Implementation and Follow-Up of Medical Abortion in Catalonia (2010-2014)

In 2011 a protocol for medical abortions (MA) up to 49 days of pregnancy was approved by the Ministry of Health of Catalonia’s autonomous government and it was progressively introduced through the public network of the Sexual and Reproductive Health Units (SRHU). In 2014, a new protocol extended to 63 days of pregnancy was set up. Data come from the official abortion registry held by the Ministry of Health, which collects statistical data from all abortions performed in Catalonia. Since 2011, the number and rate of abortions in Catalonia have decreased while the number of health centers providing abortions has increased, especially the SRHU. The proportion of MA abortions went from 0.4% (2010) to 36.9% (2014), while the percentage of early abortions (up to 7 weeks) surged by 14.7%. SRHU reported 73.4% of all MA and hospitals performed 18.7% of the total, while outpatient centers accounted for the remaining 7.9%. Compared to surgical abortions, women having had MA have higher levels of education and lower rates of unemployment. Furthermore, they have more living offspring and fewer previous terminations as well as more frequent attendance to a public family planning center.

A Systematic Bibliographical Review: Barriers and Facilitators for Access to Legal Abortion in Low and Middle Income Countries

Background: There is a complex interplay between women’s preferences, abortion services availability and the context in which these are provided. Even in countries where it is legal, denial of abortion is common, especially in low and middle income countries, forcing women to look for the service elsewhere and bringing serious consequences to the health and wellbeing of many women and their families. This non-systematic review pretends to answer the question: Which are the barriers to and facilitators for the access to legal abortion services in low and middle income countries? Methods: A non-systematic bibliographical review. Inclusion criteria: all quantitative, qualitative and evidence synthesis studies performed in low and middle income countries according to the World Bank classification for 2015 and published in English, Spanish and Portuguese language, between 2005 and 2017. Exclusion criteria: articles evaluating the efficacy of interventions, addressing the knowledge about abortion procedures among health care students and personnel, as well as those that only included sex workers. Results: The database search yield 199 articles in MEDLINE. 24 in Scopus and 38 in Scielo. A total of 22 articles including 15 countries from Africa (n = 6), Asia (n = 5), Central and South America (n = 3) and Europe (n = 1). The legal status of abortion in each of these countries was studied and described. For the analysis of the information, three categories of deepening were established: Laws and policies, Service delivery and Women’s abortion care-seeking behavior. Conclusion: the determinants of access to abortion in low and middle income countries are convoluted as multiple delays and barriers usually overlap. Similarly, stigmatization has a great impact across all the steps of abortion provision. Multiple facilitators were proposed in the three aspects of abortion provision, but they need to be adjusted depending on the context of each country.

Geometrical Evaluation of Cervical Cells. Fractal and Euclidean Diagnostic Methodology of Clinical Application

Background: The concomitant use of fractal and Euclidian measurements has led to the development of new methodologies of cell evaluation, including a diagnosis of cervical cells that set up differences between normality and various degrees of lesion, to carcinoma. Aim: To confirm the diagnostic capacity of the methodology based on fractal and Euclidian geometry for the mathematical diagnosis through a blind study of normal cells and with different types of lesion, as atypia of undetermined significance (ASCUS), low grade squamous intra-epithelial lesion (LGSIL) and high grade squamous intra-epithelial lesion (HGSIL). Methods: 100 cells of Papanicolaou tests were analyzed and divided into 4 groups according to conventional parameters: 25 normal, 25 ASCUS, 25 LGSIL and 25 HGSIL. By means of the Box-counting Fractal Space, we calculated the fractal dimension and occupying spaces of the border and surface in pixels of the cell nucleus and cytoplasm. The diagnostic parameters of the previously developed methodology were applied and compared with the conventional diagnosis, setting up sensibility, specificity, negative likelihood ratio and Kappa coefficient. Results: The values of the occupation of the border and surface of the cell nucleus and cytoplasm were consistent with the values found by the diagnostic methodology previously found. The subtraction of the nucleus and cytoplasm frontiers presented values between: 189 and 482 for normality;159 and 432 for ASCUS;126 to 401 for LGSIL and 39 to 122 for HGSIL. A sensitivity and specificity of 100%, and a Kappa coefficient of 1 were obtained. Conclusions: The capacity of the methodology to diagnose quantitatively the different stages in the evolution of the cervical cells observed in Papanicolaou tests was confirmed, from normality to HGSIL.

Chemical Constituents and Pharmacological Properties of Frankincense:Implications for Anticancer Therapy

The discovery of novel antitumor agents derived from natural plants is a principal objective of anticancer drug research.Frankincense,a widely recognized natural antitumor medicine,has undergone a systematic review encompassing its species,chemical constituents,and diverse pharmacological activities and mechanisms.The different species of frankincense include Boswellia serrata,Somali frankincense,Boswellia frereana,and Boswellia arabica.Various frankincense extracts and compounds exhibit antitumor,anti-inflammatory,and hepatoprotective properties and antioxidation,memory enhancement,and immunological regulation capabilities.They also have comprehensive effects on regulating flora.Frankincense and its principal chemical constituents have demonstrated promising chemoprophylactic and therapeutic abilities against tumors.This review provides a systematic summary of the mechanism of action underlying the antitumor effects of frankincense and its major constituents,thus laying the foundations for developing effective tumor-combating targets.

2045年实现性别平等:为女性重新构建更健康的未来

2021年6月30日至7月2日在巴黎举行的世代平等论坛是对《北京妇女行动纲要》发表25周年的纪念。1995年的《北京宣言》是促进妇女权利的一个里程碑,但令人沮丧的是,仍然没有一个国家可以声称已经实现了性别平等。到2045年,全球大多数领导人已更新迭代,《北京宣言》也将成为历史。

Priorities for research on family planning impact:recommendations of a WHO Think Tank meeting

INTRODUCTION Contraception,a novelty in the 1960s when less than 10%of couples in developing regions1 were using a method has now become a norm in much of the world.In 2023,global contracep-tive prevalence of any method was estimated at 65%and of modern methods at 59%.2 With an estimated 748 million women using a modern method,2 no other modern technology has been used voluntarily by so many people.US Centers for Disease Control has included family planning among the 10 great public health achievements of the 20th century.3 Yet,close to one in five women continue to have an unmet need for family planning in 20232 and 40%of users discontinue use within 12 months of contraceptive adoption.