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Journal of Family Planning and Reproductive Health Care. 2011 Jul; 37(3):128-31.This commentary focuses on guidance around 'missed pill' rules. It discusses the simplification of these rules taken on by the UK's Medicines and Healthcare products Regulatory Agency (MHRA) in 2010 with the aim to produce standardized guidance on the starting of combined hormonal contraceptives and on 'missed pills.'
Journal of Family Planning and Reproductive Health Care. 2004 Apr; 30(2):131.May I congratulate the Journal and the Clinical Effectiveness Unit for continuing to produce excellent Guidance for those of us working in the field of reproductive health. The wide dissemination of these articles will ensure uniformity and quality in contraception provision in primary and secondary care. I have, however, one concern. This has been alluded to in a recent article describing the consensus process for adapting the World Health Organization (WHO) Selected Practice Recommendations for UK Use. As a result of the relaxation of some of the more cautious rules a very small number of women may become pregnant. An obvious example is giving Depo- Provera injections 2 weeks late (i.e. at 14 weeks) without any precautionary measures. The Selected Practice Recommendations for Contraceptive Use were developed to improve and extend contraceptive provision in developing countries. In developed countries, however, those becoming pregnant may take a more litigious view particularly when patient information leaflets and the Summaries of Product Characteristics (SPCs) state contrary and more cautious advice. In addition, new evidence regarding follicular development potential suggests that more, rather than less, caution may be advisable. Could the Faculty of Family Planning and Reproductive Health Care or the University of Aberdeen be sued? (excerpt)
Population and development linkages: new research priorities after the Cairo and Beijing conferences.
The Hague, Netherlands, Netherlands Interdisciplinary Demographic Institute [NIDI], 1996. 23 p. (NIDI Hofstee Lecture Series 13)This document contains the text of the 1996 Hofstee Lecture organized by the Netherlands Interdisciplinary Demographic Institute. The 1996 lecture, entitled "Population and Development Linkages: New Research Priorities after the Cairo and Beijing Conferences," was delivered by Nafis Sadik, Executive Director of the UN Population Fund. Dr. Sadik suggested that research is needed to explore 1) the interrelations between population, sustainable development, and the environment and 2) to improve design and implementation of more effective reproductive health programs and solve methodological problems. After sketching the linkages between population and development, her lecture analyzed research needs to clarify the population/development relationship in terms of macroeconomic linkages, population/environment linkages (for rural and for urban environments), microeconomic linkages (such as education, poverty, and unintended poverty), and macro-microeconomic linkages. The next part of her lecture presented sociocultural research and operations research proposals to identify the constraints on full access to reproductive health services and to improve quality of care. Dr. Sadik concluded that results of investigations in the areas of methodological development; conceptual clarification; and substantive, theoretical, and applied research should be consolidated into databases to enhance policy development and measurement of progress in meeting the goals of the world population conferences. In response to this lecture, Dr. Piet Bukman of the Netherlands discussed the problem of achieving food security and the urgent need for an effective population policy that will adopt short-term as well as longterm measures to limit global population growth.
Multinational comparative clinical trial of long-acting injectable contraceptives: norethisterone enanthate given in two dosage regimens and depot-medroxyprogesterone acetate. A preliminary report.
Contraception. 1982 Jan; 25(1):1-11.A multicenter phase 3 clinical trial compared norethisterone enanthate (NET-EN) given by 2 different treatment regimens and depot-medroxyprogesterone acetate (DMPA). After 18 months of observation, preliminary findings are reported for 790 women who received NET-EN 200 mg every 60 days; for 796 women who recieved NET-EN every 60 days (200 mg) for 6 months, then 200 mg every 84 days, and for 1589 women who received DMPA 150 mg every 90 days. Overall discontinuation rates and discontinuation for bleeding and personal reasons were similar for all 3 groups after 18 months observation (61.8-63.5/100 women). Terminations due to amenorrhea were significantly higher among DMPA users (12.1 and 17.4/100 women at 12 and 18 months) than among both NET-EN groups (6.8-8.2/100 women at 12 months and 10.4-10.9/100 women at 18 months). The only significant difference in pregnancy rates observed among the 3 groups was a higher rate at 18 months among NET-EN (84 days) users (1.6/100 women), than among DMPA users (0.2/100 women). There was no overall significant difference between the 2 NET-EN groups, although between the 6 and 18 month follow-ups when the 2 NET-EN regimens diverged, the NET-EN (84 days) users' pregnancy rates rose significantly, whereas in the NET-EN (60 days) group, the pregnancy rate did not change. Weight gain was significantly higher in those subjects using NET-EN at 60 day intervals than at 84-day intervals. (author's modified)
Intercom 6(7):11. July 1978.Service-Oriented Research in Adolescent Fertility in Europe was the theme of a recent meeting sponsored by WHO in the Eastern European city of Warnemunde, German Democratic Republic (GDR). Representing formal recognition of the reality of premarital adolescent fertility and the societal problems associated with unintended and unwanted pregnancies in both developed and developing European countries, the gathering drew participants from all major regions of Europe, the U.S., and WHO's Geneva headquarters. Cosponsors included the GDR Society for Marriage and the Family, Joint Center for the Study of Health Programs Institute, University of Copenhagen, and the Transnational Family Research Institute, whose director, Henry P. Davis, presented the keynote address. An immediate follow-up meeting held in WHO's Copenhagen offices dealt with the application of research findings to the development of teen fertility programs, and country-specific priorities for research are expected to evolve from continuing consultations. Among the recommendations was a plea that the service providers, policymakers, and knowledgeable youth be brought into the planning process from the very beginning. A combined report of papers, discussions, and recommendations will be published in English, French, German, and Russian by WHO, which is expected to strengthen its role in providing information and technical consultation.(FULL TEXT)