1.  Title: Prevention of invasive pneumococcal disease in HIV-infected children: expanding the toolbox [editorial] Author: Abzug MJ; Pelton SI Source: Journal of Infectious Diseases. 2009 Apr 15;199(8):1109-11. Abstract: Invasive pneumococcal disease (IPD) remains a threat to HIV-infected children, adolescents, and adults in both developed and emerging nations. In the pre-highly active antiretroviral therapy (HAART) era, Mao et al. identified a cumulative incidence of 6.1 cases per 100 patient-years through age 7 years among HIV-infected children in Massachusetts, a rate 100-300-fold that seen in HIV-uninfected immunocompetent children in the United States. Similarly, Westwood et al. reported an IPD rate of 13 cases per 100 patient-years in Capetown, South Africa, a large proportion of which were lower respiratory tract infections. With widespread use of HAART in the United States, the rate of pneumococcal bacteremia declined by 80%, to 1.9 cases per 100 patient-years; this residual rate still remained at least 10-fold greater than that among HIV-uninfected children, and children who suffered an episode of pneumococcal bacteremia were more likely to die during follow-up than were HIV-infected children without an episode. These data identify the need to protect HIV-infected children from infection with Streptococcus pneumoniae, even in populations treated with HAART. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | MASSACHUSETTS | SOUTH AFRICA | SUMMARY REPORT | CLINICAL TRIALS | PERSONS LIVING WITH HIV/AIDS | CHILDREN | ADULTS | ADOLESCENTS | ANTIRETROVIRAL THERAPY | DISEASE PREVENTION | VACCINES | Developed Countries | North America | Americas | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Clinical Research | Research Methodology | HIV Infections | Viral Diseases | Diseases | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV | Prevention and Control | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341354 |
| 2. Peer Reviewed Title: Oral compared with intravenous sedation for first-trimester surgical abortion: a randomized controlled trial. Author: Allen RH; Fitzmaurice G; Lifford KL; Lasic M; Goldberg AB Source: Obstetrics and Gynecology. 2009 Feb;113(2 Pt 1):276-83. Abstract: OBJECTIVE: To test the equivalency of oral sedation and intravenous sedation for pain control in first-trimester surgical abortion. METHODS: Women undergoing suction curettage at less than 13 weeks of gestation were randomly assigned to oral sedation, 10 mg of oxycodone and 1 mg of lorazepam, or intravenous sedation, 100 micrograms fentanyl and 2 mg midazolam. All patients received 800 mg of preoperative ibuprofen and a 20-mL paracervical block with 1% lidocaine. The primary outcome was intraoperative pain as measured on a 21-point verbal rating scale that had a range from 0 to 100 (0=no pain and 100=worst pain ever) with an equivalence margin for the treatment group comparison of +/-10. RESULTS: Of 130 women, 65 were randomly assigned to oral sedation and 65 to intravenous sedation. The groups differed at baseline by age and preoperative ratings of depression, stress, and anxiety; however, when adjusted for these differences, the primary results were unaffected. Mean intraoperative pain scores, controlling for age and preoperative depression, stress, and anxiety, were 61.2 for oral sedation and 36.3 for intravenous sedation (mean difference 24.9, 95% confidence interval 15.9-33.9). Other findings included no difference in postoperative adverse effects and less satisfaction with pain control with oral sedation compared with intravenous sedation. CONCLUSION: Oral sedation, as studied, is not equivalent to intravenous sedation for pain control during first-trimester surgical abortion. CLINICAL TRIAL REGISTRATION:: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00337792 LEVEL OF EVIDENCE: I. Language: English Keywords: MASSACHUSETTS | RESEARCH REPORT | CLINICAL TRIALS | COMPARATIVE STUDIES | EVALUATION INDEXES | KAP SURVEYS | PREGNANT WOMEN | ANESTHESIA | ABORTION | PREGNANCY, FIRST TRIMESTER | CURETTAGE | ADMINISTRATION AND DOSAGE | PAIN | SIDE EFFECTS | SATISFACTION | Developed Countries | United States of America | North America | Americas | Clinical Research | Research Methodology | Studies | Quantitative Evaluation | Evaluation | Surveys | Sampling Studies | Population Characteristics | Demographic Factors | Population | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Obstetrical Surgery | Surgery | Drugs | Signs and Symptoms | Diseases | Psychological Factors | Behavior Document Number: 330360 Notification |
| 3. Peer Reviewed Title: Medication abortion. Author: Bartz D; Goldberg A Source: Clinical Obstetrics and Gynecology. 2009 Jun;52(2):140-50. Abstract: Medical methods for pregnancy termination in early gestation offer women an alternative to surgical evacuation and have the potential to improve access globally to safe abortion. Several drug regimens are used with varying efficacy including mifepristone plus misoprostol, misoprostol alone, and methotrexate plus misoprostol. Where available, a mifepristone plus misoprostol regimen is most frequently used and is highly effective for early abortion. We review these drug regimens along with clinical practice recommendations including patient counseling and selection, regimen administration location, expected side effects, and follow-up procedures. Overall, women who choose medical abortion report high levels of satisfaction. Language: English Keywords: UNITED STATES OF AMERICA | MASSACHUSETTS | RESEARCH REPORT | ABORTION | MISOPROSTOL | RU-486 | DRUGS | COUNSELING | Developed Countries | North America | Americas | Fertility Control, Postconception | Family Planning | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Hormone Antagonists | Hormones | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 342250 Notification |
| 4. Title: Three-dimensional ultrasound detection of abnormally located intrauterine contraceptive devices which are a source of pelvic pain and abnormal bleeding. Author: Benacerraf BR; Shipp TD; Bromley B Source: Ultrasound In Obstetrics and Gynecology. 2009 Jun 29;34(1):110-115. Abstract: OBJECTIVE: To determine whether intrauterine contraceptive devices (IUDs) that are located abnormally within the myometrium or cervix cause a higher incidence of pelvic pain and abnormal bleeding compared with normally positioned devices. METHODS: Over a period of 9 months, all patients with an IUD presenting at our unit for two-dimensional pelvic ultrasound underwent a three-dimensional (3D) volume reconstruction of the coronal view, to visualize the entire IUD within the cavity. The IUD was deemed malpositioned if any part extended past the cavity, into the myometrium or cervix. The indications for ultrasound were recorded at presentation for the exam. The presenting symptoms of patients with an abnormally located IUD were compared with those with normally positioned ones. RESULTS: Among 167 consecutive patients with an IUD evaluated using the 3D reconstructed coronal view, 28 (16.8%) had an IUD with side arms abnormally located within the myometrium. The abnormal positioning of the IUD arms wasonly detected using the 3D coronal view. A higher proportion of patients with an abnormally located IUD presented with bleeding (35.7%) or pain (39.3%) compared with those with normally positioned IUDs (15.1% with bleeding and 19.4% with pain) (P = 0.02 and 0.03, respectively). Seventy-five percent of patients with an abnormally located IUD presented with bleeding or pain compared with 34.5% of those whose IUD was normally placed (P = 0.0001). Twenty of 21 patients with an abnormally located IUD presenting with pelvic pain or bleeding reported improvement in their symptoms after IUD removal. CONCLUSION: A 3D coronal view of the uterus is useful in the visualization of IUDs. The coronal view showing the entire device and its position within the uterus may help in identifying the cause of pelvic pain and bleeding in patients with an embedded IUD. Copyright (c) 2009 ISUOG. Published by John Wiley & Sons, Ltd. Language: English Keywords: UNITED STATES OF AMERICA | MASSACHUSETTS | RESEARCH REPORT | RETROSPECTIVE STUDIES | CLIENTS | ULTRASONICS | IUD COMPLICATIONS | IUD MIGRATION | BLEEDING | PAIN | MYOMETRIUM | CERVIX | INSERTION | Developed Countries | North America | Americas | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | IUD | Contraceptive Methods | Contraception | Family Planning | Signs and Symptoms | Diseases | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Treatment Document Number: 341864 |
| 5. Peer Reviewed Title: Cervical obstruction complicating second-trimester abortion: treatment with misoprostol. Author: Borgatta L; Sayegh R; Betstadt SJ; Stubblefield PG Source: Obstetrics and Gynecology. 2009 Feb;113(2 Pt 2):548-50. Abstract: BACKGROUND: Cervical cone biopsy or loop electrosurgical excision procedures (LEEP) may lead to cervical scarring, agglutination, or stenosis. Leiomyomas may also obstruct the lower uterine segment such that instruments cannot be passed from the vagina to the gestation. CASE: Two women requested second trimester abortion. Both women had undergone cervical LEEP. In addition, one woman had a 10-cm leiomyoma, which seemed to be obstructing the lower segment. In both, the external cervical os was essentially obliterated. After administration of misoprostol, the cervix softened markedly in 18-24 hours. In both women, the cervix dilated readily and allowed dilation and evacuation of the uterus. CONCLUSION: Misoprostol resulted in the ability to evacuate the uterus vaginally, in a situation that might have otherwise resulted in hysterotomy. Language: English Keywords: MASSACHUSETTS | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | PREGNANT WOMEN | ABORTION | MISOPROSTOL | PREGNANCY, SECOND TRIMESTER | CERVICAL EFFECTS | CERVICAL LACERATION | GROWTH | TIME FACTORS | Developed Countries | United States of America | North America | Americas | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Pregnancy | Reproduction | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Diseases | Child Development | Population Dynamics Document Number: 330357 Notification |
| 6. Peer Reviewed Title: Adrenal glucocorticoid and androgen precursor dissociation in anorexia nervosa. Author: Lawson EA; Misra M; Meenaghan E; Rosenblum L; Donoho DA; Herzog D; Klibanski A; Miller KK Source: Journal of Clinical Endocrinology and Metabolism. 2009 Apr;94(4):1367-71. Abstract: CONTEXT: Anorexia nervosa is characterized by hypogonadism and relative hypercortisolemia. We have demonstrated that free testosterone levels are low in women with anorexia nervosa, with the lowest levels in those receiving oral contraceptives (OCPs), and that dehydroepiandrosterone (DHEA) sulfate is reduced only in those receiving OCPs. OBJECTIVE: The aim of the study was to determine whether adrenal steroidogenesis dysregulation contributes to decreased androgen levels in anorexia nervosa. Design and Setting: We conducted a cross-sectional study in a General Clinical Research Center. STUDY PARTICIPANTS: We studied 20 women with anorexia nervosa [10 women with anorexia nervosa receiving OCPs (AN+E) and 10 not receiving OCPs (AN-E)] and 20 healthy controls [10 healthy controls receiving OCPs (HC+E) and 10 not receiving OCPs (HC-E)]. MAIN OUTCOME MEASURES: We measured DHEA and cortisol levels in response to 250-microg cosyntropin stimulation after 1-mg overnight dexamethasone suppression. RESULTS: Mean basal and stimulated, peak stimulated, and area under the curve (AUC) cortisol levels were higher in AN-E than HC-E, but mean basal and stimulated, peak and AUC DHEA were comparable. Mean AUC and peak cortisol were higher and DHEA AUC was lower in AN+E than AN-E. However, after controlling for cortisol binding globulin levels, peak and AUC cortisol were comparable between AN+E and AN-E. After controlling for albumin levels, AUC DHEA was comparable between AN+E and AN-E. CONCLUSIONS: Adrenal glucocorticoid and androgen precursor secretion are dissociated in anorexia nervosa, with relative hypercortisolemia and a preservation of DHEA secretion. Reduced DHEA response to cosyntropin in women receiving OCPs is attributable to decreased albumin levels. In the setting of relative hypercortisolemia, reduced adrenal androgen precursor secretion is not a mechanism underlying low testosterone levels in anorexia nervosa. Language: English Keywords: MASSACHUSETTS | RESEARCH REPORT | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | CASE CONTROL STUDIES | WOMEN | DEFICIENCY DISEASES | BODY WEIGHT | TESTOSTERONE | ORAL CONTRACEPTIVES, SIDE EFFECTS | DEHYDROEPIANDROSTERONE | ANDROGENS | DEXAMETHASONE ACETATE | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Demographic Factors | Population | Nutrition Disorders | Diseases | Physiology | Biology | Hormones | Endocrine System | Contraceptive Safety | Safety | Public Health | Health Document Number: 341132 |
7.  Peer Reviewed Title: Perturbation analysis of nonlinear matrix population models. Author: Caswell H Source: Demographic Research. 2008 Mar;18(3):59-116. Abstract: Perturbation analysis examines the response of a model to changes in its parameters. It is commonly applied to population growth rates calculated from linear models, but there has been no general approach to the analysis of nonlinear models. Nonlinearities in demographic models may arise due to density-dependence, frequency-dependence (in 2-sex models), feedback through the environment or the economy, and recruitment subsidy due to immigration, or from the scaling inherent in calculations of proportional population structure. This paper uses matrix calculus to derive the sensitivity and elasticity of equilibria, cycles, ratios (e.g., dependency ratios), age averages and variances, temporal averages and variances, life expectancies, and population growth rates, for both age-classified and stage-classified models. Examples are presented, applying the results to both human and non-human populations. (author's) Language: English Keywords: MASSACHUSETTS | METHODOLOGICAL STUDIES | THEORETICAL STUDIES | MATHEMATICAL MODEL | DEMOGRAPHIC ANALYSIS | POPULATION | POPULATION THEORY | POPULATION GROWTH ESTIMATION | ENVIRONMENT | MACROECONOMIC FACTORS | AGE FACTORS | TIME FACTORS | LIFE EXPECTANCY | Developed Countries | United States of America | North America | Americas | Theoretical Models | Research Methodology | Demography | Social Sciences | Science | Sociocultural Factors | Estimation Techniques | Economic Factors | Population Characteristics | Demographic Factors | Population Dynamics | Length of Life | Mortality Document Number: 325250 |
| 8. Peer Reviewed Title: Inverse association of NSAID use and ovarian cancer in relation to oral contraceptive use and parity. Author: Wernli KJ; Newcomb PA; Hampton JM; Trentham-Dietz A; Egan KM Source: British Journal of Cancer. 2008 June 3;98(11):1781-1783. Abstract: We examined the association between non-steroidal anti-inflammatory drug (NSAID) use and ovarian cancer by potential effect modifiers, parity and oral contraceptive use, in a population-based case-control study conducted in Wisconsin and Massachusetts. Women reported prior use of NSAIDs and information on risk factors in a telephone interview. A total of 487 invasive ovarian cancer cases and 2653 control women aged 20-74 years were included in the analysis. After adjustment for age, state of residence and other covariates, ever use of NSAIDs was inversely associated with ovarian cancer in never users of oral contraceptives (odds ratio (OR=0.58, 95% confidence interval (CI) 0.42-0.80) but not for ever users (OR=0.98, 95% CI 0.71-1.35) (P-interaction = 0.03). A reduced risk with NSAID use was also noted in nulliparous women (OR=0.47, 95% CI 0.27-0.82) but not among parous women (OR=0.81, 95% CI 0.64-1.04) (P-interaction=0.05). These results suggest that use of NSAIDs were beneficial to women at greatest risk for ovarian cancer. (author's) Language: English Keywords: UNITED STATES OF AMERICA | WISCONSIN | MASSACHUSETTS | RESEARCH REPORT | CASE CONTROL STUDIES | OVARIAN CANCER | ORAL CONTRACEPTIVES | PARITY | DRUGS | RISK FACTORS | Developed Countries | North America | Americas | Studies | Research Methodology | Cancer | Neoplasms | Diseases | Contraceptive Methods | Contraception | Family Planning | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Biology Document Number: 327063 |
| 9. Peer Reviewed Title: Emergency contraception knowledge after a community education campaign. Author: Gee RE; Delli-Bovi LC; Chuang CH Source: Contraception. 2007 Nov;76(5):366-371. Abstract: This study evaluates the effectiveness of a community education campaign in the Boston community of Jamaica Plain conducted by the Massachusetts Emergency Contraception (EC) Network aimed at improving public knowledge of EC. Pre- and postintervention surveys of reproductive-age women were conducted to evaluate the effectiveness of the community education campaign. Knowledge of EC was compared before and after the intervention using surveys of community-based samples of women. One hundred eighty-eight and 290 women participated in the preintervention and postintervention surveys, respectively. Following the intervention, women were significantly more likely to have heard of EC (91% vs. 82%, p=.007), know the mechanism of action of EC (49% vs. 39%, p=.04), have discussed EC with a health care provider (38% vs. 25%, p=.003) and have received an advance prescription for EC (22% vs. 12%, p=.004), as well as were more likely to use EC in the future if needed (79% vs. 63%, p=.0002). This grassroots-basedcommunity education campaign on EC was effective in improving EC knowledge in this Boston community. (author's) Language: English Keywords: MASSACHUSETTS | UNITED STATES OF AMERICA | RESEARCH REPORT | PRE-POST TESTS | WOMEN | URBAN POPULATION | EMERGENCY CONTRACEPTION | HEALTH EDUCATION | CAMPAIGNS | COMMUNITY | KNOWLEDGE | ATTITUDES | Developed Countries | North America | Americas | Program Evaluation | Programs | Organization and Administration | Demographic Factors | Population | Population Characteristics | Contraception | Family Planning | Education | Communication Programs | Communication | Residence Characteristics | Population Distribution | Geographic Factors | Sociocultural Factors | Psychological Factors | Behavior Document Number: 321772 |
| 10. Peer Reviewed Title: Intervention rates for placental removal following induction abortion with misoprostol. Author: Green J; Borgatta L; Sia M; Kapp N; Saia K Source: Contraception. 2007 Oct;76(4):310-313. Abstract: Second-trimester terminations can be performed via surgical or medical methods. It is essential to have the ability to safely and effectively perform induction terminations to offer a full range of services. Many studies of induction abortions report routine operative removal of the placenta after a set time period resulting in high rates of operative procedures. A retrospective chart review was performed for 233 women who underwent second-trimester induction abortions between November 2003 and November 2006. All women received intraamniotic injection of digoxin for feticide 1 day prior to induction. All inductions were performed using a schedule of 400 mcg of misoprostol initially followed by 200 mcg every 6 h for a maximum of 48 h. There were three methods of administering misoprostol: (1) vaginal administration for all doses, (2) vaginal and buccal used in combination and (3) buccal for all doses. Spontaneous expulsion of the placenta was expected. Operative intervention was performed for excessive bleeding or to expedite hospital discharge after a minimum of 4 h. No manual removal of placenta was done. The rate of operative intervention for retained placentas was 6% (14/233). Most (11/14) of the patients who underwent operative extraction for retained placentas did so to expedite discharge from the hospital. Overall, expectant management to allow spontaneous expulsion of the placenta for at least 4 h was not associated with serious morbidity. Our regimen of digoxin and misoprostol with a policy of expectant management of placental passage is associated with a very low rate of instrumented removal of the placenta. In the absence of bleeding, patients may be afforded intervals to at least 4 h for spontaneous expulsion of the placenta after fetal expulsion. (author's) Language: English Keywords: UNITED STATES OF AMERICA | MASSACHUSETTS | RESEARCH REPORT | RETROSPECTIVE STUDIES | WOMEN | PREGNANCY, SECOND TRIMESTER | ABORTION | MISOPROSTOL | FETAL MEMBRANES | INTERVENTIONS | TIME FACTORS | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Pregnancy | Reproduction | Fertility Control, Postconception | Family Planning | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Fetus | Programs | Organization and Administration | Population Dynamics Document Number: 320550 Notification |
| 11. Title: Levels and correlates of alpha-fetoprotein in normal pregnancies among Caucasian and Chinese women. Author: Lagiou P; Samoli E; Lagiou A; Lambe M; Trichopoulos D Source: Journal of Cancer Prevention. 2007 Jun;16(3):178-183. Abstract: Alpha-fetoprotein has been suggested to have anti breast cancer properties both in adult life and in utero. We studied correlates of maternal serum a-fetoprotein levels in normal singleton pregnancies. This was a prospective study relying on women attending maternal units in major teaching hospitals in Boston, USA and Shanghai, China. Specifically, 212 Caucasian women in Boston, and 196 Asian women in Shanghai provided blood samples at the 16th and 27th gestational week. Maternal serum a-fetoprotein levels were measured and correlated with maternal and newborn parameters through multiple regression procedures, controlling for a set of potential confounders, including maternal levels of measured hormones. Alpha-fetoprotein was strongly inversely associated with maternal prepregnancy body mass index ( -4.73 ng/l at the 27th week per 1 kg/m2 of body mass index, with 95% confidence intervals -7.09 to -2.36), whereas it was not related to parity, gender of offspring or birth weight. Duration of gestation was inversely associated with maternal a-fetoprotein levels, particularly among Caucasian women ( -0.22 weeks per 60 ng/l of a-fetoprotein at the 27th week, with 95% confidence intervals -0.39 to -0.05). In normal pregnancies, maternal a-fetoprotein is inversely related to prepregnancy body mass index and appears to have a physiologic role on duration of gestation rather than on birth weight. (author's) Language: English Keywords: CHINA | UNITED STATES OF AMERICA | MASSACHUSETTS | RESEARCH REPORT | PROSPECTIVE STUDIES | PREGNANT WOMEN | WHITES | ASIANS | BREAST CANCER | PREVENTION AND CONTROL | PROTEINS | BODY WEIGHT | BIRTH WEIGHT | Developing Countries | Asia, Eastern | Asia | Developed Countries | North America | Americas | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Ethnic Groups | Cultural Background | Cancer | Neoplasms | Diseases | Physiology | Biology Document Number: 317541 |
| 12. Title: Papanicolaou smears induce partial immunity against sexually transmitted viral infections. Author: Shapiro S; Hoffman M; Constant D; Rosenberg L; Carrara H Source: Epidemiology. 2007 Nov;18(6):709-715. Abstract: In a case-control study of hormonal contraceptives and invasive cervical cancer, an unexpected finding was a substantial decline in the prevalence of high-risk human papillomavirus (HPV) infection according to the lifetime number of Pap smears received. Here we assess the risk of 3 sexually transmitted viral infections - herpes simplex virus 2 (HSV2), HPV, and human immunodeficiency virus (HIV) 1 and 2 - in relation to the lifetime receipt of Pap smears. Stored sera taken from 1540 controls were tested for HSV2 and HIV; cervical scrapings were tested for HPV. Confounder-adjusted odds ratios for the lifetime receipt of Pap smears were estimated, relative to never having had a Papanicolau test. For ever-receipt of a Papanicolau test, the odds ratios for HSV2 and HPV were 0.7 (95% confidence interval = 0.5-0.9) and 0.5 (0.3-0.7), respectively, and there were dose-response trends according to the lifetime number of Pap smears received (test for trend P = 0.02 and 0.04, respectively). For HSV2 the oddsratios according to last receipt declined from 0.8 for 10 or more years previously to 0.4 for less than 1 year previously (trend P = 0.002). For HPV the ORs were 0.4 (0.3-0.7) for last receipt 5-9 years previously and 0.5 (0.4-0.8) for less than 5 years previously; for HIV the odds ratio for last receipt less than 5 years previously was 0.4 (0.3-0.9). For HSV2 and HIV the crude odds ratio estimates were systematically lower than the adjusted estimates, and residual confounding cannot be ruled out. In particular, the true number of sexual partners may have been under-reported, and there was no information on the sexual activity of the male partners, or on other health behaviors of the women or their partners. We hypothesize that Pap smears may provoke a short-term immune response against sexually transmitted viral infections. (author's) Language: English Keywords: SOUTH AFRICA | UNITED STATES OF AMERICA | MASSACHUSETTS | RESEARCH REPORT | CASE STUDIES | WOMEN | HPV | CERVICAL CANCER | PAP SMEAR | SEXUALLY TRANSMITTED DISEASES | AUTOIMMUNE RESPONSE | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Viral Diseases | Diseases | Cancer | Neoplasms | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproductive Tract Infections | Infections | Antibodies | Immunologic Factors | Immunity | Immune System | Physiology | Biology Document Number: 326514 |
| 13. Peer Reviewed Title: A momentary sampling study of the affective experience following coital events in adolescents. Author: Shrier LA; Shih MC; Hacker L; de Moor C Source: Journal of Adolescent Health. 2007 Apr;40(4):357.e1-357.e8. Abstract: The purpose was to describe the affective experience following sexual intercourse among sexually active adolescents. We hypothesized that these youth would experience more positive and less negative affects following sexual intercourse than at other times in their daily lives. Approximately every 3 waking hours, sexually active adolescents aged 15-21 years used a handheld computer to report current affect and recent sexual intercourse in response to random signals. Participants also completed a report after sexual intercourse. Affect was determined by eight states, as well as composite variables for positive and negative affect. Generalized estimating equations compared affect on reports that did and did not include sexual intercourse. Each model included average affect, affect variability (standard deviation), and significant interactions with the occurrence of sexual intercourse. Based on their distribution, outcome variables were modeled as presence/absence of affect. Sixty-seven youth completed 1385 random and 392 event reports. There were 266 unique coital reports (median 2.6/participant/week); 94% were with a main partner and 49% involved condom use. Youth were more likely to report positive affect and less likely to report negative affect when they were also reporting recent sexual intercourse, as compared to noncoital reports. In multivariate analyses, participants had greater odds of reporting well being and alertness and lower odds of reporting stress and anger following sexual intercourse compared to other times. Adolescents report improvement in specific positive and negative affective states following sexual intercourse. Determining how feeling more positive and less negative after sexual intercourse may motivate or reinforce sexual intercourse will be important in understanding adolescent sexual behavior. (author's) Language: English Keywords: MASSACHUSETTS | RESEARCH REPORT | SAMPLING STUDIES | KAP SURVEYS | ESTIMATION TECHNIQUES | MATHEMATICAL MODEL | ADOLESCENTS | YOUTH | EMOTIONS | SEXUAL INTERCOURSE | COMPUTERS | CONDOM USE | PSYCHOLOGICAL FACTORS | COITAL FREQUENCY | Developed Countries | United States of America | North America | Americas | Studies | Research Methodology | Surveys | Theoretical Models | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Reproduction | Information Processing | Information | Risk Reduction Behavior | Sex Behavior Document Number: 308482 |
| 14. Peer Reviewed Title: Immigration-based disparities in adolescent girls' vulnerability to dating violence. Author: Silverman JG; Decker MR; Raj A Source: Maternal and Child Health Journal. 2007 Jan;11(1):37-43. Abstract: Little data exists on dating violence among immigrant adolescents. The present study assessed disparities in experiences of physical and sexual dating violence based on immigrant status and language spoken at home among a large representative sample of adolescent girls. Data from the 1997-2003 Massachusetts Youth Risk Behavior Surveys (N = 7,970) were analyzed. Adjusted logistic regression analyses were conducted among the full sample and sexually active sub-sample. To further clarify immigration-based effects, separate analyses were conducted within age and racial/ethnic groups. Being an immigrant was found to be protective against dating violence (OR 0.77, CI 0.60-0.98), but not among those reporting sexual intercourse. Stratified analyses revealed important differences in these effects based on age and race/ethnicity; only immigrant girls age 16 or older (OR 0.69, CI 0.48-0.99) and Hispanic immigrant girls (ORs 0.39-0.54) reported reduced risk for dating violence as compared to their non-immigrants peers. No differences in vulnerability to dating violence were detected based on immigrant status for Asian, Black, or White adolescents in stratified analyses. The social context of immigration may offer protection regarding adolescent girls' vulnerability to dating violence, but effects are not uniform across age, sexual experience, or race and ethnicity. Additional research is needed to understand how immigration, social behavior, age, race and ethnicity may interact to produce disparities in vulnerability to gender-based violence. (author's) Language: English Keywords: MASSACHUSETTS | RESEARCH REPORT | KAP SURVEYS | LONGITUDINAL STUDIES | STATISTICAL REGRESSION | ADOLESCENTS, FEMALE | IMMIGRANTS | ETHNIC GROUPS | INTERPERSONAL RELATIONS | VIOLENCE | LANGUAGE | SEXUAL INTERCOURSE | AGE FACTORS | SOCIAL BEHAVIOR | United States of America | North America | Americas | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Adolescents | Youth | Population Characteristics | Demographic Factors | Population | Migrants | Migration | Population Dynamics | Cultural Background | Behavior | Communication | Reproduction Document Number: 310717 |
| 15. Title: Health information for teens. Author: Center for Young Women's Health Source: Boston, Massachusetts, Center for Young Women's Health, Children's Hospital Boston, 2006. [3] p. Abstract: This document contains several links that you can click to view information on different health issues that adolescents will face: Nutrition and Fitness, Sexuality and Sexual Health, General Health and Development, Gynecology and Reproductive Health, Emotional Health, For Parents. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | MASSACHUSETTS | PAMPHLETS | ADOLESCENTS, FEMALE | CHILD HEALTH | HEALTH EDUCATION | NUTRITION | SEXUALITY | REPRODUCTIVE HEALTH | North America | Americas | Developed Countries | Printed Media | Mass Media | Communication | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Education | Personality | Psychological Factors | Behavior Document Number: 308067 |
| 16. Peer Reviewed Title: A comparison of maternal interview and medical record ascertainment of violence among women who had poor pregnancy outcomes. Author: Fried LE; Aschengrau A; Cabral H; Amaro H Source: Maternal and Child Health Journal. 2006;10:451-460. Abstract: This study investigated the agreement between self-reported and medical record assessment of exposure to violence and the impact of misclassification on the estimation of the association between exposure to violence and infant death and very low birthweight. The study population consisted of women who participated in two case-control studies on infant death and very low birthweight. There were 254 pairs of interviews and medical record reviews available for comparison. A total of 153 women (60.2%) reported ever being exposed to violence - 92 (60.1%) based on the interview only, 18 (11.8%) based on the medical record only, and 43 (28.1%) in both sources. The sensitivity of the violence variables was low, ranging from 16.9% to 31.9% and kappa statistics showed poor agreement. Lower rates of all types of violence were found through the medical record than through the interview. Prevalence of violence based on medical record alone had a high degree of misclassification and some odds ratios were biased toward the null. Studies in which violence is an exposure, outcome, or confounder must use participant interviews in order to gather accurate information. A combination of sources may be the most accurate. (author's) Language: English Keywords: MASSACHUSETTS | RESEARCH REPORT | METHODOLOGICAL STUDIES | COMPARATIVE STUDIES | CLASSIFICATION | CASE CONTROL STUDIES | EPIDEMIOLOGIC METHODS | PREGNANT WOMEN | RECORDS | VIOLENCE | PREGNANCY OUTCOMES | INTERVIEWS | DOMESTIC VIOLENCE | PREVALENCE | ERROR SOURCES | Developed Countries | United States of America | North America | Americas | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Information Processing | Information | Behavior | Pregnancy | Reproduction | Data Collection | Crime | Social Problems | Sociocultural Factors | Measurement Document Number: 316766 |
| 17. Peer Reviewed Title: Oral contraceptives maintain a very thin endometrium before operative hysteroscopy. Author: Grow DR; Iromloo K Source: Fertility and Sterility. 2006 Jan;85(1):204-207. Abstract: Objective: To show that early follicular-phase administration of an oral contraceptive pill (OC) consistently provides a thin endometrium, as determined by transvaginal ultrasound. This is an ideal condition when performing operative hysteroscopy. Design: Retrospective chart review of patients who have undergone ultrasound evaluation of the endometrial thickness under different hormonal conditions. Endometrial measurement was obtained during menstruation, in the late follicular phase, and in the luteal phase in 20 patients. In another group of 100 patients, endometrial measurement was made on the 18th day of OC administration, initiated during menses. Setting: A reproductive endocrinology unit in a university-affiliated medical center. Patient(s): Patients undergoing treatment for subfertility of various etiologies. Intervention(s): Transvaginal ultrasound measurements of the endometrium. Main Outcome Measure(s): Endometrial thickness by transvaginal ultrasound. Result(s): Combination QCs started on menstrual days 1-3 maintain a uniformly thin endometrium, 4.1 ± 1.6 mm (mean ± SD), comparable to menstrual endometrium (3.7 ± 1.5 mm). This was statistically thinner compared with endometrium observed in the late follicular phase (11 ± 2.0 mm) or late luteal phase (12 ± 2.3 mm). Transvaginal ultrasound measurements of the endometrium under different conditions were compared by the unpaired t-test. Conclusion(s): Oral contraceptive maintain a very thin, flat endometrium, such that lesions might be readily identified and treated during operative hysteroscopy procedures. Prevention of pregnancy and endometrial thinning with administration of OCs facilitates procedural scheduling for patients and surgeons. (author's) Language: English Keywords: UNITED STATES OF AMERICA | MASSACHUSETTS | RESEARCH REPORT | RETROSPECTIVE STUDIES | WOMEN | ULTRASONICS | HYSTEROSCOPY | ORAL CONTRACEPTIVES | ENDOMETRIAL EFFECTS | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Contraceptive Methods | Contraception | Family Planning | Endometrium | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology Document Number: 296878 |
| 18. Peer Reviewed Title: Cerebral venous sinus thrombosis in users of four hormonal contraceptives: levonorgestrel-containing oral contraceptives, norgestimate-containing oral contraceptives, desogestrel-containing oral contraceptives and the contraceptive patch. Author: Jick SS; Jick H Source: Contraception. 2006 Oct;74(4):290-292. Abstract: It has been suggested that the risk for cerebral venous sinus thrombosis (CVST) may be greater among users of the contraceptive patch than among users of oral contraceptives (OCs). From the PharMetrics database, we identified women aged 15--44 years who filled at least one prescription for either the contraceptive patch or desogestrel-containing, norgestimate-containing or levonorgestrel-containing OCs to assess the risk of CVST. The person-time of current exposure to each study drug, as well as the incidence rates (IRs) and incidence rate ratios (IRRs) of CVST, was calculated. We identified over 1 million users of the four study drugs. There were five cases of CVST among current users of desogestrel, seven cases among current users of norgestimate, two cases among current users of levonorgestrel and none among current users of the contraceptive patch. The IRs per 100,000 woman-years were 2.7 [95% confidence interval (95% CI) = 0.9--6.3], 1.6 (95% CI = 0.7--3.3), 0.7 (95% CI = 0.1--2.4) and 0.0 (95% CI = 0.0--4.8), respectively, in users of desogestrel, norgestimate, levonorgestrel and the contraceptive patch. There were two women who had CVST while not currently taking a hormonal contraceptive (IR = 0.4 per 100,000 woman-years; 95% CI = 0.1--1.3). The IRRs were 4.0 (95% CI = 0.7--42.4) for desogestrel-containing versus levonorgestrel-containing OCs, and 2.4 (95% CI=0.5--24.0) for norgestimate-containing versus levonorgestrel-containing OCs. The IRR for the patch could not be calculated. There is no evidence of an increased risk of CVST in users of the contraceptive patch compared to users of levonorgestrel-containing OCs. (author's) Language: English Keywords: UNITED STATES OF AMERICA | MASSACHUSETTS | DATA ANALYSIS | INCIDENCE | WOMEN | THROMBOSIS | CONTRACEPTIVE USAGE | CONTRACEPTIVE SAFETY | RISK FACTORS | LEVONORGESTREL | North America | Americas | Developed Countries | Research Methodology | Measurement | Demographic Factors | Population | Thromboembolism | Embolism | Vascular Diseases | Diseases | Contraception | Family Planning | Safety | Public Health | Health | Biology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents Document Number: 306804 |
| 19. Peer Reviewed Title: Risk of nonfatal venous thromboembolism in women using a contraceptive transdermal patch and oral contraceptives norgestimate and 35 micrograms of ethinyl estradiol. Author: Jick SS; Kaye JA; Russmann S; Jick H Source: Contraception. 2006 Mar;73(3):223-228. Abstract: There is concern that a new transdermal contraceptive patch containing ethinyl estradiol (EE) and the progestin norelgestromin increases the risk for venous thromboembolism (VTE) compared to previously marketed oral contraceptives (OCs). Quantitative information was obtained on the risk of nonfatal VTE in women using the contraceptive patch in comparison to women using OCs, norgestimate (either monophasic or triphasic) and 35 Ag EE (norgestimate-35), an OC that has been marketed for over a decade. Nested case-control design based on information from PharMetrics, a US-based company that collects and organizes information on claims paid by managed care plans. The study was nested among all women aged 15 to 44, who started either the contraceptive patch or norgestimate-35 after April 1, 2002. Cases were women with current use of one of these two study drugs and a documented diagnosis of VTE in the absence of identifiable clinical risk factors (idiopathic VTE). Up to four controls were matched to each case by age and calendar time. Odds ratios (ORs) comparing the risk of nonfatal VTE in new users of the two contraceptives and incidence rates of nonfatal VTE for new users of each of the study contraceptives. We identified 68 newly diagnosed, idiopathic cases of VTE in the study population. In the case-control analysis, the OR comparing the contraceptive patch to norgestimate-35 was 0.9 (95% CI 0.5-1.6). The overall incidence rate for VTE was 52.8 per 100,000 women-years (95% CI 35.8-74.9) among users of the contraceptive patch and 41.8 per 100,000 women-years among users of norgestimate-35 (95% CI 29.4-57.6), and the age-adjusted VTE incidence rate ratio (IRR) for current use of the contraceptive patch vs. norgestimate-35 was 1.1 (95% CI 0.7-1.8). The risk of nonfatal VTE for the contraceptive patch is similar to the risk for OCs containing 35 Ag ethinylestradiol and norgestimate. (author's) Language: English Keywords: UNITED STATES OF AMERICA | MASSACHUSETTS | RESEARCH REPORT | DATA ANALYSIS | STUDIES | WOMEN | ORAL CONTRACEPTIVES | ETHINYL ESTRADIOL | THROMBOEMBOLISM | CONTRAINDICATIONS | RISK FACTORS | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Embolism | Vascular Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Biology Document Number: 296211 |
| 20. Peer Reviewed Title: Simultaneous very low dose mifepristone and vaginal misoprostol for medical abortion. Author: Kapp N; Borgatta L; Ellis SC; Stubblefield P Source: Contraception. 2006 May;73(5):525-527. Abstract: This pilot study was designed to evaluate the outcome of medical abortion following simultaneous mifepristone (100 mg) and misoprostol (800µg). Enrollees had gestational ages up to 56 days and desired a medical abortion. They received 100 mg of mifepristone orally and 800 µg of misoprostol vaginally. Follow-up examination occurred in 2-7 days. A phone call 3 weeks later assessed symptoms and acceptability. A 95% success rate, as seen in higher dose studies, gives a 95% confidence interval of 88-100% for 40 subjects. Forty women were enrolled; 39 women had follow-up visits. Completed medical abortion was confirmed for 35 (90%) of 39 women. Four women had uterine aspiration. Two patients required repeat misoprostol. Median time from medication to abortion was 7 h. Most women (92%) strongly preferred taking all medications in the clinic. The simultaneous administration of vaginal misoprostol with 100 mg of oral mifepristone had the outcome of completed abortion within the predicted confidence interval. In addition, simultaneous dosing was highly acceptable. (author's) Language: English Keywords: MASSACHUSETTS | RESEARCH REPORT | CLINICAL RESEARCH | PREGNANT WOMEN | RU-486 | MISOPROSTOL | ABORTION | ADMINISTRATION AND DOSAGE | PROSTAGLANDINS, ADMINISTRATION AND DOSAGE | TIME FACTORS | CONTRACEPTIVE EFFECTIVENESS | United States of America | North America | Americas | Developed Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Prostaglandins, Synthetic | Prostaglandins | Fertility Control, Postconception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Dynamics | Contraception Document Number: 299447 Notification |
| 21. Peer Reviewed Title: Self-assessment of height, weight, and sexual maturation: validity in overweight children and adolescents. Author: Lee K; Valeria B; Kochman C; Lenders CM Source: Journal of Adolescent Health. 2006 Sep;39(3):346-352. Abstract: The purpose was to evaluate the validity of self-reported height, weight, and sexual maturation ratings among overweight children and adolescents. This cross-sectional study included 77 overweight children and adolescents (39 girls, 38 boys) aged 8--18 years, with a mean body mass index (BMI) of 35.2 ± 8.9 kg/m2 who visited the Optimal Weight for Life program at Boston Children's Hospital for weight management over a period of six months in 1999. Each patient's weight, height, and sexual maturation ratings were self-reported and measured. The intra-class correlation coefficients between measured and self-reported weights, heights, and BMI values ranged from .64 to .95 among boys, and from .49 to .84 among girls. The kappa statistics between measured and self-assessed Tanner stage ratings ranged from .21 to .50. The percentages of agreement for breast development and pubic hair ratings among girls were 37.8% and 61.1%, respectively. The percentages of agreement for pubic hair and genitalia ratings among boys were 51.7% and 40.0%, respectively. The self-assessed ratings by boys for pubic hair and genitalia were less likely to be correct with increased measured weight and height (p < .05). Boys aged 15 years or older were more likely to underestimate their pubic hair or genitalia stages than those younger than 15 years of age (p < .05). Among overweight children and adolescents aged 8--18 years, this pilot study suggests that self-reports of height, weight, and Tanner stages are not valid proxy measures for a physician's assessment. (author's) Language: English Keywords: MASSACHUSETTS | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | PILOT PROJECTS | CLINICAL RESEARCH | ADOLESCENTS | CHILDREN | ANTHROPOMETRY | OBESITY | BODY WEIGHT | SELF-PERCEPTION | CHILD DEVELOPMENT | PUBERTY | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Measurement | Physiology | Biology | Perception | Psychological Factors | Behavior | Reproduction Document Number: 304839 |
| 22. Peer Reviewed Title: Administration of live varicella vaccine to HIV-infected children with current or past significant depression of CD4+ T cells. Author: Levin MJ; Gershon AA; Weinberg A; Song LY; Fentin T Source: Journal of Infectious Diseases. 2006 Jul 15;194(2):247-255. Abstract: Varicella can be a severe illness in human immunodeficiency virus (HIV)--infected children. The licensed, live attenuated varicella vaccine is safe and immunogenic in HIV-infected children with minimal symptoms and good preservation of CD4+ T cells (Centers for Disease Control and Prevention immunologic category 1). To study the safety and immunogenicity of this vaccine in varicella-zoster virus (VZV)--naive, HIV infected children with moderate symptoms and/or more pronounced past or current decreases in CD4+ T cell counts, such children (age, 1--8 years) received 2 doses of vaccine 3 months apart. The children were observed in a structured fashion for adverse events. Blood was tested for VZV antibody and VZV-specific cell-mediated immunity (CMI) at baseline, 8 weeks after each dose, and annually for 3 years. Subjects who had no evidence of immunity 1 year after vaccination received a third dose and were retested. The vaccine was well tolerated; there were no vaccine-related, serious adverse events. Regardless of immunologic category, at least 79% of HIV-infected vaccine recipients developed VZV-specific antibody and/or CMI 2 months after 2 doses of vaccine, and 83% were responders 1 year after vaccination. HIV-infected children with a CD4+ T cell percentage of = 15% and a CD4+ T cell count of = 200 cells/mL are likely to benefit from receiving varicella vaccine. (author's) Language: English Keywords: UNITED STATES OF AMERICA | MASSACHUSETTS | CLINICAL RESEARCH | CHILD | PERSONS LIVING WITH HIV/AIDS | SAFETY | IMMUNIZATION | DEPRESSION | SIGNS AND SYMPTOMS | North America | Americas | Developed Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Public Health | Health | Primary Health Care | Health Services | Delivery of Health Care | Mental Disorders Document Number: 302203 |
| 23. Peer Reviewed Title: From menarche to menopause: trends among US women born from 1912 to 1969. Author: Nichols HB; Trentham-Dietz A; Hampton JM; Titus-Ernstoff L; Egan KM Source: American Journal of Epidemiology. 2006 Nov 15;164(10):1003-1011. Abstract: The authors investigated secular trends in age at menarche, age at menopause, and reproductive life span within a population-based cohort of US women. Study subjects were 22,774 women selected randomly as controls for a case-control study. Eligible controls were residents of Wisconsin, Massachusetts, or New Hampshire born between 1910 and 1969. Subjects completed telephone interviews in 1988-2001 and answered questions regarding reproductive and lifestyle factors. Birth cohorts were created using 5- and 10-year periods, and statistical comparisons were performed with analysis of variance. The mean age at menarche decreased by approximately 6 months for those born between 1910 and 1949 (13.1 vs. 12.7 years; p < 0.001), with a subsequent increase to 13.0 years among women born between 1960 and 1969 (p < 0.001). Among naturally menopausal women aged 60 or more years who reported never use of postmenopausal hormone therapy, the authors observed a 17-month increase in the mean age at menopause for those born between 1915 and 1939 (49.1 vs. 50.5 years; p = 0.001) after adjustment for potential confounders. They also observed an increase in the average number of reproductive years (subtracting age at menarche from age at natural menopause), from 36.1 years among women born between 1915 and 1919 to 37.7 years among the 1935-1939 cohort (p = 0.0001). These findings have implications for women's lifetime exposure to circulating endogenous hormones. (author's) Language: English Keywords: UNITED STATES OF AMERICA | MASSACHUSETTS | NEW HAMPSHIRE | WISCONSIN | RESEARCH REPORT | CASE CONTROL STUDIES | WOMEN | MENARCHE | MENOPAUSE | REPRODUCTION | HORMONES | North America | Americas | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Menstruation | Endocrine System | Physiology | Biology Document Number: 309136 |
| 24. Title: The breastfeeding teen. Author: Nicoletti A Source: Journal of Pediatric and Adolescent Gynecology. 2006 Apr;19(2):131-132. Abstract: The benefits of breastfeeding to the health of infants and mothers have been well documented. A less quantifiable positive effect of breastfeeding is the increase in the mother's self-esteem and confidence as a mother if she has successfully initiated breastfeeding. This boost to self-esteem is particularly noticeable in the teen mom. A common characteristic of teens who either consciously or unconsciously choose to become pregnant is a sense of failure, of never having achieved something worthwhile. Pregnancy and childbirth provides them with a sense of accomplishment, but they absolutely beam with pride when they successfully initiate and persevere with breastfeeding their baby. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | MASSACHUSETTS | RESEARCH REPORT | CASE STUDIES | MOTHERS | ADOLESCENT PREGNANCY | BREASTFEEDING | SELF ESTEEM | ACHIEVEMENT | North America | Americas | Developed Countries | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Psychological Factors | Behavior Document Number: 299763 |
| 25. Peer Reviewed Title: Urinary calculus associated with female genital cutting. Author: Nour NM Source: Obstetrics and Gynecology. 2006 Feb;107(2 Pt 2):521-523. Abstract: Female genital cutting is a cultural practice seen in parts of Africa and Asia. Women who have undergone type III female genital cutting (excising the external genitalia and suturing the remnant tissue to cover the urethra and part of the introitus) can suffer various long-term complications. Defibulation, a procedure that opens the overlying scar can alleviate or resolve symptoms. A 32-year-old Somali woman presenting with type III female genital cutting complained of infertility, dyspareunia, dysmenorrhea, and exquisite pain upon sitting. She underwent a defibulation procedure to create neolabia majora. Intraoperatively, a 0.8 cm urinary calculus was found beneath the urethra. Postoperatively, all of her symptoms resolved. Infibulated scars create a favorable environment for stagnant urine to crystallize and become a urinary calculus. (author's) Language: English Keywords: SOMALIA | MASSACHUSETTS | UNITED STATES OF AMERICA | RESEARCH REPORT | CASE STUDIES | WOMEN | FEMALE GENITAL CUTTING | COMPLICATIONS | UROGENITAL EFFECTS | UROGENITAL SURGERY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | North America | Americas | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Harmful Traditional Practices | Traditional Health Practices | Culture | Sociocultural Factors | Diseases | Urogenital System | Physiology | Biology | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 296800 |
| 26. Peer Reviewed Title: Perpetration of intimate partner violence associated with sexual risk behaviors among young adult men. Author: Raj A; Santana C; La Marche A; Amaro H; Cranston K Source: American Journal of Public Health. 2006 Oct;96(10):1873-1878. Abstract: We assessed the association between intimate partner violence (IPV) perpetration and sexual risk behaviors and fatherhood (having fathered children) among young men. Sexually active men aged 18 to 35 years who visited an urban community health center and who reported having sexual intercourse with a steady female partner during the past 3 months (N = 283) completed a brief self-administered survey about sexual risk behaviors, IPV perpetration, and demographics. We conducted logistic regression analyses adjusted for demographics to assess associations between IPV and sexual risk behaviors and fatherhood. Participants were predominantly Hispanic (74.9%) and Black (21.9%). Participants who reported IPV perpetration during the past year (41.3%) were significantly more likely to report (1) inconsistent or no condom use during vaginal and anal sexual intercourse, (2) forcing sexual intercourse without a condom, (3) having sexual intercourse with other women, and (4) having fathered 3 or more children. IPV perpetration was common among our sample and was associated with increased sexual risk behaviors. Urban community health centers may offer an important venue for reaching this at-risk population. (author's) Language: English Keywords: UNITED STATES OF AMERICA | MASSACHUSETTS | QUESTIONNAIRES | MEN | BLACKS | HISPANICS | SEXUAL PARTNERS | DOMESTIC VIOLENCE | SEXUAL ABUSE | RISK BEHAVIOR | SEX BEHAVIOR | ANAL SEX | RISK FACTORS | North America | Americas | Developed Countries | Demographic Factors | Population | Ethnic Groups | Cultural Background | Population Characteristics | Behavior | Crime | Social Problems | Sociocultural Factors | Biology Document Number: 307234 |
| 27. Title: Masculine gender roles associated with increased sexual risk and intimate partner violence perpetration among young adult men. Author: Santana MC; Raj A; Decker MR; La Marche A; Silverman JG Source: Journal of Urban Health: Bulletin of the New York Academy of Medicine. 2006 Jul;83(4):575-585. Abstract: This study sought to assess the association between traditional masculine gender role ideologies and sexual risk and intimate partner violence (IPV) perpetration behaviors in young men's heterosexual relationships. Sexually active men age 18--35 years attending an urban community health center in Boston were invited to join a study on men's sexual risk; participants (N = 307) completed a brief self-administered survey on sexual risk (unprotected sex, forced unprotected sex, multiple sex partners) and IPV perpetration (physical, sexual and injury from/need for medical services due to IPV) behaviors, as well as demographics. Current analyses included men reporting sex with a main female partner in the past 3 months (n = 283). Logistic regression analyses adjusted for demographics were used to assess significant associations between male gender role ideologies and the sexual risk and IPV perpetration behaviors. Participants were predominantly Hispanic (74.9%) and Black (21.9%); 55.5% were not born in the continental U.S.; 65% had been in the relationship for more than 1 year. Men reporting more traditional ideologies were significantly more likely to report unprotected vaginal sex in the past 3 months (OR/adj = 2.3, 95% CI = 1.2--4.6) and IPV perpetration in the past year (OR/adj = 2.1, 95% CI = 1.2--3.6). Findings indicate that masculine gender role ideologies are linked with young men's unprotected vaginal sex and IPV perpetration in relationships, suggesting that such ideologies may be a useful point of sexual risk reduction and IPV prevention intervention with this population. (author's) Language: English Keywords: MASSACHUSETTS | RESEARCH REPORT | KAP SURVEYS | YOUTH | MEN | HISPANICS | BLACKS | SEXUAL PARTNERS | HETEROSEXUALS | MALE ROLE | DOMESTIC VIOLENCE | SEX BEHAVIOR | RISK BEHAVIOR | CONDOM USE | CONTRACEPTIVE PREVALENCE | United States of America | North America | Americas | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Ethnic Groups | Cultural Background | Behavior | Social Behavior | Crime | Social Problems | Sociocultural Factors | Risk Reduction Behavior | Contraceptive Usage | Contraception | Family Planning Document Number: 307460 |
| 28. Peer Reviewed Title: Limitations in knowledge of HIV transmission among HIV-positive patients accessing case management services in a resource-poor setting. Author: Smith Fawzi MC; Jagannathan P; Cabral J; Banares R; Salazar J Source: AIDS Care. 2006 Oct;18(7):764-771. Abstract: HIV has increasingly become an infection of poverty. Adequate HIV transmission knowledge among HIV-positive patients is necessary to reduce the risk of secondary infection and protect those who are uninfected from transmission. This study was conducted among individuals enrolled in a program that serves impoverished HIV patients in the Boston area. Although the mean HIV transmission knowledge score was 80% for this group, a significant proportion of patients demonstrated limitations in knowledge of HIV transmission. Highly vulnerable patients, such as those who reported not accessing HIV medications, a history of sexual abuse, or problems getting clothing, had lower levels of HIV knowledge. This paper hopes to alert providers that their most vulnerable patients may be at an increased risk of re-infection or transmission due to limited HIV knowledge. Programs that serve HIV-positive patients coping with poverty and other serious problems need to ensure adequate knowledge of HIV transmission to reduce the overall burden of HIV in resource-poor settings. (author's) Language: English Keywords: UNITED STATES OF AMERICA | MASSACHUSETTS | RESEARCH REPORT | KAP SURVEYS | PERSONS LIVING WITH HIV/AIDS | LOW INCOME POPULATION | PROVIDERS WITH CLIENTS | HIV TRANSMISSION | SOCIOECONOMIC FACTORS | POVERTY | HEALTH EDUCATION | North America | Americas | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Social Class | Socioeconomic Status | Economic Factors | Health Services | Delivery of Health Care | Health | Education Document Number: 308969 |
| 29. Peer Reviewed Title: Impact of subgroup analysis on estimates of infertility. Author: Thornton KL; Goldman MB Source: Fertility and Sterility. 2006 Sep;86(3):531-533. Abstract: Conclusions regarding estimates of infertility may reflect study bias based on the definition of infertility used. Careful consideration of how the infertile population is defined, as well its use in subgroup analysis that may not be generalizable to the population of infertile women as a whole, is needed. To clinicians practicing in the midst of a society that has the public perception that infertility is increasing, an article titled "Declining Estimates of Infertility in the United States" (1) is eye catching to say the least. These investigators conclude, having obtained data from the National Fertility Survey (NFS) and the National Survey of Family Growth (NFSG), that there appears to be an overwhelming decline in 12-month infertility in married women between 1982 and 2002. Interestingly, this decrease was first noted in 1995; however there has been no significant change in the years 1995--2002. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | MASSACHUSETTS | CRITIQUE | DATA ANALYSIS | COUPLES | FERTILITY CHANGES | FERTILITY MEASUREMENTS | INFERTILITY | MARITAL STATUS | REPRODUCTIVE BEHAVIOR | SEXUALLY TRANSMITTED DISEASES | IMPACT | North America | Americas | Developed Countries | Research Methodology | Family Characteristics | Family and Household | Sociocultural Factors | Fertility | Population Dynamics | Demographic Factors | Population | Reproduction | Nuptiality | Reproductive Tract Infections | Infections | Diseases | Communication Document Number: 304995 |
| 30. Peer Reviewed Title: Can the pill dull desire forever? Source: Journal of Family Planning and Reproductive Health Care. 2005;31(3):249. Abstract: Researchers in Boston have studied women in a sexual dysfunction clinic by measuring steroid hormone binding globulin (SHBG) levels. Women taking combined oral contraceptives (COC) had a higher level of SHBG, which can lead to lower serum testosterone. Women who had stopped COC previously had slightly reduced SHBG levels but still seven times higher than women who had never taken COC. Reduced libido is a recognised symptom in women taking COC but in a recent presentation this team has suggested that the effect may last beyond the actual pill use. (excerpt) Language: English Keywords: MASSACHUSETTS | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | STEROID METABOLIC EFFECTS | TESTOSTERONE | SEXUALITY | TIME FACTORS | ORAL CONTRACEPTIVES, COMBINED | United States of America | North America | Americas | Developed Countries | Research Methodology | Demographic Factors | Population | Metabolic Effects | Physiology | Biology | Androgens | Hormones | Endocrine System | Personality | Psychological Factors | Behavior | Population Dynamics | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning Document Number: 290214 |
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