Publications by authors named "Ralph L"

Importance: Since Dobbs v Jackson Women's Health Organization (Dobbs) removed federal abortion protections, people's views about alternative models of abortion care may have been impacted, yet research on this topic is limited.

Objective: To examine changes in national support for and personal interest in advance provision (AP) and over-the-counter (OTC) access to medication abortion.

Design, Setting, And Participants: Two nationally representative cross-sectional online surveys were administered to a market research firm's panel members who were assigned female at birth (AFAB) and aged 15 to 49 years from December 2021 to January 2022 (before Dobbs) and June to July 2023 (after Dobbs).

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Background: With increasingly restricted access to facility-based abortion in the United States, pregnant people are increasingly relying on models of care that utilize history-based or no-test approaches to eligibility assessment. Minimal research has examined the accuracy of abortion patients' self-assessment of eligibility for medication abortion using their health history, a necessary step towards ensuring optimal access to history-based or no-test models, as well as potential over-the-counter access.

Objective: To examine the accuracy of pregnant people's eligibility for medication abortion determined using their self-reported health history as compared to clinician assessment with ultrasound and other tests.

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Objective: Opt-out screening for blood-borne viruses (BBVs) in emergency departments (EDs) has been established in areas with a high prevalence of HIV diagnoses in England. This multi-site study explored the attitudes of healthcare workers (HCWs) towards BBV screening in EDs post-implementation.

Design: This was a cross-sectional electronic survey of HCWs.

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Importance: Most US individuals who access abortion care pay out of pocket due to insurance coverage restrictions on abortion. More research is needed on the financial and psychological burdens of abortion seeking, particularly for those traveling across state lines for care.

Objectives: To estimate the proportion of patients seeking abortion who incur abortion-related catastrophic health expenditures (CHEs), assess whether CHE differs between those seeking care in state vs out of state, and examine the association of CHE with mental health symptoms.

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Purpose: Significant methodological shortcomings limit the validity of prior research on pregnancy decision-making and the effects of 'unintended' pregnancies on people's health and well-being. The Attitudes and Decisions After Pregnancy Testing (ADAPT) study investigates the consequences for individuals unable to attain their pregnancy and childbearing preferences using an innovative nested prospective cohort design and novel conceptualisation and measurement of pregnancy preferences.

Participants: This paper describes the characteristics of the ADAPT Study Cohort, comprised of 2015 individuals aged 15-34 years, assigned female at birth, recruited between 2019 and 2022 from 23 health facilities in the southwestern USA.

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Objective: To assess the prevalence of ever considering self-managing an abortion (SMA) and its associations with experiences of medical mistrust and mistreatment in a nationally representative sample.

Study Design: In 2021-22, we conducted a national, cross-sectional, online probability-based survey of US people assigned female at birth ages 15-49. Among those who had ever been pregnant, we ran weighted multivariable logistic regressions to examine whether having had difficulty trusting medical providers and/or experiencing medical mistreatment was associated with SMA consideration.

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Importance: With decreasing access to facility-based abortion in the US, an increase in self-managed abortion (SMA) using various methods is anticipated. To date, no studies have examined changes in SMA in the shifting policy landscape.

Objective: To estimate changes in SMA prevalence among the general US population from before to after the Supreme Court's June 2022 decision overturning federal abortion protections.

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Background: High-Intensity Multimodal Training (HIMT) refers to all styles of high-intensity combined aerobic, resistance and/or bodyweight exercise. Previous heterogeneity in exercise prescription and reporting in HIMT reduces the understanding of which factors should be considered when prescribing HIMT (e.g.

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Importance: In the US, access to medication abortion using history-based (no-test) eligibility assessment, including through telehealth and mailing of mifepristone, has grown rapidly. Additional evidence on the effectiveness and safety of these models is needed.

Objective: To evaluate whether medication abortion with no-test eligibility assessment and mailing of medications is as effective as in-person care with ultrasonography and safe overall.

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Whole virus-based inactivated SARS-CoV-2 vaccines adjuvanted with aluminum hydroxide have been critical to the COVID-19 pandemic response. Although these vaccines are protective against homologous coronavirus infection, the emergence of novel variants and the presence of large zoonotic reservoirs harboring novel heterologous coronaviruses provide significant opportunities for vaccine breakthrough, which raises the risk of adverse outcomes like vaccine-associated enhanced respiratory disease. Here, we use a female mouse model of coronavirus disease to evaluate inactivated vaccine performance against either homologous challenge with SARS-CoV-2 or heterologous challenge with a bat-derived coronavirus that represents a potential emerging disease threat.

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Objectives: Identify factors associated with presenting for abortion after 10 weeks' gestation in a large, geographically diverse sample.

Study Design: From October 2019 to March 2020, we surveyed 1089 patients seeking abortion at seven U.S.

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Objectives: The delays and challenges people encounter when seeking abortion are well-documented, but their psychological implications are understudied. Aiming to fill this gap, we explored the associations between experiences of delay-causing obstacles to abortion care and adverse mental health symptoms among individuals seeking abortion care.

Study Design: In 2019, we surveyed 784 people (of 1092 approached) ages 15-45 accessing abortion care in four clinics in abortion-supportive states: California, Illinois, and New Mexico.

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Objective: Pembrolizumab plus lenvatinib was recently approved for the treatment of advanced or recurrent endometrial carcinoma in women with disease progression on or following prior treatment with a platinum‑containing therapy in any setting, and who are not candidates for curative surgery or radiation (KEYNOTE-775/Study-309; NCT03517449). The objective was to assess the cost effectiveness of pembrolizumab plus lenvatinib compared with chemotherapy from a Swedish healthcare perspective.

Materials And Methods: A lifetime partitioned-survival model with three health states (progression free, progressed disease, death) was constructed.

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The modulation of synaptic efficacy by group I metabotropic glutamate receptors is dysregulated in several neurodevelopmental and neurodegenerative disorders impacting cognitive function. The progression and severity of these and other disorders are affected by biological sex, and differences in metabotropic glutamate receptor signalling have been implicated in this effect. In this study, we have examined whether there are any sex-dependent differences in a form of long-term depression of synaptic responses that is triggered by application of the group I metabotropic glutamate receptor agonist 3,5-dihydroxyphenylglycine (DHPG).

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Objective: Since the U.S. Supreme Court eliminated the federal right to abortion, there is a heightened need to understand public opinion about the criminalization of people who attempt to end their pregnancies outside the formal healthcare setting, referred to as self-managed abortion (SMA).

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Importance: People with disabilities face inequitable access to reproductive health (RH) services, yet the national prevalence of barriers to access experienced across disability types and statuses is unknown.

Objective: To assess the national prevalence of barriers to RH access experienced by people with disabilities.

Design, Setting, And Participants: This cross-sectional study analyzed results of an online probability-based national survey of RH experiences that was conducted from December 2021 to January 2022.

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Inactivated whole virus SARS-CoV-2 vaccines adjuvanted with aluminum hydroxide (Alum) are among the most widely used COVID-19 vaccines globally and have been critical to the COVID-19 pandemic response. Although these vaccines are protective against homologous virus infection in healthy recipients, the emergence of novel SARS-CoV-2 variants and the presence of large zoonotic reservoirs provide significant opportunities for vaccine breakthrough, which raises the risk of adverse outcomes including vaccine-associated enhanced respiratory disease (VAERD). To evaluate this possibility, we tested the performance of an inactivated SARS-CoV-2 vaccine (iCoV2) in combination with Alum against either homologous or heterologous coronavirus challenge in a mouse model of coronavirus-induced pulmonary disease.

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Article Synopsis
  • - Canada has concerningly high rates of trauma for mothers and newborns during operative vaginal deliveries, which are procedures like forceps or vacuum assistance during childbirth.
  • - There is a pressing need for greater awareness and transparency about these issues in healthcare settings to ensure that both patients and providers understand the risks involved.
  • - Immediate action is necessary to improve practices and protocols around operative vaginal delivery to reduce the trauma experienced by mothers and their infants.
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Background: Pulmonary exposure to multi-walled carbon nanotubes (MWCNTs) has been reported to exert strong pro-inflammatory and pro-fibrotic adjuvant effects in mouse models of allergic lung disease. However, the molecular mechanisms through which MWCNTs exacerbate allergen-induced lung disease remain to be elucidated. We hypothesized that protease-activated receptor 2 (PAR2), a G-protein coupled receptor previously implicated in the pathogenesis of various diseases including pulmonary fibrosis and asthma, may play an important role in the exacerbation of house dust mite (HDM) allergen-induced lung disease by MWCNTs.

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Objectives: Assess public awareness of medication abortion in the U.S.

Study Design: We conducted a cross-sectional survey in 2021-2022 with a probability-based sample, calculating the prevalence of medication abortion awareness and assessing its associations with participant characteristics using multivariable logistic regression.

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Importance: Previous research has documented individual-level barriers to reproductive health services, but few studies have examined national trends.

Objective: To determine whether the number and type of barriers to reproductive health care experienced by US women of reproductive age changed from 2017 to 2021.

Design, Setting, And Participants: This cross-sectional study used serial survey data, weighted to be nationally representative, collected in August 2017 and December 2021 from members of Ipsos's KnowledgePanel who were aged 18 to 49 years and assigned female at birth.

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This study evaluates the cost-effectiveness of imipenem/cilastatin/relebactam (IMI/REL) for treating hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia (HABP/VABP) in an 'early adjustment prescribing scenario'. An economic model was constructed to compare two strategies: continuation of empiric piperacillin/tazobactam (PIP/TAZ) versus early adjustment to IMI/REL. A decision tree was used to depict the hospitalization period, and a Markov model used to capture long-term outcomes.

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Background: Abortion stigma likely affects the terminology abortion patients, providers and the public use or avoid using to refer to abortion care. Knowing the terminology people seeking abortion prefer could help inform the language used in clinical interactions and improve patients' experiences with abortion care. However, research in the U.

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