Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:2.7.10.2 (focal adhesion kinase)
 44,029 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The weaknesses of using couple years protection (CYP) for assessing the effectiveness of various measures of family planning are discussed. Limitations had been recognized in the past but have been largely ignored in the present context. This has been due to the unavailability of local data, and other standardizations have been too cumbersome for practical use. The advantage of using CYP is that it allows for easy calculation of a level of contraceptive use without differentiation by method. This measure reflects to some extent, for instance, access to family planning services, and prevention of unwanted fertility. It also measures output, and provides program managers with a tool to adjust supply to demand. The weakness are categorized in terms of contraceptive failure rates, sporadic and infrequent use with secondary partners, wastage, substitution, differences in fecundity, local specificity, lack of a discount for time, ability to reach high priority or underserved clients, secondary effects, quality of care, and so on. These weaknesses broadly effect the relationship of CYP with fertility; it is possible that adjustments can be made to improve the measure. The deficiencies in accounting for hard to reach clients, in measuring the secondary effects in AIDs and STD prevention, and in measuring satisfaction and continuation or other facets of quality of care not be accounted for in CYP. This suggests that a comprehensive assessment must utilize a variety of indicators, such as a direct measure of contraceptive prevalence, the proportion of children born to high risk women, continuation rates, and qualitative measures of the impact of care. Improvement of CYP is suggested as an inexpensive solution. Local data should be used, since the average age at sterilization in a particular population impacts greatly on the actual CYP provided by sterilization in a specific program. Cookbook conversion factors should be revised so that condoms (100 per CYP) credit is reduced and IUDs (2.5 CYP per IUD) is increased; CYP factors need to be developed for Norplant and Lactational Amenorrhea Method (LAM). An effort by the AID Cooperating Agency Task Force on Performance Indicators is underway to address these issues, but in the meantime awareness of the issues is advised.
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PMID:What's wrong with CYP? 175 79

"Dual protection" refers to the use of methods which will prevent both unwanted pregnancy and HIV/STD infections during sexual intercourse. Such protection may be achieved through either the use of a barrier method such as a male or female condom together with another contraceptive method, or through the use of the male or female condom alone. In descending order of effectiveness, the following methods can protect against unwanted pregnancy: abstinence; sterilization; Norplant; injection; oral contraceptive pill; IUD; male condom with spermicide; male condom; female condom, diaphragm, or cervical cap; vaginal spermicide alone; and natural family planning. In descending order of effectiveness, the following methods can protect against the transmission of HIV and STDs: abstinence, nonpenetrative sex, long-term mutual monogamy with HIV testing, male condom with spermicide, male condom, female condom, diaphragm and cervical cap, and vaginal spermicide alone. When attempting to provide clients with the family planning and HIV/STD prevention method(s) which best suits their needs, clients' degrees of reproductive health, HIV/STD risk, and motivation must first be assessed. Counseling upon and selection of particular methods may then ensue, followed by skills building of method use and other prevention strategies, follow-up counseling, and HIV/STD testing and treatment either on-site or through referral.
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PMID:Dual protection against unwanted pregnancy and HIV / STDs. 1229 88

HIV-positive women may be reluctant to attend gynaecology or family planning clinics for fear of divulging their condition. Therefore, a referral clinic was opened within the HIV clinic. Retrospective case-note reviews of 197 new patients revealed 109 with a variety of medical gynaecology conditions (menorrhagia being the commonest) and 88 sought contraception. The full range of contraceptives was used, including Mirena for the treatment of menorrhagia as well as contraception and the combined pill adjusted for interaction with liver enzyme-inducing antiretroviral drugs. The acceptance of contraceptive advice and gynaecological evaluation by the patients has resulted in improved reproductive health services for these HIV-positive women. In centres with large cohorts of HIV-positive women, this type of one-stop specialist clinic will be very effective in providing high-quality reproductive health care and hence, this type of clinic is recommended for such centres.
Int J STD AIDS 2008 Aug
PMID:Contraception and medical gynaecology for HIV-positive women in a one-stop clinic. 1910 2

The copper intrauterine contraceptive device (IUCD) is strongly associated with bacterial vaginosis (BV). Hormonal influences may play a role in the control of vaginal flora. It is unclear whether use of the progesterone-incorporated intrauterine system (IUS; Mirena) is associated with abnormal vaginal flora or genital symptoms. One hundred and seventy-two women were assessed for symptoms and abnormal vaginal flora prior to and at intervals after insertion of either a copper IUCD or an IUS. Women were significantly more likely to have developed an abnormal vaginal discharge 4-6 weeks after insertion of an IUCD compared with an IUS (27% cf. 14%, P = 0.04), although this trend was not significant six months postinsertion. More women with an IUCD developed BV compared with an IUS at 4-6 weeks and six months. However, there were insufficient numbers of women with BV to demonstrate any significant difference between the vaginal flora of the two groups.
Int J STD AIDS 2009 Jun
PMID:Do users of the intrauterine system (Mirena) have different genital symptoms and vaginal flora than users of the intrauterine contraceptive device? 1945 30