***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This nonr and omized observational clinical study evaluated the safety and acceptability of intrauterine device insertion either immediately or 2 weeks after abortion , according to the patient 's preference . Participants were 300 women with first-trimester abortions who agreed to immediate or delayed insertion .  End points were bleeding patterns , pregnancy , expulsion , perforation , infection and device removal at 2 , 6 and 10 weeks after insertion , and acceptance rates before and after counseling procedures were improved . The overall initial acceptance rate was 35.8 % , and the actual acceptance rate was 31.7 % . After counseling procedures were improved , the initial and actual acceptance rates increased substantially ( 17.7 % vs. 44.3 % and 10.2 % vs. 42.0 % , respectively ) . Bleeding , expulsion rates and pain did not differ significantly between the immediate and delayed insertion groups after IUD insertion . No pregnancies , perforations or cases of pelvic inflammatory disease were recorded in either group . Immediate post-abortal insertion offers the advantage of being a painless procedure . The quality of counseling is critical to improving acceptance of post-abortion contraception Objective To examine the prevalence of outcome reporting bias — the selection for publication of a subset of the original recorded outcome variables on the basis of the results — and its impact on Cochrane review s. Design A nine point classification system for missing outcome data in r and omised trials was developed and applied to the trials assessed in a large , unselected cohort of Cochrane systematic review s. Research ers who conducted the trials were contacted and the reason sought for the non-reporting of data . A sensitivity analysis was undertaken to assess the impact of outcome reporting bias on review s that included a single meta- analysis of the review primary outcome . Results More than half ( 157/283 ( 55 % ) ) the review s did not include full data for the review primary outcome of interest from all eligible trials . The median amount of review outcome data missing for any reason was 10 % , whereas 50 % or more of the potential data were missing in 70 ( 25 % ) review s. It was clear from the publications for 155 ( 6 % ) of the 2486 assessable trials that the research ers had measured and analysed the review primary outcome but did not report or only partially reported the results . For reports that did not mention the review primary outcome , our classification regarding the presence of outcome reporting bias was shown to have a sensitivity of 88 % ( 95 % CI 65 % to 100 % ) and specificity of 80 % ( 95 % CI 69 % to 90 % ) on the basis of responses from 62 trialists . A third of Cochrane review s ( 96/283 ( 34 % ) ) contained at least one trial with high suspicion of outcome reporting bias for the review primary outcome . In a sensitivity analysis undertaken for 81 review s with a single meta- analysis of the primary outcome of interest , the treatment effect estimate was reduced by 20 % or more in 19 ( 23 % ) . Of the 42 meta-analyses with a statistically significant result only , eight ( 19 % ) became non-significant after adjustment for outcome reporting bias and 11 ( 26 % ) would have overestimated the treatment effect by 20 % or more . Conclusions Outcome reporting bias is an under-recognised problem that affects the conclusions in a substantial proportion of Cochrane review s. Individuals conducting systematic review s need to address explicitly the issue of missing outcome data for their review to be considered a reliable source of evidence . Extra care is required during data extraction , review ers should identify when a trial reports that an outcome was measured but no results were reported or events observed , and contact with trialists should be encouraged Abstract Objective To examine the extent and nature of outcome reporting bias in a broad cohort of published r and omised trials . Design Retrospective review of publications and follow up survey of authors . Cohort All journal articles of r and omised trials indexed in PubMed whose primary publication appeared in December 2000 . Main outcome measures Prevalence of incompletely reported outcomes per trial ; reasons for not reporting outcomes ; association between completeness of reporting and statistical significance . Results 519 trials with 553 publications and 10 557 outcomes were identified . Survey responders ( response rate 69 % ) provided information on unreported outcomes but were often unreliable — for 32 % of those who denied the existence of such outcomes there was evidence to the contrary in their publications . On average , over 20 % of the outcomes measured in a parallel group trial were incompletely reported . Within a trial , such outcomes had a higher odds of being statistically non-significant compared with fully reported outcomes ( odds ratio 2.0 ( 95 % confidence interval 1.6 to 2.7 ) for efficacy outcomes ; 1.9 ( 1.1 to 3.5 ) for harm outcomes ) . The most commonly reported reasons for omitting efficacy outcomes included space constraints , lack of clinical importance , and lack of statistical significance . Conclusions Incomplete reporting of outcomes within published articles of r and omised trials is common and is associated with statistical non- significance . The medical literature therefore represents a selective and biased subset of study outcomes , and trial protocol s should be made publicly available Objectives To compare two post-abortion family planning ( FP ) service packages on contraceptive use and repeat abortion rate  among young women in three cities in China . Methods In this cluster-r and omized trial , one FP service package included provision of limited information and referral to existing FP services , and the other , more comprehensive , package consisted – in addition to the above simple package – of individual counselling , free provision of contraceptive material s , and involvement of the male partner . Eight matched pairs of hospitals were certified by central ized r and omization . Women undergoing abortion were followed up for six months , and data were collected in two rounds , before and after the intervention . Results We followed a total of 2336 women younger than 25 years ( 555 before and 555 after the simple intervention package ; 634 before and 592 after the comprehensive intervention package ) . Both packages increased use of any contraceptive method , but the comprehensive approach also increased use of more effective methods . Odds ratios for consistent and correct use of condoms were 2.32 ( 95 % confidence interval 1.55–3.46 ) and 2.78 ( 1.81–4.26 ) , respectively , compared with the simple package . The rates of unwanted pregnancies and repeat abortions were somewhat reduced for both packages , with no significant statistical difference between them . Conclusion Couples who received the comprehensive post-abortion FP service appear to use more effective contraceptive methods and show better compliance Past efforts to promote  family planning in Pakistan have been disappointing , but between 1990 - 91 and 2000 - 01 contraceptive use has more than doubled . This rise has coincided with a concerted effort on the part of the Pakistani government to increase access to contraceptive services , particularly in rural areas . The Lady Health Worker Programme ( LHWP ) , initiated under the Ministry of Health in the early 1990s , aim ed at integrating family planning into the doorstep provision of primary health care . This paper presents findings from the first national evaluation of this Programme . Data are analyzed from a r and om sample survey of 4277 women living in households served by the LHWP and those living in control areas .  Logistic regression analysis was performed to determine the effect of the Programme on the uptake of modern reversible contraceptive methods  , controlling for other independent variables . The data provide strong evidence that the LHWP has succeeded in increasing modern contraceptive use among rural women . Women served by Lady Health Workers are significantly more likely to use a modern reversible method  than women in communities not served by the Programme ( OR=1.50 , 95 % CI=1.04 - 2.16 , p=0.031 ) , even after controlling for various household and individual characteristics . The model of providing doorstep services through community-based female workers should remain central to achieving universal access to safe family planning methods  by the end of the decade -- the long-term objective of Pakistan 's most recent population policy adopted in 2002 This pilot study conducted in Muzaffarnagar district in the state of Uttar Pradesh , India , demonstrates the potential for using traditional medical practitioners in the delivery of  family planning services after a brief training period . Practitioners participated continuously in the program for an intervention period of two years during which their services were accepted by the community . The impact of their involvement was reflected in increased knowledge of permanent as well as reversible contraceptive methods and in higher contraceptive use rates , especially of reversible methods adopted by women younger than 25 years ( from 8 percent to 37 percent ) , in the intervention villages , as compared with increased knowledge and use ( from 13 percent to 25 percent ) of permanent methods alone in the control villages OBJECTIVE To evaluate the addition of structured contraceptive counseling to usual care on choice , initiation , and continuation of very effective contraception after uterine aspiration . METHODS We conducted a RCT of a version of the WHO Decision-Making Tool for Family Planning Clients and Providers with women having a procedure for a spontaneous or induced abortion . Our intervention provided structured , st and ardized counseling . We r and omized women to usual care or usual care with structured counseling . Our outcomes included choosing a very effective contraceptive method and 3 months continuation . RESULTS Fifty-four percent of all participants chose a very effective method . Women in the intervention group were no more likely to choose a very effective method ( OR 0.74 , 95 % CI 0.44 , 1.26 ) or to initiate their method compared to the usual care group ( OR 0.65 , 95 % CI 0.31 , 1.34 ) . In multivariate models , structured counseling was not associated with using a very effective method at 3 months ( AOR 1.06 , 95 % CI 0.53 , 2.14 ) . CONCLUSION In this setting , structured counseling had little impact on contraceptive method choice , initiation , or continuation . PRACTICE IMPLICATION S Adding structured counseling did not increase the proportion choosing or initiating very effective contraception in a practice setting where physicians already provide individualized counseling PURPOSE To evaluate the effectiveness of a youth-friendly intervention in promoting one safe sex behavior-contraception and condom use among unmarried young people aged 15 - 24 years in Shanghai , China . METHODS The study was conducted in two towns of a suburban area of Shanghai ( one as the intervention and the other as the control ) , with comparable socio-cultural-economic and demographic characteristics . The intervention intended to build awareness and offer counseling and services related to sexuality and reproduction among  unmarried youths , in addition to the routine program activities , which were exclusively provided in the control site . Baseline surveys were conducted in both sites before the implementation of the intervention , and similar surveys were conducted in both sites 20 months after the intervention had been initiated to test the feasibility and effectiveness of the intervention . In total , 1220 unmarried young people from the intervention site and 1007 from the control site , including 1304 out-of-school youths and 923 high school students , were recruited , and about 92 % of them were successfully followed up . Four main measures were examined ( i.e. , ever contraceptive use , current regular contraceptive use , ever condom use , and contraceptive use at onset of sexual intercourse-if it occurred during the course of the intervention ) . The reasons for nonuse of contraceptives , the status of joint decision on contraception and the first method used were also assessed . Data were analyzed using Logistic regression models with dichotomous measures of contraceptive use and Generalized Estimating Equations ( GEEs ) with repeated measures . RESULTS At baseline , there was no statistical difference in contraceptive use between the intervention and control groups . After intervention , the proportions reporting regular contraceptive use and condom use in the intervention group were much higher than that in the control group ( p < .001 ) . A group x time interaction effect ( p < .0001 ) was found for regular contraceptive use and ever condom use . Logistic regression analysis with dichotomous measures of contraceptive use and GEEs with repeated measures showed similar results . The regular contraceptive use and ever condom use were correlated with subject 's occupation and family economic status , respectively . After adjusting for demographic factors , the subjects from the intervention group were 14.58 ( OR ) times as likely to use contraceptives at onset of intercourse as those from the control group ( 95%CI : 8.55 - 24.87 , p < .0001 ) . Similar results were found for both females and males . CONCLUSIONS A multifaceted intervention program that provided information and skills , as well as counseling and services , appears to have positive influences on  contraceptive practice and condom use  among unmarried young females and males in suburban Shanghai Abstract Objectives : To evaluate impact of postnatal health education for mothers  on infant care and postnatal family planning practice s in Nepal . Design : R and omised controlled trial with community follow up at 3 and 6 months post partum by interview . Initial household survey of study areas to identify all pregnant women to facilitate follow up . Setting : Main maternity hospital in Kathm and u , Nepal . Follow up in urban Kathm and u and a periurban area southwest of the city . Subjects : 540 mothers r and omly allocated to one of four groups : health education immediately after birth and three months later ( group A ) , at birth only ( group B ) , at three months only ( group C ) , or none ( group D ) . Interventions : Structured baseline household question naire ; 20 minute , one to one health education at birth and three months later . Main outcome measures : Duration of exclusive breast feeding , appropriate immunisation of infant , knowledge of oral rehydration solution and need to continue breast feeding in diarrhoea , knowledge of infant signs suggesting pneumonia , uptake of postnatal family planning . Results : Mothers in groups A and B ( received health education at birth ) 
    Output:
    
Community-based interventions and antenatal contraceptive counselling improved uptake of copper IUD contraception .