1.  Peer Reviewed Title: Pill use in the month before conception linked to risk of low birth weight, preterm delivery Author: Ball H Source: Perspectives On Sexual and Reproductive Health. 2009 Jun;41(2):128. Abstract: Women who use oral contraceptives just prior to conception may be more likely than nonusers to experience adverse birth outcomes, according to a study of health records from the Canadian province of Saskatchewan.1 Those who used the pill within 30 days of their last menstrual period had elevated odds of preterm birth and low birth weight, conditions that are associated with infant morbidity and mortality. The researchers examined records from Saskatchewan Health Databases, which contain information on 99% of the province's residents. They obtained data on physician services, hospital stays and prescription drug use in the year prior to giving birth for a random sample of 50% of women who had a pregnancy between 1997 and 2000. these outcomes. In an analysis that adjusted for women's socioeconomic and chronic disease status, pill use within 30 days of the last menstrual period was positively associated with the occurrence of very low and low birth weight (odds ratios, 3.2 and 1.9, respectively) and preterm delivery (1.6). Use 2-3 months prior to the last menstrual period was not associated with adverse birth outcomes. (excerpt) Language: English Keywords: CANADA | SUMMARY REPORT | WOMEN | CONTRACEPTIVE USAGE | ORAL CONTRACEPTIVES | PREGNANCY | LOW BIRTH WEIGHT | RISK FACTORS | Developed Countries | North America, Northern | Americas | Demographic Factors | Population | Contraception | Family Planning | Contraceptive Methods | Reproduction | Birth Weight | Body Weight | Physiology | Biology | Health Document Number: 341884 |
| 2. Title: Contraceptive use among canadian women of reproductive age: results of a national survey. Author: Black A; Yang Q; Wu Wen S; Lalonde AB; Guilbert E; Fisher W Source: Journal of Obstetrics and Gynaecology Canada. 2009 Jul;31(7):627-40. Abstract: Objective: Past studies indicate that despite a wide range of contraceptive options, Canadian women tend to use a narrow selection of contraceptive methods. New contraceptive methods have recently been introduced in Canada. The objective of this research is to characterize Canadian women's current contraceptive choices and adherence to contraceptive regimens. Methods: A national cross-sectional survey was conducted in November 2006. A standardized, confidential, Internet questionnaire was administered to female members of a previously recruited national market research panel. Percentages of current contraceptive use and consistency of use were calculated by age group, marital status, and province and were weighted according to age and region. Chi-square test was used to detect within-group differences for consistency of contraceptive use, oral contraceptive (OC) use, and condom use. Multivariate logistic regression analyses predicting consistent contraception use, OC use, and condom use were performed. Results: Of 5597 survey respondents, 3253 were eligible for data analysis. Of these women, 2751 had had vaginal intercourse in the previous six months, were not trying to conceive, and reported whether they or their partner had used contraception. Of these 2751 women, 410 (14.9%) never used contraception. Among contraception users, the most frequently used methods of contraception were condoms (54.3%), OCs (43.7%), and withdrawal (11.6%). Newer contraceptive methods were used by less than 4%. Choice of contraceptive method varied by age. Only 65.2% of respondents who were sexually active and not trying to conceive "always used" contraception. Multivariate logistic regression analyses found significantly higher odds of no contraception use in women over 40 years of age, without higher education, living in PEI or Newfoundland, married or living common-law, or having annual household incomes under $100 000. Conclusion: Despite many contraceptive options, Canadian women continue to use a narrow range of contraceptive methods and to use contraception inconsistently. Consistent contraceptive use is influenced by a number of independent social variables. Future public health initiatives should focus on raising awareness of contraception options, increased access to a variety of contraceptive methods, and assisting with contraceptive adherence. Language: English Keywords: CANADA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | SURVEYS | WOMEN | CONTRACEPTIVE USAGE | REPRODUCTIVE AGE | CONDOM USE | USER COMPLIANCE | CONTRACEPTION | ORAL CONTRACEPTIVES | Developed Countries | North America, Northern | Americas | Research Methodology | Sampling Studies | Studies | Demographic Factors | Population | Family Planning | Reproduction | Risk Reduction Behavior | Behavior | Contraceptive Methods Document Number: 342765 |
| 3. Title: Recent oral contraceptive use and adverse birth outcomes. Author: Chen XK; Wen SW; Sun LM; Yang Q; Walker MC Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2009;144:40-43. Abstract: OBJECTIVE: To examine the possible association between oral contraceptive use and adverse birth outcomes. STUDY DESIGN: We conducted a population-based cohort study of pregnant women who used oral contraceptives within 3 months before their last menstrual period. Subjects were divided into three groups, according to the interval (0-30, 31-60, and 61-90 days) between the dispensing date and their last menstrual period. For each exposed subject, 4 subjects without exposure to oral contraceptives were individually matched by infant's year of birth and plurality and by mother's age and parity. RESULTS: Oral contraceptive use within 30 days prior to the last menstrual period was associated with increased risks of very low birth weight (OR: 3.24, 95% CI: 1.18, 8.92), low birth weight (OR: 1.93, 95% CI: 1.17, 3.20), and preterm birth (OR: 1.61, 95% CI: 1.01, 2.55); however, oral contraceptive use 31-90 days prior to the last menstrual period did not increase the risk of low birth weight or preterm birth.CONCLUSION: Our results indicate the use of oral contraceptives near the time of conception may be associated with an increased risk of low birth weight and preterm birth. Language: English Keywords: CANADA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | COHORT ANALYSIS | CLINICAL RESEARCH | INFANT | PREGNANT WOMEN | PREVALENCE | PREGNANCY OUTCOMES | ORAL CONTRACEPTIVES, SIDE EFFECTS | TIME FACTORS | LOW BIRTH WEIGHT | PREMATURE BIRTH | RISK FACTORS | North America, Northern | Americas | Developed Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Measurement | Pregnancy | Reproduction | Contraceptive Safety | Safety | Public Health | Health | Population Dynamics | Birth Weight | Body Weight | Physiology | Biology Document Number: 330420 |
| 4. Title: Determinants of condom use: results of the Canadian Community Health Survey 3.1. Author: Dhalla S; Poole G Source: Canadian Journal of Public Health / Revue Canadienne De Sante Publique. 2009 Jul-Aug;100(4):299-303. Abstract: OBJECTIVES: To examine the independent effects of mood disorder, age, race/ethnicity, personal income, being a current student, having a regular medical doctor and substance use in relationship to condom use at last intercourse in a Canadian population stratified by sex. METHODS: We used Cycle 3.1 of the 2006 Canadian Community Health Survey (CCHS 3.1), a population-based, voluntary, cross-sectional survey of subjects ages 12-85 years. Data collection took place between January and December 2005. From the survey, a study sample of 20,975 people was drawn, consisting of individuals providing valid responses (yes/no) to mood disorder and last-time condom use. The question of sexual behaviours was asked only of those ages 15-49 years. Logistic regression was used to examine individual variables as potential determinants of last-time condom use stratified by sex. RESULTS: The relationship between mood disorder and condom use was non-significant in both males (AOR = 0.85, 95% CI = 0.70-1.04) and females (AOR = 0.90, 95% CI = 0.78-1.03). Increasing age was found to be inversely associated with last-time condom use in both males and females. Male factors significantly associated with last-time condom use were being of white ethnicity (AOR = 0.71, 95% CI = 0.64-0.79) and being a current student (AOR = 1.28, 95% CI =1.16-1.42). Female factors associated with last-time condom use were being of white ethnicity (AOR = 0.71, 95% CI = 0.63-0.79) and being a former drinker (AOR = 2.25, 95% CI = 1.63-3.11). CONCLUSION: Our results identify important determinants of last-time condom use in both males and females in the CCHS 3.1. These findings may have important implications for the devising and implementation of safe sex programs in a Canadian population ages 15-49 years. Language: English Keywords: CANADA | RESEARCH REPORT | HEALTH SURVEYS | STATISTICAL REGRESSION | ETHNIC GROUPS | SEXUALLY TRANSMITTED DISEASES | CONDOM USE | MENTAL DISORDERS | SEX FACTORS | AGE FACTORS | ALCOHOL USE AND ABUSE | Developed Countries | North America, Northern | Americas | Health | Data Analysis | Research Methodology | Cultural Background | Population Characteristics | Demographic Factors | Population | Reproductive Tract Infections | Infections | Diseases | Risk Reduction Behavior | Behavior Document Number: 342618 |
| 5. Title: Rates of spontaneous and therapeutic abortions following use of antidepressants in pregnancy: results from a large prospective database. Author: Einarson A; Choi J; Einarson TR; Koren G Source: Journal of Obstetrics and Gynaecology Canada. 2009 May;31(5):452-6. Abstract: OBJECTIVE: The use of antidepressants during pregnancy remains a controversial issue, and there is little information on the risk of spontaneous abortions following antidepressant exposure in early pregnancy. We sought to examine whether use of antidepressants increases the rates of spontaneous abortion (SA) and therapeutic abortion (TA) in women exposed in early pregnancy. METHODS: In a cohort of women who contacted the Motherisk program during pregnancy, we compared two groups of women, one exposed and the other not exposed to antidepressants during pregnancy, and calculated the associated rates of SA and TA. RESULTS: Among 937 women exposed to antidepressants prior to and during early pregnancy, there were 122 SAs (13.0%) including three ectopic pregnancies, and in the comparison group there were 75 SAs (8.0%) and no ectopic pregnancies. The relative risk was 1.63 (95% CI 1.24-2.14). Three-fold more women reported a TA in the exposed group, 26 (2.4%) compared to 8 (0.7%) in the non-exposed group (RR 3.25; 95% CI 1.48-7.14). A sub-analysis revealed that in both groups, of 338 women with a prior SA, 58 (17.2%) reported having a SA in the current pregnancy, compared with 61/652 (9.4%) with no prior SA (chi square = 12.09, P lt; 0.001). In the antidepressant group, the incidence was 20.7%, and in the non-exposed group, it was 13.3%. Logistic regression confirmed that only antidepressant exposure and prior SA were significantly associated with current SA. CONCLUSION: Exposure to antidepressants in the first trimester of pregnancy appears to be associated with a small but statistically significant increased risk of SA and decision to terminate a pregnancy. The risk for SA is further elevated with a history of previous SA. However, any underlying depression must be taken into consideration when evaluating these results. Language: English Keywords: CANADA | RESEARCH REPORT | PROSPECTIVE STUDIES | PREGNANT WOMEN | ABORTION, SPONTANEOUS | ABORTION | RISK FACTORS | DEPRESSION | DRUGS | PREGNANCY, FIRST TRIMESTER | INCIDENCE | INTERVIEWS | Developed Countries | North America, Northern | Americas | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy Complications | Diseases | Fertility Control, Postconception | Family Planning | Health | Mental Disorders | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Pregnancy | Reproduction | Measurement | Data Collection Document Number: 342785 Notification |
| 6. Title: A Canadian, Multicentre Study Comparing the Efficacy of a Levonorgestrel-releasing Intrauterine System to an Oral Contraceptive in Women With Idiopathic Menorrhagia. Author: Endrikat J; Shapiro H; Lukkari-Lax E; Kunz M; Schmidt W; Fortier M Source: Journal of Obstetrics and Gynaecology Canada. 2009 Apr;31(4):340-347. Abstract: Objectives: To evaluate the efficacy of a levonorgestrel-releasing intrauterine system (LNG-IUS) compared with a combined oral contraceptive containing 1 mg norethindrone acetate and 20 mg ethinyl estradiol (OC1/20) in reducing menstrual blood loss (MBL) in women with idiopathic menorrhagia. Methods: A prospective, randomized, open-label study was conducted in nine centres in Canada. Healthy women over 30 years of age suffering from idiopathic menorrhagia were treated either with LNG-IUS (n = 20) or with OC1/20 (n = 19) over 12 months. The primary endpoint was the change in MBL from baseline to 12 months. Secondary endpoints included treatment success (defined as a MBL score < 100 after 12 months), hemoglobin levels, and the menorrhagia severity score. Results: In both treatment groups, MBL decreased significantly from baseline to 12 months (P < 0.001). For the primary endpoint, the MBL score decreased significantly more in the LNG-IUS group (median from 228 to 13, mean percent change-83%) compared to the OC1/20 group (median from 290 to 72; mean percent change-68%) (P = 0.002) after 12 months. In the LNG-IUS group, 80% of subjects had treatment success compared with 36.8 % in the OC1/20 group (P < 0.009). Both treatments increased hemoglobin concentrations significantly between baseline and 12 months. The menorrhagia severity score was consistently lower in the LNG-IUS group at all study time points and was significantly lower (P = 0.045) at six months. Both treatments were well tolerated. Conclusion: Both the LNG-IUS and the combined oral contraceptive effectively decreased menstrual blood loss in women with idiopathic menorrhagia. The overall clinical benefit was more pronounced with LNG-IUS than with OC1/20. Language: English Keywords: CANADA | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | ORAL CONTRACEPTIVES, COMBINED | BLEEDING | MENORRHAGIA | TREATMENT | Developed Countries | North America, Northern | Americas | Studies | Research Methodology | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Signs and Symptoms | Diseases | Menstruation Disorders | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341573 |
| 7. Peer Reviewed Title: Bleeding pattern, tolerance and patient satisfaction with a drospirenone-containing oral contraceptive evaluated in 3488 women in Europe, the Middle East and Canada. Author: Endrikat JS; Milchev NP; Kapamadzija A; Georgievska J; Gerlinger C; Schmidt W; Feroze S Source: Contraception. 2009 Jun;79(6):428-32. Abstract: BACKGROUND: This study was conducted to assess the bleeding pattern, tolerance and patient satisfaction associated with an oral contraceptive (OC) containing 3 mg of drospirenone and 30 mcg of ethinyl estradiol under real-life conditions. STUDY DESIGN: A multicenter, prospective and observational six-cycle study was conducted in 12 countries in Europe, the Middle East and Canada. The efficacy variables included an assessment of bleeding patterns, premenstrual symptoms of water retention and patient satisfaction as determined by a visual analog scale. RESULTS: A total of 3488 women was enrolled in the study. The percentage of women with intermenstrual bleeding decreased from 27.9% at baseline to 5.4% at the end of Cycle 6, while dysmenorrhea decreased from 67% to 17.7%. Also, amenorrhea decreased from 21.3% to 7.5%. The decreases in all three parameters were statistically significant (p<.0001). Approximately 70% of the women reported abdominal bloating and/or breast tenderness at baseline and less than 38% did so at the end of Cycle 6 (p<.0001). Patient satisfaction increased for all investigated items. Upon completion of the study, 86.2% of the women answered "yes" to continuing treatment with this OC. CONCLUSION: The OC containing 3 mg of drospirenone and 30 mcg of ethinyl estradiol has beneficial effects on bleeding pattern, symptoms of water retention and patient satisfaction. Language: English Keywords: EUROPE | MIDDLE EAST | CANADA | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | KAP SURVEYS | WOMEN | BLEEDING | SATISFACTION | ORAL CONTRACEPTIVES, COMBINED | ESTRADIOL | CONTRACEPTIVE SAFETY | AMENORRHEA | METRORRHAGIA | Developed Countries | North America, Northern | Americas | Research Methodology | Studies | Surveys | Sampling Studies | Demographic Factors | Population | Signs and Symptoms | Diseases | Psychological Factors | Behavior | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Estrogens | Hormones | Endocrine System | Physiology | Biology | Safety | Public Health | Health | Menstruation Disorders Document Number: 341103 |
| 8. Title: Infodemiology and infoveillance: Framework for an emerging set of public health informatics methods to analyze search, communication and publication behavior on the Internet [editorial] Author: Eysenbach G Source: Journal of Medical Internet Research. 2009;11(1):e11. Abstract: Infodemiology can be defined as the science of distribution and determinants of information in an electronic medium, specifically the Internet, or in a population, with the ultimate aim to inform public health and public policy. Infodemiology data can be collected and analyzed in near real time. Examples for infodemiology applications include: the analysis of queries from Internet search engines to predict disease outbreaks (eg. influenza); monitoring peoples' status updates on microblogs such as Twitter for syndromic surveillance; detecting and quantifying disparities in health information availability; identifying and monitoring of public health relevant publications on the Internet (eg. anti-vaccination sites, but also news articles or expert-curated outbreak reports); automated tools to measure information diffusion and knowledge translation, and tracking the effectiveness of health marketing campaigns. Moreover, analyzing how people search and navigate the Internet for health-related information, as well as how they communicate and share this information, can provide valuable insights into health-related behavior of populations. Seven years after the infodemiology concept was first introduced, this paper revisits the emerging fields of infodemiology and infoveillance and proposes an expanded framework, introducing some basic metrics such as information prevalence, concept occurrence ratios, and information incidence. The framework distinguishes supply-based applications (analyzing what is being published on the Internet, eg. on Web sites, newsgroups, blogs, microblogs and social media) from demand-based methods (search and navigation behavior), and further distinguishes passive from active infoveillance methods. Infodemiology metrics follow population health relevant events or predict them. Thus, these metrics and methods are potentially useful for public health practice and research, and should be further developed and standardized. (Author's abstract) Language: English Keywords: CANADA | CRITIQUE | EPIDEMIOLOGY | INFORMATION DISTRIBUTION | INFORMATION RETRIEVAL SYSTEMS | INTERNET | INFLUENZA | MONITORING | COMMUNICATION | PUBLIC HEALTH | Developed Countries | North America, Northern | Americas | Health | Data Storage and Retrieval | Information Processing | Information | Information Networks | Viral Diseases | Diseases | Evaluation Document Number: 331416 |
| 9. 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 |
| 10. Peer Reviewed Title: Perinatal outcomes in a South Asian setting with high rates of low birth weight. Author: George K; Prasad J; Singh D; Minz S; Albert DS; Muliyil J; Joseph KS; Jayaraman J; Kramer MS Source: BMC Pregnancy and Childbirth. 2009;9:5. Abstract: BACKGROUND: It is unclear whether the high rates of low birth weight in South Asia are due to poor fetal growth or short pregnancy duration. Also, it is not known whether the traditional focus on preventing low birth weight has been successful. We addressed these and related issues by studying births in Kaniyambadi, South India, with births from Nova Scotia, Canada serving as a reference. METHODS: Population-based data for 1986 to 2005 were obtained from the birth database of the Community Health and Development program in Kaniyambadi and from the Nova Scotia Atlee Perinatal Database. Menstrual dates were used to obtain comparable information on gestational age. Small-for-gestational age (SGA) live births were identified using both a recent Canadian and an older Indian fetal growth standard. RESULTS: The low birth weight and preterm birth rates were 17.0% versus 5.5% and 12.3% versus 6.9% in Kaniyambadi and Nova Scotia, respectively. SGA rates were 46.9% in Kaniyambadi and 7.5% in Nova Scotia when the Canadian fetal growth standard was used to define SGA and 6.7% in Kaniyambadi and < 1% in Nova Scotia when the Indian standard was used. In Kaniyambadi, low birth weight, preterm birth and perinatal mortality rates did not decrease between 1990 and 2005. SGA rates in Kaniyambadi declined significantly when SGA was based on the Indian standard but not when it was based on the Canadian standard. Maternal mortality rates fell by 85% (95% confidence interval 57% to 95%) in Kaniyambadi between 1986-90 and 2001-05. Perinatal mortality rates were 11.7 and 2.6 per 1,000 total births and cesarean delivery rates were 6.0% and 20.9% among live births >or= 2,500 g in Kaniyambadi and Nova Scotia, respectively. CONCLUSION: High rates of fetal growth restriction and relatively high rates of preterm birth are responsible for the high rates of low birth weight in South Asia. Increased emphasis is required on health services that address the morbidity and mortality in all birth weight categories. Language: English Keywords: INDIA | CANADA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CROSS-CULTURAL COMPARISONS | LONGITUDINAL STUDIES | INFANT | INFANT, PREMATURE | PREVALENCE | BIRTH WEIGHT | LOW BIRTH WEIGHT | GESTATIONAL AGE | PERINATAL MORTALITY | GROWTH | MATERNAL MORTALITY | Asia, Southern | Asia | Developing Countries | Developed Countries | North America, Northern | Americas | Research Methodology | Comparative Studies | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Measurement | Body Weight | Physiology | Biology | Fetus | Pregnancy | Reproduction | Mortality | Population Dynamics | Child Development Document Number: 331227 |
| 11. Peer Reviewed Title: A human immunodeficiency virus risk reduction intervention for incarcerated youth: a randomized controlled trial. Author: Goldberg E; Millson P; Rivers S; Manning SJ; Leslie K; Read S; Shipley C; Victor JC Source: Journal of Adolescent Health. 2009 Feb;44(2):136-45. Abstract: PURPOSE: To evaluate, by gender, the impact of a structured, comprehensive risk reduction intervention with and without boosters on human immunodeficiency virus (HIV) knowledge, attitudes and behaviors in incarcerated youth; and to determine predictors of increasing HIV knowledge and reducing high-risk attitudes and behaviors. METHODS: This randomized controlled trial involved participants completing structured interviews at 1, 3, and 6 months. Repeated measures analysis of variance was used to analyze changes over time. The study was conducted in secure custody facilities and in the community. The study sample comprising 391 incarcerated youth, 102 female and 289 male aged 12-18, formed the voluntary sample. Participants were randomly assigned to one of three conditions: education intervention; education intervention with booster; or no systematic intervention. The outcome and predictor measures included the Rosenberg Self-Esteem Scale, Youth Self Report, Drug Use Inventory, and HIV Knowledge, Attitudes and Behavior Scale. RESULTS: The 6-month retention rate was 59.6%. At 6 months, males in the education and booster groups sustained increases in knowledge scores (p < 0.001). Females in these groups sustained increased condom attitude scores (p = 0.004). Males in the booster group sustained increased prevention attitude scores (p = 0.017). Females in the booster group reported more consistent condom use (odds ratio [OR] = 4.20; 95% confidence interval [CI] = 1.81, 9.77). Age, gender, drug use, and psychological profiles were predictive of outcome. CONCLUSIONS: The intervention and boosters led to gender-specific improvements in knowledge, attitudes, and condom use. Result variations by gender underline the importance of gender issues in prevention interventions. Predictors of success were identified to inform future HIV education interventions. Language: English Keywords: CANADA | RESEARCH REPORT | CLINICAL TRIALS | KAP SURVEYS | PRISONERS | YOUTH | HIV PREVENTION | SEX FACTORS | KNOWLEDGE | ATTITUDES | SEX BEHAVIOR | RISK BEHAVIOR | TIME FACTORS | HEALTH EDUCATION | SEX EDUCATION | Developed Countries | North America, Northern | Americas | Clinical Research | Research Methodology | Surveys | Sampling Studies | Studies | Crime | Social Problems | Sociocultural Factors | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Psychological Factors | Behavior | Population Dynamics | Education Document Number: 331072 |
| 12. Peer Reviewed Title: Depo-Provera and skeletal health: reviewing the evidence; developing and disseminating a consensus [editorial] Author: Guilbert ER; Kaunitz AM Source: Contraception. 2009 Mar;79(3):165-6. Abstract: Since the approval of injectable medroxyprogesterone acetate (DMPA, Depo-Provera®) in the United States in 1992 and Canada in 1997 and the subsequent "black box" warnings in both countries, DMPA has been the object of more than a hundred publications, including many focusing on its impact on bone mineral density. Apart from these scientific publications, articles in the Canadian lay media have raised concerns, potentially influencing clinician behavior and women's contraceptive choices and usage. (excerpt) Language: English Keywords: CANADA | CRITIQUE | RECOMMENDATIONS | CLINICAL RESEARCH | WOMEN | PHYSICIANS | DEPO-PROVERA | INJECTABLES | CONTRACEPTIVE PREVALENCE | COUNSELING | FAMILY PLANNING POLICY | SKELETAL EFFECTS | PEER REVIEW | OSTEOPOROSIS | Developed Countries | North America, Northern | Americas | Research Methodology | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Contraceptive Methods | Contraceptive Usage | Clinic Activities | Program Activities | Programs | Organization and Administration | Population Policy | Social Policy | Policy | Political Factors | Sociocultural Factors | Physiology | Biology | Evaluation Document Number: 341130 |
| 13. Peer Reviewed Title: The use of depot-medroxyprogesterone acetate in contraception and its potential impact on skeletal health. Author: Guilbert ER; Brown JP; Kaunitz AM; Wagner MS; Berube J; Charbonneau L; Francoeur D; Gilbert A; Gilbert F; Roy G; Senikas V; Jacob R; Morin R Source: Contraception. 2009 Mar;79(3):167-77. Abstract: BACKGROUND: In the fall of 2007, the controversy about the contraceptive use of depot-medroxyprogesterone acetate (DMPA) and its potential impact on skeletal health reached the media in the province of Quebec, Canada, thereby becoming a matter of concern for the lay public and physicians. In order to discuss this subject openly, the National Institute of Public Health of Quebec (INSPQ) organized a scientific meeting on February 15, 2008, with targeted physicians delegated by their medical associations in the fields of general practice, obstetrics and gynaecology, rheumatology, orthopaedic surgery, physiatry and endocrinology. STUDY DESIGN: Participants reviewed the scientific literature using the study classification method according to the level of evidence, reviewed published guidelines of medical societies and organizations on the subject and reached a consensus position. This manuscript presents a review of the literature and describes the consensus position of the targeted medical associations. RESULTS: The consensus position adopted by all the targeted medical associations determined that DMPA was a cost-effective contraceptive option that must be considered in the light of the clinical situation and preference of each woman. Candidates for injectable contraception should be informed that the use of DMPA is associated with a slight decrease in bone mineral density (BMD), which is largely, if not completely, reversible. There should not be an absolute limit to the length of time that the DMPA contraceptive is used, regardless of the woman's age. Monitoring BMD is not recommended among users of DMPA for contraceptive purposes. Finally, the consensus statement declared that, although supplements of calcium and vitamin D are beneficial for skeletal health for women in general, such supplementation should not be recommended solely based on a woman's use of DMPA. CONCLUSION: Given the scientific evidences, DMPA use remains a valid contraceptive option for women. Its potential impact on BMD must be balanced against the significant individual, familial and social consequences of unintended pregnancy. Language: English Keywords: CANADA | CONFERENCES AND CONGRESSES | LITERATURE REVIEW | CLINICAL RESEARCH | CLASSIFICATION | PHYSICIANS | DEPO-PROVERA | MEDROXYPROGESTERONE ACETATE | SKELETAL EFFECTS | SIDE EFFECTS | PANEL DISCUSSION | CONTRACEPTIVE SAFETY | TIME FACTORS | AGE FACTORS | CONTRAINDICATIONS | North America, Northern | Americas | Developed Countries | Research Methodology | Health Personnel | Delivery of Health Care | Health | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Physiology | Biology | Treatment | Medical Procedures | Medicine | Health Services | Group Meeting | Communication | Safety | Public Health | Population Dynamics | Demographic Factors | Population | Population Characteristics Document Number: 330061 |
| 14. Peer Reviewed Title: Parity and subfertility effects of continuous oral contraceptive on fertility are important. Author: Hitchcock CL; Prior JC Source: Fertility and Sterility. 2009 Aug 21; Abstract: This letter to the editor discusses parity and subfertility effects of continuous oral contraceptive on fertility and states concerns related to recent articles by Barnhart and colleagues. It expresses issues about the role of parity in the time to conception and concerns that an uncritical acceptance of this conclusion may cause harm. Language: English Keywords: CANADA | CRITIQUE | DATA ANALYSIS | CONTRACEPTION CONTINUATION | PARITY | ORAL CONTRACEPTIVES | Developed Countries | North America, Northern | Americas | Research Methodology | Contraceptive Usage | Contraception | Family Planning | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Contraceptive Methods Document Number: 342593 |
| 15. Title: Being a woman: perspectives of low-german-speaking mennonite women. Author: Kulig JC; Babcock R; Wall M; Hill S Source: Health Care For Women International. 2009 Apr;30(4):324-38. Abstract: Understanding the beliefs and knowledge related to women's sexuality is important when working with unique religious groups in order to provide culturally appropriate care. An exploratory, descriptive qualitative study generated knowledge, beliefs, and practices related to menstruation, ovulation, and family planning among Low German-speaking (LGS) Mennonite women (n = 38). There is a pervasive silence that surrounds sexuality among this group, who have a limited understanding of the physiological changes they experience. Honoring religious principles and family and community expectations through acceptable female behavior is essential. Adherence to religious principles varies by family but is not shared with the group to avoid disfavor. Language: English Keywords: CANADA | RESEARCH REPORT | QUALITATIVE RESEARCH | WOMEN | SEXUALITY | RELIGIOUS ASPECTS | BELIEFS | KNOWLEDGE | INTERVIEWS | Developed Countries | North America, Northern | Americas | Research Methodology | Demographic Factors | Population | Personality | Psychological Factors | Behavior | Religion | Sociocultural Factors | Culture | Data Collection Document Number: 341659 |
| 16. Peer Reviewed Title: Condom use among injection drug users accessing a supervised injecting facility. Author: Marshall BD; Wood E; Zhang R; Tyndall MW; Montaner JS; Kerr T Source: Sexually Transmitted Infections. 2009 Apr;85(2):121-6. Abstract: OBJECTIVES: Although supervised injecting facility (SIF) use has been associated with reductions in injection-related risk behaviours, the impact of SIFs on the sexual behaviour of injection drug users (IDUs) has not been thoroughly investigated. Therefore, we examined the patterns and predictors of condom use among SIF users in Vancouver, Canada. METHODS: We performed a longitudinal analysis of the factors associated with consistent condom use among IDUs recruited from within a SIF. RESULTS: Among 1090 individuals, 650 (59.6%) reported a sexual partner in the past 6 months at baseline. Consistent condom use was reported by 108 (25.3%) and 205 (61.6%) individuals reporting regular or casual partners, respectively. After 2 years of observation, these proportions increased to 32.9% and 69.8%, respectively. In multivariate analysis, predictors of consistent condom use with regular partners included HIV positivity (adjusted odds ratio (AOR) 2.23; 95% CI 1.51 to 3.31), injecting with a sex partner (AOR 0.50; 95% CI 0.37 to 0.68), enrollment in addiction treatment (AOR 0.68, 95% CI 0.52 to 0.89) and time since recruitment (AOR 1.29; 95% CI 1.06 to 1.55 per year). Predictors of consistent condom use with casual partners included HIV positivity (AOR 1.70; 95% CI 1.03 to 2.81), syringe borrowing (AOR 0.54; 95% CI 0.32 to 0.91) and syringe lending (AOR 0.52; 95% CI 0.32 to 0.84). CONCLUSIONS: Our results demonstrate that among SIF users, consistent condom use was more frequent among casual sex partners and among HIV positive individuals. Importantly, while the prevalence of consistent condom use was low at baseline, it increased over time. Our findings suggest a possible beneficial effect of the SIF on safer sexual practices. Language: English Keywords: CANADA | RESEARCH REPORT | LONGITUDINAL STUDIES | IV DRUG USERS | SEXUAL PARTNERS | CONDOM USE | SAFER SEX | SEX BEHAVIOR | RISK BEHAVIOR | Developed Countries | North America, Northern | Americas | Studies | Research Methodology | Drug Use and Abuse | Behavior | Risk Reduction Behavior Document Number: 341854 |
| 17. Title: Examination of a simple model of condom usage and individual withdrawal for the HIV epidemic. Author: Musgrave J; Watmough J Source: Mathematical Biosciences and Engineering. 2009 Apr;6(2):363-76. Abstract: Since the discovery of HIV/AIDS there have been numerous mathematical models proposed to explain the epidemic of the disease and to evaluate possible control measures. In particular, several recent studies have looked at the potential impact of condom usage on the epidemic [1, 2, 3, 4]. We develop a simple model for HIV/AIDS, and investigate the effectiveness of condoms as a possible control strategy. We show that condoms can greatly reduce the number of outbreaks and the size of the epidemic. However, the necessary condom usage levels are much higher than the current estimates. We conclude that condoms alone will not be sufficient to halt the epidemic in most populations unless current estimates of the transmission probabilities are high. Our model has only five independent parameters, which allows for a complete analysis. We show that the assumptions of mass action and standard incidence provide similar results, which implies that the results of the simpler mass action model can be used as a good first approximation to the peak of the epidemic. Language: English Keywords: CANADA | RESEARCH REPORT | MATHEMATICAL MODEL | CONDOM USE | CONTRACEPTIVE USE-EFFECTIVENESS | HIV PREVENTION | PROGRAM EVALUATION | Developed Countries | North America, Northern | Americas | Theoretical Models | Research Methodology | Risk Reduction Behavior | Behavior | Contraceptive Effectiveness | Contraception | Family Planning | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration Document Number: 331022 |
| 18. Peer Reviewed Title: Providing family planning and reproductive healthcare to Canadian immigrants: perceptions of healthcare providers. Author: Newbold KB; Willinsky J Source: Culture, Health and Sexuality. 2009 May;11(4):369-382. Abstract: Cultural impacts on health experiences and behaviours are profound in the area of reproductive health and family planning. Explored through interviews with family planning healthcare professionals, this paper evaluates their experiences in providing family planning and reproductive healthcare to immigrants in the Greater Toronto and Hamilton area of Ontario, Canada. Results reveal the complexity of delivering care to members of this group, particularly when dealing with language barriers, situations when professional and non-professional interpreters are used, and instances where healthcare professionals realize that they themselves have misconceptions and misunderstandings about other cultures. The paper concludes by discussing future research options and implications for the delivery of reproductive health family planning services to this population. Language: English Keywords: CANADA | RESEARCH REPORT | KAP SURVEYS | IMMIGRANTS | FAMILY PLANNING PERSONNEL | PERCEPTION | FAMILY PLANNING | FAMILY PLANNING PERSONNEL CHARACTERISTICS | FAMILY PLANNING PERSONNEL EVALUATION | REPRODUCTIVE HEALTH | DELIVERY OF HEALTH CARE | LANGUAGE | BELIEFS | CULTURAL BACKGROUND | North America, Northern | Americas | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Migrants | Migration | Population Dynamics | Demographic Factors | Population | Family Planning Programs | Psychological Factors | Behavior | Health | Communication | Culture | Sociocultural Factors | Population Characteristics Document Number: 330417 |
| 19. Title: How well protected are sexually active 15-year olds? Cross-national patterns in condom and contraceptive pill use 2002-2006. Author: Nic Gabhainn S; Baban A; Boyce W; Godeau E Author: the HBSC Sexual Health Focus Group Source: International Journal of Public Health. 2009 Jul 21; Abstract: OBJECTIVES: To present comparative data on sexual initiation, and condom use and contraceptive pill use at last intercourse among adolescents in Europe, Israel and Canada.METHODS: Data were collected by self-report questionnaire from nationally representative samples of 15 year olds in school classrooms in two cross-national surveys undertaken in 24 countries in 2001/02 and 30 countries in 2005/06.RESULTS: In 2005/06 almost 27% of those surveyed had had sex and almost 86% reported using condoms or the contraceptive pill at last intercourse. This reflects little change since 2001/02 in prevalence of sexual initiation and a general increase in being well-protected at last intercourse. There were wide variations with up to a third of sexually active 15 year olds in some countries at risk for either Sexually Transmitted Infections or pregnancy, or both.CONCLUSIONS: Most adolescents were well protected against Sexually Transmitted Infections and pregnancy, but an important minority remain at risk, with very wide cross-national differences. Language: English Keywords: CANADA | EUROPE | ISRAEL | RESEARCH REPORT | COMPARATIVE STUDIES | SAMPLING STUDIES | ADOLESCENTS | STUDENTS | FIRST INTERCOURSE | CONDOM USE | CONTRACEPTIVE USAGE | ORAL CONTRACEPTIVES | Developed Countries | North America, Northern | Americas | Middle East | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Sex Behavior | Behavior | Risk Reduction Behavior | Contraception | Family Planning | Contraceptive Methods Document Number: 342218 |
| 20. Peer Reviewed Title: First-trimester surgical abortion practices: a survey of National Abortion Federation members. Author: O'Connell K; Jones HE; Simon M; Saporta V; Paul M; Lichtenberg ES Author: National Abortion Federation Members Source: Contraception. 2009 May;79(5):385-92. Abstract: BACKGROUND: Designated providers in specialized clinics perform the majority of approximately 1.1 million first-trimester abortions carried out in the United States each year. Our objective was to assess the first-trimester surgical abortion practices of National Abortion Federation (NAF) members. STUDY DESIGN: We mailed questionnaires to NAF administrators and providers at their 364 active-member facilities in 2002. RESULTS: Two hundred eighty-nine (79%) facilities responded; we received administrative questionnaires from 273 facilities and 293 individual clinicians. NAF facilities provided at least 325,000 first-trimester surgical abortions in the United States in 2001. The majority of providers are obstetrician-gynecologists (63%), male (62%) and at least 50 years old (64%). Half of clinicians (49%) selectively utilize manual vacuum aspiration. Almost half (47%) routinely use a metal curette to verify procedure completion; these providers are more likely to be over 50 years of age or to have 20 years or more of abortion experience. Other practices are more uniform, including routine tissue examination (93%), postoperative antibiotics (88%) and contraceptive provision (oral contraceptives, 99%; depot medroxyprogesterone acetate, 79%). CONCLUSIONS: Most perioperative practices for first-trimester abortions are similar among these respondents, in accord with evidence-based guidelines. The aging of skilled practitioners raises concerns about the future availability of surgical abortion. Language: English Keywords: CANADA | UNITED STATES OF AMERICA | RESEARCH REPORT | ABORTION | PREGNANCY, FIRST TRIMESTER | CURETTAGE | CERVICAL DILATATION | SURGERY | Developed Countries | North America, Northern | Americas | North America | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Obstetrical Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342084 Notification |
| 21. Title: Putting a finger on potential predictors of oral contraceptive side effects: 2D:4D and middle-phalangeal hair. Author: Oinonen KA Source: Psychoneuroendocrinology. 2009;34:713-726. Abstract: Many women experience emotional or physical side effects when taking oral contraceptives (OCs). Despite the potential impact on women's health and well-being, there are no valid methods to screen women for their risk of OC side effects. The present paper presents the results of two studies where anthropometric indicators of androgen exposure, 2D:4D and middle-phalangeal hair, were examined for their potential as predictors of OC side effects. In study 1, 2D:4D was associated with women's reports of a history of: (a) negative mood side effects; (b) discontinuation due to negative mood side effects; (c) specific mood side effects (i.e., crying, sadness, and altered trust in one's partners) and (d) specific physical side effects (i.e., headaches, fatigue, and decreased sex drive). In study 2, 2D:4D and/or middle-phalangeal hair was/were associated with a reported history of: (a) discontinuation due to negative mood side effects; (b) specific mood-related side effects (i.e., negative mood, disrupted sleep, increased aggression, and altered trust in one's partner) and (c) specific physical side effects (i.e., headaches, decreased menstrual cramps, and increased sex drive/arousal). The general pattern was that adverse OC side effects were experienced by women with lower 2D:4D and fewer middle-phalangeal hairs. Almost all relationships remained significant when response bias was controlled. These results suggest a possible role for prenatal testosterone exposure and both androgen action and sensitivity in women's experience of OC side effects. Furthermore, these two digit measures may be useful predictors of hormonal contraceptive side effects in women. Language: English Keywords: CANADA | RESEARCH REPORT | WOMEN | SEXUAL PARTNERS | ORAL CONTRACEPTIVES, SIDE EFFECTS | ANTHROPOMETRY | ANDROGENS | SCREENING | EMOTIONS | HEADACHE | FATIGUE | CONTRACEPTION TERMINATION | SLEEPING | TESTOSTERONE | North America, Northern | Americas | Developed Countries | Demographic Factors | Population | Sex Behavior | Behavior | Contraceptive Safety | Safety | Public Health | Health | Measurement | Research Methodology | Hormones | Endocrine System | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Psychological Factors | Signs and Symptoms | Diseases | Contraception | Family Planning Document Number: 329672 |
| 22. Title: Oral contraceptive progestins and angiotensin-dependent control of the renal circulation in humans. Author: Sarna MA; Hollenberg NK; Seely EW; Ahmed SB Source: Journal of Human Hypertension. 2009 Jun;23(6):407-414. Abstract: Oral contraceptive (OC) use is associated with increased intrarenal renin-angiotensin-aldosterone system (RAA System) activity and risk of nephropathy, though the contribution of progestins contained in the OC in the regulation of angiotensin-dependent control of the renal circulation has not been elucidated. A total of 18 OC users (8 non-diabetic, 10 Type 1 diabetic) were studied in high salt balance, a state of maximal RAA System suppression. Progestational and androgenic activity of the progestin in each OC was standardized to that of the reference progestin norethindrone. Renal plasma flow (RPF) was measured by para-aminohippurate clearance at baseline and in response to angiotensin-converting enzyme (ACE) inhibition. There was a positive correlation between OC progestational activity and the RPF response to ACE inhibition (r=0.52, P=0.03). Similar results were noted with OC androgenic activity (r=0.54, P=0.02). On subgroup analysis, only non-diabetic subjects showed an association between progestational activity and angiotensin-dependent control of the renal circulation (r=0.71, P=0.05 non-diabetic; r=0.14, P=0.7 diabetic; P=0.07 between groups). Similar results were noted with respect to androgenic activity (r=0.88, P=0.005 non-diabetic; r=-0.33, P=0.3 diabetic; P=0.002 between groups). Our results suggest that the OC progestin component is a significant influence on the degree of angiotensin-dependent control of the renal circulation, though these findings may not apply to women with diabetes.Journal of Human Hypertension advance online publication, 22 January 2009; doi:10.1038/jhh.2008.148. Language: English Keywords: CANADA | RESEARCH REPORT | WOMEN | ORAL CONTRACEPTIVES | RENAL EFFECTS | CONTRACEPTIVE AGENTS, PROGESTIN | North America, Northern | Americas | Developed Countries | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Urogenital Effects | Urogenital System | Physiology | Biology | Contraceptive Agents, Female | Contraceptive Agents Document Number: 329661 |
| 23. Peer Reviewed Title: Structural and environmental barriers to condom use negotiation with clients among female sex workers: implications for HIV-prevention strategies and policy. Author: Shannon K; Strathdee SA; Shoveller J; Rusch M; Kerr T; Tyndall MW Source: American Journal of Public Health. 2009 Apr;99(4):659-65. Abstract: OBJECTIVES: We investigated the relationship between environmental-structural factors and condom-use negotiation with clients among female sex workers. METHODS: We used baseline data from a 2006 Vancouver, British Columbia, community-based cohort of female sex workers, to map the clustering of "hot spots" for being pressured into unprotected sexual intercourse by a client and assess sexual HIV risk. We used multivariate logistic modeling to estimate the relationship between environmental-structural factors and being pressured by a client into unprotected sexual intercourse. RESULTS: In multivariate analyses, being pressured into having unprotected sexual intercourse was independently associated with having an individual zoning restriction (odds ratio [OR] = 3.39; 95% confidence interval [CI] = 1.00, 9.36), working away from main streets because of policing (OR = 3.01; 95% CI = 1.39, 7.44), borrowing a used crack pipe (OR = 2.51; 95% CI = 1.06, 2.49), client-perpetrated violence (OR = 2.08; 95% CI = 1.06, 4.49), and servicing clients in cars or in public spaces (OR = 2.00; 95% CI = 1.65, 5.73). CONCLUSIONS: Given growing global concern surrounding the failings of prohibitive sex-work legislation on sex workers' health and safety, there is urgent need for environmental-structural HIV-prevention efforts that facilitate sex workers' ability to negotiate condom use in safer sex-work environments and criminalize abuse by clients and third parties. Language: English Keywords: CANADA | RESEARCH REPORT | MULTIVARIATE ANALYSIS | WOMEN | SEX WORKERS | CLIENTS | HIV PREVENTION | NEEDS ASSESSMENT | POLICY | LEGISLATION | RISK FACTORS | IMPACT | Developed Countries | North America, Northern | Americas | Data Analysis | Research Methodology | Demographic Factors | Population | Sex Behavior | Behavior | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Evaluation | Political Factors | Sociocultural Factors | Health | Communication Document Number: 330893 |
| 24. Peer Reviewed Title: First impressions: what are preclinical medical students in the US and Canada learning about sexual and reproductive health? Author: Steinauer J; LaRochelle F; Rowh M; Backus L; Sandahl Y; Foster A Source: Contraception. 2009 Jul;80(1):74-80. Abstract: BACKGROUND: This study evaluates the inclusion of sexual and reproductive health (SRH) topics in preclinical US and Canadian medical education. STUDY DESIGN: Between 2002 and 2005, we sent surveys to the student coordinators of active Medical Students for Choice chapters at 122 US and Canadian medical schools. Students reported on the preclinical curricular inclusion of 50 specific SRH topics in the broad categories of pregnancy, contraception, infertility, elective abortion, ethical and social issues, and other topics. RESULTS: We received 77 completed surveys, for an overall response rate of 63%. Coverage of pregnancy physiology and STIs/HIV was uniformly high. In contrast, inclusion of contraceptive methods and elective abortion procedures greatly varied by subtopic and geographic region. Thirty-three percent of respondents reported no coverage of elective abortion-related topics. CONCLUSIONS: Inclusion of contraception and elective abortion in preclinical medical school courses varies widely. As critical components of women's lives and health, we recommend that medical schools work to integrate comprehensive family planning content into their standard curricula. Language: English Keywords: UNITED STATES OF AMERICA | CANADA | RESEARCH REPORT | SURVEYS | MEDICAL STUDENTS | REPRODUCTIVE HEALTH | MEDICAL SCHOOLS | CURRICULUM | FAMILY PLANNING | ABORTION | ETHICS | GEOGRAPHIC FACTORS | Developed Countries | North America | Americas | North America, Northern | Sampling Studies | Studies | Research Methodology | Students | Education | Health | Schools | Fertility Control, Postconception | Sociocultural Factors | Population Document Number: 342789 Notification |
| 25. Peer Reviewed Title: Women's perceptions about seeing the ultrasound picture before an abortion. Author: Wiebe ER; Adams L Source: European Journal of Contraception and Reproductive Health Care. 2009 Apr;14(2):97-102. Abstract: OBJECTIVES: To gain a better understanding of women's perceptions and experiences of viewing the ultrasound (US) before an abortion. METHODS: This mixed-methods study included questionnaires and interviews. Women presenting for medical and surgical abortion at two urban abortion clinics completed questionnaires asking if they wished to view the US image and those women who had done so answered questions about their perceptions. A randomly selected ten women were interviewed six weeks later about their perceptions. The interviews were audio-taped, transcribed and analysed for salient themes. RESULTS: The 350 participants had a mean age of 27.6 years, 0.68 births, and were at a mean of 49.1 days gestation at the time of the procedure. Most women (254/350, 72.6%) chose to view the US and 179/219 (86.3%) found it a positive experience. Older women and those who had children were less likely to want to view the US image (p = 0.001). All ten interviewees recommended that this choice be offered to every woman and recommended more communication between care providers and patients at the time of the US. None of the women changed her mind about having the abortion after having seen the US. CONCLUSIONS: Offering the choice to view the ultrasound is both feasible and beneficial to women having abortions. Our findings support those of the only other study published on the subject. Language: English Keywords: CANADA | RESEARCH REPORT | QUALITATIVE RESEARCH | ABORTION | ULTRASONICS | PERCEPTION | INTERVIEWS | PHYSICIAN-PATIENT RELATIONS | COUNSELING | Developed Countries | North America, Northern | Americas | Research Methodology | Fertility Control, Postconception | Family Planning | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Psychological Factors | Behavior | Data Collection | Interpersonal Relations | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 341448 |
| 26. Peer Reviewed Title: Progesterone-only and non-hormonal contraception in the breast cancer survivor: Joint review and committee opinion of the Society of Obstetricians and Gynaecologists of Canada and the Society of Gynecologic Oncologists of Canada No. 179, July 2006. Source: International Journal of Gynecology and Obstetrics. 2008 Jun;101(3):309-318. Abstract: The objective was to examine the relationship between progestin-only contraception and breast cancer, and to make recommendations regarding contraception for the breast cancer survivor. The outcome was incidence of breast cancer among users of progestin-only contraception. PubMed and Medline databases were searched using the terms "breast cancer" and "progesterone," "contraception," "depot medroxyprogesterone acetate," "Micronor," "Mirena," and "subdermal implant." The citations were limited to the English language. References were searched for other relevant articles. The quality of evidence is described using the classification of the Canadian Task Force on the Periodic Health Exam. Benefits, Harms, and Costs: Providing reliable contraception and non-contraceptive benefits to breast cancer survivors versus breast cancer recurrence risk. Summary Statements: 1. Progesterone and progestins can have a proliferative, antiproliferative, or neutral effect on breast tissue, depending on the type, timing, and dose of progestin used. (I). 2. Use of depot medroxyprogesterone acetate (DMPA) does not increase the risk of breast cancer in the general population. (II-2). 3. Although not as well-studied as the combined contraceptive pill, progestin-only pills do not appear to increase the risk of breast cancer in the general population. (II-2). 4. There is insufficient evidence to comment on risk or recurrence risk of breast cancer with contraceptive implants in the general population (II-2) or among breast cancer survivors. (III). 5. The limited data available suggest that the levonorgestrel-releasing intrauterine system (LNG-IUS) does not seem to increase breast cancer risk in the general population. (II-2). 6. Sterilization and the copper intrauterine device (IUD) are the most reliable non-hormonal contraceptive methods. (II-1). 7. Other non-hormonal methods may also be appropriate given decreased fertility with advancing age and after chemotherapy. (III). 8. Further research into progestin-only contraception inthe breast cancer survivor is needed. (III). Recommendations: 1. DMPA use in a breast cancer survivor can be considered in circumstances where contraceptive or non-contraceptive benefits outweigh any unknown potential increase in recurrence risk. (III-C). 2. Use of progestin-only pills in a breast cancer survivor may be considered in a situation where known benefits outweigh any unknown potential increase in recurrence risk. (III-C). 3. Use of the LNG-IUS in the breast cancer survivor can be considered if the unique contraceptive or non-contraceptive benefits outweigh the risk of an unknown effect on recurrence. (III-C). 4. Non-hormonal contraceptive methods should be used as first-line options in the breast cancer survivor. (author's) Language: English Keywords: CANADA | RESEARCH REPORT | LITERATURE REVIEW | INCIDENCE | WOMEN | BREAST CANCER | CONTRACEPTIVE METHODS | LOW-DOSE PROGESTINS | PROGESTERONE | North America, Northern | Americas | Developed Countries | Measurement | Research Methodology | Demographic Factors | Population | Cancer | Neoplasms | Diseases | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology Document Number: 326725 |
| 27. Peer Reviewed Title: Imbalance in the peritoneal levels of interleukin 1 and its decoy inhibitory receptor type II in endometriosis women with infertility and pelvic pain. Author: Akoum A; Al-Akoum M; Lemay A; Maheux R; Leboeuf M Source: Fertility and Sterility. 2008 Jun;89(6):1618-1624. Abstract: The objective was to evaluate the levels of interleukin-1b (IL1 beta) and its inhibitory soluble interleukin-1 receptor type II (IL1R2) in the peritoneal fluid (PF) of normal women and patients with endometriosis suffering from pelvic pain and infertility. The design was a retrospective study using ELISA to measure peritoneal fluid IL1 beta and soluble IL1R2. The setting was the gynecology clinic and human reproduction research laboratory. The patient(s) were sixty-eight normal women and 154 women with endometriosis. Peritoneal fluid samples were obtained at laparoscopy. The main outcome measure(s) were IL1 beta and soluble IL1R2 concentrations in the PF samples. This study showed a marked decrease in peritoneal soluble IL1R2 levels in women with endometriosis compared to normal women and a concomitant increase in the levels of IL1 beta. Both fertile and infertile women with endometriosis had lower soluble IL1R2 and higher IL1 beta concentrations than fertile women having a normal gynecological status, but the difference was more significant in infertile endometriosis patients. Compared with normal controls, the decrease in soluble IL1R2 levels was less significant in women with endometriosis than without pelvic pain, whereas the increase in IL1 beta concentrations was statistically significant only in women with endometriosis reporting pelvic pain. This study revealed an imbalance between IL1 beta and its decoy inhibitory receptor type 2 in women with endometriosis, which was particularly obvious in those who were infertile, and suggests that a defect in the local control of IL1 may be involved in the pathophysiology of endometriosis and related infertility. (author's) Language: English Keywords: CANADA | RESEARCH REPORT | RETROSPECTIVE STUDIES | CLINICAL RESEARCH | LABORATORY PROCEDURES | WOMEN | ENDOMETRIOSIS | INFERTILITY | PAIN | PERITONEAL DISEASES | North America, Northern | Americas | Developed Countries | Studies | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Demographic Factors | Population | Diseases | Reproduction | Signs and Symptoms Document Number: 327233 |
| 28. Peer Reviewed Title: Menarche and father absence in a national probability sample. Author: Bogaert AF Source: Journal of Biosocial Science. 2008 Jul;40(4):623-636. Abstract: The relation between women's timing of menarche and father absence was examined in a national probability sample of Great Britain (NATSAL 2000; N greater than 5000). Current body mass index (as a proxy for childhood weight) was examined as a potential mediator of this relationship, along with the potential moderating role that siblings (e.g. number of older brothers) had on this relationship. As in a number of previous studies, an absent father (but not an absent mother) during childhood predicted an earlier age of puberty (i.e. an early menarche). There was no evidence that weight mediated this relationship or that siblings moderated it. Both a lower body mass index and more siblings (e.g. more younger sisters and brothers) were independent predictors of a later timing of puberty. The results confirm that certain psychosocial factors (i.e. father absence; presence of siblings) may affect the timing of sexual maturation in adolescent girls. (author's) Language: English Keywords: CANADA | RESEARCH REPORT | PROBABILITY | MOTHERS | ADOLESCENTS, FEMALE | MENARCHE | AGE FACTORS | TIME FACTORS | ONE PERSON HOUSEHOLD | FAMILY RELATIONSHIPS | SIBLINGS | PSYCHOSOCIAL FACTORS | North America, Northern | Americas | Developed Countries | Statistical Studies | Studies | Research Methodology | Parents | Family Characteristics | Family and Household | Sociocultural Factors | Adolescents | Youth | Population Characteristics | Demographic Factors | Population | Menstruation | Reproduction | Population Dynamics | Households | Behavior Document Number: 327239 |
| 29. Peer Reviewed Title: Modifying Photovoice for community-based participatory Indigenous research. Author: Castleden H; Garvin T Source: Social Science and Medicine. 2008 Mar;66(6):1393-1405. Abstract: Scientific research occurs within a set of socio-political conditions, and in Canada research involving Indigenous communities has a historical association with colonialism. Consequently, Indigenous peoples have been justifiably sceptical and reluctant to become the subjects of academic research. Community-Based Participatory Research (CBPR) is an attempt to develop culturally relevant research models that address issues of injustice, inequality, and exploitation. The work reported here evaluates the use of Photovoice, a CBPR method that uses participant-employed photography and dialogue to create social change, which was employed in a research partnership with a First Nation in Western Canada. Content analysis of semi-structured interviews (n = 45) evaluated participants' perspectives of the Photovoice process as part of a larger study on health and environment issues. The analysis revealed that Photovoice effectively balanced power, created a sense of ownership, fostered trust, built capacity, and responded to cultural preferences. The authors discuss the necessity of modifying Photovoice, by building in an iterative process, as being key to the methodological success of the project. (author's) Language: English Keywords: CANADA | METHODOLOGICAL STUDIES | THEORETICAL MODELS | RESEARCH METHODOLOGY | ACTION RESEARCH | INDIGENOUS POPULATION | COMMUNITY | POLITICAL FACTORS | COLONIALISM | CULTURAL BACKGROUND | INEQUALITIES | VISUAL AIDS | OWNERSHIP | North America, Northern | Americas | Developed Countries | Population Characteristics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors | Sociocultural Factors | Political Systems | Socioeconomic Factors | Economic Factors | Educational Methods | Educational Activities | Education Document Number: 324679 |
| 30. Title: Associations of oral contraceptive use and dietary restraint with bone speed of sound and bone turnover in university-aged women. Author: Di Giovanni G; Roy BD; Gammage KL; Mack D; Klentrou P Source: Applied Physiology, Nutrition, and Metabolism. 2008 Aug;33(4):696-705. Abstract: The associations of oral contraceptive use and cognitive dietary restraint with bone speed of sound (SOS) and bone turnover were investigated in 100 Canadian university-aged women (18-25 years old). Dietary restraint was assessed using the Dutch Eating Behavior Questionnaire (DEBQ) and daily calcium intake (Ca++) was assessed by the rapid assessment method. Quantitative ultrasound was used to measure SOS at the tibia and radius. Bone formation was estimated from plasma osteocalcin (OC), 25-OH vitamin D, and serum bone-specific alkaline phosphatase (BAP). Bone resorption was determined from serum cross-linked N-teleopeptide of type I collagen (NTx) and plasma C-terminal telopeptide of type I collagen (CTx). Weekly physical activity energy expenditure (WAeq) was assessed using a standardized questionnaire, and height, body mass, relative body fat (%BF), and chest, waist, and hip circumferences were also measured. Participants were divided into low and moderate to high dietary restrainers (LDRs and MDRs, respectively). These groups were further sub-divided into users and non-users of oral contraceptives. All groups had similar age at menarche, body composition, WAeq, and equally low levels of Ca++ and vitamin D. Within the non-users of oral contraceptives, MDR exhibited a lower tibial SOS (p Keywords: CANADA | RESEARCH REPORT | QUANTITATIVE RESEARCH | STUDENTS | WOMEN | UNIVERSITIES | DIET | VITAMIN D | SKELETAL EFFECTS | CALORIC INTAKE | Developed Countries | North America, Northern | Americas | Research Methodology | Education | Demographic Factors | Population | Schools | Nutrition | Health | Vitamins and Minerals | Physiology | Biology Document Number: 329296 |
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