as with a global measure comprised of these four measures. We used multivariable ordinal logistic regression to measure the association of each psychological distress measure with post-abortion contraceptive method effectiveness level, adjusting for sociodemographic factors, pregnancy history, trimester of abortion, and importance of avoiding pregnancy in the next year. Results We found that compared to women experiencing less stress symptoms, negative affect, and global psychological distress, women experiencing more stress symptoms [AOR = 1.028, 95% CI: 1.001-1.050], negative affect [AOR = 1.05, 95% CI: 1.01-1.09], and global psychological distress [AOR = 1.46, 95% CI: 1.09-1.95] were more likely to choose more effective versus less effective methods, ps < .05, in adjusted models. Using dichotomous psychological measures we found similar results. Conclusions Women experiencing more psychological distress before an abortion selected more effective contraceptive methods after their abortions. Future research should examine whether this distress is associated with subsequent contraceptive use or continuation. Implications The current study suggests that contraceptive providers should not assume that women experiencing more psychological distress prefer to use less effective contraceptive methods. PMID:24094755

Steinberg, Julia R.; Tschann, Jeanne M.; Henderson, Jillian T.; Drey, Eleanor A.; Steinauer, Jody E.; Harper, Cynthia C.

2013-01-01

278

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

279

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

280

Oral contraception in the former Czech and Slovak Federal Republic: attitudes and use.  

PubMed

This paper presents and discusses data on oral contraception from a national representative survey (n = 1072) on knowledge, attitudes and practice with regard to contraceptive use in the Czech and Slovak Federal Republic (CSFR). Only 7% of the women at risk of unplanned pregnancy used the pill. The low rate of use seems to be due to the general negative image of oral contraception, reinforced by the experiences of past users and opinions expressed by relative, friends, doctors, and the media. In particular, perceived psychological disadvantages have an important bearing on the decision not to use the method, whereas perceived advantages have hardly any impact. It is likely that this negative image is closely linked with the types of oral contraceptives that have been available in the country and also with the limited choice. Second- and third-generation oral contraceptives have only very recently become available. It is recommended that balanced information on the advantages and disadvantages of oral contraception be made available to doctors and to the general public on a large scale and through a variety of channels. PMID:8237567

Ketting, E; Visser, A P; Uzel, R; Lehert, P

1993-06-01

281

Cost of unintended pregnancy in Norway: a role for long-acting reversible contraception  

PubMed Central

Objectives The objective of this study was to quantify the cost burden of unintended pregnancies (UPs) in Norway, and to estimate the proportion of costs due to imperfect contraceptive adherence. Potential cost savings that could arise from increased uptake of long-acting reversible contraception (LARC) were also investigated. Methods An economic model was constructed to estimate the total number of UPs and associated costs in women aged 15–24?years. Adherence-related UP was estimated using ‘perfect use’ and ‘typical use’ contraceptive failure rates. Potential savings from increased use of LARC were projected by comparing current costs to projected costs following a 5% increase in LARC uptake. Results Total costs from UP in women aged 15–24?years were estimated to be 164 million Norwegian Kroner (NOK), of which 81.7% were projected to be due to imperfect contraceptive adherence. A 5% increase in LARC uptake was estimated to generate cost savings of NOK 7.2 million in this group. Conclusions The cost of UP in Norway is substantial, with a large proportion of this cost arising from imperfect contraceptive adherence. Increased LARC uptake may reduce the UP incidence and generate cost savings for both the health care payer and contraceptive user. PMID:25537792

Henry, Nathaniel; Schlueter, Max; Lowin, Julia; Lekander, Ingrid; Filonenko, Anna; Trussell, James; Skjeldestad, Finn Egil

2015-01-01

282

Prevalence and occurrence rate of Mycobacterium tuberculosis Haarlem family multi-drug resistant in the worldwide population: A systematic review and meta-analysis  

PubMed Central

Background: Transmission of Mycobacterium tuberculosis (M. tuberculosis) can occur in different ways. Furthermore, drug resistant in M. tuberculosis family is a major problem that creates obstacles in treatment and control of tuberculosis (TB) in the world. One of the most prevalent families of M. tuberculosis is Haarlem, and it is associated with drug resistant. Our objectives of this study were to determine the prevalence and occurrence rate of M. tuberculosis Haarlem family multi-drug resistant (MDR) in the worldwide using meta-analysis based on a systematic review that performed on published articles. Materials and Methods: Data sources of this study were 78 original articles (2002-2012) that were published in the literatures in several databases including PubMed, Science Direct, Google Scholar, Biological abstracts, ISI web of knowledge and IranMedex. The articles were systematically reviewed for prevalence and rate of MDR. Data were analyzed using meta-analysis and random effects models with the software package Meta R, Version 2.13 (P < 0.10). Results: Final analysis included 28601 persons in 78 articles. The highest and lowest occurrence rate of Haarlem family in M. tuberculosis was in Hungary in 2006 (66.20%) with negative MDR-TB and in China in 2010 (0.8%), respectively. From 2002 to 2012, the lowest rate of prevalence was in 2010, and the highest prevalence rate was in 2012. Also 1.076% were positive for MDR and 9.22% were negative (confidence interval: 95%).0020. Conclusion: Many articles and studies are performed in this field globally, and we only chose some of them. Further studies are needed to be done in this field. Our study showed that M. tuberculosis Haarlem family is prevalent in European countries. According to the presence of MDR that was seen in our results, effective control programs are needed to control the spread of drug-resistant strains, especially Haarlem family. PMID:25767526

Ramazanzadeh, Rashid; Roshani, Daem; Shakib, Pegah; Rouhi, Samaneh

2015-01-01

283

Adolescent contraception: review and guidance for pediatric clinicians.  

PubMed

The majority of adolescents initiate sexual activity during their teenage years, making contraception an important aspect of routine adolescent health care. Despite common misperceptions, all available methods of reversible contraception are appropriate for adolescent use. Contraceptive side effects profiles and barriers to use of certain methods should be considered when providing contraceptives to adolescents. In particular, ease of use, confidentiality, and menstrual effects are main concerns of adolescents. Contraceptive counseling with adolescents should describe method efficacy, discuss user preferences, explore barriers to use, counsel regarding sexually transmitted infection prevention, and consider what to do if contraception fails. Emergency contraception should be widely discussed with adolescents, as it is appropriate for use during gaps in other contraceptive use, method failure, and adolescents who are not using another form of contraception. Dual method use (condom plus a highly effective method of contraception) is the gold standard for prevention of both pregnancy and sexually transmitted infections. PMID:25358846

Potter, J; Santelli, J S

2015-03-01

284

Decreased maximal aerobic capacity with use of a triphasic oral contraceptive in highly active women: a randomised controlled trial  

PubMed Central

Background: Oral contraceptives are commonly used by women athletes. However, their effect on athletic performance is unclear. Objectives: To examine the effects of a moderate dose, triphasic oral contraceptive on measures of athletic performance in highly trained women athletes. Methods: This is a double blind, placebo controlled trial in 14 women with ovulatory menstrual cycles and maximal aerobic capacity (VO2MAX) ?50 ml/kg/min. Four measures of athletic performance were tested: VO2MAX, anaerobic capacity (anaerobic speed test), aerobic endurance (time to fatigue at 90% of VO2MAX), and isokinetic strength (Cybex II dynamometer). Height, weight, and six skinfold measurements were also recorded. All these observational tests were completed during both the follicular and mid-luteal phases of an ovulatory menstrual cycle. Cycle phases were confirmed by assaying plasma oestradiol and progesterone. Participants were subsequently randomly assigned to either a tricyclic oral contraceptive or placebo and retested in identical fashion (oral contraceptive phase). Results: Absolute and relative changes in VO2MAX from follicular to oral contraceptive phase decreased in the oral contraceptive group by 4.7%, whereas the placebo group showed a slight increase (+1.5%) over the same time period. Two of the women taking oral contraceptive had decreases of 4 and 9 ml/kg/min. In contrast, most women in the placebo group improved or maintained VO2MAX. There was also a significant increase in the sum of skinfolds in women taking oral contraceptive compared with those taking placebo (p<0.01). There were no significant changes in other physiological variables (maximum ventilation, heart rate, respiratory exchange ratio, packed cell volume) or measures of performance (anaerobic speed test, aerobic endurance, isokinetic strength) as a function of oral contraceptive treatment. Conclusions: The decrease in VO2MAX that occurs when oral contraceptive is taken may influence elite sporting performance in some women. Further studies are required to determine the mechanisms of this change. PMID:12893716

Lebrun, C; Petit, M; McKenzie, D; Taunton, J; Prior, J

2003-01-01

285

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. PMID:8342715

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

1993-01-01

286

Knowledge and attitudes towards use of long acting reversible contraceptives among women of reproductive age in Lubaga division, Kampala district, Uganda  

PubMed Central

Background Uganda has one of the highest total fertility rates globally and in Sub-Saharan Africa. Her high fertility is mainly attributed to the high unmet need for family planning. Use of Long-acting reversible contraceptives (LARC) is low (13%) in Uganda yet they are the most cost-effective contraceptives. This study aimed to assess the reproductive aged women’s knowledge, attitudes, and factors associated with use of LARC. Methods A cross-sectional study was conducted involving 565 women (15–49 years) attending private and public health facilities in Lubaga division, Kampala district. Semi-structured questionnaires were used to measure knowledge, attitudes and factors associated with use of LARC; Intra-Uterine Devices, Implants and Injectables. The outcome variable was current use of LARC. A generalized linear regression model was run in STATA version12.0. Prevalence Risk Ratios for associations between current LARC use and independent factors were obtained and regarded significant at 95% CI with p?contraceptive choices adj.PRR 1.49; (95% CI 1.18, 1.88). Contrary, perception that LARC should be used by married women was negatively associated with use of LARC adj.PRR 0.63; (95% CI 0.44, 0.90). Conclusion Knowledge about site of administration, previous use of LARC and women’s attitude that male partners’ choice influence their contraceptive decisions were positively associated with current use of LARC. Contrary, the attitude that LARC was for married women was negatively associated with its use. This study suggests a need to strengthen client education about LARC to dispel possible myths and to consider integrating male partner’s decision making in contraceptive choices for women. PMID:24636154

2014-01-01

287

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. PMID:22995540

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

2012-01-01

288

Ulipristal - a new emergency contraceptive pill.  

PubMed

Until recently, women in the UK who wanted emergency contraception had two options: an oral hormonal method (levonorgestrel), which is licensed for use up to 3 days after unprotected sexual intercourse; or a copper-bearing intrauterine device (IUD), which can be inserted up to 5 days after unprotected intercourse or up to 5 days after the earliest likely calculated ovulation. Now ulipristal acetate (ellaOne - HRA Pharma), a new oral hormonal emergency contraceptive, has been licensed in the European Union for use within 120 hours (5 days) of unprotected intercourse. Here we assess whether it is an advance for emergency contraception. PMID:20685898

2010-08-01

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. PMID:21477680

Trussell, James

2013-01-01

290

Contraceptive self?efficacy: A perspective on teenage girls' contraceptive behavior  

Microsoft Academic Search

This research investigated the relationship between the social?psychological theory of self?efficacy and teenage girls' contraceptive behavior. Data were obtained from 258 female clients, aged 20 or younger, of a family planning clinic. Four factors were extracted from the contraceptive self?efficacy (CSE) scale developed for this investigation. Regression analyses were used to determine whether CSE scores distinguished patterns of contraceptive use

Ruth Andrea Levinson

1986-01-01

291

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. PMID:2556492

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

1989-01-01

292

Resistance to activated protein C as a basis for venous thromboembolism associated with pregnancy and oral contraceptives  

Microsoft Academic Search

OBJECTIVE: Inherited resistance to activated protein C, which is caused by a single factor V gene mutation, is a frequent risk factor for thrombosis. The purpose of this study was to determine the prevalence of activated protein C resistance in women with thromboembolic complications that had occured in connection with pregnancy or use of oral contraceptives.STUDY DESIGN: Activated protein C

Margareta Hellgren; Peter J. Svensson; Björn Dahlbäch

1995-01-01

293

A history of oral contraception: from evolution to revolution.  

PubMed

Women throughout the world and throughout time have ingested substances such as mercury, diluted copper ore, and various noxious solutions in the mistaken belief that these substances would prevent pregnancy. The era of modern contraception began in 1937 with the discovery that the administration of progesterone could halt ovulation in rabbits. During the next decade, work proceeded on finding an easy and less expensive way to synthesize progesterone and to develop the synthetic estrogens mestranol and ethinyl estradiol. Initial trials in humans proved that these hormones could prevent ovulation. In 1950, with support from Margaret Sanger and Katharine Dexter McCormick, Gregory Goodwin Pincus developed the first oral contraceptive (OC), which consisted of supplemental progestin and 0.5 mg norethindrone. In the early 1990s, the Ortho Pharmaceutical Corporation introduced an OC that combined the synthetic progesterone norgestimate and 35 mcg of ethinyl estradiol. By 1988, several noncontracepting health benefits of the OC were recognized, including decreased rates of ovarian cancer, endometrial cancer, pelvic inflammatory disease, ovarian cysts, benign breast disease, iron deficiency anemia, and dysmenorrhea. These health benefits outweigh risks even in nonsmoking women over 40. In the US, 80% of women have used the OC at one time, and they are using this most popular form of reversible contraception longer than ever. PMID:7670417

1995-09-01

294

Biology of male fertility control: an overview of various male contraceptive approaches.  

PubMed

The population of our planet continues to grow at an alarming rate. If the growth continues at the present rate, the estimated current world population of about seven billion is expected to double in the next forty years. Accumulated data from surveys by the United Nations Population Control Division suggest that a majority of today's young men in many countries are willing to have fewer children than their parents did. However, the contraceptive options available to them have not changed in several decades. In spite of the general agreement that men, like women, must take full responsibility of their fertility, the availability of safe, reversible and affordable contraceptives for men have lagged behind because of the complexity of the science of the male reproductive system. Thus, the contraceptive needs of millions of men/couples go unmet every single day and results in millions of unwanted pregnancies. In this article, we intend to discuss new hormonal and non-hormonal contraceptive approaches that are at various stages of research and development and may someday provide new contraceptives for men. In addition, we intend to discuss many details of three safe, effective, affordable and reversible vas-based approaches that are inching closer to being approved for use by millions of men in multiple countries. Finally, our intention is to discuss the male contraceptive pill that will soon be available to men only in Indonesia. The availability of these male contraceptives will allow both men and women to take full control of their fertility and participate in slowing down the growth of world population. PMID:25516280

Tulsiani, D R; Abou-Haila, A

2015-04-01

295

Sexually transmitted diseases and Chlamydia trachomatis in women consulting for contraception.  

PubMed Central

To study the frequency of genital infections in women consulting their family doctor for contraception, 248 women (median age 23 years) were examined for a range of genital microorganisms. The prevalence of clue cells, Candida albicans and Trichomonas vaginalis were 21.0%, 12.9% and 2.0%, respectively. Neisseria gonorrhoeae was isolated in only one case, whereas Chlamydia trachomatis was found in 6.3% of women. A specific clinical picture for an infection with C. trachomatis in women was not seen. Given the prevalence of over 5% for C. trachomatis and the absence of typical signs and symptoms in infected women, screening for this organism is recommended in women requesting an intrauterine contraceptive device, to prevent complications such as pelvic inflammatory disease and their sequelae. PMID:2560023

Avonts, D; Sercu, M; Heyerick, P; Vandermeeren, I; Piot, P

1989-01-01

296

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

297

Modern contraception and venereal disease.  

PubMed

Data on the rising incidence of venereal disease and its relation to the use of modern contraceptives is reviewed. The World Health Organization (WHO) has estimated the existence of 100 million cases of gonorrhea annually in the world, and the disease is now the most common notifiable infection after measles. WHO reported a worldwide 90% increase in syphilis since 1960, and nonspecific urethritis (viral) has been reported as common as gonorrhea in England and Wales. Several studies indicate that sexual intercourse is initiated at a younger age and that premarital and extramarital sexual experience are increasing. Over 60% of women with gonorrhea have no symptoms; syphillis is milder in women than men, and nonspecific genital diseases are more difficult to detect in women. The mobile society promotes casual sex which favors the spread of venereal disease. Although reliable evidence is scanty, oral contraceptives fail to provide a physical barrier and could thus facilitate transmission. A recent study of 522 patients attending a venereal disease clinic in Uppsala, Sweden showed that the number of partners and frequency of intercourse had increases for 141 women on the pill. Genital infection was common, and gonorrhea was diagnosed in 67% of 250 women. Evidence further suggests that the pill's alteration of the glucose metabolism changes in the genital tract resembling pregnancy may favor the growth of vaginal candidal infestations. Evidence also indicates that IUDs may increase the incidence of pelvic infection, and the dangers of tubal blockage are likewise increased for the IUD user contracting gonorrhea. The condom remains the best protection against the spread of venereal disease particularly if it is worn prior to intercourse and throughout intercourse. PMID:12331963

Catterall, R D

1970-08-01

298

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. PMID:24143124

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

2013-01-01

299

Oral contraceptive use and mortality after 36 years of follow-up in the Nurses’ Health Study: prospective cohort study  

PubMed Central

Objective To determine whether use of oral contraceptives is associated with all cause and cause specific mortality. Design Prospective cohort study. Setting Nurses’ Health Study, data collected between 1976 and 2012. Population 121?701 participants were prospectively followed for 36 years; lifetime oral contraceptive use was recorded biennially from 1976 to 1982. Main outcome measures Overall and cause specific mortality, assessed throughout follow-up until 2012. Cox proportional hazards models were used to calculate the relative risks of all cause and cause specific mortality associated with use of oral contraceptives. Results In our population of 121?577 women with information on oral contraceptive use, 63?626 were never users (52%) and 57?951 were ever users (48%). After 3.6 million person years, we recorded 31?286 deaths. No association was observed between ever use of oral contraceptives and all cause mortality. However, violent or accidental deaths were more common among ever users (hazard ratio 1.20, 95% confidence interval 1.04 to 1.37). Longer duration of use was more strongly associated with certain causes of death, including premature mortality due to breast cancer (test for trend P<0.0001) and decreased mortality rates of ovarian cancer (P=0.002). Longer time since last use was also associated with certain outcomes, including a positive association with violent or accidental deaths (P=0.005). Conclusions All cause mortality did not differ significantly between women who had ever used oral contraceptives and never users. Oral contraceptive use was associated with certain causes of death, including increased rates of violent or accidental death and deaths due to breast cancer, whereas deaths due to ovarian cancer were less common among women who used oral contraceptives. These results pertain to earlier oral contraceptive formulations with higher hormone doses rather than the now more commonly used third and fourth generation formulations with lower estrogen doses. PMID:25361731

Charlton, Brittany M; Rich-Edwards, Janet W; Colditz, Graham A; Missmer, Stacey A; Rosner, Bernard A; Hankinson, Susan E; Speizer, Frank E

2014-01-01

300

Afro-Surinamese women in The Netherlands: sexual education, the initiation of sex, and contraceptive use.  

PubMed

Surinamese women in Holland have a higher fertility rate and a much higher abortion rate than Dutch women in general. A sample of 60 Surinamese women throughout Holland were interviewed about their experience of sexual education, their initial sexual experiences, their use of contraception and pregnancies. Factors in their sexual career associated with a heightened risk of an unplanned pregnancy are recorded. PMID:9678116

Reubsaet, H; Ineichen, B

1996-12-01

301

New frontiers in nonhormonal male contraception  

PubMed Central

The world’s population is nearing 6.8 billion, and we are in need of a male contraceptive that is safe, effective, reversible and affordable. Hormonal approaches, which employ different formulations of testosterone administered in combination with other hormones, have shown considerable promise in clinical trials, and they are currently at the forefront of research and development. However, the long-term effects of using hormones throughout a male’s reproductive life for contraception are unknown, and it may take decades before this information becomes available. Because of this, many investigators are aiming to bring a nonhormonal male contraceptive to the consumer market. Indeed, there are several distinct but feasible avenues in which fertility can be regulated without affecting the hypothalamus-pituitary-testis axis. In this review, we discuss several approaches for fertility control involving the testis that one day may lead to the development of a nonhormonal male contraceptive. PMID:20933122

Cheng, C. Yan; Mruk, Dolores D.

2015-01-01

302

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. PMID:23869460

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

2013-01-01

303

Contraceptive development: targets, approaches and challenges.  

PubMed

The control of fertility constitutes a global health issue, since overpopulation and unintended pregnancy have both major personal and societal impact. Although some regions of the world are seeing neutral or negative population growth, many developing countries are seeing explosive growth of their populations and these population changes will affect the entire globe. It is estimated that in a decade, the largest cohort of young women worldwide in human history will reach adolescence thus necessitating the need for a wide range of contraceptive options that can be used by both females and males. The contraceptive revolution that occurred in the 1960s with the development of the hormonal-based oral contraceptive for women has subsequently made a significant impact on societal dynamics in several cultures, yet there has been virtually no innovation in this field since that time. This lack of innovation contrasts dramatically with the vast enhancement of our knowledge base of the basic processes of reproduction. The genomic and proteomic revolutions have provided new tools and new targets for contraceptive development, and the results of such approaches have identified gene products that play critical roles in female and male reproduction, thus expanding the array of targets for novel and innovative female- and male-based contraceptives. This normally would herald a renaissance in contraceptive development, yet the commitment of industry to this endeavor is limited to a few firms due to the economics of contraceptive development. This chapter will consider the types of targets being considered in the development of new generations of contraceptives and will also focus on the challenges that industry has in meeting these goals. PMID:17566288

Kopf, G S

2007-01-01

304

The quest for a herbal contraceptive.  

PubMed

An oral herbal contraceptive would allow couples control their fertility without consulting a health worker, which in turn would likely markedly increase the number of couples practicing family planning. Other advantages of such a contraceptive would include the familiarity rural people have with herbal medicines, the fewer side effects associated with herbal preparations, their ready availability from local sources, and protection of privacy. There are many references to plants in India with antifertility properties. Since 1966, the Indian Council of Medical Research (ICMR) has been conducting research to identify a herbal contraceptive, as have other organizations. Plants that have exhibited antifertility activity in clinical trials include Hibiscus rosasinensis (benzene extract of the flower petals suppresses implantation); Rudrapushpaka (extract of the flower petals prevents pregnancy); Embelia ribes (pregnancy prevention); Davcus carota, Butea monosperma, and Sapindus trifoliatis (seeds have an anti-implantation effect); and Mentha arvensis (leaves have anti-implantation effect). The Central Drug Research Institute in Lucknow, India, in collaboration with the US National Institutes of Health, the World Health Organization, and the ICMR confirm anti-implantation activity in Ferula jaeschkeana, Bupleurum marginatum, Lepidium capitatum, Caesalpinia sepiaria, Lonicera japonica, Juniperus communis, Lotus corniculatus, Lamium allum, and Acacia farnesiana. In China, scientists have evaluated the cotton-seed extract gossypol as a male contraceptive. They are now studying the possible antifertility effect on men of the plant Tripterygium wilfordii. From all the aforementioned plants as well as others under investigation, three possible types of contraceptives could be developed: an anti-ovulatory contraceptive; a postcoital contraceptive; and a male contraceptive. Some obstacles to their development include difficulties in obtaining adequate quantities of the herbs, a shortage of clinical pharmacologists and clinicians interested in conducting clinical trials, and lack of long-term financial support. PMID:8241931

Chaudhury, R R

1993-01-01

305

Ulipristal acetate: the newest emergency contraceptive.  

PubMed

More than 50 percent of pregnancies in the United States are unplanned. Emergency contraception has been shown to possibly reduce the risk of pregnancy by as much as 75 percent. Ulipristal acetate is a selective progesterone receptor modulator that was approved by the U.S. Food and Drug Administration (FDA) for emergency contraceptive use in August 2010. This article reviews information on its mechanism of action, efficacy, safety and implications for women's health nurses. PMID:22900810

Wilton, Jeanne M

2012-01-01

306

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. PMID:20864007

Yee, Lynn M.; Simon, Melissa

2010-01-01

307

Counseling and provision of long-acting reversible contraception in the US: National survey of nurse practitioners  

PubMed Central

Objective Nurse practitioners (NPs) provide frontline care in women’s health, including contraception, an essential preventive service. Their importance for contraceptive care will grow, with healthcare reforms focused on affordable primary care. This study assessed practice and training needs to prepare NPs to offer high-efficacy contraceptives - IUDs and implants. Method A US nationally representative sample of nurse practitioners in primary care and women’s health was surveyed in 2009 (response rate 69%, n=586) to assess clinician knowledge and practices, guided by the CDC US Medical Eligibility Criteria for Contraceptive Use. Results Two-thirds of women’s health NPs (66%) were trained in IUD insertions, compared to 12% of primary care NPs. Contraceptive counseling that routinely included IUDs was low overall (43%). Nurse practitioners used overly restrictive patient eligibility criteria, inconsistent with CDC guidelines. Insertion training (aOR=2.4, 95%CI: 1.10 5.33) and knowledge of patient eligibility (aOR=2.9, 95%CI: 1.91 4.32) were associated with IUD provision. Contraceptive implant provision was low: 42% of NPs in women’s health and 10% in primary care . Half of NPs desired training in these methods. Conclusion Nurse practitioners have an increasingly important position in addressing high unintended pregnancy in the U.S., but require specific training in long-acting reversible contraceptives. PMID:24128950

Harper, Cynthia C.; Stratton, Laura; Raine, Tina R.; Thompson, Kirsten; Henderson, Jillian T.; Blum, Maya; Postlethwaite, Debbie; Speidel, J Joseph

2013-01-01

308

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. PMID:21631913

2011-01-01

309

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. PMID:24884539

2014-01-01

310

Use of hormonal contraceptives among immigrant and native women in Norway: data from the Norwegian Prescription Database  

PubMed Central

Objective To examine the use of hormonal contraceptives among immigrant and native women in Norway. Design Nationwide registry-based study based on merged data from the Norwegian Prescription Database, the Norwegian Population Registry, the Regular General Practitioner Database and the Medical Birth Registry. Setting Norway. Sample All women born abroad to two foreign-born parents (immigrants), or born in Norway to two Norwegian-born parents (natives) aged 16–45 years, who lived in Norway in 2008. Methods Data on all collected supplies of hormonal contraceptives in 2008 were merged with demographic, socio-economic and immigration data, information on any delivery and women's general practitioners. Main outcome measures User rates of hormonal contraception and predictors of contraceptive use. Results A total of 893 073 women were included, of whom 130 080 were immigrants. More native women (38%) used hormonal contraceptives compared with all immigrant groups (15–24%). The odds ratios for any use of hormonal contraceptives for immigrants compared with Norwegian-born women were; Nordic countries 0.53, South and Central America 0.53, Western countries 0.39, Asia 0.30, Eastern Europe 0.29, Africa 0.29. Work, education, long stay in Norway and young age of immigration predicted the use of hormonal contraceptives among immigrants. Conclusions The use of hormonal contraceptives varies between natives and immigrant groups. Further work is needed to ascertain whether these differences can be explained by higher desires for fertility, preferential use of non-hormonal contraceptives or other reasons identified through qualitative research. PMID:24931487

Omland, G; Ruths, S; Diaz, E

2014-01-01

311

A Randomized Controlled Trial to Promote Long-Term Contraceptive Use Among HIV-Serodiscordant and Concordant Positive Couples in Zambia  

PubMed Central

Abstract Background Countries facing high HIV prevalence often also experience high levels of fertility and low contraceptive use, suggesting high levels of unmet need for contraceptive services. In particular, the unique needs of couples with one or both partners HIV positive are largely missing from many current family planning efforts, which focus on the prevention of pregnancies in the absence of reduction of the risk of HIV and other sexually transmitted infections (STIs). Methods This article presents an examination of contraceptive method uptake among a cohort of HIV serodiscordant and concordant positive study participants in Zambia. Results Baseline contraceptive use was low; however, exposure to a video-based intervention that provided information on contraceptive methods and modeled desirable future planning behaviors dramatically increased the uptake of modern contraceptive methods. Conclusions Including information on family planning in voluntary counseling and testing (VCT) services in addition to tailoring the delivery of family planning information to meet the needs and concerns of HIV-positive women or those with HIV-positive partners is an essential step in the delivery of services and prevention efforts to reduce the transmission of HIV. Family planning and HIV prevention programs should integrate counseling on dual method use, combining condoms for HIV/STI prevention with a long-acting contraceptive for added protection against unplanned pregnancy. PMID:21410332

Vwalika, Bellington; Greenberg, Lauren; Ahmed, Yusuf; Vwalika, Cheswa; Chomba, Elwyn; Kilembe, William; Tichacek, Amanda; Allen, Susan

2011-01-01

312

"El Sexo no es Malo": Maternal Values Accompanying Contraceptive Use Advice to Young Latina Adolescent Daughters.  

PubMed

In this study, we utilized observational methods to identify maternal values and concerns accompanying contraceptive use advice in Latina mother-daughter sexuality conversations. The sample included non-sexually active early adolescents around 12 years of age and their mostly Spanish-speaking Latina mothers. Videotaped conversations were coded for the prevalence of messages related to four sexual values (abstinence, delay sex until older, sex is "normal", sex is "improper") and concerns about pregnancy and STD transmission. We examined whether the duration of time spent conversing about these messages was associated with participant characteristics, general communication openness, and the amount of time the dyads spent discussing contraceptive use. Results indicated that Latina mothers who had fewer years of education and lower family income talked longer to their daughters about the need to delay sex, avoid risky situations that would increase their chances of getting pregnant or acquiring an STD, and engage in self-protective practices. Less perceived openness in general communication as reported by both the mothers and the daughters was associated with increased time discussing that sex is improper. Although the duration of contraceptive use messages was brief, mothers and daughters who discussed the fact that sex is normal, and who communicated more about the importance of delaying sex, talked longer about contraceptive use practices compared to mothers and daughters who engaged in minimal discussion of these sexual values. PMID:20543876

Romo, Laura F; Bravo, Magali; Cruz, Maria Elena; Rios, Rebeca M; Kouyoumdjian, Claudia

2010-06-01

313

“El Sexo no es Malo”: Maternal Values Accompanying Contraceptive Use Advice to Young Latina Adolescent Daughters  

E-print Network

Abstract In this study, we utilized observational methods to identify maternal values and concerns accompanying contraceptive use advice in Latina mother–daughter sexuality conversations. The sample included non-sexually active early adolescents around 12 years of age and their mostly Spanish-speaking Latina mothers. Videotaped conversations were coded for the prevalence of messages related to four sexual values (abstinence, delay sex until older, sex is “normal”, sex is “improper”) and concerns about pregnancy and STD transmission. We examined whether the duration of time spent conversing about these messages was associated with participant characteristics, general communication openness, and the amount of time the dyads spent discussing contraceptive use. Results indicated that Latina mothers who had fewer years of education and lower family income talked longer to their daughters about the need to delay sex, avoid risky situations that would increase their chances of getting pregnant or acquiring an STD, and engage in self-protective practices. Less perceived openness in general communication as reported by both the mothers and the daughters was associated with increased time discussing that sex is improper. Although the duration of contraceptive use messages was brief, mothers and daughters who discussed the fact that sex is normal, and who communicated more about the importance of delaying sex, talked longer about contraceptive use practices compared to mothers and daughters who engaged in minimal discussion of these sexual values.

Laura F. Romo; Magali Bravo; Maria Elena Cruz; Rebeca M. Rios; Claudia Kouyoumdjian; C. Kouyoumdjian

2010-01-01

314

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. PMID:24015872

2013-01-01

315

Oral contraceptive hypertension and thromboembolism.  

PubMed

Oral contraceptives (OCs) are a highly effective and widely accepted means of avoiding pregnancy, but they also worsen the major atherogenic cardiovascular risk factors to some degree in all women. Some OC users may suffer severe hypertensive episodes or massive hypertriglyceridemia with pancreatitis. Mild or severe adverse effects could eventually have serious consequences beyond the childbearing years. OC use would appear imprudent for women with a history of hypertension, gestational hypertension and a family history of hypertension. Special care is needed with blacks, diabetics and women with renal disease. OCs may also affect blood clotting, fibrinolysis and platelet adhesiveness. Also, histochemical and anatomical changes in blood vessels have been noted. Both may precipitate thromboembolic events while the OC user is still at the childbearing age and may also contribute to accelerated atherogenesis in subsequent years. There is a need for more specific guidelines for monitoring women on OCs for a worsening of their cardiovascular risk profile and changes in blood coagulation. Indications and contraindications for OC use in relation to the hazard of thromboembolic sequelae need to be more explicitly defined. PMID:39810

Kannel, W B

316

Emergency contraception -- mechanisms of action.  

PubMed

Concerns regarding the mechanisms of action of emergency contraception (EC) create major barriers to widespread use and could also lead to incorrect use of EC and overestimation of its effectiveness. While the copper intrauterine device (Cu-IUD) is the most effective method available for EC, the hormonal methods are frequently considered to be more convenient and acceptable. Today, the most commonly used method for hormonal EC is levonorgestrel (LNG). More recently, the progesterone receptor modulator ulipristal acetate (UPA) has been shown to be more effective than LNG to prevent an unwanted pregnancy. The main mechanism of action of both LNG and UPA for EC is delaying or inhibiting ovulation. However, UPA appears to have a direct inhibitory effect on follicular rupture which allows it to be effective even when administered shortly before ovulation, a time period when use of LNG is no longer effective. The main mechanism of action of the Cu-IUD is to prevent fertilization through the effect of Cu ions on sperm function. In addition, if fertilization has already occurred, Cu ions influence the female reproductive tract and prevent endometrial receptivity. Based on this review of the published literature, it can be concluded that existing methods used today for EC act mainly through inhibition of ovulation or prevention of fertilization. An additional effect on the endometrium as occurs for the Cu-IUD, but not for the hormonal alternatives, seems to increase the efficacy of the method. PMID:23114735

Gemzell-Danielsson, Kristina; Berger, Cecilia; P G L, Lalitkumar

2013-03-01

317

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.

318

Counseling on contraceptives: an unfilled need.  

PubMed

The dictum that pharmacists have a fundamental responsibility to provide health care information for their patients includes the need to furnish complete and accurate information on all of the contraceptive products that currently are on the market. To help accomplish this, many different resources are available that provide guidance for comprehensive patient education on all the different products and devices. If one agrees to the principle that an individual's sexuality is an accepted element of his or her life, then promoting sexual well-being should be an important part of health care. Yet, it seems that pharmacists and other health care professionals in general have not been particularly liberated about talking about and making objective assessments on sexual matters. Health care professionals seem to need more education to enable them to provide accurate information, to augment their own knowledge bases, and to reduce their inhibitions and possible misconceptions about sexual matters. Pharmacists do not want to appear as if they are encouraging or promoting sexual activity, but, given the consequences of nonuse of contraception, socially responsible pharmacists need to disseminate basic information about the use of contraceptive products. At some level, too, objective guidelines should be established to help pharmacists in handling contraceptive information. Pharmacists can play a key role in counseling on both prescription and nonprescription methods. In fact, pharmacists may be the only health care professionals with whom a sexually active person can speak about nonprescription contraceptive methods. Some pharmacists have been reluctant to provide patient information because of the risk of possible liability. But this attitude seems to be changing. The recent emphasis on clinical functions in pharmacy practice has led to speculation that, as pharmacists come to assume new roles, they may become liable for not providing some of this information. At present, at least 22 states already have guidelines or regulations requiring pharmacists to counsel patients. To provide the most effective learning experience, active participation is the key ingredient. It is necessary to elicit active participation in the counseling process. It is not possible to give complete guidance on the subject of contraceptives to every patient that comes in the store. Nor is every person going to be receptive, at least initially, to the idea of talking about contraception with a pharmacist. Yet, the role of the pharmacist takes on greater significance now because of the controversy that continues to surround some of the safety and efficacy issues of oral contraceptives and IUDs. Brochures and other materials are available to help pharmacists counsel patients on all of the different contraceptive methods. PMID:4050672

Steadman, S

1985-09-01

319

Age-Related Bone Mineral Density, Accumulated Bone Loss Rate and Prevalence of Osteoporosis at Multiple Skeletal Sites in Chinese Women  

Microsoft Academic Search

:   We investigated the age-related bone mineral density (BMD), accumulated bone loss rate (ABLR) and the prevalence of osteoporosis\\u000a at different skeletal sites in Chinese women. BMD was measured at the anteroposterior (AP) spine, supine lateral spine (areal\\u000a BMD at the midarea [mLat] and the whole region [Lat], volumetric BMD at the middle region [MVD] and total region [TVD]), hip

Er-Yuan Liao; Xian-Ping Wu; Xiao-Ge Deng; Gan Huang; Xu-Ping Zhu; Zhao-Feng Long; Wen-Bo Wang; Wei-Li Tang; Hong Zhang

2002-01-01

320

Age-Related Bone Mineral Density, Bone Loss Rate, Prevalence of Osteoporosis, and Reference Database of Women at Multiple Centers in China  

Microsoft Academic Search

Our study surveyed age-related bone mineral density (BMD), bone loss rate, and prevalence of osteoporosis in women at multiple research centers in China. Survey results were used to establish a BMD reference database for the diagnosis of osteoporosis in Chinese women nationwide. We used dual-energy X-ray absorptiometry bone densitometers to measure BMD at posteroanterior (PA) lumbar spine (L1–L4; n=8142) and

Xiao-Guang Cheng; Ding-Zhuo Yang; Qi Zhou; Tie-Jun Zhuo; Hua-Chou Zhang; Jing Xiang; Hong-Fu Wang; Ping-Zhong Ou; Jian-Li Liu; Ling Xu; Gong-Yi Huang; Qi-Ren Huang; Howard S. Barden; Linda S. Weynand; Ken G. Faulkner; Xun-Wu Meng

2007-01-01

321

Adolescent girls' attitudes toward contraceptive subdermal implants.  

PubMed

Norplant, which has been shown to be a highly effective and acceptable contraceptive for adult women, may also be a very useful contraceptive for adolescents. This study is designed to determine the level of interest in Norplant for adolescent girls with and without children, their attitudes toward various features of Norplant, and the demographic and psychosocial factors predictive of their interest. A self-administered questionnaire was given to 112 adolescents attending our pediatric or adolescent clinic. Data from 28 adolescent mothers and 79 nulliparous adolescents were analyzed. Fifty-six percent of the subjects had heard of Norplant prior to the survey. The overall level of interest in Norplant was high; 70% of the adolescents without children, and 79% of the adolescent mothers were interested. In comparison to oral contraceptives, 73% of those without children and 89% of those with children thought Norplant would be a better contraceptive. The specific features of Norplant liked by 87% and 81% of the subjects, respectively, were not needing to take pills every day and its effectiveness in preventing pregnancy. The characteristics seen as most undesirable related to potential side effects with acne being mentioned by 87% of the subjects. Recursive partitioning analysis demonstrates that more than one prior pregnancy was the main characteristic predictive of very high levels of interest. In summary, this study demonstrates high levels of interest in Norplant by adolescents and suggests that it should be offered as a contraceptive option, especially to those girls who have previously been pregnant. PMID:7662685

Dabrow, S M; Merrick, C L; Conlon, M

1995-05-01

322

Prevalence and Correlates of Self-Rated Posttraumatic Stress Disorder and Complicated Grief in a Community-Based Sample of Homicidally Bereaved Individuals.  

PubMed

People confronted with homicidal loss have to cope with separation distress, related to their loss, and traumatic distress, associated with the circumstances surrounding the death. These reactions are related to complicated grief (CG) and posttraumatic stress disorder (PTSD). The psychological effects for people who have lost someone through homicide, in terms of PTSD and CG, are largely unclear. This cross-sectional study (a) examined the prevalence of self-rated PTSD and self-rated CG in a community-based sample of 312 spouses, family members, and friends of homicide victims and (b) aimed to identify socio-demographic, loss-related, and perpetrator-related correlates of PTSD and CG. Participants were recruited via support organizations for homicidally bereaved individuals in the Netherlands (i.e., support group), and by casemanagers of a governmental organization, which offers practical, non-psychological, support to bereaved families (i.e., casemanager group). Prevalence of self-rated PTSD was 30.9% (support group) and 37.5% (casemanager group), prevalence of CG was 82.7% (support group) and 80.6% (casemanager group). PTSD and CG severity scores varied as a function of the relationship with the victim; parents were at greater risk to develop emotional problems, compared with other relatives of the victim. Time since loss was negatively associated with PTSD and CG scores. PMID:25389188

van Denderen, Mariëtte; de Keijser, Jos; Huisman, Mark; Boelen, Paul A

2014-11-10

323

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

PubMed

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. PMID:8956712

Thompson, M S

1996-11-30

324

Pharmacokinetics and pharmacodynamics of a transdermal contraceptive patch and an oral contraceptive.  

PubMed

This open-label, randomized, 2-way crossover study characterized the pharmacokinetics and pharmacodynamics of a transdermal contraceptive patch and a norgestimate-containing oral contraceptive. Healthy women (n = 34) applied a patch once weekly for 3 consecutive weeks during each of 2 cycles and received an oral contraceptive for 21 consecutive days during each of 2 cycles. Plasma concentrations of norelgestromin and ethinyl estradiol peaked and waned after daily oral contraceptive administration, whereas they rose and reached steady-state levels after first patch application. Norelgestromin exposure was similar; ethinyl estradiol exposure was higher for the patch than oral contraceptive. Hepatic estrogenic activity, assessed by hepatic globulin synthesis, was similar for corticosteroid-binding globulin and corticosteroid-binding globulin-binding capacity and higher for sex hormone-binding globulin for the patch versus oral contraceptive. The clinical significance of the differences in pharmacokinetic and pharmacodynamic profiles between the patch and oral contraceptive is not fully known. No serious adverse events or discontinuations due to adverse events were recorded. PMID:17389559

Devineni, Damayanthi; Skee, Donna; Vaccaro, Nicole; Massarella, Joseph; Janssens, Luc; LaGuardia, Katherine D; Leung, Albert T

2007-04-01

325

A Higher Prevalence Rate of Campylobacter in Retail Beef Livers Compared to Other Beef and Pork Meat Cuts  

PubMed Central

The objectives of this study were to determine the prevalence of Campylobacter jejuni and Campylobacter coli in retail beef, beef livers, and pork meats purchased from the Tulsa (OK, USA) area and to further characterize the isolates obtained through antimicrobial susceptibility testing. A total of 97 chilled retail beef (50 beef livers and 47 other cuts), and 100 pork samples were collected. The prevalence of Campylobacter in beef livers was 39/50 (78%), while no Campylobacter was isolated from the other beef cuts. The prevalence in pork samples was 2/100 (2%). A total of 108 Campylobacter isolates (102 beef livers isolates and six pork isolates) were subjected to antimicrobial resistance profiling against sixteen different antimicrobials that belong to eight different antibiotic classes. Of the six pork Campylobacter coli isolates, four showed resistance to all antimicrobials tested. Among the beef liver isolates, the highest antibiotic resistances were to tetracyclines and ?-lactams, while the lowest resistances were to macrolides, aminoglycosides, lincosamides, and phenicols. Resistances to the fluoroquinolone, macrolide, aminoglycoside, tetracycline, ?-lactam, lincosamide, and phenicol antibiotic classes were significantly higher in Campylobacter coli than Campylobacter jejuni isolates. Multidrug Resistance (MDR) among the 102 Campylobacter (33 Campylobacter jejuni and 69 Campylobacter coli) beef liver isolates was significantly higher in Campylobacter coli (62%) than Campylobacter jejuni (39%). The high prevalence of Campylobacter in retail beef livers and their antimicrobial resistance raise concern about the safety of these retail products. PMID:23698698

Noormohamed, Aneesa; Fakhr, Mohamed K.

2013-01-01

326

A higher prevalence rate of Campylobacter in retail beef livers compared to other beef and pork meat cuts.  

PubMed

The objectives of this study were to determine the prevalence of Campylobacter jejuni and Campylobacter coli in retail beef, beef livers, and pork meats purchased from the Tulsa (OK, USA) area and to further characterize the isolates obtained through antimicrobial susceptibility testing. A total of 97 chilled retail beef (50 beef livers and 47 other cuts), and 100 pork samples were collected. The prevalence of Campylobacter in beef livers was 39/50 (78%), while no Campylobacter was isolated from the other beef cuts. The prevalence in pork samples was 2/100 (2%). A total of 108 Campylobacter isolates (102 beef livers isolates and six pork isolates) were subjected to antimicrobial resistance profiling against sixteen different antimicrobials that belong to eight different antibiotic classes. Of the six pork Campylobacter coli isolates, four showed resistance to all antimicrobials tested. Among the beef liver isolates, the highest antibiotic resistances were to tetracyclines and ?-lactams, while the lowest resistances were to macrolides, aminoglycosides, lincosamides, and phenicols. Resistances to the fluoroquinolone, macrolide, aminoglycoside, tetracycline, b-lactam, lincosamide, and phenicol antibiotic classes were significantly higher in Campylobacter coli than Campylobacter jejuni isolates. Multidrug Resistance (MDR) among the 102 Campylobacter (33 Campylobacter jejuni and 69 Campylobacter coli) beef liver isolates was significantly higher in Campylobacter coli (62%) than Campylobacter jejuni (39%). The high prevalence of Campylobacter in retail beef livers and their antimicrobial resistance raise concern about the safety of these retail products. PMID:23698698

Noormohamed, Aneesa; Fakhr, Mohamed K

2013-05-01

327

Preparing Daughters: The Context of Rurality on Mothers' Role in Contraception  

ERIC Educational Resources Information Center

Context: The United States continues to have the highest rate of adolescent childbearing among developed countries. Lack of access and disadvantage contribute to this problem, which disproportionately impacts rural women. Given the increased difficulty rural young women face regarding contraceptive access, parental communication and support play…

Noone, Joanne; Young, Heather M.

2009-01-01

328

HEALTH MATTERS Dispelling Common Myths About Intrauterine Contraception  

E-print Network

HEALTH MATTERS Dispelling Common Myths About Intrauterine Contraception Many women think of "the that's best for you and your lifestyle. Intrauterine contraception (IUC) is a convenient birth control if you think IUC might be right for you. What Is Intrauterine Contraception? If you choose to use IUC

Yener, Aylin

329

Contraceptive Availability During an Emergency Response in the United States  

PubMed Central

This article provides the evidence for contraceptive need to prevent unintended pregnancy during an emergency response, discusses the most appropriate types of contraceptives for disaster situations, and details the current provisions in place to provide contraceptives during an emergency response. PMID:23421580

Ellington, Sascha R; Kourtis, Athena P; Curtis, Kathryn M; Tepper, Naomi; Gorman, Susan; Jamieson, Denise J; Zotti, Marianne; Barfield, Wanda

2015-01-01

330

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. PMID:24897300

OlaOlorun, Funmilola M.; Hindin, Michelle J.

2014-01-01

331

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

PubMed Central

Background Migrant 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 Chinese women were over-represented among abortion clinic attendees. Methods Retrospective review of medical records at a public hospital abortion clinic involving 305 Chinese women. Previously collected data for European (n?=?277) and Maori women (n?=?128) were used for comparative analyses. Regression analyses explored correlates of contraceptive method choice. Population census data were used to calculate rates of clinic attendance across ethnic groups. Results Chinese women were not over-represented among clinic attendees, and had similar rates of contraceptive non-use pre-abortion as women in comparison groups. Use of the oral contraceptive pill by Chinese was lower pre-abortion than for other ethnic groups, but choice of this method post-abortion was similar for Chinese (46.9%, 95% CI 41–52.7) and European women (43.7%, 95% CI 37.8–49.7). Post-abortion choice of an intrauterine device did not differ significantly between Chinese (28.9%, 95% CI 23.8–34.3) and Maori women (37%, 95% CI 28.4–45.7), but was higher than uptake of this method by European women (21.7%, 95% CI 17–27.0). Age, parity and previous abortion were significant predictors of post-abortion method choice by Chinese women (p<0.05). Conclusions Following contraceptive counseling at the clinic, Chinese women chose more effective contraceptive methods for use post-abortion than they had used previously. As the population of migrant Chinese in New Zealand continues to increase, strategies are urgently needed to provide new arrivals with appropriate information and advice about contraception and where to access it, so women can be better prepared to avoid unplanned pregnancy. PMID:22768231

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

2012-01-01

332

Hormonal contraceptives and travel to high altitude.  

PubMed

Keyes, Linda E. Hormonal contraceptives and travel to high altitude. High Alt Med Biol 16:7-10, 2015-Women frequently ask about the safety and efficacy of using hormonal contraception (HC), either oral contraceptive pills (OC) or other forms, when traveling to high altitude locales. What are the risks and benefits of using HC at high altitude? Does HC affect acclimatization, exercise performance, or occurrence of acute mountain sickness? This article reviews current data regarding the risks and benefits of HC at high altitude, both demonstrated and theoretical, with the aim of helping health care providers to advise women traveling above 2500 meters. Most healthy women can safely use HC when traveling to high altitude, but should be aware of the potential risks and inconveniences. PMID:25759908

Keyes, Linda E

2015-03-01

333

Ulipristal acetate: a new emergency contraceptive.  

PubMed

Ulipristal acetate (UPA) is a newly developed emergency contraceptive currently available in the USA and Europe. It is approved as a 30 mg one-time dose taken within 120 h (5 days) of unprotected intercourse or failed contraception. This selective progesterone receptor modulator appears to be more effective than the levonorgestrel-containing emergency contraceptive, which must be taken within 72 h of unprotected intercourse. According to pharmacodynamic trials, UPA delays follicular maturation and ovulation. In addition, UPA may modulate the endometrium. Both Phase III clinical trials found that UPA does not lose efficacy within the 120-h dosing interval. Throughout all phases of clinical studies, UPA was shown to be well tolerated with only minimal adverse drug reactions, all of which are similar to competitor therapies. PMID:22114852

Sullivan, Jade L; Bulloch, Marilyn N

2011-07-01

334

Induced abortion and contraception use  

PubMed Central

Abstract Objective To determine what proportion of women seeking induced abortion in the Calgary census metropolitan area were immigrants. Design For 2 months, eligible women were asked to complete a questionnaire. Women who refused were asked to provide their country of birth (COB) to assess for selection bias. Setting Two abortion clinics in Calgary, Alta. Participants Women presenting at or less than 15 weeks’ gestational age for induced abortion for maternal indications. Main outcome measures The primary outcome was the proportion of women seeking induced abortion services who were immigrants. Secondary outcomes compared socioeconomic characteristics and contraception use between immigrant and Canadian-born women. Results A total of 752 women either completed a questionnaire (78.6%) or provided their COB (21.4%). Overall, 28.9% of women living in the Calgary census metropolitan area who completed the questionnaire were immigrants, less than the 31.2% background proportion of immigrant women of childbearing age. However, 46.0% of women who provided only COB were immigrants. When these data were combined, 34.2% of women presenting for induced abortion identified as immigrant, a proportion not significantly different from the background proportion (P = .127). Immigrant women presenting for induced abortion tended to be older, more educated, married with children, and have increased parity. They were similar to Canadian-born women in number of previous abortions, income status, and employment status. Conclusion This study suggests that immigrant women in Calgary are not presenting for induced abortion in disproportionately higher numbers, which differs from existing European literature. This is likely owing to differing socioeconomic characteristics among the immigrant women in our study from what have been previously described in the literature (typically lower socioeconomic status). Much still needs to be explored with regard to factors influencing the use of abortion services by immigrant women. PMID:25217694

du Prey, Beatrice; Talavlikar, Rachel; Mangat, Rupinder; Freiheit, Elizabeth A.; Drummond, Neil

2014-01-01

335

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. PMID:24405890

2014-01-01

336

Social marketing of contraceptives in Bangladesh.  

PubMed

Since 1975 there has been a family planning program operating in Bangladesh which advertises and commercially distributes contraceptive products in both rural and urban areas throughout the country. The program, known as the Social Marketing Project (SMP) and managed by Population Services International (PSI), now serves almost 1 million acceptors per month at an annual cost per couple of less than US$6.50, including the cost of donated contraceptives. This paper looks at the evolution of the project and its growth through the years, and addresses some primary concerns of planners of social marketing programs. PMID:6701953

Schellstede, W P; Ciszewski, R L

1984-01-01

337

Impact of Pay for Performance on Prescribing of Long-Acting Reversible Contraception in Primary Care: An Interrupted Time Series Study  

PubMed Central

Background The aim of this study was to evaluate the impact of Quality and Outcomes Framework (QOF), a major pay-for-performance programme in the United Kingdom, on prescribing of long-acting reversible contraceptives (LARC) in primary care. Methods Negative binomial interrupted time series analysis using practice level prescribing data from April 2007 to March 2012. The main outcome measure was the prescribing rate of long-acting reversible contraceptives (LARC), including hormonal and non hormonal intrauterine devices and systems (IUDs and IUSs), injectable contraceptives and hormonal implants. Results Prescribing rates of Long-Acting Reversible Contraception (LARC) were stable before the introduction of contraceptive targets to the QOF and increased afterwards by 4% annually (rate ratios ?=?1.04, 95% CI?=?1.03, 1.06). The increase in LARC prescribing was mainly driven by increases in injectables (increased by 6% annually), which was the most commonly prescribed LARC method. Of other types of LARC, the QOF indicator was associated with a step increase of 20% in implant prescribing (RR?=? 1.20, 95% CI?=? 1.09, 1.32). This change is equivalent to an additional 110 thousand women being prescribed with LARC had QOF points not been introduced. Conclusions Pay for performance incentives for contraceptive counselling in primary care with women seeking contraceptive advice has increased uptake of LARC methods. PMID:24694949

Arrowsmith, Myat E.; Majeed, Azeem; Lee, John Tayu; Saxena, Sonia

2014-01-01

338

Knowledge, Attitude, Practice, and Determinants Emergency Contraceptive Use among Women Seeking Abortion Services in Dire Dawa, Ethiopia  

PubMed Central

Background Unplanned pregnancy from casual sex, unplanned sexual activity, and sexual violence are increasing. Emergency Contraceptives (EC) are used to prevent unplanned pregnancies thereby preventing the occurrence and consequences of unplanned pregnancy. Emergency contraception is widely available in Ethiopia particularly in major cities. Yet the use of EC is very low and abortion rate in cities is high compared to the national average. Objectives To assess knowledge, attitude and practice and determinants on the use of emergency contraception among women obtaining abortion service at selected health institutions in Dire Dawa, Eastern Ethiopia. Methods A facility based cross-sectional study was conducted on 390 women selected by multi-stage random sampling technique. The samples were generated from government and private for non profit health facilities. Participant’s knowledge and attitude towards emergency contraception were measured using composite index based on 7 and 9 questions, respectively and analyzed using mean score to classify them as knowledgeable or not, and have positive attitude or not. Practice was assessed if the women reported ever use of emergency contraception. Determinants of use of emergency contraception were analyzed using logistic regression. Result Out of 390 women interviewed, 162 women (41.5%) heard about EC, only 133 (34.1%) had good knowledge, and 200 (51.3%) of the respondents had positive attitudes towards to EC. Ever use of EC was reported by 38 (9.7%). Age, living arrangement, education, marital status, religion were found to be significantly associated with the use of emergency contraceptives. Women with poor knowledge were less likely to use EC compared to the knowledgeable ones [AOR?=?0.027, 95% CI (0.007, 0.105)]. Conclusion The study identified that most respondents lack adequate knowledge on the method of EC. In addition ever use of EC is very low. Recommendations Health professions should give attention in increasing knowledge and uptake of Emergency Contraception. PMID:25330229

Abate, Meskerem; Assefa, Nega; Alemayehu, Tadesse

2014-01-01

339

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

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. PMID:24602452

2014-01-01

341

Contraception for Men: A Breakthrough New Approach  

PubMed Central

There has not been a new reversible contraceptive for men since the development of the condom, centuries ago. Matzuk et al. describe a new molecular approach using administration of a small molecule to directly and reversibly inhibit spermatogenesis in mice by blocking the function of a testicular bromodomain without apparent adverse effect on the organism or offspring. PMID:22901799

Bremner, William J.

2014-01-01

342

Long-acting hormonal contraceptives for women.  

PubMed

Following the development and widespread use of oral hormonal contraceptives, it became evident that alternative long-acting delivery systems would be required to improve contraceptive practice in some cultural settings where injectable or subdermal routes of administration are preferred. Nowadays, long-acting contraceptives constitute an important option in family planning services in many parts of the world. Indeed, two long-acting injectable contraceptives containing just a synthetic progestogen (depot-medroxyprogesterone acetate (DMPA) and norethisterone enantate (NET-EN)) have been in clinical practice for more than 20 years. The World Health Organization's (WHO) Special Programme of Research in Human Reproduction, in collaboration with the U.S. National Institute of Child Health and Human Development (NICHD) and universities primarily in developing countries undertook a synthesis programme aimed at producing an improved injectable preparation by developing new derivatives of known steroids. One such compound (levonorgestrel 17-butanoate) is now at the stage of Phase II clinical testing. In addition, the Special Programme has developed and improved once-a-month injectable formulations and assessed their safety and efficacy in different countries worldwide. After large scale clinical testing, at least two progestogen-estrogen combinations have reached the point of introductory trials. PMID:1958567

Garza-Flores, J; Hall, P E; Perez-Palacios, G

1991-01-01

343

Eppin: a molecular strategy for male contraception.  

PubMed

New male contraceptives, both hormonal and non-hormonal, have many obstacles to overcome before they reach the market as a product. For hormonal contraceptives the long-term efficacy of oligospermia in a large population of unselected men remains to be determined. For nonhormonal contraception target selection remains a primary goal. Immunocontraception, which showed great promise for many years, has recently lost its appeal. Nevertheless, immunocontraception can be utilised as a strategy, particularly in primates, to discern the function of target molecules in the male. As an example, we discuss Eppin, an epididymal protease inhibitor that coats the surface of human spermatozoa. Because Eppin is predicted to be a serine protease inhibitor with chymotrypsin-like specificity and binds semenogelin, the natural substrate of PSA (prostate specific antigen, a serine protease), we investigated whether Eppin would modulate PSA activity and the hydrolysis of semenogelin. Additionally, because antibodies to Eppin provide contraception in male monkeys, we investigated whether antibodies to Eppin would inhibit the PSA hydrolysis of semenogelin. Eppin is a specific inhibitor of PSA activity that requires leucine 87, Eppin's P1 reactive site. Although Eppin modulates the hydrolysis of semenogelin by PSA, antibodies to Eppin do not inhibit PSA activity. PMID:17644992

Wang, Zengjun; Widgren, E E; Richardson, R T; Orand, M G

2007-01-01

344

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

345

Roles of the pharmacist in the use of safe and highly effective long-acting reversible contraception: an opinion of the women's health practice and research network of the American College of Clinical Pharmacy.  

PubMed

The U.S. population continues to experience an alarmingly high rate of unintended pregnancies that have an impact on individual families and society alike. Lack of effective contraception accounts for most unintended pregnancies, along with incorrect use of contraceptives. The most common reversible contraceptive method used in the United States is the oral contraceptive pill, which has significant failure and discontinuation rates. Use of long-acting reversible contraceptive (LARC) methods has been increasing in recent years after efforts to educate providers and patients. Women are more likely to use LARC methods when barriers such as access and cost are removed. An uptake in the use of LARC methods would allow for markedly reduced contraception failure rates and higher user satisfaction and thus higher continuation rates than those seen with current contraception use. Promoting the use of LARC methods is an important strategy in improving both individual and public health outcomes by reducing unintended pregnancies. The pharmacist's role in family planning is expanding and can contribute to these efforts. Although knowledge regarding LARC has not been studied among pharmacists, a knowledge deficit exists among health care professionals in general. Thus pharmacist education and training should include LARC methods along with other contraceptives. The American College of Clinical Pharmacy Women's Health Practice and Research Network advocates for the pharmacist's role in the use of safe and highly effective LARC methods. These roles include educating patients, informing providers, facilitating access by providing referrals, and modifying institutional procedures to encourage provision of LARC methods. PMID:24989020

Rafie, Sally; McIntosh, Jennifer; Shealy, Kayce M; Borgelt, Laura M; Forinash, Alicia; Shrader, Sarah P; Koepf, Erin R; McClendon, Katie S; Griffin, Brooke L; Horlen, Cheryl; Karaoui, Lamis R; Rowe, Emily L; Lodise, Nicole M; Wigle, Patricia R

2014-09-01

346

Effectiveness of emergency contraception in women after sexual assault  

PubMed Central

Objective To assess the effectiveness of emergency single-dose levonorgestrel contraception in preventing unintended pregnancies among woman who visited the emergency department (ED) due to sexual assault (SA). Methods We conducted a retrospective chart review in a university hospital in South Korea. Cases from November 10, 2006 to November 9, 2009 were enrolled. Information from the initial visit to the ED and subsequent follow-up visits to the gynecology outpatient clinic was collected. Results In total, 1,179 women visited the ED due to SA. Among them, 416 patients had a gynecological examination and 302 patients who received emergency contraception (EC) (1.5 mg single-dose levonorgestrel) at the ED due to SA were enrolled. Ten patients did not return for follow-up examinations. In follow-up visits at the outpatient clinic, two pregnancies were confirmed, which showed the failure rate of the EC to be 0.68%. Conclusion Single-dose levonorgestrel EC is extremely effective at preventing pregnancy among victims of SA. PMID:24179870

Choi, Dong Seok; Hwang, Kyung Joo; Lee, Kyoung Mi; Kong, Tae Wook

2013-01-01

347

Use of traditional contraceptive methods in India & its socio-demographic determinants  

PubMed Central

Background & objectives: The high use of traditional contraceptive methods may have health repercussions on both partners. High failure rate, lack of protection from sexually transmitted diseases are some of the examples of these repercussions. The aim of this study was to understand the level, trends, pattern, volume and socio-demographic determinants of using traditional contraceptive methods in the Indian context. Methods: Percentages, per cent distribution, cross-tabulation and multinomial logistic regression analyses were carried out. The data from the three rounds of National Family Health Survey (NFHS) were used. The unit level District Level Household Survey (2007-2008) were mainly used to carry out the analysis in this paper. Marriage rates for States and Union Territories (UTs) were projected for the period of 2001-2011 to estimate the volume of traditional contraceptive users. These rates are required to get the number of eligible couples as on 2011 in the respective State/UT. Results: The latest round of the District Level Household Survey (2007-2008) revealed that 6.7 per cent currently married women were using traditional contraceptive methods in India. More than half of the currently married women (56%) have ever used these methods. In terms of socio-demographic determinants, the odds ratios of using these methods were significantly higher for women aged 35 years and above, rural, Hindu, other than Scheduled Castes/Tribes (SCs/STs), secondary and above educated, non-poor, having two plus living children, and at least one surviving son in most of the States as well as at the national level. The northeastern region showed higher odds ratios (5 times) of women using traditional contraceptive methods than the southern region. Interpretation & conclusions: A large number of currently married women have ever used the traditional contraceptive methods in India. On the basis of the findings from this study, the total size of those women who were using traditional methods and those who were having unmet need, and are required to use modern spacing methods of family planning in achieving the reproductive goals, is around 53 million. Women from a set of specific socio-demographic backgrounds are more likely to use these methods. A regional pattern has also emerged in use of tradition contraceptive methods in India. PMID:25673538

Ram, Faujdar; Shekhar, Chander; Chowdhury, Biswabandita

2014-01-01

348

Trends of Modern Contraceptive Use among Young Married Women Based on the 2000, 2005, and 2011 Ethiopian Demographic and Health Surveys: A Multivariate Decomposition Analysis  

PubMed Central

Introduction Accessing family planning can reduce a significant proportion of maternal, infant, and childhood deaths. In Ethiopia, use of modern contraceptive methods is low but it is increasing. This study aimed to analyze the trends and determinants of changes in modern contraceptive use over time among young married women in Ethiopia. Methods The study used data from the three Demographic Health Surveys conducted in Ethiopia, in 2000, 2005, and 2011. Young married women age 15–24 years with sample sizes of 2,157 in 2000, 1,904 in 2005, and 2,146 in 2011 were included. Logit-based decomposition analysis technique was used for analysis of factors contributing to the recent changes. STATA 12 was employed for data management and analyses. All calculations presented in this paper were weighted for the sampling probabilities and non-response. Complex sampling procedures were also considered during testing of statistical significance. Results Among young married women, modern contraceptive prevalence increased from 6% in 2000 to 16% in 2005 and to 36% in 2011. The decomposition analysis indicated that 34% of the overall change in modern contraceptive use was due to difference in women’s characteristics. Changes in the composition of young women’s characteristics according to age, educational status, religion, couple concordance on family size, and fertility preference were the major sources of this increase. Two-thirds of the increase in modern contraceptive use was due to difference in coefficients. Most importantly, the increase was due to change in contraceptive use behavior among the rural population (33%) and among Orthodox Christians (16%) and Protestants (4%). Conclusions Modern contraceptive use among young married women has showed a remarkable increase over the last decade in Ethiopia. Programmatic interventions targeting poor, younger (adolescent), illiterate, and Muslim women would help to maintain the increasing trend in modern contraceptive use. PMID:25635389

Worku, Abebaw Gebeyehu; Tessema, Gizachew Assefa; Zeleke, Atinkut Alamirrew

2015-01-01

349

[Contraception in adolescence: knowing is not enough].  

PubMed

Sexuality is the source of the biological, psychic, and social changes of adolescence. Contraception, by modifying some aspects of sexuality, can change the usual course of adolescence. Sexuality is a new experience for adolescents and is submerged in the same confusion and uncertainty as other areas of their lives. The experience of health personnel in contraception over the years has been gained in prescription for adults, who unlike adolescents are members of stable couples who have found their places in society. Women seeking contraception have usually experienced pregnancy and verified their fecundity, thereby consolidating their identities, unlike the adolescent who is still unsure of her femininity. Contraception for adolescents, by blocking 2 stages in the life of a woman (proving fecundity and experiencing maternity) is an obstacle to the total achievement of adulthood. The connection between sex and pregnancy is recognized by a 13-year-old in a theoretical way, but is not always integrated as a practical reality. Many adults have difficulty accepting the contraception requests of adolescents because they do not feel it is morally right for adolescents to have direct sexual experiences rather than daydreams. The reality of adolescent sexual lives is quite different from what most adults adults imagine it to be. Mental integration of contraception for an adolescent requires acceptance of the link between sex and pregnancy and a mental representation of oneself and one's behavior in which sexuality is considered a possibility. Many adolescents believe that they are too young to become pregnant, or are unable to make the link between sex today and pregnancy in the future, or do not perceive a possible pregnancy in negative terms. After they perceive the need for contraception and develop a desire to meet the need, adolescents must gain knowledge of the different methods available. Choice of a method will be influenced by the degree of efficacy of the method, its cost, facility of use, the frequency of intercourse, secondary effects, social or religious prohibitions, desire to keep contraceptive use secret, and the possibility of involving the partner. Failure to use the chosen means may be caused by such external factors as absence of a nearby family planning center or lack of money, or by internal factors. THe presence of an adult at the contraception consultation may be perceived by the adolescent as a means of control. The consultation may signify to the adolescent a demand for recognition of the reality of his affective and sexual life, a rite of passage, a means of transgressing parental prohibitions, and an indication of acceptance of the dissociation of sexuality from fertility. The presence of the girl's mother can complicate the consultation. Very often the health care professional confuses the role of parent with the medical role, feeling a moral responsibility beyond helping the adolescent avoid pregnancy or abortion. The best course is to be available to listen to the adolescent without prejudice in order to permit the establishment of room for reflection and maturation. PMID:3853915

Aman, M

1985-10-01

350

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. PMID:23137304

2012-01-01

351

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

352

Prevalence and early attack rate of tuberculosis among close family contacts of tuberculous patients in South India under domiciliary treatment with isoniazid plus PAS or isoniazid alone*  

PubMed Central

The authors present a report from the Tuberculosis Chemotherapy Centre, Madras, on the prevalence and attack rate of tuberculosis among close family contacts of tuberculous patients in South India undergoing domiciliary chemotherapy either with isoniazid plus PAS or with one of three regimens of isoniazid alone. The report gives (a) the prevalence of tuberculosis among the contacts at the time of diagnosis of the disease in the patients and (b) the incidence of tuberculosis in the contacts during the first year of treatment of the patients. The contacts were divided into four series, corresponding to the four chemotherapeutic regimens of the patients. The prevalence of active tuberculosis was found to be particularly high among children under five years of age, being 12.0% as compared with 7.6% for all age-groups combined. The incidence of active tuberculosis during the year of treatment of the patients was also found to be highest in the under five years' age-group—a further indication that child contacts are especially vulnerable to infection. The incidence was considerably higher in the first quarter of the year than in the other quarters, and it was lowest in the last quarter. This finding, together with the fact that the attack rates in the four contact series were not related either to the duration of bacteriological positivity in the patients or to the period of excretion of isoniazid-resistant organisms by the patients, suggests that the major risk to contacts in the first year results from exposure to the patient before treatment rather than from exposure during treatment. These results thus confirm the findings in an earlier study by the Centre of the contacts of patients in a controlled comparison of chemotherapy with isoniazid plus PAS at home and in sanatorium. PMID:14038589

Ramakrishnan, C. V.; Andrews, R. H.; Devadatta, S.; Fox, Wallace; Radhakrishna, S.; Somasundaram, P. R.; Velu, S.

1961-01-01

353

[Contraceptive technology from the administrator's perspective].  

PubMed

Despite advances in contraceptive technology and acceptance, family planning still has numerous barriers to overcome: an ideal contraceptive is lacking and cultural and religious taboos still hamper family planning programs. Political leaders and the Catholic Church have changed their attitudes somewhat in the face of the great needs of their populations and their social reality, but women have become a decisive influence in the change of attitudes concerning family planning. Cultural barriers to acceptance of family planning include the attitude that sex for women is dirty and shameful and that their only legitimate interest in it is procreative, and the belief that birth control is exclusively a concern of women, which unfortunately has been reinforced by the fact that almost all contraceptive methods are oriented to women. The limitations and difficulties faced by family planning administrators assume new dimensions when women begin to asser their right and need for family planning and demanding that services be of high quality, freely available, safe, accessible, and reliable. A brief review of currently used methods demonstrates their strengths and weaknesses. Oral contraceptives (OCs) are easy to administer, safe, and effective, and can be administered by trained nonmedical personnel to reach large populations at relatively low cost, but their use is contraindicated for large numbers of women. IUDs are effective, require only insertion and annual follow-up, and can be inserted by trained paramedical workers, but they carry a risk of infection and septic shock in case of failure. Surgical sterilization is effective but not suited to spacing pregnancies, and its initial cost and requirements for personnel and equipment are high. Male sterilization is technically much easier to perform but lacks acceptability to men. Barrier methods have no serious side effects but require a high degree of motivation and impose onerous storage requirements in tropical countries. Their efficacy depends on correct use, so that costs of information and education are high. The real reasons why so little progress had been made in developing male methods are unclear, but it is true that men dominate family planning research and administration. Although the effect of contraceptive methods on male sexual function is a major concern, very little thought has been given to their effect on female sexual functioning. The greatest needs for family planning administrators are for a safe and approprite method for young people, and for family planning service delivery to be taken over by communities and no longer viewed as the exclusive concern of health professionals and bureaucrats. Research and other efforts should be devoted to development of improved contraceptive methods and delivery structures to overcome the obstacles that have been identified. PMID:12178195

Caram, M

1984-01-01

354

Post-abortion contraception choices of women in Ghana: A one-year review.  

PubMed

Low rates of contraception in much of sub-Saharan Africa result in unplanned pregnancies, which in young, unmarried women often result in unsafe abortion. Increasing the use of highly effective forms of contraception has the potential to reduce the abortion-related mortality and morbidity. In this cross-sectional study, information collected by the post-abortion family planning counsellor was analysed. De-identified data from one year (June 2012-May 2013) were extracted from the logbook. Multivariate linear and logistic regression was performed. A total of 612 women received care for post-abortion complications from June 2012 to May 2013. Young, unmarried women, and those who were being treated for complications arising from an induced versus spontaneous abortion were more likely to report they would use 'abstinence' as their method of contraception following their treatment. This vulnerable group could benefit from an increased uptake of long-acting reversible contraceptive methods to avoid repeated unplanned pregnancies and the potential of future unsafe abortions. PMID:25599278

Rominski, Sarah D; Morhe, Emmanuel S K; Lori, Jody

2015-03-01

355

High and low contraceptive use amongst young male offenders: a qualitative interview study  

PubMed Central

Objectives There are high rates of fatherhood and sexually transmitted infections (STIs) among young incarcerated men. Here we focus on a sample of men incarcerated in a Scottish Young Offender Institution, analysing their accounts of their contraceptive use. Those who report low or no use of contraception are compared with those who report high use. Methods Semi-structured interviews with 40 young male offenders, aged 16–21?years. Participants were purposively sampled using answers from a questionnaire administered to 67 inmates. Data from those men (n=31) reporting either high (n=14) or low/no use (n=17) of contraception are analysed here. Results Low users emphasise their desire for pleasure and appear fatalistic about both pregnancy and disease prevention. High users report a strong desire to protect themselves and their ‘manliness’ by using condoms to avoid the risk of STIs and, to a lesser extent, pregnancy. Both sets of men present themselves in a traditionally masculine way, with high users emphasising power, authority and self-control to justify their non-risk-taking contraceptive behaviour. Conclusions The masculine narrative regarding self-protection, utilised by the high users, may be an effective method of intervention with potential and actual low users. Conventional masculinity valorises risk-taking but if particular forms of risk avoidance – condom use – can be legitimised as confirming one's masculinity it may be possible to persuade low users to adopt them. The opportunity to work with young men whilst incarcerated should be grasped. PMID:24736230

Buston, Katie; Parkes, Alison; Wight, Danny

2014-01-01

356

Contraception for the HIV-Positive Woman: A Review of Interactions between Hormonal Contraception and Antiretroviral Therapy  

PubMed Central

Background. Preventing unintended pregnancy in HIV-positive women can significantly reduce maternal-to-child HIV transmission as well as improve the woman's overall health. Hormonal contraceptives are safe and effective means to avoid unintended pregnancy, but there is concern that coadministration of antiretroviral drugs may alter contraceptive efficacy. Materials and Methods. We performed a literature search of PubMed and Ovid databases of articles published between January 1980 and February 2012 to identify English-language reports of drug-drug interactions between hormonal contraceptives (HCs) and antiretroviral drugs (ARVs). We also reviewed the FDA prescribing information of contraceptive hormone preparations and antiretrovirals for additional data and recommendations. Results. Twenty peer-reviewed publications and 42 pharmaceutical package labels were reviewed. Several studies of combined oral contraceptive pills (COCs) identified decreased serum estrogen and progestin levels when coadministered with certain ARVs. The contraceptive efficacy of injectable depot medroxyprogesterone acetate (DMPA) and the levonorgestrel intrauterine system (LNG-IUS) were largely unaffected by ARVs, while data on the contraceptive patch, ring, and implant were lacking. Conclusions. HIV-positive women should be offered a full range of hormonal contraceptive options, with conscientious counseling about possible reduced efficacy of COCs and the contraceptive implant when taken with ARVs. DMPA and the LNG-IUS maintain their contraceptive efficacy when taken with ARVs. PMID:22927715

Robinson, Jennifer A.; Jamshidi, Roxanne; Burke, Anne E.

2012-01-01

357

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. PMID:22069412

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

2010-01-01

358

Sexual onset and contraceptive use among adolescents from poor neighbourhoods in Managua, Nicaragua.  

PubMed

Background and objectives The prevalence of teenage pregnancies in Nicaragua is the highest in Latin-America. This study aimed to gain insight into factors which determine the sexual behaviours concerned. Methods From July until August 2011, a door-to-door survey was conducted among adolescents living in randomly selected poor neighbourhoods of Managua. Logistic regression was used to analyse factors related to sexual onset and contraceptive use. Results Data from 2803 adolescents were analysed. Of the 475 and 299 sexually active boys and girls, 43% and 54%, respectively, reported contraceptive use. Sexual onset was positively related to increasing age, male sex, alcohol consumption and not living with the parents. Catholic boys and boys never feeling peer pressure to have sexual intercourse were more likely to report consistent condom use. Having a partner and feeling comfortable talking about sexuality with the partner were associated with hormonal contraception. Conclusions Our data identified associates of adolescents' sexual behaviour related to personal characteristics (sex and alcohol use), to the interaction with significant others (parents, partners, peers) and to the environment (housing condition, religion). We interpreted those associates within the context of the rapidly changing society and the recently implemented health system reform in Nicaragua. PMID:25327958

Decat, Peter; De Meyer, Sara; Jaruseviciene, Lina; Orozco, Miguel; Ibarra, Marcia; Segura, Zoyla; Medina, Joel; Vega, Bernardo; Michielsen, Kristien; Temmerman, Marleen; Degomme, Olivier

2015-04-01

359

Simulated clients reveal programmatic factors that may influence contraceptive use in Kisumu, Kenya.  

PubMed

A better understanding of the factors influencing use of family planning has the potential to increase contraceptive prevalence and improve the ability of women and their partners to freely choose the number and spacing of their children. Investigations into factors contributing to unmet need frequently rely on data collected using household surveys or interviews with family planning clients and providers. This research utilizes qualitative information resulting from simulated client visits to investigate programmatic barriers to contraceptive use in a sample of 19 health care facilities in Kisumu East District, a city in Western Kenya. Simulated client reports indicate deficiencies in provider competence as well as tenuous relations between providers and clients. In addition, simulated client data reveal occasional absences of providers during normal facility hours of operation and requests of informal fees for services. Trainings that address specific gaps in provider medical knowledge and counseling skills as well as client-provider relations may reduce programmatic barriers to contraceptive use. In addition, improved supervision and oversight at facilities may increase physical and financial access to services. Future research investigating provider motivations may illuminate root causes of programmatic barriers. PMID:24683525

Tumlinson, Katherine; Speizer, Ilene; Archer, Linda; Behets, Frieda

2013-11-01

360

Simulated clients reveal factors that may limit contraceptive use in Kisumu, Kenya  

PubMed Central

ABSTRACT A better understanding of the factors influencing use of family planning has the potential to increase contraceptive prevalence and improve the ability of women and their partners to freely choose the number and spacing of their children. Investigations into factors contributing to unmet need frequently rely on data collected using household surveys or interviews with family planning clients and providers. Our research utilizes qualitative information resulting from simulated client visits to investigate programmatic barriers to contraceptive use in a sample of 19 health care facilities in Kisumu East District, a city in western Kenya. Simulated client reports indicate deficiencies in provider competence as well as tenuous relations between providers and clients. In addition, simulated client data reveal occasional absences of providers during normal facility hours of operation and requests of informal fees for services. Trainings that address specific gaps in provider medical knowledge and counseling skills as well as client-provider relations may reduce such programmatic barriers to contraceptive use. In addition, improved supervision and oversight at facilities may increase physical and financial access to services. Future research investigating provider motivations may illuminate root causes of programmatic barriers. PMID:24683525

Tumlinson, Katherine; Speizer, Ilene S; Archer, Linda H; Behets, Frieda

2013-01-01

361

The combined oral contraceptive pill- recent developments, risks and benefits.  

PubMed

The introduction of the birth control pill as an effective, coitally-independent method of contraception was a public health milestone of the last century. Over time, combined oral contraception (COC) formulations and pill-taking regimens have evolved with improved safety and tolerability while maintaining contraceptive efficacy. In addition to protection against pregnancy, use of combined oral contraception confers a number of significant non-contraceptive benefits to users. COC use is also associated with well-studied risks. Common side effects are generally self-limiting and improve with increasing duration of use while serious adverse events, including venous thromboembolism, are rare among healthy COC users. Contraceptive decision-making should include consideration of both the risks and benefits of a given method versus the real consequences of unintended pregnancy. PMID:25028259

Dragoman, Monica V

2014-08-01

362

Awareness regarding contraception and population control among school going adolescents.  

PubMed

Growing sexuality among adolescents increases their risk of getting reproductive tract infections and pregnancy. This Cross sectional survey was done to assess the knowledge and attitude of higher secondary school children regarding contraception and population control. Majority of students (94.4%) were aware of contraceptives and their easy availability on chemist shop. However very few were aware of name and how to use them and 60% of them considered that condom is an emergency contraceptive. Lack of employment facilities as a consequence of uncontrolled population growth was the main concern of both boys and girls. The two children norm was acceptable to most, with one son and one daughter. All perceived that there is need to be informed about contraceptives. Most of the adolescents are misinformed about contraceptives and their attitude is not favorable as far as responsibility is concerned. There is an unmet need of contraceptive & population control knowledge and attitude among school adolescents and require urgent intervention. PMID:20803909

Jahnavi, G; Patra, S R

2009-12-01

363

Contraceptive surgery and breast tumors in mice.  

PubMed

The effect of contraceptive surgical manipulations on mammary gland changes was investigated in mice models. Total hysterectomy with bilateral adnexectomy, bilateral tubal ligation, unilateral tubal ligation and moderate uterine compression were performed in various subgroups of 500 mice. Mammary gland tumors (adenomas, adenocarcinomas, squamous cell carcinomas) were observed in an average of 50% (between 20 and 66%) of the operated animals about 6 months after surgery, while the controls remained free of tumors. Surgical interference with the reproductive capacity seems to have an effect on the mammary glands, inducing neoplastic changes. The relationship of our results to the influence of contraceptive procedures on the appearance of mammary gland tumors in women is discussed. PMID:8270411

Wainrach, B; Rubinstein, E

1993-11-01

364

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

365

21 CFR 884.5360 - Contraceptive intrauterine device (IUD) and introducer.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Contraceptive intrauterine device (IUD) and introducer...884.5360 Contraceptive intrauterine device (IUD) and introducer...Identification. A contraceptive intrauterine device (IUD) is a device used...

2010-04-01

366

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

367

Prospects for new hormonal male contraceptives.  

PubMed

Overpopulation is a paramount global crisis, as it underlies virtually all major worldwide problems, including poverty, malnutrition, and warfare. It is imperative that proliferation be curbed by expediting reductions in fertility. This article discusses the demand for and acceptability of male contraceptives and the process of spermatogenesis. Endocrine control of spermatogenesis, and potential sites for disruption of male fertility, including steroid combinations and GnRH agonists and antagonists are reviewed also. Risks and benefits of these approaches are considered. PMID:7705326

Cummings, D E; Bremner, W J

1994-12-01

368

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

369

Use of Modern Contraception by the Poor Is Falling Behind  

Microsoft Academic Search

BackgroundThe widespread increase in the use of contraception, due to multiple factors including improved access to modern contraception, is one of the most dramatic social transformations of the past fifty years. This study explores whether the global progress in the use of modern contraceptives has also benefited the poorest.Methods and FindingsDemographic and Health Surveys from 55 developing countries were analyzed

Emmanuela Gakidou; Effy Vayena

2007-01-01

370

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

371

Information, education and communication for emergency contraception.  

PubMed

The utilisation of the emergency contraception pills is very low both in the public and private sectors. The major reason for this under-utilisation is the lack of awareness about the method among the users or the providers. A real need arises to aware the potential users or the healthcare providers like obstetrician and gynaecologists, medical practitioners, family planning counsellors, nurses and ANMs. Wider dissemination of information, education and communication about emergency contraception relating to the proper usage, mode of action and provision is the need. The information, education and communication materials developed should always be in languages socioculturally appropriate to the target audience. Mass media like TV, newspapers and women's magazine should also be included for dissemination of messages. Service providers should be informed correctly about the method. Healthcare providers would need basic scientific information of the contents of the emergency contraception pills, mode of action, indications, contra-indications, etc. Emphasis should be put on the method for use only as an emergency or 'second chance' when a primary method is not used or has failed. PMID:17388009

Puri, Chander P; Hazari, Kamal; Kulkarni, Ragini

2006-09-01

372

Immunopharmacology of ulipristal as an emergency contraceptive  

PubMed Central

A new progesterone antagonist, ulipristal has been made available as an emergency contraceptive. Ulipristal’s major mechanism of action as an emergency contraceptive has been ascribed to its ability to delay ovulation beyond the life span of the sperm. This paper analyzes the potential action of ulipristal (1) when unprotected intercourse and administration of ulipristal occur outside the fertility window and (2) when unprotected intercourse and administration of ulipristal occur at or within 24 hours of ovulation. When unprotected intercourse and the use of a single low dose of ulipristal occur outside of the fertility window, ulipristal behaves like a placebo. When unprotected intercourse and the use of a single low dose of ulipristal occur within the fertility window but before ovulation, ulipristal behaves like an emergency contraceptive by delaying ovulation and thereby preventing fertilization. When unprotected intercourse and the administration of ulipristal occur at or within 24 hours of ovulation, then ulipristal has an abortifacient action. It is proposed that the abortifacient mechanism of a low dose of ulipristal taken after fertilization but before implantation is due to the ability of ulipristal to block the maternal innate immune system to become immunotolerant to the paternal allogenic embryo. Progesterone’s critical immunotolerant actions involving early pregnancy factor, progesterone-induced blocking factor, and uterine natural killer cells are compromised by ulipristal. PMID:22140327

Miech, Ralph P

2011-01-01

373

Mechanism of action of levonorgestrel emergency contraception.  

PubMed

There has been much debate regarding levonorgestrel emergency contraception's (LNG-EC's) method of action since 1999 when the Food and Drug Administration first approved its use. Proponents of LNG-EC have argued that they have moral certitude that LNG-EC works via a non-abortifacient mechanism of action, and claim that all the major scientific and medical data consistently support this hypothesis. However, newer medical data serve to undermine the consistency of the non-abortifacient hypothesis and instead support the hypothesis that preovulatory administration of LNG-EC has significant potential to work via abortion. The implications of the newer data have important ramifications for medical personnel, patients, and both Catholic and non-Catholic emergency room protocols. In the future, technology such as the use of early pregnancy factor may have the potential to quantify how frequently preovulatory LNG-EC works via abortion. Lay Summary: How Plan B (levonorgestrel emergency contraception) works has been vigorously debated ever since the Food and Drug Administration approved it in 1999. Many doctors and researchers claim that it has either no-or at most-an extremely small chance of working via abortion. However, the latest scientific and medical evidence now demonstrates that levonorgestrel emergency contraception theoretically works via abortion quite often. The implications of the newer data have important ramifications for medical personnel, patients, and both Catholic and non-Catholic emergency room rape protocols. PMID:25698840

Kahlenborn, Chris; Peck, Rebecca; Severs, Walter B

2015-02-01

374

Invasive cervical cancer and combined oral contraceptives. WHO collaborative study of neoplasia and steroid contraceptives.  

PubMed Central

A multicentre, hospital based case-control study is being conducted under the auspices of the World Health Organisation to determine whether steroid contraceptives alter the risk of gynaecological, breast, and hepatic neoplasms. Preliminary results, largely from developing countries, on the relation between combined oral contraceptives and invasive cervical carcinoma showed a relative risk of 1.19 (95% confidence interval 0.99-1.44) in women who had ever used oral contraceptives. The risk increased with duration of use, giving a relative risk of 1.53 after five years. This finding supports a causal interpretation, but it could also be due to incomplete control for confounding sexual variables and other sources of bias. PMID:3919869

1985-01-01

375

Reliance on condoms for contraceptive protection among HIV care and treatment clients: a mixed methods study on contraceptive choice and motivation within a generalised epidemic  

PubMed Central

Objectives To (i) describe the contraceptive practices of HIV care and treatment (HCTx) clients in Manzini, Swaziland, including their unmet needs for family planning (FP), and compare these with population-level estimates; and (ii) qualitatively explore the causal factors influencing contraceptive choice and use. Methods Mixed quantitative and qualitative methods were used. A cross-sectional survey conducted among HCTx clients (N=611) investigated FP and condom use patterns. Using descriptive statistics, findings were compared with population-level estimates derived from Swaziland Demographic and Health Survey data, weighted for clustering. In-depth interviews were conducted with HCTx providers (n=16) and clients (n=22) and analysed thematically. Results 64% of HCTx clients reported current contraceptive use; most relied on condoms alone, few practiced dual method use. Rates of condom use for FP among female HCTx clients (77%, 95% CI 71% to 82%) were higher than population-level estimates in the study region (50% HIV-positive, 95% CI 43% to 57%; 37% HIV-negative, 95% CI 31% to 43%); rates of unmet FP needs were similar when condom use consistency was accounted for (32% HCTx, 95% CI 26% to 37%; vs 35% HIV-positive, 95% CI 28% to 43%; 29% HIV-negative, 95% CI 24% to 35%). Qualitative analysis identified motivational factors influencing FP choice: fears of reinfection; a programmatic focus on condoms for people living with HIV; changing sexual behaviours before and after antiretroviral therapy (ART) initiation; failure to disclose to partners; and contraceptive side effect fears. Conclusions Fears of reinfection prevailed over consideration of pregnancy risk. Given current evidence on reinfection, HCTx services must move beyond a narrow focus on condom promotion, particularly for those in seroconcordant relationships, and consider diverse strategies to meet reproductive needs. PMID:24695990

Church, Kathryn; Wringe, Alison; Fakudze, Phelele; Kikuvi, Joshua; Nhlabatsi, Zelda; Masuku, Rachel; Initiative, Integra; Mayhew, Susannah H

2014-01-01

376

[Status of problems with administration of hormonal contraceptives].  

PubMed

Following the application of oral hormonal contraceptives situations may occur which need fast clarification. In this report we discuss the practical aspects of forgetting to take hormonal contraceptives, the risk for birth defects, the time when to restart taking oral contraceptives after delivery and abortion, the indications for stopping the application, the taking of oral contraceptives under anticoagulant therapy, the behaviour during migraine, the raising need of ethinylestradiol in the case of epilepsy, the procedure in case of oligophrenia, the prevention of the rheumatoid arthritis as well as special questions in cases of diabetes mellitus and gestational diabetes. PMID:10091307

Göretzlehner, G; Simon, E

1999-01-01

377

Prevalence of vaccination rates in systolic heart failure: a prospective study of 549 patients by age, race, ethnicity, and sex in a heart failure disease management program.  

PubMed

Healthy People 2010 aims at immunizing 60% of high-risk adults annually against influenza and once against pneumococcal disease. The aim of this study was to evaluate the use of a standardized approach to improve vaccination rates in patients with heart failure (HF); to determine whether disparities exist based on age, race, ethnicity, or sex at baseline and follow-up; and to evaluate the impact of clinical variables on the odds of being vaccinated. A prospective study of 549 indigent patients enrolled in a systolic HF disease management program (HFDMP) began enrollment from August 2007 to January 2009 at Jackson Memorial Hospital. Patients were interviewed at their initial visit for immunization status; those without vaccinations were offered the vaccines. Prevalence of vaccination (POV) for influenza and pneumococcal disease was obtained at baseline and at follow-up. The odds ratio for being vaccinated was calculated using logistic regression. The study population comprised mostly Hispanic (56%), black (37%), and male (70%) patients, with a mean age of 56 ± 12 years and a mean ejection fraction of 25% ± 10%. The initial POV for both was 22% at baseline. At follow-up, POV improved to 60.5%. Of those not vaccinated at baseline, 17.5% refused vaccination. Odds ratios at baseline for age, race/ethnicity, and sex were 0.99 (P=.99), 0.63 (P=.08), and 0.62 (P=.14), respectively. These did not change significantly at follow-up. Prevalence of vaccination in our cohort was low. Enrollment into the HFDMP improved immunization prevalence without creating age, race, ethnicity, or sex disparities. PMID:21091613

Hebert, Kathy; Marzouka, George; Arcement, Lee; Julian, Elyse; Cortazar, Frank; Dias, Andre; Tamariz, Leonardo

2010-01-01

378

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. PMID:25012817

2014-01-01

379

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

380

A Comparative Study of Iron Uptake Rates and Mechanisms amongst Marine and Fresh Water Cyanobacteria: Prevalence of Reductive Iron Uptake.  

PubMed

In this contribution, we address the question of iron bioavailability to cyanobacteria by measuring Fe uptake rates and probing for a reductive uptake pathway in diverse cyanobacterial species. We examined three Fe-substrates: dissolved inorganic iron (Fe') and the Fe-siderophores Ferrioxamine B (FOB) and FeAerobactin (FeAB). In order to compare across substrates and strains, we extracted uptake rate constants (kin = uptake rate/[Fe-substrate]). Fe' was the most bioavailable Fe form to cyanobacteria, with kin values higher than those of other substrates. When accounting for surface area (SA), all strains acquired Fe' at similar rates, as their kin/SA were similar. We also observed homogeneity in the uptake of FOB among strains, but with 10,000 times lower kin/SA values than Fe'. Uniformity in kin/SA suggests similarity in the mechanism of uptake and indeed, all strains were found to employ a reductive step in the uptake of Fe' and FOB. In contrast, different uptake pathways were found for FeAB along with variations in kin/SA. Our data supports the existence of a common reductive Fe uptake pathway amongst cyanobacteria, functioning alone or in addition to siderophore-mediated uptake. Cyanobacteria combining both uptake strategies benefit from increased flexibility in accessing different Fe-substrates. PMID:25768677

Lis, Hagar; Kranzler, Chana; Keren, Nir; Shaked, Yeala

2015-01-01

381

THE REPRODUCTIVE YEARS The efficacy of non-contraceptive uses for hormonal contraceptives  

E-print Network

the steadily increasing popularity of “the pill ” for contraception, anecdotal evidence began to accumulate for a range of beneficial health effects, and it became widely used (without rigorous supporting evidence) for treating various gynaecological symptoms. 2 Over time, it became clear that the COCP could provide health benefits for women in three ways: by providing highly effective contraception, treating some gynaecological symptoms, and preventing some gynaecological and medical conditions. 3 In recent years, good quality evidence has begun to accumulate for the noncontraceptive health benefits of some long-acting progestogen-only methods, such as depot medroxyprogesterone acetate 4 and the levonorgestrel intrauterine system (LNG-IUS; Mirena, Schering). 5

Ian S Fraser; Gabor T Kovacs

2003-01-01

382

Good clean fun? A content analysis of profanity in video games and its prevalence across game systems and ratings.  

PubMed

Although violent video game content and its effects have been examined extensively by empirical research, verbal aggression in the form of profanity has received less attention. Building on preliminary findings from previous studies, an extensive content analysis of profanity in video games was conducted using a sample of the 150 top-selling video games across all popular game platforms (including home consoles, portable consoles, and personal computers). The frequency of profanity, both in general and across three profanity categories, was measured and compared to games' ratings, sales, and platforms. Generally, profanity was found in about one in five games and appeared primarily in games rated for teenagers or above. Games containing profanity, however, tended to contain it frequently. Profanity was not found to be related to games' sales or platforms. PMID:19514818

Ivory, James D; Williams, Dmitri; Martins, Nicole; Consalvo, Mia

2009-08-01

383

Review of the safety, efficacy and patient acceptability of the combined dienogest/estradiol valerate contraceptive pill.  

PubMed

The aim of this review is to define the role of the combined dienogest (DNG)/estradiol valerate (E2V) contraceptive pill, in terms of biochemistry, metabolic and pharmacological effects and clinical application as well. E2V is the esterified form of 17?-estradiol (E2), while dienogest is a fourth-generation progestin with a partial antiandrogenic effect. The cycle stability is achieved with 2 to 3 mg DNG, supporting contraceptive efficacy. In this new oral contraceptive, E2V is combined with DNG in a four-phasic dose regimen (the first two tablets contain 3 mg E2V; the next five tablets include 2 mg E2V + 2 mg DNG, followed by 17 tablets with 2 mg E2V + 3 mg DNG; followed by two tablets with 1 mg E2V only, and finally two placebo tablets). Duration and intensity of scheduled withdrawal bleeding are lower with this contraceptive pill, whereas the incidence and the intensity of intra-cyclic bleeding are similar to the other oral contraceptive. With this new pill the levels of high density lipoprotein increased, while the levels of prothrombin fragment 1 + 2 and D-dimer remained relatively unchanged; the levels of sex hormone binding globulin, cortisol binding globulin, thyroxine binding globulin increased. The most frequently reported adverse events are: breast pain, headache, acne, alopecia, migraine, increase of bodyweight. The satisfaction rate is about 79.4%. PMID:21151673

Guida, Maurizio; Bifulco, Giuseppe; Di Spiezio Sardo, Attilio; Scala, Mariamaddalena; Fernandez, Loredana Maria Sosa; Nappi, Carmine

2010-01-01

384

Prefrontal GABA concentration changes in women-Influence of menstrual cycle phase, hormonal contraceptive use, and correlation with premenstrual symptoms.  

PubMed

Prefrontal regions are involved in processing emotional stimuli and are a topic of interest in clinical and neurological research. Although sex steroids are potent neuromodulators, the influence of menstrual cycle phase and hormonal contraceptive use is rarely taken into account in neuroimaging studies. Our purpose was to evaluate changes in gamma-aminobutyric acid (GABA) in women, as measured by magnetic resonance spectroscopy (MRS), with phases of the menstrual cycle and use of hormonal contraceptives, and to assess correlations with premenstrual symptoms.Three MRI sessions per cycle were obtained in the natural cycle group, and two sessions in the hormonal contraceptives group. In addition to an anatomical scan, single voxel MRS in the prefrontal area was performed. After quality control, 10 women with natural cycle and 21 women taking hormonal contraceptives were included for analysis. Peripheral blood samples were obtained to determine endogenous hormone concentrations. Subjects were asked to complete a daily rating of severity of problems questionnaire, to quantify premenstrual symptoms. In the natural cycle group, we found a significant increase in prefrontal GABA concentration at the time of ovulation. Conversely, in the hormonal contraceptives group, no differences were found between the pill phase and pill-free phase. GABA concentrations did not significantly correlate with endogenous hormone levels, nor with premenstrual symptoms. Our results indicate that spectroscopically measured GABA concentrations are higher during ovulation in women with a natural menstrual cycle. We suggest that neuroimaging studies should take into account this variability. PMID:25481417

De Bondt, Timo; De Belder, Frank; Vanhevel, Floris; Jacquemyn, Yves; Parizel, Paul M

2015-02-01

385

Review of the safety, efficacy and patient acceptability of the combined dienogest/estradiol valerate contraceptive pill  

PubMed Central

The aim of this review is to define the role of the combined dienogest (DNG)/estradiol valerate (E2V) contraceptive pill, in terms of biochemistry, metabolic and pharmacological effects and clinical application as well. E2V is the esterified form of 17?-estradiol (E2), while dienogest is a fourth-generation progestin with a partial antiandrogenic effect. The cycle stability is achieved with 2 to 3 mg DNG, supporting contraceptive efficacy. In this new oral contraceptive, E2V is combined with DNG in a four-phasic dose regimen (the first two tablets contain 3 mg E2V; the next five tablets include 2 mg E2V + 2 mg DNG, followed by 17 tablets with 2 mg E2V + 3 mg DNG; followed by two tablets with 1 mg E2V only, and finally two placebo tablets). Duration and intensity of scheduled withdrawal bleeding are lower with this contraceptive pill, whereas the incidence and the intensity of intra-cyclic bleeding are similar to the other oral contraceptive. With this new pill the levels of high density lipoprotein increased, while the levels of prothrombin fragment 1 + 2 and D-dimer remained relatively unchanged; the levels of sex hormone binding globulin, cortisol binding globulin, thyroxine binding globulin increased. The most frequently reported adverse events are: breast pain, headache, acne, alopecia, migraine, increase of bodyweight. The satisfaction rate is about 79.4%. PMID:21151673

Guida, Maurizio; Bifulco, Giuseppe; Sardo, Attilio Di Spiezio; Scala, Mariamaddalena; Fernandez, Loredana Maria Sosa; Nappi, Carmine

2010-01-01

386

Prevalence of reproductive tract infections, genital prolapse, and obesity in a rural community in Lebanon.  

PubMed Central

OBJECTIVE: To determine the prevalence of reproduction-related illnesses in a rural community in Lebanon. METHODS: Data were collected through interviews with women in their homes, physical examinations and history taking by physicians in a clinic in the community, and laboratory tests. A total of 557 ever-married women aged 15-60 years were selected randomly. FINDINGS: Just over half of the sample (268, 50.6%) had five or more children, and (320, 78.9%) of women aged < 45 years were using contraception. The prevalence of reproductive tract infections was very low: six (1.2%) women had sexually transmitted diseases and 47 (9.3%) had endogenous reproductive tract infections. None had chlamydial infection or a positive serological finding of syphilis. None had invasive cervical cancer, and only one had cervical dysplasia. In contrast, genital prolapse and gynaecological morbidity were elevated. Half of the women studied (251, 49.6%) had genital prolapse, and 153 (30.2%) were obese. CONCLUSION: The prevalence of reproductive tract infections in this conservative rural community in east Lebanon was low. Possible explanations include the conservative nature of the community, the high rate of utilization of health care services, and the liberal use of antibiotics without a prescription. More importantly, the study showed an unexpectedly high prevalence of genital prolapse and obesity--a finding that has clear implications for primary health care priorities in such rural communities. PMID:14710505

Deeb, Mary E.; Awwad, Johnny; Yeretzian, Joumana S.; Kaspar, Hanna G.

2003-01-01

387

Fifty Years of Family Planning: New Evidence on the Long-Run Effects of Increasing Access to Contraception  

PubMed Central

This paper assembles new evidence on some of the longer-term consequences of U.S. family planning policies, defined in this paper as those increasing legal or financial access to modern contraceptives. The analysis leverages two large policy changes that occurred during the 1960s and 1970s: first, the interaction of the birth control pill’s introduction with Comstock-era restrictions on the sale of contraceptives and the repeal of these laws after Griswold v. Connecticut in 1965; and second, the expansion of federal funding for local family planning programs from 1964 to 1973. Building on previous research that demonstrates both policies’ effects on fertility rates, I find suggestive evidence that individuals’ access to contraceptives increased their children’s college completion, labor force participation, wages, and family incomes decades later. PMID:25339778

Bailey, Martha J.

2014-01-01

388

Time Trends of Period Prevalence Rates of Patients with Inhaled Long-Acting Beta-2-Agonists-Containing Prescriptions: A European Comparative Database Study  

PubMed Central

Background Inhaled, long-acting beta-2-adrenoceptor agonists (LABA) have well-established roles in asthma and/or COPD treatment. Drug utilisation patterns for LABA have been described, but few studies have directly compared LABA use in different countries. We aimed to compare the prevalence of LABA-containing prescriptions in five European countries using a standardised methodology. Methods A common study protocol was applied to seven European healthcare record databases (Denmark, Germany, Spain, the Netherlands (2), and the UK (2)) to calculate crude and age- and sex-standardised annual period prevalence rates (PPRs) of LABA-containing prescriptions from 2002–2009. Annual PPRs were stratified by sex, age, and indication (asthma, COPD, asthma and COPD). Results From 2002–2009, age- and sex-standardised PPRs of patients with LABA-containing medications increased in all databases (58.2%–185.1%). Highest PPRs were found in men ? 80 years old and women 70–79 years old. Regarding the three indications, the highest age- and sex-standardised PPRs in all databases were found in patients with “asthma and COPD” but with large inter-country variation. In those with asthma or COPD, lower PPRs and smaller inter-country variations were found. For all three indications, PPRs for LABA-containing prescriptions increased with age. Conclusions Using a standardised protocol that allowed direct inter-country comparisons, we found highest rates of LABA-containing prescriptions in elderly patients and distinct differences in the increased utilisation of LABA-containing prescriptions within the study period throughout the five European countries. PMID:25706152

Rottenkolber, Marietta; Voogd, Eef; van Dijk, Liset; Primatesta, Paola; Becker, Claudia; Schlienger, Raymond; de Groot, Mark C. H.; Alvarez, Yolanda; Durand, Julie; Slattery, Jim; Afonso, Ana; Requena, Gema; Gil, Miguel; Alvarez, Arturo; Hesse, Ulrik; Gerlach, Roman; Hasford, Joerg; Fischer, Rainald; Klungel, Olaf H.; Schmiedl, Sven

2015-01-01

389

Contraceptive update Y2K: Need for Contraceptive and new contraceptive options  

Microsoft Academic Search

Despite the major strides made in birth control, which have produced a decline in unintended pregnancies over the past decade and the lowest rates of teen pregnancies seen since 1974 (1,2), significant problems still remain. Almost half (48%) of US pregnancies in 1995 were unintended (1) and many more that were “intended” were not planned or prepared for (3). To

Anita Nelson

2000-01-01

390

Hormonal contraception in women with migraine: is progestogen-only contraception a better choice?  

PubMed Central

A significant number of women with migraine has to face the choice of reliable hormonal contraception during their fertile life. Combined hormonal contraceptives (CHCs) may be used in the majority of women with headache and migraine. However, they carry a small, but significant vascular risk, especially in migraine with aura (MA) and, eventually in migraine without aura (MO) with additional risk factors for stroke (smoking, hypertension, diabetes, hyperlipidemia and thrombophilia, age over 35 years). Guidelines recommend progestogen-only contraception as an alternative safer option because it does not seem to be associated with an increased risk of venous thromboembolism (VTE) and ischemic stroke. Potentially, the maintenance of stable estrogen level by the administration of progestins in ovulation inhibiting dosages may have a positive influence of nociceptive threshold in women with migraine. Preliminary evidences based on headache diaries in migraineurs suggest that the progestin-only pill containing desogestrel 75 ?g has a positive effect on the course of both MA and MO in the majority of women, reducing the number of days with migraine, the number of analgesics and the intensity of associated symptoms. Further prospective trials have to be performed to confirm that progestogen-only contraception may be a better option for the management of both migraine and birth control. Differences between MA and MO should also be taken into account in further studies. PMID:24456509

2013-01-01

391

Hormonal contraception in women with migraine: is progestogen-only contraception a better choice?  

PubMed

A significant number of women with migraine has to face the choice of reliable hormonal contraception during their fertile life. Combined hormonal contraceptives (CHCs) may be used in the majority of women with headache and migraine. However, they carry a small, but significant vascular risk, especially in migraine with aura (MA) and, eventually in migraine without aura (MO) with additional risk factors for stroke (smoking, hypertension, diabetes, hyperlipidemia and thrombophilia, age over 35 years). Guidelines recommend progestogen-only contraception as an alternative safer option because it does not seem to be associated with an increased risk of venous thromboembolism (VTE) and ischemic stroke. Potentially, the maintenance of stable estrogen level by the administration of progestins in ovulation inhibiting dosages may have a positive influence of nociceptive threshold in women with migraine. Preliminary evidences based on headache diaries in migraineurs suggest that the progestin-only pill containing desogestrel 75?g has a positive effect on the course of both MA and MO in the majority of women, reducing the number of days with migraine, the number of analgesics and the intensity of associated symptoms. Further prospective trials have to be performed to confirm that progestogen-only contraception may be a better option for the management of both migraine and birth control. Differences between MA and MO should also be taken into account in further studies. PMID:24456509

Nappi, Rossella E; Merki-Feld, Gabriele S; Terreno, Erica; Pellegrinelli, Alice; Viana, Michele

2013-01-01

392

An Examination of Emergency Contraception Use by Undergraduate College Students in the Midwest Using the Integrated Behavioural Model  

ERIC Educational Resources Information Center

The purpose of this study was to identify the factors that influence undergraduate college student use of emergency contraception (EC) and their level of knowledge about the product, in order to assist in the development of intervention programmes to increase its use, which could lead to lower rates of unintended pregnancies in this population. A…

Wohlwend, Jennifer; Glassman, Tavis; Dake, Joseph; Jordan, Timothy; Khuder, Sadik; Kimmel, Sanford

2014-01-01

393

Teens Reflect on Their Sources of Contraceptive Information  

ERIC Educational Resources Information Center

Based on semistructured interviews with a racially and ethnically diverse sample of 58 U.S. high school students, this study examines teens' exposure to contraceptive information from a range of sources and the extent to which they trust this information. Teens report exposure to contraceptive information from many individuals and places, most…

Jones, Rachel K.; Biddlecom, Ann E.; Hebert, Luciana; Mellor, Ruth

2011-01-01

394

Serum lipid levels during oral contraceptive and glucocorticoid administration 1  

Microsoft Academic Search

The effects of oral contraceptives on fasting serum lipid levels have been studied longitudinally in two groups of women. One hundred and twenty-eight subjects (group A) were tested before and during therapy; 52 subjects (group B) were tested initially during therapy and again after this had been discontinued. In both groups oral contraceptive therapy was associated with significantly raised mean

J. W. H. Doar; V. Wynn

1969-01-01

395

Ovarian neoplasms, functional ovarian cysts, and oral contraceptives  

Microsoft Academic Search

The incidence of ovarian neoplasms and functional ovarian cysts diagnosed at laparotomy or laparoscopy among the 17,000 women taking part in the Oxford Family Planning Association contraceptive study was investigated. Epithelial cancer of the ovary was only 25% as common among those who had ever taken oral contraceptives as those who had never done so (95% confidence interval 8% to

M Vessey; A Metcalfe; C Wells; K McPherson; C Westhoff; D Yeates

1987-01-01

396

Obstacles to Contraceptive Use in Pakistan: A Study in Punjab  

Microsoft Academic Search

The principal aim of this study is to assess the strength in Pakistan of a set of hypothesized obstacles to practicing contraception. Survey data are analyzed that were collected in Punjab province in 1996 and that contain unusually detailed measurement of various perceived costs of practicing contraception, as well as focused measurement of fertility motivation. The framework guiding the research

John B. Casterline; Zeba A. Sathar; Minhaj Haque

2001-01-01

397

Provision of emergency contraceptive pills to spermicide users in Ghana  

Microsoft Academic Search

This study evaluated the effect of two approaches to provision of emergency contraceptive pills (ECPs) on ECP use and unprotected intercourse among women relying on spermicides for contraception. The study enrolled 211 women at 4 family planning clinics in Ghana. At two clinics, participants were advised to return to the clinic within 3 days after unprotected intercourse to obtain ECPs.

Amy Lovvorn; Joana Nerquaye-Tetteh; Evam Kofi Glover; Alex Amankwah-Poku; Melissa Hays; Elizabeth Raymond

2000-01-01

398

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

399

The Use of Contraception by Women with Intellectual Disabilities  

ERIC Educational Resources Information Center

Background: Worldwide, contraception is frequently used by women for the prevention of conception, to regulate or postpone menstrual bleeding. The study aims to determine the use (number and method) of contraception by women with intellectual disabilities (ID), the indications, sources of referrals and relations with level of ID and age of the…

van Schrojenstein Lantman-de Valk, H. M. J.; Rook, F.; Maaskant, M. A.

2011-01-01

400

Social Work Student Attitudes Toward Contraception and the HPV Vaccine  

Microsoft Academic Search

The purpose of the current study was to examine social work student attitudes toward the social work profession's perspective on certain aspects of reproductive health in the United States: contraception, emergency contraception, and the Human Papillomavirus (HPV) vaccine. Students at a large, public, land grant university were surveyed to determine whether their personal attitudes were in line with the National

Chris Flaherty; Gretchen E. Ely; L. Shevawn Akers; Mark Dignan; Tara Bonistall Noland

2012-01-01