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1.
Title: Plan B for 17-year olds.
Source: Medical Letter On Drugs and Therapeutics. 2009 May 18;51(1312):40.
Abstract: The FDA has announced that it will lower the age for over-the-counter access to the emergency contraceptive Plan B from 18 to 17 years old. In a randomized, controlled trial, the two 0.75-mg levonorgestrel tablets in Plan B, taken 12 hours apart beginning within 72 hours after unprotected intercourse, decreased the overall pregnancy rate to 1.1% (11/976) of women who requested emergency contraception. The sooner the drug is taken after coitus, the more effective it is. Nausea and vomiting can occur with Plan B. Fetal malformations have not been associated with pregnancies that occurred despite use of levonorgestrel-only emergency contraception. (full-text)
Language: English
Keywords:
UNITED STATES OF AMERICA | USFDA | ADOLESCENTS | EMERGENCY CONTRACEPTION | ADMINISTRATION AND DOSAGE | PROGRAM ACCESSIBILITY | Developed Countries | North America | Americas | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration
Document Number: 341625

2.
Title: Contraceptive use among postpartum women - 12 states and New York City, 2004-2006.
Author: Centers for Disease Control and Prevention (CDC)
Source: MMWR. Morbidity and Mortality Weekly Report. 2009 Aug 7;58(30):821-6.
Abstract: Postpartum use of highly effective contraceptive methods can prevent unintended pregnancies and ensure adequate birth spacing. Unintended pregnancies and short interpregnancy intervals are associated with adverse maternal and infant outcomes. In 2001, the year for which the most recent data are available, 49% of all pregnancies were unintended, and 21% of women gave birth within 24 months of a previous birth. Two Healthy People 2010 goals are to increase the percentage of intended pregnancies to 70% (objective 9-1) and to reduce the percentage of births occurring within 24 months of a previous birth to 6% (objective 9-2). To estimate the prevalence and types of contraception being used by women 2-9 months postpartum, CDC analyzed data from the 2004-2006 Pregnancy Risk Assessment Monitoring System (PRAMS) from 12 states and New York City. This report summarizes those results, which indicated that 88.0% of postpartum women reported current use of at least one contraceptive method; 61.7% reported using a method defined as highly effective, 20.0% used a method defined as moderately effective, and 6.4% used less effective methods. Rates of using highly effective contraceptive methods postpartum were lowest among Asian/Pacific Islanders (35.3%), women who had wanted to get pregnant sooner (49.9%), women aged >or=35 years (53.0%), and women who had no prenatal care (54.5%). State policy makers and health-care providers can use these results to promote use of highly effective contraception among postpartum women and target interventions for those with particularly low rates of usage, including women with no prenatal care.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | DATA ANALYSIS | POSTPARTUM WOMEN | ETHNIC GROUPS | CDC | CONTRACEPTIVE USAGE | CONTRACEPTIVE METHODS CHOSEN | CONTRACEPTIVE EFFECTIVENESS | PREGNANCY, UNPLANNED | AGE FACTORS | TITLE 19 MEDICAL ASSISTANCE | Developed Countries | North America | Americas | Research Methodology | Puerperium | Reproduction | Cultural Background | Population Characteristics | Demographic Factors | Population | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Contraception | Family Planning | Reproductive Behavior | Fertility | Population Dynamics | Public Assistance | Grants | Financial Activities | Economic Factors
Document Number: 342395

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Title: Extended cycling or continuous use of hormonal contraceptives for female adolescents.
Author: Gold MA; Duffy K
Source: Current Opinion In Obstetrics and Gynecology. 2009 Jun 12;
Abstract: PURPOSE OF REVIEW: The purpose of this review is to present the most recent data on extended cycling and continuous use of hormonal contraception for female adolescents. RECENT FINDINGS: Since 2003, several new products have been US Food and Drug Administration approved to provide extended cycling or continuous use of hormonal contraception. Clinical trials have been conducted with adult women of 18 years and older and not with adolescents under age of 18 years. Studies find successful menstrual suppression using extended cycling and continuous-use regimens that are safe and effective without negative effects on the endometrium or hemostasis. Extended cycling and continuous use improves menstrual symptoms attributed to the hormone-free interval in traditional cyclic regimens. Adolescent health providers report prescribing extended cycles of contraception with increasing frequency to adolescents. It is unknown how well female adolescents tolerate breakthrough bleeding, but data suggest that bleeding is the main reason for discontinuing. Supplementation with intermittent estrogen or instituting a 4-day hormone-free interval in response to persistent bleeding may decrease this side effect; adolescents should be counseled about these options. SUMMARY: Extended cycling or continuous use of hormonal contraception offers adolescents an opportunity to decrease, delay or suppress monthly menstruation for health or personal reasons.
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | ADOLESCENTS, FEMALE | CONTRACEPTIVE METHODS | HORMONES | ADMINISTRATION AND DOSAGE | MENSTRUATION | PRODUCT APPROVAL | USFDA | COUNSELING | CONTRACEPTIVE SAFETY | CONTRACEPTIVE AGENTS, SIDE EFFECTS | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Endocrine System | Physiology | Biology | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction | Legislation | Political Factors | Sociocultural Factors | USPHS | Government Agencies | Organizations | Clinic Activities | Program Activities | Programs | Organization and Administration | Safety | Public Health | Contraceptive Agents
Document Number: 341708

Title: Confronting the legal risks of prescribing the contraceptive patch with ongoing litigation [letter]
Author: Patsner B
Source: Obstetrics and Gynecology. 2009 Jun;113(6):1367.
Abstract: The valuable commentary by Drs. Phelps and Kelver on potential liability issues for physicians prescribing the Ortho-Evra (norelgestromin/ethinyl estradiol [E2]), Ortho Women's Health & Urology, Raritan, NJ) contraceptive patch1 provides a much-needed start, but only one perspective, on this important and ongoing clinical practice issue. As a food and drug law attorney as well as a former Senior Medical Officer in the Division at the Center for Drug Evaluation and Research at the U.S. Food and Drug Administration (FDA), which handled the original approval of the contraceptive patch as well the ensuing controversy, I would like to provide additional information and a different perspective. None of the major verdicts on the contraceptive patch litigation are in yet. There is likely to be more information, some potentially negative, forthcoming on both FDA and sponsor conduct. There was a great deal of controversy within the FDA itself over whether the controversy was handled correctly, whether the original new drug application should have been approved, how the original data and the data corrections on pharmacokinetics and adverse events were reviewed and rereviewed, whether there was an attempt at "information control" of either FDA errors or unfavorable information about the product, and significant internal disagreements over the general lack of timely cooperation by the FDA with organizations such as the American College of Obstetricians and Gynecologists when the latter urgently requested guidance for its member physicians. The two studies quoted by the authors clearly do not provide a sufficient basis for their claim that "the transdermal patch may be the best choice for many patients who prefer the convenience of a weekly patch." Citing the higher incidence of venous thromboembolism in pregnancy as a possible defense to claims concerning the incidence for the contraceptive patch is largely irrelevant because the comparison in any malpractice action will be with oral contraceptives, not pregnancy.Physicians should be aware that even the best informed consent likely will provide little or no shield if they are sued in a medical malpractice action for prescribing the patch and that significant safety concerns remain for this product, particularly because it has been difficult to predict which women are at greatest risk for early embolic events. Absent an overwhelming reason for prescribing the contraceptive patch, I personally think ob-gyns should steer clear of the product. More importantly, it would have been more instructive for the authors to go to the original new drug application itself (readily accessed although the Center for Drug Evaluation and Research Web site at www.cder.fda.gov) to discuss the original safety data as well as why the approval decision was made, rather than just citing the labeling update or an FDA "Talk Paper." Even a cursory perusal of the original new drug application2 reveals many pages discussing concerns about the potentially higher risk of venous thromboembolism for this product. Because there are no firm FDA "rules" for determining the outcome of the risk-benefit calculus for any new prescription drug product, and because the patch not only did not work "better" than existing oral contraceptives but also had a potentially greater risk, the justification for approving the product was largely because it was a novel delivery system. The fact is that the FDA can and does approve new drug products that are less effective or more dangerous than existing drug products already on the market. All practicing physicians should be aware of this. When drug safety is less of an FDA priority than getting new products to market (as was the case under the Bush administration), the risks to patients will be greater. When the FDA does its job poorly, regulation of big pharma depressingly comes down to the plaintiffs' bar. (full-text)
Language: English
Keywords:
UNITED STATES OF AMERICA | TEXAS | CRITIQUE | USFDA | PRESCRIPTIONS | ETHINYL ESTRADIOL | DRUGS | CONTRACEPTION | PRODUCT APPROVAL | Developed Countries | North America | Americas | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Distributional Activities | Program Activities | Programs | Organization and Administration | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Legislation
Document Number: 341194

Peer Reviewed

Title: Confronting the legal risks of prescribing the contraceptive patch with ongoing litigation.
Author: Phelps JY; Kelver ME
Source: Obstetrics and Gynecology. 2009 Mar;113(3):712-6.
Abstract: Recent changes in U.S. Food and Drug Administration (FDA) labeling and news reports of lawsuits resulting in million-dollar settlements understandably may deter gynecologists from prescribing the transdermal contraceptive patch Ortho Evra (Ortho-McNeil Pharmaceutical, Inc., Titusville, NJ). Gynecologists who, with all good intentions, prescribe an FDA-approved drug such as the contraceptive patch potentially could find themselves liable for an adverse drug reaction. Although much of the current focus by plaintiff attorneys and the news media is on the contraceptive patch, no prescription contraceptive method is without medical risks to the patient or legal risks to the prescribing gynecologist. The purpose of this commentary is to provide an overview of the medical-legal controversies and pitfalls in prescribing the contraceptive patch as well as to outline how gynecologists can avert legal liability by providing proper informed consent. Despite FDA labeling changes and ongoing litigation, with proper informed consent, the contraceptive patch still may be the best choice for many patients who prefer the convenience of a weekly patch over a daily oral contraceptive. Also, regardless of the contraceptive option chosen, the principles of providing and documenting proper informed consent in medical records are applicable not only to providing quality care to patients, but also to protecting the legal interests of the prescribing gynecologist. By documenting proper informed consent in medical records, gynecologists should feel more at ease in prescribing the contraceptive method that best fits their individual patients' needs, even in the presence of ongoing litigation.
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | RECOMMENDATIONS | EVALUATION | PHYSICIANS | LITIGATION | RISK ASSESSMENT | PRESCRIPTIONS | CONTRACEPTIVE AGENTS, FEMALE | ADMINISTRATION AND DOSAGE | USFDA | SIDE EFFECTS | INFORMED CONSENT | RECORDS | Developed Countries | North America | Americas | Health Personnel | Delivery of Health Care | Health | Political Factors | Sociocultural Factors | Distributional Activities | Program Activities | Programs | Organization and Administration | Contraceptive Agents | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | USPHS | Government Agencies | Organizations | Information Processing | Information
Document Number: 330700

Peer Reviewed

Title: Confronting the legal risks of prescribing the contraceptive patch with ongoing litigation.
Author: Phelps JY; Kelver ME
Source: Obstetrics and Gynecology. 2009 Jun;113(6):1367-8.
Abstract: As former Senior Medical Officer in the Division at the Center for Drug Evaluation and Research at the U.S. Food and Drug Administration (FDA), which handled the original approval for Ortho Evra (norelgestromin/ethinyl estradiol [E2], Ortho Women's Health & Urology, Raritan, NJ), Dr. Patsner's insider perspective is informative and a worthwhile contribution. However, we respectfully disagree with his comments that "physicians should be aware that even the best informed consent likely will provide little or no shield if they are sued in a medical malpractice action for prescribing the patch . . ." and that ". . . ob-gyns should steer clear of the product." We stand firm that providing proper informed consent is critical not only to providing quality patient care but also to deterring potential lawsuits against physicians prescribing the contraceptive patch. Additionally, despite litigation, we believe that the contraceptive patch should remain an option for many patients. The two primary causes of action that plaintiff attorneys may pursue against physicians prescribing the contraceptive patch are 1) medical negligence for breaching the standard of care by prescribing the contraceptive patch and 2) failure to provide informed consent by not warning patients of the risks of the contraceptive patch. As long as the contraceptive patch remains U.S. Food and Drug Administration-approved, it will be difficult for plaintiff attorneys to prevail in arguing that a physician breached the standard of care by prescribing the contraceptive patch, unless it was prescribed to a patient with a known contraindication to the contraceptive patch. The vast majority of patients seeking birth control do not have known medical contraindications to the contraceptive patch. The best way to negate the other potential cause of action-failure to provide informed consent-is to provide and document informed consent in the medical records. Once informed consent is documented in the medical records, there is the legal presumption in favor of the physician that the medical records are accurate and that the patient was provided proper informed consent. However, this is a rebuttable presumption, and an injured patient will be given the opportunity to dispute that she was not properly informed of the risks and that she would not have chosen the contraceptive patch as a means of contraception if she had been properly informed of the risks. Nevertheless, the legal presumption remains that the information documented in the medical records is accurate. By documenting proper informed consent in the medical records, physicians should be more comfortable in prescribing the contraceptive method they believe best fits the needs of their patients, regardless of ongoing litigation and controversies surrounding a contraceptive product. (full-text)
Language: English
Keywords:
UNITED STATES OF AMERICA | TEXAS | CRITIQUE | USFDA | PHYSICIANS | PRESCRIPTIONS | CONTRACEPTION | PRODUCT APPROVAL | INFORMED CONSENT | Developed Countries | North America | Americas | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Health Personnel | Delivery of Health Care | Health | Distributional Activities | Program Activities | Programs | Organization and Administration | Family Planning | Legislation | Health Services
Document Number: 341195

Peer Reviewed

Title: Progress in global measles control and mortality reduction, 2000 -- 2006.
Author: MMWR. Morbidity and Mortality Weekly Report
Source: JAMA. Journal of the American Medical Association. 2008 Jan 30;299(4):400-402.
Abstract: The World Health Organization (WHO) and United Nations Children's Fund (UNICEF) comprehensive strategy for measles mortality reduction is focused on 47 priority countries. Components include (1) achieving and maintaining high coverage (greater than 90%) with the first dose of measles vaccine by age 12 months in every district of each priority country through routine immunization services; (2) ensuring that all children receive a second opportunity for measles vaccination; (3) maintaining effective case-based surveillance and monitoring of vaccination coverage; and (4) providing appropriate clinical management, including vitamin A supplementation. In 2005, the World Health Assembly set a goal for global measles control as part of the Global Immunization Vision and Strategy (GIVS): a 90% reduction in measles mortality by 2010, compared with 2000 levels. In January 2007, WHO/UNICEF reported that implementation of measles mortality reduction strategies had reduced measles mortality by 60%, from an estimated 873,000 deaths in 1999 to 345,000 deaths in 2005. This reduction exceeded the goal of 50% measles mortality reduction by 2005 (compared with 1999 levels) that had been set in 2002. This report updates previous reports by detailing (1) measles mortality reduction activities implemented during 2006 and (2) the impact of activities since 2000 on the global burden of measles and progress toward the GIVS mortality reduction goal for 2010. (author's)
Language: English
Keywords:
GLOBAL | TECHNICAL REPORT | WHO | UNICEF | CDC | CHILDREN | MEASLES | PREVENTION AND CONTROL | IMMUNIZATION | MORTALITY DECLINE | GOALS | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | USPHS | Government Agencies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Primary Health Care | Health Services | Delivery of Health Care | Health | Mortality | Population Dynamics | Planning | Organization and Administration
Document Number: 323998

10.

Title: Adverse health conditions and health risk behaviors associated with intimate partner violence - United States, 2005.
Author: United States. Center for Disease Control [CDC]
Source: MMWR. Morbidity and Mortality Weekly Report. 2008 Feb 8;57(5):113-117.
Abstract: Intimate partner violence (IPV) is defined as threatened, attempted, or completed physical or sexual violence or emotional abuse by a current or former intimate partner. IPV can be committed by a spouse, an ex-spouse, a current or former boyfriend or girlfriend, or a dating partner. Each year, IPV results in an estimated 1,200 deaths and 2 million injuries among women and nearly 600,000 injuries among men. In addition to the risk for death and injury, IPV has been associated with certain adverse health conditions and health risk behaviors. To gather additional information regarding the prevalence of IPV and to assess the association between IPV and selected adverse health conditions and health risk behaviors, CDC included IPV-related questions in an optional module of the 2005 Behavioral Risk Factor Surveillance System (BRFSS) survey. This report describes the results of that survey, which indicated that persons who report having experienced IPV during their lifetimes also are more likely to report current adverse health conditions and health risk behaviors. Although a causal link between IPV and adverse health conditions cannot be inferred from these results, they underscore the need for IPV assessment in health-care settings. In addition, the results indicate a need for secondary intervention strategies to address the health-related needs of IPV victims and reduce their risk for subsequent adverse health conditions and health risk behaviors. (excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | SURVEYS | CDC | DOMESTIC VIOLENCE | HEALTH | RISK BEHAVIOR | Developed Countries | North America | Americas | Sampling Studies | Studies | Research Methodology | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Crime | Social Problems | Behavior
Document Number: 324354

11.

Peer Reviewed

Title: An assessment of the relationship between condom labels and HIV-related beliefs and intentions.
Author: Bleakley A; Fishbein M; Holtgrave D
Source: AIDS and Behavior. 2008 May;12(3):452-458.
Abstract: The aim of this article is to examine the impact of the FDA's proposed condom package labeling on HIV-related beliefs about condom effectiveness, on intentions to recommend condoms for friends to use, and intentions to use condoms. Using a nationally representative survey we randomized 1,194 adults ages 18-65 years into one of three condom label conditions: the current label on condom packaging; a label with the proposed FDA language; and a label with CDC language on condom effectiveness. In short, there are no significant differences between the proposed FDA label and the current label on HIV-related beliefs and intentions. In contrast, from an HIV prevention perspective, the CDC condom language appears to offer a better alternative to the current condom label for unmarried populations. (author's)
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | CONDOMS | USFDA | LICENSING | HIV PREVENTION | SAFETY | PACKAGING | LANGUAGE | Developed Countries | North America | Americas | Barrier Methods | Contraceptive Methods | Contraception | Family Planning | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Product Approval | Legislation | HIV Infections | Viral Diseases | Diseases | Public Health | Health | Marketing | Economic Factors | Communication
Document Number: 325902

12.
Title: Abortion surveillance--United States, 2005.
Author: Gamble SB; Strauss LT; Parker WY; Cook DA; Zane SB; Hamdan S
Source: MMWR. Surveillance Summaries. 2008 Nov 28;57(13):1-32.
Abstract: PROBLEM/CONDITION: CDC began abortion surveillance in 1969 to document the number and characteristics of women obtaining legal induced abortions. REPORTING PERIOD COVERED: This report summarizes and describes data voluntarily reported to CDC regarding legal induced abortions obtained in the United States in 2005. DESCRIPTION OF SYSTEM: For each year since 1969, CDC has compiled abortion data by state or area of occurrence. Information is requested each year from all 50 states, New York City, and the District of Columbia. For 2005, data were received from 49 reporting areas: New York City, District of Columbia, and all states except California, Louisiana, and New Hampshire. For the purpose of trends analysis, data were evaluated from the 46 reporting areas that have been consistently reported since 1995. RESULTS: A total of 820,151 legal induced abortions were reported to CDC for 2005 from 49 reporting areas, the abortion ratio (number of abortions per 1,000 live births) was 233, and the abortion rate was 15 per 1,000 women aged 15--44 years. For the 46 reporting areas that have consistently reported since 1995, the abortion rate declined during 1995--2000 but has remained unchanged since 2000. For 2005, the highest percentages of reported abortions were for women who were known to be unmarried (81%), white (53%), and aged <25 years (50%). Of all abortions for which gestational age was reported, 62% were performed at 15 weeks' gestation (3.7% at 16--20 weeks and 1.3% at >/=21 weeks). A total of 35 reporting areas submitted data stating that they performed and enumerated medical (nonsurgical) procedures, making up 9.9% of all known reported procedures from the 45 areas with adequate reporting on type of procedure. In 2004 (the most recent years for which data are available), seven women died as a result of complications from known legal induced abortion. One death was associated with known illegal abortion. INTERPRETATION: For the 46 reporting areas that have consistently reported since 1995, the number of abortions has steadily declined over the previous 10 years. The abortion rate declined from 1995 to 2000, but remained unchanged since 2000. In 2004, as in the previous years, deaths related to legal induced abortions occurred rarely. PUBLIC HEALTH ACTION: Abortion surveillance in the United States continues to provide the data necessary for examining trends in numbers and characteristics of women who obtain legal induced abortions and to increase understanding of this pregnancy outcome. Policymakers and program planners use these data to improve the health and well-being of women and evaluate efforts to prevent unintended pregnancies.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | STATISTICAL STUDIES | WOMEN | ABORTION | CDC | HUMAN GEOGRAPHY | ABORTION RATE | PUBLIC HEALTH | MARITAL STATUS | AGE FACTORS | GESTATIONAL AGE | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Fertility Control, Postconception | Family Planning | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Geography | Social Sciences | Science | Health | Nuptiality | Population Characteristics | Fetus | Pregnancy | Reproduction
Document Number: 329496 Notification

13.

Title: Hormonal contraception: is it worth it?
Author: Hellier S
Source: Nurse Practitioner. 2008 Oct;33(10):37-9.
Abstract: As experience with the injectable progesterone contraceptive depot medroxyprogesterone (DMPA) grows, the benefits and risks of this hormonal contraception relative to the risks of unintended pregnancy and pregnancy-related health problems are being assessed. One of these health problems is bone mineral density loss. The literature is replete with evidence that DMPA lowers bone mineral density (BMD); only one small cross-sectional study did not find a strong association between DMPA use and BMD loss.4,5 This has led to concerns that DMPA-induced bone mineral density loss might lead to long-term risk of fractures. Of particular concern are adolescent women who have not yet attained their peak BMD. (excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | RECOMMENDATIONS | CLINICAL RESEARCH | WOMEN | DEPO-PROVERA | OSTEOPOROSIS | SKELETAL EFFECTS | USFDA | CONTRACEPTIVE AGENTS, SIDE EFFECTS | CONTRACEPTIVE SAFETY | CONTRACEPTION TERMINATION | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Physiology | Biology | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Safety | Public Health | Health
Document Number: 330287

14.

15.

Title: Surveillance for violent deaths - National Violent Death Reporting System, 16 states, 2005.
Author: Karch DL; Lubell KM; Friday J; Patel N; Williams DD
Source: MMWR. Morbidity and Mortality Weekly Report. 2008 Apr 11;57 Suppl 3:1-45.
Abstract: An estimated 50,000 persons die annually in the United States as a result of violence-related injuries. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) regarding violent deaths from 16 U.S. states for 2005. Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics. The reporting period was 2005. NVDRS collects data regarding violent deaths obtained from death certificates, coroner/ medical examiner reports, and law enforcement reports. NVDRS began operation in 2003 with seven states (Alaska, Maryland, Massachusetts, New Jersey, Oregon, South Carolina, and Virginia) participating; six states (Colorado, Georgia, North Carolina, Oklahoma, Rhode Island, and Wisconsin) joined in 2004 and four (California, Kentucky, New Mexico, and Utah) in 2005, for a total of 17 states. This report includes data from 16 states; data from California are not included in this report because NVDRS has been implemented only in a limited number of California cities and counties rather than statewide as in other states. For 2005, a total of 15,495 fatal incidents involving 15,962 violent deaths occurred in the 16 NVDRS states included in this report. The majority (56.1%) of deaths were suicides, followed by homicides and deaths involving legal interventions (29.6%), violent deaths of undetermined intent (13.3%), and unintentional firearm deaths (0.7%). Fatal injury rates varied by sex, race/ethnicity, age group, and method of injury. Rates were substantially higher for males than for females and for American Indians/Alaska Natives (AI/ANs) and blacks than for whites and Hispanics. Rates were highest for persons aged 20-24 years. For method of injury, the three highest rates were reported for firearms, poisonings, and hanging/strangulation/suffocation. Suicides occurred at higher rates among males, AI/ANs, whites, and older persons and most often involved the use of firearms in thehome. Suicides were precipitated primarily by mental illness, intimate partner or physical health problems, or a crisis during the previous 2 weeks. Homicides occurred at higher rates among males and young adult blacks and most often involved the use of firearms in the home or on a street/highway. Homicides were precipitated primarily by an argument over something other than money or property or in conjunction with another crime. Similar variation was reported among the other manners of death and special situations or populations highlighted in this report. This report provides the first detailed summary of data concerning violent deaths collected by NVDRS. The results indicate that deaths resulting from self-inflicted or interpersonal violence occur to a varying extent among males and females of every age group and racial/ethnic population. Key factors affecting rates of violent fatal injuries include sex, age group, method of injury, location of injury, and precipitating circumstances (e.g., mental health and substance abuse). Because additional information might be reported subsequently as participating states update their findings, the data provided in this report are preliminary. Accurate, timely, and comprehensive surveillance data are necessary for the occurrence of violent deaths in the United States to be understood better and ultimately prevented. NVDRS data can be used to track the occurrence of violence-related fatal injuries and assist pub lic health authorities in the development, implementation, and evaluation of programs and policies to reduce and prevent violent deaths and injuries at the national, state, and local levels. The continued development and expansion of NVDRS is essential to CDC's efforts to reduce the personal, familial, and societal costs of violence. Further efforts are needed to increase the number of states using NVDRS, with an ultimate goal of full national representation. (author's)
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | POPULATION | ETHNIC GROUPS | ACCIDENTS AND INJURIES | MORTALITY | CDC | SEX FACTORS | AGE FACTORS | SUICIDE | HOMICIDE | SEASONAL VARIATION | Developed Countries | North America | Americas | Cultural Background | Population Characteristics | Demographic Factors | Health | Population Dynamics | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Crime | Social Problems
Document Number: 326816

16.

Peer Reviewed

Title: The impact of over-the-counter availability of "Plan B" on teens' contraceptive decision making.
Author: Krishnamurti T; Eggers SL; Fischhoff B
Source: Social Science and Medicine. 2008 Aug;67(4):618-27.
Abstract: In ruling on the over-the-counter status (OTC) of the emergency contraceptive, "Plan B", the US Food and Drug Administration (FDA) questioned whether younger adolescent females could adequately self-select and self-medicate. That determination requires a judgment of fact, regarding how increased emergency contraceptive availability would affect adolescents' behavior, and a judgment of values, regarding the acceptability of different outcomes. We present a general approach to such problems, using analytical and empirical methods grounded in behavioral decision research. We illustrate it with findings from 30 in-depth interviews and follow-up surveys, with adolescent females aged 13-19 in the Pittsburgh area reporting how Plan B availability would affect three decisions (having sex, choosing contraceptives, using Plan B). Although the FDA expressed concern about younger teens using Plan B as their primary form of contraception, neither younger nor older teens revealed such an intention. However, teens preferred easier availability, should emergency contraceptive be needed. Incorporating an understanding of teens' decision-related perspectives can make such policies more predictable and transparent.
Language: English
Keywords:
PENNSYLVANIA | RESEARCH REPORT | KAP SURVEYS | ADOLESCENTS, FEMALE | USFDA | PHARMACY DISTRIBUTION | EMERGENCY CONTRACEPTION | CONTRACEPTIVE AVAILABILITY | VALUE ORIENTATION | DECISION MAKING | AGE FACTORS | ATTITUDES | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Adolescents | Youth | Population Characteristics | Demographic Factors | Population | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Contraception | Family Planning | Psychological Factors | Behavior
Document Number: 329264

17.

Peer Reviewed

Title: Risk of hyperkalemia in women taking ethinylestradiol/drospirenone and other oral contraceptives.
Author: Loughlin J; Seeger JD; Eng PM; Foegh M; Clifford CR; Cutone J; Walker AM
Source: Contraception. 2008 Nov;78(5):377-83.
Abstract: BACKGROUND: The oral contraceptive ethinyl estradiol 0.03 mg/drospirenone 3 mg (EE/DRSP) contains a progestin component that possesses potassium-sparing diuretic activity similar to spironolactone. We sought to determine whether EE/DRSP use might lead to adverse effects possibly attributable to hyperkalemia. STUDY DESIGN: This was a matched cohort study in which we identified oral contraceptive (OC) initiators between July 2001 and June 2004 within a large, US health plan. We matched EE/DRSP initiators to other OC initiators in a 1:2 ratio on the basis of a prediction model (propensity score) of EE/DRSP initiation that incorporated dozens of characteristics. We identified insurance claims mentioning hyperkalemia, related clinical outcomes (electrolyte disturbances, arrhythmia, syncope, myocardial infarction) and verified the underlying condition through medical record review. RESULTS: There were 22,429 EE/DRSP initiators matched to 44,858 other OC initiators, with an average follow-up of 7.6 months. A composite clinical surrogate hyperkalemia end point occurred with equal frequency in the compared groups [118 cases in EE/DRSP and 260 in comparators; rate ratio (RR) 0.9, 95% confidence interval (CI) 0.7-1.1]. The individual hyperkalemia surrogate end points exhibited similar results. One EE/DRSP initiator and four comparators were diagnosed specifically with hyperkalemia (RR 0.5, 95% CI 0.0-4.9). The results were not different when we accounted for changes in OC use during follow-up. CONCLUSION: EE/DRSP initiators are no more likely than other OC initiators to experience hyperkalemia or related clinical outcomes which could be caused by hyperkalemia during follow-up.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL RESEARCH | COHORT ANALYSIS | LONGITUDINAL STUDIES | WOMEN | ORAL CONTRACEPTIVES, SIDE EFFECTS | ETHINYL ESTRADIOL | ORAL CONTRACEPTIVES, COMBINED | RISK ASSESSMENT | LOW-DOSE PROGESTINS | HEALTH INSURANCE | HEART DISEASES | SODIUM ION LEVEL | USFDA | Developed Countries | North America | Americas | Research Methodology | Studies | Demographic Factors | Population | Contraceptive Safety | Safety | Public Health | Health | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Contraceptive Methods | Evaluation | Contraceptive Agents, Progestin | Financial Activities | Economic Factors | Diseases | Hemic System | Physiology | Biology | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors
Document Number: 329152

18.
Title: A combined oral contraceptive containing 3-mg drospirenone/ 20-microg ethinyl estradiol in the treatment of acne vulgaris: a randomized, double-blind, placebo-controlled study evaluating lesion counts and participant self-assessment.
Author: Lucky AW; Koltun W; Thiboutot D; Niknian M; Sampson-Landers C; Korner P
Source: Cutis; Cutaneous Medicine For the Practitioner. 2008 Aug;82(2):143-50.
Abstract: This study compared the efficacy of a low-dose combined oral contraceptive (COC) containing 3-mg drospirenone and 20-microg ethinyl estradiol (3-mg DRSP/20-microg EE) administered in a 24-day active pill/4-day inert pill (24/4) regimen and placebo in women with moderate acne vulgaris during 6 treatment cycles. A total of 534 participants were randomized and dispensed study medication (n = 266 [3-mg DRSP/20-microg EE 24/4 regimen COC group]; n = 268 [placebo group]). Women of reproductive age were eligible for inclusion in the study. Treatment with the 3-mg DRSP/20-microg EE 24/4 regimen COC was associated with a greater reduction from baseline to end point in individual lesion counts (papules, pustules, open and closed comedones) compared with placebo. The mean nodule count remained essentially constant throughout the study and was low in both treatment groups. There was a significantly higher probability that a participant had an improved assessment on the investigator's overall improvement rating scale (odds ratio [OR], 4.02; 95% CI [confidence interval], 2.29-7.31; P < .0001) and participant's overall self-assessment rating scale (OR, 2.82; 95% CI, 1.60-5.13; P = .0005) in the 3-mg DRSP/20-microg EE 24/4 regimen COC group than in the placebo group. The COC 3-mg DRSP/20-microg EE 24/4 regimen is a suitable option for women with moderate acne vulgaris who require contraception.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL TRIALS | DOUBLE-BLIND STUDIES | WOMEN | ETHINYL ESTRADIOL | ORAL CONTRACEPTIVES, COMBINED | ACNE | CONTRACEPTIVE AGENTS, SIDE EFFECTS | SELF-PERCEPTION | ADMINISTRATION AND DOSAGE | TREATMENT | USFDA | Developed Countries | North America | Americas | Clinical Research | Research Methodology | Studies | Demographic Factors | Population | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Contraceptive Methods | Dermatitis | Diseases | Perception | Psychological Factors | Behavior | Drugs | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors
Document Number: 328895

19.

Title: Extended- and continuous-cycle oral contraceptives.
Author: Shrader SP; Dickerson LM
Source: Pharmacotherapy. 2008 Aug;28(8):1033-40.
Abstract: Five new oral contraceptives, classified as extended- or continuous-cycle oral contraceptives, have been approved by the United States Food and Drug Administration. These agents have various combinations of estrogen and progestin, and different effects on the length of women's menstrual cycles. Usually they shorten the duration of menses, decrease the frequency of menses to 4 times/year, or completely eliminate menses. These new oral contraceptives are given in the following regimens: 24 days followed by placebo for 4 days (24/4), 84 days followed by placebo for 7 days (84/7), or continuously (without placebo). These agents contain ethinyl estradiol 20 microg-drospirenone 3 mg (24/4); ethinyl estradiol 20 microg-norethindrone 1 mg (24/4); ethinyl estradiol 30 microg-levonorgestrel 150 microg (84/7); ethinyl estradiol 30 microg-levonorgestrel 150 microg (84/7) with very low-dose ethinyl estradiol (10 microg/day) for 7 days; and ethinyl estradiol 20 microg-levonorgestrel 90 microg continuously. Clinical trials have demonstrated that extended- and continuous-cycle oral contraceptives are as effective in preventing pregnancy as traditional oral contraceptives. These new agents also have similar adverse effects; however, the only significantly different adverse effect compared with traditional oral contraceptives in clinical trials was change in bleeding pattern. These oral contraceptives are associated with more breakthrough bleeding and spotting than the traditional pills. Long-term effects on efficacy and safety are not known, as these new products generally have been used for only 1-2 years. Extended- and continuous-cycle oral contraceptives are a new option for women desiring decreased menses or for whom decreased menses may alleviate symptoms of coexisting medical conditions.
Language: English
Keywords:
UNITED STATES OF AMERICA | LITERATURE REVIEW | CLINICAL RESEARCH | WOMEN | ORAL CONTRACEPTIVES, COMBINED | USFDA | PRODUCT APPROVAL | TIME FACTORS | ETHINYL ESTRADIOL | ADMINISTRATION AND DOSAGE | ORAL CONTRACEPTIVES, LOW-DOSE | LEVONORGESTREL | SIDE EFFECTS | CONTRACEPTIVE SAFETY | LONGTERM EFFECTS | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Legislation | Population Dynamics | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Agents, Progestin | Safety | Public Health
Document Number: 329241

20.

Title: Baseline data from the Nyando Integrated Child Health and Education Project -- Kenya, 2007.
Source: MMWR. Morbidity and Mortality Weekly Report. 2007 Oct 22;56:1-4.
Abstract: Approximately 10 million children aged less than 5 years die each year in developing countries. The leading infectious causes of these deaths include acute respiratory infections, diarrhea, measles, and malaria; malnutrition contributes to approximately 50% of these deaths. To address multiple conditions that contribute to mortality, child-survival programs require effective interventions and implementation strategies. To assess the effectiveness of multiple interventions, CDC has joined with partners to create the Nyando Integrated Child Health and Education (NICHE) project to combine several proven approaches to child survival in an impoverished rural district of western Kenya. During March-April 2007, CDC began the NICHE project with a baseline survey. This report summarizes preliminary data from that survey, which determined that 1) 86.1% of surveyed households were in the poorest Kenya socioeconomic quintile and 2) among children aged 6-35 months, 21.5% had experienced an acute respiratory infection and 9.1% had experienced diarrhea in the preceding 24 hours, 28.0% had chronic malnutrition, 66.2% had anemia, and 19.8% had a positive malaria smear. Comprehensive interventions will be needed to improve living conditions and reduce the risk for death before age 5 years among children in this population. (excerpt)
Language: English
Keywords:
KENYA | PROGRESS REPORT | BASELINE SURVEYS | CHILDREN | CHILD SURVIVAL | CHILD HEALTH | INTERVENTIONS | INTEGRATED PROGRAMS | IMPLEMENTATION | CDC | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Survivorship | Length of Life | Mortality | Population Dynamics | Health | Programs | Organization and Administration | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors
Document Number: 321494

22.

Peer Reviewed

Title: Vaccine-derived poliomyelitis in Nigeria.
Source: Lancet. 2007 Oct 20;370(9596):1394.
Abstract: Eradicating poliomyelitis presents many challenges. Financing essential activities can be difficult when donors fail to meet funding targets (a US$60 million funding gap currently exists for the fourth quarter of 2007). Security issues in two of the four polio-endemic countries-Afghanistan and Pakistan-make access to children difficult for immunisation teams. And in Nigeria, low vaccine coverage and an outbreak of disease from vaccine-derived poliovirus (VDPV) could set back global eradication efforts. Over the past 10 years there have been nine outbreaks of poliomyelitis derived from the oral vaccine in nine countries. Nigeria has seen the largest outbreak; 69 children have been paralysed this year. VDPVs are rare but occur when the live virus in an oral polio vaccine mutates and reverts to neurovirulence. This loss of attenuation does not matter so much in populations who are fully immunised with oral vaccine, since they will be protected from wild and vaccine-derived poliovirus, but in Nigeria,where vaccine coverage is 39% (and even lower in some northern states), it is a problem. (excerpt)
Language: English
Keywords:
NIGERIA | UNITED STATES OF AMERICA | CRITIQUE | EVALUATION | CHILDREN | POLICYMAKERS | GOVERNMENT OFFICIALS | POLIO | VACCINES | WHO | CDC | PUBLIC OPINION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Developed Countries | North America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Administrative Personnel | Organization and Administration | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | USPHS | Government Agencies | Attitudes | Psychological Factors | Behavior
Document Number: 321884

23.

Title: Honduras final report, September 1997 - September 2005. USAID's Implementing AIDS Prevention and Care (IMPACT) project.
Author: Family Health International [FHI]. Implementing AIDS Prevention and Care Project [IMPACT]
Source: Arlington, Virginia, FHI, 2007 Aug. 12 p. (USAID Cooperative Agreement No. HRN-A-00-97-00017-00)
Abstract: From the late 1990s until 2005, Family Health International (FHI) helped the Government of Honduras strengthen its AIDS prevention activities. Through the Implementing AIDS Care and Treatment (IMPACT) Project, FHI led initiatives to reduce risk and change behavior; enhance prevention, care, and treatment services; and strengthen monitoring and evaluation systems. IMPACT/Honduras collaborated with the local umbrella nongovernmental organization (NGO) Fundacion Fomento en Salud (FSS), as well as with the Ministry of Health (MOH) and others to coordinate workshops and foster dialogue on HIV/AIDS and policy in Honduras. From 2000 to 2005, IMPACT/Honduras's HIV/AIDS strategic plan project activities reached high-risk populations. In addition, IMPACT/ Honduras helped prepare a bio-behavioral surveillance survey (Bio-BSS) that was to be implemented by the US Centers for Disease Control (CDC). (excerpt)
Language: English
Keywords:
HONDURAS | EVALUATION REPORT | EPIDEMIOLOGIC METHODS | KAP SURVEYS | HEALTH SURVEYS | QUESTIONNAIRE DESIGN | GOVERNMENT AGENCIES | NONGOVERNMENTAL ORGANIZATIONS | TARGET POPULATION | USAID | HIV PREVENTION | AIDS PREVENTION | HEALTH POLICY | RISK ASSESSMENT | CDC | Central America | Latin America | Americas | Developing Countries | Evaluation | Research Methodology | Surveys | Sampling Studies | Studies | Health | Survey Methodology | Organizations | Political Factors | Sociocultural Factors | Program Design | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | AIDS | Policy | USPHS
Document Number: 322034

24.

Title: Emergency contraception. State policies in brief as of January 1, 2007.
Author: Guttmacher Institute
Source: New York, New York, Guttmacher Institute, 2007 Jan 1. [3] p.
Abstract: Emergency contraception--a concentrated dose of the hormone found in many regular birth control pills--can prevent pregnancy when taken shortly after unprotected intercourse; it is most effective when taken within 72 hours. Until recently, Plan B, the only Food and Drug Administration (FDA)-approved product for emergency contraception on the U.S. market, was available only by prescription. On August 24, 2006, the FDA approved Plan B as an over-the-counter medication for those aged 18 and older; it remains a prescription-only drug for minors. Since the late 1990s, state legislatures have taken different paths to expand access to emergency contraception. First, some states have mandated emergency contraception-related services for women who have been sexually assaulted. Second, some states permitted a woman to obtain the medication without having to obtain a physician's prescription; with the FDA's decision, these measures will now apply only to minors. Third, one state has limited pharmacists' ability to refuse to dispense emergency contraception on moral or ethical grounds. Finally, in some states, regulations discourage pharmacists from refusing to fill prescriptions for contraceptives, with one state having gone so far as to require pharmacies that stock contraceptives to dispense all contraceptive methods. At the same time, other states have attempted to restrict access by excluding emergency contraception from state Medicaid family planning eligibility expansions or contraceptive coverage mandates, or by allowing pharmacists and potentially some pharmacies, to refuse to provide contraceptive services. (excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | EMERGENCY CONTRACEPTION | USFDA | PRESCRIPTIONS | LEGISLATION | North America | Americas | Developed Countries | Contraception | Family Planning | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Distributional Activities | Program Activities | Programs | Organization and Administration
Document Number: 310877

25.

Title: Emergency contraception. State policies in brief as of June 1, 2007.
Author: Guttmacher Institute
Source: New York, New York, Guttmacher Institute, 2007 Jun 1. [3] p. (State Policies in Brief)
Abstract: Emergency contraception-a concentrated dose of the hormone found in many regular birth control pills-can prevent pregnancy when taken shortly after unprotected intercourse; it is most effective when taken within 72 hours. Until recently, Plan B, the only Food and Drug Administration (FDA)-approved product for emergency contraception on the U.S. market, was available only by prescription. On August 24, 2006, the FDA approved Plan B as an over-the-counter medication for those aged 18 and older; it remains a prescription-only drug for minors. Since the late 1990s, state legislatures have taken different paths to expand access to emergency contraception. First, some states have mandated emergency contraception-related services for women who have been sexually assaulted. Second, some states permitted a woman to obtain the medication without having to obtain a physician's prescription; with the FDA's decision, these measures will now apply only to minors. Third, one state has limited pharmacists' ability to refuse to dispense emergency contraception on moral or ethical grounds. Finally, in some states, regulations discourage pharmacists from refusing to fill prescriptions for contraceptives, with one state having gone so far as to require pharmacies that stock contraceptives to dispense all contraceptive methods. At the same time, other states have attempted to restrict access by excluding emergency contraception from state Medicaid family planning eligibility expansions or contraceptive coverage mandates, or by allowing pharmacists and potentially some pharmacies, to refuse to provide contraceptive services. (excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | LEGISLATION | EMERGENCY CONTRACEPTION | PRODUCT APPROVAL | USFDA | HEALTH INSURANCE | PROGRAM ACCESSIBILITY | Developed Countries | North America | Americas | Political Factors | Sociocultural Factors | Contraception | Family Planning | USPHS | Government Agencies | Organizations | Financial Activities | Economic Factors | Program Evaluation | Programs | Organization and Administration
Document Number: 318020

26.

Title: Insurance coverage of contraceptives. State policies in brief as of January 1, 2007.
Author: Guttmacher Institute
Source: New York, New York, Guttmacher Institute, 2007 Jan 1. [3] p.
Abstract: While almost all insurance plans cover prescription drugs, many still do not provide coverage for the range of U.S. Food and Drug Administration (FDA)-approved prescription contraceptive drugs and devices. A number of states, however, require insurance policies that cover other prescription drugs to also cover all FDA-approved contraceptive drugs and devices, as well as related medical services. Some of these policies allow employers or insurers to refuse to cover contraceptives on religious or moral grounds. In addition, several states have limited mandates that apply to either specific types of insurers, such as health maintenance organizations (HMOs), or to coverage written for a segment of the insurance market. (Federal law requires insurance coverage of contraceptives for federal employees and their dependents; a few specific religious insurers are exempt from the requirements.) (excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | USFDA | PRESCRIPTIONS | CONTRACEPTION | HEALTH INSURANCE | RELIGION | FAMILY PLANNING PROGRAMS | North America | Americas | Developed Countries | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Distributional Activities | Program Activities | Programs | Organization and Administration | Family Planning | Financial Activities | Economic Factors
Document Number: 310879

27.

Title: Insurance coverage of contraceptives. State policies in brief as of June 1, 2007.
Author: Guttmacher Institute
Source: New York, New York, Guttmacher Institute, 2007 Jun 1. [3] p. (State Policies in Brief)
Abstract: While almost all insurance plans cover prescription drugs, many still do not provide coverage for the range of U.S. Food and Drug Administration(FDA)-approved prescription contraceptive drugs and devices. A number of states, however, require insurance policies that cover other prescription drugs to also cover all FDA-approved contraceptive drugs and devices, as well as related medical services. Some of these policies allow employers or insurers to refuse to cover contraceptives on religious or moral grounds. In addition, several states have limited mandates that apply to either specific types of insurers, such as health maintenance organizations (HMOs), or to coverage written for a segment of the insurance market. (Federal law requires insurance coverage of contraceptives for federal employees and their dependents; a few specific religious insurers are exempt from the requirements.) (excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | LEGISLATION | ORAL CONTRACEPTIVES | EMERGENCY CONTRACEPTION | USFDA | HEALTH INSURANCE | PRODUCT APPROVAL | Developed Countries | North America | Americas | Political Factors | Sociocultural Factors | Contraceptive Methods | Contraception | Family Planning | USPHS | Government Agencies | Organizations | Financial Activities | Economic Factors
Document Number: 318021

28.

Title: Trends in childhood cancer mortality -- United States, 1990 -- 2004.
Author: United States. Center for Disease Control [CDC]
Source: MMWR. Morbidity and Mortality Weekly Report. 2007 Dec;56(48):1257-1261.
Abstract: Cancer is the fourth most common cause of death (after unintentional injury, homicide, and suicide) among persons aged 1-19 years in the United States. Because recent childhood cancer mortality has not been well characterized in terms of temporal, demographic, and geographic trends, CDC analyzed cancer death rates among children (defined as aged 0-14 years) and adolescents (defined as aged 15-19 years) for the period 1990-2004 by sex, age group, race, ethnicity, U.S. Census region, and primary cancer site/leading diagnosis, using the most recent data available from the National Vital Statistics System (NVSS). This report describes the results of that analysis, which indicated that, overall, age-adjusted childhood cancer death rates decreased significantly during 1990-2004 among both sexes, both age groups, all races (except American Indians/Alaska Natives [AI/ANs]), Hispanics, non-Hispanics, and all U.S. Census regions. However, decreases in death rates varied among U.S. Census regions and betweenHispanics and non-Hispanics. Eliminating racial/ethnic health disparities is one of the overarching goals of Healthy People 2010. Further research is needed to understand geographic and ethnic disparities in childhood cancer death rates. Moreover, cancer prevention and intervention measures should be designed to reach populations that are underserved and at high risk. (author's)
Language: English
Keywords:
UNITED STATES OF AMERICA | TECHNICAL REPORT | CDC | CHILDREN | CHILD MORTALITY | CANCER | MORTALITY CHANGES | DEATH RATE | Developed Countries | North America | Americas | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Neoplasms | Diseases
Document Number: 324378

29.

Title: Pharmacy access to emergency contraception in rural and frontier communities.
Author: Bigbee JL; Abood R; Landau SC; Maderas NM; Foster DG
Source: Journal of Rural Health. 2007 Fall;23(4):294-298.
Abstract: Timely access to emergency contraception (EC) has emerged as a major public health effort in the prevention of unintended pregnancies. The recent FDA decision to allow over-the-counter availability of emergency contraception for adult women presents important rural health implications. American women, especially those living in rural and frontier areas, have one of the highest rates of unintended and teen pregnancy among developed countries. This study, conducted prior to the recent FDA ruling, evaluated the participation among California pharmacies in the pharmacy access program in December 2005, specifically comparing rural/frontier and urban pharmacies. The sample consisted of 862 California pharmacies, including 50 in rural/frontier areas, which were randomly selected and surveyed by telephone. The results indicated that similar proportions of rural/frontier pharmacies and urban pharmacies provided direct pharmacy access services (28% vs 22%, P = 0.32). However, of the 13 rural/frontier counties included in the survey, eight (62%) had no emergency contraception pharmacies. The rural/frontier pharmacies that provided emergency contraception services tended to be small, independent pharmacies in the most remote areas of the state. Among rural/frontier pharmacies that did not participate in the program, the primary reasons included lack of training or demand for emergency contraception. Only one rural/frontier pharmacist cited moral or religious opposition to providing emergency contraception. In light of the current limited over-the-counter status of emergency contraception, the role of rural and frontier pharmacies in ensuring access to emergency contraception will increase in the future. (author's)
Language: English
Keywords:
UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | SURVEYS | RURAL POPULATION | WOMEN | PHARMACISTS | PHARMACY DISTRIBUTION | EMERGENCY CONTRACEPTION | COMMUNITY-BASED DISTRIBUTION | CONTRACEPTIVE DISTRIBUTION | USFDA | CONTRACEPTIVE AVAILABILITY | Developed Countries | North America | Americas | Sampling Studies | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Nonclinical Distribution | Distributional Activities |