1.  Peer Reviewed Title: Scheduled hysterectomy for second-trimester abortion in a patient with placenta accreta. Author: Tocce K; Thomas VW; Teal S Source: Obstetrics and Gynecology. 2009 Feb;113(2 Pt 2):568-70. Abstract: BACKGROUND: As cesarean deliveries increase, so does placenta accreta. There is little evidence regarding management of patients with known or suspected abnormal placentation seeking abortion. CASE: A medically complicated patient with evidence of placenta increta on magnetic resonance imaging presented for pregnancy termination at 15 weeks of gestation. Scheduled hysterectomy was performed to avoid hemorrhage and subsequent complications. The patient did well postoperatively; her course was complicated only by a wound infection treated as an outpatient. Pathology was consistent with placenta increta. CONCLUSION: Placenta accreta has increased 13-fold in the past 30 years. In select patients with evidence of abnormal placentation, scheduled hysterectomy for termination of pregnancy is an option that may be considered. Language: English Keywords: COLORADO | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | PREGNANT WOMEN | ABORTION | CESAREAN SECTION | PREGNANCY, SECOND TRIMESTER | PREGNANCY COMPLICATIONS | HYSTERECTOMY | INFECTIONS | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Pregnancy | Reproduction | Diseases | Gynecologic Surgery | Urogenital Surgery Document Number: 330356 Notification |
| 2. Peer Reviewed Title: POWER for reproductive health: Results from a social marketing campaign promoting female and male condoms. Author: Bull SS; Posner SF; Ortiz C; Beaty B; Benton K Source: Journal of Adolescent Health. 2008 Jul;43(1):71-78. Abstract: Purpose: To evaluate effects of a 6-month social marketing campaign on awareness of, attitudes toward and use of female as well as male condoms for 15-25 year-old-women. Methods: Using a time-space sampling methodology, we conducted a cross-sectional survey of 3407 women at pre-campaign in 12 western U.S. neighborhoods on female and male condom awareness, attitudes, and use. Six of the 12 study neighborhoods were randomly selected to receive the POWER social marketing campaign designed to impact condom knowledge, attitudes, and use. The campaign was followed with another cross-sectional survey of 3,003 women in all 12 study neighborhoods on condom knowledge, attitudes, use and awareness of POWER materials. We compared pre-and post-campaign surveys to determine the efficacy of POWER and conducted post hoc analyses on post-campaign data to determine if exposure to POWER was related to higher levels of positive condom attitudes and norms and condom use. Results: We found no differences between neighborhoods with and without the POWER campaign with regard to our primary outcomes. To diagnose reasons for this null effect, we examined outcomes post hoc examining the influence of POWER exposure. Post hoc analyses show some evidence that exposure to POWER was associated with condom use. In the context of the nested trial, this raises concerns that post test only evaluations are limited. Conclusions: Establishing the efficacy of a social marketing campaign is challenging. This group randomized trial showed a null effect. Social marketing campaigns may need to have more media channels and saturation before they can show behavioral effects. Using a nested design with randomization at the community level and probability sampling introduces rigor not commonly seen in evaluations of social marketing campaigns. (author's) Language: English Keywords: UNITED STATES OF AMERICA | COLORADO | GEORGIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | SURVEYS | ADOLESCENTS, FEMALE | CONDOM USE | FEMALE CONDOMS | CONDOMS | CAMPAIGNS | PROMOTION | SOCIAL MARKETING | REPRODUCTIVE HEALTH | KNOWLEDGE | ATTITUDES | SEXUALLY TRANSMITTED DISEASES | FAMILY PLANNING | PROGRAM EVALUATION | Developed Countries | North America | Americas | Asia, Southwestern | Asia | Developing Countries | Research Methodology | Sampling Studies | Studies | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Risk Reduction Behavior | Behavior | Vaginal Barrier Methods | Barrier Methods | Contraceptive Methods | Contraception | Communication Programs | Communication | Marketing | Economic Factors | Health | Sociocultural Factors | Psychological Factors | Reproductive Tract Infections | Infections | Diseases | Programs | Organization and Administration Document Number: 327343 |
3.  Title: The effects of an individualized exercise intervention on body composition in breast cancer patients undergoing treatment. Author: Battaglini C; Bottaro M; Dennehy C; Rae L; Shields E Source: Sao Paulo Medical Journal. 2007 Jan;125(1):22-28. Abstract: Changes in metabolism have been reported in the majority of patients undergoing cancer treatment, and these are usually characterized by progressive change in body composition. The effects of aerobic exercise programs to combat the cancer and cancer treatment-related side effects, which include the negative changes in body composition, have been extensively reported in the literature. However, few resistance exercise intervention studies have hypothesized that breast cancer patients might benefit from this type of exercise. The purpose of this study was to determine whether exercise protocols that emphasize resistance training would change body composition and strength in breast cancer patients undergoing treatment. Randomized controlled trial, at the Campus Recreation Center and Rocky Mountain Cancer Rehabilitation Institute of the University of Northern Colorado, and the North Colorado Medical Center. Twenty inactive breast cancer patients were randomly assigned to a 21-week exercise group (n = 10) or a control group (n = 10). The exercise group trained at low to moderate intensity for 60 minutes on two days/week. The primary outcome measurements included body composition (skinfold method) and muscle strength (one repetition maximum). Significant differences in lean body mass, body fat and strength (p = 0.004, p = 0.004, p = 0.025, respectively) were observed between the groups at the end of the study. The results suggest that exercise emphasizing resistance training promotes positive changes in body composition and strength in breast cancer patients undergoing treatment. (author's) Language: English Keywords: COLORADO | RESEARCH REPORT | CLINICAL TRIALS | WOMEN | BREAST CANCER | TREATMENT | FITNESS | METABOLIC EFFECTS | SIDE EFFECTS | ANTHROPOMETRY | BODY WEIGHT | United States of America | North America | Americas | Developed Countries | Clinical Research | Research Methodology | Demographic Factors | Population | Cancer | Neoplasms | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology | Biology | Measurement Document Number: 316318 |
| 4. Peer Reviewed Title: Sex partner selection, social networks, and repeat sexually transmitted infections in young men: a preliminary report. Author: Ellen JM; Gaydos C; Chung SE; Willard N; Lloyd LV Source: Sexually Transmitted Diseases. 2006 Jan;33(1):18-21. Abstract: The goal of this study was to examine the risk for repeat sexually transmitted infections (STIs) associated with reducing the number of sex partners who come from within the social networks of males 13 to 25 years old in Baltimore, Maryland, and Denver, Colorado. Asymptomatic males diagnosed with chlamydia and/or gonorrhea as part of an asymptomatic chlamydia and gonorrhea male screening project were recruited and interviewed about their sexual behaviors and their perceptions of social characteristics and sexual behaviors of their sex partners. We characterized the sex partners of each participant as belonging to or not belonging to his social network. We examined whether a decrease in percentage of sex partners who were in the participant's social network was associated with repeat infection. There were 47 participants in Baltimore and 92 in Denver. In both cities, there was a trend toward a finding that decreasing the percentage of sex partners belonging to a participant's social network was protective for repeat STI. These data suggest that interventions may need to be designed to reduce the prevalence of infection in the social networks of infected men. (author's) Language: English Keywords: UNITED STATES OF AMERICA | MARYLAND | COLORADO | RESEARCH REPORT | INTERVIEWS | ADOLESCENTS, MALE | YOUTH | SEXUALLY TRANSMITTED DISEASES | GONORRHEA | CHLAMYDIA | TRANSMISSION | SOCIAL NETWORKS | SEXUAL PARTNERS | SEX BEHAVIOR | North America | Americas | Developed Countries | Data Collection | Research Methodology | Adolescents | Age Factors | Population Characteristics | Demographic Factors | Population | Reproductive Tract Infections | Infections | Diseases | Friends and Relatives | Family and Household | Behavior Document Number: 295476 |
| 5. Title: Religion and fertility in the United States: a geographic analysis. Author: Jordan L Source: [Unpublished] 2006. Presented at the Population Association of America, 2006 Annual Meeting, Los Angeles, California, March 30 - April 1, 2006. [56] p. Abstract: This paper examines the association between religious adherence and fertility rates across counties in the United States (1998-2002), controlling for other demographic and socioeconomic variables. Employing geographically weighted regression (GWR) analysis, this study finds that the relationship between religion and fertility differs remarkably over space, illustrating different spatial patterns according to religious group (e.g. Protestant-Mainline, Protestant-Evangelical, and Catholic). For Catholic adherence, there are positive, negative, and insignificant associations with fertility rates depending on the location. Such spatial patterning challenges fertility transition theory and supports cultural explanations of fertility differentials. (author's) Language: English Keywords: UNITED STATES OF AMERICA | COLORADO | SUMMARY REPORT | MULTIREGIONAL ANALYSIS | RELIGION | FERTILITY | CULTURE | POPULATION DISTRIBUTION | North America | Americas | Developed Countries | Research Methodology | Sociocultural Factors | Population Dynamics | Demographic Factors | Population | Geographic Factors Document Number: 316998 |
| 6. Title: Early start for HAART reduces treatment-related toxicities. Author: Nierengarten M Source: Lancet Infectious Diseases. 2006 Mar;6:128-129. Abstract: Along with reducing the incidence of HIV-related death and disease, initiating highly active antiretroviral therapy (HAART) early in the course of HIV infection reduces the incidence of common treatment-related toxicities. In a study presented at the 13th Conference on Retroviruses and Opportunistic Infections (Denver, CO, USA; Feb 5-9), Kenneth Lichtenstein (University of Colorado Health Sciences Center, Denver) reported a significantly decreased risk for peripheral neuropathy, renal insufficiency, and lipoatrophy in patients who initiated HAART at higher CD4 cell counts (350 cells per µL or higher) compared with those who initiated treatment at lower CD4 cell counts (200 cells per µL or lower). The potential for decreased toxicity, and a reduction in the incidence of HIV-related disease and death, was also associated with maintaining therapy for at least 95% of the time. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | COLORADO | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | ANTIRETROVIRAL THERAPY | ANTIRETROVIRAL DRUGS | TOXICITY | TREATMENT | CONTRACEPTIVE USE-EFFECTIVENESS | North America | Americas | Developed Countries | Persons Living With HIV/AIDS | Viral Diseases | Diseases | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology | Biology | Contraceptive Effectiveness | Contraception | Family Planning Document Number: 299378 |
| 7. Peer Reviewed Title: Inadvertent vesicular placement of a vaginal contraceptive ring presenting as persistent cystitis. Author: Teal SB; Craven WM Source: Obstetrics and Gynecology. 2006 Feb;107(2 Pt 2):470-472. Abstract: The NuvaRing is a soft, flexible, ringshaped vaginal contraceptive device that is placed by the user herself. Incorrect placement has not been described, because any intravaginal position allows appropriate hormonal delivery through the vaginal mucosa. A 22-year-old otherwise healthy woman presented with 2 months of urinary urgency, frequency, and pelvic pain, which were unresponsive to antibiotic therapy. Her symptoms began immediately after placement of a NuvaRing vaginal contraceptive device, which she was subsequently unable to locate. Thorough evaluation revealed the ring in the urinary bladder. Bladder or urethral foreign body should be considered in the evaluation of patients with chronic cystitis, especially if the patient uses vaginal medical devices. Intravesicular placement of a device may occur even without psychiatric or physical comorbidities. (author's) Language: English Keywords: UNITED STATES OF AMERICA | COLORADO | RESEARCH REPORT | CASE STUDIES | WOMEN | VAGINAL RING | CYSTITIS | CONTRACEPTIVE SAFETY | UROGENITAL EFFECTS | EXAMINATIONS AND DIAGNOSES | COMPLICATIONS | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Diseases | Safety | Public Health | Health | Urogenital System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 296796 |
| 8. Peer Reviewed Title: Inadvertent vesicular placement of a vaginal contraceptive ring presenting as persistent cystitis. Author: Teal SB; Craven WM Source: Obstetrics and Gynecology. 2006 Feb;107(2 Pt 2):470-472. Abstract: The NuvaRing is a soft, flexible, ringshaped vaginal contraceptive device that is placed by the user herself. Incorrect placement has not been described, because any intravaginal position allows appropriate hormonal delivery through the vaginal mucosa. A 22-year-old otherwise healthy woman presented with 2 months of urinary urgency, frequency, and pelvic pain, which were unresponsive to antibiotic therapy. Her symptoms began immediately after placement of a NuvaRing vaginal contraceptive device, which she was subsequently unable to locate. Thorough evaluation revealed the ring in the urinary bladder. Bladder or urethral foreign body should be considered in the evaluation of patients with chronic cystitis, especially if the patient uses vaginal medical devices. Intravesicular placement of a device may occur even without psychiatric or physical comorbidities. (author's) Language: English Keywords: UNITED STATES OF AMERICA | COLORADO | RESEARCH REPORT | CASE STUDIES | WOMEN | VAGINAL RING | CYSTITIS | CONTRACEPTIVE SAFETY | UROGENITAL EFFECTS | EXAMINATIONS AND DIAGNOSES | COMPLICATIONS | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Diseases | Safety | Public Health | Health | Urogenital System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care Document Number: 296797 |
| 9. Title: What if: How declines in teen births have improved poverty and child well-being in Colorado. Author: National Campaign to Prevent Teen Pregnancy Source: Washington, D.C., National Campaign to Prevent Teen Pregnancy, 2005 Apr. 3 p. Abstract: Years of research have closely linked teen pregnancy and early childbearing to a host of other critical social issues, including overall child health and well-being, out-of-wedlock births, educational attainment and workforce readiness, responsible fatherhood, and poverty in particular -- especially child poverty. For example, young children born to a mother who is a teenager, is not married, and did not finish high school are nine times more likely to be poor than children born to mothers without these three risk factors. Adolescent pregnancy and childbearing cost taxpayers at least $7 billion annually and place a serious economic burden on schools and on health, welfare and social service systems. The U.S. teen birth rate declined by 30 percent between 1991 and 2002--a significant decrease that has made major contributions to American communities. Illustrating this very point, the U.S. Congress' Joint Economic Committee completed an analysis in April 2004 that the National Campaign in turn summarized. The congressional study posed an intriguing question: if the nation's teen birth rate had remained at its 1991 level through 2002 (rather than decreasing as it did), how many more children would have been born to teen mothers and to single mothers, and what would have been the effect on poverty and on the living arrangements of children? Findings included the following: if teen birth rates had not declined nationally by 30 percent during that time, there would have been an additional 1.2 million more children born to teen mothers, approximately 460,000 additional children in poverty and almost 700,000 more children living with a single mother. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | COLORADO | RESEARCH REPORT | ADOLESCENTS, FEMALE | ADOLESCENT PREGNANCY | ONE PARENT FAMILY | BIRTH RATE | POVERTY | CHILD HEALTH | SOCIOECONOMIC FACTORS | CAMPAIGNS | FERTILITY DECLINE | North America | Americas | Developed Countries | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Family Characteristics | Family and Household | Sociocultural Factors | Fertility Measurements | Economic Factors | Health | Communication Programs | Communication | Fertility Changes Document Number: 307049 |
| 10. Peer Reviewed Title: Misoprostol as an adjunctive medication in late surgical abortion. Author: Hern WM Source: International Journal of Gynecology and Obstetrics. 2005 Mar;88(3):327-328. Abstract: A previous case-series comparison of patients receiving misoprostol treatment within an established protocol for late abortion suggested an advantage for patients receiving misoprostol (CytotecR; Pharmacia, GD Searle, Chicago). They had shorter amniotomy-to-procedure times and a lower variability in these intervals [1]. There did not appear to be any increased risk of complication for patients receiving misoprostol. This report analyzes the experience with 1040 patients in a non-blinded controlled clinical trial with sequential treatment allocation. Gestations ranged from 18 through 38 weeks. All abortions were performed by a single physician in an outpatient setting. All procedures were performed over a period of 5 years ending in June, 2004. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | COLORADO | RESEARCH REPORT | PREGNANT WOMEN | MISOPROSTOL | LAMINARIA TENTS | BLEEDING | ABORTION | North America | Americas | Developed Countries | Population Characteristics | Demographic Factors | Population | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Cervical Dilatation | Treatment | Signs and Symptoms | Diseases | Fertility Control, Postconception | Family Planning Document Number: 281468 Notification |
| 11. Title: Why lightning strikes twice: postpartum resumption of sexual activity during adolescence. Author: Kelly LS; Sheeder J; Stevens-Simon C Source: Journal of Pediatric and Adolescent Gynecology. 2005;18:327-335. Abstract: The purpose was to describe the circumstances surrounding the postpartum resumption of sexual activity in a cohort of teenage mothers. The goal was to shed new light on the reasons why teenagers who have just given birth put themselves at risk for conception. A racially and ethnically diverse group of 267 poor, predominantly unmarried, primiparous, 13–21 year olds was enrolled consecutively at delivery and followed through the third postpartum month. The primary outcome measure was weeks postpartum at resumption of sexual activity, further categorized as protected or unprotected. The analysis controlled for factors thought to influence the postpartum resumption of sexual activity among adult couples and the use of contraception during adolescence. The Kaplan-Meier method was used to estimate the time to end point and Cox proportional-hazards regression analysis to compute relevant relative risks (RR). By the end of the third postpartum month, 58% of the teenagers had had sexual intercourse and the majority (80%) used contraception when they did so. The median time to first coitus, 10.7 weeks, was unrelated to contraceptive use but was significantly shorter among teenagers who lived with their boyfriends (RR: 2.4; 95%CI: 1.7–3.4) and those who delivered prior to term (RR: 2.1; 95%CI: 1.3–3.6). The analysis revealed that the teenagers who did not use contraception at first postpartum sexual intercourse exhibited more theorized risk factors for conception than those who did and those who remained sexually abstinent. This new empirical evidence that coital activity resumes soon after delivery should dispel the normative belief that contraception is unnecessary during the puerperium. Early contraceptive vigilance may also decrease the frequency and rapidity with which teen mothers conceive, as the differences in the prevalence of teen pregnancy risk factors we uncovered suggest that decisions about using contraception (not sexual intercourse) determine the risk of rapid repeat conception. Teens with live-in boyfriends and premature babies are especially apt to benefit from the new information in this report as they resume sexual activity sooner than their peers and are less apt to use contraception when they do so. (author's) Language: English Keywords: UNITED STATES OF AMERICA | COLORADO | RESEARCH REPORT | SURVEYS | ADOLESCENTS, FEMALE | POSTPARTUM WOMEN | POSTPARTUM ABSTINENCE | ADOLESCENT PREGNANCY | CONTRACEPTIVE USAGE | SEXUAL INTERCOURSE | North America | Americas | Developed Countries | Sampling Studies | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Puerperium | Reproduction | Abstinence | Family Planning, Behavioral Methods | Family Planning | Reproductive Behavior | Fertility | Population Dynamics | Contraception Document Number: 291305 |
| 12. Peer Reviewed Title: Reducing low birthweight by resolving risks: results from Colorado's prenatal plus program. Author: Ricketts SA; Murray EK; Schwalberg R Source: American Journal of Public Health. 2005 Nov;95(11):1952-1957. Abstract: We examined low-birthweight (LBW) rates among participants in Colorado's Prenatal Plus program by prenatal risk factors (smoking, inadequate weight gain during pregnancy, and psychosocial problems) and the effect of successful resolution of these risks during pregnancy. Data for 3569 Medicaid-eligible women who received care coordination, nutritional counseling, or psychosocial counseling through the Prenatal Plus Program in 2002 were analyzed to determine the prevalence of specific risks, the proportion of women who resolved each specific risk, and the low birthweight rates for births to women who did and did not resolve risk. LBW rates were analyzed with x/2 tests of significance. Women who quit smoking had an LBW rate of 8.5%, compared with an LBW rate of 13.7% among women who did not. Women with adequate weight gain had an LBW rate of 6.7%, compared with 17.2% among women with inadequate weight gain. Women who resolved all of their risks had a low-birthweight rate of 7.0%, compared with a rate of 13.2% among women who resolved no risks. Women who had at least 10 Prenatal Plus visits were more likely to resolve their risks than were women who had fewer visits. Multidisciplinary prenatal interventions targeted toward specific risks demonstrate success at significantly improving infant birthweight. (author's) Language: English Keywords: UNITED STATES OF AMERICA | COLORADO | RESEARCH REPORT | EVALUATION | PREGNANT WOMEN | INFANT | LOW BIRTH WEIGHT | RISK FACTORS | ANTENATAL CARE | HEALTH SERVICES EVALUATION | TOBACCO USE | North America | Americas | Developed Countries | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Birth Weight | Body Weight | Physiology | Biology | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration | Behavior Document Number: 308151 |
| 13. Title: Emergency contraception: what do our patients know? Author: Abbott J; Feldhaus KM; Houry D; Lowenstein SR Source: Annals of Emergency Medicine. 2004 Mar;43(3):376-381. Abstract: Study objective: Unintended pregnancy is a major medical, social, and public health problem. Emergency contraceptive pills can prevent 75% to 85% of unintended pregnancies if administered within 72 hours of intercourse. We perform this study to measure knowledge, attitudes, practices, and perceived needs about emergency contraception in a sample of women seeking emergency department (ED) care. Methods: This was a prospective survey of women presenting to an inner-city ED during an 8-week study period. Women who were aged 18 to 45 years, English speaking, and not critically ill and who presented during 56 randomly generated 4-hour time blocks were eligible. Trained research assistants administered a 20-question survey that included questions on current sexual and contraceptive practices and knowledge, acceptance, and preferences about postcoital contraception. Results: Two hundred thirty-two women met eligibility criteria; 158 (68%) women agreed to participate. Participants and nonparticipants were similar in age, race, ethnicity, and insurance status. The participants' mean age was 30 years. Twenty-five percent were married, whereas 49% had never married and 25% were separated or divorced. Fifty-two percent (95% confidence interval [CI] 44% to 60%) reported at least 1 previous unintended pregnancy; 28% (95% CI 21% to 35%) had 1 or more previous elective abortions. Of women who had been sexually active in the past month, half (47%) reported unprotected intercourse during that time. Among all respondents, 122 (77%; 95% CI 71% to 84%) had heard of emergency contraception as a way of preventing pregnancy after unprotected intercourse. Of these respondents, one fourth to one half did not have enough knowledge to use emergency contraceptive pills effectively. Fifty-seven percent of women were willing to use emergency contraceptive pills in the future, and 16 women said they would consider a change in regular contraception to emergency contraceptive pills if widely available. Conclusion: Sexually active women seeking ED care have high rates of unintended pregnancy and abortion. There is broad acceptance of emergency contraceptive pills to prevent pregnancy, but knowledge of availability, timing, and proper use is limited. Emergency contraceptive pills are a safe, effective, and low-cost primary preventive and emergency care intervention, and information about their use should be made available to ED patients. Patients should be advised not to abandon their use of barrier or other traditional contraceptives. (author's) Language: English Keywords: UNITED STATES OF AMERICA | COLORADO | RESEARCH REPORT | CLIENTS | EMERGENCY CONTRACEPTION | KNOWLEDGE | PREGNANCY, UNPLANNED | Developed Countries | North America | Americas | Program Activities | Programs | Organization and Administration | Contraception | Family Planning | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population Document Number: 277851 |
| 14. Title: New contraceptive options: patient adherence and satisfaction [editorial] Author: Hansen LB; Saseen JJ Source: American Family Physician. 2004 Feb 15;69(4):811-812, 815-816. Abstract: More than 10 million women in the United States use oral contraceptive pills (OCPs) to prevent pregnancy. However, OCPs have a 6 percent failure rate within the first year. Data have shown that unintended pregnancy with this method of contraception often is related to incorrect or inconsistent use, side effects, or patient dissatisfaction. Adolescents are less likely than adult women to adhere to OCP regimens, and only 12 percent of adolescents continue OCP use beyond one year. It is clear that patient adherence and satisfaction are critically important for effective contraception. Recently introduced contraceptive options should improve both of these factors. In this issue of American Family Physician, Herndon and Zieman review newer contraceptive methods, including the combined hormonal vaginal ring (NuvaRing), combined hormonal injection, combination contraceptive patch (Ortho Evra), and levonorgestrel intrauterine system (Mirena). These contraceptive methods have approximately the same efficacy and safety as OCPs, but they use delivery systems that have been designed to encourage adherence and improve patient acceptability. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | COLORADO | CLIENTS | CONTRACEPTIVE USAGE | SATISFACTION | CONTRACEPTIVE USE-EFFECTIVENESS | VAGINAL RING | Developed Countries | North America | Americas | Program Activities | Programs | Organization and Administration | Contraception | Family Planning | Psychological Factors | Behavior | Contraceptive Effectiveness | Contraceptive Methods Document Number: 277854 |
| 15. Peer Reviewed Title: Consistent condom use offers protection for those with an infected partner. Author: Lane T Source: Perspectives on Sexual and Reproductive Health. 2004 Jul-Aug;36(4):[3] p.. Abstract: People with a partner who is known to be infected with gonorrhea or chlamydia have a lower risk of having either infection if they use condoms consistently than if they do not, according to an analysis of enrollment data from sexually transmitted disease (STD) clinic attendees participating in a multisite randomized controlled trial. Overall, the odds of infection were reduced by 20% if participants had used condoms consistently in the previous three months (odds ratio, 0.8). Among participants who had been informed that their partner had gonorrhea or chlamydia, the odds of infection were reduced by 60% if they reported having always used condoms in the previous three months (0.4). The investigation aimed at addressing a common drawback of previous studies evaluating the protection offered by condoms against transmission of curable STDs—namely, they did not control for whether a participant's partner was infected. According to the researchers, people with partners who are infected, or who are perceived to be infected, may have an increased likelihood of condom use; hence, condom effectiveness may have been underestimated in studies that included people who had not been exposed to STDs. To assess the importance of accounting for a partner's infection status when investigating the effectiveness of condoms against chlamydia and gonorrhea, the researchers analyzed enrollment data from Project RESPECT—a trial of HIV counseling interventions conducted at five publicly funded STD clinics in four states (Maryland, New Jersey, Colorado and California) between 1993 and 1997. Participants were heterosexual, HIV-negative, aged 14 or older and English-speaking, and had been sexually active in the past three months. A total of 4,783 participants were tested for chlamydia and gonorrhea at study entry, and completed a questionnaire about their sexual behavior and condom use during vaginal and anal intercourse in the past three months. (excerpt) Language: English Keywords: MARYLAND | NEW JERSEY | CALIFORNIA | COLORADO | SEXUALLY TRANSMITTED DISEASES | CONDOM USE | SEXUAL PARTNERS | CONTRACEPTIVE EFFECTIVENESS | RISK BEHAVIOR | SEX BEHAVIOR | GONORRHEA | CHLAMYDIA | United States of America | North America | Americas | Developed Countries | Reproductive Tract Infections | Infections | Diseases | Risk Reduction Behavior | Behavior | Contraception | Family Planning Document Number: 275087 |
| 16. Peer Reviewed Title: Consisitent use vs. ever-use of condoms: which measure is more useful? Author: Rosenberg J Source: Perspectives on Sexual and Reproductive Health. 2004 Jul-Aug;36(4):[3] p.. Abstract: Comparing the sexually transmitted disease (STD) prevalence rates of condom users and nonusers may not be as relevant as comparing those of consistent and inconsistent users, according to a study of patients' visits to a Denver STD clinic. Fifty-four percent of clinic visits were by patients who reported having used condoms in the previous four months—38% sometimes and 16% at every intercourse. Risky sexual behaviors, such as having ever had more than 10 sexual partners or recently having had new or multiple partners, were reported at a significantly greater proportion of visits by condom users than of those by nonusers. In analyses comparing condom users with nonusers, any condom use did not offer clear protection against STDs; however, in analyses comparing consistent and inconsistent condom use, consistent use significantly reduced the odds of gonorrhea and chlamydia among men and women (odds ratios, 0.7-0.9), of trichomonas in women (0.9) and of genital herpes in men (0.7). The researchers used medical record data of all female and heterosexual male patients who had visited a public STD clinic between January 1, 1990, and December 31, 2001, and reported having had at least one sexual partner in the previous four months. Data included demographic information, lifetime number of sexual partners, number and type of partners in the past four months, STD history, and condom and other contraceptive use within the past four months. The researchers calculated the prevalence rates of three bacterial infections—gonorrhea, chlamydia and trichomonas—and of three viral infections—genital herpes, genital warts and molluscum contagiosum. For viral infections, only first-time cases of genital warts and herpes and cases in which symptoms had been present for 30 days or less were included. Bivariate and logistic regression analyses were used to determine the predictors of any use and consistent use of condoms, and the associations between levels of condom use and STDs. (excerpt) Language: English Keywords: COLORADO | UNITED STATES OF AMERICA | COMPARATIVE STUDIES | CLIENTS | CLINIC VISITS | RISK BEHAVIOR | RISK REDUCTION BEHAVIOR | SEX BEHAVIOR | CONDOM USE | SEXUALLY TRANSMITTED DISEASES | PREVALENCE | North America | Americas | Developed Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Service Statistics | Behavior | Reproductive Tract Infections | Infections | Diseases | Measurement Document Number: 275085 |
| 17. Peer Reviewed Title: Consistent use is crucial to efficacy of condoms in prevention of STIs. Author: Rosenberg J Source: International Family Planning Perspectives. 2004 Sep;30(3):149-150. Abstract: Comparing the sexually transmitted infection (STI) prevalence rates of condom users and nonusers may not be as relevant as comparing those of consistent and inconsistent users, according to a U.S. study of STI clinic visits. Fifty-four percent of clinic visits were by patients who reported having used condoms in the previous four months—38% sometimes and 16% at every intercourse. Risky sexual behaviors, such as having ever had more than 10 sexual partners or recently having had new or multiple partners, were reported at a significantly greater proportion of visits by condom users than of those by nonusers. In analyses comparing condom users with nonusers, any condom use did not offer clear protection against STIs; however, in analyses comparing consistent and inconsistent condom use, consistent use significantly reduced the odds of gonorrheal and chlamydial infections among men and women (odds ratios, 0.7-0.9), of trichomoniasis in women (0.9) and of genital herpes in men (0.7). The researchers used medical records of all females and heterosexual males who had visited a public STI clinic in Denver, Colorado, between January 1, 1990, and December 31, 2001, and reported having had at least one sexual partner in the previous four months. Data included demographic information, lifetime number of sexual partners, number and type of partners in the past four months, STI history, and condom and other contraceptive use in the past four months. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | COLORADO | COMPARATIVE STUDIES | MEN | HETEROSEXUALS | CONDOM USE | RISK BEHAVIOR | SEX BEHAVIOR | SEXUALLY TRANSMITTED DISEASES | RISK REDUCTION BEHAVIOR | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Behavior | Reproductive Tract Infections | Infections | Diseases Document Number: 275092 |
| 18. Title: Hematocolpos associated with a remote history of chronic vaginitis and a diagnostic vaginal biopsy: a case report. Author: Scott SM; Schlaff W Source: Journal of Pediatric and Adolescent Gynecology. 2004;17:347-349. Abstract: Bacterial vaginitis is commonly seen in the pediatric population. Severe or recurrent cases may be associated with ulcerative lesions. We report a case of vaginal biopsies of ulcerative lesions in a 9-year-old which led to severe vaginal adhesions, stenosis, and hematocolpos. A vaginoscopy and resection from below were not successful and an exploratory laparotomy with uterine perforation and sounding into the upper vagina were required to reopen the lower vaginal canal. We recommend the limited use of vaginal biopsies in the face of a typical vaginitis presentation, and aggressive treatment to promote mucosa healing when biopsies are required. (author's) Language: English Keywords: UNITED STATES OF AMERICA | COLORADO | CRITIQUE | CASE STUDIES | CLIENTS | ADOLESCENTS, FEMALE | VAGINITIS | EXAMINATIONS AND DIAGNOSES | HISTOLOGY | VAGINAL ABNORMALITIES | ADHESIONS | INFECTIONS | Developed Countries | North America | Americas | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Biology | Signs and Symptoms Document Number: 278558 |
| 19. Title: The Electronic Report on Adolescent Pregnancy (ERAP). Author: Sheeder J; Scott S; Stevens-Simon C Source: Journal of Pediatric and Adolescent Gynecology. 2004;17:341-346. Abstract: The purpose was to create a data management system that: (1) standardizes antecedent, program, and outcome variables relevant to the shared goals of adolescent-oriented maternity programs while allowing users to add variables pertaining to unique aspects of their work; (2) cues providers to physiologic and psychosocial characteristics that predispose teenagers to adverse pregnancy and parenting outcomes, (3) standardizes patient care by guiding providers through adolescent-oriented prenatal, postpartum, and well baby visits, and (4) establishes the infrastructure to collect data from a nationally representative sample of pregnant and parenting teens. We adapted a powerful, state-of-the-art relational database framework (Microsoft Access 2000_) to create an easy-to-use data management system—The Electronic Report on Adolescent Pregnancy (ERAP)—that requires minimal training to use on a personal computer. ERAP is designed to meet the administrative and analytic needs of adolescent-oriented maternity programs. It consists of six linked core data tables (teen, pregnancy, prenatal visits, child, interconception interval, and interconception interval visits), that allow users to analyze data from these multiple views while preserving the family structure. In addition, the database standardizes methods for collecting and storing the information and automatically computing the variables needed to monitor and evaluate an adolescent-oriented maternity program. Since by adding variables and appending supplementary tables, users can modify the core database to accommodate unique aspects of their programs and/or research, ERAP is also an ideal conduit for translating research findings into clinical practice. Similarly, because ERAP actually structures the care patients receive, the database provides the infrastructure needed to develop and implement best practice guidelines for treating teen-headed families. Finally, the confidentiality of all subject data is assured because ERAP is password-protected and automatically prepares files for batched external analyses by removing personal identifiers. ERAP provides the infrastructure needed to create a teen-pregnancy databank at the national level and an efficient patient monitoring system at the program level. By standardizing variable definitions and data collection techniques, serving as a repository for data collected at multiple sites, and tracking the multidisciplinary aspects of the care patients receive, ERAP has the potential to facilitate collaboration between adolescent-oriented maternity programs, increase the scientific rigor of teen pregnancy research, and improve the quality of care individual teenheaded families receive by prompting compliance with best practice guidelines. (author's) Language: English Keywords: UNITED STATES OF AMERICA | COLORADO | CRITIQUE | HEALTH PERSONNEL | ADOLESCENT PREGNANCY | DATA STORAGE AND RETRIEVAL | COMPUTER PROGRAMS AND PROGRAMMING | MATERNAL HEALTH SERVICES | MANAGEMENT | PROGRAM EVALUATION | MONITORING | INTERVENTIONS | Developed Countries | North America | Americas | Delivery of Health Care | Health | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Information Processing | Information | Maternal-Child Health Services | Primary Health Care | Health Services | Organization and Administration | Programs | Evaluation Document Number: 278557 |
| 20. Peer Reviewed Title: Comparison of sexually transmitted disease prevalence by reported condom use: errors among consistent condom users seen at an urban sexually transmitted disease clinic. Author: Shlay JC; McClung MW; Patnaik JL; Douglas JM Source: Sexually Transmitted Diseases. 2004 Sep;31(9):526-532. Abstract: The protective effect of condom use is controversial as a result of limited data. The goal of this study was to assess the association between condom use errors in consistent condom users and the prevalence of various sexually transmitted diseases (STDs). We conducted a cross-sectional study of visits to an urban STD clinic between January 2001 and January 2003, by women, men who have sex with women (MSW), and men who have sex with men (MSM) by consistent condom users with or without a condom use error. Prevalence rates were calculated for gonorrhea, chlamydia, trichomonas, nongonococcal urethritis (NGU), and pelvic in- flammatory disease. Rates were stratified by reported errors in condom use over the past 4 months for consistent users with adjusted odds ratios calculated by logistic regression. Among 1973 consistent condom users with error information available, any condom use error was reported more commonly among women (57%) than MSW (48%), or MSM (P <0.001 for each comparison), with breakage being the most frequently reported error. Among MSW, having a condom use error was associated with gonorrhea (adjusted odds ratio [AOR], 5.53; 95% confidence interval [CI], 2.48 –12.35), chlamydia (AOR, 3.19; 95% CI, 1.80 –5.65), and NGU (AOR, 2.09; 95% CI, 1.45–3.01), whereas, for women and MSM, no associations were seen for any STD. Condom use errors were common among subjects reporting consistent condom use and for MSW, condom error was associated with a significant increased risk of STD. These data support the premise that correctness of condom use is an important methodologic issue in studies assessing condom effectiveness. (author's) Language: English Keywords: COLORADO | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CLINICAL RESEARCH | URBAN POPULATION | HOMOSEXUALS | SEXUALLY TRANSMITTED DISEASES | PREVALENCE | CONDOM USE | CONDOM FAILURE | CHLAMYDIA | GONORRHEA | United States of America | North America | Americas | Developed Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Sex Behavior | Behavior | Reproductive Tract Infections | Infections | Diseases | Measurement | Risk Reduction Behavior | Condoms | Barrier Methods | Contraceptive Methods | Contraception | Family Planning Document Number: 274899 |
| 21. Peer Reviewed Title: Comparison of sexually transmitted disease prevalence by reported level of condom use among patients attending an urban sexually transmitted disease clinic. Author: Shlay JC; McClung MW; Patnaik JL; Douglas JM Jr Source: Sexually Transmitted Diseases. 2004 Mar;31(3):154-160. Abstract: There is controversy as to the protective effect of condoms in preventing various sexually transmitted diseases (STDs). Goal: The goal of this study was to assess the association of various levels of condom use with a variety of STD. We conducted a cross-sectional study of female and heterosexual male visits to an urban STD clinic between 1990 and 2001. Prevalence rates were calculated for gonorrhea, chlamydia, trichomonas, recent-onset genital warts, first-episode herpes, and molluscum contagiosum by reported level of condom use over the past 4 months, with adjusted odds ratios (AOR) calculated by logistic regression. Among 126,220 patient visits (39% women and 61% men), condom use over the past 4 months was reported by 54%, with 38% reporting inconsistent use and 16% consistent use. Condom users reported greater sexual risk in the past 4 months than nonusers (ie, new sex partners: 63% vs. 41%, P <0.001; multiple sex partners: 60% vs. 36%, P <0.001). When all condom users were compared with nonusers, there was limited evidence of protection against specific STD. However, when the analysis was restricted to condom users, infection rates were significantly lower in consistent than inconsistent users for both men and women for gonorrhea (AOR, 0.87 and 0.71, respectfully) and chlamydia (AOR, 0.66 and 0.74, respectfully), for trichomonas in women (AOR, 0.87), and for genital herpes in men (AOR, 0.73). Comparisons of STD between condom users and nonusers are confounded by greater sexual risk in users. Comparing consistent with inconsistent users reduces this confounding, revealing protection for both men and women for nonviral STD and for genital herpes for men. (author's) Language: English Keywords: COLORADO | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | ADULTS | SEXUALLY TRANSMITTED DISEASE PREVENTION | PREVALENCE | CONDOM USE | CONTRACEPTIVE EFFECTIVENESS | GONORRHEA | GENITAL WARTS | HERPES GENITALIS | TRICHOMONIASIS | United States of America | North America | Americas | Developed Countries | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Measurement | Risk Reduction Behavior | Behavior | Contraception | Family Planning Document Number: 190820 |
| 22. Title: State facts about abortion: Colorado. Author: Alan Guttmacher Institute [AGI] Source: [New York, New York], AGI, 2003. 3 p. (State Facts about Abortion) Abstract: This article presents background information about the frequency of abortion in the United States, followed by statistics on abortion frequency, abortion services, and restrictions on abortion for the United States as a whole and Colorado specifically. Language: English Keywords: UNITED STATES OF AMERICA | COLORADO | PAMPHLETS | ADULTS | WOMEN | ABORTION | PREGNANCY | PREGNANCY, UNWANTED | PREGNANCY OUTCOMES | CONTRACEPTIVE USAGE | HEALTH FACILITIES | ABORTION LAW | North America | Americas | Developed Countries | Printed Media | Mass Media | Communication | Age Factors | Population Characteristics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Reproduction | Reproductive Behavior | Fertility | Population Dynamics | Contraception | Delivery of Health Care | Health Document Number: 175578 Notification |
| 23. Title: Knowledge of, attitudes toward, and stage of change for female and male condoms among Denver inner-city women. Author: Bull SS; Posner SF; Ortiz C; Evans T Source: Journal of Urban. 2003 Dec;80(4):658-666. Abstract: Despite availability for a decade and documented acceptability among some groups of women for the method, female condom use is still rare. We surveyed 198 young women (15–25 years old) living in the inner city of Denver about their knowledge of, attitudes toward, and practices regarding female and male condoms. Most (75%) women had ever considered using male condoms; 32% had ever considered using female condoms; and use of either was sporadic. We examined predictors for being in either precontemplation or a later stage along the change continuum at both the bivariate and multivariate levels. Our findings suggest that African Americans and younger women are more likely to contemplate using female condoms. Both lack of knowledge and positive attitudes toward female condoms in this sample suggest that programs designed to raise awareness and knowledge of female condoms while improving their image are needed. (author's) Language: English Keywords: COLORADO | RESEARCH REPORT | KAP SURVEYS | MULTIVARIATE ANALYSIS | WOMEN | BLACKS | YOUTH | FEMALE CONDOMS | SEXUALLY TRANSMITTED DISEASE PREVENTION | ATTITUDES | CONDOM USE | CONTRACEPTIVE USAGE | United States of America | North America | Americas | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Demographic Factors | Population | Ethnic Groups | Cultural Background | Population Characteristics | Age Factors | Vaginal Barrier Methods | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Psychological Factors | Behavior | Risk Reduction Behavior Document Number: 190174 |
| 24. Peer Reviewed Title: Are in-dwelling catheters necessary for 24 hours after hysterectomy? Author: Dunn TS; Shlay J; Forshner D Source: American Journal of Obstetrics and Gynecology. 2003 Aug;189(2):435-437. Abstract: OBJECTIVE: In-dwelling catheters for 24 hours after operation are used routinely in gynecologic surgery. This study assesses whether the immediate removal of an in-dwelling catheter after the operation affects the rate of recatheterization, febrile morbidity, symptomatic urinary tract infections, or subjective pain assessments. STUDY DESIGN: This study was a prospective randomized controlled trial comprised of 250 women who underwent hysterectomy and who did not require bladder suspension or strict fluid treatment. The in-dwelling catheter was removed either immediately after the operation or on the first day after the operation. The association between clinical variables and the length of catheterization were assessed by chi-squared analysis. RESULTS: Patients were assigned randomly into 2 groups, with no significant differences in the outcomes, only in the perception of pain. Clinical events included fever (>/=38.5°C) that occurred in 6 patients in the indwelling catheter group compared with 5 patients in the early removal group (P = .01), symptomatic urinary tract infections in 3 patients in both groups (P = .99), and recatheterization in 3 patients in the in-dwelling catheter group compared with 5 patients in the early removal group (P = .17). Subjectively, patients in the early removal group reported significantly less pain than did the in-dwelling group (P < .001). CONCLUSION: The early removal of in-dwelling catheters after operation was not associated with an increased rate of febrile events, urinary tract infections, or need for recatheterization. In addition, subjective pain assessment was significantly less in the early removal group. Early removal of an in-dwelling catheter immediately after operation is not associated with adverse events. (author's) Language: English Keywords: COLORADO | UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL RESEARCH | ADULTS | WOMEN | GYNECOLOGIC SURGERY | CATHETER | HYSTERECTOMY | PAIN | INFECTIONS | POSTOPERATIVE PROCEDURES | COMPLICATIONS | North America | Americas | Developed Countries | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Urogenital Surgery | Surgery | Treatment | Equipment and Supplies | Signs and Symptoms | Diseases Document Number: 187712 |
| 25. Peer Reviewed Title: Initiating contraception in sexually transmitted disease clinic setting: a randomized trial. Author: Shlay JC; Mayhugh B; Foster M; Maravi ME; Baron AE Source: American Journal of Obstetrics and Gynecology. 2003 Aug;189(2):473-481. Abstract: OBJECTIVE: Our purpose was to determine the effectiveness of sexually transmitted disease (STD) clinicinitiated contraceptive care. STUDY DESIGN: Nonpregnant women (n = 877) attending an urban STD clinic using either no contraception or only condoms were randomly assigned to either an intervention (n = 437) or control group (n = 440). Both groups received condoms with spermicide and a referral list of primary care providers (PCP) for ongoing reproductive health care, and the intervention group also received enhanced contraceptive counseling, initial provision of contraception, and facilitated referral to a PCP. Outcomes measured at 4-, 8-, and 12-month follow-up were transition to a PCP, effective contraceptive use (ECU), interval pregnancy, and STD. RESULTS: The median time to PCP transition was 79 days for the intervention group versus 115 days for the control group (P = .007). Rates of ECU were higher for the intervention group than for control group at the 4-month visit (50% vs 22%, P < .0001) as well as the 8-month visit, although in the intervention group ECU diminished over the course of the study. During follow-up, pregnancy outcomes were documented for 229 women (26.1%), for an overall pregnancy rate of 38.2 per 100 person-years of follow-up. Of the 159 pregnancies defined by patient self-report, 153 (96.2%) were described as unintended and 32 (20%) resulted in a therapeutic abortion. The pregnancy rate was 15% lower in the intervention (105/437, 24.0%) than the control group (124/440, 28.2%) (P = .16), but this difference was not statistically significant. CONCLUSION: The intervention helped women transition to a PCP and initiate ECU but did not significantly reduce the pregnancy rate. More intensive interventions are needed to prevent unintended pregnancy in this high-risk population. (author's) Language: English Keywords: COLORADO | UNITED STATES OF AMERICA | RESEARCH REPORT | CASE CONTROL STUDIES | ADULTS | WOMEN | CLINICS | CLINIC ACTIVITIES | PREGNANCY, UNPLANNED | SEXUALLY TRANSMITTED DISEASES | CONTRACEPTION | COUNSELING | CONTRACEPTIVE METHODS CHOSEN | CONDOM USE | PROGRAM EFFECTIVENESS | INTERVENTIONS | North America | Americas | Developed Countries | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Health Facilities | Delivery of Health Care | Health | Program Activities | Programs | Organization and Administration | Reproductive Behavior | Fertility | Population Dynamics | Reproductive Tract Infections | Infections | Diseases | Family Planning | Contraceptive Usage | Risk Reduction Behavior | Behavior | Program Evaluation Document Number: 187714 |
| 26. Title: Contraception counts: Colorado. Author: Alan Guttmacher Institute [AGI] Source: New York, New York, AGI, 2002 Jun. [2] p. (Contraception Counts) Abstract: This article summarizes, for the state of Colorado, the following points: pregnancy outcomes in Colorado; teen pregnancy outcomes in Colorado; women at need for contraceptive services and supplies; availability of family planning services; and impact of subsidized services. Language: English Keywords: UNITED STATES OF AMERICA | COLORADO | PAMPHLETS | CONTRACEPTION | LOW INCOME POPULATION | WOMEN | ADULTS | ADOLESCENTS, FEMALE | ADOLESCENT PREGNANCY | PREGNANCY | PREGNANCY OUTCOMES | PREGNANCY, UNPLANNED | HEALTH SERVICES | NATIONAL HEALTH SERVICES | FAMILY PLANNING | NEEDS | PUBLIC ASSISTANCE | Developed Countries | North America | Americas | Printed Media | Mass Media | Communication | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Demographic Factors | Population | Age Factors | Population Characteristics | Adolescents | Youth | Reproductive Behavior | Fertility | Population Dynamics | Reproduction | Delivery of Health Care | Health | Government Financing | Financial Activities Document Number: 175572 |
| 27. Peer Reviewed Title: Young adults on the Internet: risk behaviors for sexually transmitted diseases and HIV. Author: McFarlane M; Bull SS; Rietmeijer CA Source: Journal of Adolescent Health. 2002 Jul;31(1):11-6. Abstract: The purpose of this study is to examine the sexual behaviors and related risk factors for sexually transmitted diseases (STDs) and HIV among young adults who seek sex partners on the Internet. Study staff recruited participants in online chat rooms, bulletin boards, and other online venues. A total of 4507 participants responded to a 68-item, self-administered, online survey of Internet sex-seeking practices. The survey solicited information on sexual behavior with partners found on the Internet; in addition, a parallel set of questions addressed sexual behaviors with partners found off the Internet. Of the respondents, 1234 (27.4%) were 18-24 years old. Of the young adults, 61% were male and 75% were White. Responses from young adults were compared to those received from older adults. In addition, responses from young adults who seek sex partners online were compared to responses from young adults who do not seek sex partners online. Analyses, including logistic regression, Chi-square tests, Student's t-tests, and analyses of variance, focused on the difference between young and older adults, as well as the differences in sexual behavior with partners located online and offline. Young adults who seek sex on the Internet report substantially different sexual behavior patterns than young adults who do not seek sex on the Internet. Young adults with online partners reported sexual behaviors similar to older respondents who used the Internet to find sex partners; however, older respondents were more likely than young adults to have been tested for STD and HIV. Young adults who seek sex partners online may be at significantly greater risk for STDs than their peers who do not seek sex partners online. These data point to an urgent need for online sexual health promotion. (author's) Language: English Keywords: COLORADO | UNITED STATES OF AMERICA | RESEARCH REPORT | SURVEYS | ADOLESCENTS | SEX BEHAVIOR | RISK BEHAVIOR | SEXUALLY TRANSMITTED DISEASES | HIV INFECTIONS | SEXUAL PARTNERS | INTERNET | North America | Americas | Developed Countries | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Reproductive Tract Infections | Infections | Diseases | Viral Diseases | Information Networks | Communication Document Number: 169222 |
| 28. Peer Reviewed Title: Predictors of contraceptive discontinuation in a sexually transmitted disease clinic population. Author: Ramstrom KC; Baron AE; Crane LA; Shlay JC Source: Perspectives on Sexual and Reproductive Health. 2002 May-Jun;34(3):146-52. Abstract: Women who attend sexually transmitted disease (STD) clinics are at high risk for unintended pregnancy. Little information is available, however, on the rates of discontinuation of effective contraceptive method use among this population. As part of a study on contraceptive services offered by an STD clinic in Denver, 405 clients who accepted these services in 1995-99 were interviewed about their contraceptive practice, experience of side effects and method-use problems at baseline and at 4, 8 and 12 months of follow-up. Multivariate survival analysis was used to assess predictors of discontinuation of effective contraceptive use. Results demonstrated that 29% of women discontinued use by the end of 1 year. Cox proportional hazards models show that compared with women who reported no method-use problems, those who experienced one problem were three times as likely (hazard ratio, 3.0) to discontinue effective use, and women who had at least 2 problems were 5 times as likely (5.0) to discontinue use. The experience of side effects with either a past or a current method, however, was not associated with the risk of discontinuation. Furthermore, women who reported risky sexual behavior in the year before enrollment were significantly less likely to discontinue effective method use (hazard ratio, 0.4), as were women who were covered by medical insurance or who gained such coverage during a follow-up interval (hazard ratio, 0.5 for each). In this study population of STD clinic users, method-use problems appear to be a more fundamental issue for contraceptive compliance than the past or current experience of side effects. The unexpected association between method-use problems and the risk of discontinuation needs to be further delineated so that effective interventions addressing these problems can be developed and implemented. (author's) Language: English Keywords: COLORADO | UNITED STATES OF AMERICA | RESEARCH REPORT | MULTIVARIATE ANALYSIS | SEXUALLY TRANSMITTED DISEASES | CONTRACEPTIVE AGENTS, SIDE EFFECTS | CONTRACEPTION TERMINATION | USER COMPLIANCE | CONTRACEPTIVE USAGE DETERMINANTS | CONTRACEPTIVE USAGE | WOMEN | FAMILY PLANNING PROGRAMS | North America | Americas | Developed Countries | Data Analysis | Research Methodology | Reproductive Tract Infections | Infections | Diseases | Contraceptive Agents | Contraception | Family Planning | Behavior | Demographic Factors | Population | Programs | Organization and Administration Document Number: 169371 |
| 29. Peer Reviewed Title: Predicting pregnancy risk in women attending an STD clinic. Author: Shlay JC; Mayhugh B; Foster M; Maravi ME Source: Sexually Transmitted Diseases. 2002 Aug;29(8):491-496. Abstract: Although sexually transmitted disease (STD) clinics focus mainly on STD treatment and prevention, women attending these clinics are also at high risk for pregnancy. The goal of this study is to evaluate the relationship between certain demographic and behavioral characteristics and the probability of pregnancy in women attending an urban STD clinic. Non-contraceptive-using women in an STD clinic-initiated randomized controlled contraception study (n = 877) were interviewed at baseline, and incident pregnancies within 1 year of enrollment were measured. Association between baseline demographic and behavioral characteristics with incident pregnancy was assessed by chi-square analysis, and logistic regression was used to assess factors associated with an incident pregnancy. Among the 673 women (76.7%) for whom follow-up pregnancy information was available, 220 (32.7%) incident pregnancies occurred within 1 year. By logistic regression controlling for study assignment, incident pregnancy was associated with age < or = 19 years (odds ratio [OR], 2.8; 95% CI: 1.5-5.2), previous abortion (OR, 3.1; 95% CI: 1.7-5.4), frequency of sexual encounters of at least once a week (OR, 1.8; 95% CI: 1.2-2.6), and having a chlamydial infection at the time of enrollment (OR, 1.8; 95% CI: 1.0-3.2). With a combination of demographic and behavioral characteristics correlated by univariate analysis with incident pregnancy (i.e., age < or = 19 years, non-White race, high school/general equivalency diploma or less education, previous pregnancy, no use of birth control with last intercourse, sex at least once a week, previous abortion, > or = 3 partners within the past month, and <17 years of age at first pregnancy), the cumulative risk of pregnancy with 6 or more of the 9 characteristics was 51%, compared with 25.6% for women with < or = 5 characteristics. For this STD clinic population, a combination of demographic and behavioral characteristics was useful when combined for identifying a subgroup of women at higher risk for subsequent pregnancy. Targeted intervention by STD care providers should include the provision for both pregnancy and STD prevention counseling. (author's) Language: English Keywords: COLORADO | UNITED STATES OF AMERICA | RESEARCH REPORT | INTERVIEWS | URBAN POPULATION | WOMEN | PREGNANCY, UNPLANNED | SEXUALLY TRANSMITTED DISEASES | CONTRACEPTIVE METHODS CHOSEN | SOCIOECONOMIC FACTORS | AGE DISTRIBUTION | CULTURAL BACKGROUND | LIFE STYLE | RISK FACTORS | RISK ASSESSMENT | CLINIC ACTIVITIES | North America | Americas | Developed Countries | Data Collection | Research Methodology | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Reproductive Tract Infections | Infections | Diseases | Contraceptive Usage | Contraception | Family Planning | Economic Factors | Age Factors | Behavior | Biology | Evaluation | Program Activities | Programs | Organization and Administration Document Number: 170521 |
| 30. Title: Regional body fat distribution and insulin resistance during adolescent pregnancy. Author: Stevens-Simon C; Thureen P; Barrett J; Stamm E Source: Journal of the American Dietetic Association. 2002 Apr;102(4):563-565. Abstract: The results of this small study must be considered preliminary. Nevertheless, our findings suggest that as adiposity independent predictors of insulin resistance, ultrasonic determinations of the costal skinfold thickness or skinfold caliper determinations of the subscapular skinfold thickness could shed light on the physiologic mechanisms underlying the partitioning of nutrients between maternal and fetal tissues. These measurements could be used in epidemiologic studies to elucidate the physiologic mechanisms underlying individual differences in the effect that gestational weight gain has on fetal growth and the risk of postpartum obesity. (excerpt) Language: English Keywords: COLORADO | UNITED STATES OF AMERICA | RESEARCH REPORT | ANTHROPOMETRY | STATISTICAL STUDIES | ADOLESCENTS, FEMALE | ADOLESCENT PREGNANCY | MATERNAL PHYSIOLOGY | LIPIDS | HORMONE ANTAGONISTS | North America | Americas | Developed Countries | Measurement | Research Methodology | Studies | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Physiology | Biology | Hormones | Endocrine System Document Number: 176305 |
 |
||
 |
Information & Knowledge for Optimal Health (INFO) Project 111 Market Place Suite 310, Baltimore, MD 21202 Phone: 410-659-6300 Fax: 410-659-6266 Security & Privacy Policy |  |