<p>In Russia today women use traditional forms of birth control at unusually high rates, whereas, conversely their use of modern contraceptives is unusually low. During the Soviet period, women&rsquo;s access to modern contraceptive methods may have been limited. However, one would postulate that after the collapse of the Soviet Union, the nature of the new reforms that developed would have lent itself to an increase in modern contraception usage on par with other countries. In Russia today there is not a lack of availability of modern contraceptives. Yet, women are still not using modern contraception at a rate that is congruent with an increase in availability. What then is influencing Russian women&rsquo;s decisions? The contraceptive acceptance of Russian women today is shaped by cultural legacies of the Soviet Union surrounding both contraceptives themselves and sex and sex education. </p>

Abstract Purpose: With the US reporting 20 million newly diagnosed STI/HIV cases annually, clinical guideline compliance and EBP recommendation implementation necessitate provider practice changes for high-quality routine sexual and reproductive health services. The project's purpose was to improve sexual health history-taking (SHH) and documentation in a private primary care practice (PPCP) serving high-risk populations. The DNP project aims to determine the effect of conducting a 30-minute educational session and implementing the CDC's 5Ps on a PCP's clinical guideline adherence to SHH recommendations and documentation with patients presenting for annual wellness exams, well-woman exams, family/contraceptive counseling, or acute urogenital complaints in an urban, southeastern PPCP. Methodology: The quality improvement (QI) project implemented a standardized clinical practice change using the Stetler model's practitioner-oriented knowledge translation design. PPCP-employed NPs (n = 3) completed anonymous pre-/post-implementation surveys using SurveyMonkey, received educational resources, and implemented the CDC's 5Ps SHH tool for clinically appropriate patient encounters identified by eligible ICD-10 codes. Athena's Report Builder compiled data on SHH completion/EMR documentation and providers' intervention compliance from 2-weeks before and 2-weeks after implementation. Results: Over the four-week project period, a total of n = 1,031 EMR charts [pre-implementation (n = 513)/post-implementation (n = 518)] were reviewed for SHH completion/EMR documentation. Analysis of eligible encounters’ charts showed significant improvement in post-implementation SHH completion/EMR documentation rates (37% in pre-intervention; 82% in post-intervention). The chi-square test findings [X2 (1, N = 1031) = 43.637, p < .01] displayed a significant relation between the variables, indicating an increased likelihood of sexual health history EMR documentation by implementing the CDC'S 5Ps SHH tool. Provider survey results indicated providers support implementation and routine clinical practice of the CDC's 5Ps. Limitations: Provider sample size (n =3), geographical location, demographics served, private ownership, and SUD treatment center association limit the study's generalizability. Implications for Practice: The PPCP’s SHH tool availability for clinically relevant encounters increased SHH EMR documentation completion and frequency rates––utilizing the brief, cost-effective intervention for evaluating sexual health risks and behaviors to decrease the likelihood of adverse outcomes. Through positive, nonjudgmental sexual health information acquisition, providers can better facilitate difficult conversations with patients, promote sexual health awareness, and improve STI/HIV screening/treatment rates in a private primary care practice setting. Keywords: sexual health history

<p> This is a history between 1960 and 2000 of asylums operated in the United States for children labeled as &ldquo;severely or profoundly mentally retarded,&rdquo; and &ldquo;emotionally and behaviorally disturbed.&rdquo; I use one primary case study of the Willowbrook State School in Staten Island, New York. Willowbrook has already received some focus in the works of David and Shelia Rothman as well as Drs. David Goode, Darryl Hill, and William Bronston, and Geraldo Rivera&rsquo;s newscast in 1972. Primary focus has been given to it because it is both unique and indicative of asylums across the U.S. during the mid 20th Century. It was unique in some of the severity of treatment, which its residents experienced, but overall mirrors national trends in brutal and neglectful living conditions. It also signals larger national trends in the mid to late 70s, which carry over into the 80s and early 90s as part of the deinstitutionalization movement. I find that this movement was largely a response to the conditions for which Willowbrook became a national symbol. Furthermore, even in the wake of the deinstitutionalization movement, there are many problems with federal and state policy that disproportionately disaffect people of color as well as poor people. Finally, I argue that the historical canon must expand somewhat to take into account Deleuze and Guattari&rsquo;s ideas about Societies of Control. Many scholars, such as the Rothman, Tonya Titchkosky, Kim E. Nielsen, and others base their work on the Foucault&rsquo;s notion of a &lsquo;disciplinary&rsquo; society. But Deleuze (sometimes with Guattari) offers a sympathetic critique of Foucault&rsquo;s understanding of discipline that adds a great deal of depth to the study of asylums and deinstitutionalization in the mid to late 20th Century.</p>

This thesis examines the role and currency of medical and psychological languages and anxieties in discussions of women’s work, housework, marriage and motherhood in Britain between 1945 and 1963. More specifically, it traces the emergence of the ‘dual role’, a life balanced between work and home, as the product of competing and colliding concerns over childhood and adult illness. Arguing for a granular and contingent approach to historical knowledge and experience, it analyses a series of conversations and transformations, each of which contributed to shifts in ideals of appropriate, ethical, and healthy behaviour. In moving beyond existing histories of women, work, and home, this thesis takes a complex look at the medical politics of post-war feminism and counter-feminism. It identifies and explores important sites of contestation and collision, in which new orthodoxies and compromises were formed. Through close review of disregarded post-war literatures on motherhood, male health, housework, fatigue, loneliness, selfhood, ageing, the therapeutics and prophylaxis of productivity, overstrain, caring, morbidity, psychological conflict, and the relationship between medicine and political transformation, this thesis provides a methodical and nuanced account of the ideas and experiences which framed and bounded changing patterns of combination between work and home. It offers scholars of women’s history a more sophisticated understanding of the diversity and importance of knowledge about the mind and body – as well as the thoughts, words and actions of medical professionals – in shaping historical processes which have been widely described but insufficiently understood. For historians of medicine, it explores the political context and consequences of discourses on health, using questions over work, domesticity, marriage and motherhood to interrogate the collaborative and antagonistic convergences between feminist activism, curative therapy, and public health.

This thesis is an exploration of various aspects of oral health in the early-modern period. It examines evidence taken from texts belonging to a range of genres including surgical manuals, botanical texts, midwifery manuals, poets and plays. Building on existing academic work relating to the history of dentistry and venereal disease, it aims to assimilate material from across science and the arts in order to gain a sense of what general social expectations were in relation to the condition of the teeth and palate, and how people suffering with a decline in oral health were advised, or what treatments were available to them either from a professional or in the home. It aims to challenge existing preconceptions that people living in this period displayed a negligent attitude towards the health of their teeth and oral hygiene. The thesis contains four chapters which each focus on a different aspect of oral health, though many themes recur across all four chapters. The first chapter investigates advice that was available in print, and therefore likely to be in public consciousness, to the early-modern individual in relation to maintaining their teeth. It then considers the portrayal of unattractive teeth and bad breath in early-modern literature. Chapter Two deals with early-modern explanations of what caused the toothache and how it could be remedied. Analysis of the depictions of toothache in various poetry and plays follows in order to explore how wider society made sense of medical thinking at the time. The palate becomes the sole focus of Chapter Three, which considers what specific health concerns posed a threat to the condition of the roof of the mouth, and what difficulties could arise for the individual whose palate has been damaged by disease or injury. The thesis concludes with a chapter which investigates the history of a congenital oral birth defect, the cleft lip and palate. The thesis was designed to allow each chapter to deal with a separate facet of oral health; they encompass in turn: oral hygiene, dental pain, the impact of disease on the palate and an exploration of an oral birth defect. An undercurrent of the thesis is to use a range of material to ascertain a realistic idea of what it was like for an individual to experience oral health difficulties in this period. It is therefore interested in how society perceived people who were experiencing problems with their oral health, and what could be done to improve their quality of life. The research presented here represents a contribution to the field of the history of oral health and aims to provoke further questions relating to the responsibility early-modern individuals took for their own oral health, and the specific situations in which intervention, either surgical or medicinal, was deemed necessary.

No description available.

A detailed family health history is currently the most potentially useful tool for diagnosis and risk assessment in clinical genetics. We developed and evaluated the usability and analytic validity of a patient-driven web-based family health history collection and analysis tool. Health Heritage © guides users through the collection of their family health history by relative, generates a pedigree, completes risk assessment, stratification, and recommendations for 89 conditions. We compared the performance of Health Heritage to that of Usual Care using a nonrandomized cohort trial of 109 volunteers. We contrasted the completeness and sensitivity of family health history collection and risk assessments derived from Health Heritage and Usual Care to those obtained by genetic counselors and genetic assessment teams. Nearly half (42%) of the Health Heritage participants reported discovery of health risks; 63% found the information easy to understand and 56% indicated it would change their health behavior. Health Heritage consistently outperformed Usual Care in the completeness and accuracy of family health history collection, identifying 60% of the elevated risk conditions specified by the genetic team versus 24% identified by Usual Care. Health Heritage also had greater sensitivity than Usual Care when comparing the identification of risks. These results suggest a strong role for automated family health history collection and risk assessment and underscore the potential of these data to serve as the foundation for comprehensive, cost-effective personalized genomic medicine.

Chronic diseases are a significant cause of illness and mortality in the United States. Hereditary predisposition to chronic diseases is a useful indicator for identifying people at risk for disease development. An ideal tool for determining this predisposition is the CDC, NIH, and AAFP recommended third-degree family health history (FHH). The aim of this quantitative, cross-sectional study, based on the theoretical frameworks of social constructivism and the health belief model, was to assess the possible influence between the completed third-degree FHH and the participant's perception of disease risk. Two-hundred seventy-three participants were recruited from health care facilities and from the general population using convenience sampling. Bivariate and multivariate tests were applied to analyze the obtained data. Binary regression indicated a statistically significant association between the presence of heart disease, stroke, breast cancer, ovarian/cervical cancer, prostate cancer, colon cancer, and diabetes, and the perception of risk for the particular disease as noted in the FHH. A familial history of stroke appeared to be the strongest predictor of perception of disease risk. Moreover, increasing age, particularly within the age range of 40 to 57, was associated with increasing levels of perception of disease risk for heart disease, stroke, and prostate cancer. Individuals from the general population significantly indicated higher-than-average risk for colon cancer compared to those from health care facilities. Social change implication of this study may be the widespread implementation of a familial health history questionnaire that leads to an impactful, higher degree of disease risk awareness, prompting preventive action on the part of the individual, and leading to improved individual and population health.

No description available.

Family health history (FHH) has been recognized as an important tool in cancer prevention and health promotion. To date, literature on FHH discussions about cancer have largely focused on patient-physician communication or the dissemination of cancer-specific genetic tests results within the family. Fewer studies have sought to identify family factors that may promote FHH discussions, yet this type of information could be used to identify families needing support in having these conversations. Thus, the present study examined relations between family organization (cohesion and flexibility), communication openness, and FHH communication about cancer within a diverse group of women recruited from an urban, safety-net women's health clinic. Participants were enrolled in a randomized control trial examining the effects of an educational intervention on family communication about hereditary breast and colon cancers (Kin Fact Study). For the present study, baseline survey data for 472 women were analyzed. Participants completed measures on demographics, family organization, communication openness, and FHH communication. Average age was 34 years and 59% reported being Black. Thirty-one percent had graduated high school and 28% reported having commercial health insurance. Seventy-five percent of women reported a family history of cancer in a first or second degree relative. Descriptive statistics, correlations, and multiple linear regression and hierarchical logistic regressions, adjusting for key factors, were performed. Nineteen percent of women actively collected FHH information about cancer and 11% reported actively sharing cancer risk information with relatives. Being older, having a greater educational attainment, and having a family history of cancer was associated with having collected FHH; while being older and reporting higher levels of cohesion/flexibility was associated with sharing cancer risk information. Adjusting for demographic variables, cohesion, flexibility, and openness were not significant predictors of collecting or sharing FHH. Family history of cancer did not moderate the relationship between family organization and FHH. Cohesion and flexibility levels did significantly predict communication openness. This study contributes to a small but emergent literature in the field of FHH communication about cancer as it explores family context factors that may aid in the development of prevention interventions. Clinical implications and directions for future research are discussed.