Colonialism as a Social Determinant of Health in Puerto Rico: Using the Socioecological Model to Examine How the Jones Act Impacted Health After Hurricane María.

Introduction: Puerto Rico is a territory of the United States, making Puerto Ricans vulnerable to damaging colonial policy. The purpose of this article is to utilize the socioecological model (SEM) to evaluate how the Jones Act impacted Puerto Rico after Hurricane María, examining colonialist policy as a social determinant of health (SDOH) in Puerto Rico.

Methods: Levels of the SEM used in this examination included: , , , , and

Results: Evaluation of the Jones Act using the model demonstrated relationships between all socioecological levels.

What Nurses Need to Know About Immediate Postpartum Initiation of Long-Acting Reversible Contraception.

Initiation of long-acting reversible contraception (LARC) in the immediate postpartum period is becoming more common, resulting in increased requests for early removal, primarily because of unpredictable bleeding patterns. Competing interests of healthful spacing of pregnancies, impact on breastfeeding, risks associated with pregnancy versus contraceptive method, potential adverse effects of LARC, and timing of informed consent make immediate postpartum initiation of LARC an important issue. Nearly 40% of women do not attend a postpartum visit at all, resulting in decreased initiation of contraception and increased risk of unplanned pregnancy.

Lucky girls: unintentional avoidance of adolescent pregnancy among low-income African-American females.

Purpose: To describe lucky adolescents who unintentionally avoid pregnancy.

Design And Methods: The second phase of a descriptive qualitative study in which 17 low-income African-American females ages 19 to 26 participated in open-ended interviews on how they avoided pregnancy as adolescents.

Results: Constant comparative analysis revealed that five of the girls avoided pregnancy because they were "lucky" that others insisted they use contraceptives.