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That rate may not accurately reflect the real world effectiveness of the shots, however, since the study included only women who received them every three months, as required, Peipert says. Louis.”It definitely confirms what most people in family planning have expected, that the LARC methods are by far the most effective,” says Espey, who was not involved in the study.

There are realist, liberal, and Marxist approaches to hegemony. Historically, they are generally islands or peninsulas, which lend them a degree of security from ground invasion. The British Empire rested upon the security of the British Isles, for instance, and the United States, though not an island, is surrounded by oceans on two sides and by relatively weak allies (Canada and Mexico) to the north and south.

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