The Association of Hormonal Contraception with Depression

Hormonal contraceptives are widely used by women during their reproductive years. Currently, over 100 million women worldwide use the pill, and 82% of sexually active women in the USA will use oral contraceptive pills at some time during their reproductive years (Carrol, 2017). Oral contraceptive use, especially among adolescents, is associated with subsequent use of antidepressants and a first diagnosis of depression, suggesting depression may be a potential adverse effect of hormonal contraceptive use (Skovlund, 2016). This project focused on educating health care providers at the Community Health Center of Burlington, VT (CHCB) about the association of depression and oral contraceptives. The data was presented to physicians, nurse practitioners, physicians assistants, and pharmacists at CHCB, and subsequent providers were interviewed for more specific reactions to the data.https://scholarworks.uvm.edu/fmclerk/1457/thumbnail.jp

Health and Housing Trends of Single Homeless Adults in Chittenden County, Vermont

Introduction. Homeless individuals are at an increased risk for both physical and mental health comorbidities compared to those with stable housing. Prior studies have demonstrated that many of these individuals do not seek or receive proper medical care. This study provides a landscape analysis of health characteristics in the single adult homeless population in Chittenden County, Vermont. Methods. Interviews were conducted using a modified version of the Vulnerability Index – Service Prioritization Decision Assistance Tool to determine vulnerability indices across a range of different health and social wellness domains. Single home- less adults were sampled from community self-help clinics and transitional living and homeless shelters from September to November 2017. Results. 56 in-person surveys were conducted. Mean age of participants was 45.3 years and over half were male (63%). Extended periods or multiple episodes of homelessness were experienced most by those who reported sleeping outdoors (89%); this group also reported the highest use of emergency services (47%). The highest incidence of abuse/trauma as a contributing factor for homelessness was reported most in the 18-30 age group (71%) and least in the above 51 age group (35%). Nearly all participants owned a cell phone (86%). Conclusions. Single homeless adults self-reported a variety of health and social is- sues, including substance abuse, increased emergency department use, and in- creased abuse, trauma, and deteriorated social relationships. This study highlights different risk factors that contribute to homelessness in this select population. Future research should evaluate how to individually address these vulnerabilities to optimize health care and well-being.https://scholarworks.uvm.edu/comphp_gallery/1255/thumbnail.jp

Nurses\u27 Short-Term Sickness Absences Before and After the Implementation of a Brief Napping Opportunity During Night Shifts

BACKGROUND: Nurses who work at night have used naps to alleviate their sleepiness and fatigue. Research has shown night shifts, sleepiness, and fatigue predict nurses\u27 missed workdays. Thus, nighttime napping may have a beneficial consequence of reducing nurses\u27 sickness absences. The purpose of this brief report was to describe the difference in rates of short-term sickness absence before and after implementation of a 30-min nap opportunity in one U.S. hospital for 12-hr shift nurses. METHODS: The study was a retrospective pre-post evaluation design. Eight units provided nap opportunities for the nurses. Full-time nurses were classified into night and rotating shifts based on their 2 years of scheduling patterns. Absence data were extracted from the hospital\u27s timekeeping system and annual absence rates were computed. A single linear mixed model with rank transformed data was conducted for each group. Median estimates, minimum and maximum, and -values were reported. FINDINGS: The median absence rates for night shift nurses were 4.3% and 4.0% for the pre-napping and post-napping implementation periods, respectively; however, this difference was not statistically significant ( = .241). The median absence rates for rotating shift nurses were 2.0% and 3.9% for the pre-napping and post-napping implementation periods, respectively; and the difference increase was statistically significant ( .001). CONCLUSION/APPLICATION TO PRACTICE: A nap policy which provides nurses with the opportunity to take nighttime naps did not benefit their sickness absence rates. Future research needs to examine the actual napping process on sickness absences, as well as explore other sickness management avenues