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Zia Y, Upadhyay U, Rhew I, Kimanthi S, Congo O, Onono M, Barnabas R, Mugo N, Bukusi EA, Harrington EK. Confirmatory Factor Analysis and Validation of the Sexual and Reproductive Empowerment Scale for Adolescents and Young Adults in Kenya. Stud Fam Plann 2024. [PMID: 38604945 DOI: 10.1111/sifp.12263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Understanding the levels of power that adolescent girls and young women exercise in their sexual and reproductive lives is imperative to inform interventions to help them meet their goals. We implemented an adapted version of the Sexual and Reproductive Health Empowerment (SRE) Scale for Adolescents and Young Adults among 500 adolescent girls and young women aged 15-20 in Kisumu, Kenya. We used confirmatory factor analysis (CFA) to assess factor structure, and logistic regression to examine construct validity through the relationship between empowerment scores and ability to mitigate risk of undesired pregnancy through consistent contraceptive use. Participants had a mean age of 17.5, and most were students (61 percent), were currently partnered (94 percent), and reported having sex in the past 3 months (70 percent). The final, 26-item CFA model had acceptable fit. All subscales had Cronbach's alpha scores >0.7, and all items had rotated factor loadings >0.5, indicating good internal consistency and robust factor-variable associations. The total SRE-Kenya (SRE-K) score was associated with increased odds of the consistent method used in the past three months (adjusted odds ratio: 1.98, 95 percent CI: 1.29-3.10). The SRE-K scale is a newly adapted and valid measure of sexual and reproductive empowerment specific to adolescent girls and young women in an East African setting.
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Comfort AB, Alvarez A, Goodman S, Upadhyay U, Mengesha B, Karlin J, Shokat M, Blum M, Harper CC. Provision of DMPA-SC for self-administration in different practice settings during the COVID-19 pandemic: Data from providers across the United States. Contraception 2024; 131:110360. [PMID: 38158075 PMCID: PMC11024673 DOI: 10.1016/j.contraception.2023.110360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES Depot medroxyprogesterone acetate-subcutaneous (DMPA-SC) can be prescribed through telemedicine and self-administered, but data about availability, particularly during the COVID-19 pandemic, are limited. This study assessed changes in the availability of DMPA-SC for self-administration during the pandemic. STUDY DESIGN This study used survey data from a convenience sample of US providers engaged in contraceptive care and participating in a Continuing Medical Education-accredited contraceptive training (April 2020-April 2022; n = 849). Providers were recruited from across 503 clinics, including primary care and family planning clinics, public health departments, college and school-based health centers, independent abortion care clinics, and outpatient clinics in hospital settings. Measures included the availability of DMPA-SC for self-administration before and during the pandemic and the use of telemedicine. We used Poisson regression models and cluster-robust errors by clinic, adjusting for region, time of survey, and clinic size, to assess clinic availability of DMPA-SC for self-administration by practice setting. RESULTS Compared to the prepandemic period (4%), the availability of DMPA-SC for self-administration increased significantly during the pandemic (14%) (adjusted prevalence ratios [aPR] 3.43, 95% CI [2.43-4.85]). During the pandemic, independent abortion clinics were more likely to offer DMPA-SC for self-administration compared to primary care clinics (aPR 2.44, 95% CI [1.10-5.41]). Clinics receiving Title X funds were also more likely to provide DMPA-SC for self-administration during the pandemic compared to other clinics (aPR 2.32, 95% CI [1.57-3.43]), and more likely to offer DMPA-SC for self-administration through telemedicine (aPR 2.35, 95% CI [1.52-3.63]). Compared to the early pandemic period (April-September 2022), telemedicine access to DMPA-SC for self-administration was highest during the later pandemic time period (October 2021-April 2022) (aPR 2.10, 95% CI [1.06-4.17]). CONCLUSIONS The availability of DMPA-SC for self-administration significantly increased during the pandemic with differences by practice setting and Title X funding. However, overall method availability remains persistently low. IMPLICATIONS Despite increased availability of DMPA-SC for self-administration among US contraceptive providers during the COVID-19 pandemic, there remains a need to train providers, educate patients, and remove barriers to ensure broader availability of this method across different practice settings.
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Affiliation(s)
- Alison B Comfort
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, CA, United States.
| | - Alejandra Alvarez
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, CA, United States
| | - Suzan Goodman
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, CA, United States
| | - Ushma Upadhyay
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, CA, United States
| | - Biftu Mengesha
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, CA, United States
| | - Jennifer Karlin
- Department of Family and Community Medicine, University of California Davis, Sacramento, CA, United States
| | - Mitra Shokat
- OHSU-PSU School of Public Health, Portland, OR, United States
| | - Maya Blum
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, CA, United States
| | - Cynthia C Harper
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, CA, United States
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Holt K, Challa S, Alitubeera P, Atuyambe L, Dehlendorf C, Galavotti C, Idiodi I, Jegede A, Omoluabi E, Waiswa P, Upadhyay U. Conceptualizing Contraceptive Agency: A Critical Step to Enable Human Rights-Based Family Planning Programs and Measurement. Glob Health Sci Pract 2024; 12:e2300299. [PMID: 38346841 PMCID: PMC10906552 DOI: 10.9745/ghsp-d-23-00299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 01/23/2024] [Indexed: 03/01/2024]
Abstract
We propose a detailed framework for contraceptive agency to serve as a rights-based guide for centering individuals’ ability to make and act on their own contraceptive choices, regardless of what those choices are, in program design and evaluation.
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Affiliation(s)
- Kelsey Holt
- University of California, San Francisco, San Francisco, CA, USA.
| | - Sneha Challa
- University of California, San Francisco, San Francisco, CA, USA
| | | | - Lynn Atuyambe
- Makerere University School of Public Health, Kampala, Uganda
| | | | | | | | | | | | - Peter Waiswa
- Makerere University School of Public Health, Kampala, Uganda
| | - Ushma Upadhyay
- University of California, San Francisco, San Francisco, CA, USA
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Raymond EG, Weaver MA, Shochet T, Grant M, Boyd K, Koenig LR, Upadhyay U. Clinical outcomes of medication abortion using misoprostol-only: A retrospective chart review at an abortion provider organization in the United States. Contraception 2023; 126:110109. [PMID: 37390948 DOI: 10.1016/j.contraception.2023.110109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 06/09/2023] [Accepted: 06/21/2023] [Indexed: 07/02/2023]
Abstract
OBJECTIVES This study aimed to evaluate the effectiveness and safety of medication abortion with misoprostol-only among patients treated by an abortion provider organization in the United States during the COVID-19 pandemic. STUDY DESIGN We abstracted data from patients receiving misoprostol-only for abortion from December 2020 to December 2021. Two regimens were used, both allowing three to four doses of misoprostol 800 mcg every 3 hours but differing in the recommended administration routes (vaginal, buccal, or sublingual). We estimated the proportions of patients who had complete abortion and ongoing pregnancy in the two regimen groups in complete case analyses and after imputing missing outcomes based on pretreatment characteristics. We also estimated maximum effectiveness, assuming that all patients without known treatment failures had complete abortions. We tabulated serious adverse events. RESULTS We ascertained abortion outcomes for 476 (52%) of the total 911 treated patients. Of the 476 patients, 389 (82%) had complete abortion confirmed by test or history, and 45 (9%) had ongoing pregnancies detected after the provision of treatment. These proportions did not differ significantly between the two regimen groups in adjusted complete case analyses (p > 0.44). The results of imputed analyses were similar. Of the total 911 patients, at most 90% (95% confidence interval 88%, 92%) had complete abortion, and at least 5% (95% confidence interval 4%, 7%) had ongoing pregnancy. Serious adverse events were reported in three patients (0.6% of 487 patients with data for this outcome). CONCLUSIONS Our analysis suggests that the misoprostol-only regimens studied were safe and effective for most patients. Due to high loss to follow-up, observations from patients contacted after treatment likely somewhat underestimate true effectiveness. IMPLICATIONS Medication abortion with misoprostol-only was safe and produced complete abortion in most patients with follow-up. If loss to follow-up is high, effectiveness observed by clinics may misestimate true treatment efficacy.
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Affiliation(s)
| | - Mark A Weaver
- Department of Mathematics and Statistics, Elon University, Elon, NC, United States.
| | - Tara Shochet
- Gynuity Health Projects, New York, NY, United States.
| | | | | | - Leah R Koenig
- Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Ushma Upadhyay
- Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California, San Francisco, San Francisco, CA, United States.
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Biggs A, Foster DG, Gould H, Kimport K, Ralph L, Roberts S, Rocca C, Sisson G, Upadhyay U, Woodruff K. Commentary: The Turnaway Study: A case of self-correction in science upended by political motivation and unvetted findings. Front Psychol 2022; 13:1003116. [DOI: 10.3389/fpsyg.2022.1003116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022] Open
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Upadhyay U, Raymond E, Koenig L, Coplon L, Ricci S, Kaneshiro B, Boraas C, Winikoff B. CLINICAL ORAL ABSTRACTS. Contraception 2021. [DOI: 10.1016/j.contraception.2021.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ralph L, Foster DG, Raifman S, Biggs MA, Samari G, Upadhyay U, Gerdts C, Grossman D. Prevalence of Self-Managed Abortion Among Women of Reproductive Age in the United States. JAMA Netw Open 2020; 3:e2029245. [PMID: 33337493 PMCID: PMC7749440 DOI: 10.1001/jamanetworkopen.2020.29245] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Increasing evidence indicates that people are attempting their own abortions outside the formal health care system. However, population-based estimates of experience with self-managed abortion (SMA) are lacking. OBJECTIVE To estimate the prevalence of SMA attempts among the general US population. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional survey study was fielded August 2 to 17, 2017 among English- and Spanish- speaking, self-identified female panel members from the GfK web-based KnowledgePanel. Women ages 18 to 49 years were approached to complete a 1-time survey. Data were analyzed from September 22, 2017, to March 26, 2020. MAIN OUTCOMES AND MEASURES SMA was defined as "some women may do something on their own to try to end a pregnancy without medical assistance. For example, they may get information from the internet, a friend, or family member about pills, medicine, or herbs they can take on their own, or they may do something else to try to end the pregnancy." SMA was assessed using the question, "Have you ever taken or used something on your own, without medical assistance, to try to end an unwanted pregnancy?" Participants reporting SMA were asked about methods used, reasons, and outcomes. Factors associated with SMA experience, including age, race/ethnicity, socioeconomic status, nativity, reproductive health history, and geography, were assessed. Projected lifetime SMA prevalence was estimated using discrete-time event history models, adjusting for abortion underreporting. RESULTS Among 14 151 participants invited to participate, 7022 women (49.6%) (mean [SE] age, 33.9 [9.0] years) agreed to participate. Among these, 57.4% (95% CI, 55.8%-59.0%) were non-Hispanic White, 20.2% (95% CI, 18.9%-21.5%) were Hispanic, and 13.3% (95% CI, 12.1%-14.5%) were non-Hispanic Black; and 15.1% (95% CI, 14.1%-16.3%) reported living at less than 100% federal poverty level (FPL). A total of 1.4% (95% CI, 1.0%-1.8%) of participants reported a history of attempting SMA while in the US. Projected lifetime prevalence of SMA adjusting for underreporting of abortion was 7.0% (95% CI, 5.5%-8.4%). In bivariable analyses, non-Hispanic Black (prevalence ratio [PR], 3.16; 95% CI, 1.48-6.75) and Hispanic women surveyed in English (PR, 3.74; 95% CI, 1.78-7.87) were more likely than non-Hispanic White women to have attempted SMA. Women living below 100% of the FPL were also more likely to have attempted SMA compared with those at 200% FPL or greater (PR, 3.43; 95% CI, 1.83-6.42). At most recent SMA attempt, 20.0% (95% CI, 10.9%-33.8%) of respondents used misoprostol, 29.2% (95% CI, 17.5%-44.5%) used another medication or drug, 38.4% (95% CI, 25.3%-53.4%) used herbs, and 19.8% (95% CI, 10.0%-35.5%) used physical methods. The most common reasons for SMA included that it seemed faster or easier (47.2% [95% CI, 33.0%-61.8%]) and the clinic was too expensive (25.2% [95% CI, 15.7%-37.7%]). Of all attempts, 27.8% (95% CI, 16.6%-42.7%) of respondents reported they were successful; the remainder reported they had subsequent facility-based abortions (33.6% [95% CI, 21.0%-49.0%]), continued the pregnancy (13.4% [95% CI, 7.4%-23.1%]), had a miscarriage (11.4% [95% CI, 4.2%-27.5%]), or were unsure (13.3% [95% CI, 6.8%-24.7%]). A total of 11.0% (95% CI, 5.5%-21.0%) of respondents reported a complication. CONCLUSIONS AND RELEVANCE This cross-sectional study found that approximately 7% of US women reported having attempted SMA in their lifetime, commonly with ineffective methods. These findings suggest that surveys of SMA experience among patients at abortion clinics may capture only one-third of SMA attempts. People's reasons for attempting SMA indicate that as abortion becomes more restricted, SMA may become more common.
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Affiliation(s)
- Lauren Ralph
- Advancing New Standards in Reproductive Health, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
| | - Diana G. Foster
- Advancing New Standards in Reproductive Health, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
| | - Sarah Raifman
- Advancing New Standards in Reproductive Health, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
| | - M. Antonia Biggs
- Advancing New Standards in Reproductive Health, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
| | - Goleen Samari
- Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, New York
| | - Ushma Upadhyay
- Advancing New Standards in Reproductive Health, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
| | - Caitlin Gerdts
- Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, New York
- Ibis Reproductive Health, Oakland, California
| | - Daniel Grossman
- Advancing New Standards in Reproductive Health, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
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Upadhyay U, McCook A, Bennett A, Cartwright A, Roberts S. P16 State abortion policies and ability to obtain an abortion. Contraception 2020. [DOI: 10.1016/j.contraception.2020.07.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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McCarthy MA, Upadhyay U, Ralph L, Biggs MA, Foster DG. The effect of receiving versus being denied an abortion on making and achieving aspirational 5-year life plans. BMJ Sex Reprod Health 2020; 46:177-183. [PMID: 32098771 DOI: 10.1136/bmjsrh-2019-200456] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/19/2019] [Accepted: 01/20/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Popular support for access to abortion and contraceptive services is often based on the idea that they will help women determine the trajectory of their life course. This study examined whether receiving versus being denied an abortion affects aspirational life goal setting and attainment 5 years later. METHODS We compared women who sought and were denied an abortion because they were 3 weeks beyond the gestational limit ('Parenting-Turnaways') to those who received an abortion in the first trimester ('First-Trimesters'); received an abortion within 2 weeks of the facility's gestational limit ('Near-Limits'); and sought an abortion, were turned away and received an abortion elsewhere or placed their baby for adoption ('Non-Parenting-Turnaways'). We used mixed effects logistic regression analyses to estimate the odds of setting an aspirational plan and to estimate the odds of both setting and achieving an aspirational 5-year plan. RESULTS At 1 week post abortion-seeking, 791 women reported 1864 5-year plans, most of which were aspirational (n=1692, 91%). Parenting-Turnaways had lower odds of setting an aspirational 5-year plan than Near-Limits (OR 0.36, 95% CI 0.18 to 0.73). There were no differences by group in achieving aspirational 5-year plans among those who had them. CONCLUSIONS Soon after abortion-seeking, women denied a wanted abortion were less optimistic about their long-term futures than women who received a wanted abortion. Abortion access can help women set positive long-term goals.
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Affiliation(s)
- Molly A McCarthy
- Department of Health Promotion, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Ushma Upadhyay
- University of California San Francisco (UCSF), San Francisco, California, USA
| | - Lauren Ralph
- University of California San Francisco (UCSF), San Francisco, California, USA
| | - M Antonia Biggs
- University of California San Francisco (UCSF), San Francisco, California, USA
| | - Diana Greene Foster
- Advancing New Standards in Reproductive Health (ANSIRH), UCSF, Oakland, California, USA
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Myers C, Jones R, Upadhyay U. Predicted changes in abortion access and incidence in a post-Roe world. Contraception 2019; 100:367-373. [PMID: 31376381 DOI: 10.1016/j.contraception.2019.07.139] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/16/2019] [Accepted: 07/18/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To examine changes in travel distance and abortion incidence if Roe v. Wade were reversed or if abortion were further restricted. STUDY DESIGN We used a national database of abortion facilities to calculate travel distances from the population centroids of United States counties to the nearest publicly-identifiable abortion facility. We then estimated these travel distances under two hypothetical post-Roe scenarios. In the first, abortion becomes illegal in eight states with preemptive "trigger bans." In the second, abortion becomes illegal in an additional 13 states classified as at high risk of outlawing abortions under most circumstances. Using previously-published estimates of the short-run causal effects of increases in travel distances on abortion rates in Texas, we estimate changes in abortion incidence under each scenario. RESULTS If Roe were reversed and all high-risk states banned abortion, 39% of the national population of women aged 15-44 would experience increases in travel distances ranging from less than 1 mile to 791 miles. If these women respond similarly to travel distances as Texas women, county-level abortion rates would fall by amounts ranging from less than 1% to more than 40%. Aggregating across all affected regions, the average resident is expected to experience a 249 mile increase in travel distance, and the abortion rate is predicted to fall by 32.8% (95% confidence interval 25.9-39.6%) in the year following a Roe reversal. CONCLUSION In the year following a reversal, increases in travel distances are predicted to prevent 93,546-143,561 women from accessing abortion care. IMPLICATIONS A reversal or weakening of Roe is likely to increase spatial disparities in abortion access. This could translate to a reduction in abortion rates and an increase in unwanted births and self-managed abortions.
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Affiliation(s)
- Caitlin Myers
- Middlebury College, Middlebury, VT; Guttmacher Institute, New York, NY; Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Oakland, CA.
| | - Rachel Jones
- Middlebury College, Middlebury, VT; Guttmacher Institute, New York, NY; Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Oakland, CA
| | - Ushma Upadhyay
- Middlebury College, Middlebury, VT; Guttmacher Institute, New York, NY; Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Oakland, CA
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Harris L, Rocca C, Upadhyay U, Dworkin S, Ndunyu L, Gitome S, Bukusi E, Newmann S. Reproductive autonomy and covert contraceptive use in Nyanza, Kenya. Contraception 2018. [DOI: 10.1016/j.contraception.2018.07.088] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Singh A, Pinto L, Martin C, Rutherford N, Ragunathan A, Upadhyay U, Kapoor P, McRae M, Siddiqui A, Cantelmi D, Heyland A, Wray G, Stone J. Rudiment resorption as a response to starvation during larval development in the sea urchin Strongylocentrotus droebachiensis. CAN J ZOOL 2018. [DOI: 10.1139/cjz-2017-0261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Phenotypic flexibility (reversible phenotypic change) enables organisms to couple internal, ontogenetic responses with external, environmental cues. Phenotypic flexibility also provides organisms with the capacity to buffer stereotypical internal, developmental processes from unpredictable external, ecological events. Echinoids exhibit dramatic phenotypic flexibility in response to variation in exogenous nutrient supplies. The extent to which echinoids display this flexibility has been explored incompletely and research hitherto has been conducted predominantly on larval structures and morphologies. We investigated experimentally the extent to which the primordial juvenile, the developing rudiment, can exhibit the first phase in phenotypic flexibility among individuals. We report for the first time on rudiment regression and complete resorption as a response to starvation during larval development in the sea urchin Strongylocentrotus droebachiensis (O.F. Müller, 1776) and identify a developmental “window of opportunity” within which this can occur. Based on our observations and previous suggestions, we speculate that sea urchin rudiments might provide means of buffering development during unfavorable conditions.
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Affiliation(s)
- A. Singh
- Department of Biology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - L. Pinto
- Department of Biology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - C. Martin
- Department of Biology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - N. Rutherford
- Department of Biology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - A. Ragunathan
- Department of Biology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - U. Upadhyay
- Department of Biology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - P. Kapoor
- Department of Biology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - M. McRae
- Department of Biology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - A. Siddiqui
- Department of Biology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - D. Cantelmi
- Department of Biology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - A. Heyland
- Department of Integrative Biology, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - G. Wray
- State University of New York, Stony Brook, NY 11794, USA
| | - J.R. Stone
- Department of Biology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
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Grossman D, Ralph L, Raifman S, Upadhyay U, Gerdts C, Biggs A, Foster DG. Lifetime prevalence of self-induced abortion among a nationally representative sample of U.S. women. Contraception 2018. [DOI: 10.1016/j.contraception.2018.03.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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McCarthy M, Upadhyay U, Biggs MA, Anthony R, Holl J, Roberts SCM. Predictors of timing of pregnancy discovery. Contraception 2018; 97:303-308. [DOI: 10.1016/j.contraception.2017.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 12/01/2017] [Accepted: 12/03/2017] [Indexed: 10/18/2022]
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Aztlan EA, Foster DG, Upadhyay U. Subsequent Unintended Pregnancy Among US Women Who Receive or Are Denied a Wanted Abortion. J Midwifery Womens Health 2018; 63:45-52. [PMID: 29377521 DOI: 10.1111/jmwh.12723] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 11/21/2017] [Accepted: 11/23/2017] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Seventeen percent of women in the United States experience more than one unintended pregnancy in their lifetimes. However, few studies examine how the resolution of unintended pregnancy, whether in birth or abortion, affects the likelihood of a subsequent unintended pregnancy. Our objective was to determine whether receiving or being denied a wanted abortion is associated with subsequent unintended pregnancy. METHODS The Turnaway Study, a 5-year, prospective cohort study, followed women who sought an abortion at one of 30 abortion facilities across the United States between 2008 and 2010. Secondary analysis of the Turnaway data analyzed the effects of various factors on time to subsequent unintended pregnancy. RESULTS By 5 years, the rate of unintended pregnancy was 42 per 100 women with no difference between those who received and those who were denied a wanted abortion. Women aged 35 to 46 years (vs those aged 20-24 years), women with a college degree (vs women who had completed high school or obtained a general education diploma), and foreign-born (vs native-born) women had a reduced rate of a subsequent unplanned pregnancy (adjusted hazard ratio [AHR], 0.30; 95% confidence interval [CI], 0.16-0.57; AHR, 0.54, 95% CI, 0.30-0.97; AHR, 0.44; 95% CI, 0.25-0.77, respectively). Higher parity and a history of depression were positively associated with a higher rate of subsequent unintended pregnancy. There was no difference in the outcomes of these unintended pregnancies by study group; approximately one-sixth ended in miscarriage and one-quarter of subsequent unintended pregnancies ended in abortion. DISCUSSION Neither receiving nor being denied abortion is associated with subsequent unintended pregnancy risk. Other factors such as nativity, parity, age, and mental health history are associated with multiple unintended pregnancies. Ensuring access to abortion services will not increase the likelihood that women will experience subsequent unintended pregnancies.
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Affiliation(s)
- Ndola Prata
- University of California Global Health Institute Women's Health, Gender, and Empowerment Center of Expertise, San Francisco, CA, USA. .,Department of Maternal and Child Health, UC Berkeley School of Public Health, 50 University Hall, Berkeley, CA, USA.
| | - Paula Tavrow
- University of California Global Health Institute Women's Health, Gender, and Empowerment Center of Expertise, San Francisco, CA, USA.,Department of Community Health Sciences, UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA, USA
| | - Ushma Upadhyay
- University of California Global Health Institute Women's Health, Gender, and Empowerment Center of Expertise, San Francisco, CA, USA.,Department of Obstetrics, Gynecology, & Reproductive Science, University of California, San Francisco School of Medicine, San Francisco, CA, USA
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Cartwright A, Karunaratne M, Barr-Walker J, Johns N, Upadhyay U. The long journey for an abortion: mapping cities and states with limited abortion access. Contraception 2017. [DOI: 10.1016/j.contraception.2017.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Upadhyay U, Johns N, Kerns J, Meckstroth K, Foster D. Distance traveled and source of care after abortion: evidence from the California state Medicaid program. Contraception 2016. [DOI: 10.1016/j.contraception.2016.07.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Kahn C, Upadhyay U, Stidham Hall K, Kolenic G, Zochowski M, Dalton V, Harris L. Reproductive autonomy: adapting a scale to account for religious influences on women’s contraceptive use. Contraception 2014. [DOI: 10.1016/j.contraception.2014.05.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Taylor D, Upadhyay U, Desai S, James E, AbiSamra R. Defining and tracking abortion complications: how do we do it, and why does that matter? Contraception 2014. [DOI: 10.1016/j.contraception.2014.05.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Upadhyay U. Development of a reproductive autonomy measure to predict contraceptive use. Contraception 2012. [DOI: 10.1016/j.contraception.2011.11.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Robey B, Upadhyay U. Speeding the reproductive revolution. People Planet 2002; 8:18-9. [PMID: 12322000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Canales JJ, Capper-Loup C, Hu D, Choe ES, Upadhyay U, Graybiel AM. Shifts in striatal responsivity evoked by chronic stimulation of dopamine and glutamate systems. Brain 2002; 125:2353-63. [PMID: 12244091 DOI: 10.1093/brain/awf239] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Dopamine and glutamate are key neurotransmitters in cortico-basal ganglia loops affecting motor and cognitive function. To examine functional convergence of dopamine and glutamate neurotransmitter systems in the basal ganglia, we evaluated the long-term effects of chronic stimulation of each of these systems on striatal responses to stimulation of the other. First we exposed rats to chronic intermittent cocaine and used early-gene assays to test the responsivity of the striatum to subsequent acute motor cortex stimulation by application of the GABA(A) (gamma-aminobutyric acid alpha subunit) receptor antagonist, picrotoxin. Reciprocally, we studied the effects of chronic intermittent motor cortex stimulation on the capacity for subsequent acute dopaminergic treatments to induce early-gene activation in the striatum. Prior treatment with chronic intermittent cocaine induced motor sensitization and significantly potentiated the striatal expression of Fos-family early genes in response to stimulation of the motor cortex. Contrary to this, chronic intermittent stimulation of the motor cortex down-regulated cocaine-induced gene expression in the striatum, but enhanced striatal gene expression induced by a full D1 receptor agonist (SKF 81297) and did not change the early-gene response elicited by a D2 receptor antagonist (haloperidol). These findings suggests that repeated dopaminergic stimulation produces long-term enhancement of corticostriatal signalling from the motor cortex, amplifying cortically evoked modulation of the basal ganglia. By contrast, persistent stimulation of the motor cortex inhibits cocaine-stimulated signalling in the striatum, but not signalling mediated by individual dopamine receptor sites, suggesting that chronic cortical hyperexcitability produces long-term impairment of dopaminergic activity and compensation at the receptor level. These findings prompt a model of the basal ganglia function as being regulated by opposing homeostatic dopamine-glutamate neurotransmitter interactions. The model provides a framework for analysing the neurological alterations associated with disorders of the basal ganglia and their treatment with pharmacotherapies affecting dopamine and glutamate neurotransmitter systems.
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Affiliation(s)
- J J Canales
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, 45 Carleton Street, Cambridge, MA 02139, USA
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