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At least 19 recordsLinked to original sources
PubMed1980

Teaching family planning management and evaluation skills.

In the last several years the need for training schemes in family planning programme administration has become increasingly apparent with the rapid growth of family planning services throughout the world. This paper reports on the development and use of a series of 16 practical classroom training exercises designed for teaching planning, management and evaluation skills. Each exercise can be introduced, worked and discussed in a morning or an afternoon. It is available in an individual booklet, which contains worksheets, blank tables and step-by-step instructions for working the exercise, along with a discussion of the skills being taught. Topics covered include demographic rates and concepts, the Dryfoos-Polgar-Varkey formula, risk factor analysis, target-setting, case load forecasting, service statistics, contraceptive supplies, manpower planning, couple-year of protection, cost-effectiveness, contraceptive use-effectiveness, life table techniques, numerator analysis, fertility pattern method, sampling methods and questionnaire design. These curriculum materials concentrate on imparting through the medium of actual experience a series of specific management techniques of a quantitative nature that will enhance the ability of the trainees to plan, administer and evaluate any family planning programme anywhere in the world. The exercises in this series have been tested in the family planning training programmes at Columbia University and at Downstate Medical Center in New York. They have also been used in WHO workshops in Thailand and Tanzania and in training programmes in France, Kenya and Nicaragua.

Family Planning Services↗
PubMed1986

The analysis of vaginal bleeding patterns induced by fertility regulating methods. World Health Organization Special Programme of Research, Development and Research Training in Human Reproduction.

Contraceptive methods often induce disturbances in vaginal bleeding patterns which are the main reason for women to discontinue method use. Knowledge of these changes is essential for effective counselling and product development and necessitates adequate methods of collection and analysis of vaginal bleeding data. These issues were reviewed by clinicians, medical statisticians and computer analysts during several consultations organized by the World Health Organization Special Programme of Research, Development and Research Training in Human Reproduction and their discussions are summarized in this paper. Recommendations are made on the use of menstrual diary cards for data collection. It is suggested that the analysis of menstrual patterns be based on the reference period method developed by Rodriguez et al. in 1976 to which several modifications in terminology and choice of summary statistics are proposed. While these are presented as the minimum required for the comparability of studies, other points of analysis are identified which need further study, in an attempt to stimulate research in this field by other investigators.

Clinical Trials as Topic↗
PubMed1990

Time to pregnancy--a model and its application.

Biological fertility is poorly measured by the number of children born in industrially advanced societies. The time elapsing from when a couple decides to have a child to clinically recognizable pregnancy is a useful alternative. Time to pregnancy can be collected in broad categories in large samples. A model for condensing important information from such data is presented, which fits several large samples of reported waiting times. It is shown that multiparous women conceive more quickly than primiparous women.

Birth Intervals↗
PubMed1992

Age patterns of marital fertility: revising the Coale-Trussell method.

"This article revises the Coale-Trussell method for analyzing data from the World Fertility Survey by proposing and testing alternative log-linear and log-multiplicative models. The models, in one form or another, represent the structural constraint underlying the Coale-Trussell method on the variation in the age pattern of human fertility. With a Poisson distribution assumption for the number of births, several parameters of the models are simultaneously estimated via maximum likelihood. It is shown that the new approach can be adopted whenever fertility limitation is compared across multiple populations or subpopulations."

Age Factors↗
PubMed1994

The use of modern and traditional methods of fertility control in Bangladesh: a multivariate analysis.

An attempt has been made to study the use pattern of traditional and modern methods of fertility control among currently married women of reproductive ages utilizing the 1989 BFS data. Bivariate analysis has been employed to study the differentials in the use pattern by some selected demographic and socio-economic characteristics. Also, multivariate logistic regression analysis has been used to identify independent contributions of each selected covariate. It has been observed, however, that there is universality of knowledge about contraceptive methods. Of the total 31 percent, about 23 percent were using modern methods and the rest, 8 percent, traditional methods. Analysis using a logistic regression model showed that visits of family planning workers have very strong and positive influence on the current use of modern contraceptives as compared to traditional methods. Duration of effective marriage also emerged as a strong determinant of modern versus traditional methods use but it influenced modern methods use negatively. Also, administrative division is an important variable. Residents of Rajshahi division were significantly more (relative odds of 2.5) likely to be using modern methods than residents of Chittagong division. The likelihood of women having electricity in their household of being a current user of modern contraceptives is almost 2 times higher compared to women without electricity in their households. Education and occupation of husbands also exerts effect on current use of modern contraceptives. The odds of current use of modern methods among women whose husbands have secondary and higher level of education is one-and-a-half times higher than that of women with husbands having no formal education. However, wives of landowners were less (relative odds of 0.72) likely to use these methods as compared to traditional methods than wives of labourers or farmers. The probability of current use of modern contraceptives was higher (relative odds of 1.5) among women who discussed family planning with their husbands than those who did not.

Adult↗
PubMed1988

A micro-computer software for the analysis of menstrual diaries: the menstrual diary system.

A microcomputer software was developed to analyse menstrual diaries following the reference period method as described in the article "The analysis of vaginal bleeding patterns induced by fertility regulating methods" published in this journal (Contraception, 34:253-260, 1986). The programme allows the analysis of groups of diaries selected according to subjects' characteristics recorded at commencement of the diary. It also offers flexibility in selecting options of analysis within the reference period method. The output can be presented graphically as Box-whisker plots. A tutorial is included in the package.

Contraception↗
PubMedDate not supplied

Menstrual bleeding patterns in untreated women and with long-acting methods of contraception. Task Force on Long-Acting Systemic Agents for Fertility Regulation.

The bleeding patterns recorded by women using one of two new types of long-acting hormonal contraception, a levonorgestrel-releasing vaginal ring or a monthly injectable, have been compared with those in an untreated group and those experienced by women using either a combined oral contraceptive (OC) or depot-medroxyprogesterone acetate (DMPA). The frequency of bleeding was very similar between the combined pill users, the ring users and the untreated women, who all recorded an average of 3.2-3.3 bleeding/spotting episodes every 90 days. Monthly injectable users had slightly fewer episodes. Women using a monthly injectable or a vaginal ring had longer bleeding/spotting episodes (5 days) than combined pill users (4 days). However, the untreated women and DMPA users had the longest episodes, averaging 6 days. The median value of the within-woman mean length of bleeding-free intervals was 20.6 days among ring users, 22.3 days in the untreated group, 23.6 days among women given a combined OC or a monthly injectable, and 27.4 days in the DMPA group. Women using any of the long-acting methods had more variable bleeding patterns than untreated women or combined pill users. Over a year of method use, however, the lengths of the bleeding-free intervals recorded by vaginal ring and monthly injectable users became more predictable. It is concluded that these newer methods do not produce the marked bleeding disturbances seen with DMPA.

Adolescent↗
PubMed1989

Recognition of ovulatory/anovulatory cycle pattern in adolescents by mucus self-detection.

The high frequency of anovulation during adolescence raises the question of whether a method for the recognition of ovulation by self-detection of cervical mucus patterns is useful in teenagers. We performed a secondary analysis of 1049 completely recorded cycles of 235 teen women 15-17 years of age with a gynecologic age from less than 1 to 7 years. These subjects had learned to monitor their fertility patterns using the Billings Ovulation Method. The cycles were analyzed by the length of the mucus and luteal phases and recorded "peak symptom." Ovulatory cycles were grouped by the length of the luteal phase, short (4-8 days) and average (8-18 days), and plotted against gynecologic age. The frequency of anovulatory cycles was comparable to Vollman's age-stratified monophasic cycle groups. Ovulatory patterns were found at gynecologic ages of 1 year, 49%; 2 years, 60%; 3 years, 72%; 4 years, 61%; 5 years, 86%; and 6 years, 71%. The study proved that teen-age women can distinguish patterns of ovulation and anovulation by self-detection of cervical mucus.

Adolescent↗
PubMed2001

Excess breast cancer risk and the role of parity, age at first childbirth and exposure to radiation in infancy.

Exposure to ionizing radiation is a known risk factor for breast cancer and the fertility pattern is a recognized modifier of breast cancer risk. The aim of this study was to elucidate the interaction between these 2 factors. This study is based on a Swedish cohort of 17 202 women who had been irradiated for skin haemangiomas in infancy between 1920 and 1965. The mean age at treatment was 6 months and the median breast dose was 0.05 Gy (range 0-35.8 Gy). Follow-up information on vital status, parity, age at first childbirth and breast cancer incidence was retrieved through record linkage with national population registers for the period 1958-1995. Analyses of excess relative risk (ERR) models were performed using Poisson regression methods. In this cohort, the fertility pattern differed from that in the Swedish population, with significantly fewer childbirths overall and before 25 years of age but more childbirth after that age. There were 307 breast cancers in the cohort and the standardized incidence ratio (SIR) was 1.22 (95% CI 1.09-1.36). A linear dose-response model with stratification for fertility pattern and menopausal status resulted in the best fit of the data. ERR/Gy was 0.33 (95% CI 0.17-0.53). In absolute terms this means an excess of 2.1 and 5.4 cases per Gy per 10(4) breast-years in the age groups 40-49 and 50-59 years respectively. The fertility pattern influenced the breast cancer risk in this irradiated population in a similar way to that observed in other studies. SIR at dose = 0 was highest, 2.31, among postmenopausal nulliparous women (95% CI 1.48-3.40, n = 62). SIR at dose = 0 was lowest in pre- or postmenopausal women with a first childbirth before 25 years of age; 0.89 (0.71-1.09) and 0.88 (0.58-1.25) respectively. Thus, in addition to the dose-effect response in the cohort, part of the breast cancer excess could be explained by a different fertility pattern. The estimates of ERR/Gy for the various categories of age at first childbirth, number of children, menopausal status and ovarian dose were very similar, contradicting any interaction effects on the scale of relative risk.

Adult↗