Bridging the Divide White Paper on Medication Abortion: Overview of Research & Policy in the United States

Medication abortion (also called medical abortion) is a safe method of abortion available for the past 15 years in the US. The Bridging the Divide white paper summarizes the scientific evidence related to the current medication abortion process and potential changes to the process that could make it even safer and more accessible for patients, as well as policy considerations and directions for future research. In the fall of 2000, the US Food & Drug Administration (FDA) approved the drug Mifeprex© (generic: mifepristone) for use in medication abortions. That approval included requirements that affect both patients and providers and that are far more specific than typical requirements for prescription drugs. The package insert (also known as the product label) indicated procedures for mifepristone prescribers to follow, based on the regimen used during the drug’s pre-approval clinical trials. FDA has not approved any other abortion drugs besides Mifeprex. Fifteen years later, in March 2016, the FDA approved an updated label for Mifeprex, marking an important step forward for access to abortion care and for evidence-based policy. Although the new label is progress toward policy that is informed and driven by scientific research, the change came many years after research data had demonstrated the safety and efficacy of widely used evidence-based protocols. In the intervening years, some states took advantage of the outdated requirements in the product label and implemented restrictive policy measures that prevented their residents from accessing care based on the latest evidence and best practice. The Bridging the Divide white paper on the current state of medication abortion evidence and policy can be found below, along with a shorter summary document for policy-makers and a recently published commentary from the journal Women’s Health Issues

The pleasure imperative? Reflecting on sexual pleasure’s inclusion in sex education and sexual health

This article offers an empirically grounded contribution to scholarship exploring the ways in which pleasure is ‘put to work’ in sex and sexuality education. Such research has cautioned against framing pleasure as a normative requirement of sexual activity and hence reproducing a ‘pleasure imperative’. This paper draws on interviews with sexual health and education practitioners who engaged with Pleasure Project resources and training between 2007 and 2016. Findings suggest that practitioners tend to understand pleasure within critical frameworks that allow them to avoid normalising and (re)enforcing a pleasure imperative. Accounts also show negotiations with, and strategic deployments of, values surrounding sexual pleasure in society and culture. While some accounts suggest that a pleasure imperative does run the risk of being reproduced by practitioners, notably this is when discussing more ‘contentious’ sexual practices. Interviews also demonstrate that practitioners attempting to implement a pleasure agenda are faced with a range of challenges. While some positive, holistic, and inclusive practice has been afforded by a pleasure approach, we argue that the importance of a critical framework needs to be (re)emphasised. The paper concludes by highlighting areas for further empirical research

Bridging the Divide White Paper: Long-Acting Reversible Contraception (LARC) in the United States

Long-acting reversible contraceptive (LARC) methods – specifically, intrauterine devices (IUDs) and subcutaneous hormone-releasing implants – demonstrate great potential in reducing unintended pregnancy. Although LARC methods have had a rocky history in the US and use rates have remained low here in comparison to other countries where the methods are available, there has been a significant increase in uptake of newer LARC products in recent years. Researchers have identified this change as a likely contributor to the declines seen in unintended pregnancy, abortion, and teen pregnancy rates. Decades of research have shown that current LARC methods are highly safe and effective, yet research has identified many barriers that may prevent a woman who chooses a LARC as the contraceptive method that best meets her needs and preferences from getting it. These include inadequate provider knowledge and training, lack of awareness and education among potential users, and financial and health system barriers. There are also, however, encouraging research findings from assessments of interventions designed to reduce these barriers. Despite the recent advances, some barriers to full, voluntary, and successful use of LARC methods remain but have the potential to be addressed through policy: implementation of insurance coverage for LARC insertion and removal, both under private plans and public programs, such as Medicaid; development of clinical performance measures for clinicians and/or health centers; and establishment of practices that ensure confidentiality and non-coercive provision of LARC methods, particularly for vulnerable populations

Children\u27s attitudes to a hospital familiarisation programme

Many young children are admitted to the emergency departments of our childrens hospitals without the opportunity to receive any preparation in terms of what to expect and what to do or not to do (Health Department of W A, 2000). Surrounded by strange people, environment, smells, sounds and medical equipment, and confronted with possibly painful and invasive procedures, many young children become stressed and anxious. Negative psychological effects may have immediate and/or long lasting psychological consequences (Zuckerberg, 1994; 0 Byrne, Peterson & Saldana, 1997). It is important to protect young childrens rights and to minimise upset and trauma whenever possible. To meet the needs of children who may experience unplanned hospitalisation, preventative measures have been taken by the Association for the Welfare of Children in Hospital (AWCH). One of these preventative measures is a Hospital Familiarisation Programme (HFP) designed to prepare healthy young children for possible hospitalisation. This study investigated the effect of the HFP on 5 years olds understanding of common items of medical equipment and procedures, using a Medical Equipment and Procedures Test (MEPT). In addition, their feelings towards possible hospitalisation and medical intervention were obtained by the use of a Hospital Intervention Footings Index (HIFI). A Solomon Four Group design (Salkind, 1997) was employed with a total sample of 84 five-year-olds drawn from 4 pre-primary centres in a large metropolitan \u27 primary school. The treatment consisted of a Hospital Familiarisation Session conducted by a presenter from the Association for the Welfare of Children iii Hospital, W.A. An analysis of variance revealed th8t there was a significant increase in the childrens understanding of medical equipment and procedures, as well as an increase in positive feelings towards medical intervention as a result of the Hospital Familiarisation Programme. On the basis of these results and from a review of the research literature and an analysis of developmental theories, some modifications to the presentation of the HFP were suggested to maximise its effectiveness. Further recommendations were also made for current practice and future research investigation

Osteogenic effects of simvastatin-loaded mesoporous titania thin films

The use of statins in the field of bone regeneration is under current investigation due to the existing demand for non-toxic anabolic agents capable of enhancing bone formation in cases of substantial loss. Simvastatin, a coenzyme currently prescribed in clinics to inhibit cholesterol biosynthesis, has been proven to promote osteogenic differentiation by stimulating bone formation and inhibiting osteoclasts activity. We present the loading of simvastatin in mesoporous TiO2 thin films toward combining the pro-osteogenic properties of this molecule with the demonstrated bioactivity of titania. TiO2 thin films processing and characterization were carried out, as well as evaluation of MC3T3-E1 pre-osteoblasts viability when directly incubated with different concentrations of simvastatin, followed by the analysis of osteogenic activity promoted by simvastatin upon loading in the thin films. The accessible porosity of 36% quantified on the 95 ± 5 nm thick mesoporous thin films, together with pore diameters of 5.5 nm, necks between pores of 2.8 nm and interpore distances of 12 ± 2 nm allow the loading of the simvastatin molecule, as confirmed by FTIR spectroscopy. Simvastatin was found to promote MC3T3-E1 pre-osteoblasts viability at concentrations ≤0.01 g l−1, with a cytotoxicity threshold of 0.05 g l−1. We additionally found that film loadings with 0.001 g l−1 simvastatin promotes statistically higher MC3T3-E1 pre-osteoblast proliferation whereas a higher concentration of 0.01 g l−1 leads to statistically higher osteogenic activity (ALP synthesis), after 21 days of incubation, as compared to unloaded films. These results demonstrate the potential of simvastatin local administration based on bioactive mesoporous thin films to promote pro-osteogenic properties. By focusing this strategy on the coating of metallic prostheses, the supply of simvastatin to the target tissue can be favored and risks of systemic side effects will be reduced while enhancing the osteointegration of the implants.Fil: Lopez Alvarez, Miriam. Universidad de Vigo; EspañaFil: López Puente, Vanesa. Universidad de Vigo; EspañaFil: Rodriguez Valencia, Cosme. Universidad de Vigo; EspañaFil: Angelome, Paula Cecilia. Comisión Nacional de Energía Atómica. Centro Atómico Constituyentes; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Liz Marzan, Luis M. Ikerbasque; EspañaFil: Serra, Julia. Universidad de Vigo; EspañaFil: Pastoriza Santos, Isabel. Universidad de Vigo; EspañaFil: Gonzalez, Pio. Universidad de Vigo; Españ

ANÁLISE DAS REAÇÕES QUÍMICAS A PARTIR DA UTILIZAÇÃO DE CATALISADORES

A utilização de catalisadores heterogêneos na indústria estás se tornando cada vez mais frequente para o desenvolvimento de novos processos químicos. Esses catalisadores possuem vantagens como: estabilidade, fácil regeneração, separação entre catalisador-produto, além de serem reutilizáveis, não corrosivos e melhoram o rendimento de vários processos, como por exemplo a produção de Biodiesel, tornando-se um aliado no combate à poluição ambiental. Um dos métodos mais utilizados de catalise heterogênea, é por meio de ácido-sólido, onde verificou maior eficiência nas reações aravés do aumento da velocidade de reação e pelo seu poder de reutilização sem perder sua atividade e seletividade. A catálise heterogênea geralmente envolve a etapa de adsorção dos reagentes nos locais de superfície menos coordenados, a ativação dos reagentes fixados e a recuperação dos sítios ativos da superfície. Portanto, toda e qualquer modificação realizada no catalisador afetaria substancialmente todo o processo. Tendo em vista os aspectos observados, muitos estudos vem ocorrendo para a diminuição de catalisadores homogêneos, principalmente aqueles que carregam ácidos minerais na sua composição, estes são muito utilizados na refinação de produtos químicos, o que leva a grande produção de resíduos e por consequência uma maior poluição do meio ambiente. Em contra partida, a principal característica dos catalisadores heterogêneos é a de que ele se encontra em estado físico diferente dos reagentes e produtos do sistema, sendo possível sua reciclagem

ATIVIDADE ANTIMICROBIANA E CITOTÓXICA DO ÁCIDO GÁLICO, RESVERATROL E QUERCETINA CONTRA BACTÉRIAS PROMOTORAS DA ACNE

A acne vulgar é uma dermatose inflamatória crônica nas glândulas sebáceas epiteliais. A principal promotora desta inflamação é a superprodução de sebo e alta concentração de tecidos mortos nos folículos pilosos (acne inflamatória), aumento na concentração de colônias de Propioniumbacterium acnes, Staphylococcus aureus e Staphylococcus epidermidis, causando erupções, inflamações periglandulares e queda da barreira imunológica da epiderme. Os métodos atuais de tratamento para a acne, seja por cremes ou antibióticos, apesar de eficazes se mostram muito agressivos, causando alergias, ressecamento, descamação e sensibilização da epiderme. Tendo em vista estes fatores, este estudo avaliou in vitro as propriedades citotóxicas e antimicrobianas dos antioxidantes ácido gálico, resveratrol e quercetina frente as bactérias promotoras da acne. Nos testes antimicrobianos por disco difusão algumas concentrações obtiveram grandes resultados, desta forma, conseguimos suplementar o assunto estudado, obtendo como base, testes positivos com o uso de flavonóides no combate contra as bactérias promotoras da acne.  Os antioxidantes apresentam diversas atividades interesantes como antiinflamatória, antineoplásica, cicatrizante, antifúngica e antiprotozoária. Apesar disso, estudos que avaliam a eficácia destes, contra as bactérias promotoras da acne ainda são escassos. Este trabalho permitiu descobrir novos usos para estes antioxidantes possibilitando estudos in vivo com o intuito de comprovar sua eficácia e introduzir terapia antioxidante no tratamento da acne vulgar