Preserving the Reproductive Rights of Girls and Women in the Era of COVID-19: The Need for a Least Restrictive Solution

Fairchild and colleagues assert that while “equal” on the surface, the rapidly implemented, society-wide public health restrictions enacted in response to the COVID-19 pandemic veil harsh inequities (Fairchild et al. 2020). These inequities are particularly apparent in the deep erosion of sexual and reproductive health rights for women and girls

Dynamics of the New American Majority, 2010-2030: An Initial Look at Population Size, Growth, and Electoral Participation

In the past year, VPC and CVI commissioned a team of social science researchers to size the gaps and opportunities in voter turnout and registration of the New American Majority, which includes people of color, young people, and unmarried women. The research team included Professor Bernard L. Fraga, Professor Zachary Peskowitz, and Caitlin Gilbert. They have provided impressive data and analysis underscoring the importance of VPC and CVI's work to engage the New American Majority (NAM) in democracy in equal proportion to their presence in society through voter registration, mobilization, and education.

Comparison of an additional early visit to routine postpartum care on initiation of long-acting reversible contraception: A randomized trial

Objective To investigate whether an early 3-week postpartum visit in addition to the standard 6-week visit increases long-acting reversible contraception (LARC) initiation by 8 weeks postpartum compared to the routine 6-week visit alone. Study design We enrolled pregnant and immediate postpartum women into a prospective randomized, non-blinded trial comparing a single 6-week postpartum visit (routine care) to two visits at 3 and 6 weeks postpartum (intervention), with initiation of contraception at the 3-week visit, if desired. All participants received structured contraceptive counseling. Participants completed surveys in-person at baseline and at the time of each postpartum visit. A sample size of 200 total participants was needed to detect a 2-fold difference in LARC initiation (20% vs. 40%). Results Between May 2016 and March 2017, 200 participants enrolled; outcome data are available for 188. The majority of LARC initiation occurred immediately postpartum (25% of the intervention arm and 27% of the routine care arm). By 8 weeks postpartum, 34% of participants in the intervention arm initiated LARC, compared to 41% in the routine care arm (p=.35). Overall contraceptive initiation by 8 weeks was 83% and 84% in the intervention and routine care arms, respectively (p=.79). There was no difference between the arms in the proportion of women who attended at least one postpartum visit (70% vs. 74%, p=.56). Conclusion The addition of a 3-week postpartum visit to routine care does not increase LARC initiation by 8 weeks postpartum. The majority of LARC users desired immediate rather than interval postpartum initiation

Curriculum Integration of Pregnancy Termination and Family Planning in Didactic Medical Education

Background: Given that one in four women will seek an abortion before age 45, there is an urgent need to demystify abortion-related topics and expand providers’ foundational knowledge about pregnancy termination and family planning. An effective way of addressing gaps in women’s reproductive healthcare is integration of the public health importance, legal factors, and counseling surrounding family planning and pregnancy termination into medical school curricula in accordance with Association of Professors of Gynecology and Obstetrics (APGO) guidelines. Objective: Determine whether Indiana University School of Medicine’s (IUSM’s) current pregnancy termination and family planning curricula follow proposed APGO educational guidelines. Evaluate medical student preparedness and interest surrounding family planning and pregnancy termination. Methods: To assess the alignment between IUSM and APGO educational guidelines, session learning objectives (SLOs) from the didactic course Endocrine, Reproductive, Musculoskeletal, Dermatologic Systems (ERMD) syllabus were compared to the relevant APGO objectives. Data was collected through a survey via Qualtrics disseminated to all IUSM students which was intended to assess students’ feelings of preparedness providing accurate medical information regarding reproductive health topics, including contraception, abortion, ethical and legal implications of pregnancy termination, personal values clarification, and others, as well as interest in integrating those topics into IUSM curriculum. Results: Participants (n=303) were primarily female (61.72%) and White (74.43%) and included students who had completed the Reproductive Block of the Endocrine, Reproductive, Musculoskeletal, and Dermatologic Systems (ERMD) Course and the OB/GYN Clerkship (35.64%), only the ERMD Course (25.08%), or neither (39.27%). Across all levels of undergraduate medical education, the majority (60.80%) of students expected to learn about family planning and contraception in preclinical or clinical years of medical school. Overall, 85.67% of students believed that IUSM should enhance its reproductive and sexual health coverage in the current curriculum, including expanding family planning and contraception didactic training

Student-Perceived Preparedness in Contraceptive and Abortion Counseling

Project Background: Upwards of 25% of women will seek an abortion by age 45; however, 17% of accredited American medical schools lack any formal abortion-related curriculum, and only 50% offer a clinical elective exposing students to abortion counseling and procedures. The gap between the large number of women seeking this care and the small amount of curriculum designed to prepare students to effectively counsel and provide this care is stark, and it represents an urgent area of study and curriculum re-design. Methods: We performed a cross-sectional survey of students at all levels of medical training to assess student-perceived level of preparedness to provide non-directive counseling on reproductive health topics, such as contraception and abortion. Preparedness was measured on a 6-point preparedness scale (1=very unprepared and 6=very prepared). Mean scores were analyzed as a whole and stratified by training level. We also performed a comparative analysis of the Association of Professors of Gynecology and Obstetrics (APGO) abortion-related learning objectives (LOs) and the corresponding LOs in our didactic reproductive health course curriculum at our institution. Results: Our preliminary survey population (n=57) included majority female (66.7%) and underclassmen (MS1 = 42.1%, MS2 = 31.6%), and varied in intended specialty. Mean preparedness to provide contraception and abortion counseling score was 2.26±0.55. When stratified to include only students in their clinical years (MS3/4, dual degree), mean preparedness score only slightly increased to 2.97±0.75. Our curriculum analysis revealed that LOs from our didactic reproductive health course covered all 5 APGO LOs on Family Planning, but did not cover 2 of the 4 APGO LOs on Pregnancy Termination. Conclusions: We identified gaps in our institution’s Pregnancy Termination curriculum, as defined by the nationally recognized APGO LOs. We also identified that current didactic and clinical training at our institution inadequately prepares medical students to provide comprehensive reproductive health counseling to women, based on mean self-reported preparedness scores. The next step is to disseminate a more in-depth survey from Feb-Mar 2021 to the same student population to further evaluate student perceptions about preparedness for reproductive health counseling compared to preparedness to counsel about hypertension management to determine whether student preparedness in family planning significantly lags preparedness in other areas of medicine. Our ultimate goal is to positively influence curriculum enhancement in comprehensive reproductive health care at our institution

Aging in Falmouth: Assessing current and future needs of our aging population

This report describes the collaborative efforts undertaken by the Town of Falmouth Council on Aging Senior Center and the Center for Social and Demographic Research on Aging, within the McCormack Graduate School at the University of Massachusetts Boston. Beginning in Spring 2013, these organizations joined to conduct a needs assessment to investigate the needs, interests, preferences and opinions of the Town’s older resident population, with respect to aging in Falmouth. The focus of this report is on two cohorts of Falmouth residents—those aged 45 to 59 (referred to as “Boomers”), and the cohort of individuals who are currently aged 60 and over (“Seniors”)

Evaluating Needs of Older Adults in Massachusetts Communities

Throughout Massachusetts, the ongoing demographic shift toward an older population has required most cities and towns to reevaluate the adequacy of services and programs for older adults. By 2030, the vast majority of municipalities in Massachusetts will have unprecedented proportions of people age 60 or over

Aging in Boston: Preparing today for a growing tomorrow

Boston’s population is becoming older than ever before. The oldest Baby Boomer is approaching 70 and reinventing what it means to be a “senior citizen.” Waves of Boomers will forge a new path into later life, creating a population of seniors that is larger and more long-lived than previous cohorts, and diverse in new ways. In 2010, more than 14% of Boston’s residents were 60 years or older, representing 88,000 older people. By 2030, projected increases in the older population will result in as many as 130,000 seniors residing in Boston. How will Boston accommodate its growing older population? What steps may promote livability for Boston residents of all ages; where residents will want to, and can expect to, age in place with security, dignity, and well-being

Interactions between hymenopteran species associated with gall‐forming wasps : the Leptocybe invasa community as a case study

1. Leptocybe invasa is native to Australia and induces galls on various species of Eucalyptus. Two genetically distinct lineages of this wasp have been detected outside its native range, namely, Leptocybe Lineage A and Leptocybe Lineage B. 2. The parasitoid Selitrichodes neseri was released in South Africa as a biological control agent against L. invasa. Another parasitoid of L. invasa, Quadrastichus mendeli, as well as Megastigmus zebrinus (parasitoid) and Megastigmus pretorianensis (role unknown), have also been recorded emerging from L. invasa galls. The objective of this study was to investigate the interactions between the different hymenopterans associated with L. invasa galls in South Africa. 3. L. invasa galls were dissected and species‐specific primers and restriction enzymes were used to identify the larvae where interactions were noted. 4. S. neseri, Q. mendeli and M. zebrinus were confirmed to parasitize Leptocybe Lineage A, and S. neseri was confirmed to parasitize Leptocybe Lineage B. Furthermore, there were direct interactions between these parasitoids, where parasitoids were found parasitising each other. The gall forming experiment confirmed that M. pretorianensis is not a gall former, but other potential roles remain uncertain.Supporting Information: Table S1. Species specific primers and their annealing temperatures for the hymenopteran species associated with Leptocybe invasa galls and the expected fragment sizes amplified by each species‐specific primer for the region Cyt b. Table S2. The fragment sizes of digested Cyt b amplicons using the AseI restriction enzyme for Leptocybe invasa (A and B), Selitrichodes neseri, Megastigmus zebrinus, Megastigmus pretorianensis and Quadrastichus mendeli.https://onlinelibrary.wiley.com/journal/146195632021-10-13hj2021BiochemistryForestry and Agricultural Biotechnology Institute (FABI)GeneticsMicrobiology and Plant PathologyZoology and Entomolog

Dietary Microbes Modulate Transgenerational Cancer Risk

Environmental factors are suspected in the increase of obesity and cancer in industrialized countries but are poorly understood. Here, we used animal models to test how future generations may be affected by Westernized diets. We discover long-term consequences of grandmothers' in utero dietary exposures, leading to high rates of obesity and frequent cancers of lung and liver in two subsequent generations of mice. Transgenerational effects were transplantable using diet-associated bacteria communities alone. Consequently, feeding of beneficial microbes was sufficient to lower transgenerational risk for cancer and obesity regardless of diet history. Targeting microbes may be a highly effective population-based approach to lower risk for cancer.National Institutes of Health (U.S.) (RO1CA108854)National Institutes of Health (U.S.) (U01 CA164337)National Institutes of Health (U.S.) (P30-ES002109