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Physical and psychological changes during menopause can be especially tumultuous for autistic people: difficulties with sensory sensitivity and daily functioning may be exacerbated. Through individual interviews, we examined the language used by seven peri- or post-menopausal autistic people to construct their experiences, and to consider the implications for their wellbeing and identities. Our analysis, which utilised thematic decomposition, yielded three discursive themes. The theme "Uncertainty about Changes" addressed how limited awareness and understanding of menopause combined with difficulties recognising internal states. However, with "Growing Self-Awareness and Self-Care", some participants made conscious efforts to resist negative societal constructions of both autism and menopause. The theme "Navigating Support Options" addressed the interpersonal and systemic barriers participants faced when seeking support. There is a need for accessible information for autistic people experiencing menopause, and greater professional awareness.

Background: To encourage people to lead healthier lifestyles, governments in many countries publish guidelines for alcohol intake, physical activity (PA), and fruit and vegetable (FV) intake. However, there is a need for better understanding of whether people understand such guidelines, consider them useful, and adhere to them. University students are a group worthy of attention because although they are less likely than older adults to exceed U.K. weekly alcohol intake guidelines or to be inactive, they are also less likely to meet FV consumption targets. Furthermore, because behavior during youth predicts adult behavior, it is important to identify influences on healthier behavior. Method: An online survey was completed by 559 U.K. university students. Key outcome variables were knowledge of guidelines, motivation to adhere to them, and adherence to them. Results: A total of 72% adhered to guidelines for alcohol intake, 58% for PA, and 20% for FV intake. Students generally had poor or moderate knowledge of guidelines, perceived them as only moderately useful, and were only moderately motivated to adhere to them. Greater motivation to adhere to guidelines was not significantly related to more accurate knowledge. However, it was related to greater familiarity, and perceiving guidelines as useful and realistic, and greater conscientiousness. Discussion: There is a need to ensure that students understand the U.K. guidelines for alcohol intake, PA, and FV intake. However, simply increasing knowledge may not lead to greater adherence to the guidelines: There is also a need to focus on improving perceptions of how useful and realistic they are.

Physical and psychological changes during menopause can be especially tumultuous for autistic people: difficulties with sensory sensitivity and daily functioning may be exacerbated. Through individual interviews, we examined the language used by seven peri- or post-menopausal autistic people to construct their experiences, and to consider the implications for their wellbeing and identities. Our analysis, which utilised thematic decomposition, yielded three discursive themes. The theme 'Uncertainty about Changes' addressed how limited awareness and understanding of menopause combined with difficulties recognising internal states. However, with 'Growing Self-Awareness and Self-Care', some participants made conscious efforts to resist negative societal constructions of both autism and menopause. The theme 'Navigating Support Options' addressed the interpersonal and systemic barriers participants faced when seeking support. There is a need for accessible information for autistic people experiencing menopause, and greater professional awareness., Author(s): Marianna Karavidas [sup.1] , Richard O. de Visser [sup.1] [sup.2] Author Affiliations: (1) grid.12082.39, 0000 0004 1936 7590, School of Psychology, University of Sussex, , Brighton, UK (2) grid.414601.6, [...]

: Objective: To enumerate pregnancy outcomes for a representative sample of women in Australia surveyed in 2012?2013 (primary aim) and compare these with women surveyed in 2001?2002 (secondary aim). Methods: Computer?assisted telephone interviews with over 10,000 women aged 16?69 years (participation rate 68.4%). Results are weighted for chance of selection and to reflect the population as a whole. Results: Of women with experience of vaginal intercourse, 75.1% had ever been pregnant, 18.4% reported difficulties getting pregnant and 10.0% had had fertility treatment. Of those who had been pregnant, 91.3% had ever had a live birth, 34.3% a miscarriage, 22.8% an abortion and 2.3% a stillbirth; 0.9% had relinquished a child for adoption. The proportion first pregnant in their 30s was 11% among women aged 60?69 and 26% among those aged 40?49. Fewer older women reported difficulties getting pregnant. Of the 21,882 pregnancies reported, 70% led to live births and 10% were terminated. Compared with our 2001?2002 survey, fewer women reported ever having been pregnant. Giving up newborns for adoption has become very rare. Conclusions: Falling fertility since the 1960s reflects greater access to contraception and abortion and higher opportunity costs of childbearing. Implications for public health: These findings on women's lifetime reproductive experiences complement routine annual data collections., Over the last few decades several shifts have occurred in the pattern of births in Australia.[sup.1-4] The total fertility rate since 1976 has been lower than the level of 2.1 [...]

Objective: Research shows that personal relevance may affect the impact of alcohol-related health information. This study explored alcohol consumption during the UK Covid-19 lockdown, and whether a message emphasising the effect of alcohol on the immune system was more effective in altering intentions to follow low-risk drinking guidelines than other messages about the effects of alcohol on health. Methods & Measures: From April to June 2020, 953 drinkers completed an online questionnaire, and were randomly allocated to exposure to a control condition or one of three messages emphasising the impact of alcohol on: the immune system; mental health; or physical health. Outcome variables were: concern about alcohol intake, and intention to adhere to low-risk drinking guidelines. Results: Pre-post ANCOVAs revealed that participants in the immunity message group had significantly stronger intention to adhere to low-risk guidelines than the control group (after controlling for initial intention). Concern for the effect of alcohol on health was not significantly affected. Conclusion: During Covid-19 lockdown, a message emphasising the impact of alcohol on the immune-system had a greater effect on intention to observe low-risk drinking guidelines than other messages. Contextually relevant messages could be used for alcohol health campaigns and for improving alcohol labelling. [ABSTRACT FROM AUTHOR]

Sexuality education (SE) can be acquired through different sources. In a cross-sectional online study with Spanish and Portuguese participants (N = 595), we examined differences between formal traditional sources (i.e., mandatory SE received in schools), formal modern sources (e.g., SE received in courses), informal traditional sources (e.g., talks with friends and family), and informal modern sources (e.g., pornography and online content) and their contribution to sexual health and well-being outcomes. Results showed that sexual and reproductive health were among the most addressed topics across all sources. Nearly all participants received SE from informal sources, whereas more than two-thirds received SE from formal traditional sources. Results of a linear regression model showed that participants who perceived more influence from formal traditional sources reported using condoms more often, were more focused on disease prevention, and enacted more sexual health communication, but were also less sex-positive. Participants who perceived more influence from both types of informal sources attributed more importance to SE topics but reported having condomless sex more frequently and were more focused on pleasure promotion. Still, participants who perceived more influence from informal traditional sources also endorsed more internal/external consent, were more sexually satisfied, were more sex-positive, and enacted more sexual health practices. Lastly, participants who perceived more influence from informal modern sources were also more likely to have been diagnosed with a sexually transmitted infection. Only a small proportion of participants received SE from formal modern sources and had to be excluded from this analysis. Some differences between Spain and Portugal are discussed. Taken together, our findings highlight the need to consider different sources for a more comprehensive and inclusive SE, in articulation with sociocultural and political contexts. [ABSTRACT FROM AUTHOR]

The well-being of individuals is influenced by their beliefs about gender roles, which are influenced by cultural factors. It is therefore important to compare links between gender role beliefs and well-being in cultures that are more or less gender equitable. This study examined links between gender role beliefs and well-being among young adults in the patriarchal culture of Pakistan and the more egalitarian culture of the United Kingdom (UK). Participants were 1141 university students aged 17–30 (mean = 21.56, SD = 2.54): 411 Pakistani women, 307 Pakistani men, 318 UK women, and 105 UK men. Analyses revealed stronger associations between gender role beliefs and well-being among respondents from Pakistan than respondents from the UK. Furthermore, whereas similar patterns of association were found among women in the two countries, the direction of some associations differed between men in Pakistan and the UK. Moderation models also highlighted variations in the links between egalitarian gender role beliefs and well-being outcomes among women and men in the two countries. Considering our results in the context of other research, there is a need to acknowledge young adults' gender identity concerns when providing, and encouraging engagement with, health care. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to increase understanding of factors that influence adoptive mothers' psychological and emotional well‐being. The aims were to compare mothers' self‐reported emotional state 12 months after child placement to the time of the interview and to identify factors that challenge and support maternal mental health. Background: Mothers who adopt children face unique challenges that put them at a heightened risk of negative mental health. There is a need for better understanding of the influences on their psychological and emotional well‐being. Method: This qualitative study involved nine in‐depth semistructured interviews. Transcripts were analyzed using reflexive thematic analysis. Results: The themes offered broad insights, including the consistency of negative mental health across time associated with demands of "extreme parenting," strains within and across relationships, and deprioritizing self‐care. Factors associated with positive mental health included development of love; attachment and sense of family identity; learning, competence, and "therapeutic parenting," and the ability to "offload." Conclusion: The emotional and psychological well‐being of mothers who adopt children should be validated and recognized as important to the overall adjustment of adoptive families. Implications: Adoption agencies should take a proactive approach to addressing the mental health needs of adoptive mothers, providing comprehensive information, ongoing support, and regular assessments. [ABSTRACT FROM AUTHOR]

Reports worldwide have been showing increasing rates of sexually transmitted infections (STIs) and condomless sex in recent years. Research has identified several individual and situational variables that can determine the decision to use condoms or forgo their use. We argue that such a decision can also be shaped by motives related to pleasure and safety (i.e., regulatory focus in sexuality). Using open ended questions, we asked 742 Portuguese and Spanish adults to indicate situations and reasons that could inform the decision making process with casual partners and the functions/attributes related to condoms. Using thematic analyses, we coded the drivers of condomless sex and condom use into themes and subthemes, and computed their frequencies. Using quantitative measures, we also asked participants to indicate their condom use expectancies and perceived barriers. Comparing participants according to regulatory focus revealed some differences. Pleasure promotion participants were more likely to consider that condom use decision making is driven by unexpectedness, pleasure, and intimacy pursuit, attached more pleasure reduction functions to condoms, expected more negative outcomes in condom use, and endorsed more sensation and partner barriers in condom use. In contrast, disease prevention participants were more likely to consider that condom use decision making is driven by adequate sexual education, responsibility, and behavioral control, and attached more health protective functions to condoms. These differences can inform the development of tailored intervention and awareness campaigns aimed at helping people to use condoms more consistently with casual partners and to avoid behaviors that put them at risk of STI transmission. [ABSTRACT FROM AUTHOR]

Aims: The first aim was to explore whether university students possess the information, motivation and behavioural skills required to adhere to government guidelines for alcohol consumption expressed in "units" of alcohol. The second aim was to identify correlates of greater motivation to adhere to guidelines and greater capacity to monitor alcohol unit intake. Methods: An online questionnaire was completed by 614 university students aged 18-30 living in South-East England. Key outcome variables were motivation to adhere to unit-based guidelines and a novel measure of accuracy of estimating recent alcohol unit intake. Findings: Respondents had poor knowledge of unit-based guidelines and their motivation to adhere to them was low. Only half of the sample had the skills to accurately estimate the alcohol unit content of their recent alcohol consumption. Greater capacity to accurately estimate recent alcohol unit intake and greater motivation to adhere to unit-based guidelines were related to psychological traits of greater conscientiousness and less extraversion, greater familiarity with unit-based guidelines and more positive attitudes toward them, and more moderate alcohol use. Conclusions: Taking into consideration people's beliefs and psychological traits could increase the effectiveness of health behaviour change strategies to curb alcohol consumption.

Objectives: Disengagement from Early Intervention in Psychosis (EIP) services is pronounced in individuals from racially minoritized or diverse ethnic backgrounds, lesbian, gay, bisexual, transgender, and queer or questioning individuals, and individuals from some religious or spiritual backgrounds. The Early Youth Engagement in first episode psychosis study (EYE‐2) is a cluster randomized controlled trial that tests a new engagement intervention. The current study aimed to (i) explore perspectives of service users from diverse backgrounds in relation to spirituality, ethnicity, culture and sexuality on engagement and the EYE‐2 approach and (ii) use an evidence‐based adaptation framework to incorporate their needs and perspectives into the EYE‐2 resources and training. Methods: This qualitative study used semi‐structured interviews to explore service users' experiences and perspectives on EYE‐2 approaches and resources. The study was conducted within EIP teams across three inner‐city sites in England chosen to reflect diverse urban populations. Topic guides covered participant's identity, perceptions of EYE‐2 resources, and experience of using mental health services. Transcribed interviews underwent thematic analysis. Results: In this study, 21 service users aged 18 to 35 (M = 25.4; SD = 5.5) participated in semi‐structured interviews. Seven key themes were identified across the four domains of the cultural adaptation framework: Differing cognitions and beliefs; multiple facets of culture; language as a barrier to engagement; stigma and discrimination; adaptations to EYE‐2 resources; trust in therapeutic alliance; and individual differences in therapeutic preferences. Conclusions: The emergent themes highlighted a need to cater to various aspects of cultural diversity when developing EIP materials and services. [ABSTRACT FROM AUTHOR]

Alcohol control strategies vary between countries and reflect differences in drinking cultures. This study explored how perceived effectiveness of alcohol control strategies varies according to individual characteristics and country of residence. A cross-sectional online survey was completed by 1910 university students in Denmark, England, Germany, Italy, Portugal, and Switzerland. It assessed the perceived effectiveness of 11 alcohol control strategies. Correlates included sensation-seeking, alcohol outcome expectancies, drink refusal self-efficacy, and Alcohol Use Disorders Identification Test (AUDIT) scores. Bivariate analysis using mixed-measures MANOVA and Pearson correlations were followed by linear regression to identify multivariate correlates. These analyses revealed that educational strategies (e.g. teaching people skills to resist peer pressure) were considered more effective than restrictive strategies (e.g. raising the legal drinking age). Perceived effectiveness was greater among women and lighter drinkers. Country of residence also explained unique variance. The findings highlight the need to consider the potential impact of drinking culture in alcohol-related harm-reduction strategies. [ABSTRACT FROM AUTHOR]

Key Points: Question: Is practitioner-supported mindfulness-based cognitive therapy self-help (MBCT-SH) clinically effective and cost-effective compared with practitioner-supported cognitive behavioral therapy self-help (CBT-SH) for adults experiencing mild to moderate depression? Findings: In this randomized clinical trial of 410 participants with mild to moderate depression, practitioner-supported MBCT-SH led to significantly greater reductions in depressive symptom severity at 16 weeks postrandomization compared with practitioner-supported CBT-SH. The probability of MBCT-SH being cost-effective compared with CBT-SH exceeded 95%. Meaning: Practitioner-supported MBCT-SH for mild to moderate depression was clinically effective and cost-effective compared with currently recommended practitioner-supported CBT-SH and should be made routinely available to adults experiencing mild to moderate depression. This randomized clinical trial evaluates whether practitioner-supported mindfulness-based cognitive therapy self-help is superior to practitioner-supported cognitive behavioral therapy self-help at reducing depressive symptom severity at 16 weeks postrandomization among patients with mild to moderate depression. Importance: Depression is prevalent. Treatment guidelines recommend practitioner-supported cognitive behavioral therapy self-help (CBT-SH) for mild to moderate depression in adults; however, dropout rates are high. Alternative approaches are required. Objective: To determine if practitioner-supported mindfulness-based cognitive therapy self-help (MBCT-SH) is superior to practitioner-supported CBT-SH at reducing depressive symptom severity at 16 weeks postrandomization among patients with mild to moderate depression and secondarily to examine if practitioner-supported MBCT-SH is cost-effective compared with practitioner-supported CBT-SH. Design, Setting, and Participants: This was an assessor- and participant-blinded superiority randomized clinical trial with 1:1 automated online allocation stratified by center and depression severity comparing practitioner-supported MBCT-SH with practitioner-supported CBT-SH for adults experiencing mild to moderate depression. Recruitment took place between November 24, 2017, and January 31, 2020. The study took place in 10 publicly funded psychological therapy services in England (Improving Access to Psychological Therapies [IAPT]). A total of 600 clients attending IAPT services were assessed for eligibility, and 410 were enrolled. Participants met diagnostic criteria for mild to moderate depression. Data were analyzed from January to October 2021. Interventions: Participants received a copy of either an MBCT-SH or CBT-SH workbook and were offered 6 support sessions with a trained practitioner. Main Outcomes and Measures: The preregistered primary outcome was Patient Health Questionnaire (PHQ-9) score at 16 weeks postrandomization. The primary analysis was intention-to-treat with treatment arms masked. Results: Of 410 randomized participants, 255 (62.2%) were female, and the median (IQR) age was 32 (25-45) years. At 16 weeks postrandomization, practitioner-supported MBCT-SH (n = 204; mean [SD] PHQ-9 score, 7.2 [4.8]) led to significantly greater reductions in depression symptom severity compared with practitioner-supported CBT-SH (n = 206; mean [SD] PHQ-9 score, 8.6 [5.5]), with a between-group difference of −1.5 PHQ-9 points (95% CI, −2.6 to −0.4; P =.009; d = −0.36). The probability of MBCT-SH being cost-effective compared with CBT-SH exceeded 95%. However, although between-group effects on secondary outcomes were in the hypothesized direction, they were mostly nonsignificant. Three serious adverse events were reported, all deemed not study related. Conclusions and Relevance: In this randomized clinical trial, practitioner-supported MBCT-SH was superior to standard recommended treatment (ie, practitioner-supported CBT-SH) for mild to moderate depression in terms of both clinical effectiveness and cost-effectiveness. Findings suggest that MBCT-SH for mild to moderate depression should be routinely offered to adults in primary care services. Trial Registration: isrctn.org Identifier: ISRCTN13495752 [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to explore (a) how people interpret responsible drinking messages on alcohol product labels, and (b) the acceptability of including health information on labels. Design: Qualitative interviews. Methods: Face‐to‐face semi‐structured interviews were conducted with 20 people aged 21–63; 18 were classified risky drinkers using AUDIT‐C. They were shown three sets of alcohol product labels: one including three responsible drinking messages (drink responsibly), one with three positively worded health messages (drinking less reduces risks) and one with three negatively worded health messages (drinking more increases risks). Health messages included information about cancer, liver and heart disease. Results: Thematic analysis identified three themes: ambiguity about alcohol labelling; identifying oneself as responsible; and acceptability of enhanced product labelling. Participants were critical of responsible drinking messages and wary of conflicting health information in the media. They positioned themselves as responsible, knowledgeable drinkers and distanced themselves from problem drinkers. They did not appear to support the inclusion of health information on labels; however, novel information was considered more impactful. Conclusions: Responsible drinking messages were seen by our sample as an alcohol industry ploy. Although health messages about cancer were seen as potentially impactful, the ability of consumers to position themselves as unproblematic drinkers means that they may not see the information on the label as relevant to themselves. Understanding factors that increase the personal relevance of messages is needed, alongside an exploration of a wider range of methods for alcohol health communication. [ABSTRACT FROM AUTHOR]

The aims of this exploratory qualitative study were to increase our understanding of heterosexual young adults knowledge and beliefs about sexually transmitted infections (STIs) other than HIV, to explore their beliefs about the factors that influence condom use for STI prevention, and to explore their ideas about how best to promote condom use for STI prevention. Data came from a qualitative study that used 11 group discussions with 53 heterosexual men and women aged 18-25. Respondents thought that STI infection and unplanned pregnancy were equally likely, but were less concerned about STIs than unplanned pregnancy. Respondents gave several reasons for their low levels of concern about STIs. They also suggested several means to promote condom use for STI prevention. They supported multi-faceted condom promotion campaigns, using multiple styles of communication and a variety of media. The range of suggestions given by participants suggests that rather than employing a "one size fits all" strategy, a variety of different approaches are needed to promote condom use for STI prevention.

A sustainably intensified (SI) organic vegetable rotation, employing plant-based fertilizers, more crops, reduced tillage, and cover crops was compared to common practice (CP) where plants were fertilized with animal manure, typically one crop was grown per season, soil was plowed and often left bare over winter. Second and third-year results are presented. Nitrogen (N) input obtained within the rotation from N2 fixed by legume cover crops was higher under SI (34% potential self-sufficiency) than CP (5%). Marketable yields of cabbage, celeriac, leek, lettuce, and onion were similar, and aboveground dry matter increased by 16% under SI (8.6 Mg ha−1) compared to CP (7.5 Mg ha−1). Nitrogen use efficiency (N output/ N input) was 8–16% higher under SI compared to CP, mainly due to the full year clover. Nitrogen surface balance (N input – N output) was higher for SI compared to CP, indicating increased N leaching risk under SI. Short season and shallow-rooted crops under SI left more mineral N to 2.5 m depth in autumn than deeper-rooted crops under CP. Cover crops indicated to mitigate N leaching risk. Vegetable production can be intensified sustainably using more yielding crops, cover crops, reduced tillage, and plant-based fertilizers. [ABSTRACT FROM AUTHOR]