| 1. Title: Catching up on contraception. Author: Allen K Source: Australian Family Physician. 2009 Jun;38(6):380-2. Abstract: BACKGROUND: Providing contraceptive advice is a core activity in general practice. There have been numerous changes to the contraceptive options available in Australia over the past 10 years. It is important that general practitioners are aware of these changes so that they can advise patients appropriately. OBJECTIVE: This article examines the changes that have occurred in contraception over the past decade and discusses the implications of these changes to clinical practice. DISCUSSION: Up-to-date knowledge about how the combined oral contraceptive pill works is reflected in changes to packaging and formulations, with varying success. Other changes include the over-the-counter availability of emergency contraceptive pills and the new combined hormonal vaginal ring. There has been a resurgence in intrauterine device use and their insertion has Level 1 (nonprocedural) indemnity status in most medical defence organisations. Bleeding with long acting progestogen only contraception remains a problem and management options include antiprostaglandins, tranexamic acid, doxycycline, the combined oral contraceptive pill and removal of the device. Sterilisation remains an option for older men and women and newer methods are available. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | KNOWLEDGE | ORAL CONTRACEPTIVES, COMBINED | EMERGENCY CONTRACEPTION | SATISFACTION | VAGINAL RING | STERILIZATION, SEXUAL | INFORMED CHOICE | Oceania | Developed Countries | Sociocultural Factors | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Psychological Factors | Behavior | Contraceptive Usage Document Number: 341574 |
2.  Peer Reviewed Title: Evidence behind the WHO guidelines: hospital care for children: what is the evidence that BCG vaccination should not be used in HIV-infected children? Author: Bannister C; Bennett L; Carville A; Azzopardi P Source: Journal of Tropical Pediatrics. 2009 Apr;55(2):78-82. Abstract: The World Health Organization has produced guidelines for the management of common illnesses in hospitals with limited resources. This series reviews the scientific evidence behind WHO's recommendations. The WHO guidelines, and more reviews are available at: http://www.ichrc.org. This review addresses the question: What is the evidence that BCG vaccination should not be used in HIV-infected children? The limited evidence currently available has been the basis of the WHO recommendation that BCG vaccination should not be used in HIV-positive children, as severe complications appear more commonly in HIV-infected individuals [8]. This decision is supported by the findings from the Fallo [13] and Hesseling [18, 20] studies. Although the WHO have suggested that HIV-infected infants should not be vaccinated this is obviously difficult in countries where BCG vaccination is administered before HIV status can be detected. Many high HIV-burden countries do not have viral-specific testing (such as PCR) routinely available to adequately assess the infection status of every new born infant. More research needs to be undertaken in this area to clarify the situation, and treating clinicians need to be made aware of this issue with all its complexity. The WHO recommendation highlights the need for viral-specific testing to be widely available in developing countries. This will ensure HIV-infected infants are not exposed to BCG which may be potentially dangerous and HIV-exposed but uninfected infants are not denied this important vaccine. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | WHO | STANDARDS | CHILDREN | HOSPITALS | DELIVERY OF HEALTH CARE | VACCINES | HIV INFECTIONS | Oceania | Developed Countries | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health Facilities | Health | Medical Procedures | Medicine | Health Services | Viral Diseases | Diseases Document Number: 341013 |
| 3. Title: Emergency contraception - knowledge and attitudes in a group of Australian university students. Author: Calabretto H Source: Australian and New Zealand Journal of Public Health. 2009 Jun;33(3):234-9. Abstract: OBJECTIVE: To explore first year Australian university students' knowledge and attitudes about emergency contraception and their understanding of the risk for pregnancy. METHOD: A self-report questionnaire was completed by a convenience sample of 627 first year on-campus students from both health and non-health disciplines. RESULTS: Knowledge about emergency contraception (EC) was generally poor including misunderstanding that it can only be used the 'morning after', as well as where it may be accessed. Its potential use was, however, more highly accepted as a preventative measure after unprotected sexual intercourse than abortion in the event of unplanned pregnancy. Women had better knowledge than men, and on a number of measures there were significant differences between these groups. CONCLUSIONS: Poor knowledge about the timing, accessibility, action and side effects of EC may act as a barrier to its use in the event of unprotected sexual intercourse. Although EC has been available in Australia as a Schedule 3 medication since 2004, its availability from pharmacies is not well known, nor is access from other primary health care providers. Implications: The lack of knowledge about EC may lead to its underutilisation and underlines the need for future educational strategies about EC as well as the need for health professionals who provide contraceptive services to discuss EC with clients. Health promotion campaigns which are both general as well as gender-specific may improve overall community knowledge about this method of contraception. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | SAMPLING STUDIES | STUDENTS | UNIVERSITIES | EMERGENCY CONTRACEPTION | KNOWLEDGE | ATTITUDES | ABORTION | QUESTIONNAIRES | CONTRACEPTIVE METHOD ACCEPTABILITY | Oceania | Developed Countries | Studies | Research Methodology | Education | Schools | Contraception | Family Planning | Sociocultural Factors | Psychological Factors | Behavior | Fertility Control, Postconception | Contraceptive Usage Document Number: 342310 Notification |
| 4. Title: Factors influencing the duration of pregnancy termination with vaginal misoprostol for fetal abnormality. Author: Dickinson JE; Doherty DA Source: Prenatal Diagnosis. 2009 May;29(5):520-4. Abstract: OBJECTIVE: Evaluation of factors influencing the duration of second-trimester pregnancy interruption with vaginal misoprostol for fetal abnormality. METHODS: All medical terminations >or=13 weeks of gestation 1/1997 to 12/2007 were prospectively identified. Cases receiving vaginal misoprostol 400 microg 6-hourly were extracted from the database and outcomes reviewed. RESULTS: This consecutive case series comprised 1066 women. Median maternal age was 31 years [interquartile range (IQR) 26, 36] and 15.4% had at least one prior cesarean delivery. Principal indications for termination were aneuploidy (37.6%), neural tube defects (15.9%) and cardiac anomalies (9.4%). Median gestation at termination was 19.5 weeks (IQR 17.9, 21). Median abortion interval was 16.1 h (IQR 12, 23.5). Lower maternal age (median duration 17.6 vs 15.2 vs 13.6 h, age < 30 vs 30-39 vs > 40 years, p < 0.001), nulliparity (median duration 19 vs 14.3 h, nulliparous vs parous, p < 0.001) and increasing gestation (median duration 13 vs 17.8 h, <16 vs >20 weeks, p < 0.001) were associated with abortion prolongation. Controlling for gestation, age and parity, apart from musculoskeletal abnormalities (associated with abortion prolongation, p = 0.03), the specific fetal anomaly did not influence duration. CONCLUSIONS: Three factors: nulliparity, younger maternal age and increasing gestation, were associated with abortion prolongation. Apart from musculoskeletal abnormalities, the fetal anomaly had no impact on abortion duration. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | CONGENITAL ABNORMALITIES | ABORTION | MISOPROSTOL | TIME FACTORS | AGE FACTORS | NULLIPARITY | Oceania | Developed Countries | Neonatal Diseases and Abnormalities | Diseases | Fertility Control, Postconception | Family Planning | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Population Dynamics | Demographic Factors | Population | Population Characteristics | Parity | Fertility Measurements | Fertility Document Number: 342614 Notification |
| 5. Peer Reviewed Title: The Relationship Between Rejection Sensitivity and Compliant Condom Use. Author: Edwards GL; Barber BL Source: Archives of Sexual Behavior. 2009 Sep 4; Abstract: Those who are rejection sensitive anxiously expect and readily perceive rejection. Rejection sensitivity is hypothesized to predict behavior; however, this link may be more evident in some contexts than others. The current study examined the link between rejection sensitivity and condom use. Australian young adults in romantic (n = 649, 70% female) and casual (n = 144, 76.2% female) relationship contexts completed measures on rejection sensitivity, condom use preferences, and condom use. Regression analysis showed that rejection sensitivity predicted condom use when participants' condom use preferences were at odds with those they thought their partner held. Specifically, highly rejection-sensitive individuals who preferred more frequent condom use reported using condoms less often, if that was what they thought their partners wanted. The results lend support to the model of rejection sensitivity in that individuals comply more with their perceived partner's preferences if they are more rejection-sensitive. The results also highlight the need to take the situational context into consideration when examining links between personality dispositions and behavior. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | STATISTICAL REGRESSION | YOUTH | CONDOM USE | SEX BEHAVIOR | DECISION MAKING | INTERPERSONAL RELATIONS | PERCEPTION | QUESTIONNAIRES | Oceania | Developed Countries | Data Analysis | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Risk Reduction Behavior | Behavior | Psychological Factors Document Number: 342840 |
| 6. Title: Previous abortion and risk of pre-term birth: a population study. Author: Freak-Poli R; Chan A; Tucker G; Street J Source: Journal of Maternal-Fetal and Neonatal Medicine. 2009 Jan;22(1):1-7. Abstract: OBJECTIVE: This population study was undertaken to determine whether previous abortion is an independent risk factor for pre-term birth and to calculate population-attributable risks for risk factors. METHODS: All South Australian first singleton births in 1998-2003 (n = 42 269) were included in a multivariable logistic regression analysis, comparing pre-term births with term births. RESULTS: Risk factors for pre-term birth were found to be: being indigenous, single, a smoker [adjusted odds ratio (AOR) 1.28, 95% confidence interval 1.17-1.41], age 40 years or older, reproductive technology assistance, threatened miscarriage, antepartum haemorrhage, urinary tract infection, pregnancy hypertension and suspected intra-uterine growth restriction. A previous spontaneous abortion was of borderline statistical significance, whereas a previous induced abortion (AOR 1.25, 1.13-1.40) was an independent risk factor. A dose-response relationship was found with increasing number of previous spontaneous or induced abortions. Population-attributable risks were highest for pregnancy hypertension (12.4%) and antepartum haemorrhage (9.2%). Smoking and previous induced abortion had risks of 4.7% and 2.7%, respectively. Among indigenous women, 51% of whom smoked, 16.4% of pre-term birth could be attributed to smoking. CONCLUSIONS: A previous induced abortion and smoking during pregnancy (particularly among indigenous women) are preventable risk factors for pre-term birth. Their population-attributable risks are likely to be under-estimates from under-reporting. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PREGNANT WOMEN | INDIGENOUS POPULATION | PREVALENCE | ABORTION | RISK ASSESSMENT | PREMATURE BIRTH | RISK FACTORS | REPRODUCTIVE TECHNOLOGIES | ABORTION, SPONTANEOUS | MATERNAL AGE | PREECLAMPSIA | Oceania | Developed Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Measurement | Fertility Control, Postconception | Family Planning | Evaluation | Pregnancy Outcomes | Pregnancy | Reproduction | Health | Pregnancy Complications | Diseases | Parental Age | Age Factors Document Number: 330718 Notification |
| 7. Title: The effects of hormonal contraceptives on bone turnover markers and bone health. Author: Herrmann M; Seibel MJ Source: Clinical Endocrinology. 2009 Sep 9; Abstract: Abstract Sex hormones are important regulators of bone metabolism. As hormonal contraceptives contain either estrogens or progestins, or a combination thereof, it is conceivable that these widely used agents have an effect on bone metabolism and bone health. The main users of hormonal contraceptives, adolescent girls and young women, are still building bone and accruing bone mass and may therefore be particularly susceptible to the effects of hormonal contraceptives on bone. Despite these concerns, the effects of hormonal contraceptives on bone health are still poorly understood. As biochemical markers of bone turnover have been proven useful tools in the assessment and monitoring of bone metabolism, we reviewed the effects of combined and gestagen-only hormonal contraceptives on bone turnover markers and related effects on bone mineral density and fracture risk in premenopausal women, as documented in the literature until January 2009. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | LITERATURE REVIEW | WOMEN | ADOLESCENTS, FEMALE | SKELETAL EFFECTS | ORAL CONTRACEPTIVES | ORAL CONTRACEPTIVES, COMBINED | Oceania | Developed Countries | Demographic Factors | Population | Adolescents | Youth | Age Factors | Population Characteristics | Physiology | Biology | Contraceptive Methods | Contraception | Family Planning Document Number: 342760 |
| 8. Title: Breast cancer in young women and its impact on reproductive function. Author: Hickey M; Peate M; Saunders CM; Friedlander M Source: Human Reproduction Update. 2009 May-Jun;15(3):323-39. Abstract: BACKGROUND: Breast cancer is the most common cancer in women in developed countries, and 12% of breast cancer occurs in women 20-34 years. Survival from breast cancer has significantly improved, and the potential late effects of treatment and the impact on quality of life have become increasingly important. Young women constitute a minority of breast cancer patients, but commonly have distinct concerns and issues compared with older women, including queries regarding fertility, contraception and pregnancy. Further, they are more likely than older women to have questions regarding potential side effects of therapy and risk of relapse or a new primary. In addition, many will have symptoms associated with treatment and they present a management challenge. Reproductive medicine specialists and gynaecologists commonly see these women either shortly after initial diagnosis or following adjuvant therapy and should be aware of current management of breast cancer, the options for women at increased genetic risk, the prognosis of patients with early stage breast cancer and how adjuvant systemic treatments may impact reproductive function. METHODS: No systematic literature search was done. The review focuses on the current management of breast cancer in young women and the impact of treatment on reproductive function and subsequent management. With reference to key studies and meta-analyses, we highlight controversies and current unanswered questions regarding patient management. RESULTS: Chemotherapy for breast cancer is likely to negatively impact on reproductive function. A number of interventions are available which may increase the likelihood of future successful pregnancy, but the relative safety of these interventions is not well established. For those who do conceive following breast cancer, there is no good evidence that pregnancy is detrimental to survival. We review current treatment; effects on reproductive function; preservation of fertility; contraception; pregnancy; breastfeeding and management of menopausal symptoms following breast cancer. CONCLUSION: This paper provides an update on the management of breast cancer in young women and is targeted at reproductive medicine specialists and gynaecologists. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | BREAST CANCER | SURGERY | DRUGS | GENETICS | FERTILITY | CONTRACEPTION | PREGNANCY | BREASTFEEDING | MENOPAUSE | AGE FACTORS | TAMOXIFEN | Oceania | Developed Countries | Cancer | Neoplasms | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Biology | Population Dynamics | Demographic Factors | Population | Family Planning | Reproduction | Infant Nutrition | Nutrition | Population Characteristics | Fertility Agents | Reproductive Control Agents Document Number: 341960 |
| 9. Peer Reviewed Title: The emergency contraceptive pill rescheduled: a focus group study of women's knowledge, attitudes and experiences. Author: Hobbs M; Taft AJ; Amir LH Source: Journal of Family Planning and Reproductive Health Care. 2009 Apr;35(2):87-91. Abstract: BACKGROUND AND METHODOLOGY: The levonorgestrel-containing emergency contraceptive pill (ECP), amongst other strategies, has the potential to assist in reducing unintended pregnancy and abortion rates. Since the rescheduling of the ECP in January 2004 to over-the-counter (OTC) status from pharmacies in Australia, there is little information about Australian women's ECP knowledge, attitudes or practice. The aim of the study was to explore Australian women's knowledge of, attitudes towards and experiences of using the ECP, particularly since it has been available OTC. This paper reports a qualitative study using six focus groups, which were conducted between February and June 2007 in four Australian states with 29 women aged 16-29 years. RESULTS: Participants had a lack of specific knowledge about the ECP. Most were positive about the ECP being available OTC, however some expressed concerns about younger women misusing it. Women's experiences obtaining the ECP from the pharmacy were both positive and negative. Most women said they would use the ECP again if required and would recommend it to a friend. Pharmacists were seen as important suppliers of the ECP but women felt it was not their role to provide advice about contraception or sexually transmitted infections. DISCUSSION AND CONCLUSIONS: The findings from this study confirm views from other studies, which suggest that although women have some concerns in relation to OTC supply of the ECP, they believe that the deregulation of the ECP is a positive step. The data also suggest that women need to be provided with more information and education about the ECP. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | FOCUS GROUPS | WOMEN | EMERGENCY CONTRACEPTION | KNOWLEDGE | ATTITUDES | LEVONORGESTREL | CONTRACEPTIVE USAGE | CONTRACEPTIVE AVAILABILITY | AGE FACTORS | Oceania | Developed Countries | Data Collection | Research Methodology | Demographic Factors | Population | Contraception | Family Planning | Sociocultural Factors | Psychological Factors | Behavior | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Population Characteristics Document Number: 330948 |
| 10. Title: The spermostatic and microbicidal actions of quinones and maleimides: towards a dual purpose contraceptive agent. Author: Hughes LM; Griffith R; Carey A; Butler T; Donne SW; Beagley KW; Aitken RJ Source: Molecular Pharmacology. 2009 Mar 31; Abstract: There is an urgent need to develop safe, effective dual-purpose contraceptive agents that combine the prevention of pregnancy with protection against sexually transmitted disease. Here we report the identification of a group of compounds that on contact with human spermatozoa induce a state of 'spermostasis', characterized by the extremely rapid inhibition of sperm movement without compromising cell viability. These spermostatic agents were more active and significantly less toxic than the reagent in current clinical use, nonoxynol 9, giving therapeutic indices (ratio of spermostatic to cytotoxic activity) that were orders of magnitude greater than this traditional spermicide. Although certain compounds could trigger reactive oxygen species generation by spermatozoa, this activity was not correlated with spermostasis. Rather, the latter was associated with alkylation of two major sperm tail proteins that were identified as A Kinase Anchoring Proteins (AKAP3 and AKAP4) by mass spectrometry. As a consequence of disrupted AKAP function, the abilities of cAMP to drive PKA-dependent activities in the sperm tail such as the activation of SRC and the consequent stimulation of tyrosine phosphorylation, were suppressed. Furthermore, analysis of microbicidal activity using Chlamydia, revealed powerful inhibitory effects at the same low micromolar doses that suppressed sperm movement. In this case, the microbicidal action was associated with alkylation of MOMP, a major Chlamydial membrane protein. Taken together, these results have identified for the first time a novel set of cellular targets and chemical principles capable of providing simultaneous defense against both fertility and the spread of sexually transmitted disease. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | MICROBICIDES | SPERM IMMOBILIZING AGENTS | CONTRACEPTIVE AGENTS, FEMALE | SEXUALLY TRANSMITTED DISEASE PREVENTION | NONOXYNOL-9 | SPERMICIDAL CONTRACEPTIVE AGENTS | Oceania | Developed Countries | Research Methodology | Demographic Factors | Population | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Agents | Contraception | Family Planning | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases Document Number: 330928 |
| 11. Title: Innovative pediatric palliative care programs in four countries. Author: Knapp C; Madden V; Marston J; Midson R; Murphy A; Shenkman E Source: Journal of Palliative Care. 2009 Summer;25(2):132-6. Abstract: Over the past three decades, pediatric palliative care programs have been developed and refined throughout the world. The purpose of this study was to provide information on experiences from four of those programs, yet we acknowledge that there are many other innovative programs that deserve recognition for the services they provide to children and families. This study is limited in that it is unable to compare outcomes from the four programs, such as patient-reported quality of life, that might help to better understand the impact of pediatric palliative care. Nonetheless, information sharing can inspire and educate others with the overarching goal of globally advancing pediatric palliative care. Language: English Keywords: AUSTRALIA | SOUTH AFRICA | UNITED KINGDOM | UNITED STATES OF AMERICA | SUMMARY REPORT | CHILD HEALTH SERVICES | CARE AND SUPPORT | DELIVERY OF HEALTH CARE | IMPLEMENTATION | PROGRAM DESIGN | OBSTACLES | COUNSELING | REFERRAL AND CONSULTATION | FUNDS | Oceania | Developed Countries | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Europe, Western | Europe | North America | Americas | Maternal-Child Health Services | Primary Health Care | Health Services | Health | Programs | Organization and Administration | Clinic Activities | Program Activities | Financial Activities | Economic Factors Document Number: 342874 |
| 12. Peer Reviewed Title: Reasons for termination of pregnancy in women aged 35 and over [letter] Author: Lee W; Mazza D Source: Medical Journal of Australia. 2009 Aug 3;191(3):188-9. Abstract: This letter speaks about the reasons women aged 35 and over are terminating pregnancy in Melbourne, Australia. In addition to reasons for termination, it also includes the contraceptive methods used by the women prior to the pregnancy and determines that further qualitative research is needed to explore the women's understanding of fertility and pregnancy risk. Language: English Keywords: AUSTRALIA | CRITIQUE | RETROSPECTIVE STUDIES | ABORTION | AGE FACTORS | MOTIVATION | CONTRACEPTIVE METHODS CHOSEN | Oceania | Developed Countries | Studies | Research Methodology | Fertility Control, Postconception | Family Planning | Population Characteristics | Demographic Factors | Population | Psychological Factors | Behavior | Contraceptive Usage | Contraception Document Number: 342939 Notification |
| 13. Title: Outcomes for subsequent pregnancy in women who have undergone misoprostol mid-trimester termination of pregnancy. Author: Mirmilstein V; Rowlands S; King JF Source: Australian and New Zealand Journal of Obstetrics and Gynaecology. 2009 Apr;49(2):195-7. Abstract: In Australia, the most common method of mid-trimester termination of pregnancy (TOP) is by medical induction with the prostaglandin E 1 analog misoprostol. This study was undertaken to compare the pregnancy outcomes of women who had undergone a misoprostol mid-trimester TOP in their last pregnancy with those of a similar cohort of women without a history of misoprostol TOP. This study suggests a possibility that medical mid-trimester TOP with misoprostol increases the risk of preterm or very preterm delivery in a subsequent pregnancy but larger studies are needed to confirm or dismiss this. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | RETROSPECTIVE STUDIES | CONTROL GROUPS | WOMEN | PREGNANCY OUTCOMES | ABORTION | MISOPROSTOL | PREMATURE BIRTH | RISK FACTORS | Oceania | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Pregnancy | Reproduction | Fertility Control, Postconception | Family Planning | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Health Document Number: 342384 Notification |
| 14. Title: Knowledge of emergency contraception amongst tertiary students in far North Queensland. Author: Mohoric-Stare D; DE Costa C Source: Australian and New Zealand Journal of Obstetrics and Gynaecology. 2009 Jun;49(3):307-11. Abstract: BACKGROUND: Emergency contraception (EC) has been available in Australia without prescription since 2003. However, there has been little research into the extent of knowledge of the actions, effectiveness and availability of EC among the general population. AIMS: To determine the extent of knowledge of EC among tertiary students in Far North Queensland, and their ability to access EC in the region. METHODS: A questionnaire was distributed to tertiary students in Cairns asking about their knowledge of EC, its effectiveness and its availability over-the-counter in pharmacies, as well as their willingness to access EC themselves if indicated, in settings in which they may be known, and in those where they would be unknown. RESULTS: Of 500 questionnaires 460 were returned; 29% of participants had used EC in the past. Only 20% understood the correct timeframe in which EC can be used; 40% were not aware of its availability over-the-counter in pharmacies, and more than 20% felt unable to purchase EC in a pharmacy where they could be recognised. Only 44% of participants were aware of the cost of EC. CONCLUSION: A significant lack of information regarding the availability, methods of action and limitations of EC was noted in this well-educated population. There was also a high proportion of participants who felt unable to access EC in a pharmacy where they might be known, a factor limiting accessibility of the method in small town and community settings. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | STUDENTS | EMERGENCY CONTRACEPTION | KNOWLEDGE | QUESTIONNAIRES | CONTRACEPTIVE AVAILABILITY | CONTRACEPTIVE EFFECTIVENESS | AWARENESS | Oceania | Developed Countries | Education | Contraception | Family Planning | Sociocultural Factors Document Number: 341798 |
| 15. Title: Fear and fertility in inflammatory bowel disease: a mismatch of perception and reality affects family planning decisions. Author: Mountifield R; Bampton P; Prosser R; Muller K; Andrews JM Source: Inflammatory Bowel Diseases. 2009 May;15(5):720-5. Abstract: BACKGROUND: Smaller family size and voluntary childlessness has been reported in IBD; however, the disease-related reasons for this from a patient viewpoint are not described. The aims were to 1) determine whether IBD patients' perceptions of the issues surrounding IBD, pregnancy, and childbearing influence their reproductive behavior, and 2) describe these specific perceptions and concerns related to fertility and pregnancy. METHODS: All contactable subjects between 18-50 years of age from a hospital-based IBD database were surveyed by postal questionnaire. Data were obtained regarding age, gender, IBD diagnosis and treatment, body image and sexual relationships, as well as both objective and subjective data regarding fertility and pregnancy. Comparisons were made to community norms where data were available. Contingency tables with Fisher's exact test were used. RESULTS: Of 365 subjects, 255 responded (70%). The mean age was 35.5 years overall, 34.7 years for women. In all, 34% of participants were male, 127 had Crohn's disease (CD), 85 ulcerative colitis (UC), and 5 indeterminate colitis (IC). The average fertility rate was no different between women with CD and UC (1.0 and 1.2 births/woman, respectively; P = 0.553), compared with 1.81 for all Australian women. Although 42.7% of IBD patients reported a fear of infertility, patients only sought medical fertility advice at the same rate as the general population. Fear of infertility was most evident in women, those with CD, and those reporting previous surgery. Specific patient concerns, which appear to have decreased patients' family size, included IBD heritability, the risk of congenital abnormalities, and medication teratogenicity. CONCLUSIONS: The unusually high response rate indicates the centrality of reproductive issues to IBD patients. "Voluntary" childlessness in this group appears to result from concerns about adverse reproductive outcomes that may not be justified. Patients require accurate counseling addressing fertility and pregnancy outcomes in IBD to assist in their decision making. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | SURVEYS | CLIENTS | GASTROINTESTINAL EFFECTS | PERCEPTION | FEAR | PREGNANCY | FERTILITY | CONGENITAL ABNORMALITIES | VOLUNTARY CHILDLESSNESS | Oceania | Developed Countries | Sampling Studies | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Physiology | Biology | Psychological Factors | Behavior | Emotions | Reproduction | Population Dynamics | Demographic Factors | Population | Neonatal Diseases and Abnormalities | Diseases | Reproductive Behavior Document Number: 342482 |
| 16. Peer Reviewed Title: Does readily available emergency contraception increase women's awareness and use? Author: Novikova N; Weisberg E; Fraser IS Source: European Journal of Contraception and Reproductive Health Care. 2009 Feb;14(1):39-45. Abstract: BACKGROUND: In Australia just over half of all women of reproductive age have experienced an unplanned pregnancy, many of which could have been avoided by use of emergency contraception. A dedicated emergency contraceptive pill (ECP) pack became available on prescription in Australia in 2002, and over the counter in 2004. OBJECTIVES: To determine if availability of a dedicated over the counter ECP pack in Australia increased knowledge and use of emergency contraception (EC). MATERIAL AND METHODS: Women attending three free-standing abortion clinics in Sydney answered an anonymous questionnaire on their knowledge and use of the ECP. Group 1 (208 women) was recruited prior to a dedicated ECP pack being available, group 2 (308) after it was available on prescription, and group 3 (202) after it became available over the counter. RESULTS: Women who had heard about EC were significantly younger (p < 0.005). The mean age of women who had never heard about EC was 29.8 years compared to 26.3 for women who had heard about EC. More women expressed awareness of the ECP after it became available over the counter. Women in group 2 attained a higher educational level than women in the other groups (p < 0.005). There was a significant trend to increased use of the ECP in women of higher educational level (p < 0.005). The use of EC did not increase significantly with improved availability and access. CONCLUSIONS: Among women seeking termination of pregnancy wider availability of the ECP has increased women's awareness of EC but not use. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | KAP SURVEYS | WOMEN | CONTRACEPTIVE USAGE | EMERGENCY CONTRACEPTION | CONTRACEPTIVE AVAILABILITY | PHARMACY DISTRIBUTION | CONTRACEPTIVE DISTRIBUTION | KNOWLEDGE | CONTRACEPTIVE PREVALENCE | AGE FACTORS | EDUCATIONAL STATUS | Developed Countries | Oceania | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Contraception | Family Planning | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Sociocultural Factors | Population Characteristics | Socioeconomic Status | Socioeconomic Factors | Economic Factors Document Number: 330346 |
| 17. Title: Internal or infernal devices: experiences of contraception among Australian women living with hepatitis C. Author: Olsen A; Banwell C; Dance P Source: Health Care For Women International. 2009 Jun;30(6):456-74. Abstract: In this article we seek to delineate the experiences of contraceptive use by Australian women living with hepatitis C. Using semi-structured, in-depth interviews, 109 women with hepatitis C from two cities in Australia, Melbourne (Victoria) and Canberra (the Australian Capital Territory), were interviewed about their alcohol and other drug use, their contraceptive history, and their experiences of hepatitis C. We aimed to understand why such a high proportion of women living with hepatitis C (66%) had previously reported that they were not currently using contraception. Many women had used contraception at some stage of their lives but were no longer using it because they had experienced contraceptive failure or uncomfortable side effects. Others were concerned about the impact of contraception on their fertility, were planning to get pregnant or considered themselves to be celibate. Hepatitis C appeared to have little impact on their contraceptive practices, but some women's illicit drug use had an important influence. Illicit drug use was, for some, an encouragement to seek long-term forms of contraception that reduced their chances of pregnancy while for others drug taking hampered their contraceptive use. In compliance with health promotion campaigns of the last two decades, women were generally more concerned about preventing sexually transmissible infections than pregnancies, particularly with new or casual partners. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | INTERVIEWS | WOMEN | HEPATITIS | CONTRACEPTION FAILURE | CONTRACEPTIVE USAGE | CONTRACEPTIVE AGENTS, SIDE EFFECTS | PREGNANCY | SEXUALLY TRANSMITTED DISEASE PREVENTION | PREVENTION AND CONTROL | Oceania | Developed Countries | Data Collection | Research Methodology | Demographic Factors | Population | Viral Diseases | Diseases | Contraception | Family Planning | Contraceptive Agents | Reproduction | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections Document Number: 341019 |
| 18. Title: Contraception and pregnancy then and now: examining the experiences of a cohort of mid-age Australian women. Author: Read C; Bateson D; Weisberg E; Estoesta J Source: Australian and New Zealand Journal of Obstetrics and Gynaecology. 2009 Aug;49(4):429-33. Abstract: BACKGROUND: More than 50% of women who have an unplanned pregnancy report using a contraceptive method. Since the launch of the pill 50 years ago, a number of cross-sectional surveys have examined contraceptive use in the Australian context. There is, however, little data on contraceptive use and efficacy over a woman's reproductive years. AIM: To determine the pattern of contraceptive use of Australian women over their reproductive lifespan, with particular emphasis on the relationship between contraceptive use and pregnancy. METHOD: One thousand women from the mid-age cohort of the Australian Women's Longitudinal Study were invited to participate in the Family Planning survey by completing a questionnaire about their reproductive histories. RESULTS: Completed questionnaires were received for 812 women. The contraceptive pill was the most commonly ever used contraceptive method at 94% and also the most commonly used method prior to all pregnancies. Contraceptive failure increased with increasing gravidity; 11.4% with the first pregnancy to 23.0% with the fourth pregnancy, while 28.8% of the respondents reported an 'accidental' pregnancy due to stopping contraception for reasons such as concern about long-term effects and media stories. CONCLUSIONS: While surveys indicate that 66-70% of Australian women use a contraceptive method, more than half of unplanned pregnancies apparently occur in women using contraception. The modern Australian woman, in common with her predecessors, still faces significant challenges in her fertility management. This survey provides a longitudinal perspective on contraceptive use in relation to pregnancy and highlights the issue of efficacy of contraceptives in real-life situations. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | COHORT ANALYSIS | WOMEN | PREGNANCY, UNPLANNED | PREGNANCY | CONTRACEPTION | AGE FACTORS | Oceania | Developed Countries | Research Methodology | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Reproduction | Family Planning | Population Characteristics Document Number: 342556 |
| 19. Title: Effect of oral contraceptive cycle phase on performance in team sport players. Author: Rechichi C; Dawson B Source: Journal of Science and Medicine In Sport / Sports Medicine Australia. 2009 Jan;12(1):190-5. Abstract: The purpose of this study was to examine whether common team sport performance variables (anaerobic power, reactive strength and repeat sprint ability) are affected by acute hormonal fluctuation within a monophasic oral contraceptive (OC) cycle. Ten female team sport athletes completed performance tests at three time points of a single OC cycle, during the consumption phase (CONS), early (WITH1) and late in the withdrawal phase (WITH2). Tests included drop jumps (30cm and 45cm heights), a counter movement jump, a 10s cycle sprint test and a 5x 6s repeated sprint cycle test. Resting endogenous serum oestradiol and progesterone concentrations were also measured. No significant differences were observed between phases for the counter movement jump and cycle tests (total work and peak power). Reactive strength measured from the 30cm drop height was significantly lower during WITH2 (162+/-38cms(-1)) compared to both CONS (177+/-44cms(-1)) and WITH1 (178+/-40cms(-1)) (p<0.05). Reactive strength measuredfrom the 45cm drop height was significantly higher in CONS (178+/-48cms(-1)) compared to both WITH1 and WITH2 (161+/-39cms(-1) and 158+/-29cms(-1), respectively) (p<0.05). Serum oestradiol levels were greater during WITH2 compared to both WITH1 and CONS (p<0.05) but there was no difference in serum progesterone levels. The results demonstrate that for female team sport athletes, only reactive strength varied significantly throughout an OC cycle, possibly due to the action of hormones on neuromuscular timing and the stretch-shortening cycle. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | ATHLETES | SPORTS | LOW-DOSE PROGESTINS | ORAL CONTRACEPTIVES | MUSCULAR EFFECTS | Oceania | Developed Countries | Population Characteristics | Demographic Factors | Population | Social Behavior | Behavior | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Contraceptive Methods | Physiology | Biology Document Number: 341744 |
| 20. Title: Pregnancy and protection: perceptions, attitudes and experiences of Australian female adolescents. Author: Skinner SR; Smith J; Fenwick J; Hendriks J; Fyfe S; Kendall G Source: Women and Birth. 2009 Jun;22(2):50-6. Abstract: BACKGROUND AND PURPOSE: Despite decades of research, development and evaluation of educational and promotional strategies to prevent teenage pregnancy, we have only a limited understanding of the strategies that are effective and why. This study sought to explore female teenagers' attitudes, perceptions and experiences of contraceptive use, and describe the influence of this on pregnancy risk. METHODS: A qualitative approach was used to explore the contraceptive behaviour in a purposive sample of sexually active Australian females aged 14-19 years. Teenagers were drawn from three sub-groups: antenatal and postnatal services (pregnant-continuing); termination services (pregnant-terminating); and sexual health clinics (never-pregnant). Sixty-eight individual, semi-structured interviews were conducted. Thematic analysis was employed to analyse the data and generate a rich, description of contraceptive behaviour. RESULTS: Whilst participants were familiar with contraception, many used it inconsistently. Commitment to pregnancy prevention was firmly located within participants' attitudes toward teenage pregnancy and parenthood, perceptions of pregnancy risk and perceptions of the costs and benefits of using contraception. Further, motivation to use contraception fluctuated in different contexts, such as romantic relationships. CONCLUSIONS: Our research highlights the importance of attitudes toward contraception, pregnancy and parenthood in shaping teenagers' motivation to use contraception. Educational and prevention programs must address the spectrum of attitudes underlying teenagers' contraceptive and reproductive decisions in order to alter pathways to teenage pregnancy and early parenting. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | QUALITATIVE RESEARCH | ADOLESCENTS, FEMALE | CONTRACEPTIVE USAGE | CONDOM USE | ADOLESCENT PREGNANCY | ATTITUDES | PERCEPTION | INTERVIEWS | ALCOHOL USE AND ABUSE | CONTRACEPTIVE USAGE DETERMINANTS | MOTIVATION | Oceania | Developed Countries | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Risk Reduction Behavior | Behavior | Reproductive Behavior | Fertility | Population Dynamics | Psychological Factors | Data Collection Document Number: 342480 |
| 21. Peer Reviewed Title: A randomized controlled trial of treatment options for troublesome uterine bleeding in Implanon users. Author: Weisberg E; Hickey M; Palmer D; O'Connor V; Salamonsen LA; Findlay JK; Fraser IS Source: Human Reproduction. 2009 Aug;24(8):1852-61. Abstract: BACKGROUND: Pilot data have indicated that both doxycycline alone and mifepristone combined with ethinyl estradiol (EE) are effective in stopping episodes of bleeding in Implanon users with troublesome bleeding. We compared four treatments against a placebo in Implanon users and tested whether repeated treatment improved subsequent bleeding patterns. METHOD: Implanon users aged 18-45 years were randomized to treatment with (i) mifepristone 25 mg given twice on day 1 followed by 4 days of EE 20 microg; (ii) doxycycline 100 mg twice daily for 5 days; (iii) mifepristone 25 mg given twice on day 1 plus doxycycline 100 mg twice daily for 5 days; (iv) doxycycline 100 mg twice daily with EE 20 microg daily; and (v) placebo twice daily for 5 days. The primary end-point was the number of days of bleeding/spotting immediately following initiation of the first 5-day course of each therapy, compared with placebo. RESULTS: There were 204 women assigned to treatment. Mifepristone in combination with either EE or doxycycline was significantly more effective in stopping an episode of bleeding (mean 4.0 days (CI 3.5-4.6) and 4.4 days (CI 3.8-5.2), respectively) than doxycycline alone or in combination with EE, or placebo (6.4 days (CI 4.4-9.2), 6.4 days (CI 4.8-8.6) and 6.4 days (CL 5.1-8.0), respectively). CONCLUSION: Mifepristone combined with either EE or doxycycline was significantly more effective than placebo in terminating an episode of bleeding in Implanon users. However there was no improvement in subsequent bleeding patterns. Trial registration number: ACTR # 012605000206628. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | CONTROL GROUPS | CONTRACEPTIVE IMPLANTS | CONTRACEPTIVE AGENTS, SIDE EFFECTS | MENSTRUATION DISORDERS | TREATMENT | RU-486 | ETHINYL ESTRADIOL | ANTIBIOTICS | ENDOMETRIAL EFFECTS | Oceania | Developed Countries | Research Methodology | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Drugs | Endometrium | Uterus | Genitalia, Female | Genitalia | Urogenital System Document Number: 342798 |
| 22. Title: Rights to emergency contraception. Author: Weisberg E; Fraser IS Source: International Journal of Gynaecology and Obstetrics. 2009 Jun 17; Abstract: Emergency contraception (EC) provides women with a safe means of preventing pregnancy following unprotected sexual intercourse or potential contraceptive failure, and is accepted as a legitimate method of fertility control. The right of women to access EC, along with other contraceptive methods, needs to be affirmed. The consequences of unintended pregnancy are serious, imposing appreciable burdens on children, women, men, and families. Every child has the right to be a wanted child and not enter this world because its mother was denied access to EC. For maximum effectiveness, barriers to access must be removed. It is essential that EC pills are available over-the-counter with no minimum age for access. There is a tension between the rights of women to access EC without medical or legal intervention and the rights of providers who have a conscientious objection to provision on religious or moral grounds. The principles of autonomy, non-maleficence, and beneficence all weigh in favor of the rights of a woman faced with the possibility of an unintended pregnancy to unrestricted access to EC against providers whose religious views are opposed to this. Language: English Keywords: AUSTRALIA | CRITIQUE | PROVIDERS WITH CLIENTS | EMERGENCY CONTRACEPTION | CONTRACEPTIVE AVAILABILITY | OBSTACLES | REPRODUCTIVE RIGHTS | CONTRACEPTIVE MODE OF ACTION | CONTRACEPTIVE SAFETY | LEGISLATION | RELIGIOUS ASPECTS | Oceania | Developed Countries | Health Services | Delivery of Health Care | Health | Contraception | Family Planning | Organization and Administration | Human Rights | Political Factors | Sociocultural Factors | Safety | Public Health | Religion Document Number: 341749 |
| 23. Title: A systematic review of trend studies of women seeking termination of pregnancy. Author: Abigail W; Power C Source: Journal of Clinical Nursing. 2008 Nov;17(22):2951-62. Abstract: AIMS AND OBJECTIVES: This article reports a systematic review of trend studies (1995-2006) which answers five questions: What are the patterns of: 1 Age of women seeking termination of pregnancy; 2 First ever pregnancy ending in a termination; 3 Contraception usage at the time of conception; 4 Contraception chosen immediately postoperatively; and 5 Referral sources to termination of pregnancy services. BACKGROUND: Fertility patterns are changing and there is evidence to indicate that the numbers of older women conceiving for the first time are increasing. At the same time, there are new methods of contraception widely available. Little is known about the implications of these changes on termination patterns. DESIGN: An extensive electronic search of databases such as CINAHL, MEDLINE In-Process (OVID) and was conducted from January 1995-June 2006 for trend studies in pregnancy terminations. METHODS: Articles chosen were based on trend studies greater than five years, contained primary quantitative research and official government statistical reports. RESULTS: Results of the search showed age that was unable to be compared because of the many variations in measurements and time periods, and there was only limited research worldwide of trends in contraception at the time of conception in relation to a termination of pregnancy. Additionally, there were no studies worldwide in the past 11 years, which specifically examined trends in the characteristics of the number of first-ever pregnancies which ended in a termination, contraception choices postoperative to a termination of pregnancy, or referral source to a termination of pregnancy provider. CONCLUSION: Little is reported in the literature on trends in the five characteristics related to pregnancy termination. RELEVANCE TO CLINICAL PRACTICE: Evidence about the changing patterns of women seeking pregnancy termination is needed to inform policy and practice, and to ensure that health promotion strategies are underpinned by accurate information that reflects the needs of the populations of women in relation to their reproductive health. Language: English Keywords: AUSTRALIA | LITERATURE REVIEW | KAP SURVEYS | WOMEN | ABORTION | NURSES AND NURSING | AGE FACTORS | CONTRACEPTIVE USAGE | CONTRACEPTIVE PREVALENCE | CONTRACEPTIVE METHODS CHOSEN | REFERRAL AND CONSULTATION | INFORMATION SOURCES | CONTRACEPTION FAILURE | Developed Countries | Oceania | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Health Personnel | Delivery of Health Care | Health | Population Characteristics | Contraception | Program Activities | Programs | Organization and Administration | Information Document Number: 330073 Notification |
| 24. Peer Reviewed Title: Bridging the gap between male and female fertility control; contraception-on-demand. Author: Aitken RJ; Hughes LM; Griffith R; Baker MA Source: Contraception. 2008 Oct;78(4 Suppl 1):S28-S35. Abstract: Contraception-on-demand refers to contraceptive methods that are only employed when needed, such as barrier or postcoital methods, as opposed to technologies, such as the IUD or pill, where the exposure is continuous irrespective of the risk of pregnancy. The development of women-centered approaches to contraception-on-demand is a high priority in current contraceptive research, with emphasis on the 15- to 25-year-old demographic. Since this cohort of potential users is also at high risk of contracting sexually transmitted disease, topical methods that would provide simultaneous protection against both fertility and infection are of particular interest. This review examines the current strategies that are being pursued to achieve this objective. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | FERTILITY | CONTRACEPTION | SEXUALLY TRANSMITTED DISEASES | VAGINAL BARRIER METHODS | VAGINAL SPERMICIDES | Developed Countries | Oceania | Population Dynamics | Demographic Factors | Population | Family Planning | Reproductive Tract Infections | Infections | Diseases | Barrier Methods | Contraceptive Methods Document Number: 308218 |
| 25. Title: Is there a role for use of levonorgestrel intrauterine system in women with chronic pelvic pain? Author: Anpalagan A; Condous G Source: Journal of Minimally Invasive Gynecology. 2008 Nov-Dec;15(6):663-6. Abstract: This review focuses on the available evidence for the use of levonorgestrel (LNG) intrauterine system (IUS) in women with chronic pelvic pain (CPP). We have searched MEDLINE, Pubmed, Embase, and the Cochrane electronic library with the keywords "chronic pelvic pain," "endometriosis," "Mirena IUS," and "levonorgestrel IUS" from 1956 through April 2008. Review articles, randomized trials, prospective cohort studies, and retrospective studies were analyzed and the available evidence included in this review. Case reports were not included in the analysis. Laparoscopic surgery was shown to be useful in clarifying the underlying cause in women with CPP, with 70% having abnormal findings at laparoscopy. Endometriosis, particularly deep infiltrating endometriosis, is found in 40% to 60% of women with dysmenorrhea. Laparoscopic excision of endometriosis was shown to be associated with improvement of symptoms in 70% to 80% of women. Up to 36% need repeated surgery during a 5-year period after the primary procedure. The absolute reduction in recurrence of dysmenorrhea in women who also had the LNG IUS inserted at the time of surgery was 35% (95% CI 9%-61%). The LNG IUS was shown also to reduce the blood flow in the uterine artery and the subendometrial spiral arteries. This may explain the reduction in primary dysmenorrhea in women who have the LNG IUS inserted. Insertion of the LNG IUS at the time of primary laparoscopic surgery in women with CPP caused by endometriosis has the potential to reduce postoperative pain scores. This medical approach is also a promising alternative to repeated laparoscopic surgery especially in those women who have continuing symptoms after laparoscopic excision of endometriosis. This nonsurgical option could potentially reduce the rate of repeated laparoscopies in women with CPP and, in turn, reduce overall intervention rates. Although growing evidence exists that the LNG IUS can be useful in this group of women, large randomized controlled studies are needed to validate its benefits in day-to-day practice. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | LITERATURE REVIEW | WOMEN | PELVIC INFLAMMATORY DISEASE | ENDOMETRIOSIS | IUD | LAPAROSCOPY | LEVONORGESTREL | Oceania | Developed Countries | Demographic Factors | Population | Reproductive Tract Infections | Infections | Diseases | Contraceptive Methods | Contraception | Family Planning | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents Document Number: 330290 |
| 26. Title: Emergency contraception [letter] Author: Barker S Source: Australian Family Physician. 2008 Aug;37(8):599. Abstract: The Clockwork Young People's Health Service sees a large number of young women requiring emergency contraception (EC). Past experience suggests that these women constitute a particularly at risk group. A pilot study in 2002 demonstrated a chlamydia rate twice that of the rest of the population screened.1 In 2005, an ongoing quality assurance activity in the form of an anonymous survey of all emergency contraception users was commenced. Its purpose was to confirm our suspicions of this being a high risk group, to ensure women requesting EC receive appropriate care and follow up, and to help direct our service's increasing preventive efforts. Responses to the survey have been fairly consistent over the 3 years. Results in 2007 were: of 85 EC recipients aged 13-24 years, 34 (40%) had used EC at least once before, 41 (48.2%) had been on regular contraception in the past but had stopped using this, 32 (37.6%) had been using a condom at the time (but were either aware of an accident with it or were wanting extra protection), 56 (65.9%) were with a partner whom they classed as 'regular' (34.1% were with a casual partner), and 34 (40%) had been drinking or using drugs before the unprotected sex (47%). Our survey results raise a number of topical issues. First, the increased binge drinking trend is currently receiving attention, but the binge drinking by-product of unplanned, unsafe sex has not been highlighted. Clearly it should be. Young women need to be alerted to the possibility of poor decisions/coercion when they are drunk. Second, even though there are recognised benefits for young people being able to purchase EC over-the-counter (in particular, availability on the weekend means that it can be taken closer to the common time for unplanned, unprotected sex) the downside is that a timely opportunity to screen and educate is missed. Perhaps we should be at least ensuring that health access information is supplied at the time of purchase. Finally, with the release of The Sexual and Reproductive Health of Young Victorians report2 there has been some discussion about the provision of EC by nondoctors. Perhaps what the survey suggests is that the imparting of thorough, accurate information about sexual health, including access information, and scheduling a follow up appointment is important; who does this is less important. We need to remain mindful that young EC users are indeed at high risk -of future unplanned pregnancies, STIs, unhealthy relationships, inappropriate alcohol use (and all that is associated with this), and poor self esteem. Ideally all young women should have adequate time at initial presentation and all should be scheduled follow up appointments to look at these issues and the importance of taking control of their reproductive lives. (full text) Language: English Keywords: AUSTRALIA | RESEARCH REPORT | CONTRACEPTIVE PREVALENCE SURVEYS | WOMEN | EMERGENCY CONTRACEPTION | CHLAMYDIA | CONDOM USE | CONTRACEPTIVE USAGE | CONTRACEPTION TERMINATION | ALCOHOL USE AND ABUSE | DRUG USE AND ABUSE | CONTRACEPTIVE AVAILABILITY | Developed Countries | Oceania | Family Planning Surveys | Family Planning | Demographic Factors | Population | Contraception | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Risk Reduction Behavior | Behavior Document Number: 329108 |
| 27. Peer Reviewed Title: Three fertility compromises and two transitions. Author: Caldwell JC Source: Population Research and Policy Review. 2008 Aug;27(4):427-446. Abstract: Demographers and those concerned with population policy are increasingly focusing on the steep fertility declines that occurred in developed countries from the 1960s and the consequent widespread below-replacement fertility levels. The decline has been termed the Second Demographic Transition. This paper argues that the recent demographic change can best be understood and analyzed if we broaden the concept to include the first demographic transition, and the three demographically more settled periods preceding, separating, and following the two fertility transitions. These more settled periods or "compromises" are examined to ascertain their nature and so to help predict the likely developments in the present or third compromise. It is argued that the third compromise has now extended for 20 years with little movement in fertility rates or other socioeconomic behavior which has been said to be associated with the second transition, and that this provides sufficient evidence for analysis. The approach has two key aspects. First, it is confined in Europe to countries that distinctly experienced the full five demographic periods, namely northwestern and central Europe. Second, the analysis gains strength by including non-European countries that progressed through all five stages, namely the English-speaking countries of overseas European settlement: USA, United Kingdom, Australia, and New Zealand. Language: English Keywords: NEW ZEALAND | AUSTRALIA | UNITED KINGDOM | UNITED STATES OF AMERICA | RESEARCH REPORT | DEMOGRAPHIC TRANSITION | BELOW REPLACEMENT FERTILITY | POPULATION POLICY | POPULATION THEORY | Developed Countries | Oceania | Europe, Western | Europe | North America | Americas | Population Dynamics | Demographic Factors | Population | Population Decrease | Social Policy | Policy | Political Factors | Sociocultural Factors | Demography | Social Sciences | Science Document Number: 327927 |
| 28. Title: Filshie clip closure: determination of closure through the analysis of X-rays. Author: Clegg RE Source: Journal of Forensic and Legal Medicine. 2008 Nov;15(8):510-5. Abstract: The Filshie method is a tubal occlusion method commonly used to prevent pregnancy. In medical negligence cases where it is suspected that closure of a Filshie clip may be faulty, lawyers may call on expert surgeons to assess whether or not a clip is closed on the basis of visual examination of the X-rays. However, it is not uncommon for experts to disagree. The aim of this work was to reduce the uncertainty in determining whether or not Filshie clips had been correctly closed. An estimate of the error in the estimate of the clip height was made by propagating measurement errors through a mathematical model. The effects of angle of presentation of the clip, digitisation of the image and resolution of the measurements were studied and the method was applied to two cases. The analysis indicated that measurement errors were least when the digitisation of the image was at 600dpi, angle of presentation of the clip was less than 40 degrees and the measurements could be made to an accuracy of +/-1pixel. Under these conditions it was possible to determine clip closure height with an error of less than +/-0.2mm. Language: English Keywords: AUSTRALIA | RESEARCH REPORT | CLINICAL RESEARCH | MATHEMATICAL MODEL | WOMEN | TUBAL OCCLUSION | SURGICAL ERROR | ERROR SOURCES | COMPUTER PROGRAMS AND PROGRAMMING | PHYSICAL EXAMINATIONS AND DIAGNOSES | Developed Countries | Oceania | Research Methodology | Theoretical Models | Demographic Factors | Population | Female Sterilization | Sterilization, Sexual | Family Planning | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Information Processing | Information | Examinations and Diagnoses Document Number: 329376 |
| 29. Peer Reviewed Title: HIV/AIDS knowledge and attitudes among West African immigrant women in Western Australia. Author: Drummond PD; Mizan A; Wright B Source: Sexual Health. 2008 Sep;5(3):251-9. Abstract: BACKGROUND: Most women who live in sub-Saharan countries have heard of HIV/AIDS, but there is still widespread misunderstanding about how HIV is spread, the consequences of infection, and how to protect against infection. The aim of the present study was to investigate knowledge about HIV and attitudes towards condom use in West African refugees who had settled in Perth, Western Australia, within the past 5 years. METHODS: Knowledge about transmission of HIV, myths about how HIV is spread, incorrect beliefs about protective factors, the effectiveness of condoms in protecting against sexually transmissible infections, and attitudes towards condom use were investigated by survey in 51 West African women, and in 100 Australian women for comparison. Where possible, each West African woman was matched for age and level of education with an Australian woman. RESULTS: Knowledge of HIV was poorest in the least educated West African women, but many of the more highly educated women also had misconceptions about how HIV is spread, how to protect against HIV, and the effectiveness of condoms in protecting against HIV. Moreover, most West African women held negative attitudes towards condom use. Within the Australian sample, HIV knowledge was greatest in women with tertiary qualifications, and was greater in younger than older women; in addition, attitudes towards condom use differed across the age span. CONCLUSIONS: The findings in the present study suggest that educational programs that focus on knowledge about HIV should be tailored to meet the needs and cultural sensitivities of newly emerging immigrant communities, and should target particular demographic groups within the Australian population. Language: English Keywords: AUSTRALIA | AFRICA, SUB SAHARAN | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | IMMIGRANTS | KNOWLEDGE | ATTITUDES | HIV INFECTIONS | INTERNATIONAL MIGRATION | HIV PREVENTION | CONDOM USE | BELIEFS | EDUCATIONAL STATUS | AGE FACTORS | Developed Countries | Oceania | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Migrants | Migration | Population Dynamics | Demographic Factors | Population | Sociocultural Factors | Psychological Factors | Behavior | Viral Diseases | Diseases | Risk Reduction Behavior | Culture | Socioeconomic Status | Socioeconomic Factors | Population Characteristics Document Number: 329201 |
30.  Title: Sexual health for people with intellectual disability. Author: Eastgate G Source: Salud Pública de México. 2008;50 Suppl 2:S255-S259. Abstract: People with intellectual disability experience the same range of sexual needs and desires as other people. However, they experience many difficulties meeting their needs. They may be discouraged from relieving sexual tension by masturbating. They face a high risk of sexual abuse. They are likely not to be offered the full range of choices for contraception and sexual health screening. Poor education and social isolation may increase their risk of committing sexual offences. However, with appropriate education and good social support, people with intellectual disability are capable of safe, constructive sexual expression and healthy relationships. Providing such support is an essential part of supporting people with intellectual disability. (author's) Language: English Keywords: AUSTRALIA | RECOMMENDATIONS | DISABLED PERSONS AND DISABILITIES | MENTAL RETARDATION | SEXUALITY | SEX EDUCATION | SOCIAL ADJUSTMENT | SEXUAL ABUSE | CONTRACEPTIVE METHODS | PROGRAM ACCESSIBILITY | SOCIAL WELFARE | PREGNANCY, UNPLANNED | Developed Countries | Oceania | Population Characteristics | Demographic Factors | Population | Intelligence | Personality | Psychological Factors | Behavior | Education | Social Behavior | Crime | Social Problems | Sociocultural Factors | Contraception | Family Planning | Program Evaluation | Programs | Organization and Administration | Economic Factors | Reproductive Behavior | Fertility | Population Dynamics Document Number: 327283 |
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