The impact of abortion bans on short-term housing needs.

OBJECTIVES: State-level abortion bans in the United States have created a complex legal landscape that forces many prospective patients to travel long distances to access abortion care. The financial strain and logistical difficulties associated with travelling out of state for abortion care may present an insurmountable barrier to some individuals, especially to those with limited resources. Tracking the impact of these abortion bans on travel and housing is crucial for understanding abortion access and economic changes following the Dobbs U.S. Supreme Court decision. STUDY DESIGN: This study used occupancy data from an average of 2,349,635 (standard deviation = 111,578) U.S. Airbnb listings each month from October 1st, 2020, through April 30th, 2023, to measure the impact of abortion bans on travel for abortion care and the resulting economic effects on regional economies. METHODS: The study used a synthetic difference-in-differences design to compare monthly-level occupancy rate data from 1-bedroom entire-place Airbnb rentals within a 30-min driving distance of abortion clinics in states with and without abortion bans. RESULTS: The study found a 1.4 percentage point decrease in occupancy rates of Airbnbs around abortion clinics in states where abortion bans were in effect, demonstrating reductions in Airbnb use in states with bans. In the 6-month period post Dobbs, this decrease translates to 16,548 fewer renters and a $1.87 million loss in revenue for 1-bedroom entire-place Airbnbs within a 30-min catchment area of abortion facilities in states with abortion restrictions. CONCLUSION: This novel use of Airbnb data provides a unique perspective on measuring demand for abortion and healthcare services and demonstrates the value of this data stream as a tool for understanding economic impacts of health policies.

Implications for women of Louisiana's law requiring abortion providers to have hospital admitting privileges.

BACKGROUND: In 2014, Louisiana passed a law requiring abortion providers to have hospital admitting privileges. This law is temporarily on hold while a court case challenging it continues. We aimed to describe the population who would be affected if the law goes into effect and how closures of between three and five Louisiana abortion facilities would affect the distance Louisiana women would need to travel for an abortion. STUDY DESIGN: We abstracted patient data from three of the five Louisiana abortion care facilities in the year before the law was scheduled to take effect. We then estimated distance traveled and distances women would need to travel if clinics close. FINDINGS: Half (53%) of women who had an abortion had no education beyond high school, most were black (62%) or white (30%), three fourths (73%) had a previous live birth, and most (89%) were having a first-trimester abortion. Seventy-nine percent resided in Louisiana and 15% in Texas. The parishes in which abortion patients resided had lower median income and higher percentage poverty than the Louisiana average. Abortion patients residing in Louisiana traveled a mean distance of 58 miles each way for an abortion. If all Louisiana facilities close, the mean distance women would need to travel would more than triple to 208 miles, and the proportion of Louisiana women of reproductive age who live more than 150 miles from an abortion facility would increase from 1% to 72%. CONCLUSION: The admitting privileges law will likely significantly increase the distance Louisiana women need to travel for an abortion. This burden is likely to disproportionately affect Louisiana's more vulnerable residents. IMPLICATIONS: If all Louisiana abortion facilities close due to Louisiana's hospital admitting privileges law, the mean distance women would need to travel for an abortion would more than triple from 58 to 208 miles. Louisiana's law would thus present a considerable burden on many Louisiana women, particularly those who are more vulnerable.

Medical applications of implantable drug delivery microdevices based on MEMS (Micro-Electro-Mechanical-Systems).

Drug delivery microdevices based on MEMS (Micro-Electro-Mechanical-Systems) represent the next generation of active implantable drug delivery systems. MEMS technology has enabled the scaling down of current delivery modalities to the micrometer and millimeter size. The complementary use of biocompatible materials makes this technology potentially viable for a wide variety of clinical applications. Conditions such as brain tumors, chronic pain syndromes, and infectious abscess represent specialized clinical diseases that will likely benefit most from such drug delivery microdevices. Designing MEMS microdevices poses considerable technical and clinical challenges as devices need to be constructed from biocompatible materials that are harmless to human tissue. Devices must also be miniaturized and capable of delivering adequate pharmacologic payload. Balancing these competing needs will likely lead to the successful application of MEMS drug delivery devices to various medical conditions. This work reviews the various factors that must be considered in optimizing MEMS microdevices for their appropriate and successful application to medical disease.

Shifts in striatal responsivity evoked by chronic stimulation of dopamine and glutamate systems.

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.

MST responses to pursuit across optic flow with motion parallax.

Self-movement creates the patterned visual motion of optic flow with a focus of expansion (FOE) that indicates heading direction. During pursuit eye movements, depth cues create a retinal flow field that contains multiple FOEs, potentially complicating heading perception. Paradoxically, human heading perception during pursuit is improved by depth cues. We have studied medial superior temporal (MST) neurons to see whether their heading selectivity is also improved under these conditions. The responses of 134 MST neurons were recorded during the presentation of optic flow stimuli containing one or three speed-defined depth planes. During pursuit, multiple depth-plane stimuli evoked larger responses (71% of neurons) and stronger heading selectivity (70% of neurons). Responses to the three speed-defined depth-planes presented separately showed that most neurons (54%) preferred one of the planes. Responses to multiple depth-plane stimuli were larger than the averaged responses to the three component planes, suggesting enhancing interactions between depth-planes. Thus speed preferences create selective responses to one of many depth-planes in the retinal flow field. The presence of multiple depth-planes enhances those responses. These properties might improve heading perception during pursuit and contribute to relative depth perception.

Toward a blue revolution.

PIP: Coordinated policies and responses to problems at international, national and local levels are required in achieving a blue revolution in water management. Countries have agreed to numerous recommendations at international conferences on water. Thus, a water resource strategy by the international development community and national governments has been put into action. Crafting and implementing a national water strategy is essential to sustainable development in countries with water shortages, wherein, national governments give water resource management their highest priority. Poor communities had notable distribution of water either through special arrangements with water authority or with private vendors. Thus, a vital part of a long-term solution is the worldwide recognition of the links between rapidly growing populations and shrinking water supplies.^ieng

Speeding the reproductive revolution.

PIP: In 1994, at the International Conference on Population and Development (ICPD) held in Cairo, the international community set the goal of ensuring universal access to reproductive health care by 2015 and agreed to finance its costs. Few governments and donor countries, however, have made good on commitments made at the ICPD. Reproductive health is not improving and may actually be getting worse. Specific goals to be reached by 2015 include meeting all unmet need for family planning, reducing maternal mortality by 75% compared with 1990 levels, and reducing infant mortality to lower than 35 deaths/1000 births. Reaching these and the related reproductive health goals of the ICPD was calculated to cost about US$17 billion/year until 2000, then to increase to $22 billion/year by 2015 (in constant 1993 US dollars). Developing countries agreed to pay 66% of the cost, while donor countries paid the remainder. Immediately after the ICPD, reproductive health funding increased substantially, then declined again, with most donor countries failing to meet their funding commitments. Failure to deliver on the promised financial support for the ICPD goals will result in higher levels of unintended pregnancies, induced abortions, cases of maternal mortality, and infant deaths. Governments need to be convinced that paying for reproductive health programs is an urgent priority and that developing countries, donor countries, and multilateral institutions all have much to gain from reaching the ICPD goals.^ieng

Why family planning matters.

PIP: This Population Reports issue focuses on family planning and the importance of advocacy in family planning programs. Key evidences supporting family planning programs are summarized. This article presents the importance of advocacy for the improvement of the family planning programs in developing countries. Advocacy for family planning is becoming crucial as demand for reproductive health care grows. As many as 600 million people have used contraception, and millions more would do so with better access to good-quality services. Although fertility levels are falling in much of the world, rapid population growth remains a critical issue in most developing countries. This is where advocacy is very much needed. Through advocacy, many individuals and countries will benefit especially in the area of family planning. The benefits include saving the lives of women and children; offering women more choices; and encouraging adoption of safer sexual behavior. Through effective family planning programs, population growth will also be affected. Slower population growth helps protect the environment and it aids development.^ieng