"I Should Be Pregnant So Many Times By Now": Risk Perception, Numeracy, and Young Women's Contraceptive Use

Conception is probabilistic: any instance of sexual intercourse without contraception may lead to a pregnancy, but whether any one instance of sex results in pregnancy is a matter of chance. The underlying probability of conceiving is not easily inferred from either outcome, and judgments about risk require fairly sophisticated quantitative reasoning skills (numeracy) that many Americans adults do not have. Still, women’s deliberations about risk may be tremendously important for their subsequent behavior. In this dissertation, I consider the impact of risk perception and health numeracy on young women’s contraceptive use. I use data from the Relationship Dynamics & Social Life study, a longitudinal survey of women aged 18/19 living in a Michigan county. RDSL data include weekly measurement of sex, contraception, pregnancy desire, and pregnancies, and quarterly measurement of women’s estimates of their pregnancy risk. The first empirical chapter finds evidence of a reciprocal relationship between women’s pregnancy risk estimates and their actual experiences with sex, contraception, and pregnancy. I find that women’s pregnancy risk estimates tend to decrease over time. Women who avoid pregnancy despite having sex without contraception tend to revise their estimates of pregnancy risk downward; in turn, lower estimates of pregnancy risk predict sex without contraception in later weeks. The second empirical chapter examines a competing set of risk perceptions: women’s concerns about side effects and other long-term health consequences of hormonal contraception. Sex without contraception is more likely and more frequent among women expressing greater concerns about side effects. Side effect concerns predict less use of the contraceptive pill/patch/ring, intrauterine devices (IUDs), and contraceptive implants, and more reliance on non-hormonal methods such as condoms and withdrawal. The final empirical chapter considers whether low numeracy is related to ineffective contraceptive use. In this analysis, I categorize women as low, medium, or high numeracy based on the logical consistency of their answers to survey items about the risk of pregnancy. Numeracy is not associated with women’s sexual behavior, but it does predict contraceptive use among sexually active women. Lower numeracy is associated with a higher likelihood and higher frequency of sex without contraception, more gaps in contraceptive use, and more switches to less effective contraceptive methods. Lower numeracy women also have lower odds of using the pill/patch/ring, IUD, and implant versus condoms as their primary method of contraception. Collectively, these analyses demonstrate that misunderstandings about the risk and probabilistic nature of pregnancy, concerns about contraceptive side effects, and poor numeracy are barriers to effective contraceptive use among young women who wish to avoid or delay pregnancy.PHDSociologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttps://deepblue.lib.umich.edu/bitstream/2027.42/143977/1/ejela_1.pd

FP-11-05 Adoptive Parents in the U.S., 2007

Using the NSAP data, this Profile describes the parents of adopted children in the U.S

FP-11-06 Adoption Motivations Among U.S. Parents

Using the National Survey of Adoptive Parents (NSAP), this Family Profile describes the adoption motivations of approximately 1.8 million adopted children’s parents in the U.S

Contraceptive Desert? Black-White Differences in Characteristics of Nearby Pharmacies

Objectives: Race differences in contraceptive use and in geographic access to pharmacies are well established. We explore race differences in characteristics of nearby pharmacies that are likely to facilitate (or not) contraceptive purchase. Study design: We conducted analyses with two geocode-linked datasets: (1) the Relationship Dynamics and Social Life (RDSL) project, a study of a random sample of 1003 women ages 18-19 living in a county in Michigan in 2008-09; and (2) the Community Pharmacy Survey, which collected data on 82 pharmacies in the county in which the RDSL study was conducted. Results: Although young African-American women tend to live closer to pharmacies than their white counterparts (1.2 miles to the nearest pharmacy for African Americans vs. 2.1 miles for whites), those pharmacies tend to be independent pharmacies (59 vs. 16%) that are open fewer hours per week (64.6 vs. 77.8) and have fewer female pharmacists (17 vs. 50%), fewer patient brochures on contraception (2 vs. 5%), more difficult access to condoms (49% vs. 85% on the shelf instead of behind glass, behind the counter, or not available), and fewer self-check-out options (3 vs. 9%). More African-American than white women live near African-American pharmacists (8 vs. 3%). These race differences are regardless of poverty, measured by the receipt of public assistance. Conclusions: Relative to white women, African-American women may face a contraception desert, wherein they live nearer to pharmacies, but those pharmacies have characteristics that may impede the purchase of contraception

Integrating agriculture and health research for development: LCIRAH as an interdisciplinary programme to address a global challenge.

The multiple burdens of persistent undernutrition and micronutrient deficiencies, along with the rapidly growing rates of overweight, obesity, and associated chronic diseases, are major challenges globally. The role of agriculture and the food system in meeting these challenges is very poorly understood. Achieving food security and addressing malnutrition in all its forms, a Sustainable Development Goal, requires an understanding of how changing food systems affect health outcomes and the development of new tools to design and evaluate interventions. An interinstitutional programme to address this interdisciplinary research challenge is described. Over the past seven years, the Leverhulme Centre for Integrative Research on Agriculture and Health has built a portfolio of successful and innovative research, trained a new cadre of interdisciplinary researchers in “Agri‐Health,” and built an international research community with a particular focus on strengthening research capacity in low‐ and middle‐income countries. The evolution of this programme is described, and key factors contributing to its success are discussed that may be of general value in designing interdisciplinary research programmes directed at supporting global development goals

Fanny Copeland and the geographical imagination

Raised in Scotland, married and divorced in the English south, an adopted Slovene, Fanny Copeland (1872 – 1970) occupied the intersection of a number of complex spatial and temporal conjunctures. A Slavophile, she played a part in the formation of what subsequently became the Kingdom of Yugoslavia that emerged from the First World War. Living in Ljubljana, she facilitated the first ‘foreign visit’ (in 1932) of the newly formed Le Play Society (a precursor of the Institute of British Geographers) and guided its studies of Solčava (a then ‘remote’ Alpine valley system) which, led by Dudley Stamp and commended by Halford Mackinder, were subsequently hailed as a model for regional studies elsewhere. Arrested by the Gestapo and interned in Italy during the Second World War, she eventually returned to a socialist Yugoslavia, a celebrated figure. An accomplished musician, linguist, and mountaineer, she became an authority on (and populist for) the Julian Alps and was instrumental in the establishment of the Triglav National Park. Copeland’s role as participant observer (and protagonist) enriches our understanding of the particularities of her time and place and illuminates some inter-war relationships within G/geography, inside and outside the academy, suggesting their relative autonomy in the production of geographical knowledge

Increased Incidence of Choroid Plexus Carcinoma Due to the Germline TP53 R337H Mutation in Southern Brazil

International audienceBACKGROUND: Choroid plexus carcinomas (CPC) are rare tumors predominantly found in children. Given the high frequency of the germline R337H mutation in the TP53 gene in southern Brazil, we have evaluated the frequency of the R337H mutation in families with CPC in children. METHODOLOGY/PRINCIPAL FINDINGS: The present series included 29 patients that were admitted to the same institution from 1992 to 2010, including 22 children with CPC (0.08-13.6 years of age at diagnosis) and 7 children with papilloma of the choroid plexus (Pp; 0.5-9.8 years of age). Surgical resection was possible in 28 children. Blood and/or tumor DNA was extracted and analyzed using PCR-RFLP and results were confirmed by sequencing 240 bp of the TP53 exon 10. The patients, all parents, and some relatives submitted samples for blood DNA analysis. In addition, we have also examined the presence of the mutation in DNA from paraffin-embedded tumor samples to evaluate loss of heterozygosity. We found 63.3% (14/22) of the CPC patients positive for the germline R337H mutation; CPC samples were either heterozygous (n = 7), lost only the wild-type (n = 4), or only the R337H copy (n = 2). One CPC sample was not available. All Pp cases (7/7, 100%) were negative for R337H. Cure (>5 years survival free of disease) was observed in 18.1% of the CPC cases with the R337H mutation (2/11), 71.4% of the Pp (5/7), and 25% of CPC cases negative for the R337H mutation (2/8). Family history of cancer (with 2 or more cancer cases) was exclusively identified on the parental side segregating the R337H mutation, and 50% (7/14) of them were compatible with Li-Fraumeni-like syndrome. SIGNIFICANCE: Our results show for the first time that the R337H TP53 mutation is responsible for 63% of the CPC cases in children, suggesting a higher incidence of CPC in southern Brazil

The impact of the initial COVID-19 outbreak on young adults’ mental health: a longitudinal study of risk and resilience factors

Few studies assessing the effects of COVID-19 on mental health include prospective markers of risk and resilience necessary to understand and mitigate the combined impacts of the pandemic, lockdowns, and other societal responses. This population-based study of young adults includes individuals from the Neuroscience in Psychiatry Network (n = 2403) recruited from English primary care services and schools in 2012–2013 when aged 14–24. Participants were followed up three times thereafter, most recently during the initial outbreak of the COVID-19 outbreak when they were aged between 19 and 34. Repeated measures of psychological distress (K6) and mental wellbeing (SWEMWBS) were supplemented at the latest assessment by clinical measures of depression (PHQ-9) and anxiety (GAD-7). A total of 1000 participants, 42% of the original cohort, returned to take part in the COVID-19 follow-up; 737 completed all four assessments [mean age (SD), 25.6 (3.2) years; 65.4% female; 79.1% White]. Our findings show that the pandemic led to pronounced deviations from existing mental health-related trajectories compared to expected levels over approximately seven years. About three-in-ten young adults reported clinically significant depression (28.8%) or anxiety (27.6%) under current NHS guidelines; two-in-ten met clinical cut-offs for both. About 9% reported levels of psychological distress likely to be associated with serious functional impairments that substantially interfere with major life activities; an increase by 3% compared to pre-pandemic levels. Deviations from personal trajectories were not necessarily restricted to conventional risk factors; however, individuals with pre-existing health conditions suffered disproportionately during the initial outbreak of the COVID-19 pandemic. Resilience factors known to support mental health, particularly in response to adverse events, were at best mildly protective of individual psychological responses to the pandemic. Our findings underline the importance of monitoring the long-term effects of the ongoing pandemic on young adults’ mental health, an age group at particular risk for the emergence of psychopathologies. Our findings further suggest that maintaining access to mental health care services during future waves, or potential new pandemics, is particularly crucial for those with pre-existing health conditions. Even though resilience factors known to support mental health were only mildly protective during the initial outbreak of the COVID-19 pandemic, it remains to be seen whether these factors facilitate mental health in the long term