Search

BackgroundPatients find technology tools to be more approachable for seeking sensitive health-related information, such as reproductive health information. The inventive conversational ability of artificial intelligence (AI) chatbots, such as ChatGPT (OpenAI Inc), offers a potential means for patients to effectively locate answers to their health-related questions digitally.ObjectiveA pilot study was conducted to compare the novel ChatGPT with the existing Google Search technology for their ability to offer accurate, effective, and current information regarding proceeding action after missing a dose of oral contraceptive pill.MethodsA sequence of 11 questions, mimicking a patient inquiring about the action to take after missing a dose of an oral contraceptive pill, were input into ChatGPT as a cascade, given the conversational ability of ChatGPT. The questions were input into 4 different ChatGPT accounts, with the account holders being of various demographics, to evaluate potential differences and biases in the responses given to different account holders. The leading question, "what should I do if I missed a day of my oral contraception birth control?" alone was then input into Google Search, given its nonconversational nature. The results from the ChatGPT questions and the Google Search results for the leading question were evaluated on their readability, accuracy, and effective delivery of information.ResultsThe ChatGPT results were determined to be at an overall higher-grade reading level, with a longer reading duration, less accurate, less current, and with a less effective delivery of information. In contrast, the Google Search resulting answer box and snippets were at a lower-grade reading level, shorter reading duration, more current, able to reference the origin of the information (transparent), and provided the information in various formats in addition to text.ConclusionsChatGPT has room for improvement in accuracy, transparency, recency, and reliability before it can equitably be implemented into health care information delivery and provide the potential benefits it poses. However, AI may be used as a tool for providers to educate their patients in preferred, creative, and efficient ways, such as using AI to generate accessible short educational videos from health care provider-vetted information. Larger studies representing a diverse group of users are needed.

Whilst early and mid-20th century family planning practices have been qualitatively studied, the transition towards a more consistent use of contraceptive methods during the following decades has gained less attention. In this article, we suggest that institutions, experts, and policy frameworks, together with socially shared beliefs, create a societal infrastructure that may support or hinder access to contraceptives. We ask how this contraceptive infrastructure shaped individuals’ efforts to control childbearing in the context of the growing availability of contraceptive devices in the 1960s and early 1970s Finland. Our study draws from a diverse collection of sources on individual experiences, expert discussions, and public debate. Many individuals did not immediately trust contraceptives as effective or suitable for their life situations. This is comparable to any adoption of a new health technology. The institutional structures – within which the physicians and educators worked – originated from the previous decades and were shaped by past norms and practices. Furthermore, support and guidance from experts were not readily available, as the arrival of new contraceptive technologies placed physicians in a novel domain. Hence, the medical community remained cautious and non-uniform. We emphasize the role of abortion in ensuring attainable fertility control and creating a new sense of control over fertility. Despite the public recognition of contraceptive needs, Finnish society liberalized abortion legislation years before implementing comprehensive contraceptive guidance. The lack in the development of the contraceptive infrastructure contributed to relying on abortions. Our study nuances the generalization of Western Europe promoting contraceptives and, respectively, Eastern Europe leaning on abortion as an essential method of fertility control. Only with the development of the Finnish welfare state and the public effort for universal access to contraceptive guidance did consistent contraceptive practices emerge, with legal abortion ultimately becoming an auxiliary rather than the primary means of fertility control. [ABSTRACT FROM AUTHOR]

Free-roaming dog populations ensue from irresponsible dog ownership and abandonment. The Society for the Prevention of Cruelty to Animals (SPCA) in Hong Kong SAR offers practical solutions to control dog population growth by providing a range of different birth control programs. We present the first results of a trial Trap Neuter Return (TNR) program in Hong Kong SAR; with a free-roaming dog population on Cheung Chau Island (southwest). During the 3-year study, the SPCA undertook surveys to assess population size and trapped, desexed, and, where possible, rehomed free-roaming dogs. We report that a total of 182 dogs were encountered during the period. We estimate that an average of 75% of the population was desexed, reaching the threshold for successful TNR studies. The results of our study show that TNR can assist with free-roaming dog population control and provide guidance for future programs, in Asia and Hong Kong SAR. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the impact of age on disease recurrence in idiopathic subglottic stenosis (iSGS) patients. Methods: This was a retrospective chart review of iSGS patients treated with laser wedge excision. Patients did not have prior surgery. Survival rates free of recurrence were estimated using the Kaplan–Meier methods, and associations were evaluated using Cox Proportional Hazards models. Results: Eighty‐five female patients were included in the study. Most patients (68%) were postmenopausal, had first period at or before 13 years of age, had at least one full‐term pregnancy (82%), were not undergoing hormone replacement therapy (93%), were not using hormonal birth control (88%), and were either partially or completely compliant with triple therapy regime (80%). There was a statistically significant average reduction in risk of recurrence of 5% for every additional year of age (p < 0.0001). When compared to patients older than 65 years of age, patients less than 35 were nearly 10 times more likely to recur (p = 0.002), and patients 55–65 and 45–55 years of age were 8 and 5 times more likely to recur, respectively (p = 0.003 and 0.009). Additionally, females on birth control showed decreased risk of recurrence of 74% compared with their counterparts (p = 0.04). Conclusion: This is the first study to demonstrate an inverse relationship between age and disease recurrence in patients with iSGS following surgery. Using age as a surrogate for menopausal status, these results suggest that increased age and/or birth control provide a protective effect through decreased recurrence rates, possibly mediated by decreased estrogen levels. Level of Evidence: 4 Laryngoscope, 135:198–205, 2025 [ABSTRACT FROM AUTHOR]

At rest, the menstrual cycle phase impacts ventilation and chemosensitivity. However, during exercise there is inconclusive evidence that the menstrual cycle phase affects ventilation or chemosensitivity. We sought to examine the influence of menstrual phase and hormonal birth control (BC) on chemosensitivity. We tested 12 males and 20 females (10 BC; 10 normally menstruating, NBC) on three occasions. Day 1 was a maximal exercise test and days 2 (follicular phase) and 3 (luteal phase) consisted of three bouts of chemosensitivity testing during cycle exercise at 30% of peak work rate. Females‐BC and males completed day 3 approximately 2 weeks after day 2, with females‐BC tested during the active phase of their birth control. There were no differences between the two experimental days for any groups for any (hypercapnia, hypoxia, and hyperoxia) chemosensitivity tests, p > 0.05. Females‐BC had a significantly lower average response to transient hypercapnia than both females‐NBC and males (38% and 42% lower, respectively, p < 0.05). Females‐NBC had a significantly smaller change in ventilation to hyperoxia compared to males, −11.7 ± 5.9 versus −17.9 ± 5.4%, respectively (p < 0.05). We conclude that the day‐to‐day variability in chemosensitivity is not different between males, females‐BC and NBC. [ABSTRACT FROM AUTHOR]

Summary Background Objective Methods Results Conclusion Maternal obesity and excessive weight gain during pregnancy are associated with higher birth weight and increased risk of childhood obesity.This study investigated the effect of a high‐protein and low‐glycaemic‐index (HPLGI) diet during pregnancy on offspring body composition and metabolic health.We conducted a dietary intervention study in pregnant women with a pre‐pregnancy BMI of 28–45 kg/m2 who were randomly assigned to an HPLGI diet or a moderate‐protein moderate‐glycaemic‐index (MPMGI) diet. A total of 208 offspring born to these women were followed‐up from birth to 5 years of age.No differences were found on BMI z‐scores at different ages; however, offspring born to women on the HPLGI diet exhibited 0.43 mmol/L higher glucose levels (p = 0.017) at birth compared with the MPMGI diet. At 3 years of age, HPLGI offspring had 0.09 mmol/L lower levels of HDL‐cholesterol (p = 0.018) and 16% higher levels of triglycerides (p = 0.044). At 5 years of age, they had 0.25 mmol/L higher total cholesterol levels (p = 0.027) and 0.27 mmol/L higher LDL‐cholesterol levels (p = 0.003) compared with the MPMGI diet.An HPLGI diet during pregnancy may lead to adverse metabolic outcomes in the offspring, necessitating further investigation into long‐term health implications. [ABSTRACT FROM AUTHOR]

Reproductive success in captive non-human primates (NHPs) has increased the demand for safe, effective, and reversible population control methods. This review provides an overview of the current literature on hormonal and non-hormonal contraceptives as reproductive control methods in NHPs. Where available, behavioral and welfare implications, as well as drug efficacy, reversibility, and associated adverse effects, are considered. However, a paucity of data exists for NHPs, particularly in regard to non-hormonal contraceptives, emphasizing the need for institutions to share their experiences with reproductive management techniques in the species under their care. [ABSTRACT FROM AUTHOR]

Purpose: Intrauterine device is one of the most preferred birth control method in the world. Being able to predict that the intrauterine device will not dislocate is very important in terms of preventing unwanted pregnancies. Here, we evaluated the role of uterocervical angle in displacement of intrauterine device and to determine whether it has a discriminative role for displacement. Methods: This cross-sectional case–control study was conducted at an obstetrics and gynecology clinic of a university-affiliated training and research hospital. A total of 108 patients between June 2021 and September 2021 were included. While 36 patients in the case group had intrauterine device displacement, 72 patients in the control group had normal intracavitary intrauterine device detected under transvaginal ultrasound. Demographic characteristics, parameters related to intrauterine device and uterus were recorded. Uterocervical angle was measured in all the patients. Results: There was no statistically significant difference in terms of sociodemographic features, parameters related to uterus size and intrauterine device. The median uterocervical angle was significantly higher in intrauterine device displacement group as compared to controls [159.5 (90–177) vs 146 (118–169) degrees, p < 0.001)]. Uterocervical angle > 156 degree discriminates intrauterine device displacement with 66.67% sensitivity and 80.56% specificity (AUC = 0.763). Conclusion: A larger uterocervical angle may suggest an increased likelihood of intrauterine device displacement. Thus, uterocervical angle seems to have a potential to play a crucial role in the monitoring and management of intrauterine device users even in patients with similar sized uterus. [ABSTRACT FROM AUTHOR]

Background/Introduction: On June 24, 2022, the Supreme Court overturned the 1973 verdict in the Roe v. Wade legal suit that had established the constitutional right to medical abortion [1]. With the right to abortion now being left to the states, many restrictions regarding abortion procedures are being established [2]. We aim to evaluate whether this has led to an increase in the number of birth control prescriptions and sterilisation procedures at Cape Fear Valley Medical Centre in rural North Carolina. Methods: SlicerDicer program within EPIC medical records database was used to retrieve the records of all women that had an obstetrics and gynaecology appointment with Cape Fear Valley Health System between 11/01/21-12/31/2022 for contraception. The data was sorted into race/ethnicity, age, and types of birth control. Principal outcomes measured the trends in birth control prescription or sterilisation procedure appointments before and after the overturn of Roe v. Wade. Results: Contraceptive pill prescriptions decreased from 51.70% to 32.40%. IUD insertions decreased from 39.40% to 11.30%. Injectable birth control remained consistent, at approximately 16%. Nexplanon implantations dropped from 20.60% to 9.70%. Lastly, sterilisation procedures increased from 6.7% to 10.7%. Conclusion: Majority of birth control prescriptions decreased following the overturn of Roe v. Wade, except for sterilisation, which increased by 4.0%. This may indicate that women are now looking for more permanent birth control options after the overturn of Roe v. Wade. Future research should investigate whether similar trends of increasing prevalence of sterilisation procedures is seen throughout the United States. SHORT CONDENSATION: We aim to assess the impact of the Supreme Court overturn regarding the Roe v. Wade legal suit on contraceptive decisions in rural North Carolina. [ABSTRACT FROM AUTHOR]

Rural adolescent pregnancy is a serious public health issue, largely due to low contraceptive use. Existing data focuses on urban populations. Using a positive youth development framework, we examine associations between modifiable protective factors and birth control use in a rural population. Prior to an evidence-based health education program, students in 10th grade health class in two low-to-middle income rural schools completed surveys. For contraceptive use at last sex, students could check all methods that applied which were collapsed into three rank-ordered categories: none, condoms only, and hormonal contraception. Predictor variables included sexual self-efficacy (six items, α = 0.66, "able to say no"), parent connectedness (five items, α = 0.94, "satisfaction with your parent/guardian?"), language acculturation (one item, "in your home do you speak..."), school connectedness (five items, α = 0.85, "I feel close to people at my school") and adverse childhood experiences (eight item score). These variables were entered into a multivariable logistic ordinal regression. The sample (N = 287) was 52% female, 48% LatinX and 49% white. Higher sexual self-efficacy and parent connectedness scores significantly increased the odds of using more effective birth control. Higher language acculturation (more likely to speak another language at home) suggested less likely to use more effective birth control. School connection and adverse childhood experiences were not significant in the final model. Contraception focused interventions in rural communities should address modifiable protective factors, such as self-efficacy and parent connection. Interventions need to be trauma-informed and language accessible. [ABSTRACT FROM AUTHOR]

Background/Objectives: To support women's informed decisions and reproductive self-care, confident reproductive health-related knowledge is needed, supported by adequate health literacy (HL). No corresponding survey has been carried out in Hungary on inequalities to provide information addressing education. Materials and Methods: In the current cross-sectional online survey, 301 women of reproductive age (27.16 ± 0.36 years) were asked with the Hungarian versions of validated and standardised questionnaires about reproductive knowledge on hormones, ovulation, menstrual cycle, pregnancy signs and birth control (Knowledge of Female Body Scale—KFB), and HL (Brief Health Literacy Screening Tool—BRIEF). Spearman correlation and multivariable linear regression analyses were utilised, with a significance level set at p < 0.05. IBM SPSS version 28.0 (IBM SPSS, Armonk, NY, USA: IBM Corp.) and G*Power (version 3.1.9.7; Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany) software. The STROBE checklist was followed. The Clinical Trial Registry Nr. is NCT06146673. Results: The KFB composite score was high (20.01 ± 2.33); 86.374% had "high knowledge". Still, lacking information was identified for the mechanisms of certain contraceptive methods and early physical signs of pregnancy. A significant difference was also found in the KFB scores in the case of higher age (p = 0.019), higher education level (p = 0.018) and previous live birth (p = 0.028). A positive correlation was found between KFB and HL (p < 0.001), education (p = 0.005), and age (p = 0.021). A multiple regression analysis (R2 = 0.087, p < 0.001) indicated that both HL (p < 0.001) and age (p = 0.003) are potential positive predictors of adequate reproductive knowledge, whereas induced abortion (p = 0.013) might serve as an inverse predictor. Conclusions: Inequalities in women's knowledge about their reproductive system and HL were found, and it was significantly the lowest in their highest conception probability age. Therefore, in addition to targeted education, HL also needs improvement. [ABSTRACT FROM AUTHOR]

Background: Valproates are recognized for their significant teratogenic risks, which can lead to physical defects and developmental disorders when used during pregnancy. To mitigate these risks, the Pregnancy Prevention Program (PPP) was developed by European regulators for patients and healthcare professionals (HCPs). Despite the crucial nature of this program, the implementation of the PPP does not appear to be fully effective. This situation highlights the need for a deeper understanding of HCPs' knowledge, attitudes, and behaviors regarding the PPP. Methods: A cross-sectional study using anonymous electronic questionnaires was conducted. The questionnaires were developed by a board of experts from eight different EU countries and were distributed among prescribers (general practitioners (GPs), neurologists, and psychiatrists) and pharmacists. Descriptive statistics were used to analyze the obtained data on participants' knowledge, attitudes, and behaviors regarding the prescribing and dispensing of valproate-containing medicines to women of reproductive age, as well as the impact of PPP materials on their work. Results: The study results indicate that while HCPs in Latvia are generally aware of valproate teratogenic risks, significant gaps remain in the implementation of the PPP. A considerable number of both prescribers and pharmacists expressed the belief that they are not responsible for educating patients about the PPP, attributing this responsibility to other specialists. Furthermore, barriers such as a lack of time and accessible materials were identified. Conclusions: The roles and responsibilities of HCPs should be clearly defined to improve adherence to the PPP. Further research is needed to assess prescription and dispensing strategies, as well as HCPs' attitudes toward the PPP. Additionally, re-evaluating and enhancing the accessibility of PPP materials is essential in effective risk management and better patient care. [ABSTRACT FROM AUTHOR]

BackgroundObjectiveMethodsResultsConclusionOur understanding of how nursing and midwifery students in Australia are prepared to support people in unintended pregnancy prevention and care is currently limited.This study examined Australian nursing and midwifery students and recent graduates’ perspectives on their preparation and confidence in providing unintended pregnancy prevention and care.A descriptive, cross-sectional online survey of nursing and midwifery students and graduates was undertaken. An invitation email with information sheet and link to the survey was sent to heads of departments at Australian universities for distribution to nursing and midwifery students. Social media platforms of professional organisations were used to promote the study to nurses and midwives within two years of graduation. The survey instrument was based on US educational competencies for unintended pregnancy prevention and care, adapted for the Australian context.Participants (N = 109) from 14 institutions completed the survey. The majority of (92%) expressed that nursing and midwifery graduates should possess unintended pregnancy prevention and care knowledge and skills. Five competencies, out of 29, were identified as taught as core curriculum by 50% or more of participants; reproductive anatomy and physiology (72%); effective communication skills encompassing culture, sexual orientation, and gender identity (58%), understanding how contraceptives work (54%), obtaining a sexual/reproductive history (53%), and identifying preconception health risks (50%). Students felt well prepared to provide independent care related to pregnancy testing (44%), pregnancy prevention (26%), sexual history taking (23%), ethical/legal considerations around abortion (9%), options counseling/referral (5%), and pre/post-abortion care (5%).With the decriminalization of abortion care, the Australian nursing and midwifery workforce must prepare students to care for people in all aspects of pregnancy prevention, early pregnancy decision-making, and abortion services. Our data show students are interested in this preparation but the entry-to-practice curricula has not yet been standardized to enable this. [ABSTRACT FROM AUTHOR]

Background: To ensure the acceptability and effectiveness of potential Multipurpose Prevention Technologies (MPTs), understanding user needs, and preferences are crucial to inform the design of MPTs. This article aims to explore the perceptions towards potential MPT use and to explore the needs of multiple stakeholders in India within their social and behavioural contexts. Methods: A qualitative multicentric study was conducted in three Indian states—Maharashtra, Karnataka, and Tamil Nadu. The study involved a total of 222 interviews: 77 in-depth interviews with women, including those from the general population, HIV-positive women, and street and brothel-based Female Sex Workers (FSWs); 84 in-depth interviews with men and 61 key informant interviews were conducted. Three focus group discussions were conducted with FSWs. Interviews explored perceptions of the potential MPTs, needs, and factors that may potentially affect their use and adherence. Interviews and FGDs were transcribed and translated verbatim. Thematic analysis approach was used to analyse the data in NVivo version 8. Result: The following themes highlight the need and preferences among women for the potential MPT product: 1) Overall perceptions about new MPT, 2) People at high risk need long acting products, 3) Condom versus new MPT: potential of MPT, 4) Women empowerment through MPTs 5) Secrecy and confidentiality 6) Non-stigmatising MPT product positioning. Conclusion: Several stakeholders in this study expressed their need for new MPTs, but concerns regarding confidentiality, privacy, stigma and, adherence were identified. Besides efficacy, characteristics such as the size, packaging, formulation, and texture of MPTs, should be taken into account when designing the MPT products, also considering the needs of women, specially, female sex workers. [ABSTRACT FROM AUTHOR]

During pregnancy, the maternal cardiovascular (CV) system undergoes major haemodynamic alterations ensuring adequate placental perfusion and a healthy pregnancy course. Hypertensive disorders of pregnancy (HDP) occur in almost 10% of gestations and preeclampsia, a more severe form, in 3–4%. Women with HDP demonstrated impaired myocardial function, biventricular chamber dysfunction and adverse biventricular remodelling. Shortly after delivery, women who experienced HDP express increased risk of classic CV risk factors such as hypertension, renal disease, abnormal lipid profile, and diabetes. Within the first two decades following a HDP, women experience increased rates of heart failure, chronic hypertension, ischaemic heart and cerebral disease. The mechanism underlying the relationship between HDP in younger women and CV disease later in life could be explained by sharing pre‐pregnancy CV risk factors or due to a direct impact of HDP on the maternal CV system conferring a state of increased susceptibility to future metabolic or haemodynamic insults. Racial disparities in CV risk and social determinants of health also play an important role in their remote CV risk. Although there is general agreement that women who suffered from HDP should undertake early CV screening to allow appropriate prevention and timely treatment, a screening and intervention protocol has not been standardized due to limited available evidence. In this review, we discuss why women with hypertensive pregnancy may be disproportionately affected by heart failure with preserved ejection fraction and how cardiac remodelling during or after pregnancy may influence its development. [ABSTRACT FROM AUTHOR]

Simple Summary: This study explores a new way to control fertility in male mice by combining two substances: quinestrol, a synthetic hormone, and ketoconazole, a medication usually used to treat fungal infections. The researchers wanted to see if adding ketoconazole could make quinestrol more effective, so less of the hormone would be needed. They tested different combinations of these two substances on male mice and checked their impact on fertility-related factors like sperm count and reproductive organ size. The most promising results came from a low dose of quinestrol combined with ketoconazole, which significantly reduced sperm count and lowered testosterone levels after 10 days. Even after 30 days, this combination continued to exhibit some suppressive effects on reproductive capacity. The study also found that ketoconazole helped to slow down the body's metabolism of quinestrol, making it work more effectively. This study suggests that using ketoconazole alongside quinestrol could be a safer and more efficient way to control fertility, potentially offering a new approach for managing populations of certain animal species. This study investigates whether ketoconazole, a CYP3A4 inhibitor, can enhance the suppressive effects of quinestrol on reproductive capacity, potentially allowing for a reduced quinestrol dosage while maintaining its efficacy. A total of 104 healthy adult male mice were divided into two groups, assessed at 10 and 30 days. Within each group, six treatment categories were tested: the control (CK), quinestrol alone (Q1, Q5), and quinestrol combined with varying doses of ketoconazole (Q1 + K0.4, Q1 + K2, Q5 + K0.4). The key parameters measured included internal and reproductive organ weights, sperm density, sperm motility, sperm abnormalities, and CYP3A4 enzyme content in intestinal and liver tissues. After 10 days, the combination of a low dose of quinestrol with ketoconazole (Q1 + K0.4) showed the most significant pronounced effects in reducing reproductive potential, with notable reductions in epididymal weight, sperm density, sperm abnormality rate and vitality, serum hormone levels, and CYP3A4 content in the small intestine and liver. Although some reproductive parameters returned to near-baseline levels after 30 days, the Q1 + K0.4 regimen continued to exhibit reduced seminal vesicle weight and testosterone levels. Importantly, the combination did not significantly increase CYP3A4 enzyme content, indicating effective metabolic inhibition. The combination of quinestrol and ketoconazole, especially the Q1 + K0.4 regimen, demonstrated the most noticeable impact on reducing reproductive capacity. This regimen significantly reduced key reproductive parameters and showed strong metabolic inhibition, suggesting that ketoconazole substantially enhances the efficacy of quinestrol in fertility control. [ABSTRACT FROM AUTHOR]

Pest rodents persistently undermine crop yields and food security. Fertility control could be a viable alternative for managing rodent populations. This study investigates the antifertility effects of various concentrations of clarithromycin combined with 1.0 mg/kg quinestrol on male rodents to determine an effective contraceptive dose that minimizes quinestrol usage, addressing key concerns such as potential environmental residue, which may impact ecological balance, and poor palatability, which could reduce ingestion and limit the sterilant's effectiveness. Male mice were divided into five groups and administered different doses of clarithromycin or clarithromycin and quinestrol for three consecutive days, while the control group received sunflower seed oil only. After seven days, organ weights, reproductive organ weights, sperm density, serum hormone levels, and CYP3A4 content in small intestinal and liver tissues were measured to assess persistent effects. Compared with the control group, all treatment groups had significant reductions in epididymal weight, seminal vesicle weight, and serum T and LH levels. Higher concentrations of clarithromycin (2 mg/kg and 10 mg/kg) significantly impacted reproductive metrics, including sperm density, organ weights, and serum LH and testosterone levels, though complete sterilization was not achieved, with more than 60 million cauda epididymal spermatozoa remaining. However, the combination demonstrated potential as an effective strategy for male fertility control. The combination of 2.0 mg/kg clarithromycin and quinestrol can mitigate organ enlargement seen with quinestrol alone. This combination also decreased total enzyme content, thereby diminishing quinestrol's induction of CYP3A4, which may increase the sterilization effectiveness of the treatment. [ABSTRACT FROM AUTHOR]

Background: Fertility is one of the three main components which determines the size, structure, and composition of a population, and fertility preferences are important measures for forecasting fertility levels of a population. Therefore, this study aims to assess the impacts of the inequalities in the utilization of key maternal health services on fertility preference among high parity women in four selected regions (i.e., Afar, Beninshangul-Gumuz, Gambella and Somali) of Ethiopia. Methods: The study used data collected for the 2016 Ethiopian Demographic and Health Surveys (EDHS) survey. It includes a total of 977 high parity women (104 urban and 873 rural) residing in the four regions of the study. Bivariate logistic regression was used to select the potential variables by using a cut off p-value < 0.2 and then the multivariable logistic regression analyses were performed to assess the association between the selected explanatory variables (i.e., control and exposure variables) and the outcome variable (i.e. fertility preference). Further, the study employed a Population Attributable Fractions (PAFs) to examine the population level impacts of the inequalities in maternal and child health service variables on fertility preference. Results: The results showed that religion, household wealth index, place of delivery and contraceptive use were significantly associated with fertility preference. The results of the PAFs analysis indicated that contraceptive use had the biggest impact (80%), meaning that non-use of contraceptive increased fertility preference among women in the four regions. Similarly, out of health facility delivery increased fertility preference by 37%. Conclusion: The study findings underscore the critical factors influencing women's fertility preferences in the studied regions. Low utilization of maternal health services had an impact on fertility preference, accounting for more than half of the observed variations in fertility preferences. To address this issue, targeted interventions are recommended: enhancing access to maternal health services, strengthening fertility control programs, promoting the benefits of using these services, and actively addressing inequalities. [ABSTRACT FROM AUTHOR]

Introduction: Preeclampsia is one of the causes of maternal death. The prevalence of preeclampsia cases in Indonesia is quite high, namely 34.1%. One of the risk factors for preeclampsia is a history of using hormonal contraception. For this reason, this study aims to know the influence of hormonal contraceptive risk factors on the incidence of preeclampsia. Materials and methods: This research was a case control analytical observational study. Samples were 24 cases and 24 controls. The independent variable was hormonal contraception, and the dependent variable was preeclampsia. Data was collected through medical records at the Pangkur Community Health Center, Ngawi Regency. Chi-square analysis test with a significance level of P<0.05. Results: The results of this study indicated that exposure to hormonal birth control for the incidence of preeclampsia was 66.6%, while exposure to hormonal Contraception for non-preeclampsia events was 25%. From the results of the analysis with the Chi-Square test, the significance value of P = 0.009. Conclusion: It can be concluded that there was an influence of hormonal contraceptive risk factors on the incidence of preeclampsia. It's recommended that potential acceptors undergo counseling before making a decision by looking at the short-term and long-term effects. [ABSTRACT FROM AUTHOR]

Introduction: Screening for substance use during pregnancy is critical for enhancing maternal health and perinatal outcomes. However, disparities persist in screening and intervention rates within maternity services. This retrospective case note review explored contemporaneous practices around screening and interventions for substance use among pregnant women during routine antenatal care. Methods: A random sample of 100 sets of maternity records were reviewed. Eligible cases included any woman attending initial pregnancy assessments at one of two South Australian metropolitan Hospital‐based antenatal clinics, from July 2019–September 2020. Screening rates for past and current alcohol, tobacco and other substance use were identified and compared with data from a subset of a nationally representative survey. Intervention details and referral pathways were also assessed. Results: The final sample of eligible cases (n = 93) demonstrated prioritisation of screening for current use, over past use, across all substances (p < 0.001). Screening was most likely for tobacco and least likely for e‐cigarettes (p < 0.001). Significant underreporting of past use compared with the benchmark was identified for all substances (except tobacco, p = 0.224). Interventions typically involved written resources, which were usually declined by clients. Discussion and Conclusions: Despite longstanding recommendations, screening and intervention practices for substance use appear inconsistent. With the recent emergence of vaping, no evidence of updated approaches to identifying e‐cigarette consumption in pregnant women was found. Several opportunities for enhancing routine screening and intervention practices within antenatal clinics were identified, and will inform the development of policy directives, targeted training modules, and other resources for health professionals working in these services. [ABSTRACT FROM AUTHOR]

Direct democracy has come to the forefront of the abortion debate. Since Dobbs v. Jackson Women's Health Organization, the seismic Supreme Court decision overruling Roe v. Wade and Casey v. Planned Parenthood, a number of high-profile ballot measures about abortion have drawn both public attention and substantial turnout. The result in every such election since Dobbs has favored the pro-choice side, even in some culturally conservative states. Surveys of public opinion in the wake of Dobbs suggest that there is significant support for abortion rights and opposition to highly restrictive laws in most states. This misalignment between public opinion and abortion law is precisely the circumstance that direct democracy, and especially the initiative, is well situated to mitigate. Yet, paradoxically, precisely where direct democracy seems most needed, it is being most aggressively resisted by legislative opponents of abortion rights. In this Article, I examine this paradox, along with the reconfigured countermajoritarian difficulty that has emerged since Dobbs. It is now state legislatures in many states, and not courts, that are frustrating democratic resolution of abortion policy. All of this suggests the need to recalibrate institutional debates about abortion. [ABSTRACT FROM AUTHOR]

Globally, human–wildlife conflicts continue to increase, owing to human population growth and expansion. Many of these conflicts concern the impacts of invasive non‐native species. In the UK, the invasive, non‐native grey squirrel Sciurus carolinensis negatively affects tree health and has caused the decline of the native red squirrel Sciurus vulgaris. Oral contraceptives are being developed to manage the impacts of the grey squirrel. To be effective, contraceptives will need to be deployed at a landscape scale, and will require a delivery system that is practical and economically viable. Understanding grey squirrel feeding behaviour is important so that delivery methods can be designed so that a sufficient number of target individuals receive an effective contraceptive dose at a time of year that will ensure their infertility throughout peak times of breeding. The main aims of this study were to assess how sex, season, squirrel density and bait point density influenced; (1) the probability of a squirrel visiting a feeder and (2) the amount of bait consumed from feeders. Field trials were conducted on six woodland populations of squirrels in three seasons, with four days of bait deployment via purpose‐designed squirrel‐specific bait hoppers with integrated PIT‐tag readers. It was possible to deliver multiple doses on most days to most male and female grey squirrels, with bait deployment more likely to be effective in spring, immediately before the second annual peak in squirrel breeding, followed by winter, immediately before the first peak in breeding. The results from this study could be used to design methods for delivering oral contraceptive baits to grey squirrels in the future and the methods used could be applied to other small mammal species and other bait delivery systems. © 2024 Crown copyright and The Author(s). Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry. This article is published with the permission of the Controller of HMSO and the King's Printer for Scotland. [ABSTRACT FROM AUTHOR]

This study compared the mechanical and physiological load placed on Division I female collegiate lacrosse athletes (1) with and without hormone contraceptive (HC) use and (2) with and without menstruation during training and games. Athletes' (20.6 ± 1.5 years, HC users = 9, naturally cycling (NC) athletes = 9) workloads—total distance traveled (TD, m), max speed (km∙h−1), accelerations (repetitions), decelerations (repetitions), and high-intensity distance (HID, m)—were measured through VX Sport wearable microtechnology in training sessions (n = 87/athlete) and games (n = 17/athlete). Analyses showed no statistical group differences based on HC use or not, and no differences during menstruation versus non-menstruation for training or games. However, while not statistically different, athletes taking HCs performed worse during menstruation, with a 5.1% decline in decelerations, 3.4% decline in TD and HID, 1.2% decline in max speed, and 1% decline in accelerations. NC athletes did not show this same decline with menses. Given that withdrawal bleeding exacerbates performance reduction of HC users, it may be beneficial for these athletes to consider skipping their withdrawal bleed if it is likely to coincide with a game. Further research needs to be carried out to see if these trends are consistent across other female athletes in other sports. [ABSTRACT FROM AUTHOR]

Abstract Background Contraception knowledge and attitudes are largely formed from conversations within one’s social network. More recently, this network has expanded to include social media. As the fastest growing social media platform, we aimed to assess popular contraception videos on TikTok for content understandability, actionability and accuracy. Methods This is a secondary analysis of the most viewed, contraception-specific TikTok videos that were previously coded as containing educational messaging in a content-analysis study. We assessed videos for understandability (ability to explain a key message) and actionability (identify what they can do to act on that message) using the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V) instrument and for Currency, Relevance, Authority, Accuracy, and Purpose (CRAAP) using a modified instrument within the health information education literature. Results The 174 videos with educational content scored as understandable but not actionable in PEMAT-A/V assessment, with videos created by healthcare providers (HCPs) performing better than those by non-HCPs in six of eleven domains of understandability. Videos overall scored well in relevance and purpose within the CRAAP assessment. Videos created by HCP’s (n = 99) scored higher than those by non-HCPs (n = 75) in relevance (score = 3.9 versus 3.3), authority (score = 4.8 versus 1.7), accuracy (score = 6.0 versus 3.5), and purpose (score = 7.1 versus 5.7) [all p

Visual research methods are increasingly utilised in educational research and scholars have used them to develop accounts of sexuality in schooling contexts. This article advances this work with an analysis of secondary students’ drawings of their experiences with sexuality education. We performed a thematic analysis on 150 drawings created during participatory focus group discussions (FGDs) among students in 30 Thai general secondary and vocational schools. We present summaries of six key themes identified in the visual data (‘emphasis on puberty, anatomy, and reproduction’; ‘emphasis on preventing pregnancy and infection’; ‘emphasis on the negative consequences of sex’; ‘hidden curriculum of heteronormativity’; ‘absence of complexities in the images’; and ‘a traditional classroom environment’). Conducted as a part of a multi-method study that also included teacher and student surveys, the analysis of students’ drawings highlighted the nature of Thai sexuality education from a complementary vantage point. While our previously reported survey findings indicated relatively comprehensive topic coverage, our interpretation of the student drawings suggests that pregnancy prevention may be emphasised over other topic areas. Our analysis of the drawings also supported earlier survey findings pointing at a lecture-heavy approach to teaching and learning rather than more learner-centred pedagogy. [ABSTRACT FROM AUTHOR]

Background : Perinatal anxiety is common: up to 40% of pregnant women and new mothers experience high levels of anxiety. Given its prevalence, interventions that are low-intensity, highly accessible and cost-efficient, and target modifiable risk factors for anxiety are needed. Repetitive negative thinking (RNT)—such as worrying about ways things will go wrong in the future or ruminating about past negative events—is a risk factor for the development of anxiety. RNT is maintained by the tendency to generate negative interpretations of ambiguous situations. Methods: A parallel two-arm randomised controlled trial will assess the efficacy of adding interpretation training (RELAX) to usual maternity care. Participants (N = 268) will be randomised to (i) 12 sessions of online interpretation training (RELAX) plus usual care, or (ii) usual care alone. We will assess anxiety, depression, RNT, and work and social adjustment at baseline, plus 4, 8 and 36 weeks later. Discussion: Should the intervention result in lower levels of anxiety than usual care, it could be an accessible, cost-effective way to help women who are vulnerable to experiencing anxiety in the perinatal period. Trial registration: ISRCTN 12754931. Registered 25th May 2023, prior to recruitment. [ABSTRACT FROM AUTHOR]

Persistent tuberculosis (TB) in cattle populations in England has been associated with an exchange of infection with badgers (Meles meles). A badger control policy (BCP) commenced in 2013. Its aim was to decrease TB incidence in cattle by reducing the badger population available to provide a wildlife reservoir for bovine TB. Monitoring data from 52 BCP intervention areas 200–1600 km2 in size, starting over several years, were used to estimate the change in TB incidence rate in cattle herds, which was associated with time since the start of the BCP in each area. A difference in differences analysis addressed the non-random selection and starting sequence of the areas. The herd incidence rate of TB reduced by 56% (95% Confidence Interval 41–69%) up to the fourth year of BCP interventions, with the largest drops in the second and third years. There was insufficient evidence to judge whether the incidence rate reduced further beyond 4 years. These estimates are the most precise for the timing of declines in cattle TB associated with interventions primarily targeting badgers. They are within the range of previous estimates from England and Ireland. This analysis indicates the importance of reducing transmission from badgers to reduce the incidence of TB in cattle, noting that vaccination of badgers, fertility control and on farm biosecurity may also achieve this effect. [ABSTRACT FROM AUTHOR]

Objective Data Sources and Setting Study Design Data Collection/Extraction Methods Principal Findings Conclusion The 2020 Family First Coronavirus Response Act (FFCRA) extended Medicaid coverage for enrollees without rechecking eligibility. Before that, women were eligible for Medicaid coverage up to 60 days postpartum. We examine the FFCRA's effect on Medicaid postpartum coverage, depression symptoms, and birth control use beyond 60 days after delivery.We use data from the 2016–2021 Pregnancy Risk Assessment Monitoring System (PRAMS). The primary sample includes 56,828 women who were income eligible up to 60 days postpartum or beyond in their state.We employ a difference‐in‐differences design comparing outcomes before and after the FFCRA between women who were not income eligible for Medicaid coverage beyond 60 days postpartum in their state and those who were income eligible. We estimate models without and with controlling for state‐specific trends in outcomes over time.N/A.There is an 8.1 percentage‐point increase in the likelihood of having Medicaid coverage without controlling for state‐specific trends, and 5.4 percentage‐points when controlling for state‐specific trends (both p < 0.05). There is a decline in likelihood of being uninsured by 3 percentage‐points (p < 0.05) without state‐specific trends and a smaller and non‐significant decline when including state‐specific trends. Estimated effects on depression symptoms and birth control use are small and statistically non‐significant.Following the FFCRA, there was an increase in Medicaid coverage beyond 60 days postpartum among women who would have been income ineligible for Medicaid after 60 days. However, there is a less pronounced effect on likelihood of being uninsured, which might be partly due to some switching from private to Medicaid coverage. There were no discernable effects on depression symptoms and birth control use. Examining additional health and health care utilization measures over a longer postpartum period is needed to further understand the FCCRA effects on these outcomes. [ABSTRACT FROM AUTHOR]

Hormonal contraceptives (HCs) are one of the most highly prescribed classes of drugs in the world used for both contraceptive and noncontraceptive purposes. Despite their prevalent use, the impact of HCs on the brain remains inadequately explored. This review synthesizes recent findings on the neuroscience of HCs, with a focus on human structural neuroimaging as well as translational, nonhuman animal studies investigating the cellular, molecular, and behavioral effects of HCs. Additionally, we consider data linking HCs to mood disorders and dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and stress response as a potential mediator. The review also addresses the unique sensitivity of the adolescent brain to HCs, noting significant changes in brain structure and function when HCs are used during this developmental period. Finally, we discuss potential effects of HCs in combination with smoking-derived nicotine on outcomes of ischemic brain damage. Methodological challenges, such as the variability in HC formulations and user-specific factors, are acknowledged, emphasizing the need for precise and individualized research approaches. Overall, this review underscores the necessity for continued interdisciplinary research to elucidate the neurobiological mechanisms of HCs, aiming to optimize their use and improve women’s health. [ABSTRACT FROM AUTHOR]

The development and regulation of hormonal contraception has been problematic—with concerns and safety of patients often being disregarded. Better birth control prescribing may lie in genetic testing. Direct-to-consumer genetic testing aimed at "personalizing the pill" exists, but regulations and clinical guidelines must adapt to meet the diverse needs of patients. This article analyzes emerging socio-ethical-legal tensions as hormonal contraceptives enter the pharmacogenomic era. Using a narrative lens, the author concludes that further patient-centered research—grounded in the voices of distinct populations—should inform policy so as to better serve birth control users and avoid the historical injustices with respect to hormonal contraception. [ABSTRACT FROM AUTHOR]

To date, research on the welfare impacts of wildlife contraceptives has mostly been focused on the potential harms of contraceptives. However, there are compelling theoretical reasons to expect direct and indirect welfare benefits of wildlife contraceptives. These positive welfare effects would be experienced by more than just the treated individuals, because per capita resource availability will increase with decreasing numbers of individuals sharing a resource. In the present article, we discuss the potential for wildlife contraceptives to alleviate resource competition and their associated negative welfare effects at different scales. These effects are expected to vary across contexts and would presumably be stronger when wildlife contraceptives are used with the explicit purpose of improving wild animal welfare. The potential for considerable welfare gains for wildlife through the targeted use of contraceptives highlights the importance of both species-specific studies on the welfare benefits of wildlife contraceptives and further research on the links between population dynamics and wild animal welfare. [ABSTRACT FROM AUTHOR]

At the beginning of the pandemic, SARS-CoV-2 infection represented a great medical burden worldwide, as targeted and effective therapeutic options were lacking. This resulted in the revival of existing molecules and the increasing popularity of over-the-counter nutritional supplements. Among the latter, lactoferrin has been investigated as an adjuvant in COVID-19 therapy with conflicting results, mainly depending on different study designs. Considering that lactoferrin is one of the main components of human breast milk with anti-microbial and anti-inflammatory activity, it is conceivable that such bioactive molecule could be effective in supporting anti-SARS-CoV-2 infection therapy, especially in infants and pregnant women, two subpopulations that have been poorly evaluated in the existing clinical trials. This narrative review is intended to offer insight into the existing literature on lactoferrin's biological functions and protective effects against COVID-19, with a special focus on pregnant women and their infants. [ABSTRACT FROM AUTHOR]

Introduction: Progress in male contraception development faces the challenge of a lack of regulatory precedent and guidelines on the evidence (trial design and primary endpoint) required for marketing approval. Moreover, the development of a male contraceptive is complicated by the fact that the clinical treatment effect; prevention of pregnancy, is not measured in the patient receiving the intervention. Discussion: Regulatory precedent and guidelines exist for female hormonal contraceptives but their applicability to male contraceptive products likely varies based on the mode of action and the anticipated pharmacodynamic effects of the product. The unique attributes of male contraceptives, including the frequent delay between the intervention (e.g., vasectomy and hormonal methods) and ultimate contraceptive effect, sperm suppression near azoospermia, and pregnancy prevention need to be addressed. Conclusion: This article describes the regulatory challenges faced by developers of male contraceptive products and offers proposals, paving the way for the development of both hormonal methods and non‐hormonal approaches. Our article intends to suggest the directions but cannot substitute for the advice of regulatory agencies. [ABSTRACT FROM AUTHOR]

Despite the projected impact of new male contraceptives, resources and investments directed at their development remain limited in part due to concerns that men would not actually use them. Now, more than 30 studies have been conducted over the last 30 years—regionally and internationally, within clinical trials, and across populations—examining men and women's attitudes towards new male contraceptive methods, all consistently demonstrating interest in and willingness to use new methods. Yet even these studies, inclusive of competitive contraceptive market projections, seem not to be convincing enough. Rather than study whether men would be willing to use male contraceptives, more resources should be devoted to developing the infrastructure and supporting the cultural changes needed to ensure that when new male contraceptives inevitably emerge, that they will be disseminated quickly and made readily accessible. Men's views on what their roles are in society, families, relationships, and pregnancy prevention are changing in ways that may impact what they consider to be acceptable contraceptive risks. As society moves toward more gender equitable beliefs, men's positive involvement in contraception might organically develop into an expected behavior. Interventions aimed at sensitizing men toward gender equitable beliefs may pay dividends in improving male contraceptive acceptability. The current lack of a reversible male contraceptive method prevents us from collecting data that might disprove presumptions that men would be unwilling to take on responsibility for pregnancy prevention. However, studies of men's involvement in (1) over‐the‐counter emergency contraception, (2) vasectomy, and (3) abortion offer case studies for men's increasing consciousness of opportunities for shared contraceptive responsibility, the structural and sociopolitical barriers that men face when trying to participate in family planning, and how these might translate into new male contraceptive interest and development. [ABSTRACT FROM AUTHOR]

Many female military service members choose to use hormonal contraception to prevent pregnancy and/or to control or suppress menses. Hormonal contraception, which comes in many different forms based on dose, estrogen/progestin type, and route of administration (oral, vaginal, transdermal, implant, intrauterine device, injectable), may cause side effects, some of which can influence military medical readiness, or the health status necessary to perform assigned missions. This expert review summarizes the evidence around common military-relevant side effects of hormonal contraception that could impact readiness, including effects on weight and body composition, bone health, psychological health, and physical performance, and serves as a tool for uniformed and civilian clinicians counseling female service members about hormonal contraception. Current evidence suggests some hormonal contraception can lead to weight and fat gain, may modulate susceptibility to mood or mental health disorders, and could impact bone mineral density and stress fracture risk; more research is needed on physical performance effects. Clinicians must be familiar with readiness considerations of each type of hormonal contraception to provide comprehensive patient education and allow for optimal shared decision-making about hormonal contraception use among female Service members. Considering the relative lack of data on the effects of nonoral hormonal contraception routes on readiness outcomes and the growing interest in long-acting reversible contraceptives among female service members, future research should continue to investigate effects of all hormonal contraception methods available to service members. [ABSTRACT FROM AUTHOR]

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This study sought to investigate the prominence of U.S. birth control pioneer and eugenicist Margaret Sanger in social media discourse through a critical disinformation studies lens. Using computational and qualitative analysis techniques, 60 months of public Facebook posts and Google search data were analyzed to explore the scope, reach, and engagement with messages that reference Sanger and examine how injustice frames utilizing Sanger's historical ties to eugenics are being used today to misinform and disinform on abortion and other issues. Injustice frames featuring Sanger were deployed to portray abortion as a method for Black genocide; vilify feminism as racist, anti-woman, and anti-motherhood; and depict the Black Lives Matter social justice movement and cancel culture as hypocritical. This analysis also captured a moment in time when Sanger's legacy was being reconsidered by Planned Parenthood, the organization she founded, indicating that a long-sought-after reckoning with the racist roots of the early birth control movement in the United States may be underway—with both predictable and unpredictable rippling effects in disinformative spaces. [ABSTRACT FROM AUTHOR]

Melasma is a benign but emotionally distressing skin condition that reduces patients' quality of life, with prevalence rates during pregnancy ranging from 36.4% to 75%. Troublingly, up to 30% of cases are reported to persist after delivery, even ten years later. And recurrence and aggravation are common in subsequent pregnancies. This review examines the risk factors and mechanisms associated with melasma during pregnancy and summarized corresponding preventive strategies. We emphasize the critical role of photoprotection, including the use of sunscreens from the first trimester, in reducing the incidence of melasma. [ABSTRACT FROM AUTHOR]

ABSTRACT In recent decades, the integration of horses (Equus ferus) in European rewilding initiatives has gained widespread popularity due to their potential for regulating vegetation and restoring natural ecosystems. However, employing horses in conservation efforts presents important challenges, which we here explore and discuss. These challenges encompass the lack of consensus on key terms inherent to conservation and rewilding, the entrenched culture and strong emotions associated with horses, low genetic diversity and high susceptibility to hereditary diseases in animals under human selection, as well as insufficient consideration for the social behaviour of horses in wild‐living populations. In addition, management of wild‐living horses involves intricate welfare, ethics and legislative dimensions. Anthropocentric population‐control initiatives may be detrimental to horse group structures since they tend to prioritise individual welfare over the health of populations and ecosystems. To overcome these challenges, we provide comprehensive recommendations. These involve a systematic acquisition of genetic information, a focus on genetic diversity rather than breed purity and minimal veterinary intervention in wild‐living populations. Further, we advise allowing for natural top‐down and bottom‐up control – or, if impossible, simulating this by culling or non‐lethal removal of horses – instead of using fertility control for population management. We advocate for intensified collaboration between conservation biologists and practitioners and enhanced communication with the general public. Decision‐making should be informed by a thorough understanding of the genetic makeup, common health issues and dynamics, and social behaviour in wild‐living horse populations. Such a holistic approach is essential to reconcile human emotions associated with horses with the implementation of conservation practices that are not only effective but also sustainable for the long‐term viability of functional, biodiverse ecosystems, while rehabilitating the horse as a widespread wild‐living species in Europe. [ABSTRACT FROM AUTHOR]

In April 1965, the Turkish Parliament passed the law legalizing birth control, including the pills and the use of intrauterine devices. This article examines the beginnings and expansion of family planning in Turkey in the 1960s by tracing the encounters of American experts, Turkish physicians along with bureaucrats, and thousands of urban squatter dwelling and rural women and men. Different from the previous historical accounts framing family planning as an insular and state-driven modernization project, it provides a transnational history of family planning in Turkey by unearthing intimate links between the discourses of development and histories of family, sexuality, and reproduction. By using Population Council documents, Turkish official papers, Parliament minutes, visual materials, and national and feminist press accounts, this article demonstrates that family planning practices with new technologies of contraceptives constituted often-neglected but indispensable components of infrastructure in the formation of technologies of governance in Turkey in Cold War context. [ABSTRACT FROM AUTHOR]

Fueled by economic growth, among other factors, environmental degradation is one of the most serious challenges facing humanity in the twenty‐first century. Although extensive research has been conducted on the relationship between economic growth and environmental quality, the findings are inconclusive. This study investigated the relationship between economic growth and environmental quality in Ethiopia from 1981 to 2016 using non‐linear autoregressive distributive lag and two‐step least squares models. First, the study finds that the relationship between economic growth and environmental quality is asymmetric. Second, economic growth negatively affects environmental quality. Third, the positive environmental effect of a negative shock on economic growth is stronger than that of a positive shock. Fourth, energy consumption and population growth negatively affect environmental quality, whereas the effects of renewable energy consumption, natural resources, trade openness and human capital are positive. Fifth, an inverted N‐shaped relationship exists between economic growth and environmental quality, where GDP per capita greater than $686.770 contributes to environmental quality. Therefore, high and sustainable economic growth, renewable energy consumption, population control, resource conservation, trade openness and human capital accumulation are required to improve the environmental quality of Ethiopia. The limitation of this study is that it examines the direct impact of economic growth on environmental quality. It would be better to examine the potential indirect impact of economic growth via variables, such as institutional quality and human capital. [ABSTRACT FROM AUTHOR]

Fertility control has traditionally been applied in zoos to control captive populations, and reversible contraception is important. However, contraceptive methods for male bears have not been reported. We aimed to establish a reversible contraceptive for male brown bears by investigating the effects of a gonadotropin‐releasing hormone (GnRH) vaccine (Improvac®) that was developed for the immune castration of pigs. We vaccinated six bears with two sequential doses of 400 (n = 2) or 600 μg Improvac® (n = 4) with a 1‐month interval during the pre‐breeding season (February to April). We compared the reproductive parameters (testosterone levels and semen parameters) of the six vaccinated and four non‐vaccinated (control) bears once during the breeding season (May or June). To investigate whether the reproductive performance could be restored in the following year of contraception, we also compared the reproductive parameters once during the breeding season in two bears between the year with GnRH vaccination and the following year without vaccination. Vaccination treatments suppressed reproductive parameters in 5 bears, although vaccination with 400 μg of Improvac® was not effective in one bear. Testosterone levels and the rate of progressive sperm motility were significantly lower, and total sperm count and testis size tended to be lower in vaccinated bears, compared with the controls. Blood biochemical findings and direct observations after Improvac® vaccination did not reveal side effects. Moreover, testosterone levels and spermatogenic scores of two bears were restored in the following year. We confirmed that the Improvac® vaccine elicited a reversible contraceptive effect in male brown bears. [ABSTRACT FROM AUTHOR]

Introduction: Structural racism plays a major role in reproductive health inequities. Colorism, discrimination based on skin color, may profoundly impact reproductive health access and service delivery. However, quantitative research in this area is limited. Methods: We administered an online survey of women (n = 1,299) aged 18–44 from Harris County, Texas to assess the relationship between skin color discrimination and reproductive health service avoidance. The survey included questions on demographics, self-reported skin tone, and dichotomous measures of previous discrimination experiences and avoidance of care because of perceived discrimination. Binary logistic regression was used to examine whether race/ethnicity, skin tone, and previous discrimination experiences were related to avoidance of contraceptive care because of perceived discrimination. Results: Approximately one-third (31.5%) of the sample classified themselves as non-Hispanic Whites (31.5%), 22.4% as Black, 27.4% as Hispanic and born within the US, and 7.6% as Hispanic born outside of the US. Approximately one-third of women classified themselves in the lightest skin tones, whereas almost one in five women classified themselves in the darkest skin tone palates. Darker skin tones had increasingly greater odds of reporting that they avoided seeking birth control out of a concern for discrimination compared to the lightest skin tone. After adjusting for race/ethnicity and sociodemographic variables (model 3), darker skin tones remained significantly associated with avoiding birth control. Discussion: This study demonstrates the role that skin color discrimination plays in negative reproductive health experiences. While this is not surprising given that those with racist ideologies developed the concept of these racial and ethnic categories, the apparent association with darker skin colors and avoidance of seeking birth control provides evidence that structural and individual racism continues to have far-reaching and insidious consequences. Conclusion: Contraception is recognized for reducing maternal mortality, improving child health, increasing female empowerment, and decreasing poverty. However, not all women equally enjoy the benefits of access to contraception. Addressing colorism within reproductive healthcare has become critically important as the nation becomes increasingly diverse. Focusing on skin tone-based discrimination and its roots in anti-blackness expands our understanding beyond a Black–White binary traditionally applied when addressing racism in healthcare delivery. [ABSTRACT FROM AUTHOR]

Background: HIV incidence remains high in South Africa, with ~ 60% of all new HIV infections among adolescent girls and women (Country factsheets HIV and AIDS Estimates, 2022). Oral pre-exposure prophylaxis (PrEP), approved for HIV prevention in South Africa since 2015, is hampered by low uptake and adherence, particularly among adolescent girls and young women (AGYW). Combining oral PrEP with oral contraceptives could increase PrEP uptake, persistence and address unmet needs for contraception. We investigated the acceptability of a dual prevention pill (DPP), combining oral PrEP and a combined oral contraceptive (COC) for HIV and pregnancy prevention among women in Johannesburg, South Africa. Methods: Between March-July 2021, we conducted 12 focus group discussions (FGDs) with adolescent girls and women (n = 74) aged 16–40 stratified by ages (16–17, 18–24, 25–40), half of whom were COC users. We explored adolescent girls and women's opinions about the DPP concept, existing HIV and pregnancy prevention options, and input on perceived facilitators and barriers to DPP use. FGDs were conducted in English or isiZulu, using a standardized interview guide. FGDs were audio-recorded, transcribed to English and analyzed using ethnographic content analysis. Results: The majority viewed the DPP favorably as a multipurpose option preventing unplanned pregnancy and HIV. Most saw it as a convenient "two-in-one" solution, requiring one clinic visit for both PrEP and COCs. AGYW were viewed as the most likely to benefit from the DPP due to the likelihood of multiple partners and unplanned sex, possibly preventing school dropout from unplanned pregnancy or HIV acquisition. The DPP was perceived to be more reliable than condoms, especially when condom negotiation is limited. Benefits were also seen by participants in rape cases, protecting against pregnancy and HIV. DPP use barriers included side effect concerns, unsupportive partners and judgmental healthcare providers. Conclusions/significance: The DPP was perceived as acceptable for HIV and pregnancy prevention to AGYW in Johannesburg and its dual indications helpful in supporting improved PrEP uptake and persistence. DPP implementation programs need to consider solutions to potential barriers, like education on DPP benefits, coupled with reliable side effect support and healthcare provider sensitization as part of routine sexual health services to encourage uptake and adherence. [ABSTRACT FROM AUTHOR]