The State of the Science of Natural Family Planning Fifty Years after Humane Vitae: A Report from NFP Scientists’ Meeting Held at the US Conference of Catholic Bishops, April 4, 2018

A one-day meeting of physicians, professional nurses, and scientists actively involved in Natural Family Planning (NFP) research was held to review the state of the science of NFP and consider future priorities. The meeting had four objectives: (i) determine the gaps in research evidence for secure methods of NFP among women of all reproductive categories, (ii) determine the gaps in the research and development of new technology for providing NFP services, (iii) determine the gaps in the research that determine the benefits and challenges with use of NFP among married couples, and (iv) provide prioritized ideas for future research needs from the analysis of evidence gaps from objectives above. This article summarizes the discussion and conclusions drawn from topics reviewed. While much has been accomplished in the fifty years since Humane vitae, there are still many gaps to address. Five areas for future research in NFP were identified as high priority: (1) well-designed method effectiveness studies among various reproductive categories including important subpopulations (postpartum, perimenopause, posthormonal contraceptive), normally cycling women (especially US women), and comparative studies between NFP methods; (2) validation studies to establish the benefit of charting fertility signs (both currently known and potential new indicators) as a screening tool for women’s health issues; (3) ongoing independent evaluation of fertility monitoring apps to provide users perspective on the relative merits of each and to identify those most worthy of further effectiveness testing; (4) studies evaluating the impact of new technologies on NFP adoption, use, and persistence; and (5) creation of a shared database across various NFP methods to collaborate on shared research interests, longitudinal studies, and so on. This summarizes a meeting to review the scientific and medical progress related to natural family planning made in the 50 years since Humane Vitae and to define priorities for future work. Areas reviewed included the evidence for avoiding pregnancy in normally cycling, postpartum, and perimenopausal women, the impact of new technology, including fertility charting apps, on NFP, and the impact on relationships and personal well-being from use of NFP. Five priority focus areas for future research were also identified

Accuracy of the Ovulon Fertility Monitor to Predict and Detect Ovulation

The purpose of this pilot study was to correlate the three biologic markers of the Ovulon fertility monitor (a long-term predictive peak about 6 days before ovulation, a short-term predictive peak about 1 day before ovulation, and a nadir at the time of ovulation) with the peak in cervical mucus and the luteinizing hormone (LH) surge in the urine. Ten volunteer subjects (mean age 30.2 years) monitored their cervical-vaginal mucus, the surge of LH in the urine with a home assay test, and their vaginal electrical readings (with Ovulon monitors) on a daily basis for one to four menstrual cycles. In 19 of the 21 cycles that indicated a LH surge, there was a strong positive correlation between the LH surge and the peak of cervical-vaginal mucus (r = 0.96, P ≤ .01), and between the LH surge and both the Ovulon nadir and Ovulon short-term predictive peak (r = 0.84, P ≤ .01), and a modest positive correlation between the long-term Ovulon predictive peak and the LH surge (r = 0.62, P ≤ .01). The time of optimal fertility as determined by the peak in cervical mucus, the LH surge, and the Ovulon was similar. The Ovulon has potential as a reusable device to help women determine their fertile period

Natural Family Planning and Marital Chastity: The Effects of Periodic Abstinence on Marital Relationships

Marital chastity is the practice of periodic abstinence with use of natural family planning (NFP). The purpose of this study was to determine the influence of the most common methods of contraception (female sterilization, oral contraceptive pills, and condoms) and NFP on divorce/separation and cohabitation rates among reproductive age women. The study involved an extensive review of the literature on the effects of practice of NFP on marital dynamics and a statistical analysis of 2,550 ever-married women in the (2015–2017) National Survey of Family Growth data set. Importance of religion and frequency of church attendance were included in the analysis. With ever-use of NFP, 14 percent were divorced or separated, and 27 percent to 39 percent were divorced or separated with ever-use of oral contraceptive pills. Stepwise logistic regression indicated that ever-use of contraception was associated with increased odds of divorce or separation (odds ratio [OR] = 2.05; confidence interval [CI]: 1.96–2.49) and cohabitation (2.95, CI: 2.20–3.95). Ever-use of NFP yielded 58 percent lower odds for divorce or separation. Frequent church attendance was associated with lower odds of divorce or separation and cohabitation. Although there are lower odds of divorce among NFP users, the reason might be due to their religiosity

An Arabic Version of the Spiritual Well-Being Scale

This article reports on two studies to develop and validate an Arabic language version of the Spiritual Well-Being Scale (SWBS). The first study was a pilot study at a major government university in Jordan (N = 75, students). The second and main study was conducted in 5 large regional hospitals in Jordan (N = 63, patients). The SWBS was translated from English to Arabic and reviewed by an expert panel for language, cultural, and spiritual consistency. The Arabic version of the SWBS was revised after the results of the pilot study and further reviewed by an expert panel. The resulting data were subjected to descriptive and factor analysis. Results showed that the final version of the SWBS used in the main study had a two-factor structure consistent with previous studies. Descriptive data for a range of demographic variables are presented. Issues of inadequate translation and lack of variation in responses for some items are identified and the results discussed in light of dominant Islamic theological frameworks. © 2012 Taylor and Francis Group, LLC

Early Failure of Articular Surface Replacement XL Total Hip Arthroplasty

Abstract: The ASR (articular surface replacement) XL (DePuy, Warsaw, Ind) metal-on-metal hip arthroplasty offers the advantage of stability and increased motion. However, an alarming number of early failures prompted the evaluation of patients treated with this system. A prospective study of patients who underwent arthroplasty with the ASR XL system was performed. Patients with 2-year follow-up or any revision were included. Failure rates, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and radiographs were evaluated. Ninety-five patients (105 hips) were included. There were 16 revisions. Thirteen (12%) were aseptic acetabular failures. Eight were revised for aseptic loosening; 4, for metallosis; 1, for malposition; 2, for infection; and 1, for periprosthetic fracture. Mean time to revision was 1.6 years (0.18-3.4 years). The ASR XL with a revision rate of 12% is the second reported 1 piece metal-on-metal system with a significant failure rate at early follow-up. This particular class of implants has inherent design flaws that lead to early failure. Large diameter metal-on-metal articulations in total hip arthroplasty offers the theoretical advantage of improved stability and increased range of motion compared with smaller diameter bearings The ASR (articular surface replacement) XL total hip arthroplasty system by DePuy (Warsaw, Ind) was initially developed as an alternative to total hip arthroplasty. This total hip system offers a nonmodular metal-on-metal acetabular component, which was initially designed for hip surface replacements, paired with a large diameter femoral head. The acetabular cup is less than a hemisphere, allowing for greater range of motion as well as a degree of bone conservation. The ASR XL head system was then developed, which allowed surgeons to use traditional femoral stems to be matched with larger femoral heads. Although the less-than-hemispherical acetabulum offers a greater theoretical range of motion, the preparation and insertion of a nonmodular cup introduce possible technical errors that may account for early failures. Early failures of less than 2 years of large head metalon-metal hip systems have been reported in another 1 piece metal-on-metal syste

Učinkovitost u zadacima fine motorike i prostornih odnosa tijekom menstrualnog ciklusa

Various studies have shown fl uctuations in task performance during the menstrual cycle. The aim of this study was to see the effects of the menstrual cycle on performing fi ne motor and spatial tasks of different level of complexity in twenty students aged 18 to 21 years, with regular menstrual cycle (28 to 30 days). The students performed O’Connor Finger Dexterity Test and mental rotation test during the menstrual, late follicular, and midluteal phase. Before the tests were performed, we administered Spielberger’s State-Trait Anxiety Inventory for each phase. After the tasks were completed, the subjects ranked their diffi culty on Borg’s scale. The results showed the best performance in both tests in the midluteal phase (with sex hormones at their peak). The anxiety level and task diffi culty ranking were the highest in the menstrual phase, when the hormone levels were the lowest.Različita su istraživanja pokazala promjene učinkovitosti tijekom menstrualnog ciklusa. U zadacima u kojima su uspješnije žene, najveća učinkovitost događa se tijekom kasne folikularne ili srednje lutealne faze. U zadacima u kojima su pak uspješniji muškarci najveća je učinkovitost nađena u menstrualnoj fazi. Na osnovi uporabe zadataka fi ne motorike i prostornih zadataka različitih razina kompleksnosti, cilj ovog istraživanja bio je ispitati utjecaj menstrualnog ciklusa na kognitivne funkcije. U istraživanju je sudjelovalo dvadeset ispitanica, dobi od 18 do 21 godinu, s redovitim menstrualnim ciklusima (28 do 30 dana). Ispitanice su izvodile O’Connorov deksterimetar i zadatke mentalne rotacije tijekom menstrualne, kasne folikularne i srednje lutealne faze. Prije izvođenja zadataka, u svakoj fazi ciklusa primijenjen je Spielbergerov upitnik stanja anksioznosti. Nakon izvođenja zadataka, ispitanice su procjenjivale njihovu težinu na Borgovoj skali. Rezultati su pokazali najbolju učinkovitost u oba zadatka u fazi visokih razina spolnih hormona (srednja lutealna faza). Stanje anksioznosti i procijenjene težine zadataka bili su najviši u menstrualnoj fazi, kada su razine spolnih hormona najniže

Obesity in total hip arthroplasty—does it really matter?: A meta-analysis

Discussion persists as to whether obesity negatively influences the outcome of hip arthroplasty. We performed a meta-analysis with the primary research question of whether obesity has a negative effect on short- and long-term outcome of total hip arthroplasty. We searched the literature and included studies comparing the outcome of hip arthroplasty in different weight groups. The methodology of the studies included was scored according to the Cochrane guidelines. We extracted and pooled the data. For continuous data, we calculated a weighted mean difference and for dichotomous variables we calculated a weighted odds ratio (OR). Heterogeneity was calculated using I(2) statistics. 15 studies were eligible for data extraction. In obese patients, dislocation of the hip (OR = 0.54, 95% CI: 0.38-0.75) (10 studies, n = 8,634), aseptic loosening (OR = 0.64, CI: 0.43-0.96) (6 studies, n = 5,137), infection (OR = 0.3, CI: 0.19-0.49) (10 studies, n = 7,500), and venous thromboembolism (OR = 0.56, CI: 0.32-0.98) (7 studies, n = 3,716) occurred more often. Concerning septic loosening and intraoperative fractures, no statistically significant differences were found, possibly due to low power. Subjective outcome measurements did not allow pooling because of high heterogeneity (I(2) = 68%). Obesity appears to have a negative influence on the outcome of total hip replacemen