scholarly journals How do users of a ‘digital-only’ contraceptive service provide biometric measurements and what does this teach us about safe and effective online care? A qualitative interview study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037851
Author(s):  
Paula Baraitser ◽  
Hannah McCulloch ◽  
Alessandra Morelli ◽  
Caroline Free
Keyword(s):  
Oral Contraceptive ◽  
Service Use ◽  
Sampling Strategy ◽  
Accurate Information ◽  
Combined Oral Contraceptive ◽  
Contraceptive Service ◽  
Online Pharmacy ◽  
Qualitative Interview Study ◽  
Wide Range ◽  
Biometric Measurements

ObjectivesTo describe user experience of obtaining and uploading biometric measurements to a ‘digital-only’ contraceptive service prior to a prescription for the combined oral contraceptive (COC). To analyse this experience to inform the design of safe and acceptable ‘digital-only’ online contraceptive services.SettingAn online contraceptive service available free of charge to women in South East London, UK.ParticipantsTwenty participants who had ordered the combined oral contraceptive (COC) online. Our purposive sampling strategy ensured that we included participants from a wide range of ages and those who were and were not prescribed the COC.InterventionA ‘digital-only’ contraceptive service that prescribes the COCafter an online medical history and self-reported height, weight and blood pressure (BP) with pills prescribed by a GMC registered doctor, dispensed by an online pharmacy and posted to the user.DesignSemistructured interviews with a purposive sample of 20 participants who were already enrolled in a larger study of this service.AnalysisInductive, thematic analysis of the interviews assisted by NVivo qualitative analysis software.ResultsUsers valued the convenience of ‘digital-only care’ but experienced measuring BP but not height or weight as a significant barrier to service use. They actively engaged in work to understand and measure BP through a combination of recent/past measurements, borrowed machines, health service visits and online research. They negotiated tensions around maintaining a trusting relationship with the service, meeting its demands for accurate information while also obtaining the contraception that they needed.ConclusionDigital strategies to build trusting clinical relationships despite a lack of face-to-face contact are needed in ‘digital-only’ health services. This includes acknowledgement of work required, evidence of credible human support and a digital interface that communicates the health benefits of collaborating with an engaged clinical team.

Serum copper in rural women taking combined oral contraceptive

2007 ◽  
Vol 15 (1) ◽  
Author(s):  
S Akhter ◽  
AK Shamsuzzaman ◽  
M Banarjee ◽  
SA Seema ◽  
K Deb
Keyword(s):  
Oral Contraceptive ◽  
Rural Women ◽  
Serum Copper ◽  
Combined Oral Contraceptive

Efficacy and safety of drospirenone-containing microdosage combined oral contraceptive use with starting contraception

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 9-13
Author(s):  
A R Khachaturian ◽  
E V Misharina ◽  
M I Yarmolinskaya
Keyword(s):  
Blood Pressure ◽  
Body Weight ◽  
Oral Contraceptive ◽  
Waist Circumference ◽  
Young Women ◽  
Iron Metabolism ◽  
Serum Iron ◽  
The Body ◽  
Menstrual Bleeding ◽  
Combined Oral Contraceptive

Androgen-dependent dermopathy, as well as premenstrual syndrome of varying severity in young women, can cause emotional depression, difficulties in social adaptation and even depressive disorders. The aim of the study was to study the safety and efficacy of using a combined oral contraceptive (COC) Dimia® containing 20 μg ethinyl estradiol and 3 mg drospirenone in young women, as well as its therapeutic effects in androgen-dependent dermopathy. Materials and methods. The study included 57 young women aged 23.1±2.2 years with signs of androgen-dependent dermopathy. The evaluation of the change in the character of menstrual bleeding, the anthropometric parameters (body weight, waist circumference and hips), the therapeutic effect of the drug on the symptoms of androgen-dependent dermopathy, as well as the dynamics of arterial pressure, hemoglobin level, serum iron have been studied. The psycho-emotional state was assessed using the SAN questionnaire (well-being-activity-mood). Results. During 6 months of observation, there was no significant change in the body mass index, waist circumference, and hips, and the drug did not affect the blood pressure numbers. Against the background of taking the drug, there was an increase in the parameters of iron metabolism (hemoglobin content, serum iron). After 3 months of taking the contraceptive with drospirenone, the number of patients with a complaint about the abundance of menstruation decreased more than twofold (from 22.8 to 10.5%), and after 6 months of taking the drug no patient noted the profuse nature of menstruation. Before the start of taking COC with drospirenone, 57.9% of women reported painful menstrual bleeding. Against the background of taking the contraceptive within 3 months, this complaint was stopped in all patients. Sufficient efficacy of treatment of androgen dependent dermopathy in young women with the help of a microdosed drospirenone-containing combined oral contraceptive is estimated from the dermatological acne index. The analysis of the SAN questionnaire made it possible to reveal the improvement in the psychoemotional state of patients on the background of taking the drug. The conclusion. The results obtained proved the effectiveness and safety of the microclinized COC Dimia®. The drug has no significant effect on body weight, blood pressure, provides reliable control of the cycle and a decrease in menstrual bleeding, which results in stabilization of iron metabolism in the body. Dimia® is effective in the treatment of androgen-dependent dermopathy and can be recommended to young women for starting contraception.

Explanation Beyond Causation

2018 ◽  
Keyword(s):  
Philosophy Of Science ◽  
Case Studies ◽  
Philosophical Study ◽  
Accurate Information ◽  
Contemporary Philosophy ◽  
Causal Information ◽  
Causal Explanations ◽  
Turn On ◽  
Detailed Case ◽  
Wide Range

Explanations are very important to us in many contexts: in science, mathematics, philosophy, and also in everyday and juridical contexts. But what is an explanation? In the philosophical study of explanation, there is long-standing, influential tradition that links explanation intimately to causation: we often explain by providing accurate information about the causes of the phenomenon to be explained. Such causal accounts have been the received view of the nature of explanation, particularly in philosophy of science, since the 1980s. However, philosophers have recently begun to break with this causal tradition by shifting their focus to kinds of explanation that do not turn on causal information. The increasing recognition of the importance of such non-causal explanations in the sciences and elsewhere raises pressing questions for philosophers of explanation. What is the nature of non-causal explanations—and which theory best captures it? How do non-causal explanations relate to causal ones? How are non-causal explanations in the sciences related to those in mathematics and metaphysics? This volume of new essays explores answers to these and other questions at the heart of contemporary philosophy of explanation. The essays address these questions from a variety of perspectives, including general accounts of non-causal and causal explanations, as well as a wide range of detailed case studies of non-causal explanations from the sciences, mathematics and metaphysics.

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