Purpose The purpose of this study was to describe adolescents’ and young adults’ concerns about confidential reproductive health care and experience with time alone with a provider, and examine the association of these confidentiality issues with receipt of contraceptive services. Methods Data from the 2013 to 2015 National Survey of Family Growth were analyzed using Poisson regression to describe 15- to 25-year-olds’ confidential reproductive health-care concerns and time alone with a provider at last health-care visit according to sociodemographic characteristics. We also assessed whether confidentiality issues were associated with obtaining contraceptive services among females. Results Concerns about confidential reproductive health care were less common among 15- to 17-year-olds who were covered by Medicaid compared to their parents’ private insurance (adjusted risk ratio [ARR] = .61, confidence interval [CI] .41–.91) and had high-school graduate mothers compared to college-graduate mothers (ARR = .68, CI .47–.99), and were more common among those who lived with neither parent compared to living with both parents (ARR = 2.0, CI 1.27–3.16). Time alone with a provider was more common among black girls than white girls (ARR = 1.57, CI 1.11–2.22) and less common among girls covered by Medicaid than those with parents’ private insurance (ARR = .72, CI .56–.92). Time alone was less common among boys living with neither parent compared to living with two parents (ARR = .48, CI .25–.91) and with high-school graduate mothers compared to college-graduate mothers (ARR = .59, CI .42–.84). Among sexually experienced girls and women, confidentiality concerns were associated with a reduced likelihood of having received a contraceptive service in the past year. Conclusions Greater efforts are needed to support young Americans in receiving confidential care.
CONTEXT: Bangladesh is unique in including menstrual regulation (MR)
ObjectivesIn 2013, the majority of women lived in states considered hostile to abortion rights, or states with numerous abortion restrictions. By comparison, 31% lived in supportive states. This study examined differences in abortion service delivery according to the policy climate in which clinics must operate.MethodsData come from the 2014 Abortion Provider Census, which contains information about all known abortion-providing facilities in the United States. In addition to number and type of facility, we examine several aspects of abortion care: provision of only early medication abortion (EMA-only) whether an advanced practice clinician provided abortions, gestational parameters, and average charge for procedure. All indicators were examined nationally and according to whether the clinic was in a state that was hostile, middle ground, or supportive of abortion rights.ResultsIn 2014, hostile and supportive states accounted for the same proportion of all U.S. abortions—44% (each) —although 57% of women age 15 to 44 lived in hostile states. Hostile states had one-half as many abortion-providing facilities as supportive ones. EMA-only facilities accounted for 37% of clinics in supportive states compared with 8% in hostile states. Sixty-five percent of clinics in supportive states reported that advanced practice clinicians provided abortion care, compared with 3% in hostile states. After cost of living adjustments, a first-trimester surgical abortion was most expensive in middle-ground states ($470) and least expensive in supportive states ($402).ConclusionsThe distribution of abortion services, the type of facility in which they are provided, and the amount a facility charges all vary according to the abortion policy climate.
is a world-leading expert in meta-analysis and systematic reviews. Currently a professor in the Department of Health Services, Policy and Practice and co-director of the Center for Evidence-based Medicine at Brown University, Professor Lau has applied evidence-based methods to a variety of clinical, biomedical and healthcare topics; has developed reliable and efficient methods and tools to conduct systematic reviews and meta-analyses; and has advanced an understanding on the impact of factors that may contribute to differences of results in scientific studies. His past research includes cumulative metaanalysis of randomized controlled trials, comparison of results from large trials and meta-analyses of small trials, effect of baseline risk in the interpretation of clinical trial results, and empirical evaluation of existing methods of combining data. His current focus is on a Web-based repository of systematic review data, reviews of diagnostic tests, nutrition, clinical practice guidelines, and dissemination of evidencebased methods to varied health-care disciplines. This report is a conversation from an adapted version of an interview, more or less chronologically arranged, between Joseph C. Cappelleri as interviewer and Joseph Lau as interviewee, with Meghan Ingerick recording and transcribing the interview. Copyright © 2014 John Wiley & Sons, Ltd.History has been defined in many ways. One of them is as "the branch of knowledge that records and analyzes past events" (www.thefreedictionary.com). History is obviously important in general but why should a modern journal on research synthesis include a new section on history? Surely there is enough to learn, read, and research about current developments without focusing on things in the past.There are several reasons for the study of history within research synthesis that make it relevant. Only one of them will be highlighted here, as follows: knowing where we have been lends character, life, and substance to where we are and expect to go. History anchors our profession into a time frame that unites a continuum of experience and knowledge -what does not work, what works, what works better -into a cohesiveness of belonging integral to our development, allowing us to view the lives and works of others in the past within a social context of time and a longitudinal movement of progress. Appreciation of that time frame enables a more considered look into the current development of ideas and new avenues of research.In the current issue of Research Synthesis Methods, the inaugural essay is published on the history of research synthesis from the perspective of a pioneer in the field: Dr. Joseph Lau. Currently a professor in the Department of Health Services, Policy and Practice and co-director of the Center for Evidence-based Medicine at Brown University, Professor Joseph Lau is a world-leading expert in meta-analysis and systematic reviews. In addition to applying evidence-based methods to a variety of clinical, biomedical and health-care topics, he is interested in dev...
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