1.  Peer Reviewed Title: Women's perspectives on family planning service quality: an exploration of differences by race, ethnicity and language. Author: Becker D; Klassen AC; Koenig MA; LaVeist TA; Sonenstein FL; Tsui AO Source: Perspectives On Sexual and Reproductive Health. 2009 Sep;41(3):158-65. Abstract: CONTEXT: Despite calls to make family planning services more responsive to the values, needs and preferences of clients, few studies have asked clients about their experiences or values, and most have used surveys framed by researchers', rather than clients', perspectives. METHODS: Forty in-depth interviews exploring lifetime experiences with and values regarding services were conducted with 18-36-year-old women who visited family planning clinics in the San Francisco Bay Area in 2007. Women were categorized as black, white, English- or Spanish-speaking Latina, or of mixed ethnicity to allow examination of differences by racial, ethnic and language group. Interviews were audiotaped, transcribed and coded thematically; matrices were then used to compare the themes that emerged across the subgroups. RESULTS: Eight themes emerged as important to women's views of services: service accessibility, information provision, attention to client comfort, providers' personalization of care, service organization, providers' empathy, technical quality of care and providers' respect for women's autonomy. Women reported that it was important to feel comfortable during visits, to feel that their decision-making autonomy was respected, to have providers show empathy and be nonjudgmental, and to see the same provider across visits. The only notable difference among racial, ethnic and language groups was that Spanish-speaking Latinas wanted to receive language-appropriate care and contraceptive information. CONCLUSIONS: Future surveys of family planning service quality should include measures of the factors that women value in such care, and efforts to improve providers' communication and counseling skills should emphasize the personalization of services and respect for clients' autonomy. Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | INTERVIEWS | FAMILY PLANNING SURVEYS | WOMEN | CLIENTS | ETHNIC GROUPS | FAMILY PLANNING | LANGUAGE | HEALTH SERVICES | QUALITY OF HEALTH CARE | COMMUNICATION | COUNSELING | Developed Countries | North America | Americas | Data Collection | Research Methodology | Demographic Factors | Population | Program Activities | Programs | Organization and Administration | Cultural Background | Population Characteristics | Delivery of Health Care | Health | Health Services Evaluation | Program Evaluation | Clinic Activities Document Number: 342713 |
| 2. Peer Reviewed Title: Social Network Influences on Male and Female Condom Use Among Women Attending Family Planning Clinics in the United States. Author: Choi KH; Gregorich SE Source: Sexually Transmitted Diseases. 2009 Aug 21; Abstract: BACKGROUND:: Research has shown that social networks play an important role in determining health behaviors. However, little is known about their influence on male and female condom use among women. METHODS:: We analyzed data obtained from 157 sexually-active women who enrolled in the Female Condom Intervention Trial from June 2003 to November 2004 in Northern California and completed an audio computer-assisted self interview at baseline and 3-months. RESULTS:: At the 3-month assessment, the mean number of male and female "conversation" network members (i.e., nonspouse/sex partner people with whom respondents had discussed male and female condoms in the past 3 months) was 1.62 and 1.03, respectively. Results of multiple logistic regression analyses showed that male and female condom use was higher among women with at least 1 network member who encouraged using the male condom (OR, 3.39; 95% CI, 1.52, 7.56) and the female condom (OR, 6.03; 95% CI, 1.95, 18.61), respectively. Female condom use was also associated with having "dense" female condom conversation networks (i.e., at least 2 of respondents' network members knew one another; OR, 8.42; 95% CI, 3.05, 23.29). CONCLUSIONS:: The significant association between conversation network characteristics and male and female condom use suggests that more research is needed to better understand the role of conversation networks in affecting condom use among women. Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | FAMILY PLANNING ACCEPTORS | WOMEN | SOCIAL NETWORKS | CONDOM USE | FEMALE CONDOMS | HIV PREVENTION | INTERPERSONAL COMMUNICATION | QUESTIONNAIRES | SEX BEHAVIOR | Developed Countries | North America | Americas | Family Planning Programs | Family Planning | Demographic Factors | Population | Friends and Relatives | Family and Household | Sociocultural Factors | Risk Reduction Behavior | Behavior | Vaginal Barrier Methods | Barrier Methods | Contraceptive Methods | Contraception | HIV Infections | Viral Diseases | Diseases | Communication Document Number: 342592 |
| 3. Peer Reviewed Title: Complications of surgical abortion. Author: Diedrich J; Steinauer J Source: Clinical Obstetrics and Gynecology. 2009 Jun;52(2):205-12. Abstract: Surgical abortion is one of the most common procedures performed in reproductive-aged women and when performed by a skilled provider in the appropriate setting, it is one of the safest surgeries. Though the risk of complications is low, it increases exponentially with gestational age. Factors increasing risk of morbidity may be demographic, such as increasing patient age; medical, such as prior cesarean delivery; and procedural, such as inadequate dilation. This chapter will provide information on how to recognize factors that increase risk, steps to minimize risk, and to identify and manage complications promptly. Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | WOMEN | ABORTION | PREGNANCY, SECOND TRIMESTER | MORBIDITY | BLEEDING | POSTABORTION CARE | CERVICAL LACERATION | Developed Countries | North America | Americas | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Diseases | Signs and Symptoms | Health Services | Delivery of Health Care | Health Document Number: 342243 Notification |
| 4. Peer Reviewed Title: Cost savings from the provision of specific methods of contraception in a publicly funded program. Author: Foster DG; Rostovtseva DP; Brindis CD; Biggs MA; Hulett D; Darney PD Source: American Journal of Public Health. 2009 Mar;99(3):446-51. Abstract: OBJECTIVES: We examined the cost-effectiveness of contraceptive methods dispensed in 2003 to 955,000 women in Family PACT (Planning, Access, Care and Treatment), California's publicly funded family planning program. METHODS: We estimated the number of pregnancies averted by each contraceptive method and compared the cost of providing each method with the savings from averted pregnancies. RESULTS: More than half of the 178,000 averted pregnancies were attributable to oral contraceptives, one fifth to injectable methods, and one tenth each to the patch and barrier methods. The implant and intrauterine contraceptives were the most cost-effective, with cost savings of more than $7.00 for every $1.00 spent in services and supplies. Per $1.00 spent, injectable contraceptives yielded savings of $5.60; oral contraceptives, $4.07; the patch, $2.99; the vaginal ring, $2.55; barrier methods, $1.34; and emergency contraceptives, $1.43. CONCLUSIONS: All contraceptive methods were cost-effective-they saved more in public expenditures for unintended pregnancies than they cost to provide. Because no single method is clinically recommended to every woman, it is medically and fiscally advisable for public health programs to offer all contraceptive methods. Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | COST EFFECTIVENESS | CONTRACEPTIVE METHODS | ORAL CONTRACEPTIVES | INJECTABLES | BARRIER METHODS | IUD | CONTRACEPTIVE IMPLANTS | Developed Countries | North America | Americas | Evaluation Indexes | Quantitative Evaluation | Evaluation | Contraception | Family Planning Document Number: 330488 |
| 5. Peer Reviewed Title: Analysis of pain and satisfaction with office-based hysteroscopic sterilization. Author: Levie M; Weiss G; Kaiser B; Daif J; Chudnoff SG Source: Fertility and Sterility. 2009 Aug 13; Abstract: OBJECTIVE: To assess pain and patient satisfaction with office-based hysteroscopic sterilization. DESIGN: This prospective, observational study was designed to assess patient pain perception and satisfaction with office-based hysteroscopic sterilization using the Essure device (Conceptus, Mountain View, CA). SETTING: Faculty practice office at an inner-city urban medical center. PATIENT(S): Women seeking hysteroscopic sterilization. INTERVENTION(S): Office hysteroscopic sterilization under local anesthesia. MAIN OUTCOME MEASURE(S): Pain assessed at the time of the procedure by a 0-10 visual scale and satisfaction by a 1-5 scale. RESULT(S): From June 2003 to June 2006, 209 patients were recruited. The mean scores for average procedural pain, most procedural pain, and average menstrual pain were 2.6 +/- 2.1, 3.3 +/- 2.5, and 3.6 +/- 2.6, respectively. Standardized pain scores revealed that 149 subjects (70%) experienced average pain that was less than or equal to the pain experienced with their menses. Mean satisfaction rating for the procedure was 4.7 +/- 0.71. CONCLUSION(S): Office-based hysteroscopic sterilization performed with local anesthesia alone is well tolerated, and patients are satisfied with this method for permanent sterilization. Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | PROSPECTIVE STUDIES | CLIENTS | PAIN | SATISFACTION | HEALTH SERVICES | STERILIZATION, SEXUAL | MENSTRUATION | Developed Countries | North America | Americas | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Signs and Symptoms | Diseases | Psychological Factors | Behavior | Delivery of Health Care | Health | Family Planning | Reproduction Document Number: 342551 |
| 6. Title: Provision of contraceptive counseling by internal medicine residents. Author: Lohr PA; Schwarz EB; Gladstein JE; Nelson AL Source: Journal of Women's Health. 2009 Jan-Feb;18(1):127-31. Abstract: BACKGROUND: Internists care for women of reproductive age, but little is known about internists' training in contraceptive counseling or provision of contraceptive methods. METHODS: We surveyed 152 residents in nine internal medicine programs in Los Angeles County during the 2004-2005 academic year. The self-administered, 29-item survey included demographic, contraceptive practice pattern, and training variables. Descriptive statistics and multivariable logistic regression were used to illustrate counseling and prescribing practices and to identify predictors of counseling and provision of contraceptives. RESULTS: Most (95%) future internists surveyed reported clinical responsibility for women of reproductive age. However, few (17%) routinely provided contraceptive counseling, and 39% rarely or never provided contraceptive counseling. Residents had prescribed contraception on a median of 2 (range 0-30) occasions in the past year. Some formal education in contraceptive methods was reported by 51% of respondents; however, 75% of residents reported a desire for more training about contraception. CONCLUSIONS: Internal medicine residents commonly care for women of reproductive age but infrequently assess or address contraceptive needs. Further training on how to provide contraception is desired by many internal medicine residents. Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | MEDICAL STUDENTS | WOMEN | REPRODUCTIVE AGE | CONTRACEPTIVE METHODS | CONTRACEPTION | NEEDS | COUNSELING | PERFORMANCE IMPROVEMENT | Developed Countries | North America | Americas | Students | Education | Demographic Factors | Population | Reproduction | Family Planning | Economic Factors | Clinic Activities | Program Activities | Programs | Organization and Administration | Management Document Number: 331217 |
| 7. Peer Reviewed Title: Analgesia/pain management in first trimester surgical abortion. Author: Meckstroth KR; Mishra K Source: Clinical Obstetrics and Gynecology. 2009 Jun;52(2):160-70. Abstract: Management of pain during abortion is a critical aspect of patient care. Although it is not always possible to offer a range of pain control options in every setting, individualizing pain medications as much as possible for patients' preferences is likely to improve satisfaction with the abortion experience. Evidence suggests that higher volume (at least 200 mg lidocaine) and deeper injections are beneficial for cervical block. Adding intravenous sedation with a moderate dose of fentanyl and midazolam reduces the pain scores. Oral benzodiazepines may improve satisfaction and anxiety. Deep sedation and general anesthesia are important options for women with significant medical conditions or complicated procedures. Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | PAIN | ABORTION | ANALGESIA | ANESTHESIA | EVALUATION | Developed Countries | North America | Americas | Signs and Symptoms | Diseases | Fertility Control, Postconception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342248 Notification |
| 8. Peer Reviewed Title: Oral contraceptive pretreatment in women undergoing controlled ovarian stimulation in ganirelix acetate cycles may, for a subset of patients, be associated with low serum luteinizing hormone levels, reduced ovarian response to gonadotropins, and early pregnancy loss. Author: Meldrum DR; Scott RT Jr; Levy MJ; Alper MM; Noyes N Source: Fertility and Sterility. 2009 May;91(5):1963-5. Abstract: Oral contraceptive pretreatment facilitated scheduling of pure FSH/GnRH antagonist cycles but in a small subset of patients was associated with low serum LH levels, reduced ovarian response, and early pregnancy loss. Supplementation with LH could be examined as a possible way to improve cycle outcome. Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | WOMEN | GONADOTROPINS, PITUITARY | IMPLANTATION | ABORTION, SPONTANEOUS | PREGNANCY | ORAL CONTRACEPTIVES | Developed Countries | North America | Americas | Demographic Factors | Population | Gonadotropins | Hormones | Endocrine System | Physiology | Biology | Pregnancy, First Trimester | Reproduction | Pregnancy Complications | Diseases | Contraceptive Methods | Contraception | Family Planning Document Number: 341248 |
| 9. Peer Reviewed Title: Accuracy of information given by Los Angeles County pharmacies about emergency contraceptives to sham patient in need. Author: Nelson AL; Jaime CM Source: Contraception. 2009 Mar;79(3):206-10. Abstract: BACKGROUND: As emergency contraception (EC) becomes increasingly available without prescription, it is important that women in need be provided accurate information about its use. STUDY DESIGN: A telephone survey of all retail pharmacies in Los Angeles County was conducted by women posing as a 23-year-old who wanted to prevent pregnancy after an unprotected act of intercourse. RESULTS: One thousand four hundred sixty unduplicated pharmacies listed in the Yellow Pages 2007 were called between October 2007 and April 2008. Sixty-nine percent had EC available on site; 19% referred the caller elsewhere. The remainder said nothing could be done or hung up. Multiple calls and multiple recitations of the situation were needed in over one third of calls. Isolated incidents of inappropriate comments occurred. CONCLUSION: While most pharmacies provided information about EC that was consistent with labeling, barriers still exist to both accurate information and timely access to that product. Language: English Keywords: CALIFORNIA | RESEARCH REPORT | SURVEYS | WOMEN | PHARMACISTS | PHARMACY DISTRIBUTION | FAMILY PLANNING EDUCATION | EMERGENCY CONTRACEPTION | TELECOMMUNICATIONS | United States of America | North America | Americas | Developed Countries | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Education | Contraception | Family Planning | Broadcast Media | Mass Media | Communication Document Number: 330057 |
| 10. Title: Serious adverse events associated with the use of misoprostol alone for cervical preparation prior to early second trimester abortions (12-16 weeks) [letter] Author: Nucatola D; Saulsberry V; Gatter M; Roth N Source: Contraception. 2009 Feb;79(2):158. Abstract: We write to correct an inadvertent misstatement in our recent article. In it, we stated that "patients generally prefer a 1-day procedure which can be performed with misoprostol, but not with laminaria." Use of same-day laminaria is an option. While it is true that patients generally prefer a 1-day procedure, it is not true that this can only be achieved with same-day misoprostol. The use of same-day laminaria for this purpose is also available, safe and effective. Indeed, the Society for Family Planning guidelines for cervical preparation before abortions at 20 weeks state that early in the second trimester, overnight dilation is not required. In our clinical setting, we have chosen not to utilize single-day cervical preparation with laminaria for reasons related to procedure pain and cost as well as staffing and patient flow. We apologize for any confusion this may have caused. (full-text) Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | CRITIQUE | MISOPROSTOL | ABORTION | PROGRAM EFFECTIVENESS | Developed Countries | North America | Americas | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Fertility Control, Postconception | Family Planning | Program Evaluation | Programs | Organization and Administration Document Number: 331058 Notification |
| 11. Title: Transcervical sterilization: a comparison of essure(r) permanent birth control system and adiana(r) permanent contraception system. Author: Palmer SN; Greenberg JA Source: Reviews In Obstetrics and Gynecology. 2009 Spring;2(2):84-92. Abstract: Transcervical sterilization has moved female sterilization from a minimally invasive laparoscopic technique, which requires entry into the abdominal cavity, to a less invasive hysteroscopic procedure. Along with the decreased potential for complications, its ease of performance with minimal anesthesia has facilitated a move from the operating room to the office. This review compares the available data on transcervical sterilization procedures to better understand the strengths and weakness of each system. Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | CONTRACEPTION RESEARCH | FEMALE CONTRACEPTION | CERVIX | LAPAROSCOPY | FEMALE STERILIZATION | TUBAL OCCLUSION | USFDA | PRODUCT APPROVAL | Developed Countries | North America | Americas | Contraception | Family Planning | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Sterilization, Sexual | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Legislation Document Number: 342044 |
| 12. Peer Reviewed Title: Infectious complications of pregnancy termination. Author: Rahangdale L Source: Clinical Obstetrics and Gynecology. 2009 Jun;52(2):198-204. Abstract: Infectious complications are a significant source of morbidity and mortality associated with pregnancy termination worldwide. However, in areas where abortion practices are legal, the risk of infection is very low. Proper technique, prophylaxis, and initial management of septic abortion have led to a significant decrease in risk of serious complications such as sepsis and death. Clinical features, management, and prevention of postabortal infection will be reviewed in the setting of legalized abortion. Language: English Keywords: GLOBAL | UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | WOMEN | ABORTION | ENDOMETRIOSIS | INFECTIONS | Developed Countries | North America | Americas | Demographic Factors | Population | Pregnancy Complications | Diseases Document Number: 342244 Notification |
| 13. Peer Reviewed Title: Follicular development in a 7-day versus 4-day hormone-free interval with an oral contraceptive containing 20 mcg ethinyl estradiol and 1 mg norethindrone acetate. Author: Rible RD; Taylor D; Wilson ML; Stanczyk FZ; Mishell DR Jr Source: Contraception. 2009 Mar;79(3):182-8. Abstract: BACKGROUND: Combined oral contraceptive (COC) formulations with 20 mcg ethinyl estradiol (EE) have a greater incidence of ovarian hormone production and follicular development, which can be managed by shortening the number of hormone-free days per COC cycle. This study evaluates differences in follicular development during a 7-day versus 4-day hormone-free interval in a COC regimen with 20 mcg EE and 1 mg norethindrone acetate. STUDY DESIGN: Forty-one healthy women were randomized in an open-label fashion to this formulation in either a 24/4 or a 21/7 day regimen for three cycles. Estradiol, progesterone, follicle-stimulating hormone, luteinizing hormone and inhibin B were measured daily from Cycle 2, Day 21 to Cycle 3, Day 3 and on Day 7 of Cycle 3. Follicular diameter and Hoogland score were calculated on Cycle 2, Days 21, 24 and 28 and Cycle 3, Days 3 and 7. RESULTS: Sixty-six percent of subjects in the 21/7 group and 70% of the subjects in the 24/4 group developed a follicle greater than 10 mmdiameter. Ovarian steroid hormone levels, Hoogland scores and bleeding patterns were not statistically significant between the groups. CONCLUSION: In contrast to prior studies, this analysis suggests no difference in follicle development or bleeding patterns among women receiving a 21/7 or 24/4 regimen of a 20-mcg EE/1-mg norethindrone acetate COC. Language: English Keywords: CALIFORNIA | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | COMPARATIVE STUDIES | WOMEN | FOLLICLE STIMULATING HORMONE | ORAL CONTRACEPTIVES, COMBINED | ETHINYL ESTRADIOL | NORETHINDRONE | ADMINISTRATION AND DOSAGE | MENSTRUATION | TIME FACTORS | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Demographic Factors | Population | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Physiology | Biology | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Progestin | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction | Population Dynamics Document Number: 330059 |
| 14. Peer Reviewed Title: Barriers to adolescents' getting emergency contraception through pharmacy access in California: differences by language and region. Author: Sampson O; Navarro SK; Khan A; Hearst N; Raine TR; Gold M; Miller S; de Bocanegra HT Source: Perspectives On Sexual and Reproductive Health. 2009 Jun;41(2):110-8. Abstract: CONTEXT: In California, emergency contraception is available without a prescription to females younger than 18 through pharmacy access. Timely access to the method is critical to reduce the rate of unintended pregnancy among adolescents, particularly Latinas. METHODS: In 2005-2006, researchers posing as English- and Spanish-speaking females-who said they either were 15 and had had unprotected intercourse last night or were 18 and had had unprotected sex four days ago-called 115 pharmacy-access pharmacies in California. Each pharmacy received one call using each scenario; a call was considered successful if the caller was told she could come in to obtain the method. Chi-square tests were used to assess differences between subgroups. In-depth interviews with 22 providers and pharmacists were also conducted, and emergent themes were identified. RESULTS: Thirty-six percent of all calls were successful. Spanish speakers were less successful than English speakers (24% vs. 48%), and callers to rural pharmacies were less successful than callers to urban ones (27% vs. 44%). Although rural pharmacies were more likely to offer Spanish-language services, Spanish-speaking callers to these pharmacies were the least successful of all callers (17%). Spanish speakers were also less successful than English speakers when calling urban pharmacies (30% vs. 57%). Interviews suggested that little cooperation existed between pharmacists and clinicians and that dispensing the method at clinics was a favorable option for adolescents. CONCLUSIONS: Adolescents face significant barriers to obtaining emergency contraception, but the expansion of Spanish-language services at pharmacies and greater collaboration between providers and pharmacists could improve access. Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | ADOLESCENTS | HISPANICS | LANGUAGE | EMERGENCY CONTRACEPTION | OBSTACLES | PHARMACY DISTRIBUTION | PROGRAM ACCESSIBILITY | Developed Countries | North America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Ethnic Groups | Cultural Background | Communication | Contraception | Family Planning | Organization and Administration | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Program Evaluation Document Number: 341529 |
| 15. Title: Contraceptive hormone use and cardiovascular disease. Author: Shufelt CL; Bairey Merz CN Source: Journal of the American College of Cardiology. 2009 Jan 20;53(3):221-31. Abstract: Contraceptive hormones, most commonly prescribed as oral contraceptives (OCs), are a widely utilized method to prevent ovulation, implantation, and, therefore, pregnancy. The Women's Health Initiative demonstrated cardiovascular risk linked to menopausal hormone therapy among women without pre-existing cardiovascular disease, prompting a review of the safety, efficacy, and side effects of other forms of hormone therapy. A variety of basic science, animal, and human data suggests that contraceptive hormones have antiatheromatous effects; however, relatively less is known regarding the impact on atherosclerosis, thrombosis, vasomotion, and arrhythmogenesis. Newer generation OC formulations in use indicate no increased myocardial infarction risk for current users, but a persistent increased risk of venous thromboembolism. There are no cardiovascular data available for the newest generation contraceptive hormone formulations, including those that contain newer progestins that lower blood pressure, as well as the nonoral routes (transdermal and vaginal). Current guidelines indicate that, as with all medication, contraceptive hormones should be selected and initiated by weighing risks and benefits for the individual patient. Women 35 years and older should be assessed for cardiovascular risk factors including hypertension, smoking, diabetes, nephropathy, and other vascular diseases, including migraines, prior to use. Existing data are mixed with regard to possible protection from OCs for atherosclerosis and cardiovascular events; longer-term cardiovascular follow-up of menopausal women with regard to prior OC use, including subgroup information regarding adequacy of ovulatory cycling, the presence of hyperandrogenic conditions, and the presence of prothrombotic genetic disorders is needed to address this important issue. Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | WOMEN | HORMONES | ORAL CONTRACEPTIVES | HORMONE REPLACEMENT THERAPY | CARDIOVASCULAR EFFECTS | CONTRACEPTIVE USE-EFFECTIVENESS | RISK BEHAVIOR | RISK FACTORS | SCREENING | Developed Countries | North America | Americas | Demographic Factors | Population | Endocrine System | Physiology | Biology | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Effectiveness | Behavior | Examinations and Diagnoses Document Number: 329606 |
| 16. Peer Reviewed Title: Second-trimester induction of labor. Author: Vargas J; Diedrich J Source: Clinical Obstetrics and Gynecology. 2009 Jun;52(2):188-97. Abstract: Second-trimester abortions are most commonly performed in the United States via dilation and evacuation; however, there are instances in which the use of systemic abortifacients is necessary. Lack of trained staff to perform late abortion procedures, fetal anomalies, and patient preference are important considerations when selecting the method of termination. Second-trimester abortions with misoprostol-only protocols require higher doses, side effects are more common, and the time to complete the abortion is longer in comparison to mifepristone-misoprostol combinations. Feticidal agents are recommended to avoid transient fetal survival. This chapter will review medical induction methods between gestational ages of 14 and 24 weeks that are commonly used in the United States. Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | ABORTION | PREGNANCY, SECOND TRIMESTER | SIDE EFFECTS | MISOPROSTOL | Developed Countries | North America | Americas | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology Document Number: 342245 Notification |
| 17. Peer Reviewed Title: What physicians need to know about the legal status of abortion in the United States. Author: Weitz TA Source: Clinical Obstetrics and Gynecology. 2009 Jun;52(2):130-9. Abstract: Abortion is the most politically contested social issue in the United States, a debate that manifests itself in extensive regulation of abortion as a health care service. This study provides a brief history of the judicial acceptance of abortion regulation and an overview of the most common forms of abortion regulation affecting physicians in the United States. The article concludes with a discussion of pending threats to the legal right to abortion in the United States and recommended resources where physicians can find assistance to comply with existing laws. Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | ABORTION | PHYSICIANS | LEGISLATION | Developed Countries | North America | Americas | Fertility Control, Postconception | Family Planning | Health Personnel | Delivery of Health Care | Health | Political Factors | Sociocultural Factors Document Number: 342251 Notification |
| 18. Peer Reviewed Title: Pregnancy intention and preterm birth: differential associations among a diverse population of women. Author: Afable-Munsuz A; Braveman P Source: Perspectives on Sexual and Reproductive Health. 2008 Jun;40(2):66-73. Abstract: Studies published to date provide mixed evidence on the relationship between unintended pregnancy and preterm birth, and none take into consideration that the meaning of unintended pregnancy may vary across racial and ethnic groups. Data from the 1999-2003 rounds of the Maternal and Infant Health Assessment, a population-based, representative survey of postpartum women in California, were used to assess the relationship between pregnancy intention and preterm birth. For racial and ethnic groups in which an association was found, sequential logistic regression was conducted to further examine the relationship while controlling for socioeconomic characteristics. In unadjusted results, pregnancy intention was associated with preterm birth among both whites and immigrant Latinas, but not among blacks or U.S.-born Latinas. Among whites, compared with women who reported that their pregnancy was intended, those who were unsure about their pregnancy had elevated odds of preterm birth (odds ratio, 1.4), as did those who reported their pregnancy was unwanted (1.7) or mistimed (1.4). Among immigrant Latinas, those who reported being unsure about their pregnancy were at higher risk of preterm birth than were those who reported an intended pregnancy (1.6). After adjustment for socioeconomic factors, the association remained significant for immigrant Latinas who were unsure about their pregnancy (1.5), but none of the associations remained significant for whites. Women's interpretations of questions about pregnancy intention and their social experiences regarding pregnancy intention may vary by race or ethnicity. Studies on the association between pregnancy intention and preterm birth may need to be group-specific. Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | STATISTICAL REGRESSION | ETHNIC GROUPS | PREGNANCY, UNPLANNED | PREMATURE BIRTH | SOCIOECONOMIC FACTORS | REPRODUCTIVE BEHAVIOR | Developed Countries | North America | Americas | Data Analysis | Research Methodology | Cultural Background | Population Characteristics | Demographic Factors | Population | Fertility | Population Dynamics | Pregnancy Outcomes | Pregnancy | Reproduction | Economic Factors Document Number: 308656 |
| 19. Title: Who is using emergency contraception? Awareness and use of emergency contraception among California women and teens. Author: Baldwin SB; Solorio R; Washington DL; Yu H; Huang YC Source: Women's Health Issues. 2008 Sep-Oct;18(5):360-368. Abstract: Emergency contraception (EC) reduces women's risk for pregnancy after unprotected intercourse, and women's awareness of the method is increasingly important for expanding access. However, knowledge of EC alone does not predict use, and few population data exist to describe EC use among those aware of the method. Using data from the 2003 California Health Interview Survey, we measured EC awareness among 11,392 women ages 15-44, and EC use among 7,178 respondents who were aware of EC and at risk for pregnancy. Using x2 analyses and multivariable logistic regression, we examined population characteristics that epidemiologically predict EC awareness and use, including age, race/ethnicity, income, health insurance status, usual source of health care, immigration status, languages spoken at home, and urban versus rural residence. Nearly 76% of respondents had heard of EC, but awareness was lower among teens, women of color, poor women, women with publicly funded health insurance, those without a usual source of care, immigrants, non-English-language speakers, and rural residents. Among women aware of EC, about 4% reported having used the method in the previous year; young age, low income, attending a community/government clinic for care or not having a source of care, and living in an urban area significantly increased the odds for using EC. Among California women in 2003, awareness and use of EC remained low. However, similar rates of use were reported among racial, ethnic, and linguistic subgroups. Those most likely to report use of the method included population groups at high risk for unintended pregnancy. (author's) Language: English Keywords: CALIFORNIA | UNITED STATES OF AMERICA | RESEARCH REPORT | EMERGENCY CONTRACEPTION | AWARENESS | YOUTH | ADOLESCENTS, FEMALE | WOMEN | SURVEYS | ETHNIC GROUPS | PHARMACIES | SOCIOCULTURAL FACTORS | SOCIOECONOMIC FACTORS | North America | Americas | Developed Countries | Contraception | Family Planning | Knowledge | Age Factors | Population Characteristics | Demographic Factors | Population | Adolescents | Sampling Studies | Studies | Research Methodology | Cultural Background | Health Facilities | Delivery of Health Care | Health | Economic Factors Document Number: 328167 |
| 20. Peer Reviewed Title: Sex trade in a male-to-female transgender population: psychosocial correlates of inconsistent condom use. Author: Clements-Nolle K; Guzman R; Harris SG Source: Sexual Health. 2008 Feb;5(1):49-54. Abstract: Research suggests that because of economic necessity, many male-to-female (MTF) transgender individuals trade sex for money, drugs, housing, and other things they may need. To date, no studies have quantitatively assessed psychosocial correlates of condom use with this population. The authors conducted a cross sectional study with 190 MTF transgender individuals involved in sex trade in San Francisco, California. Multivariate logistic regression was used to determine factors independently associated with inconsistent condom use during receptive anal sex with exchange partners. About one fifth of our participants reported inconsistent condom use during receptive anal sex in the past 6 months. In the multivariate model, low self-esteem [adjusted odds ratio (AOR)=3.09; 95% confidence interval (CI) (1.28, 7.47)], a history of forced sex or rape [AOR=2.91; 95% CI (1.06, 8.01)], and use of crack-cocaine [AOR=2.59; 95% CI (1.09, 6.13)] were independently associated with inconsistent condom use. Findings highlight an urgent need for multilevel risk reduction interventions for MTF transgender individuals involved in sex trade. Such interventions will be most effective if they address the psychosocial context of sexual risk taking by focusing on issues such as low self-esteem, sexual violence, and illicit drug use. Language: English Keywords: CALIFORNIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | KAP SURVEYS | MULTIVARIATE ANALYSIS | MEN HAVING SEX WITH MEN | SEX WORKERS | PSYCHOSOCIAL FACTORS | CONDOM USE | ANAL SEX | SELF ESTEEM | RAPE | DRUG USE AND ABUSE | CONTRACEPTIVE USAGE DETERMINANTS | United States of America | North America | Americas | Developed Countries | Research Methodology | Surveys | Sampling Studies | Studies | Data Analysis | Sex Behavior | Behavior | Risk Reduction Behavior | Psychological Factors | Crime | Social Problems | Sociocultural Factors | Contraceptive Usage | Contraception | Family Planning Document Number: 322848 |
| 21. Title: Editorial summary of symposium on hypertensive disorders of pregnancy. Author: Druzin ML; Charles B; Johnson AL Source: Current Opinion in Obstetrics and Gynecology. 2008 Apr;20(2):91-95. Abstract: Hypertensive disorders of pregnancy, particularly the preeclampsia/eclampsia syndrome, remain the leading causes of worldwide pregnancy-related maternal and neonatal mortality and morbidity. This group of conditions are a 'riddle wrapped in a mystery inside an enigma' to quote Winston Churchill. We are fortunate to have contributions from leading clinical experts who have devoted many years of their professional careers attempting to solve this conundrum. Dr Jack Moodley has provided us with a perspective on clinical management in under-resourced countries. Referral to experts, aggressive treatment of hypertension and use of magnesium sulfate improves care. Dr Shennan focuses on the assessment of risk, close antenatal surveillance and timely delivery. Dr Uzan continues to champion the use of aspirin for prevention of preeclampsia, even though the evidence is contradictory. Dr Sibai addresses the lack of evidence for calcium, vitamin C and E in prevention of preeclampsia. Dr Von Dadelszen is developing a new paradigm for the classification of these disorders and emphasizes the importance of evidence-based intervention. Evidence suggests that treatment of severe hypertension, seizure prophylaxis with magnesium sulfate, and management by experienced healthcare professionals will improve maternal, fetal and neonatal outcomes. Well designed studies will lead to evidence-based improvement in caring for mothers and babies world-wide. (author's) Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | CRITIQUE | LITERATURE REVIEW | PREGNANT WOMEN | PREGNANCY | PREECLAMPSIA | ECLAMPSIA | HYPERTENSION | Developed Countries | North America | Americas | Population Characteristics | Demographic Factors | Population | Reproduction | Pregnancy Complications | Diseases | Vascular Diseases Document Number: 326661 |
| 22. Peer Reviewed Title: Adolescent experiences with the vaginal ring. Author: Epstein LB; Sokal-Gutierrez K; Ivey SL; Raine T; Auerswald C Source: Journal of Adolescent Health. 2008 Jul;43(1):64-70. Abstract: Purpose: To understand racial/ethnic minority adolescent females' experiences with the vaginal ring. Methods: We conducted in-depth interviews with a clinic-based sample of 32 young women aged 15-24 years who had used the vaginal ring. Results: Qualitative analysis using grounded theory revealed that adolescents undergo a multistage process when trying the ring and adopting ring use. These stages include hearing about the ring, initial reactions, first experiences with insertion and removal, and first sexual experiences. Adolescents subsequently enter an assessment and adjustment stage in which they decide whether to adopt or discontinue ring use. Ultimately they share their experiences with friends. Conclusions: The model developed provides a context within which providers may advise adolescents as they begin use of the ring. Some specific recommendations are offered. (author's) Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | QUALITATIVE RESEARCH | ADOLESCENTS, FEMALE | VAGINAL RING | REPRODUCTIVE HEALTH | CONTRACEPTIVE METHODS | CONTRACEPTION | PROGRAM ACCEPTABILITY | Developed Countries | North America | Americas | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Family Planning | Health | Program Evaluation | Programs | Organization and Administration Document Number: 327342 |
| 23. Peer Reviewed Title: Provider advice to women may vary by women's social class and ethnicity. Author: Hollander D Source: Perspectives on Sexual and Reproductive Health. 2008 Mar;40(1):54. Abstract: Low-income black and Latina women surveyed in the Los Angeles area were more likely than middle-class whites to say that during a current or recent pregnancy, a health care professional had advised them to limit their childbearing. In a multivariate analysis of the survey results, ethnicity and social class were the only characteristics associated with the odds that women had received this kind of advice. Low-income Latinas (along with women who had large families and unmarried women) also had elevated odds of saying that their doctor or someone else had discouraged them from having children. The survey sample consisted of 193 low income and 146 middle-class women who were pregnant or had given birth in the previous five years. Women were considered low income if they were on welfare, had health coverage through Medi-Cal (California's Medicaid program) or were uninsured; low income participants were recruited at offices of the Special Supplementary Food Program for Women, Infants and Children. Women were classified as middle-class if they had a college or graduate degree and had health insurance other than Medi-Cal; these women were recruited at a variety of locations in middle-class neighborhoods and through electronic mailing lists. (excerpt) Language: English Keywords: CALIFORNIA | RESEARCH REPORT | KAP SURVEYS | COMPARATIVE STUDIES | HISPANICS | WOMEN | SOCIOECONOMIC STATUS | INCOME | SOCIAL CLASS | CONTRACEPTION | FEMALE STERILIZATION | REFERRAL AND CONSULTATION | SOCIAL DISCRIMINATION | RACE RELATIONS | PHYSICIAN-PATIENT RELATIONS | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Socioeconomic Factors | Economic Factors | Family Planning | Sterilization, Sexual | Program Activities | Programs | Organization and Administration | Social Problems | Sociocultural Factors | Political Factors | Interpersonal Relations | Behavior Document Number: 325190 |
| 24. Peer Reviewed Title: Differences in HIV vaccine acceptability between genders. Author: Kakinami L; Newman PA; Lee SJ; Duan N Source: AIDS Care. 2008 May;20(5):542-546. Abstract: The development of safe and efficacious preventive HIV vaccines offers the best long-term hope of controlling the AIDS pandemic. Nevertheless, suboptimal uptake of safe and efficacious vaccines that already exist suggest that HIV vaccine acceptability cannot be assumed, particularly among communities most vulnerable to HIV. The present study aimed to identify barriers and motivators to future HIV vaccine acceptability among low socioeconomic, ethnically diverse men and women in Los Angeles County. Participants completed a cross-sectional survey assessing their attitudes and beliefs regarding future HIV vaccines. Hypothetical HIV vaccine scenarios were administered to determine HIV vaccine acceptability. Two-sided t-tests were performed, stratified by gender, to examine the association between vaccine acceptability and potential barriers and motivators. Barriers to HIV vaccine acceptability differed between men and women. For women, barriers to HIV vaccine acceptability were related to their intimate relationships (p less than 0.05), negative experiences with health care providers (p less than 0.05) and anticipated difficulties procuring insurance (p less than 0.01). Men were concerned that the vaccine would weaken the immune system (p less than 0.005) or would affect their HIV test results (p less than 0.05). Motivators for women included the ability to conceive a child without worrying about contracting HIV (p less than 0.10) and support from their spouse/significant other for being vaccinated (p less than 0.10). Motivators for men included feeling safer with sex partners (p less than 0.05) and social influence from friends to get vaccinated (p less than 0.005). Family support for HIV immunization was a motivator for both men and women (p less than 0.10). Gender-specific interventions may increase vaccine acceptability among men and women at elevated risk for HIV infection. Among women, interventions need to focus on addressing barriers due to gendered power dynamics in relationships and discrimination in health care. Among men, education that addresses fears and misconceptions about adverse effects of HIV vaccination on health and the importance of vaccination as one component of integrated HIV prevention may increase vaccine acceptability. (author's) Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | CLIENTS | LOW INCOME POPULATION | VACCINES | HIV PREVENTION | SEX FACTORS | OBSTACLES | MOTIVATION | RESEARCH AND DEVELOPMENT | PROGRAM ACCEPTABILITY | Developed Countries | North America | Americas | Program Activities | Programs | Organization and Administration | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Psychological Factors | Behavior | Technology | Program Evaluation Document Number: 326944 |
| 25. Title: Unemployment among women. Examining the relationship of physical and psychological intimate partner violence and posttraumatic stress disorder. Author: Kimerling R; Alvarez J; Pavao J; Mack KP; Smith MW Source: Journal of Interpersonal Violence. 2008;:[14] p. Abstract: Prior research has demonstrated that intimate partner violence (IPV) is associated with employment instability among poor women. The current study assesses the broader relationship between IPV and women's workforce participation in a population-based sample of 6,698 California women. We examined past-year IPV by analyzing specific effects of physical violence, psychological violence, and posttraumatic stress disorder (PTSD) symptoms as predictors of unemployment. Results indicated substantial rates of unemployment among women who reported IPV, with rates of 20% among women who experienced psychological violence, 18% among women who experienced physical violence, and 19% among women with PTSD symptoms. When the relationship was adjusted for demographic characteristics and educational attainment, PTSD (adjusted odds ratio [AOR] = 1.60; 95% confidence interval [CI] = 1.22, 2.09) and psychological violence (AOR = 1.78; 95% CI = 1.36, 2.32), but not physical violence, were associated with unemployment.Implications for supported employment programs and workplace responses to IPV are discussed. (author's) Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | SUMMARY REPORT | PROSPECTIVE STUDIES | WOMEN | DOMESTIC VIOLENCE | MENTAL HEALTH | GASTROINTESTINAL EFFECTS | PSYCHOLOGICAL FACTORS | STRESS | SIDE EFFECTS | IMPACT | EMPLOYMENT | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Crime | Social Problems | Sociocultural Factors | Health | Physiology | Biology | Behavior | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Communication | Macroeconomic Factors | Economic Factors Document Number: 326733 |
| 26. Title: Effect of reproductive factors and oral contraceptives on breast cancer risk in BRCA1/2 mutation carriers and noncarriers: results from a population-based study. Author: Lee E; Ma H; McKean-Cowdin R; Van Den Berg D; Bernstein L; Henderson BE; Ursin G Source: Cancer Epidemiology, Biomarkers and Prevention. 2008 Nov;17(11):3170-8. Abstract: BACKGROUND: Multiparity and breast-feeding reduce breast cancer risk, whereas oral contraceptive use may slightly increase breast cancer risk in the general population. However, the effects of these factors in BRCA1 and BRCA2 mutation carriers are less clear. METHODS: Case patients were 1,469 women from Los Angeles County ages 20 to 49 years with newly diagnosed breast cancer. Control subjects were 444 women without breast cancer, individually matched to a subset of cases on race, age, and neighborhood. BRCA1/2 genes were sequenced in the cases, and odds ratios of breast cancer associated with various reproductive and hormonal factors in BRCA1/2 mutation carriers and noncarriers were estimated using multivariable logistic regression. RESULTS: Ninety-four women had a deleterious BRCA1 or BRCA2 mutation. Number of full-term pregnancies was inversely associated with breast cancer risk regardless of BRCA1/2 mutation status. Longer breast-feeding duration was protective among noncarriers but not among mutation carriers; however, this apparent effect modification was not statistically significant (P = 0.23). Neither oral contraceptive use overall nor the use of low-dose oral contraceptives was associated with an increased risk of breast cancer in any subgroup. CONCLUSIONS: Our results suggest that parity protects against breast cancer in BRCA1/2 mutation carriers, whereas breast-feeding does not. Our data suggest no association between oral contraceptive use and breast cancer risk in BRCA1/2 mutation carriers. Further confirmation that currently available low-dose oral contraceptives do not increase breast cancer risk in carriers is important from a public health perspective given the high prevalence of oral contraceptive use in the United States. Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | CASE STUDIES | WOMEN | MULTIPARITY | BREAST CANCER | ORAL CONTRACEPTIVES, LOW-DOSE | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Parity | Fertility Measurements | Fertility | Population Dynamics | Cancer | Neoplasms | Diseases | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning Document Number: 330082 |
27.  Title: Combined oral contraceptive use and epithelial ovarian cancer risk: Time-related effects. Author: Lurie G; Wilkens LR; Thompson PJ; McDuffie KE; Carney ME Source: Epidemiology. 2008 Mar;19(2):237-243. Abstract: Although the protective effect of oral contraceptives (OCs) use against epithelial ovarian cancer is well-established, there remain gaps in our understanding of the contributions of time-related characteristics of OC use to risk. This population-based case-control study, carried out in Hawaii and Los Angeles 1993-2006, included 813 cases of epithelial ovarian cancer and 992 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression. Epithelial ovarian cancer risk was reduced 5 or more years after initiation of OC use (OR = 0.18; CI = 0.08-0.39). Each year of use provided a 5% reduction (CI = 2%-8%) in risk. A positive gradient in risk with time since first OC use was independent of duration of OC use. The inverse association of OCs with risk was attenuated decades after last use, but was not affected by age at first or last use. OC use for less than 1 year was associated with decreased ovarian cancer risk (OR = 0.45; CI = 0.26-0.79) only among recent users (less than or equal to 20 years from diagnosis/interview). Women who used OCs for a year or more were protected for at least 3 decades after they stopped use. Reduction in epithelial ovarian cancer risk associated with OC use became apparent after a short latency period and short duration of use, and was long-lasting. Time since first use and time since last use seem to modify the association of OCs with ovarian cancer risk independently of duration of use. (author's) Language: English Keywords: UNITED STATES OF AMERICA | HAWAII | CALIFORNIA | RESEARCH REPORT | WOMEN | OVARIAN CANCER | ORAL CONTRACEPTIVES | RISK FACTORS | TIME FACTORS | LONGTERM EFFECTS | Developed Countries | North America | Americas | Demographic Factors | Population | Cancer | Neoplasms | Diseases | Contraceptive Methods | Contraception | Family Planning | Biology | Population Dynamics Document Number: 325019 |
| 28. Peer Reviewed Title: Treatment of acne using a 3-milligram drospirenone/20-microgram ethinyl estradiol oral contraceptive administered in a 24/4 regimen: a randomized controlled trial. Author: Maloney JM; Dietze P Jr; Watson D; Niknian M; Lee-Rugh S Source: Obstetrics and Gynecology. 2008 Oct;112(4):773-81. Abstract: OBJECTIVE: To assess the efficacy of the combined oral contraceptive containing 3-mg drospirenone/20-microgram ethinyl estradiol (3-mg drospirenone/20-microgram ethinyl estradiol) administered as 24 consecutive days of active treatment after a 4-day hormone-free interval (24/4 regimen) compared with placebo for the treatment of moderate acne vulgaris. METHODS: Healthy females aged 14-45 years with moderate acne were randomized in this double-blind study to 3-mg drospirenone/20-microgram ethinyl estradiol (n=270) or placebo (n=268) for six cycles of 28 days. The primary outcome measures of acne lesion counts and Investigator Static Global Assessment scale ratings were assessed at baseline and during cycles 1, 3, and 6. RESULTS: The percentage reduction from baseline to endpoint for total lesions is 46.3% for 3-mg drospirenone/20-microgram ethinyl estradiol 24/4 combination oral contraceptive group and 30.6% for placebo group (P<.001). The likelihood of participants in the 3-mg drospirenone/20-microgram ethinyl estradiol 24/4 regimen group having "clear" or "almost clear" skin as rated by the investigators at endpoint was about threefold (odds ratio 3.13, 95% confidence interval 1.69-5.81; P=.001) greater than in the placebo group. The 3-mg drospirenone/20-microgram ethinyl estradiol 24/4 regimen was well tolerated. CONCLUSION: The low-dose combined oral contraceptive containing 3-mg drospirenone/20-microgram ethinyl estradiol administered in a 24/4 regimen significantly reduced acne lesion counts more effectively than placebo and demonstrated greater improvement in the Investigator Static Global Assessment rating of acne. The safety profile was consistent with low-dose combined oral contraceptive use. Language: English Keywords: CALIFORNIA | RESEARCH REPORT | CLINICAL RESEARCH | DOUBLE-BLIND STUDIES | EVALUATION INDEXES | WOMEN | ACNE | ETHINYL ESTRADIOL | ORAL CONTRACEPTIVES, COMBINED | ADMINISTRATION AND DOSAGE | HEALTH STATUS INDEXES | ORAL CONTRACEPTIVES, SIDE EFFECTS | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Quantitative Evaluation | Evaluation | Demographic Factors | Population | Dermatitis | Diseases | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Contraceptive Methods | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Safety | Safety | Public Health Document Number: 329095 |
| 29. Title: Abortion costs, sexual behavior, and pregnancy rates. Author: Medoff MH Source: Social Science Journal. 2008;:[17] p. Abstract: This paper empirically examines the question: Do the direct (price) and indirect (restrictive abortion laws) costs of obtaining an abortion have an impact on the likelihood of women becoming pregnant? Using the economic model of fertility control, the empirical results find that increases in the real price of obtaining an abortion cause a statistically and numerically significant decrease in the pregnancy rate of all women of childbearing age (15-44 years) and teens (ages 15-19). A state parental involvement law is also found to decrease the pregnancy rate of all women of childbearing age and an even numerically larger decrease for teens. A state Medicaid funding restriction of abortion, waiting period law, and mandatory counseling law do not have a statistically significant impact on the pregnancy rate of either group. Taken together the empirical results are consistent with the hypothesis that women's sexual behavior is influenced by the direct and indirect cost of obtaining an abortion. (author's) Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | ADOLESCENTS, FEMALE | ABORTION | ABORTION LAW | FERTILITY DETERMINANTS | PREGNANCY RATE | SEX BEHAVIOR | FEES | IMPACT | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Fertility | Population Dynamics | Fertility Measurements | Behavior | Financial Activities | Economic Factors | Communication Document Number: 324825 Notification |
| 30. Title: Promoting environmental justice through community-based participatory research: The role of community and partnership capacity. Author: Minkler M; Vasquez VB; Tajik M; Petersen D Source: Health Education and Behavior. 2008 Feb;35(1):119-137. Abstract: Community-based participatory research (CBPR) increasingly is being used to study and address environmental justice. This article presents the results of a cross-site case study of four CBPR partnerships in the United States that researched environmental health problems and worked to educate legislators and promote relevant public policy. The authors focus on community and partnership capacity within and across sites, using as a theoretical framework Goodman and his colleagues' dimensions of community capacity, as these were tailored to environmental health by Freudenberg, and as further modified to include partnership capacity within a systems perspective. The four CBPR partnerships examined were situated in NewYork, California, Oklahoma, and North Carolina and were part of a larger national study. Case study contexts and characteristics, policy-related outcomes, and findings related to community and partnership capacity are presented, with implications drawn for other CBPR partnerships with a policy focus. (author's) Language: English Keywords: UNITED STATES OF AMERICA | NEW YORK | CALIFORNIA | OKLAHOMA | NORTH CAROLINA | RESEARCH REPORT | CASE STUDIES | ENVIRONMENTAL POLLUTION | INEQUALITIES | COMMUNITY PARTICIPATION | RESEARCH ACTIVITIES | PROGRAM EVALUATION | PUBLIC HEALTH | Developed Countries | North America | Americas | Studies | Research Methodology | Environmental Degradation | Environment | Socioeconomic Factors | Economic Factors | Organization and Administration | Programs | Health Document Number: 324662 |
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