Use of contraception by Spanish women after delivery / Hábitos anticonceptivos tras el parto en las mujeres españolas

Objective: To study peripartum use of contraception in women taking long-acting reversible contraceptives (LARCs). Material and methods: Observational, cross-sectional, multicenter, nationwide study of women of reproductive age (18-49 years) attending a gynecology clinic to request LARCs for the first time or to restart treatment. Results: The study population comprised 1,660 patients (1,657 evaluable), with a mean (SD) age of 38.6 (5.7) years. Most already had children (1.9 [0.7] children/patient). During the previous 5 years, 44% of the patients had been pregnant; this was unintended in 10.3% of cases. The main contraceptive method used during the first year after the last delivery was the condom (42.7%), followed by oral contraceptives (16.2%), levonorgestrel-releasing intrauterine devices (7.5%), and the vaginal ring (6.5%). We found that 14.4% of women did not use any contraceptive method during the first year after delivery. Conclusions: LARCs, which are highly effective and easy to apply, continue to be underused after delivery in Spain

Objetivo: estudio de los hábitos anticonceptivos alrededor del embarazo en mujeres que utilizan métodos anticonceptivos reversibles de larga duración. Material y métodos: estudio observacional, transversal, multicéntrico y nacional, en mujeres en edad reproductiva (18-49 años) que acudían a la consulta ginecológica solicitando anticoncepción de larga duración por primera vez o para reiniciar tratamiento. Resultados: se incluyeron 1.660 mujeres (1.657 válidas), con una edad de 38,6 +/- 5,7 años, la mayoría de las cuales ya tenía hijos (1,9 +/- 0,7 hijos/mujer). Un 44% de las pacientes tuvieron un embarazo en los últimos 5 años de los que el 10,3% no fue planificado. El principal método anticonceptivo utilizado durante el primer año después del último parto fue el preservativo (42,7%), seguido de los anticonceptivos orales (16,2%), el dispositivo intrauterino liberador de levonorgestrel (7,5%) y el anillo vaginal (6,5%). Un 14,4% de las mujeres no utilizaron ningún método anticonceptivo durante el primer año posparto. Conclusiones: el uso de métodos anticonceptivos reversibles de larga duración, métodos de mayor efectividad y comodidad, están infrautilizados tras el parto

Use of the levonorgestrel-releasing intrauterine device in Spain / Uso del dispositivo intrauterino liberador de levonorgestrel (DIU-LNG) en España

Objective: To assess sociodemographic characteristics and the reasons for choosing the 52-mg levonorgestrel-releasing intrauterine device (LNG-IUD) for birth control among Spanish women. Material and methods: Observational, cross-sectional, multicenter, nationwide study women of reproductive age (18-49 years) attending a gynecological clinic to request long-acting reversible contraception (LARC). Results: The study population comprised 1612 women with a mean age of 38.6±5.7 years. Most women (91.7%) were primi/multiparous (1.9±0.7 children/woman), and 78.9% no longer wished to become pregnant. Women had no experience of LARC methods. The gynecologist was the main source of information (67.1%). The main reasons for choosing LARC were contraceptive efficacy (94.0%), long duration of action (62.5%), ease of use (61.3%), and safety (59.9%). Conclusions: Women who choose the LNG-IUD are mainly older than 38 years and primi/multiparous, with no previous experience in the use of LARC. They particularly appreciate contraceptive efficacy, long duration of action, ease of use, and safety

Objetivo: determinar las características sociodemográficas y los motivos de elección del dispositivo intrauterino liberador de levonorgestrel 52mg (DIU-LNG) como método anticonceptivo entre mujeres españolas. Material y métodos: estudio observacional, transversal, multicéntrico y nacional, en mujeres en edad reproductiva (18-49 años) que acudían a consulta ginecológica solicitando anticoncepción de larga duración (LARC). Resultados: la edad media de las mujeres del estudio fue de 38,6±5,7 años, primi/multiparas (91,7%) (1,9±0,7 hijos/mujer), con deseo genésico finalizado (78,9%), sin experiencia en los métodos LARC y el ginecólogo fue la principal fuente de información (67,1%). Los principales motivos de elección fueron la eficacia anticonceptiva (94,0%), larga duración (62,5%), comodidad de uso (61,3%) y seguridad (59,9%). Conclusiones: las mujeres que eligen el DIU-LNG son principalmente mayores de 38 años y primi/multíparas, sin experiencia previa en el uso de los LARC. Valoran principalmente la eficacia anticonceptiva, larga duración, comodidad y seguridad

Money, Food, and Daily Life Objects Are Similarly Shared in the Dictator Game. A Study among Poles and Tsimane'.

The dictator game (DG) is one of the most popular methods for measuring sharing behaviors. However, the matter of goods used in the game has rarely been examined and discussed. We conducted a study in which all participants played standard version of DG in one of the three versions - "money," "food," or "daily life objects" sharing. Further, we wanted to expand the generalizability of our findings by investigating whether patterns in sharing various goods are independent of culture and the level of market integration. Thus, the study was conducted among people who function daily under the conditions of low market integration (109 Tsimane' - forager-horticulturists from Bolivian Amazon) and in a society highly integrated with the market-based economy (85 Polish people). We observed that among both Polish and Tsimane' people the participants were equally likely to share money, food and small, daily life objects with an unknown partner, which implies that generosity might not be related with the type of possessed resources. However, regardless of the kind of goods given, Tsimane' people were less eager to share with anonymous others than Polish people. We present several implications of our findings for studies on generosity and altruism.

Efficacy of Essure hysteroscopic sterilization--5 years follow up of 1200 women.

OBJECTIVE: To assess the efficacy of the Essure hysteroscopic birth control device after 5 years follow up. STUDY DESIGN: Retrospective analysis of case series. SETTING: Outpatient hysteroscopy facility in a large teaching hospital. SUBJECTS: One-thousand three-hundred and twenty-one women who underwent hysteroscopic sterilization with Essure device (Conceptus, Inc., Mountain View, CA) between January 2003 and May 2005. INTERVENTION(S): Hysteroscopic tubal sterilization using Essure system. MAIN OUTCOME MEASURE: Efficacy/effectiveness, failure rate. RESULTS: Satisfactory insertion was accomplished in the first attempt in 1166 women (97.16%). After the second attempt, successful insertion rate rise to 98.6%. (n = 31, 2.6%). Three pregnancies had been reported after 5 years follow up, which implies an overall absolute rate of 0.25%. This represents a Pearl index of 0.05 after 72,000 months of surveillance. All of them occurred in the first year of use of the microinsert. There has been no unintended pregnancy in the next 4 years. CONCLUSION(S): Essure has the lowest Pearl index never published being the most effective permanent birth control system to date. Unintended pregnancies tend to occur in the first year after the insertion, and can be avoided encouraging women to accomplish the protocol.

Guía de práctica clínica sobre prevención primaria y secundaria del ictus / Primary and secondary prevention of stroke: A guideline

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