Publications (9)29.6 Total impact
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Article: Observational research with adolescents: a framework for the management of the parental permission.
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ABSTRACT: BACKGROUND: Waiving parent permission can be an option in some epidemiological and social research with adolescents. However, exemptions have not been uniformly considered or applied. Our aim is to critically assess the different factors that could be taken into account when making decisions about waiving active parental permission in observational research with adolescents. DISCUSSION: In some cases alternatives to parental permission could be applied to protect the rights of both adolescents and parents and also to assure the benefits to adolescents as a group that can come from appropriately conducted studies. However, the criteria of ensuring minimal risk can be difficult to define and apply and a distinction between harm and discomfort is reviewed. Waiving active parental permission could be acceptable when the risk of harm is minimal; when the research questions are related to an activity for which adolescents are not legally considered to be children; when the risk of harm or discomfort may increase if parental permission is required; and when risk of discomfort is low because the questionnaire is not potentially offensive for some adolescents and/or for some parents. SUMMARY: Stringent rules concerning parental permission in some studies could be detrimental to adolescents. A framework and a decision tree guide are proposed to help researchers and Research Ethics Committees in their decisions on whether active parental permission must be obtained.BMC Medical Ethics 01/2013; 14(1):2. · 1.74 Impact Factor -
Article: Intrauterine device and cervical cancer: we need more evidence.
The lancet oncology 12/2011; 12(13):1185-6; author reply 1186-7. · 14.47 Impact Factor -
Article: Choice of birth control methods among European women and the role of partners and providers.
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ABSTRACT: The choice of a birth control method is influenced by sociocultural and personal factors. We explored the perceived influences in women's choice of a birth control method in five European countries (Germany, France, the UK, Romania and Sweden), where contraception is widely used. This is a cross-sectional study of 1137 randomly selected women aged 18-49 years. An anonymous, 31-item questionnaire related to birth control methods was used. Logistic regression was used to identify variables associated with partner participation in choice of a contraceptive. Oral contraceptives were mainly used in Germany (54.3%), France (50.5%) and Sweden (34.6%) and condoms in the UK (29.6%) and Romania (22.9%). Sweden showed the highest use of intrauterine devices (IUD, 19%). Romania had the lowest use of contraception. Oral contraceptives and IUDs use were frequently suggested by providers instead of by women. Choosing the method with the partner was associated with age [odds ratio (OR)=0.97, 95% confidence interval (CI) 0.94-0.99], being a university graduate (OR=1.59, 95% CI 1.01-2.29), married (OR=1.52, 95% CI 1.01-2.29) and with using a method that requires partner's cooperation (OR=8.18, 95% CI 5.46-12.27). Hormonal contraceptives and IUDs are commonly recommended by providers rather than requested by women. Partner preferences are taken into account when his cooperation in the use of the method is needed. As fertility care is a male and female issue, there is still more room for actively involving both women and men in their choice of a birth control method.Contraception 12/2011; 84(6):558-64. · 2.72 Impact Factor -
Article: Dietary patterns and difficulty conceiving: a nested case-control study.
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ABSTRACT: To investigate potential associations between dietary patterns (defined using factor analysis) and difficulty conceiving. Case-control study nested in a Spanish cohort of university graduates (Seguimiento Universidad de Navarra [SUN] Project). Female university graduates all over Spain participating in the SUN Project. A total of 485 women, aged 20-45 years, reporting having presented with difficulty getting pregnant, and 1,669 age-matched controls who had at least one child. None. Reported difficulty getting pregnant. Data were collected from baseline and follow-up questionnaires of the SUN Project. Two dietary patterns were identified. They were labeled as "Mediterranean-type" and "Western-type" patterns. A lower risk of difficulty getting pregnant was apparent in the highest quartile of adherence to the Mediterranean-type pattern compared with the lowest quartile (odds ratio 0.56, 95% confidence interval 0.35-0.95). Greater adherence to the Western-type dietary pattern showed no association with this outcome. A greater adherence to the Mediterranean-type dietary pattern may enhance fertility. Further evidence about the relationship between this dietary pattern and fertility is needed to develop nutritional interventions for women desiring to get pregnant.Fertility and sterility 09/2011; 96(5):1149-53. · 3.97 Impact Factor -
Article: Knowledge and beliefs about mechanism of action of birth control methods among European women.
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ABSTRACT: Adequate knowledge is essential for making informed decisions. We attempted to determine the level of knowledge about mechanisms of action of birth control methods in five representative samples of European women. Randomly selected women, aged 18-49 years, completed an anonymous survey in Germany, France, the UK, Sweden and Romania (N=1137). Participants were asked about how contraceptive methods work and if providers should inform them about this issue. Multiple linear regression was used to evaluate women's characteristics associated with their knowledge of mechanisms of action. The majority of women identified the unequivocal mode of action of condoms, sterilization and abortion. Fewer than 2% identified all possible mechanisms of action of hormonal contraceptives and intrauterine devices. Highly educated women correctly identified the mechanism or mechanisms of action of more methods than less educated women (β=0.22, 95% confidence interval 0.01-0.43). Regardless of their sociodemographic characteristics and their belief about when human life begins, most women (75%) stated that the provider should inform them about possible postfertilization effects. European women have low knowledge about mechanisms of action of several contraceptive methods. The majority want to be informed about possible postfertilization effects. Since adequate knowledge is essential for making informed decisions, providers are encouraged to inform women about all possible mechanisms of action of contraceptives.Contraception 06/2011; 85(1):69-77. · 2.72 Impact Factor -
Article: Spanish women's attitudes towards post-fertilization effects of birth control methods.
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ABSTRACT: Some methods of family planning, such as oral contraceptives, emergency pill or intrauterine device, may occasionally work after fertilization. These effects may be important to some women. We explored Spanish women's attitudes towards contraceptive choices that may have occasional post-fertilization mechanisms of action. Cross-sectional study in a Spanish representative sample of 848 potentially fertile women, aged 18-49. Data were collected using a 30-item questionnaire about family planning. Logistic regression was used to identify variables associated with women's attitudes towards post-fertilization effects. The majority of women were married, had completed high school and had at least one child. Forty-five percent of women would not consider using a method that may work after fertilization and 57% would not consider using one that may work after implantation. Forty-eight percent of the sample would stop using a method if they learned that it sometimes works after fertilization, increasing to 63% when referring to a method that sometimes works after implantation. Women who believe that human life begins at fertilization, those who believe it is important to distinguish between spontaneous and induced embryo losses and women who report having a religion were less likely to consider the use of a method with some post-fertilization effects. The possibility of post-fertilization effects may influence Spanish women's choice of a family planning method. Information about mechanisms of action of birth control methods should be disclosed to women so that they can make informed choices.European journal of obstetrics, gynecology, and reproductive biology 04/2010; 151(1):56-61. · 1.97 Impact Factor -
Article: Relationships, love and sexuality: what the Filipino teens think and feel.
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ABSTRACT: In order to achieve a change among teens' sexual behavior, an important step is to improve our knowledge about their opinions concerning relationships, love and sexuality. A questionnaire including topics on relationships, love and sexuality was distributed to a target population of 4,000 Filipino students from third year high school to third year college. Participants were obtained through multi-stage sampling of clusters of universities and schools. This paper concentrates on teens aged 13 to 18. Students reported that they obtained information about love and sexuality mainly from friends. However, they valued parents' opinion more than friends'. They revealed few conversations with their parents on these topics. A majority of them would like to have more information, mainly about emotion-related topics. Almost half of respondents were not aware that condoms are not 100% effective in preventing STIs or pregnancies. More girls, compared to boys, were sensitive and opposed to several types of sexism. After adjusting for sex, age and institution, the belief of 100% condom effectiveness and the approval of pornography and sexism were associated with being sexually experienced. There is room for further encouraging parents to talk more with their children about sexuality, specially aspects related to feelings and emotions in order to help them make better sexual choices. Indeed, teens wish to better communicate with their parents on these issues. Condoms are regarded as safer than what they really are by almost half of the participants of this study, and such incorrect knowledge seems to be associated with sexual initiation.BMC Public Health 09/2009; 9:282. · 2.00 Impact Factor -
Article: Women's attitudes towards mechanisms of action of family planning methods: survey in primary health centres in Pamplona, Spain.
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ABSTRACT: Informed consent in family planning includes knowledge of mechanism of action. Some methods of family planning occasionally work after fertilization. Knowing about postfertilization effects may be important to some women before choosing a certain family planning method. The objective of this survey is to explore women's attitudes towards postfertilization effects of family planning methods, and beliefs and characteristics possibly associated with those attitudes. Cross-sectional survey in a sample of 755 potentially fertile women, aged 18-49, from Primary Care Health Centres in Pamplona, Spain. Participants were given a 30-item, self-administered, anonymous questionnaire about family planning methods and medical and surgical abortion. Logistic regression was used to identify variables associated with women's attitudes towards postfertilization effects. The response rate was 80%. The majority of women were married, held an academic degree and had no children. Forty percent of women would not consider using a method that may work after fertilization but before implantation and 57% would not consider using one that may work after implantation. While 35.3% of the sample would stop using a method if they learned that it sometimes works after fertilization, this percentage increased to 56.3% when referring to a method that sometimes works after implantation. Women who believe that human life begins at fertilization and those who consider it is important to distinguish between natural and induced embryo loss were less likely to consider the use of a method with postfertilization effects. Information about potential postfertilization effects of family planning methods may influence women's acceptance and choice of a particular family planning method. Additional studies in other populations are necessary to evaluate whether these beliefs are important to those populations.BMC Women s Health 02/2007; 7:10. -
Article: Women's attitudes towards mechanisms of action of family planning methods
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ABSTRACT: Background: Informed consent in family planning includes knowledge of mechanism of action. Some methods of family planning occasionally work after fertilization. Knowing about postfertilization effects may be important to some women before choosing a certain family planning method. The objective of this survey is to explore women's attitudes towards postfertilization effects of family planning methods, and beliefs and characteristics possibly associated with those attitudes. Methods: Cross-sectional survey in a sample of 755 potentially fertile women, aged 1849, from Primary Care Health Centres in Pamplona, Spain. Participants were given a 30-item, self-administered, anonymous questionnaire about family planning methods and medical and surgical abortion. Logistic regression was used to identify variables associated with women's attitudes towards postfertilization effects. Results: The response rate was 80%. The majority of women were married, held an academic degree and had no children. Forty percent of women would not consider using a method that may work after fertilization but before implantation and 57% would not consider using one that may work after implantation. While 35.3% of the sample would stop using a method if they learned that it sometimes works after fertilization, this percentage increased to 56.3% when referring to a method that sometimes works after implantation. Women who believe that human life begins at fertilization and those who consider it is important to distinguish between natural and induced embryo loss were less likely to consider the use of a method with postfertilization effects. Conclusion: Information about potential postfertilization effects of family planning methods may influence women's acceptance and choice of a particular family planning method. Additional studies in other populations are necessary to evaluate whether these beliefs are important to those populations.BMC Women's Health, 7:10.
Top co-authors
Top Journals
- Contraception (2)
- BMC Public Health (1)
- BMC Women s Health (1)
- BMC Medical Ethics (1)
- The lancet oncology (1)
Institutions
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2010–2011
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Universidad de Navarra
- Department of Preventive Medicine and Public Health
Pamplona, Navarre, Spain
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