DOCSLIB.ORG

The Relationship Between Female Genital Aesthetic Perceptions and Gynecological Care

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

Examining the Vulva: The Relationship between Female Genital Aesthetic Perceptions and Gynecological Care By Vanessa R. Schick B.A. May 2004, University of Massachusetts, Amherst A Dissertation Submitted to The Faculty of Columbian College of Arts and Sciences of The George Washington University in Partial Satisfaction of the Requirements for the Degree of Doctor of Philosophy January 31, 2010 Dissertation directed by Alyssa N. Zucker Associate Professor of Psychology and Women’s Studies The Columbian College of Arts and Sciences of The George Washington University certifies that Vanessa R. Schick has passed the Final Examination for the degree of Doctor of Philosophy as of August 19, 2009. This is the final and approved form of the dissertation. Examining the Vulva: The Relationship between Female Genital Aesthetic Perceptions and Gynecological Care Vanessa R. Schick Dissertation Research Committee: Alyssa N. Zucker, Associate Professor of Psychology & Women's Studies, Dissertation Director Laina Bay-Cheng, Assistant Professor of Social Work, University at Buffalo, Committee Member Maria-Cecilia Zea, Professor of Psychology, Committee Member ii © Copyright 2009 by Vanessa R. Schick All rights reserved iii Acknowledgments The past five years have changed me and my research path in ways that I could have never imagined. I feel incredibly fortunate for my mentors, colleagues, friends and family who have supported me throughout this journey. First, I would like to start by expressing my sincere appreciation to my phenomenal dissertation committee and all those who made this dissertation possible: Without Alyssa Zucker, my advisor, my journey would have been an entirely different one. Few advisors would allow their students to forge their own research path. However, she let me follow my passion, even when it led me into unchartered waters. I would not be where I am today without her support and guidance. I am forever thankful to her for taking a chance on me. I feel incredibly fortunate to have had the opportunity to work with Laina Bay-Cheng over the past five years. Her thoughtful revisions never ceased to amaze me. She continuously challenged me to think about things in ways that I would have never considered. I am a better researcher because of her. I never realized how influential a single course could be before I took one with Maria- Cecilia Zea. The space that she created for openness and acceptance allowed me and my research to flourish in ways that I had not thought possible. Her faith in me gave me the confidence to take the risks that have had made my research possible. I am incredibly thankful to my outside dissertation committee members. I cannot thank Rolf Peterson and Florence Haseltine enough for offering to be on my committee despite their busy schedules and my condensed timeline. It was truly an honor to have such iv distinguished members on my committee. Their unique input on my dissertation was invaluable. I would be remiss not to thank all of all of the RA’s who have helped me over the years. In particular, I would like to send a special thank you to Katie Armstrong. I feel incredibly fortunate to have had her as both a student and an RA. I am deeply appreciative for her enthusiastic and careful work. Finally, I would like to thank everyone at the Center for Sexual Health Promotion for providing me with a motive to finish my dissertation. I could not have imagined a more perfect opportunity. Most importantly, this dissertation would not have been possible without the women that took the time to share their personal thoughts and feelings with me. I am thankful to each and every one of them. I would like to thank all of the mentors, colleagues and friends who helped me to grow both personally and academically over the years: First, I would like to thank everyone that I worked with at the Society for Women’s Health Research including Florence Haseltine, Stephanie Pincus, and Suzanne Stone. The skills that I learned while there will likely apply in my future in ways that I can only imagine. I would not have gotten through the past five years without the support of colleagues and friends. Annette Kaufman, I will be forever grateful that I came into this program with someone as supportive and thoughtful as you. Laura Landry and Andrea Mercurio, thank v you for taking me under your wing. Brandi Rima, I feel fortunate to have had the opportunity to work with you over the past several years. I cherish you as both a co- worker and a friend. Thaddeus Russell Sullivan, I cannot thank you enough for your unwavering support over the past several months. Tini Town, although we have had some ups and downs over the past several years, your consistent use of the litter box over the past few months has helped me to maintain my sanity in ways that you cannot even imagine. Above all, I would like to express my gratitude to Sarah Calabrese. Words cannot express how meaningful she has been to me over the past five years. She is undeniably one of the most remarkable people I have ever known personally or professionally. I do not know what I am going to without my better half. I would like to thank the family members who influenced the person that I am today: Grandma and Aunt Bobbie, you showed me that one can be both elegant and refined without being either passive or submissive. I have always admired your seemingly smooth social graces. Frank, you made me recognize that I was stronger than I realized. Thank you to Jordan, Max, Jenna, Jason and the many other family members who have touched my life in various ways. At risk of writing an acknowledgment section that surpasses the length of my dissertation, I would like to thank all of my brothers and sisters individually. Maleese, thank you for always wearing such big shoes. I have had to run in circles trying to fill them. Jared, you have always been wise beyond your years. I envy your tenacity. Ezra, the good in you is absolutely undeniable. Rosalind, your pure kindness is an inspiration. Sophie, I hope to be as versatile as you when I grow-up. Sam, my munchkin, I knew how vi special you would be to me before you could even speak. You are truly my Okapi. Thank you all for helping me keep it all in perspective. Finally, I would like to thank my parents whose love and support made this possible. Dad, many people have told me that I work harder than anyone they have ever met. I often respond by telling them that they have never met my father. I am in awe of your ability to manage a business and raise a family. Your strength and resilience inspires me everyday. I would also like to thank my mother, who has always encouraged me to take the road less traveled. She has never suppressed my creativity, even when it meant letting me walk out of the house in a jacket made of bubble wrap and pants sewn together with Astroturf. I have never had to question her faith in me. Lastly, I would like to dedicate the dissertation to my stepmother Ellen. She was an incredibly humble person who, if alive today, would find this gesture uncomfortable and embarrassing. However, her role in this dissertation was undeniable. Her battle with gynecological cancer was at the root of the topic of the dissertation. Additionally, although Ellen never had the opportunity to finish her dissertation, I was recently surprised to find out that her topic (speaking about the unspeakable) parallels my own research (exposing taboos/ opening closed discourses), illustrating her enduring influence on me. Although she never got to see where my graduate path ended, I can only hope that the direction was one that made her proud. She was truly one of the most wonderful people that I have ever had the opportunity to know. Oddly, she always told me that she envisioned me being the happiest in Bloomington, IN. I sure hope that she was right. vii Abstract of Dissertation Examining the Vulva: The Relationship between Female Genital Aesthetic Perceptions and Gynecological Care Despite the known benefits of gynecological exams, women’s concerns about displaying their genitalia may function as a deterrent to care. While little is known about women’s genital perceptions, the current rise of female genital cosmetic surgeries suggests that women may be dissatisfied with the deviation of their vulva from a uniform appearance ideal. Thus, the current study investigated the construction of this ideal and the relationship to gynecological care. Specifically, the current study tested a path through which exposure to either a constrained or varied vulva picture set would differentially activate a concatenation of cognitions and emotions that would, in turn, predict gynecological care perceptions and intentions. Young, undergraduate women (N=485) completed the on-line survey at a computer of their choosing. Contrary to the hypothesis, picture set exposure was unrelated to vulva perceptions. However, as predicted, young women’s genital perceptions were significantly related to their gynecological care perceptions and intentions. viii Table of Contents Acknowledgments ii Abstract vi List of Figures……………………………………………………………….............. xii List of Tables ……………………………………………………………………….. xiii Chapter I. INTRODUCTION……………………………………………………………. 1 Examining Female Genitalia: A Critical Analysis ……………………... 3 Genital Discontent and Pap Smear Intentions…………………………... 8 Rational-Emotive Behavior Therapy Model………………………… 9 An ABC Path from Genital Discontent to Pap smear Intentions……. 11 Activating Genital Perceptions via Female Genital Images…………. 11 Genital Perceptions as an Antecedent to Generalized Genital Concerns……………………………………………………………... 13 The Relationship between Genital Dissatisfaction and Exam Embarrassment....................................................................................
Recommended publications
  • A Study on Cervical Screening by PAP Smear and Correlation with Microbiological and Clinical Finding

    A Study on Cervical Screening by PAP Smear and Correlation with Microbiological and Clinical Finding

    International Journal of Health and Clinical Research, 2021;4(5):280-283 e-ISSN: 2590-3241, p-ISSN: 2590-325X ____________________________________________________________________________________________________________________________________________ Original Research Article A study on cervical screening by PAP smear and correlation with microbiological and clinical finding Sona Goyal1, Manish Kumar Singhal2*,Kamlesh Yadav3, Rachna Agrawal4, Neil Sharma 5 1Consultant Pathologist, Department of Pathology, NIA , Jaipur, Rajasthan, India 2Associate Professor, Department of Pathology, Govt Medical college, Bhartapur, Rajasthan, India 3Professor, Department of Pathology, SMS Medical college Jaipur, Rajasthan, India 4Assistant Professor, Department of Anatomy, Govt Medical college , Bhartapur, Rajasthan, India 5Assistant Professor, Department of Pathology, Govt Medical college, Bhartapur, Rajasthan, India Received: 03-01-2021 / Revised: 08-02-2021 / Accepted: 25-02-2021 Abstract Introduction: Cervical cancer is one of the most common cause in India with over 75% of incidence and mortality. The objective of cervical cancer screening, therefore, is the detection of these lesions before developing into invasive cervical cancer.Methods: This prospective study was carried out over 2 year at the Department of Obstetrics and Gynaecology in National Institute of Ayurveda, Jaipur. Pap smears were collected from 400 sexually active women who were more than 21 years of age.Result: Most common findings were Inflammatory lesion (46.5%), followed by NILM(30%). Atrophic smear was seen in 16 cases (4%), rest had abnormal cellular changes in the form of ASCUS (1.25 %), LSIL (2 %) and Carcinoma (1%).Conclusion : Inflammatory smear is most common cytological finding in premenopausal age group . Epithelial cell abnormality is most common finding in premenopausal and postmenopausal age groups. Pap smear examination can be coupled with culture and sensitivity of vaginal swab to provide adequate treatment.
  • Developmental Abnormalities Easy to Misdiagnose

    Developmental Abnormalities Easy to Misdiagnose

    8 Gynecology O B .GYN. NEWS • March 15, 2005 Developmental Abnormalities Easy to Misdiagnose BY JANE SALODOF MACNEIL inappropriate surgery, according to Dr. even an entity called obstructed hemi- Abnormalities of the vulva include con- Contributing Writer Zurawin, chief of the section of pediatric vagina.” genital labial fusion, which he said could and adolescent gynecology at Baylor and Clitoral hypertrophy is the only devel- be corrected with a simple flap proce- H OUSTON — Developmental abnor- of the gynecology service at Texas Chil- opmental abnormality of the clitoris, ac- dure. Surgery is rarely used, however, for malities of the vulva and vagina are often dren’s Hospital in Houston. cording to Dr. Zurawin. It used to be acquired labial agglutination. “This is one easy to correct, but also easy to misdiag- “You need to be familiar with the syn- treated by clitoridectomy with “very un- of most common referrals from pediatri- nose, Robert K. Zurawin, M.D., warned at dromes before you treat. Many people satisfactory results,” he said, describing cians, because they don’t know what to do a conference on vulvovaginal diseases are confronted with these conditions, and more conservative procedures in use to- with it and they are afraid,” Dr. Zurawin sponsored by Baylor College of Medicine. they don’t know what they really are,” he day. “This is mainly a cosmetic problem said. Many physicians have not been trained said. “With the obstructions, for example, for patients, and the surgical management He attributed most cases to diaper rash, to recognize these rare disorders and, as a they may just think it is an imperforate hy- is resection of the enlarged clitoris,” he bubble baths, and detergents that can in- result, run the risk of doing excessive or men and are not even aware that there is said.
  • Vaginal Screening After Hysterectomy in Australia

    Vaginal Screening After Hysterectomy in Australia

    CATEGORY: BEST PRACTICE Vaginal screening after hysterectomy in Australia Objectives: To provide advice on vaginal This statement has been developed and screening after hysterectomy. reviewed by the Women’s Health Committee and approved by the RANZCOG Target audience: Health professionals Board and Council. providing gynaecological care. A list of Women’s Health Committee Values: The evidence was reviewed by the Members can be found in Appendix A. Women’s Health Committee (RANZCOG), and applied to local factors relating to Disclosure statements have been received Australia. from all members of this committee. Background: This statement was first developed by Women’s Health Disclaimer This information is intended to Committee in November 2010 and provide general advice to practitioners. This reviewed in March 2020. information should not be relied on as a substitute for proper assessment with respect Funding: This statement was developed by to the particular circumstances of each RANZCOG and there are no relevant case and the needs of any patient. This financial disclosures. document reflects emerging clinical and scientific advances as of the date issued and is subject to change. The document has been prepared having regard to general circumstances. First endorsed by RANZCOG: November 2010 Current: March 2020 Review due: March 2023 1 1. Introduction In December 2017, the National Cervical Screening Program in Australia changed from 2 yearly cervical cytology testing to 5 yearly primary HPV screening with reflex liquid-based cytology for those women in whom oncogenic HPV is detected in women aged 25–74 years. New Zealand has not yet transitioned to primary HPV screening.
  • 2021 – the Following CPT Codes Are Approved for Billing Through Women’S Way

    2021 – the Following CPT Codes Are Approved for Billing Through Women’S Way

    WHAT’S COVERED – 2021 Women’s Way CPT Code Medicare Part B Rate List Effective January 1, 2021 For questions, call the Women’s Way State Office 800-280-5512 or 701-328-2389 • CPT codes that are specifically not covered are 77061, 77062 and 87623 • Reimbursement for treatment services is not allowed. (See note on page 8). • CPT code 99201 has been removed from What’s Covered List • New CPT codes are in bold font. 2021 – The following CPT codes are approved for billing through Women’s Way. Description of Services CPT $ Rate Office Visits New patient; medically appropriate history/exam; straightforward decision making; 15-29 minutes 99202 72.19 New patient; medically appropriate history/exam; low level decision making; 30-44 minutes 99203 110.77 New patient; medically appropriate history/exam; moderate level decision making; 45-59 minutes 99204 165.36 New patient; medically appropriate history/exam; high level decision making; 60-74 minutes. 99205 218.21 Established patient; evaluation and management, may not require presence of physician; 99211 22.83 presenting problems are minimal Established patient; medically appropriate history/exam, straightforward decision making; 10-19 99212 55.88 minutes Established patient; medically appropriate history/exam, low level decision making; 20-29 minutes 99213 90.48 Established patient; medically appropriate history/exam, moderate level decision making; 30-39 99214 128.42 minutes Established patient; comprehensive history exam, high complex decision making; 40-54 minutes 99215 128.42 Initial comprehensive
  • Colposcopy.Pdf

    Colposcopy.Pdf

    CCololppooscoscoppyy ► Chris DeSimone, M.D. ► Gynecologic Oncology ► Images from Colposcopy Cervical Pathology, 3rd Ed., 1998 HistoHistorryy ► ColColpposcopyoscopy wwasas ppiioneeredoneered inin GGeermrmaanyny bbyy DrDr.. HinselmannHinselmann dduriurinngg tthhee 19201920’s’s ► HeHe sousougghtht ttoo prprooveve ththaatt micmicrroscopicoscopic eexaminxaminaationtion ofof thethe cervixcervix wouwoulldd detectdetect cervicalcervical ccancanceerr eeararlliierer tthhaann 44 ccmm ► HisHis workwork identidentiifiefiedd severalseveral atatyypicalpical appeappeararanancceses whwhicichh araree stistillll usedused ttooddaay:y: . Luekoplakia . Punctation . Felderung (mosaicism) Colposcopy Cervical Pathology 3rd Ed. 1998 HistoHistorryy ► ThrThrooughugh thethe 3030’s’s aanndd 4040’s’s brbreaeaktkthrhrouougghshs wwereere mamaddee regregaarrddinging whwhicichh aapppepeararancanceess wweerere moremore liklikelelyy toto prprogogressress toto invinvaasivesive ccaarcinomrcinomaa;; HHOOWEWEVVERER,, ► TheThessee ffiinndingsdings wweerere didifffficiculultt toto inteinterrpretpret sincesince theythey werweree notnot corcorrrelatedelated wwithith histologhistologyy ► OneOne resreseaearcrchherer wwouldould claclaiimm hhiiss ppatatientsients wwithith XX ffindindiingsngs nevernever hahadd ccaarcinomarcinoma whwhililee aannothotheerr emphemphaatiticcallyally belibelieevedved itit diddid ► WorldWorld wiwidede colposcopycolposcopy waswas uunnderderuutitillizizeedd asas aa diadiaggnosticnostic tooltool sseeconcondadaryry ttoo tthheseese discrepadiscrepannciescies HistoHistorryy
  • 2021 HEDIS Reference Guidefor Primary Care

    2021 HEDIS Reference Guidefor Primary Care

    2021 HEDIS Reference Guide for Primary Care Cervical Cancer Screening (CCS) Patient Profile MVP members 21–64 years of age who have been screened for cervical cancer. Appropriate screening is defined by one of the following criteria: • Women 21–64 years of age who have a cervical cytology performed within the last three years (the measurement year and up to two years prior) • Women 30–64 years of age who have a cervical high-risk human papillomavirus (hrHPV) testing performed within the last five years (Note: Evidence of hrHPV testing within the last 5 years also captures patients who had cotesting; therefore additional methods to identify cotesting are not necessary.) • Women 30-64 years of age who had cervical cytology cotesting within the last five years Those excluded are women who have had a hysterectomy with no residual cervix (complete, total, or radical abdominal or vaginal hysterectomy), cervical agenesis, or acquired absence of cervix any time during the member's history through December 31 of the measurement year. How to Implement Best Practices and Improve Performance • Documentation in the medical record must include the name of the cervical screening, date of the test, and the result. This may be documented in an office note or a lab report, and can be submitted. • Cervical biopsies are not valid for primary cervical cancer screening and cannot be submitted. • When documenting medical/surgical history, avoid the use of “hysterectomy” alone, as this is not sufficient evidence that the cervix was removed. Be specific: “TAH”, TVH”, etc. • Documentation of “hysterectomy” alone in combination with documentation that the “patient no longer needs cervical cancer screening,” does meet criteria.
  • Diagnostic Tests for Vaginosis/Vaginitis

    Diagnostic Tests for Vaginosis/Vaginitis

    Alberta Heritage Foundation for Medical Research Diagnostic tests for vaginosis/vaginitis Christa Harstall and Paula Corabian October 1998 HTA12 Diagnostic tests for vaginosis/vaginitis Christa Harstall and Paula Corabian October 1998 © Copyight Alberta Heritage Foundation for Medical Research, 1998 This Health Technology Assessment Report has been prepared on the basis of available information of which the Foundation is aware from public literature and expert opinion, and attempts to be current to the date of publication. The report has been externally reviewed. Additional information and comments relative to the Report are welcome, and should be sent to: Director, Health Technology Assessment Alberta Heritage Foundation for Medical Research 3125 Manulife Place, 10180 - 101 Street Edmonton Alberta T5J 3S4 CANADA Tel: 403-423-5727, Fax: 403-429-3509 This study is based, in part, on data provided by Alberta Health. The interpretation of the data in the report is that of the authors and does not necessarily represent the views of the Government of Alberta. ISBN 1-896956-15-7 Alberta's health technology assessment program has been established under the Health Research Collaboration Agreement between the Alberta Heritage Foundation for Medical Research and the Alberta Health Ministry. Acknowledgements The Alberta Heritage Foundation for Medical Research is most grateful to the following persons for their comments on the draft report and for provision of information. The views expressed in the final report are those of the Foundation. Dr. Jane Ballantine, Section of General Practice, Calgary Dr. Deirdre L. Church, Microbiology, Calgary Laboratory Services, Calgary Dr. Nestor N. Demianczuk, Royal Alexandra Hospital, Edmonton Dr.
  • Key Points: • a Pap Test and Pelvic Exam Are Important Parts of A

    Key Points: • a Pap Test and Pelvic Exam Are Important Parts of A

    Key Points: • A Pap test and pelvic exam are important parts of a woman’s routine health care because they can detect cancer or abnormalities that may lead to cancer of the cervix (see Question 3). • Women should have a Pap test at least once every three years, beginning about three years after they begin to have sexual intercourse, but no later than age 21 (see Question 6). • If the Pap test shows abnormalities, further tests an/or treatment may be necessary (see Question 11). • Human papillomavirus (HPV) infection is the primary risk factor for cervical cancer (see Question 13). 1. What is a Pap test? The Pap test (sometimes called a Pap smear) is a way to examine cells collected from the cervix (the lower, narrow end of the uterus). The main purpose of the Pap test is to find abnormal cell changes that may arise from cervical cancer or before cancer develops. 2. What is a pelvic exam? In a pelvic exam, the uterus, vagina, ovaries, fallopian tubes, bladder, and rectum are felt to find any abnormality in their shape or size. During a pelvic exam, an instrument called a speculum is used to widen the vagina so that the upper portion of the vagina and the cervix can be seen. 3. Why are a Pap test and pelvic exam important? A Pap test and pelvic exam are important parts of a woman’s routine health care because they can detect abnormalities that may lead to invasive cancer of the cervix. These abnormalities can be treated before cancer develops.
  • Cervical Cancer Screening Guidelines Reviewed and Approved by CHAC Clinical Committee on August 8, 2018

    Cervical Cancer Screening Guidelines Reviewed and Approved by CHAC Clinical Committee on August 8, 2018

    Cervical Cancer Screening Guidelines Reviewed and approved by CHAC Clinical Committee on August 8, 2018 Cervical Cancer Screening Description: The percentage of women 21–64 years of age who were screened for cervical cancer using either of the following criteria: • Women age 21–64 who had cervical cytology performed every 3 years. • Women age 30–64 who had cervical cytology/ HPV co-testing every 5 years. Numerator: Documentation of one or more of the following cancer screenings and date(s) Women with one or more screenings for cervical cancer. Appropriate screenings are defined by any one of the following criteria: Cervical cytology performed during the measurement period or the two years prior to the measurement period for women who are at least 21 years old at the time of the test Cervical cytology/human papillomavirus (HPV) co-testing performed during the measurement period or the four years prior to the measurement period for women who are at least 30 years old at the time of the test _____________________________________________________________ Denominator: Ages 23-64 with a visit in the measurement period Denominator Exclusions: Women who had a hysterectomy with no residual cervix Patients who were in hospice care during the measurement year Measure Source: eCQI Resource Center, CMS (Aligns with CY 2018 UDS requirements) https://ecqi.healthit.gov/ecqm/measures/cms124v6 Health care providers play a critical role in raising awareness of cervical cancer and increasing screening among women and HPV vaccination among boys and girls. What is the problem and what is known about it so far? Cancer is the leading cause of death in Vermont.
  • FGM – Female Genital Mutilation Kvinnlig Könsstympning

    FGM – Female Genital Mutilation Kvinnlig Könsstympning

    Trollhättan, 17+18/11 2016 Senior FGM – Female Genital Mutilation Kvinnlig Könsstympning Dr. med. Johannes Leidinger, MD., MPH. Senior Consultant in Gynaecology and Obstetrics Överläkare på Kvinnokliniken Södersjukhuset Stockholm & Mälarsjukhuset Eskilstuna Lehrbeauftragter/Dozent der Ludwig-Maximilians-Universität München 16 days of activism 2016 From 25 November, the International Day for the Elimination of Violence against Women, to 10 December, Human Rights Day, the 16 Days of Activism against Gender-Based Violence Campaign is a time to galvanize action to end violence against women and girls around the world. http://www.unwomen.org/en/what-we-do/ending-violence-against-women/ take-action/16-days-of-activism#sthash.zXvSzU8E.dpuf Sexual Violence: ¨ Rape ¨ Indecent Assault ¨ Forced Marriage ¨ Sexual Slavery http://www.eldis.org ¨ FGM (Female Genital Mutilation) ¨ Forced Pregnancy ¨ Forced Abortion ¨ Sexual Harassment WHO: FGM ¨ „FGM comprises all procedures that involve altering or injuring the female genitalia for non­ medical reasons - , and is recognized internationally as a violation of the human rights of girls and women. It reflects deep-rooted inequality between the sexes, and constitutes an extreme form of discrimination against women and girls.“ Program 18 Nov 2016, 9-12 am ¨ Nomenklatur ¨ Klassifikation ¨ Global Prevalens ¨ Förklaringsmodeller ¨ Medicinska komplikationer ¨ Nationell & internationell Lagstiftning ¨ Vård i Sverige – AMEL-mottagning – Operativa rekonstruktioner – Desert Flower Scandinavia ¨ Global perspektiv – Internationella strategier (WHO och NGOs) – Medicalization of FGM Terminology ¨ The expression ”Female Genital Mutilation" gained growing support from the late 1970s. The word ”mutilation” establishes a clear linguistic distinction from male circumcision, and emphasizes the gravity and harm of the act. ¨ In 1990, this term was adopted at the ”3rd Conference of the Inter-African Committee on Traditional Practices Affecting the Health of Women and Children”, in Addis Ababa, Ethiopia.
  • Laboratory Test: Wet Prep Standing Order in N.C

    Laboratory Test: Wet Prep Standing Order in N.C

    Laboratory Test: Wet Prep Standing Order in N.C. Board of Nursing Format INSTRUCTIONS FOR LOCAL HEALTH DEPARTMENT STAFF ONLY Use the approved language in this standing order to create a customized standing order exclusively for your agency. Print the customized standing order on agency letterhead. Review standing order at least annually and obtain Medical Director’s signature. Standing order must include the effective start date and the expiration date. Assessment Subjective Findings The following subjective criteria meet the requirement for an STD ERRN to collect a Wet Prep by standing order: Vaginal discharge with or without foul odor Dyspareunia Dysuria New or multiple sex partner(s) Lack of condom use Reports contact to: Chlamydia (CT), Gonorrhea Asymptomatic (GC), Non-Gonococcal Urethritis (NGU), Pelvic Anonymous sex Inflammatory Disease (PID), Mucopurulent Cervicitis (MPC), or Trichomonas vaginalis (TV) Objective Findings If one or more of these clinical findings are present, the STD ERRN shall collect a Wet Prep by standing order: 1. vaginal discharge 2. endocervical discharge 3. foul odor 4. cervical inflammation, usually manifest as edema or easily induced cervical bleeding upon cervical swabbing 5. petechiae on cervix 6. vaginal or vulva irritation 7. warts or other abnormal growths in vagina or on cervix 8. vaginal exposure within last 60 days 9. verified contact Gonorrhea, Chlamydia, NGU, MPC or Trichomonas Plan of Care Implementation A registered nurse or STD ERRN employed or contracted by the local health department may order a Wet Prep collected by the STD ERRN or other medical provider. Nursing Actions A. Specimen Collection by STD ERRN: To collect a Wet Prep specimen: 1.
  • GM EUR Generic Funding Request Form NOTE

    GM EUR Generic Funding Request Form NOTE

    2017-19 Effective Use of Resources Treatment Policies GM EUR Team Contacts Tel Email Version 5.7 Funding applications / Process 0161 212 6250 [email protected] List Last Updated 22 January 2019 Policy development 0161 212 6212 [email protected] Approval Funding Approval Category Notes Funding Request Forms Required Individual Funding Request A decision has been taken not to commission a specific treatment. Funding will only be approved if there is evidence of clinical GM EUR Generic Funding Request Form Yes (Exceptional Case) Approval (IFR) exceptional circumstances. NOTE: GM policies have specific funding request forms, please see the end column on the The Commissioner has specifically requested that funding is sought for a particular treatment. The treatment must not be Yes blue coloured rows below. Individual Prior Approval (IPA) undertaken without funding approval from commissioners. Exceptional circumstances do not always have to be demonstrated. PbR Excluded Lists Monitored Approval (MA) The specific treatment may be undertaken in line with agreed EUR policy criteria/routine commissioning arrangements provided the policy criteria is met, clinicians can refer patients without seeking approval. If the patient does not meet the policy NOTE: Only applies if the patient No PbR Excluded Devices List PbR Excluded Drugs List criteria clinicians should apply for Individual Funding Request (Exceptional Case) Approval. Audits may be undertaken to meets the policy critiera. ensure adherence with agreed commissioning arrangements.