Decision aids for randomised controlled trials : a qualitative exploration of stakeholders' views

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. Funding: This work was supported by personal fellowship award (to KG) from the Chief Scientist Office of the Scottish Governments Health and Social Care Directorates, grant number [PDF/09/01]. The Health Services Research Unit is supported by a core grant from the Chief Scientist Office of the Scottish Government Health and Social Care Directorates.Peer reviewedPublisher PD

Strengthening the ethical assessment of placebo-controlled surgical trials : three proposals

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Determining information for inclusion in a decision-support intervention for clinical trial participation : A modified Delphi approach

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The Next Frontier for Men\u27s Contraceptive Choice: College Men\u27s Willingness to Pursue Male Hormonal Contraception

Unplanned pregnancy is a concern for emerging adult men, but their contraceptive options are limited. With male hormonal contraception clinical trials in progress, it is important to investigate men’s attitudes toward alternative contraception. Many social factors, such as masculine norms, may hinder their interest. This study used the prototype–willingness model to investigate college men’s willingness to pursue hormonal contraception. Male college students (N = 160; Mage = 19.37, SD = 1.33; 61.9% White) read a description of male contraception clinical trials and filled out a questionnaire assessing prototype–willingness and masculinity constructs. Multinomial logistic regression revealed that men perceiving greater male contraceptive use and more favorable prototypes of a typical user had higher odds of having high willingness compared with no willingness (norms: odds ratio [OR] = 29.78, 95% confidence interval [CI] [5.79, 153.18]; prototypes: OR = 3.93, 95% CI [1.96, 7.87]). Men rating higher avoidance of femininity had lower odds of having high willingness compared with no willingness (OR = .60, 95% CI [.40, .92]). Perceived risk of unplanned pregnancy failed to associate with willingness to use contraception, suggesting the importance of men’s social cognitions (norms and favorable images) and identity (masculinity) when promoting male hormonal contraception. Men’s avoidance of femininity may hinder their willingness, but promotion of male norms and favorable male users may enhance clinical trial recruitment and eventual public health campaigns to expand men’s contraceptive options. Future studies should examine diverse college and noncollege samples to determine the generalizability of these results to the broader emerging adult male population

The Next Frontier for Men\u27s Contraceptive Choice: College Men\u27s Willingness to Pursue Male Hormonal Contraception

Unplanned pregnancy is a concern for emerging adult men, but their contraceptive options are limited. With male hormonal contraception clinical trials in progress, it is important to investigate men’s attitudes toward alternative contraception. Many social factors, such as masculine norms, may hinder their interest. This study used the prototype–willingness model to investigate college men’s willingness to pursue hormonal contraception. Male college students (N = 160; Mage = 19.37, SD = 1.33; 61.9% White) read a description of male contraception clinical trials and filled out a questionnaire assessing prototype–willingness and masculinity constructs. Multinomial logistic regression revealed that men perceiving greater male contraceptive use and more favorable prototypes of a typical user had higher odds of having high willingness compared with no willingness (norms: odds ratio [OR] = 29.78, 95% confidence interval [CI] [5.79, 153.18]; prototypes: OR = 3.93, 95% CI [1.96, 7.87]). Men rating higher avoidance of femininity had lower odds of having high willingness compared with no willingness (OR = .60, 95% CI [.40, .92]). Perceived risk of unplanned pregnancy failed to associate with willingness to use contraception, suggesting the importance of men’s social cognitions (norms and favorable images) and identity (masculinity) when promoting male hormonal contraception. Men’s avoidance of femininity may hinder their willingness, but promotion of male norms and favorable male users may enhance clinical trial recruitment and eventual public health campaigns to expand men’s contraceptive options. Future studies should examine diverse college and noncollege samples to determine the generalizability of these results to the broader emerging adult male population

Supervision and culture: Meetings at thresholds

Counsellors are required to engage in supervision in order to reflect on, reflexively review, and extend their practice. Supervision, then, might be understood as a partnership in which the focus of practitioners and supervisors is on ethical and effective practice with all clients. In Aotearoa/New Zealand, there has recently been interest in the implications for supervision of cultural difference, particularly in terms of the Treaty of Waitangi as a practice metaphor, and when non-Māori practitioners counsel Māori clients. This article offers an account of a qualitative investigation by a group of counsellors/supervisors into their experiences of supervision as cultural partnership. Based on interviews and then using writing-as-research, the article explores the playing out of supervision’s contribution to practitioners’ effective and ethical practice in the context of Aotearoa/New Zealand, showing a range of possible accounts and strategies and discussing their effects. Employing the metaphor of threshold, the article includes a series of reflections and considerations for supervision practice when attention is drawn to difference

Mapping for Maternal and Newborn Health: The Distributions of Women of Childbearing Age, Pregnancies and Births.

The health and survival of women and their new-born babies in low income countries has been a key priority in public health since the 1990s. However, basic planning data, such as numbers of pregnancies and births, remain difficult to obtain and information is also lacking on geographic access to key services, such as facilities with skilled health workers. For maternal and newborn health and survival, planning for safer births and healthier newborns could be improved by more accurate estimations of the distributions of women of childbearing age. Moreover, subnational estimates of projected future numbers of pregnancies are needed for more effective strategies on human resources and infrastructure, while there is a need to link information on pregnancies to better information on health facilities in districts and regions so that coverage of services can be assessed. This paper outlines demographic mapping methods based on freely available data for the production of high resolution datasets depicting estimates of numbers of people, women of childbearing age, live births and pregnancies, and distribution of comprehensive EmONC facilities in four large high burden countries: Afghanistan, Bangladesh, Ethiopia and Tanzania. Satellite derived maps of settlements and land cover were constructed and used to redistribute areal census counts to produce detailed maps of the distributions of women of childbearing age. Household survey data, UN statistics and other sources on growth rates, age specific fertility rates, live births, stillbirths and abortions were then integrated to convert the population distribution datasets to gridded estimates of births and pregnancies.These estimates, which can be produced for current, past or future years based on standard demographic projections, can provide the basis for strategic intelligence, planning services, and provide denominators for subnational indicators to track progress. The datasets produced are part of national midwifery workforce assessments conducted in collaboration with the respective Ministries of Health and the United Nations Population Fund (UNFPA) to identify disparities between population needs, health infrastructure and workforce supply. The datasets are available to the respective Ministries as part of the UNFPA programme to inform midwifery workforce planning and also publicly available through the WorldPop population mapping project

Behavioural optimisation to address trial conduct challenges : case study in the UK-REBOA trial

Acknowledgements We thank the UK-REBOA site staf for dedicating their time to be interviewedPeer reviewedPublisher PD