1.  Peer Reviewed Title: Adolescent gynecology. Author: Sanfilippo JS; Lara-Torre E Source: Obstetrics and Gynecology. 2009 Apr;113(4):935-47. Abstract: Given new developments in the field of adolescent reproductive health, this review focuses on highlighting new guidelines and practice patterns in evaluation and management of adolescent gynecologic problems. First, understanding the proper techniques for the initial examination is key to establishing a long-term relationship with this age group. Reservations about the first gynecologic examination are common, and the practitioner's goal is foremost to make the patient as comfortable as possible. Preventive health in this patient population is key, and practitioners should become comfortable with providing education about topics as diverse as sexuality, eating disorders, and dating violence. Furthermore, the frequency with which teenagers report sexual activity and the high unintended pregnancy rate in this age group makes counseling regarding effective contraception essential. Additionally, practitioners are encouraged to take the opportunity to discuss the availability of the human papillomavirus (HPV) vaccine with adolescents. In 2007, adolescents were designated as a special population, given the frequency with which they acquire and clear mild HPV-related cervical dysplasia. More conservative treatment in this population is generally favored. During their transition through puberty, disorders of menstruation become the most common complaint requiring the attention of the gynecologist. Most commonly, anovulation serves as the cause behind such abnormal bleeding. Polycystic ovarian syndrome can develop in early puberty and carry its consequences into adulthood. Infertility, diabetes, and hirsutism mark the most important components of the syndrome and require age-appropriate management. Finally, the consequences of endometriosis on the future fertility of adolescents have brought early intervention to light. Recognition and prompt treatment are advocated to prevent the future implications of this disease. Language: English Keywords: UNITED STATES OF AMERICA | VIRGINIA | RESEARCH REPORT | ADOLESCENTS, FEMALE | EXAMINATIONS AND DIAGNOSES | ADOLESCENT HEALTH | GYNECOLOGY | PREVENTIVE MEDICINE | HPV | CYTOLOGY | HISTOLOGY | BLEEDING | UTERINE EFFECTS | ORAL CONTRACEPTIVES | TREATMENT | IUD | VAGINAL BARRIER METHODS | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Viral Diseases | Diseases | Biology | Signs and Symptoms | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Contraceptive Methods | Contraception | Family Planning | Barrier Methods Document Number: 341227 |
| 2. Peer Reviewed Title: An abstinence program's impact on cognitive mediators and sexual initiation. Author: Weed SE; Ericksen IH; Lewis A; Grant GE; Wibberly KH Source: American Journal of Health Behavior. 2008 Jan 1;32(1):60-73. Abstract: The objectives were to evaluate the impact of an abstinence education program on sexual intercourse initiation and on possible cognitive mediators of sexual initiation for virgin seventh graders in suburban Virginia. Measures of sexual behavior and 6 mediating variables were compared at 3 time periods for program participants and a matched comparison group (n=550), controlling for pretest differences. At posttest, program students scored significantly better on 4 of the 6 mediators. After one year, program students had a substantially lower risk of sexual initiation than did comparison students (RR=.457, P=.008). The program achieved a significant reduction in teen sexual initiation, and the role of the cognitive mediators was supported. (author's) Language: English Keywords: UNITED STATES OF AMERICA | VIRGINIA | RESEARCH REPORT | COMPARATIVE STUDIES | ADOLESCENTS | STUDENTS | SEX EDUCATION | ABSTINENCE | PREGNANCY | SEXUALLY TRANSMITTED DISEASES | IMPACT | PROGRAM EVALUATION | Developed Countries | North America | Americas | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Family Planning, Behavioral Methods | Family Planning | Reproduction | Reproductive Tract Infections | Infections | Diseases | Communication | Programs | Organization and Administration Document Number: 322450 |
| 3. Peer Reviewed Title: Does meloxicam increase the incidence of anovulation induced by single administration of levonorgestrel in emergency contraception? A pilot study. Author: Massai MR; Forcelledo ML; Brache V; Tejada AS; Salvatierra AM Source: Human Reproduction. 2007;22(2):434-439. Abstract: Levonorgestrel (LNG) consistently prevents follicular rupture only when it is given before the onset of the ovulatory stimulus. As locally synthesized prostaglandin (PG) plays a crucial role in follicular rupture and cyclooxygenase-2 (cox-2) catalyses the final step of PG synthesis, we reasoned that adding a cox-2 inhibitor to LNG would prevent follicular rupture even after the ovulatory process had been triggered by the gonadotrophin surge. Forty-one women were divided into two groups. One was treated when the size of the leading follicle was 15-17 mm (n = 10) and the other when it was ³18 mm (n = 31). Each woman contributed with one cycle treated with LNG 1.5 mg single dose plus placebo and another treated with LNG + meloxicam (Melox) 15 mg, in a randomized order. Serial blood sampling for the assay of LH and follicular monitoring by transvaginal ultrasound were performed before and after treatment. Follicular rupture failed to occur within the 5-day period that followed treatment in 50 and 70% of cycles treated with LNG + Placebo and LNG + Melox, respectively, in the 15-17 mm group (P = 0.15) and in 16 and 39% of cycles treated with LNG + Placebo and LNG + Melox, respectively, in the = 18 mm group (P < 0.052). The overall proportion of cycles with no follicular rupture or ovulatory dysfunction increased significantly by the addition of Melox to LNG (66 versus 88%, P < 0.012; n = 41-matched pairs). The trend towards increased incidence of no follicular rupture when Melox was combined with LNG suggests that the addition of a cox-2 inhibitor has the potential to improve the contraceptive efficacy of LNG by a pre-fertilization effect. (author's) Language: English Keywords: VIRGINIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PILOT PROJECTS | CASE CONTROL STUDIES | WOMEN | ANOVULATION | LEVONORGESTREL | EMERGENCY CONTRACEPTION | ADMINISTRATION AND DOSAGE | INCIDENCE | FOLLICLE STIMULATING HORMONE | Developed Countries | United States of America | North America | Americas | Research Methodology | Studies | Demographic Factors | Population | Ovarian Effects | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System Document Number: 312200 |
| 4. Peer Reviewed Title: Fourteen-day safety and acceptability study of the universal placebo gel. Author: Schwartz JL; Ballagh SA; Kwok C; Mauck CK; Weiner DH Source: Contraception. 2007 Feb;75(2):136-141. Abstract: This study evaluated the effect of the so-called universal placebo compared to the polystyrene sulfonate (PSS) placebo on genital irritation. A single-center, Phase I, randomized, closed-label study was performed to evaluate the genital irritation of microbicide placebo gels. Thirty healthy, sexually abstinent women were randomly assigned to apply 3.5 mL of either the universal placebo or the PSS placebo gel intravaginally twice daily for 14 days. Genital irritation was assessed by signs as seen on pelvic examination and colposcopy and reports of symptoms. Vaginal health was assessed by wet mounts, Gram stains for Nugent score and polymorphonuclear leukocytes, and semiquantitative vaginal cultures. Acceptability was assessed as reported on the follow-up questionnaire. The universal placebo was less irritating than the PSS placebo with a lower proportion of women experiencing signs and/or symptoms of genital irritation throughout follow-up (36% compared to 80%, p=.0253). The universal placebo was associated with few and mild genital symptoms, few and minor colposcopic findings and good vaginal health with no clinically significant changes in genital flora. Most participants found the feel of the universal placebo gel neutral or pleasant, and all participants found it odorless. The universal placebo appeared safe and acceptable when used twice daily for 14 days. The strategy of creating a de novo inert universal placebo is a successful approach. The universal placebo is appropriate for use as a placebo gel in HIV prevention trials with microbicide candidates. (author's) Language: English Keywords: UNITED STATES OF AMERICA | VIRGINIA | RESEARCH REPORT | LABORATORY PROCEDURES | CLIENTS | MICROBICIDES | VAGINAL GEL | SEXUALLY TRANSMITTED DISEASES | SAFETY | CONTRACEPTIVE METHOD ACCEPTABILITY | North America | Americas | Developed Countries | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Activities | Programs | Organization and Administration | Drugs | Treatment | Vaginal Spermicides | Contraceptive Methods | Contraception | Family Planning | Reproductive Tract Infections | Infections | Diseases | Public Health | Contraceptive Usage Document Number: 311552 |
| 5. Peer Reviewed Title: Safety and efficacy of an extended-regimen oral contraceptive utilizing continuous low-dose ethinyl estradiol. Author: Anderson FD; Gibbons W; Portman D Source: Contraception. 2006 Mar;73(3):229-234. Abstract: The objective was to assess the efficacy and safety of Seasonique, a 91-day extended-regimen oral contraceptive (OC) utilizing continuous low-dose ethinyl estradiol (EE) during the typical hormone-free interval. A multicenter, open-label, 1-year study of Seasonique [30 µg EE/150 Ag levonorgestrel (LNG)] for 84 days followed by EE 10 µg for 7 days was conducted in sexually active, adult women of childbearing potential. All patients completed daily electronic diaries to monitor compliance and bleeding. Method failure rate was 0.78 (Pearl index) and 0.64% (life table analysis). Cycle control and safety of the regimen were similar to that reported for other OCs. This study demonstrates that Seasonique is effective, safe and well tolerated for the prevention of pregnancy. (author's) Language: English Keywords: UNITED STATES OF AMERICA | VIRGINIA | RESEARCH REPORT | WOMEN | ORAL CONTRACEPTIVES | ETHINYL ESTRADIOL | PREGNANCY | SAFETY | CONTRACEPTIVE EFFECTIVENESS | Developed Countries | North America | Americas | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Reproduction | Public Health | Health Document Number: 296212 |
| 6. Peer Reviewed Title: Characteristics of adult women who abstain from sexual intercourse. Author: Nettleman M; Ingersoll KS; Ceperich SD Source: Journal of Family Planning and Reproductive Health Care. 2006;32(1):23-24. Abstract: The objectives were to evaluate demographic and behavioural characteristics of sexually active women compared to those who had abstained from intercourse in the past 6 months. The study participants were women of childbearing age from six sites in three states in the USA. Survey questions were asked of women who were not surgically sterile and who had not gone through menopause. The main outcome measures were correlates of sexual abstinence. Of the 1801 respondents, 244 (14%) reported abstaining from intercourse in the past 6 months. Univariate analysis revealed that abstinent women were less likely than sexually active women to have used illicit drugs [odds ratio (OR) 0.47; 95% CI 0.35-0.63], to have been physically abused (OR 0.44, 95% CI 0.31-0.64), to be current smokers (OR 0.59, 95% CI 0.45-0.78), to drink above risk thresholds (OR 0.66, 95% CI 0.49-0.90), to have high Mental Health Inventory-5 scores (OR 0.7, 95% CI 0.54-0.92) and to have health insurance (OR 0.74, 95% CI 0.56-0.98). Abstinent women were more likely to be aged over 30 years (OR 1.98, 95% CI 1.51-2.61) and to have a high school education (OR 1.38, 95% CI 1.01-1.89). Logistic regression showed that age >30 years, absence of illicit drug use, absence of physical abuse and lack of health insurance were independently associated with sexual abstinence. Prolonged sexual abstinence was not uncommon among adult women. Periodic, voluntary sexual abstinence was associated with positive health behaviours, implying that abstinence was not a random event. Future studies should address whether abstinence has a causal role in promoting healthy behaviours or whether women with a healthy lifestyle are more likely to choose abstinence. (author's) Language: English Keywords: UNITED STATES OF AMERICA | TEXAS | FLORIDA | VIRGINIA | RESEARCH REPORT | FERTILITY SURVEYS | WOMEN | COITAL FREQUENCY | ABSTINENCE | TOBACCO USE | ALCOHOL USE AND ABUSE | PHYSICAL ABUSE | RISK BEHAVIOR | North America | Americas | Developed Countries | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Sex Behavior | Behavior | Family Planning, Behavioral Methods | Family Planning | Violence Document Number: 294323 |
7.  Title: What if: How declines in teen births have improved poverty and child well-being in Virginia. 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 | VIRGINIA | 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: 307011 |
| 8. Peer Reviewed Title: Psychosocial, behavioral, and cultural predictors of sexual risk for HIV infection among Latino men who have sex with men. Author: Jarama SL; Kennamer JD; Poppen PJ; Hendricks M; Bradford J Source: AIDS and Behavior. 2005 Dec;9(4):513-523. Abstract: This study sought to replicate and extend an investigation by Diaz et al. (1999) on determinants of HIV risk among Latino gay and bisexual men living in San Francisco who were predominantly English-speaking. Compared to the Diaz et al. study, the current study sample consisted of predominantly Spanish-speaking MSM, who resided outside of HIV/AIDS epicenters and whose countries of origin were primarily Central & South American. The relationships of unprotected anal sex and multiple sexual partners with demographic, developmental, behavioral, cultural and psychosocial variables were examined. Data were collected in a convenience sample of 250 participants (primarily immigrants from El Salvador) residing in Virginia. Most men in the sample had more than one sexual partner in the last 3 months (62%) and more than a third had unprotected anal sex with a casual partner in the same time period. Communication about HIV, sexual attraction, machismo, and experiences of discrimination based on homosexual behavior were predictive of HIV risk behaviors. The findings support an integrative approach to investigating HIV risk among Latino MSM. Implications for prevention programs are discussed. (author's) Language: English Keywords: UNITED STATES OF AMERICA | VIRGINIA | RESEARCH REPORT | HISPANICS | MEN HAVING SEX WITH MEN | PSYCHOSOCIAL FACTORS | CULTURE | HIV PREVENTION | AIDS PREVENTION | RISK BEHAVIOR | ANAL SEX | PARTNER COMMUNICATION | North America | Americas | Developed Countries | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Sex Behavior | Behavior | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | AIDS | Interpersonal Relations Document Number: 298467 |
| 9. Title: Sexual abuse of vulnerable young and old women. Author: Roberto KA; Teaster PB Source: Violence Against Women. 2005 Apr;11(4):473-504. Abstract: Aggregated data from 125 substantiated Adult Protective Services cases of sexually abused women were collected during a 5-year period. Women older than 59 years represented 63% of the cases. Regardless of age, the most common types of abuse involved sexualized kissing and fondling and unwelcome sexual interest in the women’s body. Most identified perpetrators were older males. Family members were most likely to abuse women living in the community, whereas women living in facilities usually experienced abuse by another resident. Perpetrators were prosecuted and convicted in six cases. About 12% of the women continued to be at risk of further sexual abuse. (author's) Language: English Keywords: UNITED STATES OF AMERICA | VIRGINIA | RESEARCH REPORT | CASE STUDIES | WOMEN | OLDER ADULTS | YOUTH | DISABLED PERSONS AND DISABILITIES | SEXUAL ABUSE | GROUP HOMES | North America | Americas | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Adults | Age Factors | Population Characteristics | Crime | Social Problems | Housing | Residence Characteristics | Population Distribution | Geographic Factors Document Number: 283508 |
| 10. Peer Reviewed Title: A comparison of techniques to assess cervicovaginal irritation and evaluation of the variability between two observers. Author: Ballagh SA; Mauck CK; Henry D; Archer DF; Abercrombie T Source: Contraception. 2004;70:241-249. Abstract: Colposcopy is used to evaluate effects of new vaginal products on cervicovaginal epithelium as part of the US Food and Drug Administration-mandated product approval process, yet few aspects of its use have been investigated. Objectives: To determine the effect of the colposcopic examination itself on the number and type of findings seen, to compare colposcopy with the AviScope hand-held device and the naked eye and to compare the findings reported by two examiners during a single visit. Fourteen healthy women volunteered for five paired examinations in random order: (1) naked eye inspection plus colposcopy done twice by a single examiner; (2) naked eye inspection plus AviScope examination, then naked eye inspection plus colposcopy by a single examiner; (3) Examination 2 repeated with the order of device reversed; (4) naked eye inspection plus colposcopy done by two examiners; (5) Examination 4 repeated with the order of examiner reversed. The colposcopic examinations were done per published standards but were limited to the areas visible without manipulation of the speculum. Length of colposcopic examination averaged 7 min. The number of colposcopic findings found when the examination was done twice by the same clinician was not statistically different (p = 0.12), suggesting that the examination itself did not induce findings. More findings were seen using magnification than naked eye. A similar number of findings were seen by AviScope compared to the colposcope (p = 0.99), but clinically significant findings were “undercalled” or “overcalled” by the AviScope. A weighted kappa score of the “worst” colposcopic finding was 0.32 (SE 0.10, p = 0.00), indicating moderate agreement between examiners. The colposcopic examination is not burdensome nor does it induce findings. If naked eye observation were used alone in practice, these data suggest that half the colposcopically detected findings would be missed. Using the naked eye observation for screening would minimally reduce the number of magnified observations carried out. For detecting epithelial changes, the colposcope seems to be the most sensitive technique, followed by the AviScope. (author's) Language: English Keywords: VIRGINIA | METHODOLOGICAL STUDIES | COMPARATIVE STUDIES | CLINICAL TRIALS | WOMEN | COLPOSCOPY | CERVIX | VAGINAL ABNORMALITIES | EXAMINATIONS AND DIAGNOSES | PHYSICAL EXAMINATIONS AND DIAGNOSES | SCREENING | United States of America | North America | Americas | Developed Countries | Studies | Research Methodology | Clinical Research | Demographic Factors | Population | Endoscopy | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Diseases Document Number: 273571 |
| 11. Title: Strengthening community-based programming for juvenile sexual offenders: Key concepts and paradigm shifts. Author: Hunter JA; Gilbertson SA; Vedros D; Morton M Source: Child Maltreatment. 2004 May;9(2):177-189. Abstract: The past decade has been witness to a sharp increase in residential placement of adjudicated delinquent youth, including juvenile sexual offenders. It is argued that this trend has fiscal implications and may be clinically contraindicated for less characterologically disturbed and dangerous youth. The authors advocate greater investment of public funds in the development and refinement of community-based intervention programs. It is believed that clinically and legally integrated programming, using newer social-ecological methodologies and supports, offers promise of reducing the number of youth who require residential placement, shortening residential lengths of stay and improving the transition of residentially treated youth back into community settings. Key concepts relevant to bolstering community-based programming for juvenile sexual offenders are identified and discussed. Two programs are described, and program evaluation data reviewed, in support of the viability of innovative community-based approaches to the management of this population. (author's) Language: English Keywords: VIRGINIA | CRITIQUE | RECOMMENDATIONS | EVALUATION | ADOLESCENTS | PRISONERS | RAPE | SEXUAL ABUSE | CONTRAINDICATIONS | COMMUNITY HEALTH SERVICES | MENTAL HEALTH | INTEGRATED PROGRAMS | ECOLOGY | GOVERNMENT FINANCING | Developed Countries | United States of America | North America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Crime | Social Problems | Sociocultural Factors | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Primary Health Care | Programs | Organization and Administration | Environment | Financial Activities | Economic Factors Document Number: 304070 |
| 12. Peer Reviewed Title: A Phase I comparative postcoital testing study of three concentrations of C31G. Author: Mauck CK; Creinin MD; Barnhart KT; Ballagh SA; Archer DF Source: Contraception. 2004;70:227-231. Abstract: C31G is a broad-spectrum antibacterial agent that shows contraceptive properties in vitro. This postcoital testing study evaluated the ability of three C31G concentrations, 0.5%, 1.0% and 1.7%, administered as a 3.5-mL dose of a vaginal gel to prevent sperm from entering mid-cycle cervical mucus. Irritation of the genitalia and acceptability were also assessed. At baseline, a mid-cycle cervical mucus test and a postcoital test were performed within 24 h of each other without use of any study products to establish normal mid-cycle cervical mucus and sperm penetration. Subjects then completed up to three test cycles using one of the three concentrations of study product during intercourse. Twenty-two of the 61 women enrolled completed a baseline cycle and at least one test cycle. An average of 14.6 progressively motile sperm per high power field was seen at baseline. This was reduced to 0.3 after use of 0.5% C31G, 0.5 after use of 1.0% C31G, and 0.4 after use of 1.7% C31G. There was no significant difference between test products (p = 1.000) but each test product was significantly different from baseline (p < 0.002). Very little genital irritation was observed. There were more reports of leakage and messiness with increasing C31G concentration. This study suggests that all three concentrations of C31G are likely to give reasonable results in a contraceptive effectiveness trial. Based on the results of this and other trials, the 1.0% concentration has been selected for further development, including Phase III trials of contraceptive effectiveness. (author's) Language: English Keywords: VIRGINIA | RESEARCH REPORT | CLINICAL RESEARCH | COMPARATIVE STUDIES | WOMEN | CERVICAL MUCUS | ANTIBIOTICS | CONTRACEPTIVE EFFECTIVENESS | FERTILITY CONTROL, POSTCOITAL | SPERM TRANSPORT INHIBITION | MENSTRUAL CYCLE | VAGINAL GEL | ADMINISTRATION AND DOSAGE | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Demographic Factors | Population | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Drugs | Treatment | Contraception | Family Planning | Inhibition of Fertilization | Contraceptive Mode of Action | Menstruation | Reproduction | Vaginal Spermicides | Contraceptive Methods Document Number: 273572 |
| 13. Peer Reviewed Title: Effects of mifepristone on vascular endothelial growth factor and thrombospondin-1 mRNA in Ishikawa cells: implication for the endometrial effects of mifepristone. Author: Mirkin S; Archer DF Source: Contraception. 2004;70:327-333. Abstract: Mifepristone has been used for both medical termination of pregnancy and emergency contraception. Mifepristone may have both an antiovulatory activity and an antiproliferative effect on the endometrium. We have evaluated the effect of mifepristone on vascular endothelial growth factor (VEGF) and thrombospondin-1 (TSP-1) using Ishikawa cells in vitro. Mifepristone, progesterone and 17ß-estradiol at concentrations of 1.0, 0.1 and 0.01 µM, were added to confluent cells and further cultured for additional 24 h. Total RNA was extracted from control and treated cells. After reverse transcription, VEGF, TSP-1 and ß-actin cDNAs were amplified with polymerase chain reaction spiked with 33p-dCTP. The relative abundance of VEGF 121 and 165 isoforms and TSP-1 mRNA were measured by scintillation spectroscopy. Mifepristone and progesterone did not stimulate VEGF mRNA 121 and 165 isoforms, while 17ß-estradiol increased both VEGF isoforms. Mifepristone did not stimulate TSP-1 mRNA at any concentration, but progesterone increased TSP-1 mRNA, and this effect was inhibited with mifepristone. 17ß-Estradiol did not increase TSP-1 expression. We hypothesized, based on these data, that the clinical finding of endometrial antiproliferative effect and low vaginal bleeding rate observed in women using mifepristone may be related to lack of stimulation of these angiogenic factors. (author's) Language: English Keywords: VIRGINIA | RESEARCH REPORT | CLINICAL RESEARCH | GENETIC TECHNIQUES | PREGNANT WOMEN | RU-486 | ENDOMETRIAL CANCER | ORAL CONTRACEPTIVES, SIDE EFFECTS | EMERGENCY CONTRACEPTION | PROGESTERONE ANALYSIS | ESTRADIOL | ORAL CONTRACEPTIVES, COMBINED | United States of America | North America | Americas | Developed Countries | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Population Characteristics | Demographic Factors | Population | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Cancer | Neoplasms | Diseases | Contraceptive Safety | Safety | Public Health | Health | Contraception | Family Planning | Progesterone | Progestational Hormones | Estrogens | Oral Contraceptives | Contraceptive Methods Document Number: 274833 |
| 14. Title: Personal narratives of adolescent mothers-to-be: contraception, decision making, and future expectations. Author: Spear HJ Source: Public Health Nursing. 2004 Jul;21(4):338-346. Abstract: Results not discussed in a previously published qualitative study are presented in this article. Analysis of the personal narratives of eight pregnant adolescents who attended an alternative school for pregnant teens yielded the following categories: decision making, contraceptive behavior and sexual attitudes, and future expectations. The findings revealed that decisions regarding pregnancy were made with little deliberation and some participants implied that pregnancy was planned. Although knowledgeable about how to prevent pregnancy, participants did not consistently practice contraception and their sexual experiences were marked by indifference and lacked intimacy. Future expectations consistently included support from the fathers of their unborn children. Implications for nursing practice and further research are discussed. (author's) Language: English Keywords: UNITED STATES OF AMERICA | VIRGINIA | RESEARCH REPORT | INTERVIEWS | ADOLESCENTS, FEMALE | PREGNANT WOMEN | ADOLESCENT PREGNANCY | SEX BEHAVIOR | DECISION MAKING | INTERPERSONAL RELATIONS | CONTRACEPTIVE USAGE | ATTITUDES | Developed Countries | North America | Americas | Data Collection | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Behavior | Contraception | Family Planning | Psychological Factors Document Number: 194960 |
| 15. Title: Reproductive issues for persons with HIV [letter] [reply] Author: Williams CD; Thomas TS; Finnerty JJ Source: American Journal of Obstetrics and Gynecology. 2004 May;190(5):1487-1490. Abstract: We read with interest the review work by Williams et al, in which reproductive issues for persons with human immunodeficiency virus (HIV) are considered from different points of view. We think that this paper was necessary if we aim to reach a consensus in the treatment of these couples; almost all the questions that can be raised to the professional in the medical field are answered in the article. Regarding male partners who test HIV positive, we firmly agree with the affirmation that there is a demonstrated independence between the seminal and blood viral load and in the lack of relevance of viral blood levels in the assisted conception, because only seminal viral load will be important for us. A sample with an absence of viral load (undetectable) after being washed will always be used in assisted reproduction independently of the blood viral load. Moreover, certainly an HIV-negative result of the tests after the sperm wash does not mean that no HIV particles are present, because the detection limit of the most common detection methods is 50 to 100 copies/ mL, which means that we can be using samples with viral loads under these limits. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | VIRGINIA | CRITIQUE | PERSONS LIVING WITH HIV/AIDS | RESEARCH REPORT | ARTIFICIAL INSEMINATION | HIV PREVENTION | HIV TESTING | SEMEN | LABORATORY PROCEDURES | IN VITRO | FERTILIZATION | Developed Countries | North America | Americas | HIV Infections | Viral Diseases | Diseases | Reproductive Technologies | Reproduction | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Seminal Vesicles | Genitalia, Male | Genitalia | Urogenital System | Physiology | Biology | Clinical Research | Research Methodology Document Number: 192803 |
| 16. Title: Plasma sterilization. Source: Futurist. 2003 Sep-Oct;:16-17. Abstract: Move over, autoclave. Step aside, toxic chemicals. There's a new type of sterilization so effective and versatile that it can kill bacteria on everything from food packaging to spacecraft. Plasma sterilization, developed by researchers at Old Dominion University in Norfolk, Virginia, an the University of California in San Diego, may even have applications in decontaminating biological warfare agents. Plasma, a collection of electrically charged particles and non-charged particles, is sometimes called the fourth state of matter. Just as heat turns water (a liquid) into steam (a gas), heat can turn steam into plasma. Thus, most plasma is thousands of degrees centigrade and impractical for daily use. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | VIRGINIA | OKLAHOMA | FEMALE STERILIZATION | BLOOD PROTEINS | CONTRACEPTION RESEARCH | Developed Countries | North America | Americas | Sterilization, Sexual | Family Planning | Hemic System | Physiology | Biology | Contraception Document Number: 284414 |
| 17. Title: State facts about abortion: Virginia. Author: Alan Guttmacher Institute [AGI] Source: [New York, New York], AGI, 2003. 3 p. (State Facts about Abortion) Abstract: This article presents background information about the frequency of abortion in the United States, followed by statistics on abortion frequency, abortion services, and restrictions on abortion for the United States as a whole and Virginia specifically. Language: English Keywords: UNITED STATES OF AMERICA | VIRGINIA | PAMPHLETS | ADULTS | WOMEN | ABORTION | PREGNANCY | PREGNANCY, UNWANTED | PREGNANCY OUTCOMES | CONTRACEPTIVE USAGE | HEALTH FACILITIES | ABORTION LAW | North America | Americas | Developed Countries | Printed Media | Mass Media | Communication | Age Factors | Population Characteristics | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | Reproduction | Reproductive Behavior | Fertility | Population Dynamics | Contraception | Delivery of Health Care | Health Document Number: 175663 Notification |
| 18. Title: HIV test kit selection: operational considerations for VCT and PMTCT services. Author: John Snow [JSI]. DELIVER Source: Arlington, Virginia, JSI, DELIVER, [2003]. [4] p. Abstract: In general, when countries or programs have developed national guidelines and recommended standard kits, the criteria for product selection may be limited to sensitivity and specificity and some basic requirements. Nonetheless, to facilitate expansion of quality VCT and PMTCT services at lower-level health facilities in resource constrained settings, it may be necessary to consider additional criteria pertaining to feasibility and user-friendliness of the HIV test kits. This document provides a checklist of additional criteria that may enhance the quality of services and reduce program costs. It also presents an example from Uganda (where a phased approach was used) of how the product selection process might work. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | VIRGINIA | UGANDA | TECHNICAL REPORT | CLIENTS | HIV TESTING | EQUIPMENT AND SUPPLIES | TECHNOLOGY | LOGISTICS | STORAGE AND WAREHOUSES | TIME FACTORS | DECISION MAKING | Developed Countries | North America | Americas | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Program Activities | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Economic Factors | Management | Population Dynamics | Demographic Factors | Population | Behavior Document Number: 182136 |
| 19. Peer Reviewed Title: New research confirms efficacy of NuvaRing. Author: Archer D; Ballagh S Source: Contraceptive Technology Update. 2003 Jun;24(6):68-69. Abstract: A multicenter clinical trial, using the ethinyl estradiol (EE)/etonogestrel (ETG) vaginal ring, has shown high levels of efficacy with an overall Pearl Index of 0.65 per 100 women years of use. This clinical finding of contraceptive efficacy is confirmed in studies in which ovarian function has been assessed using transvaginal ultrasound along with serum levels of follicle-stimulating hormone (FSH), estradiol, and progesterone. These pharmacodynamic studies have shown inhibition of follicular development with resultant low levels of estradiol, suppressed levels of FSH, and no evidence of ovulation based on serum progesterone levels. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | VIRGINIA | VAGINAL RING | NONOXYNOL-9 | SPERMICIDAL CONTRACEPTIVE AGENTS | PRODUCT APPROVAL | PROGRAM EFFECTIVENESS | Developed Countries | North America | Americas | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents | Legislation | Program Evaluation | Programs | Organization and Administration Document Number: 178044 |
| 20. Title: Delinquents' safe sex attitudes. Relationships with demographics, resilience factors, and substance use. Author: Chang VY; Bendel TL; Koopman C; McGarvey EL; Canterbury RJ Source: Criminal Justice and Behavior. 2003 Apr;30(2):210-229. Abstract: This study examined demographic and psychosocial factors associated with safe sex attitudes among incarcerated adolescents. Researchers and correction staff interviewed 820 adolescents (691 males and 129 females) incarcerated in the Virginia juvenile justice system concerning safe sex attitudes, gender, age, ethnicity, length of time lived with biological father and mother, HIV/AIDS knowledge, self-esteem, hopefulness, perceived social support from family, alcohol use, and drug use. The results indicated that safe sex attitudes were positively related to being female, being African American, and having higher HIV/AIDS knowledge, self-esteem, and hopefulness, and they were negatively related to alcohol use and drug use. Resilience factors such as HIV/AIDS knowledge, self-esteem, and hopefulness may be an especially salient component of HIV prevention in incarcerated adolescents. (author's) Language: English Keywords: VIRGINIA | RESEARCH REPORT | DEMOGRAPHIC ANALYSIS | KAP SURVEYS | PRISONERS | ADOLESCENTS | ATTITUDES | SAFER SEX | DEMOGRAPHIC FACTORS | SELF ESTEEM | SUBSTANCE ADDICTION | PSYCHOSOCIAL FACTORS | HIV TRANSMISSION | Developed Countries | United States of America | North America | Americas | Research Methodology | Surveys | Sampling Studies | Studies | Youth | Age Factors | Population Characteristics | Population | Psychological Factors | Behavior | Sex Behavior | Social Problems | HIV Infections | Viral Diseases | Diseases Document Number: 284125 |
| 21. Title: Risk of breast cancer with progestins: critical assessment of current data. Author: Santen RJ Source: Steroids. 2003;68:953-964. Abstract: Whether progestins protect against the risk of breast cancer or enhance that risk has been a major area of controversy over the past several years. Observational studies have reported conflicting results and experimental studies examining whether progestins exert mitogenic or anti-mitogenic actions on breast tissue report divergent results. Based upon a wide range of animal, epidemiologic and clinical data, most investigators agree that estrogens contribute to the development of breast neoplasms. However, the additional effect of progestins on this risk has been the subject of substantial discussion and controversy. A variety of experiments have been carried out using human breast cancer cells grown in vitro and as xenografts in nude mice. These studies demonstrated both mitogenic and anti-mitogenic effects depending upon the precise experimental conditions. Two potential reasons for these differences include differential metabolism of progestins into inhibitory pregnenes or stimulatory 5-alpha-reduced pregnanes or the presence of a protein (GPR 30) which allows the anti-mitogenic effects of progestins to be manifest. Based upon the conflicting nature of the results in experimental studies, we believe that only data in patients provide substantial insight into the actions of progestins on the intact human breast. Studies have now demonstrated that cell proliferation and breast density is higher during the luteal than during the follicular phase of the menstrual cycle. In postmenopausal women, long-term exposure to estrogen plus a progestin results in a marked enhancement of proliferation of the terminal duct lobular units as well as in breast density. These data, taken together, provide substantial evidence that progestins are mitogenic on the human breast when given long term to postmenopausal women. To critically evaluate the observational studies regarding breast cancer risk from progestins, we developed a set of stringent criteria for acceptance of individual studies. Four of the five studies meeting these criteria reported a greater risk of breast cancer with combination estrogen/progestin regimens than with estrogen alone. More importantly, the first randomized, prospective, controlled trial of the risk of breast cancer with an estrogen/progestin combination (the Women’s Health Initiative Study) has now been published. This study reported a 26% increased relative risk of breast cancer with the estrogen/progestin combination. Based upon these data, we believe that progestins do add to the risk of breast cancer over and above that imparted by estrogen alone. The attributable risk during use for 5 years or less is small but increases logarithmically during long-term use. The majority of data regarding progestins are derived from regimens using MPA. However, we conclude from our analysis that the burden of proof regarding progestins has now shifted. One must now prove that an estrogen/progestin combination is safe with respect to breast cancer rather than having to prove it harmful. (author's) Language: English Keywords: UNITED STATES OF AMERICA | VIRGINIA | RESEARCH REPORT | LITERATURE REVIEW | WOMEN | LOW-DOSE PROGESTINS | RESEARCH AND DEVELOPMENT | BREAST CANCER | MENOPAUSE | HORMONE REPLACEMENT THERAPY | RISK FACTORS | ESTROGENS | North America | Americas | Developed Countries | Demographic Factors | Population | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Technology | Economic Factors | Cancer | Neoplasms | Diseases | Reproduction | Treatment | Biology | Hormones | Endocrine System | Physiology Document Number: 285243 |
| 22. Title: Eugenics and sterilization in the heartland. Author: Wehmeyer ML Source: Mental Retardation. 2003 Feb;41(1):57-60. Abstract: On May 2, 2002, Mark Warner, governor of the Commonwealth of Virginia, apologized for "Virginia's participation in eugenics," which he categorized as a "shameful effort in which state government never should have been involved" ("Virginia Apologizes," 2002). Governor Warner's apology was issued on the 75th anniversary of the United States Supreme Court's decision in Buck v. Bell (1927), which "opened the floodgates" (Smith & Polloway, 1993) for the wholesale sterilization of people with epilepsy or who were then classified as feeble- minded. It was also the anniversary of Justice Oliver Wendell Holmes' now infamous statement that "three generations of imbeciles are enough" Fittingly, Virginia also dedicated a historical marker to the memory of Carrie Buck, who became the first person to be forcibly sterilized under Virginia's 1924 law on sterilization, upheld by the 1927 Supreme Court decision. Virginia has received the lion's share of publicity with regard to human sterilization, in part due to the infamy of the Buck v. Bell case and its impact on the subsequent rate of sterilizations; in part because so many sterilizations were performed in that state after Buck v. Bell; and in part because the voices in our field that have most persistently and eloquently reminded us not to forget this portion of our past have often come from Virginia (Smith, 1994, 1995; Smith & Nelson, 1989; Smith & Polloway, 1993). It is worth noting, however, that in considering the appropriate response to the occasion of Virginia's apology, the stain of sterilization is not limited to the Commonwealth of Virginia but permeates the fabric of our country. There are, undoubtedly, many more apologies owed. Virginia was neither first to the sterilization scene nor, perhaps, the most enthusiastic of its enactors (although Kevless, 1995, noted that by the end of the 1940s, Virginia was second nationally in the total number of sterilizations performed, accounting for roughly one seventh of all sterilizations in the country up to that time. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | VIRGINIA | EUGENICS | STERILIZATION, SEXUAL | Developed Countries | North America | Americas | Genetics | Biology | Family Planning Document Number: 284266 |
| 23. Peer Reviewed Title: Total versus subtotal hysterectomy: a survey of gynecologists. Author: Zekam N; Oyelese Y; Goodwin K; Colin C; Sinai I Source: Obstetrics and Gynecology. 2003 Aug;102(2):301-305. Abstract: OBJECTIVE: To estimate the attitudes and practice of gynecologists in the Washington, DC, Maryland, and Virginia area regarding total versus subtotal abdominal hysterectomy. METHODS: A questionnaire with 18 questions on physicians’ attitudes and practice regarding total versus subtotal hysterectomy was mailed to 1647 gynecologists in Washington, Maryland, and Virginia. RESULTS: The corrected response rate was 51.2%. Forty-five percent of respondents stated that they always removed the cervix. The most common reason cited was to eliminate the risk of cervical cancer. The most common reason for subtotal hysterectomy was surgical difficulty leading to an intraoperative change of procedure. Only 17.8% of respondents always counseled women regarding the advantages and disadvantages of both total and subtotal hysterectomy; 63% rarely or never did. Nineteen percent always offered women a choice between the procedures; 61% rarely or never did. Eighty-eight percent of respondents felt that the risk of cancer in the cervical stump was small or negligible. Gender of the physicians or year of completion of residency made no significant impact on patients being counseled about both procedures or being offered a choice between the two. CONCLUSION: Most gynecologists surveyed favor total abdominal hysterectomy over subtotal hysterectomy. Few counsel women regarding the options of total and subtotal hysterectomy or offer a choice between the procedures. Given that there are no convincing data proving the superiority of either procedure over the other, it may be reasonable to discuss the potential advantages and disadvantages of both procedures with women undergoing hysterectomy for benign disease and to offer them a choice. (author's) Language: English Keywords: UNITED STATES OF AMERICA | DISTRICT OF COLUMBIA | MARYLAND | VIRGINIA | RESEARCH REPORT | QUESTIONNAIRES | PHYSICIANS | GYNECOLOGY | ATTITUDES | HYSTERECTOMY | CERVIX | Developed Countries | North America | Americas | Health Personnel | Delivery of Health Care | Health | Medicine | Health Services | Psychological Factors | Behavior | Gynecologic Surgery | Urogenital Surgery | Surgery | Treatment | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology Document Number: 182497 |
| 24. Title: Greater Expectations / Postponing Sexual Involvement. Source: Educator's Update. 2002 Feb;6(4):6. Abstract: This article describes the work of the "Greater Expectations/Postponing Sexual Involvement" program delivered by Virginia League for Planned Parenthood to middle school students in public school health classes and community settings. This two- component abstinence-based program is designed to empower youth with the information and skills they need to handle the physical, emotional, and social changes of adolescence. Language: English Keywords: VIRGINIA | UNITED STATES OF AMERICA | ADOLESCENTS | YOUTH | STUDENTS | PRIMARY SCHOOLS | PUBLIC HEALTH | SEX EDUCATION | North America | Americas | Developed Countries | Age Factors | Population Characteristics | Demographic Factors | Population | Education | Schools | Health Document Number: 169844 |
| 25. Title: Contraception counts: Virginia. Author: Alan Guttmacher Institute [AGI] Source: New York, New York, AGI, 2002 Jun. [2] p. (Contraception Counts) Abstract: This article summarizes, for the state of Virginia, the following points: pregnancy outcomes in Virginia; teen pregnancy outcomes in Virginia; women at need for contraceptive services and supplies; availability of family planning services; and impact of subsidized services. Language: English Keywords: UNITED STATES OF AMERICA | VIRGINIA | PAMPHLETS | CONTRACEPTION | LOW INCOME POPULATION | WOMEN | ADULTS | ADOLESCENTS, FEMALE | ADOLESCENT PREGNANCY | PREGNANCY | PREGNANCY OUTCOMES | PREGNANCY, UNPLANNED | HEALTH SERVICES | NATIONAL HEALTH SERVICES | FAMILY PLANNING | NEEDS | PUBLIC ASSISTANCE | Developed Countries | North America | Americas | Printed Media | Mass Media | Communication | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Demographic Factors | Population | Age Factors | Population Characteristics | Adolescents | Youth | Reproductive Behavior | Fertility | Population Dynamics | Reproduction | Delivery of Health Care | Health | Government Financing | Financial Activities Document Number: 175718 |
| 26. Peer Reviewed Title: Poorly controlled type I diabetes mellitus in young men selectively suppresses luteinizing hormone secretory burst mass. Author: López-Alvarenga JC; Zariñán T; Olivares A; González-Barranco J; Veldhuis JD Source: Journal of Clinical Endocrinology and Metabolism. 2002 Dec;87(12):5507-5515. Abstract: Alterations in the reproductive axis function are present to a variable extent in patients with type 1 diabetes mellitus (IDDM). Results from studies in IDDM men have yielded discrepant findings, which may reflect nonuniform patient selection criteria, age, diabetic status, duration of the disease and differences in sampling protocols. To more clearly define the impact of early diabetic alterations in the male reproductive axis, we applied a combined strategy of patient selection restricted to young men with relatively short duration of IDDM, dual control groups, multiparameter deconvolution analysis to assess LH secretory activity, and assessment of time-dependent changes in human chorionic gonadotropin (hCG)-stimulated serum testosterone concentrations. Three groups of subjects were studied: 11 young men with poorly controlled IDDM, 9 well controlled diabetics, and 9 healthy men. All volunteers underwent blood sampling at 10-min intervals before and after 2 consecutive iv pulses of 10 µg GnRH. On a separate day, 40 IU/kg hCG were given im, and blood samples were collected before hCG administration, every 60 min thereafter for 6 h, and then 24, 48, and 72 h after the injection. Mean serum LH concentrations across the basal 6-h sampling period were significantly (P < 0.05) decreased in men with poorly controlled IDDM (11 ± 1.6 IU/liter) compared with those in well controlled diabetics (19 ± 1.8 IU/liter) and healthy controls (19 ± 1.5 IU/liter). Multiple parameter deconvolution analysis revealed a 50% reduction in the mass of LH secreted per burst and the pulsatile LH secretion rate in poorly controlled IDDM (mass of LH secreted/burst, 7 ± 1.1 vs. 12 ± 2.1 and 13 ± 1.5 IU/liter; LH secretion rate, 47 ± 6.3 vs. 78 ± 10 and 87 ± and 11 IU/liter•6 h; poorly controlled vs. well controlled IDDM and healthy controls, respectively; P < 0.05 for both parameters). Uncontrolled IDDM patients had significantly (P < 0.05) lower integrated serum LH concentrations after the first and second GnRH pulses (first GnRH pulse, 4460 ± 770 vs. 7250 ± 1200 and 5120 ± 910 IU/liter; second pulse, 4700 ± 615 vs. 7640 ± 881 and 7100 ± 1230 IU/liter; poorly controlled vs. well controlled IDDM and healthy men, respectively) and markedly attenuated LH secretory burst mass after the second GnRH stimulus (49 ± 8.8 vs. 90 ± 13 and 83 ± 19 IU/liter; poorly controlled vs. well controlled IDDM and healthy controls, respectively). The biological to immunological ratio of LH released in baseline conditions was higher in uncontrolled IDDM patients (0.81 ± 0.10) than in controlled IDDM (0.37 ± 0.08) and healthy controls (0.48 ± 0.06; P < 0.01), whereas LH released in response to exogenous GnRH exhibited comparable ratios among the three study cohorts. Baseline serum testosterone levels as well as absolute and incremental responses to exogenous hCG did not differ by degree of metabolic control. Collectively, these results indicate that the function of the hypothalamic-gonadotrope axis is compromised in young men with poorly controlled IDDM, such that the amplitude of spontaneous pulsatile and exogenous GnRH-stimulated LH secretion is attenuated. This central hypogonadotropism is paradoxically associated with the presence in the circulation of gonadotropin molecules with enriched biological activity, which is evidently sufficient to temporarily maintain normal total testosterone concentrations in the earlier stages of IDDM. (author's) Language: English Keywords: UNITED STATES OF AMERICA | VIRGINIA | RESEARCH REPORT | CLIENTS | MEN | DIABETES | TREATMENT | REPRODUCTIVE HEALTH | AGE FACTORS | Developed Countries | North America | Americas | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Characteristics Document Number: 296190 |
| 27. Title: Global performance improvement. PI global team builds on storehouse of experience. Author: Luoma M Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, School of Medicine, Program for International Training in Health [INTRAH], PRIME Project, 2002 Sep. [2] p. (PRIME PAGES: PI-5USAID Grant No. HRN-A-00-99-00022-00) Abstract: Looking back on the 28 Performance Needs Assessments (PNAs) that PRIME has conducted, Global Team members discovered much useful information: “Performers” are mostly primary-level health care providers, but occasionally include supervisors, trainers, district health managers and family planning clients themselves. Most PNAs take two to three months to implement but completion times have ranged from less than a month to more than a year. Key clients and stakeholders most often consist of providers, Ministry of Health (MOH) staff, USAID staff, clients and community members, but have also encompassed collaborating agencies (CAs) and non-MOH government officials. In most cases, the majority of the five PI performance factors are missing from providers’ work lives. Consequently, lists of initial interventions are often long. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | VIRGINIA | SUMMARY REPORT | PROVIDERS WITH CLIENTS | REPRODUCTIVE HEALTH | MATERNAL HEALTH SERVICES | PERFORMANCE IMPROVEMENT | NEEDS ASSESSMENT | PROGRAM SUSTAINABILITY | WASTE MANAGEMENT | Developed Countries | North America | Americas | Health Services | Delivery of Health Care | Health | Maternal-Child Health Services | Primary Health Care | Management | Organization and Administration | Evaluation | Programs | Environment Document Number: 181373 |
| 28. Title: Making women-controlled methods a priority. A report on the International Advocates Meeting of the Global Campaign for Microbicides and Prevention Options for Women. Source: Women's Health Journal. 2001 Jul-Sep;(3):34-8. Abstract: The Global Campaign for Microbicides and Prevention Options for Women organized the International Advocates Meeting in Warrenton, Virginia from June 28 to July 1, 2001. 64 participants from 23 countries attended the meeting, which aimed to convene microbicide and female condom advocates to share experiences and consolidate the efforts of the Global Campaign; to offer skill-building in advocacy for microbicides and the female condom; to explore new avenues for unidentified advocacy; and to discuss issues in research, development and distribution of microbicides and the female condom. The meeting consisted of plenary presentations, concurrent sessions, and breakout sessions of working groups by region. Among the issues discussed were basic scientific information about the vagina's natural defense mechanisms; importance of microbicides in preventing sexually transmitted diseases; updates on the female condom and some frequently asked questions about the product; product development and clinical trials of microbicides; acceptability of microbicides in various cultures; and media advocacy. Language: English Keywords: VIRGINIA | CONFERENCES AND CONGRESSES | FEMALE CONDOMS | RESEARCH AND DEVELOPMENT | CONTRACEPTION RESEARCH | MICROBICIDES | UNITED STATES OF AMERICA | North America | Americas | Developed Countries | Vaginal Barrier Methods | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Technology | Economic Factors | Drugs | Treatment Document Number: 163455 |
| 29. Title: "Spermistatics" may lead to new contraceptives. Source: Contraceptive Technology Update. 2001 Dec;22(12):143-4. Abstract: A class of molecules that may lead to new forms of contraceptives has been identified by scientists at the University of Virginia Health System's Center for Recombinant Gamete Contraceptive Vaccinogens in Charlottesville. John Herr, PhD, center director and professor of cell biology at the university announces that scientists coined the word ‘spermistatic’ to define molecules that agglutinate and coat sperm, rather than direct membrane lysis, as is the case with detergent-based spermicides. The scientists theorize that by binding to the sperm surface, the recombinant antisperm antibody monoclonal antibodies inhibit sperm penetration into cervical mucus. Moreover, scientists are examining its use as a cream or foam carrier for women. If such molecules could be proven safe and effective for human use, products using this novel technology would give women another option in female-controlled methods. Language: English Keywords: UNITED STATES OF AMERICA | VIRGINIA | CONTRACEPTIVE AGENTS | SPERMICIDAL CONTRACEPTIVE AGENTS | Developed Countries | North America | Americas | Contraception | Family Planning Document Number: 162157 |
| 30. Title: Workshop summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention, June 12-13, 2000, Hyatt Dulles Airport, Herndon, Virginia. Author: United States. National Institutes of Health [NIH]. National Institute of Allergy and Infectious Diseases Source: [Unpublished] 2001 Jul 20. 27, [19] p. Abstract: This paper presents the proceedings of a workshop on 'Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention held in June 2000 in Virginia. The workshop was held to evaluate the published evidence establishing the effectiveness of latex male condoms in preventing HIV/AIDS and other STDs. The scope was limited to male condoms made from natural rubber latex; the effectiveness of condoms in preventing infections transmitted via penile-vaginal intercourse; and examined 8 STDs: HIV infection, gonorrhea, chlamydia, syphilis, chancroid, trichomoniasis, genital herpes, and genital human papilloma virus. Language: English Keywords: VIRGINIA | SUMMARY REPORT | RETROSPECTIVE STUDIES | DATA COLLECTION | STUDY DESIGN | CONDOM USE | SEXUALLY TRANSMITTED DISEASE PREVENTION | CONTRACEPTION RESEARCH | WORKSHOPS | UNITED STATES OF AMERICA | North America | Americas | Developed Countries | Studies | Research Methodology | Risk Reduction Behavior | Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Contraception | Family Planning | Education Document Number: 170189 |
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