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An examination of the age-specific fertility rate shows that the decline in fertility has been most pronounced among younger women as a result of rising age at marriage and among older women as family planning has become more widespread order kamagra oral jelly 100 mg without a prescription erectile dysfunction doctor brisbane. It is obtained by multiplying by five the sum of age-specific fertility rates divided by 1 cheap 100 mg kamagra oral jelly otc impotence age 40,000 kamagra oral jelly 100 mg generic erectile dysfunction zinc deficiency. Conclusions the emergence of economic problems related to order 100 mg kamagra oral jelly amex erectile dysfunction lipitor the fall in rubber prices and to ris ing unemployment prompted the government of Malaysia to launch the National Family Planning Program in 1966. The program was designed to reduce the birth rate, in order to safeguard maternal and child health and to increase per capita income. The change in official policy represented the triumph of economics and health over politics in a multiethnic country, with Islam as the national religion. The family planning associations had stressed the benefits of planned parenthood, as well as the considerable demand for family planning services. Several community and political leaders, notably Khir Johari, had advocated strongly for family planning, without much opposition. By the early 1970s, family planning services had been extended to all parts of the country, through integration with the maternal and child health programs of the Ministry of Health. Even though the national family planning program did not fully achieve its rather ambitious target for the number of acceptors or its demographic targets, it had done reasonably well in the initial period despite constraints in finance, staff, and facilities. As a statutory body, the board had been able to harness the support and cooperation of relevant agencies and partners, in particular the Ministry of Health, the family plan ning associations, and the private practitioners in delivering contraceptive services. In 1981, the government under the leadership of Prime Minister Mahathir Mohamad adopted different development strategies with great emphasis on the industrialization program, to be supported by a larger population and a larger domestic market. Malaysia is now a major destination for foreign labor, which constitutes about 10 percent of the labor force. In a speech to a political gathering in 1982, the Prime Minister announced a new demographic target, to achieve a population of 70 million by 2100. That became an official policy in the Midterm Review of the Fourth Malaysia Plan (1981?85). The National Family Planning Program was renamed the National Population and Fam ily Development Program. With the de-emphasis of family planning following the shift from an anti-natalist to a pro-natalist policy, greater emphasis has been placed on marriage and parenting counseling, reproductive health, and gender issues. Great emphasis has also been placed on human resource development and improved status of women. The de-emphasis of family planning has resulted in a substantial decline in family planning acceptance among the Malays, who have always been more likely to respond positively to government policies than the non-Malays. Some countries that have undergone very rapid fertility declines are now having difficulty reversing the trend. Malaysia can learn from the experience of these countries by implementing programs to achieve a more harmonious balance between population and development. Marriage Family Formation in Peninsular Malaysia: Analytic Report on the 1984/85 Malaysian Population and Family Survey. Awareness of the implications of rapid popu lation growth for development was high among top government officials, academics, influential people from the private sector, and local media. A number of factors facilitated the implementation of a family planning program to operationalize the fertility reduction policy. The first was the existence of a fairly extensive health infrastructure consisting of hospitals, rural health units, puericulture centers (maternal and child health care centers established in rural areas by non governmental institutions and financed by the Philippine Charity Sweepstakes, few of which remain in existence today), and private hospitals and clinics. These facili ties were complemented by highly trained physicians, nurses, and midwives. The delivery of family planning services could be added to the wide range of services already offered. Second, the concept of family planning and the provision of services had been already introduced as early as the prewar years by voluntary organizations, private institutions, and private physicians. These, together with technical personnel from the College of Medicine of the University of the Philippines and from the Department of Health, were a readily available group of trainers who could train various family planning service providers in clinical settings. Third, donors were available that were willing to provide financial support and technical assistance for the implementation of a nationwide family planning program. Given the high-level government support and the various facilitating factors, expectations were high that the evolving family planning program was on its way toward achieving the goals of moderating population growth and stimulating socioeconomic development. However, while other countries in the region did achieve the author gratefully acknowledges the helpful comments and suggestions provided by Carol Carpenter-Yaman and Warren Robinson during the preparation of this chapter. In looking back at what appeared initially to be a promising family planning pro gram, one can see several discordant notes. At the same time, while the funding for many activities was assured by a number of donors, their number and their different mandates and requirements made coordination difficult. As the family planning program began to decentralize and outreach activities became more exten sive, local governments were expected to finance and implement the outreach activ ities in their respective jurisdictions, but whether local financing would actually be forthcoming in a sustained and adequate manner in view of the different financing capacities and commitments of individual local government units was not clear. This prevented the implementation of a stronger and sustained program that involved the use of mod ern contraceptives. Thus, what appeared to be the beginnings of a strong program to reduce fertility in the late 1960s and early 1970s was actually a fragile program that could be stopped in its tracks by inaction emanating from the Office of the President. One of its semi-autonomous units is the Institute of Maternal and Child Health, which is responsible for extending services to rural areas. The Family Planning Association of the Philippines is established to provide education, information, and clinic services. The University of the Philippines Population Institute organizes the first Conference on Population with support from the Population Council. The Institute of Maternal and Child Health sets up the National Training Center for Maternal Health Service in accordance with an agreement between the National Economic Council, the Institute of Maternal and Child Health, and the U. The Family Planning Association of the Philippines and the Planned Parenthood Movement in the Philippines are merged to form the Family Planning Organization of the Philippines.
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The recruitment from acne support forums will surely bias results in favour of those who have sought such help purchase 100mg kamagra oral jelly otc impotence medication. Should the sample be widened buy kamagra oral jelly 100 mg cheap impotence treatments, or this point considered more explicitly at this stage purchase kamagra oral jelly 100 mg free shipping severe erectile dysfunction causes. Major amendments required (for reviewer): Confirmation of making the above minor amendments (for students): I have noted and made minor amendments one and two (above) before starting my research and collecting data order kamagra oral jelly 100mg online erectile dysfunction diabetes symptoms. I have discussed points three and four with my supervisor (Ken Gannon) and he is happy with my current sample design and use of Survey Monkey. If you are not sure about whether your proposed amendment warrants approval consult your supervisor or contact Dr Mark Finn (Chair of the School Research Ethics Committee). When submitting this request form, ensure that all necessary documents are attached (see below). A copy of your previously approved ethics application with proposed amendments(s) added as tracked changes. For example an updated recruitment notice, updated participant information letter, updated consent form etc. Note that approval must be given for significant change to research procedure that impacts on ethical protocol. Recruitment and data collection are not to commence until your proposed amendment has been approved. The study is being conducted as part of my Doctoral degree in Clinical Psychology at the University of East London. Project Title An Exploration of Emotional Distress in Adults with Acne Project Description this study aims to explore how much different psychological factors predict emotional distress in adults with acne. Some people feel unsure about participating in psychological research as they may think the researcher thinks any difficulties are all in their minds. Research has shown that acne is a condition many people find distressing, and that it impacts their lives in a range of different ways. My hope is that the research will inform the ways professionals respond when working with people living with acne. Participants will be asked to complete a series of questionnaires online, which should take approximately 20 minutes. There is a possibility that some people might become distressed about their acne whilst answering the questionnaires. If you decide to participate and this happens to you, you have the right to withdraw from the study at any stage, and appropriate organisations you could contact are detailed at the bottom of this letter. Confidentiality of the Data Participants will complete the questionnaires online using secure software. The email addresses of those wanting to be entered into the prize draw will be collected. The addresses will be stored in a password protected excel file (including no other participant data) on a password protected computer. Email addresses will be stored separately from participants questionnaire responses, which will therefore be anonymised. This questionnaire response data will be kept for three years following the study and destroyed after this point. As identifying information will not be collected for those not wishing to enter the prize draw, these participants responses will be anonymous. Disclaimer You are not obliged to take part in this study and should not feel coerced. Should you choose to withdraw from the study you may do so without disadvantage to yourself and without any obligation to give a reason. If you decide to withdraw from the study after you have completed and submitted your responses to the questionnaires, please email the researcher to inform them of this (citing your participant identification number, which will be given to you on completion of the questionnaires) before 29th February 2016 to ensure your data is not included in the analyses. If you are happy to continue you will be asked to indicate your consent prior to your participation. Yours sincerely, Susie Clark Organisations you could contact should you feel distressed about your acne are:? Changing Faces provides free advice, information and emotional support to people living with a condition that affects their appearance. They have a Support Service Helpline (telephone 0300 012 0275 open 10am-4pm, Monday to Friday) or you could email them at support@changingfaces. The purpose of the study is to explore how much different psychological factors predict emotional distress in adults with acne. Analyses of the findings will involve examining any gender differences in emotional distress. It is important to explore the role of gender as previous studies have found greater levels of emotional distress in female adults with acne than males (Kellett & Gawkrodger, 1999; Hassan, Grogan, Clark-Carter, Richards, & Yates, 2009). Evolutionary theory is the only framework that has been used to explain this, however the explanation has not been tested empirically. This study aims to build on this explanation by extending the application of Objectification Theory (Fredrickson & Roberts, 1997). Objectification Theory proposes that sexual objectification experiences of women promote self-objectification (where people treat themselves as objects to be looked upon and evaluated based upon bodily appearance) which manifests as persistent body-surveillance. In turn, self-objectification and body surveillance promote greater body shame and emotional distress. This study will examine whether Objectification Theory, as well as wider dermatological factors. The findings may offer further possible explanations of emotional distress among adults with acne and of any gender differences in distress.
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When the first demographic survey in the Philippines was conducted in 1968 buy kamagra oral jelly 100 mg with mastercard erectile dysfunction beta blockers, 81% of all contraceptive users were using traditional contraceptive methods (Abejo et al purchase 100mg kamagra oral jelly overnight delivery erectile dysfunction vitamin d. Currently purchase kamagra oral jelly 100mg with visa erectile dysfunction 35, about one in every three women who are currently using a contraceptive method rely on traditional contraceptive methods 100mg kamagra oral jelly sale impotence of organic origin meaning, a level that has remained nearly constant over the past 10 years. Across Southeast Asia, the Philippines ranks second to Cambodia in the share of traditional contraceptive method use among currently married women using contraceptive methods (Figure 1). Percentage of traditional contraceptive method use among currently married women who are using contraceptives, Southeast Asia, 2015 30. The use of traditional contraceptive methods Traditional contraceptive methods include periodic abstinence or rhythm, withdrawal, and folkloric methods. Periodic abstinence or the calendar method (rhythm) has been widely used among Filipino couples. Earlier studies on family planning behavior have noted that even without any effort from the government to promote periodic abstinence as part of the family planning program, it was a popular method among Filipino couples (Laing 1987). It was often practiced in combination with withdrawal and with modern methods such as condom or foam. In a study on contraceptive use in 1978, more than a quarter of Filipino couples were practicing one form or another of this method (Verzosa et al. Alongside periodic abstinence, there was also high reliance on withdrawal as a family planning method. This stems from the fact that withdrawal does not entail cost and can be used spontaneously by couples. More recent studies have looked into the reasons why women or couples shy away from more effective modern methods of contraception. The most common reasons are fear of their side effects, lack of knowledge on different methods, and inconvenience of use, in contrast to the relative ease in adopting traditional contraceptive methods. A study of urban poor women in Manila found that traditional contraceptive methods, particularly withdrawal, are preferred because of their absence of side effects, safety, agreeability with partner, and ease of 3 use (Cruz, Marquez, and Kabamalan 2016). A review of qualitative studies on nonuse of modern contraceptive methods among young women in developing countries pointed to factors such as lack of knowledge and poor access to services, a common perception that modern family planning methods and services are only for married women, as well as the negative social norms around premarital sexual activity. The difficulties that young women often encounter in accessing modern contraceptive methods lead many to use traditional methods instead (Williamson et al. Such observations are pertinent to the Philippines, where social norms discourage sexual activity outside of marriage. In addition, reproductive health services are provided mainly to married women/couples. An analysis of traditional contraceptive method use in India found higher likelihood of traditional contraceptive method use among highly educated, urban, non-poor women (Ram, Shekhar, and Chowdhury 2014). Such a pattern debunks a common assumption that traditional contraceptive methods are preferred more by poor and less educated women. The choice of traditional contraceptive methods among educated women indicates their understanding of how methods such as rhythm work, as well as their knowledge of the ovulation cycle. In contrast, withdrawal use in Turkey was found to be associated with rural women, and women with less education, lower socioeconomic status, and living in more crowded households (Cindoglu, Sirkeci, and Sirkeci 2008). A similar study by Hubacher and colleagues in Honduras in 1996, found that among women using contraception, the choice of withdrawal versus modern contraceptive methods was significantly predicted by their distance from a health facility, marital status, residence, age, number of living children, and education. The decision to use rhythm relative to modern methods was associated with distance from a health facility. Also, women who wanted another child were more likely than women who did not want more children to prefer rhythm than modern methods (Hubacher et al. With this as background, a study on the levels, patterns, and determinants of traditional contraceptive method use can provide valuable information on the dynamics of contraceptive use 4 in the Philippines. In this paper, we focus on traditional contraceptive method use and explore why its prevalence has remained substantial over the past 10 years. Research questions While contraceptive prevalence has increased in the Philippines, the rise has been gradual. Among current contraceptive users, however, the share of traditional contraceptive method use has been consistent, at around 30%. In this paper, we explore the following research questions: 1) What characteristics of women are associated with the use of traditional contraceptive methods? Moreover, this information is important for designing programs and policies that could encourage couples to switch from traditional contraceptive methods to more reliable and efficient modern methods. Conceptual Framework this study considers contraceptive method use, and in particular preference for traditional contraceptive methods, to be a function of several factors: the background characteristics of the woman herself, those of her husband or partner, her fertility intentions, and her exposure to family planning messages. Figure 2 graphically presents the link between these factors and the choice of contraceptive method. Both designs provide data that is representative of the country and each of the 17 administrative regions. The analytic sample is restricted to fecund, currently married (formally or consensually), sexually active women (those who reported having had sexual intercourse in the four weeks prior to the survey) of reproductive age 15-49 and who were currently using any contraceptive method at the time of the survey. Such women are assumed to be exposed to the chance of pregnancy and are therefore likely to need a family planning method if they want to space or limit births. Women who reported using folkloric methods (98 cases for all survey years) were excluded from the analytic sample. These criteria resulted to a total of 11,815 women in the study, distributed as follows: 3,613 women in 2003, 3,663 women in 2008, and 4,539 women in 2013. Before the datasets were merged, all variables used in the analysis were harmonized across the three survey years. Key Variables and Measures the outcome variable is type of contraceptive method currently used, which was derived from the following question: Are you or your husband/partner currently doing something or using any method to delay or avoid getting pregnant?
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