Class of 2005 Abstract / Objectives: Describe the prevalence of alcohol and tobacco use in college women who use emergency contraception (EC) or oral contraceptives. Methods: This study was a descriptive, retrospective study that utilized patient charts to obtain clinical data including emergency contraception utilization, hormonal contraception utilization, alcohol and tobacco use. The primary dependent variables were smoking status and alcohol use. The overall prevalence of alcohol and tobacco use was calculated by counting the total number and percentage for each substance. Determining if descriptive variables vary according to type of contraception, groups were compared using a t-test for independent groups and a Chi square, respectively. The a priori alpha level is 0.05. Results: The most important finding in this study is students that obtained EC reported drinking alcohol at a significantly higher level than students who used hormonal contraception. 49% of students who used EC reported drinking 5 or more drinks a week. The data for the alcohol use was the only data that was found to be statistically significant (p<0.05). In this study 22% of students who requested EC had unprotected sex. A positive result seen in this study was that only 2% of the EC students requested EC more than once in the spring semester. Freshman composed 54% of the students that used EC during this study. Other data that was of interest was that 33% of students that used EC were currently using oral contraception but only 25% claimed that oral contraception incompliance was the reason for EC utilization. Implications: Prevalence of alcohol use is significantly higher in students who use EC than students who used hormonal contraception. This leads to the conclusion that students that use alcohol are more likely to engage in unprotected sex and therefore request EC. This study also has shown that nurses and physicians need to get more accurate information from students regarding tobacco and alcohol use.

Brazil’s healthcare system currently offers a wide range of contraception options and emergency contraception (EC) has been among them since the late 1990s. Abortion, however, is severely legally restricted and high rates of both teenage pregnancy and unsafe abortion plague the country. Given this context, levonorgestrel emergency contraceptive pills (ECPs) could play a significant role women’s health and lives. This research aimed to examine the journey of this medication in Brazilian society and assess its availability in three cities located in different regions of the country. To address these research objectives, I performed a textual and discourse analysis of written materials as well as a mystery client study. Despite the wide availability of ECPs in retail pharmacies, I found that religious beliefs and conservative values still hinder accessibility. The results suggest that awareness raising campaigns are needed and long overdue. However, there is also a need to employ novel strategies for improving access and engaging healthcare professionals. Further research and advocacy related to women’s reproductive health and rights in general, and EC in particular, appears warranted.

In recent years, there have been many updates in hormonal emergency contraception. Levonorgestrel emergency contraception has been available for several years to prevent pregnancy when used within 72 hours after unprotected intercourse or contraceptive failure, and it was recently approved for nonprescription status for patients aged 17 years or older. Current research suggests that the primary mechanism of action is delaying ovulation. Ulipristal is the newest emergency contraception, available by prescription only, approved for use up to 120 hours after unprotected intercourse or contraceptive failure. The primary mechanism of action is delaying ovulation. When compared with levonorgestrel emergency contraception, ulipristal was proven noninferior in preventing pregnancy. Evidence suggests that ulipristal does not lose efficacy from 72-120 hours; however, more studies are warranted to support this claim. Many misconceptions and controversies about hormonal emergency contraception still exist. Research does not support that increased access to emergency contraception increases sexual risk-taking behavior. Several studies suggest that health care providers, including pharmacists, could benefit from increased education about emergency contraception. It is important for pharmacists to remain up-to-date on the most recent hormonal emergency contraception products and information, as pharmacists remain a major point of access to emergency contraception.

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In the United Kingdom (UK) there is easy access to a wide range of contraceptive methods, available at no cost. In addition, oral emergency contraception (EC) (1.5 mg levonorgestrel) is now widely available from the community pharmacy. In spite of this, unintended pregnancy is common. In 2014 in England and Wales, 184,571 induced abortions were performed, and in Scotland, the corresponding figure was 11,475. Long acting reversible methods such as contraceptive implants and intrauterine contraception, are amongst the most effective methods available and National Institute for Health and Care Excellence (NICE) recommends that increased uptake can lead to fewer unintended pregnancies. However, uptake of long acting reversible contraceptive (LARC) methods remains low. The majority of women who require to use EC do so following unprotected sex or an accident with a condom. Increasingly women in Great Britain prefer to attend a pharmacy for EC rather than a sexual and reproductive health (SRH) service or general practitioner (GP). Starting an effective on-going method of contraception after EC use is clearly important if women are to avoid unintended pregnancy. Community pharmacists in the UK and most other high income countries are usually unable to provide any on-going contraception except condoms. So we have created a situation where EC is provided almost solely from settings where other more effective methods of contraception cannot be immediately provided. Novel strategies are therefore required to facilitate both uptake and continuation of the most effective methods of contraception, in order to prevent unintended pregnancy for more women. This thesis presents a mixture of biomedical, clinical and health services research to evaluate a series of strategies aimed at improving uptake of the most effective methods of contraception. Two studies investigated patient knowledge and information provision relating to contraceptive methods. The first sought to determine if women held misconceptions about intrauterine methods of contraception, and revealed that although myths persist in a small number of women, a lack of knowledge about these methods was also evident. The second study aimed to determine if the use of a digital video disc (DVD) to provide contraceptive information was acceptable and informative to women, and identified that it is, and could possibly enhance patient consultations. Studies three, four and five investigated strategies aimed at increasing the uptake of effective on-going contraception, following emergency contraception provided from a community pharmacy, and patient and health care provider attitudes to such approaches. They showed that simple interventions such as supplying one month of a progestogen only pill (POP), or offering rapid access to a family planning clinic (FPC), hold promise as strategies to increase the uptake of effective contraception after EC and that both women and clinicians were positive about such measures. Additionally, the problems encountered in conducting these studies provided valuable feedback to inform further development of research methods in the community pharmacy setting, and larger scale studies of such interventions. Community SRH services may be well placed to deliver more abortion care in the UK, and consequently this may result in greater uptake of contraception post abortion. Study six aimed to determine the views of health professionals working in SRH regarding their attitudes towards providing more abortion services and also the views of staff within one community SRH centre in Scotland where a service providing early medical abortion was due to commence. It showed there is clear support amongst health professionals in community SRH in the UK towards greater participation in provision of abortion care services.

Pregnancy intention is extensively examined in the literature and the concept of "unintended" pregnancy is considered a significant health problem. Large efforts have been made to reduce negative health consequences presumably associated with pregnancies that are unexpected, unwanted, or mistimed but have had limited impact. A study was conducted to examine contextual issues surrounding women's experiences with pregnancy intention its intersection with knowledge, perceptions, and use of emergency contraception in a population of female university students. The project was a mixed method study including a survey examining demographic characteristics, sexual history, and knowledge and use characteristics in addition to interviews exploring prospective perceptions of pregnancy intention. An integrative review informed the background of the study demonstrating the need for expansion of current concepts of pregnancy intention that inform measurement and subsequent interventions. Quantitative survey results provide new information including higher rates of use in comparison to previous studies but persistence of misinformation. Qualitative interview findings illustrate a process by which individual agency in terms of sexual and pregnancy decision making is influenced by a precursor of the embodiment of convictions and empowerment. Combined conclusions confirm the need of exploring the role of the social context on pregnancy intention, suggest ways in which nurses can empower women to be their own agents of health, and start discussions of how intervention approaches to pregnancy intention can be improved.

<p>It is not mandatory for the student to declare a pregnancy to her educational institution. It does however become more complicated for the student nurse, because she has to provide a health service while she is a student during her clinical placement. The researcher has noticed that student nurses do fall pregnant during their undergraduate studies at the University of the Western Cape. The researcher was unsure why this phenomenon is occurring amongst undergraduate nursing students. He identified the need to measure the level of knowledge of pregnancy prevention amongst undergraduate nurses, their level of utilization of such services and their attitudes towards falling pregnant during their studies. This study is of a quantitative nature whereby the researcher made use of a descriptive design. The method of data collection utilized was an anonymous self administered questionnaire form. The population under study was the registered undergraduate nursing students in 2008 at the University of the Western Cape. This population consisted of 1031 individuals. Their ethnic background represents the South African demography. An exhaustive sampling approach was used and 401 individuals gave consent to participate in the study. Through this research the researcher hypothysed and proved that the level of knowledge of contraception amongst undergraduate student nurses is indeed inadequate and that this low level of knowledge on the subject area leads to incorrect and inconsistent and non use of contraception in their own lives.</p>

The purpose of this study was to use the Theory of Planned Behavior (TPB) to predict university students’ intention to use emergency contraception (EC). The study explored the utility of the TPB model constructs (attitude [A], subjective norm [SN], perceived behavioral control [PBC]) as well as recent past behavior (RPB) to predict students’ intention to utilize EC. The study also investigated the significance of demographic and personal characteristics—age and gender in particular—as they relate to the TPB components and RPB. A web-based survey, developed from three structured focus groups, was pretested and emailed to 2,000 university students. An overall usable response rate of 21.0 percent was obtained. In general, university students intended to use EC should the need occur, held favorable attitudes toward the use of EC, were somewhat influenced by social norms regarding EC use, and perceived themselves to have some control over EC utilization. For direct measures (TPB), A, SN, and PBC were significant predictors of intention to use EC. The direct model explained 49.2 percent of the variance in intention. Using indirect measures, A and SN were significant predictors of intention, but PBC was not; the indirect model accounted for 41.3 percent of the variance in intention to take EC. Attitude was the strongest TPB predictor for both models, followed by SN and PBC. The RPB variable did not significantly improve the TPB model. While hypothesized age differences were not significant, gender differences showed female students having a more favorable A and SN as well as a stronger PBC (direct measures) toward the use of EC. In addition, several statistically significant relationships occurred between demographic/personal characteristics and the TPB constructs. In summary, this study identified several key factors that partially explain why university students either intend or do not intend to use EC if needed. The TPB has utility in predicting utilization of EC in university students. Focusing particular attention on A, as well as SN and PBC, will allow researchers, educators, healthcare professionals, and legislators to develop strategies and educational programs to enable men and women to use EC responsibly. / text

<p>It is not mandatory for the student to declare a pregnancy to her educational institution. It does however become more complicated for the student nurse, because she has to provide a health service while she is a student during her clinical placement. The researcher has noticed that student nurses do fall pregnant during their undergraduate studies at the University of the Western Cape. The researcher was unsure why this phenomenon is occurring amongst undergraduate nursing students. He identified the need to measure the level of knowledge of pregnancy prevention amongst undergraduate nurses, their level of utilization of such services and their attitudes towards falling pregnant during their studies. This study is of a quantitative nature whereby the researcher made use of a descriptive design. The method of data collection utilized was an anonymous self administered questionnaire form. The population under study was the registered undergraduate nursing students in 2008 at the University of the Western Cape. This population consisted of 1031 individuals. Their ethnic background represents the South African demography. An exhaustive sampling approach was used and 401 individuals gave consent to participate in the study. Through this research the researcher hypothysed and proved that the level of knowledge of contraception amongst undergraduate student nurses is indeed inadequate and that this low level of knowledge on the subject area leads to incorrect and inconsistent and non use of contraception in their own lives.</p>