'Failed' contraception in a rural South African population

Objective. To investigate whether the free availability of contraception affects the need for termination of pregnancy (TOP).Design. Case-control study.Setting. South African rural hospitaLPopulation. Three thousand and ninety-five TOP seekers and 439 non-pregnant controls.Methods. Structured questionnaire followed by ultrasonography.Main outcome measures. Current use or recent discontinuation of contraception and the reason for discontinuation.Results. Less than one-third (28.6%) of TOP seekers claimed to be using contraception versus 85.0% of controls. Injectable contraception (IC)was preferred by the controls and oral contraception (OC) by TOP seekers (x2 = 48.5, p < 0.0001, OR 0.34 (95% confidence interval 0.25, 0.46)). The percentage of discontinuation of hormonal contraception was higher in controls (x2 = 6.3, p = 0.012, OR 0.51 (0.31, 0.85)). The reason for discontinuation of hormonal contraception was obtained from 31.2% of TOP seekers and 63.3% of controls; no reason for discontinuation was acknowledged by 30.1% of the former and 6.3% of the latter (x2 = 33.4, p < 0.0001, OR 6.40 (3.25, 12.56)). Side-effects of hormonal contraception prompted more discontinuation in the failed-contraception group (x2 = 120.5, p < 0.0001, OR 49.4 (21.6, 112.5)). Poor compliance and absence of an acknowledged reason for discontinuing hormonal contraception  resulted in 173 unwanted pregnancies.                                                                                                                                      Conclusion. In South Africa two main components of women's reproductive health and rights are freely available, namely contraception and TOP. Not using contraception is one of the main causes of unwanted pregnancy. Better education of both service providers and users is needed to improve use, compliance and perseverance with contraception

Separation-survivability - the elusive moral cut-off point?

LetterThe original publication is available at http://www.samj.org.za[No abstract available]Publisher’s versio

Prognostic implications of mean nuclear diameter in breast cancer.

The mean nuclear diameter of 100 breast cancers was measured on tissue sections, to evaluate its importance for early prognosis. The cases were subdivided into 3 subgroups: small (25.5% of cases), medium (63.3%) and large (11.2%) nuclei. Early recurrence and mortality rates were investigated in each of the categories. Increasing nuclear size was shown to be related to mortality from metastatic disease. However, large-nucleus tumours had an inverse relationship with lymphnode involvement and possibly with recurrence rate. Hence, in our material nuclear size as a sole criterion was not a good indicator of the early behaviour of operable breast cancer

The Future of Dancefloors: Building More Flexible, Open and Innovative Clubbing Experiences

Nightclubs across the world are in a state of crisis due to COVID-19, and neither inaction or ‘business as usual’ are viable options if the industry is to survive it. It has never been more important to question, innovate and re-imagine the status quo

Attending school after treatment for a brain tumor: Experiences of children and key figures

Reintegration into school is a milestone for childhood brain tumor survivors, as well as for their parents, teachers, and healthcare providers. We explored their experiences following the school re-entry by conducting semi-structured interviews. Thematic analysis resulted in four main themes: "school performance," "psychosocial well-being," "support and approach," and "communication and collaboration." Children were pleased to return to school despite confrontation with adverse outcomes. Parents, teachers, and healthcare providers identified current and future concerns and challenges, as well as opportunities for academic and personal development. Their experiences highlight the importance of coordinated and systematic follow-up in close collaboration with healthcare providers

A multidimensional view? Evaluating the different and combined contributions of diaries and interviews in an exploration of asexual identities and intimacies

This article evaluates the relative contributions of diaries and interviews in multiple methods qualitative research exploring asexual identities and intimacies. Differentiated by three core differences: reflective time-frame (the day just had/lifetime), context (alone/with researcher) and mode (written/verbal), these methods had the potential to generate a multidimensional view of our topics. Using five cases in which data from both interviews and diaries were collected, this article explores how the intermeshed issues of identity and intimacy were constructed in each method, as well as reflecting on what was gained by their combination. Our analysis leads us to conclude that multiple methods do not always produce a fuller or a more rounded picture of individual participants’ lives. Nevertheless, the decision to collect data using different strategies did increase our chances of finding a method that suited individual participants, whether in style or focus