Improving abortion underreporting in the United States: a cognitive interview study

Background: Abortion is a difficult-to-measure behavior with extensive survey underreporting, which compromises the ability to study and monitor abortion. The purpose of this study was to improve our understanding of how women interpret and respond to survey items asking if they have ever had an abortion. Methods: We developed multiple new questions hypothesized to improve abortion reporting, using approaches that aim to clarify which experiences to report as an induced abortion; reduce the stigma and sensitivity of induced abortion; reduce the sense of intrusiveness of asking about abortion; and increase the motivation to report. We conducted cognitive interviews with cisgender women aged 18-49 in two US states (N=64) to iteratively assess these new approaches and questions for improving abortion reporting. Results: Our findings suggest that including abortion as part of a list of other sexual and reproductive health services, asking a yes/no question about lifetime experience of abortion instead of asking about number of abortions, and developing an improved introduction to abortion questions may help to elicit more accurate survey reports. Conclusions: Opportunities exist to improve survey measurement of abortion. Reducing underreporting of abortion in surveys has the potential to improve sexual and reproductive health research that relies on pregnancy histories.

Employee Conflicts Leading Towards Hostile Work Environment: A Case of Health Center

The communication style of an organization plays a significant role in achieving the goal. In the healthcare industry aspects of communication among co-workers and management play a very sensitive role. Nicobar health private limited (NHPL) (imaginary) is a large organization. This case study present issues on versions of the communication gap between higher authorities and subordinate employees that lead to traumatized lifetime experience of an employee within the organization while rendering her duties. The differences between two individuals (senior and subordinate) turned into workplace harassment. Communication barriers promoted harassment at workplace, therefore this case study tries to touch these issues and it will also provide suggestions for further improvement in employee communication with reference to a safe workplace.

COVID-19 Pandemic: Response by Department of Community Medicine in a Medical College of Mumbai, India

The role of community medicine in epidemiology and disease outbreaks is significant. Covid-19 pandemic was an opportunity to realize this potential.Here we present the role of Community Medicine department of a Medical College in Mumbai, which was a global hotspot for Covid -19. The responses were initiated in the first week of February, prior to the detection of the first case in the city. With the progression of the pandemic, the roles have changed and adapted accordingly. The activity of Community Medicine department is unique to this specialty and has provided a lifetime experience for its residents andfaculty.Our purpose here is to project the roles depicted in this model so that some of them can be followed by community medicine departments of other colleges and continued post-pandemic too.

The Edinburgh Lifetime Musical Experience Questionnaire (ELMEQ): Responses and non-musical correlates in the Lothian Birth Cohort 1936

There is growing evidence of the potential effects of musical training on the human brain, as well as increasing interest in the potential contribution of musical experience to healthy ageing. Conducting research on these topics with older adults requires a comprehensive assessment of musical experience across the lifespan, as well as an understanding of which variables might correlate with musical training and experience (such as personality traits or years of education). The present study introduces a short questionnaire for assessing lifetime musical training and experience in older populations: the Edinburgh Lifetime Musical Experience Questionnaire (ELMEQ). 420 participants from the Lothian Birth Cohort 1936 completed the ELMEQ at a mean age of 82 years. We used their responses to the ELMEQ to address three objectives: 1) to report the prevalence of lifetime musical experience in a sample of older adults; 2) to demonstrate how certain item-level responses can be used to model latent variables quantifying experience in different musical domains (playing a musical instrument, singing, self-reported musical ability, and music listening); and 3) to examine non-musical (lifespan) correlates of these domains. In this cohort, 420 of 431 participants (97%) completed the questionnaire. 40% of participants reported some lifetime experience of playing a musical instrument, starting at a median age of 10 years and playing for a median of 5 years. 38% of participants reported some lifetime experience of singing in a group. Non-musical variables of childhood environment, years of education, childhood cognitive ability, female sex, extraversion, history of arthritis and fewer constraints on activities of daily living were found to be associated, variously, with the domains of playing a musical instrument, singing, self-reported musical ability, and music listening. The ELMEQ was found to be an effective research tool with older adults and is made freely available for future research.

The Effect of Unsuccessful Past Repurchases on Future Repurchasing Decisions

We find that managers are less likely to repurchase stocks when they lose money on past stock repurchases but find no robust evidence that past gains on repurchases influence future repurchasing activity. This asymmetric sensitivity is strongest for young CEOs and those with the shortest tenure. Also, future repurchases are more sensitive to past repurchase losses for CEOs whose previous lifetime experience with the stock market is unfavorable. The sensitivity of future repurchases to past losses costs firms, on average, about 3.7% per year. When this cost is decomposed into systematic and idiosyncratic components, we find that nearly half (1.8%) comes from mistiming idiosyncratic shocks. Past losses on repurchases have a significant and negative impact on the CEO’s future bonus and increase the likelihood that future CEO termination is involuntary. We also find that negative outcomes from past repurchases encourage the subsequent use of dividends. Our findings suggest that outcomes of past repurchases have economically significant consequences through both nonbehavioral (career concerns) and behavioral (snakebite effect) factors. This paper was accepted by Tyler Shumway, finance.

Intimate partner violence and maternal health services utilization: evidence from 36 National Household Surveys

Background High rates of maternal mortality and intimate partner violence (IPV) are both major worldwide health challenges. Evidence from single-country samples suggests that IPV may be an important risk factor for low utilization of maternal health services, but there is little large-scale evidence on this association. This paper evaluates whether IPV is a risk factor for low utilization of maternal health services in a large cross-country sample, and also compiles evidence on the relative effects of different forms of IPV. Methods We analyze the association between intimate partner violence and utilization of maternal health care, using a dataset compiling all Demographic and Health Surveys that report data on intimate partner violence. Using data on 166,685 women observed in 36 countries between 2005 and 2016, we estimate logistic regression models to analyze the relationship between lifetime experience of IPV and utilization of antenatal care (ANC), facility delivery care, and postnatal care. We estimate both unadjusted models and models adjusted for geographic and sociodemographic characteristics that are generally correlated with utilization of maternal health care (including age, education, number of children, wealth status, marital status, and urbanity). Results Lifetime experience of any IPV is associated with decreased use of maternal health services in a broad sample of births observed in lower and middle-income countries: in particular, the utilization of four or more ANC visits, the number of ANC visits, and the utilization of facility care at birth. This association remains statistically significant even after adjusting for country of residence, subnational region of residence, and additional individual-level covariates; however, there is no statistically significant association between experience of any IPV and postnatal care. The only form of IPV significantly associated with care utilization is physical IPV. Conclusions Women experiencing physical intimate partner violence show lower levels of utilization of maternal health services in a large sample of developing and middle-income countries. Given that reduced utilization of maternal health services is correlated with maternal and neonatal health outcomes, this pattern suggests that IPV prevention may be an important component of interventions targeting enhanced maternal and neonatal health.

Physical activity is associated with lower cerebral beta-amyloid and cognitive function benefits from lifetime experience–a study in exceptional aging

Background Exceptional agers (85+ years) are characterized by preserved cognition presumably due to high cognitive reserve. In the current study, we examined whether personality, risk and protective factors for dementia as well as quality of life are associated with core features of Alzheimer’s disease (amyloid-deposition and hippocampal volume) as well as cognition in exceptional aging. Methods We studied 49 exceptional agers (average 87.8 years, range 84–94 years), with preserved activities of daily living and absence of dementia. All participants received a detailed clinical and neuropsychological examination. We used established questionnaires to measure lifetime experience, personality, recent physical and cognitive activity as well as quality of life. Cerebral amyloid-deposition was estimated by 18-[F]-Flutemetamol-PET and manual hippocampal volumetry was performed on 3D T1 MRI images. Results In this sample of exceptional agers with preserved activities of daily living, we found intact cognitive performance in the subjects with the highest amyloid-load in the brain, but a lower quality of life with respect to autonomy as well as higher neuroticism. Higher self-reported physical activity in the last twelve months went with a lower amyloid load. Higher self-reported leisure-time/ not work-related activity went with better executive functioning at older age. Conclusion Even in exceptional aging, high amyloid load may subtly influence personality and quality of life. Our findings support a close relationship between high physical activity and low amyloid-deposition and underscore the importance of extracurricular activities for executive functions. As executive functions are known to be a central resource for everyday functioning in fostering extracurricular activities may be effective in delaying the onset of dementia.

Psychotic Experiences and Hikikomori in a Nationally Representative Sample of Adult Community Residents in Japan: A Cross-Sectional Study

Psychotic experiences (PEs) may be associated with hikikomori. In the present study, we analyzed interview data from a community-based representative sample (N = 1,616) in Japan to know the association of PEs over a life time, as well as the two components, hallucinatory experiences (HEs) and delusional experiences (DEs), with lifetime experience of hikikomori (severe social withdrawal). Logistic regression analysis was used to estimate the association between any PE, any HE, and any DE; and hikikomori, adjusting for socio-demographics and other psychopathologies (mental disorder in the past 12 months or having autistic spectrum disorder trait). Any PE was significantly associated with hikikomori [odds ratio (OR) =3.44, 95% CI = 1.14–10.33] after adjustment for sociodemographic factors, although the association attenuated after adjusting for other psychopathologies. Any DE remained significantly associated with hikikomori, even after adjustment for all the covariates (OR = 10.50, 95% CI = 1.57–70.29). Any HE was not significantly associated with hikikomori. DEs may be associated with hikikomori. However, because the study sample was small and the temporal association between DEs and hikikomori was unclear, a future study is needed to examine a causal relationship between DEs and hikikomori.

Traumatic events and psychotic experiences: a nationally representative study in Thailand

Aims Most research exploring the link between traumatic events and psychotic experiences has focused on either Australia, Europe or North America. In this study, we expand the existing knowledge to Thailand and investigate the impact of the type and the number of traumatic events on psychotic experiences in Thailand. Methods We used data from the nationally representative 2013 Thai National Mental Health Survey (TNMHS), including questions on traumatic events and psychotic experiences. We regressed the lifetime experience of hallucinations or delusions against the following independent variables: the experience of any traumatic event during lifetime (dichotomous; hypothesis 1); the experience of either no traumatic event, one interpersonal, one unintentional or both interpersonal and unintentional traumatic events (categorical; hypothesis 2) and the number of traumatic events experienced during lifetime (categorical; hypothesis 3). We adjusted the regression models for sociodemographic indicators and psychiatric disorders, and considered survey weights. Results About 6% (95% confidence interval: 4.9–7.0) of the respondents stated that they had either hallucinatory or delusional experiences during their lifetime. The risk of reporting such experiences was more than doubled as high among respondents who had experienced at least one traumatic event during their lifetime than among those who had not yet experienced one, with higher risks for interpersonal or multiple traumatic events. Our results further indicated an increase in the risk of psychotic experiences as the number of traumatic events increased, with up to an eight-fold higher risk for people exposed to five or more traumatic events in their lifetime, compared to those with no traumatic events. Conclusions Individuals reporting interpersonal or multiple traumatic events face much higher risk of psychotic experiences. Effective and widely accessible secondary prevention programmes for people having experienced interpersonal or multiple traumatic events constitute a key intervention option.