Factors Associated with Acute Telemental Health Consultations in Older Veterans.

Introduction: The United States Veterans Health Administration is a leader in the use of telemental health (TMH) to enhance access to mental healthcare amidst a nationwide shortage of mental health professionals. The Tennessee Valley Veterans Affairs (VA) Health System piloted TMH in its emergency department (ED) and urgent care clinic (UCC) in 2019, with full 24/7 availability beginning March 1, 2020. Following implementation, preliminary data demonstrated that veterans ≥65 years old were less likely to receive TMH than younger patients.

Evidence-based consensus guidelines for the management of catatonia: Recommendations from the British Association for Psychopharmacology.

The British Association for Psychopharmacology developed an evidence-based consensus guideline on the management of catatonia. A group of international experts from a wide range of disciplines was assembled. Evidence was gathered from existing systematic reviews and the primary literature.

A woman with a normal uterus and duplicated cervices: A case report and review of a Müllerian anomaly.

Müllerian duct anomalies (MDAs) are common and can lead to problems with menstrual flow, pregnancy, and fertility. This is a case report of a 21-year-old woman with an incidentally found bicollis uterus with vaginal septum, which challenges the previously held principles of embryology and further supports the current theories that explain these transitional forms of female reproductive anomalies. Due to the irregularity found during the physical examination, detailed imaging with magnetic resonance helped to delineate the anatomy of the reproductive system and genitourinary (GU) tract, uncovering and confirming the anatomical abnormality.

Integration of a Relationship-focused Counseling Intervention with Delivery of the Dapivirine Ring for HIV Prevention to Women in Johannesburg: Results of the CHARISMA Pilot Study.

Biomedical, female-initiated HIV prevention methods can help reduce disproportionately high HIV rates among women in sub-Saharan Africa, but male partner resistance and intimate partner violence (IPV) may impact ability to ensure effective use. To support consistent use of the dapivirine vaginal ring (VR), we pilot-tested the impact of the CHARISMA relationship counseling intervention ("CHARISMA") with women enrolled in the multi-site open-label Microbicide Trials Network (MTN) 025/HOPE trial at the Wits Reproductive Health and HIV Research Institute (Wits RHI) site in Johannesburg, South Africa. Lay counselors used a 42-item tool with five subscales to assess relationships and IPV and provide tailored counseling at enrolment, followed by a booster counselling session at Month 1 and follow-up checks at Months 3 and 6.

Acceptability and feasibility of the CHARISMA counseling intervention to support women's use of pre-exposure prophylaxis: results of a pilot study.

Background: Women may need or seek male partner approval to safely and consistently use oral antiretroviral pre-exposure prophylaxis (PrEP) or vaginal microbicides. We developed CHARISMA, a counseling intervention to support women's relationships and their ability to consistently use HIV prevention products.

Methods: In a pilot study with 95 female participants in Johannesburg, South Africa, lay counselors implemented CHARISMA, assessing participants' relationship(s) with their male partner(s) and barriers or facilitators to HIV prevention method use, and then providing tailored, interactive counseling.

Benign, Borderline, and Malignant Pediatric Adnexal Masses: A 10-Year Review.

Study Objective: To investigate the incidence, clinical features, tumor markers, radiologic findings, types of surgeries, and histologies for adnexal masses in female pediatric and adolescent patients.

Design: Retrospective chart review.

Setting: Children's Health in Dallas and Plano, Texas from 2009 to 2018.

Factors influencing women's decisions about pregnancy spacing: Findings from a focus group discussion study.

Objectives: Very short interpregnancy intervals are associated with negative health outcomes for mothers and children, and pregnancies with very short interpregnancy intervals are more likely to be unintended than pregnancies that are more widely spaced. The objective of this study was to improve understanding of women's motivations regarding pregnancy spacing.

Methods: In 2017, we conducted 8 focus group discussions with 49 English- and Spanish-speaking postpartum women in central North Carolina.

Patients' and Caregivers' Experiences with the Multi-Payer Advanced Primary Care Practice Demonstration.

Background: The patient-centered medical home (PCMH) model aims to improve primary health care using a patient-centered approach. Little qualitative research has investigated how the PCMH model affects patient experience with care.

Objective: To understand Medicaid and Medicare patient and caregiver experiences with PCMHs participating in the Multi-Payer Advanced Primary Care Practice (MAPCP) Demonstration.

Squamous Carcinoma of the Cervix in a 15-Year-Old with Congenital HIV: A Case Report.

Background: Human papillomavirus (HPV) is the most prevalent sexually transmitted infection (STI) worldwide. Immunocompetent hosts have intact defense mechanisms to prevent HPV infection, but immunocompromised patients are at higher risk for complications, including HPV-related cancers. Most of these cancers originate from high-risk HPV strains in sexually active patients.

Age Moderates Perceived COVID-19 Disruption on Well-Being.

Background And Objectives: It is not fully understood how large-scale events affect well-being. Older adults showed the highest levels of resilience following the September 11th (9/11) terrorist attacks, but during the severe acute respiratory syndrome outbreak, there were no age-related differences in well-being. The current study examined the Coronavirus Disease 2019 (COVID-19) disruption on well-being throughout adulthood.

Technology and rehabilitation training for community health workers: Strengthening health systems in Malawi.

Community health workers (CHWs) have been effectively utilised in resource-limited settings to combat a growing demand for health access that cannot be met by the current workforce. The purpose of this study was to evaluate a CHW training programme in Malawi that integrated technology into rehabilitation care delivery. This was a retrospective cross-sectional study of a training programme conducted in December 2018.

Bleeding disorders in adolescents with heavy menstrual bleeding in a multicenter prospective US cohort.

Heavy menstrual bleeding is common in adolescents. The frequency and predictors of bleeding disorders in adolescents, especially with anovulatory bleeding, are unknown. Adolescents referred for heavy menstrual bleeding underwent an evaluation of menstrual bleeding patterns, and bleeding disorders determined The primary outcome was the diagnosis of a bleeding disorder.

Generating CHARISMA: Development of an Intervention to Help Women Build Agency and Safety in Their Relationships While Using PrEP for HIV Prevention.

This article describes the development of the Community Health clinic model for Agency in Relationships and Safer Microbicide Adherence intervention (CHARISMA), an intervention designed to address the ways in which gender norms and power differentials within relationships affect women's ability to safely and consistently use HIV pre-exposure prophylaxis (PrEP). CHARISMA development involved three main activities: (1) a literature review to identify appropriate evidence-based relationship dynamic scales and interventions; (2) the analysis of primary and secondary data collected from completed PrEP studies, surveys and cognitive interviews with PrEP-experienced and naïve women, and in-depth interviews with former vaginal ring trial participants and male partners; and (3) the conduct of workshops to test and refine key intervention activities prior to pilot testing. These steps are described along with the final clinic and community-based intervention, which was tested for feasibility, acceptability, and preliminary effectiveness in Johannesburg, South Africa.

Therapy for anogenital verrucae in preadolescent children with topical and systemic treatment.

Background/objectives: Anogenital verrucae (AV) are benign, human papillomavirus (HPV)-induced tumors of the anogenital skin and mucosa. Medical therapy for AV in preadolescents has not been well studied. We explore the efficacy and safety profile of sinecatechins 15% ointment and imiquimod 5% cream in the treatment of AV, alone and in combination therapy with other commonly used medications.

Female reproductive structures found in inguinal hernia sacs: A retrospective review.

Background: In female infants undergoing herniorrhaphy, there is a reported incidence of 15%-20% of prolapsed adnexal structures. Our primary aim is to confirm the incidence of adnexal tissue in hernia sacs at the time of repair and to further delineate the clinical characteristics of this population at a major pediatric institution.

Methods: Retrospective chart review of all cases of herniorrhaphy in female patients less than the age of 18 from June 2009 to December 2015 in a large tertiary referral children's hospital.

Vulvar Nodules: A Rare Presentation of Mastocytosis.

Background: Mastocytosis is a rare benign disorder characterized by the finding of mast cells in the skin and other organs, occurring in adult as well as pediatric age groups. The cutaneous form is the most common presentation in childhood and is rarely located on the vulva.

Case: A 9-year-old prepubertal girl presented with bilateral vulvar nodules found incidentally by her pediatrician.

Managing chronic conditions care across primary care and hospital systems: lessons from an Australian Hospital Avoidance Risk Program using the Flinders Chronic Condition Management Program.

Objective The study aimed to determine the impact of the Flinders Chronic Condition Management Program for chronic condition self-management care planning and how to improve its use with Bendigo Health's Hospital Admission Risk Program (HARP). Methods A retrospective analysis of hospital admission data collected by Bendigo Health from July 2012 to September 2013 was undertaken. Length of stay during admission and total contacts post-discharge by hospital staff for 253 patients with 644 admissions were considered as outcome variables.

A Computerized Family Planning Counseling Aid: A Pilot Study Evaluation of Smart Choices.

Context: Resource constraints may make it challenging for family planning clinics to provide comprehensive contraceptive counseling; technological tools that help providers follow recommended practices without straining resources merit evaluation.

Methods: A pilot study using a two-group, posttest-only experimental design evaluated Smart Choices, a computer-based tool designed to help providers offer more patient-centered counseling and enable patients to participate proactively in the counseling session. In two North Carolina family planning clinics, 214 women received usual counseling in March-May 2013, and 126 women used Smart Choices in May-July 2013.

Argentina's Successful Implementation Of A National Human Papillomavirus Vaccination Program.

Every year around fourteen million people globally are infected with human papillomavirus (HPV), the sexually transmitted virus that is the cause of most cervical cancers. A number of vaccines have been developed to protect against HPV, but in many countries, HPV vaccination rates have been low compared with rates for other recommended vaccines. Parental concerns, cost, and lack of information and awareness among both health professionals and parents are cited as important barriers to HPV vaccination.

Feasibility and acceptability of a computer-based tool to improve contraceptive counseling.

Objective: The objective was to test the feasibility and acceptability of a computerized tool, Smart Choices, designed to enhance the quality of contraceptive counseling in family planning clinics. The tool includes (a) a questionnaire completed by patients and summarized in a printout for providers and (b) a birth control guide patients explore to learn about various contraceptive methods.

Study Design: In 2 family planning clinics, we conducted interviews with 125 women who used the Smart Choices computerized tool and 7 providers.

From mission to measures: performance measure development for a Teen Pregnancy Prevention Program.

The Office of Adolescent Health (OAH) sought to create a comprehensive set of performance measures to capture the performance of the Teen Pregnancy Prevention (TPP) program. This performance measurement system needed to provide measures that could be used internally (by both OAH and the TPP grantees) for management and program improvement as well as externally to communicate the program's progress to other interested stakeholders and Congress. This article describes the selected measures and outlines the considerations behind the TPP measurement development process.

Risk of early sexual initiation and pregnancy among youth reported to the child welfare system.

This study found that youth involved with the child welfare system have high rates of sexual risk behaviors and outcomes, including forced sex, early age at first sex, low contraceptive use, and pregnancy, which are more than double those of adolescents from the general population. Caseworkers may need training in how to address sexual risk factors and may need to support caregivers in addressing these issues with their children. Findings highlight the importance for case-workers, caregivers, and others to address the sexual and reproductive health needs of maltreated youth.

Patterns of preconception, prenatal and postnatal care for diabetic women by obstetrician-gynecologists.

Objective: To assess barriers to and quality of care received by diabetic pregnant women from obstetrician-gynecologists.

Study Design: A questionnaire was mailed to 1,000 representative practicing Fellows of the American College of Obstetricians and Gynecologists; 74 did not treat pregnant patients and 510 (55.1%) returned completed surveys.