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The number of women using long-acting reversible contraception (LARC)-intrauterine devices (IUDs) and implants-is increasing and 14% of contraceptive users in the United States adopt LARC. We examined correlates of LARC never-use in a population-based survey of reproductive-aged women in Ohio.We analyzed data from the 2018-19 Ohio Survey of Women. We examined the prevalence of LARC never-use and reasons for never-use among ever users of contraception (N = 2388). Using Poisson regression to generate prevalence ratios (PRs), we examined associations between selected correlates (demographic factors, healthcare access/quality measures, and religious/political views) and LARC never-use.Most Ohio women (74%) had never used LARC. Commonly reported reasons for not using an IUD or an implant were preferring a different method (46% and 45%, respectively), not wanting an object inside their body (45% and 43%), side effect concerns (39% and 33%), insertion/removal concerns (31% and 25%), and unfamiliarity (13% and 20%). Conservative political views (PR: 1.12, 95% confidence interval [CI]: 1.04-1.22), pro-life affiliation (PR: 1.11, 95% CI: 1.02-1.20), placing high importance on religion in daily life (PR: 1.15, 95% CI: 1.06-1.26), and being non-Hispanic white as compared to non-Hispanic Black (PR: 1.20, 95% CI: 1.02-1.41) were significantly associated with LARC never-use. Findings were generally similar for models analyzing IUD and implant never-use separately.Among ever-users of contraception, LARC never-use was associated with having conservative political views, being religious, and having a pro-life affiliation. Except for race/ethnicity, demographic and healthcare measures were not associated with LARC never-use among women in Ohio.

The development of science, society, and medicine leads to steady increases in average life expectancy. As a result, science is facing new challenges, including the prevention of dementia and the maintenance of efficient cerebral performance as people age. Bilingualism is among the protective factors preventing cognitive decline and maintaining cerebral neuroplasticity. However, the debate on the neuroprotective properties of bilingualism is still relevant. This article discusses the phenomenon of neurocognitive reserve (NCR) and determines the relationship between bilingualism and components of NCR such as brain reserve, neural reserve, and neural compensation. In addition, the article provides an overview of studies on the neural and cognitive mechanisms of the influence of bilingualism on the healthy functioning of the brain during aging. In conclusion, we briefly discuss how bilingualism can protect the brain from aging through the interaction between the brain and the cognitive components of NCR.

To evaluate whether the prevalence of postpartum contraceptive use was lower among people who delivered at a Catholic hospital compared to a non-Catholic hospital.We linked 2015-2018 Pregnancy Risk Assessment Monitoring System (PRAMS) survey data from five states to hospital information from the corresponding birth certificate file. People with a live birth self-reported their use of contraception methods on the PRAMS survey at 2-6 months postpartum, which we coded into two dichotomous (yes vs. no) outcomes for use of female sterilization and highly-effective contraception (female/male sterilization, intrauterine device, implant, injectable, oral contraception, patch, or ring). We conducted multilevel log-binomial regression to examine the relationship between birth hospital type and postpartum contraception use adjusting for confounders.Prevalence of female sterilization for people who delivered at a Catholic hospital was 51% lower than that of their counterparts delivering at a non-Catholic hospital (adjusted prevalence ratio: 0.49; 95% confidence interval: 0.37-0.65).We found lower use of postpartum female sterilization, but no difference in highly effective contraception overall, for people who delivered at a Catholic hospital compared to a non-Catholic hospital.

We tested whether CSD500 (Futura Medical; Guildford, UK), a novel condom containing erectogenic gel designed to increase penile firmness, penile size, and erection duration, results in greater sexual pleasure. In 2017-2020, we randomized heterosexual couples in Thanh Hoa, Vietnam to use CSD500 (N = 248) or standard condoms (N = 252) and followed them up for six months. Women completed the Quality of Sexual Experience (QSE) scale; men completed the QSE, Sexual Experience Questionnaire (SEX-Q), and 11 condom acceptability items. Female participants' mean age was 32.1 years (

S.F.E.G., a 52–year–old woman of Filipino origin, with no previous cardiology except arterial hypertension under therapy, came to our attention for a witnessed episode of cardiac arrest at home. Rescued by the emergency medical team, who found ventricular fibrillation at presentation, and performed ACLS with ROSC obtained after 3 DC shocks. The first ECG was unremarkable (sinus rhythm, diffuse ST depression). Total body CT was negative. Admitted to the Coronary Unit, the echocardiogram was normal for cavity dimensions and kinetics, as well was coronary angiography except for “short intramyocardial course in the second segment of LAD with slight systolic "milking". In the following days, however, there was a significant rise in HsTnI (1,000 → 47,000 ng/L), with concomitant sudden ventricular bigeminy and negative anterior T waves, akinesia of the anterior apical segments of the LV at cardiac ultrasound (not present at admission), in a patient still intubated and therefore with a non–evaluable clinic. Coronary angiography was repeated, which highlighted this time significant vasospasm affecting the middle segment of the LAD, that regressed after intracoronary nitrates. She was extubated without neurological sequelae, and subjected to ICD implantation by secondary prevention. To treat the vasospastic angina she was discharged with calcium channel blockers at the maximum tolerated dosage, as per guidelines (diltiazem 120mg TID + nifedipine 60mg BID). One month later the patient returned to our attention due to worsening dyspnoea, abdominal pain and anasarca (ascites, bilateral pleural effusion, peripheral oedemas). Hospitalized in a medical setting and treated with diuretics for suspected heart failure, despite the echocardiogram showing preserved biventricular systolic function, normal diastolic function, no valve disease, no pericardial effusion. BNP was 359 pg/mL, subsequently decreasing to 148 pg/mL. After excluding every other possible causes even with total body CT, our hypothesis was that of calcium channel blocker collateral effect (vasodilatory edema). We tapered the dosage until only diltiazem 60mg TID was mainteined, obtaining a significant clinical improvement (weight loss by 10 kg), without further recurrence of coronary vasospasm. This clinical case demonstrates the potential lethality of coronary vasospasm, and a rare complication during therapy with high doses of calcium channel blockers, with very few cases described in the literature.

Cholinergic interneurons (CINs) in the striatum respond to salient stimuli with a multiphasic response, including a pause, in neuronal activity. Slice-physiology experiments have shown the importance of dopamine D2 receptors (D2Rs) in regulating CIN pausing, yet the behavioral significance of the CIN pause and its regulation by dopamine in vivo is still unclear. Here, we show that D2R upregulation in CINs of the nucleus accumbens (NAc) lengthens the pause in CIN activity ex vivo and enlarges a stimulus-evoked decrease in acetylcholine (ACh) levels during behavior. This enhanced dip in ACh levels is associated with a selective deficit in the learning to inhibit responding in a Go/No-Go task. Our data demonstrate, therefore, the importance of CIN D2Rs in modulating the CIN response induced by salient stimuli and point to a role of this response in inhibitory learning. This work has important implications for brain disorders with altered striatal dopamine and ACh function, including schizophrenia and attention-deficit hyperactivity disorder (ADHD).

Most studies investigating abortion attitudes use nationally representative data, leaving a need for studies of variation within a state. This study investigates abortion opinion among women in Ohio, a state with restrictive abortion policies, as well as how individual-level characteristics are associated with abortion opinions. Data comes from the Ohio Survey of Women, which was administered from October 2018 to June 2019 to women aged 18–44 years in Ohio (n = 2529; analytic n = 2356). From six questions capturing abortion opinion, we developed a composite measure indicating whether respondents felt “supportive,” “unsupportive,” or “mixed” toward abortion. We examined correlates of abortion opinions using multinomial logistic regression, with “mixed” as the reference category. We applied survey weights in all analyses so that the results are representative of our population as a whole (Ohio women aged 18–44). Fifty-three percent of respondents were supportive of abortion, with 30% offering mixed views and 17% being unsupportive. Most sociodemographic variables were inconsistent in their significance. Independents (odds ratio [OR]: 0.44, 95% confidence interval [CI]: 0.30–0.65) and Democrats (OR: 0.23, CI: 0.14–0.39) were significantly less likely to be unsupportive versus mixed than Republicans. Democrats (OR: 0.4.54, CI: 3.17–6.79) were more likely to be supportive than mixed compared to Republicans, as were those with some other political affiliation (OR: 3.38, CI: 1.89–6.04). Compared to those who never attend religious services, those who attend once per week or more were significantly more likely to be unsupportive than mixed (OR: 3.54, CI: 2.04–6.13), and less likely to be supportive than mixed (OR: 0.33, CI: 0.19–0.55). Additionally, Protestants (OR: 0.62, CI: 0.39–0.97), other Christians (OR: 0.33, CI: 0.39–0.57), and those of other denominations (OR: 0.47, CI: 0.24–0.93) were less likely than those unaffiliated with a religious denomination to be supportive than mixed. Knowing someone who had an abortion or having had one oneself increased odds of being supportive over mixed (OR: 2.16, CI: 1.64–2.84), while being from rural Appalachia decreased odds of being supportive (OR: 0.70, CI: 0.50–0.97). Black respondents were more likely to feel mixed compared to white respondents, having lower odds of being both unsupportive (OR: 0.23, CI: 0.10–0.55) and supportive (OR: 0.55, CI: 0.34–0.91) than mixed. Overall, a majority of women of reproductive age in Ohio were supportive of abortion, with political affiliation and religious service attendance correlating with abortion opinion. The relatively high amount of support for abortion in Ohio highlights an inconsistency between opinion and Ohio’s restrictive legislative landscape.

Objectives We sought to quantify the prevalence of ever attendance at a crisis pregnancy center (CPC) among adult, reproductive-age women in Ohio and identify demographic factors associated with ever attendance. Study Design We analyzed data from the Ohio Survey of Women, a survey of adult, reproductive-age women (N = 2529) conducted in 2018 to 2019. We calculated unadjusted and adjusted prevalence ratios (PRs) to evaluate the possible associations between demographic factors and ever CPC attendance. Analyses used statistical weights to be population-representative. Results Analyses are based on women reporting ever (n = 291) or never CPC attendance (n = 2151). Prevalence of ever CPC attendance was 13.5%. Ever CPC attendance was higher among women of Black, non-Hispanic race/ethnicity (adjusted PR, 2.1; 95% confidence interval [CI], 1.4–3.2) and currently in the lowest socioeconomic status (SES) stratum (defined as less than a college degree and annual household income less than $75,000) (aPR, 1.6; 95% CI, 1.1–2.3) compared to those of other race/ethnicity and in the highest SES stratum. Conclusions Disparities exist among adult women in Ohio regarding their ever use of CPCs. Because CPCs typically are not medical facilities and may provide inaccurate information, future studies should evaluate a wider range of correlates of recent CPC attendance. Implications Findings from a population-based survey of adult, reproductive-age women in Ohio indicate that ever attendance to a CPC for pregnancy-related care is not rare, and this attendance is higher among Black/non-Hispanic women and those of low SES compared to other women.

The purpose of this chapter is to provide an overview of the development and implementation of a currently running, interdisciplinary program between school psychology and special education within a Hispanic-serving institution. Due to critical shortages of school psychologists and special educators across the country, novel practices in interdisciplinary collaborative training may aid in recruitment and retention efforts while enhancing service delivery for racially, ethnically, and linguistically diverse (RELD) students with high intensity needs. The chapter highlights approaches and components including (1) focus on an equity-based and integrated framework for personnel preparation, (2) recruitment and retention activities to attract diverse scholars, (3) planning and delivery of shared collaborative coursework and field experiences, (4) reflection of the lessons learned, and (5) recommendations to other preparation programs in providing interdisciplinary training and support to RELD personnel.

It was first posited, more than five decades ago, that the etiology of schizophrenia involves overstimulation of dopamine receptors. Since then, advanced clinical research methods, including brain imaging, have refined our understanding of the relationship between striatal dopamine and clinical phenotypes as well as disease trajectory. These studies point to striatal dopamine D2 receptors, the main target for all current antipsychotic medications, as being involved in both positive and negative symptoms. Simultaneously, animal models have been central to investigating causal relationships between striatal dopamine D2 receptors and behavioral phenotypes relevant to schizophrenia. We begin this article by reviewing the circuit, cell-type and subcellular locations of dopamine D2 receptors and their downstream signaling pathways. We then summarize results from several mouse models in which D2 receptor levels were altered in various brain regions, cell-types and developmental periods. Behavioral, electrophysiological and anatomical consequences of these D2 receptor perturbations are reviewed with a selective focus on striatal circuit function and alterations in motivated behavior, a core negative symptom of schizophrenia. These studies show that D2 receptors serve distinct physiological roles in different cell types and at different developmental time points, regulating motivated behaviors in sometimes opposing ways. We conclude by considering the clinical implications of this complex regulation of striatal circuit function by D2 receptors.

Background Reports from around the world suggest that rates of preterm birth decreased during COVID‐19 lockdown measures. Aims To compare the prevalence of preterm birth and stillbirth rates during COVID‐19 restriction measures with infants born at the same maternity centre during the same weeks in 2013–2019. Materials and Methods Deidentified data were extracted from the Mater Mothers’ healthcare records database. This is a supra‐regional tertiary perinatal centre. Logistic regressions were used to examine singleton live preterm birth rates during the beginning of COVID‐19 restrictions (16 March‐17 April; ‘early’; 6955 births) and during the strictest part of COVID‐19 restrictions (30 March‐1 May; ‘late’; 6953 births), according to gestational age subgroups and birth onset (planned or spontaneous). We adjusted for multiple covariates, including maternal age, body mass index, ethnicity, parity, socioeconomic status, maternal asthma, diabetes mellitus and/or hypertensive disorder. Singleton stillbirth rates were also examined between 16 March–1 May. Results Planned moderate/late preterm births declined by more than half during early COVID‐19 restrictions compared with the previous seven years (29 vs an average of 64 per 1000 births; adjusted odds ratio 0.39, 95% CI 0.22–0.71). There was no effect on extremely or very preterm infants, spontaneous preterm births, or stillbirth rates. Rolling averages from January to June revealed a two‐week non‐significant spike in spontaneous preterm births from late April to early May, 2020. Conclusions Together with evidence from other nations, the pandemic provides a unique opportunity to identify causal and preventative factors for preterm birth.

Background and objective The incidence of melanoma has increased significantly, and early diagnosis is the most effective way to reduce associated deaths. Dermoscopy increases diagnostic accuracy in melanoma and analysis of dermoscopic structures can help in the estimation of tumor thickness. The aim of this study was to analyze the influence of Breslow thickness on the dermoscopic characteristics of melanoma. Material and methods Observational, cross-sectional study of patients with histologically confirmed melanoma and dermoscopic images of the tumor. The patients were divided into 3 groups: melanoma in situ, thin melanoma (≥ 1 mm Breslow thickness), and thick melanoma (≥ 1 mm Breslow thickness). Age, sex, tumor location, and histologic and dermoscopic characteristics were analyzed in all cases. Results We studied 215 patients: 88 with melanoma in situ, 73 with thin melanoma, and 54 with thick melanoma. The frequency of the following dermoscopic features increased with increasing Breslow thickness: the blue-white veil (P Conclusions Dermoscopy not only improves diagnostic accuracy for pigmented lesions but also helps in the preoperative assessment of Breslow thickness in melanoma.

Objectives We describe the prevalence and correlates of nonuse of preferred contraceptive method among women 18-44 years of age in Ohio using contraception. Study Design The population-representative Ohio Survey of Women had 2529 participants in 2018–2019, with a response rate of 33.5%. We examined prevalence of preferred method nonuse, reasons for nonuse, and satisfaction with current method among current contraception users (n = 1390). We evaluated associations between demographic and healthcare factors and preferred method nonuse. Results About 25% of women reported not using their preferred contraceptive method. The most common barrier to obtaining preferred method was affordability (13%). Those not using their preferred method identified long-acting methods (49%), oral contraception (33%), or condoms (21%) as their preferred methods. The proportion using their preferred method was highest among intrauterine device (IUD) users (86%) and lowest among emergency contraception users (64%). About 16% of women using permanent contraception reported it was not their preferred method. Having the lowest socioeconomic status (versus highest) (prevalence ratio [PR]: 1.47, 95% CI: 1.11–1.96), Hispanic ethnicity (versus non-Hispanic white) (PR: 1.83, 95% CI: 1.15–2.90), reporting poor provider satisfaction related to contraceptive care (PR: 2.33, 95% CI: 1.02–5.29), and not having a yearly women's checkup (PR: 1.31, 95% CI: 1.01–1.68) were significantly associated with nonuse of preferred method. Compared to preferred-method nonusers, higher proportions of preferred-method users reported consistent contraceptive use (89% vs. 73%, p Conclusions Affordability and poor provider satisfaction related to contraceptive care were associated with nonuse of preferred contraceptive method. Those using their preferred method reported more consistent use. Implications Cost is an important barrier for women in obtaining their preferred contraceptive methods. Low quality birth control care may also be a barrier to preferred-method use. Removal of cost barriers and improvement in contraceptive counseling strategies may increase access to preferred contraceptive methods.

A lack of information, research, and teacher training exists on the effective implementation of Common Core State Standards (CCSS) or other state standards for struggling learners. The pace and standardization of the curriculum are often at odds with the unique learning needs of students from diverse backgrounds. Researchers in one large urban school district conducted a series of focus groups with special educators to identify their perceptions of these standards and the training needs associated with effective implementation of the standards. The results revealed a pressing need for professional development to facilitate effective implementation of the standards for struggling learners in urban settings. Implications for teacher preparation and urban education are discussed.

Objectives: Diabetes may delay milk letdown, and perceiving milk production as insufficient can lead to breastfeeding cessation. We evaluated whether prepregnancy or gestational diabetes is associated with cessation of breastfeeding by 1 week postpartum. Methods: We analyzed 2016-2018 data from 42 sites in the Pregnancy Risk Assessment Monitoring System, a population-based survey of women with a recent live birth. Participants were surveyed 2-6 months after childbirth. We used logistic regression models to evaluate the relationship between prepregnancy or gestational diabetes only and breastfeeding Results: Among 82 050 women who initiated breastfeeding, 4.5% reported breastfeeding Conclusions: We found no association between a history of diabetes prepregnancy or gestational diabetes only and breastfeeding

Background The use of antagonists of P2Y12 platelets receptors as antiplatelets drugs is a cornerstone in the treatment of ACS. Many efforts are made to understand the right timing of beginning this therapy with the purpose to reduce intra– and periprocedural complications (stent thrombosis, no reflow phenomenon). The rationale behind “pretreatment” (administration of antagonists of P2Y2 platelet receptor before the coronarography) is valuable but the evidences are lacking, also in the setting of ACS–STEMI. Method and Objectives We conduct an observational, monocentric (Ospedale dell’Angelo – Venezia Mestre), retrospective study including patients with STEMI (1st January 2016 – 9th august 2018). We compared two strategies of administration of clopidogrel, ticagrelor and prasugrel (pretreatment vs no pretreatment). Primary endpoints were bleeding BARC 3–5, acute or subacute stent thrombosis and TIMI flow grade > 0 in the culprit coronary. Secondary endpoints were cardiovascular and no cardiovascular in–hospital mortality and in–hospital neurological complications. Results We studied 501 patients (199 in the group pretreated and 302 in the group no pretreated). The median time from first medical contact to PCI was 70,5 minutes in the pretreated group and 60 minutes in the no pretreated group (p = 0.022). No significant differences between the two groups were observed in terms of acute or subacute stent thrombosis (OR 3.72 [0.82–14.20], p = 0.09) e TIMI flow grade > 0 in the culprit coronary (OR 1.11 [0.77–1.58], p = 0.58). In the multivariate analysis we observed that bleeding BARC 3–5 significantly were increased in the pretreated group (adjusted OR 2.78 [1.13–6.83, p = 0.025). In the subgroup analysis, the pretreated subjects with age > 75 were at augmented risk of bleeding BARC 3–5. Conclusions Pretreatment in the setting of ACS–STEMI is not associated with benefits in terms of acute or subacute stent thrombosis and perfusion of culprit coronary but may cause clinically relevant bleedings, in particular in the elderly (age > 75).

BACKGROUND: Low contraceptive knowledge may limit contraception initiation or continuation and, consequently, could represent an important, modifiable cause of unintended pregnancy. OBJECTIVE: The objective of this analysis was to identify correlates of knowledge among women at risk of unintended pregnancy. Methods: We analyzed data from a study of 222 young women attending a public clinic in Kingston in November 2018 to March 2019. We measured contraceptive knowledge with 7 questions on method reversibility, ability to use covertly, contraindications and side effects. We used multivariable linear regression to evaluate correlates of summary knowledge scores and report beta coefficients, which represent differences in mean summary knowledge scores. FINDINGS: Mean knowledge score was low (2.7; range=0–7). Only 30.2% of participants correctly identified intrauterine devices as more effective than oral contraception, male condoms and withdrawal. Women who reported that their provider discussed contraception scored higher (adjusted ß=0.37, p-value=0.05) than those not reporting this. Women who perceived implants as very/mostly safe scored higher (adjusted ß=0.45, p-value=0.01) than those perceiving the device as mostly/very unsafe. Finally, compared to contraception non-users, women using less-effective contraception had a lower score (adjusted ß=−0.40, p-value=0.04) while those using effective contraception did not differ in scores (ß=−0.30, p-value=0.18). CONCLUSION: Overall, we found poor contraceptive knowledge among young women in Kingston. Providers appeared to hold an important role in women’s understanding of contraception. CLINICALTRIALS.GOV IDENTIFIER: NCT03775642

Objective Single-visit intrauterine device (IUD) insertion protocols are recommended. We assessed the availability of single-visit IUD insertions, and whether access to these services varies by age, race or parity. Study design Using audit study methodology, we called a random sample of 396 obstetrician-gynecology practices in Ohio while posing as a potential client seeking an IUD insertion appointment. Callers used eight standardized scripts and noted justifications for protocols offered by clinic staff. Practices were randomized to follow a balanced 3×2 factorial design, whereby practices were assigned to one of two conditions: (1) age (18 vs. 30 years of age); (2) race (white vs. black); and (3) parity. Multivariable logistic regression was used to control for clinics rural vs. urban location while considering the effects of these variables on service provision. Results Almost all (95%) of the practices called offered IUD placement, of which 92% required multiple appointments for IUD insertion. Although access to single-visit IUD services did not vary by age or race, we found that parity was associated with clinics’ willingness to schedule a single-visit insertion visit (OR = 3.84, 95% CI = 1.23, 12.04). The most frequent justification provided by clinic staff for their multiple-appointment protocol was the need to verify insurance coverage or order the device directly through the patient’s insurance company. Conclusion Ohio patients seeking IUD placement must typically make more than one clinic visit. Implications Efforts are needed to reassure Ohio clinics that IUDs are routinely covered by insurers and to increase access to same-day IUD placement for women in Ohio, as the requirement to attend multiple clinics appointments to obtain a desired contraceptive may pose an insurmountable barrier to care for those with the fewest resources.

Background: Bevacizumab is approved in combination with chemotherapy for the treatment of ovarian cancer, either in first-line therapy or for patients with recurrent disease not previously treated with the same drug. We aimed to test the value of continuing bevacizumab beyond progression after first-line treatment with the same drug. Methods: In our open-label, randomised, phase 3 trial done at 82 sites in four countries, we enrolled women (aged ≥18 years) who had previously received first-line platinum-based therapy including bevacizumab, and had recurrent (≥6 months since last platinum dose), International Federation of Gynaecology and Obstetrics stage IIIB–IV ovarian cancer with an Eastern Cooperative Oncology Group performance status 0–2. Patients were randomly assigned (1:1) to receive a carboplatin-based doublet intravenously (carboplatin area under the concentration curve [AUC] 5 on day 1 plus paclitaxel 175 mg/m2 on day 1, every 21 days; carboplatin AUC 4 on day 1 plus gemcitabine 1000 mg/m2 on days 1 and 8, every 21 days; or carboplatin AUC 5 on day 1 plus pegylated liposomal doxorubicin 30 mg/m2 on day 1, every 28 days), or a carboplatin-based doublet plus bevacizumab (10 mg/kg intravenous every 14 days combined with pegylated liposomal doxorubicin–carboplatin, or 15 mg/kg every 21 days combined with gemcitabine–carboplatin or paclitaxel–carboplatin). Evaluable disease according to RECIST 1.1 guidelines was required before randomisation. Randomisation was done through the trial website with a minimisation procedure, stratified by centre, time of recurrence, performance status, and type of second-line chemotherapy. The primary endpoint was investigator-assessed progression-free survival, analysed on an intention-to-treat basis. Safety was assessed in all participants who received at least one dose. This trial is registered with ClinicalTrials.gov, NCT01802749 and EudraCT 2012-004362-17. Findings: Between Dec 6, 2013, and Nov 11, 2016, 406 patients were recruited (203 [50%] assigned to the bevacizumab group and 203 [50%] to the standard chemotherapy group). 130 patients (64%) in the bevacizumab group and 131 (65%) in the standard chemotherapy group had progressed after receiving a last dose of platinum more than 12 months before, and 146 patients (72%) in the bevacizumab group and 147 (72%) in the standard chemotherapy group had progressed after completion of first-line bevacizumab maintenance. 161 participants (79%) progressed in the standard chemotherapy group, as did 143 (70%) in the bevacizumab group. Median progression-free survival was 8·8 months (95% CI 8·4–9·3) in the standard chemotherapy group and 11·8 months (10·8–12·9) in the bevacizumab group (hazard ratio 0·51, 95% CI 0·41–0·65; log-rank p

There is a paucity of data on whether Australian university students are meeting specific nutrient guidelines, and the relationship between diet and physical activity patterns with body composition and metabolic health. In this study, biomedical students from The University of Queensland were recruited (150 males and 211 females, 19–25 years), and nutritional intake (ASA24-Australia) and physical activity levels (Active Australia Survey) quantified. Body composition (height, waist circumference, body mass, BMI, and percentage body fat, BOD POD) and metabolic health (oral glucose tolerance test) were also measured. Median daily energy intake was 6760 kJ in females and 10,338 kJ in males, with more than 30% of total energy coming from energy-dense, nutrient-poor foods. Only 1 in 10 students met fruit or vegetable recommendations, with less than one third meeting recommendations for fibre, calcium, and potassium. Intakes of calcium and iron were particularly low among female students, with only 16% and 6% of students meeting the recommended dietary intake (RDI), respectively. The majority of males and almost half of all females exceeded the suggested dietary target (SDT) for sodium. Sufficient physical activity (≥150 min over ≥5 sessions per week) was met by more than 80% of students. Body composition and blood glucose concentrations were largely normal but an early sign of insulin resistance (HOMA-IR &gt, 2.0), measured in a subset of students, was present in 21% of males and 17% of females. Modest reductions in blood glucose levels and percentage body fat were associated with increasing vigorous activity. Low intakes of fibre, calcium, and potassium could be corrected by increasing fruit, vegetable, and dairy intake, and, among females, health promotion messages focusing on iron-rich foods should be prioritised. While these nutrient deficiencies did not translate into immediate metabolic heath concerns, dietary behaviours can track into adulthood and have lasting effects on overall health.

The relationship between housing instability and reproductive healthcare is understudied. We examined the association between housing insecurity and access and utilization of general healthcare, contraceptive healthcare, and abortion care.Using data from a population-representative survey of adult reproductive-age Ohio women (N = 2,529), we assessed housing insecurity (not paying rent/mortgage on time in the past year). We examined associations between housing insecurity and the following outcomes: (1) not being able to access general healthcare in the past year; (2) experiencing delays or difficulties in accessing contraceptive healthcare in the past year; and (3) ever having an abortion. We used unadjusted and adjusted logistic regression models. We selected confounders a priori and included age, socioeconomic status, and healthcare status.Overall, 10.6% of Ohio women of adult reproductive age experienced housing insecurity. Approximately 27.5% of respondents were not able to access general healthcare and 10.4% experienced delays or difficulties in accessing contraceptive care. Compared to housing-secure respondents, housing-insecure women were less able to access general healthcare (adjusted odds ratio [aOR]:2.16; 95% confidence interval [CI]:1.45-3.23) and more likely to experience delays or difficulties when accessing contraceptive care (aOR:1.74; 95% CI:1.00-3.04). Insecure housing was not statistically associated with ever having an abortion (aOR:1.76; 95% CI:0.93-3.34).In this study, recent housing insecurity was associated with poorer access to general and contraceptive healthcare. Studies utilizing multidimensional measures of housing insecurity and other material insecurity measures are needed to further explore the relationship between material insecurity and access to general and contraceptive care.

A key barrier to the consistent use of condoms is their negative effect on sexual pleasure. Although sexual pleasure is a primary motivation for engaging in sex and is an integral part of overall sexual health, most programs to improve sexual health operate within a pregnancy and disease-prevention paradigm. A new condom, CSD500 (Futura Medical Developments; Surrey, UK), containing an erectogenic drug was developed for use among healthy couples to improve sexual pleasure by increasing penile firmness, size and erection duration. We conducted a randomized controlled trial to test whether promoting the novel condom CSD500 for improved sexual pleasure is effective in reducing condomless sex compared to the provision of standard condoms with counseling for pregnancy and disease prevention. We randomized 500 adult, heterosexual, monogamous couples in Thanh Hoa province, Vietnam to receive either CSD500 (n = 248) or standard condoms (n = 252). At enrollment and after 2, 4, and 6 months, we interviewed women and sampled vaginal fluid to test for the presence of prostate-specific antigen (PSA), an objective, biological marker of recent semen exposure. We registered the protocol before trial initiation at ClinicalTrials.gov (identifier: NCT02934620). Overall, 11.0% of women were PSA positive at enrollment. The proportion of follow-up visits with PSA-positivity did not differ between the intervention (6.8%) and control arms (6.7%; relative risk, 1.01; 95% confidence interval, 0.66–1.54). Thus, we found no evidence that promoting an erectogenic condom to women in a monogamous, heterosexual relationship in Vietnam reduced their exposure to their partner’s semen. These findings might not hold for other populations, especially those with a higher frequency of condomless sex.

Despite overwhelming data supporting the safety of abortion care in the U.S., public perceptions of abortion safety vary widely. While evidence suggests that the public overestimates abortion risk, few studies have analyzed why people think abortion is safe or unsafe.Using data from the Ohio Survey of Women, a representative survey of women aged 18 to 44 years with a residential address in Ohio, we examined responses to 2 questions about abortion safety perceptions: the first asked respondents to rate abortion safety in Ohio, and the second asked respondents why they chose this rating of abortion safety. We analyzed these responses with inductive and deductive approaches.There were 2529 responses, of which 1368 (54%) provided a response to the open-ended question about abortion safety. From this subset, 529 gave open-ended responses indicating that they perceive abortion as safe, with 47% attributing this perception to the procedure being performed by a professional in a regulated environment. In contrast, 370 gave open-ended responses indicating that they perceive abortion as unsafe; the most common explanations referred to health risks (19%) and that safety depends on preexisting health conditions (19%).Many participants perceived abortion as safe because it is performed by professionals in a clinical environment or because of personal experiences with abortion. Those perceiving a lack of safety provided more varied responses, including that abortion was dangerous due to a detrimental effect on mental health or protesters at abortion clinics.We identified that women have a broad range of reasons for perceiving abortion as safe or unsafe. Providers should be aware of this diversity of abortion safety perceptions so that they can best engage with their patients.This updated characterization of pain experienced during an evidence-based medication abortion regimen may allow for better pain-related counseling, tailoring of opioid prescription practices, and improvement in patient satisfaction.