Pregnancy and Parenthood During Medical School.

Purpose: The stress of pregnancy and parenthood during the intense educational experience of medical school could increase the risk of student burnout. Because 9.2 percent of U.

Gulf War Illness: Challenges Persist.

It has been more than 20 years since the United States and coalition forces entered Kuwait and Iraq. Actual combat was of remarkably short duration: less than 1 week of sustained ground activity and 6 weeks of air missions. Thus, it was surprising when approximately 200,000 returning US veterans were affected by a chronic multi-symptom illness that came to be known as Gulf War Illness (GWI).

Medicare charge-receipt data: results for South Dakota.

Background: The 2013 release of 2011 financial information by the Centers for Medicare and Medicaid Services (CMS) caused concern because some hospitals had charges that appeared to be exorbitantly high compared to reimbursement rates.

Methods: Charges and receipts for South Dakota were compared to national data. The study was restricted to nine discharge codes likely to be seen by an adult hospitalist service.

Vaccinating through a lifetime: adult priorities.

Vaccination strategies for adults have recently been updated to include newer vaccine products and to reflect the changing epidemiology of vaccine-preventable diseases in adults. New products include vaccines against shingles and the human papillomavirus, and a combination vaccine which contains an acellular pertussis component (Tdap). In some cases, existing vaccines have been re-formulated to provide alternate routes of delivery, as is the case with the influenza vaccine, or more effective formulations, as is the case with the meningococcal vaccine.

Time from pregnancy recognition to prenatal care and associated newborn outcomes.

Objective: To examine the relationship between newborn outcomes and late prenatal care initiation after recognition of pregnancy.

Design: Secondary data analysis of the Pregnancy Risk Assessment and Monitoring System (PRAMS) data for the United States.

Setting: Twenty-nine states.

Scheduling the first prenatal visit: office-based delays.

Objective: The purpose of this study was to evaluate the office-based component of delayed entry into prenatal care.

Study Design: Phone numbers for all obstetrics offices in a single state were obtained from a commercial list. A research assistant who posed as a newly pregnant, fully insured woman asked each clinic when she should come in for her first prenatal visit.

Time of pregnancy recognition and prenatal care use: a population-based study in the United States.

Background: A woman who does not recognize her pregnancy early may not initiate prenatal care early. This study examined the relationship between the time of pregnancy recognition and the time of initiation of prenatal care, and the number of prenatal visits among women of childbearing age.

Methods: This study analyzed the Pregnancy Risk Assessment and Monitoring System (PRAMS) data for the United States.

Late recognition of pregnancy as a predictor of adverse birth outcomes.

Objective: We examined the relationship between the time of recognition of pregnancy and birth outcomes, such as premature births, low birthweight (LBW), admission to the neonatal intensive care unit (NICU), and infant mortality.

Study Design: A secondary analysis was performed using the Pregnancy Risk Assessment and Monitoring System (PRAMS) multistate data from 2000-2004. The sample consisted of 136,373 women who had a live childbirth.

Utilization of home pregnancy testing among women at risk for unintended pregnancy.

Purpose: We sought to determine whether a brief intervention increased home pregnancy test utilization among women at risk for unintended pregnancy.

Methods: The intervention included education, consultation with a nurse, and the provision of a free home pregnancy test kit. Participants were 35 women aged 18-39 years from a Medicaid population who were having unprotected intercourse and who were not trying to conceive.

Why women risk unintended pregnancy.

Background: To reduce unintended pregnancy, it is necessary to understand why women have unprotected intercourse when they do not desire pregnancy.

Methods: We devised a survey of 42 potential reasons why women have unprotected intercourse based on the responses of a focus group we had previously convened. We administered the survey to women between the ages of 18 and 39 years who were visiting primary care clinics and were not trying to get pregnant.

Self-testing for pregnancy among women at risk: a randomized controlled trial.

Background: The timing of pregnancy recognition affects early pregnancy and the timing of prenatal care. Little research has been done on how to make women at risk more alert to the possibility of pregnancy.

Design: The study was an RCT performed and analyzed between 2006 and 2007.

Risk drinking and contraception effectiveness among college women.

Risk drinking, especially binge drinking, and unprotected sex may co-occur in college women and increase the risks of STI exposure and pregnancy, but the relationships among these behaviors are incompletely understood. A survey was administered to 2012 women of ages 18-24 enrolled in a public urban university. One-quarter of the college women (23%) drank eight or more drinks per week on average, and 63% binged in the past 90 days, with 64% meeting criteria for risk drinking.

Reasons for unprotected intercourse in adult women.

Background: Despite the increased availability of contraception, unprotected intercourse and unintended pregnancy are common among adult women. We sought to identify reasons why adult women at risk of unintended pregnancy have unprotected intercourse.

Methods: A comprehensive search of electronic databases of MEDLINE, CINAHL, and PSYCHOINFO, from 1995 to 2005, was conducted.

Reasons for unprotected intercourse: analysis of the PRAMS survey.

Objectives: This study was conducted to identify reasons why women had unprotected intercourse that led to an unintended pregnancy.

Methods: As part of the Pregnancy Risk Assessment Monitoring System (PRAMS) survey, women with a recent unintended viable pregnancy were asked after the birth why they had not used birth control.

Results: Of 7856 respondents, 33% felt they could not get pregnant at the time of conception, 30% did not really mind if they got pregnant, 22% stated their partner did not want to use contraception, 16% cited side effects, 10% felt they or their partner were sterile, 10% cited access problems and 18% selected "other.

Reasons for unprotected intercourse in adult women: a qualitative study.

Despite the focus on adolescents, most unintended pregnancies occur in adults. The objective of this study was to identify reasons why adult women have unprotected intercourse when they do not desire pregnancy. We held 4 focus groups to explore reasons for unprotected intercourse.

Preventing alcohol-exposed pregnancies: a randomized controlled trial.

Background: Prenatal alcohol exposure is a leading preventable cause of birth defects and developmental disabilities in the United States.

Design: A randomized controlled trial (2002-2005; data analyzed 2005-2006) of a brief motivational intervention to reduce the risk of an alcohol-exposed pregnancy (AEP) in preconceptional women by focusing on both risk drinking and ineffective contraception use.

Setting/participants: A total of 830 nonpregnant women, aged 18-44 years, and currently at risk for an AEP were recruited in six diverse settings in Florida, Texas, and Virginia.