USC-led global study finds new way to reduce bias in family planning clinics

A new USC-led study shows that targeted interventions can reduce provider bias in family planning clinics and improve care for young women — an important step toward advancing global reproductive health and gender equity.

University of Southern California

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Zachary Wagner is an economist at the Center for Economic and Social Research. His research uses economic theory and econometrics to study how people make decisions about health and health care around the globe. Wagner’s topical expertise includes take-up of health technology, quality of care in low-income countries, disasters and health, health insurance for the poor, community health workers, HIV/AIDS, child diarrhea, private sector health care, the opioid crisis, and family planning. 

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Credit: USC Dornsife College of Letters, Arts and Sciences

Millions of young women around the world face stigma and bias when seeking reproductive health services, often limiting their access to contraception and quality care. A new USC-led study conducted in over 200 clinics across Burkina Faso, Tanzania, and Pakistan shows that a focused intervention combining storytelling, peer support, and provider incentives can reduce this bias and expand contraceptive access for the young women who need it most.

“Young women — especially those who are unmarried or don’t have children — often face subtle but powerful barriers when trying to access contraception,” said Zachary Wagner, a health economist at the Center for Economic and Social Research at the USC Dornsife College of Letters, Arts and Sciences and the study’s corresponding author. “This bias can shape the care they receive — or whether they seek care at all.”

Published in The Economic Journal, the findings offer a promising way to improve reproductive health services by tackling the root causes of provider bias. By promoting more respectful and inclusive care, the intervention helps ensure that young women — regardless of their marital status or motherhood — can make informed choices about contraception.

Shifting provider attitudes

Bias in family planning clinics can take many forms. For example, providers may tell young women they are “too young” to be sexually active and suggest abstinence instead. Others may limit contraceptive options based on age or marital status, implying that young women shouldn’t use certain methods or any contraception at all, Wagner said.

In collaboration with the nonprofit Pathfinder International, the researchers designed a three-part intervention that was randomly assigned to 227 clinics across Burkina Faso, Tanzania and Pakistan. First, healthcare providers attended educational sessions where they heard first hand stories from young women about their experiences with bias, alongside honest reflections from providers who recognized their own past prejudices.

To sustain progress, providers joined a dedicated WhatsApp group to share experiences, offer support, and reinforce learning throughout the year. Regular in-person refresher sessions kept the focus on reducing bias, while clinics demonstrating the greatest improvements received quarterly awards to motivate ongoing progress.

To assess how providers treated different types of patients, the study used “mystery shoppers”—young women trained to pose as real clients seeking family planning services. These shoppers were randomly assigned profiles varying by age, marital status, and motherhood status. They completed the full consultation like any other client but did not select a contraceptive method, instead saying they needed more time or wanted to discuss their options with family members.

Alongside mystery shopper data, researchers collected exit surveys and conducted qualitative interviews with providers and clients to gain a fuller understanding of clinic practices.

The results showed that clinics receiving the intervention offered young women a broader range of contraceptive options—including long-acting methods—and treated them with greater respect and empathy. This improvement was especially notable for women without children, who initially faced the highest levels of bias.

“Our interpretation is that the women most likely to experience bias—such as younger, unmarried women without children — simply don’t visit clinics very often,” Wagner said. “While our mystery shoppers represented these groups, many real women in these categories are unlikely to seek care.”

Among patients surveyed after their visits, there was little difference in contraceptive methods provided, largely because most weren’t at high risk of bias in the first place, he added.

“The intervention’s success across three very different countries shows its potential for broader impact,” Wagner said. “Reducing provider bias is a crucial step toward ensuring all young women can make informed decisions about their reproductive health.”

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Journal

The Economic Journal

DOI

10.1093/ej/ueaf012 

Method of Research

Experimental study

Subject of Research

People

Article Title

Reducing Bias Among Health Care Providers: Experimental Evidence from Tanzania, Burkina Faso and Pakistan

Article Publication Date

3-Jun-2025

GIG WORK FOR CAT LADIES

Telehealth can improve care for cats with chronic health issues

Research finds informal video visits beneficial for humans and pets

University of California - Davis

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Caring for a cat with chronic health conditions can be challenging for all involved, from the process of getting to a veterinary clinic to the stress of being in a strange environment with new smells and animals.

Researchers at the University of California, Davis, worked with pet owners across the United States and Canada to determine whether video telehealth visits could help improve care and the home environment for cats with feline degenerative joint disease, commonly referred to as feline arthritis.

The findings, published in the journal Frontiers in Veterinary Science, show that video calls where pet owners can ask questions and get non-medical advice can be beneficial. More than 95% of those who took part in the research said they would pay for telehealth visits, though most were willing to pay a little less than for in-clinic appointments.

“Teleadvice is meant to provide advice and support for caregivers caring for their cats,” said lead author Grace Boone, an assistant specialist in the UC Davis Animal Welfare Epidemiology Lab. “We found that overall everybody was quite interested in video telehealth for home management of their cats and their mobility issues.”

A common ailment

Routine veterinary care is important to prevent, mitigate and treat health and behavioral problems. And feline arthritis is quite common, present in roughly 6% to 30% of cats under age 10 and from 64% to 92% of those older than 10, Boone said.

“Cats are great at hiding signs of pain,” said Carly Moody, senior author on the paper and an assistant animal science professor. “These conditions are prevalent and pain is a serious health and welfare issue that needs to be addressed. Telehealth is beneficial because it allows you to take out that clinic stressor for some aspects of care.”

The researchers recruited 106 pet owners whose cats had mobility issues. Each one filled out a questionnaire about their cat’s mobility, barriers to getting in-person care and how they felt about telehealth.

Pet owners in the test group took the survey and participated in six video visits — one every three weeks over four months — and then retook the survey. The control group only received the questionnaire at the beginning of the research and four months later. A presentation on caring for cats with mobility issues also was offered to all participants at the end.

In the home video session, Boone asked general questions about the cat’s wellbeing and mobility, and suggested modifications if owners asked for advice. Suggestions included elevated food and water dishes to ease neck strain, larger litter boxes with shorter walls, and additional steps to access favorite places. Pet owners reported that the visits helped them understand their cats’ needs, making them more confident in how they cared for their cats.

“There’s a lot of in-home modifications that can be implemented to increase cat comfort in the home,” Moody said. “Telehealth allows veterinary professionals to see and understand the cat’s home environment and make recommendations which can be helpful for the cat.”

Advice not medicine

Telehealth visits don’t require a veterinarian. A registered veterinary technician or other knowledgeable staff member can conduct the calls, answer questions and give advice. They are not meant to replace in-person veterinary care but rather supplement it, Moody said.

“There’s ways you can incorporate telehealth to make it easier for the owner and the cat and increase the number of visits and support an owner is receiving, particularly when they’re caring for a cat that requires chronic high levels of care at home,” Moody said.

The visits have the potential to foster better veterinarian-client-patient relationships. “Rather than being something that detracts from in-person care, I think you can improve it and help supplement it,” Boone said.

Evaluating changes in the home

Next up is to determine whether recommended changes based on expert advice can improve a cat’s wellbeing in the home.

“I think it would be really interesting to look at these interventions and specifically say, ‘Are they helpful?’ If somebody’s not willing to change a lot of things in their home, you could prioritize the ones that make the most difference for the cat’s welfare,” Moody said.

Moody’s lab may also examine whether telehealth could be beneficial for other health issues like obesity and disease prevention.

Hao-Yu Shih from the Mayo Clinic and Daniel Pang, who is affiliated with the University of Calgary and University of Montreal in Canada, contributed to the research. It was supported by the American Society for the Prevention of Cruelty to Animals and the family foundation Maddie’s Fund.

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Journal

Frontiers in Veterinary Science

DOI

10.3389/fvets.2025.1510006 

Method of Research

Survey

Subject of Research

Animals

Article Title

Incorporating video telehealth for improving at-home management of chronic health conditions in cats: a focus on chronic mobility problems

 

Birds may be drinking on the wing, but in moderation

University of Chicago Press Journals

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A new paper published in Ecological and Evolutionary Physiology examines alcohol consumption in avian species. 

In “The proof is in the plumage: a method for detecting dietary ethanol exposure in birds by testing for ethyl glucuronide in feathers,” authors Cynthia Y. Wang-Claypool, Ammon Corl, Joseph Jones, Jimmy A. McGuire, Rauri C.K. Bowie and Robert Dudley investigated whether birds that eat sugar-rich foods—like fruit and nectar—might regularly consume alcohol produced by natural fermentation. Alcohol naturally results from fermentation of sugary foods like fruit and nectar. 

Avian inebriation may reduce survival and reproductive success, including, but not limited to, increased predation risk due to impaired flight performance as well as injury or death due to accidental collisions during flight.

The authors hypothesized that detection and levels of a byproduct of alcohol metabolism called ethyl glucuronide (EtG) would vary among species with different dietary specializations, specifically suggesting that nectarivores and frugivores would have higher levels of EtG than other dietary groups. “To date, occurrence of this molecule has not been studied in vertebrates other than humans and several other mammalian taxa,” they noted.

Ethyl glucuronide stays in the body after alcohol breaks down. Using chemical analysis, the authors tested feathers and liver samples from 17 bird species, largely determined by what samples they could obtain from salvage specimens donated to the Museum of Vertebrate Zoology in Berkeley, California. “The method that we used to test for EtG requires destructive sampling of feathers, and we necessarily used specimens that the museum already had in abundance,” they wrote.

As expected, hummingbirds (i.e., predominantly nectar feeders) often had EtG in their feathers, suggesting sugar-rich foods like nectar may ferment and produce ethanol. “Artificial nectar feeders (like those in people's yards) might be a source of ethanol if the sugar water ferments. This might explain high EtG levels in Anna’s Hummingbirds from urban areas," the authors note. However, EtG was also present in birds with other diets, like seeds, insects, and other animals.

The results suggest that avian exposure to ethanol is not restricted to species with diets specialized on sugary foods. Therefore, the authors conclude, “exposure of animals to ethanol could be much more widespread than has been previously recognized.” 

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Ecological and Evolutionary Physiology primarily publishes original research examining fundamental questions about how the ecological environment and/or evolutionary history interact with physiological function, as well as the ways physiology may constrain behavior. For EEP, physiology denotes the study of function in the broadest sense, across levels of organization from molecules to morphology to organismal performance and on behavior and life history traits.

Contact: Mallory Gevaert / mgevaert@uchicago.edu

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Journal

Ecological and Evolutionary Physiology

DOI

10.1086/735669 

Article Title

The Proof Is in the Plumage: A Method for Detecting Dietary Ethanol Exposure in Birds by Testing for Ethyl Glucuronide in Feathers

 

Can social media predict teen health risks?

UTA researchers to track 250 Texas teens’ social media use, mental health and behavior over time

University of Texas at Arlington

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This fall, researchers from The University of Texas at Arlington will launch an ambitious study to explore how teens’ everyday experiences on social media may shape their mental health and potential substance use.

UT Arlington School of Social Work Professors Melissa Lewis and Dana Litt, in collaboration with lead investigator Karrie Curry, a research scientist at the University of North Texas Health Science Center, will follow 250 adolescents of varied backgrounds from across Texas. Through daily surveys over six weeks, the team will capture how specific types of social media engagement affect participants’ feelings of anxiety and depression and tendency toward risky behavior, such as substance use.

A 12-month follow-up will help determine whether those short-term interactions predict more serious problems over time.

Unlike most previous research, which has focused on how much time teens spend online, this study will dig deeper into what they’re seeing, sharing and responding to on social media, and how those interactions influence a range of health behaviors.

“We’re going to look at specific engagement with content related to the health behaviors we’re interested in,” Dr. Litt said. “Is a teen just viewing content about substance use or mental health, or are they sharing it? Does that difference matter? We’re trying to understand exactly what about it is risky across certain days and over time.”

The study could help lead to better prevention strategies and provide parents guidance on how their children navigate the complex digital world.

“There’s research showing the risks of being online, but also some benefits,” Litt said. “This study could help highlight both sides and create talking points for parents—for example, asking questions like ‘What do you enjoy online?’ ‘What makes you happy?’ ‘What makes you sad?’

"Balancing the conversation, not just focusing on the scary parts, can really help. That’s something this research could lead to—future studies, prevention and interventions.”

Parent interventions don’t necessarily need to be about a specific topic like social media, mental health or alcohol; it’s really about conversation strategies, Lewis said.

“If something happens, like a problem with a peer or something on social media, parents need to approach those conversations in a way that encourages participation instead of just reacting with anger,” she said.

The study’s findings could serve as a foundation and inform strategies to prevent harm and promote healthy development in adolescents.

About The University of Texas at Arlington (UTA)

Celebrating its 130th anniversary in 2025, The University of Texas at Arlington is a growing public research university in the heart of the thriving Dallas-Fort Worth metroplex. With a student body of over 41,000, UTA is the second-largest institution in the University of Texas System, offering more than 180 undergraduate and graduate degree programs. Recognized as a Carnegie R-1 university, UTA stands among the nation’s top 5% of institutions for research activity. UTA and its 280,000 alumni generate an annual economic impact of $28.8 billion for the state. The University has received the Innovation and Economic Prosperity designation from the Association of Public and Land Grant Universities and has earned recognition for its focus on student access and success, considered key drivers to economic growth and social progress for North Texas and beyond.

 

Pitt study has upended decades-old assumptions about brain plasticity

University of Pittsburgh

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A) Two-photon image of a basal dendrite of L2/3 neuron loaded with Alexa 594. In this example, the spine is ~40 μm below the surface of the slice. Scale bar, 2 μm. (B) Voltage-clamp traces corresponding to single uncaging trials recorded sequentially at the locations indicated by the orange spots in (A). A 0.5-ms uncaging pulse was delivered at the time indicated by the arrowhead. Laser intensity was the same for each trial. Scale bar, 50 pA and 20 ms. (C) Sample image of L2/3 pyramidal neuron (inset) and enlarged dendritic segment (yellow box). Representative sample traces (color coded to match the spine with uEPSC) of some spines are depicted with uEPSC before TCM (black) and after TCM application (gray). Scale bar, 10 pA and 20 ms; 5 and 50 μm (inset). (D) Summary graph, (E) cumulative probability, and (F) probability density plots of uEPSC amplitudes induced by two-photon uncaging of MNI-glutamate onto a single spine head under the baseline condition (black) and after TCM application (gray). (D) Paired t test; 73/4; T72 = 4.98, ****P < 0.0001. Lines in (F) indicate the mixed Gaussian fit of the uEPSC amplitude distribution.

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Credit: Courtesy of Oliver Schlüter Lab/University of Pittsburg

A new study from Pitt researchers challenges a decades-old assumption in neuroscience by showing that the brain uses distinct transmission sites — not a shared site — to achieve different types of plasticity. The findings, published in Science Advances, offer a deeper understanding of how the brain balances stability with flexibility, a process essential for learning, memory and mental health.

Neurons communicate through a process called synaptic transmission, where one neuron releases chemical messengers called neurotransmitters from a presynaptic terminal. These molecules travel across a microscopic gap called a synaptic cleft and bind to receptors on a neighboring postsynaptic neuron, triggering a response.

Traditionally, scientists believed spontaneous transmissions (signals that occur randomly) and evoked transmissions (signals triggered by sensory input or experience) originated from one type of canonical synaptic site and relied on shared molecular machinery. Using a mouse model, the research team — led by Oliver Schlüter, associate professor of neuroscience in the Kenneth P. Dietrich School of Arts and Sciences — discovered that the brain instead uses separate synaptic transmission sites to carry out regulation of these two types of activity, each with its own developmental timeline and regulatory rules.

“We focused on the primary visual cortex, where cortical visual processing begins,” said Yue Yang, a research associate in the Department of Neuroscience and first author of the study. “We expected spontaneous and evoked transmissions to follow a similar developmental trajectory, but instead, we found that they diverged after eye opening.”

As the brain began receiving visual input, evoked transmissions continued to strengthen. In contrast, spontaneous transmissions plateaued, suggesting that the brain applies different forms of control to the two signaling modes.

To understand why, the researchers applied a chemical that activates otherwise silent receptors on the postsynaptic side. This caused spontaneous activity to increase, while evoked signals remained unchanged — strong evidence that the two types of transmission operate through functionally distinct synaptic sites.

This division likely enables the brain to maintain consistent background activity through spontaneous signaling while refining behaviorally relevant pathways through evoked activity. This dual system supports both homeostasis and Hebbian plasticity, the experience-dependent process that strengthens neural connections during learning.

“Our findings reveal a key organizational strategy in the brain,” said Yang. “By separating these two signaling modes, the brain can remain stable while still being flexible enough to adapt and learn.”

The implications could be broad. Abnormalities in synaptic signaling have been linked to conditions like autism, Alzheimer’s disease and substance use disorders. A better understanding of how these systems operate in the healthy brain may help researchers identify how they become disrupted in disease.

“Learning how the brain normally separates and regulates different types of signals brings us closer to understanding what might be going wrong in neurological and psychiatric conditions,” Yang said.

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Journal

Science Advances

DOI

10.1126/sciadv.ads5750 

Method of Research

Experimental study

Subject of Research

Animals

Article Title

Distinct transmission sites within a synapse for strengthening and homeostasis

New book details the good, bad and unexpected of ibuprofen

University of California - Davis

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What you don’t know about ibuprofen, one of the world’s most popular painkillers, could well fill a book — and that book has just been published, authored by Professor Aldrin Gomes and 36 of his current and former students at the University of California, Davis.

“Ibuprofen is an affordable and widely used medication that has transformed pain management for millions worldwide,” said Gomes, who teaches in the Department of Neurobiology, Physiology and Behavior. “However, its story serves as a powerful reminder of the delicate balance between benefit and risk.”

Ibuprofen is ubiquitous, with many people taking it several days a month for headaches, aches and pains, or to control fevers. But peel back the label on that bottle in your bathroom cupboard and there is a list of adverse side effects: stroke, heart attack, heart failure, stomach bleeding. One study found that ibuprofen tripled the risk of stroke while other studies found an increased risk of stroke ranging from 10% to 50%, Gomes said. This risk begins within the first few weeks of regular, daily use.

Ibuprofen interacts with more than 400 other prescription drugs; dropped pills can be toxic to pets; and it finds its way into waterways, harming fish and plants.

“These are things most people don’t know,” he said.

Gomes’ lab studies the biochemical pathways through which ibuprofen and other painkillers affect the body, both positively to control pain, fever and inflammation, and negatively to cause side effects. He is especially interested in how and why these drugs affect the cardiovascular system.

A lab learning project

Gomes was inspired to write the book because he found that undergraduate students entering his lab knew almost nothing about the potential negative effects of ibuprofen.

“I thought it would be good for the students, and it became a lab project,” he said. Gomes is passionate about mentoring undergraduates: In January he received a Presidential Award for Excellence in Science, Mathematics and Engineering Mentoring from the outgoing Biden administration. So he was looking for ways to bring more undergraduates into his lab to do experiential learning that would complement their bench research projects.

Since the book project began, all students working in Gomes’ lab have been invited to take part, including writing, editing and illustrating.

“Being part of this project taught me that good science is not just about making discoveries, but about how effectively we communicate them,” said Ahmad Ikram, a recent graduate from UC Davis and major contributing author to the book. “Each chapter reflects our effort to bridge the gap between data and understanding, and to tell the story of ibuprofen in a way that truly connects.”

The book includes chapters on how ibuprofen works to ease pain and inflammation and reduce fevers; how it can affect the heart, liver, gastrointestinal tract and kidneys; how to use painkillers responsibly; and natural alternatives for pain relief.

Additional contributors to the book are: Omnia Ali, Mariza Azmat, Emily Barson, Priyanka Basu, Igor Bejenari, Jillian Cellucci, Celeste Do, Ryan Dulong, Daisaku Edwards, Jaime Morales Gallardo, Emily Gartrell, Massie Gardizi, Timothy Gutierrez, Christina Jung, Cierra Hall, Tan Hua, Nicole Lonsway, Aparna Manoj, Natalie Nashed, Rachel Nguyen, Irene Park, Gabriela Rivera, Lauren Roehrs, Siona Samanta, Erik-Matthew Sario, Gaia Soldano, Vanessa Su, Isabella Tan, Jacob Tuazon, Mackenze Trpcic, Tanishq Vaidya, Yael Vainberg, Christina Vyoda, Yue (Cynthia) Yu and Yuhan Zhang. Qian Xu, M.D., Ph.D., vice president of clinical development of Jiangsu Hengrui Medicine Company, acted as a technical consultant and contributor.

“The Comprehensive Guide to Ibuprofen: The Good, the Bad and the Unexpected” is published June 3 by Mystic River Books. It is available on Amazon as an e-book, paperback or hardcover.