Depot medroxyprogesterone acetate (DMPA) is a long acting progesterone only contraceptive agent. Side effects such as irregular bleeding patterns and weight gain are attributed to discontinuation. The purpose of this study was to describe depot medroxyprogesterone acetate discontinuation after weight gain in 17 to 19 year-old adolescent girls.

The purpose of the study is to contribute to the development of a tool that can support the rehabilitation care worker towards intervention planning and the monitoring of their clients. The National Health Insurance and the Framework and Strategy for Disability and Rehabilitation of the South African Department of Health are strategies to work towards accessible, affordable, equitable and quality health care, which includes health promotion, disease prevention, curative, rehabilitation and palliative services for all South Africans. Both strategies emphasise the use of community health workers and mid-level workers as a key component of primary health care. In the Western Cape provincial Department of Health a new cadre, namely the rehabilitation care worker has been introduced as a member of the rehabilitation team. The introduction of the rehabilitation care worker is still in the pilot phase. The rehabilitation care workers face many barriers to providing effective care. One such challenge is the lack of a contextually relevant resource tool to collect information on the rehabilitation and health needs of persons with disabilities. The aim of the study was to develop a contextually relevant resource tool that would support the rehabilitation care worker in understanding and documenting how the rehabilitation and related health needs of persons with disabilities are met in home- and community-based settings. Three specific objectives were defined: i) to develop the content and domains of the rehabilitation and health information tool; ii) to establish the validity (face and content) of the rehabilitation and health information tool; and, iii) to test the application of the rehabilitation and health information tool on a sample of persons with disabilities. This study was an exploratory descriptive study adopting a sequential mixed methods design. There were two phases in this study. Phase 1 involved qualitative research methods in the development of the rehabilitation and health information tool through the use of document review and a focus group discussion with experts. Phase 2 of the study involved quantitative research methods in the field testing of the rehabilitation and health information tool by the rehabilitation care workers on a sample of persons with disabilities. The results of phase 1 included the development of the rehabilitation and health information tool, which was deemed by the experts to be a comprehensive, contextually relevant tool with face and content validity and could be easily administered by the rehabilitation care worker. The conceptual framework of the International Classification of Functioning, Disability and Health provided domains that could comprehensively document the multidimensional needs of persons with disabilities. The result was a draft rehabilitation and health information tool with 17 questions ranging across the domains of activities of daily living, sexual health, health behaviours, barriers and facilitators to good health, finance and understanding of disability. Changes were proposed to the wording, layout and flow of the tool and the persons with disabilities’ goals were included as an element . The inclusion of the end users as experts in the development resulted in a richer understanding needed for the shaping of this tool. The results of phase 2 highlighted that the rehabilitation and health information tool was able to describe the rehabilitation and health needs of persons with disabilities. Additionally the tool was able to document the specific goals of the persons with disabilities which is useful to plan and monitor intervention. The rehabilitation care workers reported the tool to be useful, easy to use, and provided a structured manner to collect information. They also reported that it was useful in stimulating conversations on sensitive topics. However, it was indicated that it took too long to complete and there were components that were incomplete. The rehabilitation and health information tool requires further refinement, validation and further follow-up testing before it can be formally adopted and implemented as part of the rehabilitation care worker’s standard practice.

<p>Public health infrastructure (PHI) serves as the core foundation for essential public health and its services. However, the U.S. PHI has been weakened by understaffing, underfunding, limited resources and partnerships, and outdated data and information systems over the past few decades. The recent COVID-19 pandemic exacerbated its vulnerability and weakened nature, resulting in increased health disparities and worse health outcomes in general for the nation. The goal of this study was to identify elements of local PHI that are associated with the completion of 20 key public health activities while adjusting for state differences. Cross-sectional secondary data were acquired and linked from two national surveys of local health departments, the National Profile of Local Health Departments survey and the National Longitudinal Survey of Public Health Systems. In total, 20 multivariable logistic regression models were created to analyze the relationships between variables. State fixed effects were used in multivariable models to control for state differences. It was found that state differences affected the correlations of infrastructure variables. Several staffing elements, abilities to provide certain services, and participation in certain types of actions were strongly correlated with the completion of best practice activities. These findings will add to the discussion of what the minimum necessary elements of PHI may be.</p>

The Visiting Nurse Association of Indianapolis, formerly the Public Health Nursing Association of Indianapolis, is a nonofficial community agency in Marion County. It was incorporated January 11, 1913. According to its constitution, it was organized to "provide graduate registered nurses to teach needy individuals and the general public hygiene, cleanliness, and the proper care of the sick; to prevent disease; and to render such aid as may from time to time be proper."I This organization has provided nursing care in homes, in clinics, in industries, and in other situations outside the hospitals since its beginning. Since 1921 it also has provided field experience for student nurses from basic schools of nursing and since 1937, for students from Indiana University, Division of Nursing Education. The purpose of this paper is to present an historical account of the activities of the Visiting Nurse Association from 1913 through 1959.

Obesity and inactivity are prevalent among central Appalachian adolescents. Appalachian residents have been labeled "fatalistic," a time perspective unsupportive of health-promoting behaviors such as regular participation in physical activity. The theory of planned behavior has been used extensively to explain the physical activity behaviors of adolescents. Constructs within the theory of planned behavior include attitudes toward the behavior, subjective norms, perceived behavioral control, and intention to perform the behavior. The purpose of this study was to determine the time perspective of central Appalachian adolescents and examine the relationship between time perspective and the constructs within the theory of planned behavior. A descriptive, correlational design was used to examine time perspective and the physical activity behaviors of a convenience sample of 185 central Appalachian adolescents. Data collection occurred in school. Results indicate central Appalachian adolescents are hedonistic with positive attitudes toward the past. Females were more future-oriented than males. Future oriented students were more likely to plan to attend college. Constructs within the theory of planned behavior were moderate predictors of physical activity that lasted long enough or was intense enough to produce sweat.

BACKGROUND: This presentation concerns the evaluation of an additional clinical experience in case management for senior baccalaureate students. During their final leadership course, nursing students can elect to do an additional 80-hour precepted clinical experience focusing on case management in primary care clinics. As part of that experience, they rotate through seven nurse-managed rural primary health clinics in Tennessee. METHOD: As part of the evaluation process, students and preceptors were asked to review the experiences that students had participating in the clinical. RESULTS: For the most part, students were highly satisfied with the case management experience and thought it provided an additional skill set for them as they were completing their final year in nursing school and preparing to enter the nursing workforce as graduates of the Bachelor of Science in Nursing program. CONCLUSION: A community case management clinical opportunity in primary care allows a community experience for students that provides them with an opportunity to witness an RN practicing to the full scope of the license.

No description available.

Introduction & Background Black infant mortality rate is 122% higher than that of non-Hispanic white infants. In a 2021 CDC study, Black women’s maternal mortality rate was 69.9 deaths per 100,000 live births, 2.6 times the rate for non-Hispanic White women. Purpose Statement & Research Question The purpose of our research was to explore reasons why Black maternal mortality is higher than White and non-Hispanic populations and what contributing health disparities are causing higher mortality rates in black infants and mothers compared to their non-Hispanic white counterparts, in the United States. Literature Review: We found articles under 5 years old from Cinhal database. Findings Examples of inclusion and exclusion criteria in our studies included: ages between 18-39, whether they had hypertension during pregnancy, or were between 22-43 weeks of gestation. Main findings from our studies include mistrust between health providers and the black pregnant women negatively impacted their adherence to safe sleep practice, and 32% of women in another study reported that they were not able to initiate their first prenatal care visit as early as preferred due to a myriad of barriers. Conclusions & Nursing Interventions The take-home message of our studies was that disparities are multifactorial. Some major nursing implications we found are that perinatal nurses should assess the psychological wellbeing in Black women throughout pregnancy and advocate for Black women who report high levels of stress, depressive symptoms, or psychological distress.

Background People with type 1 diabetes make up approximately two million of the American population. Every day, these two million people struggle to fight this lifelong, sometimes life threatening disease. While type 1 diabetes currently has no cure, there are technologies that can make diabetes management more effective. This study surveyed the type 1 diabetes (T1D) young adult population aged 18-30, to evaluate what technologies and tools are most often associated with achieving optimal glycemic control (OGC). Methodology The instrument is a 35 question, investigator developed survey that is designed to measure how often a participant utilizes the technology identified in each question, with the response choices ranging from 0 (never) to 5 (multiple times daily). In addition, there were some yes/no and fill-in-the-blank questions to identify demographic variables. The technology topics that were explored are 1) mode of insulin therapy, 2) mode of blood glucose monitoring therapy, 3) mode of communication with designated care provider, 4) electronic applications used, 5) demographic variables, and 6) pertinent comorbidities. This information was used to evaluate variables that assist T1Ds in achieving optimal glycemic control. Participants were invited to participate in this study via email using the Students with Diabetes email listserv. The email contained the IRB approved explanation of research letter, which informed participants of the study and the research being conducted. If the student chose to participate, they checked a box that served as an electronic signature, and they continued on to the 35-question survey. All responses to the survey will be kept confidential; as the survey and research did not require any personal identifying information. Data regarding the specific demographics, technologies used for diabetes control, and hemoglobin A1C levels were recorded and analyzed. The results of the survey will be shared with the participants via the same email list-serv by which they were originally recruited. Results There were 59 participants. A total of 21 out of 59 respondents had optimal glycemic control (A1C less than 7.0, per American Diabetes Association guidelines). Eighty eight percent of those with OGC wore their CGMs all the time, while only 66% of those with IGC wore their CGMs all the time. Ninety five percent of those with OGC used their insulin pumps all the time, while 89% of those with IGC did. It is likely that the combination of both CGMs and insulin pumps worn all the time are the most powerful tools to achieving OGC. Students that were employed, enrolled in classes, and still under their parent’s insurance plans had a higher incidence of optimal glycemic control. Discussion It was hypothesized that those with OGC would have a higher incidence of diabetes technology use. This PI found that even though almost all participants had access to the diabetes technology, still only 37% of the participants had optimal glycemic control. There are many components to diabetes care that impact glycemic control that were not explored within this scope of this diabetes technology study. Conclusions It is likely that both CGMs and insulin pumps worn all the time are the most powerful tools to achieving OGC. Students who graduate from college and transition to adulthood are vulnerable as they may encounter added stressors such as employment, and financial responsibility that cause them to deviate from the recommendations for diabetes technology use. Care providers need to be cognizant that young adulthood is a vulnerable time in terms of OGC and optimal diabetes management. Providers need to work with young adults, and encourage them to adhere to the recommended diabetes care regime.

Women with gynecological (GYN) cancer experience a wide spectrum of physical, emotional and social effects after diagnosis and treatment of their cancer. The insufficient availability of local support groups, limited transportation for the rural Chinese population and a shortage of oncologists make it difficult to have face-to-face support groups for Chinese GYN cancer patients. However, the wide access of Internet has provided an opportunity for people to have online support groups. The purpose of this study was to observe and describe the types of support given to and by Chinese GYN cancer survivors in a QQ chat group. This was a qualitative study that used the directed content analysis approach. A QQ group was observed for two weeks between March 10th (12:01am) and March 24st (11:59pm) 2018 Beijing time. Observed online posts were copied and pasted into a WORD ™ document for analysis. There were 4 themes observed: sharing experience, information exchange, emotional support and Guardian Against Cancer group member benefits. The results of the study suggested that women supported each other but little evidence-based support was observed. Healthcare providers should be monitoring and engaging in conversations with group members. Well-planed and organized information sessions should also be beneficial for members. Further research on understanding members’ needs on online support groups and the effectiveness of intervention should be conducted.