Deborah L. Billings

Exploring Rape Myths, Gendered Norms, Group Processing, and the Social Context of Rape Among College Women: A Qualitative Analysis

The purpose of this research is to explore the negotiation strategies of college women as they interpret ambiguous rape scenarios. In focus groups, 1st- and 4th-year college women were presented with a series of three vignettes depicting incidents that meet the legal criteria for rape yet are ambiguous due to the presence of cultural rape myths, contexts involving alcohol consumption, varying degrees of consent, and a known perpetrator. These contexts are critical in understanding how college women define rape. Key findings indicated many of these college women utilized rape myths and norms within their peer groups to interpret rape scenarios.

HEALTH CARE-BASED INTERVENTIONS FOR WOMEN WHO HAVE EXPERIENCED SEXUAL VIOLENCE A Review of the Literature

Thirty publications that evaluated health care-based interventions for women who experienced sexual violence were reviewed. The findings highlight that clinicians often need training in the provision sexual assault care, and that not all emergency departments have sexual assault care protocols. Studies examining effectiveness found that Sexual Assault Nurse Examiner programs are very helpful, that health care-based sexual assault treatment settings attract more women than do forensic-based settings, that sexual assault survivors often prefer a combination of medication and counseling treatment, and that preexam administration of a video explaining the collection of forensic evidence may reduce womens stress during the procedure. Studies on postexposure HIV prophylaxis found that many women did not complete the treatment regimen, often because of side effects. Emergency contraception to prevent postrape pregnancy is not consistently offered to women. Only one study reported on abortion as part of the range of sexual assault services.

Roles of pharmacists in expanding access to safe and effective medical abortion in developing countries: A review of the literature

Unsafe abortion continues to be a major contributor to maternal mortality and morbidity around the world. This article examines the role of pharmacists in expanding womens access to safe medical abortion in Latin America, Africa, and Asia. Available research shows that although pharmacists and pharmacy workers often sell abortion medications to women, accurate information about how to use the medications safely and effectively is rarely offered. No publication covered effective interventions by pharmacists to expand access to medical abortion, but lessons can be learned from successful interventions with other reproductive health services. To better serve women, increasing awareness and improving training for pharmacists and pharmacy workers about unsafe abortion – and medications that can safely induce abortion – are needed.

Misoprostol Alone for Early Medical Abortion in a Latin American Clinic Setting

Abstract Misoprostol is being used widely by women throughout Latin America, often based on instructions passed along through friends, acquaintances or professionals who may have little information about safe and effective use. This paper presents the experience of a Latin American clinic working in a legally restrictive setting that offers misoprostol as one option to women seeking early pregnancy termination. Between February 2001 and June 2002, 3,225 women who attended the clinic chose to use misoprostol rather than vacuum aspiration. 89.9% returned for follow-up, of whom 76.4% had had a complete abortion within 72 hours, using one, two or three doses of 800 micrograms of misoprostol administered by the woman herself vaginally every 24 hours. The first 78 women who returned for follow-up at 72 hours responded to a questionnaire regarding their experiences. Satisfaction with the abortion process was high, despite some pain, chills, diarrhoea and/or nausea. Seventy-two of the 78 women said they would use misoprostol again if they needed to terminate another pregnancy and would recommend it to a friend. Having a clinic where staff are knowledgeable and experienced in misoprostol use is particularly important in settings where abortion is stigmatised, unsafe abortion common and access to safe services limited. Résumé Le misoprostol est largement utilisé par les femmes en Amérique latine, souvent sur le conseil d’amis, de connaissances ou de professionnels qui peuvent Átre mal informés de son utilisation s re et efficace. Cet article présente l’expérience d’un dispensaire latino-américain travaillant dans un environnement juridiquement restrictif qui offre le misoprostol comme option aux femmes souhaitant interrompre précocement une grossesse. De février 2001àjuin 2002, 3255 femmes s’étant rendues au dispensaire ont choisi d’utiliser le misoprostol plutÁt qu’une aspiration. Des 89.9% de femmes revenues pour un contrÁle, 76,4% avaient avorté complètement dans les 72 heures, avec une, deux ou trois doses de 800 microgrammes de misoprostol qu’elles s’étaient administrées par voie vaginale toutes les 24 heures. Les 78 premières femmes revenues pour un contrÁle 72 heures après ont réponduàun questionnaire. Le taux de satisfaction était élevé, malgré quelques douleurs, des frissons, et des épisodes de diarrhée et/ou de nausées. Soixante-douze femmes sur 78 ont déclaré qu’elles utiliseraientànouveau le misoprostol si elles souhaitaient interrompre une autre grossesse et le recommanderaientàune amie. Quand l’avortement est stigmatisé, les avortements non médicalisés sont fréquents et l’accèsàdes services s rs est limité, il est particulièrement important de compter sur un dispensaire où le personnel connaît et sait utiliser le misoprostol. Resumen El misoprostol es utilizado ampliamente por las mujeres en toda Latinoamérica, quienes se basan a menudo en las indicaciones de sus amigas, conocidas o profesionales quienes posiblemente tengan poca información sobre su uso seguro y eficaz. En este artáculo se expone la experiencia de una clánica latinoamericana, en un entorno legalmente restrictivo, que ofrece el misoprostol como una opción para las mujeres que desean interrumpir su embarazo en etapas iniciales. Entre febrero de 2001 y junio de 2002, 3,225 mujeres que consultaron a esta clánica optaron por utilizar el misoprostol en vez de la aspiración endouterina. El 89.9% regresó a consulta de control; de éstas, el 76.4% presentó un aborto completo dentro de las 72 horas posteriores a la autoadministración de una, dos o tres dosis de 800 microgramos de misoprostol por váa vaginal cada 24 horas. Las primeras 78 mujeres que regresaron a control indicaron una alta satisfacción con el proceso de aborto, pese a algunos dolores, escalofráos, diarrea y/o náuseas. De las 78 mujeres, 72 expresaron que volveráan a usar el misoprostol si necesitaran interrumpir otro embarazo y se lo recomendaráan a una amiga. En los entornos donde el aborto es estigmatizado, el aborto inseguro es común y el acceso a los servicios seguros es limitado, es importante contar con una clánica cuyo personal posea conocimientos y experiencia en el uso del misoprostol.

Low glycemic index vegan or low-calorie weight loss diets for women with polycystic ovary syndrome: a randomized controlled feasibility study

The aim of this randomized pilot was to assess the feasibility of a dietary intervention among women with polycystic ovary syndrome (PCOS) comparing a vegan to a low-calorie (low-cal) diet. Overweight (body mass index, 39.9 ± 6.1 kg/m(2)) women with PCOS (n = 18; age, 27.8 ± 4.5 years; 39% black) who were experiencing infertility were recruited to participate in a 6-month randomized weight loss study delivered through nutrition counseling, e-mail, and Facebook. Body weight and dietary intake were assessed at 0, 3, and 6 months. We hypothesized that weight loss would be greater in the vegan group. Attrition was high at 3 (39%) and 6 months (67%). All analyses were conducted as intention-to-treat and presented as median (interquartile range). Vegan participants lost significantly more weight at 3 months (-1.8% [-5.0%, -0.9%] vegan, 0.0 [-1.2%, 0.3%] low-cal; P = .04), but there was no difference between groups at 6 months (P = .39). Use of Facebook groups was significantly related to percent weight loss at 3 (P < .001) and 6 months (P = .05). Vegan participants had a greater decrease in energy (-265 [-439, 0] kcal/d) and fat intake (-7.4% [-9.2%, 0] energy) at 6 months compared with low-cal participants (0 [0, 112] kcal/d, P = .02; 0 [0, 3.0%] energy, P = .02). These preliminary results suggest that engagement with social media and adoption of a vegan diet may be effective for promoting short-term weight loss among women with PCOS; however, a larger trial that addresses potential high attrition rates is needed to confirm these results.

Education as Contested Terrain: Nicaragua, 1979-1993.

Introduction - political and educational change in Nicaragua education under tha FSLN education under the Chamarro government pre-university education higher education literacy and adult basic education conclusions.

Community education efforts enhance postabortion care program in Ghana.

As in most countries in the developing world unsafe abortion devastates the health and lives of women in Ghana. It is the highest single contributor to its maternal mortality ratio of 740 deaths per 100000 live births. Although complications of abortion are treatable delays in prompt treatment increase the risk of morbidity and death. To address the problem of unsafe abortion and delays in seeking care for women a comprehensive operations research project aimed at improving womens access to postabortion services was implemented in Ghana. Community education was an integral component of the postabortion care project implemented under the US Agency for International Developments MotherCare contract. The experiences and lessons that were learned from incorporating community education into the program are presented in the paper. Through this strategy women men adolescents community leaders and the community at large were made aware of the risks and signs of unsafe abortions and its complications and the availability of services by trained midwives. This approach in being both strategic and sustainable directly complements the national Safe Motherhood health education program of Ghana and could be easily integrated into other reproductive health programs in various settings.

Fatty acids in breast milk associated with asthma-like symptoms and atopy in infancy: a longitudinal study.

Objective. The relationship between fatty acids (FAs) in breast milk and the risk of childhood allergies is controversial. We prospectively investigated the relationship between FAs in colostrum and breast milk and asthma-like symptoms (AS) and atopy in infancy. Methods. Pregnant women were recruited in Columbia and Charleston, South Carolina. Colostrum and mature milk samples were collected. The concentrations of n-3 FAs (eicosapentaenoic acid, α-linolenic acid, docosapentaenoic acid, and docosahexaenoic acid) and n-6 FAs (linoleic acid, arachidonic acid, and eicosadienoic acid) were determined by gas chromatography. AS were ascertained at 6 and 12 months of age and atopy (skin prick test) at 12 months. FAs were dichotomized (high vs. median and low). Generalized estimating equations were used to determine the effect of FAs on repeated AS, compensating for intra-individual correlations and adjusting for confounders. Log-linear regression was used to analyze atopy. Results. FAs were analyzed in 24 colostrum and 78 breast milk samples. High levels of total n-6 (lipid based) FAs in breast milk were associated with an increased risk of AS in infants (risk ratio (RR) = 2.91; 95% confidence interval (CI): 1.37, 6.18), even after controlling for total n-3 FAs (RR = 2.07, 95% CI: 1.12, 3.85). High levels of total n-3 FAs controlling for n-6 FAs decreased the risk of atopy at the age of 12 months. Conclusions. High levels of total n-6 polyunsaturated fatty acids (PUFAs) in breast milk are associated with an increased risk for AS, whereas high levels of total n-3 PUFAs decreased the risk of atopy. These data suggest that the effects of n-3 and n-6 PUFAs on allergic disorders should be further explored.

Understanding internet sex-seeking behaviour and sexual risk among young men who have sex with men: evidences from a cross-sectional study

Objective Internet sex-seeking is common among young men who have sex with men (MSM). However, research examining its association with risky sexual behaviour has produced mixed findings, possibly due to various operational definitions of internet sex-seeking which fail to account for its multi-dimensionality. This study purposed to: (1) examine if the way internet sex-seeking behaviour is operationalised influences its association with risky sexual behaviour (unprotected anal intercourse (UAI) and casual sex) and (2) determine the association of each operational definition with sexual risk. Methods We recruited 263 sexually-experienced young MSM (18–29 years) and operationalised internet sex-seeking behaviour in four ways: (i) ever used the internet to meet other men, (ii) currently own a profile on a website dedicated to meeting other men, (iii) ever physically met a man you initially met online and (iv) ever had sex with a man you met online. Using binomial regression, we examined the association of each operationalisation with UAI and casual sex. Results Only MSM who reported physically meeting a man they met online and those who ever had sex with a man they met online were more likely to report a history of UAI (p<0.05), while MSM who engaged in all forms of internet sex-seeking were more likely to engage in casual sex (p<0.05). However, the strength of these associations varied according to the mode of operationalisation. Conclusions The way internet sex-seeking is operationalised in research is differentially associated with sexual risk. Against this backdrop, the utility of these operational definitions in future research and inferences drawn from such research must be interpreted with caution. Findings have important implications for sexual health research and methodology, survey development, sexual health prevention interventions, and evaluating sexual risk among young MSM.

MIDWIVES AND POSTABORTION CARE: EXPERIENCES, OPINIONS, AND ATTITUDES AMONG PARTICIPANTS AT THE 25TH TRIENNIAL CONGRESS OF THE INTERNATIONAL CONFEDERATION OF MIDWIVES

Midwifery practice may not include caring for women experiencing complications from unsafe abortion, despite the importance of this care for the health and lives of millions of women around the world. This article summarizes data collected from midwives from 41 countries who attended the 25th Triennial Congress of the International Confederation of Midwives in 1999, focusing on their experiences with, and attitudes toward, the provision of postabortion care. Barriers to provision of postabortion care and factors for changes in postabortion care-related policies were explored. Midwives from developing countries, where complications from unsafe abortion present a serious public health problem, were cognizant of the need to authorize, train, and equip midwives in postabortion care, including the use of uterine evacuation of incomplete abortion with manual vacuum aspiration. Changes in policy and practice are needed throughout the world so that women will have access to quality, compassionate postabortion care services regardless of where they live. Ensuring that midwives are able to provide such services will help to reduce abortion-related morbidity and mortality.