Medication Abortion Within a Student Health Care Clinic: A Review of the First 46 Consecutive Cases

Abstract

Objective: Medication abortion with mifepristone and misoprostol has been available in the United States since 2000. The authors reviewed the first 46 medication abortion cases conducted at a university-based student health care clinic to determine the safety and feasibility of medication abortion in this type of clinical setting. Participants: Female patients presenting for medication abortion at a student health care clinic between October 1, 2006, and April 1, 2009. Methods: Retrospective consecutive case review. Results: Successful completion not requiring uterine aspiration occurred in 85% of the cases that were not lost to follow-up. Six cases (15%) required uterine aspiration for completion: 3 underwent uterine aspiration only; 3 had aspiration after failing an additional dose of misoprostol. Only 1 patient visited the emergency room. There were no hospitalizations. Conclusions: Medication abortion services in a student health care clinic are safe and feasible. However, additional treatment may be required with some patients.     

Trial and Lifetime Smoking Risks Among African American College Students

Abstract

The authors surveyed 614 African American university students to determine the magnitude of cigarette use, identify risk factors, and develop models to predict smoking. More than half (58.3%) of the participants had smoked at least once, and 9.3% of that group were lifetime smokers. Among the lifetime smokers, 71.3% had smoked during the 30 days preceding the survey. More women (66.8%) than men (56.1%) had tried smoking and were classed as lifetime smokers. Residence, parental, and peer smoking (current and childhood) were associated with trying smoking; age, race/ethnicity, and marital status were additional factors for becoming a lifetime smoker. The risk of being a lifetime smoker was reduced when neither friends nor parents of the student smoked and the student viewed spirituality as important. The results of this study add to the growing understanding of health risk behaviors among African Americans and can be useful in reducing smoking.     

Man Up Monday: An integrated public health approach to increase sexually transmitted infection awareness and testing among male students at a midwest university

ABSTRACT

Objective: This campaign sought to (a) increase awareness of sexual health and chlamydia testing; (b) motivate students, particularly sexually active men who do not pursue regular sexually transmitted infection (STI) testing, to get tested; and (c) improve the capacity of the student health center to provide free chlamydia testing and treatment for all students. Participants: Students enrolled at a 4-year public research university (N = 333). Methods: Collaborative partnerships formed the foundation of a campus marketing and testing campaign, with treatment for students testing positive for chlamydia. Results: A total of 333 students were tested over 5 consecutive Mondays, showing a chlamydia incidence of 9.6%. The incidence for females and males were 8.6% and 10.8%, respectively. Conclusions: The campaign was effective in reaching men, an at-risk population not traditionally emphasized in STI testing.     

Five-year all-cause mortality rates across five categories of substantiated elder abuse occurring in the community

ABSTRACT

Elder abuse increases the likelihood of early mortality, but little is known regarding which types of abuse may be resulting in the greatest mortality risk. This study included N = 1,670 cases of substantiated elder abuse and estimated the 5-year all-cause mortality for five types of elder abuse (caregiver neglect, physical abuse, emotional abuse, financial exploitation, and polyvictimization). Statistically significant differences in 5-year mortality risks were found between abuse types and across gender. Caregiver neglect and financial exploitation had the lowest survival rates, underscoring the value of considering the long-term consequences associated with different forms of abuse. Likewise, mortality differences between genders and abuse types indicate the need to consider this interaction in elder abuse case investigations and responses. Further mortality studies are needed in this population to better understand these patterns and implications for public health and clinical management of community-dwelling elder abuse victims.     

The International Migration of Nurses in Long-Term Care

This article describes five major factors that are affecting patterns of international migration among nurses who work in long-term care settings:

• Demographic drivers–The aging of the populations in developed countries and the low to negative growth in the working-age population will increase the demand for international workers to provide long-term care services.

• Gender and race–A dual labor market of long-term care workers, increasingly made up of women of color, is becoming internationalized by the employment of migrating nurses from developing countries.

• Credentialing–The process of credentialing skilled workers creates barriers to entry for migrating nurses and leads to “decredentialing” where registered nurses work as licensed practical nurses or aides.

• Colonial history and geography–The colonial histories of many European countries and the United States have increased migration from former colonies in developing countries to former colonial powers.

• Worker recruitment–Efforts to limit the recruitment of health care workers from some developing countries have had little effect on migration, in part because much of the recruitment comes through informal channels of family and friends.

     

Characterizing Mother’s Dating After Divorce

Mothers dating after divorce is a dynamic process, where not all mothers date the same way after divorce. However, few studies have examined the different ways that mothers date after divorce, which should influence maternal well-being, risk behaviors, and the quality of their relationships. This study characterizes four different approaches to mothers’ repartnering (referred to as repartnering histories): no dating, dating one partner monogamously, dating multiple partners serially, and dating multiple partners simultaneously. Each repartnering history is characterized by demographic variables, relationship quality, and maternal well-being. Implications of the study are discussed.     

Comprehending and Rehabilitating Roman Catholic Clergy Offenders of Child Sexual Abuse

Many have studied Roman Catholic clergy who have sexually abused children, but the range of investigations remains disconnected. This article brings together various disciplinary perspectives to form a comprehensive view. A review of the literature is first undertaken to comprehend how clergy offenders have been conceptualized in psychosocial, sociocultural, and moral-religious studies. These perspectives are then used as a foundation for examining how these clergy can be rehabilitated. Three rehabilitative modalities—psychological treatment, rehabilitation through restorative justice, and ritual healing—are explored. The article concludes with a discussion of the insights gained from the literature review and how the modalities can be advanced in an interdependent and considered approach.     

How Heterosexism Plagues Practitioners in Services for Lesbians and Their Families

Barriers to services for lesbians and their families have been well documented in the literature (DeCrescenzo, 1984; Harris, Schatz, & O'Hanlan, 1994; Nightengale, & Owen, 1995; Mallon, 1998), especially among medical professionals and social service providers. This study seeks to explore the prevalence of heterosexism and homophobia among mental health practitioners who identify as qualified providers for lesbians and the recipients' perspectives regarding the services they have received. Of the twenty-five practitioners who responded, 48% of them “knew personally of incidences of professional bias against lesbian clients.” Interestingly, only 26% of the 98 families reported heterosexual bias from their providers.     

Research Note: The LIVITY study: research challenges and strategies for engaging with the black caribbean community in a study of HIV infection

There is an increasing incidence of new HIV‐1 diagnoses among black Caribbeans in the UK, but there has been limited research in this area. The LIVITY study is the first in‐depth epidemiological and behavioural study to examine the impact of HIV among black Caribbeans in the UK. The UK black Caribbean community has traditionally been regarded as less likely to participate in clinical research and surveys. We identified three major challenges to recruitment to the LIVITY study: general distrust of the research process; the considerable stigma surrounding HIV in the black Caribbean community and the sensitivity of obtaining detailed sexual histories. The strategies devised to help overcome these barriers to optimise recruitment included: the establishment of a black Caribbean Community Advisory Group to facilitate communication between the community and the researchers and assist in questionnaire design to improve acceptability to the participants; use of healthcare practitioners as gatekeepers; extensive piloting and modification of the questionnaire among black Caribbean patients; reassurances of confidentiality during recruitment; and ethnic matching between interviewer and study participants. Another challenge was the high rate of loss to follow‐up among eligible patients, potentially compromising the study’s generalisability. Nevertheless, use of the above strategies resulted in a satisfactory enrolment rate of 57%, who were representative of all eligible patients.     

Diagnosing Discrimination: Stress from Perceived Racism and the Mental and Physical Health Effects*

Differences in health between racial groups in the United States are significant and persistent. Many studies have documented these differences as a result of a variety of different social factors. An emerging emphasis is the impact of racism in its various forms on physical and mental health. Social stress theory conceptualizes racism as a social stresssor which can produce negative health consequences for racial minorities. This study uses binary logit and negative binomial regression models of four items from the 2004 Behavioral Risk Factor Surveillance System (BRFSS) to test social stress theory and examine the relationship between stress symptoms from perceived racism and overall health (N = 32,585). The effect of race on the experience of emotional and physical stress symptoms from racism is substantial. Furthermore, experiencing both emotional and physical stress from perceived racist treatment is an important factor in predicting the number of poor mental and physical health days, indicating that the experience of stress from perceived racism is related to overall poorer health.