http://hdl.handle.net/10027/7540 Sun, 19 May 2013 21:37:25 GMT 2013-05-19T21:37:25Z http://hdl.handle.net/10027/8375 Women's Preferences for the Location of Abortion Services: A Pilot Study in Two Chicago Clinics Logsdon, Melissa B.; Godfrey, Emily M.; Handler, Arden Between July and December 2006, 209 women at a university-based primary care center and a freestanding abortion clinic completed a verbally administered questionnaire in which they were asked their preference for the location of early abortion services. Sixty women seeking primary care services at the university-based clinic and 149 women seeking first-trimester abortion services at an abortion clinic completed the questionnaire. Sixty-seven percent (67%) of women surveyed at the university-based primary care facility and 69% at the abortion clinic indicated a preference for abortion services from their regular health care provider. A statistically significant association (P = 0.002) was found between comfort speaking with a regular health care provider about pregnancy prevention and preference for the provision of abortion services from a regular health care provider. Women may feel more comfortable undergoing an early abortion procedure with a provider with whom they have an established relationship. The integration of early abortion services into primary care practice may increase continuity of care among women seeking an abortion. Post print version of article may differ from published version. The original publication is available at springerlink.com; DOI: 10.1007/s10995-010-0722-4 Sun, 01 Jan 2012 06:00:00 GMT http://hdl.handle.net/10027/8375 2012-01-01T06:00:00Z http://hdl.handle.net/10027/8328 Primary care of the liver transplant recipient Sohn, Augustine J.; Jeon, Hoonbae; Ahn, Joseph Chronic rejection of liver graft is an insidious process. Major immunosuppression medications such as tacrolimus, cyclosporin, and sirolimus have dose-related toxicity and narrow therapeutic windows. Certain drugs can affect metabolism of calcineurin inhibitors. Primary care physicians should be vigilant for any unusual opportunistic infection in liver transplant recipients. The quality of life of liver transplant recipients is an important aspect of care by primary care physicians. Alcohol relapse and possibility of depression in liver transplant recipients should be a continuous concern for primary care physicians. This article provides a guideline for the care of liver transplant recipients. NOTICE: this is the author’s version of a work that was accepted for publication in Primary Care: Clinics in Office Practice. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Primary Care: Clinics in Office Practice, VOL 38, Issue 3, Sept. 2011; DOI: 10.1016/j.pop.2011.05.006 Thu, 01 Sep 2011 05:00:00 GMT http://hdl.handle.net/10027/8328 2011-09-01T05:00:00Z http://hdl.handle.net/10027/8234 Contraceptive Methods and Use by Women Aged 35 and Over: A Qualitative Study of Perspectives Godfrey, Emily M.; Chin, Nancy P.; Fielding, Stephen L.; Fiscella, Kevin; Dozier, Ann Background: More than 30% of the pregnancies in women aged 35 and over are unintended. This paper compares perceptions about contraceptive methods and use among women with and without an unintended pregnancy after turning age 35. Methods: Semi-structured, in-depth interviews were conducted with 17 women. They were all 35 to 49 years old, regularly menstruating, sexually active, not sterilized, not desiring a pregnancy in the near future, and at least 3 months postpartum. We purposely sampled for women who had had at least one unintended pregnancy after age 35 (n = 9) and women who did not (n = 8). We assessed partnership, views of pregnancy and motherhood, desired lifestyle, perceived advantages and disadvantages of using and obtaining currently available well-known reversible contraceptives in the U.S. "We also assessed contraceptive methods used at any time during their reproductive years, including current method use and, if appropriate, circumstances surrounding an unintended pregnancy after age 35." Each interview was taped and transcribed verbatim. Data were analyzed using Grounded Theory. Analysis focused on partnership, views of pregnancy, motherhood, desired lifestyle and perceived advantages and disadvantages of various reversible contraceptive methods. Results: The women without an unintended pregnancy after age 35 were more likely to (1) use contraceptive methods that helped treat a medical condition, (2) consider pregnancy as dangerous, or (3) express concerns about the responsibilities of motherhood. The women who experienced an unintended pregnancy after age 35 were more likely to (1) report unstable partnerships, (2) perceive themselves at lower risk of pregnancy, or (3) report past experiences with unwanted contraceptive side effects. There was a greater likelihood a woman would choose a contraceptive method if it was perceived as easy to use, accessible, affordable and had minimal side effects. Conclusions: Women’s perspective on contraceptive use after age 35 varies. Public health messages and health providers’ care can help women in this age group by reviewing their fertility risks, as well as all contraceptive methods and their associated side effects. The impact of such interventions on unintended pregnancy rates in this age group should be tested in other areas of evidence-based medicine. © 2011 Godfrey et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/license/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The original version is available through BioMed Central at DOI: 10.1186/1472-6874-11-5. Wed, 16 Feb 2011 06:00:00 GMT http://hdl.handle.net/10027/8234 2011-02-16T06:00:00Z http://hdl.handle.net/10027/7786 Patient-Centered Care for Muslim Women: Provider and Patient Perspectives Hasnain, Memoona; Connell, Karen J.; Menon, Usha; Tranmer, Patrick A. OBJECTIVE: The purpose of this study was twofold: (1) to address the gap in existing literature regarding provider perspectives about provision of high-quality, culturally appropriate, patient-centered care to Muslim women in the United States and (2) to explore congruence between provider and patient perceptions regarding barriers to and recommendations for providing such care. METHODS: Using a cross-sectional study design, a written survey was administered to a convenience sample of healthcare providers (n = 80) and Muslim women (n = 27). RESULTS: There was considerable congruence among patients and providers regarding healthcare needs of Muslim women. A majority (83.3%) of responding providers reported encountering challenges while providing care to Muslim women. A majority (93.8%) of responding patients reported that their healthcare provider did not understand their religious or cultural needs. Providers and patients outlined similar barriers/challenges and recommendations. Key challenges included lack of providers' understanding of patients' religious and cultural beliefs; language-related patient-provider communication barriers; patients' modesty needs; patients' lack of understanding of disease processes and the healthcare system; patients' lack of trust and suspicion about the healthcare system, including providers; and system-related barriers. Key recommendations included provider education about basic religious and cultural beliefs of Muslim patients, provider training regarding facilitation of a collaborative patient-provider relationship, addressing language-related communication barriers, and patient education about disease processes and preventive healthcare. CONCLUSIONS: Both providers and patients identify significant barriers to the provision of culturally appropriate care to Muslim women. Improving care would require a flexible and collaborative care model that respects and accommodates the needs of patients, provides opportunities for training providers and educating patients, and makes necessary adjustments in the healthcare system. The findings of this study can guide future research aimed at ensuring high-quality, culturally appropriate, patient-centered healthcare for Muslim women in the United States and other western countries. This is a copy of an article published in the Journal of Women's Health © 2011 [copyright Mary Ann Liebert, Inc.]; Journal of Women's Health is available online at: http://www.liebertonline.com. DOI: 10.1089/jwh.2010.2197 Thu, 20 Jan 2011 06:00:00 GMT http://hdl.handle.net/10027/7786 2011-01-20T06:00:00Z