Change in Contraceptive Use Within South Carolina Medicaid Following the Choose Well Contraceptive Access Initiative: Did COVID-19 Alter the Trends?

Objectives: COVID-19 hit at the midpoint of Choose Well, a statewide contraceptive access initiative commenced in South Carolina (SC) in 2017. This study assessed whether the pandemic altered the trends in contraceptive use among SC Medicaid during the first half of Choose Well.

Methods: Contraception use among 333,253 women was analyzed from 2017 to 2022, divided into (January 2017-February 2020) and (March 2020-December 2022) periods.

Postpartum Insurance Loss: Predicting Factors, Associations with Postpartum Health Service Utilization, and the Role of Medicaid Expansion.

Objectives: This study investigated the predictors of postpartum insurance loss (PPIL), assessed its association with postpartum healthcare receipt, and explored the potential buffering role of Medicaid expansion.

Methods: Data from the 2016-2020 Pregnancy Risk Assessment Monitoring System (PRAMS) were analyzed, covering 197,820 individuals with live births. PPIL was determined via self-reported insurance status before and after pregnancy.

Intrauterine inflammation and postnatal intravenous dopamine alter the neurovascular unit in preterm newborn lambs.

Background: Intrauterine inflammation is considered a major cause of brain injury in preterm infants, leading to long-term neurodevelopmental deficits. A potential contributor to this brain injury is dysregulation of neurovascular coupling. We have shown that intrauterine inflammation induced by intra-amniotic lipopolysaccharide (LPS) in preterm lambs, and postnatal dopamine administration, disrupts neurovascular coupling and the functional cerebral haemodynamic responses, potentially leading to impaired brain development.

Contraceptive Method Use Among a Population-Based Cohort During the South Carolina Choose Well Initiative.

Importance: Evaluating the impact of statewide contraceptive access initiatives is necessary for informing health policy and practice.

Objective: To examine changes in contraceptive method use among a cohort of women of reproductive age in South Carolina during the Choose Well contraceptive access initiative.

Design, Setting, And Participants: In this cohort study, baseline data from the initial Statewide Survey of Women administered from October 1, 2017, to April 30, 2018, to a probability-based sample of women of reproductive age in South Carolina and a peer state (Alabama) were linked with 3 follow-up surveys given in 2019, 2020, and 2021.

Contraceptive counseling, method satisfaction, and planned method continuation among women in the U.S. southeast.

Objectives: We used the validated Person-Centered Contraceptive Counseling (PCCC) scale to examine experiences with counseling and associations between counseling quality, method satisfaction, and planned method continuation at the population level in two southeastern states.

Study Design: We used data from the Statewide Survey of Women, a probability-based sample of reproductive-aged women in Alabama and South Carolina in 2017/18. We included women using a contraceptive method and reporting a contraceptive visit in the past year (n = 1265).

Diffractive order Mueller matrix ellipsometry for the design and manufacture of polarization beam splitting metasurfaces.

Optical metasurface technology promises an important potential for replacing bulky traditional optical components, in addition to enabling new compact and lightweight metasurface-based devices. Since even subtle imperfections in metasurface design or manufacture strongly affect their performance, there is an urgent need to develop proper and accurate protocols for their characterization, allowing for efficient control of the fabrication. We present non-destructive spectroscopic Mueller matrix ellipsometry in an uncommon off-specular configuration as a powerful tool for the characterization of orthogonal polarization beam-splitters based on a-Si:H nanopillars.

Impact of the Choose Well Contraceptive Access Initiative on Method Use Among Women Enrolled in South Carolina's Medicaid Program: A Mid-line Assessment.

Introduction: A six-year statewide contraceptive access initiative focused on equitable access to contraception, removing cost barriers, capacity building and training, raising consumer awareness, and expanding contraceptive care at safety net clinics was implemented in South Carolina beginning in 2017. This study assessed changes in contraceptive method use among women enrolled in the South Carolina Medicaid program during the first three years of Choose Well.

Methods: Contraception use among a retrospective cohort of women aged 15 to 45 enrolled in South Carolina Medicaid from 2012 to 2020 was examined.

Creatine in the fetal brain: A regional investigation of acute global hypoxia and creatine supplementation in a translational fetal sheep model.

Background: Creatine supplementation during pregnancy is a promising prophylactic treatment for perinatal hypoxic brain injury. Previously, in near-term sheep we have shown that fetal creatine supplementation reduces cerebral metabolic and oxidative stress induced by acute global hypoxia. This study investigated the effects of acute hypoxia with or without fetal creatine supplementation on neuropathology in multiple brain regions.

Association of Health Insurance with Contraceptive Use and Interpersonal Quality of Contraceptive Care in the Southeast United States.

Objectives: Health insurance remains an important dimension of contraceptive access. This study investigated the role of insurance in contraceptive use, access, and quality in South Carolina and Alabama.

Methods: The study used a cross-sectional statewide representative survey that assessed reproductive health experiences and contraceptive use among reproductive-age women in South Carolina and Alabama.

Contraception Use and Pregnancy Outcomes for Alabama Medicaid Enrollees: A Baseline Analysis Using 2012-2017 Data.

Objectives: Access to the full range of contraceptive methods, including long-acting reversible contraception (LARC), is key for preventing unintended pregnancies and improving health outcomes. In 2019, Alabama Medicaid started paying for LARC devices for postpartum women. In anticipation of evaluating the impact of this programmatic change, we conducted a baseline study exploring contraception use and pregnancy-end outcomes for enrollees before the change.

Medial versus lateral camera port placement for robotic nephron-sparing surgery: evaluating surgical complications and outcomes.

As the growing popularity of robotic-assisted laparoscopic procedures for the treatment of renal cancer increases, there exists a variation in surgical technique among institutions and surgeons alike. One variation that exists in robotics is the anatomical placement of the camera port (medial versus lateral camera port placement). The purpose of this study is to evaluate surgical complications and outcomes in comparison to site of camera port placement during nephron-sparing surgery in an academic setting.

Excitatory and inhibitory neuron imbalance in the intrauterine growth restricted fetal guinea pig brain: Relevance to the developmental origins of schizophrenia and autism.

Neurodevelopmental disorders such as schizophrenia and autism are thought to involve an imbalance of excitatory and inhibitory signaling in the brain. Intrauterine growth restriction (IUGR) is a risk factor for these disorders, with IUGR onset occurring during critical periods of neurodevelopment. The aim of this study was to determine the impact of IUGR on excitatory and inhibitory neurons of the fetal neocortex and hippocampus.

Evaluating the Efficacy of Employing Local Anesthetic Prostatic Blocks During Rezum Procedure.

Introduction Rezum is a minimally invasive, outpatient procedure using convective water vapor to relieve outlet obstruction from benign prostatic hyperplasia (BPH). Evidence on the technical approach of Rezum therapy, particularly pain control, is lacking. The purpose of this study was to evaluate the efficacy of utilizing a local anesthetic prostate block for postoperative pain control during Rezum therapy for BPH.

Rising to Meet the Moment: What Does the Public Health Workforce Need to Modernize?

Objective: This study uses findings from the most recent iterations of the Public Health Workforce Interest and Needs Survey (PH WINS) to describe importance, skill level, and gaps of key public health competencies as well as characteristics associated with gaps.

Design: Repeated cross-sectional analysis of the 2017 and 2021 PH WINS data.

Setting: State and local health departments.

Ranges of pregnancy preferences and contraceptive use: Results from a population-based survey in the southeast United States.

Context: Understanding how pregnancy preferences shape contraceptive use is essential for guiding contraceptive interventions and policies that center individuals' preferences and desires. Lack of rigorous measurement of pregnancy preferences, particularly on the population level, has been a methodologic challenge.

Methods: We investigated associations between prospective pregnancy preferences, measured with a valid instrument, the Desire to Avoid Pregnancy (DAP) scale, and contraceptive use in a representative sample of 2601 pregnancy-capable self-identified women, aged 18-44 years, in Alabama and South Carolina (2017-2018).

Changes in Adolescent Birth Rates within Appalachian Subregions and Non-Appalachian Counties in the United States, 2012-2018.

Background: Adolescent births are associated with numerous challenges. While adolescent birth rates have declined across the U.S.

Multilevel Influences on Providers' Delivery of Contraceptive Services: A Qualitative Thematic Analysis.

Introduction: Access to a full range of contraceptive services is essential for quality health care. Contraceptive provision practices of primary care providers play an important role in patients' decision-making about their reproductive health care. Understanding the multilevel factors influencing contraceptive care delivery in primary care settings is critical for advancing quality care.

Creatine supplementation reduces the cerebral oxidative and metabolic stress responses to acute in utero hypoxia in the late-gestation fetal sheep.

Prophylactic creatine treatment may reduce hypoxic brain injury due to its ability to sustain intracellular ATP levels thereby reducing oxidative and metabolic stress responses during oxygen deprivation. Using microdialysis, we investigated the real-time in vivo effects of fetal creatine supplementation on cerebral metabolism following acute in utero hypoxia caused by umbilical cord occlusion (UCO). Fetal sheep (118 days' gestational age (dGA)) were implanted with an inflatable Silastic cuff around the umbilical cord and a microdialysis probe inserted into the right cerebral hemisphere for interstitial fluid sampling.

Medicaid Cost Savings from Provision of Contraception to Beneficiaries in South Carolina, 2012-2018.

This study assesses cost savings associated with specific contraceptive methods provided to beneficiaries enrolled in South Carolina Medicaid between 2012 and 2018. Incremental cost-effectiveness ratios, defined as the additional cost of contraception provision per live birth averted, were estimated for 4 contraceptive methods (intrauterine devices [IUDs], implants, injectable contraceptives, and pills), relative to no prescription method provision, and savings per dollar spent on method provision were calculated. Costs associated with publicly funded live births were derived from published sources.

Evidence and Implications of the Affordable Care Act for Racial/Ethnic Disparities in Diabetes Health During and Beyond the Pandemic.

Amid the global pandemic, it becomes more apparent that diabetes is a pressing health concern because racial/ethnic minorities with underlying diabetes conditions have been disproportionately affected. The study proposes a multiyear examination to document the role of the Affordable Care Act (ACA) in racial/ethnic disparities in diabetes health. Using the Behavioral Risk Factor Surveillance System from 2011 to 2019, the study with a pre-post design investigated changes in access to care and diabetes health among non-White minorities compared with Whites before and after the ACA by conducting multivariable linear regression, with state-fixed effects and robust standard errors.

The Effects of In Utero Fetal Hypoxia and Creatine Treatment on Mitochondrial Function in the Late Gestation Fetal Sheep Brain.

Near-term acute hypoxia in utero can result in significant fetal brain injury, with some brain regions more vulnerable than others. As mitochondrial dysfunction is an underlying feature of the injury cascade following hypoxia, this study is aimed at characterizing mitochondrial function at a region-specific level in the near-term fetal brain after a period of acute hypoxia. We hypothesized that regional differences in mitochondrial function would be evident, and that prophylactic creatine treatment would mitigate mitochondrial dysfunction following hypoxia; thereby reducing fetal brain injury.

Dispersion of resonant modes in patch antenna lattices.

Spectroscopic polar angle resolved Mueller matrix ellipsometry at multiple azimuthal incidences, together with a full-field model, reveal new details in the interplay between localized gap surface plasmon resonances and propagating surface plasmon polaritons (SPPs) in a rectangular array of metal-insulator-metal patches. A plane-wave expansion of the field in the insulator shows that the fundamental localized resonances are composed of oppositely propagating modes. Sharp dispersive resonances observed in p-polarization, excited near the opening of diffracted orders, are shown to be grating coupled SPPs.

Contraceptive Use and Pregnancy Outcomes Among Women Enrolled in South Carolina Medicaid Programs.

Objective: State medicaid programs provide access to effective contraception for people with lower incomes. This study examined contraception use and pregnancy among reproductive-age women enrolled in the South Carolina Medicaid, by eligibility program and socio-demographic sub-groups.

Methods: A retrospective cohort of women aged 15-45 who were newly eligible for South Carolina Medicaid from 2012 to 2016 was examined.