Initial Disclosure Research Articles

Experiences and preferences of women with CAH and parents about disclosure of childhood surgery

Complete disclosure of childhood genital surgery to patients with congenital adrenal hyperplasia (CAH) is a critical part of CAH care. There are no guidelines or uniform recommendations on the timing and content of surgical disclosure discussions. Our objective was to describe the experiences and preferences of females with CAH and parents of females with CAH who underwent childhood genital surgery regarding surgical disclosure. We conducted an anonymous cross-sectional online survey of females with CAH (46XX, ≥16 years [y] old) and parents of females with CAH who underwent genital surgery before age 4y in North America. Participants reported experiences, preferences, and advice about initial ("first time you were told") and complete disclosure ("told all details"). Non-parametric statistics and qualitative analysis were used. Participants included 59 females with CAH (median age: 37y, 92% White, 93% non-Hispanic) and 41 parents (median: 36y, 85% White, 93% non-Hispanic, daughter median: 26y). The 76% of females who received complete disclosure were younger (median age: 33y) and underwent surgery more recently (median decade: 1980s) than the 14% who received only initial disclosure (median: 47y, 1970s) and the 10% who did not receive any disclosure (median: 60y, 1960s, p=0.0003, Summary Figure). Females reported median ages of initial and complete disclosure as 7-10y and 11-13y, respectively. Disclosure was preferred by 98% of females with initial disclosure by age 14y and complete disclosure by 18y. Parents reported similar findings. Most disclosures were by mothers (initial: 82%, complete: 64%). Doctors were more involved in complete vs. initial disclosures (complete: 47%, initial: 13%, p<0.001). Qualitative analysis of advice about surgical disclosure revealed 8 themes. Disclosure of childhood genital surgery to women with CAH has increased over time. Although timing of disclosure varied, women preferred disclosure, and that it be initiated before age 14y and completed by age 18y.

“But I wanted to talk about it”: Technology-assisted child sexual abuse victims’ reasoning for delayed disclosure

BackgroundVictim disclosure is crucial in uncovering and preventing child sexual abuse, but many victims are reluctant to disclose. While research on child sexual abuse has identified a range of barriers and facilitators for disclosure, the disclosure process for technology-assisted child sexual abuse (TA-CSA) is largely unexplored. ObjectiveGain a first-person perspective on TA-CSA disclosure. Participants and settingSeven young women (aged 7–13 at onset of abuse, 17–24 at interview) were interviewed about the barriers to disclosure they had faced and potential facilitating factors that would have helped them disclose earlier. MethodsThe interviews were analyzed using data-driven reflexive thematic analysis. ResultsA wish to tell captures the desire to have had someone to share abusive experiences with. Fearing who would find out encapsulates the fear that disclosing to one person will spread beyond the initial disclosure. A need for a cue reflects the participants' lack of knowledge and the need for invitations to talk about sex and abuse. Fearing it was my fault conveys the participants' sense of guilt and their wish to understand that they were not to blame. ConclusionsDespite a wish to disclose, shame, guilt, and fear were barriers that held them back. Knowledge about TA-CSA, and invitations to the topic were seen as potential facilitators. Four suggested facilitating factors for disclosure, which society and the adult world should prioritize, were synthesized from the interviews: open dialogue on sensitive topics, providing an opportunity to tell, allowing the child to be in control of the story, and lifting the shame and self-blame.

Effect of disclosing AI-generated content on prosocial advertising evaluation

With advancements in generative artificial intelligence (AI) technology, there is a growing concern about its ethical implications, transparency, and consumer reactions to AI-generated content. Building on the persuasion knowledge model and algorithm aversion literature, this study explores the effects of AI disclosure in prosocial advertising on consumer attitudes and donation intentions. The findings of Study 1 indicate that the initial disclosure of AI-generated content leads to unfavourable attitudes towards ads, with perceived ad credibility serving as a mediating factor. In Study 2, participants who perceived AI as more human-like rather than machine-like tended to experience a diminished negative impact of AI disclosure. Study 3 also highlights the crucial role of perceived ad credibility in influencing donation intentions following the disclosure of AI-generated content. The theoretical and practical implications of our findings for social marketers and nonprofit organizations are discussed further.

Capital Market Consequences of Information about Individual Auditors

Synopsis The research problem This study examines the capital market consequences of the voluntary disclosure of individual auditor information. Specifically, we examined whether and how the disclosure of auditor qualification certificates is associated with information asymmetry and investors’ responses to earnings. Motivation Regulators have recently started to focus on disclosing auditor information beyond their names such as in China, where it is increasingly important in practice. Although prior studies have demonstrated benefits associated with the mandatory disclosure of partners’ names, there is relatively little evidence of the usefulness of additional information about individual auditors that could be provided voluntarily. This study sheds light on the economic consequences of disclosing detailed information about individual auditors and extends the voluntary disclosure literature. The test hypotheses We tested the following hypotheses in this study: (a) voluntary disclosure of auditor qualification certificates is associated with lower information asymmetry and (b) voluntary disclosure of auditor qualification certificates is not associated with investors’ reactions to corporate earnings announcements. Target population Stakeholders of listed companies and audit firms, including company managers, investors, and accounting regulators. Adopted methodology Ordinary least squares regressions, archival data, interviews, and machine learning methods to obtain initial data. Analyses We first crawled the annual audit reports of listed companies in China and used machine learning methods to capture voluntary disclosure of auditor qualification certificates. In a sample of more than 14,000 Chinese company-years from 2012 to 2018, we identified 10.5% of the observations voluntarily disclosing auditor qualification certificates. We used the bid-ask spread as the proxy of information asymmetry, and the earnings response coefficient refers to the coefficient on unexpected earnings to the cumulative abnormal returns. Findings We found that the voluntary disclosure of auditor qualification certificates is associated with lower information asymmetry and stronger market reaction to earnings announcements. The main results hold through various robustness tests. Cross-sectional analyses show that this association is less pronounced when a company employs a larger audit firm or has higher analyst coverage. Further, the specific information conveyed by the auditor qualification certificate, such as the auditor’s facial trustworthiness, helps explain the economic consequences associated with voluntary auditor qualification certificate disclosure. Moreover, an initial disclosure of auditor qualification certificates is associated with greater effects.

The effects of a client's social media disclosure and audience engagement on auditor judgment

The rapid rise of social media enables companies to disclose information to the public instantly. Thus, auditors may initially receive client information via a client's social media account instead of through private, client-to-auditor communication. Drawing on Social Penetration Theory, we conduct an experiment to investigate how a client's initial disclosure via social media (versus private disclosure) and audience engagement of the client's posts (e.g., number of “likes,” “replies,” and “reposts”) affects auditors' perception of the auditor-client relationship and their evaluation of the client-provided information. We find that when auditors initially receive client information via social media with high audience engagement, they are less willing to accept the client's preference than when the same information is disclosed privately or publicly with minimal audience engagement. Our findings are consistent with auditors perceiving client disclosure via social media with high audience engagement as a significant violation of their communication expectations such that their relational closeness with the client weakens and causes them to respond critically. We contribute to the literature on the use of social media for corporate disclosure, which has implications for the auditor-client relationship and audit quality.

Investor response to engagement quality review hours

PurposeThis study aims to investigate whether mandated disclosure of engagement quality review hours provides new information that affects investors’ decision-making.Design/methodology/approachIn 2014, Korean authorities mandated that audit engagement quality review hours must be disclosed in their audit reports. Using this unique field setting in Korea, this study presents empirical evidence of the policy initiative’s effect on earnings reliability by examining both pre- and post-implementation periods.FindingsFollowing the initial disclosure of engagement quality review hours in 2014, the authors observe that the capital market’s valuation of quarterly earnings surprises, measured by earnings response coefficients (ERCs), was significantly lower for firms with high levels of abnormal engagement quality review hours than for other firms. This paper also finds that the observed association between engagement quality review hours and ERCs in the postregulation period hinges on the probability of earnings management, proxied by discretionary accruals and just meeting or beating analyst earnings forecast.Originality/valueThis paper suggests that the policy mandating disclosure of engagement quality review hours provides original information that the market considers relevant for appraising the reliability of reported earnings.

Child Sexual Abuse in Boys: A Retrospective Investigation

Background: Although recent studies have increased public awareness of child sexual abuse, certain aspects of the issue remain unclear. While research on sexual abuse in girls is abundant, there is limited focus on boys in our country. This study aims to explore the characteristics of cases involving sexual abuse of boys in the province of Türkiye. Methods: The study is descriptive and retrospective in nature. A total of 245 boys who underwent forensic interviews for alleged sexual abuse between September 2017 and March 2023 at the Child Advocacy Center in the province of Türkiye were retrospectively examined. Results: The study included 245 boys aged 3-18 with a mean age of 11.04±3.39. The most common type of sexual abuse was non-penetrative contact (57.6%). Delayed disclosure was primarily attributed to factors such as threat, fear, and shame. Sexual abuse predominantly occurred in public places (56.5%). There were significant among age groups concerning the identity of the reporters, initial disclosure persons, the existence of abuse, and reporting time. However, no significant differences were found in the presence of multiple suspects, recurrent abuse, and the incident location. Post-abuse behavioral changes in children included fear of the perpetrator (15.5%), emotional changes (15.5%), physiological changes (9.4%), and the displaying of risky behaviors (4.1%). Conclusion: The study emphasized the importance of not overlooking sexual abuse among male children. The findings underscore the need for enhanced awareness and intervention strategies to address sexual abuse in boys within the country.

LGBTQ Young Adults' Identity Disclosure in the Workplace: A Longitudinal Qualitative Analysis of Disclosure Intentions and Outcomes.

Research shows that LGBTQ workers make strategic decisions about whether to disclose their sexual and gender identities to their colleagues as they assess potential costs and benefits. The present study sought to extend this literature by examining how they plan their identity disclosure in future workplace interactions and why they may diverge from their initial intentions. The analysis used longitudinal data from in-depth interviews, in which young LGBTQ workers reported disclosure intentions and their outcomes two years later. Participants often expressed intentions to disclose their LGBTQ identities while emphasizing the importance of identity disclosure for self-authenticity and the LGBTQ community's visibility. Sometime over the course of the study, however, a substantial number of participants did not carry out their intentions because of unanticipated workplace constraints such as a lack of opportunities for personal conversations, an expectation for professionalism, and an absence of LGBTQ colleagues. However, participants who diverged from their initial disclosure intentions maintained an identity as an open LGBTQ person by emphasizing their willingness for disclosure.

Parental Experiences with Newborn Screening and Gene Replacement Therapy for Spinal Muscular Atrophy.

Spinal muscular atrophy (SMA) is a genetic neurodegenerative disorder with onset predominantly in infants and children. In recent years, newborn screening and three treatments, including gene replacement therapy (Onasemnogene abeparvovec-xioi), have become available in the United States, aiding in the diagnosis and treatment of children with SMA. To evaluate parents' experiences with newborn screening and gene replacement therapy and to explore best practices for positive newborn screen disclosure and counseling of families. We conducted semi-structured interviews (n = 32) and online surveys (n = 79) of parents whose children were diagnosed with SMA (on newborn screening or symptomatically) and treated with gene replacement therapy. Gene replacement therapy was most parents' first treatment choice, although concerns regarding long term efficacy (65%) and safety (51%) were common. Information provided during the newborn screening disclosure was quite variable. Only 34% of parents reported the information provided was sufficient and expressed need for more information about treatment. Although many parents experienced denial of the diagnosis at initial disclosure, 94% were in favor of inclusion of SMA on newborn screening. Parents were almost universally anxious following diagnosis and over half remained anxious at the time of study participation with uncertainty of the future being a key concern. Many parents had difficulty processing information provided during their first clinic appointment due to its complexity and their emotional state at the time. Utilizing this data, we provide a recommendation for the information provided in newborn screening disclosure, propose adjustments to education and counseling during the first clinic visit, and bring awareness of parents' mental health difficulties.

The Kornblum DeLaMare rearrangement in natural product synthesis: 25 years of innovation.

Covering: 1998 up to the end of 2023Since its initial disclosure in 1951, the Kornblum DeLaMare rearrangement has proved an important synthetic transformation and has been widely adopted as a biomimetic step in natural product synthesis. Utilising the base catalysed decomposition of alkyl peroxides to yield a ketone and alcohol has found use in many syntheses as well as a key strategic step, including the unmasking of furans, as a biomimetic synthetic tool, and the use of the rearrangement to install oxygen enantioselectively. Since ca. 1998, its impact as a synthetic transformation has grown significantly, especially given the frequency of use in natural product syntheses, therefore this 25 year time period will be the focus of the review.

Labor Market Consequences of Pay Transparency: Evidence from the Initial Pay Ratio Disclosure

Labor Market Consequences of Pay Transparency: Evidence from the Initial Pay Ratio Disclosure

Tinjauan Akuntansi Aset Tak Berwujud dalam Industri Sepak Bola di PT Bali Bintang Sejahtera Tbk Review of

Football is the most popular sport in the world. Its popularity makes football a professional industry that generates trillions of rupiah. This rapid development requires the football team to pay attention to its accounting records. One of the most important assets to pay attention to in accounting for a football team is players and team officials, which are classified as intangible assets. This study aims to determine and understand the accounting treatment of football team players and officials and to determine the suitability of their treatment with the Statement of Financial Accounting Standards Number 19 regarding intangible assets. The research object chosen was the first football team to become a public company in Indonesia, PT Bali Bintang Sejahtera Tbk or Bali United FC. The accounting treatments discussed include general policies, initial recognition and measurement, measurement after initial recognition, amortization, impairment, derecognition, disposal, and disclosure. The method used in collecting data is literature study and secondary data in the form of the 2019 Financial Statements of PT Bali Bintang Sejahtera Tbk. The intangible assets in the form of players and team officials at PT Bali Bintang Sejahtera Tbk are called registration. Based on the results of the study, it can be concluded that the accounting treatment of players and team officials at PT Bali Bintang Sejahtera Tbk is in accordance with Statement of Financial Accounting Standards Number 19.

Insights into the Regioselectivity of Metal-Catalyzed Aryne Reactions.

The synthetic potential of unsymmetrically substituted aryne intermediates is significantly hindered by regioselectivity issues. Current methods for inducing regioselectivity all rely on substrate control and are focused on non-metallated arynes. Before our initial disclosure, there was no systematic study regarding the regioselectivity of metal-catalyzed aryne reactions. By exploiting ligand control, we have induced regioselectivity in a palladium-catalyzed aryne annulation to form phenanthridinones (up to 9:91 r.r.). Through this study we have investigated: ligand effects, influence of steric perturbation, and the impact of the aryne precursor.

The Ramifications in Implementing the U.S.-Style Discovery System To Enhance Evidence-Gathering in Korea

The Korean judiciary has been subject to heavy criticism due to the insufficiency of fact-findings at trial. Such lack of fact-findings has been attributed to several factors. First, there is no strong mechanism for evidence- gathering at trial proceedings which tend to bog down with a series of long and ineffective exchange of documents between the parties. Secondly, fact-findings are allowed at appellate courts in Korea so that litigants expect to continue fact-gathering at appellate level, without committing to the complete fact-finding at trial courts. There has been significant debate surrounding the necessity of addressing the issues pertaining to the trial procedures in Korea—especially on the fact-gathering system. As one of the most effective ways to do so, the U.S.-style discovery system has been considered. There are particular features of the U.S. discovery system that the Korean judiciary and the bar have shown a strong inclination towards adopting: party-initiated evidence gathering; prescheduled discovery and trial dates; and mandatory initial disclosures.&#x0D; However, in order to successfully adopt the U.S.-style discovery system, gaining an understanding of the drawbacks of the U.S. discovery is imperative —adversarial and competitive lawyering in discovery; insufficient judicial roles; problems of mandatory initial disclosure and notice-pleading; and abusive use of discovery. In addition to the analysis of the above problems, this article also discusses the lessons that the Korean judiciary and bar should learn from the American experience before adopting the discovery system. Lastly, it makes several proposals for the Korean judicial reform that can contribute to the successful implementation of the new discovery system.

SEBI and the Reform on Sustainable Finance (Part 2 of 3)

In the backdrop of increasing interest in sustainable finance around the globe as well as in domestic market, SEBI after extensive consultation with market participants revised its regulatory framework for issuance and listing of green debt securities. The Regulatory framework was revised to enhance the scope of definition of green debt security to include pollution prevention and control and eco efficient products within the ambit of eligible categories to raise funds through issuance of green debt securities. Further, the concept of Blue Bonds (related to sustainable water management and marine sector), Yellow Bonds (related to solar energy) and Transition Bonds (related to transitioning to a more sustainable form of operations) was introduced as sub categories of green debt security. To facilitate transparency and informed investment decision making, SEBI also updated the initial and continuous disclosure requirements for issuance and listing of green debt securities. Appointment of third party auditor/certifier for reviewing/certifying the processes for project evaluation and selection criteria, post – issue management of the use of the proceeds raised through issuing green debt security etc. , impact reporting and disclosure of major elements of Business Responsibility and Sustainability Reporting are some of the major changes to the extant disclosure requirements.

A New Look on Cooperative Identity in the Light of the EU Prospectus Regulation and Blockchain-Based Public Equity Financing

Сooperative identity has distinct features which formed over a century ago. Legislation of many countries recognises the value of traditional cooperatives by providing them with special regulatory regimes, like tax exemptions. These exact features make cooperatives unattractive when it comes to competing with investor-owned companies for public equity capital. The article looks into the traditional cooperatives within the legal framework of raising public equity capital through the offer of blockchain-based tokens (crypto-assets). The analysis focuses on existing non-blockchain EU regulations, the EU Prospectus Regulation specifically. The study looks into the distinct features of the cooperative identity, analyses the specifics of prospectus regulations, and applies the criteria underlying the initial disclosure obligation when making a public offer to sell equity-based blockchain tokens by cooperatives. The article concludes that complying with the traditional cooperative identity allows entities to access public equity financing using crypto-assets without publishing a prospectus under the Prospectus Regulation. This conclusion is only a first step in analysing the cooperative identity changes when membership is offered in transferable blockchain tokens. Blockchain, cooperative principles, Prospectus, public equity, investment, cooperative rebates, ICOs, MiCA, securities, information asymmetry

Association of Higher Ocrelizumab Exposure With Reduced Disability Progression in Multiple Sclerosis.

Ocrelizumab improved clinical and MRI measures of disease activity and progression in three phase 3 multiple sclerosis (MS) studies. Post hoc analyses demonstrated a correlation between the ocrelizumab serum concentration and the degree of blood B-cell depletion, and body weight was identified as the most influential covariate on ocrelizumab pharmacokinetics. The magnitude of ocrelizumab treatment benefit on disability progression was greater in lighter vs heavier patients. These observations suggest that higher ocrelizumab serum levels provide more complete B-cell depletion and a greater delay in disability progression. The current post hoc analyses assessed population exposure-efficacy/safety relationships of ocrelizumab in patients with relapsing and primary progressive MS. Patients in OPERA I/II and ORATORIO were grouped in exposure quartiles based on their observed individual serum ocrelizumab level over the treatment period. Exposure-response relationships were analyzed for clinical efficacy (24-week confirmed disability progression (CDP), annualized relapse rate [ARR], and MRI outcomes) and adverse events. Ocrelizumab reduced new MRI lesion counts to nearly undetectable levels in patients with relapsing or primary progressive MS across all exposure subgroups, and reduced ARR in patients with relapsing MS to very low levels (0.13-0.18). A consistent trend of higher ocrelizumab exposure leading to lower rates of CDP was seen (0%-25% [lowest] to 75%-100% [highest] quartile hazard ratios and 95% confidence intervals; relapsing MS: 0.70 [0.41-1.19], 0.85 [0.52-1.39], 0.47 [0.25-0.87], and 0.34 [0.17-0.70] vs interferon β-1a; primary progressive MS: 0.88 [0.59-1.30], 0.86 [0.60-1.25], 0.77 [0.52-1.14], and 0.55 [0.36-0.83] vs placebo). Infusion-related reactions, serious adverse events, and serious infections were similar across exposure subgroups. The almost complete reduction of ARR and MRI activity already evident in the lowest quartile, and across all ocrelizumab-exposure groups, suggests a ceiling effect. A consistent trend of higher ocrelizumab exposure leading to greater reduction in risk of CDP was observed, particularly in the relapsing MS trials, and was not associated with a higher rate of adverse events. Higher ocrelizumab exposure may provide improved control of disability progression by reducing disease activity below that detectable by ARR and MRI, and/or by attenuating other B-cell-related pathologies responsible for tissue damage. This analysis provides Class III evidence that higher ocrelizumab serum levels are related to greater reduction in risk of disability progression in patients with multiple sclerosis. The study is rated Class III because of the initial treatment randomization disclosure that occurred after inclusion in the open-label extension. ClinicalTrials.gov Identifier: NCT01247324 (OPERA I), NCT01412333 (OPERA II), and NCT01194570 (ORATORIO).

Development and Validation of the Disclosure Expectancy Scale.

Although the disclosure of traumatic experiences is believed to influence trajectories of post-trauma recovery, less is known about individual differences that affect survivors' motivation to share. The current project describes the development and evaluation of the Disclosure Expectancy Scale (DExS), a novel instrument intended to assess survivors' expectations about the potential risks and benefits of disclosure. Items targeting both positive and negative expectancies were generated based on existing research and the authors' clinical experience with various survivor populations. Preliminary analyses in trauma-exposed undergraduates (N = 359) offer support for hypothesized positive and negative expectancy dimensions with evidence for the convergent and discriminant validity of scores. Subsequent evaluation in active-duty, help-seeking military personnel (N = 35) provides further evidence of validity based on correlations with relevant clinical measures. A final regression demonstrating unique effects of initial disclosure expectancies on post-traumatic stress disorder (PTSD) severity following trauma-focused treatment highlights the predictive validity of DExS scores.

Caring for Transgender Youth with Eating Disorders in a Day Treatment Program

Background: The treatment of transgender youth with an eating disorder presents particular considerations due to the unique combination of body dissatisfaction, drive for thinness, malnutrition coupled with the evolving gender identity in the midst of biological and physical changes. At this time, public awareness, societal acknowledgment and legislative initiatives have led to wider acceptance of Lesbian, Gay, Bi-sexual and Transgender rights. However, at the same time, transgender youth are at increased risk for mental health problems, including eating disorders. Objective: To describe two cases of trans adolescents with anorexia nervosa treated in a day treatment program. Methods: In this paper, the two clinical vignettes of transgender adolescent with anorexia nervosa will be discussed. The focused care included specific attention to the initial disclosure of gender identity in a safe space, name and pronoun preferences as well as wardrobe and hair style changes. In addition, treatment focused on the reduction of social anxiety around meal consumption with special attention given to the impact of weight on the development of secondary sex characteristics. Themes of identity, rejection and secrecy were explored. Conclusion: In summary, the treatment of transgender youth with anorexia nervosa is more complex than treatment of cis gender youth. Additional issues, such as hormonal treatments, the development of secondary sexual characteristics as well as social and cultural factors can exacerbate eating disorder symptoms. Treatment should focus on understanding the etiology and the trajectory of the disorder within this lens.

Abortion decision-making process trajectories and determinants in low- and middle-income countries: A mixed-methods systematic review and meta-analysis.

SummaryBackgroundAbout 45.1% of all induced abortions are unsafe and 97% of these occur in low- and middle-income countries (LMICs). Women's abortion decisions may be complex and are influenced by various factors. We aimed to delineate women's abortion decision-making trajectories and their determinants in LMICs.MethodsWe searched Medline, EMBASE, PsychInfo, Global Health, Web of Science, Scopus, IBSS, CINAHL, WHO Global Index Medicus, the Cochrane Library, WHO website, ProQuest, and Google Scholar for primary studies and reports published between January 1, 2000, and February 16, 2021 (updated on June 06, 2022), on induced abortion decision-making trajectories and/or their determinants in LMICs. We excluded studies on spontaneous abortion. Two independent reviewers extracted and assessed quality of each paper. We used “best fit” framework synthesis to synthesise abortion decision-making trajectories and thematic synthesis to synthesise their determinants. We analysed quantitative findings using random effects model. The study protocol is registered with PROSPERO number CRD42021224719.FindingsOf the 6960 articles identified, we included 79 in the systematic review and 14 in the meta-analysis. We identified nine abortion decision-making trajectories: pregnancy awareness, self-reflection, initial abortion decision, disclosure and seeking support, negotiations, final decision, access and information, abortion procedure, and post-abortion experience and care. Determinants of trajectories included three major themes of autonomy in decision-making, access and choice. A meta-analysis of data from 7737 women showed that the proportion of the overall women's involvement in abortion decision-making was 0.86 (95% CI:0.73–0.95, I2 = 99.5%) and overall partner involvement was 0.48 (95% CI:0.29–0.68, I2 = 99.6%).InterpretationPolicies and strategies should address women's perceptions of safe abortion socially, legally, and economically, and where appropriate, involvement of male partners in abortion decision-making processes to facilitate safe abortion. Clinical heterogeneity, in which various studies defined “the final decision-maker” differentially, was a limitation of our study.FundingNuffield Department of Population Health DPhil Scholarship for PL, University of Oxford, and the Medical Research Council Career Development Award for MN (Grant Ref: MR/P022030/1).