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Title: Eliminating world poverty: Building our common future.
Author: Akkerhuys Z; Allan T; Andreyeva R; Arthy B; Chalinder P
Source: Norwich, United Kingdom, The Stationery Office, 2009 Jul. 154 p.
Abstract: The White Paper represents a fundamental shift in the way the UK delivers development aid, refocusing resources onto fragile countries and for the first time treating security and justice as a basic service alongside health, education, water and sanitation. Fifty per cent of new bilateral funding will be committed to fragile countries. Key announcements in Building our Common Future include: A renewed commitment to 0.7 per cent of UK Gross National Income (GNI) for international development, meaning a contribution of Ł9bn per year by 2013; Measures to reduce maternal mortality rates and potentially save the lives of six million mothers and babies by 2015; Plans to support over eight million more children in Africa to go to school; Doubling of funding to Ł1bn for African infrastructure including transport, energy and trade in the region; A tripling of funding to support developing countries to recover stolen assets, and new resources to Interpol, as part of a major effort to stamp out corruption; Increased investment in the Central Emergency Response Fund for humanitarian aid at the UN.
Language: English
Keywords:
UNITED KINGDOM | SUMMARY REPORT | POVERTY | ECONOMIC FACTORS | CHILD HEALTH | EDUCATION | Developed Countries | Europe, Western | Europe | Socioeconomic Factors | Health
Document Number: 331494

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Title: Oral contraceptives and the risk of multiple sclerosis: A review of the epidemiologic evidence.
Author: Alonso A; Clark CJ
Source: Journal of the Neurological Sciences. 2009 May 7;
Abstract: Multiple sclerosis (MS) is more frequent in women than in men, suggesting that sex hormones could play a role in the development of MS. For this reason, several studies have assessed whether use of oral contraceptives modifies the risk of MS. In this article, we review the methodology and results of published epidemiologic studies addressing this issue. On the whole, the existing epidemiologic evidence does not support an important effect of oral contraceptive use on the risk of MS, though it does suggest that oral contraceptives might delay the onset of the disease.
Language: English
Keywords:
UNITED KINGDOM | UNITED STATES OF AMERICA | LITERATURE REVIEW | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | WOMEN | ORAL CONTRACEPTIVES, SIDE EFFECTS | CONTRACEPTIVE SAFETY | CENTRAL NERVOUS SYSTEM EFFECTS | RISK ASSESSMENT | EPIDEMIOLOGY | Developed Countries | Europe, Western | Europe | North America | Americas | Research Methodology | Demographic Factors | Population | Safety | Public Health | Health | Central Nervous System | Physiology | Biology | Evaluation
Document Number: 341145

3.
Title: Emergency contraception: how does it work?
Author: Baird DT
Source: Reproductive Biomedicine Online. 2009;18 Suppl 1:32-6.
Abstract: Emergency (or post-coital) contraception is any substance or device that is used to prevent pregnancy after unprotected intercourse. Currently used hormonal methods of emergency contraception (high-dose combined oral contraceptive pill or levonorgestrel) prevent about 50-80% of pregnancies. Research has demonstrated that these methods inhibit the midcycle surge of LH from the pituitary and, if given at least 2 days before ovulation, ovulation is delayed or prevented. Ovulation still occurs if administration is delayed until ovulation is imminent. Biological data that suggest that the most likely mode of action is by preventing fertilization are supported by the clinical observation that the greater the interval between coitus and administration the greater the chance of pregnancy. There are no data supporting the view that levonorgestrel can impair the development of the embryo or prevent implantation. In contrast, other very effective methods of emergency contraception, such as mifepristone and intrauterine devices, can also inhibit implantation.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | EMERGENCY CONTRACEPTION | IUD | RU-486 | LEVONORGESTREL | CONTRACEPTIVE EFFECTIVENESS | Developed Countries | Europe, Western | Europe | Contraception | Family Planning | Contraceptive Methods | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents
Document Number: 330739

Peer Reviewed

Title: Teenagers and emergency contraception in the UK: a focus group study of salient beliefs using concepts from the Theory of Planned Behaviour.
Author: Bayley J; Brown K; Wallace L
Source: European Journal of Contraception and Reproductive Health Care. 2009 Jun;14(3):196-206.
Abstract: OBJECTIVES: To explore teenagers' beliefs about emergency contraception (EC) within a Theory of Planned Behaviour (TPB) framework. METHODS: Six single sex focus groups comprising a total of 25 female and 23 male pupils aged 13-16 years conducted in schools in Central England. RESULTS: Attitudes to emergency contraception (EC) were mainly positive about the rewards of avoiding teenage pregnancy. Participants had positive beliefs about the effectiveness of EC, although knowledge of crucial time limits varied. EC use was more socially acceptable than teenage pregnancy, yet both outcomes were perceived negatively. Motivation to comply with social pressure was influenced by the appraisal of individuals' intentions. Participants reported high self efficacy in accessing EC, but had concerns over confidentiality and access. CONCLUSIONS: Desire to avoid pregnancy was high in this group, but practical factors and attitudes may be more important for those ambivalent about pregnancy. Adolescents perceive accessing EC as difficult, are concerned about confidentiality, and anticipate negative reactions from staff. Data support the TPB as a suitable framework for understanding attitudes to EC use. Further research should apply quantitative TPB measures to EC use in a wider teenage sample in order to identify potential psychological factors to target in an intervention.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | FOCUS GROUPS | ADOLESCENTS | STUDENTS | EMERGENCY CONTRACEPTION | ATTITUDES | BELIEFS | KNOWLEDGE | PEER PRESSURE | MOTIVATION | CONTRACEPTIVE USAGE | Developed Countries | Europe, Western | Europe | Data Collection | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Contraception | Family Planning | Psychological Factors | Behavior | Culture | Sociocultural Factors | Psychosocial Factors
Document Number: 341801

Peer Reviewed

Title: Principles of contraceptive care: choice, acceptability and access.
Author: Belfield T
Source: Best Practice and Research. Clinical Obstetrics and Gynaecology. 2009 Apr;23(2):177-185.
Abstract: Unintended pregnancy, abortion and sexually transmitted infection rates are high in the UK. Research shows that women and men do know about contraception, but do not always use it or use it poorly and inconsistently. This chapter addresses the issues around contraceptive decision-making and choice, and the influences that affect uptake and use.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | CLIENTS | CONTRACEPTION | CONTRACEPTIVE METHODS | CONTRACEPTIVE MODE OF ACTION | INFORMATION | KNOWLEDGE | INFORMED CHOICE | PROGRAM ACCEPTABILITY | PROGRAM ACCESSIBILITY | Developed Countries | Europe, Western | Europe | Program Activities | Programs | Organization and Administration | Family Planning | Sociocultural Factors | Contraceptive Usage | Program Evaluation
Document Number: 329668

Title: Why embarrassment inhibits the acquisition and use of condoms: A qualitative approach to understanding risky sexual behaviour.
Author: Bell J
Source: Journal of Adolescence. 2009 Apr;32(2):379-91.
Abstract: This article is based on research commissioned by the UK Government's Teenage Pregnancy Unit. The Living on the Edge (LOTE) study qualitatively explored factors that shape young people's experiences and attitudes towards sexual behaviour and young parenthood in three linked seaside and rural areas in England. It identifies embarrassment as a key risk factor in young people's sexual behaviour and demonstrates why engaging in protective behaviour and seeking information and advice, can be constrained by fear of embarrassment and concerns about how they are regarded by others. This paper also argues that embarrassment around condom use is not necessarily restricted to adolescence. Embarrassment is a deeply unpleasant experience for everyone and people (young and old) are motivated to avoid it. Implications and recommendations for future policy and service provision are highlighted.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | QUALITATIVE RESEARCH | ADOLESCENTS | EMOTIONS | SELF-PERCEPTION | FEAR | CONDOM USE | RISK BEHAVIOR | SEX BEHAVIOR | Developed Countries | Europe, Western | Europe | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Psychological Factors | Behavior | Perception | Risk Reduction Behavior
Document Number: 342414

Title: Combined oral contraceptive use and the risk of systemic lupus erythematosus.
Author: Bernier MO; Mikaeloff Y; Hudson M; Suissa S
Source: Arthritis and Rheumatism. 2009 Mar 30;61(4):476-481.
Abstract: OBJECTIVE: To assess whether the risk of incident systemic lupus erythematosus (SLE) is associated with the use of combined oral contraceptives (COCs), because studies of the link between exogenous hormonal exposure and the risk of SLE have produced conflicting results. METHODS: We conducted a population-based nested case-control study among women ages 18-45 years, using the UK's General Practice Research Database. All incident cases of SLE from 1994-2004 (n = 786) were identified in the database and matched with up to 10 controls (n = 7,817) among women without SLE at the time of the case's diagnosis. RESULTS: The adjusted rate ratio (RR) of incident SLE associated with any use of COC was 1.19 (95% confidence interval [95% CI] 0.98-1.45), whereas with current use it was 1.54 (95% CI 1.15-2.07). The rate was particularly increased in current users who had only recently started COC use (RR 2.52, 95% CI 1.14-5.57) compared with longer-term current users (RR 1.45, 95% CI 1.06-1.99). The risk appearedto be particularly elevated with current exposure to first- or second-generation contraceptives (RR 1.65, 95% CI 1.20-2.26), and increasing with the dose of ethinyl estradiol (RR 1.42, 1.63, and 2.92 for Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | CASE CONTROL STUDIES | LONGITUDINAL STUDIES | WOMEN | ORAL CONTRACEPTIVES, COMBINED | SYSTEMIC LUPUS ERYTHEMATOSUS | PREVALENCE | RISK FACTORS | RISK ASSESSMENT | Developed Countries | Europe, Western | Europe | Research Methodology | Studies | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Diseases | Measurement | Health | Evaluation
Document Number: 330926

Peer Reviewed

Title: Involving pharmacists in sexual health research: experience from an emergency contraception study.
Author: Black K; Anderson C; Kubba A; Wellings K
Source: Journal of Family Planning and Reproductive Health Care. 2009 Jan;35(1):41-3.
Abstract: BACKGROUND: Community pharmacists are expanding their sphere of activity within primary health care, increasing their role not only in health care but also research. METHODS AND RESULTS: We describe the challenges encountered in carrying out a pilot study of women obtaining emergency hormonal contraception through different providers, including pharmacies, highlighting deficiencies in understanding and experience of the research process, which impacted on the study in substantial ways. CONCLUSIONS: As pharmacists expand their role, training and professional development will need to be enhanced to support them in their contribution to health care and research.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | EMERGENCY CONTRACEPTION | PHARMACISTS | EDUCATION | HOME CARE | PHARMACY DISTRIBUTION | SEX EDUCATION | HEALTH | RESEARCH AND DEVELOPMENT | Developed Countries | Europe, Western | Europe | Contraception | Family Planning | Health Personnel | Delivery of Health Care | Care and Support | Health Services | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Technology | Economic Factors
Document Number: 329636

10.

Peer Reviewed

Title: Delivery of chlamydia screening to young women requesting emergency hormonal contraception at pharmacies in Manchester, UK : a prospective study.
Author: Brabin L; Thomas G; Hopkins M; O'Brien K; Roberts SA
Source: BMC Women's Health. 2009 Mar 26;9(1):7.
Abstract: ABSTRACT: BACKGROUND: More women are requesting Emergency Hormonal Contraception (EHC) at pharmacies where screening for Chlamydia trachomatis is not routinely offered. The objective of this study was to assess the uptake of free postal chlamydia screening by women under 25 years who requested EHC at pharmacies in Manchester, UK. METHODS: Six Primary Care Trusts (PCTs) that had contracted with pharmacies to provide free EHC, requested the largest EHC providers ([greater than or equal to] 40 doses annually) to also offer these clients a coded chlamydia home testing kit. Pharmacies kept records of the ages and numbers of women who accepted or refused chlamydia kits. Women sent urine samples directly to the laboratory for testing and positive cases were notified. Audit data on EHC coverage was obtained from PCTs to assess the proportion of clients eligible for screening and to verify the uptake rate. RESULTS: 33 pharmacies participated. Audit data for 131 pharmacy months indicated that only 24.8% (675/2718) of women provided EHC were also offered chlamydia screening. Based on tracking forms provided by pharmacies for the whole of the study, 1348 /2904 EHC clients (46.4%) who had been offered screening accepted a screening kit. 264 (17.6%) of those who accepted a kit returned a sample, of whom 24 (9.1%) were chlamydia-positive. There was an increase in chlamydia positivity with age (OR: 1.2 per year; 1.04 to 1.44; p = 0.015). CONCLUSIONS: Chlamydia screening for EHC pharmacy clients is warranted but failure of pharmacists to target all EHC clients represented a missed opportunity for treating a well defined high-risk group.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | YOUTH | SCREENING | EMERGENCY CONTRACEPTION | CHLAMYDIA | PHARMACY DISTRIBUTION | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Demographic Factors | Population | Age Factors | Population Characteristics | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraception | Family Planning | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration
Document Number: 330849

11.

Title: Maternal mortality in low-income countries: what interventions have been evaluated and how should the evidence base be developed further?
Author: Burchett HE; Mayhew SH
Source: International Journal of Gynaecology and Obstetrics. 2009 Apr;105(1):78-81.
Abstract: OBJECTIVE: This article reviews the evidence for the effectiveness of non-clinical interventions to reduce maternal mortality in low-income settings and identifies the gaps in the evidence base. METHODS: A systematic search was conducted to identify reviews and evaluations of non-clinical interventions to reduce maternal mortality in lower-income countries with high maternal mortality published between 1997 and 2008. Studies were reviewed to identify the topic focus, study design, and outcomes measured. RESULTS: There were 109 intervention evaluations and 30 reviews identified. Studies had been conducted in less than half of the countries and were generally poor quality. More studies focused on tertiary prevention (i.e., preventing death) rather than secondary prevention (i.e., preventing complications). More interventions sought to address quality of care than delays in seeking or accessing care. CONCLUSIONS: While evidence partly reflects difficulties in evaluating complex public health interventions, more robust study designs are possible to evaluate interventions to reduce maternal mortality. In addition, better standardized outcome measures are needed. This overview identifies topic areas neglected by intervention research.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | INTERVENTIONS | LOW INCOME POPULATION | MATERNAL MORTALITY | EVALUATION | RESEARCH METHODOLOGY | Developed Countries | Europe, Western | Europe | Programs | Organization and Administration | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Mortality | Population Dynamics | Demographic Factors | Population
Document Number: 341377

12.

Peer Reviewed

Title: Contraception and gynaecological care.
Author: Cameron S
Source: Best Practice and Research. Clinical Obstetrics and Gynaecology. 2009 Apr;23(2):211-220.
Abstract: Hormonal contraception, through suppression of ovarian activity or endometrial proliferation, can be used to treat and prevent a range of gynaecological disorders. There is evidence to support the effectiveness of the levonorgestrel intra-uterine system (LNG-IUS), combined oral contraceptive pill (COC) and progestogen-only injectable depot-medroxyprogesterone acetate for treating heavy menstrual bleeding and dysmenorrhoea. COCs are also an effective treatment for acne and hirsuitism, and may lessen the symptoms of premenstrual syndrome. There is good evidence that COCs can significantly reduce the risk of both ovarian and endometrial cancer. There is also some evidence that COCs may prevent ovarian cysts, endometrial hyperplasia and fibroids. The LNG-IUS may be used as endometrial protection in women using hormone replacement therapy or tamoxifen. This chapter will deal with the evidence for both treatment and prevention of a range of gynaecological disorders of different hormonal contraceptive methods.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | ORAL CONTRACEPTIVES | IUD | GYNECOLOGY | IUD, HORMONE RELEASING | Developed Countries | Europe, Western | Europe | Contraceptive Methods | Contraception | Family Planning | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 329666

13.

Peer Reviewed

Title: The rising proportion of repeat teenage pregnancies in young women presenting for termination of pregnancy from 1991 to 2007.
Author: Collier J
Source: Contraception. 2009 May;79(5):393-6.
Abstract: BACKGROUND: It is difficult to fully ascertain the number of teenagers in the United Kingdom who have more than one pregnancy before the age of 20 years. The national abortion figures represent one of the few ways one can investigate on a national scale whether there is an increase in the number of young women presenting with a repeat pregnancy. STUDY DESIGN: Datasheets regarding legally induced abortions carried out in England and Wales from 1991 to 2007 were downloaded from the Office of National Statistics and Department of Health websites. Age-specific data were extracted. RESULTS: Among young women less than 20 years old who present for abortion in England and Wales, those with recorded previous pregnancies have steadily risen from 1991 to 2007 both in absolute number and in proportion. The increase in the proportion of abortions that are subsequent to a previous birth was by 42% (from 0.080 to 0.115), and the increase in the proportion of abortions subsequent to a previous abortion was by 68% (from 0.081 to 0.134). CONCLUSIONS: These data provide evidence that repeat teenage pregnancies are on the increase. Urgent attention is required to improve contraceptive advice and services targeted specifically at teenagers who have previously conceived.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | ADOLESCENTS | YOUTH | ADOLESCENT PREGNANCY | ABORTION | FERTILITY MEASUREMENTS | Developed Countries | Europe, Western | Europe | Age Factors | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Fertility Control, Postconception | Family Planning
Document Number: 342083 Notification

14.

Title: Recent heterosexual partnerships and patterns of condom use: a weighted analysis.
Author: Copas AJ; Mercer CH; Farewell VT; Nanchahal K; Johnson AM
Source: Epidemiology. 2009 Jan;20(1):44-51.
Abstract: BACKGROUND: In epidemiologic studies of sexual partnerships, characteristics are often collected in part through detailed questions concerning recent partnerships. These data present challenges for analysis. First, although research interest generally lies in all partnerships in a certain time period, participants may be asked to provide detailed information only concerning their most recent, up to a fixed number. As more recent partnerships may differ from others, a simple analysis of these data may lead to bias. Second, the total number of partnerships for a study participant may be informative, so the analyst must choose between inference for the population of partnerships or for a typical partnership from the population of individuals. Third, data may be more fully recorded for study participants than their partners, and not all partners may be eligible to participate. METHODS: We propose weighting to deal with these challenges. Weighting provides a sensitivity analysis for the possible selection bias due to incomplete reporting. We analyze heterosexual condom use in Britain, using data from the National Survey of Sexual Attitudes and Lifestyles 2000. RESULTS: The sensitivity of estimates to possible selection bias is low. We find that the choice of population for inference is important for prevalence estimates, but has relatively little impact on measures of association. By defining within-participant partnership predictors we demonstrate how participants vary their condom use. We establish that, at least for male participants, shorter partnership duration is linked to a higher probability of condom use at last sex but lower probability at first sex. CONCLUSION: We recommend a weighted analysis approach to recent partnership data, which can be simply implemented in standard survey analysis software. In other surveys the sensitivity of estimates to possible selection bias may be substantial and this will need to be assessed in each case.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | HETEROSEXUALS | SEXUAL PARTNERS | ATTITUDES | LIFE STYLE | CONDOM USE | Developed Countries | Europe, Western | Europe | Sex Behavior | Behavior | Psychological Factors | Risk Reduction Behavior
Document Number: 341365

15.

Peer Reviewed

Title: Repeat abortion: facts and issues.
Author: Das S; Adegbenro A; Ray S; Amu O
Source: Journal of Family Planning and Reproductive Health Care. 2009 Apr;35(2):93-5.
Abstract: BACKGROUND: The commonest reason for undertaking termination of pregnancy (TOP) in the UK is as defined by Clause 2 of the Abortion Act. There are no agreed criteria for defining 'recurrent abortion seekers'. We aimed to review the characteristics of women requesting termination of at least two consecutive pregnancies within 24 months of the first and to identify any factors for seeking repeat TOP. METHODS: The database of patients that attended our Fertility Control Services from 2001 to 2006 was evaluated. Demographic data, contraceptive use in the cycle of conception and reasons for request were assessed for possible associations with repeat TOP. RESULTS: The incidence was 2.3% as defined by our criteria. Financial circumstances was the commonest reason for seeking TOP (75%). The combined oral contraceptive pill and condom were the commonest forms of contraception in these patients before the first TOP (35% and 38%, respectively). Long-acting reversible contraception (LARC) was used by only 8% of women before their TOP. Although 58% accepted LARC following TOP, only 2% continued its use thereafter and 50% of women were not using any contraception at the time of the repeat TOP. CONCLUSION: This study suggests that social workers and perhaps psychologists should be part of the peri-abortion counselling team. Contraceptive counselling should emphasise the side effects of LARC to improve compliance. Follow-up to ensure compliance and involvement of partners in decision-making could help to reduce the incidence of repeat TOP.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | RETROSPECTIVE STUDIES | ABORTION | CONTRACEPTION TERMINATION | USER COMPLIANCE | EMERGENCY CONTRACEPTION | COUNSELING | PSYCHOLOGICAL FACTORS | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Fertility Control, Postconception | Family Planning | Contraception | Behavior | Clinic Activities | Program Activities | Programs | Organization and Administration
Document Number: 341653

17.

Peer Reviewed

Title: Attitudes towards the male contraceptive pill in men and women in casual and stable sexual relationships.
Author: Eberhardt J; van Wersch A; Meikle N
Source: Journal of Family Planning and Reproductive Health Care. 2009 Jul;35(3):161-5.
Abstract: BACKGROUND AND METHODOLOGY: Men's and women's attitudes towards the male contraceptive pill and their trust in the effective use of the male pill were investigated, as well as the associated variables of reported health behaviours, perceived self-efficacy and type of sexual relationship, using a questionnaire survey. RESULTS: Although both sexes had a favourable attitude towards the male pill, females had a more positive attitude than men. Conversely, women had less trust that men would use the male pill effectively. Males in stable sexual relationships were more positive about the male pill than those in casual sexual relationships. Gender, relationship type and trust in the effective use of the male pill reliably predicted attitude towards the male pill. High perceived self-efficacy was related to engaging in more health behaviours, and in men a positive association between health behaviours and attitude towards the male pill has been found. DISCUSSION AND CONCLUSIONS: A positive attitude towards the male pill does not automatically imply that the individual is confident about its effective use. Once the male pill is widely available, promotional campaigns could target not only men but also their female partners, as the latter tend to come into contact with health services more frequently. In order to increase confidence in effective implementation, a variety of presentations of the male pill should be made available in line with individual needs and lifestyles.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | SAMPLING STUDIES | MALE CONTRACEPTION | ORAL CONTRACEPTIVES | ATTITUDES | BELIEFS | QUESTIONNAIRES | MALE ROLE | SEX FACTORS | AGE FACTORS | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Contraception | Family Planning | Contraceptive Methods | Psychological Factors | Behavior | Culture | Sociocultural Factors | Social Behavior | Population Characteristics | Demographic Factors | Population
Document Number: 342138

18.

19.

Peer Reviewed

Title: Adolescent access to emergency contraception: a comment on the UK context.
Author: Fallon D
Source: European Journal of Contraception and Reproductive Health Care. 2009 Apr;14(2):120-6.
Abstract: The provision of emergency contraception (EC) in the United Kingdom (UK) has been transformed over the past decade through advances in pharmacology and the implementation of governmental measures to reduce teenage pregnancy rates. This paper considers how these issues have developed in the current social and political context with specific reference to adolescent access to EC in the UK. It highlights the concerns caused by increased availability of EC and the tension between adolescent rights to confidential treatment and advice, and professional anxiety about encouraging secrecy or parental deception. It concludes that adolescents, whilst benefiting from increased access to EC may also face a series of challenges as a result.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | CLINICAL RESEARCH | ADOLESCENTS, FEMALE | EMERGENCY CONTRACEPTION | CONTRACEPTIVE AVAILABILITY | GOVERNMENT PROGRAMS | ADOLESCENT PREGNANCY | PREVENTION AND CONTROL | POLITICAL FACTORS | CONFIDENTIAL INFORMATION | FAMILY PLANNING EDUCATION | PARENTAL CONSENT | Developed Countries | Europe, Western | Europe | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Programs | Organization and Administration | Reproductive Behavior | Fertility | Population Dynamics | Diseases | Sociocultural Factors | Ethics | Education
Document Number: 330933

20.

Peer Reviewed

Title: Contraceptive failure of Depo-Provera®: long-acting reversible contraceptive (LARC) methods do fail too.
Author: Farmer L; Patel E
Source: Journal of Family Planning and Reproductive Health Care. 2009 Jan;35(1):59-60.
Abstract: This article reports on a case report of a 28-year-old woman, gravida 4 para 1, presenting to primary care for contraception. She opted for Depo-Provera. The patient re-presented with symptoms of nausea 6 weeks following her second Depo-Provera injection. A pregnancy test was positive. A dating ultrasound scan was arranged. This took place 7 weeks after her second Depo-Provera injection and showed a viable pregnancy at 9 weeks 2 days estimated gestation, indicating that conception would have occurred around the time of the second injection. The patient opted for a termination of pregnancy and had a copper-bearing intrauterine device fitted at the time of abortion.
Language: English
Keywords:
UNITED KINGDOM | SUMMARY REPORT | CASE STUDIES | CONTRACEPTION FAILURE | DEPO-PROVERA | PREGNANCY | ADMINISTRATION AND DOSAGE | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Contraceptive Usage | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Reproduction | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 329635

21.

Title: Systematic analysis of research underfunding in maternal and perinatal health.
Author: Fisk NM; Atun R
Source: BJOG. 2009 Feb;116(3):347-56.
Abstract: BACKGROUND: Little published evidence supports the widely held contention that research in pregnancy is underfunded compared with other disease areas. OBJECTIVES: To assess absolute and relative government and charitable funding for maternal and perinatal research in the UK and internationally. SEARCH STRATEGY, SELECTION CRITERIA, DATA COLLECTION, AND ANALYSIS: Major research funding bodies and alliances were identified from an Internet search and discussions with opinion leaders/senior investigators. Websites and annual reports were reviewed for details of strategy, research spend, grants awarded, and allocation to maternal and/or perinatal disease using generic and disease-specific search terms. MAIN RESULTS: Within the imprecision in the data sets, < or =1% of health research spend in the UK was on maternal/perinatal health. Other countries fared better with 1-4% investment, although nonexclusive categorisation may render this an overestimate. In low-resource settings, government funders focused on infectious disease but not maternal and perinatal health despite high relative disease burden, while global philanthropy concentrated on service provision rather than research. Although research expenditure has been deemed as appropriate for 'reproductive health' disease burden in the UK, there are no data on the equity of maternal/perinatal research spend against disease burden, which globally may justify a manyfold increase. AUTHOR'S CONCLUSIONS: This systematic review of research expenditure and priorities from national and international funding bodies suggests relative underinvestment in maternal/perinatal health. Contributing factors include the low political priority given to women's health, the challenging nature of clinical research in pregnancy, and research capacity dearth as a consequence of chronic underinvestment.
Language: English
Keywords:
UNITED KINGDOM | LITERATURE REVIEW | EVALUATION | POLICYMAKERS | GOVERNMENT | NONGOVERNMENTAL ORGANIZATIONS | CHILDBIRTH | MATERNAL-CHILD HEALTH SERVICES | FINANCIAL ACTIVITIES | ECONOMIC FACTORS | PREGNANCY | GRANTS | RESEARCH ACTIVITIES | EXPENDITURES | Developed Countries | Europe, Western | Europe | Administrative Personnel | Organization and Administration | Political Factors | Sociocultural Factors | Organizations | Pregnancy Outcomes | Reproduction | Primary Health Care | Health Services | Delivery of Health Care | Health | Research Methodology
Document Number: 331089

22.

Title: Gender and migration: West Indians in comparative perspective.
Author: Foner N
Source: International Migration. 2009 Jun;47(1):3-29.
Abstract: This article explores gender issues in West Indian migration by taking a comparative -cross-national -perspective. The focus is on the three major West Indian migration movements of the mid- and late-twentieth and early twenty-first centuries -to the United States, Britain, and Canada. A comparative approach has a number of benefits for the study of West Indian migration. It not only points to similarities and contrasts in gender-related patterns among West Indian migrants in the United States, Britain, and Canada but also forces us to try to account for them. It brings out, in an especially dramatic way, the role of the context of reception and the receiving country's immigration policies in shaping male-female differences in West Indian migration flows as well as immigrant adaptation. The comparative analysis of the three migrations in this article explores the reasons for and patterns of West Indian migration as they relate to gender, including the practice of leaving children behind in the Caribbean, as well as aspects of the labour market incorporation of West Indian men and women when they have arrived and settled in the migrant destination. More specifically, the comparisons raise some intriguing questions. Why, for example, did West Indian women comprise a greater proportion of the migrations to the United States and Canada than to Britain? Why were West Indian women more likely to work in caregiving jobs in private homes in the United States and Canada than in Britain? And have the dynamics of transnational motherhood differed in the North American and British contexts?
Language: English
Keywords:
CARIBBEAN | CANADA | UNITED KINGDOM | UNITED STATES OF AMERICA | HISTORICAL REVIEW | COMPARATIVE STUDIES | DOMESTIC WORKERS | MIGRATION | GENDER ISSUES | MIGRATION POLICY | FAMILY RELATIONSHIPS | Developing Countries | Americas | Developed Countries | North America, Northern | Europe, Western | Europe | North America | Studies | Research Methodology | Labor Force | Human Resources | Economic Factors | Population Dynamics | Demographic Factors | Population | Sociocultural Factors | Population Policy | Social Policy | Policy | Political Factors | Family Characteristics | Family and Household
Document Number: 341298

23.

Peer Reviewed

Title: Contraception for adolescents.
Author: French RS; Cowan FM
Source: Best Practice and Research. Clinical Obstetrics and Gynaecology. 2009 Apr;23(2):233-247.
Abstract: Ensuring that sexually active adolescents are using contraception consistently and correctly is an effective means of reducing unplanned pregnancy. Use of highly effective long-acting reversible methods, such as subdermal implants, is low. We need to challenge the perception that the pill and condoms, the most commonly used contraceptive methods, are always the most suitable methods for young people. Changes in adolescent sexual behaviour, including increased number of sexual partners, is consistent with a rise in sexually transmitted infections. No contraceptive methods, with the exception of male or female sterilisation, are contra-indicated solely on the grounds of age. Young people need to be counselled about both the benefits and risks associated with each method so that they can make an informed choice. Most of the clinical evidence on contraceptive use comes from studies of 'older' women, with little research identified that specifically addressed implications for adolescent contraceptive use.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | ADOLESCENTS | CONTRACEPTION | ORAL CONTRACEPTIVES | CONDOMS | Developed Countries | Europe, Western | Europe | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Family Planning | Contraceptive Methods | Barrier Methods
Document Number: 329656

24.

Peer Reviewed

Title: Use of contraceptive services in Britain: findings from the second National Survey of Sexual Attitudes and Lifestyles (Natsal-2).
Author: French RS; Mercer CH; Johnson AM; Fenton KA; Erens B; Wellings K
Source: Journal of Family Planning and Reproductive Health Care. 2009 Jan;35(1):9-14.
Abstract: OBJECTIVE: To describe contraceptive service use and identify demographic and sexual behavioural characteristics associated with use (and non-use) of different services. METHODS: Probability survey sample of men and women aged 16-44 years, resident in Britain. Participants comprised 3369 men and 4375 women reporting vaginal intercourse in the last year (excluding those reporting exclusive use of sterilisation or medical investigations for infertility). Main outcome measures were use of contraceptive services, grouped as: general practice, community contraceptive clinics, retail services and nonuse of services. RESULTS: General practice was the most commonly reported source of contraceptive supplies for women (59.2%), while retail services were most frequently reported by men (42.7%). 16.3% of women and 7.3% of men reported using more than one type of service. 20.7% of women and 45.1% of men had used no service in the last year, and amongst 16-17-year-olds the proportions reporting non-use of services was 13.8% and 31.2%, respectively. Use of community contraceptive clinics was associated with being younger, childless, single and reporting more heterosexual partners in the last year. CONCLUSIONS: There was relatively little 'shopping around' between different services, suggesting that choice of contraceptive providers ensures a range of needs is met for most people. While general practice is the most commonly used source of supplies, community contraceptive clinics are seeing those potentially at higher sexual health risk, particularly the young and those with multiple partners. Ways of improving young people's access to services for contraceptive supplies need to be addressed.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | SURVEYS | CONTRACEPTION | CONTRACEPTIVE USAGE | SEX BEHAVIOR | LIFE STYLE | ATTITUDES | FAMILY PLANNING PROGRAMS | PROGRAM ACCESSIBILITY | Developed Countries | Europe, Western | Europe | Sampling Studies | Studies | Research Methodology | Family Planning | Behavior | Psychological Factors | Program Evaluation | Programs | Organization and Administration
Document Number: 329637

25.

Peer Reviewed

Title: Development of a scrotal vasocutaneous fistula producing viable spermatozoa 9 years after vasectomy.
Author: Gaden S; Kasraie J
Source: Fertility and Sterility. 2009 Mar;91(3):929.e17-9.
Abstract: OBJECTIVE: To describe a case of scrotal vasocutaneous fistula discharging viable sperm. DESIGN: Case report. SETTING: A hospital-based assisted conception center. PATIENT(S): A 37-year-old male presenting for fertility treatment 9 years after vasectomy with a scrotal vasocutaneous fistula that caused a painful, intermittently rupturing, subcutaneous cyst. INTERVENTION(S): Analysis of fistula discharge and planned fistula resection with vasovasostomy. MAIN OUTCOME MEASURE(S): Diagnostic semen analysis to determine presence or absence of spermatozoa in fistula discharge. RESULT(S): A very low concentration of live spermatozoa were identified in the fistula discharge. CONCLUSIONS(S): We believe this is the first time that live spermatozoa, potentially suitable for assisted conception treatment using intracytoplasmic sperm injection have been identified in the discharge from a vasocutaneous fistula.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | CASE STUDIES | MEN | VASECTOMY | SPERMATOZOA | FISTULA | TREATMENT | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Demographic Factors | Population | Male Sterilization | Sterilization, Sexual | Family Planning | Germ Cells | Genitalia | Urogenital System | Physiology | Biology | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 341006

26.

Peer Reviewed

Title: Prevention of tamoxifen induced endometrial polyps using a levonorgestrel releasing intrauterine system long-term follow-up of a randomised control trial.
Author: Gardner FJ; Konje JC; Bell SC; Abrams KR; Brown LJ; Taylor DJ; Habiba M
Source: Gynecologic Oncology. 2009 Sep;114(3):452-6.
Abstract: OBJECTIVES: In a RCT, we have previously shown that the levonorgestrel intrauterine system (LNG-IUS, Mirena) produces a decidual response protecting the endometrium at one year follow-up. We here report on the long-term follow-up of this group of women, to test the hypothesis that a LNG-IUS could prevent the pro-proliferative uterine responses of tamoxifen for up to 4.5 years. METHODS: A randomised-controlled trial of postmenopausal women who had taken at least one year of adjuvant tamoxifen therapy. RESULTS: One hundred twenty-two women were recruited. Nine were found to be ineligible after randomisation. The average duration of follow-up was 26.25 months (IQR 14.5-36 months) in the surveillance group and 24.2 months (IQR 13.75-32.5 months) in the LNG-IUS group. Women with LNG-IUS in situ at the time of final assessment had decidualised endometrium, and no polyps. In the surveillance group new polyps arose in 8 cases. There were 3 new polyps in the group initially randomised to LNG-IUS, one in a patient who did not have the device inserted and 2 occurred in patients following the removal of the LNG-IUS. Univariate Cox proportional hazards regression models identified only endometrial thickness at trial entry as a statistically significant variable (HR 1.12, 95% CI 1.02 to 1.22, p=0.01) for the development of polyps. CONCLUSION: This study confirms that LNG-IUS induces benign endometrial changes and prevents endometrial polyps but only during its use in women taking tamoxifen. Endometrial thickness is a risk factor for the development of polyps.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | CONTROL GROUPS | CLIENTS | BREAST CANCER | TAMOXIFEN | ENDOMETRIAL EFFECTS | IUD, HORMONE RELEASING | LEVONORGESTREL | HYSTEROSCOPY | ULTRASONICS | Developed Countries | Europe, Western | Europe | Research Methodology | Program Activities | Programs | Organization and Administration | Cancer | Neoplasms | Diseases | Fertility Agents | Reproductive Control Agents | Family Planning | Endometrium | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | IUD | Contraceptive Methods | Contraception | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342402

27.

Peer Reviewed

Title: Provision of contraception services and advice for women with cystic fibrosis.
Author: Gatiss S; Mansour D; Doe S; Bourke S
Source: Journal of Family Planning and Reproductive Health Care. 2009 Jul;35(3):157-60.
Abstract: BACKGROUND AND METHODOLOGY: As the prognosis of patients with cystic fibrosis (CF) improves, issues of sexual health, fertility, pregnancy and contraception are increasingly important. In order to plan the provision of a contraception and sexual health service for women with CF we studied their sexual and reproductive history, their current usage of contraception, the sources and quality of advice they had received, and their particular needs using a confidential questionnaire sent to all women over 16 years of age attending a regional CF centre. RESULTS: Of 55 women (mean age 29.7 years) surveyed, 42 (76%) responded. Thirty-three women (79%) were sexually active and 13 (31%) had experienced 19 pregnancies, five (26%) of which were unplanned. Only half of the women who responded were using contraception. No woman used female sterilisation, the progestogen implant, intrauterine system (IUS) or copper-bearing intrauterine device (IUD) for contraception. Twenty-six (62%) women reported not having received contraceptive advice specific to CF and 24 (57%) said that they had not been warned about the potential interaction between broad-spectrum antibiotics and the combined pill. DISCUSSION: Women with CF have a relatively high rate of unplanned pregnancy and do not receive optimal advice or use the full range of contraceptive methods. CF teams lack training in contraception and contraceptive services may not have a detailed knowledge of CF and its complications. New strategies are needed to focus the knowledge and skills of both teams in providing better services for women with CF.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | WOMEN | CLIENTS | HEREDITARY DISEASES | COMPLICATIONS | CONTRACEPTIVE USAGE | FERTILITY | PREGNANCY | QUESTIONNAIRES | ANTIBIOTICS | GENETIC COUNSELING | Developed Countries | Europe, Western | Europe | Demographic Factors | Population | Program Activities | Programs | Organization and Administration | Diseases | Contraception | Family Planning | Population Dynamics | Reproduction | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Counseling | Clinic Activities
Document Number: 342139

28.

Peer Reviewed

Title: How well do women recall past contraceptive use? A pilot study.
Author: Guttinger AK; Chen ZE
Source: Journal of Family Planning and Reproductive Health Care. 2009 Jul;35(3):173-5.
Abstract: BACKGROUND AND METHODOLOGY: Many women use a variety of contraceptive methods during their reproductive lives. Investigating this exposure is one of the most frequently performed epidemiological investigations. Accurate recall of methods used, as well as validating this information, can be difficult. A pilot study compared recalled contraceptive use over 5 years with that documented in the case notes of 30 women. RESULTS: 47% of episodes of method use were accurately recalled to the month of starting method use; this figure rose to 94% when episodes with disagreement within +/-12 months were also considered. Similarly, 44% and 91% of episodes were accurately recalled to the month and within +/-12 months of stopping method use, respectively. Accuracy of recall for duration of use followed a similar pattern. 7% of users were unable to distinguish between use of a combined pill and a progestogen-only pill and one-third of women using an intrauterine contraceptive were unable to distinguish an intrauterine device (IUD) from the intrauterine system (IUS). DISCUSSION AND CONCLUSIONS: Almost all women can recall accurately which contraceptive methods they have used in the past year but are less accurate in respect of exact starting and stopping dates. Some women confuse the combined pill with the progestogen-only pill and others confuse the IUD and the IUS. The findings need to be replicated in other settings and with populations of less well-educated women.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | SAMPLING STUDIES | WOMEN | CONTRACEPTIVE USAGE | CONTRACEPTIVE METHOD SWITCHING | CONTRACEPTION CONTINUATION | TIME FACTORS | SELF-PERCEPTION | INTERVIEWS | RECORDS | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Demographic Factors | Population | Contraception | Family Planning | Population Dynamics | Perception | Psychological Factors | Behavior | Data Collection | Information Processing | Information
Document Number: 342136

29.

Peer Reviewed

Title: Non - contraceptive benefits and risks of contraception
Author: Haider Z; D'Souza R
Source: Best Practice and Research: Clinical Obstetrics and Gynaecology. 2009 Apr;23(2):249-262.
Abstract: Contraception is primarily used to prevent pregnancy. However, a user should be aware of both the possible non-contraceptive benefits she/he may experience and any potential risks to her/his health. These issues should be discussed as fully as possible, using current, evidence-based information prior to commencing a method. Some methods may be prescribed solely for their noncontraceptive benefits for a woman who does not require it for contraception. Potential risks to a woman?s health may make certain methods unacceptable if concurrent medical problems or lifestyle issues exist. This chapter discusses the main non-contraceptive benefits and risks for each contraceptive method in turn.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | CONTRACEPTIVE AGENTS, SIDE EFFECTS | RISK ASSESSMENT | COUNSELING | FAMILY PLANNING EDUCATION | CONTRAINDICATIONS | CONTRACEPTIVE METHODS | Developed Countries | Europe, Western | Europe | Research Methodology | Demographic Factors | Population | Contraceptive Agents | Contraception | Family Planning | Evaluation | Clinic Activities | Program Activities | Programs | Organization and Administration | Education | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 341507

30.

Peer Reviewed

Title: Sexual behaviour, condom use and rates of sexually transmitted infections in HIV clinic attendees in South East London.
Author: Hamlyn E; Welz T; Rebaudengo S; Simms H; Poulton M
Source: International Journal of STD and AIDS. 2009 Sep 16;
Abstract: The aim of this study was to examine sexual behaviour, condom use and rates of sexually transmitted infections (STIs) among attendees at a dedicated on-site STI clinic at a South London HIV centre. Data were prospectively collected by using a nurse-completed questionnaire. Ninety-eight percent of women reported one or no sexual partners in the preceding three months, whereas 57% of men who have sex with men (MSM) reported two or more partners. Only 28% of women, 53% of heterosexual men and 29% of MSM always used a condom for vaginal or anal intercourse. Positive STI diagnoses were found in 17.5% of women, 20% of heterosexual men and 49% of MSM. Twenty percent of patients who reported always using a condom and 38% of MSM reporting no sexual activity in the preceding three months had an STI. These results highlight the need for safe sex promotion and STI screening in HIV-infected patients regardless of self-reported sexual activity.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | PROSPECTIVE STUDIES | CLIENTS | PERSONS LIVING WITH HIV/AIDS | HETEROSEXUALS | MEN HAVING SEX WITH MEN | CONDOM USE | SEX BEHAVIOR | SEXUALLY TRANSMITTED DISEASES | PREVALENCE | QUESTIONNAIRES | CLINIC ACTIVITIES | SCREENING | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Behavior | Risk Reduction Behavior | Reproductive Tract Infections | Infections | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342841


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