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Dive into the research topics where Amy G. Bryant is active.

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Featured researches published by Amy G. Bryant.


Health Psychology | 2002

Coping with body image changes following a disfiguring burn injury

James A. Fauerbach; Leslie J. Heinberg; John W. Lawrence; Amy G. Bryant; Linda Richter; Robert J. Spence

The influence of emotion-focused coping on distress following disfiguring injury was examined. Two types of emotion-focused coping (i.e., venting emotions vs. mental disengagement) were assessed in 78 patients with burn injury at baseline during acute hospitalization. Body image dissatisfaction (BID) was assessed 1 week and 2 months following discharge. Use at baseline of both venting emotions and mental disengagement, compared with use of only one or neither of these coping methods, was associated at the 2-month postdischarge follow-up with significantly higher BID related to nonfacial aspects of appearance and with a greater negative social impact of disfigurement. D. M. Wegners (1994) theoretical model of mental control and a proposed motivational analysis are used to interpret these findings.


Journal of Burn Care & Rehabilitation | 2001

Barriers to employment among working-aged patients with major burn injury

James A. Fauerbach; L. Engrav; Karen J. Kowalske; S. Brych; Amy G. Bryant; John H. Lawrence; G. Li; Andrew M. Munster; B. J. de Lateur

The purpose of this study was to examine the prevalence of preexisting and burn-related impairments and to describe their association with preburn employment status. Data gathered during the acute hospitalization were analyzed on a consecutive series of burn patients aged 16 to 64 years (N = 770) enrolled in a prospective, longitudinal, multicenter study. Patients who were unemployed before the injury were more likely than those who were employed to report being alcohol-dependent (36 vs 18%), abusing other drugs (22 vs 10%), having received psychiatric treatment in the past year (21 vs 6%), and having preexisting physical disability (23 vs 3%); all were significant at P < .001). Of the unemployed patients who received toxicologic screening at admission, 49% tested positive for alcohol and 39% positive for other drugs, percentages that were significantly higher than 26 and 31%, respectively, for the employed. With adjustment for age, sex, race, and education, variables that were most predictive of preinjury unemployment status were preexisting physical disability (odds ratio, 51.0; 95% confidence interval, 7.7-336.9) and being alcohol-positive at admission (odds ratio, 2.8; 95% confidence interval, 1.2-6.8). Unemployed and employed patients also differed significantly in injury patterns and clinical outcomes, with inhalation injury and psychiatric distress being more prevalent among the unemployed and both hand burns and hand surgery among the employed. The greater prevalence of preexisting impairments among survivors who were unemployed before the injury helps explain why preburn employment status is such a powerful determinant of postburn work outcomes, and suggests the need to include psychosocial services in a program of comprehensive rehabilitation.


Obstetrics & Gynecology | 2011

Second-Trimester Abortion for Fetal Anomalies or Fetal Death: Labor Induction Compared With Dilation and Evacuation

Amy G. Bryant; David A. Grimes; Joanne M. Garrett; Gretchen S. Stuart

OBJECTIVE: To compare the safety and effectiveness of dilation and evacuation (D&E) and labor-induction abortion performed for fetal anomalies or fetal death in the second trimester. METHODS: We performed a retrospective cohort study of second-trimester abortions performed for fetal indications. We compared the frequency of complications and effectiveness of abortions performed at 13–24 weeks for these indications. We calculated proportions of patients with complications for these two methods and controlled for confounding using a log binomial model. RESULTS: Labor-induction abortions had higher complication rates and lower effectiveness than did D&E. Thirty-two of 136 women undergoing labor induction (24%) experienced one or more complications, in contrast to 9 of 263 women (3%) undergoing D&E (unadjusted relative risk 6.9 [95% confidence interval 3.4–14.0]). When controlled for confounding, the adjusted risk ratio for labor induction was 8.5 (95% confidence interval 3.7–19.8) compared with D&E. CONCLUSION: Dilation and evacuation is significantly safer and more effective than labor induction for second-trimester abortion for fetal indications. Bias and chance are unlikely explanations for these large discrepancies. Women facing this difficult decision should be offered a choice of methods and be provided information about their comparative safety and effectiveness. LEVEL OF EVIDENCE: II


Contraception | 2014

Crisis pregnancy center websites: Information, misinformation and disinformation

Amy G. Bryant; Subasri Narasimhan; Katelyn Bryant-Comstock; Erika E. Levi

OBJECTIVE Most states with 24-h waiting periods prior to abortion provide state resource directories to women seeking abortion. Our objective was to evaluate the information on abortion provided on the websites of crisis pregnancy centers listed in these resource directories. STUDY DESIGN We performed a survey of the websites of crisis pregnancy centers referenced in state resource directories for pregnant women. We searched for these state-provided resource directories online. We contacted state Departments of Health and Human Services for a print copy when a directory could not be found online. The crisis pregnancy center websites were evaluated for the information provided on abortion. Standardized data collection tools were used. Descriptive statistics were generated. RESULTS Resource directories of 12 states were procured. A total of 254 websites referring to 348 crisis pregnancy centers were identified. Overall, a total of 203/254 [80%, 95% confidence interval (CI) 75%-84%] of websites provided at least one false or misleading piece of information. The most common misleading or false information included on the websites were a declared link between abortion and mental health risks (122/254 sites; 48%, 95% CI 42%-54%), preterm birth (54/254; 21%, 95% CI 17%-27%), breast cancer (51/254; 20%, 95% CI 16%-25%) and future infertility (32/254; 13%, 95% CI 9%-17%). CONCLUSION Most crisis pregnancy centers listed in state resource directories for pregnant women provide misleading or false information regarding the risks of abortion. States should not list agencies that provide inaccurate information as resources in their directories.


Obstetrics & Gynecology | 2015

Intrauterine Device Placement During Cesarean Delivery and Continued Use 6 Months Postpartum: A Randomized Controlled Trial.

Erika E. Levi; Gretchen S. Stuart; Matthew L. Zerden; Joanne M. Garrett; Amy G. Bryant

OBJECTIVE: To compare intrauterine device (IUD) use at 6 months postpartum among women who underwent intracesarean delivery (during cesarean delivery) IUD placement compared with women who planned for interval IUD placement 6 or more weeks postpartum. METHODS: In this nonblinded randomized trial, women who were undergoing a cesarean delivery and desired an IUD were randomized to intracesarean delivery or interval IUD placement. The primary outcome was IUD use at 6 months postpartum. A sample size of 112 (56 in each group) was planned to detect a 15% difference in IUD use at 6 months postpartum between groups. RESULTS: From March 2012 to June 2014, 172 women were screened and 112 women were randomized into the trial. Baseline characteristics were similar between groups. Data regarding IUD use at 6 months postpartum were available for 98 women, 48 and 50 women in the intracesarean delivery and interval groups, respectively. A larger proportion of the women in the intracesarean delivery group were using an IUD at 6 months postpartum (40/48 [83%]) compared with those in the interval group (32/50 [64%], relative risk 1.3, 95% confidence interval 1.02–1.66). Among the 56 women randomized to interval IUD insertion, 22 (39%) of them never received an IUD; 14 (25%) never returned for IUD placement, five (9%) women declined an IUD, and three (5%) had a failed IUD placement. CONCLUSION: Intrauterine device placement at the time of cesarean delivery leads to a higher proportion of IUD use at 6 months postpartum when compared with interval IUD placement. LEVEL OF EVIDENCE: I


Contraception | 2013

Contraceptive adherence among HIV-infected women in Malawi: a randomized controlled trial of the copper intrauterine device and depot medroxyprogesterone acetate.

Lisa Haddad; Carrie Cwiak; Denise J. Jamieson; Caryl Feldacker; Hannock Tweya; Mina C. Hosseinipour; Irving Hoffman; Amy G. Bryant; Gretchen S. Stuart; Isaac Noah; Linly Mulundila; Bernadette Samala; Patrick Mayne; Sam Phiri

OBJECTIVE To evaluate contraceptive adherence to the copper intrauterine device (Cu-IUD) and the injectable depot medroxyprogesterone acetate (DMPA) among women with HIV in Lilongwe, Malawi. METHODS We randomized 200 HIV-infected women on highly active antiretroviral therapy (HAART) to either the Cu-IUD or DMPA and followed these women prospectively, evaluating adherence and factors associated with nonadherence. RESULTS There was no difference in contraceptive adherence: 68% of Cu-IUD and 65% of DMPA users were adherent at 48 weeks. Receiving first-choice contraceptive was not associated with adherence. Women commonly cited partners disapproval as an indication for discontinuation. Women who experienced heavy menstruation and first-time contraceptive users were more likely to be nonadherent. Among ongoing users at study conclusion, 95% were happy with their method, and 98% would recommend their method to a friend. CONCLUSION Contraceptive adherence between the Cu-IUD and DMPA was similar at 1 year. With similar adherence and similar high rates of satisfaction among users of both methods at 1 year, the Cu-IUD offers a hormone-free alternative to DMPA. IMPLICATIONS Adherence to the Cu-IUD and DMPA is similar at 1 year among HIV-infected women on HAART in a randomized controlled trial. Despite high method satisfaction, partner disapproval and heavy bleeding contribute to reduced adherence. Receiving a method that differs from participants first-choice method did not influence adherence.


Contraception | 2015

The experiences and adaptations of abortion providers practicing under a new TRAP law: a qualitative study

Rebecca J. Mercier; Mara Buchbinder; Amy G. Bryant; Laura Britton

OBJECTIVE Abortion laws are proliferating in the United States, but little is known about their impact on abortion providers. In 2011, North Carolina instituted the Womans Right to Know (WRTK) Act, which mandates a 24-h waiting period and counseling with state-prescribed information prior to abortion. We performed a qualitative study to explore the experiences of abortion providers practicing under this law. STUDY DESIGN We conducted semistructured interviews with 31 abortion providers (17 physicians, 9 nurses, 1 physician assistant, 1 counselor and 3 clinic administrators) in North Carolina. Interviews were audio-recorded and transcribed. Interview transcripts were analyzed using a grounded theory approach. We identified emergent themes, coded all transcripts and developed a thematic framework. RESULTS Two major themes define provider experiences with the WRTK law: provider objections/challenges and provider adaptations. Most providers described the law in negative terms, though providers varied in the extent to which they were affected. Many providers described extensive alterations in clinic practices to balance compliance with minimization of burdens for patients. Providers indicated that biased language and inappropriate content in counseling can negatively impact the patient-physician relationship by interfering with trust and rapport. Most providers developed verbal strategies to mitigate the emotional impacts for patients. CONCLUSIONS Abortion providers in North Carolina perceive WRTK to have a negative impact on their clinical practice. Compliance is burdensome, and providers perceive potential harm to patients. The overall impact of WRTK is shaped by interaction between the requirements of the law and the adaptations providers make in order to comply with the law while continuing to provide comprehensive abortion care. IMPLICATIONS Laws like WRTK are burdensome for providers. Providers adapt their clinical practices not only to comply with laws but also to minimize the emotional and practical impacts on patients. The effects on providers, frequently not a central consideration, should be considered in ongoing debates regarding abortion regulation.


Contraception | 2012

Feasibility of postpartum placement of the levonorgestrel intrauterine system more than 6 h after vaginal birth

Gretchen S. Stuart; Amy G. Bryant; Erica O'Neill; Irene A. Doherty

BACKGROUND The objective of this study was to determine the feasibility of postpartum levonorgestrel intrauterine system (LNG-IUS) placement on the postpartum ward. STUDY DESIGN This case-series study took place in a teaching hospital in North Carolina. Women were followed for 6 months, and data on method satisfaction, study design satisfaction and expulsion were collected. Descriptive statistics were used. RESULTS Forty women enrolled. Twenty-nine women (73%) received the LNG-IUS at a median of 20 h (range 7-48 h) after delivery, and all reported that they would recommend this method of contraception to a friend. Eleven women had a spontaneous expulsion (38%; 95% confidence interval 21, 58). CONCLUSION Placement of LNG-IUS more than 6 h postpartum was acceptable to women in this study. The expulsion rate of 38% had statistical instability and should be interpreted with caution. However, our report may assist with individual counseling of women interested in postpartum LNG-IUS placement, or in future study designs.


Hastings Center Report | 2016

Reframing Conscientious Care: Providing Abortion Care When Law and Conscience Collide.

Mara Buchbinder; Dragana Lassiter; Rebecca J. Mercier; Amy G. Bryant; Anne Drapkin Lyerly

Much of the debate on conscience has addressed the ethics of refusal: the rights of providers to refuse to perform procedures to which they object and the interests of the patients who might be harmed by their refusals. But conscience can also be a positive force, grounding decision about offering care.


PLOS ONE | 2015

Pregnancy Prevention and Condom Use Practices among HIV-Infected Women on Antiretroviral Therapy Seeking Family Planning in Lilongwe, Malawi

Lisa Haddad; Caryl Feldacker; Denise J. Jamieson; Hannock Tweya; Carrie Cwiak; Thomas Chaweza; Linly Mlundira; Jane Chiwoko; Bernadette Samala; Fanny Kachale; Amy G. Bryant; Mina C. Hosseinipour; Gretchen S. Stuart; Irving Hoffman; Sam Phiri

Background Programs for integration of family planning into HIV care must recognize current practices and desires among clients to appropriately target and tailor interventions. We sought to evaluate fertility intentions, unintended pregnancy, contraceptive and condom use among a cohort of HIV-infected women seeking family planning services within an antiretroviral therapy (ART) clinic. Methods 200 women completed an interviewer-administered questionnaire during enrollment into a prospective contraceptive study at the Lighthouse Clinic, an HIV/ART clinic in Lilongwe, Malawi, between August and December 2010. Results Most women (95%) did not desire future pregnancy. Prior reported unintended pregnancy rates were high (69% unplanned and 61% unhappy with timing of last pregnancy). Condom use was inconsistent, even among couples with discordant HIV status, with lack of use often attributed to partner’s refusal. Higher education, older age, lower parity and having an HIV negative partner were factors associated with consistent condom usage. Discussion High rates of unintended pregnancy among these women underscore the need for integ rating family planning, sexually transmitted infection (STI) prevention, and HIV services. Contraceptive access and use, including condoms, must be improved with specific efforts to enlist partner support. Messages regarding the importance of condom usage in conjunction with more effective modern contraceptive methods for both infection and pregnancy prevention must continue to be reinforced over the course of ongoing ART treatment.

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Gretchen S. Stuart

University of North Carolina at Chapel Hill

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Erika E. Levi

University of North Carolina at Chapel Hill

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Mara Buchbinder

University of North Carolina at Chapel Hill

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Rebecca J. Mercier

Thomas Jefferson University

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Denise J. Jamieson

Centers for Disease Control and Prevention

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Irving Hoffman

University of North Carolina at Chapel Hill

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James A. Fauerbach

Johns Hopkins University School of Medicine

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Mina C. Hosseinipour

University of North Carolina at Chapel Hill

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