Does Immediate Access to Birth Control Help Prevent Pregnancy? A Comparison of Onsite Provision Versus Off Campus Referral for Contraception at Two School-Based Clinics

PURPOSE: The purpose of this study was to assess the impact of different policies on access to hormonal contraception and pregnancy rates at two high school-based clinics. METHODS: Two clinics in high schools (Schools A and B), located in a large urban district in the southwest US, provide primary medical care to enrolled students with parental consent; the majority of whom have no health insurance coverage. The hormonal contraceptive dispensing policy of at School clinic A involves providing barrier, hormonal and emergency contraceptive services on site. School clinic B uses a referral policy that directs students to obtain contraception at an off-campus affiliated family planning clinic. Baseline data (age, race and history of prior pregnancy) on female students seeking hormonal contraception at the two clinics between 9/2008-12/2009 were extracted from an electronic administrative database (AHLERS Integrated System). Data on birth control use and pregnancy tests for each student was then tracked electronically through 3/31/2010. The outcomes measures were accessing hormonal contraception and positive pregnancy tests at any point during or after birth control use were started through 12/2009. The appointment keeping rate for contraceptive services and the overall pregnancy rates were compared between the two schools. In addition the pregnancy rates were compared between the two schools for students with and without a prior history of pregnancy. RESULTS: School clinic A: 79 students sought hormonal contraception; mean age 17.5 years; 68% were > 18 years; 77% were Hispanic; and 20% reported prior pregnancy. The mean duration of the observation period was 13 months (4-19 months). All 79 students received hormonal contraception (65% pill and 35% long acting progestin injection) onsite. During the observation period, the overall pregnancy rate was 6% (5/79); 4.7% (3/63) among students with no prior pregnancy. School clinic B: 40 students sought hormonal contraception; mean age 17.5 years; 52% > 18 years; 88 % were Hispanic; and 7.5% reported prior pregnancy. All 40 students were referred to the affiliated clinic. The mean duration of the observation period was 11.9 months (4-19 months). 50% (20) kept their appointment. Pills were dispensed to 85% (17/20) and 15% (3/20) received long acting progestin injection. The overall pregnancy rate was 20% (8/40); 21.6% (8/37) among students with no prior pregnancy. A significantly higher frequency of students seeking hormonal contraception kept their initial appointment for birth control at the school dispensing onsite contraception compared to the school with a referral policy for contraception (p<0.05). The pregnancy rate was significantly higher for the school with a referral policy for contraception compared to the school with onsite contraceptive services (p< 0.05). The pregnancy rate was also significantly higher for students without a prior history of pregnancy in the school with a referral policy for contraception (21.6%) versus the school with onsite contraceptive services (4.7%) (p< 0.05). CONCLUSION: This preliminary study showed that School clinic B with a referral policy had a lower appointment keeping rate for contraceptive services and a higher pregnancy rate than School clinic A with on-site contraceptive services. An on-site dispensing policy for hormonal contraceptives at high school-based health clinics may be a convenient and effective approach to prevent unintended first and repeat pregnancies among adolescents who seek hormonal contraception. This study has strong implications for reproductive health policy, especially as directed toward high-risk teenage populations.

Cervical cancer screening in Hispanic women as compared with other ethnic groups on an urban campus

Although Pap screening has decreased morbidity and mortality from cervical cancer, reported statistics indicate that among ethnic groups, Hispanic women are one of the least likely to follow screening guidelines. Human papillomavirus (HPV), a major risk factor for cervical cancer, as well as pre-cancerous lesions, may be detected by early Pap screening. With a reported 43% prevalence of HPV infection in college women, regular Pap screening is important. The purpose of this descriptive, cross-sectional survey was to examine self-reported cervical cancer screening rates in a target population of primarily Mexican-American college women, and to discover if recognized correlates for screening behavior explained differences in screening rates between this and two other predominant groups on the University of Houston Downtown campus, non-Hispanic white and African-American. The sample size consisted of 613 women recruited from summer 2003 classes. A survey, adapted from an earlier El Paso study, and based on constructs of the Health Belief Model (HBM), was administered to women ages 18 and older. It was found that although screening rates were similar across ethnic groups, overall, the Hispanic group obtained screening less frequently, though this did not reach statistical significance. However, a significant difference in lower screening rates was found in Mexican American women ages <25. Additionally, of the predicted correlates, the construct of perceived barriers from the HBM was most significant for the Mexican American group for non-screening. For all groups, knowledge about cervical cancer was negatively correlated with ever obtaining Pap screening and screening within the past year. This implies that if health counseling is given at the time of women's screening visits, both adherence to appropriate screening intervals and risk factor avoidance may be more likely. Studies such as these are needed to address both screening behaviors and likelihood of follow-up for abnormal results in populations of multicultural, urban college women. ^

Aligning Library Strategy and Structure With the Campus Academic Plan: A Case Study

Colleges and universities’ missions are typically comprised of educating students, training professionals, engaging in scholarship and research, promoting creative activity, improving healthcare, and providing public service. Academic libraries exist to support these core functions, yet most academic libraries are organized based on library functions rather than the primary missions of their college or university. This paper describes one academic library’s attempt to align library strategy and structure with its university’s academic plan.

Comparing Campus Discipline Rates: A Multivariate Approach for Identifying Schools with Significantly Different than Expected Exclusionary Discipline Rates

Campus behavior management is important for ensuring classroom order and promoting positive academic outcomes. Previous studies have shown the importance of individual student and campus personnel characteristics and campus context for explaining campus discipline rates (e.g., rates of suspension and expulsion). Assessing campus discipline rates, while controlling for these individual and campus characteristics, is important for the monitoring, evaluation, and intervention role of policymakers as well as state and federal level education agencies. Systems or metrics exist that measure other student outcomes (i.e., academic performance) with controls for individual and campus characteristics, but none exist that monitor these differences for discipline rates across campuses. In this paper, we use a multivariate model to analyze a longitudinal, statewide dataset for all secondary students in Texas from 2000 to 2008 in order to examine how campus discipline rates differ across schools with statistically similar students, teachers, and campus characteristics. The findings are important for understanding that some schools with similar characteristics have significantly different exclusionary discipline rates, and they are important for informing policy and agency level decision-making. The methodology described can easily be used by monitoring agencies as well as local school districts.

El campus virtual de la U.N.Cuyo : un espacio interactivo de aprendizaje : proyecto pedagógico con modalidad a distancia para la terminalidad de estudios de EGB3 y Educación Polimodal EDITEP

Este libro describe el Campus Virtual de la Universidad Nacional de Cuyo, diseñado como plataforma informática para la enseñanza y el aprendizaje. Se editó como material de aprendizaje destinado al personal de seguridad pública de la Provincia de Mendoza en el marco del proyecto pedagógico con modalidad a distancia para la terminalidad de estudios de EGB3 y Educación Polimodal –EDITEP–, implementado a partir de la firma del Convenio entre la Universidad Nacional de Cuyo y el Gobierno de la Provincia de Mendoza, en octubre de 2003.

Evaluación de características de interés agronómico de damascos cv. Modesto

El cultivar de damascos Modesto es de introducción relativamente reciente en Mendoza (Argentina). El objetivo del trabajo fue evaluar las siguientes características de interés agronómico: la época de floración y la calidad de los frutos en cosecha y en postcosecha. El estudio se realizó en un monte comercial durante 2007 y 2008. Se registraron tres estados fenológicos: "D" (corola visible), "F" (flor abierta) y "H" (fruto cuajado). Se estableció el inicio de la floración, la plena floración y el fin de la misma. En los frutos las evaluaciones y mediciones se realizaron en el momento de la recolección y después del período de maduración de la fruta conservada en cámara frigorífica. Se determinó: color de fondo, peso, diámetro, firmeza de pulpa, contenido de sólidos solubles, pH, acidez titulable, presencia de hongos y desórdenes fisiológicos. Los resultados muestran que el cultivar Modesto florece en una época intermedia en la zona E de la provincia de Mendoza. La fecha de plena floración en los dos años del estudio fue el 8 de setiembre. En los estados de madurez evaluados los frutos reúnen los atributos de calidad demandados por el consumidor: alto CSS, color anaranjado en la madurez, buena firmeza de pulpa; sin embargo, el rápido, descenso de la firmeza durante la maduración en poscosecha obliga a una comercialización acelerada. Después del almacenamiento en cámara frigorífica durante treinta días y un período de maduración de dos días, la futa presentó el desorden harinosidad con una incidencia superior al 60%; esto señala que el cv. Modesto no puede almacenarse por un período tan prolongado.

Del campus a las calles. La nueva izquierda norteamericana : Singularidades y analogías con las experiencias latinoamericanas

Fil: Bozza, Juan Alberto. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.

Del campus a las calles. La nueva izquierda norteamericana : Singularidades y analogías con las experiencias latinoamericanas

Fil: Bozza, Juan Alberto. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.

Del campus a las calles. La nueva izquierda norteamericana : Singularidades y analogías con las experiencias latinoamericanas

Fil: Bozza, Juan Alberto. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.