We explored how physicians conceptualize their role in contraceptive counseling at the time of abortion, including identifying clinician attitudes that may lead to patients' perceptions of contraceptive coercion.
 
  We conducted individual semi-structured interviews using questions based on components of the Theory of Planned Behavior. We recruited physician abortion providers using purposeful sampling to attain diversity in practice setting and geographic practice region. We analyzed transcribed interviews using initial and values coding methods.
 
  We interviewed 39 participants across the United States, who primarily self-reported as White female obstetrician gynecologists (OB/GYNs) aged 25 to 44. Over half of participants practiced in an academic setting. Participants perceived providing patient education and taking a patient-centered approach as part of their role in contraceptive counseling. Participants also believed it was their responsibility to prevent unintended pregnancies and subsequent abortionsling practices and physicians must examine their personal values and motivations behind recommending contraception after an abortion.
 Considering contraceptive counseling as a means to prevent subsequent abortion may lead to coercive practices, especially with specific patient populations. Moral codes and abortion stigma influence physicians' counseling practices and physicians must examine their personal values and motivations behind recommending contraception after an abortion.Clarithromycin retained in waste activated sludge (WAS) inevitably enters the anaerobic digestion system. So far, the complex impacts and fate of clarithromycin in continuous operated WAS anaerobic digestion system are still unclear. In this study, two semi-continuous long-term reactors were set up to investigate the effect of clarithromycin on biogas production and antibiotic resistance genes (ARGs) during WAS anaerobic digestion, and a batch test was carried out to explore the potential metabolic mechanism. Experimental results showed that clarithromycin at lower concentrations (i.e., 0.1 and 1.0 mg/L) did not affect biogas production, whereas the decrease in biogas production was observed when the concentration of clarithromycin was further increased to 10 mg/L. Correspondingly, the relative abundance of functional bacteria in WAS anaerobic digestion (i.e., Anaerolineaceae and Microtrichales) was reduced with long-term clarithromycin exposure. The investigation of ARGs suggested that the effect of methylation belonging to the target site modification played a critical role for the anaerobic microorganisms in the expression of antibiotic resistance, and ermF, played dominated ARGs, presented the most remarkable proliferation. In comparison, the role of efflux pump was weakened with a significant decrease of two detected efflux genes. During WAS anaerobic digestion, clarithromycin could be partially degraded into metabolites with lower antimicrobial activity including oleandomycin and 5-O-desosaminyl-6-O-methylerythronolide and other metabolites without antimicrobial activity.
  We aimed to synthesize available cohorts about the relationship between various types of noise and hypertension, and to explore the potential dose-response relationship between them in an updated meta-analysis.
 
  PubMed and Embase were searched through October 2019 to identify cohort studies that met predetermined inclusion criteria. A random-effects model was used to combine the results of included studies. Dose-response meta-analysis was conducted to examine the potential dose-response relationship.
 
  Eleven cohort studies involving 224,829 participants were included in this systematic review. Pooled result showed that living or working in environment with noise exposure was significantly associated with increased risk of hypertension (RR 1.18; 95% CI 1.06 to 1.32), with low heterogeneity (P=0.098, I
  =42.1%). We found no evidence of a nonlinear association of elevated noise with hypertension risk (P=0.443).  https://www.selleckchem.com/products/gsk-2837808A.html  The summary risk ratio of hypertension for an increment of per 10dB(A) of noise was 1.13 (95% CI 0.99 to 1.28), with moderate heterogeneity (P=0.003, I
  =72.1%).
 
  Integrated evidence from cohort studies supports the hypothesis that exposure to noise may be a risk factor of hypertension.
 Integrated evidence from cohort studies supports the hypothesis that exposure to noise may be a risk factor of hypertension.
  Studies of prenatal per- and polyfluoroalkyl substances (PFAS) and attention deficit hyperactivity disorder (ADHD)-related behaviors in children are inconsistent.
 
  To examine associations between maternal serum PFAS concentrations and child behavior in 241 mother-child dyads within the Health Outcomes and Measures of the Environment (HOME) Study.
 
  We quantified perfluorooctanoate (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), and perfluorononanoate (PFNA) in maternal serum collected during pregnancy or at delivery. We evaluated a total of 17 outcomes of child behavior using the Behavioral Assessment System for Children-2 (BASC-2) at 5 and 8 years (n=240) and ADHD diagnostic symptoms and criteria with the Diagnostic Interview Schedule for Children-Young Child (DISC-YC) at 5 years (n=190). We used linear mixed models and logistic regression with generalized estimating equations to assess associations between PFAS and continuous or dichotomous "at risk" BASC-2 scores; negative bth increased problems with both externalizing and internalizing behaviors. No associations were noted between PFOA and child neurobehavior.
 Prenatal PFOS and PFNA were consistently associated with measures related to hyperactive-impulsive type ADHD across two validated assessment instruments. PFHxS was associated with increased problems with both externalizing and internalizing behaviors. No associations were noted between PFOA and child neurobehavior.The present study is an attempt to assess the spatial and seasonal variation of nutrients and heavy metals in mangroves water in the Gulf of Kachchh, India. The surface water samples were collected during pre- and post-monsoon to evaluate the hydrochemical processes occurring in the region. Seasonal changes and anthropogenic inputs have influenced the nutrients and metal concentrations. The results suggest high salinity (Pre-monsoon ±45.59 PSU; post-monsoon ±45.36 PSU) and chloride (Pre-monsoon ±30251 mg/L; post-monsoon ±29536 mg/L) concentration in both the seasons. Average values of Sulfate (SO4-), Nitrate (NO3-), Dissolved silica (DSi), and Phosphate (PO43-) was 2503.69 mg/L, 10.47 mg/L, 35.41 mg/L and 0.85 mg/L in pre-monsoon, and 3474.50 mg/L, 13.66 mg/L, 31.54 mg/L and 0.64 mg/L in post-monsoon, respectively. Nutrient ratios indicate phosphorus limitation in both the seasons. Cluster and Principal Component analysis signifies that sampling locations in cluster 3 and factor 1 majorly impacted due to seawater mixing, high evaporation and discharge of brine from saltpans, while cluster 2, 3 and factor 2 indicates the anthropogenic source.