A Review and Look Ahead at Criminalizing Pregnancy in the Name of State Interest in Fetal Life

Across the United States, and especially in communities that are highly policed and in places hostile to abortion, pregnant people are dying, suffering, being separated from their children and families, and going to jail and prison in purported service of the state interest in fetal life recognized in Roe v. Wade and expanded in Planned Parenthood of Pennsylvania v. Casey. This Article focuses on two common practices that cause these harms: criminalizing pregnant people and denying them medical decision-making authority. While these practices are not new, the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization is accelerating them. With abortion returned to the states without a U.S. constitutional floor, the state interest in fetal life can go largely unchecked with respect to all pregnant people, not just those who need abortions. In this Article, we look back at several cases from the 1990s and early 2000s involving denials of medical decision-making authority and criminalization of pregnant people for substance use during pregnancy. We also discuss contemporary instances of these phenomenon, focusing on Alabama’s Child Chemical Endangerment Act and 1997 Wisconsin Act 292, both of which are currently and fervently used to punish pregnant people for actual or suspected substance use and which fail entirely to advance fetal or parental well-being. Based on our survey of these past and present cases, we reflect on several legal arguments and strategies to demand and restore full personhood for pregnant people. We link pregnancy criminalization to legally cognizable animus, observing that hallmark features of such animus abound when substance use during pregnancy is criminalized. We link environmental injustice to pregnancy criminalization, observing that it is irrational to punish and jail people for “polluting” the micro-environment of the womb in service of an interest in fetal life when all people—particularly the most policed—are perniciously, macro-environmentally exposed to toxins that impact reproduction and pregnancy. We reiterate that informed consent to medical treatment is the bedrock guarantee of healthcare and bodily autonomy—and pregnancy demands rather than diminishes this guarantee—and that drug tests without consent that lead to law enforcement consequences violate both this and the Fourth Amendment. We also very briefly emphasize that mandatory reporting of suspected child abuse or neglect based on a positive drug test fails to protect anyone and that mandatory reporters can challenge this obligation where it frustrates core professional duties. Together, all of these threads intersect to show that criminalizing pregnancy and denying pregnant people medical decision-making authority is about the social control and exclusion that punishment accomplishes. The impulse to control and exclude surely varies intersectionally, corresponding to the expectations and stereotypes about parenting applicable to the punished person or community. But in the end, in every case, no fetal life, no parental life, no family life, and no constitutional right or medical objective is protected or furthered when pregnancy is criminalized and pregnant people are denied medical decision-making authority

Intranasal Inhalation of Oxytocin Improves Face Processing in Developmental Prosopagnosia

Developmental prosopagnosia (DP) is characterised by a severe, lifelong impairment in face recognition. Little work has attempted to improve face processing in these individuals, but intriguingly, recent evidence suggests oxytocin can improve face processing in both healthy participants and individuals with autism. This study examined whether oxytocin could also improve face processing in individuals with DP. Ten adults with the condition and 10 matched controls were tested using a randomized placebo-controlled double-blind within-subject experimental design (AB-BA). Each participant took part in two testing sessions where they inhaled 24IU of oxytocin or placebo spray and completed two face processing tests: one assessing face memory and the other face perception. Results showed main effects of both participant group and treatment condition in both face processing tests, but the two did not interact. Specifically, the performance of DP participants was significantly lower than control performance under both oxytocin and placebo conditions, but oxytocin improved processing to a similar extent in both groups

Clonal Hematopoiesis of Indeterminate Potential as a Novel Risk Factor for Donor-Derived Leukemia

Hematopoietic stem cell transplantation (HSCT) is a critical treatment modality for many hematological and non-hematological diseases that is being extended to treat older individuals. However, recent studies show that clonal hematopoiesis of indeterminate potential (CHIP), a common, asymptomatic condition characterized by the expansion of age-acquired somatic mutations in blood cell lineages, may be a risk factor for the development of donor-derived leukemia (DDL), unexplained cytopenias, and chronic graft-versus-host disease. CHIP may contribute to the pathogenesis of these significant transplant complications via various cell-autonomous and non-cell-autonomous mechanisms, and the clinical presentation of DDL may be broader than anticipated. A more comprehensive understanding of the contributions of CHIP to DDL may have important implications for the screening of donors and will improve the safety of HSCT. The objective of this review is to discuss studies linking DDL and CHIP and to explore potential mechanisms by which CHIP may contribute to DDL

Putative Mechanisms Underlying Cardiovascular Disease Associated with Clonal Hematopoiesis of Indeterminate Potential

Characterized by the expansion of somatic mutations in the hematopoietic lineages of aging individuals, clonal hematopoiesis of indeterminate potential (CHIP) is a common condition that increases the risk of developing hematological malignancies and cardiovascular disease (CVD). The presence of CHIP-associated mutations in hematopoietic stem and progenitor cells (HSPCs) suggests that these mutations may alter the functions of the diverse hematopoietic lineages, many of which influence the pathogenesis of CVD. Inflammation may be a potential pathogenic mechanism, linking both CVD and hematological malignancy. However, it remains unknown whether CHIP-associated CVD and hematological malignancy are features of a common disease spectrum. The contributions of CHIP-associated mutations to both CVD and hematological malignancy underscore the importance of stem cell biology in pathogenesis and treatment. This review discusses possible mechanisms underlying the contributions of multiple hematopoietic lineages to CHIP-associated CVD and the putative pathogenic links between CHIP-associated CVD and hematological malignancy

Use of Electronic Health Record Access and Audit Logs to Identify Physician Actions Following Noninterruptive Alert Opening: Descriptive Study

BACKGROUND: Electronic health record (EHR) access and audit logs record behaviors of providers as they navigate the EHR. These data can be used to better understand provider responses to EHR-based clinical decision support (CDS), shedding light on whether and why CDS is effective. OBJECTIVE: This study aimed to determine the feasibility of using EHR access and audit logs to track primary care physicians\u27 (PCPs\u27) opening of and response to noninterruptive alerts delivered to EHR InBaskets. METHODS: We conducted a descriptive study to assess the use of EHR log data to track provider behavior. We analyzed data recorded following opening of 799 noninterruptive alerts sent to 75 PCPs\u27 InBaskets through a prior randomized controlled trial. Three types of alerts highlighted new medication concerns for older patients\u27 posthospital discharge: information only (n=593), medication recommendations (n=37), and test recommendations (n=169). We sought log data to identify the person opening the alert and the timing and type of PCPs\u27 follow-up EHR actions (immediate vs by the end of the following day). We performed multivariate analyses examining associations between alert type, patient characteristics, provider characteristics, and contextual factors and likelihood of immediate or subsequent PCP action (general, medication-specific, or laboratory-specific actions). We describe challenges and strategies for log data use. RESULTS: We successfully identified the required data in EHR access and audit logs. More than three-quarters of alerts (78.5%, 627/799) were opened by the PCP to whom they were directed, allowing us to assess immediate PCP action; of these, 208 alerts were followed by immediate action. Expanding on our analyses to include alerts opened by staff or covering physicians, we found that an additional 330 of the 799 alerts demonstrated PCP action by the end of the following day. The remaining 261 alerts showed no PCP action. Compared to information-only alerts, the odds ratio (OR) of immediate action was 4.03 (95% CI 1.67-9.72) for medication-recommendation and 2.14 (95% CI 1.38-3.32) for test-recommendation alerts. Compared to information-only alerts, ORs of medication-specific action by end of the following day were significantly greater for medication recommendations (5.59; 95% CI 2.42-12.94) and test recommendations (1.71; 95% CI 1.09-2.68). We found a similar pattern for OR of laboratory-specific action. We encountered 2 main challenges: (1) Capturing a historical snapshot of EHR status (number of InBasket messages at time of alert delivery) required incorporation of data generated many months prior with longitudinal follow-up. (2) Accurately interpreting data elements required iterative work by a physician/data manager team taking action within the EHR and then examining audit logs to identify corresponding documentation. CONCLUSIONS: EHR log data could inform future efforts and provide valuable information during development and refinement of CDS interventions. To address challenges, use of these data should be planned before implementing an EHR-based study.

Investigating the Psychosocial Determinants of Physical Activity in Older Adults: A Qualitative Approach

Objective: Despite the benefits of physical activity (PA), only one-third of older adults meet the recommended levels. The present study focused on psychosocial determinants of PA following retirement. Social cognitive theory (SCT) was used to better understand pre- and post-retirement adults’ thoughts about PA, the reasons why some individuals are more active than others, and how PA is incorporated into daily life after retirement. Design: Seven focus groups of older adults (N = 37, M = 64, SD = 5.20; males = 20) representing a range of PA levels and retirement length participated in one of seven focus groups. Results: Aligned with SCT, self-efficacy beliefs along with perceptions about barriers and benefits of PA were among the major determinants of PA. Findings highlighted the importance of social support, positive outcome expectations and self-regulatory strategies as motivators. The lack of structure in retirement was a hindrance to incorporating PA into daily routine but, when incorporated, PA provided a sense of purpose in the lives of retired individuals. Conclusion: It is important to understand the meaning of retirement as a life transition and how it affects beliefs about PA to inform SCT-based health promotion interventions targeting individuals in retirement age

Heart Development, Coronary Vascularization and Ventricular Maturation in a Giant Danio (Devario malabaricus)

Giant danios (genus Devario), like zebrafish, are teleosts belonging to the danioninae subfamily of cyprinids. Adult giant danios are used in a variety of investigations aimed at understanding cellular and physiological processes, including heart regeneration. Despite their importance, little is known about development and growth in giant danios, or their cardiac and coronary vessels development. To address this scarcity of knowledge, we performed a systematic study of a giant danio (Devario malabaricus), focusing on its cardiac development, from the segmentation period to ten months post-fertilization. Using light and scanning electron microscopy, we documented that its cardiovascular development and maturation proceed along well defined dynamic and conserved morphogenic patterns. The overall size and cardiovascular expansion of this species was significantly impacted by environmental parameters such as rearing densities. The coronary vasculature began to emerge in the late larval stage. More importantly, we documented two possible loci of initiation of the coronary vasculature in this species, and compared the emergence of the coronaries to that of zebrafish and gourami. This is the first comprehensive study of the cardiac growth in a Devario species, and our findings serve as an important reference for further investigations of cardiac biology using this species

Teacher perspectives on language learning psychology

Research into the psychology of language learning has grown exponentially in the last decade, yet, teacher perspectives on the field have been surprisingly absent from this body of research. The present study was designed to address this gap. Drawing on a survey with 311 foreign language teachers working at different school levels in 3 European countries, and on individual, semi-structured interviews with 11 teachers, the study focuses on the psychological aspects of language learning which teachers felt were particularly important in their own settings. In particular, teachers’ beliefs, experiences and teaching strategies were explored. The data also revealed strong interconnections between language learning psychology constructs, differences across contexts, and a perceived link between learner and teacher psychology

Motivations and barriers to prosthesis users participation in physical activity, exercise and sport : a review of the literature

The UK will host the Paralympics in 2012 and the Commonwealth Games in 2014 showcasing the talents of elite athletes and aiming to inspire the population to become involved. However, low levels of physical activity (PA) are prevalent: only 40% of men and 28% of women meet the minimum UK recommendations. The limb absent population is no exception. To determine if people with limb amputations are participating in physical activity and sport; whether post-amputation activity levels match pre-amputation levels; and if there are motivations and barriers to participation. Study design: Literature review Five reviewers systematically search of peer reviewed and gray literature in seven bibliographic databases and the Cochrane Library. Results: Following rigorous elimination, 12 articles were finally included in the review and critically appraised. Four themes were identified: components, rehabilitation outcomes, body image and motivations and barriers to participation. People with limb absence are not participating in PA conducive to health benefits, and only a minority participate in exercise and sports. Participation following amputation does not mirror that of pre-amputation levels, and more barriers than motivations exist to adopting and maintaining a physically active lifestyle. This literature review aims to inform those involved in rehabilitation and ongoing care of those with limb absence about what motivates or precludes their participation in physical activity, exercise and sport. Such knowledge could be applied to improving health and well being in this population