Determining the impact of the Zika pandemic on primary care providers' contraceptive counseling of non-pregnant patients in the US: a mixed methods study.

BACKGROUND: Global pandemics like Zika (ZIKV) factor into pregnancy planning and avoidance, yet little is known about how primary care providers (PCPs) incorporate public health guidance into contraceptive counseling. Study objectives include: 1) determining the impact of the ZIKV pandemic on contraceptive counseling changes; and 2) assessing PCP knowledge and practice regarding contraception, ZIKV, and CDC ZIKV guidelines. METHODS: Study components included: (1) a retrospective review of electronic health records of non-pregnant, reproductive age women presenting for preventive health visits between 2014 and 2017 assessed using interrupted time series analyses (ITSA) to identify changes in documentation of ZIKV risk assessment and contraceptive counseling; and (2) a sequential, cross-sectional study with quantitative surveys and qualitative, semi-structured interviews of PCPs providing preventive care to non-pregnant patients at eight federally qualified health centers in Utah. We performed descriptive analyses on survey data and analyzed qualitative data for dominant themes using a modified Health Belief Model. RESULTS: We conducted 6634 chart reviews yielding 9840 visits. The ITSA did not reveal changes in ZIKV risk assessment or contraceptive counseling. Twenty-two out of 40 (55%) eligible providers participated in the provider component. Participants averaged 69 and 81% correct on contraceptive and ZIKV knowledge questions, respectively. Sixty-five percent reported counseling consistent with CDC ZIKV guidelines. Qualitative analysis found providers unlikely to prioritize ZIKV risk assessment in contraceptive counseling for non-pregnant patients. CONCLUSIONS: PCPs who care for non-pregnant women are knowledgeable about contraception and ZIKV; however, there was no change in ZIKV risk assessment or contraceptive counseling. This stresses the importance of developing strategies to improve guideline uptake.

Description of buoyant fibers adhering to Argonauta nouryi (Cephalopoda: Argonautidae) collected from the stomach contents of three top predators in the Mexican South Pacific.

Argonauta nouryi Lorois, 1852 is an octopod that inhabits the holopelagic zone, the objective of this study was to describe the occurrence of buoyant fibers adhering to the body and mantle cavity of A. nouryi females found in the stomach contents from Euthynnus lineatus (skipjack), Coryphaena hippurus (dolphinfish), and Istiophorus platypterus (sailfish). Stomach contents from 224 individuals were examined. All female evaluated presented fibers adhering to the mantle cavity; 92.6% of the fibers measured 0.25 to 5 mm in length and hyaline was the dominant color (72%). The amount of fibers in the fish stomach contents with A. nouryi was significantly greater than in stomachs without; this suggests that the fibers might be introduced via A. nouryi. Findings of this work could be related to the discharge of solid materials in the water column.