Contraceptive usage for spacing of childbirth is an important indicator for understanding family planning practices as well as fertility transitions. Fertility transition are especially important in sub-Saharan Africa where fertility remains high in many countries. However, estimates and short-term projections are generally not available for countries in this region. We developed a Bayesian hierarchical time series model to estimate and project usage of contraceptives for spacing by 5-year age groups for all countries in sub-Saharan Africa for the years 1985-2030. Estimating country-age-year specific usage is challenging due to limited data availability. We use Bayesian hierarchical models to share information across countries and spline regression to share information across age groups. Temporal changes are captured with logistic growth curves and autocorrelated distortion terms. Models are validated with out of sample exercises which test the model's ability to project into the future as well as the models ability to estimate historical trends. Validation results show the model is well calibrated. Estimates reveal noteworthy variability across countries and across age groups.

Objectives: Women with substance use disorders often experience unique challenges to obtaining contraception and adhering to user-dependent methods. As a result, this at-risk population of women tends to have higher than average rates of unintended pregnancy. The objective of this study was to describe contraceptive use, pregnancy intentions, and adequacy of access to reproductive healthcare among women receiving opioid agonist therapy in northeast Tennessee. Methods: A cross-sectional survey was piloted among female patients aged 18 to 55 years from two opioid agonist therapy clinics. Descriptive analyses were conducted using logistic regression to evaluate the statistical significance of bivariate associations. Results: Of 91 participants, 84% reported having health insurance, with 70% perceiving having adequate access to health care. More than half had a history of unwanted pregnancy (53%), among whom few (23.1%) reported the consistent use of contraception at time of conception. Although most desired to avoid pregnancy (90%), only 59% of women reported the current use of regular contraception. Most of those not using regular contraception believed that they were not at risk for pregnancy (54.3%). Conclusions: Although most participants reported adequate access to health care and a desire to avoid pregnancy, few reported the consistent use of regular contraception. Furthermore, misperceptions regarding pregnancy risk were common among participants. Research is needed to identify barriers to contraceptive acceptance and causes of pregnancy risk misperceptions in this population of women at increased risk of unintended pregnancy.

Objective: Capacity building and training to improve contraceptive care is essential for patient-centered care and reproductive autonomy. This study assessed the feasibility of translating the knowledge and skills gained from contraception trainings into improvements in practice. Study Design: Participants completed surveys following contraceptive care trainings provided to family planning clinic and hospital obstetric providers and staff as a part of the Choose Well contraceptive access initiative in South Carolina. Surveys assessed participants’ intent to change their practice post-training and anticipated barriers to implementing change. A mixed-methods approach was utilized including descriptive analysis of Likert scale responses and thematic content analysis to synthesize open-ended, qualitative responses. Results: Data were collected from 160 contraceptive training sessions provided to 4814 clinical and administrative staff between 2017 and 2019. Post-training surveys were completed by 3464 participants (72%), and of these, 2978 answered questions related to the study outcomes. Most respondents (n = 2390; 80.7%) indicated intent to change their practice and 35.5% (n = 1044) anticipated barriers to implementing intended changes. Across all training categories, organizational factors (time constraints, policies and practices, infrastructure/resources) were the most frequently perceived barrier to improving contraceptive services. Structural factors related to cost for patients were also identified as barriers to IUD and implant provision. Conclusion: The trainings were successful in influencing family planning staff and providers’ intent to improve their contraceptive practices, yet some anticipated barriers in translating training into practice. Improvements in organizational and structural policies are critical to realizing the benefits of trainings in advancing quality contraceptive care. Implications: In addition to training, coordinated efforts to address organizational practices and resources, coupled with system-level policy changes are essential to facilitate the delivery and sustainability of patient-centered contraceptive care.

Sweden has a high rate of unintended pregnancies (UP) despite being a rather open society regarding sexual health education. New technology provides new possibilities to improve access by providing contraceptive consultations online, but will that lower the rate of UP? Very few studies have been done on the people working with the young women to find out what can be done to improve the quality of the contraceptive counseling. That is why this study involved two midwives practicing at a youth center at an early stage of the design process. Cultural Probes was used as method to better understand what needs midwives experience in their daily work. Three key findings stating the needs of the midwives were knowledge, missed appointments and trust. In addition, a service evaluation was done to investigate when and how midwives and young women interact. Making the contraceptive consultations available online with a digital care provider would make it more accessible for the young women and the results of this study do not contradict that hypothesis. However, availability is not the sole influencing factor on contraceptive usage. This study shows that encouragement for young women to seek general knowledge and information about contraceptives prior to the consultation is an important factor in order to improve the quality of contraceptive counselling. / Trots Sveriges relativt öppna samhälle gällande sex och sexualundervisning så har vi en väldigt hög frekvens av oönskade graviditeter. Ny teknik möjliggör att hålla preventivmedel konsultationer online vilket leder bättre tillgänglighet, men frågan är om det räcker för att sänka frekvensen oönskade graviditeter? Väldigt få studier har gjort på barnmorskorna som jobbar med de unga kvinnorna för att får reda på vad mer som kan göras för att höja kvaliteten på preventivmedelsrådgivningen. Därför har denna studie, i ett tidigt stadie av designprocessen, involverat två barnmorskor praktiserande på en ungdomsmottagning. Cultural Probes användes som metod för att bättre förstå vilka behov barnmorskor upplever i deras dagliga arbete. Det främsta resultatet summeras i tre teman: kunskap, missade besök och förtroende. Dessutom utfördes en serviceutvärdering av hela kundresan för att ta reda på när och hur barnmorskor och unga kvinnor interagerar. Genom att möjliggöra preventivmedelsrådgivning online genom digital vård så skulle tillgängligheten förbättras för de unga kvinnorna och denna hypotes är inget som denna studie motsätter sig. Men tillgänglighet är inte den enda faktorn som påverkar användandet av preventivmedel. Denna studie visar att uppmuntran till att få unga kvinnor att söka kunskap och information om preventivmedel innan själva besöket är en viktig del som skulle kunna förbättra kvaliteten på preventivmedelsrådgivningen

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[pt] Este trabalho foi desenvolvido a partir do projeto aprovado no Edital Meninas e Mulheres nas Ciências Exatas e da Terra, Engenharias e Computação, da Fundação Carlos Chagas de Apoio à Pesquisa do Estado do Rio de Janeiro (FAPERJ), que teve como objetivo promover o interesse de jovens mulheres para a pesquisa científica com projetos desenvolvidos em escolas públicas do estado do Rio de Janeiro. O cigarro e o anticoncepcional são temas comuns entre os jovens por isso, foram escolhidos como objeto de estudo deste trabalho. O cigarro apresenta substâncias tóxicas que causam doenças crônico-degenerativas. Por sua vez, os anticoncepcionais atuam nos hormônios que podem desregular os ciclos de elementos essenciais no organismo. Assim, o objetivo desse trabalho foi avaliar, empregando ferramentas estatísticas, a composição elementar de cabelos de pessoas fumantes e mulheres que tomam anticoncepcionais, comparadas à de pessoas que não usam essas substâncias. As amostras de cabelo foram coletadas de voluntários das 5 escolas e analisadas seguindo a metodologia estabelecida no Labspectro, Laboratório de Espectrometria Atômica, da PUC-Rio, para o mineralograma capilar, que consiste na determinação multielementar por espectrometria de massas com plasma indutivamente acoplado (ICP-MS). Utilizando o teste Kruskal-Wallis, foram identificadas concentrações significativamente menores (p menor que 0,05) de Na e Mg no grupo dos fumantes, e de Cu nos cabelos de mulheres que tomam anticoncepcionais. Na análise de correlação de Spearman, foram identificadas maiores correlações entre Cu/Pb e Cr/As, para o grupo de fumantes, enquanto correlações entre Co/Se/I para mulheres que tomam anticoncepcional. As análises de componentes principais confirmaram a análise de Spearman, mas não foi possível estabelecer separação dos grupos estudados. Dessa forma, o fumo e o uso de anticoncepcionais interferem nos resultados do mineralograma capilar, sendo necessários mais estudos para avaliar as implicações dessas diferenças à saúde. / [en] This work was developed from the project approved in the Call for Proposals for Girls and Women in the Exact and Earth Sciences, Engineering and Computing,from the Carlos Chagas Foundation for Research Support in the State of Rio de Janeiro (FAPERJ), which aimed to promote young women s interest in scientific research with projects developed in public schools in the state of Rio de Janeiro.Cigarettes and contraceptives are common themes among young people, who oftenend up using them prematurely and were therefore chosen as the subject of this study. Cigarettes contain toxic substances that cause chronic degenerative diseases due to nicotine addiction. In turn, contraceptives act on hormones that can disruptthe cycles of essential elements in the body. The aim of this study was therefore to evaluate, using statistical tools, the elemental composition of the hair of smokers and women who take contraceptives, compared to that of people who do not use these substances. The hair samples were collected from volunteers from the schools participating in the project and analyzed following the methodology established at Labspectro, the Atomic Spectrometry Laboratory at PUC-Rio, for the capillary mineralogram, which consists of multi-elemental determination by inductively coupled plasma mass spectrometry (ICP-MS). Using the Kruskal Wallis test, significantly lower concentrations (p less than 0.05) of Na and Mg were identified in the group of smokers, and of Cu in the hair of women taking contraceptives. In Spearman s correlation analysis, higher correlations were identified for some toxic elements, such as Cu/Pb and Cr/As, for the group of smokers, while correlations involving Co, Se and I were obtained for women taking contraceptives. Principal component analysis confirmed the results of Spearman s analysis, but it was not possible to establish a clear and distinct separation of the groups studied. Thus, it can be concluded that smoking and the use of contraceptives interfere with the results of the hair mineralogram, and further studies are needed to assess the health implications of these differences.

With approximately 8.5 million unwanted cats euthanized in the U.S. annually, convenient, cost effective methods of sterilization are greatly needed. Current spay/neuter techniques, such as surgery and hormonal intervention, are not satisfying this need due to their high cost, significant expertise required, and the need for feral cats to be collected and brought into clinics for treatment. The aim of this research is to develop a safe contraceptive vaccine that could be delivered to the feral cat population in bait without compromising non-feline species. Feline Herpes Virus (FHV) is a feline specific virus. The USDA has approved the immunization of cats with an attenuated, non-pathogenic strain of FHV expressing foreign antigens. In our research, we have partially replaced Glycoprotein I of FHV to express a fusion protein of Flagellin (FliC), Enhanced Green Fluorescent Protein (EGFP), and Gonadotropin Releasing Hormone (GnRH). FliC has been shown to stimulate a heightened antibody response when antigens are expressed as fusion proteins with it. GnRH, a major reproductive hormone responsible for the development of testes and ovaries in felines, is the target of our vaccine vector. Expression of EGFP will allow tracking of the viral vector. The expression of the fusion protein (FliC-EGFP-GnRH) is expected to stimulate an antibody and cell mediated immune response directed towards feline GnRH, which will provide an immunocontraceptive effect specific to cats. / Master of Science

Research indicates that female athletes have a higher risk of musculoskeletal injuries. Hormone fluctuations throughout the different periods of the menstruation cycle impacts the risk of injuries for women. Contraceptive use, most used in the form of an oral contraceptive pill, directly effects hormones and menstrual cycle related symptoms, with evidence of ameliorating some symptoms. Oral contraceptive use is suggested to influence musculoskeletal injuries in female athletes. However, there is little research and data that explores the direct relationship between oral contraceptive use and the injury rates of female athletes. Within this systematic review, five articles investigating this relationship fulfilled the inclusion criteria and were analyzed. Three of the reviewed articles supported a positive and potentially preventative factor, while the other two allude towards no correlation between oral contraceptive use and the rate of injury for female athletes. Findings suggest that more research needs to be conducted on this research topic to determine a concise understanding of the relationship between oral contraceptive use and the injury rates of female athletes.