Attitudes of women and pharmacists on the opportunity to obtain a progestogen-only pill over the counter - Italian outcomes

PURPOSE

Scrutinizing, among potential providers and users, the perceived claim and interest for over the counter (OTC) accessibility of a progestogen-only pill (POP).

METHODS

Cross-sectional, descriptive study based on an online survey of 1000 women and 100 pharmacists in Italy, part of a larger sample including Germany and Spain.

RESULTS

Hormonal contraceptive methods are used by 35%; 5% of women reported currently not using contraception, 40% using a barrier method, and 20% a method considered less effective than male condoms (including 16% withdrawal and 4% natural methods and fertility/contraceptive applications). Almost 80% of women felt knowledgeable about the different contraceptive method, but about 1/3 had experienced difficulty accessing their oral contraceptive (OC) in the past two years. Women reacted positively to the proposition of an OTC-POP and 85% agreed that they would discuss the decision to buy it with their doctor; 75% reported they would continue to see their doctor for other reproductive health issues, including screening. The most frequent barrier is cost (reported by 25-33% of women) followed by long waiting times for doctor appointments and lack of personal time to schedule an appointment.Pharmacists (66%) would be likely/fairly likely to recommend the POP after appropriate training, agreeing that the benefits of an OTC-POP included improved access for women, saving them time and giving them more independence.

CONCLUSIONS

Potential users of contraception in Italy have a positive attitude toward OTC-POP, with doctors continuing to have a relevant role. Following training, pharmacists are also positive.

The views of women and pharmacists on the desirability of a progestogen-only pill over the counter. Results of a survey in Germany, Italy and Spain

PURPOSE

To explore the perceived need and enthusiasm for over the counter (OTC) progestogen-only pills (POP).

MATERIALS AND METHODS

A web-based survey of 1000 sexually active women (16-45) and 100 pharmacists in Germany, Italy and Spain.

RESULTS

Despite not wanting to conceive, 5-6% of women in each country were not using contraception and 8-20% were using methods less effective than condoms. At least 74% of respondents felt knowledgeable about the different contraceptives available but at least 1/3 had experienced difficulty accessing oral contraceptive (OCs) in the past two years. The cost of contraceptives, the need to see a doctor and long waits for appointments were cited as barriers for not using OCs. The majority agreed they would discuss with their doctor the decision to buy the POP, consult about side effects and other reproductive health issues. Over 2/3 of pharmacists in each country would be very, or fairly, likely to recommend the POP, agreeing that the benefits included improved access for women, and offered them more independence.

CONCLUSIONS

Asked directly, women in Germany, Spain and Italy currently using contraception are positive about a POP OTC. Pharmacists are also positive, with the overwhelming majority in favour of providing POPs.

Plasmid-encoded protein: the principal factor in the "metabolic burden" associated with recombinant bacteria

Experimental elucidation of the metabolic load placed on bacteria by the expression of foreign protein is presented. The host/vector system is Escherichia coli RR1/pBR329 (amp(r), cam(r), and let(r)). Plasmid content results, which indicate that the plasmid copy number monotonically increases with decreasing growth rate, are consistent with the literature on ColE1-like plasmids. More significantly, we have experimentally quantified the reduction in growth rate brought about by the expression of chloramphenicol-acetyl-transferase (CAT) and beta-lactamase. Results indicate a nearly linear decrease in growth rate with increasing foreign protein content. Also, the change in growth rate due to foreign protein expression depends on the growth rate of the cells. The observed linear relationship is media independent and, to our knowledge, previously undocumented. Furthermore, the induction of CAT, mediated by the presence of chloramphenicol, is shown to occur only at low growth rates, which further increases the metabolic load.Results are vdelineated with the aid of a structured kinetic model representing the metabolism of recombinant E. coli. In this article, several previous hypotheses and model predictions are justified and validated. This work provides an important step in the development of comprehensive, methabolically-structured, kinetic models capable of prediciting optimal conditions for maximizing product yield.

Gas concentration effects on secondary metabolite production by plant cell cultures

One aspect of secondary metabolite production that has been studied relatively infrequently is the effect of gaseous compounds on plant cell behavior. The most influential gases are believed to be oxygen, carbon dioxide and other volatile hormones such as ethylene and methyl jasmonate. Organic compounds of interest include the promising antimalarial artemisinin (known as "qing hao su" in China where it has been a folk remedy for centuries) that is produced by Artemisia annua (sweet wormwood) and taxanes used for anticancer therapy that are produced by species of Taxus (yew). The suspension cultures of both species were grown under a variety of dissolved gas conditions in stoppered culture flasks and under conditions of continuous headspace flushing with known gas mixtures. An analysis is presented to show the culture conditions are such that equilibrium between the culture liquid and gas head-space is assured. The growth rate of the cells and their production rates of artemisinin and paclitaxel were determined. These and other parameters are correlated as functions of the gas concentrations. Interdependence of ethylene and methyl jasmonate is also explored with respect to regulation of secondary metabolite formation.

Methyl jasmonate induced production of taxol in suspension cultures of Taxus cuspidata: ethylene interaction and induction models

Suspension cultures of Taxus cuspidata were challenged with various concentrations and combinations of methyl jasmonate and ethylene. Taxol productivity increased 19-fold when T. cuspidata suspension cultures were exposed to 5 ppm ethylene and 10 microM methyl jasmonate. This increase was 15-fold when either 0 or 10 ppm ethylene was combined with 10 microM methyl jasmonate. The induction of taxol occurred within 51 h after elicitation and would reduce fermentation times and costs. Ethylene concentration at 50 ppm had an inhibitory effect on taxol production but not on phosphate uptake rate, suggesting independent regulation of taxol and physiological functions of the cell. A simple induction model is proposed to explain the action and effects of both ethylene and methyl jasmonate with regard to receptor binding and regulatory systems in plants.