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W Cates

Publications and source records attributed to W Cates.

At least 199 records · Page 11Linked to original sources
PubMedDate not supplied

Contraceptive failure in the United States: an update.

This report provides an update of the authors' previous estimates of first-year probabilities of contraceptive failure for all methods of contraception. Estimates are provided of failure during typical use (which includes both incorrect and inconsistent use) and during perfect use (correct use at every act of intercourse). The difference between these two probabilities provides a measure of how forgiving of imperfect use each method is. These revisions are prompted by recent studies that provide the first estimates of failure during perfect use for periodic abstinence and the cervical cap, by more complete evaluations of implants, and by the appearance of the Copper T 380A and disappearance of other IUDs from the US market. Also provided is a more complete explanation of how the previous estimate of the probability of becoming pregnant while relying solely on chance should be interpreted, and this estimate is revised slightly downward.

Clinical Trials as Topic↗
PubMedDate not supplied

Screening for sexually transmitted diseases by family planning providers: is it adequate and appropriate?

Of more than 3,000 women interviewed in the 1982 National Survey of Family Growth (NSFG) who had made at least one family planning visit in the 12 months preceding the interview, 50 percent report that they were tested for a sexually transmitted infection. Black women are far more likely to have been screened than are white women (67 percent compared with 47 percent); moreover, a racial differential is seen in every subgroup examined. There is also a large difference in the proportion screened according to the woman's source of family planning care: Those who attended a clinic are much more likely to have been screened than are women who saw a private doctor (62 percent and 43 percent, respectively). As with the race differential, this relationship persists after other variables are controlled for. In addition, women who live in the South are more likely to have been screened than are residents of other regions (58 percent compared with 46 percent). Differences by metropolitan and non-metropolitan area of residence are small and are not statistically significant. Differences by marital status and age at first intercourse appeared statistically significant in preliminary analyses, but when controls for other factors were introduced, these differences became nonsignificant. Since many characteristics that are believed to be important risk markers for sexually transmitted infections are also predictors of whether a woman will be screened for such infections, current screening practices appear, in general, to target the appropriate groups.

Adolescent↗
PubMedDate not supplied

Progress toward the 1990 objectives for sexually transmitted diseases: good news and bad.

The problem of sexually transmitted diseases (STDs) in the United States has been growing, in both scope and complexity, at an alarming rate. As evidence of the emergence of these diseases as a primary national concern, the Surgeon General has designated them as 1 of 15 priority areas in which further actions are required to improve the health of the American people. The key targets for the 1990 objectives for the nation in the STD area include reducing the incidence of gonorrhea; gonococcal pelvic inflammatory disease; and primary, secondary, and congenital syphilis. This report updates progress toward these objectives. There is good news with respect to the continuing success of proven methods in preventing and controlling both gonorrhea and syphilis. However, the picture is less bright with respect to control of other STDs that have gained new prominence--Chlamydia, herpesvirus, human papillomavirus, and human T-cell lymphotropic virus type III infections. Escalating interest in STDs reflects more recent appreciation of their relation to reproductive outcomes. STD organisms clearly have a far-reaching effect on the nation's population, including the capacity to reproduce, the rate of perinatal infection, the incidence of genital cancers, and the occurrence of acquired immune deficiency syndrome (AIDS). Some major hurdles still must be faced before the 1990 objectives can be successfully met. The population at risk will remain large, fueling the STD epidemic and taxing existing resources. Public sector support may not keep up with inflation, much less keep pace with the expanding spectrum of sexually transmitted disease. From a public health vantage, however, the opportunities for further advances in controlling STDs have never been greater.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Publicity and the public health: the elimination of IUD-related abortion deaths.

Widespread publicity in the mass media about the dangers of leaving an IUD in place in a pregnant uterus was apparently more effective than traditional scientific publication and drug package inserts in getting doctors to remove devices from pregnant patients. This suggests that such publicity could be effective in improving clinical practice and the public health in other instances, such as getting doctors to prescribe and women to request birth control pills with lower doses of estrogen, and persuading women to obtain early rather than the riskier midtrimester abortions.

Abortion, Septic↗
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Impact of vacuum aspiration abortion on future childbearing: a review.

Ever since induced abortion was legalized in the United States, there has been a running controversy over whether induced abortion affects subsequent childbearing; for example, it has been claimed that women who terminate a pregnancy are at a greater risk of miscarrying a subsequent pregnancy or of having a low-birth-weight baby. Ten studies of the later impact of first-trimester induced abortion by vacuum aspiration (the dominant method in the United States) are examined here; they find that compared with women who carry their first pregnancy to term, women whose first pregnancy ends in induced abortion have no greater risk of bearing low-birth-weight babies, delivering prematurely or suffering spontaneous abortions in subsequent pregnancies. However, these studies also show that induced abortion of a woman's first pregnancy does not have the protective effect on her first live birth that carrying a first birth to term has on later deliveries. In addition, some evidence from other studies links dilatation and curettage (D&C) procedures with later infertility, but most studies have found no such association. No definite conclusions can be reached about the impact of multiple induced abortions, since the results of 13 different epidemiologic studies are almost evenly divided between those that show no effect and those reporting related reproductive problems.

Abortion, Induced↗
PubMedDate not supplied

The public health need for abortion statistics.

As with the delivery of any medical service, abortion has definite public health effects that should be evaluated. The Center for Disease Control (CDC) has monitored the impact of abortion in three ways: (a) conducting epidemiologic surveillance of legally induced abortion beginning in 1969. (b) funding a multicenter study of abortion morbidity beginning in 1971, and (c) undertaking surveillance of abortion-related mortality beginning in 1972. These activities are intended to identify health problems related to abortion, to assess the magnitude of these problems, and to make recommendations directed at eliminating the problems. In addition to the Programmatic uses of abortion data, the CDC statistics have also provided a basis for both legislative and judicial decisions that have had national and local impact. The CDC and the National Center for Health Statistics are currently working collectively to strengthen the reporting of national abortion statistics so that the public health need for abortion statistics can be met.

Abortion, Legal↗
PubMedDate not supplied

Abortion facilities and the risk of death.

While the number of abortions performed annually in the United States has increased steadily since 1969, the proportion of abortions performed in hospitals has been declining since 1975. Between 1974 and 1977, 1,229,000 abortions were performed at 12 or fewer weeks' gestation in U.S. hospitals, while 2,730,000 were performed in free-standing clinics and doctors' offices. Over the same period, there were 19 deaths which resulted from in-hospital procedures, and 17 from abortions performed in nonhospital facilities. The crude death-to-case rate are 1.5 deaths per 100,000 procedures for hospital abortions, and 0.6 deaths per 100,000 abortions performed in nonhospital facilities. When these rates are adjusted for the presence of preexisting medical conditions and for the concurrent performance of sterilizations, the death-to-case rates for first-trimester abortions performed in both kinds of facilities were about 0.7.

Abortion, Legal↗
PubMedDate not supplied

Improving reproductive health: integrating STD and contraceptive services.

The International Conference on Population and Development held in Cairo in 1994 recommended that family planning (FP) services be expanded, with more attention given to the prevention and treatment of sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV). Although such integration of FP and STD services seems a natural union, historical, philosophical, and structural differences in the two fields pose obstacles to integration in many settings. This paper examines selected experiences with FP/STD integration in the United States and developing countries and reviews practical issues that have application to FP providers, STD prevention programs, and those in general practice. Priority areas for future research include: 1) the usefulness and uses of STD risk assessment in FP populations, 2) the relationship between STD/HIV transmission and use of various contraceptive methods, 3) the feasibility of getting high-risk individuals to use dual methods for pregnancy and STD prevention, and 4) the impact adding STD services will have on training requirements, clinic costs, and quality of care within established FP programs. As clinicians in public and private settings assume more comprehensive roles in the provision of both types of services, program managers can facilitate the process of FP and STD service integration by promoting a focus on meeting the client's reproductive health needs.

Developing Countries↗
PubMedDate not supplied

Practicing preventive medicine: a national survey of general preventive medicine residency graduates--United States, 1991.

We conducted a national survey of all physicians who graduated from preventive medicine residency (PMR) programs between 1979 and 1989. We mailed a self-administered questionnaire to all PMR graduates of the 43 U.S. programs in General Preventive Medicine and Public Health, requesting information on their current professional activities. Out of 1,070 PMR graduates, 797 (75%) responded to the survey. Overall, graduates were distinguished from other physicians by both work setting and work activities. PMR graduates worked predominantly in institutional settings: in federal or state health agencies, academia, or hospitals/clinics. In addition to maintaining their involvement in clinical medicine, PMR graduates were heavily involved in epidemiologic research and program management. This unique blend of organizational skills, expertise in population-based research, and clinical experience makes PMR graduates an increasingly important human resource as health care reform increases the population of patients being cared for in a managed care setting.

Female↗