Search results for: long-acting reversible contraceptives (LARC)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 223

Search results for: long-acting reversible contraceptives (LARC)

223 Factors Associated with the Use of Long-Acting Reversible Contraceptive Methods among Women of Reproductive Age 15-49 Years in Jinja District

Authors: Helen Nelly Naiga, Christopher Garimoi Orach

Abstract:

Introduction: Long-acting reversible contraceptive (LARC) methods are highly effective. However, LARC use in Uganda is low (13%). We assessed the factors associated with the use of long-acting reversible contraceptives among women of reproductive age (15-49 yrs) in Jinja District. Methods: We conducted a facility-based cross-sectional study. A total of 314 women aged 15–49 years attending public health facilities (1 hospital and 3 health center IV) in Jinja district, were randomly selected. A total of 6 key informants and 6 in-depth interviews were conducted. Logistic regression analysis was conducted using Stata version 14. Qualitative data were analysed using thematic analysis. Results: The study found that 40.45% of the respondents had ever used LARC. The commonest LARC method used was implanting (38.22%). The factors significantly associated with use of LARC were employment (AOR =2.91; 95% CI (1.05-8.08), access to LARC methods (AOR =4.48; 95% CI (1.24-16.21), husband support (AOR =4.90; 95% CI (1.56-15.41), and experience of no side effects (AOR =3.48; 95% CI (1.00-12.19). Conclusion and recommendations: The study showed that 4 in 10 women of reproductive age in Jinja District were using LARC. The factors associated with LARC use were employment, husband support, access to LARC methods, and the lack of side effects. There is a need to strengthen client education, improve accessibility to LARC methods at all levels of health centers, improve male partner’s decision-making in LARC use and manage the side effects effectively.

Keywords: family planning, implants, intrauterine device, long-acting reversible contraceptives (LARC)

Procedia PDF Downloads 206
222 The Views of Health Care Professionals outside of the General Practice Setting on the Provision of Oral Contraception in Comparison to Long-Acting Reversible Contraception

Authors: Carri Welsby, Jessie Gunson, Pen Roe

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Currently, there is limited research examining health care professionals (HCPs) views on long-acting reversible contraception (LARC) advice and prescription, particularly outside of the general practice (GP) setting. The aim of this study is to systematically review existing evidence around the barriers and enablers of oral contraception (OC) in comparison to LARC, as perceived by HCPs in non-GP settings. Five electronic databases were searched in April 2018 using terms related to LARC, OC, HCPs, and views, but not terms related to GPs. Studies were excluded if they concerned emergency oral contraception, male contraceptives, contraceptive use in conjunction with a health condition(s), developing countries, GPs and GP settings, were non-English or was not published before 2013. A total of six studies were included for systematic reviewing. Five key areas emerged, under which themes were categorised, including (1) understanding HCP attitudes and counselling practices towards contraceptive methods; (2) assessment of HCP attitudes and beliefs about contraceptive methods; (3) misconceptions and concerns towards contraceptive methods; and (4) influences on views, attitudes, and beliefs of contraceptive methods. Limited education and training of HCPs exists around LARC provision, particularly compared to OC. The most common misconception inhibiting HCPs contraceptive information delivery to women was the belief that LARC was inappropriate for nulliparous women. In turn, by not providing the correct information on a variety of contraceptive methods, HCP counselling practices were disempowering for women and restricted them from accessing reproductive justice. Educating HCPs to be able to provide accurate and factual information to women on all contraception is vital to encourage a woman-centered approach during contraceptive counselling and promote informed choices by women.

Keywords: advice, contraceptives, health care professionals, long acting reversible contraception, oral contraception, reproductive justice

Procedia PDF Downloads 127
221 Utilization of Long Acting Reversible Contraceptive Methods, and Associated Factors among Female College Students in Gondar Town, Northwest Ethiopia, 2018

Authors: Woledegebrieal Aregay

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Introduction: Family planning is defined as the ability of individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. It is part of a strategy to reduce poverty, maternal, infant and child mortality; empowers women by lightening the burden of excessive childbearing. Family planning is achieved through the use of different contraceptive methods among which the most effective method is modern family planning methods like Long-Acting Reversible Contraceptive (LARCs) which are IUCD and Implant and these methods have multiple advantages over other reversible methods. Most importantly, once in place, they do not require maintenance and their duration of action is long, ranging from 3 to10 years. Methods: An institutional-based cross-sectional study was conducted in Gondar town among female college students from April-May. A simple random sampling technique was employed to recruit a total of 1166 study subjects. Descriptive variables were computed for all predictors & dependent variables. The presence of an association between covariates & LARC use was observed by two tables’ findings using the chi-square test. Bivariate logistic regression was conducted to identify all possible factors affecting LARC utilization & its crude Odds Ratio, 95% Confidence Interval (CI) & P-value was observed. A multivariable logistic regression model was developed to control possible confounding variables. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) &P-values will be computed to identify significantly associated factors (P < 0.05) with LARC utilization. Result: Utilization of LARCs was 20.4%, the most common is Implant 86(96.5%), and followed by Intra-Uterine Contraceptive Device (IUCD) 3(3.5%). The result of the multivariate analysis revealed that the significant association of marital status of the respondent on utilization of LARC [AOR 3.965(2.051-7.665)], discussion of the respondent about LARC utilization with the husband/boyfriend [AOR 2.198(1.191-4.058)], and attitude of the respondent on implant was found to be associated [AOR 0.365(0.143-0.933)].Conclusion: The level of knowledge and attitude in this study was not satisfactory, the utilization of long-acting reversible contraceptives among college students was relatively satisfactory but if the knowledge and attitude of the participant has improved the prevalence of LARC were increased.

Keywords: utilization, long-acting reversible contraceptive, Ethiopia, Gondar

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220 Determinants of Long Acting Reversible Contraception Utilization among Women (15-49) in Uganda: Analysis of 2016 PMA2020 Uganda Survey

Authors: Nulu Nanono

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Background: The Ugandan national health policy and the national population policy all recognize the need to increase access to quality, affordable, acceptable and sustainable contraceptive services for all people but provision and utilization of quality services remains low. Two contraceptive methods are categorized as long-acting temporary methods: intrauterine contraceptive devices (IUCDs) and implants. Copper-containing IUCDs, generally available in Ministry of Health (MoH) family planning programs and is effective for at least 12 years while Implants, depending on the type, last for up to three to seven years. Uganda’s current policy and political environment are favorable towards achieving national access to quality and safe contraceptives for all people as evidenced by increasing government commitments and innovative family planning programs. Despite the increase of modern contraception use from 14% to 26%, long acting reversible contraceptive (LARC) utilization has relatively remained low with less than 5% using IUDs & Implants which in a way explains Uganda’s persistent high fertility rates. Main question/hypothesis: The purpose of the study was to examine relationship between the demographic, socio-economic characteristics of women, health facility factors and long acting reversible contraception utilization. Methodology: LARC utilization was investigated comprising of the two questions namely are you or your partner currently doing something or using any method to delay or avoid getting pregnant? And which method or methods are you using? Data for the study was sourced from the 2016 Uganda Performance Monitoring and Accountability 2020 Survey comprising of 3816 female respondents aged 15 to 49 years. The analysis was done using the Chi-squared tests and the probit regression at bivariate and multivariate levels respectively. The model was further tested for validity and normality of the residuals using the Sharipo wilks test and test for kurtosis and skewness. Results: The results showed the model the age, parity, marital status, region, knowledge of LARCs, availability of LARCs to be significantly associated with long acting contraceptive utilization with p value of less than 0.05. At the multivariate analysis level, women who had higher parities (0.000) tertiary education (0.013), no knowledge about LARCs (0.006) increases their probability of using LARCs. Furthermore while women age 45-49, those who live in the eastern region reduces their probability of using LARCs. Knowledge contribution: The findings of this study join the debate of prior research in this field and add to the body of knowledge related to long acting reversible contraception. An outstanding and queer finding from the study is the non-utilization of LARCs by women who are aware and have knowledge about them, this may be an opportunity for further research to investigate the attribution to this.

Keywords: contraception, long acting, utilization, women (15-49)

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219 Reducing Inequalities for the Uptake of Long-Term Reversible Contraceptive Methods through Special Family Planning Camps: A High Impact Service Delivery Model of Family Planning Practices

Authors: Ghulam Mustafa Halepota, Zaib Dahar

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Background: Low acceptance of FP services, particularly in hard to reach areas where geographic, economic, or social barriers limit-service uptake. Moreover, limited resources appeared to be a reflection of dismal contraceptive use in Pakistan. People’s Primary Health Care Initiative (PPHI) is a Public Private Partnership Program of Government of Sindh which aims to improve maternal child health through accessible family planning services in far flung areas. In 2015 PPHI launched special family planning camps to have achieved a rapid improvement in CPR. On quarterly basis, these camps focus on Long Acting Reversible Contraceptives (LARC). These camps are arranged at 250 BHU Plus (24/7 MCHCs). The Organization manages 1140 primary health care facilities all over Sindh province and focuses on maternal, newborn and child health which includes antenatal care, labor/delivery, postnatal care, family planning, immunization, nutrition, BEmONC, CEmONC, diagnostic laboratories, ambulance services. Under the FPRH program, the organization launched special family planning camps in far flung areas to achieve a rapid improvement in CPR-committed to FP 2020 goal. Objective: To assess the performance of special FP camps for the improvement of long acting reversible contraceptive in hard to reach areas. Methodology: Outreach camps are organized on quarterly basis in 250 BHUs and maternal and child health centers (available-24/7). Using observational study design, the study reports 2 years data of special FP camps conducted in 23 various districts of Sindh during April 2015-April 2017. These special camps served a range of modern contraceptive methods including IUCDs, implants, condoms, pills, and injections. Moreover, 125 male medical officers are trained across Sindh in LARC and 554 female have been trained in implants and IUCD insertions. MSI Impact calculator was used to determine health and demographic impact of services. Results: This intervention has brought exceptional results, and the response has been overwhelming in time. Total 2048 special camps during 2015 till April 2017 have been carried out. 231796 MWRAs visited camps 91% opted modern FP, of which 45% opted Implants, 6% selected IUCDs from LARC (long term reversible contraceptive) from short term, 17% opted injectable 18% choose pills, and 12% used condoms. This intervention created a high contraceptive impact in rural Sindh an estimated 125048 FP users have been created, of this 111846 LARC users and 13498 are SARC users, through this intervention an estimated 55774 unintended pregnancies, 36299 live births, 9394, 80 maternal deaths, 926 and 6077 unsafe abortion have been averted. Moreover, the intervention created an economic impact and saved 2,409,563 direct health expenditure on each woman with reproductive age. Conclusion: Special FP Camps along with routine services is an effective and acceptable model for increase in provision of long-acting and permanent methods in hard to reach areas. This innovative approach by PHHI-Sindh has also been adopted in other provinces of Pakistan.

Keywords: inequalities, special camps, family planning services, hard to reach areas

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218 Culture and Religion Informed Perspectives on the Use of Contraceptives among Married Women in Contemporary South Africa

Authors: Malesa Kgashane Johannes

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The ineffective use of contraceptives among married couples has always been a challenge. This article discusses the culture-religious normative barriers that infringe on married women’s rights, justice, and dignity. The study was qualitative in nature and focused on understanding how religion and culture contribute to women’s ineffective use of contraceptives within marriage. Exploratory, descriptive, and contextual designs were applied. Twenty-eight (28) participants were interviewed, and the data was analysed through Tesch’s steps of qualitative analysis. The findings of the study highlighted the role played by religion and culture as barriers to women’s effective use of contraceptives within marriage.

Keywords: women, contraceptives, religion, culture, marriage

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217 Modern Contraceptives versus Traditional Contraceptives and Abortion: An Ethnography of Fertiliy Control Practices in Burkina Faso

Authors: Seydou Drabo

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This paper examines how traditional contraceptives and abortion practices challenges the use of modern contraceptives in Burkina Faso. It demonstrates how fears and ‘superstitions’ interact with knowledge about modern contraceptives methods to determine use in a context where other way of controlling fertility (traditional contraceptives, abortion) are available to women in the public, private and traditional health sectors. Furthermore, these issues come at the time when Burkina Faso is among countries with a high fertility rate which (6.0 in 2010) and a very low used of contraceptives as only 16% of married women of childbearing age were using a contraceptive method in 2010. The country also has a young population since 33 % of the population is between 10-24 years old and this number is expected to increase by 2050, generating fears that a growing population of youth will put excessive pressure on available resources, including access to education, health services, and employment. Despite over two decades of dedicated policy attention, 24% of women of reproductive age (15-49) was estimated to have an unmet need for contraception in 2010. This paper draws on ethnographic fieldwork conducted since march 2016 (The research is still in progress) in Burkina Faso. Data were collected from 25 women (users and non-users of modern contraceptives and /or traditional contraceptives, post abortion care patients), 4 street drugs vendors and 3 traditional healers through formal and informal interviews, as well as direct observation. The findings show that a variety of contraceptives methods and abortion drugs or methods, both traditional and modern circulate and are available to women. Traditional contraceptives called African contraceptives by some of our participants refer to several birth control method including plants decoction, magical ring, waist necklace, a ritual done with a mixture of lay coming from termite mound and menses. Abortion is a practice that is done in secret through the use of abortion drugs or through intra uterine manoeuvres. Modern contraceptives include Oral contraceptive, implants, injectable. Stereotypes about modern contraceptives, having regular menstrual cycles and adopt of natural birth control methods, bad experience with modern contraceptives methods, the side effect of modern contraceptives, irregularity of sexual activities and the availability of emergency contraceptives are among factors that limit their use among women. In addition, a negative perception is built around modern contraceptives seen as the drug of ‘white people’. In general, the information on these drugs circulates in women’s social network (first line of information on contraceptive). Some women prefer using what they call African contraceptives or inducing an abortion over modern contraceptives because of their side effect. Furthermore, the findings show that women practices and attitudes in controlling birth varies throughout different phases of their lives. Beyond global discourses and technical solution, the issue of Family planning is all about social practices.

Keywords: abortion, Burkina Faso, contraception, culture, women

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216 Low-Cost Reversible Logic Serial Multipliers with Error Detection Capability

Authors: Mojtaba Valinataj

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Nowadays reversible logic has received many attentions as one of the new fields for reducing the power consumption. On the other hand, the processing systems have weaknesses against different external effects. In this paper, some error detecting reversible logic serial multipliers are proposed by incorporating the parity-preserving gates. This way, the new designs are presented for signed parity-preserving serial multipliers based on the Booth's algorithm by exploiting the new arrangements of existing gates. The experimental results show that the proposed 4×4 multipliers in this paper reach up to 20%, 35%, and 41% enhancements in the number of constant inputs, quantum cost, and gate count, respectively, as the reversible logic criteria, compared to previous designs. Furthermore, all the proposed designs have been generalized for n×n multipliers with general formulations to estimate the main reversible logic criteria as the functions of the multiplier size.

Keywords: Booth’s algorithm, error detection, multiplication, parity-preserving gates, quantum computers, reversible logic

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215 High Capacity Reversible Watermarking through Interpolated Error Shifting

Authors: Hae-Yeoun Lee

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Reversible watermarking that not only protects the copyright but also preserve the original quality of the digital content have been intensively studied. In particular, the demand for reversible watermarking has increased. In this paper, we propose a reversible watermarking scheme based on interpolation-error shifting and error precompensation. The intensity of a pixel is interpolated from the intensities of neighbouring pixels, and the difference histogram between the interpolated and the original intensities is obtained and modified to embed the watermark message. By restoring the difference histogram, the embedded watermark is extracted and the original image is recovered by compensating for the interpolation error. The overflow and underflow are prevented by error precompensation. To show the performance of the method, the proposed algorithm is compared with other methods using various test images.

Keywords: reversible watermarking, high capacity, high quality, interpolated error shifting, error precompensation

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214 Religious Beliefs and Their Effects on the Use of Contraceptives in Female College Students

Authors: Amy Kless, Peter Reuter

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The purpose of this study was to explore the association between the teachings of religious doctrine on the use of contraceptives and its influence on the behavior of female college students. The religious doctrine of both Christian and non-Christian religions states that sexual intercourse shall only take place between people that are married. Additionally, the teachings of most Christian and non-Christian religions prohibit the use of contraceptives during sexual intercourse. Being away from home for the first time, students that grew up in religious households may stop attending church services or stop practicing religion entirety. The college years are also a time for sexual exploration. The desire for sexual exploration leaves many students, both religious and non-religious, with having to choose between abstaining from sexual intercourse or using a form of contraceptive to prevent pregnancy. Of 1,130 female students anonymously surveyed at a southern university between Spring 2016 and Fall 2020, 50% reported having religious beliefs. Less than 50% of the students who reported having religious beliefs attend church services on a regular basis. Nearly 75% of the same students reported having participated in sexual intercourse with close to 60% utilizing some form of contraceptive to prevent pregnancy. The data suggest that female college students do not follow religious teachings on abstinence from premarital sex or the ban on the use of contraceptives.

Keywords: contraceptives, females, intercourse, religion

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213 Factors Associated with Contraceptive Use and Nonuse, among Currently Married Young (15-24 Years) Women in Nepal

Authors: Bishnu Prasad Dulal, Sushil Chandra Baral, Radheshyam Bhattarai, Meera Tandan

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Background: Non-use of contraceptives is a leading cause of unintended pregnancy. This study was done to explore the potential predictors of contraceptive used by young women, and the findings can inform policy makers to design the program to reduce unintended pregnancy for younger women who have a longer time of fecundity. Methodology: A nationally representative cross-sectional household survey was conducted by Health Research and Social Development Forum in 2012. Total 2259 currently married young women (15-24 years) were selected for the analysis out of 8578 women of reproductive age interviewed from the total 10260 households using systematic sampling. Binary logistic regression was used to identify factors associated with the use of modern contraceptive methods. Findings: The prevalence of modern contraceptive methods among young women was 25.2 %. Use of contraceptives was significantly associated with age at first marriage <15 year of age (OR:1.95) and ever delivered (OR: 1.8). Muslim women were significantly less likely to use contraceptives. Development region, wealth quintile, and awareness of abortion site were also statistically associated factors to use of contraceptives. Conclusion: The prevalence of contraceptives uses among young married women (25.2%) was lower than national prevalence (43%) of contraceptives use among married women of reproductive age. Our analysis focused on examining the association between women’s characteristics-related factors and use and nonuse of modern contraceptives. Awareness of safe abortion site is significantly associated while level of education was not. It is an interesting finding but difficult to interpret which needs further analysis on the basis of education. Maybe due to the underlying socio-religious practice of Muslim people, they had lower use of contraceptives. Programmers and policy makers could better help young women by increasing intervention activities to have a regular use of contraceptive-covering poor, Dalit and Muslim, and low aged women in order to reduce unintended pregnancy.

Keywords: unintended pregnancy, contraceptive, young women, Nepal

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212 New Segmentation of Piecewise Moving-Average Model by Using Reversible Jump MCMC Algorithm

Authors: Suparman

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This paper addresses the problem of the signal segmentation within a Bayesian framework by using reversible jump MCMC algorithm. The signal is modelled by piecewise constant Moving-Average (MA) model where the numbers of segments, the position of change-point, the order and the coefficient of the MA model for each segment are unknown. The reversible jump MCMC algorithm is then used to generate samples distributed according to the joint posterior distribution of the unknown parameters. These samples allow calculating some interesting features of the posterior distribution. The performance of the methodology is illustrated via several simulation results.

Keywords: piecewise, moving-average model, reversible jump MCMC, signal segmentation

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211 The Influence of Age and Education on Patients' Attitudes Towards Contraceptives in Rural California

Authors: Shivani Thakur, Jasmin Dominguez Cervantes, Ahmed Zabiba, Fatima Zabiba, Sandhini Agarwal, Kamalpreet Kaur, Hussein Maatouk, Shae Chand, Omar Madriz, Tiffany Huang, Saloni Bansal

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Contraceptives are an effective public health achievement, allowing for family planning and reducing the risk of sexually transmitted diseases (STDs). California’s rural Central Valley has high rates of teenage pregnancy and STDs. Factors affecting contraceptive usage here may include religious concerns, financial issues, and regional variations in the accessibility and availability of contraceptives. The increasing population and diversity of the Central Valley make the understanding of the determinants of unintended pregnancy and STDs increasingly nuanced. Patients in California’s Central Valley were surveyed at 6 surgical clinics to assess attitudes toward contraceptives. The questionnaire consisted of demographics and 14 Likert-scale statements investigating patients’ feelings regarding contraceptives. Parametric and non-parametric analysis was performed on the Likert statements. A correlation matrix for the Likert-scale statements was used to evaluate the strength of the relationship between each question. 76 patients aged 18-75 years completed the questionnaire. 90% of the participants were female, 76% Hispanic, 36% married, 44% with an income range between 30-60K, and 83% were between childbearing ages. 60% of participants stated they are currently using or had used some type of contraceptive. 25% of participants had at least one unplanned pregnancy. The most common type of contraceptives used were oral contraceptives(28%) and condoms(38%). The top reasons for patients’ contraceptive usage were: prevention of pregnancy (72%), safe sex/prevention of STDs (32%), and regulation of menstrual cycle (19%). Further analysis of Likert responses revealed that contraception usage increased due to approval of contraceptives (x̄=3.98, σ =1.02); partner approval of contraceptives (x̄=3.875, σ =1.16); and reduced anxiety about pregnancy (x̄=3.875, σ =1.23). Younger females (18-34 years old) agreed more with the statement that the cost of contraceptive supplies is too expensive than older females (35-75 years old), (x̄=3.2, σ = 1.4 vs x̄=2.8, σ =1.3, p<0.05). Younger females (44%) were also more likely to use short-acting contraceptive methods (oral and male condoms) compared to older females (64%) who use long-acting methods (implants/ intrauterine devices). 51% of Hispanic females were using some type of contraceptive. Of those Hispanic females who do not use contraceptives, 33% stated having no children, and all plan to have at least one child in the future. 35% of participants had a bachelor's degree. Those with bachelor’s degrees were more likely to use contraceptives, 58% vs 51%, p<0.05, and less likely to have unplanned pregnancy, 50% vs. 12%, p<0.01. There is increasing use and awareness among patients in rural settings concerning contraceptives. Our finding shows that younger women and women with higher educational attainment tend to have more positive attitudes towards the use of contraceptives. This work gives physicians an understanding of patients’ concerns about contraceptive methods and offers insight into culturally competent intervention programs that respect individual values.

Keywords: contraceptives, public health, rural california, women of child baring age

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210 Fault Tolerant and Testable Designs of Reversible Sequential Building Blocks

Authors: Vishal Pareek, Shubham Gupta, Sushil Chandra Jain

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With increasing high-speed computation demand the power consumption, heat dissipation and chip size issues are posing challenges for logic design with conventional technologies. Recovery of bit loss and bit errors is other issues that require reversibility and fault tolerance in the computation. The reversible computing is emerging as an alternative to conventional technologies to overcome the above problems and helpful in a diverse area such as low-power design, nanotechnology, quantum computing. Bit loss issue can be solved through unique input-output mapping which require reversibility and bit error issue require the capability of fault tolerance in design. In order to incorporate reversibility a number of combinational reversible logic based circuits have been developed. However, very few sequential reversible circuits have been reported in the literature. To make the circuit fault tolerant, a number of fault model and test approaches have been proposed for reversible logic. In this paper, we have attempted to incorporate fault tolerance in sequential reversible building blocks such as D flip-flop, T flip-flop, JK flip-flop, R-S flip-flop, Master-Slave D flip-flop, and double edge triggered D flip-flop by making them parity preserving. The importance of this proposed work lies in the fact that it provides the design of reversible sequential circuits completely testable for any stuck-at fault and single bit fault. In our opinion our design of reversible building blocks is superior to existing designs in term of quantum cost, hardware complexity, constant input, garbage output, number of gates and design of online testable D flip-flop have been proposed for the first time. We hope our work can be extended for building complex reversible sequential circuits.

Keywords: parity preserving gate, quantum computing, fault tolerance, flip-flop, sequential reversible logic

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209 Rapid Sexual and Reproductive Health Pathways for Women Accessing Drug and Alcohol Treatment

Authors: Molly Parker

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Unintended pregnancy rates in Australia are amongst the highest in the developed world. Women with Substance Use Disorder often have riskier sexual behavior with nil contraceptive use and face disproportionately higher unintended pregnancies and Sexually Transmitted Infections, alongside Substance Use in Pregnancy (SUP) climbing at an alarming rate. In an inner-city Drug and Alcohol (D&A) service, significant barriers to sexual and reproductive health services have been identified, aligning with research. Rapid pathways were created for women seeking D&A treatment to be referred to Sexual and Reproductive Health services for the administration of Long-acting reversible contraception (LARC) and sexual health screening. For clients attending a D&A service, this is an opportunistic time to offer sexual and reproductive health services. Collaboration and multidisciplinary team input between D&A and sexual health and reproductive services are paramount, with rapid referral pathways being identified as the main strategy to improve access to sexual and reproductive health support for this population. With this evidence, a rapid referral pathway was created for women using the D&A service to access LARC, particularly in view of fertility often returning once stable on D&A treatment. A closed-ended survey was used for D&A staff to identify gaps in reproductive health knowledge and views of referral accessibility. Results demonstrated a lack of knowledge of contraception and appropriate referral processes. A closed-ended survey for clients was created to establish the need and access to services and to quantify data. A follow-up data collection will be reviewed to access uptake and satisfaction of the intervention from clients. Sexual health screening access was also identified as a deficit, particularly concerning due to the higher rates of STIs in this cohort. A rapid referral pathway will be undergoing implementation, reducing risks of untreated STIS both pre and post-conception. Similarly, pre and post-intervention structured surveys will be used to identify client satisfaction from the pathway. Although currently in progress, the research and pathway aim to be completed by December 2023. This research and implementation of sexual and reproductive health pathways from the D&A service have significant health and well-being benefits to clients and the wider community, including possible fetal/infancy outcomes. Women now have rapid access to sexual and reproductive health services, with the aim of reducing unplanned pregnancies, poor outcomes associated with SUP, client/staff trauma from termination of pregnancy, and client/staff trauma following the assumption of care of the child due to substance use, the financial cost for out of home care as required, the poor outcomes of untreated STIs to the fetus in pregnancy and the spread of STIs in the wider community. As evidence suggests, the implementation of a streamlined referral process is required between D&A and sexual and reproductive health services and has positive feedback from both clinicians and clients in improving care.

Keywords: substance use in pregnancy, drug and alcohol, substance use disorder, sexual health, reproductive health, contraception, long-acting reversible contraception, neonatal abstinence syndrome, FASD, sexually transmitted infections, sexually transmitted infections pregnancy

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208 Design and Implementation of Testable Reversible Sequential Circuits Optimized Power

Authors: B. Manikandan, A. Vijayaprabhu

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The conservative reversible gates are used to designed reversible sequential circuits. The sequential circuits are flip-flops and latches. The conservative logic gates are Feynman, Toffoli, and Fredkin. The design of two vectors testable sequential circuits based on conservative logic gates. All sequential circuit based on conservative logic gates can be tested for classical unidirectional stuck-at faults using only two test vectors. The two test vectors are all 1s, and all 0s. The designs of two vectors testable latches, master-slave flip-flops and double edge triggered (DET) flip-flops are presented. We also showed the application of the proposed approach toward 100% fault coverage for single missing/additional cell defect in the quantum- dot cellular automata (QCA) layout of the Fredkin gate. The conservative logic gates are in terms of complexity, speed, and area.

Keywords: DET, QCA, reversible logic gates, POS, SOP, latches, flip flops

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207 Design of Parity-Preserving Reversible Logic Signed Array Multipliers

Authors: Mojtaba Valinataj

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Reversible logic as a new favorable design domain can be used for various fields especially creating quantum computers because of its speed and intangible power consumption. However, its susceptibility to a variety of environmental effects may lead to yield the incorrect results. In this paper, because of the importance of multiplication operation in various computing systems, some novel reversible logic array multipliers are proposed with error detection capability by incorporating the parity-preserving gates. The new designs are presented for two main parts of array multipliers, partial product generation and multi-operand addition, by exploiting the new arrangements of existing gates, which results in two signed parity-preserving array multipliers. The experimental results reveal that the best proposed 4×4 multiplier in this paper reaches 12%, 24%, and 26% enhancements in the number of constant inputs, number of required gates, and quantum cost, respectively, compared to previous design. Moreover, the best proposed design is generalized for n×n multipliers with general formulations to estimate the main reversible logic criteria as the functions of the multiplier size.

Keywords: array multipliers, Baugh-Wooley method, error detection, parity-preserving gates, quantum computers, reversible logic

Procedia PDF Downloads 224
206 New Segmentation of Piecewise Linear Regression Models Using Reversible Jump MCMC Algorithm

Authors: Suparman

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Piecewise linear regression models are very flexible models for modeling the data. If the piecewise linear regression models are matched against the data, then the parameters are generally not known. This paper studies the problem of parameter estimation of piecewise linear regression models. The method used to estimate the parameters of picewise linear regression models is Bayesian method. But the Bayes estimator can not be found analytically. To overcome these problems, the reversible jump MCMC algorithm is proposed. Reversible jump MCMC algorithm generates the Markov chain converges to the limit distribution of the posterior distribution of the parameters of picewise linear regression models. The resulting Markov chain is used to calculate the Bayes estimator for the parameters of picewise linear regression models.

Keywords: regression, piecewise, Bayesian, reversible Jump MCMC

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205 Energy-Dense and High-Power Li-Cl₂/I₂ Batteries by Reversible Chemical Bonds

Authors: Pei Li, Chunyi Zhi

Abstract:

Conversion-type lithium-ion batteries show great potential as high-energy-density, low-cost and sustainable alternatives to current transition-metal-based intercalation cells. Li-Cl₂/Li⁻I₂ conversion batteries, based on anionic redox reactions of Cl⁻/Cl⁰ or I⁻/I⁰, are highly attractive due to their superior voltage and capacity. However, a redox-active and reversible chlorine cathode has not been developed in organic electrolytes. And thermodynamic instability and shuttling issues of iodine cathodes have plagued the active iodine loading, capacity retention and cyclability. By reversible chemical bonds, we develop reversible chlorine redox reactions in organic electrolytes with interhalogen bonds between I and Cl for Li-I₂ batteries and develop a highly thermally stable I/I₃--bonded organic salts with iodine content up to 80% as cathode materials for the rechargeable Li-I₂ batteries. The demonstration of reversible chemical bonds enabled rechargeable Li-halogen batteries opens a new avenue to develop halogen compound cathodes.

Keywords: conversion-type, chlorine, halogen cathode, high energy density, iodine, interhalogen bond, lithium-ion batteries

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204 Knowledge, Attitude and Practices of Contraception among the Married Women of Reproductive Age Group in Selected Wards of Dharan Sub-Metropolitan City

Authors: Pratima Thapa

Abstract:

Background: It is very critical to understand that awareness of family planning and proper utilization of contraceptives is an important indicator for reducing maternal and neonatal mortality and morbidity. It also plays an important role in promoting reproductive health of the women in an underdeveloped country like ours. Objective: To assess knowledge, attitude and practices of contraception among married women of reproductive age group in selected wards of Dharan Sub-Metropolitan City. Materials and methods: A cross-sectional descriptive study was conducted among 209 married women of reproductive age. Simple random sampling was used to select the wards, population proportionate sampling for selecting the sample numbers from each wards and purposive sampling for selecting each sample. Semi-structured questionnaire was used to collect data. Descriptive and inferential statistics were used to interpret the data considering p-value 0.05. Results: The mean ± SD age of the respondents was 30.01 ± 8.12 years. Majority 92.3% had ever heard of contraception. Popular known method was Inj. Depo (92.7%). Mass media (85.8%) was the major source of information. Mean percentage score of knowledge was 45.23%.less than half (45%) had adequate knowledge. Majority 90.4% had positive attitude. Only 64.6% were using contraceptives currently. Misbeliefs and fear of side effects were the main reason for not using contraceptives. Education, occupation, and total income of the family was associated with knowledge regarding contraceptives. Results for Binary Logistic Regression showed significant correlates of attitude with distance to the nearest health facility (OR=7.97, p<0.01), education (OR=0.24, p<0.05) and age group (0.03, p<0.01). Regarding practice, likelihood of being current user of contraceptives increased significantly by being literate (OR=5.97, p<0.01), having nuclear family (OR=4.96, p<0.01), living in less than 30 minute walk distance from nearest health facility (OR=3.34, p<0.05), women’s participation in decision making regarding household and fertility choices (OR=5.23, p<0.01) and husband’s support on using contraceptives (OR=9.05, p<0.01). Significant and positive correlation between knowledge-attitude, knowledge-practice and attitude-practice were observed. Conclusion: Results of the study indicates that there is need to increase awareness programs in order to intensify the knowledge and practices of contraception. The positive correlation indorses that better knowledge can lead to positive attitude and hence good practice. Further, projects aiming to increase better counselling about contraceptives, its side effects and the positive effects that outweighs the negative aspects should be enrolled appropriately.

Keywords: attitude, contraceptives, knowledge, practice

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203 Segmentation of Piecewise Polynomial Regression Model by Using Reversible Jump MCMC Algorithm

Authors: Suparman

Abstract:

Piecewise polynomial regression model is very flexible model for modeling the data. If the piecewise polynomial regression model is matched against the data, its parameters are not generally known. This paper studies the parameter estimation problem of piecewise polynomial regression model. The method which is used to estimate the parameters of the piecewise polynomial regression model is Bayesian method. Unfortunately, the Bayes estimator cannot be found analytically. Reversible jump MCMC algorithm is proposed to solve this problem. Reversible jump MCMC algorithm generates the Markov chain that converges to the limit distribution of the posterior distribution of piecewise polynomial regression model parameter. The resulting Markov chain is used to calculate the Bayes estimator for the parameters of piecewise polynomial regression model.

Keywords: piecewise regression, bayesian, reversible jump MCMC, segmentation

Procedia PDF Downloads 338
202 Effects of Reversible Watermarking on Iris Recognition Performance

Authors: Andrew Lock, Alastair Allen

Abstract:

Fragile watermarking has been proposed as a means of adding additional security or functionality to biometric systems, particularly for authentication and tamper detection. In this paper we describe an experimental study on the effect of watermarking iris images with a particular class of fragile algorithm, reversible algorithms, and the ability to correctly perform iris recognition. We investigate two scenarios, matching watermarked images to unmodified images, and matching watermarked images to watermarked images. We show that different watermarking schemes give very different results for a given capacity, highlighting the importance of investigation. At high embedding rates most algorithms cause significant reduction in recognition performance. However, in many cases, for low embedding rates, recognition accuracy is improved by the watermarking process.

Keywords: biometrics, iris recognition, reversible watermarking, vision engineering

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201 The Pharmacology and Physiology of Steroid Oral Contraceptives

Authors: Ragy Raafat Gaber Attaalla

Abstract:

PIP: This review, based on 2 large-scale studies, discusses the pharmacology and physiology of oral steroid contraceptives (OCs). The pharmacological distinction between synthetic and naturally occurring steroids centers on changes in biological activity dependent on compound formulation and an individual's metabolism. OC mechanism of action is explained as the main prevention of ovulation by interference with gonadotropin-releasing hormone. Since some 52 metabolic alterations have been reported in OC users, these phenomena are dealt with in 3 categories: 1) effects on the primary target organs of the female reproductive tract (ovary, myometrium, endometrium, cervix, vagina, breasts, and hypothalamus), 2) general metabolic effects (serum proteins, carbohydrate metabolism, lipid metabolism, water and electrolyte metabolism, body weight, tryptophan metabolism, and vitamins and minerals), and 3) effects on other organ systems (liver, central nervous system, skin, genitourinary, gastrointestinal tract, eye, immune phenomena, and effect on subsequent fertility). The choice of the proper OC formulation and use of OCs by adolescents are discussed. Assessment of OC safety, contraindications, and patient monitoring are provided.

Keywords: steroid oral contraceptives, ovulation, female reproductive tract, metabolic effects

Procedia PDF Downloads 70
200 Factors Affecting the Uptake of Modern Contraception Services in Oyo State, Nigeria

Authors: Folajinmi Oluwasina, Magbagbeola Dairo, Ikeoluwapo Ajayi

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Contraception has proven to be an effective way of controlling fertility and spacing births. Studies have shown that contraception can avert the high-risk pregnancies and consequently reduce maternal deaths up to 32%. Uptake of modern contraception is promoted as a mechanism to address the reproductive health needs of men and women, as well as the crucial challenge of rapid population increase. A cross- sectional descriptive study using a two- stage systematic sampling technique was used to select 530 women of reproductive age out of 20,000 households. Respondents were interviewed using a semi-structured questionnaire. Knowledge was assessed on a 5 point score in which a score of ≤ 2 rated poor while perception was scored on 36 points score in which a score of ≤ 18 was rated low. Data were analyzed using descriptive statistics, Chi-square test and logistic regression at p< 0.05. There were 530 respondents. Age of respondents was 30.3 ±7.8 years, and 73.0% were married. About 90% had good knowledge of contraception while 60.8% had used contraceptives. The commonest source of information about contraception was mass media (72.8%). Minority (26.1%) obtained husbands approval before using contraceptive while 20.0% had used modern contraceptives before the first birth. Many (54.5%) of the respondents agreed that contraception helps in improving standard of living and 64.7% had good perception about contraception. Factors that hindered effective uptake of contraception services included poor service provider’s attitude (33.3%) and congestion at the service centers (4.5%). Respondents with nonuse of contraceptive before first birth are less likely to subsequently use contraceptives (OR= 0.324, 95% CI= 0.1-0.5). Husband approval of contraceptives use was the major determinant of women’s contraceptive use (OR = 3.4, 95% CI = 1.3-8.7). Respondents who had family planning centers not more than 5 kilometers walking distance to their residence did not significantly use contraception services (41.5%) more than 21.1% of those who had to take means of transportation to the service venues. This study showed that majority of the respondents were knowledgeable and aware of contraception services, but husband’s agreement on the use of modern contraceptives remains poor. Programmes that enhances husbands approval of modern contraception is thus recommended.

Keywords: contraception services, service provider’s attitude, uptake, husbands approval

Procedia PDF Downloads 336
199 Reversible and Adaptive Watermarking for MRI Medical Images

Authors: Nisar Ahmed Memon

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A new medical image watermarking scheme delivering high embedding capacity is presented in this paper. Integer Wavelet Transform (IWT), Companding technique and adaptive thresholding are used in this scheme. The proposed scheme implants, recovers the hidden information and restores the input image to its pristine state at the receiving end. Magnetic Resonance Imaging (MRI) images are used for experimental purposes. The scheme first segment the MRI medical image into non-overlapping blocks and then inserts watermark into wavelet coefficients having a high frequency of each block. The scheme uses block-based watermarking adopting iterative optimization of threshold for companding in order to avoid the histogram pre and post processing. Results show that proposed scheme performs better than other reversible medical image watermarking schemes available in literature for MRI medical images.

Keywords: adaptive thresholding, companding technique, data authentication, reversible watermarking

Procedia PDF Downloads 268
198 Rapid Situation Assessment of Family Planning in Pakistan: Exploring Barriers and Realizing Opportunities

Authors: Waqas Abrar

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Background: Pakistan is confronted with a formidable challenge to increase uptake of modern contraceptive methods. USAID, through its flagship Maternal and Child Survival Program (MCSP), in Pakistan is determined to support provincial Departments of Health and Population Welfare to increase the country's contraceptive prevalence rates (CPR) in Sindh, Punjab and Balochistan to achieve FP2020 goals. To inform program design and planning, a Rapid Situation Assessment (RSA) of family planning was carried out in Rawalpindi and Lahore districts in Punjab and Karachi district in Sindh. Methodology: The methodology consisted of comprehensive desk review of available literature and used a qualitative approach comprising of in-depth interviews (IDIs) and focus group discussions (FGDs). FGDs were conducted with community women, men, and mothers-in-law whereas IDIs were conducted with health facility in-charges/chiefs, healthcare providers, and community health workers. Results: Some of the oft-quoted reasons captured during desk review included poor quality of care at public sector facilities, affordability and accessibility in rural communities and providers' technical incompetence. Moreover, providers had inadequate knowledge of contraceptive methods and lacked counseling techniques; thereby, leading to dissatisfied clients and hence, discontinuation of contraceptive methods. These dissatisfied clients spread the myths and misconceptions about contraceptives in their respective communities which seriously damages community-level family planning efforts. Private providers were found reluctant to insert Intrauterine Contraceptive Devices (IUCDs) due to inadequate knowledge vis-à-vis post insertion issues/side effects. FGDs and IDIs unveiled multi-faceted reasons for poor contraceptives uptake. It was found that low education and socio-economic levels lead to low contraceptives uptake and mostly uneducated women rely on condoms provided by Lady Health Workers (LHWs). Providers had little or no knowledge about postpartum family planning or lactational amenorrhea. At community level family planning counseling sessions organized by LHWs and Male Mobilizers do not sensitize community men on permissibility of contraception in Islam. Many women attributed their physical ailments to the use of contraceptives. Lack of in-service training, job-aids and Information, Education and Communications (IEC) materials at facilities seriously comprise the quality of care in effective family planning service delivery. This is further compounded by frequent stock-outs of contraceptives at public healthcare facilities, poor data quality, false reporting, lack of data verification systems and follow-up. Conclusions: Some key conclusions from this assessment included capacity building of healthcare providers on long acting reversible contraceptives (LARCs) which give women contraception for a longer period. Secondly, capacity building of healthcare providers on postpartum family planning is an enormous challenge that can be best addressed through institutionalization. Thirdly, Providers should be equipped with counseling skills and techniques including inculcation of pros and cons of all contraceptive methods. Fourthly, printed materials such as job-aids and Information, Education and Communications (IEC) materials should be disseminated among healthcare providers and clients. These concluding statements helped MCSP to make informed decisions with regard to setting broad objectives of project and were duly approved by USAID.

Keywords: capacity building, contraceptive prevalence rate, family planning, Institutionalization, Pakistan, postpartum care, postpartum family planning services

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197 Difference Expansion Based Reversible Data Hiding Scheme Using Edge Directions

Authors: Toshanlal Meenpal, Ankita Meenpal

Abstract:

A very important technique in reversible data hiding field is Difference expansion. Secret message as well as the cover image may be completely recovered without any distortion after data extraction process due to reversibility feature. In general, in any difference expansion scheme embedding is performed by integer transform in the difference image acquired by grouping two neighboring pixel values. This paper proposes an improved reversible difference expansion embedding scheme. We mainly consider edge direction for embedding by modifying the difference of two neighboring pixels values. In general, the larger difference tends to bring a degraded stego image quality than the smaller difference. Image quality in the range of 0.5 to 3.7 dB in average is achieved by the proposed scheme, which is shown through the experimental results. However payload wise it achieves almost similar capacity in comparisons with previous method.

Keywords: information hiding, wedge direction, difference expansion, integer transform

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196 Exploiting JPEG2000 into Reversible Information

Authors: Te-Jen Chang, I-Hui Pan, Kuang-Hsiung Tan, Shan-Jen Cheng, Chien-Wu Lan, Chih-Chan Hu

Abstract:

With the event of multimedia age in order to protect data not to be tampered, damaged, and faked, information hiding technologies are proposed. Information hiding means important secret information is hidden into cover multimedia and then camouflaged media is produced. This camouflaged media has the characteristic of natural protection. Under the undoubted situation, important secret information is transmitted out.Reversible information hiding technologies for high capacity is proposed in this paper. The gray images are as cover media in this technology. We compress gray images and compare with the original image to produce the estimated differences. By using the estimated differences, expression information hiding is used, and higher information capacity can be achieved. According to experimental results, the proposed technology can be approved. For these experiments, the whole capacity of information payload and image quality can be satisfied.

Keywords: cover media, camouflaged media, reversible information hiding, gray image

Procedia PDF Downloads 298
195 New Estimation in Autoregressive Models with Exponential White Noise by Using Reversible Jump MCMC Algorithm

Authors: Suparman Suparman

Abstract:

A white noise in autoregressive (AR) model is often assumed to be normally distributed. In application, the white noise usually do not follows a normal distribution. This paper aims to estimate a parameter of AR model that has a exponential white noise. A Bayesian method is adopted. A prior distribution of the parameter of AR model is selected and then this prior distribution is combined with a likelihood function of data to get a posterior distribution. Based on this posterior distribution, a Bayesian estimator for the parameter of AR model is estimated. Because the order of AR model is considered a parameter, this Bayesian estimator cannot be explicitly calculated. To resolve this problem, a method of reversible jump Markov Chain Monte Carlo (MCMC) is adopted. A result is a estimation of the parameter AR model can be simultaneously calculated.

Keywords: autoregressive (AR) model, exponential white Noise, bayesian, reversible jump Markov Chain Monte Carlo (MCMC)

Procedia PDF Downloads 324
194 Reversible Information Hitting in Encrypted JPEG Bitstream by LSB Based on Inherent Algorithm

Authors: Vaibhav Barve

Abstract:

Reversible information hiding has drawn a lot of interest as of late. Being reversible, we can restore unique computerized data totally. It is a plan where mystery data is put away in digital media like image, video, audio to maintain a strategic distance from unapproved access and security reason. By and large JPEG bit stream is utilized to store this key data, first JPEG bit stream is encrypted into all around sorted out structure and then this secret information or key data is implanted into this encrypted region by marginally changing the JPEG bit stream. Valuable pixels suitable for information implanting are computed and as indicated by this key subtle elements are implanted. In our proposed framework we are utilizing RC4 algorithm for encrypting JPEG bit stream. Encryption key is acknowledged by framework user which, likewise, will be used at the time of decryption. We are executing enhanced least significant bit supplanting steganography by utilizing genetic algorithm. At first, the quantity of bits that must be installed in a guaranteed coefficient is versatile. By utilizing proper parameters, we can get high capacity while ensuring high security. We are utilizing logistic map for shuffling of bits and utilization GA (Genetic Algorithm) to find right parameters for the logistic map. Information embedding key is utilized at the time of information embedding. By utilizing precise picture encryption and information embedding key, the beneficiary can, without much of a stretch, concentrate the incorporated secure data and totally recoup the first picture and also the original secret information. At the point when the embedding key is truant, the first picture can be recouped pretty nearly with sufficient quality without getting the embedding key of interest.

Keywords: data embedding, decryption, encryption, reversible data hiding, steganography

Procedia PDF Downloads 263