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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 �9bn 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 �1bn 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

5.
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

Title: Quantitative analysis of DHEA and androsterone in female urine: investigating the effects of menstrual cycle, oral contraception and training on exercise-induced changes in young women.
Author: Bayle ML; Enea C; Goetinck P; Lafay F; Boisseau N; Dugue B; Flament-Waton MM; Grenier-Loustalot MF
Source: Analytical and Bioanalytical Chemistry. 2009 Feb;393(4):1315-25.
Abstract: Dehydroepiandrosterone (DHEA) and its metabolite androsterone (A) are natural steroids secreted in high quantities in human body. To assess the influence of oral contraceptives, menstrual cycle phase, and also physical exercise (acute and chronic such as training) on these metabolites excretions, a collection of 28 female urine specimens was organized. A three-extraction-step method was developed, and the analyses were performed by gas chromatography-mass spectrometry using deuterated 19-noretiocholanolone as the internal standard. Sample hydration state was found to be of great importance for kinetic studies, as it directly influenced the concentrations. No influence of menstrual cycle and training was found for androsterone and DHEA. However, oral contraceptive intake lowered DHEA excretion in urine and A seems to be slightly affected by exercise.
Language: English
Keywords:
FRANCE | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | ATHLETES | MENSTRUAL CYCLE | ORAL CONTRACEPTIVES | FITNESS | DEHYDROEPIANDROSTERONE | ANALYSIS | LABORATORY EXAMINATIONS AND DIAGNOSES | PHYSIOLOGY | Developed Countries | Europe, Western | Europe | Research Methodology | Demographic Factors | Population | Population Characteristics | Menstruation | Reproduction | Contraceptive Methods | Contraception | Family Planning | Health | Androgens | Hormones | Endocrine System | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 330963

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

10.

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

11.

Peer Reviewed

Title: Religious socialisation and fertility: transition to third birth in the Netherlands.
Author: Berghammer C
Source: European Journal of Population. 2009 Aug;25(3):297-324.
Abstract: Although previous studies have demonstrated that religious people in Europe have larger families, the role played by religious socialization in the context of contemporary fertility behavior has not yet been analysed in detail. This contribution specifically looks at the interrelation between religious socialisation and current religiosity and their impact on the transition to the third child for Dutch women. It is based on data of the first wave of the Netherlands Kinship Panel Study (2002-2004) and uses event history analysis. The transitions to first, second and third birth are modeled jointly with a control for unobserved heterogeneity. The findings provide evidence for an impact of women�s current church attendance as well as religious socilisation measured by their fathers� religious affiliation, when they were teenagers. A religious family background remains influential even when a woman has stopped attending church. The effects of religious indicators strengthen over cohorts. Moreover, the combined religious make-up of the respondent�s parents also significantly determines the progression of the third child.
Language: English
Keywords:
NETHERLANDS | RESEARCH REPORT | EVENT HISTORY ANALYSIS | RELIGION | SOCIAL BEHAVIOR | CULTURE | FERTILITY | DEMOGRAPHIC TRANSITION | Europe, Western | Europe | Developed Countries | Demographic Analysis | Research Methodology | Sociocultural Factors | Behavior | Population Dynamics | Demographic Factors | Population
Document Number: 339899

12.

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

13.

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

14.

Title: Adolescents' cortisol responses to awakening and social stress; effects of gender, menstrual phase and oral contraceptives. The TRAILS study.
Author: Bouma EM; Riese H; Ormel J; Verhulst FC; Oldehinkel AJ
Source: Psychoneuroendocrinology. 2009 Jul;34(6):884-93.
Abstract: Studies on the influence of sex hormones on cortisol responses to awakening and stress have mainly been conducted in adults, while reports on adolescents are scarce. We studied the effects of gender, menstrual cycle phase and oral contraceptive (OC) use on cortisol responses in a large sample of adolescents. Data come from TRAILS (TRacking Adolescents' Individual Lives Survey), a prospective population study of Dutch adolescents. This study uses data of 644 adolescents (age 15-17 years, 54.7% boys) who participated in a laboratory session including a performance-related social stress task (public speaking and mental arithmetic). Free cortisol levels were assessed by multiple saliva samples, both after awakening and during the laboratory session. No significant effects of gender and menstrual phase on cortisol responses to awakening were found, while girls using OC displayed a slightly blunted response (F(1, 244)=5.30, p=.02). Cortisol responses to social stress were different for boys and free-cycling girls (F(3, 494)=9.73, p<.001), and OC users and free-cycling girls (F(3, 279)=15.12, p<.001). Unexpectedly, OC users showed no response at all but displayed linearly decreasing levels F(1, 279)=19.03, p<.001) of cortisol during the social stress test. We found no effect of menstrual cycle phase on cortisol responses to social stress (F(3, 157)=0.58, p=.55). The absence of a gender difference in the adolescents' cortisol awakening response found in this study is consistent with previous reports. Our results further suggest that adolescent OC users display slightly blunted cortisol responses after awakening, and that gender differences in cortisol responses to social stress during adolescence are comparable to those described for adult populations, that is, stronger responses in men than in women. Whereas previous work in adults suggested blunted stress responses in OC users compared to men and free-cycling women, adolescent OC users showed no cortisol response. Effects of type of OC could not be studied because of low numbers of OC that were only progestin based.
Language: English
Keywords:
NETHERLANDS | RESEARCH REPORT | PROSPECTIVE STUDIES | ADOLESCENTS | GENDER ISSUES | MENSTRUATION | ORAL CONTRACEPTIVES | STRESS | HORMONES | TRANSCORTIN BOUND CORTISOL ALTERATIONS | Europe, Western | Europe | Developed Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Sociocultural Factors | Reproduction | Contraceptive Methods | Contraception | Family Planning | Psychological Factors | Behavior | Endocrine System | Physiology | Biology | Hematological Effects | Hemic System
Document Number: 342582

15.

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

16.

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

17.

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

18.

Title: Progestogen-only contraceptives and the risk of stroke: a meta-analysis.
Author: Chakhtoura Z; Canonico M; Gompel A; Thalabard JC; Scarabin PY; Plu-Bureau G
Source: Stroke; A Journal of Cerebral Circulation. 2009 Apr;40(4):1059-62.
Abstract: BACKGROUND AND PURPOSE: The association between combined oral contraceptives (OC) use and increased risk of stroke has been reported. While progestogen-only contraceptives (POC) are commonly used worldwide, their impact on cardiovascular disease remains unclear. METHODS: A meta-analysis based on EMBASE and MEDLINE referenced literature corresponding to OCs marketed since 1960 was carried out. Eligible articles assessing the risk of stroke in relation to OC or POC were reviewed, and relevant studies were extracted. All types of POC and routes of administration were taken into account in the meta-analysis. RESULTS: Six case-control studies were identified. The combined odd ratio (OR) showed no increase in the risk of stroke among POC users (OR=0.96; 95% confidence interval: 0.70 to 1.31). This result was similar according to the route of administration (either implant or injectable or oral POC). CONCLUSIONS: Data from observational studies show that POC use is not associated with an increased risk of stroke. However, these results are based on limited data. Further investigations are needed in women with risk factors of stroke.
Language: English
Keywords:
FRANCE | LITERATURE REVIEW | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CASE CONTROL STUDIES | COMPARATIVE STUDIES | WOMEN | PREVALENCE | ORAL CONTRACEPTIVES, SIDE EFFECTS | CONTRACEPTIVE AGENTS, PROGESTIN | RISK ASSESSMENT | CEREBROVASCULAR EFFECTS | CONTRACEPTIVE IMPLANTS | INJECTABLES | Developed Countries | Europe, Western | Europe | Research Methodology | Studies | Demographic Factors | Population | Measurement | Contraceptive Safety | Safety | Public Health | Health | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Evaluation | Physiology | Biology | Contraceptive Methods
Document Number: 331085

19.

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

20.

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

21.

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

23.

Peer Reviewed

Title: Effects of oral contraception with ethinylestradiol and drospirenone on oxidative stress in women 18-35 years old.
Author: De Groote D; d'Hauterive SP; Pintiaux A; Balteau B; Gerday C; Claesen J; Foidart JM
Source: Contraception. 2009 Aug;80(2):187-93.
Abstract: BACKGROUND: Oral contraceptives (OCs) with estrogens and progestins may affect oxidative stress (OS) status. STUDY DESIGN: A group of 32 women using oral contraceptives (OCU) containing 0.03 mg ethinylestradiol and 3 mg drospirenone have been compared to a matched control group of 30 noncontraception users (NCU). Blood levels of antioxidants, trace elements and markers of lipid peroxidation were assessed by biochemical methods. A microarray analysis of whole blood mRNA levels of 200 genes involved in OS-dependant pathway was also performed. RESULTS: Levels of zinc, vitamin E and antibodies to oxidized low-density lipoproteins (LDLs) were not significantly different between the two groups. On the other hand, significant increases in the mean levels of lipid peroxides (+176%, p<.001), oxidized LDLs (+145%, p<.002), copper (+103%, p<.001), Cu/Zn ratio (+100%, p<.001) and a significant decrease in the mean level of beta-carotene (-41%, p<.01) were observed in the OCU compared to NCU. There was a highly significant positive correlation between the lipid peroxide levels and the copper-to-zinc ratio. From the 200 genes tested by microarray, one coding for HSP70 was significantly up-regulated (log(2) fold change=+ 0.45, p<.02) and one coding for inducible nitric oxide synthase significantly down-regulated (log(2) fold change=-0.24, p<.05) in the OCU compared to the NCU. CONCLUSIONS: The recently introduced combination of ethinylestradiol and drospirenone induced the heightening of lipid peroxidation correlated with high levels of copper, a situation that could be associated with increased cardiovascular risk.
Language: English
Keywords:
BELGIUM | RESEARCH REPORT | CONTROL GROUPS | WOMEN | ORAL CONTRACEPTIVES, COMBINED | ETHINYL ESTRADIOL | LOW-DOSE PROGESTINS | ORAL CONTRACEPTIVES, SIDE EFFECTS | METABOLIC EFFECTS | CARDIOVASCULAR EFFECTS | SERUM COPPER LEVEL | Europe, Western | Europe | Developed Countries | Research Methodology | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Progestin | Contraceptive Safety | Safety | Public Health | Health | Physiology | Biology | Hemic System
Document Number: 342303

24.

Title: Perinatal mortality and morbidity in a nationwide cohort of 529,688 low-risk planned home and hospital births.
Author: de Jonge A; van der Goes BY; Ravelli AC; Amelink-Verburg MP; Mol BW; Nijhuis JG; Bennebroek Gravenhorst J; Buitendijk SE
Source: BJOG. 2009 Aug;116(9):1177-84.
Abstract: OBJECTIVE: To compare perinatal mortality and severe perinatal morbidity between planned home and planned hospital births, among low-risk women who started their labour in primary care. DESIGN: A nationwide cohort study. SETTING: The entire Netherlands. POPULATION: A total of 529,688 low-risk women who were in primary midwife-led care at the onset of labour. Of these, 321,307 (60.7%) intended to give birth at home, 163,261 (30.8%) planned to give birth in hospital and for 45,120 (8.5%), the intended place of birth was unknown. METHODS: Analysis of national perinatal and neonatal registration data, over a period of 7 years. Logistic regression analysis was used to control for differences in baseline characteristics. MAIN OUTCOME MEASURES: Intrapartum death, intrapartum and neonatal death within 24 hours after birth, intrapartum and neonatal death within 7 days and neonatal admission to an intensive care unit. RESULTS: No significant differences were found between planned home and planned hospital birth (adjusted relative risks and 95% confidence intervals: intrapartum death 0.97 (0.69 to 1.37), intrapartum death and neonatal death during the first 24 hours 1.02 (0.77 to 1.36), intrapartum death and neonatal death up to 7 days 1.00 (0.78 to 1.27), admission to neonatal intensive care unit 1.00 (0.86 to 1.16). CONCLUSIONS: This study shows that planning a home birth does not increase the risks of perinatal mortality and severe perinatal morbidity among low-risk women, provided the maternity care system facilitates this choice through the availability of well-trained midwives and through a good transportation and referral system.
Language: English
Keywords:
NETHERLANDS | RESEARCH REPORT | COHORT ANALYSIS | RETROSPECTIVE STUDIES | PREGNANT WOMEN | MIDWIVES AND MIDWIFERY | PERINATAL MORTALITY | CHILDBIRTH | PREGNANCY OUTCOMES | RISK FACTORS | MATERNAL AGE | Europe, Western | Europe | Developed Countries | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Mortality | Population Dynamics | Pregnancy | Reproduction | Parental Age | Age Factors
Document Number: 342276

25.

Title: Estrogens and the risk of complex regional pain syndrome (CRPS).
Author: de Mos M; Huygen FJ; Stricker BH; Dieleman JP; Sturkenboom MC
Source: Pharmacoepidemiology and Drug Safety. 2009 Jan;18(1):44-52.
Abstract: OBJECTIVE: Since complex regional pain syndrome (CRPS) shows a clear female predominance, we investigated the association between the cumulative as well as current exposure to estrogens, and CRPS. METHODS: A population-based case-control study was conducted in the Integrated Primary Care Information (IPCI) project in the Netherlands. Cases were identified from electronic records (1996-2005) and included if they were confirmed during a visit (using International Association for the Study of Pain Criteria), or had been diagnosed by a specialist. Controls were matched to cases on gender, age, calendar time, and injury. Measures of cumulative endogenous estrogen exposure were obtained by questionnaire and included age of menarche and menopause, menstrual life, and cumulative months of pregnancy and breast-feeding. Current estrogen exposure at CRPS onset was retrieved from the electronic medical records and determined by current pregnancy or by the use of oral contraceptive (OC) drugs or hormonal replacement therapy (HRT). RESULTS: Hundred and forty-three female cases (1493 controls) were included in analyses on drug use and pregnancies, while cumulative endogenous estrogen exposure was studied in 53 cases (58 controls) for whom questionnaire data were available. There was no association between CRPS and either cumulative endogenous estrogen exposure, OC, or HRT use. CRPS onset was increased during the first 6 months after pregnancy (OR: 5.6, 95%CI: 1.0-32.4), although based on small numbers. DISCUSSION: We did not find an association between CRPS onset and cumulative endogenous estrogen exposure or current OC or HRT use, but more powered studies are needed to exclude potential minor associations.
Language: English
Keywords:
NETHERLANDS | RESEARCH REPORT | CASE STUDIES | RECORDS | PAIN | ESTROGENS | HORMONES | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Information Processing | Information | Signs and Symptoms | Diseases | Endocrine System | Physiology | Biology
Document Number: 329753

26.

Peer Reviewed

Title: The 1991-2004 evolution in life expectancy by educational level in Belgium based on linked census and population register data. L'evolution de l'esperance de vie par niveau d'instruction en Belgique de 1991 a 2004 sur la base de donnees de recensement liees au registre de la population.
Author: Deboosere P; Gadeyne S; Oyen HV
Source: European Journal of Population. 2008 May;25(2):175-196.
Abstract: The aim of this study is to determine trends in life expectancy by educational level in Belgium and to present elements of interpretation for the observed evolution. The analysis is based on census data providing information on educational level linked to register data on mortality for the periods 1991-1994 and 2001-2004. Using exhaustive individual linked data allows to avoid selection bias and numerator-denominator bias. The trends reveal a general increase in life expectancy together with a widening social gap. Summary indices of inequality based on life expectancies show, however, a more complex pattern and point to the importance to include the shifts in population composition by educational level in an overall assessment of the evolution of inequality by educational level.
Language: English
Keywords:
BELGIUM | RESEARCH REPORT | DATA LINKAGE | LIFE EXPECTANCY | EDUCATIONAL STATUS | HEALTH | INEQUALITIES | MORTALITY | DEATH RECORDS | CENSUS | Europe, Western | Europe | Developed Countries | Data Collection | Research Methodology | Length of Life | Population Dynamics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Vital Statistics | Population Statistics
Document Number: 340174

27.

Peer Reviewed

Title: Profile of the progesterone derivative chlormadinone acetate - pharmocodynamic properties and therapeutic applications.
Author: Druckmann R
Source: Contraception. 2009 Apr;79(4):272-81.
Abstract: Chlormadinone acetate (CMA) is a derivative of progesterone (17alpha-acetoxy-6-chloro-4,6-pregnadiene-3,20-dione), first synthesized in 1961 and is used as an orally effective progestogen in hormone replacement therapy (HRT), and in combination with ethinyl estradiol (EE) in contraception since 1999. Chlormadinone acetate has a strong progestogenic effect - about one-third higher than that of progesterone - and may vary depending on the previous effect of an estrogen, i.e., estrogens may promote the formation of progesterone receptors and proliferation of the endometrium. Like progesterone, it is anti-estrogenic and has no partial androgenic effect (at the doses used for contraception and HRT). In contrast to progesterone, it has a slight glucocorticoid effect, a pronounced anti-androgenic effect and no anti-mineralocorticoid effect. No pregnancy-maintaining effect of CMA has been demonstrated in humans. The anti-androgenic effect of CMA is presumed to be the result of both its binding to androgen receptors - competitively inhibiting the effect of endogenous testosterone and dihydrotestosterone - and the competitive inhibition of 5alpha-reductase. In this respect, dosing of CMA is crucial; agonistic effects are observed when doses are increased from those optimal for an antagonistic effect. Chlormadinone acetate has a strong anti-gonadotropic effect, through negative feedback on gonadotropin secretion, and has been used for more than 20 years alone for contraception in arterial risk patients. The clinical and metabolic tolerability of CMA has been demonstrated in numerous clinical studies with duration of treatment of up to 2.5 years. The more recent application of CMA as an oral contraceptive in combination with EE (Neo Eunomin, Belara) has proven highly successful, with studies reporting excellent contraceptive efficacy, high tolerability and adherence due to a good side effect profile and positive effects on preexisting dysmenorrhea, skin and hair conditions.
Language: English
Keywords:
FRANCE | RESEARCH REPORT | ORAL CONTRACEPTIVES | CONTRACEPTIVE AGENTS, PROGESTIN | PROGESTERONE | CONTRACEPTIVE EFFECTIVENESS | Developed Countries | Europe, Western | Europe | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Female | Contraceptive Agents | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology
Document Number: 341633

28.

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

29.

30.

Title: Effects of menstrual cycle, oral contraception, and training on exercise-induced changes in circulating DHEA-sulphate and testosterone in young women.
Author: Enea C; Boisseau N; Ottavy M; Mulliez J; Millet C; Ingrand I; Diaz V; Dugue B
Source: European Journal of Applied Physiology. 2009;106:365-373.
Abstract: The objective of this study was to ascertain the effects of menstrual cycle, oral contraception, and training status on the exercise-induced changes in circulating DHEA-sulphate and testosterone in young women. Twenty-eight healthy women were assigned to an untrained group (n = 16) or a trained group (n = 12) depending on their training background. The untrained group was composed of nine oral contraceptive users (OC+) and seven eumenorrheic women (OC-). The trained group was composed of OC+ subjects only. All the OC+ subjects were taking the same low-dose oral contraception. Three laboratory sessions were organised in a randomised order: a prolonged exercise test until exhaustion, a short-term exhaustive exercise test, and a control session. Blood specimens were collected before, during and after the exercise tests and at the same time of the day during the control session. Basal circulating testosterone was significantly lower in trained as compared to untrained subjects. In all subjects, the prolonged exhaustive exercise induced a significant increase in circulating DHEA-s and testosterone. The short-term exercise induced a significant increase in circulating DHEA-s in untrained eumenorrheic and in trained OC users only. Menstrual phases in OC- did not influence the responses. It was found that exhaustive physical exercise induced an increase in circulating DHEA-s and testosterone in young women. Oral contraception may limit short-term exercise-induced changes.
Language: English
Keywords:
FRANCE | RESEARCH REPORT | WOMEN | PHYSIOLOGY | ANDROGENS | FITNESS | METABOLIC EFFECTS | Developed Countries | Europe, Western | Europe | Demographic Factors | Population | Biology | Hormones | Endocrine System | Health
Document Number: 330573


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