1.  Title: Risk factors for triple-negative breast cancer in women under the age of 45 years. Author: Dolle JM; Daling JR; White E; Brinton LA; Doody DR; Porter PL; Malone KE Source: Cancer Epidemiology, Biomarkers and Prevention. 2009 Apr;18(4):1157-66. Abstract: Little is known about the etiologic profile of triple-negative breast cancer (negative for estrogen receptor/progesterone receptor/human epidermal growth factor), a breast cancer subtype associated with high mortality and inadequate therapeutic options. We undertook this study to assess the risk for triple-negative breast cancer among women 45 years of age and younger in relation to demographic/lifestyle factors, reproductive history, and oral contraceptive use. Study participants were ascertained in two previous population-based, case-control studies. Eligible cases included all primary invasive breast cancers among women ages 20 to 45 years in the Seattle-Puget Sound area, diagnosed between January 1983 and December 1992, for whom complete data was obtained for estrogen receptor, progesterone receptor, and human epidermal growth factor status (n = 897; including n = 187 triple-negative breast cancer cases). Controls were age matched and ascertained via random digit dialing. Oral contraceptive use > or =1 year was associated with a 2.5-fold increased risk for triple-negative breast cancer (95% confidence interval, 1.4-4.3) and no significantly increased risk for non-triple-negative breast cancer (P(heterogeneity) = 0.008). Furthermore, the risk among oral contraceptive users conferred by longer oral contraceptive duration and by more recent use was significantly greater for triple-negative breast cancer than non-triple-negative breast cancer (P(heterogeneity) = 0.02 and 0.01, respectively). Among women < or =40 years, the relative risk for triple-negative breast cancer associated with oral contraceptive use > or =1 year was 4.2 (95% confidence interval, 1.9-9.3), whereas there was no significantly increased risk with oral contraceptive use for non-triple-negative breast cancer among women < or =40 years, nor for triple-negative breast cancer or non-triple-negative breast cancer among women 41 to 45 years of age. In conclusion, significant heterogeneity exists for the association of oral contraceptiveuse and breast cancer risk between triple-negative breast cancer and non-triple-negative breast cancer among young women, lending support to a distinct etiology. Language: English Keywords: UNITED STATES OF AMERICA | WASHINGTON | RESEARCH REPORT | CASE CONTROL STUDIES | BREAST CANCER | RISK FACTORS | ORAL CONTRACEPTIVES | TIME FACTORS | AGE FACTORS | Developed Countries | North America | Americas | Studies | Research Methodology | Cancer | Neoplasms | Diseases | Health | Contraceptive Methods | Contraception | Family Planning | Population Dynamics | Demographic Factors | Population | Population Characteristics Document Number: 341655 |
| 2. Title: Endometrial hyperplasia risk in relation to recent use of oral contraceptives and hormone therapy. Author: Epplein M; Reed SD; Voigt LF; Newton KM; Holt VL; Weiss NS Source: Annals of Epidemiology. 2009 Jan;19(1):1-7. Abstract: PURPOSE: We sought to examine the relationship between recent use of oral contraceptives and hormone therapy and endometrial hyperplasia (EH) risk. METHODS: Cases comprised women diagnosed with complex EH (n = 289) or atypical EH (n = 173) between 1985 and 2003. One age-matched control was selected for each case; excluded were women with a prior hysterectomy or diagnosis of EH or endometrial cancer. Hormone use in the 6 months prior to the date of the case's first symptoms was ascertained using a pharmacy database and medical records. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. RESULTS: Three (1.1%) cases had used oral contraceptives, compared to 16 (6.0%) controls (OR = 0.2, 95% CI: 0.0-0.6). Fifty-one (16.8%) cases had taken estrogen-only hormone therapy, in contrast to two (0.7%) controls (OR = 37.6, 95% CI: 8.8-160.0). The risk of EH among estrogen plus progestin hormone users did not differ from that of non-users (OR = 0.7, 95% CI: 0.4-1.1). CONCLUSIONS: This study suggests that previous findings of the association of estrogen-only hormone therapy with increased risk of EH and the lack of an association between estrogen plus progestin hormone therapy and EH risk are likely to apply to both complex EH and atypical EH. Further examination of the association between oral contraceptives and EH, with greater numbers of OC users, is warranted. Language: English Keywords: WASHINGTON | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CASE CONTROL STUDIES | WOMEN | PREVALENCE | ENDOMETRIAL CANCER | HORMONE REPLACEMENT THERAPY | CONTRACEPTIVE SAFETY | ORAL CONTRACEPTIVES, SIDE EFFECTS | TIME FACTORS | CONTRACEPTIVE AGENTS, ESTROGEN | ORAL CONTRACEPTIVES, COMBINED | CONTRACEPTIVE AGENTS, PROGESTIN | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Demographic Factors | Population | Measurement | Cancer | Neoplasms | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Safety | Public Health | Population Dynamics | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Contraceptive Methods Document Number: 330386 |
| 3. Peer Reviewed Title: Successful management of second-trimester postabortion hemorrhage with an intrauterine tamponade balloon. Author: Madden T; Burke AE Source: Obstetrics and Gynecology. 2009 Feb;113(2 Pt 2):501-3. Abstract: BACKGROUND: Legally induced abortion is a safe procedure. However, hemorrhage is a significant cause of abortion-related morbidity and mortality. We describe a case in which a uterine tamponade balloon was successfully used to control a second-trimester postabortion hemorrhage. CASE: A gravida 1 para 0 woman underwent dilation and evacuation at 18 weeks of gestation for fetal aneuploidy. Her procedure was complicated by intraoperative hemorrhage not resulting from uterine atony. This was successfully managed by tamponade with a large intrauterine balloon. CONCLUSION: Uterine balloon tamponade should be considered in the management of second-trimester postabortion hemorrhage unresponsive to medical therapy. Language: English Keywords: WASHINGTON | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | WOMEN | PREGNANCY, SECOND TRIMESTER | POSTABORTION | POSTABORTION CARE | BLEEDING | ABORTION | TREATMENT | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Demographic Factors | Population | Pregnancy | Reproduction | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases | Fertility Control, Postconception | Family Planning | Medical Procedures | Medicine Document Number: 330359 Notification |
| 4. Peer Reviewed Title: Second-trimester surgical abortion. Author: Prager SW; Oyer DJ Source: Clinical Obstetrics and Gynecology. 2009 Jun;52(2):179-87. Abstract: Surgical abortion in the second trimester became popularized in the 1970s, and now accounts for the majority of abortion procedures performed in this country. Dilation and evacuation is the most commonly used method in the second trimester, but dilation and curettage can be used with earlier gestations, and intact dilation and extraction accounts for a minority of later procedures. These various procedures will be addressed in detail. Other considerations such as preoperative and intraoperative use of ultrasound, use of uterotonics, pain management, appropriate location for second-trimester abortion provision, and routine postoperative care will also be reviewed. Language: English Keywords: UNITED STATES OF AMERICA | WASHINGTON | RESEARCH REPORT | ABORTION | PREGNANCY, SECOND TRIMESTER | HYSTEROTOMY | GYNECOLOGIC SURGERY | POSTABORTION CARE | Developed Countries | North America | Americas | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Urogenital Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342246 Notification |
| 5. Title: Emergency contraception: legal consequences of medical classification. Author: Gerber E Source: Journal of Law, Medicine and Ethics. 2008 Summer;36(2):428-31. Abstract: Pharmacists with religious or ethical objections to prescribing emergency contraception won the latest round in the fight over conscience clauses in a case that could have broader implications for attempts to restrict access to contraception. In Stormans, Inc. v. Selecky, a federal District Court in Washington State granted an injunction to block the enforcement of regulations that would have forbidden pharmacists to refuse to dispense emergency contraception on the grounds of religious or ethical objections. In its decision, the court applied Supreme Court abortion precedent without explicitly ruling whether emergency contraception should be legally categorized as a form of abortion or as contraception. However, the legal status of emergency contraception affects the strength of the defendants' claims that the law was justified on the grounds of preventing sex discrimination. In neglecting to rule one way or the other, the court not only failed to adequately consider the sex discrimination claim but also may have opened the door to more restrictive regulation on contraceptives generally. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | WASHINGTON | CRITIQUE | EMERGENCY CONTRACEPTION | LEGISLATION | PHARMACIES | RELIGIOUS ASPECTS | ETHICS | COURT DECISION | Developed Countries | North America | Americas | Contraception | Family Planning | Political Factors | Sociocultural Factors | Health Facilities | Delivery of Health Care | Health | Religion | Litigation Document Number: 328354 |
| 6. Title: Retrospective assessment of the association between drinking and condom use. Author: Leigh BC; Morrison DM; Hoppe MJ; Beadnell B; Gillmore MR Source: Journal of Studies On Alcohol and Drugs. 2008 Sep;69(5):773-6. Abstract: OBJECTIVE: Retrospective reports of the association between drinking and high-risk sexual behavior can be biased by implicit theories of the effects of drinking or may represent post hoc justifications instead of accurate reports of behavior. Using data from a daily diary study, we compared daily reports of condom use when drinking and not drinking with the same participants' reports of these behaviors from a retrospective questionnaire administered after diary collection was complete. METHOD: Participants included adolescents (n=145), adult sexually transmitted disease clinic clients (n=167), college students (n=145), and men who have sex with men (n=147). All participants reported their alcohol consumption and sexual activity daily for 8 weeks and then completed a retrospective questionnaire about their behavior over the diary period. RESULTS: Participants' retrospective judgments about whether they used condoms more or less when drinking were not significantly related to their behavior as reported in the diary. Fewer than two thirds of the participants were accurate in their recollection of the association of condom use and drinking. Teenagers and men who have sex with men were more likely to retrospectively overestimate the negative effect of alcohol on condom use. CONCLUSIONS: Retrospective questions about the association between drinking and condom use were consistent with actual behavior only among people who consistently either never or always used condoms. These individuals correctly reported that drinking had no effect on their condom use. For people whose condom use varies, questions about associations between drinking and sex may be difficult to answer, owing to their conditional nature, and may lead to error. Language: English Keywords: UNITED STATES OF AMERICA | WASHINGTON | RESEARCH REPORT | RETROSPECTIVE STUDIES | RESPONDENTS | ALCOHOL USE AND ABUSE | CONDOM USE | SEXUAL RESPONSIBILITY | Developed Countries | North America | Americas | Studies | Research Methodology | Surveys | Sampling Studies | Behavior | Risk Reduction Behavior | Sex Behavior Document Number: 328688 |
| 7. Peer Reviewed Title: Pediatric highly active antiretroviral therapy in Africa: potential benefits of a family-centered model [letter] Author: Reddi A; Leeper SC; Sunpath H Source: Journal of Infectious Diseases. 2008 Sep 15;198(6):938-9; author reply 939-40. Abstract: To the Editor-We read with interest the article by Goicoechea et al. on the role of antiretroviral medications and tenofovirassociated kidney dysfunction. The authors concludedthatregimensbasedonritonavirboosted protease inhibitor (PI/r) were associated with a greater decline in kidney function than regimens based on nonnucleoside reverse-transcriptase inhibitors (NNRTIs) among patients receiving tenofovir. However, the majority (75%) of patients in their analysis who were receiving a PI/r-based regimen were receiving lopinavir/ritonavir, and a similar proportion (79%) of patients who were receiving an NNRTI-based regimen were receiving efavirenz. Thus, we suggest that their findings may relate more to the specific effect of lopinavir/ ritonavir regimens, versus that of efavirenz- based regimens, on tenofovirassociated kidney dysfunction, rather than to PIs or NNRTIs as a class. We performed similar analyses in an observational cohort with a larger sample size and found that amprenavir-based regimens were associated with a greater decline in kidney function than efavirenzbased regimens among 445 patients who initiated tenofovir treatment. Our findings also suggested that ritonavir boosting did not account for the differences between agents. In addition, the concurrent use of didanosine with tenofovir was associated with an increased risk of kidney dysfunction. A second issue in the article by Goicoechea and colleagues is the decision to only include patients who received tenofovir for 48 weeks. The authors stated that 48 (24%) of 199 patients did not start or discontinued tenofovir before week 40 and were excluded. It is not clear whether patients who discontinued use of tenofovir before 48 weeks did so because of kidney dysfunction. In our cohort, severe declines in kidney function, although uncommon, occurred on average 3-4 months after initiation of tenofovir treatment (range, 3-9 months), whereas more moderate declines generally occurred after 6 months (mean, 7 months [range, 1-33 months]). In conclusion, the article by Goicoechea et al. [1] provides interesting information on risk factors for tenofovirassociated kidney dysfunction. Future studies of larger cohorts of patients are needed to examine the roles of all individual medications, rather than the roles of classes of medications, in tenofovirassociated kidney dysfunction. (full text) Language: English Keywords: WASHINGTON | RESEARCH REPORT | CRITIQUE | CLINICAL RESEARCH | COHORT ANALYSIS | PERSONS LIVING WITH HIV/AIDS | RENAL EFFECTS | ANTIRETROVIRAL THERAPY | SIDE EFFECTS | HIV INFECTIONS | TIME FACTORS | RISK FACTORS | United States of America | North America | Americas | Developed Countries | Research Methodology | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Urogenital Effects | Urogenital System | Physiology | Biology | HIV | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Dynamics | Demographic Factors | Population Document Number: 329110 |
| 8. Peer Reviewed Title: Incidence of neonatal herpes simplex virus infections in two managed care organizations: Implications for surveillance. Author: Xu F; Gee JM; Naleway A; Zangwill KM; Ackerson B Source: Sexually Transmitted Diseases. 2008 Jun;35(6):592-598. Abstract: The objectives were to estimate the incidence of neonatal herpes simplex virus (HSV) infections and to assess the utility of surveillance methods for neonatal herpes in 2 managed care populations. We identified potential cases using 15 discharge International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9) codes for neonatal HSV and other diseases clinically consistent with this diagnosis. We also searched laboratory databases for positive HSV tests and investigated deaths during the neonatal period. We performed medical chart review using a standardized form. Two pediatric infectious disease specialists reviewed the forms of infants who had a positive HSV test or received a herpes-related diagnosis and made a determination as confirmed, probable, or not a case. Among 270,703 infants born from 1997 to 2002, we identified 737 potential cases and completed medical chart abstraction for 699 (95%). Final review identified 35 confirmed or probable cases of neonatal HSV, and the incidence was 12.9 per 100,000 live births. Only 24 (69%) of the 35 cases were confirmed by laboratory testing. Among the 24 confirmed cases, 22 (92%) received an ICD-9 code of 054.xx or 771.2. Among the 60 infants that received an ICD-9 code of 054.xx or 771.2, only 31 (52%) were confirmed or probable cases of neonatal HSV after final review. About 30% of neonatal HSV cases were not laboratory confirmed. The use of ICD-9 codes of 054.xx and 771.2 was a sensitive but not specific method to identify cases of neonatal herpes. (author's) Language: English Keywords: UNITED STATES OF AMERICA | CALIFORNIA | OREGON | WASHINGTON | RESEARCH REPORT | INFANT | HERPES GENITALIS | INCIDENCE | NEONATAL DISEASES AND ABNORMALITIES | EXAMINATIONS AND DIAGNOSES | TESTING | NEONATAL MORTALITY | Developed Countries | North America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Measurement | Research Methodology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Infant Mortality | Mortality | Population Dynamics Document Number: 327422 |
| 9. Title: Elevated end-of-treatment serum INSL3 is associated with failure to completely suppress spermatogenesis in men receiving male hormonal contraception. Author: Amory JK; Page ST; Anawalt BD; Coviello AD; Matsumoto AM Source: Journal of Andrology. 2007 Jul-Aug;28(4):548-554. Abstract: The administration of testosterone plus a progestogen functions as a male contraceptive by inhibiting the release of pituitary gonadotropins. After 3 to 4 months of treatment, most men are azoospermic or severely oligospermic (less than or equal to 1 million sperm/mL). However, 10% to 20% of men have persistent sperm production despite profound gonadotropin suppression. Since insulin-like factor 3 (INSL3) has been shown to prevent germ cell apoptosis in mice, we hypothesized that INSL3 might be higher in men with persistent spermatogenesis during treatment with male hormonal contraceptives. In a retrospective analysis, we measured serum INSL3 in 107 men from 3 recent male hormonal contraceptive studies and determined the relationship between suppression of spermatogenesis and serum INSL3. At the end of treatment 63 men (59%) were azoospermic and 44 men (41%) had detectable sperm in their ejaculates. Baseline INSL3 did not predict azoospermia; however, end of treatment serum INSL3 was significantly higher in nonazoospermic men compared with those with azoospermia (median [interquartile range]: 95 [73-127] pg/mL vs 80 [67-101] pg/mL; P = .03). Furthermore, serum INSL3 was positively correlated with sperm concentration (r = .25; P = .009) at the end of treatment and was significantly associated with nonazoospermia by multivariate logistic regression (P = .03). After 6 months of treatment with a hormonal male contraceptive regimen, higher serum INSL3 concentrations were associated with persistent sperm production. INSL3 may play a role in preventing complete suppression of spermatogenesis in some men on hormonal contraceptive regimens. This finding suggests that INSL3 may be a potential target for male contraceptive development. (author's) Language: English Keywords: UNITED STATES OF AMERICA | WASHINGTON | RESEARCH REPORT | MEN | SPERMATOGENESIS BLOCKING AGENTS | TESTOSTERONE | CONTRACEPTIVE AGENTS, PROGESTIN | TREATMENT | Developed Countries | North America | Americas | Demographic Factors | Population | Contraceptive Agents, Male | Contraceptive Agents | Contraception | Family Planning | Androgens | Hormones | Endocrine System | Physiology | Biology | Contraceptive Agents, Female | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 313638 |
| 10. Peer Reviewed Title: Miglustat has no apparent effect on spermatogenesis in normal men. Author: Amory JK; Muller CH; Page ST; Leifke E; Pagel ER Source: Human Reproduction. 2007 Mar;22(3):702-707. Abstract: In mice, administration of the glycosphingolipid biosynthesis inhibitor miglustat results in reversible infertilty, characterized by impaired sperm motility and markedly abnormal sperm morphology. This observation suggested that miglustat might have utility for fertility control in man. To ascertain the impact of miglustat on human spermatogenesis, we conducted a pilot study of miglustat administration in normal men. After a 2-week baseline period, seven normal men were administered miglustat 100 mg, orally, twice daily for 6 weeks. During treatment, subjects had frequent seminal fluid analyses to assess the impact of treatment on sperm concentration, motility and morphology and the ability to undergo the acrosome reaction by in vitro assays. Five subjects completed all aspects of the study. In these subjects, there was no apparent effect of miglustat on sperm concentration, motility or sperm morphology after 6 weeks of therapy. In addition, no changes in acrosome structure or function were observed with treatment, despite therapeutic concentrations of miglustat in the serum and seminal plasma. All subjects experienced gastrointestinal upset, diarrhoea and mild weight loss during treatment. No other abnormalities in blood counts, serum chemistries, vision or overall health were observed. In contrast to the observations in mice, the oral administration of miglustat does not appear to affect human spermatogenesis. Further elucidation of the mechanism underlying the species specificity of miglustat may improve our understanding of the role of glycosphingolipids in spermatogenesis and result in alternative approaches to male fertility control. (author's) Language: English Keywords: WASHINGTON | RESEARCH REPORT | PILOT PROJECTS | CLINICAL RESEARCH | MEN | LABORATORY ANIMALS | SPERMATOGENESIS BLOCKING AGENTS | ADMINISTRATION AND DOSAGE | SPERM COUNT | SPERMATOZOA | SIDE EFFECTS | BODY WEIGHT | DIARRHEA | LIPIDS | ENZYME INHIBITORS | United States of America | North America | Americas | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Contraceptive Agents, Male | Contraceptive Agents | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Germ Cells | Genitalia | Urogenital System | Physiology | Biology | Diseases | Enzymes and Enzyme Inhibitors Document Number: 312204 |
| 11. Peer Reviewed Title: Longitudinal study of herpes simplex virus type 2 infection using viral dynamic modelling. Author: Crespi CM; Cumberland WG; Wald A; Corey L; Blower S Source: Sexually Transmitted Infections. 2007 Oct;83(5):359-364. Abstract: Rates of reactivation of herpes simplex virus type 2 (HSV-2) change over time and these changes affect transmission and clinical management strategies. We conducted a longitudinal study of HSV-2 infection to quantify rates of change in HSV-2 reactivation, mucosal shedding and recurrences of genital lesions, using a newly available model of HSV within-host dynamics. A cohort of 18 women was studied at two time periods spaced 2 years apart. The cohort provided daily mucosal swabs for HSV PCR analysis for 10 weeks during each time period and recorded recurrences in diaries. We fit the model of HSV dynamics to the mucosal shedding data using Bayesian methods to produce estimates of HSV reactivation, shedding and longitudinal rates of change. The model was validated using a separate group of 67 individuals. According to the viral dynamic modelling results, rates of HSV-2 reactivation from latency in the ganglia varied .10-fold among the women, and were estimated to be >/= 10% higher than rates of mucosal shedding episodes for many individuals. The mucosal shedding associated with each reactivation typically lasted 1-3 days. Reactivation frequency was estimated to be declining by three reactivations a year on average. The median number of recurrences, based on patient diaries, declined from 6.8 per year to 2.1 per year over the 2-year period. Rates of HSV-2 reactivation, shedding and recurrence generally decline over time but remain high in some individuals 4-5 years after primary infection. Viral dynamic modelling provides quantification of HSV infection that cannot be obtained by other methods. (author's) Language: English Keywords: WASHINGTON | RESEARCH REPORT | CLINICAL RESEARCH | LONGITUDINAL STUDIES | MATHEMATICAL MODEL | ESTIMATION TECHNIQUES | TARGET POPULATION | HERPES GENITALIS | TIME FACTORS | SIGNS AND SYMPTOMS | SEX FACTORS | Developed Countries | United States of America | North America | Americas | Research Methodology | Studies | Theoretical Models | Program Design | Programs | Organization and Administration | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Population Dynamics | Demographic Factors | Population | Population Characteristics Document Number: 319497 |
| 12. Title: Risk of preterm delivery in relation to vaginal bleeding in early pregnancy. Author: Hossain R; Harris T; Lohsoonthorn V; Williams MA Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2007 Dec;135(2):158-163. Abstract: The objective was to examine the relationship between vaginal bleeding during early pregnancy and preterm delivery. Study subjects (N = 2678) provided information regarding socio-demographic, biomedical, and lifestyle characteristics. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI). Any vaginal bleeding in early pregnancy was associated with a 1.57-fold increased risk of preterm delivery (95% CI: 1.16-2.11). Vaginal bleeding was most strongly related with spontaneous preterm labor (OR = 2.10) and weakly associated with preterm premature rupture of membrane (OR = 1.36) and medically induced preterm delivery (OR = 1.32). As compared to women with no bleeding, those who bled during the first and second trimesters had a 6.24-fold increased risk of spontaneous preterm labor; and 2-3-fold increased risk of medically induced preterm delivery and preterm premature rupture of membrane, respectively. Vaginal bleeding, particularly bleeding that persists acrossthe first two trimesters, is associated with an increased risk of preterm delivery. (author's) Language: English Keywords: WASHINGTON | THAILAND | RESEARCH REPORT | EPIDEMIOLOGY | PREGNANT WOMEN | PREMATURE BIRTH | BLEEDING | RISK FACTORS | PREGNANCY, FIRST TRIMESTER | PREGNANCY, SECOND TRIMESTER | PREGNANCY COMPLICATIONS | Developed Countries | United States of America | North America | Americas | Asia, Southeastern | Asia | Developing Countries | Public Health | Health | Population Characteristics | Demographic Factors | Population | Pregnancy Outcomes | Pregnancy | Reproduction | Signs and Symptoms | Diseases | Biology Document Number: 322801 |
| 13. Title: Choques of reproduction and transnationality in the Yakima Valley. Author: Maurer S Source: Journal of Developing Societies. 2007;23(1-2):71-88. Abstract: This article explores the relational production of gendered discourses of reproduction that have emerged in newspaper debates over Mexican immigration and in interviews with Mexican migrant women conducted in 2003-2004 in Washington State's Yakima Valley. It argues that gendered discourses of reproduction are being deployed in the governance of Mexican migration and settlement in the Yakima Valley. It also claims that Mexican migrant women are both recomposing and resisting racialized and gendered national borders through these discourses in their narratives of migration and settlement. (author's) Language: English Keywords: MEXICO | WASHINGTON | RESEARCH REPORT | EVALUATION | WOMEN | IMMIGRANTS | MIGRANT WORKERS | NEWSPAPERS | GENDER ISSUES | INTERNATIONAL MIGRATION | LABOR MIGRATION | SETTLEMENT AND RESETTLEMENT | WOMEN'S STATUS | North America | Americas | Developing Countries | Developed Countries | United States of America | Demographic Factors | Population | Migrants | Migration | Population Dynamics | Labor Force | Human Resources | Economic Factors | Printed Media | Mass Media | Communication | Sociocultural Factors | Socioeconomic Factors Document Number: 320683 |
| 14. Title: Intratesticular androgens and spermatogenesis during severe gonadotropin suppression induced by male hormonal contraceptive treatment. Author: Page ST; Kalhorn TF; Bremner WJ; Anawalt BD; Matsumoto AM Source: Journal of Andrology. 2007 Sep-Oct;28(5):734-741. Abstract: Male hormonal contraceptive regimens function by suppressing gonadotropin secretion, resulting in a dramatic decrease in testicular androgen biosynthesis and spermatogenesis. Animal studies suggest that persistent intratesticular (iT)-androgen production has a stimulatory effect on spermatogenesis in the setting of gonadotropin suppression. We hypothesized that men with incompletely suppressed spermatogenesis (> 1 000 000 sperm/mL) during male hormonal contraceptive treatment would have higher iTandrogen concentrations than men who achieved severe oligospermia (Language: English Keywords: WASHINGTON | RESEARCH REPORT | CLINICAL RESEARCH | MEN | ANDROGENS | TESTIS | SPERMATOGENESIS BLOCKING AGENTS | CONTRACEPTIVE AGENTS, MALE | GONADOTROPINS | FOLLICLE STIMULATING HORMONE | Developed Countries | United States of America | North America | Americas | Research Methodology | Demographic Factors | Population | Hormones | Endocrine System | Physiology | Biology | Genitalia, Male | Genitalia | Urogenital System | Contraceptive Agents | Contraception | Family Planning | Gonadotropins, Pituitary Document Number: 319476 |
| 15. Peer Reviewed Title: Magnetic resonance imaging of SILCS diaphragm: Anatomical considerations and corroboration with clinical fit. Author: Yang CC; Maravilla KR; Kilbourne-Brook M; Austin G Source: Contraception. 2007 Sep;76(3):238-244. Abstract: We performed a pilot study to evaluate in vivo the fit of the new SILCS diaphragm, a single-size cervical barrier, using magnetic resonance imaging (MRI) in a group of women varying in body mass and parity. Two healthy premenopausal women were recruited for each of the following groups: body mass index (BMI) < 25, BMI = 25-30 and BMI > 30. One woman in each group was nulliparous and one was multiparous. Subjects were instructed on the placement of the SILCS diaphragm. Each subject underwent three MRI scans: baseline, with the SILCS diaphragm in place and after placement of intravaginal contrast and simulated intercourse. The SILCS diaphragm was easily identified on MRI. In all subjects, the diaphragm covered the cervix. The position of the diaphragm did not change after simulated intercourse. The appropriate position of the diaphragm, as assessed by the subjects and the practitioner, was corroborated by the MR images. The intravaginal contrast was not readily visible on the images, precluding assessment of the diaphragm's barrier properties. MRI confirms the anatomic position of the SILCS diaphragm in vivo, among a sample of women varying in body mass and parity. (author's) Language: English Keywords: UNITED STATES OF AMERICA | WASHINGTON | RESEARCH REPORT | PILOT PROJECTS | WOMEN | PARITY | VAGINAL DIAPHRAGM | BODY WEIGHT | INSERTION | CONTRACEPTION RESEARCH | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Fertility Measurements | Fertility | Population Dynamics | Vaginal Barrier Methods | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Physiology | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 319365 |
| 16. Peer Reviewed Title: Unsafe sexual behavior and correlates of risk in a probability sample of men who have sex with men in the era of highly active antiretroviral therapy. Author: Brewer DD; Golden MR; Handsfield HH Source: Sexually Transmitted Diseases. 2006 Apr;33(4):250-255. Abstract: The objective was to assess the levels and correlates of potential exposure to and transmission of HIV in a contemporary, community-based probability sample of men who have sex with men (MSM). In 2003, 311 sexually active MSM participated in a random-digit dial telephone survey in Seattle neighborhoods with a high prevalence of MSM. The primary outcomes were potential exposure to and transmission of HIV, defined as unprotected anal intercourse with a man of opposite or unknown HIV status in the preceding 12 months. Fourteen percent of respondents reported being HIV-positive, 77% reported being HIV-negative, and 8% had not been tested. Of 241 HIV-negative MSM, 25 (10%; 95% confidence interval [CI], 7-15%) were potentially exposed to HIV; among 45 HIV-positive MSM, 14 (31%; 95% CI, 20-46%) were potential HIV-transmitters. Among HIV-negative men, the strongest bivariate correlates of potential exposure to HIV were recent bacterial sexually transmitted disease (odds ratio [OR], 5.8), number of recent male sexual partners (OR, 1.01 per partner), recent sex at a bathhouse (OR, 9.1), and recent use of sildenafil (OR, 4.4), amyl nitrite (OR, 6.2), and methamphetamine (OR, 8.0). Among HIV-infected men, the strongest correlates of potential HIV transmission were recent use of amyl nitrite (OR, 3.1), number of recent male sex partners (OR, 1.07 per partner), and having a male spouse or domestic partner (OR, 0.3). Most MSM knew their HIV status and adopted safer sexual behaviors to reduce their risk of HIV acquisition or transmission. However, 10% of HIV-negative MSM and 31% of HIV-positive MSM recently engaged in behaviors that placed them at high risk for acquiring or transmitting HIV. (author's) Language: English Keywords: UNITED STATES OF AMERICA | WASHINGTON | RESEARCH REPORT | SURVEYS | MEN HAVING SEX WITH MEN | PERSONS LIVING WITH HIV/AIDS | HIV TRANSMISSION | SAFER SEX | SEX BEHAVIOR | RISK BEHAVIOR | ANAL SEX | CONDOM USE | MULTIPLE PARTNERS | DRUG USE AND ABUSE | ANTIRETROVIRAL THERAPY | North America | Americas | Developed Countries | Sampling Studies | Studies | Research Methodology | Behavior | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Risk Reduction Behavior | Sexual Partners | HIV Document Number: 298611 |
| 17. Peer Reviewed Title: Hormonal exposures and the risk of intracranial meningioma in women: a population-based case-control study. Author: Custer B; Longstreth WT Jr; Phillips LE; Koepsell TD; Van Belle G Source: BMC Cancer. 2006 Jun 7;6:152. Abstract: The role of exogenous hormone exposures in the development of meningioma is unclear, but these exposures have been proposed as one hypothesis to explain the over-abundance of such tumors in women. The association between oral contraception (OC) or hormone replacement therapy (HRT) and intracranial meningioma in women was investigated using a population-based, matched case-control study. Exposures for 143 cases and 286 controls matched on age within five years were obtained by interview. Diagnoses were confirmed histopathologically and estrogen and progesterone receptor assays conducted. Although risk of meningioma appeared modestly elevated in past OC users (OR = 1.5, 95% CI 0.8 -- 2.7), and in current users (OR = 2.5, 95% CI 0.5 -- 12.6), the confidence intervals were wide. No significant association between meningioma risk and duration of OC use was found. Likewise, risk of meningioma was only weakly associated with past use of HRT (OR = 0.7, 95% CI 0.4 -- 1.3), and not at all with current use of HRT (OR = 1.0, 95% CI 0.5 -- 2.2). Of 142 available specimens, 2 (1%) expressed estrogen receptors, whereas 130 (92%) expressed progesterone receptors (PR). OC use was associated with increased risk of a meningioma expressing less rather than more PR (OR = 3.2, 95% CI 1.3 -- 8.0). Overall, in post menopausal women, HRT use appeared to confer a non-significant protective effect, and was not associated with low or high PR expressing meningiomas. This study found little evidence of associations between meningioma and exogenous hormone exposures in women but did suggest that some hormonal exposures may influence tumor biology in those women who develop meningioma. (author's) Language: English Keywords: WASHINGTON | RESEARCH REPORT | CASE CONTROL STUDIES | EPIDEMIOLOGIC METHODS | WOMEN | MENINGITIS | ORAL CONTRACEPTIVES, SIDE EFFECTS | PREVALENCE | HORMONE REPLACEMENT THERAPY | RISK ASSESSMENT | CONTRACEPTIVE AGENTS, ESTROGEN | PROGESTERONE | HORMONE RECEPTORS | United States of America | North America | Americas | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Central Nervous System Effects | Central Nervous System | Physiology | Biology | Contraceptive Safety | Safety | Public Health | Health | Measurement | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Evaluation | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Progestational Hormones | Hormones | Endocrine System | Membrane Proteins Document Number: 306458 |
| 18. Peer Reviewed Title: Chlamydial infections among female adolescents screened in juvenile detention centers in Washington State, 1998-2002. Author: Lofy KH; Hofmann J; Mosure DJ; Fine DN; Marrazzo JM Source: Sexually Transmitted Diseases. 2006 Feb;33(2):63-67. Abstract: The objective of this study was to assess trends in Chlamydia trachomatis positivity and associated risk factors among detained female adolescents. The goal of this study was to determine trends in prevalence of chlamydia among detained female adolescents. We retrospectively reviewed risk factor data and chlamydia results collected by providers during 1998-2002 at four large juvenile detention centers in Washington State that routinely screen female adolescents for C. trachomatis. Of 3,593 tests, a total of 493 (13.7%) were positive for chlamydia. High chlamydia positivity was sustained throughout the 5-year period (range, 12.5-15.0%) with no statistically significant trends in positivity. Independent risk factors for chlamydial infection included report of more than one sex partner in the previous 60 days (adjusted odds ratio [OR] = 1.56, 95% confidence interval [CI] = 1.19 -2.04) and previous chlamydial infection within 12 months (adjusted OR = 1.87, 95% CI = 1.45-2.40). Efforts are needed to promote chlamydia screening programs in juvenile detention centers because these sites have access to high-risk sexually active female adolescents. (author's) Language: English Keywords: UNITED STATES OF AMERICA | WASHINGTON | RESEARCH REPORT | RETROSPECTIVE STUDIES | ADOLESCENTS, FEMALE | PRISONERS | CHLAMYDIA | SCREENING | RISK FACTORS | ADOLESCENT HEALTH | Developed Countries | North America | Americas | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Crime | Social Problems | Sociocultural Factors | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Biology Document Number: 296244 |
| 19. Peer Reviewed Title: Human papillomavirus infection among sexually active young women in the United States: implications for developing a vaccination strategy. Author: Manhart LE; Holmes KK; Koutsky LA; Wood TR; Kenney DL Source: Sexually Transmitted Diseases. 2006 Aug;33(8):502-508. Abstract: Population-level data on prevalence and distribution of human papillomavirus (HPV) types in the United States are necessary to guide optimal vaccination strategies. Urine specimens from 3262 women ages 18 to 25 in the National Longitudinal Study of Adolescent Health (Wave III) were tested and typed for HPV. Poststratification sampling weights generated nationally representative estimates. Overall HPV prevalence was 26.9% and as high as 14.3% among women with 1 lifetime partner but did not vary by geographic region. High-risk types were detected in 20%; ~10% were infected with types in current candidate vaccines. HPV infection was independently associated with mixing sex with alcohol, a black partner, > 3 lifetime sex partners, being single, and illegal drug use. Having a current sex partner and receptive oral sex were inversely associated with HPV. HPV prevalence was high throughout the country, even among women with only 1 lifetime partner, suggesting early and widespread rather than targeted immunization of young women. (author's) Language: English Keywords: UNITED STATES OF AMERICA | WASHINGTON | RESEARCH REPORT | PREVALENCE | YOUTH | ADOLESCENTS, FEMALE | HPV | SEXUALLY TRANSMITTED DISEASES | RISK BEHAVIOR | ALCOHOL USE AND ABUSE | SEX BEHAVIOR | North America | Americas | Developed Countries | Measurement | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Adolescents | Viral Diseases | Diseases | Reproductive Tract Infections | Infections | Behavior Document Number: 302878 |
| 20. Peer Reviewed Title: Chlamydia screening in at-risk adolescent females: An evaluation of screening practices and modifiable screening correlates. Author: McClure JB; Scholes D; Grothaus L; Fishman P; Reid R Source: Journal of Adolescent Health. 2006 Jun;38(6):726-733. Abstract: The purpose was to identify modifiable correlates of chlamydia screening that could offer intervention targets to enhance screening. We surveyed a representative sample of primary care providers (n = 186) at an integrated healthcare delivery system to document their self-reported adherence to annual screening of sexually-active adolescents and to identify specific, modifiable constructs that were correlated with annual chlamydia screening. To cross-validate providers' self-report, we also used automated data to examine adolescent screening in an anonymous sample of primary care providers (n = 143). Forty-two percent of providers reported annual chlamydia screening of sexually-active adolescents. Univariate correlates of annual screening were: provider type (non-physician) (p = .01), female gender (p = .001), fewer years of clinical experience (p = .001), greater perceived knowledge about chlamydia (p = .001), greater confidence across a range of screening-related activities (p = .01), greater comfort recommending screening for sexually transmitted diseases (p = .001), and greater perceived patient comfort discussing sexual issues (p < .01). In multivariate analyses, providers' perceived knowledge, confidence, comfort, and perceived patient comfort continued to be significantly associated with annual chlamydia screening after controlling for other relevant provider characteristics. Self-reported screening practices were consistent with observed screening rates in the anonymous provider sample. Routine chlamydia screening among asymptomatic, at-risk adolescent females could be enhanced through additional intervention targeting specific provider attitudes and beliefs about chlamydia screening. (author's) Language: English Keywords: WASHINGTON | RESEARCH REPORT | KAP SURVEYS | MULTIVARIATE ANALYSIS | ADOLESCENTS, FEMALE | PHYSICIANS | HEALTH PERSONNEL | CHLAMYDIA | SCREENING | DELIVERY OF HEALTH CARE | TIME FACTORS | KNOWLEDGE | ATTITUDES | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Population Dynamics | Sociocultural Factors | Psychological Factors | Behavior Document Number: 301523 |
| 21. Title: Preclinical safety and efficacy assessments of dendrimer-based (SPL 7013) microbicide gel formulations in a nonhuman primate model. Author: Patton DL; Sweeney YT; McCarthy TD; Hillier SL Source: Antimicrobial Agents and Chemotherapy. 2006 May;50(5):1696-1700. Abstract: Three gel formulations (1%, 3%, and 5% [wt/wt]) of SPL7013, a dendrimer known to have antiviral (anti-human immunodeficiency virus and anti-herpes simplex virus) activities, completed a range of preclinical tests in the pigtailed macaque models for vaginally and rectally applied topical microbicide safety assessments. The vaginal safety profile of the 3% SPL7013 gel formulation was equal to that of the 1% formulation but was superior to that of the 5% formulation. The 3% SPL7013 gel was further evaluated for rectal safety and for antichlamydial efficacy with cervical challenge with Chlamydia trachomatis. This first-generation dendrimer-based product was shown to be safe to the vaginal and rectal microenvironments with repeated daily use. However, a single intravaginal application of the 3% (wt/wt) SPL7013 gel did not provide protection from the acquisition of cervical chlamydial infection. (author's) Language: English Keywords: UNITED STATES OF AMERICA | WASHINGTON | RESEARCH REPORT | RESEARCH AND DEVELOPMENT | LABORATORY PROCEDURES | LABORATORY ANIMALS | MICROBICIDES | HIV PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | VAGINAL GEL | SAFETY | North America | Americas | Developed Countries | Technology | Economic Factors | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Clinical Research | Research Methodology | Drugs | Treatment | HIV Infections | Viral Diseases | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Vaginal Spermicides | Contraceptive Methods | Contraception | Family Planning | Public Health Document Number: 307057 |
| 22. Peer Reviewed Title: Agreement between women's and providers' assessment of hormonal contraceptive risk factors. Author: Shotorbani S; Miller L; Blough DK; Gardner J Source: Contraception. 2006 May;73(5):501-506. Abstract: The objective was to measure agreement between women's self-administered risk factor questionnaire and their providers' evaluation of their medical eligibility for hormonal contraceptive use. This was an anonymous cross-sectional study. Participants were women 15-45 years old who completed a 20-item self-administered questionnaire. Women were recruited from six public health family planning clinics in the Seattle Metropolitan area. A matching medical evaluation questionnaire was completed concurrently by each participant's health care provider. Using provider evaluation as the "gold standard" against which we compared self-reported medical history, we calculated participant-provider agreement with point estimates and 95% confidence interval (CI). Of 399 participant and provider pairs, participant-provider agreement was obtained for 392 participant pairs. The majority of the participants (90.3%) were 15-30 years old and 77.7% had used a hormonal contraceptive method for more than 1 year. The estimated proportion of the overall agreement was 96% (95% CI, 0.92- 0.98). Women were more likely to report severe headaches (12.4% vs. 3.3%), possible pregnancy (7.3% vs. 3.5%) and smoking (6.2% vs. 2.1%) than providers, but less likely to report smoking more than 15 cigarettes per day (2.6% vs. 9.2%) and irregular menses (6.5% vs. 9.9%). Overall, a high proportion of the women in this study completed our medical history questionnaire in concordance with their health care providers' same-day medical evaluation. Agreement on critical medical eligibility criteria such as hypertension was well above 90%. For criteria on which there was disagreement, women were more likely to identify contraindications than were their providers. (author's) Language: English Keywords: WASHINGTON | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | COMPARATIVE STUDIES | WOMEN | HEALTH PERSONNEL | RISK ASSESSMENT | CONTRACEPTIVE SAFETY | PERCEPTION | HEADACHE | TOBACCO USE | United States of America | North America | Americas | Developed Countries | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Delivery of Health Care | Health | Evaluation | Safety | Public Health | Psychological Factors | Behavior | Signs and Symptoms | Diseases Document Number: 299437 |
| 23. Title: Associations between fracture incidence and use of depot medroxyprogesterone acetate and anti-epileptic drugs in women with developmental disabilities. Author: Watson KC; Lentz MJ; Cain KC Source: Women's Health Issues. 2006 Nov-Dec;16(6):346-352. Abstract: We sought to evaluate any association between incidence of osteoporotic fractures and use of depot medroxyprogesterone acetate (DMPA) and/or anti-epileptic drugs (AEDs) among women and girls with developmental disabilities. Cross-sectional population-based observational study of all noninstitutionalized females with developmental disabilities age = 13 who received fee-for-service Medicaid in Washington State during 2002 (n = 6,773), using administrative data. In a sample of 6,773 females, 140 women (2%) had an osteoporotic fracture during 2002. Among 340 users of DMPA, 13 (3.8%) had an osteoporotic fracture with an odds ratio of 2.4 (95% confidence interval [CI], 1.3-4.4) for fracture compared to nonusers. Among 1,909 users of AEDs, 60 (3.1%) had an osteoporotic fracture with an odds ratio of 1.9 (95% CI, 1.3-2.6) for fracture compared to nonusers. We controlled for use of drugs (DMPA or AEDs), age and race (as white or other racial and ethnic groups). Use of either AEDs or DMPA by women with developmental disabilities is associated with significantly increased incidence of fracture. Women and girls who have developmental disabilities may be poor candidates for DMPA use owing to increased risk of fractures. Further research is indicated to 1) determine the specific risks profile of DMPA for this population, 2) explore alternative means of managing significant menstrual problems and contraceptive needs in this population, and 3) screen current and previous users of DMPA and chronic users of AEDs for osteoporosis risk, regardless of age. (author's) Language: English Keywords: WASHINGTON | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CROSS SECTIONAL ANALYSIS | WOMEN | DISABLED PERSONS AND DISABILITIES | MEDROXYPROGESTERONE ACETATE | SKELETAL EFFECTS | CENTRAL NERVOUS SYSTEM EFFECTS | MENTAL RETARDATION | DRUGS | INCIDENCE | CONTRACEPTIVE AGENTS, SIDE EFFECTS | CONTRACEPTIVE SAFETY | Developed Countries | United States of America | North America | Americas | Research Methodology | Demographic Factors | Population | Population Characteristics | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Physiology | Biology | Central Nervous System | Intelligence | Personality | Psychological Factors | Behavior | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Safety | Public Health Document Number: 312827 |
24.  Peer Reviewed Title: Expanding access to emergency contraception through state systems: the Washington State experience. Author: Weldin M; Hutchings J; Hayes M; McAllister S; Harris C Source: Perspectives on Sexual and Reproductive Health. 2006 Dec;38(4):220-224. Abstract: Access to family planning and reduction of unintended pregnancy are long-standing priorities for Washington State's Department of Health (DOH) and Department of Social and Health Services (DSHS). Working together to ensure that all pregnancies are intended (consciously and clearly desired at the time of conception), the two agencies provide family planning counseling and a broad choice of contraceptive methods through a range of health and social service programs. When a dedicated product for emergency contraception became available in 1998, widespread integration of relevant information and services became one more strategy the agencies used to realize the goal of reducing unintended pregnancy in the state. Since 1997, the Program for Appropriate Technology in Health (PATH) has collaborated with state colleagues to increase access to emergency contraception. In a series of interviews conducted in December 2003, PATH asked administrators, managers and others who were involved in the initial process to describe the experience. The story that emerged, described here, is one of strong, high-level support for family planning services that created an ideal platform for expanding emergency contraception services, establishing collaborations between relevant agencies, and increasing the number of state programs and the range of service providers offering emergency contraception services. The result was an innovative approach to service delivery that made it possible to reach underserved and low-income populations, including those not served by Title X--funded clinics. Our objective in sharing Washington State's experience is to stimulate further state-level innovation for expanding access to emergency contraception. (excerpt) Language: English Keywords: WASHINGTON | SUMMARY REPORT | PREGNANCY, UNPLANNED | EMERGENCY CONTRACEPTION | HEALTH INSURANCE | FAMILY PLANNING | COUNSELING | LEGISLATION | PROGRAM ACCESSIBILITY | United States of America | North America | Americas | Developed Countries | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Contraception | Financial Activities | Economic Factors | Clinic Activities | Program Activities | Programs | Organization and Administration | Political Factors | Sociocultural Factors | Program Evaluation Document Number: 309750 |
| 25. Peer Reviewed Title: Condom use and the risk of genital human papillomavirus infection in young women. Author: Winer RL; Hughes JP; Feng Q; O'Reilly S; Kiviat NB Source: New England Journal of Medicine. 2006 Jun 22;354(25):45-54. Abstract: The objective was to evaluate whether the use of male condoms reduces the risk of male-to-female transmissi on of human papillomavirus (HPV) infection, longitudinal studies explicitly designed to evaluate the temporal relationship between condom use and HPV infection are needed. We followed 82 female university students who reported their first intercourse with a male partner either during the study period or within two weeks before enrollment. Cervical and vulvovaginal samples for HPV DNA testing and Papanicolaou testing were collected at gynecologic examinations every four months. Every two weeks, women used electronic diaries to record information about their daily sexual behavior. Cox proportional-hazards models were used to evaluate risk factors for HPV infection. The incidence of genital HPV infection was 37.8 per 100 patient-years at risk among women whose partners used condoms for all instances of intercourse during the eight months before testing, as compared with 89.3 per 100 patient-years at risk in women whose partners used condoms less than 5 percent of the time (adjusted hazard ratio, 0.3; 95 percent confidence interval, 0.1 to 0.6, adjusted for the number of new partners and the number of previous partners of the male partner). Similar associations were observed when the analysis was restricted to high-risk and low-risk types of HPV and HPV types 6, 11, 16, and 18. In women reporting 100 percent condom use by their partners, no cervical squamous intraepithelial lesions were detected in 32 patient-years at risk, whereas 14 incident lesions were detected during 97 patient-years at risk among women whose partners did not use condoms or used them less consistently. Among newly sexually active women, consistent condom use by their partners appears to reduce the risk of cervical and vulvovaginal HPV infection. (author's) Language: English Keywords: WASHINGTON | RESEARCH REPORT | LONGITUDINAL STUDIES | EPIDEMIOLOGIC METHODS | WOMEN | STUDENTS | SEXUAL PARTNERS | CONDOM USE | VIRAL DISEASES | SEXUALLY TRANSMITTED DISEASE PREVENTION | FIRST INTERCOURSE | PREVALENCE | Developed Countries | United States of America | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Education | Sex Behavior | Behavior | Risk Reduction Behavior | Diseases | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Measurement Document Number: 303567 |
| 26. Title: What if: How declines in teen births have improved poverty and child well-being in Washington. 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 | WASHINGTON | 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: 307009 |
| 27. Peer Reviewed Title: Same-day administration of depot-medroxyprogesterone acetate injection: a retrospective chart review. Author: Balkus J; Miller L Source: Contraception. 2005;71:395-398. Abstract: A chart review of clients administered depot-medroxyprogesterone acetate (DMPA) injection in September of 2000 was performed to assess implementation of a same-day injection administration protocol irregardless of menstrual cycle day. Women were classified into one of the three categories: (1) routine injection (injection given as specified by the package label), (2) same-day start injection (no injection for more than 6 months, did not meet labeled criteria for administration and received an injection the day of the visit) or (3) same-day restart injection (injection given within 6 months prior to receiving an injection at the visit despite being late for their injection). Of the 228 women receiving an injection, 104 (46%) had a non-routine same-day injection, meaning almost half of the women receiving a contraceptive injection would have had to return for another visit if this protocol had not been in place. Among these women administered a same-day injection, 23 (22%) were also dispensed emergency contraception. Only 1 of the 104 women was subsequently identified to have become pregnant. Other pregnancies are presented to illustrate the importance of adherence to pregnancy testing at the time of injection and revisit, and the need for backup contraception. Using a same-day injection protocol, women can have increased access to injection contraception, and proper adherence to a protocol can assure few pregnancies. (author's) Language: English Keywords: WASHINGTON | RESEARCH REPORT | RETROSPECTIVE STUDIES | CLINICAL RESEARCH | WOMEN | PREGNANT WOMEN | INJECTABLES | MEDROXYPROGESTERONE ACETATE | ADMINISTRATION AND DOSAGE | TIME FACTORS | EMERGENCY CONTRACEPTION | CONTRACEPTIVE AVAILABILITY | United States of America | North America | Americas | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Population Characteristics | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Drugs | Treatment | Population Dynamics Document Number: 284469 |
| 28. Title: Promoting the safety and use of hormonal contraceptives. Author: Gardner J; Miller L Source: Journal of Women’s Health. 2005;14(1):53-60. Abstract: Nearly one half of all pregnancies in the United States are unintended despite the availability of safe and effective contraceptives. The morbidity and mortality from unintended pregnancy are not insignificant. Currently available hormonal contraceptives are very effective, safe, and available for most American women. National and international institutions have removed the pelvic examination as a requirement for initiating the prescription for hormonal contraceptives, substituting instead a medical history and a blood pressure measurement. However, problems with uneven access, prescription requirements, conflicting information on the package instructions for initiating and continuing use, and incorrect perceptions of excess risk of contraceptive products may lead women to use them less than effectively or not at all. Newer progestins have been shown to have more risk of thrombosis than older formulations, instead of improved safety. In considering how hormonal contraceptives might be made safer, recommendations are made for improved availability and effective use. These include expanding the numbers and types of providers and the compensation for these services; reconsidering the need for prescription; revising labels to reflect the safety of the current formulations; communicating the safety of the current formulations; encouraging the use of the older progestins; exploring alternate schedules, such as extended or continuous oral contraceptive (OC) use; promoting same-day initiation of methods rather than waiting for menses; and ensuring universal access to emergency contraception as an adjunct to effective ongoing contraceptive methods. (author's) Language: English Keywords: UNITED STATES OF AMERICA | WASHINGTON | CRITIQUE | WOMEN | FAMILY PLANNING ACCEPTORS | CONTRACEPTIVE SAFETY | CONTRACEPTIVE USAGE | ORAL CONTRACEPTIVES | CONTRACEPTIVE AVAILABILITY | FAMILY PLANNING POLICY | Developed Countries | North America | Americas | Demographic Factors | Population | Family Planning Programs | Family Planning | Safety | Public Health | Health | Contraception | Contraceptive Methods | Population Policy | Social Policy | Policy Document Number: 280982 |
| 29. Peer Reviewed Title: Towards errorless condom use: a comparison of two courses to improve condom use skills. Author: Lindemann DF; Brigham TA; Harbke CR; Alexander T Source: AIDS and Behavior. 2005 Dec;9(4):451-457. Abstract: Traditionally, researchers have focused HIV/AIDS prevention efforts on increasing condom use, yet few researchers have assessed condom use skills. Because incorrect condom use may lead to condom failure, promoting condom use without ensuring participants have the skills necessary for correct condom use may lead to increased risk of exposure. This study compared the effects of two condom use courses on condom use skills. These courses were administered as part of a HIV/AIDS educational program for college students. Participants in the treatment groups (n = 179) attended either a limited, 1-Session, or extensive, 3-Session, condom use course, and an additional 108 participants served as a Control Group. Condom use skills increased among participants in both treatment groups; however, the greatest improvement was among those in the 3-Session Group. This finding supports use of the extensive, 3-Session course as a more effective means for improving condom use skills. (author's) Language: English Keywords: UNITED STATES OF AMERICA | WASHINGTON | RESEARCH REPORT | STUDENTS | PEER EDUCATORS | CONDOM USE | CONDOM FAILURE | INTERVENTIONS | HIV PREVENTION | SEX EDUCATION | TRAINING ACTIVITIES | INSTRUCTION | North America | Americas | Developed Countries | Education | Risk Reduction Behavior | Behavior | Condoms | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Training Programs Document Number: 298463 |
| 30. Title: Evaluation of a community-based exercise progam for elderly Korean immigrants. Author: Sin MK; Belza B; LoGerfo J; Cunningham S Source: Public Health Nursing. 2005 Sep-Oct;22(5):407-413. Abstract: The objective was to evaluate feasibility and effectiveness of a modified exercise program for elderly Korean immigrants (EKIs). Design and sample: Intervention study with EKI residents of a senior house (n = 13, age range 67—86 years, mean age 77 years), recruited through posted fliers and with help from a Korean social worker. Intervention: A Korean—American instructor taught a modified version of an evidence-based exercise program 3 times weekly, 50 min per session, for 12 weeks. Program was evaluated with the Quality Health Outcomes Model. System and client characteristics were taken into consideration because elderly Koreans have their own values and beliefs, which influence their health management behaviors. Evaluation measures included exercise adherence, preintervention and postintervention health outcomes, and satisfaction with the exercise program. Group discussion was used to evaluate satisfaction with the exercise program. Participants showed improved health outcomes on muscle strength, agility/balance, and blood pressure after the exercise program. All participants were satisfied with the exercise program, and participation rates were good (nine participants attended = 80% of classes). The exercise program was feasible for this sample and should be evaluated in a larger population of EKIs and in populations of other ethnic minorities. (author's) Language: English Keywords: REPUBLIC OF KOREA | WASHINGTON | EVALUATION REPORT | KAP SURVEYS | OLDER ADULTS | COMMUNITY | IMMIGRANTS | COMMUNITY HEALTH SERVICES | FITNESS | TRAINING PROGRAMS | USER COMPLIANCE | HEALTH STATUS INDEXES | SATISFACTION | PARTICIPATION | Asia, Eastern | Asia | Developed Countries | United States of America | North America | Americas | Evaluation | Surveys | Sampling Studies | Studies | Research Methodology | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors | Migrants | Migration | Population Dynamics | Primary Health Care | Health Services | Delivery of Health Care | Health | Education | Behavior | Psychological Factors | Social Behavior Document Number: 291332 |
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