Results: We analyzed 1,402 surveys and 15 in-depth interviews. Many (32%) CL participants reported greater difficulty refilling medications and a minority (14%) reported greater difficulty accessing HIV care during the pandemic. Most (99%) Opt4Mamas participants reported no difficulty refilling medications or accessing HIV/pregnancy care. Among the CL participants, older women were less likely (aOR = 0.95, 95% CI: 0.92–0.98) and women with more children were more likely (aOR = 1.13, 95% CI: 1.00–1.28) to report difficulty refilling medications. Only 2% of (...) CL participants reported greater difficulty managing FP and most (95%) reported no change in likelihood of using FP or desire to get pregnant. Qualitative analysis revealed three major themes: (1) adverse organizational/economic implications of the pandemic, (2) increased importance of pregnancy prevention during the pandemic, and (3) fear of contracting COVID-19. (shrink)

Marion Godman makes the argument that Pathological Withdrawal Syndrome (PWS) makes the case for psychiatric disorders as a natural kind. Godman argues that we can classify kinds according to their shared ‘grounding’, but we need not know what the grounding is to know that the natural is a natural kind. However, I argue that Godman erroneously classifies PWS as its own natural kind when it is in fact a variant of depression, which is its own natural kind. Cooper highlights culture-bound (...) syndromes, which can explain the discrepancy between the different diagnosis rates for psychiatric disorders among different cultures. Taking culture-bound syndromes into account, I conclude that PWS is a type of depression that is culture-specific. (shrink)

This Ideas and Opinions article revisits an argument from Judith Jarvis Thomson in her essay “A Defense of Abortion” that abortion can be an ethical choice even if we assume that fetuses have full moral personhood and moral rights. The authors examine the implications of laws that require a pregnant person to care for another with their body and what other impositions states may also require of citizens to care for others.

Pressure and influences on school leaders as school policy makers during COVID-19 have made the task of interpreting, translating and implementing guidance more a complex and essential operation. School leaders need to prioritise and balance ever-changing government policy advice, against limitations of school buildings, the welfare of students and staff as well as the needs of the communities their schools serve. By surveying and interviewing headteachers, senior leaders and governors, this paper identifies the inputs school leaders have had to react (...) and respond to when creating policy in the context of COVID-19. The paper addresses the nature of, and factors affecting, pressures school leaders feel in authoring policy. The considerable challenges school-based policy makers face in implementing social distancing policy are non-trivial and increase tension to what is already highly stressful work. The report draws on data collected from a randomised, stratified sample of primary and secondary school leaders from across England in early June 2020, during the time of social distancing and school closure for most students. Findings suggest quality, quantity and frequency of top-down communication have contributed to school leader stress, while horizontal communication and collaboration between school leaders and across school communities helped to support leaders during rapid change. We recommend government and the education sector address communication, collaboration and change, to harness the challenges and opportunities identified by school leaders during the COVID-19 pandemic. (shrink)

Progress in addiction science is hampered by disagreements and ambiguity around its core construct: addiction. Addiction Ontology (AddictO) offers a path to a solution of the kind that has addressed similar problems in other areas of science: a set of clearly and uniquely defined entities to which terms such as ‘addiction’, addictive disorder’ and ‘substance dependence ’can be applied for ease of reference while recognizing that it is the construct definitions and their unique IDs that are central, not the terms.

Bioethics journals have lagged behind medical and science journals in exploring the threat of conflict of interest (COI) to the integrity of publications. Some recent discussions of COI that have occurred in the bioethics literature are reviewed. Discussions of what has been termed the ?Healy affair? unintentionally demonstrate that the direct and indirect influence of undisclosed COI may come from those who call for protection from the undue influence of industry. Paradoxically, the nature and tone of current discussions may (...) serve to dull sensitivities to what is indeed a serious set of issues facing bioethics. Some proposals are presented to address COI and other challenges to the integrity of bioethics and its journals. COI is too important a topic to be left to ideologues, and there is no substitute for readers' caution and skepticism as tools in dealing with the full range of biases that exist in published papers. (shrink)