Knowledge,Attitudes, and Informational Behaviors of College Students in Regard to the Human Papillomavirus

Abstract

Objective: To assess students’ human papillomavirus (HPV) knowledge, attitudes, and behaviors. Participants/ Methods: Students (N = 1,282) at a large, public university in the Northeast United States completed a questionnaire during February 2008 assessing HPV knowledge, prevalence, transmission, cervical cancer risk and stigma; sexual behavior, vaccination status, as well as past and preferred sources of information about HPV and sexual health. Results: A majority of respondents know of HPV. However, understanding was insufficient in several important areas. Overwhelmingly, respondents heard about HPV via television commercials yet preferred to obtain sexual health information from physicians. Hearing about HPV on a TV commercial was associated with increased knowledge. More knowledge of HPV was associated with less stigma. Men exhibit a higher level of stigma and less knowledge than women. Conclusions: Publicly funded health campaigns aimed at increasing knowledge about HPV are overdue and necessary. This is especially true for efforts targeting young adults about this extremely common sexually transmitted infection (STI).     

Is Hba1c level of diabetic patients associated with penile prosthesis implantation infections?

Background and objectives: Diabetes mellitus is an important risk factor for erectile dysfunction (ED). Penile prosthesis implantation surgery is the final solution for diabetic patients with ED, but infections thereof are still a serious risk factor. While some studies suggest that most infections associated with penile prosthesis implantation are associated to high glycated hemoglobin (HbA1c) levels, other research did support such relationship.

Materials and methods: The current study assessed retrospectively, the association between HbA1c level and penile prosthesis surgery infection. We retrieved and reviewed the records of 300 diabetic patients who had penile prosthesis surgery at our Institution (January 2012–November 2016). Patients’ mean age was 55.26?±?10.9 years (31% patients were <50 years of age), and mean HbA1c was 7.60?±?1.90%.

Results: Infection rate among diabetics was 0.67%. Prevalence of prosthesis infection among patients with HbA1c?≤?9% was 0.9%, compared with 0% among patients with HbA1c?>?9%. Prosthesis infection risk did not significantly increase with higher HbA1c levels, with no meaningful difference in the median or mean level of HbA1c in the infected and non-infected diabetic patients.

Conclusion: Findings do not support the use of HbA1c values among diabetic patients who are candidates for penile prosthesis implantation surgery in order to identify and exclude those who might be prone to increased risk of prosthesis infections. Future studies would benefit from larger sample sizes in order to support or refute our findings.     

The Effect of Mixing Events on the Dynamics of pH1N1 Outbreaks at Small Residential Colleges

Abstract

Objective: The authors examine the dynamics and the impact of all-campus events on pH1N1 spread at Bates College in fall 2009, with comparisons to 3 other campuses. Participants: Students (N = 285) presented or called in to the Bates Health Center with symptoms consistent with influenza-like illness. Methods: Health Center staff at Bates collected data on the outbreak; data from other colleges are from Web sites and journal articles. Data were analyzed using a mathematical model for influenza. Results: Bates held 2 vaccine clinics mid-outbreak. The data are consistent with the hypothesis that the vaccine clinics may have altered routine student interactions, facilitating transmission of pH1N1 among students who otherwise might not have encountered each other. Conclusion: The vaccine clinics, held when vaccine became available, were too late to halt transmission. The disruptions to campus rhythms due to the vaccine clinics may instead have contributed to pH1N1 spread.     

College Health Nursing: State of the Art

Abstract

“Mucopurulent Cervicitis—The Ignored Counterpart in Women of Urethritis in Men,” Robert C. Brunham, et al. Among 100 randomly selected nonmenstruating women attending a clinic for sexually transmitted diseases, we assessed objective criteria for the clinical diagnosis of mucopurulent cervicitis. Visualization of yellow mucopurulent endocervical secretions on a white swab and the presence of 10 or more polymorphonuclear leukocytes per microscopical field (at a magnification of 1000) in satisfactory gram-stained endocervical smears were independently correlated with cervical Chlamydia trachomatis infection. Neither finding correlated with gonorrhea or genital herpes, although herpes caused characteristic cervical ulcerations. C. trachomatis was isolated from the cervix of 20 of 40 women with mucopurulent cervicitis but of only 2 of 60 without it. The overall prevalence of mucopurulent cervicitis among women attending the clinic (40 per cent) exceeded that of nongonococcal urethritis among men in the same clinic, and the prevalence of C. trachomatis infection was higher in mucopurulent cervicitis than in nongonococcal urethritis, a condition that is conventionally treated with tetracyclines. These findings support recommendations for the treatment of mucopurulent cervicitis and should guide the selective use of confirmatory diagnostic tests for C. trachomatis infection. (New England Journal of Medicine 1984;311:1–6.)

“Oral Contraceptives, Chlamydia trachomatis Infection, and Pelvic Inflammatory Disease: A Word of Caution About Protection,” A. EUGENE WASHINGTON, et al. Management of pelvic inflammatory disease (PID) and decisions about contraception are being influenced by reports that oral contraceptives decrease the risk of PID. To evaluate the validity of this association, we have examined published epidemiologic evidence and reviewed relevant information from other disciplines. Current information does not permit the generalization that oral contraceptives protect against all forms of PID. Most studies conducted (1) have been limited to hospitalized women, who represent less than 25% of all PID cases and are likely to have relatively severe forms of the disease, and (2) have failed to distinguish between gonococcal and nongonococcal PID. While oral contraceptives may provide some protection against gonococcal PID, no basis exists for assuming similar protection is provided against chlamydial PID. In fact, epidemiologic and biologic evidence suggests that infection with Chlamydia trachomatis, the leading cause of nongonococcal PID, is enhanced by oral contraceptives. We judge the conclusion that oral contraceptives protect against all PID to be premature, and urge caution in its application in health policy and clinical decisions. (Journal of the American Medical Association 1985;253:2246–50.)     

Condom Use Completeness,Perceptions, and Sexual Quality at Most Recent Sexual Event: Results from a U.S. Nationally Representative Probability Sample

Abstract

Objectives: To explore perceptions of condoms associated with complete use and evaluate relationships between condom perceptions, condom use, and sexual quality.

Methods: Using data from a U. S. nationally representative probability sample, we assessed individuals’ condom use perceptions and related characteristics of their most recent sexual event through bivariate and regression analyses (n?=?234).

Results: Most participants reported complete condom use and neutral or positive perceptions of condoms. Though incomplete use was associated with orgasm among women, arousal and pleasure did not differ by gender or duration of condom use.

Conclusions: We found no evidence that delayed application or early condom removal increased sexual arousal or pleasure, which may help sexual health promotion interventions address negative cultural ideas about condoms.     

Risk Factors for Chlamydia Trachomatis Infection in a California Collegiate Population

Abstract

Chlamydia trachomatis infection in college students has not undergone a detailed large-scale evaluation. The authors undertook a cross-sectional study of 4,086 students enrolled on the campuses of California State University, Sacramento, and 3 local community colleges from fall 2000 through spring 2002. They used an outreach screening model to determine the presence of infection by testing urine for chlamydial DNA by polymerase chain reaction. Participants completed demographic and behavioral risk questionnaires and a chlamydia knowledge assessment. Overall, 3.4% of participants tested positive for infection. Screening of male and female students was evenly distributed and incidence rates for males (3.03%) and females (3.78%) were similar. Variables associated with significantly increased risk were younger than 25 years, ethnicity other than White, more than one sexual partner in the preceding year or a new partner in the preceding 2 months, and current symptoms. Innovative outreach programs to screen a majority of at-risk college students should be developed.     

A Novel,Self-guided,Home-Based Intervention to Improve Condom Use Among Young Men Who Have Sex With Men

Abstract

Objective: This pilot study tested the efficacy of a brief, novel, theory-driven, self-guided, home-based intervention designed to promote condom use among young men who have sex with men (YMSM). Participants: Thirty YMSM were recruited from a large public US midwestern university during spring of 2012. Methods: The intervention was tested using a repeated measures design with the primary follow-up assessment occurring 6 weeks after enrollment. Results: Forty-five percent of men reported a reduced frequency of unprotected insertive penile–anal intercourse in the past 30 days compared with baseline (p = .01). Consistency of condom use improved (p = .013), as did motivation to use condoms correctly, condom use self-efficacy, and condom attitudes. All participants indicated that they were glad they participated, would recommend the program, and that overall, they had liked the program. Conclusions: This pilot study supports an expanded trial of this intervention with MSM at high-risk of acquiring human immunodeficiency virus/sexually transmitted infections (HIV/STIs).     

No Fear,Just Relax and Play: Social Anxiety,Alcohol Expectancies,and Drinking Games Among College Students

Abstract

Objective: The authors examined the association between social anxiety and drinking game (DG) involvement as well as the moderating role of social anxiety–relevant alcohol outcome expectancies (AOE) in social anxiety and DG involvement among college students. Participants: Participants were 715 students (74.8% women, M _age = 19.46, SD = 1.22) from 8 US colleges. Methods: Data were collected via self-report survey from Fall 2005 to Spring 2007. Results: Tension Reduction and Liquid Courage AOE moderated the association between social anxiety and DG participation. Tension Reduction AOE and DG participation were positively related among those with high social anxiety, but were associated negatively for those with low social anxiety. Liquid Courage AOE were associated with increased DG participation for those with low social anxiety, but not for those with high social anxiety. Conclusions: Findings suggest that social anxiety acts as a protective or a risk factor for DG participation among college students, depending upon AOE.     

College Women's Experiences with Physically Forced,Alcohol- or Other Drug-Enabled,and Drug-Facilitated Sexual Assault Before and Since Entering College

Objective: Research has shown associations between college women's alcohol and/or drug consumption and the risk of sexual assault, but few studies have measured the various means by which sexual assault is achieved.

Participants: The authors' Campus Sexual Assault Study obtained self-report data from a random sample of undergraduate women (N = 5,446).

Methods: The authors collected data on sexual assault victimization by using a cross-sectional, Web-based survey, and they conducted analyses assessing the role of substance use. The authors also compared victimizations before and during college, and across years of study.

Results: Findings indicate that almost 20% of undergraduate women experienced some type of completed sexual assault since entering college. Most sexual assaults occurred after women voluntarily consumed alcohol, whereas few occurred after women had been given a drug without their knowledge or consent.

Conclusions: The authors discuss implications for campus sexual assault prevention programs, including the need for integrated substance use and sexual victimization prevention programming.     

Exploring the Association Between Dispositional Cancer Worry,Perceived Risk,and Physical Activity Among College Women

Abstract

Objective: In this study, the authors explored the association between dispositional cancer worry (DCW), risk perceptions (RP), and physical activity (PA) among college females. Participants: Four hundred fifty-one females from a midwestern university completed an online survey in September/October 2012. Methods: DCW severity, DCW frequency, RP, and PA were measured along with qualitative data about PA as cancer prevention. Results: Sixty-nine percent of participants did not meet PA recommendations. DCW severity was a significant predictor of meeting PA recommendations (odds ratio = 1.2, 95% confidence interval [1.00, 1.38]; p = .05). Qualitative data revealed a lack of knowledge about breast cancer risk and PA as cancer prevention. Conclusions: College women do not engage in enough PA nor feel at risk for developing breast cancer. A lack of knowledge exists about the cancer prevention benefit of PA. Results indicate a need for PA interventions that both educate breast cancer risk and motivate health protective behaviors.     

Rates of Asymptomatic Nonurethral Gonorrhea and Chlamydia in a Population of University Men Who Have Sex With Men

ABSTRACT

Objective: To evaluate a text message (SMS) program as a booster to an in-person alcohol intervention with mandated college students. Participants: Undergraduates (N = 224; 46% female) who violated an on-campus alcohol policy over a 2-semester period in 2014. Methods: The SMS program sent drinking-related queries each Thursday and Sunday and provided tailored feedback for 6 weeks. Response rates to SMS drinking-related queries and the associations between weekend drinking plans, drinking-limit goal commitment, and alcohol consumption were examined. Gender differences were explored. Results: Ninety percent of SMS queries were completed. Weekend binge drinking decreased over 6 weeks, and drinking-limit goal commitment was associated with less alcohol consumption. Compared with women, men had greater reductions in alcohol consumption when they committed to a drinking-limit goal. Conclusions: Preliminary evidence suggests that an SMS program could be useful as a booster for helping mandated students reduce weekend binge drinking.     

Psychotropic Drug Use Among College Students: Patterns of Use,Misuse, and Medical Monitoring

Abstract

Objective: To assess whether college students who use psychotropic drugs are (1) aware of potential side effects, (2) appropriately monitored by prescribing physicians, and (3) taking medications as prescribed. Participants: Fifty-five college students, currently taking psychotropic medications, were recruited between Summer 2008 and Fall 2009. Methods: Participants were given interviews assessing (1) interactions with prescribing physicians, (2) patterns of psychotropic drug use, and (3) Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) substance use disorders. Results: Twenty-five percent of participants did not remember being assessed for suicidal ideation. A large number of participants took their medications in different quantities or frequencies than prescribed and 35% of participants met DSM criteria for substance dependence. Conclusions: Many students are misusing psychotropic medications and this misuse is not being communicated with prescribing physicians.     

Reacting to the Uncooperative,Severely Disturbed Student: A Survey of Health Center Policies

Abstract

All members of the Pacific Coast College Health Association were surveyed to determine their policies for evaluating and restricting the attendance of severely disturbed students who were not cooperative with mental health intervention.

One hundred of the 135 institutions returned questionnaires. Fifty-eight percent of the respondents reported that they medically exclude or otherwise restrict students due to their emotional condition. Privately funded schools were more likely to restrict than were tax supported schools. The more residential the campus, the more probable the students were to be restricted. The mean number of students excluded during one academic year was 3.15 (range = 0–25). Despite general recognition of the difficulties involved in responding to uncooperative, severely disturbed students, only 7% of the restrictive schools had written policies which detailed the procedures to be followed when considering restricting students for mental health reasons.

The need to develop clear procedures which respond to the needs of the students as well as the institutions was emphasized.

“Acquired Immune Deficiency in Haitians: Opportunistic Infections in Previously Healthy Haitian Immigrants,” JEFFREY VIEIRA, et al. We describe acquired immune deficiency manifested by opportunistic infections in 10 previously healthy heterosexual Haitian men. The opportunistic pathogens included Toxoplasma gondii (in four patients), Cryptococcus neoformans (in one), Pneumocystis carinii (in four patients), and Candida albicans (in three). Six of the patients also had Mycobacterium tuberculosis. Immunologic studies of three patients showed a decrease in the numbers and activity of helper T cells, with normal or increased populations of supporessor T cells. Serologic markers for previous infections from hepatitis A, cytomegalovirus, and herpes simplex virus were detected in several patients. Six of the patients died despite specific antimicrobial therapy. The clinical and immunologic findings in these 10 Haitians are similar to those reported in drug addicts and homosexuals with the acquired immune-deficiency syndrome.     

Antibiotic Resistance in Urinary Tract Infections in College Students

Abstract

Objective: To determine resistance to antibiotics of Escherichia coli in uncomplicated urinary tract infections (uUTIs) in female college students. Participants: Symptomatic patients presenting to a student health service from September 2008 to December 2009. Methods: Clean catch midstream urine samples were tested for urinalysis (UA) and culture and sensitivity. Results: Of 168 students enrolled in the study, 138 had positive UA, and 94 of these grew >100,000 colonies/mL of E. coli. Ampicillin resistance was 31.9%, trimethoprim-sulfamethoxazole (TMP-SMX) resistance 16.0%, ciprofloxacin resistance 4.3%, amoxicillin/clavulanate resistance 3.2%, and nitrofurantoin resistance 1.1%. The sensitivity of UA was 95.4% and the positive predictive value was 87.0% (p ≤ .001). Specificity was 77.5% and negative predictive value 92.9%. Conclusions: In healthy college women with uUTI symptoms, TMP-SMX should not be universally used for empirical therapy, whereas use of ciprofloxacin, amoxicillin/clavulanate, and nitrofurantoin are appropriate.     

Social influences on use of cigarettes,e-cigarettes,and hookah by college students

ABSTRACT

Objectives: (1) Compare social norms and perceived peer use between college student cigarette, e-cigarette, and/or hookah users and nonusers; and (2) determine variables associated with social influences. Participants: Undergraduate students attending a large university in the Southeast United States (N = 511). Methods: An April 2013 online survey assessed use of 3 types of tobacco, social norms, perception of peer use, number of smokers in life, exposure to secondhand smoke, and demographic characteristics. Results: Participants indicated greater acceptance of emerging tobacco products than for cigarettes and consistently overestimated the percent of peers who use various tobacco products. Males and current users had higher social norm scores for all 3 forms of tobacco. Conclusion: To counter marketing of alternative tobacco products, education about the dangers of their use needs to be implemented across college campuses as part of a comprehensive tobacco control strategy that also includes tobacco-free campus policies.     

Efficacy of a Web-Based,Tailored, Alcohol Prevention/Intervention Program for College Students: Initial Findings

Abstract

Objective: Reduce college student at-risk drinking (ARD) using a Web-based brief motivational alcohol prevention/intervention called Michigan Prevention and Alcohol Safety for Students (M-PASS). Participants: Participants included 1,137 randomly sampled first-year college students, including 59% female, 80% white, and averaged age 18.1 years. Methods: Intervention group participants (n = 616) attended 4 online M-PASS sessions, receiving feedback tailored to individual drinking patterns and concepts from 4 behavior change theories. Control group participants (n = 521) completed a mid-phase survey, and both groups were surveyed at baseline and posttest. Results: Evidence of M-PASS's efficacy was found. The intervention was associated with advanced stage of change, lower tolerance of drinking and drink/driving, fewer reasons to drink, and use of more strategies to avoid ARD. Preliminary evidence of behavioral change was also found. Efficacy was greater for women than men. Conclusions: Web-based programs may be useful in reducing alcohol-related risk among college students. Further evaluation is needed.     

Attention-deficit/hyperactivity disorder–specific stimulant misuse,mood, anxiety,and stress in college-age women at high risk for or with eating disorders

ABSTRACT

Objective: To examine the misuse of attention-deficit/hyperactivity disorder (ADHD)-specific stimulants in a college population at high risk for or with clinical or subclinical eating disorders. Participants: Four hundred forty-eight college-age women aged 18–25 at high risk for or with a clinical or subclinical eating disorder. Methods: Participants completed assessments of stimulant misuse and psychopathology from September 2009 to June 2010. Results: Greater eating disorder pathology, objective binge eating, purging, eating disorder–related clinical impairment, depressive symptoms, perceived stress, and trait anxiety were associated with an increased likelihood of stimulant misuse. Subjective binge eating, excessive exercise, and dietary restraint were not associated with stimulant misuse. Conclusions: ADHD-specific stimulant misuse is associated with eating disorder and comorbid pathology among individuals at high risk for or with clinical or subclinical eating disorders. Screening for stimulant misuse and eating disorder pathology may improve identification of college-age women who may be engaging in maladaptive behaviors and inform prevention efforts.     

The Nurse Practitioner: History,Current Conflicts,and Future Survival

Abstract

“A Community-Based Outbreak of Infection With Penicillin-Resistant Neisseria Gonorrhoeae Not Producing Penicillinase (Chromosomally Mediated Resistance),” HAWAZIN FARUKI, et al. From February through November of 1983, 199 cases of penicillin-resistant Neisseria gonorrhoeae infection were identified in a localized epidemic in Durham, North Carolina. The isolates did not produce beta-lactamase but were usually resistant to penicillin (minimum inhibitory concentration, 2.0 to 4.0 μg per milliliter), and 15 of 16 patients treated with 4.8 million units of penicillin G procaine plus 1.0g of probenecid did not respond to therapy. Recognition of the outbreak was impeded by a lack of routine surveillance for resistance other than that mediated by beta-lactamase. All epidemic isolates had a single serotype, auxotype, and antibiotic-susceptibility profile. The outbreak was halted by changing the treatment for all patients and their contacts to spectinomycin, and by intensive epidemiologic case-finding efforts. The emergence of such resistant strains poses potential major public health problems and indicates a need for reassessment of current surveillance procedures. (New England Journal of Medicine 1985;313:607–11.)

“Primary Tubal Infertility in Relation to the Use of an Intrauterine Device,” JANET R. DALING, et al. Women who use an intrauterine device (IUD) are at increased risk of acute pelvic inflammatory disease, but the relation of the IUD to subsequent infertility is not established. We interviewed 159 nulligravid women with tubal infertility to determine their prior use of an IUD. Their reponses were compared with those of a matched group who conceived their first child at the time the infertile women started trying to become pregnant. The risk of primary tubal infertility in women who had ever used an IUD was 2.6 times that in women who had never used one (95 per cent confidence interval, 1.3 to 5.2). The observed difference between cases and controls was not uniform for different types of IUD. The relative risk associated with use of a Dalkon Shield was 6.8 (1.8 to 25.2), and that associated with use of either a Lippes Loop or Saf-T-Coil IUD was 3.2 (0.9 to 12.0). The smallest elevation in risk was found among users of copper-containing IUDs (relative risk, 1.9 [0.9 to 4.0] for all women who had ever used a copper-containing IUD). The relative risk for women who used only a copper-containing IUD was 1.3 (0.6 to 3.0).

We conclude that use of the Dalkon Shield (and possibly of plastic IUDs other than those that contain copper) can lead to infertility in nulligravid women. (New England Journal of Medicine 1985;312:937–41.)     

An Exploration of Violence Among Homeless Women with Emotional Disabilities

Abstract

This research found a high incidence of violence among homeless women with emotional disabilities. The study reports that 82 percent of the homeless women with emotional disabilities had a history of violence in their lives. The most common form of violence was physical; the least common was sexual abuse. The practice and policy implications for these findings are discussed. It is suggested that the Olmstead v. L. C. (1998) ruling under the Americans With Disabilities Act might force states to provide better services to homeless women with a history of violence and emotional disabilities.     

Proceedings of the Fifty-Eighth Annual Meeting of the American College Health Association San Diego,California, 1980

Abstract

Objective: The objective of this study was to assess dietary intakes and eating habits of female college athletes and compared them with the minimum sports nutrition standards. Participants: Data were obtained from 52 female college athletes from a National Collegiate Athletic Association (NCAA) Division I university between January 2009 and May 2010. Methods: Participants completed anthropometric measurements and dietary assessment using a 3-day food record, a 24-hour recall, and a nutrition questionnaire. Results: t tests indicated the energy and carbohydrate intakes were below the minimum recommended amount (p < .001), with only 9% of the participants meeting their energy needs. Seventy-five percent of the participants failed to consume the minimum amount of carbohydrates that is required to support training. The majority of the participants reported no regular breakfast, 36% consumed < 5 meals/day, and only 16% monitored their hydration status. Conclusions: Effective nutrition interventions are needed to improve dietary intakes and eating habits of female college athletes.