Young Adult Males' Perspectives of Male Hormonal Contraception.

OBJECTIVE: To evaluate the willingness of young adult males to use male hormonal contraception and to determine the most desirable formulation. METHODS: An institutional review board-approved survey measuring the willingness to use MHC was dispersed to two distinct populations: University of Cincinnati postgraduate programs and Cincinnati Health Department clinics. Questions on the survey allowed for the collection of demographic characteristics, as well as the preferred method of MHC, and concerns regarding potential adverse effects. This survey was directed at young adult males; therefore, only male participants who were 18 to 35 years old were included for analysis. Results were reported as frequencies in each group and χ2 analyses were performed to compare groups, with a P < 0.05 considered significant. RESULTS: Of 162 total survey participants, 45% would use MHC, whereas 30.9% were unsure and 23.5% would not use MHC. Overall, the University of Cincinnati survey population was more likely to be interested in using MHC than the Cincinnati Health Department population (P < 0.05). In both populations, most were interested in using the injectable form. Cited concerns deterring participants from using MHC were different between these two populations, with University of Cincinnati participants more frequently expressing concerns about possible failure of the contraceptive method, whereas Cincinnati Health Department participants had concerns about potential adverse effects (P < 0.001). CONCLUSIONS: There is significant interest among young adult males in using various forms of MHC, especially in injectable form. Differences in views of MHC were seen in two distinct male populations. Specifically, males who achieved a higher level of education, were employed, or in a relationship were found to more frequently be willing to use MHC. With further research and funding, MHC may serve as a significant way to decrease unintended pregnancies in the future.

Emergency department utilization of case-managed patients following benign gynecologic surgery.

BACKGROUND: Case management has been shown to reduce the amount of unnecessary emergency department visits among Medicaid or uninsured patients. This study aims to determine whether case management is associated with decreased unnecessary emergency department visits among benign gynecology surgical patients in the first 30 days following surgery. RESULTS: Out of 875 patients, there were a total of 58 return visits to the emergency department within 30 days and only 6 readmissions. Twenty-four emergency department visits occurred in the case-managed group, and thirty-eight emergency department visits occurred in the non-case-managed group. The two factors that were statistically significant for increase odds of return to the emergency department were the type of surgery (inpatient versus outpatient) and case management. The odds for returning to the emergency department for those not receiving case management was found to be 4.53 to that of the case-managed group when controlling for BMI, age, marital status, and type of surgery. CONCLUSION: In an effort to reduce healthcare costs, case management is a promising intervention to help postoperative patients manage their care while minimizing emergency department visits.

The effect of maternal obesity on the rate of failed induction of labor.

OBJECTIVE: The purpose of this study was to quantify the relationship between class of obesity and rate of failed induction of labor. STUDY DESIGN: Using the Ohio Department of Health's birth certificate database from January 1, 2006, through December 31, 2007, we performed a population-based cohort study that compared failed induction of labor rates between obese and normal-weight women. RESULTS: The rate of induction is associated with increasing body mass index from 28% in normal-weight women to 34% in class III obese women (body mass index, ≥40 kg/m2). Induction failure rates are also associated with increasing obesity class from 13% in normal-weight women to 29% in class III obese women. Women with class III obesity without a previous vaginal delivery and a macrosomic fetus had the highest rate of failed induction at 80%. CONCLUSION: Obesity is associated with an increased risk of failed labor induction that appears to be related directly to increasing class of obesity.