727 research outputs found
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Estimating the proportion of Medicaid-eligible pregnant women in Louisiana who do not get abortions when Medicaid does not cover abortion.
BackgroundTo estimate the proportion of pregnant women in Louisiana who do not obtain abortions because Medicaid does not cover abortion.MethodsTwo hundred sixty nine women presenting at first prenatal visits in Southern Louisiana, 2015-2017, completed self-administered iPad surveys and structured interviews. Women reporting having considered abortion were asked whether Medicaid not paying for abortion was a reason they had not had an abortion. Using study data and published estimates of births, abortions, and Medicaid-covered births in Louisiana, we projected the proportion of Medicaid births that would instead be abortions if Medicaid covered abortion in Louisiana.Results28% considered abortion. Among women with Medicaid, 7.2% [95% CI 4.1-12.3] reported Medicaid not paying as a reason they did not have an abortion. Existing estimates suggest 10% of Louisiana pregnancies end in abortion. If Medicaid covered abortion, this would increase to 14% [95% CI 12, 16]. 29% [95% CI 19, 41] of Medicaid eligible pregnant women who would have an abortion with Medicaid coverage, instead give birth.ConclusionsFor a substantial proportion of pregnant women in Louisiana, the lack of Medicaid funding remains an insurmountable barrier to obtaining an abortion. Forty years after the Hyde Amendment was passed, lack of Medicaid funding for abortion continues to have substantial impacts on women's ability to obtain abortions
The associations of everyday and major discrimination exposure with violence and poor mental health outcomes during the COVID-19 pandemic
Research on discrimination and risks for violence and mental health issues under the pandemic is notably absent. We examined the relative effects of perceived everyday discrimination (e.g., poorer service, disrespectful treatment in a typical week) and major experiences of race-based discrimination (e.g., racial/ethnic discrimination in housing or employment at any point in the lifetime) on experiences of violence and the PHQ-4 assessment of symptoms of depression and anxiety under the pandemic. We analyzed state-representative cross-sectional survey data from California adults (NâŻ=âŻ2114) collected in March 2021. We conducted multivariate regression models adjusting for age, race/ethnicity, gender, sexual identity, income, and disability. One in four Californians (26.1%) experienced everyday discrimination in public spaces, due most often to race/ethnicity and gender. We found that everyday discrimination was significantly associated with past year physical violence (single form Adjusted Odds Ratio [AOR] 5.0, 95% CI 2.5â10.3; multiple forms AOR 2.6, 95% CI 1.1â5.8), past year sexual violence (multiple forms AOR 2.5, 95% CI 1.4â4.4), and mental health symptoms (e.g., severe symptoms, multiple forms AOR 3.3, 95% CI 1.6â6.7). Major experiences of race-based discrimination (reported by 10.0% of Californians) were associated with past year sexual violence (AOR 2.0, 95% CI 1.1â3.8) and severe mental health symptoms (AOR 2.7, 95% CI 1.2â6.2). Non-race-based major discrimination (reported by 23.9% of Californians) was also associated with violence and mental health outcomes Everyday discrimination, more than major experiences of discrimination, was associated with higher risk for violence and poor mental health outcomes during the pandemic. Non-race-based forms of major discrimination independently were also associated with these negative outcomes. Findings indicate that efforts to reduce and ultimately eliminate discrimination should be a focus of public health and COVID-19 rebuilding efforts
Assessing the impact of CHARM2, a family planning program on gender attitudes, intimate partner violence, reproductive coercion, and marital quality in India
Using a two-armed cluster randomised controlled trial, CHARM2 (Counselling Husbands to Achieve Reproductive health and Marital equity), a 5-session gender equity and family planning intervention for couples in rural India, showed an impact on family planning outcomes in primary trial analyses. This study examines its effects on gender-equitable attitudes, intimate partner violence, reproductive coercion, and marital quality. We used multilevel mixed-effects models to assess the intervention impact on each outcome. Both male (aIRR at 9 months: 0.64, C.I.: 0.45,0.90; aIRR at 18 months: 0.25, C.I.: 0.18,0.39) and female (aIRR at 9 months: 0.57, C.I.: 0.46,0.71; aIRR at 18 months: 0.38, C.I.: 0.23,0.61) intervention participants were less likely than corresponding control participants to endorse attitudes accepting physical IPV at 9- and 18-month follow-ups. Men in the intervention, compared to those in the control condition, reported more gender-equitable attitudes at 9- and 18 months (Ă at 9 months: 0.13, C.I.: 0.06,0.20; Ă at 18 months: 0.26, C.I.: 0.19,0.34) and higher marital quality at the 18-month follow-up (Ă: 0.03, C.I.: 0.01,0.05). However, we found no effects on womenâs experiences of IPV, reproductive coercion, or marital quality. CHARM2 shows promise in improving menâs and womenâs attitudes towards gender equality and male perceptions of marital quality. Still, IPV and reproductive coercion reductions may require more intensive programming than that provided within this 5-session model focused on family planning
A gender synchronized family planning intervention for married couples in rural India: study protocol for the CHARM2 cluster randomized controlled trial evaluation.
BackgroundPrior research from India demonstrates a need for family planning counseling that engages both women and men, offers complete family planning method mix, and focuses on gender equity and reduces marital sexual violence (MSV) to promote modern contraceptive use. Effectiveness of the three-session (two male-only sessions and one couple session) Counseling Husbands to Achieve Reproductive Health and Marital Equity (CHARM) intervention, which used male health providers to engage and counsel husbands on gender equity and family planning (GEâ+âFP), was demonstrated by increased pill and condom use and a reduction in MSV. However, the intervention had limited reach to women and was therefore unable to expand access to highly effective long acting reversible contraceptives such as the intrauterine device (IUD). We developed a second iteration of the intervention, CHARM2, which retains the three sessions from the original CHARM but adds female provider- delivered counseling to women and offers a broader array of contraceptives including IUDs. This protocol describes the evaluation of CHARM2 in rural Maharashtra.MethodsA two-arm cluster randomized controlled trial will evaluate CHARM2, a gender synchronized GEâ+âFP intervention. Eligible married couples (n =â1200) will be enrolled across 20 clusters in rural Maharashtra, India. Health providers will be gender-matched to deliver two GEâ+âFP sessions to the married couples in parallel, and then a final session will be delivered to the couple together. We will conduct surveys on demographics as well as GE and FP indicators at baseline, 9-month, and 18-month follow-ups with both men and women, and pregnancy tests at each time point from women. In-depth interviews will be conducted with a subsample of couples (n =â50) and providers (n =â20). We will conduct several implementation and monitoring activities for purposes of assuring fidelity to intervention design and quality of implementation, including recruitment and tracking logs, provider evaluation forms, session observation forms, and participant satisfaction surveys.DiscussionWe will complete the recruitment of participants and collection of baseline data by July 2019. Findings from this work will offer important insight for the expansion of the national family planning program and improving quality of care for India and family planning interventions globally.Trial registrationClinicalTrial.gov, NCT03514914
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Regulating working families in the European Union: a history of disjointed strategies
Families in market economies worldwide have long been confronted with the demands of participating in paid work and providing care for their dependent members. The social, economic and political contexts within which families do so differ from country to country but an increasing number of governments are being asked to engage, or better engage, with this important area of public policy. What seems like a relatively simple goal â to enable families to better balance care-giving and paid employment â has raised several difficulties and dilemmas for policy makers which have been approached in different ways. This paper aims to identify and critique the nature and development of the means by which legal engagement with work-family reconciliation has, historically, been framed in the European Union. In doing so, and with reference to specific cohorts of workers, we demonstrate how disjointed the strategies are in relation to working carers and argue that the EU is unlikely to provide the legal framework necessary to bring about effective change in this fundamentally important area of social policy
La polĂtica antidrogas: nuevos horizontes de cambio en el control de la oferta y la demanda
96 p.De acuerdo con la OrganizaciĂłn Mundial de la Salud (OMS, 1994) una sustancia o droga psicoactiva es aquella que, al ingerirse, afecta procesos mentales, como la cogniciĂłn o la memoria. El tĂ©rmino es asemejado generalmente con el de psicotrĂłpico y ambas expresiones refieren al grupo de sustancias, legales e ilegales, de interĂ©s para la polĂtica en materia de drogas. En general, la literatura refiere con el tĂ©rmino psicotrĂłpico, a medicamentos utilizados principalmente en el tratamiento de los trastornos mentales, como los ansiolĂticos, sedantes, antidepresivos, anti manĂacos y neurolĂ©pticos.
Bajo la categorĂa de sustancias psicotrĂłpicas se encuentran los estupefacientes, acepciĂłn utilizada para referirse a sustancias cuya acciĂłn sedante, analgĂ©sica, narcĂłtica y euforizante puede conducir al acostumbramiento y a la toxicomanĂa, por lo cual tienen un elevado potencial de abuso y / o dependencia psĂquica/fĂsica. Entre ellos, se cuentan los estimulantes -cocaĂna, cafeĂna, nicotina-, los alucinĂłgenos -Peyote y Psilocybes, los opiĂĄceos -morfina, heroĂna-, y los sedantes/hipnĂłticos -alcohol- (OMS, 1994).PrĂłlogo
IntroducciĂłn
CapĂtulo 1. El panorama global: evoluciĂłn reciente del fenĂłmeno del consumo de sustancias psicoactivas
CapĂtulo 2. La junta internacional de fiscalizaciĂłn de estupefacientes y la eficacia de la polĂtica antidrogas: el caso colombiano
CapĂtulo 3. Hacia nuevos horizontes del anĂĄlisis de polĂtica antidrogas
Conclusiones
BibliografĂ
LSST: from Science Drivers to Reference Design and Anticipated Data Products
(Abridged) We describe here the most ambitious survey currently planned in
the optical, the Large Synoptic Survey Telescope (LSST). A vast array of
science will be enabled by a single wide-deep-fast sky survey, and LSST will
have unique survey capability in the faint time domain. The LSST design is
driven by four main science themes: probing dark energy and dark matter, taking
an inventory of the Solar System, exploring the transient optical sky, and
mapping the Milky Way. LSST will be a wide-field ground-based system sited at
Cerro Pach\'{o}n in northern Chile. The telescope will have an 8.4 m (6.5 m
effective) primary mirror, a 9.6 deg field of view, and a 3.2 Gigapixel
camera. The standard observing sequence will consist of pairs of 15-second
exposures in a given field, with two such visits in each pointing in a given
night. With these repeats, the LSST system is capable of imaging about 10,000
square degrees of sky in a single filter in three nights. The typical 5
point-source depth in a single visit in will be (AB). The
project is in the construction phase and will begin regular survey operations
by 2022. The survey area will be contained within 30,000 deg with
, and will be imaged multiple times in six bands, ,
covering the wavelength range 320--1050 nm. About 90\% of the observing time
will be devoted to a deep-wide-fast survey mode which will uniformly observe a
18,000 deg region about 800 times (summed over all six bands) during the
anticipated 10 years of operations, and yield a coadded map to . The
remaining 10\% of the observing time will be allocated to projects such as a
Very Deep and Fast time domain survey. The goal is to make LSST data products,
including a relational database of about 32 trillion observations of 40 billion
objects, available to the public and scientists around the world.Comment: 57 pages, 32 color figures, version with high-resolution figures
available from https://www.lsst.org/overvie
The Global Burden of Disease Study 2010: Interpretation and Implications for the Neglected Tropical Diseases
This article analyzes the "Global Burden of Disease Study 2010" and examines the study's implications for neglected tropical diseases
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