Can NFP be taught in two short,easy lessons? Simplified NFP for isolated and/or busy couples

Researchers used life table rates from study and comparison groups from rural and urban areas of Cagayan de Oro City, the Philippines to test a simplified method of teaching natural family planning (NFP) defined by calendar, mucus, and cervix indicators. This method included a 6 page booklet, 2 30-minute training sessions, and a question and answer period. Fear of side effects from other contraceptive methods was the leading reason for using NFP (79.4% urban, 85.8% rural). Religious motivation and fear of side effects followed for urban couples, but the percentage was low (14.6%). In rural areas, religious motivation place 3rd (4.1%) preceded by other reasons (6.9%). User error resulted in low accidental pregnancy rates (.8%). Method failure was responsible for higher failure rates than user error, but they were still relatively low (3.4% total). In rural areas, the reason for failure was unclear in 2.6% of couples, but it was only .9% among urban couples. Rural couples who used NFP to space births (spacers) had 2 times the failure rate of those rural couples who used NFP to limit births (limiters) [69% vs. 31%]. Urban spacers had a higher failure rate than urban limiters, but the difference was smaller than it was for rural couples (54.8% vs. 45.2%). Lactation did not have a clear effect on failure rates. For example, in urban areas, partially lactating women had a lower failure rate than nonlactating women (41.9% vs. 58.1%), but in rural areas, lactation had the opposite effect (63.6% for lactating women and 36.4% for nonlactating women). Risk taking resulted in more 6 month pregnancy rates among urban couples than rural couples (12.3% vs. 8.2%). At the end of 6 months, 67.5% of all couples still used the new simplified NFP method (70.3% rural vs. 64.7% urban). Therefore the new simplified NFP method was an effective method for spacing or limiting births.     

Alternative Markov Properties for Chain Graphs

Graphical Markov models use graphs to represent possible dependences among statistical variables. Lauritzen, Wermuth, and Frydenberg (LWF) introduced a Markov property for chain graphs (CG): graphs that can be used to represent both structural and associative dependences simultaneously and that include both undirected graphs (UG) and acyclic directed graphs (ADG) as special cases. Here an alternative Markov property (AMP) for CGs is introduced and shown to be the Markov property satisfied by a block-recursive linear system with multivariate normal errors. This model can be decomposed into a collection of conditional normal models, each of which combines the features of multivariate linear regression models and covariance selection models, facilitating the estimation of its parameters. In the general case, necessary and sufficient conditions are given for the equivalence of the LWF and AMP Markov properties of a CG, for the AMP Markov equivalence of two CGs, for the AMP Markov equivalence of a CG to some ADG or decomposable UG, and for other equivalences. For CGs, in some ways the AMP property is a more direct extension of the ADG Markov property than is the LWF property.     

Marital Conflict Trajectories and Associations With Children's Disruptive Behavior

We seek to identify heterogeneous trajectories of marital conflict during the early childhood period, identify predictors associated with these trajectories, and examine associations between trajectory group membership and children's disruptive behavior. Participants were 469 families examined 4 times when the children were 2 to 54 months of age. Maternal reports of marital conflict, adverse childhood experiences, depressive symptoms, and sociodemographic characteristics were collected, and averaged maternal and paternal reports of child disruptive problems were used. Using growth mixture modeling, 3 trajectories of marital conflict were identified: high increasing (21.8%), high decreasing (7%), and low stable (71.2%). Maternal adverse childhood experiences predicted increased risk of belonging in the high‐increasing group, whereas depressive symptoms predicted increased risk of belonging in the high‐decreasing group. Importantly, children of mothers in the high‐increasing group exhibited higher levels of disruptive behavior at 54 months when compared with children of mothers in the high‐decreasing and low‐stable groups.