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  • March 19, 2018 7:47 AM | Ashley Monson (Administrator)

    Kristy Goodman, PA-C presented an STI update on Wednesday, March 14, 2018. Click here to view her presentation in our webinar library. Thank you again Kristy!


  • March 06, 2018 8:45 AM | Ashley Monson (Administrator)

    Strelow, Brittany MPAS, PA-C; Fellows, Nicole MPAS, PA-C; Fink, Stephanie R. MPAS, PA-C; O'Laughlin, Danielle J. MPAS, PA-C; Radke, Gladys MPAS, PA-C; Stevens, Joy MPAS, PA-C; Tweedy, Johanna M. APRN, CNP, DNP

    Journal of the American Academy of PAs: March 2018 - Volume 31 - Issue 3 - p 15–18

    doi: 10.1097/01.JAA.0000530288.83376.8e

    CME: Women's Health

    Abstract

    Postpartum depression, which affects 10% to 20% of women in the United States, can significantly harm the health and quality of life for mother, child, and family. This article reviews the risk factors, pathophysiology, clinical manifestations, diagnosis, and treatment of postpartum depression with specific focus on women of advanced maternal age.

    Read more


  • February 24, 2018 5:32 AM | Ashley Monson (Administrator)

    Public Comment on Draft Research Plan: Screening for Bacterial Vaginosis in Pregnant Women to Prevent Preterm Delivery

    The U.S. Preventive Services Task Force posted today a draft research plan on screening for bacterial vaginosis in pregnant women to prevent preterm delivery. The draft research plan is available for review and public comment from February 22, 2018 through March 21, 2018. To review the draft research plan and submit comments, go here.


  • February 22, 2018 1:42 PM | Ashley Monson (Administrator)

    Now Accepting 2018 APAOG Awards Nominations!

    Nominations are due March 16, 2018. The awards process is the single most important means that APAOG has for recognizing PAs who have made significant contributions in women's health. Awards will be presented at the APAOG Reception at the AAPA National Conference (more information to come). View the 2018 Awards Grid for full award details

    >> Click Here To Submit Your Award Nomination Form  


  • February 08, 2018 7:59 AM | Ashley Monson (Administrator)

    The U.S. Preventive Services Task Force seeks comments on a draft recommendation statement and draft evidence review on screening for syphilis infection in pregnant women. The Task Force found strong evidence of benefit in screening all pregnant women for syphilis. The draft recommendation statement and draft evidence review are available for review and public comment from February 6, 2018 to March 5, 2018 here


  • February 05, 2018 9:43 AM | Ashley Monson (Administrator)

    This week, a first-of-its-kind study examining US women's and teen's interest in over-the-counter (OTC) access to a progestin-only birth control pill (POP) was published in Women's Health Issues. The research, authored by myself and Daniel Grossman (Advancing New Standards in Reproductive Health, UCSF), found 39% of adults and 29% of teens reported likely use of an OTC POP, with interest increasing to 46% for adults and 40% for teens if the pill were covered by insurance. The level of interest was similar to findings from a 2013 study on OTC birth control pills that didn't specify a hormonal formulation, suggesting that the type of pill that goes OTC matters less to people than the increase in access.

    Other notable findings include:

    • Nearly one in four adults and teens not currently using contraception said they would be interested in using an OTC POP.
    • A clear majority of women (85%) reported they would continue to visit their health care provider to obtain gynecologic screenings, such as Pap smears and tests for infection.
    • Among current condom users interested in an OTC POP, a majority of adults (61%) and teens (71%) said they would likely continue to use condoms while using an OTC pill.

    Kate Grindlay Kelly 
    Project Director/Associate
    Ibis Reproductive Health

    The Oral Contraceptives (OCs) Over-the-Counter (OTC) Working Group is a coalition of reproductive health, rights, and justice organizations, nonprofit research and advocacy groups, university-based researchers, and prominent clinicians who share a commitment to providing all women of reproductive age easier access to safe, effective, acceptable, and affordable contraceptives. The working group was established in 2004 to explore the potential of over-the-counter access to oral contraceptives to reduce disparities in reproductive health care access and outcomes, and to increase opportunities for women to access a safe, effective method of contraception, free of unnecessary control, as part of a healthy sexual and reproductive life.

    The working group is coordinated by Ibis Reproductive Health.

    Ibis Logo- high res



  • January 31, 2018 8:57 AM | Ashley Monson (Administrator)

    Weekly / December 22, 2017 / 66(50);1383–1385

    Loretta Gavin, PhD1; Karen Pazol, PhD2; Katherine Ahrens, PhD1 (View author affiliations)

    View suggested citation

    In April 2014, CDC published “Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs” (QFP), which describes the scope of services that should be offered in a family planning visit and how to provide those services (e.g., periodicity of screening, which persons are in need of services, etc.) (1). The sections in QFP include the following: Determining the Client’s Need for Services; Contraceptive Services; Pregnancy Testing and Counseling; Clients Who Want to Become Pregnant; Basic Infertility Services; Preconception Health Services; Sexually Transmitted Disease Services; and Related Preventive Health Services. In addition, the QFP includes an appendix entitled Screening Services for Which Evidence Does Not Support Screening.

    CDC and the Office of Population Affairs developed QFP recommendations by conducting an extensive review of published evidence, seeking expert opinion, and synthesizing existing clinical recommendations from CDC, agencies such as the U.S. Preventive Services Task Force (USPSTF), and professional medical associations such as the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics.

    The scope of preventive services related to reproductive health is constantly evolving as new scientific findings are published and clinical recommendations are modified accordingly. Being knowledgeable about the most current recommendations is an important step toward providing the highest quality care to patients. To keep QFP current with the latest recommendations, CDC and the Office of Population Affairs publish occasional updates that summarize newly published clinical recommendations. The first of these updates was published in March 2016 (2), and covered guidelines published during April 2014–December 2015. This report summarizes recommendations from guidelines published during January 2016–April 2017. CDC and the Office of Population Affairs prepared these updates by searching for materials from CDC, USPSTF, and other professional medical organizations that had recommendations referenced in the original QFP. When updated recommendations were identified, they were evaluated for changes in implications for providing family planning care. CDC and the Office of Population Affairs determined that none of the newly published recommendations marked a substantial shift in how family planning care should be provided, and therefore did not seek additional review to consider the implications for the QFP for this update. Technical reviews from clinical experts representing a broad range of family planning providers might be appropriate for future updates.

    Updated recommendations that have implications for clinical practice for family planning providers are highlighted ( Box). In addition, an updated reference list for each section in the QFP is provided for all recommendations published during January 2016–April 2017, including those that did not result in any change in recommended clinical practices for family planning providers.

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    Updated Reference List, by QFP Section

    Determining the Client’s Need for Services

    1. American College of Obstetricians and Gynecologists’ Committee on Health Care for Underserved Women. Committee opinion no. 654: reproductive life planning to reduce unintended pregnancy. Obstet Gynecol 2016;127:e66–9. CrossRef  PubMed

    Contraceptive Services

    1. Curtis KM, Tepper NK, Jatlaoui TC, et al. U.S. medical eligibility criteria for contraceptive use, 2016. MMWR Recomm Rep 2016;65(No. RR-3). CrossRef  PubMed
    2. Curtis KM, Jatlaoui TC, Tepper NK, et al. U.S. selected practice recommendations for contraceptive use, 2016. MMWR Recomm Rep 2016;65(No. RR-4). CrossRef  PubMed
    3. American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice. Committee opinion no. 670: immediate postpartum long-acting reversible contraception. Obstet Gynecol 2016;128:e32–7. CrossRef  PubMed
    4. American College of Obstetricians and Gynecologists’ Committee on Gynecologic Practice Long-Acting Reversible Contraceptive Expert Work Group. Committee opinion no. 672: clinical challenges of long-acting reversible contraceptive methods. Obstet Gynecol 2016;128:e69–77. CrossRef  PubMed

    Clients Who Want to Become Pregnant

    1. Pfeifer S, Butts S, Fossum G, et al. ; Practice Committee of the American Society for Reproductive Medicine in collaboration with the Society for Reproductive Endocrinology and Infertility. Optimizing natural fertility: a committee opinion. Fertil Steril 2017;107:52–8. CrossRef  PubMed

    Preconception Health Services

    1. American College of Obstetricians and Gynecologists’ Committee on Health Care for Underserved Women. Committee opinion no. 654: reproductive life planning to reduce unintended pregnancy. Obstet Gynecol 2016;127:e66–9. CrossRef  PubMed
    2. Kim DK, Riley LE, Harriman KH, Hunter P, Bridges CB. Advisory Committee on Immunization Practices recommended immunization schedule for adults aged 19 years or older—United States, 2017. MMWR Morb Mortal Wkly Rep 2017;66:136–8. CrossRef  PubMed
    3. Robinson CL, Romero JR, Kempe A, Pellegrini C; Advisory Committee on Immunization Practices (ACIP) Child/Adolescent Immunization Work Group. Advisory Committee on Immunization Practices recommended immunization schedule for children and adolescents aged 18 years or younger—United States, 2017. MMWR Morb Mortal Wkly Rep 2017;66:134–5. CrossRef PubMed
    4. US Preventive Services Task Force. Folic acid supplementation for the prevention of neural tube defects: preventive medication. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2017. https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/folic-acid-for-the-prevention-of-neural-tube-defects-preventive-medication
    5. US Preventive Services Task Force. Depression in adults: screening. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2016. https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/depression-in-adults-screening1
    6. US Preventive Services Task Force. Depression in children and adolescents: screening. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2016. https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/depression-in-children-and-adolescents-screening1

    Sexually Transmitted Disease Services

    1. US Preventive Services Task Force. Syphilis infection in nonpregnant adults and adolescents: screening. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2016. https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-nonpregnant-adults-and-adolescents

    Related Preventive Health Services

    1. US Preventive Services Task Force. Breast cancer: screening. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2016. https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast-cancer-screening1
    2. US Preventive Services Task Force. Gynecological conditions: periodic screening with the pelvic examination. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2017. https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/gynecological-conditions-screening-with-the-pelvic-examination

    Screening Services for Which Evidence Does Not Support Screening

    1. US Preventive Services Task Force. Genital herpes infection: serologic screening. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2016. https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/genital-herpes-screening1

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    Conflict of Interest

    No conflicts of interest were reported.

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    Corresponding author: Katherine Ahrens, kate.ahrens@hhs.gov, 240-453-2831.

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    1Office of Population Affairs, U.S. Department of Health and Human Services, Rockville, Maryland; 2Division of Reproductive Health, CDC.

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    References

    1. Gavin L, Moskosky S, Carter M, et al. Providing quality family planning services: recommendations of CDC and the U.S. Office of Population Affairs. MMWR Recomm Rep 2014;63(No. RR-04). PubMed
    2. Gavin L, Pazol K. Update: providing quality family planning services—recommendations from CDC and the U.S. Office of Population Affairs, 2015. MMWR Morb Mortal Wkly Rep 2016;65:231–4. CrossRef  PubMed


  • January 24, 2018 8:15 AM | Ashley Monson (Administrator)

    AAPA
    How can hospitals and health systems create an inclusive workplace culture for PAs? In a new article, the AAPA Center for Healthcare Leadership and Management (CHLM) spoke with one PA leader who shares what her hospital did to positively impact the work environment for its PA employees. Creating an inclusive culture is one criteria for CHLM’s new Employer of Excellence Awards, which recognize hospitals and health systems focused on providing a supportive work environment for PAs. Nominate your employer or encourage them to apply today!


  • January 23, 2018 10:04 AM | Ashley Monson (Administrator)

    JAAPA
    Inhaled nitrous oxide (N 2 O) has been used worldwide for more than 100 years as labor analgesia but has not gained widespread use in the United States. Nitrous oxide provides a noninvasive option for laboring women. This article outlines its efficacy and safety as an analgesic compared with epidural and IV pain medications.

    Learn more.

  • January 22, 2018 9:37 AM | Ashley Monson (Administrator)

    An examination appearing in PLOS One of an unpublished study from 2009 suggested that information the FDA used to approve doxylamine-pyridoxine for treatment of nausea and vomiting in pregnant women showed the drug was not effective.

    The drug is included in the American College of Obstetricians and Gynecologists’ (ACOG) guidelines as the first-line pharmacological therapies for nausea and vomiting for women who are pregnant.

    “Pregnant women should be given accurate information about this and other treatments,” Navindra Persaud, MD, department of family and community medicine, St. Michael’s Hospital in Toronto, told Healio Family Medicine. “Unfortunately, this information [regarding doxylamine-pyridoxine] has not been available to women taking the medication.”

    In the DIC-301 trial from 2009, the efficacy of both doxylamine 10 mg and pyridoxine 10 mg taken from two to four times per day vs. placebo in the treatment of nausea and vomiting was assessed in 280 pregnant women matched in a 1:1 ratio. Information from 131 active treatment participants and 125 control participants were analyzed. By study’s end, 101 active treatment participants and 86 control participants provided primary outcome measures. Symptoms were scored by utilizing the 13-point pregnancy unique quantification of emesis scale between baseline and 14 days using an ANCOVA.

    Using previously unpublished data obtained from public trial registration information, FDA review documents and study report documents from Health Canada, Persaud and colleagues re-analyzed the data from this study to address differences in prior reports of the trial. They found that there was a 0.73 point improvement (95% CI, 0.21-1.25) in symptoms scores with doxylamine-pyridoxine vs. placebo “when last observation carried forward imputation was used for missing data.” However, they added that this difference was not statistically significant when using different approaches to address the missing data (eg, 0.38; 95% CI, –0.08 to 0.84 using complete data).

    Persaud and colleagues also reported that symptom scores plateau after day 10 and “improved substantially” during the 2-week trial in both groups; however, the difference between groups also decreased after the 10th day.

    “Both of these findings could be explained by the natural history of the condition, that is, by the resolution of symptoms irrespective of treatment. This natural resolution could account for the lack of clinical important difference between groups,” Persaud and colleagues wrote.

    According to Persaud, doxylamine-pyridoxine is still a popular option for pregnant women and approved for use in the U.S. and Canada. He told Healio Family Medicine that four prescriptions for the medication were filled for every five live births in Canada in 2014.

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