Gonococcal Perihepatitis: Diagnosis and Management in a College Population

Abstract

Although gonococcal perihepatitis is not a common clinical problem, it should be in the differential diagnosis of patients who present with right upper quadrant pain and a subsequent positive gonorrhea culture. With the increasing incidence of venereal disease, more cases of gonococcal perihepatitis are anticipated, and an awareness of its protean manifestations should be known and considered by all health care providers. This is especially true for physicians treating college students, as the sequelae of pelvic infection can be severe tissue injury to the reproductive organs with resultant involuntary infertility.

This paper presents three cases of diagnosed gonococcal perihepatitis in a college population with a complete literature review of this disease entity.     

College Health as a Partner in the Care of Pediatric Cancer Survivors

Abstract

Objective: This study reviews an initiative to educate providers on pediatric cancer survivor care and to establish a cancer survivor registry in a college health center. Participants: Participants were University of Georgia (UGA) college health providers. Methods: Providers attended lectures on survivor care and were encouraged to register on Cancer SurvivorLink. Changes in provider familiarity and practice were measured using baseline and follow-up surveys. A survivor registry was created using health entrance forms and medical records abstraction. Results: Twenty-four providers registered on SurvivorLink, and 16 completed both surveys. Familiarity with survivor care (p = .003) and a survivor health care plan (p = .016) increased. Likelihood to deliver survivor care increased (p = .01). UGA follows 95 survivors; 71 diagnosed at < 21 years. Among survivors diagnosed at < 21 years, 91% reported their diagnosis on entrance forms. Conclusions: Through education and optimization of health informatics, college health centers can identify and provide survivor care to this medically vulnerable population.     

Abstracts of the Scientific Programs of the American College Health Association Fifty-Seventh Annual Meeting May 22-25, 1979, Washington,D.C.

Abstract

This article focuses on a therapeutic approach to help women deal with the feelings of grief and guilt they may feel as a result of a voluntary termination of a pregnancy. Available medical and psychological literature indicates that, from a public health perspective, significant psychological problems related to an abortion are “minuscule.” Several women the author saw during the 1992/93 academic year who considered themselves to be extremely religious and prolife had undergone elective abortion. They experienced tremendous guilt and grief 4 to 6 months after the procedure. The author recommends that college health center medical and counseling providers who must deal with this issue help the woman validate her loss by revisiting the site of her abortion to reflect upon the experience and to hold a Gestalt dialogue with the fetus to end the relationship. The provider or someone else should accompany the woman to the site because of the increasing potentiality for violence on the part of prolife protesters.     

College students with congenital heart disease: A critical time for transition

As medical and surgical advances improve, more young adults with congenital heart disease (CHD) are attending college. This case study illustrates some of the issues that these young adults may face as they attend college and discusses the role that college health practitioners can play in easing that transition. Participants: A case of a male with CHD presenting to the college health clinic with a new onset headache. Methods: The authors discuss some of the unique challenges that college health practitioners may face when caring for students with CHD. In addition, they make recommendations on how best to care for these patients and how best to coordinate care with CHD students other care providers. Results: This student with a history of coarctation of the aorta presented with new onset headaches and was found to have high blood pressure. He was diagnosed with recurrent coarctation, underwent percutaneous treatment with stenting and quickly resumed classes. Conclusions: As more students with CHD enter college, college health providers will need to understand some of the health risks that CHD students face. In addition, understanding some of the optimal ways to coordinate care with CHD providers can ease the transition that CHD students face as they enter college.     

Barriers to substance use disorder treatment in a sub-acute setting

ABSTRACT

With the changing times, it is essential integrate behavioral health within the primary care of patients. The need is based on the research that links a number of health issues being directly to substance use and mental health diagnosis. With the current opioid epidemic there is a need to address substance use disorders when treating patients in different health care settings. Despite the necessity of integrated care, there are barriers to addressing addiction in sub-acute care settings. With the lack of buy-in from the patients and health care providers and the stigma surrounding addiction it is time to address the barriers that prevents integration of care where it is most needed.     

Gender Preference toward Providers of Genital Examinations and Frequency of Genital Self-Examination among College Students

Abstract

Both male and female students who utilize Brandeis University Health Services for primary care were assessed regarding their preference as to the gender of providers of genital examinations, together with the frequency with which each sex and academic class performs genital self-examinations, during a two-month period of the 1981 Spring Semester, using a brief self-administered questionnaire.

Among 234 undergraduate and graduate student men and women who returned questionnaires, women and men preferred to be examinated by same-sex examiners; less than half of the women and nearly none of the men would want a chaperone present during the examination, even when the examiner is not the same gender. An increasing percentage of these young women perform breast examinations as they get older, but there is no comparable rise in testicular self-examinations with increasing age among the men. It is important for physicians who care for adolescents and young adults in university health services to provide access to same-gender health care providers when genital exams are done. It is also important to educate men about testicular examinations, just as women are educated about breast examinations.     

Culturally-Protective Health Practices

ABSTRACT

Everyday pregnancy care may play an important role in explaining why Mexican immigrant women have positive birth outcomes despite relatively low incomes, low formal education levels, and lack of access to medical care. The paper is based on findings from a qualitative study utilizing in-depth ethnographically-in-formed interviews with 41 Mexican immigrant women in Chicago who had recently given birth. Results indicate that everyday pregnancy care guides maternal behaviors in pregnancy and has important effects on birth weight. Implications for the design of prenatal health care and social services for immigrant women are discussed.     

Urban college student self-report of hookah use with health care providers

Objective: This study's purpose was to describe urban college students’ communication about hookah with health care providers. Participants: Participants included a random sample of undergraduate urban college students and health care providers. Methods: Students surveyed determined the epidemiology of hookah use in this population, how many health care providers asked about hookah, and how many students admitted hookah use to a physician. Results: Of 375 students surveyed, 78 (20.8%) had never tried it, 284 (75.7%) had smoked hookah at least once, and 64 students (22.6%) were classified as frequent hookah smokers. Only 15 (4.7%) reported a health care provider asking about hookah during visits, whereas 36 (12.7%) admitted their hookah use to a health care provider. Conclusion: Hookah use was found to be highly prevalent among students in one urban university. This study supports the hypothesis that few health care providers broach the topic with patients. Additional research on health consequences of hookah use, education, and improved screening is warranted.     

A Qualitative Analysis of College Women's Leaving Processes in Abusive Relationships

Abstract

Objective: This study assessed the process of leaving an abusive dating relationship utilizing a qualitative design. Methods: Participants included 123 college women in abusive dating relationships who participated at the beginning and end of a 10-week academic quarter. Results: Qualitative content analyses were used to analyze the transcribed responses to an open-ended question about women's leaving processes over the interim period. A variety of categories and themes emerged for women in different stages of the leaving process, consistent with the Transtheoretical Model of Change and Investment Model. Data also underscored women's lack of acknowledgment, minimization, and normalization of abuse. Conclusions: These data demonstrate the importance of dating violence intervention and prevention programming on college campuses and offer information that may be useful to college health providers who assist women in abusive dating relationships.     

College Health Service and the Fast-Food Value System

Abstract

Objective: To estimate and compare the prevalence of overweight and obesity among self-identified lesbian, bisexual, and heterosexual college age women. Methods: A secondary analysis of the Spring 2006 National College Health Assessment was conducted with 31,500 female college students (aged 18 to 25 years) to compare body mass index (calculated from self-reported height and weight) among lesbian, bisexual and heterosexual college women. Results: Compared to heterosexuals female college students, lesbians and bisexual women were both significantly more likely to be overweight or obese. Lesbians were also less likely to be underweight compared to heterosexual college women. Conclusions: Self-identified lesbian and bisexual college women were more likely to be overweight or obese than their heterosexual counterparts. Health care professionals and educators should target these high-risk populations for obesity prevention programs. This study highlights the need for additional research examining the potential risk factors for overweight and obesity among young sexual minority women.     

Primary Care Screening of Depression and Treatment Engagement in a University Health Center: A Retrospective Analysis

Abstract

Objectives: This retrospective study analyzed a primary care depression screening initiative in a large urban university health center. Depression detection, treatment status, and engagement data are presented. Participants: Participants were 3,713 graduate and undergraduate students who presented consecutively for primary care services between January and April 2006. Methods: A standardized 2-tiered screening approach for an inception cohort of students utilizing primary services. Primary care providers were trained to triage students with depressive symptoms. Results: Six percent of participants had clinically significant depressive symptoms (CSD). Severe depressive symptoms were found in less than 1.0% of participants. Male rates of severe depressive symptoms were more than double that of females. Only 35.7% of untreated depressed participants started treatment within 30 days following identification. Conclusions: Systematic primary care depression screening in a college health center is a promising approach to identify untreated students with depression. More study is needed to improve rates of treatment engagement.     

Variations in Provider Capacity to Offer Accessible Health Care for People with Disabilities

Abstract

Since social workers are likely to practice in a range of health care settings, their training focusing on human behavior in the social environment could help providers develop strategies to improve access to care for people with disabilities. In this article, results from a comprehensive survey of providers about access to health care for people with a broad range of disabilities are reported. Results suggest that a minority of providers report difficulty serving people with disabilities. However, dentists and mental health/substance abuse providers are significantly less likely than other providers to report that they provide accessible services to individuals with disabilities. These providers are less likely to report having had training related to mobility impairments, providing mirrors at their facility, having an accessible door, or providing assistance with personal care needs, and are more likely to report that their building poses a barrier for people with disabilities. Social workers are well positioned to take a leadership role in working with providers and patients to improve access to health care for people with disabilities. A social work framework of understanding the individual in a social environment may be the most appropriate perspective for creating innovative strategies for addressing the complex, multidimensional needs of people with disabilities who experience limited access to care.     

Intimate partner violence,trauma, and mental health need among female community college students

ABSTRACT

Objective: The impact of interpersonal violence on college students has received considerable attention, yet no studies have been conducted among community college students, who comprise 40% of all American college students, and have unique risk factors and needs. Community College students are more likely to be women, people of color, working, parenting, and first generation college students. Participants: Data were collected from a simple random sample from four community colleges (n=435). Methods: A cross-sectional quantitative survey was used to assess the extent of intimate partner violence, trauma exposure, sexual violence, and associated mental health consequences among female students. Results: Over 27% of participants reported IPV in the past year, while 25% reported sexual assault and 34% reported other uncomfortable sexual experiences in their lifetime. Nearly 20%of participants were currently reporting PTSD symptoms. Conclusions: Community Colleges should work with service providers to build their capacity to respond to students' needs.     

Health Status and Pregnancy Outcome in Patients Attending Prenatal Care

ABSTRACT

Maternal mortality tends to be ignored as a major public health problem. In addition to a high number of deaths, women also suffer from long-term disabilities related to complications of pregnancy and childbirth. Most of these deaths occur in developing countries and are complicated by living in rural areas, having a lack of resources and a lack of untrained individuals to assist with the pregnancy and delivery. The advantages of prenatal care in preventing complications and death are discussed.     

Smoking among New England College Men and Women

Abstract

Smoking behavior was examined among college students at 34 New England colleges. Women were more often smokers (44%) than men (32%) and were also more likely to smoke daily than men (23 vs. 16%). Men in private colleges were significantly less likely to smoke (22%) than those in public colleges (26%). At both public and private colleges, women were more likely to smoke than men. Smoking was inversely related to health habits for both men and women.

The percentage of college women who smoked is similar to that reported for the general population, while that for men is less. Prevention programs should be targeted to girls in the primary and secondary grades, as well as to college women, and support for smoking cessation should be made available on college campuses.     

Screening and Brief Intervention for Tobacco Use by Student Health Providers on College Campuses

Abstract

Objective: This study assessed college students’ reports of tobacco screening and brief intervention by student health center providers. Participants: Participants were 3,800 students from 8 universities in North Carolina. Methods: Web-based survey of a stratified random sample of undergraduates. Results: Fifty-three percent reported ever visiting their student health center. Of those, 62% reported being screened for tobacco use. Logistic regression revealed screening was higher among females and smokers, compared to nonsmokers. Among students who were screened and who reported tobacco use, 50% reported being advised to quit or reduce use. Brief intervention was more likely among current daily smokers compared to current nondaily smokers, as well as at schools with higher smoking rates. Screening and brief intervention were more likely at schools with lower clinic caseloads. Conclusions: Results highlight the need to encourage college health providers to screen every patient at every visit and to provide brief intervention for tobacco users.     

Student Bodies,Past and Present

Abstract

This article examines how the field of college health has evolved over time to address the needs of an increasingly diverse student population. The central argument is that college and university health programs developed in conjunction with shifting standards of medical care and public health practices in the United States. The author reviews the role of college health programs as public health agencies for campus communities, and describes contemporary public health challenges facing college campuses. She shows how the history of college health is intertwined with the history of diversity in higher education. In particular, the author outlines how the growth of health services made higher education accessible to women, racial minorities, veterans, and persons with disabilities.     

Relationship of Interpersonal Behaviors and Health-Related Control Appraisals to Patient Satisfaction and Compliance in a University Health Center

Objective: The authors' aim was to evaluate patient-provider relationships in a college health center. Participants: Eighty student patients and their health-care providers. Methods: Patients completed a measure of perceived health competence before a consultation and measures of provider participatory behavior and interpersonal behavior before and after the consultation. They evaluated their satisfaction with care and compliance after the consultation and again 2 weeks later. Providers completed measures of their participatory behavior and patients' interpersonal behavior after the consultation. Results: Patients preferred to be well informed and to have their preferences taken into account, and generally felt competent at managing their own health affairs. They indicated they obtained the high level of participation they desired. Patients desired and actually experienced friendly and submissive providers. Degree of match between patients' desired and actual level of involvement in their care was associated with greater satisfaction. A greater match between the extent to which they desired the provider to be affiliative and the provider's actual affiliative behavior was associated with more satisfaction. No variables were predictive of patient compliance. Conclusion: The authors discuss results in terms of the influence of situational factors characteristic of a college health center.     

A Perilous Paradox: The Contraceptive Behavior of College Students

Abstract

Currently, college students live in a social environment where contraceptive technology is highly effective, contraceptive information and methods are widely available, and premarital sexual activity is generally condoned. Paradoxically, data indicate that these students are poor contraceptive users, and that pregnancy and abortion rates among college students are surprisingly high. Since these social conditions should result in adequate contraceptive usage, other less obvious and overtly less rational factors must be influencing the behavior of this population.

The objectives of this article are to a) describe more fully the paradoxical nature of the problem of contraceptive use among college students, in part by a review of the research on collegiate contraceptive and sexual behavior; b) examine theories which have been offered to explain contraceptive behavior in college populations; and c) discuss implications of existing data and theories for the contraceptive education of young adults. This is a topic which has been relatively neglected as attention has been focused on the sexual and reproductive behavior of younger adolescents. It is also an area where professionals have failed to incorporate the implications of theory and research to the actual delivery of contraceptive health services.