Rachel Rubin

Vaginal Evisceration During Pessary Fitting and Treatment With Immediate Colpocleisis

BACKGROUND: Complications from pessaries are rare and occur predominantly as a result of neglect and loss to follow-up. We report a case of vaginal evisceration at the time of pessary insertion, which was repaired with concomitant colpocleisis. CASE: An 82-year-old woman with stage IV pelvic organ prolapse (POP) presented for a routine pessary fitting, which resulted in vaginal evisceration and displacement of the pessary into the abdomen. She was treated successfully with immediate colpocleisis after transvaginal removal of the pessary and repair of the rupture site. CONCLUSION: Pessary insertion can result in vaginal evisceration. Both POP and vaginal rupture can be successfully treated with removal of the pessary, closure of the vaginal defect, and LeFort colpocleisis all in one session.

Perceptions of Character Development at a Trade College: Triangulating Student, Alumni, Administrator, and Teacher Perspectives

Higher education may be a setting wherein character is revealed or developed. The purpose of this study was to investigate stakeholders’ perspectives about the processes involved in character development at a postsecondary institution with a trade and character education focus: Williamson College. The authors analyzed qualitative data from administrators, teachers, students, and alumni regarding their perceptions of the character development process at Williamson College and to ascertain which features of the context each group viewed as essential for character development. The authors then triangulated across sources to examine alignment in stakeholders’ perceptions. Each stakeholder group identified two essential facets of Williamson College: (1) structure and discipline and (2) interpersonal relationships. The groups varied, however, on which aspects of these themes they highlighted. We discuss the implications of these findings for the Williamson College context as well as for the development, implementation, and evaluation of character-based models of higher education.

Promoting Adolescent Sexual Health in Youth Programming: Implications of a Positive Youth Development Perspective

Sexual activity may be a part of positive, adaptive youth development, particularly in the later years of adolescence. Through promoting positive youth development (PYD), youth development programs can take an active role in improving adolescent sexual health. In this chapter, we emphasize the positive potential of adolescent sexuality development. We review research regarding the interplay between indicators of PYD and indicators of adolescent sexual behavior and sexual health and research on the role of youth development programs in addressing adolescent sexual health outcomes. We specifically explore the “Big Three” aspects of youth development programs: youth–adult relationships, skill building, and opportunities for leadership. We conclude with additional suggestions for how youth development programs can support both PYD and sexual health in integrated ways, by implementing policies and practices that support queer inclusivity, racial justice, and trauma-informed approaches.