Guest guest Posted April 30, 2010 Report Share Posted April 30, 2010 Dr FehringI have a former nicu nurse friend who is very interested in getting trained.  Do you all offer online training similar to Baron's course? Can you please point me in the right direction to help this friend join our cohort. Any information including price and class schedules would be greatly appreciated. Many thanks! Sincerely, Hundredmark, RN,BSN  An interesting response to the study that has been posted by : Hany Lashen, Senior Clinical Lecturer / Honorary Consultant in Reproductive Medicine University of Sheffield Send response to journal: Dear Sir I read with interest the findings of this paper prompted by the immediate media attraction this paper has received. There is a magnificent amount of data in this study that renders it worthy of publication however, despite addressing the weakness of the study the authors have neglected 2 major weaknesses; the first is the self selection which lies in the reason for not taking the pill in the first place. Did the never users want to and were deemed not suitable for health reasons, strong family history or obesity. In such case the 2 groups started the study on unequal footing with regard to their health and disease risk. Some of them may had suffered infertility problems and had no reason to take to take the pill in the first place, which explains the difference in parity between the groups. Such group have their pertinent health risk such as ovarian and endometrial cancer. Second, there is no mention of body weight or any other anthropometric measures in the data collected. Given that obesity is a strong confounder of most of the diseases assessed by the study and a contraindication to taking the pill, I consider neglecting to collect such data a major flaw in the study. The study was started in the late 60s and obesity has only become a major problem relatively recently therefore the chance of including equal number of obese and overweight women in the 2 groups is very unlikely and the chance of selection bias is subsequently high. In fact, the contra-indications to prescribing the pill would have been more adhered to in those days when obesity and overweight were less common than under the current climate allowing more opportunity that the non-users were more likely to be either overweight or obese. Another issue in support of selection bias, albeit inadvertent in this case, is the significantly higher risk of violent death which reflects common personality traits or environmental exposure pertinent to those who chose the combined contraceptive which is mentioned in a pure scientific context and not meant in any negative sense. The drop out rate reach one third of the population which was commented upon by the authors nevertheless, its significance was conveniently played down. I do not wish to reduce the significance of the study, in fact I applaud the authors for the magnificent work which offers a justifiable reassurance that the pill does not carry the once thought high risk of disease and cancer. Furthermore, despite the inferiority of this evidence compared to a prospective randomised trial, it is cost effective and offers a reasonable degree of comprehensibility. Competing interests: None declared ________________________________________ From: nfpprofessionals [nfpprofessionals ] on behalf of alicia [ahuntleyinterserv] Sent: Friday, March 12, 2010 8:39 PM To: NFP list Subject: there has to be something wrong with this study http://news.yahoo.com/s/nm/20100312/hl_nm/us_contraceptive_pill_risk Has anyone had a chance to read the actual study? Harry Truman once quipped, "I never give them hell. I just tell the truth and they think its hell." ahuntleyinterserv ------------------------------------ Quote Link to comment Share on other sites More sharing options...
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