Use of emergency contraception by US teens: effect of access on promptness of use and satisfaction

STUDY OBJECTIVE

To examine the effect of policies regarding access to emergency contraception (EC) on teens' promptness of EC use and satisfaction with EC access experience.

SETTING

Online survey.

PARTICIPANTS

Females, ages 14 to 19, who had engaged in unprotected intercourse at a time when they were aware of EC.

MAIN OUTCOME MEASURES

Outcomes included promptness of EC use and satisfaction with EC access experience. Outcomes were compared according to method of obtaining EC and state policies regarding EC access.

RESULTS

Surveys were completed by 531 teens from 49 states; 58% were Caucasian and 14% were African American. Only 48% of participants reported ever using EC. Teens who obtained EC without a prescription were more likely to use EC within 24 hours of unprotected intercourse (odds ratio = 2.17; 95% confidence interval: 1.06-4.44). Minors who obtained EC in pharmacist-access states were more likely to be satisfied with their EC access experience (odds ratio = 3.05; 95% confidence interval: 1.11-8.35).

CONCLUSION

Fewer than half of participants had used EC, despite being aware of EC at the time of unprotected intercourse. Policies allowing minors to access EC without a prescription may increase timely use of EC.

Associations between depressive symptoms and sexual risk behavior in a diverse sample of female adolescents

STUDY OBJECTIVE

To determine associations between depressive symptoms, locus of control, and sexual outcomes in a predominantly African-American cohort of female adolescents.

DESIGN

A computerized assessment was administered to participants as part of a larger randomized clinical trial. We assessed sexual risk behaviors (SRBs) via self-report, and we assessed depressive symptoms using the Center for Epidemiologic Studies Depression Scale. We used multivariate regression to determine associations between depressive symptoms and outcomes while controlling for covariates.

SETTING

This was a secondary analysis of baseline data collected during a randomized clinical trial intended to prevent unintended pregnancy and sexually transmitted infections (STIs).

PARTICIPANTS

572 adolescent females, ages 13 to 21 years, were recruited via a hospital-based adolescent clinic and community-wide advertisements.

MAIN OUTCOME MEASURES

Participants reported on prior sexual intercourse, number of lifetime partners, frequency of intercourse, history of pregnancies and STIs, and locus of control.

RESULTS

Two thirds of the sample had been sexually active. In a model that controlled for all covariates, those with a high level of depressive symptoms had higher odds of having had intercourse (adjusted OR = 2.29; 95% CI = 1.18-4.43). High levels of depressive symptoms were also independently associated with increased numbers of lifetime sexual partners and an external locus of control. However, when depression and locus of control were included in the same model, locus of control was not independently associated with SRBs.

CONCLUSION

These findings support other literature demonstrating an association between depression and SRBs, particularly in a largely African-American population. They further suggest that perceived control does not fully explain the relationship between depression and SRBs.

Medicolegal aspects of neurotology

In their professional capacity, physicians interact with the legal profession in a variety of ways. The interaction occurs most often in the situation where an individual suffering from a bodily injury seeks the recovery of monetary benefits through the legal system. This article reviews the manner in which physicians are contacted by attorneys in connection with workers' compensation cases and civil tort cases. It will also set forth various definitions of disability and contrast those definitions with the concept of impairment as that term is used in the medical profession. Suggestions for patient evaluation and a summary of the legal basis for the recovery of benefits are also presented.

A static model for the nanolight discharge

A stationary model for a spark light source at high current densities and gas pressures is developed. The model assumes that the plasma is in local thermodynamic equilibrium and radiates like a blackbody. The equations employed are the energy balance equation and the circuit equation. The energy balance includes ohmic heating, radiation loss, loss to the boundaries, and ionization. The maximum temperature (radiance) of the source is calculated as a function of gas pressure and initial voltage. A good agreement is found with the previously published experimental results of the nanolight discharge light source. This model is general and can be extended to any high pressure discharge which can be considered stationary.