Combatting Abortion Misinformation and Disinformation in Medical Education

Abstract Introduction: Although abortion has historically been federally legal, functional access to abortion care has been thwarted by inflammatory political discourse. Abortion misinformation and disinformation have been deliberately intertwined into political agendas and ideologies, widening the gap between the lay public’s perception of and patients’ lived experience with abortion care. The politicization of abortion care has adverse effects on its provision and training along lines of inequity and marginalization established by preexisting systems of oppression and structural violence. Critical feminist pedagogy—an examination of class, gender, and sexuality on patriarchal misrepresentations of abortion information—can guide medical students to recognize and combat abortion misinformation and disinformation. Objectives: We apply critical feminist pedagogy to abortion education in medical school curricula to equip students to recognize 1) motives underlying false abortion messaging and 2) mechanisms to produce abortion misinformation and disinformation. We propose interventions that allow medical students to leverage their professional status and privilege in improving the U.S. abortion discourse throughout their careers. Proposed Approaches: We contextualize two classifications of misinformation and disinformation utilized by the anti-abortion movement. We then discuss how educational interventions addressing both of these mechanisms can be adapted through a feminist lens to teach medical students about the complexity of pregnancy decision-making and empower them to debunk false abortion messaging. First, we explore the hijacking of false sensationalized narratives by anti-abortion efforts to frame care-seeking patients as ‘immoral’ and thereby distort our collective knowledge regarding abortion care. We posit that narrative medicine and the complexity of real patient stories can overpower this misleading imagery and allow students to integrate lived realities within their conceptualization of abortion. Second, we examine the co-opting of medical language by the anti-abortion movement to influence abortion policymaking. We propose that curricula allowing medical students to push back against abortion misinformation and disinformation can help them practice debunking false messages while also supporting the public health importance of safe abortion care. Conclusions: Medical students need to recognize and combat the plethora of false abortion messaging in our current post-Roe sociopolitical landscape. Innovations framed within a feminist pedagogy in undergraduate medical education can help trainees understand the importance of reproductive justice, pregnancy decision-making, and abortion care in the context of the patient experience. Over time, these lessons can train future physicians to engage in equitable, accurate conversations about abortion care both inside and outside the exam room

Young Children’s Meta-Ignorance

Meta-ignorance is an awareness of one’s own knowledge or lack of knowledge. The goal of this dissertation is to examine the development of children’s meta-ignorance between 14 months and 42 months. I examine the hypothesis that children have some awareness of their own epistemic states, notably states of knowledge and ignorance. In Study 1, eight children’s use of the mental verb know was examined when they were between 18 and 36 months. Children (from the Child Language Data Exchange System) used know to affirm their own knowledge and that of their interlocutor. When they used know in the context of asking a question, they typically asked about their interlocutor’s knowledge states and not their own. Conversely, they often denied their own knowledge but rarely their interlocutor’s. Finally, they rarely referred to a third party’s knowledge. In Study 2, 64 children’s production of the flip gesture (hold two hands palm up out to the side to communicate “I don’t know”) was examined when they were between 14 and 42 months. The video recordings were from the Language Development Project. Flip gestures were observed at 14 months, which is four months before a minority of children were first observed saying: “I don’t know.” Children often flipped following their interlocutors’ comments and questions, suggesting that children used flips in a dialogic fashion. When children flipped, their interlocutors often interpreted flips as an expression of ignorance and responded accordingly. Study 3 involved an experiment in which 52 children aged 16 to 37 months were presented with familiar and unfamiliar pictures and asked to label them. For familiar pictures, children mostly produced the correct name. For unfamiliar pictures, children were more likely to display signs of uncertainty, including turning to gaze at an adult, producing a filled pause such as Um, asking for help, and saying I don’t know. Children’s ability to produce I DON’T KNOW flips, to say I don’t know, and to express uncertainty when asked to name unfamiliar objects indicates that they come to express a simple understanding of knowledge and ignorance in the course of the second and third year

Birthplace in Australia: Processes and interactions during the intrapartum transfer of women from planned homebirth to hospital

© 2017 Elsevier Ltd Objective the aim of the study was to explore the views and experiences of women, midwives and obstetricians on the intrapartum transfer of women from planned homebirth to hospital in Australia. Design a Constructivist Grounded Theory approach was taken, to conceptualise the social interactions and processes grounded in the data. Setting urban and regional areas in four states of south-eastern Australia. Participants semi-structured qualitative interviews were conducted with 36 women, midwives and obstetricians who had experienced an intrapartum homebirth transfer within three years prior to the interview. Interviews were audio recorded and transcribed verbatim. Findings women who were transferred to hospital from a planned homebirth made physical and psychological journeys out of their comfort zone, as they faced the uncertainty of changing expectations for their birth. The trusting relationship between a woman and her homebirth midwife was crucial to women's sense of safety and well-being in hospital. Midwives and obstetricians, when congregating in the hospital birthing rooms of transferred women, also felt out of their comfort zones. This was due to the challenges of converging with others who possessed conflicting paradigms of safety and risk in birth that were at odds with their own, and adapting to different routines, roles and responsibilities. These differences were derived from diverse professional, social and personal influences and often manifested in stereotyping behaviours and ‘us and them’ dynamics. When midwife-woman partnerships were respected as an inclusive part of women's care, collaboration ensued, conflict was ameliorated, and smooth transfers could be celebrated as successes of the maternity care system. Key conclusions supporting woman centred care in homebirth transfers means acknowledging the social challenges of collaborating in the unique context of a transferred woman's hospital birthing room. Understanding the power of the midwife-woman partnership, and its value to the health and well-being of each woman and her baby, is key to facilitating a successful transfer. Implications for practice the midwife-woman partnership played a central role in providing the necessary support and advocacy for women transferred out of their comfort zone. When midwives worked together in an integrated system to provide the necessary care and support for women who were transferred, greater levels of collaboration emerged and women's perceptions of their quality of care was high. In practice, this meant health professionals respecting each other's roles, responsibilities and expertise, and ameliorating ‘us and them’ dynamics

Genetic Associations and Architecture of Asthma-COPD Overlap

BACKGROUND: Some people have characteristics of both asthma and COPD (asthma-COPD overlap), and evidence suggests they experience worse outcomes than those with either condition alone. RESEARCH QUESTION: What is the genetic architecture of asthma-COPD overlap, and do the determinants of risk for asthma-COPD overlap differ from those for COPD or asthma? STUDY DESIGN AND METHODS: We conducted a genome-wide association study in 8,068 asthma-COPD overlap case subjects and 40,360 control subjects without asthma or COPD of European ancestry in UK Biobank (stage 1). We followed up promising signals (P < 5 x 10(-6)) that remained associated in analyses comparing (1) asthma-COPD overlap vs asthma-only control subjects, and (2) asthma-COPD overlap vs COPD-only control subjects. These variants were analyzed in 12 independent cohorts (stage 2). RESULTS: We selected 31 independent variants for further investigation in stage 2, and discovered eight novel signals (P < 5 x 10(-8)) for asthma-COPD overlap (meta-analysis of stage 1 and 2 studies). These signals suggest a spectrum of shared genetic influences, some predominantly influencing asthma (FAM105A, GLB1, PHB, TSLP), others predominantly influencing fixed airflow obstruction (IL17RD, C5orf56, HLA-DQB1). One intergenic signal on chromosome 5 had not been previously associated with asthma, COPD, or lung function. Subgroup analyses suggested that associations at these eight signals were not driven by smoking or age at asthma diagnosis, and in phenome-wide scans, eosinophil counts, atopy, and asthma traits were prominent. INTERPRETATION: We identified eight signals for asthma-COPD overlap, which may represent loci that predispose to type 2 inflammation, and serious long-term consequences of asthma.Peer reviewe

Platelet-Related Variants Identified by Exomechip Meta-analysis in 157,293 Individuals

Platelet production, maintenance, and clearance are tightly controlled processes indicative of platelets important roles in hemostasis and thrombosis. Platelets are common targets for primary and secondary prevention of several conditions. They are monitored clinically by complete blood counts, specifically with measurements of platelet count (PLT) and mean platelet volume (MPV). Identifying genetic effects on PLT and MPV can provide mechanistic insights into platelet biology and their role in disease. Therefore, we formed the Blood Cell Consortium (BCX) to perform a large-scale meta-analysis of Exomechip association results for PLT and MPV in 157,293 and 57,617 individuals, respectively. Using the low-frequency/rare coding variant-enriched Exomechip genotyping array, we sought to identify genetic variants associated with PLT and MPV. In addition to confirming 47 known PLT and 20 known MPV associations, we identified 32 PLT and 18 MPV associations not previously observed in the literature across the allele frequency spectrum, including rare large effect (FCER1A), low-frequency (IQGAP2, MAP1A, LY75), and common (ZMIZ2, SMG6, PEAR1, ARFGAP3/PACSIN2) variants. Several variants associated with PLT/MPV (PEAR1, MRVI1, PTGES3) were also associated with platelet reactivity. In concurrent BCX analyses, there was overlap of platelet-associated variants with red (MAP1A, TMPRSS6, ZMIZ2) and white (PEAR1, ZMIZ2, LY75) blood cell traits, suggesting common regulatory pathways with shared genetic architecture among these hematopoietic lineages. Our large-scale Exomechip analyses identified previously undocumented associations with platelet traits and further indicate that several complex quantitative hematological, lipid, and cardiovascular traits share genetic factors

Author Correction: Multi-ancestry genome-wide association analyses improve resolution of genes and pathways influencing lung function and chronic obstructive pulmonary disease risk

Correction to: Nature Geneticshttps://doi.org/10.1038/s41588-023-01314-0, published online 13 March 2023. In the version of the article initially published, the sample sizes in the main text and Supplementary Tables 1 and 2 were incorrect. In the abstract, the last paragraph of the Introduction, the first paragraph of the Results, the top box in Figure 1a and the Supplementary Information, the total sample size has been corrected from 580,869 to 588,452 participants and the size of the European cohort from 468,062 to 475,645. Some of the effect sizes in Supplementary Table 14 (columns W, Z, AC, AF) had the wrong sign. There was also an error in Supplementary Table 3 where the sample size instead of the variant count was shown for EXCEED. The errors do not affect the conclusions of the study. Additionally, two acknowledgments for use of INTERVAL pQTL and Lung eQTL consortium data were omitted from the Supplementary Information. These errors have been corrected in the Supplementary Information and HTML and PDF versions of the article

Genetic diversity fuels gene discovery for tobacco and alcohol use

Tobacco and alcohol use are heritable behaviours associated with 15% and 5.3% of worldwide deaths, respectively, due largely to broad increased risk for disease and injury(1-4). These substances are used across the globe, yet genome-wide association studies have focused largely on individuals of European ancestries(5). Here we leveraged global genetic diversity across 3.4 million individuals from four major clines of global ancestry (approximately 21% non-European) to power the discovery and fine-mapping of genomic loci associated with tobacco and alcohol use, to inform function of these loci via ancestry-aware transcriptome-wide association studies, and to evaluate the genetic architecture and predictive power of polygenic risk within and across populations. We found that increases in sample size and genetic diversity improved locus identification and fine-mapping resolution, and that a large majority of the 3,823 associated variants (from 2,143 loci) showed consistent effect sizes across ancestry dimensions. However, polygenic risk scores developed in one ancestry performed poorly in others, highlighting the continued need to increase sample sizes of diverse ancestries to realize any potential benefit of polygenic prediction.Peer reviewe

Alignment of the CMS tracker with LHC and cosmic ray data

© CERN 2014 for the benefit of the CMS collaboration, published under the terms of the Creative Commons Attribution 3.0 License by IOP Publishing Ltd and Sissa Medialab srl. Any further distribution of this work must maintain attribution to the author(s) and the published article's title, journal citation and DOI.The central component of the CMS detector is the largest silicon tracker ever built. The precise alignment of this complex device is a formidable challenge, and only achievable with a significant extension of the technologies routinely used for tracking detectors in the past. This article describes the full-scale alignment procedure as it is used during LHC operations. Among the specific features of the method are the simultaneous determination of up to 200 000 alignment parameters with tracks, the measurement of individual sensor curvature parameters, the control of systematic misalignment effects, and the implementation of the whole procedure in a multi-processor environment for high execution speed. Overall, the achieved statistical accuracy on the module alignment is found to be significantly better than 10μm