Human papillomavirus vaccine and Pap tests on college campuses: How do historically black colleges and universities (HBCUs) measure up?

ABSTRACT

Objective: The availability of cervical cancer prevention services at college health centers was compared between historically black colleges and universities (HBCUs) and non-HBCUs.

Methods: Four-year, non–primarily distant learning colleges, matching HBCUs with randomly selected non-HBCUs within the same states (N = 136) were examined. Data were collected (2014–2015 academic year) on the availability of human papillomavirus (HPV) vaccine and Pap tests at college health centers. HBCUs were compared with non-HBCUs using conditional logistic regression, and correlates of offering these services were identified. Results: Many institutions did not offer HPV vaccine or Pap tests. Fewer HBCUs offered HPV vaccine (18% vs 53%) and Pap tests (50% vs 76%) compared with non-HBCUs. In multivariable analyses, HBCUs remained less likely than non-HBCUs to offer HPV vaccine (odds ratio [OR] = 0.07, 95% confidence interval [CI]: 0.02–0.26) and Pap tests (OR = 0.19, 95% CI: 0.06–0.61). Conclusions: Greater effort is needed to make cervical cancer prevention services available at colleges, especially at HBCUs.     

Bayesian graphical modelling: a case-study in monitoring health outcomes

Bayesian graphical modelling represents the synthesis of several recent developments in applied complex modelling. After describing a moderately challenging real example, we show how graphical models and Markov chain Monte Carlo methods naturally provide a direct path between model specification and the computational means of making inferences on that model. These ideas are illustrated with a range of modelling issues related to our example. An appendix discusses the BUGS software.     

通用引物PCR方法检测生殖道HPV

目的 :通用引物PCR技术检测生殖道人乳头瘤病毒 方法 :根据国外文献报道的基因序列选出一对寡核苷酸引物 ,其扩增片断为 450bp 结果 :在 450bp处出现DNA扩增带者为阳性 ,用于临床标本的检测 ,其阳性率为 30 % (2 9/96) 结论 :通用引物PCR技术检测生殖道HPV -DNA快速、敏感、可靠     

The impact of outpatient priming for induction of labour on midwives’ work demand,work autonomy and satisfaction

BackgroundInduction of labour often begins with the application of a priming agent to soften the cervix, generally requiring women to stay in hospital overnight (inpatient priming). An alternative is outpatient priming by a midwife, where women are allowed to go home following priming. This approach has the potential to impact, either positively or negatively, on the midwives involved.QuestionTo what extent did the introduction of outpatient priming influence midwives’ work demands, work autonomy, stress and job satisfaction.MethodsA before–after study (with two separate cross-sectional samples) was conducted alongside a randomized controlled trial of outpatient versus inpatient priming, conducted at two metropolitan teaching hospitals in Australia. Midwives completed a questionnaire before the introduction of outpatient priming and again approximately two years later.Findings208 midwives participated (response rates-time 1:81% (87/108); time 2:78% (121/156)). A mixed model analysis test of pre-post intervention differences found no changes in work demand, work autonomy and satisfaction. At time 2, over 80% of midwives reported that the introduction of the practice had reduced or made no difference to their work stress and workload, and 93% reported that outpatient priming had increased or had no impact on their job satisfaction. Furthermore, 97% of respondents were of the opinion that the option of outpatient priming should continue to be offered.ConclusionResults suggest that outpatient priming for induction of labour is viable from a midwifery practice perspective, although more research is needed.     

The effectiveness of medical interventions aimed at preventing preterm birth: a literature review

Background

Preterm birth is a significant global health problem with serious short and long term consequences. This paper reviews the research literature to answer the question how effective are the medical interventions that aim to reduce the rates of preterm birth?

Methods

A systematic search was carried out in CINAHL, Cochrane, Medline and Embase in relation to following medical treatments aimed at preventing preterm births: anti-infective medications, tocolytics, progesterone and cervical cerclage. The research underpinning each type of intervention is critically analysed in order to establish the validity of knowledge claims that are made for each type of intervention.

Findings

In relation to reducing the rates of preterm births, anti-infectives are only effective in the presence of known infection. Screening for infections during pregnancy is ineffective. Tocolytic agents are not effective in decreasing the preterm birth rates. Progesterone seems to be effective in a select group of pregnant women at higher risk of preterm birth. Cervical cerclage plays a small and an occasional role in preventing some preterm births.

Conclusions

This literature review demonstrates that medical interventions aimed at preventing, not just delaying, preterm birth, are not effective at a population level. Providing holistic, antenatal midwifery care for women living in socio-economic disadvantage and/or with an increased risk of preterm birth seems to be a promising strategy to address the negative effects of the social determinants of disease and thus to reduce the rate of preterm births at an individual and a population level.