1.  Peer Reviewed Title: Return to fertility following discontinuation of oral contraceptives. Author: Barnhart KT; Schreiber CA Source: Fertility and Sterility. 2009 Mar;91(3):659-63. Abstract: OBJECTIVES: To provide an overview of the studies that have evaluated the return to fertility following cessation of oral contraceptives (OCs), including recent evidence in women discontinuing extended-cycle and continuous-use regimens. DESIGN: Comprehensive review. PATIENT(S): None. INTERVENTION(S): Relevant articles were identified through a PubMed literature search (1960-2007) and a cross-reference of published data. MAIN OUTCOME MEASURE(S): Time to fertility following contraceptive use. RESULT(S): Numerous studies have demonstrated some delay in the time to conception in previous users of OCs who discontinued use in order to conceive, but this impairment appears to be temporary and typically limited to the early months following cessation of OC use. Reported 12-month conception rates in former cyclic OC users range from 72%-94% and are similar to those observed in women discontinuing intrauterine devices (71%-92%), progestin-only contraceptives (70%-95%), condoms (91%), and natural family planning (92%). There is a limited amount of data on the time to conception in women stopping extended-cycle and continuous-use OCs, but the data suggest that subsequent return to fertility is generally comparable to that of cyclic OCs. CONCLUSION(S): A comprehensive survey of reported data indicates that the return of fertility in former OC users (both cyclic and extended/continuous regimens) in women who stop use in order to conceive is comparable to that observed with other contraceptive methods. Language: English Keywords: UNITED STATES OF AMERICA | PENNSYLVANIA | LITERATURE REVIEW | FERTILITY | ORAL CONTRACEPTIVES | CONTRACEPTIVE USAGE | REVERSIBILITY | Developed Countries | North America | Americas | Population Dynamics | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning Document Number: 330562 |
| 2. Peer Reviewed Title: Interest in Intrauterine Contraception Among Seekers of Emergency Contraception and Pregnancy Testing. Author: Schwarz EB; Kavanaugh M; Douglas E; Dubowitz T; Creinin MD Source: Obstetrics and Gynecology. 2009 Apr;113(4):833-839. Abstract: OBJECTIVE:: To estimate the interest in using intrauterine contraception among women and adolescent girls seeking emergency contraception or walk-in pregnancy testing. METHODS:: We surveyed 412 women and adolescent girls who requested emergency contraception or pregnancy testing at four family planning clinics in Pittsburgh, Pennsylvania. The 41-item survey assessed knowledge of, attitudes toward, and interest in using an intrauterine device (IUD). Data were analyzed using chi and Fisher exact tests and multivariable logistic regression methods. RESULTS:: The response rate was 85%. Twelve percent (95% confidence interval [CI] 9-15) of women and adolescent girls surveyed expressed interest in same-day insertion of an IUD, and 22% (95% CI 18-26) wanted more information about IUDs. Interest in same-day IUD insertion increased with higher education level, prior unwanted pregnancy, and experience with barriers to use of contraception. CONCLUSION:: Same-day IUD insertion may be a reasonable way to increase the use of highly-effective contraception among women and adolescent girls seeking emergency contraception or walk-in pregnancy testing. LEVEL OF EVIDENCE:: II. Language: English Keywords: UNITED STATES OF AMERICA | PENNSYLVANIA | RESEARCH REPORT | SURVEYS | ADOLESCENTS, FEMALE | EMERGENCY CONTRACEPTION | PREGNANCY TESTS | IUD | CONTRACEPTIVE USAGE | Developed Countries | North America | Americas | Sampling Studies | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods Document Number: 330855 |
| 3. Peer Reviewed Title: Internet death notices as a novel source of mortality surveillance data. Author: Boak MB; M'ikanatha NM; Day RS; Harrison LH Source: American Journal of Epidemiology. 2008;167(5):532-539. Abstract: Concerns about bioterrorism and influenza have focused attention on identifying novel data sources to enhance public health surveillance. The authors evaluated free Pittsburgh Post-Gazette Internet death notices for Allegheny County, Pennsylvania, as a potentially timely source of mortality data. Data abstracted from Internet death notices for 1998-2001 were compared with mortality records from the Pennsylvania Department of Health. Approximately 75% (44,294/60,281) of state records had death notices, and 91% (44,294/48,651) of death notices corresponded to a state record. There was a 2-day median lag from the date of death to online death notice publication. The date of death, gender, age, and name data were nearly 90% accurate and 60-100% complete. Increasing education and age were independently associated with increased Pittsburgh Post-Gazette reporting. Being non-White, female, or a nursing home resident were independently associated with decreased reporting. The Pittsburgh Post-Gazette Internet death notices provided accurate, timely mortality data for nearly three fourths of all Allegheny County deaths. (author's) Language: English Keywords: PENNSYLVANIA | RESEARCH REPORT | METHODOLOGICAL STUDIES | DATA COLLECTION | MINORITY GROUPS | NOTIFICATION | DEATH RECORDS | VITAL STATISTICS | INTERNET | MORTALITY | TIME FACTORS | NEWSPAPERS | SEX FACTORS | LENGTH OF LIFE | EDUCATIONAL STATUS | Developed Countries | United States of America | North America | Americas | Research Methodology | Population Characteristics | Demographic Factors | Population | Political Factors | Sociocultural Factors | Population Statistics | Information Networks | Communication | Population Dynamics | Printed Media | Mass Media | Socioeconomic Status | Socioeconomic Factors | Economic Factors Document Number: 324948 |
| 4. Title: Comparison of scales for evaluating premenstrual symptoms in women using oral contraceptives. Author: Coffee AL; Kuehl TJ; Sulak PJ Source: Pharmacotherapy. 2008 May;28(5):576-583. Abstract: The study objective was to compare two scales used in research to evaluate daily premenstrual mood symptoms during use of a monophasic oral contraceptive. The design was a subanalysis of data from a prospective study. The setting was the University-affiliated medical center. One hundred two reproductive-aged (18-48 yrs) women taking a monophasic oral contraceptive containing ethinyl estradiol and drospirenone in the standard 21-7 fashion (21 days of hormones followed by 7 days of placebo), and who had self-identified premenstrual symptoms of headache, mood changes, or pelvic pain. Subjects completed a single-item questionnaire, the Scott & White Daily Diary of Symptoms, and a multiple-item questionnaire, the Penn State Daily Symptom Report (DSR), to assess their premenstrual symptoms. The Scott & White diary used a visual analog scale of 0-10 to assess pelvic pain, headache, and mood (a composite of anxiety, depression, and irritability). The Penn State DSR contained 17 items: 10 behavioral and seven physical components, each rated on a scale of 0-4, with one item that specifically rated mood swings. Scores from the two scales were compared by using Spearman correlation coefficients, the Kendall W for concordance, and linear regression of ranked sums for study cycles. The Scott & White mood score significantly correlated with the total of the 17 items on the Penn State DSR, as well as the 10 behavioral items, the seven physical items, and the single mood-swing item (p less than 0.0001); specific coefficients of concordance were 0.44, 0.23, 0.10, and 0.28, respectively, and R2 values were 0.39, 0.39, 0.30, and 0.34, respectively. The daily Scott & White mood score was positively correlated with all 17 elements of the Penn State DSR (0.25-0.57). The greatest correlation was seen with the mood-swing element. Both instruments demonstrated the same patterns during the 21-7 oral contraceptive cycle, with symptoms increasing immediately before and peaking during the 7-day hormone-free interval. A single-itemdaily mood score using a rating scale of 0-10 was concordant with a relatively complex 17-element symptom index and demonstrated the same pattern of change during cycles of oral contraception. The simple scoring system offers an advantage, especially in clinical studies of long duration. (author's) Language: English Keywords: PENNSYLVANIA | UNITED STATES OF AMERICA | RESEARCH REPORT | ORAL CONTRACEPTIVES | PREMENSTRUAL TENSION | HEADACHE | PAIN | SIGNS AND SYMPTOMS | Developed Countries | North America | Americas | Contraceptive Methods | Contraception | Family Planning | Menstruation Disorders | Diseases Document Number: 326939 |
| 5. Title: Evaluation and community prevention coalitions: Validation of an integrated web-based / technical assistance consultant model. Author: Feinberg ME; Gomez BJ; Puddy RW; Greenberg MT Source: Health Education and Behavior. 2008 Feb;35(1):9-21. Abstract: Community coalitions (CCs) have labored with some difficulty to demonstrate empirical evidence of effectiveness in preventing a wide range of adolescent problem behaviors. Training and technical assistance (TA) have been identified as important elements in promoting improved functioning of CCs. A reliable, valid, and inexpensive method to assess functioning of CCs has been developed and is tested in this article in the context of Pennsylvania's Communities That Care (CTC) model. A CC Web-based questionnaire was developed and administered to more than 79 communities (867 participants) and the validity and reliability were assessed through multiple means, including the use of a companion TA implementation feed back questionnaire completed by TAs assigned to each of the sites. Results indicated adequate to good psychometric properties on internal reliability of the Web-based questionnaire, moderate construct validity across different reports of functioning, and relative stability through out the course of 1 year. Implications for a variety of community prevention coalitions interested in a relatively low-cost, user friendly, and suitable methodology for evaluating coalition functioning are discussed. In addition, areas of application for future research including linking coalition functioning with the quality and nature of technical assistance, levels of risk and protective factors, and large data sets of youth risk factor and problem behavior data are highlighted. (author's) Language: English Keywords: UNITED STATES OF AMERICA | PENNSYLVANIA | RESEARCH REPORT | METHODOLOGICAL STUDIES | EVALUATION | ADOLESCENTS | COMMUNITY WORKERS | RISK REDUCTION BEHAVIOR | TECHNICAL ASSISTANCE | COMMUNITY PARTICIPATION | INTERNET | QUESTIONNAIRES | Developed Countries | North America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Behavior | Programs | Organization and Administration | Information Networks | Communication Document Number: 324659 |
| 6. Peer Reviewed Title: The impact of over-the-counter availability of "Plan B" on teens' contraceptive decision making. Author: Krishnamurti T; Eggers SL; Fischhoff B Source: Social Science and Medicine. 2008 Aug;67(4):618-27. Abstract: In ruling on the over-the-counter status (OTC) of the emergency contraceptive, "Plan B", the US Food and Drug Administration (FDA) questioned whether younger adolescent females could adequately self-select and self-medicate. That determination requires a judgment of fact, regarding how increased emergency contraceptive availability would affect adolescents' behavior, and a judgment of values, regarding the acceptability of different outcomes. We present a general approach to such problems, using analytical and empirical methods grounded in behavioral decision research. We illustrate it with findings from 30 in-depth interviews and follow-up surveys, with adolescent females aged 13-19 in the Pittsburgh area reporting how Plan B availability would affect three decisions (having sex, choosing contraceptives, using Plan B). Although the FDA expressed concern about younger teens using Plan B as their primary form of contraception, neither younger nor older teens revealed such an intention. However, teens preferred easier availability, should emergency contraceptive be needed. Incorporating an understanding of teens' decision-related perspectives can make such policies more predictable and transparent. Language: English Keywords: PENNSYLVANIA | RESEARCH REPORT | KAP SURVEYS | ADOLESCENTS, FEMALE | USFDA | PHARMACY DISTRIBUTION | EMERGENCY CONTRACEPTION | CONTRACEPTIVE AVAILABILITY | VALUE ORIENTATION | DECISION MAKING | AGE FACTORS | ATTITUDES | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Adolescents | Youth | Population Characteristics | Demographic Factors | Population | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Contraception | Family Planning | Psychological Factors | Behavior Document Number: 329264 |
| 7. Peer Reviewed Title: Effects of continuous versus cyclical oral contraception: a randomized controlled trial. Author: Legro RS; Pauli JG; Kunselman AR; Meadows JW; Kesner JS Source: Journal of Clinical Endocrinology and Metabolism. 2008 Feb;93(2):420-429. Abstract: Context: Continuous oral contraception may better suppress the ovary and endometrium, lending itself to the treatment of other medical conditions. Objective: Our objective was to determine the effects of continuous vs. cyclical oral contraception. Design: This was a randomized double-blind trial. Setting: This trial was performed at an academic medical center in Pennsylvania. Patients: A total of 62 healthy women with regular menses were included in the study. Intervention: Cyclical oral contraception (21-d active/7-d placebo given for six consecutive 28-d cycles) vs. continuous (168-d active pill) therapy using a monophasic pill (20 ug ethinyl estradiol and 1 mg norethindrone acetate) was examined. Main Outcome Measures: The primary outcome was vaginal bleeding, and secondary outcomes included hormonal, pelvic ultrasound, quality of life, and safety measures. Results: There was no statistically significant difference in the number of total bleeding days between groups, but moderate/heavy bleedingwas significantly greater with the cyclical regimen [mean 11.0 d (SD 8.5) vs. continuous 5.2 d (SD 6.8); P=0.005], with both groups decreasing over time. Endogenous serum and urinary estrogens measured over six cycles were significantly lower (P = 0.02 and 0.04, respectively) in the continuous group than the cyclical group. Women in the continuous group also had a smaller ovarian volume and lead follicle size over the course of the trial by serial ultrasound examinations. The Moos Menstrual Distress Questionnaire showed that women on continuous therapy had less associated menstrual pain (P = 0.01) and favorable improvements in behavior (P = 0.04) during the premenstrual period. Conclusions: Continuous oral contraception does not result in a reduction of bleeding days over a 168-d period of observation but provides greater suppression of the ovary and endometrium. These effects are associated with improved patient symptomatology. (author's) Language: English Keywords: PENNSYLVANIA | RESEARCH REPORT | CLINICAL TRIALS | DOUBLE-BLIND STUDIES | WOMEN | ORAL CONTRACEPTIVES | ADMINISTRATION AND DOSAGE | ETHINYL ESTRADIOL | PAIN | MENSTRUATION | QUALITY OF LIFE | BLEEDING | ULTRASONICS | CONTRACEPTIVE SAFETY | NORETHINDRONE ACETATE | Developed Countries | United States of America | North America | Americas | Clinical Research | Research Methodology | Studies | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Signs and Symptoms | Diseases | Reproduction | Social Welfare | Economic Factors | Safety | Public Health | Norethindrone | Contraceptive Agents, Progestin Document Number: 327773 |
| 8. Title: Adolescent female acne: etiology and management. Author: Olutunmbi Y; Paley K; English JC 3rd Source: Journal of Pediatric and Adolescent Gynecology. 2008 Aug;21(4):171-6. Abstract: Acne vulgaris, a multifactorial condition often conferring significant psychosocial morbidity, affects an estimated 40 million people in the United States. The majority of these individuals are adolescents and young adults. The pathophysiology of the condition is still not fully known, but it is believed to be related in part to excess sebum production, follicular hyperkeratinization, microbial colonization by P acnes, and inflammation. Prior to initiating treatment in a female patient, a hyperandrogenic state must be considered and ruled out through history, physical exam, and laboratory evaluation if necessary. Treatment options are vast and include hormonal therapy among others. Hormonal therapies have long been noted to reduce acne lesions and offer a valuable adjuvant to standard therapy. Hormonal agents are thought to improve acne by blocking the androgen receptor and/or decreasing circulating androgens which leads to decreased sebum production. Hormonal treatment options include spironolactone, other antiandrogens, and oral contraceptives. The use of these agents to effectively treat acne has been demonstrated in several randomized, placebo-controlled clinical trials. Optimal results are often achieved with combination therapy with the goal of targeting multiple pathogenic pathways in acne development. Language: English Keywords: UNITED STATES OF AMERICA | PENNSYLVANIA | RESEARCH REPORT | ADOLESCENTS, FEMALE | ACNE | MANAGEMENT | TREATMENT | ORAL CONTRACEPTIVES | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Dermatitis | Diseases | Organization and Administration | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning Document Number: 328622 |
| 9. Title: Should female relatives of factor V Leiden carriers be screened prior to oral contraceptive use? A cost-effectiveness analysis. Author: Smith KJ; Monsef BS; Ragni MV Source: Thrombosis and Haemostasis. 2008 Sep;100(3):447-52. Abstract: Venous thromboembolism (VTE) is three-fold higher among FV Leiden (FVL) carriers receiving oral contraceptives (OCPs) than in the general population. FVL screening, however, is not routinely performed before prescribing OCP, and the cost-effectiveness of this strategy is unknown. A decision tree model was constructed to evaluate FVL screening and prophylactic anticoagulation (AC) strategies in female relatives of FVL carriers. In the model, AC was low molecular weight heparin, given warfarin embryopathy risks. VTE morbidity, mortality, and other clinical parameters were obtained from published studies. Drug costs were based on average wholesale price, and counseling included VTE risk with OCP use and FVL status. Outcomes included medical costs, effectiveness measured as quality-adjusted-life-years (QALY), and the incremental cost-effectiveness ratio (ICER) over 30 years, with cost and effectiveness discounted at 3%/year. FVL screening and counselling without prophylactic AC cost less and was more effective than no screening in this population, but was less effective than screening, counselling, and prophylaxis during high-risk periods, which gained 0.083 QALY, for an ICER of $147/QALY gained. Screening with counselling and long-term AC cost $3,536 with minimal QALY gain and an ICER >$600,000/QALY. Screening, OCP counseling, and prophylactic AC during high-risk periods was favoured and cost <$20,000/QALY, unless: (a) high-risk prophylaxis cost >$4,231 (base $932), (b) long-term prophylaxis cost <$1199 (base $6,546), or (c) VTE relative risk reduction with prophylaxis was <21% (base 90%). In conclusion, screening, counselling and prophylactic AC during high-risk periods in female relatives of FVL carriers is an economically favourable strategy. Language: English Keywords: UNITED STATES OF AMERICA | PENNSYLVANIA | RESEARCH REPORT | COST EFFECTIVENESS | COST BENEFIT ANALYSIS | WOMEN | ORAL CONTRACEPTIVES | THROMBOSIS | GENETICS | SCREENING | RISK FACTORS | Developed Countries | North America | Americas | Evaluation Indexes | Quantitative Evaluation | Evaluation | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Thromboembolism | Embolism | Vascular Diseases | Diseases | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 328689 |
| 10. Peer Reviewed Title: Implementing an advance emergency contraception policy: what happens in the real world? Author: Whittaker PG; Armstrong KA; Adams J Source: Perspectives on Sexual and Reproductive Health. 2008 Sep;40(3):162-70. Abstract: CONTEXT: Advance provision of emergency contraception increases the likelihood of its use, yet little is known about the factors that influence successful implementation of an advance provision policy in publicly funded family planning clinics. METHODS: Data on knowledge of, attitudes toward and use of emergency contraception were collected from 211 patients attending four Title X-funded clinics in Pennsylvania in 2001-2002. In addition, 22 staff from the four clinics were interviewed regarding barriers to and facilitators of advance provision in 2004-2005, and 111 staff from 46 clinics completed related surveys in 2005. Qualitative data underwent content analysis, and frequencies and bivariate associations between variables were calculated for the survey data. RESULTS: Most patients said they would use emergency contraception (80%) and believed it should be easy to obtain (93%), although 46% thought it is a form of abortion. Patients' familiarity with the method, attitudes toward it and self-efficacy regarding its use were not associated with most demographic or reproductive health characteristics. While nearly all interviewed staff endorsed routine advance provision, only about half of survey respondents offered it "very often" at patients' initial or annual visits. Barriers to advance provision included staff prejudgment of patients' needs and ability to use the method, time constraints and inefficiencies in clinic procedures. CONCLUSIONS: Strategies that may facilitate advance provision of emergency contraception include emphasizing the need for staff to offer it during all patient visits, providing patient-friendly information and streamlining clinic procedures. Language: English Keywords: PENNSYLVANIA | RESEARCH REPORT | KAP SURVEYS | WOMEN | FAMILY PLANNING PERSONNEL | EMERGENCY CONTRACEPTION | KNOWLEDGE | ATTITUDES | STAFF ATTITUDE | CLIENT-STAFF RELATIONS | CONTRACEPTIVE PREVALENCE | CONTRACEPTIVE AVAILABILITY | PERCEPTION | ABORTION | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Family Planning Programs | Family Planning | Contraception | Sociocultural Factors | Psychological Factors | Behavior | Interpersonal Relations | Contraceptive Usage | Fertility Control, Postconception Document Number: 329167 Notification |
| 11. Title: Prepregnancy obesity predicts poor vitamin D status in mothers and their neonates. Author: Bodnar LM; Catov JM; Roberts JM; Simhan HN Source: Journal of Nutrition. 2007 Nov;137(11):2437-2442. Abstract: Obesity is a risk factor for vitamin D deficiency, but this relation has not been studied among pregnant women, who must sustain their own vitamin D stores as well as those of their fetuses. Our objective was to assess the effect of prepregnancy BMI on maternal and newborn 25-hydroxyvitamin D [25(OH)D] concentrations. Serum 25(OH)D was measured at 4-21 wk gestation and predelivery in 200 white and 200 black pregnant women and in their neonates' cord blood. We used multivariable logistic regression models to assess the independent association between BMI and the odds of vitamin D deficiency [25(OH)D < 50 nmol/L] after adjustment for race/ethnicity, season, gestational age, multivitamin use, physical activity, and maternal age. Compared with lean women (BMI < 25), pregravid obese women (BMI $30) had lower adjusted mean serum 25(OH)D concentrations at 4-22 wk (56.5 vs. 62.7 nmol/L; P < 0.05) and a higher prevalence vitamin D deficiency (61 vs. 36%; P < 0.01). Vitamin D status of neonates born to obese mothers was poorer than neonates of lean mothers (adjusted mean, 50.1 vs. 56.3 nmol/L; P < 0.05). There was a dose-response trend between prepregnancy BMI and vitamin D deficiency. An increase in BMI from 22 to 34 was associated with 2-fold (95% CI: 1.2, 3.6) and 2.1-fold (1.2, 3.8) increases in the odds of mid-pregnancy and neonatal vitamin D deficiency, respectively. The rise in maternal obesity highlights that maternal and newborn vitamin D deficiency will continue to be a serious public health problem until steps are taken to identify and treat low 25(OH)D. (author's) Language: English Keywords: UNITED STATES OF AMERICA | PENNSYLVANIA | RESEARCH REPORT | PREGNANT WOMEN | MOTHERS | VITAMIN D | INFANT | OBESITY | RISK FACTORS | PREGNANCY OUTCOMES | VITAMINS AND MINERALS | AGE FACTORS | Developed Countries | North America | Americas | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Physiology | Biology | Youth | Body Weight | Pregnancy | Reproduction Document Number: 321819 |
| 12. Peer Reviewed Title: Developing an HPV vaccine to prevent cervical cancer and genital warts. Author: Bryan JT Source: Vaccine. 2007 Apr 20;25(16):3001-3006. Abstract: The challenges of the journey from target identification through development of a prophylactic quadrivalent human papillomavirus (HPV) vaccine have been met in Gardasil. Cervical cancer is the second leading cause of cancer-related death in women worldwide. Approximately 70% of cervical cancer is caused by infection with HPV types 16 and 18 and ~90% of genital warts are caused by HPV types 6 and 11. The quadrivalent HPV vaccine was generated by expression of the major capsid protein (L1) of HPV types 16, 18, 6 and 11 in yeast. L1 proteins self assemble into pentamer structures and these pentamer structures come together to form virus-like particles (VLPs). The VLPs are antigenically indistinguishable from HPV virions. The VLPs contain no viral DNA and therefore the vaccine is non-infectious. Gardasil is composed of VLPs of HPV types 16, 18, 6 and 11 conjugated to a proprietary amorphous aluminum hydroxyphosphate sulfate adjuvant. The results of a rigorous clinical program have demonstrated that the vaccine is safe and highly efficacious in preventing dysplasias, cervical intraepithelial neoplasias (CIN 1-3) the precursors of cervical cancer and external genital lesions caused by vaccine-HPV types. In conclusion, Gardasil addresses a major medical need, that is, reduction of HPV-related disease including cervical cancer as a safe, immunogenic, and highly efficacious vaccine. (author's) Language: English Keywords: UNITED STATES OF AMERICA | PENNSYLVANIA | RESEARCH REPORT | WOMEN | HPV | CERVICAL CANCER | PREVENTION AND CONTROL | VACCINES | TREATMENT | RESEARCH AND DEVELOPMENT | North America | Americas | Developed Countries | Demographic Factors | Population | Viral Diseases | Diseases | Cancer | Neoplasms | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Technology | Economic Factors Document Number: 313336 |
13.  Title: Sex-related communication with mothers and close friends during the transition to university. Author: Lefkowitz ES; Espinosa-Hernandez G Source: Journal of Sex Research. 2007 Feb;44(1):17-27. Abstract: The current study examines communication about sex-related topics with close friends and mothers during the first semester of college. Students (N = 182; 50% female; mean age = 18.5) completed surveys about the frequency and quality of their sex-related communication with same-sex close friends and mothers and about their sexual experience and attitudes. Sex-related communication was more frequently reported by women than by men and as occurring with close friends more frequently than with mothers. Sexually active students discussed most topics more frequently than did abstinent students. Communication with close friends was a stronger correlate of sexual attitudes than was communication with mothers. Finally, the quality of communication with close friends was more strongly associated with sexual experience and attitudes than was communication with mothers. Findings suggest the importance of understanding the role of friends in assigning meaning to sexual behaviors and beliefs. (author's) Language: English Keywords: PENNSYLVANIA | RESEARCH REPORT | KAP SURVEYS | FRIENDS AND RELATIVES | MOTHERS | STUDENTS | UNIVERSITIES | PARENTAL INVOLVEMENT | INTERPERSONAL COMMUNICATION | SEX BEHAVIOR | SEX FACTORS | ATTITUDES | BELIEFS | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Family and Household | Sociocultural Factors | Parents | Family Relationships | Family Characteristics | Education | Schools | Child Rearing | Behavior | Communication | Population Characteristics | Demographic Factors | Population | Psychological Factors | Culture Document Number: 321336 |
| 14. Title: The influence of behavioral inhibition / approach systems and message framing on the processing of persuasive health messages. Author: Shen L; Dillard JP Source: Communication Research. 2007 Aug;34(4):433-467. Abstract: Two experiments examine the role of message framing and behavioral inhibition/ approach systems (BIS/BAS) on affect, cognition, attitude, and behavioral intention. The results show that advantage framing yields stronger positive emotions, whereas disadvantage framing produces stronger negative emotions. BIS and BAS show a complex pattern of associations with emotions that is not wholly consistent with either the approach-avoidance or valence aspects of affect. There is an interaction between BIS/BAS and message frame on persuasion such that BIS correlates positively with dominant cognitive response under disadvantage framing, but BAS does so under advantage framing. These findings are contextualized in process models (structural equation modeling) that include anger, fear, attitude, and behavioral intention. (author's) Language: English Keywords: UNITED STATES OF AMERICA | PENNSYLVANIA | RESEARCH REPORT | ATTITUDES | BEHAVIOR | EMOTIONS | FEAR | ANGER | PERSUASION | HEALTH EDUCATION | COMMUNICATION STRATEGY | MESSAGE DEVELOPMENT | HEALTH SERVICES | Developed Countries | North America | Americas | Psychological Factors | Communication | Education | Delivery of Health Care | Health Document Number: 322402 |
| 15. Peer Reviewed Title: School-based screening for chlamydia trachomatis and Neisseria gonorrhoeae among Philadelphia public high school students. Author: Asbel LE; Newbern EC; Salmon M; Spain CV; Goldberg M Source: Sexually Transmitted Diseases. 2006 Oct;33(10):614-620. Abstract: The prevalence of sexually transmitted diseases among adolescents is high. Innovative screening and treatment programs need evaluation. The objectives of this study were to identify, treat, and describe the prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) infections among Philadelphia public high school students. We analyzed cross-sectional data from the first year of an annual program offering education, screening, and treatment for CT and GC. For the school year analyzed, screening took place between January 2003 and June 2003. In the first year, 19,394 students aged 12--20 years were voluntarily tested; 1052 students were identified with GC, CT, or both; 1051 received treatment. Prevalence of CT among females (95% confidence interval [CI] = 8.1) was 3.3 times higher than among males (95% CI = 2.5%). Attending disciplinary schools and residing in high reported morbidity areas were also related to higher prevalence of CT and GC. A high prevalence of CT infections was identified among Philadelphia public high school students. This program demonstrated the effectiveness of a school-based screening program to identify and treat these infections. (author's) Language: English Keywords: PENNSYLVANIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CROSS SECTIONAL ANALYSIS | ADOLESCENTS | SCHOOL AGE POPULATION | SCHOOL-BASED SERVICES | SCREENING | CHLAMYDIA | GONORRHEA | SECONDARY SCHOOLS | PREVALENCE | SEX FACTORS | RISK FACTORS | HUMAN GEOGRAPHY | United States of America | North America | Americas | Developed Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Programs | Organization and Administration | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Schools | Education | Measurement | Biology | Geography | Social Sciences | Science | Sociocultural Factors Document Number: 307353 |
| 16. Peer Reviewed Title: The challenge and enjoyment of the interpretation of epidemiologic data. Author: Barnhart KT Source: Fertility and Sterility. 2006 Sep;86(3):527-528. Abstract: The trend toward a decline in the percentage of women with infertility in the United States appears real. While the factors associated with this trend are likely many, complex, and interrelated, we cannot overlook the positive impact of those individuals who practice in the field of reproductive medicine. Stephen and Chandra's (1) article "Declining Estimates of Infertility in the United States: 1982--2002" is intriguing in many ways. A realistic first reaction is: Can this trend be correct? Our population is aging; there is still an epidemic of sexually transmitted disease that may result in tubal damage; there is heightened attention to environmental toxins that may affect many aspects of reproduction; and (thankfully) my office is still full. How can the percentage of women with infertility be decreasing? As pointed out by the investigators, this trend of a decrease in rates of infertility has been a well kept secret. The challenge is to understand what may be affecting this trend. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | PENNSYLVANIA | CRITIQUE | BLACKS | HISPANICS | WOMEN | INFERTILITY | North America | Americas | Developed Countries | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Reproduction Document Number: 304992 |
| 17. Peer Reviewed Title: Availability of emergency contraception at rural and urban pharmacies in Pennsylvania. Author: Chuang CH; Shank LD Source: Contraception. 2006 Apr;73(4):382-385. Abstract: Pharmacy availability of emergency contraception (EC) is necessary for timely access to this important contraceptive method. This is especially important in rural areas where pharmacies are fewer and further apart. This study was conducted using a telephone survey of 186 pharmacies located in the northeast region of Pennsylvania. Only 32% of the pharmacies had EC in stock, which did not differ by rural or urban location. Pharmacies that stocked EC in rural counties were less likely to have evening store hours compared with urban counties (p = .01). Pharmacies that did not stock EC most frequently cited lack of perceived need as the reason (61%). Emergency contraception availability in pharmacies is uniformly low in this region of Pennsylvania, creating a significant access barrier. Although there were no significant differences in EC availability between rural and urban pharmacies, additional barriers in rural settings could impede timely access to EC for rural women. (author's) Language: English Keywords: UNITED STATES OF AMERICA | PENNSYLVANIA | RURAL AREAS | URBAN AREAS | RESEARCH REPORT | SURVEYS | PHARMACISTS | EMERGENCY CONTRACEPTION | PHARMACY DISTRIBUTION | CONTRACEPTIVE AVAILABILITY | North America | Americas | Developed Countries | Geographic Factors | Population | Sampling Studies | Studies | Research Methodology | Health Personnel | Delivery of Health Care | Health | Contraception | Family Planning | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration Document Number: 298535 |
| 18. Title: Women's experiences with emergency contraception in an internal medicine practice. Author: Cunnane MS; Dickson G; Cook RL Source: Journal of Women's Health. 2006 Nov;15(9):1080-1089. Abstract: Emergency contraceptive pills (ECPs) are effective for preventing unintended pregnancy. Whether patients in primary care settings receive physician counseling regarding ECPs has not been evaluated. We conducted a cross-sectional telephone survey of reproductive-age women who sought care at a university-based general internal medicine clinic regarding receipt of physician counseling about ECPs, knowledge and experiences with ECPs, and attitudes toward using ECPs. One hundred forty-nine women aged 18--45 completed the survey. Eighty percent of respondents (n = 119) were at risk for unintended pregnancy. Although all women in the sample had seen an internist in the previous 12 months, only 10% had received physician counseling about ECPs. There was little difference in the proportion of women who received counseling about ECPs comparing those who received care from an obstetrician/gynecologist and an internist with women who received care from an internist alone (13% vs. 8%, p = 0.529). Receipt of ECP counseling was not associated with the consistency of current contraceptive use. No women who were married or over the age of 40 were counseled about ECPs. The majority of participants (92%) had heard of ECPs, although most (54%) had learned about them through the media. Fifty-four percent of women would be likely to use ECPs to prevent unintended pregnancy. Only a fraction of women seeing internists for their primary care are receiving counseling about ECPs, irrespective of receiving care from an obstetrician/gynecologist. As primary care physicians, internists should determine risk for unintended pregnancy, assess patients' knowledge and attitudes toward ECPs, and provide counseling about this effective therapy. (author's) Language: English Keywords: PENNSYLVANIA | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | WOMEN | EMERGENCY CONTRACEPTION | KNOWLEDGE | ATTITUDES | PREGNANCY, UNPLANNED | COUNSELING | INFORMATION SOURCES | MASS MEDIA | RISK ASSESSMENT | United States of America | North America | Americas | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Contraception | Family Planning | Sociocultural Factors | Psychological Factors | Behavior | Reproductive Behavior | Fertility | Population Dynamics | Clinic Activities | Program Activities | Programs | Organization and Administration | Information | Communication | Evaluation Document Number: 309565 |
| 19. Peer Reviewed Title: Pregnancy in perinatally HIV-infected adolescents. Author: Levine AB; Aaron E; Foster J Source: Journal of Adolescent Health. 2006 Jun;38(6):765-768. Abstract: Long-term survival of patients with congenital human immunodeficiency virus (HIV) infection has resulted in a growing cohort of perinatally infected adolescents and young adults who are sexually active and becoming pregnant. Two cases are presented to report our management of pregnancies resulting from unprotected sexual practices in perinatally HIV-infected adolescents who were HIV serodiscordant. An integrated approach, involving the specialties of pediatrics, obstetrics and gynecology, and infectious disease, along with social services, was used to provide comprehensive care to these patients. There is a need to address reproductive health issues, especially risky sexual behaviors, in adolescents who are HIV infected. (author's) Language: English Keywords: PENNSYLVANIA | RESEARCH REPORT | CASE STUDIES | INTERDISCIPLINARY STUDIES | ADOLESCENTS, FEMALE | PREGNANT WOMEN | PERSONS LIVING WITH HIV/AIDS | MOTHER-TO-CHILD TRANSMISSION | ADOLESCENT PREGNANCY | HIV INFECTIONS | PREGNANCY COMPLICATIONS | SEX BEHAVIOR | RISK BEHAVIOR | Developed Countries | United States of America | North America | Americas | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Transmission | Infections | Reproductive Behavior | Fertility | Population Dynamics | Behavior Document Number: 301530 |
| 20. Peer Reviewed Title: Effects of long-term use of nonoxynol-9 on vaginal flora. Author: Schreiber CA; Meyn LA; Creinin MD; Barnhart KT; Hillier SL Source: Obstetrics and Gynecology. 2006 Jan;107(1):136-143. Abstract: Products containing nonoxynol-9 have been used as spermicidal contraceptives for many years, but limited data have been published describing the long-term effects of nonoxynol-9 use on the vaginal microbial ecosystem. This longitudinal study was conducted to examine the effects of nonoxynol-9 on the vaginal ecology. Vaginal swabs were obtained from 235 women enrolled in a randomized clinical trial before initiation of use of 1 of 5 different formulations of nonoxynol-9 for contraception, and up to 3 more samples were gathered over 7 months of use. The swab samples were evaluated in a single laboratory. The prevalence of several constituents of the normal vaginal flora was evaluated. The associations between nonoxynol-9 dosage, formulation, average product use per week, and number of sex acts per week were calculated. The changes in prevalence of vaginal microbes after nonoxynol-9 use were minimal for each of the different nonoxynol-9 formulations. However, when both nonoxynol-9 concentration and number of product uses are taken into account, nonoxynol-9 did have dose-dependant effects on the increased prevalence of anaerobic gram-negative rods (odds ratio [OR] 2.4, 95% confidence interval [CI] 1.1-5.3), H/2O/2-negative lactobacilli (OR 2.0, 95% CI 1.0-4.1), and bacterial vaginosis (OR 2.3, 95% CI 1.1- 4.7). This study demonstrated that most nonoxynol-9 users experienced minimal disruptions in their vaginal ecology. There were no differences between the different formulations evaluated with respect to changes in vaginal microflora. However, independent of the nonoxynol-9 formulation, there was a dose-dependent effect with increased exposure to nonoxynol-9 on the risk of bacterial vaginosis and its associated flora. (author's) Language: English Keywords: PENNSYLVANIA | RESEARCH REPORT | LONGITUDINAL STUDIES | CLINICAL TRIALS | EPIDEMIOLOGIC METHODS | WOMEN | NONOXYNOL-9 | VAGINA | VAGINAL ABNORMALITIES | SPERMICIDAL CONTRACEPTIVE AGENTS | PREVALENCE | BACTERIAL AND FUNGAL DISEASES | VAGINOSIS | Developed Countries | United States of America | North America | Americas | Studies | Research Methodology | Clinical Research | Demographic Factors | Population | Contraceptive Agents | Contraception | Family Planning | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Diseases | Measurement | Infections Document Number: 296634 |
| 21. Peer Reviewed Title: Nausea, emesis, and muscle weakness in a pregnant adolescent. Author: Srinivas SK; Sukhan S; Elovitz MA Source: Obstetrics and Gynecology. 2006 Feb;107(2 Pt 2):481-484. Abstract: Gitelman syndrome is a rare autosomal recessive disorder that presents in early adulthood with fatigue, muscle cramps and electrolyte abnormalities. A 17-year-old African-American woman presented at 17 weeks of pregnancy with nausea, emesis, profound lower extremity proximal muscle weakness, hypokalemia, and hypomagnesemia. After a thorough evaluation, Gitelman syndrome was diagnosed. The patient was maintained on high levels of potassium and magnesium supplementation throughout the rest of her pregnancy and delivered a healthy infant. In pregnancy, nausea and emesis is most commonly attributed to hyperemesis gravidarum. However, an atypical presentation of these symptoms and/or the coexistence of less common complaints warrant further investigation. (author's) Language: English Keywords: UNITED STATES OF AMERICA | PENNSYLVANIA | RESEARCH REPORT | CASE STUDIES | ADOLESCENTS, FEMALE | PREGNANT WOMEN | NAUSEA | FATIGUE | VOMITING | RENAL EFFECTS | MUSCULAR EFFECTS | ELECTROLYTE BALANCE | PREGNANCY COMPLICATIONS | EXAMINATIONS AND DIAGNOSES | Developed Countries | North America | Americas | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Signs and Symptoms | Diseases | Urogenital Effects | Urogenital System | Physiology | Biology | Homeostasis | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 296798 |
| 22. Peer Reviewed Title: A randomized controlled trial testing an HIV prevention intervention for Latino youth. Author: Villarruel AM; Jemmott JB 3d; Jemmott LS Source: Archives of Pediatrics and Adolescent Medicine. 2006 Aug;160(8):772-777. Abstract: The objective was to test the efficacy of a prevention intervention to reduce sexual risk behavior among Latino adolescents. Design: Randomized controlled trial from April 2000 through March 2003, with data collection before and after intervention and at 3, 6, and 12 months. Setting: Northeast Philadelphia schools. Participants: Latinos aged 13 through 18 years (249 males and 304 females); 81.6% retained at 12-month follow-up. Interventions: The HIV and health-promotion control interventions consisted of six 50-minute modules delivered by adult facilitators to small, mixed-gender groups in English or Spanish. Main Outcome Measure: Self-reported sexual behavior. Analyses using generalized estimation equations over the follow-up period revealed that adolescents in the HIV intervention were less likely to report sexual intercourse (odds ratio, 0.66; 95% confidence interval [CI], 0.46-0.96), multiple partners (odds ratio, 0.53; 95% CI, 0.31-0.90), and days of unprotected intercourse (relative risk, 0.47; 95% CI, 0.26-0.84) and more likely to report using condoms consistently (odds ratio, 1.91; 95% CI, 1.24-2.93). Baseline sexual experience and language use moderated intervention efficacy. Adolescents assigned to the HIV intervention who were sexually inexperienced at baseline reported fewer days of unprotected sex (relative risk, 0.22; 95% CI, 0.08-0.63); Spanish speakers were more likely to have used a condom at last intercourse (odds ratio, 4.73; 95% CI, 1.72-12.97) and had a greater proportion of protected sex (mean difference, 0.35; P < .01) compared with similar adolescents in the health-promotion intervention. Results provide evidence for the efficacy of HIV intervention in decreasing sexual activity and increasing condom use among Latino adolescents. (author's) Language: English Keywords: PENNSYLVANIA | RESEARCH REPORT | CASE CONTROL STUDIES | KAP SURVEYS | HISPANICS | HIV PREVENTION | PROMOTION | HEALTH EDUCATION | SEX EDUCATION | SEX BEHAVIOR | RISK BEHAVIOR | SAFER SEX | United States of America | North America | Americas | Developed Countries | Studies | Research Methodology | Surveys | Sampling Studies | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Marketing | Economic Factors | Education | Behavior Document Number: 306412 |
| 23. Title: What if: How declines in teen births have improved poverty and child well-being in Pennsylvania. 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 | PENNSYLVANIA | 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: 307017 |
| 24. Peer Reviewed Title: Vaginal distribution of two volumes of the novel microbicide gel cellulose sulfate (2.5 and 3.5 mL). Author: Barnhart KT; Pretorius ES; Shaunik A; Timbers K; Nasution M Source: Contraception. 2005;72:65-70. Abstract: This was a blinded crossover study to determine the in vivo distribution of 2.5 and 3.5 mL of 6% cellulose sulfate gel. This potential vaginal microbicide was mixed with dilute gadolinium chelate and inserted into the vagina. Magnetic resonance imaging was performed at baseline and repeated after 5, 20, 35 and 50 min with subjects either resting or ambulating between data acquisitions. Use of 2.5 mL with no ambulation gave low linear spread (53.1% of vaginal length) and surface contact (61.7%) at 50 min. Using 3.5 mL of gel with ambulation improved linear spread (84.5%) and surface contact (85.9%) of the gel in the same time interval without significant leakage. Most linear spreading took place in the first 5 min after insertion, although lateral spreading continued to increase with time especially when ambulation took place. Leakage and gel was not a significant problem at either volume. (author's) Language: English Keywords: PENNSYLVANIA | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | WOMEN | MICROBICIDES | ADMINISTRATION AND DOSAGE | VAGINAL GEL | LABORATORY EXAMINATIONS AND DIAGNOSES | PHYSICAL EXAMINATIONS AND DIAGNOSES | TIME FACTORS | Developed Countries | United States of America | North America | Americas | Research Methodology | Studies | Demographic Factors | Population | Drugs | Treatment | Vaginal Spermicides | Contraceptive Methods | Contraception | Family Planning | Examinations and Diagnoses | Population Dynamics Document Number: 288304 |
| 25. Peer Reviewed Title: Group B streptococcal vaginitis in postpubertal adolescent girls. Author: Clark LR; Atendido M Source: Journal of Adolescent Health. 2005;36:437-440. Abstract: The purpose of this study was to explore the clinical findings, diagnosis, and treatment of group B streptococcal (GBS) vulvovaginitis in a sample of adolescent girls and young women found to have this condition. Descriptive retrospective analysis of charts of 13 adolescent girls and young women found to have GBS vulvovaginitis was performed. Of the girls and young women with GBS vulvovaginitis, almost all were found to have a purulent vaginal discharge (n = 12). Three had frank cervicitis and/or vaginitis on examination. Only 1 was diagnosed accurately with GBS vulvovaginitis at the time of the visit and 4 were treated with appropriate antibiotics at the time of the visit. GBS vulvovaginitis is a poorly diagnosed disease entity in the adolescent and young adult population. Further study is needed in the epidemiology of GBS vaginitis in postpubertal adolescent girls and women to improve the recognition, pathogenesis, and treatment of GBS vaginitis. (author's) Language: English Keywords: UNITED STATES OF AMERICA | PENNSYLVANIA | RESEARCH REPORT | RETROSPECTIVE STUDIES | ADOLESCENTS, FEMALE | SEXUAL INTERCOURSE | LABORATORY EXAMINATIONS AND DIAGNOSES | BACTERIAL AND FUNGAL DISEASES | Developed Countries | North America | Americas | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproduction | Examinations and Diagnoses | Infections | Diseases Document Number: 286029 |
| 26. Peer Reviewed Title: HIV / AIDS and African immigrant women in Philadelphia: structural and cultural barriers to care. Author: Foley EE Source: AIDS Care. 2005 Nov;17(8):1030-1043. Abstract: Although African immigration to American cities is increasing, there is little published demographic or epidemiological data on this population. As growing numbers of HIV-positive Africans seek care at public health centres in the city of Philadelphia, medical personnel are confronted with the challenges of serving this population. This qualitative study explores the perspectives of HIV service providers who are treating this new patient group, and it examines the cultural and structural barriers African women face in the area of HIV prevention, testing, and treatment in the city of Philadelphia. These barriers include legal status, linguistic problems, fear of the American health system, misunderstandings about modes of transmission of HIV, and lack of awareness about antiretroviral treatment. Culturally appropriate education about HIV prevention and treatment needs to be developed for African immigrants, and medical personnel need to understand the experiences, fears, and concerns of this population. (author's) Language: English Keywords: AFRICA, SUB SAHARAN | UNITED STATES OF AMERICA | PENNSYLVANIA | RESEARCH REPORT | QUALITATIVE RESEARCH | PERSONS LIVING WITH HIV/AIDS | IMMIGRANTS | HEALTH PERSONNEL | NEEDS ASSESSMENT | HIV PREVENTION | TREATMENT | HIV TESTING | CULTURAL BACKGROUND | UTILIZATION OF HEALTH CARE | Developing Countries | Africa | North America | Americas | Developed Countries | Research Methodology | HIV Infections | Viral Diseases | Diseases | Migrants | Migration | Population Dynamics | Demographic Factors | Population | Delivery of Health Care | Health | Evaluation | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Population Characteristics | Health Services Document Number: 291284 |
| 27. Peer Reviewed Title: Personal fulfillment motivates adolescents to be physically active. Author: Haverly K; Davison KK Source: Archives of Pediatrics and Adolescent Medicine. 2005 Dec;159(12):1115-1120. Abstract: The objectives were to identify factors that motivate adolescents to be physically active; to assess differences in motivators for groups at risk for physical inactivity, including girls vs boys, overweight vs nonoverweight youth, and youth with low vs high perceived sport competence; and to assess links between activity motivation and physical activity. Design: Cross-sectional study. Setting: A middle school in rural central Pennsylvania. Participants: Two hundred two girls (n = 92) and boys (n = 110). Main Exposure: Motivations to be physically active were assessed using the Activity Motivation Scale. Perceived sport competence was measured by the Physical Self Description Questionnaire. Participants' height and weight were measured and used to classify their overweight status. Main Outcome Measure: Three self-reported measures were used to assess adolescents' physical activity. Adolescents were most likely to report personal fulfillment as the strongest motivating factor for physical activity (mean [SD], 3.49 [0.56]), followed by weight-based motivation (mean [SD], 2.39 [0.93]), peer motivation (mean [SD], 2.09 [0.67]), and parent motivation (mean [SD], 1.72 [0.73]; F = 680.74; P < .001). Overweight adolescents reported significantly higher weight-based motivation (mean [SD], 2.84 [0.79]) compared with nonoverweight adolescents (mean [SD], 2.06 [0.89]; F = 40.52; P < .001), and adolescents with low perceived sport competence reported significantly lower personal fulfillment motivation (mean [SD], 3.20 [0.68]) compared with adolescents with higher perceived sport competence (mean [SD], 3.69 [0.32]; F = 52.31; P < .001). Personal fulfillment was the only motivating factor that showed a consistent moderate to strong association with physical activity across all regression models. Personal fulfillment motivation should be considered when designing physical activity promotion programs for adolescents. (author's) Language: English Keywords: PENNSYLVANIA | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | ADOLESCENTS | MOTIVATION | FITNESS | OBESITY | SPORTS | SELF-PERCEPTION | ANTHROPOMETRY | SEX FACTORS | PEER PRESSURE | PARENTAL INVOLVEMENT | United States of America | North America | Americas | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Psychological Factors | Behavior | Health | Body Weight | Physiology | Biology | Social Behavior | Perception | Measurement | Psychosocial Factors | Child Rearing Document Number: 294178 |
| 28. Peer Reviewed Title: Adding a skills-based component to STD prevention efforts may increase their success among teenagers. Author: Hollander D Source: Perspectives on Sexual and Reproductive Health. 2005 Sep;37(3):157-158. Abstract: Interventions that emphasize STD risk reduction skills may be more effective at lowering the prevalence of risky behaviors and preventing infection among teenage women than programs that simply provide information about how to reduce risk. In a randomized controlled trial conducted in Philadelphia, participants in a skills-based STD prevention intervention reported less unprotected sex one year later than did a control group, who received a general health promotion intervention. They also had a lower STD incidence and reported less involvement with multiple partners and less unprotected sex while drunk or high than controls. Outcomes among young women who received an information-based STD prevention intervention did not differ from those among controls. The interventions were part of a project designed to lower the risk of health problems among inner-city black and Hispanic teenage women. Using group discussions, videotapes, games and exercises in a single 250-minute session, the STD prevention programs addressed the high rates of HIV and other STDs among black and Hispanic young women, personal vulnerability, substance use, and condom use and negotiation skills. They differed only in that the skills-based intervention had participants practice putting condoms on anatomical models and engage in role-playing exercises to increase condom negotiation skills. The trial was open to sexually experienced, nonpregnant 12–19-year-olds obtaining family planning care at a hospital adolescent medicine clinic. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | PENNSYLVANIA | RESEARCH REPORT | CASE CONTROL STUDIES | ADOLESCENTS, FEMALE | SEXUALLY TRANSMITTED DISEASE PREVENTION | RISK REDUCTION BEHAVIOR | INTERVENTIONS | SAFER SEX | North America | Americas | Developed Countries | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Behavior | Programs | Organization and Administration | Sex Behavior Document Number: 290249 |
| 29. Peer Reviewed Title: Lea's Shield: colposcopic and microbiological testing during 8 weeks of use. Author: Mauck CK; Creinin MD; Rountree W; Callahan MM; Hillier SL Source: Contraception. 2005;72:53-59. Abstract: The aims of this study were to assess the effects of Lea’s ShieldR plus nonoxynol-9 spermicide on signs and symptoms of female genital irritation and cervical and vaginal microflora during 8 weeks of use with intercourse and to analyze problems associated with the use of the device. In this open-label, single-arm study, participants were evaluated by pelvic examination, colposcopy and vaginal and cervical cultures. About 13% of women (4/30) reported symptoms of irritation, and minor product-related colposcopic findings were seen in about one third (11/30). Although average colony counts for enterococcus, Escherichia coli and anaerobic gram-negative rods increased during product use, no clinical diagnoses of infection were made. Most users reported at least one problem using Lea’s Shield. Lea’s Shield, when used for 8 weeks during intercourse, is associated with evidence of genital irritation in a minority of users and with changes in vaginal microflora that do not appear to correlate with clinical infections. (author's) Language: English Keywords: PENNSYLVANIA | RESEARCH REPORT | KAP SURVEYS | CLINICAL RESEARCH | WOMEN | COLPOSCOPY | VAGINAL DIAPHRAGM | NONOXYNOL-9 | SIGNS AND SYMPTOMS | CONTRACEPTIVE SAFETY | GENITAL EFFECTS, FEMALE | BACTERIAL AND FUNGAL DISEASES | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Vaginal Barrier Methods | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Spermicidal Contraceptive Agents | Contraceptive Agents | Diseases | Safety | Public Health | Health | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Infections Document Number: 288302 |
| 30. Peer Reviewed Title: Timing of puberty and sexuality in men and women. Author: Ostovich JM; Sabini J Source: Archives of Sexual Behavior. 2005 Apr;34(2):197-206. Abstract: We examined the relations among timing of puberty, timing of first experience of sexual arousal, strength of sex drive, and sexual attitudes and behaviors in 277 men (M age, 22.4 years) and women (Mage, 21.8 years). Kinsey had suggested that earlier maturers have a stronger sex drive and, therefore, engage in a higher frequency of sexual behaviors (including same-sex contacts) than do later maturers. The purpose of this study was to test Kinsey’s claim. Participants completed questionnaires on pubertal timing, timing of first experience of sexual arousal, sex drive in adulthood, sexual attitudes (e.g., sociosexuality or degree of comfort with casual sex), and sexual behaviors (e.g., lifetime number of sexual partners). Timing of puberty (i.e., emergence of secondary sex characteristics) was related to these variables for men but not for women. Timing of first sexual arousal was related to several aspects of adult sexuality in both sexes, but particularly in women. Earlier first sexual arousal was associated with having a higher sex drive, a less restricted sociosexual orientation, and with having had more sexual partners than was later first sexual arousal. Earlier first sexual arousal, but not timing of puberty, was related to sexual orientation for women only. We discuss classes of explanations for these results. (author's) Language: English Keywords: PENNSYLVANIA | RESEARCH REPORT | KAP SURVEYS | STUDENTS | SEXUALITY | PUBERTY | UNIVERSITIES | AGE FACTORS | ATTITUDES | SEX BEHAVIOR | SEX FACTORS | United States of America | North America | Americas | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Education | Personality | Psychological Factors | Behavior | Reproduction | Schools | Population Characteristics | Demographic Factors | Population Document Number: 292799 |
 |
||
 |
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 |  |