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Venus. 金星。
Q Medicine Pub Date : 2017-07-01 DOI: 10.1136/jfprhc-2016-101664
Abi Berger
LARC use decreases as perceived barriers to use increase Perceived barriers are the strongest predictor of women’s use of long-acting forms of reversible contraception (LARC), with use decreasing as barriers increase. In one Welsh qualitative study barriers included fear and embarrassment. Ironically, increases in “health motivation to reduce pregnancy” and “perceived behavioural control” reduced the odds of a woman using LARC – which might seem counterintuitive until one considers that women who score highly on these parameters probably see themselves as able to manage the use of non-LARC methods.
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引用次数: 0
Correction: 'Authors' response to comment on 'Postpartum contraception: a missed opportunity to prevent unintended pregnancy and short inter-pregnancy intervals'. 更正:“作者对“产后避孕:错过了防止意外怀孕和缩短妊娠间隔的机会”评论的回应。
Q Medicine Pub Date : 2017-07-01 DOI: 10.1136/jfprhc-2017-101759corr1
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引用次数: 1
Response to 'Safety issue with TT380 Slimline intrauterine contraceptive device'. 对“TT380 Slimline宫内节育器安全问题”的回应。
Q Medicine Pub Date : 2017-07-01 DOI: 10.1136/jfprhc-2017-101826
Colin G Parker
Estrogen promotes bone health, long-term replacement delaying osteoporosis,1 while sex steroids given for menstrual irregularity to premenopausal women increase bone mass.2 We therefore assessed the relation between reproductive health and fracture risk in postmenopausal women (≥50 years) in the US National Health and Nutrition Examination Survey (NHANES).3 In the 2013–2014 survey, fracture risk as FRAX scores4 was reported in an osteoporosis questionnaire with calculation of the 10-year risk of major hip fracture. We collected data on the age at last menstrual period, last live birth, and first live birth as continuous variables, and documented history of pregnancy …
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引用次数: 2
What is the future for sexual and contraceptive services? 性和避孕服务的未来是什么?
Q Medicine Pub Date : 2017-07-01 DOI: 10.1136/jfprhc-2017-101764
Su Everett
It is always difficult to write about something you are passionate about objectively, and sexual health is one such subject for me. So, the following is my personal view on the massive changes taking place within sexual health. I do this from a standpoint of having worked in sexual health both as a clinician and a lecturer since 1985 and 1998, respectively, but also as someone who has worked as a practice nurse for 8 years.There is a nervous edge around sexual health currently, as sexual health services within London are fighting for contracts. This has meant that sexual health services are competing against each other, whereas usually there are close links between sexual health services as staff move between services. If a service wins the contract then their future is assured for the time being. However, if they lose, then their service is unlikely to survive and will only continue in the current format until July 2017, and there will inevitably be job losses. Currently sexual health services that  have lost contracts are unable to give information to patients about the future of their service. Already nurses within these departments are leaving sexual health services as they are worried that they might not have a job come July. The loss of expertise will be sorely missed; the specialist skills of health professionals working this area involve identifying and caring for those at risk of grooming, sexual abuse, sexual assault and sex work. It is a special person who works in this area and sensitively listens to, and supports, the men and women who access these services.Since 2013 Local Authorities have provided contraceptive service funding, but with significant government cutbacks and pressure on Local Authorities’ budgets these services are at risk.1 One …
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引用次数: 0
Access to contraception: why patient choice matters. 获得避孕:为什么病人的选择很重要。
Q Medicine Pub Date : 2017-07-01 DOI: 10.1136/jfprhc-2017-101775
Seán Richard Cassidy, Charlotte Cohen, Kimberley Forbes, Nneka Nwokolo, Sara Day
The Department of Health’s ‘A Framework for Sexual Health Improvement in England’ states an ambition to “increase access to all methods of contraception, including long-acting reversible contraception (LARC) methods and emergency hormonal contraception, for women of all ages and their partners”.1 The London Sexual Health Transformation Project is a collaboration between 29 London boroughs aiming to improve access to sexual health and contraceptive services. Their vision is for a network of integrated ‘one-stop shops’ working closely with primary care to provide basic family planning services, with fewer Level 3 centres serving people with more complex sexual health needs.2 Individuals with complex contraception needs may include people living with …
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引用次数: 1
Influences in fertility decisions among HIV-infected individuals in Lilongwe, Malawi: a qualitative study. 马拉维利隆圭艾滋病毒感染者生育决定的影响:一项定性研究。
Q Medicine Pub Date : 2017-07-01 Epub Date: 2016-06-16 DOI: 10.1136/jfprhc-2015-101395
Lisa B Haddad, Alexandra B Hoagland, Karen L Andes, Bernadette Samala, Caryl Feldacker, Kingsley Chikaphupha, Hannock Tweya, Jane Chiwoko, Fannie Kachale, Denise J Jamieson, Sam Phiri

Background: The motivation to have a child may be complex with numerous influencing factors, particularly among individuals living with HIV. This study sought to understand factors influencing fertility decision-making for HIV-infected men and women in Lilongwe, Malawi.

Methods: Thirteen focus groups were conducted among HIV-infected individuals enrolled in antiretroviral treatment services.

Results: Participants identified a hierarchy of influences in fertility decisions including the importance of childbearing, patriarchal influence, family influences and concern regarding HIV transmission.

Conclusions: Addressing fertility conversations beyond the confines of a relationship may be important, as family plays a significant role in fertility choices. Childbearing remains a fundamental desire among many individuals with HIV; however, concerns regarding transmission risk need to be addressed with efforts made to overcome misconception and assist individuals in balancing what may be competing influences.

背景:生孩子的动机可能是复杂的,有许多影响因素,特别是在艾滋病毒感染者中。这项研究试图了解影响马拉维利隆圭艾滋病毒感染者生育决策的因素。方法:在参加抗逆转录病毒治疗服务的艾滋病毒感染者中进行了13个焦点小组。结果:参与者确定了生育决策的影响等级,包括生育的重要性、父权制影响、家庭影响和对艾滋病毒传播的关注。结论:家庭在生育选择中扮演着重要的角色,因此在关系范围之外进行生育对话可能很重要。生育仍然是许多艾滋病毒感染者的基本愿望;然而,需要通过努力克服误解和帮助个人平衡可能相互竞争的影响来解决有关传播风险的关切。
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引用次数: 3
Assessing women's satisfaction with family planning services in Mozambique. 评估莫桑比克妇女对计划生育服务的满意度。
Q Medicine Pub Date : 2017-07-01 Epub Date: 2016-09-08 DOI: 10.1136/jfprhc-2015-101190
Leonardo Chavane, Martinho Dgedge, Patricia Bailey, Osvaldo Loquiha, Marc Aerts, Marleen Temmerman

Background: The contraceptive prevalence rate in Mozambique was estimated as 11.3% in the last Demographic and Health Survey. The impact of family planning (FP) on women's health and on the reduction of maternal mortality is well known.

Methods: Acknowledging the importance of user satisfaction in the utilisation of health services, exit interviews were used to assess women's satisfaction with FP services in Mozambique. The survey, conducted in 174 health facilities, was representative at the national level, covered all provinces, and both urban and rural areas.

Results: Overall, 86% of respondents were satisfied with FP services, but issues such as insufficient supplies of oral contraceptives and the low quality of healthcare provider/client interactions were given as reasons for women's dissatisfaction.

Conclusion: Defined actions at the level of health service provision are needed to tackle the identified issues and ensure improved satisfaction with, and better utilisation of, FP services in Mozambique.

背景:在上一次人口与健康调查中,莫桑比克的避孕普及率估计为11.3%。计划生育对妇女健康和降低产妇死亡率的影响是众所周知的。方法:认识到用户满意度在卫生服务利用中的重要性,使用退出访谈来评估莫桑比克妇女对计划生育服务的满意度。这项调查在174个卫生机构进行,在全国一级具有代表性,涵盖所有省份以及城市和农村地区。结果:总体而言,86%的受访者对计划生育服务感到满意,但诸如口服避孕药供应不足和卫生保健提供者/客户互动质量低等问题是妇女不满意的原因。结论:需要在卫生服务提供层面采取明确的行动,以解决已确定的问题,并确保提高莫桑比克计划生育服务的满意度和更好地利用计划生育服务。
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引用次数: 28
The Complete Guide to Fertility Awareness. 生育意识完整指南。
Q Medicine Pub Date : 2017-07-01 Epub Date: 2017-03-27 DOI: 10.1136/jfprhc-2017-101770
Su Everett
Jane Knight. Abingdon, UK: Routledge, 2017. ISBN-13: 978-1-138-79010-0. Price £29.99. Pages: 448 (paperback)This book is an extensive update of the 1996 edition, Fertility: Fertility Awareness and Natural Family Planning . The first and second editions of this book (written by Elizabeth Clubb and Jane Knight) have been extremely important sources of information on fertility awareness. Consequently I am really pleased to finally see a new edition published. The original book comprised 192 pages (the new edition has 448 pages), so this is an extensive update of the book and justifies the descriptor ‘Complete Guide’.There are 20 chapters: Part one contains chapters on fertility awareness, male fertility, female fertility, …
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引用次数: 5
Reproductive history and fracture risk in postmenopausal women in a US national survey. 美国一项全国性调查显示,绝经后妇女的生殖史和骨折风险。
Q Medicine Pub Date : 2017-07-01 DOI: 10.1136/jfprhc-2017-101808
Prasanna Santhanam, Steven P Rowe, Lilja B Solnes
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引用次数: 1
"My friend who bought it for me, she has had an abortion before." The influence of Ghanaian women's social networks in determining the pathway to induced abortion. “我的朋友给我买的,她以前做过人流。”加纳妇女的社会网络对决定人工流产途径的影响。
Q Medicine Pub Date : 2017-07-01 Epub Date: 2017-03-22 DOI: 10.1136/jfprhc-2016-101502
Sarah D Rominski, Jody R Lori, Emmanuel Sk Morhe

Background: Even given the liberal abortion law in Ghana, abortion complications are a large contributor to maternal morbidity and mortality. This study sought to understand why young women seeking an abortion in a legally enabling environment chose to do this outside the formal healthcare system.

Methods: Women being treated for complications arising from a self-induced abortion as well as for elective abortions at three hospitals in Ghana were interviewed. Community-based focus groups were held with women as well as men, separately. Interviews and focus group discussions were conducted until saturation was reached.

Results: A total of 18 women seeking care for complications from a self-induced abortion and 11 seeking care for an elective abortion interviewed. The women ranged in age from 13 to 35 years. There were eight focus groups; two with men and six with women. The reasons women self-induce are: (1) abortion is illegal; (2) attitudes of the healthcare workers; (3) keeping the pregnancy a secret; and (4) social network influence. The meta-theme of normalisation of self-inducing' an abortion was identified.

Discussion: When women are faced with an unplanned and unwanted pregnancy, they consult individuals in their social network whom they know have dealt with a similar situation. Misoprostol is widely available in Ghanaian cities and is successful at inducing an abortion for many women. In this way, self-inducing abortions using medication procured from pharmacists and chemical sellers has become normalised for women in Kumasi, Ghana.

背景:即使给予自由堕胎法在加纳,堕胎并发症是一个很大的贡献者产妇发病率和死亡率。这项研究试图理解为什么年轻女性在法律允许的环境中寻求堕胎,选择在正规医疗保健系统之外这样做。方法:对在加纳三家医院接受自流产和选择性流产并发症治疗的妇女进行访谈。分别与妇女和男子举行了以社区为基础的焦点小组。访谈和焦点小组讨论一直进行到饱和为止。结果:共采访了18例因自行流产并发症就诊的妇女和11例因选择性流产就诊的妇女。这些女性的年龄从13岁到35岁不等。有八个焦点小组;两个男人,六个女人。妇女自产的原因有:(1)堕胎是非法的;(2)医护人员的态度;(三)对怀孕保密的;(4)社会网络影响。确定了自我诱导堕胎正常化的元主题。讨论:当女性面临意外怀孕时,她们会向社交圈中有过类似经历的人咨询。米索前列醇在加纳的城市广泛使用,并成功地为许多妇女引产。这样,在加纳库马西,使用药剂师和化学品销售商提供的药物进行自我引产已成为常态。
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引用次数: 17
期刊
Journal of Family Planning and Reproductive Health Care
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