Consistent Use Research Articles

Acceptability of two spermicides in five countries

Data from a large, international, multicenter, randomized trial were analyzed to compare the acceptability of two nonoxynol-9 spermicide preparations. Women who wished to use a spermicide for contraception were randomly assigned to use either a foaming tablet (n = 383) or a nonoxynol-9 film (n = 382) for 28 weeks as their only method of contraception. Participants completed questionnaires about acceptability of the assigned product 4 weeks after admission and at discontinuation. Women in both groups had very favorable opinions of the spermicide. The proportion of women who said that they liked their assigned product very much was 50% in the tablet group and 55% in the film group. Significantly more women in the film group rated the spermicide difficult to insert and stated that the product stuck to the finger during insertion. More women in the tablet group said that the product was messy and that, at least once, it did not dissolve. In both groups, liking the product was significantly associated with consistency of use, but not with subsequent pregnancy. Participants’ male partners had little influence on participants’ opinions about, or use of, the spermicides. Although previous analyses showed that both spermicides are associated with high pregnancy rates, they are both highly acceptable to most women.

Culture and sexual practices in response to HIV among Aboriginal people living on-reserve in Ontario

This study explores some of the unique aspects of Aboriginal culture that characterize responses to HIV/AIDS in Canada, specifically high-risk sexual behaviour. Six hundred and fifty eight status Indians were randomly selected from eleven Aboriginal reserves to participate in an AIDS-related health survey. Interview techniques were developed to respond to cultural and community sensitivities. Responses from a subset of 566 individuals who answered all relevant questions were analysed using descriptive statistics and logistic regression to clarify the association between cultural variables and risk-taking. Participation in intercourse was associated with familiarity with Aboriginal traditions, learning about sex from partners and speaking an Aboriginal language. Condom use and the consistency of use were associated with learning about sex from family and through health services. Important challenges exist for the integration of traditional learning methods with knowledge of HIV/AIDS. It is important to understand the conflicting paradigms of Aboriginal tradition, modern medicine and public health service. An awareness of the complexity of culture and differences within and between communities is critical to future research in this area.

European dimensions of coffee: Rapid inspection of a data set using Q-PCA

From the ‘ESN coffee data set’ the data from the two attributes that were used in all countries, bitter and burnt, were selected for analysis. The consistency of use of these attributes, over all countries, was studied using (Q-mode) Principal Component Analysis. In addition, the result from this analysis was used to study the agreement between the replicate coffees. The conclusion was that there were some deviant assessors in France, and that there might exist systematic differences between the replicates.

Do spermicides containing nonoxynol-9 prevent sexually transmitted infections? A meta-analysis.

There are conflicting opinions on whether to recommend spermicides containing nonoxynol-9 for prevention of sexually transmitted diseases, including human immunodeficiency virus (HIV). To systematically review and summarize the medical literature on the effect of spermicides containing nonoxynol-9 on prevention of gonorrhea, chlamydial infection, and HIV. Meta-analysis. Potential articles were identified through computerized literature searches. Articles were included if the design was clinical trial, cohort, case-control, or cross-sectional; original outcome data were presented for gonorrhea, chlamydial infection, or HIV; and spermicides containing nonoxynol-9 were used separately from other barrier methods. Study characteristics including design, population, spermicide dose, and delivery method were abstracted. Relative risks (RR) and 95% confidence intervals (CI) were determined from information published in the study or from study authors. Summary risk estimates were computed for clinical trials. Twelve eligible articles were identified, including six clinical trials and six observational studies. Eleven articles evaluated gonorrhea; each found a reduced risk of infection with spermicide use. Among six clinical trials, the summary RR was 0.62 (95% CI, 0.49-0.78). The five articles evaluating chlamydial infection also found significant reduction among spermicide users, with the four clinical trials having a summary RR of 0.75 (95% CI, 0.62-0.91). The degree of spermicidal protection against gonorrhea and chlamydial infection did not differ materially among studies with different study designs or spermicidal preparations (i.e., sponge, gel, suppository, or film). Three studies evaluated degree of protection according to consistency of use and found stronger protection with more consistent use. The two studies on spermicidal prevention of HIV had contrasting results: An observational study found a significant protective effect (RR = 0.1), whereas a clinical trial found a nonsignificantly increased risk (RR = 1.7). Nonoxynol-9-containing spermicides have an appreciable protective effect against both gonorrhea and chlamydial infection, and wider use of spermicides might substantially reduce the incidence of these diseases. However, insufficient data exist to judge their effect on HIV transmission, and more research on the effect of nonoxynol-9 on HIV transmission is urgently needed to make evidence-based clinical decisions and public health recommendations in the future.

Compliance, Counseling and Satisfaction with Oral Contraceptives: A Prospective Evaluation

Oral contraceptive users' risk of accidental pregnancy may be higher than it should be, because of inconsistent pill-taking. However, few reliable data are available on pill users' everyday experiences with their method, especially characteristics that may affect consistency of use. Two months after initiating or resuming oral contraceptive use, a nationwide sample of 943 women completed questionnaires examining their compliance with instructions for proper use, the quality of their interactions with their provider, their satisfaction with the method, and the frequency and costs of visits or calls to their providers because of pill-related side effects. Regression analyses were used to determine the factors associated with compliance difficulties and method dissatisfaction. In all, 47% of users missed one or more pills per cycle, and 22% missed two or more. Women who lacked an established pill-taking routine, who did not read and understand all of the informational material accompanying the pill package, or who experienced spotting or heavy bleeding had increased odds of missing two or more pills per cycle. Method satisfaction was most likely among women who were aware of the pill's noncontraceptive benefits, were satisfied with their relationship with their provider, had used the pill in the past and experienced few side effects. Some 22% of users called their provider at least once about pill-related side effects, and 9% made at least one visit for this reason; these women spent $25 and $62, respectively, to treat side effects. Improving pill use is a shared responsibility of the provider, the patient and, to a lesser degree, pill manufacturers. Awareness of potential difficulties such as inadequate counseling is a key step in helping women use oral contraceptives effectively.

Contraception in the United States: an overview and priorities for improvement.

Unintended pregnancy is a serious public health problem in the US, associated with excess risks of prenatal fetal exposure to alcohol, drugs, and smoking; late prenatal care; low birth weight and infant death; child abuse and neglect; and physical abuse of the mother. A decline by more than two years in the average age of puberty in the last century and increases in the average age at marriage have extended the interval during which unmarried women need contraceptive protection. International experience provides evidence that the number of unwanted pregnancies in the US can be reduced through greater accessibility to contraceptive services. At present, approximately 30% of poor Americans (11.5 million people) have neither health insurance nor Medicaid coverage. Although 85% of health insurance plans cover sterilization, only 40% provide coverage for the 5 most widely used reversible methods (IUDs, implants, injectables, diaphragm, and oral contraceptives). About half of the 3.2 million unintended pregnancies each year in the US occur to couples using no contraceptive method; the rest involve couples who are using a reversible method, but have difficulties using it consistently and correctly or experience a method failure. Needed are interventions to shorten or eliminate the "no method" interval through access to a full range of contraceptive options, including emergency contraception, and to improve correctness and consistency of use. In addition, health policies that devote unlimited resources to the treatment of adverse medical outcomes associated with unintended pregnancy while placing low priority on the prevention of such births and reimbursement policies that impose financial disincentives for the use of cost-effective reversible methods should be reconsidered.

The Diaphragm

Using a diaphragm as a barrier contraceptive has received little attention in recent literature. A discussion of the role of the diaphragm to prevent pregnancy, as well as sexually transmitted diseases, is presented. A procedure for properly fitting the diaphragm is described. To ensure compliance, a review of a plan for education and practice by users is outlined.

Inconsistent contraceptive use among female college students: implications for intervention.

The authors evaluated the longitudinal consistency of use of contraceptive and barrier methods among female college students attending a student health clinic. The majority of students using unreliable methods of contraception during follow-up did not report unreliable contraceptive use at the baseline observation. Of 213 women who participated, 33% used unreliable contraception; 9% only at baseline, 14% only during 6-month follow-up, and 9% at both. Selection of a contraceptive method varied considerably over time. Of those using the oral contraceptive pill at baseline, 31% did not use this method during follow-up, and 43% of those using condoms at baseline had intercourse without a condom during follow-up. Single observations are inadequate to detect unreliable contraceptive use in this population; cross-sectional studies will fail to detect important transitions in contraceptive use. Interventions to prevent pregnancy and sexually transmitted disease among female college students should include a focus on the consistency of contraceptive use.

An assessment of the consistency of ASA physical status classification allocation.

The American Society of Anesthesiologists' (ASA) Physical Status Classification was tested for consistency of use by anaesthetists. A postal questionnaire was sent to 113 anaesthetists of varying experience working in the Northern Region of England. They were asked to allot ASA grades to 10 hypothetical patients. Ninety-seven (85.8%) responded to two mailings. In no case was there complete agreement on ASA grade, and in only one case were responses restricted to two of the five possible grades. In one case there was a significant difference in answers between anaesthetists with the FRCA (or equivalent) qualification, and those without. So much variation was observed between individual anaesthetist's assessments when describing common clinical problems that the ASA grade alone cannot be considered to satisfactorily describe the physical status of a patient.

Impact on sexually transmitted disease spread of increased condom use by young females, 1987-1992.

Sexual behaviour data are crucial for understanding the spread of sexually transmitted diseases (STD). Over a period (1987-1992) in which the HIV epidemic increased public awareness of safe sexual practices, we describe predictors of condom use, changes in condom use over time, and the estimated effects of these changes on the spread of STD. Condom use reported by females aged 18-35 years with non-cohabiting partners was analysed using data from two cross-sectional postal surveys performed 5 years apart (1987 and 1992) on two separate representative samples of 10,000 subjects aged 18-60 years living in Norway. A simple mathematical model was used to assess the effects of selection bias. A more complicated model was used to predict the effects of condom use on the prevalence of STD in a population which includes a core group of highly sexually active subjects. We found an increase in the prevalence of condom use in the latest intercourse from 14% to 20% with non-foreign partners and from 10% to 38% with foreign partners, from 1987 to 1992. In a logistic regression model, low frequency of intercourse, high education, one lifetime partner, and late sexual debut were predictors for condom use. Controlled for these variables, the odds ratio (OR) for condom use in 1992 versus 1987 was 1.4 (95% confidence interval [CI]: 0.9-2.0) if the partner was non-foreign, and 7.1 (95% CI: 2.5-20.5) if the partner was foreign. Not using other contraceptive methods was a strong predictor for condom use; OR = 17.4 (95% CI: 8.0-38.0). Condom use in the first intercourse with the last partner was a strong predictor for condom use in the last intercourse; OR = 19.2 (95% CI: 8.2-45.3). It appeared unlikely that the increase in condom use could be explained by response bias. The predicted reductions in STD prevalence due to the increase in condom use ranged from zero to 30% depending on consistency of use, and on the agent that is transmitted. Condom use among 18-35 year old women has increased over the period, particularly with foreign partners. Condoms are used primarily as contraception. The prevalences of STD with high transmission rates are not reduced by inconsistent condom use, while the prevalences of STD with low transmission rates are reduced by both consistent and inconsistent condom use. Condom use in a core group is more effective for reducing the STD prevalence than condom use in the non-core group for gonorrhoea and HIV. For chlamydial infection, condom use in the non-core group is more effective.

Maori word‐processing for indigenous New Zealand young children

AbstractWe argue that there is an important and as yet unmet need for software that allows each cultural group to express the written word in an indigenous character set. As an example, we present a word‐processing system, Ta Kupu, designed for use in teaching the Maori language to children. The program simplifies the input task by taking advantage of the structural features of the Maori language. The system also includes a data logging, evaluation, and analysis tool, Tirohia, that permits teachers to evaluate a child's familiarity with the word‐processor. The main features of the evaluation software include: the ability to replay a record of a child's interaction in real time; facilities for summarising a child's consistency of use and level of performance; and the capability of examining interaction log files at a fine‐grained level. We also address the application of these data logging and evaluation techniques to the areas of human factors research, interface design and interface evaluation.

Consistency of use of phonological processes by a sample of educable mentally impaired children.

A group of 10 educable mentally impaired children (M age = 10 yr., 4 mo.) were assessed for use of phonological process under three speaking conditions: production of single words, imitated sentences, and connected speech samples. Only the process of gliding showed significant differences in use among conditions. Results generally indicated that any of those three speaking conditions were viable for eliciting use of phonological processes by such subjects. Results are also discussed in terms of individual differences.

Clustering and Consistency of Use of Medicines Among Mid-Aged Women

This paper describes the use of drugs among middle-aged Massachusetts women from 1982 to 1986. Data were obtained from follow-up interviews of women (n = 2565) who were premenopausal in a baseline survey of a representative sample of women with an age range of 45-55. In the first follow-up interview, 92% of women had used nonprescribed drugs ("current use"), but most only sporadically, while 47% had used prescribed drugs. The use of different types of drugs was concentrated in the same women, and women who had used prescribed drugs had also used nonprescribed drugs more often than the other women. In the first follow-up, women were classified as nonusers (includes sporadic nonprescribed drug use), nonprescribed medicine users, prescribed drug users, and mixed users; 43% of the women were in a different class three years later. Comparison of individual drug groups also showed changes in the user status between the two surveys. With the exception of poorer health, users of nonprescribed and prescribed drugs were similar to nonusers. Because use of drugs is common, further research on both its determinants and appropriateness is needed.

Premarital Sexual Guilt and Contraceptive Attitudes and Behavior

The relationship between premarital sexual guilt and contraceptive attitudes and behavior including reasons for nonuse of contraception were obtained for 335 sexually active single women ages 13-20 attending birth control centers in Ontario. Significant relationships were found between premarital sexual guilt and type of contraceptive method used at last intercourse and consistency of use of contraceptive methods. High guilt subjects were significantly more embarrassed about coming to the birth control clinic and having an internal examination than were low guilt subjects. Also high guilt subjects were more likely to believe that it was difficult to obtain birth control pills and were less likely to receive birth control information by reading on their own. Sexual guilt was also significantly related to 7 of 20 reasons for not using contraception. (Authors)

Social ecology of adult males in a confined troop of Japanese macaques ( Macaca fuscata)

Younger subjects among the 20 adult males in the Oregon troop of Japanese macaques ( Macaca fuscata) had more diverse patterns of use of resting areas. Rank was correlated with consistency of use of paths, as males of lower rank made ‘detours’ to avoid other animals. Males of higher rank used the most preferred and least abundant resting and movement areas and ate from the densest food patches. Old males and males of high rank were more site-attached to shelter areas. Site-attachment may decrease agonistic encounters, since low-ranking males routinely avoided areas most often used by the site-attached and high-ranking males. Alteration of site-attachment by manipulation of resource distribution may alter frequency of agonistic encounters.

ASA physical status classifications: a study of consistency of ratings.

The American Society of Anesthesiologists' (ASA) Physical Status Classification was tested for consistency of use by a questionnaire sent to 304 anesthesiologists. They were requested to classify ten hypothetical patients. Two hundred fifty-five (77.3 percent) responded to two mailings. The mean number of patients rated consistently was 5.9. Four patients elicited wide ranges of responses. Age, obesity, previous myocardial infarction, and anemia provoked controversy. There was no significant difference in responses from different regions of the country. Academic anesthesiologists rated a greater number identical than did those in private practice (P less than 0.01). There was no difference in ratings between those who used the classification for billing purposes and those who did not. The ASA Physical Status Classification is useful but suffers from a lack of scientific precision.

Consistency of use of the International Patent Classification

KO KNOWLEDGE ORGANIZATION , Seite 30 - 32

An interactive pseudo-assembler for introductory computer science

Since 1968 the University of Iowa Computer Science Department has used a locally developed E asy A ssembler SY stem (EASY) to accomplish a better comprehension of the concepts taught in the segment of the introductory computing course which dealt with internal structure and organization. In the fall of 1973 my attention focused on EASY (with all of its problems) as a likely candidate for a computerized-interactive-tutorial segment of this course. Since the consistency of use and precision in presentation were important aspects of teaching the concepts related to EASY, such an approach seemed natural.

An interactive pseudo-assembler for introductory computer science

Since 1968 the University of Iowa Computer Science Department has used a locally developed E asy A ssembler SY stem (EASY) to accomplish a better comprehension of the concepts taught in the segment of the introductory computing course which dealt with internal structure and organization. In the fall of 1973 my attention focused on EASY (with all of its problems) as a likely candidate for a computerized-interactive-tutorial segment of this course. Since the consistency of use and precision in presentation were important aspects of teaching the concepts related to EASY, such an approach seemed natural.

Self-management treatment of smoking behavior

Twenty nine habitual smokers were randomly assigned to one of three treatments: (1) self-management treatment (SMT), (2) self-monitoring plus social reinforcement (SMSR), and (3) no-treatment control (NT). An analysis of covariance of mean smoking frequency, with pre-treatment smoking frequency as the covariate, revealed that at treatment termination (7 weeks) SMT and SMSR means were significantly lower than the NT mean and there was no significant difference between the former 2 groups. At follow-up, 80 days after treatment termination, the no significant difference between these latter 2 groups. Further analyses indicated that both SMT and SMSR groups had significantly reduced means at both treatment termination and follow-up, relative to pretreatment. Further, neither SMT nor SMSR groups revealed significant relapses over the follow-up interim. Self-report data revealed significant relapses over the follow-up interim. Self-report data revealed a substantial (0.77) and significant partial correlation between consistency of use of SMT techniques and treatment gains. Results were interpreted as suggesting: (1) the efficacy of a “comprehensive” self-management treatment package and (2) the potential importance of extended treatment durations.