Intravascular large B-cell lymphoma(IVLBCL),a rare subtype of non-Hodgkin lymphoma,is classified as an independent subtype of extranodal diffuse large B-cell lymphoma(DLBCL)in the 2008 World Health Organization(WHO)Cl...Intravascular large B-cell lymphoma(IVLBCL),a rare subtype of non-Hodgkin lymphoma,is classified as an independent subtype of extranodal diffuse large B-cell lymphoma(DLBCL)in the 2008 World Health Organization(WHO)Classification(Turner et al.,2010).The 5th edition of the World Health Organization(WHO 2022)classification of hematolymphoid tumors retains this subtype(Alaggio et al.,2022).IVLBCL,which is characterized by neoplastic lymphocyte proliferation within the lumen of small blood vessels,tends to invade organs,such as the nervous system,skin,bone marrow(BM),and lung(D'Angelo et al.,2019;Satoh et al.,2019;Vasquez et al.,2019;Fukami et al.,2020).展开更多
Objective To calculate unmet need for contraception according to revised definition, mapping the contraception service needs and analyze factors related to the unmet need for contraception in Nusa Tenggara Barat （NTB...Objective To calculate unmet need for contraception according to revised definition, mapping the contraception service needs and analyze factors related to the unmet need for contraception in Nusa Tenggara Barat （NTB）. Methods This research design was cross sectional, using data from Indonesia Demographic and Health Survey 2012. Subjects were from 1 362 household, and were married women aged 15-49 years in NTB Province （685 women）. Calculating method of unmet need for contraception used revised version, and analysis method was univariate, bivariate, and multivariate （Logistic regression）. Results Majority of married women aged 15-49 years in NTB need contraception service （73.1%）. However, it was known that met need for contraception was only 56.0%. Meanwhile, unmet need rate for contraception in NTB was 17.1%, specifically 11.5% for spacing and 5.6% for limiting. Factors contributing to unmet need for contraception in NTB were： household assets at above average （OR=O. 77）, parity of 2-3 children （OR=0. 73）, women with junior high school education level （0R=0.68）, never be visited by health workers （OR=O. 68）. Conclusions Factors that contribute to unmet need for contraception in NTB are household assets, parity, education level and visited by health workers. Government has to prioritize those f our factors in policy intervention and promotion of family planning participation program in NTB.展开更多
Due to the optimal results obtained in kidney transplantation and to the lack of interest of the industries,new innovative drugs in kidney transplantation are difficult to be encountered.The best strategy to find the ...Due to the optimal results obtained in kidney transplantation and to the lack of interest of the industries,new innovative drugs in kidney transplantation are difficult to be encountered.The best strategy to find the new drugs recently developed or under development is to search in the sections of kidney transplantation still not completely covered by the drugs on the market.These unmet needs are the prevention of delayed graft function(DGF),the protection of the graft over the long time and the desensitization of preformed anti human leukocyte antigen antibodies and the treatment of the acute antibody-mediated rejection.These needs are particularly relevant due to the expansion of some kind of kidney transplantation as transplantation from non-heart beating donor and in the case of antibody-incompatible grafts.The first are particularly exposed to DGF,the latter need a safe desensitization and a safe treatments of the antibody mediated rejections that often occur.Particular caution is needed in treating these drugs.First,they are described in very recent studies and the follow-up of their effect is of course rather short.Second,some of these drugs are still in an early phase of study,even if in well-conducted randomized controlled trials.Particular caution and a careful check need to be used in trials launched 2 or 3 years ago.Indeed,is always necessary to verify whether the study is still going on or whether and why the study itself was abandoned.展开更多
Background: Understanding the magnitude of unmet contraceptive need and the underlying determinants will help the programs and services to respond effectively. Aim: Identify the prevalence and determinants of unmet co...Background: Understanding the magnitude of unmet contraceptive need and the underlying determinants will help the programs and services to respond effectively. Aim: Identify the prevalence and determinants of unmet contraceptive need among married women in the childbearing period in Minia Governorate. Methods: Community-based cross-sectional study was done among married women of child bearing age (18 - 49 years). Total 534 study participants were selected randomly and interviewed by using pretested structured questionnaire. Results: Overall level of unmet need was 12.7%. Women age > 35 years old were about three times (adjusted OR = 2.88, 95% CI: 1.13 - 7.35) more likely to have unmet need for family planning compared to younger women. Women who had more children (adjusted OR = 1.32, 95% CI: 1.04 - 1.67), more female offspring (adjusted OR = 1.37, 95% CI: 1.09 - 1.65), and women whose partner had non-supportive attitude towards family planning (adjusted OR = 2.96, 95% CI: 1.53 - 5.72) were more likely to have unmet need. Conclusion: The prevalence of unmet need of family planning among women in Minia Governorate remains high. Therefore, family planning programs that cover the older woman’s need for limiting and that focus on couples could be useful in reducing the rate of unmet need.展开更多
The study was conducted to assess the magnitude and associated factors of unmet need for family planning among women of reproductive age group with disabilities who are members of disabled associations in Bahir Dar to...The study was conducted to assess the magnitude and associated factors of unmet need for family planning among women of reproductive age group with disabilities who are members of disabled associations in Bahir Dar town. Institution based cross-sectional study was carried out. A total of 337 women of reproductive age group with disabilities were included in the study with simple random sampling. Data were collected through face-to-face interview, coded, cleaned and entered by Epi info 2002 and analyzed with SPSS version 16 computer software. Logistic regression was used to assess possible associations. The magnitude of unmet need for family planning among women with disabilities was 24.3%. Women with disabilities in the age group of 25-29 had 80% less likely to have unmet need than women above 35 years old. Women with disability who have no education were 11 times more likely to have unmet need than those who have secondary education. Women who desire to have more than 3 children have more likely to have unmet need than those who need to have 1-2 children. Unmet need for family planning among women with disabilities was high in Bahir Dar town. Age, Educational status and desired number of children were found to have statistically significant association with unmet need for family planning. Hence, it is important to encourage people with disabilities to attained formal education and the associations should provide short term trainings in accordance with their age group.展开更多
Biologics have greatly improved the management of rheumatoid arthritis (RA), demonstrating efficacy and safety in alleviating symptoms, inhibiting bone erosion, and preventing loss of function. Unmet therapeutic needs...Biologics have greatly improved the management of rheumatoid arthritis (RA), demonstrating efficacy and safety in alleviating symptoms, inhibiting bone erosion, and preventing loss of function. Unmet therapeutic needs in RA remain;however, further advances require an understanding of issues left unaddressed under the current treatment paradigm. Most biologic-na?ve and biologic-pretreated patients who initiate a biologic therapy, for example, do not reach American College of Rheumatology 50% (ACR50) response, and few achieve remission. Responses are often not durable, prompting frequent treatment switching. Predictive markers are unavailable to guide therapy selection, and clinical trial data are lacking on whether a tumor necrosis factor inhibitor (TNFi) is the best first-line biologic and on the optimal sequence of use for the different biologics. Risk of serious infection is the major safety concern. Translating preclinical and clinical findings into new therapeutics may help address unmet needs. An increasing body of evidence indicates that the cytokine interleukin (IL)-17A represents an important therapeutic target;ongoing trials with IL-17A inhibitors will determine whether these agents can address some of the unmet needs associated with current biologics.展开更多
Many adolescent girls are pressured into having sex at an early age, which puts them at high risk of unwanted pregnancies and unsafe abortions. The overall objective of this study was to evaluate the unmet needs of ad...Many adolescent girls are pressured into having sex at an early age, which puts them at high risk of unwanted pregnancies and unsafe abortions. The overall objective of this study was to evaluate the unmet needs of adolescents who give birth. A descriptive cross-sectional study was carried out in three university hospitals in Yaoundé, Cameroon: Yaoundé Central Hospital, Yaoundé Gyneco-Obstetrics and Pediatric Hospital and the District Hospital of Biyem-Assi, from February 1, 2020 to June 30, 2020. Included were any teenage mothers speaking English or French. Data were entered using CSPRO 7.3, analyzed by Excel 2010 and SPSS version 23.0. The tools used to express our results were the number, the frequency, the mean, the odds ratio (OR) and the P. P was significant if less than 5%. Of a total of 2692 births recorded, 188 (7%) were from adolescents. Of these, 157 fulfilling our selection criteria were recruited and data analyzed. The average age of the participants was 17.9 ± 1.12 years with extremes of 13 and 19, the average parity was 1.2 ± 0.4 with extremes of 1 and 3. Out of 157 participants, 2 who fell in the age range of 10 to 14 years (100%) and 106 of 155 (68.4%) whose age ranged from 15 to 19 years had unmet need for family planning. Only unmarried participants had unmet needs after multivariate analysis [aOR 2.4 (1.1 - 5.3);p = 0.035)]. Being unmarried was independently associated with the occurrence of unmet needs. The intensification of campaigns for provider behavior changes communication and the creation of services dedicated to the sexual and reproductive health of adolescents would help to reduce the rate of unmet needs for family planning among adolescent girls.展开更多
Worldwide women have to cope up with heavy burden of unwanted pregnancies, mistimed, unplanned, with risk to their health. Their children and families also suf-fer. Such pregnancies are root cause of induced abortions...Worldwide women have to cope up with heavy burden of unwanted pregnancies, mistimed, unplanned, with risk to their health. Their children and families also suf-fer. Such pregnancies are root cause of induced abortions （safe/unsafe） and grave consequences. Women, their partners can, for most part, prevent unwanted pregnancies by using contraceptives. However many women either do not use any contraceptive or use methods, with high failure rates. These women account for 82% of pregnancies that are not desired. Remaining unintended pregnancies occur among women who use modern contraceptive, either because they had diffculty using method consistently or because of failure. Helping women, their partner use modern contracep-tives effectively is essential in achieving Millennium Development Goals for improving women’s health, reducing poverty. If all women in developing countries use modern contraceptives, there would be 22 million less unplanned births, 25 million fewer induced, 15 million fewer unsafe abortions, 90000 less maternal deaths and 390000 less children losing their mothers. Also making abortion services broadly legal, by understand-ing size, type of unmet needs, most important by creating awareness in communities can surely help tackle this problem to a large extent.展开更多
A statistician from the Re-gional F amily Planning Committee told reporters that a su1vey on the deliverability and public requirement for contraception services was con-ducted in December 1996 through-out the Tibet A...A statistician from the Re-gional F amily Planning Committee told reporters that a su1vey on the deliverability and public requirement for contraception services was con-ducted in December 1996 through-out the Tibet Autonomous Re gion by the Technical Service Station of the Committee.展开更多
Introduction: Unmet need for family planning (UNFP) is defined as women with unmet needs who want to stop or delay childbearing but are not using any method of contraception. The objective of this study was to analyze...Introduction: Unmet need for family planning (UNFP) is defined as women with unmet needs who want to stop or delay childbearing but are not using any method of contraception. The objective of this study was to analyze the factors associated with unmet needs for family planning among couples living in rural and urban areas of Guinea in 2019. Methodology: This was a prospective, analytical cross-sectional, multicenter study of a six-month period from August 1, 2018 to January 31, 2019, focusing on couples with unmet needs for family planning. Result: Among 189 couples interviewed, 567 had UNFP (33.3%), the reasons for not using modern contraceptive methods were desire for pregnancy (AOR = 2.74, 95% CI: 1.74, 4.31), husband’s refusal (AOR = 0.23, 95% CI: 0.06, 0.81), spousal attitude (AOR = 0.20, 95% CI: 0.130, 30), birth spacing (AOR = 2.10% to 95%: 1.16, 3.82), difficulty with a new pregnancy (AOR = 0.17, 95% CI: 0.04, 0.74), and spousal attitude (AOR = 0.20, 95% CI: 0.14, 0.30). Conclusion: The involvement of spouses, especially in rural communities, would help achieve family planning objectives and reduce unmet needs for family planning.展开更多
In 2009, China strengthened its public health service system. Since then, the country has made remarkable achievements in community-based chronic disease prevention and control;however, certain groups still have unmet...In 2009, China strengthened its public health service system. Since then, the country has made remarkable achievements in community-based chronic disease prevention and control;however, certain groups still have unmet needs. During 2019 to 2029, China will consolidate the top-level design of its medical health system. During this period, the coordination of department policies, improvement of service delivery mechanisms, building an integrated health service system, and other issues will be highlighted. This study will provide a basis for designing China’s chronic disease prevention and control system during the next stage of development. We will consider the unmet needs of patients with chronic diseases as an indicator for remodeling the prediction system in combination with the elements and structural theories of complex health systems. In this article, we first introduce the definition and measurement methods of unmet needs. Second, we identify the existing unmet needs found among patients with chronic diseases with reference to the chronic disease prevention and control policies of China as well as current service items. Finally, we propose the design of community chronic disease service package for the next development stage based on unmet needs of patients with chronic diseases. We also provide suggestions for how to improve China’s chronic care delivery system.展开更多
Background The aim of this study was to identify similarities and diferences in the unmet supportive care needs(USCN)of families of children with major chronic health conditions(CHCs)using a universal need assessment ...Background The aim of this study was to identify similarities and diferences in the unmet supportive care needs(USCN)of families of children with major chronic health conditions(CHCs)using a universal need assessment tool.Methods A cross-sectional online survey involving parents of children with congenital heart disease(CHD),type 1 diabetes mellitus(T1D),cancer,and asthma diagnosed within the last 5 years recruited via social media and support organizations.Thirty-four items assessing the USCN across six domains(care needs,physical and social needs,informational needs,support needs,fnancial needs,child-related emotional needs)were responded to on a 4-point Likert scale[no need(1)to high need(4)].Descriptive statistics identifed the level of need,and linear regressions identifed factors associated with higher need domain scores.Due to small numbers,the asthma group was excluded from comparisons across CHCs.Results One hundred and ninety-four parents completed the survey(CHD:n=97,T1D:n=50,cancer:n=39,and asthma:n=8).Parents of children with cancer were most likely to report at least one USCN(92%),followed by parents of children with T1D(62%).The fve most commonly reported USCN across CHCs were drawn from four domains:child-related emotional,support,care,and fnancial.Three need items were included in the top fve needs for all conditions.A higher USCN was associated with a greater frequency of hospital visits and the absence of parental support.Conclusions Using a universal need assessment tool,this is one of the frst studies to characterize USCN in families of children diagnosed with common CHCs.While proportions endorsing diferent needs varied across conditions,the most endorsed needs were similar across the illness groups.This suggests that support programs or services could be shared across diferent CHCs.展开更多
To explore the rate and influencing factors of unmet need for postpartum family planning(PPFP)in China.We conducted a retrospective cohort study at 60 hospitals in 15 provinces that were in eastern,central,and western...To explore the rate and influencing factors of unmet need for postpartum family planning(PPFP)in China.We conducted a retrospective cohort study at 60 hospitals in 15 provinces that were in eastern,central,and western regions of China.Participants were women who delivered a live birth at the study sites with an interval of 13 to 24 months between delivery and interviews.We selected participants using cluster randomization approach,and the first 300 postpartum women who gave a birth at each study hospital after the initial month that had been selected were interviewed.Information on the women’s background characteristics,pregnancy history,time when menstruation and sexual activity resumed after childbirth,the adoption of contraceptive method,breastfeeding,and any pregnancy or pregnancy outcome after delivery were collected.We performed life-table analysis to estimate the rate of unmet need for PPFP and a 2-level logistic regression model to explore factors that influence unmet need for PPFP within the first 24 months postpartum.A total,19,939 postpartum women were screened in this study,of which,17,466(87.6%)were eligible for this analysis.The rates of unmet needs for any FP methods were 23.9%(95%confidence interval[CI]23.3-24.6%),11.8%(95%CI 11.3-12.3%);10.6%(95%CI 10.1-11.1%)at 6,12,and 24 months postpartum;these rates for modern FP methods were 35.5%(95%CI 34.7-36.2%),25.6%(95%CI 24.9-26.2%),and 24.6%(95%CI 23.9-25.2%),respectively.Results of 2-level logistic regression analysis showed that less-educated young women,those who had only one child or delivered by vaginal delivery at secondary hospitals,were associated with increased risk of unmet need for PPFP.Approximately 31%of women who had unmet need for PPFP reported a pregnancy during the first 24 months postpartum,which was significantly higher than the level for their counterparts(10.0%).The level of unmet need for PPFP in China was high,resulting in a high pregnancy rate within 24 months after delivery.Women’s age,education level,prior pregnancy and abortion histories,and delivery method were significantly associated with the risk of unmet need for PPFP.National PPFP guidelines that integrate PPFP services into prenatal and postnatal care are urgently needed and should be implemented throughout the coun-try as soon as possible.PPFP services should promote the use of modern contracep-tive methods.展开更多
Every individual has the right to make their own choices about their sexual and reproductive health.Family planning,including contraceptive information and services,is fundamental to all individuals’health and human ...Every individual has the right to make their own choices about their sexual and reproductive health.Family planning,including contraceptive information and services,is fundamental to all individuals’health and human rights,including adolescents.Bangladesh made a commitment at the Nairobi summit(ICPD+25)in 2019 to address three zeros,including the unmet need for family planning by 2030-a big challenge where unmarried adolescents are excluded from most Sexual and Reproductive Health and Rights(SRHR)information and services.However,unmet need for family planning amongst adolescents in the country is high.A literature review of relevant research papers,survey reports,and policy documents has been conducted(i)to demonstrate the current situation of unmet need and SRHR-FP for adolescents in Bangladesh;(ii)to identify unique barriers and challenges faced by adolescents in accessing SRHR-FP information and using services in Bangladesh;(iii)to analyze and identify gaps in the current policies,strategies,and plans to address unmet need and SRHR in Bangladesh;and to provide recommendations for adapting policies and improving best practices.This paper demonstrates that although Bangladesh has policies designed to support youth rights and access to comprehensive sexuality education and relevant services,there are immense implementation gaps.Social stigma and taboos are overpowering the implementation of policies that need critical attention.Also,interventions are needed to address the significant gap in data on unmarried adolescents and their use of family planning services,which limits the analysis of the current situation of unmarried adolescents.展开更多
文摘Intravascular large B-cell lymphoma(IVLBCL),a rare subtype of non-Hodgkin lymphoma,is classified as an independent subtype of extranodal diffuse large B-cell lymphoma(DLBCL)in the 2008 World Health Organization(WHO)Classification(Turner et al.,2010).The 5th edition of the World Health Organization(WHO 2022)classification of hematolymphoid tumors retains this subtype(Alaggio et al.,2022).IVLBCL,which is characterized by neoplastic lymphocyte proliferation within the lumen of small blood vessels,tends to invade organs,such as the nervous system,skin,bone marrow(BM),and lung(D'Angelo et al.,2019;Satoh et al.,2019;Vasquez et al.,2019;Fukami et al.,2020).
文摘Objective To calculate unmet need for contraception according to revised definition, mapping the contraception service needs and analyze factors related to the unmet need for contraception in Nusa Tenggara Barat （NTB）. Methods This research design was cross sectional, using data from Indonesia Demographic and Health Survey 2012. Subjects were from 1 362 household, and were married women aged 15-49 years in NTB Province （685 women）. Calculating method of unmet need for contraception used revised version, and analysis method was univariate, bivariate, and multivariate （Logistic regression）. Results Majority of married women aged 15-49 years in NTB need contraception service （73.1%）. However, it was known that met need for contraception was only 56.0%. Meanwhile, unmet need rate for contraception in NTB was 17.1%, specifically 11.5% for spacing and 5.6% for limiting. Factors contributing to unmet need for contraception in NTB were： household assets at above average （OR=O. 77）, parity of 2-3 children （OR=0. 73）, women with junior high school education level （0R=0.68）, never be visited by health workers （OR=O. 68）. Conclusions Factors that contribute to unmet need for contraception in NTB are household assets, parity, education level and visited by health workers. Government has to prioritize those f our factors in policy intervention and promotion of family planning participation program in NTB.
文摘Due to the optimal results obtained in kidney transplantation and to the lack of interest of the industries,new innovative drugs in kidney transplantation are difficult to be encountered.The best strategy to find the new drugs recently developed or under development is to search in the sections of kidney transplantation still not completely covered by the drugs on the market.These unmet needs are the prevention of delayed graft function(DGF),the protection of the graft over the long time and the desensitization of preformed anti human leukocyte antigen antibodies and the treatment of the acute antibody-mediated rejection.These needs are particularly relevant due to the expansion of some kind of kidney transplantation as transplantation from non-heart beating donor and in the case of antibody-incompatible grafts.The first are particularly exposed to DGF,the latter need a safe desensitization and a safe treatments of the antibody mediated rejections that often occur.Particular caution is needed in treating these drugs.First,they are described in very recent studies and the follow-up of their effect is of course rather short.Second,some of these drugs are still in an early phase of study,even if in well-conducted randomized controlled trials.Particular caution and a careful check need to be used in trials launched 2 or 3 years ago.Indeed,is always necessary to verify whether the study is still going on or whether and why the study itself was abandoned.
文摘Background: Understanding the magnitude of unmet contraceptive need and the underlying determinants will help the programs and services to respond effectively. Aim: Identify the prevalence and determinants of unmet contraceptive need among married women in the childbearing period in Minia Governorate. Methods: Community-based cross-sectional study was done among married women of child bearing age (18 - 49 years). Total 534 study participants were selected randomly and interviewed by using pretested structured questionnaire. Results: Overall level of unmet need was 12.7%. Women age > 35 years old were about three times (adjusted OR = 2.88, 95% CI: 1.13 - 7.35) more likely to have unmet need for family planning compared to younger women. Women who had more children (adjusted OR = 1.32, 95% CI: 1.04 - 1.67), more female offspring (adjusted OR = 1.37, 95% CI: 1.09 - 1.65), and women whose partner had non-supportive attitude towards family planning (adjusted OR = 2.96, 95% CI: 1.53 - 5.72) were more likely to have unmet need. Conclusion: The prevalence of unmet need of family planning among women in Minia Governorate remains high. Therefore, family planning programs that cover the older woman’s need for limiting and that focus on couples could be useful in reducing the rate of unmet need.
文摘The study was conducted to assess the magnitude and associated factors of unmet need for family planning among women of reproductive age group with disabilities who are members of disabled associations in Bahir Dar town. Institution based cross-sectional study was carried out. A total of 337 women of reproductive age group with disabilities were included in the study with simple random sampling. Data were collected through face-to-face interview, coded, cleaned and entered by Epi info 2002 and analyzed with SPSS version 16 computer software. Logistic regression was used to assess possible associations. The magnitude of unmet need for family planning among women with disabilities was 24.3%. Women with disabilities in the age group of 25-29 had 80% less likely to have unmet need than women above 35 years old. Women with disability who have no education were 11 times more likely to have unmet need than those who have secondary education. Women who desire to have more than 3 children have more likely to have unmet need than those who need to have 1-2 children. Unmet need for family planning among women with disabilities was high in Bahir Dar town. Age, Educational status and desired number of children were found to have statistically significant association with unmet need for family planning. Hence, it is important to encourage people with disabilities to attained formal education and the associations should provide short term trainings in accordance with their age group.
文摘Biologics have greatly improved the management of rheumatoid arthritis (RA), demonstrating efficacy and safety in alleviating symptoms, inhibiting bone erosion, and preventing loss of function. Unmet therapeutic needs in RA remain;however, further advances require an understanding of issues left unaddressed under the current treatment paradigm. Most biologic-na?ve and biologic-pretreated patients who initiate a biologic therapy, for example, do not reach American College of Rheumatology 50% (ACR50) response, and few achieve remission. Responses are often not durable, prompting frequent treatment switching. Predictive markers are unavailable to guide therapy selection, and clinical trial data are lacking on whether a tumor necrosis factor inhibitor (TNFi) is the best first-line biologic and on the optimal sequence of use for the different biologics. Risk of serious infection is the major safety concern. Translating preclinical and clinical findings into new therapeutics may help address unmet needs. An increasing body of evidence indicates that the cytokine interleukin (IL)-17A represents an important therapeutic target;ongoing trials with IL-17A inhibitors will determine whether these agents can address some of the unmet needs associated with current biologics.
文摘Many adolescent girls are pressured into having sex at an early age, which puts them at high risk of unwanted pregnancies and unsafe abortions. The overall objective of this study was to evaluate the unmet needs of adolescents who give birth. A descriptive cross-sectional study was carried out in three university hospitals in Yaoundé, Cameroon: Yaoundé Central Hospital, Yaoundé Gyneco-Obstetrics and Pediatric Hospital and the District Hospital of Biyem-Assi, from February 1, 2020 to June 30, 2020. Included were any teenage mothers speaking English or French. Data were entered using CSPRO 7.3, analyzed by Excel 2010 and SPSS version 23.0. The tools used to express our results were the number, the frequency, the mean, the odds ratio (OR) and the P. P was significant if less than 5%. Of a total of 2692 births recorded, 188 (7%) were from adolescents. Of these, 157 fulfilling our selection criteria were recruited and data analyzed. The average age of the participants was 17.9 ± 1.12 years with extremes of 13 and 19, the average parity was 1.2 ± 0.4 with extremes of 1 and 3. Out of 157 participants, 2 who fell in the age range of 10 to 14 years (100%) and 106 of 155 (68.4%) whose age ranged from 15 to 19 years had unmet need for family planning. Only unmarried participants had unmet needs after multivariate analysis [aOR 2.4 (1.1 - 5.3);p = 0.035)]. Being unmarried was independently associated with the occurrence of unmet needs. The intensification of campaigns for provider behavior changes communication and the creation of services dedicated to the sexual and reproductive health of adolescents would help to reduce the rate of unmet needs for family planning among adolescent girls.
文摘Worldwide women have to cope up with heavy burden of unwanted pregnancies, mistimed, unplanned, with risk to their health. Their children and families also suf-fer. Such pregnancies are root cause of induced abortions （safe/unsafe） and grave consequences. Women, their partners can, for most part, prevent unwanted pregnancies by using contraceptives. However many women either do not use any contraceptive or use methods, with high failure rates. These women account for 82% of pregnancies that are not desired. Remaining unintended pregnancies occur among women who use modern contraceptive, either because they had diffculty using method consistently or because of failure. Helping women, their partner use modern contracep-tives effectively is essential in achieving Millennium Development Goals for improving women’s health, reducing poverty. If all women in developing countries use modern contraceptives, there would be 22 million less unplanned births, 25 million fewer induced, 15 million fewer unsafe abortions, 90000 less maternal deaths and 390000 less children losing their mothers. Also making abortion services broadly legal, by understand-ing size, type of unmet needs, most important by creating awareness in communities can surely help tackle this problem to a large extent.
文摘A statistician from the Re-gional F amily Planning Committee told reporters that a su1vey on the deliverability and public requirement for contraception services was con-ducted in December 1996 through-out the Tibet Autonomous Re gion by the Technical Service Station of the Committee.
文摘Introduction: Unmet need for family planning (UNFP) is defined as women with unmet needs who want to stop or delay childbearing but are not using any method of contraception. The objective of this study was to analyze the factors associated with unmet needs for family planning among couples living in rural and urban areas of Guinea in 2019. Methodology: This was a prospective, analytical cross-sectional, multicenter study of a six-month period from August 1, 2018 to January 31, 2019, focusing on couples with unmet needs for family planning. Result: Among 189 couples interviewed, 567 had UNFP (33.3%), the reasons for not using modern contraceptive methods were desire for pregnancy (AOR = 2.74, 95% CI: 1.74, 4.31), husband’s refusal (AOR = 0.23, 95% CI: 0.06, 0.81), spousal attitude (AOR = 0.20, 95% CI: 0.130, 30), birth spacing (AOR = 2.10% to 95%: 1.16, 3.82), difficulty with a new pregnancy (AOR = 0.17, 95% CI: 0.04, 0.74), and spousal attitude (AOR = 0.20, 95% CI: 0.14, 0.30). Conclusion: The involvement of spouses, especially in rural communities, would help achieve family planning objectives and reduce unmet needs for family planning.
基金National Natural Science Foundation of China(No. 71603278)Key Program of the National Natural Science Foundation of China(No.71734003)+1 种基金Youth Project of Educational Reform of China Pharmaceutical University(No. 2017XJQN32)a research project on postgraduate educational reform under "double first-class" capability construction from China Pharmaceutical University(No. 3151920118)。
文摘In 2009, China strengthened its public health service system. Since then, the country has made remarkable achievements in community-based chronic disease prevention and control;however, certain groups still have unmet needs. During 2019 to 2029, China will consolidate the top-level design of its medical health system. During this period, the coordination of department policies, improvement of service delivery mechanisms, building an integrated health service system, and other issues will be highlighted. This study will provide a basis for designing China’s chronic disease prevention and control system during the next stage of development. We will consider the unmet needs of patients with chronic diseases as an indicator for remodeling the prediction system in combination with the elements and structural theories of complex health systems. In this article, we first introduce the definition and measurement methods of unmet needs. Second, we identify the existing unmet needs found among patients with chronic diseases with reference to the chronic disease prevention and control policies of China as well as current service items. Finally, we propose the design of community chronic disease service package for the next development stage based on unmet needs of patients with chronic diseases. We also provide suggestions for how to improve China’s chronic care delivery system.
基金Open access funding is enabled and organized by CAUL and its Member Institutionsfunded by a Deakin University PhD Scholarship.
文摘Background The aim of this study was to identify similarities and diferences in the unmet supportive care needs(USCN)of families of children with major chronic health conditions(CHCs)using a universal need assessment tool.Methods A cross-sectional online survey involving parents of children with congenital heart disease(CHD),type 1 diabetes mellitus(T1D),cancer,and asthma diagnosed within the last 5 years recruited via social media and support organizations.Thirty-four items assessing the USCN across six domains(care needs,physical and social needs,informational needs,support needs,fnancial needs,child-related emotional needs)were responded to on a 4-point Likert scale[no need(1)to high need(4)].Descriptive statistics identifed the level of need,and linear regressions identifed factors associated with higher need domain scores.Due to small numbers,the asthma group was excluded from comparisons across CHCs.Results One hundred and ninety-four parents completed the survey(CHD:n=97,T1D:n=50,cancer:n=39,and asthma:n=8).Parents of children with cancer were most likely to report at least one USCN(92%),followed by parents of children with T1D(62%).The fve most commonly reported USCN across CHCs were drawn from four domains:child-related emotional,support,care,and fnancial.Three need items were included in the top fve needs for all conditions.A higher USCN was associated with a greater frequency of hospital visits and the absence of parental support.Conclusions Using a universal need assessment tool,this is one of the frst studies to characterize USCN in families of children diagnosed with common CHCs.While proportions endorsing diferent needs varied across conditions,the most endorsed needs were similar across the illness groups.This suggests that support programs or services could be shared across diferent CHCs.
文摘To explore the rate and influencing factors of unmet need for postpartum family planning(PPFP)in China.We conducted a retrospective cohort study at 60 hospitals in 15 provinces that were in eastern,central,and western regions of China.Participants were women who delivered a live birth at the study sites with an interval of 13 to 24 months between delivery and interviews.We selected participants using cluster randomization approach,and the first 300 postpartum women who gave a birth at each study hospital after the initial month that had been selected were interviewed.Information on the women’s background characteristics,pregnancy history,time when menstruation and sexual activity resumed after childbirth,the adoption of contraceptive method,breastfeeding,and any pregnancy or pregnancy outcome after delivery were collected.We performed life-table analysis to estimate the rate of unmet need for PPFP and a 2-level logistic regression model to explore factors that influence unmet need for PPFP within the first 24 months postpartum.A total,19,939 postpartum women were screened in this study,of which,17,466(87.6%)were eligible for this analysis.The rates of unmet needs for any FP methods were 23.9%(95%confidence interval[CI]23.3-24.6%),11.8%(95%CI 11.3-12.3%);10.6%(95%CI 10.1-11.1%)at 6,12,and 24 months postpartum;these rates for modern FP methods were 35.5%(95%CI 34.7-36.2%),25.6%(95%CI 24.9-26.2%),and 24.6%(95%CI 23.9-25.2%),respectively.Results of 2-level logistic regression analysis showed that less-educated young women,those who had only one child or delivered by vaginal delivery at secondary hospitals,were associated with increased risk of unmet need for PPFP.Approximately 31%of women who had unmet need for PPFP reported a pregnancy during the first 24 months postpartum,which was significantly higher than the level for their counterparts(10.0%).The level of unmet need for PPFP in China was high,resulting in a high pregnancy rate within 24 months after delivery.Women’s age,education level,prior pregnancy and abortion histories,and delivery method were significantly associated with the risk of unmet need for PPFP.National PPFP guidelines that integrate PPFP services into prenatal and postnatal care are urgently needed and should be implemented throughout the coun-try as soon as possible.PPFP services should promote the use of modern contracep-tive methods.
文摘Every individual has the right to make their own choices about their sexual and reproductive health.Family planning,including contraceptive information and services,is fundamental to all individuals’health and human rights,including adolescents.Bangladesh made a commitment at the Nairobi summit(ICPD+25)in 2019 to address three zeros,including the unmet need for family planning by 2030-a big challenge where unmarried adolescents are excluded from most Sexual and Reproductive Health and Rights(SRHR)information and services.However,unmet need for family planning amongst adolescents in the country is high.A literature review of relevant research papers,survey reports,and policy documents has been conducted(i)to demonstrate the current situation of unmet need and SRHR-FP for adolescents in Bangladesh;(ii)to identify unique barriers and challenges faced by adolescents in accessing SRHR-FP information and using services in Bangladesh;(iii)to analyze and identify gaps in the current policies,strategies,and plans to address unmet need and SRHR in Bangladesh;and to provide recommendations for adapting policies and improving best practices.This paper demonstrates that although Bangladesh has policies designed to support youth rights and access to comprehensive sexuality education and relevant services,there are immense implementation gaps.Social stigma and taboos are overpowering the implementation of policies that need critical attention.Also,interventions are needed to address the significant gap in data on unmarried adolescents and their use of family planning services,which limits the analysis of the current situation of unmarried adolescents.
