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BackgroundContraceptive choice is central to reproductive autonomy. The internet, including social networking sites like Reddit, is an important resource for people seeking contraceptive information and support. A subreddit dedicated to contraception, r/birthcontrol, provides a platform for people to post about contraception. ObjectiveThis study explored the use of r/birthcontrol, from the inception of the subreddit through the end of 2020. We describe the web-based community, identify distinctive interests and themes based upon the textual content of posts, and explore the content of posts with the most user engagement (ie, “popular” posts). MethodsData were obtained from the PushShift Reddit application programming interface from the establishment of r/birthcontrol to the start date of analysis (July 21, 2011, to December 31, 2020). User interactions within the subreddit were analyzed to describe community use over time, specifically the commonality of use based on the volume of posts, the length of posts (character count), and the proportion of posts with any and each flair applied. “Popular” posts on r/birthcontrol were determined based on the number of comments and “scores,” or upvotes minus downvotes; popular posts had 9 comments and a score of ≥3. Term Frequency-Inverse Document Frequency (TF-IDF) analyses were run on all posts with flairs applied, posts within each flair group, and popular posts within each flair group to characterize and compare the distinctive language used in each group. ResultsThere were 105,485 posts to r/birthcontrol during the study period, with the volume of posts increasing over time. Within the time frame for which flairs were available on r/birthcontrol (after February 4, 2016), users applied flairs to 78% (n=73,426) of posts. Most posts contained exclusively textual content (n=66,071, 96%), had comments (n=59,189, 86%), and had a score (n=66,071, 96%). Posts averaged 731 characters in length (median 555). “SideEffects!?” was the most frequently used flair overall (n=27,530, 40%), while “Experience” (n=719, 31%) and “SideEffects!?” (n=672, 29%) were most common among popular posts. TF-IDF analyses of all posts showed interest in contraceptive methods, menstrual experiences, timing, feelings, and unprotected sex. While TF-IDF results for posts with each flair varied, the contraceptive pill, menstrual experiences, and timing were discussed across flair groups. Among popular posts, intrauterine devices and contraceptive use experiences were often discussed. ConclusionsPeople commonly wrote about contraceptive side effects and experiences using methods, highlighting the value of r/birthcontrol as a space to post about aspects of contraceptive use that are not well addressed by clinical contraceptive counseling. The value of real-time, open-access data on contraceptive users’ interests is especially high given the shifting landscape of and increasing constraints on reproductive health care in the United States.

Tropical instability waves (TIWs) are oceanic features that form around the equatorial Pacific cold tongue and influence the large-scale circulation and coupled climate variability including El Niño–Southern Oscillation. Local air–sea coupling over TIWs is thought to play an important role in the atmosphere and ocean's energy and tracer budgets but is not well captured in coarse-resolution models. In this study, we isolate the impacts of TIW thermal (sea surface temperature–driven) and current (surface current–driven) feedbacks by removing TIW signatures in air–sea coupling fields in a high-resolution regional coupled model. The thermal feedback is found to damp TIW temperature variance by a factor of 2, associated both with the direct dependence of surface heat fluxes on SST (∼74%) and indirect impacts on surface winds (∼35%) and air temperature and humidity (∼−9%). These changes lead to cooling of the cold tongue SST by up to 0.1°C through reduced TIW-driven meridional heat fluxes and associated small changes in atmospheric circulation. The current feedback is decomposed into TIW (i.e., mesoscale) and mean (i.e., large-scale) components using separate experiments, with both having distinct impacts on TIWs and the mean state. The mesoscale current feedback reduces TIW eddy kinetic energy (EKE) by 22% through the eddy wind work, while the mean current feedback induces a further reduction of 8% by extracting energy from the mean currents and thus reducing barotropic EKE shear production. An improved understanding of small-scale tropical Pacific processes is needed to address biases in coarse-resolution models that impact their predictions and projections of Pacific climate variability and change. Significance Statement: Tropical instability waves (TIWs) are oceanic features with ∼1000-km wavelengths that propagate westward on either side of the eastern equatorial Pacific cold tongue. TIWs drive lateral and vertical heat fluxes that impact several aspects of El Niño–Southern Oscillation. While climate models with a moderate, 1/4° ocean resolution can capture some TIW variability, they fail to properly represent many associated processes such as the impact of TIWs on the overlying atmosphere. Using sensitivity studies performed using a high-resolution regional coupled model, we study the impact of TIW air–sea coupling on the eastern Pacific climate system. Increased understanding of small-scale processes from studies such as this is essential to understand and address biases in models used for seasonal climate predictions and projections in the Pacific region. [ABSTRACT FROM AUTHOR]

A holistic review is given of the Southern Ocean dynamic system, in the context of the crucial role it plays in the global climate and the profound changes it is experiencing. The review focuses on connections between different components of the Southern Ocean dynamic system, drawing together contemporary perspectives from different research communities, with the objective of closing loops in our understanding of the complex network of feedbacks in the overall system. The review is targeted at researchers in Southern Ocean physical science with the ambition of broadening their knowledge beyond their specific field, and aims at facilitating better‐informed interdisciplinary collaborations. For the purposes of this review, the Southern Ocean dynamic system is divided into four main components: large‐scale circulation; cryosphere; turbulence; and gravity waves. Overviews are given of the key dynamical phenomena for each component, before describing the linkages between the components. The reviews are complemented by an overview of observed Southern Ocean trends and future climate projections. Priority research areas are identified to close remaining loops in our understanding of the Southern Ocean system. Plain Language Summary: The United Nations has identified 2021–2030 as the Decade of Ocean Science, with a goal to improve predictions of ocean and climate change. Improved understanding of the Southern Ocean is crucial to this effort, as it is the central hub of the global ocean. The Southern Ocean is the formation site for much of the dense water that fills the deep ocean, sequesters the majority of anthropogenic heat and carbon, and controls the flux of heat to Antarctica. The large‐scale circulation of the Southern Ocean is strongly influenced by interactions with sea ice and ice shelves, and is mediated by smaller scale processes, including eddies, waves, and mixing. The complex interplay between these dynamic processes remains poorly understood, limiting our ability to understand, model and predict changes to the Southern Ocean, global climate and sea level. This article provides a holistic review of Southern Ocean processes, connecting the smallest scales of ocean mixing to the global circulation and climate. It seeks to develop a common language and knowledge‐base across the Southern Ocean physical science community to facilitate knowledge‐sharing and collaboration, with the aim of closing loops on our understanding of one of the world's most dynamic regions. Key Points: Contemporary perspectives are reviewed on the different components of the Southern Ocean dynamic system from distinct research communitiesKey connections between different components of Southern Ocean dynamics are highlightedCross‐cutting priorities for future Southern Ocean physical science are identified [ABSTRACT FROM AUTHOR]

Height and body mass data is often self-reported by study participants. However, the accuracy of self-reported height and body mass data compared to these same measures collected by researchers is unknown. The purpose of this study was to compare the accuracy of self-reported height and body mass data to measured values within the US law enforcement population, and the impact these estimations have on the accuracy of BMI classifications. METHODS: Self-reported and measured height and body mass data for thirty-three (n = 33) male law enforcement officers (age: 40.48 ± 6.66 yrs; measured height: 180.42 ± 6.87 cm; measured body mass: 100.82 ± 19.86 kg) were utilized for this analysis. RESULTS: Paired samples t-tests revealed no significant differences in estimated and measured height (p=.830), body mass (p = .527) or BMI (p = .623). CONCLUSION: Self-reported height and body mass was accurate for calculating BMI within this population sample.

Recent observations suggest that El Niño–Southern Oscillation (ENSO) impacts basal melting of West Antarctic ice shelves, yet sparse ocean observations limit our understanding of the associated processes. Here we investigate how ENSO events modulate subsurface West Antarctic shelf temperatures using high‐resolution global ocean‐sea ice model simulations. During El Niño, the subsurface shelf warming between 150 m and the shelf bottom can be up to 0.5°C in front of ice shelves. This warming arises from a weaker Amundsen Sea Low (ASL) and weaker coastal easterlies that reduce on‐shelf Ekman transport of cold surface waters, enabling enhanced transport of warm Circumpolar Deep Water (CDW) onto the shelf. A largely opposite response occurs during La Niña, with a stronger ASL and stronger Ekman transport that results in less cross‐shelf CDW transport and cooling in the subsurface. These findings have implications for interpreting basal melting on interannual to decadal time‐scales in West Antarctica. Plain Language Summary: El Niño‐Southern Oscillation (ENSO) is the Earth's dominant year‐to‐year climate variation. The impacts of its two phases, El Niño and La Niña, extend from the tropics to Antarctica through atmospheric waves. Past studies have suggested that West Antarctic ice shelves melt more during El Niño because of warmer ocean waters at the ice shelf bases. However, oceanic changes during El Niño lead to warming on the shelf near the ice which is difficult to isolate. That is because ENSO is only one of many drivers that impact shelf water temperatures. In this work, we simulate isolated ENSO events using an ocean circulation model. We show that during El Niño, the on‐shelf flow of cold surface waters in West Antarctica, driven by coastal easterly winds, is reduced because the winds weaken. To balance out this mass deficit at the surface, more warm CDW flows onto the continental shelf below. During La Niña, we see a largely opposite response. Stronger coastal easterlies increase the on‐shelf flow of cold surface waters and less CDW is flowing onto the shelf. Our results show the link between ENSO and mass loss of the West Antarctic ice shelves and ice sheet. Key Points: Ocean‐sea ice model simulations of El Niño and La Niña events illustrate how they modulate West Antarctic shelf temperaturesEl Niño weakens coastal easterlies, reduces on‐shelf Ekman flow of cold waters, increasing cross‐shelf flow of warm Circumpolar Deep Water (CDW)The La Niña shelf circulation response is largely opposite and reduces cross‐shelf transport of warm CDW [ABSTRACT FROM AUTHOR]

Background: The STOMP agenda (Stopping Over‐Medication of People with learning disabilities, autism, or both) drew focus to individuals with a diagnosis of a learning disability being prescribed psychotropic medication to manage 'behaviours that challenge'. The following study is an audit of two community learning disability services in the London boroughs of Westminster and Kensington and Chelsea for compliance with national guidance on the use of medication in this population, the impact of the COVID‐19 pandemic, and equality, diversity and anti‐racism. Method: Routinely collected data were audited relating to clients identified in each service, totalling 54 participants. Data were audited against five standards: minimum effective dose, medication reviews, alternative multidisciplinary input, the impact of the COVID‐19 pandemic and equality, diversity and anti–racism. Comparisons were made to the overall caseload (N = 365) where appropriate. Results: Evidence demonstrated a greater risk of receiving psychotropic medication to manage behaviours that challenge for service users from racialised backgrounds, further evidencing institutional and/or individualised racism within practice for this population. Prescriptions also increased in dosage during the COVID‐19 pandemic exacerbated by insufficient provision of alternative input and regular multi‐disciplinary review as required by national guidance. Conclusions: Community learning disability teams require dedicated, co‐produced STOMP pathways to review those at risk of over‐medication. Additional research is required to explore individual and systemic factors contributing to ethnic disparities in medication prescription for behaviours that challenge among people with learning disabilities. Further recommendations are considered around developing data collection, service user involvement, and future directions. Accessible summary: Abuse at care home (Winterbourne View) led the NHS to start a campaign known as STOMP to make sure people with learning disabilities and/or autism got the right medication.We looked at the medications people with learning disabilities in our area were given. We looked at how often these medications were checked by a doctor. We looked at what other support people were given.We also looked at how people with learning disabilities were affected by COVID‐19. We also looked at differences between people from different racial backgrounds.We found that some people were given more medications to manage their behaviour. We found that the medications were not checked as often as they should be. This happened most for Black, Brown, and Asian people.We spoke to a local service user project about our findings. They said they think racism is one of the reasons for more medications. They also said it is bad that people are on too much medication and that people should get more support. [ABSTRACT FROM AUTHOR]