There's an App for That: Exploring the Market for Contraceptive Fertility Tracking Apps in the Philippines.

For generations, women have relied on fertility awareness methods to plan and prevent pregnancy, for over a decade, many have been aided by digital tools to do so. New contraceptive fertility tracking apps (CFTAs)-that are backed by clinical efficacy trials to support their effectiveness as contraception-have the potential to enhance method choice and offer users a unique contraceptive option, but there is little evidence to inform the decisions around expanding access, particularly in low-and middle-income countries. We conducted a mixed methods study with quantitative online surveys (n = 1600) and qualitative interviews (n = 36) to explore the potential appeal of and demand for a hypothetical CFTA in one such market, the Philippines. Interest in using a CFTA was high among our Internet-engaged, urban study population, with 83.9% "definitely" or "probably" interested in using it. Across demographic profiles, respondents perceived the appeal of the method as "natural" and "convenient." A majority were willing to pay for the method, though notably at a price (5.20 USD) below that of currently available CFTAs. We discuss various important factors to be considered before bringing a method like this to new markets, including the potential implications of equity constraints in reaching a wider market and the unexpected prevalence of other period-tracking apps not intended as contraception being used in this market that could complicate any future roll-out. These issues could be explored further with additional research.

Early childhood memories of individuals convicted of sexual offences.

This study used innovative transdisciplinary methods to describe the nature and extent of early childhood memories recalled by 84 adults convicted of sexual offences. The timing of the memories, level of detail recalled and way memories were recollected were largely consistent with extant memory research. One important finding, however, was that more than 30% of our participants recalled particularly traumatic and distressing childhood experiences - a much higher proportion than previously observed in nonoffending samples. The extent to which these memories laid the foundation for subsequent emotional content and feature in the evolution of cognitive schemata is not yet well understood. With that in mind, we consider the implications of our findings for the event centrality in self-narratives. We recommend the inclusion of treatment modalities that maximise as yet unrecognised and undervalued narrative inclinations and story-telling abilities of a complicated population of individuals with rich lived experience that stands to benefit greatly from such approaches.

Acceptability of physical activity signposting for pre-frail older adults: a qualitative study to inform intervention development.

Frailty is a medical condition common in older adults characterised by diminished strength and reduced physiologic function in which individuals are more vulnerable to multiple adverse health outcomes. Pre-frailty is an intermediate stage associated with some minor health outcomes. However, the main risk is progression toward moderate/severe frailty. Evidence shows physical activity interventions to be effective in slowing or modifying the progression of frailty. Researchers at the University of Manchester are developing a behaviour change intervention targeting pre-frail older adults, signposting them to group-based physical activity classes known to be effective for delaying/slowing frailty. This paper reports on the initial intervention development work with key stakeholders exploring the practicality of taking forward this intervention and identifying uncertainties to be explored in the feasibility stage. These included issues around physical activity messaging, the use of the term 'frail', identification/recruitment of pre-frail older adults, and the acceptability of behaviour change techniques. There was overwhelming support for a proactive approach to addressing pre-frailty issues. Given that a large proportion of older adults are estimated to be pre-frail, interventions aimed at this group have the potential to support healthy ageing, positively impacting on frailty outcomes and providing wider population health benefits.

The Ripple Effects of Post-Conviction Traumatic Stress in People Required to Register as Sex Offenders and their Families.

Post-Conviction Traumatic Stress (PCTS) describes the cognitive, psychological, and physiological symptoms of trauma that result from a range of experiences with the criminal justice system. This pilot study aimed to empirically validate the construct of PCTS utilizing the Post-Traumatic Checklist (PCL-5), an existing measure of Post-Traumatic Stress Disorder (PTSD) according to DSM-5 diagnostic criteria. Using mixed methods, the survey asked about the traumagenic impact of arrests, court proceedings, incarceration, probation/parole supervision, and sex offender registration requirements in a sample of people required to register as sexual offenders (RSOs; n = 290) and their family members (n = 126). The PCL-5 was used to estimate the prevalence of PTSD and to explore the unique presentation of symptoms. Findings indicated that 69% of registrants and 62% of family members reported clinically significant indicators of PTSD. Examples of specific symptom presentations are illustrated through qualitative responses. Implications for clinical treatment, policy, and future research related to PCTS are discussed.

Barriers and Enablers Influencing Women's Adoption and Continuation of Vaginally Inserted Contraceptive Methods: A Literature Review.

Most vaginally inserted methods have limited availability and use despite offering characteristics that align with many women's stated preferences (e.g., nonhormonal and/or on demand). The objective of this review was to identify enablers and barriers to women's adoption and continuation of vaginally inserted contraceptive methods in low- and middle-income countries (LMICs). We searched three databases (PubMed, Embase, and Web of Science) and 18 websites using keywords related to five vaginally inserted contraceptive methods (diaphragm, vaginal ring, female condom, copper intrauterine device [IUD], hormonal IUD) and terms associated with their adoption and continuation. Searches were limited to resources published between January 2010 and September 2020. Studies eligible for inclusion in our review presented results on women's use and perspectives on the enablers and barriers to adoption and continuation of the vaginally inserted contraceptive methods of interest in LMICs. Relevant studies among women's partners were also included, but not those of providers or other stakeholders. Data were coded, analyzed, and disaggregated according to a framework grounded in family planning (FP) literature and behavioral theories common to FP research and program implementation. Our initial search yielded 13,848 results, with 182 studies ultimately included in the analysis. Across methods, we found common enablers for method adoption, including quality contraceptive counseling as well as alignment between a woman's preferences and a method's duration of use and side effect profile. Common barriers included a lack of familiarity with the methods and product cost. Notably, vaginal insertion was not a major barrier to adoption in the literature reviewed. Vaginally inserted methods of contraception have the potential to fill a gap in method offerings and expand choice. Programmatic actions should address key barriers and enable voluntary use.

Detection probability and density estimation of fin whales by a Seaglider.

A single-hydrophone ocean glider was deployed within a cabled hydrophone array to demonstrate a framework for estimating population density of fin whales (Balaenoptera physalus) from a passive acoustic glider. The array was used to estimate tracks of acoustically active whales. These tracks became detection trials to model the detection function for glider-recorded 360-s windows containing fin whale 20-Hz pulses using a generalized additive model. Detection probability was dependent on both horizontal distance and low-frequency glider flow noise. At the median 40-Hz spectral level of 97 dB re 1 µPa2/Hz, detection probability was near one at horizontal distance zero with an effective detection radius of 17.1 km [coefficient of variation (CV) = 0.13]. Using estimates of acoustic availability and acoustically active group size from tagged and tracked fin whales, respectively, density of fin whales was estimated as 1.8 whales per 1000 km2 (CV = 0.55). A plot sampling density estimate for the same area and time, estimated from array data alone, was 1.3 whales per 1000 km2 (CV = 0.51). While the presented density estimates are from a small demonstration experiment and should be used with caution, the framework presented here advances our understanding of the potential use of gliders for cetacean density estimation.

Evading Detection: What Do We Know about Men Charged with Extrafamilial Child Sexual Abuse following Delayed Detection?

Most child sexual abuse (CSA) remains unreported and undetected. Despite this, much of what we know about perpetrators of CSA is derived from samples of convicted CSA offenders. Significant knowledge gaps remain about those who have evaded detection. This study addresses this gap with an in-depth content analysis of the case files of ten convicted child sexual offenders (CSOs) with the longest detection lag, selected from a broader group (n = 349) of men incarcerated at the Massachusetts Treatment Center (MTC). Participants were examined on a range of offender characteristics including Adverse Childhood Experiences (ACEs), cognitive distortions, antisocial traits, indicators of pedophilia and Machiavellian or narcissistic traits, offense facilitating factors, and grooming behavior. A tentative profile emerged with the following characteristics: direct experience of childhood abuse, various cognitive distortions, specialized rather than versatile criminal history, pedophilic traits, Machiavellian traits, and engaging in a range of offense-facilitating behaviors including grooming. We provide insight into offenders who evade detection for CSA and set the foundation for further research to inform prevention strategies for law enforcement agencies and child-serving organizations.

Desistance From Sexual Offending.

PURPOSE OF REVIEW: This article reviews the growing body of knowledge on desistance from sexual offending. Although the cessation of offending is a standard observation in criminology and has been demonstrated by people who commit all manner of crimes, it has only recently been considered relevant for individuals convicted of sexual offences. RECENT FINDINGS: Desistance from crime is a natural human process and has been observed even among those people who commit sexual offences. The clearest distinction between sexual and nonsexual offenders is the way they are treated by the criminal justice system. Desistance can occur in different ways, for different people, and under different circumstances. It can occur naturally, with or without formal therapeutic assistance or criminal justice intervention. Comparatively few sexual offenders truly warrant the restrictive approaches of enhanced community supervision to which so many people are now subject. A growth industry devoted to sustaining the belief that there is something very different (and identifiable) about sexual offenders has resulted in increasingly dangerous trends in our criminal justice system's response to this crime.

Acoustic detection range and population density of Cuvier's beaked whales estimated from near-surface hydrophones.

The population density of Cuvier's beaked whales is estimated acoustically with drifting near-surface hydrophone recorders in the Catalina Basin. Three empirical approaches (trial-based, distance-sampling, and spatially explicit capture-recapture) are used to estimate the probability of detecting the echolocation pulses as a function of range. These detection functions are used with two point-transect methods (snapshot and dive-cue) to estimate density. Measurement errors result in a small range of density estimates (3.9-5.4 whales per 1000 km2). Use of multiple approaches and methods allows comparison of the required information and assumptions of each. The distance-sampling approach with snapshot-based density estimates has the most stringent assumptions but would be the easiest to implement for large scale surveys of beaked whale density. Alternative approaches to estimating detection functions help validate this approach. The dive cue method of density estimation has promise, but additional work is needed to understand the potential bias caused by animal movement during a dive. Empirical methods are a viable alternative to the theoretical acoustic modeling approaches that have been used previously to estimate beaked whale density.

On the use of the Lloyd's Mirror effect to infer the depth of vocalizing fin whales.

The interference between the direct path and the sea surface reflection of a signal as measured by a receiver is called Lloyd's Mirror effect (LME). It results in a frequency-dependent interference pattern that can be observed in a spectrogram. LME depends on the receiver depth, signal source depth, signal frequency, and slant range between source and receiver. Knowing three of these parameters a priori, LME can be used to estimate the third parameter, such as source depth. Here, the work in Pereira et al. (2016) was expanded to estimate the depth of a vocalizing fin whale recorded by an ocean-bottom seismometer (OBS). In Pereira et al. (2016), the depth of a vocalizing fin whale was inferred by manually comparing spectrograms of LME transmission loss models with observed LME. This study developed an automated procedure to perform the same task using the LME interference pattern observed in the spectrograms of the hydrophone and the vertical channel of the OBS. The results show that the joint use of the two channels was the best approach to estimate a source depth using LME. LME provides a non-intrusive approach for estimating the depth at which a fin whale was vocalizing.

Fin whale acoustic presence and song characteristics in seas to the southwest of Portugal.

Fin whales were once abundant in the seas to the southwest of Portugal, but whaling activities decreased their numbers considerably. Acoustic data from ocean bottom seismometers provide an opportunity to detect fin whales from their notes, data that would otherwise be logistically challenging and expensive to obtain. Based on inter-note interval and frequency bandwidth, two acoustic patterns produced by fin whales were detected in the study area: pattern 1, described from fin whales in the Mediterranean Sea, and pattern 2, associated with fin whales from the northeast North Atlantic Ocean (NENA). NENA fin whales travel into the western Mediterranean Sea, but the Mediterranean population has not been documented to travel regularly into the NENA. In this study, 11 months of acoustic data recorded southwest of Portugal in the NENA were used to characterize 20-Hz fin whale notes into these patterns. Pattern 2 was the most common and occurred mostly in November-January. Pattern 1 occurred less frequently and mostly in September-December, February and April, which suggested a limited excursion of whales from the Mediterranean Sea. There were also occasions when the two patterns were recorded simultaneously. Results suggest that fin whales from the NENA and Mediterranean Sea might mix in the area during part of the year.

Comparison of fin whale 20 Hz call detections by deep-water mobile autonomous and stationary recorders.

Acoustically equipped deep-water mobile autonomous platforms can be used to survey for marine mammals over intermediate spatiotemporal scales. Direct comparisons to fixed recorders are necessary to evaluate these tools as passive acoustic monitoring platforms. One glider and two drifting deep-water floats were simultaneously deployed within a deep-water cabled hydrophone array to quantitatively assess their survey capabilities. The glider was able to follow a pre-defined track while float movement was somewhat unpredictable. Fin whale (Balaenoptera physalus) 20 Hz pulses were recorded by all hydrophones throughout the two-week deployment. Calls were identified using a template detector, which performed similarly across recorder types. The glider data contained up to 78% fewer detections per hour due to increased low-frequency flow noise present during glider descents. The glider performed comparably to the floats and fixed recorders at coarser temporal scales; hourly and daily presence of detections did not vary by recorder type. Flow noise was related to glider speed through water and dive state. Glider speeds through water of 25 cm/s or less are suggested to minimize flow noise and the importance of glider ballasting, detector characterization, and normalization by effort when interpreting glider-collected data and applying it to marine mammal density estimation are discussed.

Roaring and repetition: How bowhead whales adjust their call density and source level (Lombard effect) in the presence of natural and seismic airgun survey noise.

Over 500 000 automated and manual acoustic localizations, measured over seven years between 2008 and 2014, were used to examine how natural wind-driven noise and anthropogenic seismic airgun survey noise influence bowhead whale call densities (calls/km2/min) and source levels during their fall migration in the Alaskan Beaufort Sea. Noise masking effects, which confound measurements of behavioral changes, were removed using a modified point transect theory. The authors found that mean call densities generally rose with increasing continuous wind-driven noise levels. The occurrence of weak airgun pulse sounds also prompted an increase in call density equivalent to a 10-15 dB change in natural noise level, but call density then dropped substantially with increasing cumulative sound exposure level (cSEL) from received airgun pulses. At low in-band noise levels the mean source level of the acoustically-active population changed to nearly perfectly compensate for noise increases, but as noise levels increased further the mean source level failed to keep pace, reducing the population's communication space. An increase of >40 dB cSEL from seismic airgun activity led to an increase in source levels of just a few decibels. These results have implications for bowhead acoustic density estimation, and evaluations of the masking impacts of anthropogenic noise.

The quantity and distribution of biofilm growth of Escherichia coli strain ATCC 9723 depends on the carbon/energy source.

Escherichia coli strain 15 (ATCC 9723) formed robust biofilms of two distinct forms on glass tubes. In rich, low-osmolarity medium, the biofilms were restricted to the air/liquid interface, resulting in rings attached to the glass. As it was not evident that these biofilms extended across the liquid surface, we termed them 'ring' rather than 'pellicle' biofilms. In minimal medium supplemented with a non-fermentable substrate as the carbon/energy source, we observed either robust ring biofilms or little biofilm of any type, depending on the substrate. In contrast, fermentable substrates (sugars and sugar derivatives) supported robust biofilms covering most of the solid/liquid interface, which we termed 'tube-covering biofilms'. Maximal biofilm growth was observed when the sugar was a relatively poor substrate, supporting slow growth and known to cause minimal dephosphorylation of regulatory protein Enzyme IIAGlucose of the phosphotransferase system. Compounds found to be inhibitors of biofilm growth, such as lactate, caused a shift from tube-covering to ring form at low concentration and complete loss of biofilm growth at high when added to minimal medium supplemented with a fermentable substrate. Exogenous cAMP activated biofilm growth under all conditions tested, leading to more intense ring or tube-covering biofilms and/or to a shift from ring to tube-covering form.

Comparison of estimated 20-Hz pulse fin whale source levels from the tropical Pacific and Eastern North Atlantic Oceans to other recorded populations.

Passive acoustic monitoring, mitigation, animal density estimation, and comprehensive understanding of the impact of sound on marine animals all require accurate information on vocalization source level to be most effective. This study focused on examining the uncertainty related to passive sonar equation terms that ultimately contribute to the variability observed in estimated source levels of fin whale calls. Differences in hardware configuration, signal detection methods, sample size, location, and time were considered in interpreting the variability of estimated fin whale source levels. Data from Wake Island in the Pacific Ocean and off Portugal in the Atlantic Ocean provided the opportunity to generate large datasets of estimated source levels to better understand sources of uncertainty leading to the observed variability with and across years. Average seasonal source levels from the Wake Island dataset ranged from 175 to 188 dB re 1 µPa m, while the 2007-2008 seasonal average detected off Portugal was 189 dB re 1 µPa m. Owing to the large inherent variability within and across this and other studies that potentially masks true differences between populations, there is no evidence to conclude that the source level of 20-Hz fin whale calls are regionally or population specific.

The Pursuit of Primary Human Goods in Men Desisting From Sexual Offending.

The good lives model proposes at least 10 primary human goods that are thought to be common to all individuals which, when secured, contribute to enhanced well-being and life satisfaction. Prosocial attainment of primary human goods is thought to promote desistance from crime. However, individuals convicted of sexual offenses face significant obstacles upon their reentry into the community that likely undermine their ability to obtain such goods. The current study explored the pursuit and attainment of primary human goods in a U.S. sample of men convicted of sexual offenses. We interviewed 42 men released into the community to examine the extent to which they desired and pursued primary human goods. Results highlighted that participants valued many of the human goods outlined in the good lives model, but their means to achieve them were restricted considerably by their correctional status. "Interpersonal relationships" and "life/survival" emerged most frequently during the interviews and were identified as the two most important goods. We discuss the negative impact of recent policies on participants' ability to pursue and attain human goods as well as the value of attending regular treatment in obtaining the goods of "knowledge" and "community." Implications for policy and directions for future research are provided.

Diving behavior of Cuvier's beaked whales inferred from three-dimensional acoustic localization and tracking using a nested array of drifting hydrophone recorders.

Echolocation pulses from Cuvier's beaked whales are used to track the whales' three-dimensional diving behavior in the Catalina Basin, California. In 2016, five 2-element vertical hydrophone arrays were suspended from the surface and drifted at ∼100-m depth. Cuvier's beaked whale pulses were identified, and vertical detection angles were estimated from time-differences-of-arrival of either direct-path signals received on two hydrophones or direct-path and surface-reflected signals received on the same hydrophone. A Bayesian state-space model is developed to track the diving behavior. The model is fit to these detection angle estimates from at least four of the drifting vertical arrays. Results show that the beaked whales were producing echolocation pulses and are presumed to be foraging at a mean depth of 967 m (standard deviation = 112 m), approximately 300 m above the bottom in this basin. Some whales spent at least some time at or near the bottom. Average swim speed was 1.2 m s-1, but swim direction varied during a dive. The average net horizontal speed was 0.6 m s-1. Results are similar to those obtained from previous tagging studies of this species. These methods may allow expansion of dive studies to other whale species that are difficult to tag.

Two unit analysis of Sri Lankan pygmy blue whale song over a decade.

Sri Lankan pygmy blue whale song consists of three repeated units: (1) low frequency pulsive unit, (2) frequency modulated (FM) upsweep, and (3) long tonal downsweep. The Unit 2 FM unit has up to three visible upsweeps with energy concentrated at approximately 40, 50, and 60 Hz, while the Unit 3 (∼100 Hz) tonal downsweep is the most distinct unit lasting 20-30 s. Spectral characteristics of the Units 2 and 3 song elements, along with ocean sound levels, were analyzed in the Indian Ocean from 2002 to 2013. The peak frequency of the tonal Unit 3 calls decreased from approximately 106.5 to 100.7 Hz over a decade corresponding to a 5.4% decrease. Over the same time period, the frequency content of the Unit 2 upsweeps did not change as dramatically with only a 3.1% change. Ambient sound levels in the vocalization bands did not exhibit equivalent patterns in amplitude trends. Analysis showed no increase in the ambient sound or compensated peak amplitude levels of the tonal downsweeps, eliminating the presence of a Lombard effect. Here it is proposed that each song unit may convey different information and thus may be responding to different selective pressures.

Fin whale density and distribution estimation using acoustic bearings derived from sparse arrays.

Passive acoustic monitoring of marine mammals is common, and it is now possible to estimate absolute animal density from acoustic recordings. The most appropriate density estimation method depends on how much detail about animals' locations can be derived from the recordings. Here, a method for estimating cetacean density using acoustic data is presented, where only horizontal bearings to calling animals are estimable. This method also requires knowledge of call signal-to-noise ratios, as well as auxiliary information about call source levels, sound propagation, and call production rates. Results are presented from simulations, and from a pilot study using recordings of fin whale (Balaenoptera physalus) calls from Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO) hydrophones at Wake Island in the Pacific Ocean. Simulations replicating different animal distributions showed median biases in estimated call density of less than 2%. The estimated average call density during the pilot study period (December 2007-February 2008) was 0.02 calls hr-1 km2 (coefficient of variation, CV: 15%). Using a tentative call production rate, estimated average animal density was 0.54 animals/1000 km2 (CV: 52%). Calling animals showed a varied spatial distribution around the northern hydrophone array, with most detections occurring at bearings between 90 and 180 degrees.

Community pharmacist-led intervention to identify persons with diabetes not on statin therapy.

OBJECTIVES: To demonstrate the effectiveness of a community pharmacist-led intervention to identify persons with diabetes not receiving statin therapy. SETTING: Five pharmacy locations within 1 district of a chain community pharmacy. PRACTICE DESCRIPTION: Walgreens Pharmacy is a national retail chain community pharmacy with global affiliations. Walgreens Pharmacy locations use clinical pharmacy services to provide complete quality patient care. PRACTICE INNOVATION: A pharmacist intervention workflow model and screening algorithm for the Centers for Medicare and Medicaid Services (CMS) Statin Use in Persons with Diabetes quality measure were developed to identify measure-eligible patients in a community pharmacy setting. This new measure was implemented within the Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) dashboard. The study aimed to demonstrate that community pharmacist intervention is effective for helping to close therapy gaps; the focus of this study was identifying patients who have diabetes but are not on statin therapy. EVALUATION: The primary outcome included the percentage of patients flagged for intervention by the pharmacist, and the secondary outcome included the number of statin prescriptions received for the measure-eligible intervention population. RESULTS: At study initiation, EQuIPP reported a total of 103 patients were SUPD measure eligible at the intervention pharmacies (combined). After the 90-day study duration, 29.1% (n = 30) of SUPD measure-eligible patients were identified with the use of the workflow intervention. From those identified, 40% (n = 12) gave verbal consent for the pharmacist to intervene with their physician, and of those, 58.3% (n = 7) received statin prescriptions. Pharmacy A increased their EQuIPP-based performance measure by 3.3%, Pharmacy B 4.2%, Pharmacy D 2.4%, and Pharmacy E 3.5%, and Pharmacy C decreased by 1.0%. CONCLUSION: Implementation of a community pharmacist-led identification process successfully identified SUPD measure-eligible patients. Community pharmacist-led intervention resulted in an increase in the number of statin prescriptions written for measure-eligible patients.