Search PubMed⌕ Search

Biomedical subjects

J Boggess

Publications and source records attributed to J Boggess.

9 recordsLinked to original sources
PubMed2001

Cervical neoplasia risk in women provided hormonal contraception without a Pap smear.

The study was conducted to determine whether women using a demonstration program providing hormonal birth control without concurrent pelvic examination (First Stop) are at higher risk of cervical neoplasia compared to women using traditional family planning clinics. Using retrospective ion of medical charts, we compared risk factors for cervical neoplasia among 400 First Stop clients and 400 traditional site clients matched on age, race, and contraceptive method. We determined prevalence of these factors: previous abnormal cervical smear, <16 years at first intercourse, multiple sexual partners, high parity, history of sexually transmitted infections, and current cigarette smoking. First Stop clients were not at greater likelihood of having any risk factor for cervical neoplasia except high parity. First Stop clients who failed to follow through on a referral to a traditional clinic were not more likely to be of higher risk than those who did follow through. Of 13 First Stop clients with the highest risk profiles (previous abnormal cervical smear plus one other risk factor), one did not follow through with referral. First Stop clients choosing hormonal contraception without a pelvic examination do not appear to be at substantially higher risk of cervical neoplasia. Future research should quantify more precisely the risks and benefits of the general application of this strategy on a population level.

Adolescent↗
PubMed1997

Risk factors for adult paternity in births to adolescents.

OBJECTIVE: To examine the risk factors for adult (aged 20 years and older) paternity in births to teenagers (14-17 years of age). METHODS: This was a population-based, retrospective cohort analysis of 27,215 adolescent mothers residing in California who had a live singleton birth during 1993. Adjusted risks for adult paternity by paternal and maternal characteristics were derived from comparisons of adult-teen and teen-teen couples. RESULTS: Adult fathers, who were responsible for 49.2% of births to teenage mothers, were a mean of 6.4 years older than the mother. The most important risk factors for adult paternity were as follows: father's (odds ratio [OR] 5.19; 95% confidence interval [CI] 4.43, 6.08) or mother's (OR 1.33; 95% CI 1.14, 1.55) educational attainment of at least 3 years lower than expected for their age, two or more previous live births (OR 3.34; 95% CI 2.48, 4.53), mother's birthplace outside the United States (OR 2.33; 95% CI 2.11, 2.58), father's (OR 2.16; 95% CI 1.98, 2.36) or mother's (OR 1.28; 95% CI 1.15, 1.42) educational attainment 1-2 years lower than expected for their age, one previous live birth (OR 1.92; 95% CI 1.75, 2.12), and Asian (OR 1.29; 95% CI 1.04, 1.62) or African American race (OR 1.25; 95% CI 1.06, 1.46) of the father. CONCLUSIONS: Teenage pregnancy prevention programs must address adult paternity, which contributed to almost half of the births in our study. These programs should consider education adequacy, cultural beliefs and practices, previous live births, and race and ethnicity when designing programs to decrease the number of adults involved in teenage births.

Adolescent↗
PubMed1994

Nurse practitioners.

Explore the source record for details and available documents.

Attitude of Health Personnel↗
PubMed1982

Immature male and adult male interactions in bisexual langur (Presbytis entellus) troops.

One bisexual troop of langurs (Presbytis entellus) was intensively investigated for 32 months at the Junbesi-Ringmo study site in Nepal. Observations occurred during three separate studies and span a period of 6 years. All members of the study troop could be individually recognized throughout the three studies. During this investigation data were collected on immature male (from birth to 5 years of age) social relations with adult males. Social relations between these two classes of males varied both in type and in frequency of behaviors displayed. During the first study, when the troop was predominantly multi-male, young males directed various tense behaviors toward adult males. Monthly rates of occurrence of such behaviors fluctuated and showed a positive correlation with rates of agonistic behaviors between adult males. In contrast, interactions between the adult and immature males were considerably more relaxed during the second and third studies when the troop had but 1 adult male. Based on the results of these studies, and data evaluated from other studies of P. entellus, it is hypothesized that the frequency and patterning of interactions between adult males affect adult male relations with young males.

Age Factors↗
PubMed1982

The implementation of model standards in local health departments.

Four local health departments in California tested a process of state/local negotiations for the purpose of implementing model standards in community preventive health services. The standards, which covered five program areas, had been developed by a collaborative work group of representatives from the United States Conference of City Health Officers, the National Association of County Health Officials, the Association of State and Territorial Health Officials, the American Public Health Association, and the US Department of Health, Education, and Welfare. Evaluation of the project indicates that the success of the negotiation transactions and results varied, both among local health departments and program areas. A number of factors have been identified as influencing the negotiations, including the availability of baseline data, the extent to which individual programs are currently affected by required standards of performance, and health department attitude toward the project. The future utility of this model is considered within the broader context of changes now occurring in the financing and organization of public health within the United States. Project findings suggest that the Model Standards negotiations could provide state and local levels of government with a valuable management tool for determining health care priorities and generating objective programmatic data for budget justification.

Attitude of Health Personnel↗
PubMed1979

Troop male membership changes and infant killing in langurs (Presbytis entellus).

Almost all studies of Presbytis entellus have resulted in observations of troop male membership changes. Reports from three studies indicate that in some cases troop male membership change occurs through rapid and complete adult male replacement with attendant infant mortality. Data from other investigations of P. entellus show or suggest a different pattern of troop male membership change with no infant mortality. The phenomena of infant killing and rapid male replacement are evaluated on the basis of review of data from ten P. entellus studies. While these and my own data indicate that male social instability (i.e. frequent changes in troop male membership) is species-typical for P. entellus, they do not support the hypothesis that infant killing represents part of an evolved male reproductive strategy.

Aggression↗
PubMedDate not supplied

Provision of hormonal contraceptives without a mandatory pelvic examination: the first stop demonstration project.

CONTEXT: First Stop, an 18-month demonstration project that operated in 1996-1997, was designed to offer low-income adult women in California hormonal contraceptives without requiring a pelvic examination. METHODS: An evaluation was undertaken to assess the contraceptives adopted by First Stop clients, compare health risks of these women with risks among women using traditional family planning clinics and assess clients'satisfaction. Data on 2,065 First Stop clients and 1,507 women attending traditional clinics were collected through several self- and clinician-administered instruments, including questionnaires, a telephone survey and medical chart abstractions. RESULTS: After the initial First Stop visit, 38% of women adopted a more effective method than they had used at last sex, 4 7% remained with the same method, 12% switched to a less-effective method and 3% accepted no method. Of clients who were referred for additional medical care, 73% followed through on their referrals. Compared with clients at traditional clinics, First Stop clients were less likely to have a regular source of health care, but more likely to have made a health care visit in the past year. Most First Stop clients valued the project's services; 76% said it was important to be able to receive pills or injections without a pelvic examination. CONCLUSIONS: Programs that provide hormonal contraceptives without requiring a pelvic examination can expand low-income women's access to these methods and improve the chances that they will obtain other reproductive health services.

Adult↗
PubMedDate not supplied

A profile of the adolescent male family planning client.

CONTEXT: Family planning programs and policies increasingly focus on the male partner's roles and responsibilities in contraceptive decision-making and use. To effectively tailor services for males, policymakers and providers must refine their understanding of men's psychosocial and reproductive health needs. METHODS: Using self-administered questionnaires, 1,540 sexually active males aged 19 and younger who attended family planning clinics in California provided information about their sexual behavior, contraceptive use, pregnancy and parenting history, and psychosocial characteristics. Logistic regression was used to examine factors that contributed to effective contraceptive use. RESULTS: Although 73% of participants reported having used a birth control method at first intercourse, only 59% said that they or their partner had used an effective method at last intercourse, and 35% had used no method. If the client was uncomfortable with his method, the odds that he had used an effective method at last intercourse were reduced (odds ratio, 0.4). The likelihood of use at last intercourse was increased among males who agreed with their partner about their method and those who had never impregnated a partner (1.4 and 1.9, respectively). CONCLUSIONS: To adequately serve young males, clinics must take into account their sexual and contraceptive histories. But screening should go beyond traditional family planning techniques to discuss how to improve communication with partners and other lifestyle issues that may interfere with consistent use.

Adolescent↗