Measuring Cognitive and Psychosocial Accessibility to Modern Contraception: A Comprehensive Framework

Nowadays, more than ever, the improvement of access to family planning (FP) has become an international goal. What constitutes access to FP? Current human rights-based contraceptive guidelines indicate that access begins as soon as women or couples express a desire to avoid pregnancy and their risk of unintended pregnancy is established. However, few studies have sought to define and measure cognitive and psychosocial access to contraception. To propose a comprehensive framework for the cognitive and psychosocial accessibility of contraception, we critically analyzed the literature on attitudes toward FP. The main dimensions that emerged were knowledge about FP, fear of side effects, approval of contraception, and contraceptive agency. We then identified and adjusted some questions that can capture these dimensions more comprehensively. As a result, we developed a questionnaire module comprising 15 questions, which was integrated into the 6th round of the PMA2020 survey in Burkina Faso in 2019. This research highlighted that previous studies have collected separate dimensions of contraceptive access, and the psychosocial dimension tended to be neglected. Our results demonstrate that it is possible to collect comprehensive data on cognitive and psychosocial dimensions of access to family planning.

Female Contraception: Comparative Study of Biometrics and Vascularization of the Uterus at Sylvanus Olympio University Hospital (Togo)

Female contraception uses both hormonal and non-hormonal methods. The aim of the study is to determine the impact of female contraception on uterine vascularisation and the endometrium. Method: It was a descriptive comparative study with an analytical aim. It took place at the University Clinic of Obstetrics Gynaecology and the Radiology and Medical imaging Department of Sylvanus Olympio University Hospital in Lomé over a two-month period from May 15, 2023 to July 15, 2023. Group 1 included women using a modern contraceptive method and group 2 women not using a modern contraceptive method. Epidata 3.1 and R 4.0.4 software were used to process the data. Results: Each group included 50 women. There were no significant differences in uterine and endometrial biometrics. All women on contraception had their zone 1 vascularized, without vascularisation of zone 2, without significant difference with women without contraception The pulsatility index was greater than 3 in 51% (n = 51) of women, including 62.7% (n = 32) of women without contraception and 37.3% (n = 19) of women on contraception, with a statistically significant difference (p = 0.009). Conclusion: Contraceptive methods do not influence the biometry of the uterus. However, uterine artery Doppler indices can predict abnormal uterine bleeding.

The Use of Modern Contraception after Childbirth in an Urban Health Center in Bangui, CAR

Introduction: The use of modern postpartum contraception not only reduces unplanned pregnancies but also improves the well-being of mother and child. The present study aims to identify the determinants of postpartum contraceptive use in a first level health facility. Methodology: This was a 6-month cross-sectional study conducted at the Urban Health Center of Castors. Postpartum women who presented within 42 days of delivery and who had a live child were included after informed consent. Results: Of 318 women enrolled during the study period, 106 were currently using a modern contraceptive method, for a prevalence of 33.3%. The mean age of the women was 25.3 years (±3.6), with extremes of 14 and 49 years. The age group [20 to 29] was the most represented with 52.8%. More than half of the women were in couples (54.7%) and had completed secondary education (53.8%). These women were mostly students (42.5%) and primiparous or pauciparous (70.7%). The most used contraceptive method was injectables (depot medroxyprogesterone acetate) (43.4%), followed by male condoms (23.6%) and oral contraceptives (17.9%). The unmet need for contraception was 40.6%. The main reasons for non-use were the desire to have more children (41.5%), fear of side effects (34.9%) and spousal opposition (12.3%). Factors associated with contraceptive non-use were educational level, occupation and parity. Conclusions: The rate of modern contraceptive use in the postpartum period is low in the study population. Interventions to increase the use of effective contraceptive methods are needed, especially among young women.

1-MCP与MT联合处理对芒果保鲜效果的影响

为探究1-甲基环丙烯(1-MCP)与褪黑素(MT)联合处理对芒果保鲜效果的影响,该研究用0.1 mg/L 1-MCP和0.2 mmol/L MT联合处理芒果后,于25℃贮藏10 d,每2 d取样测定相关指标。结果显示:1-MCP和MT联合处理可以延缓芒果果皮叶绿素降解和类胡萝卜素含量升高,在贮藏第10天,处理组的果皮叶绿素为0.078 mg/g,是对照组的5.27倍;延缓了果肉L*值的下降和a*、b*值的升高,抑制原果胶降解和可溶性果胶含量的升高,贮藏第6天处理组的原果胶含量比对照高2.53倍,而可溶性果胶含量比对照低44.04%,同时在贮藏前期显著抑制了多聚半乳糖醛酸酶(PG)和纤维素酶(Cx)活性,降低了β-半乳糖苷酶(β-Gal)活性,并且维持了果肉更完整的细胞结构,但果肉类黄酮含量在贮藏中期显著低于对照。综上,1-MCP和MT联合处理保持了芒果良好的外观品质,延缓了细胞壁物质的降解,提高了货架期品质。

50mT静磁场试验装置的研制和性能验证

为了满足有源植入式医疗器械标准中静磁场试验要求,研制了一款静磁场抗扰度试验装置。在输入电流约4.75 A条件下,该装置的磁通密度可以达到50 mT,且试验均匀域的磁通密度均匀性偏差达到2.8%。在0.055~50mT范围内,磁通密度的线性度达到了0.6%。该装置还可以实现对电压、电流、时间、温度以及电磁场曝露等参数进行有效地监控。该研究为有源植入式医疗器械的静磁场抗扰度试验提供了理论和技术支撑。

Low dose gossypol for male contraception

Aim: To ascertain whether the side effects of gossypol, hypokalemia and irreversibility, could be avoided on dose re-duction. Methods: Seventy-seven male volunteers were divided into 3 groups: control (22 cases), 10 mg gossypol(29 cases) and 12.5 mg (26 cases). Serum levels of testosterone, FSH and LH were measured by RIA and potassiumby flame photometry. Spema counts and motility were examined before and regularly after treatment for the evaluationof contraceptive efficacy. Results: The average sperm density and motility started to decrease significantly by theend of month 2 of medication and gradually reached the infertility levels ( < 4 million /mL) in both treated groups. Af-ter that the 10 mg group was asked to take the same dose every other day for up to a total observation period of 16-18months for the maintenance of infertility. Subjects in the 12.5 mg group did not take gossypol any more so as to ob-serve the length of the loading dose required, but in a few, a maintenance dose of 12.5 mg every other day was insti-tuted for a few more months. In both treated groups, none of the spouses was pregnant during the maintenance dose pe-riod. Serum levels of potassium, FSH, LH and testosterone were not significantly changed and not a single volunteercomplained of myoasthenia. After cessation of drug administratioin, the semen data returned to pretreatment levels.Conclusion: A regimen with 10 or 12.5 mg of gossypol as the daily loading dose and 35 or 43.75 mg as the week-ly maintenance dose could induce infertility in male volunteers without developing hypokalemia or irreversibility.(Asian J Androl 2000 Dec; 2: 283-287)

Vas deferens, a site of male contraception: an overview

The vas deferens is a site which can be exploited for male contraception without undue side effects. The only ef-fective technique available for male contraception is vasectomy, being practiced world wide, despite that it is a perma-nent surgical procedure and its successful reversal is not assured. Although no-scalpel vasectomy minimizes surgicalprocedures, the fate of its reversal is akin to that of vasectomy. Several occlusive and non-occlusive vasal procedureswhich claim to be reversible without surgical intervention, possess more disadvantages than advantages. Vas occlusionwith plug, ' Shug' or medical grade silicone rubber, although claimed to produce reversible azoospermia without affect-ing spermatogenesis, requires skilled microsurgery for their implantation and later removal. RISUG^R, a non-scleroticpolymer styrene maleic anhydride (SMA), could be more advantageous than vasectomy and other vas occlusive proce-dures in that it could be a totally non-invasive procedure by 'no-scalpel injection' and 'non-invasive reversal'. It isclaimed to offer long-term contraception without adverse side effects and also to be possible as a male spacing methodby repeated vas occlusion and non-invasive reversal. The drug is currently under multicentre Phase Ⅲ clinical trial.

Approaches to post-testicular contraception

The induction of infertility in males of several species through epididymal interference is more difficult to achieveby reduction of the mounts of epididymal secretions (eg α-glucosidase, L-carnitine) or immunological interferencewith secreted proteins ( eg D/E, P34H, P26h) than by direct actions of drugs on sperm function (eg inhibition ofglyceraldehyde 3-phosphate dehydrogenase by chloro-compounds). The latter approach holds promise for mankind ashuman sperm are susceptible to glycolytic inhibition. Future contraceptive developments may arise from production oftargeted inhibitors, research on the displacement of sperm proteins in the epididymis and interference with sperm plasmamembrane ion channels.

Development of methods of male contraception: impact of the World Health Organization Task Force

Objective: To give an historical record of the research of the World Health Organization (WHO) Task Force to develop methods of male contraception; to examine the social, political, medical, pharmaceutical, funding, and other factors that influenced progress; and to suggest reasons why such methods are only now becoming available. Design: Review of basic and clinical research over 30 years. Setting: Task force of a multinational agency and collaborating agencies. Conclusion(s): Through the involvement of many international scientists, the WHO Task Force has uniquely contributed to the exploratory phases of the research in male contraception and by its multicenter contraceptive efficacy studies has accelerated progress towards the ideal hormonal method. Despite an adverse climate involving social and political attitudes, funding constraints, and pharmaceutical industry hesitations, WHO formed coalitions with governments and international agencies to sustain research with results that apply to men in culturally diverse populations and thereby to influence activities across the whole range of global reproductive health and family planning.

产教融合背景下基于MTS理论的金融知识学习及教学模式研究

在产教融合背景下,金融类课程的教学模式正向问题导向型转变。金融知识学习及教学通过产学协同,并匹配不同学生的学习特征和所要传授的知识特征,实现人才培养质量的提升。产教融合的模式中,混合型师资队伍建设是核心环节,通过案例研究,基于多团队系统理论,探讨产教融合背景下如何构建由校内教师、行业专家和学生组成的多元化教学团队,并分析其运行机制和效果;同时,基于学习模型的教学支持与模式创新,结合学生学习特征,对主要教学方法进行体系化梳理,并优化教学方法,形成教学方案。

Hormonal contraception in Chinese men: variations insuppression of spermatogenesis with injectable testosteroneundecanoate and levonorgestrel implants

Aim: To explore the causes of the difference in spermatogenic suppression between responders and non-responders in Chinese men treated with levonorgestrel (LNG) implants plus testosterone undecanoate (TU) injectable. Methods: The 16 Chinese volunteers treated were divided into two groups in regard to the sperm count during the treatment period, 7 men in the responder group (Group R), including 6 azoospermia and one severe oligozoospermia, and the remaining 9 in the non-responder group (Group N), including 4 oligozoospermia and 5 with sperm counts greater than 20×106/mL. The differences in serum profiles of FSH, LH, T, LNG and T/LH ratio were compared between the two groups and the correlation between the seminal fluid parameters and serum reproductive hormones was analyzed. Results: The serum FSH level was lower in Group R than that in Group N (P<0.05), while the serum LH and LNG levels were higher in Group R than those in Group N (P<0.05). The sperm density (P<0.01, r=0.235), motility (P<0.01, r=0.326) and vitality (P<0.01, r=0.219) showed significantly positive correlation with the serum FSH level. Conclusion: The blood LNG and T levels, the degree of FSH inhibition and/or the sensitivity of the pituitary-testis axis to exogenous steroids, as well as the individual spermatogenetic potential and the functional status of the Leydig cells may be factors bringing about individual differences in spermatogenic suppression in Chinese men treated with LNG and TU.

Three new methods for male contraception

The methods devised for male contraception are meagre. In the crrrent communication, we review 3 recently de-veloped methods applied for male contraception: testicular suspension, polyester-induced azoospermia and prolactin in-jection. The testicle was suspended in the superficial inguinal pouch close to the scrotal neck using 2 methods: stitchand ball. The azoospermic effect of the polyester sling seems to be due to 1) creation of electrostatic field across theintrascrotal structures, and 2) disordered thermoregulation. Prolactin administration, as a contraceptive method is effi-cient and safe and has the potential to be developed as a male contraceptive. The effect of the above mentioned 3methods is reversible. These methods, especially testicular suspension and polyester suspensors, are simple and easilyapplicable and were well acceptable by the subjects. (Asian J Androl 1999 Dec; 1: 161 - 167)

Hormonal contraception for human males:prospects

Development of an ideal hormonal contraceptive for man has been the goal of several research workers during thepast few decades. Suppression of pituitary gonadotropic hormones, which in turn would inhibit spermatogenesis whilemaintaining normal libido and potentia has been the approach for a contraceptive agent. Intramuscularly administeredand orally active testosterone or testosterone in combination with progesterone have been shown to cause inhibition ofspermatogenesis resulting in azoospermia in normal men. Similarly testosterone has been used in combination with go-nadotropin releasing hormone antagonists and agonists to inhibit pituitary gonadotropic hormone release. Immunologicalapproach to neutralize the circulating levels of follicle stimulating hormone has also been shown to cause inhibition ofspermatogenesis. The available literature shows that testosterone causes reversible azoospermia without any significantside effects in Asian population effectively and appears to be a promising chemical for control of fertility in man.

Interference with the formation of the epididymal microenvironment——a new strategy for male contraception?

The cystic fibrosis transmembrane conductance regulator (CFIR) or the small conductance cAMP-activated chlo-ride channel encoded by the CFTR gene has been shown to play an important role in the formation of the epididymalfluid microenvironment. Recent work in our laboratory has shown that this protein is also expressed by developing germcells indicating a role of this protein in spermatogenesis. In view of the fact that the CFTR gene has a far reaching andwidespread effect on human reproduction, understanding the role of CFTR in the male reproductive tissues and its inter-vention by pharmacological agents can open a new avenue of research into the development of novel male contracep-tives. (Asian J Androl 2000; 2: 39 - 45 )

Predictors for partial suppression of spermatogenesis of hormonal male contraception

Aim： To analyze factors influencing the efficacy of hormonal suppression of spermatogenesis for male contraception. Methods： A nested case-control study was conducted, involving 43 subjects, who did not achieve azoospermia or severe oligozoospermia when given monthly injections of 500 mg testosterone undecanoate （TU）, defined as partial suppressors compared with 855 subjects who had suppressed spermatogenesis （complete suppressors）. Sperm density, serum testosterone, luteinizing hormone （LH） and follicle stimulating hormone （FSH） concentrations at the baseline and the suppression phase were compared between partial and complete suppressors. Polymorphisms of androgen receptor （AR） and three single nucleotide variants and their haplotypes of FSH receptor （FSHR） genes determined by polymerase chain reaction （PCR） and DNA sequencing technique were compared between 29 partial and 34 complete suppressors. Results： Baseline serum LH level was higher and serum LH as well as FSH level during the suppression phase was less suppressed in partial suppressors. Additionally, in a logistic regression analysis larger testis volume, higher serum FSH concentrations alone, or interaction of serum LH, FSH, testosterone and sperm concentrations were associated with degree of suppression. The distribution of polymorphisms of AR or FSH receptor genes did not differ between partial and complete suppressors. In cases with incomplete FSH suppression （FSH 〉 0.2 IU/L）, the chances of reaching azoospermia were 1.5 times higher in the subjects with more than 22 CAG triplet repeats. Conclusion： Partial suppression of spermatogenesis induced by 500 mg TU monthly injections is weakly influenced by hormonal and clinical features but not polymorphism in AR and FSHR genes.

Assessment of level of knowledge and utilization of emergency contraception among female students of Hawassa University, south Ethiopia

Introduction: Emergency contraception is used as an emergency procedure to prevent unintended pregnancy secondary to an unprotected se xual intercourse and method failure. Hence, this study assessed the level of knowledge and utilization of emergency contraception among undergraduate regular female students of Hawassa University, south Ethiopia. Methods: An institution-based cross-sectional survey was conducted among female students of Hawassa University in December 2012. Seven hundred seventy six of the students were sampled by using multistage sampling technique. Pretested structured questionnaire was used to collect the data. Results: The majority 719 (92.7%) of female university students ever had sexual intercourse and 17 (2.2%) experienced forced sex. Eight (47%) of these 17 students experienced unintended pregnancy all of which resulted in an induced abortion. Three hundred seventy nine (72.2%) of the respondents had knowledge about emergency contraceptives and only 41 (10.8%) of them had ever used emergency contraceptives;oral contraceptive pills were the most widely used form of all emergency contraceptives 41 (10.8%). Age, marital status and age at menarche were associated with knowledge of emergency contraception;moreover, residence, year of study and experience of forced sex were found to be predictors of emergency contraception utilization. Conclusion: Female university students had been experiencing high rate of unintended sexual practice and pregnancy, low knowledge level and utilization of emergency contraceptives;moreover, they had no youth-friendly access to the services. Therefore, there is a need for collaborated effort to improve service access and scale up their utilization level to prevent unwanted pregnancy.

Evaluation of intratesticular chlorhexidine gluconate for chemical contraception in dogs

Objective:To investigate the contraceptive effect of intratesticular injection of chlorhexidine gluconate in dogs and compare it with that of zinc gluconate neutralized with arginine.Methods:Twenty-four sexually mature male mongrel dogs were randomly divided by replicate into four groups(n=6 per group).GroupⅡreceived intra-testicular injection of 2 mL zinc gluconate(10 mg/mL)neutralized with arginine.GroupⅡreceived intratesticular injection of 2 mL chlorhexidine gluconate(5%w/v).GroupⅢreceived intratesticular injection of 2 mL chlorhexidine gluconate(4%w/v).GroupⅣdid not receive any treatment and served as the control group.Testicular morphometry was conducted on day 0,7,15 and 30 after treatment.Semen was collected and evaluated on day 0 and 30.Data were analyzed using repeated measures analysis of variance.Results:There was no difference in the mean values of various parameters between dogs treated with zinc gluconate and those treated with chlorhexidine gluconate at any of the time points.In dogs treated with zinc gluconate or chlorhexidine gluconate,there was a significant increase in the testicular morphometric parameters on day 7 followed by a significant reduction thereafter(day 15 and 30).In contrast,there was no change in any of the parameters in the control untreated dogs during the course of the study.Compared to the pre-treatment values,the mean scrotal circumference and the mean paired testicular volume and testicular weight on day 30 were significantly lower in the treated dogs.Semen samples collected on day 30 from treated dogs were found to be azoospermic,whereas no change in semen quality was observed in the control untreated dogs.Conclusions:Intratesticular injection of chlorhexidine gluconate(5%w/v and 4%w/v)is equally as effective as zinc gluconate neutralized with arginine for chemical contraception in dogs.

Intrauterine contraception and menstrual bleeding

After more than half a century of development,the intrauterine contraception(IUD)has become a relatively mature method of contraception and treatment of gynecological diseases.This paper reviewed the development of IUDs,different types of IUDs,and some problems due to them,such as bleeding,infection,malposition,dislocation,expulsion,etc.And the causes of clinical side effects,complications,and corresponding treatments of IUDs were overviewed as well.

Male contraception:prospects for the new millennium

Effective regulation of human fertility has global consequences in terms of resource depletion, pollution and pover-ty. Current family planning services predominantly target a female clientele with few significant developments in malefertility regulation for over a century. The last two decades have witnessed a gathering interest, initially from the scien-tific community, and laterally from industry, in the development of safe, reliable, reversible methods of contraceptionfor men. This review summarises the methods of male fertility regulation which are currently available and critically ex-amines the published data on novel developments in male hormonal contraception which offer the potential of improvedcontraceptive choice for all in new millennium. (Asian J Androl 2000; 2: 3 - 12)