Women's Experiences Using Telemedicine to Attend Abortion Information Visits in Utah: A Qualitative Study

IntroductionUtah requires abortion patients to wait at least 72 hours between attending mandatory information sessions and having an abortion. In 2015, Planned Parenthood Association of Utah began offering telemedicine as a way for patients to attend state-mandated information visits. The purpose of this study was to evaluate patients’ experiences using telemedicine to attend abortion information visits.MethodsBetween April and October 2017, we conducted 18 in-depth interviews with women who used telemedicine to attend state-mandated information visits. Interviews were qualitatively analyzed using iterative thematic techniques to identify themes related to experience and acceptability of telemedicine to attend information visits.Main FindingsWomen reported telemedicine helped to minimize the burdens of cost, travel, and time associated with attending two in-person visits. Those who lived near a clinic that offered in-person information sessions reported the additional benefit of maintaining privacy by not being seen at the clinic. Overall, women reported that telemedicine was easy to use and felt the nurse was attentive to their emotions over video. A minority of women said they would have preferred an in-person visit, but the burdens of attending in person led them to choose telemedicine.ConclusionsThe findings from this study indicate that telemedicine is highly acceptable to patients as a mode of attending state-mandated information visits for abortion. Although telemedicine does not eliminate the logistical and financial burdens previously found to be associated with Utah's 72-hour waiting period and two-visit requirement, telemedicine may reduce the burdens associated with two-visit requirements for abortion and should be adopted in states that require face-to-face information sessions.     

Public (Mis)understanding of the UV Index

The ultraviolet index (UVI) has been regularly reported in Australia for a decade but utilisation remains extremely low ( approximately 5%). Blunden, Lower, and Slevin, in a 2004 Journal of Health communication article, suggest that Australians' understanding of the UVI is "good," and education to increase awareness of the index is therefore no longer warranted. To test this position, focus groups were conducted followed by an intercept survey of 404 residents of Perth, Western Australia, aged 16-44 years, to explore understanding and familiarity with the UVI. Results suggested that far from being "good," the familiarity and understanding of the UVI of at least half of Australians is poor. This was exemplified by the following: mean estimations of average UVI values in summer and winter being highly exaggerated (19.8 and 11.8, respectively); 61.2% not appreciating that the UVI is independent of temperature; at least 55.0% not appreciating that UV conditions peak at solar noon; and 23.3% of 22-44 year olds confusing the UVI with a "burn-time" measure. People who do not understand the UVI are unlikely to utilise it effectively. It therefore remains possible that utilisation of the UVI remains low because understanding is poor. Future efforts to improve utilisation of the UVI, particularly among those looking at new display formats, may therefore be ineffective, unless they also incorporate strategies to facilitate understanding of the measure.     

(Mis)interpretation of body weight in adult women and men

INTRODUCTION: This study examined what methods people use to determine and interpret their body weight, and what factors are associated with either an underestimation of overweight or an overestimation of a healthy body weight. METHOD: The study used self-reported data on weight and height. Data were collected by means of questionnaires (n = 722). RESULTS: In comparison with unaware overweight individuals, aware overweight respondents had a significantly lower score on comparing their body to that of others and on listening to remarks from others as methods to determine and interpret their body weight. The same was true for respondents with a correct perception of their healthy body weight compared with respondents who overestimated their healthy body weight. Respondents with a correct perception also had a significantly lower score on using the need to change to a different clothing size to determine body weight. Underestimation of overweight was significantly associated with body mass index (BMI), intense physical activity, knowledge of a healthy weight range and body comparison; overestimation of healthy body weight was significantly associated with gender, BMI, weight loss history and media influences. DISCUSSION: The study had a cross-sectional design, and therefore no causal relations could be determined. Despite this, the study provided more insight into the way people estimate and judge their body weight.     

A Preliminary Study of Eighth Grade Students' Attitudes Toward Rape Myths and Women's Roles

ABSTRACT: This preliminary study examined the relationship between sex-role stereotypes of women and beliefs in rape myths among adolescents. A 35-item survey was completed by 211 female and males in eighth grade health classes. Findings indicate both females and males accept some rape myths and sex-role stereotyping of women. The data also indicated an association between belief in rape myths and sex-role stereotyping of women. Few racial and age differences emerged. The most profound differences involved gender. Most adolescents rejected rape myths, but 10% of girls and 30% of boys tended to accept rape myths. Most females (98.2%) and males (83.3%) rejected sex-role stereotypes of women. According to feminist perspective, sex-role stereotyping of women's role in society is associated with tolerance of sexual violence toward women.     

(Mis)Understanding Cleveland: foundational issues and the sexual abuse of children

Summary. The Cleveland case led to the widespread condemnation of a new system for the diagnosis, initial treatment, and management of child sexual abuse. The Butler-Sloss Report identifies what went wrong as resulting from poor organisational links among agencies and poor interpersonal skills among professionals. Without denying that these faults occurred, this paper claims that what happened in Cleveland did so primarily because those making policy ignored two foundational issues inherent in the problem of child abuse: the status of the child in society and hence the State's justification in intervening on her behalf, and the status of abuse and the abuser and the consequences of their medicalisation. Analysis of these foundational issues suggests what additional steps will need to be taken if we are to deal effectively with sexually abused children and their families.     

(Mis)use of factor analysis in the study of insulin resistance syndrome

Over the last decade, factor analysis has been used increasingly to describe patterns of simultaneous occurrence of the central components of the insulin resistance syndrome. In this paper, the authors describe factor analysis, review studies that have used factor analysis to examine the insulin resistance syndrome, and explore how factor analysis might be used to increase our understanding of this syndrome. Most studies that they reviewed gave vague reasons for using factor analysis and did not demonstrate an understanding of the use and limitations of this statistical method. Confirmatory factor analysis based on sound theoretical concepts and a clear understanding of the statistical methods may provide some insights into the pathophysiology of the syndrome. However, to date none of the studies has adopted this approach, and other statistical approaches and study designs are likely to provide greater understanding of the syndrome.     

中国“不明原因肺炎”预警病例现状及其临床研究

目的了解我国“不明原因肺炎（PUO）”预警病例的现状和临床特征,为其病例定义等的改进工作提供一定的参考依据。方法在2个项目省选择省级、地市级和县级医院各1所,对其2008年4月1日-2009年3月31日期间“社区获得性肺炎”住院患者的临床资料进行筛选及分析。结果共调查1 506份“社区获得性肺炎”患者病历,其中442例（29.35%）患者符合现有“PUO”的病例定义。此442例患者发病多在冬季(32.35%);男性占60.63%,≤14岁患者占57.24%;临床主要表现为急性起病,发热伴咳嗽、咳痰,预后良好（治愈率>95%）;未引发重大公共卫生事件。结论“社区获得性肺炎”住院患者中符合现有“PUO”定义的预警病例占相当比例,但临床经过良好。建议对临床症状、体征或影像学支持肺炎诊断的患者积极进行流行病学史的询问,以及时且较为特异地发现“PUO”预警病例。     

Abortion complications in Abidjan (Ivory Coast)

The aim of this study was to describe the various methods of abortion used by women admitted to an obstetrics department in Abidjan (Ivory Coast) for abortion complications. The study was retrospective, and was based on the medical files of all 472 women admitted for abortion complications during a 3-year period (1993-1995). The introduction of plant stems into the uterus, the use of certain instruments, use of vaginal preparations, and ingestion of plants were the most common abortion methods. Seventeen maternal deaths were registered, giving a maternal mortality rate of 3.6%. A high number of previous pregnancies and the ingestion of plants to provoke abortion were factors associated with the highest risk for maternal death. Complications of "local" abortion methods accounted for a high proportion of maternal deaths.     

Meanings of Being Pregnant and Having Decided on Abortion: Young Swedish Women's Experiences

In-depth interviews about the experience of being pregnant and having decided on abortion were conducted with 10 young Swedish women. A phenomenological-hermeneutic study disclosed a complex life world summarised as “I'm happy about my fertility but I choose not to give life now.” Four themes were revealed: encountering an unexpected understanding of oneself and one's fertility, desiring to be understood by trusted others, trying out different positions in relation to pregnancy and abortion, and approaching planned adult motherhood. The results indicate that addressing young women's concerns about fertility might be important in reproductive care.     

Women's and Providers' Experiences with Medical Abortion Provided Through Telemedicine: A Qualitative Study

BackgroundIn states requiring physicians to dispense mifepristone, the small number of providers offering the method limits its uptake. In 2008, Planned Parenthood of the Heartland in Iowa began providing medical abortion via telemedicine at clinics without an on-site physician. The purpose of this study was to evaluate patients' and providers' experiences with telemedicine provision of medical abortion.MethodsBetween October 2009 and February 2010, in-depth interviews were conducted at Planned Parenthood clinics with 25 women receiving medical abortion services (20 telemedicine patients and 5 in-person patients) and 15 clinic staff. Data were analyzed qualitatively for themes related to acceptability of the telemedicine service delivery model.FindingsPatients and providers cited numerous advantages of telemedicine, including decreased travel for patients and physicians and greater availability of locations and appointment times compared with in-person provision. Overall, patients were positive or indifferent about having the conversation with the doctor take place via telemedicine, with most reporting it felt private/secure and in some cases even more comfortable than an in-person visit. However, other women preferred being in the same room with the physician, highlighting the importance of informing women about their options so they can choose their preferred service modality.ConclusionsThe findings from this study indicate that telemedicine can be used to provide medical abortion in a manner that is highly acceptable to patients and providers with minimal impact on the clinic.Practice ImplicationsThis information demonstrates the feasibility of telemedicine to extend the reach of physicians and improve abortion access in rural settings.     

妇女常见病防治工作监督评估框架构建研究

为强化妇女常见病防治工作相关政策的落实和执行效率,本研究以目标为导向的评估理论为指导,运用头脑风暴法和德尔菲法,从工作投入,服务提供、利用与质量控制和服务结局三个维度研究构建符合我国国情的妇女常见病防治工作监督评估框架,体现了妇女常见病防治工作的整体性、层级性和复杂性,也体现了卫生服务评价的核心思想。     

针对流动人口开展流产后计划生育服务的必要性研究

目的了解北京市寻求人工流产的年轻流动妇女避孕、流产相关情况以及流产后获得计划生育服务的现状,探讨对流动人口开展流产后计划生育服务的必要性。方法采用自行设计的调查问卷,对1008名25岁以下的人工流产妇女进行横断面调查。对其中624名流动人口的数据进行对比分析。结果流动人口中77.1%为未婚,≤19岁占11.1%,初中以下文化程度占22.9%,工作不稳定占23.2%,月收入≤1000元占46.5%,16.5%的人经历过高危流产;本次流产原因是未避孕及不知道避孕方法的比例分别为64.1%和11.8%,与户籍妇女相比均有统计学意义(P<0.05)。流产后没有接受任何避孕宣教服务的占35.1%,没有接受计划生育咨询服务的占84.1%,5.47%的人表示医生向其提供了避孕药具,10.42%的人表示医生向其建议转诊(获得药具或宣教)。结论与户籍妇女相比,流动人口中人工流产妇女的年龄相对较小,文化程度较低,工作不稳定、收入低,避孕知识欠缺,避孕方法使用率低,高危流产比例高,而现有流产后计划生育服务提供的数量和内容有限,应针对其特点加强流产后计划生育服务。