DKT International

Abstract BackgroundThis paper identifies how patient-centered family planning care has been defined, conceptualized, and measured, describes tools to make family planning care more patient-centered, and discusses their impact on patient satisfaction and family planning outcomes.MethodsWe systematically searched PubMed and SCOPUS for documents on “patient-centered family planning counseling or support” published between 2013 and 2022. Eligibility criteria included discussion of 1) a strategy for providing patient-centered care, 2) an intervention that used a patient- centered approach, or 3) evidence of the impact of patient-centered approaches. We excluded documents that only recommended using patient-centered approaches. To assess how studies conceptualized patient-centered care, we reviewed how the concept was measured. We identified tools for patient-centered care, and mapped them against the main domains of patient-centered care. We reported the available evidence of the impact on those tools without further statistical analysis.ResultsOur review is based on 33 documents, including three theoretical articles and three systematic reviews. Nine studies addressed women’s experiences with family planning counseling, five discussed instruments for measuring the patient-centeredness of care, ten discussed tools for patient-centered family planning, and three discussed broader counseling programs.We identified important differences in how patient-centered family planning care was defined and measured, although most studies emphasized patients’ needs and preferences, respect for the patient, and informed decision-making. We identified six tools for increasing the patient-centeredness of family planning counseling. None of the tools addressed all domains of patient-centered care. Evidence about the impact of these tools is scarce. Overall, the tools appeared well accepted by both providers and patients. There was some evidence that the tools improved patients’ perception about the quality of care, but no evidence that the tools improved family planning outcomes.DiscussionLimitations of our study include that our search was restricted to two databases, and that the studies predominantly focused on Western countries which may limit the generalizability of the findings. Wider use of existing scales to measure patient-centered family planning care may help standardize the definition of patient-centered care and strengthen the evidence base. Although tools for patient-centered care improve the patient experience, there is a need to identify strategies for translating this into improved family planning outcomes. In addition, there is a need to test patient- centered approaches in a wider range of settings.

Background: This paper aims to promote the use of interrupted time series analyses of routine data as a responsive feedback tool to improve public health programs on an ongoing basis. This methodology is demonstrated by measuring the effect of a radio campaign to promote a family planning call center in Nigeria on the demand for family planning information and explains how the results were used to adapt the program. Methods: We used a single group interrupted time series design (ITS) as a responsive feedback mechanism to determine whether the radio campaign influenced use of the Honey&Banana call center. ITS is ideal when a control group is not available and assumes that an interruption of the trend in the outcome measure occurs after the intervention starts. ITS uses the pre-intervention trend to predict what would have happened if the intervention were absent. Results: After conducting ITS analyses, the results show that the number of calls requesting family planning information increased throughout the campaign period, with a gain of about 500 additional calls per month, and then decreased after the campaign ended. However, the number of calls gained from the campaign was substantially lower than anticipated. Conclusions: While end-of-project impact evaluations are necessary, there should be regular feedback system to provide program implementers with information about the status of the project, such as failures, successes, and areas of improvements. This would allow implementers to make necessary adjustments as needed throughout the intervention period. The finding that the radio campaign was not living up to expectations helped program implementers to end the campaign prematurely and re-allocate resources to a more promising activity. Our research shows that basic ITS analysis of routine data can be a useful tool for receiving regular feedback to guide programming improvements.

ObjectivesMean axes of rotation [MAR] of cervical joints are an effective measure of spine pathology. Khan Kinetic Treatment [KKT] is known to relieve symptoms, but its biomechanical effects have not been quantified. This study assesses KKT efficacy using MAR correction and its associated effects.MethodsThe intervention applies vibrations via stylus to a bony landmark of the spine. Using saggital plane cervical X-rays, pre-post intervention MARs were computed for 44 patients with chronic neck pain. The study was randomized, single blinded, and sham controlled for outcome measure comparisons. Mechanical input was assessed using a load cell and vertebral acceleration and the outcome measures were: 1. cervical MARs, 2. self-reported neck pain, 3. neck disability index scores, and 4. psycho-social assessments.Results1. Average peak force on vertebrae during treatment was 10.3 N and the average peak acceleration was 2.19G, 2. KKT improved pain and neck disability scores significantly over shams, 3. KKT correct...

> “We didn't get anything done this week. We were too busy coordinating.” > > Memo from Chinese family planning worker to his supervisor (2009) It has become almost axiomatic that family planning programmes should be coordinated and, to the extent possible, integrated with each other. I believe this is a mistake. The use of contraceptives in the developing world has accelerated astonishingly in the past 30 years and, while government programmes remain very important, contraceptives and contraceptive services are increasingly supplied through a large variety of independently managed, generally uncoordinated activities. Attempts to coordinate these efforts, however well intentioned, tend to weaken them. In most developing countries, particularly the poorest ones, couples get their contraceptives primarily from private sources. In Indonesia in 2007, for example, only 22% of modern method users relied on the public sector.1 The other 78%, over 20 million couples, got their family planning from midwives, pharmacies and non-pharmacy stores, including a social marketing programme that today serves 5 million couples. In Bangladesh, a slight majority, 57%, relied on public sources including government field workers in 2004, but the rest counted on pharmacies, shops and private clinics. In Cambodia (2005), modern method users relied on uncoordinated private sources 60% of the time. These included clinics, doctors, shops and community distributors. In the Dominican Republic (2002), more than half of the couples seeking birth control relied on the private sector. And in the Democratic Republic of Congo (2007), where usage is admittedly …

For many years the social marketing of contraceptives was held to be an interesting but not a central part of the international family planning movement. The heavy lifting everyone thought would be performed by government programs managed by developing country government agencies that would provide services and contraceptives free of charge. This attitude is changing. Although government programs are still the largest family planning service providers in many countries the contraceptive needs of poor populations are increasingly being met by a wide variety of independently managed contraceptive social marketing (CSM) programs and by a growing number of commercial contraceptive suppliers. In 2005 social marketing programs served the contraceptive needs of 36.7 million couples in 73 countries and provided hundreds of millions of condoms for HIV/AIDS prevention. This contribution means that social marketing programs accounted for about six percentage points of the contraceptive prevalence in thedeveloping world (excluding China) and roughly 20 percent of the birth spacing methods used by couples in developing countries. (excerpt)

Social marketing programs that market and distribute subsidized contraceptives in developing countries do not make money, nor are they intended to. Indeed, attempts to make them profitable have generally undermined the effectiveness of such programs, particularly in very poor countries (Harvey, 1999, pp. 213-225). The purpose of such programs is to make contraceptives available to even the lowest-income people in developing country markets and, as such, subsidization of overall project activities will always be required. Indeed, contraceptive services, along with health services in general, are subsidized for low-income people in industrialized countries, leading one expert to suggest that it is “patently absurd” to withdraw contraceptive subsidies “for people who struggle to survive on a dollar a day” (The Lancet Eds., 1990, p. 659). However, there are numerous parties involved in contraceptive social marketing (CSM) projects in the countries of Asia, Africa, and Latin American that do make money from their role in social marketing, and these businesses and entrepreneurs benefit significantly from the parts they play. Such private businesses include, most prominently, advertising agencies, product distribution firms, market research firms, and ancillary businesses like vehicle manufacturers and importers, makers of promotional paraphernalia - from calendars to pens to T-shirts, and others.

Biological particulates collected on air filters during shuttle missions (STS-40 and STS-42) were identified using pyrolysis-gas chromatography/mass spectrometry (Py-GC/MS). A method was developed for identifying the atmospheric particles and their sources through the analysis of standard materials and the selection of "marker" compounds specific to the particle type. Pyrolysis spectra of biological standards were compared with those of airborne particles collected during two space shuttle missions; marker compounds present in the shuttle particle spectra were matched with those of the standards to identify the source of particles. Particles of 0,5--1-mm diameter and weighing as little as 40 micrograms could be identified using this technique. The Py-GC/MS method identified rat food and soilless plant-growth media as two sources of particles collected from the shuttle atmosphere during flight.

The pharmacokinetics and bioavailability of scopolamine were evaluated in six healthy male subjects receiving 0.4 mg of the drug by either oral or intravenous administration. Plasma and urine samples were analyzed using a radioreceptor binding assay. After iv administration, scopolamine concentrations in the plasma declined in a biexponential fashion, with a rapid distribution phase and a comparatively slow elimination phase. Mean and SE values for volume of distribution, systemic clearance, and renal clearance were 1.4 +/- 0.3 liters/kg, 65.3 +/- 5.2 liters/hr, and 4.2 +/- 1.4 liters/hr, respectively. Mean peak plasma concentrations were 2909.8 +/- 240.9 pg/ml following iv administration and 528.6 +/- 109.4 pg/ml following oral administration. Elimination half-life of the drug was 4.5 +/- 1.7 hr. Bioavailability of the oral dose was variable among subjects, ranging between 10.7 and 48.2%. The variability in absorption and poor bioavailability of oral scopolamine indicate that this route of administration may not be reliable and effective.

ADVERTISEMENT RETURN TO ISSUEPREVArticleNEXTProduction of valinomycin, an insecticidal antibiotic, by Streptomyces griseus var. flexipertum var. nov.Rod M. Heisey, Jamin Huang, Saroj K. Mishra, James E. Keller, James R. Miller, Alan R. Putnam, and Themistocles D. J. D'SilvaCite this: J. Agric. Food Chem. 1988, 36, 6, 1283–1286Publication Date (Print):November 1, 1988Publication History Published online1 May 2002Published inissue 1 November 1988https://pubs.acs.org/doi/10.1021/jf00084a039https://doi.org/10.1021/jf00084a039research-articleACS PublicationsRequest reuse permissionsArticle Views268Altmetric-Citations19LEARN ABOUT THESE METRICSArticle Views are the COUNTER-compliant sum of full text article downloads since November 2008 (both PDF and HTML) across all institutions and individuals. These metrics are regularly updated to reflect usage leading up to the last few days.Citations are the number of other articles citing this article, calculated by Crossref and updated daily. Find more information about Crossref citation counts.The Altmetric Attention Score is a quantitative measure of the attention that a research article has received online. Clicking on the donut icon will load a page at altmetric.com with additional details about the score and the social media presence for the given article. Find more information on the Altmetric Attention Score and how the score is calculated. Share Add toView InAdd Full Text with ReferenceAdd Description ExportRISCitationCitation and abstractCitation and referencesMore Options Share onFacebookTwitterWechatLinked InRedditEmail Other access optionsGet e-Alertsclose Get e-Alerts