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1.
Proc Natl Acad Sci U S A ; 119(11)2022 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-35217532

RESUMO

The impacts of interferon (IFN) signaling on COVID-19 pathology are multiple, with both protective and harmful effects being documented. We report here a multiomics investigation of systemic IFN signaling in hospitalized COVID-19 patients, defining the multiomics biosignatures associated with varying levels of 12 different type I, II, and III IFNs. The antiviral transcriptional response in circulating immune cells is strongly associated with a specific subset of IFNs, most prominently IFNA2 and IFNG. In contrast, proteomics signatures indicative of endothelial damage and platelet activation associate with high levels of IFNB1 and IFNA6. Seroconversion and time since hospitalization associate with a significant decrease in a specific subset of IFNs. Additionally, differential IFN subtype production is linked to distinct constellations of circulating myeloid and lymphoid immune cell types. Each IFN has a unique metabolic signature, with IFNG being the most associated with activation of the kynurenine pathway. IFNs also show differential relationships with clinical markers of poor prognosis and disease severity. For example, whereas IFNG has the strongest association with C-reactive protein and other immune markers of poor prognosis, IFNB1 associates with increased neutrophil to lymphocyte ratio, a marker of late severe disease. Altogether, these results reveal specialized IFN action in COVID-19, with potential diagnostic and therapeutic implications.


Assuntos
Sangue/metabolismo , COVID-19/imunologia , Interferons/sangue , Proteoma , Transcriptoma , COVID-19/sangue , Estudos de Casos e Controles , Conjuntos de Dados como Assunto , Humanos , Pacientes Internados
2.
Am J Community Psychol ; 73(3-4): 337-359, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38303610

RESUMO

Adolescents are sexually assaulted at remarkably high rates. Adolescents are also unique given the specific dynamics of adolescent sexual assault, their current stage in human development, their limited legal standing and rights, and their experiences navigating postassault services and resources. While literature exists within each of these domains, it is somewhat disconnected and overlooks how adolescents are often relegated to the margins in research and practice. The purpose of this integrative review is to (1) provide a more complete understanding of adolescent sexual assault and survivors' nuanced needs; (2) frame adolescent survivors as a too-often-overlooked oppressed group that researchers and responders must consider and center in their work, lest contribute to their further marginalization; and (3) inspire and orient social justice-minded scholar activists to various action steps to take to center and prioritize adolescents in research and practice. Through our intersectional feminist approach, we offer specific action steps for social justice-minded scholar activists to recenter adolescents in their research and practice.


Assuntos
Delitos Sexuais , Humanos , Adolescente , Vítimas de Crime/psicologia , Feminino , Justiça Social , Sobreviventes/psicologia , Masculino , Feminismo
3.
Health Mark Q ; : 1-19, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38836584

RESUMO

Both health and the environment are critical public health issues that have a considerable impact on young adults. However, they have different characteristics that influence how messaging is received. In our study, we examine the influence of three personal factors (issue involvement, behavioral change intention, and product use) on young adults' perception of messages for these two public health issues from both first- and third-person perspectives. We found various patterns when comparing the two public health issues, first-person and third-person measures, and the perceived threat and likelihood of contributing to the issues. We also discuss practical implications and suggestions based on our findings.

4.
Am J Respir Crit Care Med ; 206(3): 321-336, 2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35536696

RESUMO

Rationale: Methylation integrates factors present at birth and modifiable across the lifespan that can influence pulmonary function. Studies are limited in scope and replication. Objectives: To conduct large-scale epigenome-wide meta-analyses of blood DNA methylation and pulmonary function. Methods: Twelve cohorts analyzed associations of methylation at cytosine-phosphate-guanine probes (CpGs), using Illumina 450K or EPIC/850K arrays, with FEV1, FVC, and FEV1/FVC. We performed multiancestry epigenome-wide meta-analyses (total of 17,503 individuals; 14,761 European, 2,549 African, and 193 Hispanic/Latino ancestries) and interpreted results using integrative epigenomics. Measurements and Main Results: We identified 1,267 CpGs (1,042 genes) differentially methylated (false discovery rate, <0.025) in relation to FEV1, FVC, or FEV1/FVC, including 1,240 novel and 73 also related to chronic obstructive pulmonary disease (1,787 cases). We found 294 CpGs unique to European or African ancestry and 395 CpGs unique to never or ever smokers. The majority of significant CpGs correlated with nearby gene expression in blood. Findings were enriched in key regulatory elements for gene function, including accessible chromatin elements, in both blood and lung. Sixty-nine implicated genes are targets of investigational or approved drugs. One example novel gene highlighted by integrative epigenomic and druggable target analysis is TNFRSF4. Mendelian randomization and colocalization analyses suggest that epigenome-wide association study signals capture causal regulatory genomic loci. Conclusions: We identified numerous novel loci differentially methylated in relation to pulmonary function; few were detected in large genome-wide association studies. Integrative analyses highlight functional relevance and potential therapeutic targets. This comprehensive discovery of potentially modifiable, novel lung function loci expands knowledge gained from genetic studies, providing insights into lung pathogenesis.


Assuntos
Metilação de DNA , Epigenoma , Ilhas de CpG , Metilação de DNA/genética , Epigênese Genética/genética , Epigenômica , Estudo de Associação Genômica Ampla , Humanos , Recém-Nascido , Pulmão
5.
J Community Psychol ; 51(5): 1917-1934, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-36508478

RESUMO

Community psychologists (CPs) are committed to value-based praxis, an interdisciplinary orientation, and an ecological approach to community collaboration in pursuit of social justice and liberation. Because no setting is immune to the impacts of the intersecting systems of oppression in which we are embedded, CPs end up working in a wide array of settings, and often as the only CP in the setting. This dynamic-operating as a "lone" CP-may be rewarding as the CP is able to provide unique value at work, or may present specific challenges, particularly if the CP's sense of community or mattering is compromised. We interviewed n = 31 lone CP to explore their work experiences, including the benefits, challenges, and what they need to thrive in their current setting. Findings reveal a wide array of experiences among CPs, related to their community psychology, and other identities. Participants consistently discussed the important role of values in their decision-making and experiences at work, and provide specific recommendations as to how the Society for Community Research and Action (SCRA) can ensure all CPs across all settings can thrive. This includes providing more tangible and relational support, changing SCRA's culture and priorities, and improving community psychology undergraduate and graduate training.


Assuntos
Justiça Social , Humanos
6.
J Infect Dis ; 226(12): 2105-2112, 2022 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-36214778

RESUMO

BACKGROUND: The British Antarctic bases offer a semiclosed environment for assessing the transmission and persistence of seasonal respiratory viruses. METHODS: Weekly swabbing was performed for respiratory pathogen surveillance (including SARS-CoV-2), at 2 British Antarctic Survey bases, during 2020: King Edward Point (KEP, 30 June to 29 September, 9 participants, 124 swabs) and Rothera (9 May to 6 June, 27 participants, 127 swabs). Symptom questionnaires were collected for any newly symptomatic cases that presented during this weekly swabbing period. RESULTS: At KEP, swabs tested positive for non-SARS-CoV-2 seasonal coronavirus (2), adenovirus (1), parainfluenza 3 (1), and respiratory syncytial virus B (1). At Rothera, swabs tested positive for non-SARS-CoV-2 seasonal coronavirus (3), adenovirus (2), parainfluenza 4 (1), and human metapneumovirus (1). All bacterial agents identified were considered to be colonizers and not pathogenic. CONCLUSIONS: At KEP, the timeline indicated that the parainfluenza 3 and adenovirus infections could have been linked to some of the symptomatic cases that presented. For the other viruses, the only other possible sources were the visiting ship crew members. At Rothera, the single symptomatic case presented too early for this to be linked to the subsequent viral detections, and the only other possible source could have been a single nonparticipating staff member.


Assuntos
Infecções por Adenoviridae , COVID-19 , Infecções por Paramyxoviridae , Infecções Respiratórias , Vírus , Humanos , COVID-19/epidemiologia , Pandemias , SARS-CoV-2 , Estudos Prospectivos , Regiões Antárticas , Infecções por Paramyxoviridae/epidemiologia , Inquéritos e Questionários
7.
Cerebellum ; 21(6): 963-975, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34855135

RESUMO

To identify gait and balance measures that are responsive to change during the timeline of a clinical trial in Friedreich ataxia (FRDA), we administered a battery of potential measures three times over a 12-month period. Sixty-one ambulant individuals with FRDA underwent assessment of gait and balance at baseline, 6 months and 12 months. Outcomes included GAITRite® spatiotemporal gait parameters; Biodex Balance System Postural Stability Test (PST) and Limits of Stability; Berg Balance Scale (BBS); Timed 25-Foot Walk Test; Dynamic Gait Index (DGI); SenseWear MF Armband step and energy activity; and the Friedreich Ataxia Rating Scale Upright Stability Subscale (FARS USS). The standardised response mean (SRM) or correlation coefficients were reported as effect size indices for comparison of internal responsiveness. Internal responsiveness was also analysed in subgroups. SenseWear Armband daily step count had the largest effect size of all the variables over 6 months (SRM = -0.615), while the PST medial-lateral index had the largest effect size (SRM = 0.829) over 12 months. The FARS USS (SRM = 0.824) and BBS (SRM = -0.720) were the only outcomes able to detect change over 12 months in all subgroups. The DGI was the most responsive outcome in children, detecting a mean change of -2.59 (95% CI -3.52 to -1.66, p < 0.001, SRM = -1.429). In conclusion, the FARS USS and BBS are highly responsive and can detect change in a wide range of ambulant individuals with FRDA. However, therapeutic effects in children may be best measured by the DGI.


Assuntos
Ataxia de Friedreich , Criança , Humanos , Ataxia de Friedreich/diagnóstico , Índice de Gravidade de Doença , Marcha/fisiologia , Progressão da Doença , Equilíbrio Postural/fisiologia
8.
Am J Community Psychol ; 70(3-4): 255-264, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35698858

RESUMO

Community psychology has long valued reflexive praxis as a critical part advancing our research and action. In this Virtual Special Issue (VSI), we, a group of community psychologists and gender-based violence (GBV) researchers at many different points in our careers, reflected on GBV publications that have appeared in AJCP. We examine the ways in which community psychology broadly and articles in AJCP more specifically have conceptualized GBV as a sociocultural issue, how GBV intersects with other oppressions and forms of violence, the tension when systems that aspire to support survivors are inequitable and focused on ameliorative change, and the importance of interventions being locally informed and locally driven. By highlighting selected GBV-focused articles published in AJCP, this VSI discusses (a) understanding and transforming culture via robust research and local partnerships, (b) targeting effective interventions for survivors, (c) invoking systems and targeting change in institutional environments, and (d) making connections between local efforts and broader social movements. To continue to move forward, we conclude we must reflect, embrace methodological plurality, partner, and push for structural change. Reflective questions regarding research and action are offered, to address gender-based violence.


Assuntos
Violência de Gênero , Humanos , Violência de Gênero/psicologia , Violência/prevenção & controle , Sobreviventes/psicologia
9.
Am J Community Psychol ; 70(3-4): 458-474, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35901455

RESUMO

Sexual Assault Nurse Examiners (SANEs) provide expert, comprehensive medical forensic care to patients who present for services following a sexual assault. Because SANEs are not consistently available, telehealth technology is being explored as a means to provide access to this expert care (i.e., teleSANE). During the COVID-19 pandemic, teleSANE offered additional potential benefits by reducing the length of time spent and number of providers in patient exam rooms, the need for personal protective equipment that was in high demand and short supply, and provider anxiety related to providing in-person care. In the summer of 2020, the Massachusetts SANE program rapidly and temporarily converted five hospitals from in-person SANE care to teleSANE. An evaluation team interviewed 23 providers using a rapid research and evaluation methods approach to assess the temporary model and inform the future of SANE care. Evaluation findings reveal it is possible to rapidly and temporarily convert hospitals from in-person to teleSANE care in a time of broad uncertainty, and that such a change requires intensive and thoughtful planning; a shared commitment to being supportive, flexible, and responsive; and specific experience and expertise. Considerations for communities exploring how best to ensure consistent, equitable access to SANEs are discussed.


Assuntos
COVID-19 , Delitos Sexuais , Humanos , COVID-19/epidemiologia , Pandemias
10.
Am J Community Psychol ; 67(1-2): 3-6, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33720435

RESUMO

This special issue of The American Journal of Community Psychology originated from the Society for Community Research and Action Criminal Justice interest group, with a goal of exploring the work of community psychologists intersecting with criminal justice research, practice, and policy and shaped by our shared values-equity, collaboration, creative maladjustment, social justice, and social science in the service of social justice. In this introduction, we discuss the socio-historical context of the special issue, followed by an outline of the special issue organization, and brief summary of the included papers. Across 13 papers and an invited commentary, we see the ways in which community psychologists are: (1) delivering and evaluating services, programming, or other supports to address the needs of system-involved people; and (2) working to improve the systems, structures, and interactions with units of criminal justice systems. Across these two sections, authors highlight the guiding role of our values to influence change within and outside of criminal-legal systems.


Assuntos
Direito Penal , Transtornos Mentais , Humanos , Justiça Social , Estados Unidos
11.
Am J Community Psychol ; 67(1-2): 166-178, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-32511777

RESUMO

In jurisdictions throughout the United States, thousands of sexual assault kits (SAKs; also known as a "rape kits") have not been submitted by the police for forensic DNA testing. DNA evidence may be helpful to sexual assault investigations and prosecutions by identifying perpetrators, revealing serial offenders through DNA matches across cases, and exonerating those who have been wrongly accused. This paper describes a longitudinal action research project conducted in Detroit, Michigan after that city discovered approximately 11,000 untested sexual assault kits in a police department storage facility. We conducted a root cause analysis to examine individual, organizational, community, and societal factors that contributed to the development of the rape kit backlog in Detroit. Based on those findings, we implemented and evaluated structural changes to increase staffing, promote kit testing, and retrain police and prosecutors so that cases could be reopened for investigation and prosecution. As we conducted this work, we also studied how this action research project impacted the Detroit criminal justice system. Participating in this project changed stakeholders' attitudes about the utility of research to address community problems, the usefulness of DNA evidence in sexual assault cases, and the impact of trauma on survivors. The results led to new protocols for SAK testing and police investigations, and new state legislation mandating SAK forensic DNA testing.


Assuntos
Vítimas de Crime , Estupro , Delitos Sexuais , Direito Penal , Pesquisa sobre Serviços de Saúde , Humanos , Aplicação da Lei , Estados Unidos
12.
Omega (Westport) ; : 302228211052341, 2021 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-34971334

RESUMO

Medical assistance in dying (MAiD) has been legal in Canada since 2016 and some incarcerated patients who are at the end of their lives are eligible for the procedure. Interviews with nine incarcerated men at a federal penitentiary in Canada provide insight into some of the ways that people who are navigating aging and end-of-life in prison think about MAiD. Interview themes are organized around: experience with death and dying; possibilities and barriers related to applications for release from prison at end-of-life; experiences of peer-caregiving in a prison palliative care program; support for MAiD and the expansion of eligibility criteria; what a good death looks like. Themes are contextualized alongside federal guidelines related to end-of-life care (EOLC) and MAiD for prisoners, highlighting that sound policy requires both generalizable principles and attention to nuance. MAiD rests on patient voluntariness, and thus autonomy over EOLC decisions is paramount for prisoners.

13.
Omega (Westport) ; 84(1): 267-288, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31771434

RESUMO

Since medical assistance in dying (MAiD) became legal in Canada in 2016, there have been concerns about vulnerable people feeling pressured to end their lives. It is important to understand what people in marginalized communities know and feel about MAiD in order to help prevent any pressure to hasten death and to prevent any barriers to accessing assisted death. This qualitative study explored the perceptions and experiences of MAiD and other end-of-life care options with 46 people who were illicit substance users, living in poverty, or who worked with marginalized people in these communities. Six broad themes were identified: the importance of family, friends, and community; the effects of the opioid crisis; barriers to accessing end-of-life care services; support for MAiD; the difference between suicide and MAiD; and what constitutes a good death. Findings from this research may be used to help inform future legislation, professional guidelines, and standards of best practice.


Assuntos
Transtornos Relacionados ao Uso de Substâncias , Suicídio Assistido , Canadá , Humanos , Assistência Médica , Percepção , Pobreza
14.
J Pediatr ; 220: 146-153.e2, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32143931

RESUMO

OBJECTIVE: To assess the importance of genetic and nongenetic risk factors contributing to hepatic fat accumulation in a multiethnic population of youth. STUDY DESIGN: We investigated the relationship between genetic factors and hepatic fat fraction (HFF) in 347 children aged 12.5-19.5 years. We examined 5 single nucleotide polymorphisms previously associated with HFF and a weighted genetic risk score (GRS) and examined how these associations varied with ethnicity (Hispanic vs non-Hispanic white) and body mass index (BMI) category. We also compared how much variation in HFF was explained by genetic factors vs cardiometabolic factors (BMI z-score and the Homeostasis Model of Insulin Resistance) or diet. RESULTS: PNPLA3 rs738409 and the GRS were each associated with HFF among Hispanic (ß = 0.39; 95% CI, 0.16-0.62; P = .001; and ß = 0.20; 95% CI, 0.05-0.34; P = .007, respectively) but not non-Hispanic white (ß = 0.04; 95% CI, -0.18 to 0.26; P = .696; and ß = 0.03; 95% CI, -0.09 to 0.14; P = .651, respectively) youth. Cardiometabolic risk factors explained more of the variation in HFF than genetic risk factors among non-lean Hispanic individuals (27.2% for cardiometabolic markers vs 6.4% for rs738409 and 4.3% for the GRS), and genetic risk factors were more important among lean individuals (2.7% for cardiometabolic markers vs 12.6% for rs738409 and 4.4% for the GRS). CONCLUSIONS: Poor cardiometabolic health may be more important than genetic factors when predicting HFF in overweight and obese young populations. Genetic risk is an important contributor to pediatric HFF among lean Hispanics, but further studies are necessary to elucidate the strength of the association between genetic risk and HFF in non-Hispanic white youth.


Assuntos
Fígado Gorduroso/epidemiologia , Fígado Gorduroso/genética , Tecido Adiposo/anatomia & histologia , Adolescente , Índice de Massa Corporal , Criança , Estudos de Coortes , Feminino , Hispânico ou Latino , Humanos , Fígado/anatomia & histologia , Masculino , Polimorfismo de Nucleotídeo Único , Medição de Risco , População Branca , Adulto Jovem
15.
Death Stud ; 44(12): 802-807, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31088340

RESUMO

This is a secondary analysis of three qualitative studies about MAiD in which researchers asked about the differences between suicide and MAiD. In all, researchers interviewed 52 Canadians; 7 were people who had requested MAiD and had been found ineligible, 6 were MAiD providers and 39 were socially and economically marginalized. The overwhelming response was that MAiD is better than suicide in the context of suffering at the end of life. Whereas these people perceived suicide as uncertain, difficult, and something that was usually done alone and without support, they thought MAiD was certain, painless, and more socially acceptable.


Assuntos
Suicídio/psicologia , Adulto , Idoso , Atitude do Pessoal de Saúde , Canadá , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Suicídio Assistido/psicologia
16.
Opt Express ; 27(22): 31978-31988, 2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31684419

RESUMO

Large diameter, flying focus driven ionization waves of arbitrary velocity (IWAV's) were produced by a defocused laser beam in a hydrogen gas jet, and their spatial and temporal electron density characteristics were measured using a novel, spectrally resolved interferometry diagnostic. A simple analytic model predicts the effects of power spectrum non-uniformity on the IWAV trajectory and transverse profile. This model compares well with the measured data and suggests that spectral shaping can be used to customize IWAV behavior and increase controlled propagation of ionization fronts for plasma-photonics applications.

17.
J Org Chem ; 84(16): 10306-10320, 2019 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-31322900

RESUMO

Systematic investigation of intramolecular silyloxypyrone-based [5 + 2] cycloadditions revealed three significant factors impacting conversion to cycloadduct: (1) the silyl transfer group has a substantial influence on the rate of reaction, and the robust t-butyldiphenylsilyl group was found to be more effective overall than the conventional t-butyldimethylsilyl group; (2) α,ß-unsaturated esters were generally more reactive than terminal olefins and afforded appreciable quantity of cycloadduct even at room temperature; and (3) the proximity of the tether to the silyl transfer group revealed a critical alignment trend between the pyrone and the alkene. Taken together, these investigations provided insight regarding the steric and electronic parameters that impact the scope and limitation of these reactions.

18.
J Phys Chem A ; 123(7): 1343-1352, 2019 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-30680993

RESUMO

Six 2,4,6,8-tetrarylbenzo[1,2- d:4,5- d']bisoxazoles (BBOs) were synthesized: three bearing phenyl substituents at the 2- and 6-positions and three bearing perfluorophenyl groups at those positions. The influence of perfluoro-aryl group substitution on the physical, optical, and electronic properties of 2,4,6,8-tetrarylbenzo[1,2- d:4,5- d']bisoxazoles (BBO) was evaluated using both experimental and theoretical methods. The density functional theory (DFT) model was found to be well-matched to the experimental optical data, as evidenced by the UV-vis spectra. Both cyclic voltammetry (CV) and ultraviolet photoelectron spectroscopy (UPS) were used to determine the position of the HOMO with varying results. The values obtained by CV were deeper than those obtained via UPS and correlated well with the theoretical calculations. However, the UPS values were more consistent with the expected outcomes for a system with segregated frontier molecular orbitals (FMOs). The UPS results are also supported by the electrostatic potential maps, which indicate that the electron density within the LUMO and HOMO is nearly completely localized along the 2,6- or 4,8-axis, respectively. The summation of the results indicates that strongly electron-withdrawing groups can be used to selectively tune the LUMO level with minor perturbation of the HOMO, something that is challenging to accomplish in typical donor-acceptor systems.

19.
Am J Community Psychol ; 64(1-2): 255-276, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31059130

RESUMO

Prior research has consistently documented that the vast majority of sexual assault cases do not progress through the criminal justice system. However, there is less agreement in prior work on how race influences case progression, resulting in a literature frequently described as "inconsistent." This systematic review examines all prior research that has included race as an independent variable in predicting the criminal justice system response to sexual assault (N = 34) in an effort to provide insight into seemingly disparate findings. We assess each study for the degree to which race was a focal point of interest, if and what theory was used to inform the investigation of race, how samples were drawn, and how and whose race was measured. Results illustrate that findings in prior research are not inconsistent, but rather unite to tell a nuanced story of the role of race in the criminal justice system response to sexual assault. The review demonstrates how decisions made by researchers throughout the research process can have significant impacts on reported findings, and how such findings may be used to influence policy and practice.


Assuntos
Direito Penal , Etnicidade/estatística & dados numéricos , Delitos Sexuais/legislação & jurisprudência , Delitos Sexuais/estatística & dados numéricos , População Branca/estatística & dados numéricos , Direito Penal/legislação & jurisprudência , Direito Penal/estatística & dados numéricos , Humanos , Grupos Raciais , Delitos Sexuais/etnologia , Estados Unidos
20.
Health Care Women Int ; 40(7-9): 950-980, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31158324

RESUMO

We conducted a comprehensive literature review on abortion in seven African countries to synthesize and analyze the landscape of abortion-related scientific knowledge, with the aim of informing abortion-access related research and programs in the region. We find that that abortion is common, despite legal restrictions, and often occurs outside of the formal health care system. Use of medication abortion was reported to be low, potentially due to legal restrictions and insufficient provider training across the continent. Creative interventions that could improve people's knowledge of and access to safe medication abortion were identified and described.


Assuntos
Aborto Induzido/estatística & dados numéricos , Aborto Induzido/normas , África/epidemiologia , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Gravidez
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