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Objective: To compare the frequency of the provision of contraceptive counseling at the time of clinical pregnancy test at family planning clinics to other clinical settings among women who wish to avoid pregnancy for the next 2 years or longer.Study Design: This was a secondary data analysis of the 2011-2017 National Survey of Family Growth. It used logistic regression to estimate the relationship between receiving contraceptive counseling with source of care, age, educational attainment, race/ethnicity, poverty status, marital status, insurance status, and pregnancy history among 1790 women aged 15-44 who received in-clinic pregnancy tests and sought to avoid pregnancy for the next two years or longer.Results: Most clinical pregnancy tests were performed by private practices (52%), community health clinics (20%), and other clinical settings (19%); 8% were performed by family planning clinics. Family planning clinics more frequently provided contraceptive counseling with pregnancy tests than other clinical settings (78% at family planning clinics versus 62% at private doctor's offices and 49% at other settings; aOR = 0.45 [0.25, 0.82], and aOR = 0.26 [0.13, 0.52]). Regardless of clinical setting, age, marital status, income, and pregnancy history, women were more likely to receive contraceptive counseling along with in-clinic pregnancy testing if they were Black (aOR = 1.84 [1.17, 2.90]); they were less likely to receive contraceptive counseling following in-clinic pregnancy test if they had educational attainment higher than a high school education (aOR = 0.53 [0.34, 0.82] and aOR = 0.57 [0.33, 0.99]).Conclusion: Contraceptive counseling at the time of clinical pregnancy testing for women who wish to avoid pregnancy is more common at family planning clinics, but it varies by education and race.Implications: Efforts are needed to ensure that women who wish to avoid pregnancy consistently receive contraceptive counseling when seeking clinical pregnancy testing. [ABSTRACT FROM AUTHOR]

Highlights • Correspondence between perceptions and instrumented change is termed P delta I. • Perceptions of change correspond with instrumented change for some phenomena. • P delta I may influence environmental decisions and consequently adaptive capacity. • The perceptions of our respondents are set within the research of perception of climate and environmental change. Abstract Decisions and responses to environmental change are arguably based on whether decision-makers perceive change. We explore the idea of how the difference, or delta, between perceptions of environmental change and instrumented measures of environmental change (P delta I or PΔI) may be a factor in maladaptive versus adaptive responses. Two case-studies in Alaska, U.S.A. are used to assess the statistical correlation between natural resource managers and non-profit interest group (NGO) representatives' perceptions of environmental change and instrumented measures of environmental change. Environmental change was examined for summer and winter air temperature, stream water temperature, summer rainfall, Chinook salmon abundance and size, and residential land-use development. Results suggest that natural resource managers and NGO respondents do not always perceive change in the environment that is consistent with instrumented measures of change. We discuss the implications of this delta between perceptions and instrumented data because they are important for adaptive policies. [ABSTRACT FROM AUTHOR]

Objective: Earlier pregnancy discovery is important in the context of prenatal and abortion care. We evaluated characteristics associated with later pregnancy discovery among women seeking abortion care.Study Design: Data come from a survey of women seeking abortion care at four family planning facilities in Utah. The participants completed a survey during the state-mandated abortion information visit they are required to complete prior to having an abortion. The outcome in this study was pregnancy discovery before versus after 6 weeks since respondents' last menstrual period (LMP). We used logistic regression to estimate the relationship between sociodemographic and health-related independent variables of interest and pregnancy discovery before versus after 6 weeks.Results: Among the 458 women in the sample, 28% discovered their pregnancy later than 6 weeks since LMP. Most (n=366, 80%) knew the exact date of their LMP and a significant minority estimated it (n=92, 20%). Those who estimated the date of their LMP had higher odds of later pregnancy discovery than those who knew the exact date (adjusted odds ratio (aOR)=1.81[1.07-3.07]). Those who used illicit drugs weekly, daily, or almost daily had higher odds of later pregnancy discovery (aOR=6.33[2.44, 16.40]).Conclusion: Women who did not track their menstrual periods and those who frequently used drugs had higher odds of discovering their pregnancies later.Implications: Women who estimated the date of their LMP and who frequently used drugs may benefit from strategies to help them recognize their pregnancies earlier and link them to care when they discover their pregnancies later. [ABSTRACT FROM AUTHOR]

A cost of illness (COI) study was undertaken to estimate the magnitude and range of lifetime effects associated with child maltreatment in Australia, using an incidence-based approach. Costs were primarily estimated through calculation of population attributable fractions (PAFs) to determine the marginal effects of child maltreatment on a range of outcomes. PAFs were then applied to estimates of expenditure, inflated to 2014–15 Australian dollars, projected over the life course, according to a baseline age of incident cases for child maltreatment in 2012–13, and discounted at 7% per annum. Sensitivity analysis was conducted using a best and lower bound estimate of incidence of child abuse. The best estimate of the total estimated lifetime financial costs for incident cases of child maltreatment in 2012–13 was $9.3 billion (a cost per child maltreated of $176,437), with a lower bound of $5.8 billion. The best estimate of lifetime costs associated with reduced quality of life and premature mortality (non-financial costs) for all incident cases of child maltreatment in 2012–13 was $17.4 billion, or $328,757 per child maltreated. The considerable lifetime costs associated with child maltreatment warrants an expansion of existing investment in primary and secondary prevention and targeted support services for children and families at risk. [ABSTRACT FROM AUTHOR]

Contemporary life-course research predominantly classifies offenders according to patterns of offending volume over time, however it is not clear how useful these classifications are for identifying the most harmful offenders. The current study uses a novel methodology to explore trajectories of offending harm over the early life course, drawing on longitudinal offending data for an Australian birth cohort. Crime harm values from the modified Western Australian Crime Harm Index were applied to major offence types evident among offenders in the cohort (N = 27,079), from ages 10 to 30 years. Group-based trajectory modelling (GBTM) was applied to both to offences and harm values to determine discernible trajectories of offending and harm. GBTM analyses indicated four distinct harm trajectories in the cohort: early adult peak high harm (1.6%); adult escalating harm (4.4%); declining moderate harm (5.9%); and low harm (88.2%). Low volume offenders comprised the largest number of offenders in the higher harm groups, while among chronic offender groups the profile of harm was very mixed. This study finds that the traditional offender classifications do not effectively identify high-harm offenders. Findings are discussed with respect to life-course conceptualisations of offender pathways and challenges in identifying high harm offenders. • Contemporary life-course criminology has focussed on offence counts to classify offenders. • Offending trajectories do not effectively identify offenders who produce most harm. • Low-rate offenders can be produce high levels of offending-related harm. • Chronic offenders have a mixed harm profile. • Offending harm is more concentrated among offenders than offending volume. [ABSTRACT FROM AUTHOR]

Abstract: Fetal alcohol syndrome (FAS), a condition occurring in some children of mothers who have consumed alcohol during pregnancy, is characterized by physical deformities and learning and memory deficits. The chick hippocampus, whose functions are controlled by interneurons expressing calcium-binding proteins parvalbumin (PV) and calretinin (CR), is involved in learning and memory mechanisms. Effects on growth and development and hippocampal morphology were studied in chick embryos exposed to 5% and 10% ethanol volume/volume (vol/vol) for 2 or 8 days of gestation. There was a significant dose-dependent reduction (P <.05) in body weight and mean number per section of PV and CR expressing hippocampal neurons in ethanol-exposed chicks, without alterations in neuronal nuclear size or hippocampal volume, compared appropriate controls. Moreover, when chicks exposed to 5% ethanol for 2 and 8 days of gestation were compared, no significant differences were found in body parameters or neuronal counts. Similarly, exposure to 10% ethanol did not induce any significant changes in chicks exposed for 2 or 8 gestational days. Thus, these results suggest that gestational ethanol exposure induces a reduction in the mean number per section of PV and CR expressing hippocampal neurons, and could be a possible mechanism responsible for learning and memory disorders in FAS. [Copyright &y& Elsevier]

Objective: To conduct a systematic review and meta-analysis and estimate the economic costs attributable to child and adolescent bullying victimization in Australia.Method: The costs of bullying victimization were measured from a societal perspective that accounted for costs associated with health care, education resources, and productivity losses. A prevalence-based approach was used to estimate the annual costs for Australians who experienced bullying victimization in childhood and adolescence. This study updated a previous systematic review summarizing the association between bullying victimization and health and nonhealth outcomes. Costs were estimated by calculating population attributable fractions to determine the effects of bullying victimization on increased risk of adverse health outcomes, such as anxiety disorders, depressive disorders, intentional self-harm, and tobacco use. A top-down approach to cost estimation was taken for all outcomes of interest except for costs incurred by educational institutions and productivity losses of victims' caregivers, for which a bottom-up cost estimation was applied.Results: Annual costs in Australian dollars (AUD) in 2016 on health and nonhealth outcomes attributable to child and adolescent bullying victimization were estimated at AUD $763 million: AUD $750 million for health system costs with AUD $147 million for anxiety disorders, AUD $322 million for depressive disorders, AUD $57 million for intentional self-harm, and AUD $224 million for tobacco use; AUD $7.5 million for productivity losses of victims' caregivers; and AUD $6 million for educational services.Conclusion: The findings from this study suggest a substantial annual cost to Australian society as a result of bullying victimization with more than 8% of annual mental health expenditure in Australia estimated to be attributable to bullying victimization. [ABSTRACT FROM AUTHOR]

Child maltreatment is a complex phenomenon, with four main types (childhood sexual abuse, physical abuse, emotional abuse, and neglect) highly interrelated. All types of maltreatment have been linked to adverse health consequences and exposure to multiple forms of maltreatment increases risk. In Australia to date, only burden attributable to childhood sexual abuse has been estimated. This study synthesized the national evidence and quantified the burden attributable to the four main types of child maltreatment. Meta-analyses, based on quality-effects models, generated pooled prevalence estimates for each maltreatment type. Exposure to child maltreatment was examined as a risk factor for depressive disorders, anxiety disorders and intentional self-harm using counterfactual estimation and comparative risk assessment methods. Adjustments were made for co-occurrence of multiple forms of child maltreatment. Overall, an estimated 23.5% of self-harm, 20.9% of anxiety disorders and 15.7% of depressive disorders burden in males; and 33.0% of self-harm, 30.6% of anxiety disorders and 22.8% of depressive disorders burden in females was attributable to child maltreatment. Child maltreatment was estimated to cause 1.4% (95% uncertainty interval 0.4–2.3%) of all disability-adjusted life years (DALYs) in males, and 2.4% (0.7–4.1%) of all DALYs in females in Australia in 2010. Child maltreatment contributes to a substantial proportion of burden from depressive and anxiety disorders and intentional self-harm in Australia. This study demonstrates the importance of including all forms of child maltreatment as risk factors in future burden of disease studies. [ABSTRACT FROM AUTHOR]