Anxiety and Depression Symptoms After the Dobbs Abortion Decision

Importance

In 2022, the US Supreme Court abolished the federal right to abortion in the Dobbs v Jackson Women's Health Organization decision. In 13 states, abortions were immediately banned via previously passed legislation, known as trigger laws.

Objective

To estimate changes in anxiety and depression symptoms following the Dobbs decision among people residing in states with trigger laws compared with those without them.

Design, Setting, and Participants

Using the nationally representative repeated cross-sectional Household Pulse Survey (December 2021-January 2023), difference-in-differences models were estimated to examine the change in symptoms of depression and anxiety after Dobbs (either the June 24, 2022, Dobbs decision, or its May 2, 2022, leaked draft benchmarked to the baseline period, prior to May 2, 2022) by comparing the 13 trigger states with the 37 nontrigger states. Models were estimated for the full population (N = 718 753), and separately for 153 108 females and 102 581 males aged 18 through 45 years.

Exposure

Residing in states with trigger laws following the Dobbs decision or its leaked draft.

Main Outcomes and Measures

Anxiety and depression symptoms were measured via the Patient Health Questionnaire-4 ([PHQ-4]; range, 0-12; scores of more than 5 indicate elevated depression or anxiety symptoms; minimal important difference unknown).

Results

The survey response rate was 6.04% overall, and 87% of respondents completed the PHQ-4. The population-weighted mean age was 48 years (SD, 17 years), and 51% were female. In trigger states, the mean PHQ-4 scores in the baseline period and after the Dobbs decision were 3.51 (95% CI, 3.44 to 3.59) and 3.81 (95% CI, 3.75 to 3.87), respectively, and in nontrigger states were 3.31 (95% CI, 3.27 to 3.34) and 3.49 (95% CI, 3.45 to 3.53), respectively. There was a significantly greater increase in the mean PHQ-4 score by 0.11 (95% CI, 0.06 to 0.16; P < .001) in trigger states vs nontrigger states. From baseline to after the draft was leaked, the change in PHQ-4 was not significantly different for those in trigger states vs nontrigger states (difference-in-differences estimate, 0.09; 95% CI, -0.03 to 0.21; P = .15). From baseline to after the Dobbs opinion, there was a significantly greater increase in mean PHQ-4 scores for those in trigger states vs nontrigger states among females aged 18 through 45 years (difference-in-differences estimate, 0.23; 95% CI, 0.08 to 0.37; P = .002). Among males aged 18 through 45 years, the difference-in-differences estimate was not statistically significant (0.14; 95% CI, -0.08 to 0.36; P = .23). Differences in estimates for males and females aged 18 through 45 were statistically significant (P = .02).

Conclusions and Relevance

In this study of US survey data from December 2021 to January 2023, residence in states with abortion trigger laws compared with residence in states without such laws was associated with a small but significantly greater increase in anxiety and depression symptoms after the Dobbs decision.

Antidiscrimination Laws as Essential Tools for Achieving LGBTQ+ Health Equity

This Viewpoint discusses a pending US Supreme Court case to determine the extent to which people who identify as LGBTQ+ are protected under state antidiscrimination laws in the commercial marketplace.

Implications of Dobbs for the (Re)Criminalization of Intimacy Among LGBTQ Individuals

This Viewpoint outlines how the revival of now defunct state-level antisodomy laws would harm the health care of LGBTQ individuals should the US Supreme Court reverse itself and urges medical professionals and their societies to advocate for the immediate abolition of antisodomy laws.

When Doctors are "Doxxed:" An Analysis of Information Posted on an Antiabortion Website

OBJECTIVES

To systematically review information posted about abortion providers on an antiabortion website.

STUDY DESIGN

Within a purposive sample of 64 abortion providers in 24 states, we reviewed 921 documents posted on the website.

RESULTS

Extensive provider personal information obtained via public records laws and other public sources was posted on the website in an accessible and searchable format.

CONCLUSIONS

Public records laws and other public sources of information have opened potent avenues for collecting and disseminating providers' personal information.

IMPLICATIONS

This website fits into a larger pattern of longstanding efforts to intimidate, threaten, and vilify providers.

Reproductive Injustice at the US Border

The detention of immigrants inside US borders is not a new phenomenon. However, a dramatic shift has occurred in both the number and treatment of immigrants in detention.We examine recent changes in immigration policies that have systematized the mistreatment of children and pregnant immigrants, including a ban on abortion for unaccompanied minors in immigration detention, the neglect and mistreatment of pregnant immigrants in detention, and the separation and prolonged detention of parents and children in unsafe facilities.We employ the reproductive justice framework to demonstrate how these policies violate all 3 primary values of reproductive justice: the right to have children, the right not to have children, and the right to parent children in safe and secure environments. We argue that, when analyzed through the lens of reproductive justice, these policies can be seen as manifestations of a single targeted strategy to control the reproductive autonomy of migrants as a tool of immigration enforcement. We conclude with a call to action to the public health community.

A review of the evidence and cost of therapies for cutaneous lupus erythematosus

Cutaneous lupus erythematosus (CLE)-a common presentation of lupus erythematosus-may exist independently or as a part of the systemic manifestations of systemic lupus erythematosus. The effects of living with and treating a chronic condition such as CLE can be debilitating to a patient's health and finances. The management of patients with CLE is made particularly challenging by poor compliance, limited therapeutic options, scarcity of evidence supporting their use, and significant differences in costs of medications. Effective management of CLE should center on prevention, individualized treatment regimens, and a mutual understanding of the challenges that patients with CLE face. This article seeks to provide an overview of the efficacy, safety, and cost of therapeutic options for CLE.

Educating workers about tuberculosis

At a state penitentiary, workers are told that the communicable disease unit is a safe environment in which to work due to the negative air pressure in the isolation rooms and the improved ventilation system. However, nobody is trained to monitor the system or understands the role of negative air pressure, and isolation room doors are occasionally left open. As a result, workers are reluctant to work in the unit. At a soup kitchen, workers refuse to serve people with HIV due to fear of tuberculosis transmission. They have heard that people infected with HIV are likely to have TB and, therefore, to protect themselves, they feel the soup kitchen should not serve people with HIV. In a large, urban social service agency, workers buy masks and begin wearing them to work when they hear a coworker has tuberculosis. Pictures of them in the newspaper instigate a string of similar actions in other agencies. Emergency room workers in a city hospital have been told they are not at increased risk of contracting TB, because they do not have prolonged contact with infectious patients. However, when they discover that several coworkers tested positive on PPD screening tests, they go to their union demanding action.

Determination of pesticides in indoor air and dust

Improved analytical and sampling methods were developed for the multiresidue determination of pesticides in indoor air. Air analysis consists of adsorption of the pesticides in 1 m(3) of air onto Tenax TA via an air sampling pump, desorption with acetone and determination and quantitation by gas chromatography/mass spectrometry (GC/MS) with chemical ionization on an ion trap mass spectrometer. Limits of detection for the 23 pesticides studied ranged from 0.5 ng/m(3) for chlorpyrifos and diazinon to 30 ng/m(3) for o-phenylphenol (approximately 0.5-30 parts per trillion on a w/w basis). A simple method for the detection of pesticides in dust was also developed. This method involves emptying the contents of a vacuum cleaner bag into a standard household food processor and extracting 1 g homogenized dust with acetone before GC/MS. Limits of detection were 25-100 ppb because of interferences by common household chemicals. However, pesticide concentrations were higher in dust than in air, therefore, analysis of dust is a better indicator of indoor pesticide exposure.

Glycation of lysozyme in a restricted water environment

Fast atom bombardment mass spectrometry (FAB) was used to determine the glycation sites of lysozyme in a restricted water environment. A 30-day incubation at 25 degrees C, and 65% relative humidity (R.H.) resulted in glycation at lysine-1 while a much shorter (3-day) incubation at 50 degrees C and 65% R.H. resulted in diglycation at lysine-1 as well as glycation at lysine-13 and lysine-33.

Determination of daminozide in apples by gas chromatography/chemical ionization mass spectrometry

A method using gas chromatography/chemical ionization mass spectrometry (GC/CIMS) for the determination of daminozide residues in apples has been developed. Daminozide was separated from the sample matrix by water extraction and cation exchange, converted to the methyl ester by treatment with HCl-methanol, and determined by GC/CIMS using succinonitrile as an internal standard. The detection level was 0.05 ppm. Recoveries were 92-104% from apples spiked at the 0.05-0.5 ppm levels. Of the 25 apple samples analyzed, only 2 were positive for daminozide (1.04 and 0.32 ppm).

Determination of linuron in potatoes using capillary column gas chromatography/mass spectrometry

A convenient method for the determination of the N-methyl,N-methoxy-phenylurea herbicide (linuron) in potatoes has been developed. The herbicide is extracted from potatoes using a slightly modified Luke multiresidue procedure. The extract is analyzed directly by gas chromatography with cold on-column injection, using an ion trap mass spectrometer in the chemical ionization mode as the detector. Quantitation is performed using p-bromonitrobenzene as the internal standard. The limit of detection is 0.1 ppm. Recoveries of linuron in potatoes averaged 112 +/- 6% at the 0.5 ppm level, and 110 +/- 2% at the 0.2 ppm level. No linuron residues were found in 25 potato samples that were analyzed by this method. Two other N-methyl,N-methoxy-phenylurea herbicides, metobromuron and chlorbromuron, are also sufficiently stable to be determined by this method, but the N,N-dialkyl-phenylurea herbicides neburon, diuron, and monuron are too thermally unstable and degrade in the gas chromatograph.

Photolysis primes biodegradation of benzo[a]pyrene

14C-labeled benzo[a]pyrene (BaP) was used as a model-compound for polycyclic aromatic hydrocarbons (PAH) in order to assess the effect of photolytic pretreatment on the subsequent fate of BaP in sewage sludge and soil test systems. Photolysis was performed in methanolic solution with or without 0.1 M H2O2, under either UV light (300 nm) or natural sunlight. The presence of H2O2 greatly enhanced the rate of photolysis both with UV and with natural sunlight. Intact BaP resisted biodegradation in both test systems. Photolysis transformed BaP to polar materials that were subject to increased mineralization and binding in both biological test systems. As shown by the Ames assay, photolysis decreased the mutagenicity of BaP to test strains TA98 and TA104 only moderately. The photolysate had an increased acute toxicity and lost its need for activation by S-9 enzymes. However, during subsequent incubation in soil or sewage sludge, mutagenicity decreased rapidly by one to two orders of magnitude and acute toxicity disappeared due to the mineralization and binding of photoproducts to humic materials. Photolysis of BaP and similar PAH compounds represents a useful treatment option that could be applied to certain PAH-containing petroleum refinery sludge and to coal tar residues in order to facilitate their detoxification and environmentally safe disposal.

Automated sample cleanup for pesticide multiresidue analysis. III. Evaluation of complete system for screening subtolerance residues in vegetables

An automated continuous flow sample cleanup system intended for rapid screening of foods for pesticide residues in fresh and processed vegetables has been developed. Recovery and precision data for 8 pesticides in each of 3 crops are compared for the automated and manual procedures. Average recovery for samples fortified with pesticides between 0.026 and 0.277 ppm was 98% for the automated system and 92% for the manual procedure. Average coefficient of variation was 6.6% for the automated system and 4.2% for the manual procedure. In another evaluation, the automated system gave an average recovery of 95% for 12 pesticides commonly found in imported foods; the manual procedure gave an average recovery of 91%. Thus, the results obtained so far indicate that the automated system for sample cleanup gives results comparable to those obtained by manual procedures.

The effect of anti-promoters and calcium antagonists on V-79 Chinese hamster lung fibroblasts exposed to phorbol myristate acetate

The effect of calcium antagonists and representative compounds from several classes of anti-promoters including anti-inflammatory sterols, protease inhibitors, retinoids and cyclic nucleotides on metabolic cooperation in cells treated with phorbol-12-myristate-13-acetate (PMA) was determined. Each compound was tested for its effect on metabolic cooperation and also for its ability to reverse or modify the inhibitory properties of PMA on intercellular communication at noncytotoxic exposure concentrations. Of all the compounds tested only cyclic AMP was able to antagonize the inhibitory effect of PMA. trans-Retinoic acid inhibited metabolic cooperation slightly at high exposure concentrations and acted synergistically with PMA to strongly inhibit intercellular communication in a dose-dependent manner.

The effect of some experimental parameters on the inhibition of metabolic cooperation by phorbol myristate acetate

The effect of cell density, PMA exposure time, concentration, pre-exposure and binding activity on the recovery of V 79 HGPRT- Chinese hamster cells in the metabolic cooperation assay was determined. A PMA exposure interval of only 1 min resulted in maximum recovery of HGPRT- cells. PMA began to inhibit metabolic cooperation at a dose as low as 0.1 ng/ml final media concentration. The recovery of HGPRT- cells varied according to cell density in the presence or absence of PMA, although the magnitude of this effect was much greater in untreated cells. Pre-exposure of cells to PMA increased the recovery of both post-PMA-treated and non-treated HGPRT- cells in a dose-dependent manner. [3H]PMA was rapidly bound to or taken up by V 79 cells. These results suggest that the inhibitory effect of PMA on metabolic cooperation in V 79 cells involves receptor binding.

Automated sample cleanup for pesticide multiresidue analysis. Part II--Design and evaluation of column chromatography module

An automated, continuous flow system is described for Florisil column chromatography of pesticide residues from food extracts. Evaluation of the system using 5 common organochlorine and organophosphorus pesticides in 2 crop matrices demonstrates essentially no difference in recovery or precision between automated and currently used manual analyses. The automated procedure uses only 20% of the solvents and adsorbents used in the manual procedure and is 3 times faster.

Quantification and confirmation of four Fusarium mycotoxins in corn by gas chromatography-mass spectrometry-selected ion monitoring

A rapid method for the simultaneous determination of T-2 toxin, HT-2 toxin, diacetoxyscirpenol and zearalenone has been developed. Corn samples (10 g) are extracted with methanol, defatted with hexane and subsequently cleaned-up using both reversed-phase (C18) and normal-phase (silica gel) Sep-Pak cartridges. Confirmation of identity is made by gas chromatography-mass spectrometry-selected ion monitoring of three ions characteristic of the trimethylsilyl derivatives of the mycotoxins. Use of deuterated internal standards makes the method quantitatively reliable and increases sensitivity. Confirmation of identity as well as quantitation can be achieved at levels of ca. 20-50 ppb, depending on the mycotoxin. Detection limits (without confirmation of identity) are estimated at 1-20 ppb. Recoveries at the 46-111 ppb level ranged from 80 to 103% with coefficients of variation ranging from 1.6 to 14.2%.

Automated sample cleanup for pesticide multiresidue determination. I. Evaluation of solvent partitioning module

An automated continuous flow procedure is described that improves the cost effectiveness and precision of AOAC methodology for multiresidue pesticide determinations in nonfatty foods. Individual modules capable of performing automated solvent partitioning and automated column chromatography were constructed and integrated into a continuous flow system. Data are presented comparing the recoveries and precision for the determination of 8 pesticides (aldrin, dieldrin, p,p'-DDT, ethion, heptachlor epoxide, lindane, parathion, and ronnel) partitioned from 2 food crops (spinach and tomatoes) by both the manual and automated procedures.

Inhibition of metabolic cooperation by cigarette smoke condensate and its fractions in V-79 Chinese hamster lung fibroblasts

This study was performed to determine the usefulness of the intercellular metabolic cooperation assay for analysis of a complex mixture and to compare the results obtained with previously conducted in vivo tumor promoter assays. One hundred 2R1 cigarettes were smoked according to Federal Trade Commission guidelines and the resulting condensate was separated into a water/methanol-soluble fraction (which was further partitioned into acidic and basic components) and an organic solvent-soluble fraction (which was then chromatographed on silicic acid with petroleum ether, benzene/petroleum ether, benzene, ether, and methanol). The following fractions were positive in the metabolic cooperation assay (in decreasing order of activity): organic solvent-soluble, acidic, whole condensate, and water/methanol-soluble fractions as well as the ether, benzene, and benzene/petroleum ether eluates. The basic fraction and the petroleum ether and methanol eluates were negative. In general, the metabolic cooperation assay results were comparable to previously published results obtained on mouse skin.

Presence of four Fusarium mycotoxins and synthetic material in 'yellow rain'. Evidence for the use of chemical weapons in Laos

Analysis of a 'yellow rain' sample by selected ion monitoring revealed the presence of three trichothecenes: T-2 toxin, diacetoxyscirpenol and 4-deoxynivalenol in concentrations of at least 48, 42 and 58 ppm, respectively. The concentration of zearalenone, another Fusarium mycotoxin, was estimated to be at least 265 ppm. Evidence for a formulation which contained polyethylene glycol was also obtained.

Mutagenic potency of haloacroleins and related compounds

2-Chloroacrolein, the ultimate mutagen, formed on metabolism of the carcinogenc herbicides, diallate and sulfallate, and its 2-bromo-, 2,3-dichloro- and 2,3,3-trichloro- analogs are much more potent mutagens in the Ames Salmonella typhimurium strain TA1U0 assay than any other aldehydes examined previously or in this study. Polymer formation on reaction of deoxyadenosine with the difunctional 2-chloroacrolein probably involves crosslinking via Schiff base formation at the carbonyl group and Michael addition at the doubts bond.

Gas-liquid chromatographic/mass spectrometric screening method for T-2 toxin in milk

A method for the analysis of T-2 toxin in milk is presented. Ethyl acetate extracts of milk samples which had been spiked with T-2 toxin were purified by thin layer chromatography and derivatized with N,O-bis(trimethylsilyl)acetamide to produce the T-2 toxin trimethylsilyl ether (T-2 toxin-TMS). N,O-bis(trimethylsilyl-d9)acetamide was used to make T-2 toxin d9-trimethylsilyl ether (T-2 toxin-d9 TMS) which was added to the derivatized milk extract as an internal standard. Samples were analyzed by combined gas-liquid chromatography/mass spectrometry using either electron impact ionization or chemical ionization mass spectrometry. In electron impact ionization analyses, simultaneous monitoring of the T-2 toxin-TMS fragment ion at m/z 436 and the T-2 toxin-d9TMS fragment ion at m/z 445 gave a T-2 toxin-TMS detectability estimated at 6 microgram/kg. In chemical ionization analyses, the T-2 toxin-TMS fragment ion at m/z 377 and the T-2 toxin-d9TMS fragment ion at m/z 386 were simultaneously monitored to give a T-2 toxin-TMS detectability estimated at 3 microgram/kg. Average recovery was 85% at 200 microgram/kg and 65% at 20 microgram/kg.

Novel activation mechanism for the promutagenic herbicide diallate

The potent bacterial mutagen 2-chloroacrolein is formed from the carcinogenic herbicide S-2,3-dichloroallyl diisopropylthiocarbamate (diallate) on incubation with hepatic microsomal monooxygenases or on reaction with m-chloroperbenzoic acid. A proposed activation mechanism for this promutagen involves sulfoxidation followed by [2,3] sigmatropic rearrangement and 1,2-elimination reactions. A portion of the highly reactive intermediate, diallate sulfoxide (proximate mutagens), is attacked by glutathione in a reaction which competes with its transformation to the ultimate mutagen, 2-chloroacrolein.

Analysis of vinyl chloride by mass fragmentography

Vinyl chloride is analyzed by mass fragmentography by simultaneously recording its m/e 62 and 64 ions. The minimum quantity necessary for detection is 8.7 X 10(-12) g/10 ml injection. At this level the coefficient of variation is 8.51%.

Insect metabolism of photoaldrin and photodieldrin

Photoaldrin and photodieldrin, sunlight products of adrin and dieldrin, are rapidly metabolized to a more toxic material by flies and mosquito larvae. It is suggested that this conversion is the cause for the enhanced toxicities of the photoproducts.