Sexual and Reproductive Health Advocacy Successes, Failures, and Needs in the United States: Perspectives From Key Stakeholders.

Physician advocates for sexual and reproductive health (SRH) care have been active in the United States for decades. Despite such activism, access to SRH services has been fraught with persistent restrictions, particularly for abortion care. We sought the perspectives of key stakeholders on what makes for an effective SRH physician advocate and thoughts about the successes, failures, and needs of the abortion advocacy movement.

Stakeholder perspectives in New York State on reproductive health and pregnancy intention screening in primary care: A qualitative study.

Objective: To assess New York State stakeholders' perspectives regarding providing reproductive health services in primary care settings, including asking patients about pregnancy intentions and providing long-acting reversible contraception (LARC).

Study Design: We conducted semistructured key-informant interviews (n = 22) with stakeholders representing diverse sectors, including primary care (family medicine) and specialty (obstetrician/gynecologist) physicians, health educators/promoters, advocates, and public health/health care professionals. Grounded theory methodology informed sampling and thematic analysis within and across sectors.

Understanding community family medicine preceptors' involvement in educational scholarship: perceptions, influencing factors and promising areas for action.

Background: Residency training is increasingly occurring in community settings. The opportunity for community-based scholarship is untapped and substantial. We explored Community Family Medicine Preceptors' understanding of Educational Scholarship (ES), looked at barriers and enablers to ES, and identified opportunities to promote the growth of ES in this setting.

The association of pregnancy control, emotions, and beliefs with pregnancy desires: A new perspective on pregnancy intentions.

Context: Standard pregnancy intentions measures do not always align with how people approach pregnancy. Studies that have investigated beyond a binary framework found that those with "ambivalent" feelings towards pregnancy are less likely to use contraception consistently, but the reasons for this are unclear. We sought to gain a nuanced understanding of pregnancy desires, and how perceptions about pregnancy are associated with contraceptive use.

Effectively engaging physicians in system change.

What started as a prospective study to support clinical leaders and inform strategies to engage their peers in system change was impacted due to a rapidly evolving political agenda amid a pandemic, affecting both organizations and outcomes. Participants in this mixed methods study in one Local Health Integrated Network (LHIN) in Ontario included clinical leaders and community physicians over a period of 14 months. As the provincial government shifted regional healthcare governance from LHINs to Ontario Health Teams, there was an increase in the engagement of community physicians and leaders identified a noticeable culture shift with the potential to drive change.

Women's Perspectives on Reproductive Health Services in Primary Care.

Background And Objectives: Primary care providers (PCPs) are increasingly offering reproductive health (RH) services to help address patients' unmet contraceptive needs and improve pregnancy outcomes. We sought to understand patient perspectives on receipt of RH services in primary care settings.

Methods: We used a purposeful stratified sampling approach to recruit women aged 21 to 40 years into focus groups (FGs) and in-depth interviews (IDIs).

Primary care patients' preferences for reproductive health service needs assessment and service availability in New York Federally Qualified Health Centers.

Objectives: Expanding reproductive health services in primary care could increase access to preconception and contraceptive services. We assessed patients' preferences around wording, frequency and staffing for reproductive health service needs assessment and availability of a range of reproductive health services in primary care.

Study Design: We implemented a cross-sectional anonymous survey of adults in the waiting rooms of four Federally Qualified Health Centers (FQHCs) in New York State in 2017.

Physician perspectives on routine pregnancy intention screening and counseling in primary care.

Objectives: To assess factors associated with routine pregnancy intention screening by primary care physicians and their support for such an initiative.

Study Design: We conducted a cross-sectional survey study of 443 primary care physicians in New York State. We performed multivariable logistic regression analyses of physician support for routine pregnancy intention screening and implementation of screening in the last year.

Iodination of Dimethenamid in Chloraminated Water: Active Iodinating Agents and Distinctions between Chlorination, Bromination, and Iodination.

Few studies have elucidated the agent(s) that generate iodinated disinfection byproducts during drinking water treatment. We present a kinetic investigation of iodination of dimethenamid (DM), a model compound lacking acid-base speciation. Water chemistry parameters (pH, [Cl], [Br], [I], and [pH buffer]) were systematically varied.

Aqueous Chlorination Kinetics of Cyclic Alkenes-Is HOCl the Only Chlorinating Agent that Matters?

Although Cl and ClO have been recognized as highly reactive constituents of free available chlorine (FAC), robust rate constants for Cl and ClO remain scarce in the environmental literature. In this work, we explored the chlorination kinetics of three structurally related alkenes (α-ionone, β-ionone, and dehydro-β-ionone), a class of compounds whose reactivities with Cl and ClO have not been previously investigated. Second-order rate constants for Cl, ClO, and HOCl were computed from experimental rate constants obtained at various pH values, [Cl], and [FAC].

The Intersectionality of Racial and Gender Discrimination among Teens Exposed to Dating Violence.

Objective: Driven by intersectionality, a central tenet of Critical Race Theory, this study examines the combined associations of racial and gender discrimination, which are interlocking, macro-level social forces, and teen dating violence (TDV).

Design: Self-report surveys were administered via Audio Computer Assisted Self Interview (ACASI) equipment. Logistic regression models were used to estimate associations between racial and gender discrimination and TDV.

Development of a wellness trust to improve population health: Case-study of a United States urban center.

Across the United States health systems are recognizing the urgency of addressing the social determinants of health in order to improve population health. Wellness trusts, modeled after financial trusts support primary health prevention in community settings, provide an innovative opportunity for better community-clinical linkages, collaboration, and impact. This study aimed to understand the necessary tenets for a wellness trust in Brooklyn, New York (USA) and examined community interest and political will; administrative, financing, and leadership structures; and metrics and data sources to monitor and assess impact.

National evaluation of policies governing funding for wheelchairs and scooters in Canada: Évaluation nationale des politiques régissant le financement des fauteuils roulants, des triporteurs et des quadriporteurs au Canada.

Background: Wheelchairs, scooters, and related equipment are essential for the well-being of individuals with limited mobility and impact participation, health, and quality of life.

Purpose: Our objective was to identify and evaluate policies governing equipment funding for Canadian adults. We reviewed funding legislation and program documentation for adult Canadians (≥18 years of age) covered by their provincial, territorial, or federal health care plan.

National approaches to promote sports and physical activity in adults with disabilities: examples from the Netherlands and Canada.

Purpose: This study described how the Dutch and Canadian governments promote high performance sports, recreational sports, and physical activity (PA) among adults with disabilities on a national level.

Methods: An internet-based study was conducted to identify and select relevant documents and websites containing information about the national approach to promote disability sports and physical activities in the Netherlands and Canada.

Results: Both governments promote high performance sports in similar ways, but use different strategies to promote recreational sports and physical activities.

Chlorination Revisited: Does Cl Serve as a Catalyst in the Chlorination of Phenols?

The aqueous chlorination of (chloro)phenols is one of the best-studied reactions in the environmental literature. Previous researchers have attributed these reactions to two chlorine species: HOCl (at circum-neutral and high pH) and HOCl (at low pH). In this study, we seek to examine the roles that two largely overlooked chlorine species, Cl and ClO, may play in the chlorination of (chloro)phenols.

Reactivity of BrCl, Br₂, BrOCl, Br₂O, and HOBr toward dimethenamid in solutions of bromide + aqueous free chlorine.

HOBr, formed via oxidation of bromide by free available chlorine (FAC), is frequently assumed to be the sole species responsible for generating brominated disinfection byproducts (DBPs). Our studies reveal that BrCl, Br(2), BrOCl, and Br(2)O can also serve as brominating agents of the herbicide dimethenamid in solutions of bromide to which FAC was added. Conditions affecting bromine speciation (pH, total free bromine concentration ([HOBr](T)), [Cl(-)], and [FAC](o)) were systematically varied, and rates of dimethenamid bromination were measured.

Determination of pharmaceuticals and antiseptics in water by solid-phase extraction and gas chromatography/mass spectrometry: analysis via pentafluorobenzylation and stable isotope dilution.

A sensitive yet robust analytical method is presented for the simultaneous determination of 12 human pharmaceuticals (valproic acid, phenytoin, ibuprofen, gabapentin, acetaminophen, gemfibrozil, naproxen, ketoprofen, secobarbital, phenobarbital, 5-fluorouracil, and diclofenac) and 6 antiseptics (biosol, biphenylol, p-chloro-m-cresol, p-chloro-m-xylenol, chlorophene, and triclosan). The method employs solid-phase extraction (SPE) followed by a novel pentafluorobenzylation using a mixture of acetontrile/water (1/1, v/v). The method is simple to perform (derivatization can be completed in a single test tube) and eliminates the need for any solvent/SPE cartridge drying or blow-down.

Abiotic reduction reactions of dichloroacetamide safeners: transformations of "inert" agrochemical constituents.

Safeners are so-called "inert" constituents of herbicide formulations added to protect crops from the toxic effects of herbicides. We examined the reactivity of three dichloroacetamide safeners and 12 structural analogues [all neutral compounds of the form Cl(2)CXC(═O)NRR'; X = H, Cl; R-groups include alkyl, branched alkyl, n-allyl, and cyclic moieties] in one homogeneous and two heterogeneous reductant systems: solutions of Cr(H(2)O)(6)(2+), suspensions of Fe(II)-amended goethite, and suspensions of Fe(II)-amended hematite. Analyses of reaction products indicate each safener can undergo stepwise hydrogenolysis (replacement of chlorine by hydrogen) in each system at near-neutral pH.

Assessing the reactivity of free chlorine constituents Cl₂, Cl₂O, and HOCl toward aromatic ethers.

Cl(2) and Cl(2)O are highly reactive electrophiles capable of influencing rates of disinfection byproduct (DBP) precursor chlorination in solutions of free available chlorine (FAC). The current work examines how organic compound structure influences susceptibility toward chlorination by Cl(2) and Cl(2)O relative to the more abundant (but less reactive) electrophile HOCl. Chlorination rates and products were determined for three aromatic ethers, whose reactivities with FAC increased in the order: 3-methylanisole <1,3-dimethoxybenzene <1,3,5-trimethoxybenzene.

Achievement of personalized pain goal in cancer patients referred to a supportive care clinic at a comprehensive cancer center.

Background: Cancer pain initiatives recommend using the personalized pain goal to tailor pain management. This study was conducted to examine the feasibility and stability of personalized pain goal, and how it compares to the clinical pain response criteria.

Methods: Records of 465 consecutive cancer patients seen in consultation at the Supportive Care Clinic were reviewed.