Measuring a Critical Component of Contraceptive Decision Making: The Contraceptive Concerns and Beliefs Scale.

INTRODUCTION: Concerns about safety and side effects from contraceptives are widespread and related to reluctance to use them. Measuring these concerns is an essential component of understanding contraceptive decision-making and guiding contraceptive and interpregnancy clinical care. METHODS: We used qualitative research and item response theory to develop and test a psychometric instrument to measure contraceptive concerns and beliefs. We developed 55 candidate scale items and tested them among 572 adolescents and adults across nine California healthcare facilities in 2019-2020. We derived a 6-item scale and assessed differences by age and social determinants of health with multivariable regression. RESULTS: In qualitative data, participants voiced both concerns and positive beliefs about contraception. Quantitative survey respondents were aged 21 years on average, and 24% were parous. Over half (54%) worried contraception has dangerous side effects, and 39% worried it is unnatural. The mean Contraceptive Concerns score, increasing with higher concerns, was 1.85 (SD: 1.00, range 0-4, α = 0.81). Items fit a partial credit item response model and met prespecified criteria for internal structure validity. Contraceptive use declined with increasing Concerns score (adjusted prevalence ratio [aPR] = 0.81 [0.72-0.92]). Scores were elevated among Black (mean: 2.06; aß = 0.34 [0.09, 0.59]) and Multiracial or other race (2.11; aß = 0.34 [0.02, 0.66]) respondents vs. White (1.66), but not Latinx respondents (1.81; aß = 0.11 [- 0.11, 0.33]). Scores were also elevated among participants with lower maternal education (high school/Associate's 1.89 versus college 1.60; aß = 0.28 [0.04, 0.53]). DISCUSSION: The psychometrically robust Concerns instrument can be used in research to measure autonomous contraceptive decision-making and to design person-centered care.

Assessment of prevalence of dry eye among medical students using ocular surface disease index questionnaire - Is COVID-19 to be really blamed?

Purpose: An undergraduate research conducted during the pre-covid times, to highlight the importance of screen time and its association with dry eye in medical students. The aim was to study the prevalence of dry eye among medical students using the ocular surface index (OSDI) questionnaire. Methods: This was a cross-sectional study. This study was conducted among medical students using an OSDI questionnaire in the pre-covid times. Based on the pilot study, the minimum sample size calculated was 245. A total of 310 medical students participated in the study. These medical students answered the OSDI questionnaire. The OSDI score was used to categorize students with dry eye as mild (13-22 points), moderate (23-32 points), and severe (33-100 points). In addition, the associations between the OSDI score and possible risk factors such as gender, contact lens/spectacle wear, laptop/mobile usage, and duration of exposure to air conditioners were also studied. Results: The analysis of the study revealed that out of 310 students, dry eye was seen in 143 (46.1%) and severe dry eyes were seen in 50 (16.1%). A high OSDI score (>13 points) was associated with the usage of a laptop/mobile for more than 6 h in 40 (52.6%) (P < 0.001). Conclusion: The prevalence of dry eye among medical students was 46.1% in the present study. Longer duration of usage of visual display units (laptop/mobile) was the only factor that showed a statistically significant association with dry eye in our study.

Improving Capacity at School-based Health Centers to Offer Adolescents Counseling and Access to Comprehensive Contraceptive Services.

STUDY OBJECTIVES: Many pediatric providers serving adolescents are not trained to offer comprehensive contraceptive services, including intrauterine devices (IUDs) and implants, despite high safety and satisfaction among adolescents. This study assessed an initiative to train providers at school-based health centers (SBHCs) to offer students the full range of contraceptive methods. DESIGN: Surveys were administered at baseline pre-training and at follow-up 3 months post-training. Data were analyzed using generalized estimating equations for clustered data to examine clinical practice changes. SETTING: Eleven contraceptive trainings at SBHCs across the United States from 2016-2019. PARTICIPANTS: A total of 260 providers from 158 SBHCs serving 135,800 students. INTERVENTIONS: On-site training to strengthen patient-centered counseling and to equip practitioners to integrate IUDs and implants into contraceptive services. MAIN OUTCOME MEASURES: The outcomes included counseling experience on IUDs and implants, knowledge of patient eligibility, and clinician method skills. RESULTS: At follow-up, providers were significantly more likely to report having enough experience to counsel on IUDs (adjusted odds ratio [aOR], 4.08; 95% confidence interval [CI], 2.62-6.36]) and implants (aOR, 3.06; 95% CI, 2.05-4.57). Provider knowledge about patient eligibility for IUDs, including for adolescents, increased (P < .001). Providers were more likely to offer same-visit IUD (aOR, 2.10; 95% CI, 1.41-3.12) and implant services (aOR, 1.66; 95% CI, 1.44-1.91). Clinicians' skills with contraceptive devices improved, including for a newly available low-cost IUD (aOR, 2.21; 95% CI, 1.45-3.36). CONCLUSIONS: Offering evidence-based training is a promising approach to increase counseling and access to comprehensive contraceptive services at SBHCs.

Eye donation - awareness and willingness among attendants of patients at various clinics in Melaka, Malaysia.

AIM: Corneal blindness accounts for 3.42% of blindness in Malaysia; the rate of eye donation is low. The aim of the study was to assess the awareness about eye donation and willingness to donate eyes among attendants of patients at various clinics in Melaka, Malaysia. MATERIALS AND METHODS: This observational study was conducted on attendants who accompanied patients (n = 400) visiting various outpatient departments of the General Hospital and two peripheral clinics in Melaka between August and October 2007. The participants answered a questionnaire (Malay and English versions) which included demographic profile, awareness of eye donation, knowledge regarding facts of eye donation, and willingness to donate eyes. Univariate and multivariate logistic regression was performed at 5% level of significance. RESULTS: Awareness of eye donation was observed in 276 (69%) participants. Multivariate analysis showed that awareness was more among females when compared to males (P = 0.009). Of the 276 participants who were aware of eye donation, only 34.42% were willing to donate eyes. Willingness was more among the Indian race (P = 0.02) and males (P = 0.02). Educational status did not influence the willingness to donate eyes. CONCLUSIONS: Although majority of participants were aware of eye donation, willingness to donate eyes was poor.

Assessment of awareness of diabetic retinopathy among the diabetics attending the peripheral diabetic clinics in melaka, malaysia.

In view of the alarming increase in the incidence of diabetes mellitus in Malaysia, we conducted a study to assess the awareness of complications of diabetes among the diabetics attending the peripheral clinics in Melaka. The study period was from January 2007 to December 2007. 351 patients were included in the study. 79.8% were aware of the complications of diabetes mellitus and 87.2% were aware that diabetes can affect the eyes. However, only 50% of the patients underwent an ophthalmological evaluation. Although awareness was good, the motivation to undergo the assessment was poor.