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Background: Contraceptive use is vital in reducing the risk of unintended pregnancies and early motherhood. Despite the well-established benefits, the uptake of modern contraceptive methods among adolescent girls and young women (AGYW) is sub-optimal in sub-Saharan Africa. Furthermore, the discontinuation rate of modern contraceptive use poses a significant challenge to its effectiveness. Objective: We aimed to determine a 12-month modern contraceptive discontinuation rate, reasons for discontinuation, and associated factors among AGYW in Tanzania. Design: Retrospective nested within the cross-sectional utilizing quantitative approach. Methods: We retrospectively analysed calendar data on contraceptive use collected in the 2022 Tanzania Demographic and Health Survey (2022 TDHS). The 2022 TDHS data collection was implemented between February and July 2022. The study population comprised AGYW aged 15–24 years. The unit of analysis was the contraceptive episode of use, defined as the period between the start of use and the termination of the method. Our analysis was mainly based on the discontinuation due to dissatisfaction with the method. We used a life-table method to estimate the contraceptive discontinuation rates. A frailty model was employed to assess the factors associated with the discontinuation rate. Results: A total of 668 AGYW with a mean (±standard deviation) age of 21.5 ± 2.1 years were included in the analysis. The overall prevalence of 12-month discontinuation rate due to dissatisfaction with the method was 32.3%. Higher discontinuation rates were observed among injectable and pills. The main reasons for discontinuation were side effects (13.7%) and change in menstrual cycle (8%). Factors associated with higher discontinuation rates included higher age (adjusted hazard ratio (aHR) 1.64, 95% confidence interval (CI) 1.06–2.51 for the 20–24 age group), residing in households headed by a female (aHR 1.40, 95% CI 1.05–1.85), and residing in the western zone (aHR 1.87, 95% CI 1.21–2.90). Conclusion: This study revealed a high prevalence rate of modern contraceptive discontinuation among AGYW in Tanzania. The management of side effects needs to be incorporated into programs aimed at promoting the sustained use of modern contraceptive methods. Plain language summary: Modern contraceptive discontinuation and associated factors among adolescent girls and young women in Tanzania Why was the study done? Unintended pregnancies among adolescent girls and young women (AGYW) are a significant public health concern in sub-Saharan Africa. The use of modern contraceptives is crucial in reducing this issue, yet their effectiveness is compromised by high discontinuation rates. Understanding the factors and reasons for discontinuation is important for developing targeted interventions. What did the researchers do? This study aimed to determine the discontinuation rate and associated factors of modern contraceptives due to dissatisfaction and fertility-related reasons among AGYW in Tanzania. We analysed the 2022 Tanzania demographic and health survey (2022 TDHS) to estimate the 12-month discontinuation rate, reasons for discontinuation, and predictors of discontinuation among AGYW in Tanzania. What did the researchers find? The study revealed that about one-third of discontinuation of modern contraceptives methods occurred within 12 months, mainly due to reported side effects. The highest discontinuation rate was observed among injectable and pills methods. It was found that older AGYW, those living in female-headed households, and those from the western zone of Tanzania were more likely to discontinue from modern contraceptive use. What do the findings mean? The findings highlight the need for targeted programs focused on promoting sustained modern contraceptive use among AGYW. [ABSTRACT FROM AUTHOR]

Why do so few women hold elected office on local government bodies? The answer to this question encompasses a combination of barriers to running for office. The research discussed in this article involved two surveys conducted in Wisconsin. The findings indicate that in addition to systemic barriers, such as time away from work, many women are hesitant to serve on local governing bodies for other reasons, including concerns related to confidence and potentially inaccurate perceptions. This cautiousness was not as evident in male potential candidates. Understanding the barriers women face may inform how Extension educators work to address skewed compositions of local governing bodies as part of capacity-building efforts.

Background: Apolipoprotein E4 (APOE4) is associated with a greater response to neuroinflammation and the risk of developing late-onset Alzheimer's disease (AD), but the mechanisms for this association are not clear. The activation of calcium-dependent cytosolic phospholipase A2 (cPLA2) is involved in inflammatory signaling and is elevated within the plaques of AD brains. The relation between APOE4 genotype and cPLA2 activity is not known. Methods: Mouse primary astrocytes, mouse and human brain samples differing by APOE genotypes were collected for measuring cPLA2 expression, phosphorylation, and activity in relation to measures of inflammation and oxidative stress. Results: Greater cPLA2 phosphorylation, cPLA2 activity and leukotriene B4 (LTB4) levels were identified in ApoE4 compared to ApoE3 in primary astrocytes, brains of ApoE-targeted replacement (ApoE-TR) mice, and in human brain homogenates from the inferior frontal cortex of persons with AD dementia carrying APOE3/4 compared to APOE3/3. Higher phosphorylated p38 MAPK but not ERK1/2 was found in ApoE4 primary astrocytes and mouse brains than that in ApoE3. Greater cPLA2 translocation to cytosol was observed in human postmortem frontal cortical synaptosomes with recombinant ApoE4 than ApoE3 ex vivo. In ApoE4 astrocytes, the greater levels of LTB4, reactive oxygen species (ROS), and inducible nitric oxide synthase (iNOS) were reduced after cPLA2 inhibition. Conclusions: Our findings implicate greater activation of cPLA2 signaling system with APOE4, which could represent a potential drug target for mitigating the increased neuroinflammation with APOE4 and AD. [ABSTRACT FROM AUTHOR]

Medications for type 2 diabetes (T2DM) offer a promising path for discovery and development of effective interventions for dementia syndromes. A common feature of dementia syndromes is an energy failure due to reduced energy supply to neurons and is associated with synaptic loss and results in cognitive decline and behavioral changes. Among diabetes medications, glucagon‐like peptide‐1 (GLP‐1) receptor agonists (RAs) promote protective effects on vascular, microglial, and neuronal functions. In this review, we present evidence from animal models, imaging studies, and clinical trials that support developing GLP‐1 RAs for dementia syndromes. The review examines how changes in brain energy metabolism differ in conditions of insulin resistance and T2DM from dementia and underscores the challenges that arise from the heterogeneity of dementia syndromes. The development of GLP‐1 RAs as dementia therapies requires a deeper understanding of the regional changes in brain energy homeostasis guided by novel imaging biomarkers. [ABSTRACT FROM AUTHOR]

Background: It is not clear whether triglyceride DHA‐based formulations (TG‐DHA) can sufficiently enrich brain DHA. Animal studies suggest that phosphatidylcholine (PC) and lyso‐phosphatidylcholine (LPC) lipids might be preferred brain DHA substrates. The goal of this study is to assess the effect of high‐dose TG‐DHA supplementation on DHA‐containing PC (PC‐DHA) and LPC (LPC‐DHA) lipid species in plasma and total cerebrospinal fluid (CSF) DHA as a surrogate for brain DHA incorporation. Method: We conducted a randomized clinical trial stratified by DHA treatment (n=14) and placebo (n=14) status in non‐demented older participants (CDR ≤ 0.5, age ³ 55 years old). Participants were provided 2,040 mg DHA daily in the form of TG‐DHA for six months. Plasma and CSF were obtained at baseline and after supplementation. Participants were also stratified by ApoE ε4 status, an allele known to increase Alzheimer's disease (AD) risk. PC and LPC lipid species from plasma and CSF were isolated and examined by LC/MS‐MS. Total fatty acids in CSF were measured via GC/MS‐MS. Result: Among all participants, PC‐DHA represented 39% of total DHA in plasma, while LPC‐DHA represented 1.8% of total DHA. PC‐DHA increased by 69% and 19% in plasma and CSF, respectively, following supplementation compared to placebo (p<0.0001 for both). Plasma LPC‐DHA increased by 140% in the treatment group compared to placebo (p<0.0001). Increases in plasma PC‐DHA and LPC‐DHA were both significantly correlated to changes in total DHA in CSF (R=0.8 and 0.57, respectively, p<0.003 for both). A trend toward greater increases in PC‐DHA in non‐ApoE ε4 carriers compared to carriers were also observed. Conclusion: Our data indicate that high‐dose TG‐DHA supplementation effectively increases DHA phospholipid incorporation in plasma and CSF. We acknowledge that CSF may not exactly reflect brain lipid uptake but provides useful information on brain DHA bioavailability. Our findings support that high‐dose TG DHA supplementation are brain penetrant and can help answer whether enriching brain DHA can slow down cognitive decline in patients at risk of AD. [ABSTRACT FROM AUTHOR]