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In a review of 34 studies, investigators identify community pharmacies as safe and accessible locations for adolescents seeking care on sexual and reproductive health. Adolescents often face greater barriers to reproductive health care than adults, and community pharmacies are very accessible within both urban and rural settings.¹

Adolescents often are at higher risk of unwanted pregnancy, unsafe abortion, and sexually transmitted infections due to the inadequate knowledge of protective practices, according to the World Health Organization (WHO). Furthermore, adolescent pregnancy can also be associated with higher risks of health issues, including anemia, postpartum hemorrhaging, and mental disorders, including depression. WHO states that for sexual and reproductive health services for adolescents, “these are either not available or are provided in a way that makes adolescents feel unwelcome and embarrassed.”²

Investigators of the current study conducted a systematic review to examine adolescents’ experiences and acceptability of contraception and abortion clinical and dispensing services in community pharmacies. Eligible studies were published from 2000 onwards due to a shift in the pharmacist’s scope of practice since 2000. Studies of any design were considered and included or focused on data on patients aged 10 to 19 years.

Investigators ultimately included 34 studies in the final analysis, with 24 from the US, 4 from the UK, 2 from Australia, and 1 each from Switzerland, Canada, and New Zealand. Of the studies, 21 focused on emergency contraceptive pills and 10 focused on broader contraceptive methods, and 32 studies were considered high quality, with the other 2 being moderate quality.¹

Investigators found that adolescents and pharmacists agreed that the delivery of contraceptive services for adolescents was accessible at the pharmacy level and pharmacists were considered knowledgeable sources of information. Furthermore, adolescents viewed pharmacists as acceptable sources of information regarding contraception and preferred them as health care professionals for the information.

Pharmacies were seen as accessible and convenient for these services; however, adolescents did anticipate judgmental attitudes and were concerned about confidentiality, specifically related to the layout of the pharmacy. Pharmacists also identified lack of access to medical history as a potential reason that pharmacies were not suited for these services, and they identified needs for additional training regarding providing contraceptive information and counseling adolescents.¹

However, investigators found that adolescents did experience embarrassment and pharmacist judgment that did impact their overall experience. They mentioned feeling embarrassed due to poor privacy, awkwardness when interacting with pharmacy staff, and judgement from pharmacy staff. Furthermore, embarrassment for patients was worth it when they felt that the pharmacy staff lacked sensitivity, were dismissive, were unhelpful or negative, or asked repetitive or intrusive questions unrelated to care.¹

Additionally, investigators noted that pharmacists’ and pharmacy staff’s attitudes towards providing contraception were influenced by their beliefs on contraception as well as age and adolescent sexual activity. Empathetic care was identified as a factor in making adolescents feel more comfortable, which included approachability, awareness of stigma, nonjudgmental and respectful environments, and keeping a mindful tone and expression. Pharmacists also recognized the importance of respect and empathy.¹

Investigators concluded that pharmacies were accessible and convenient sources for sexual and reproductive health care services and pharmacists can provide adolescents with comprehensive information. The authors stated, “From the pharmacists’ perspective, their attitudes and comfort regarding adolescent sexual activity and contraception provision (including ECP [emergency contraceptive pill]), along with their need for further training, appeared to influence their acceptability to provide these services.”¹

READ MORE: Women's Health Resource Center

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REFERENCES

1. Stephenson J, Bailey JV, Blandford A, et al. An interactive website to aid young women's choice of contraception: feasibility and efficacy RCT. Health Technol Assess. 2020;24(56):1-44. doi:10.3310/hta24560

2. World Health Organization. Adolescent sexual reproductive heath. Accessed August 14, 2025. https://www.who.int/southeastasia/activities/adolescent-sexual-reproductive-health

Officials have confirmed 12,786 Oropouche cases in 11 countries in the Americas so far this year, according to an epidemiologic update from the Pan American Health Organization (PAHO) today, while the United Kingdom has logged its first-ever cases. 

Five deaths in Brazil

Seven countries have documented local transmission and four have imported cases, PAHO said. Officials have confirmed five deaths, all in Brazil.

In 2024, the region recorded 16,239 cases across 11 countries and one territory, including 4 deaths, PAHO said. Last year, Brazil had 13,785 cases, including 4 deaths. This year’s deaths were in the states of Espirito Santo and Rio de Janeiro.

The virus, which is primarily transmitted by the Culicoides paraensis midge, made a resurgence in the Americas in 2023. As was seen last year, Brazil has the vast majority of this year’s cases (11,888), followed by Panama (501), Peru (330), Cuba (28), Colombia (26), Venezuela (5), and Guyana (1). 

Imported cases have been reported in Uruguay, Chile, Canada, and the United States.

Though most patients recover within 2 to 3 weeks, as many as 60% will experience relapses, and in rare cases infections could lead to meningitis or encephalitis. Case-patients present with a high fever and headaches for the first week after infection, and can be mistaken for dengue patients. 

The virus’s spread to non-endemic areas, such as urban regions in Cuba, is driven by factors like climate change

“The virus’s spread to non-endemic areas, such as urban regions in Cuba, is driven by factors like climate change, deforestation, and urbanization of forested areas, which boost the midge population,” PAHO said in a news release. 

Travel-related cases in UK, plus chikungunya

Meanwhile, UK health officials today confirmed three Oropouche virus cases in people who had traveled to Brazil, the first ever in the country. 

UK officials are also reporting twice as many travel-related chikungunya cases as they usually see this time of year. Cases have been identified in people who traveled to Sri Lanka, India, and Mauritius.

“A total of 73 cases were reported between January and June 2025. The same period in 2024 saw 27 cases. 2025 has the highest number of cases recorded in this period to date,” officials said. 

Chikungunya is a mosquito-borne infection, with most patients experiencing fever and joint pain.  Up to 12% of patients will still experience symptoms after 3 years. 

“Chikungunya can be a nasty disease and we’re seeing a worrying increase in cases among travellers returning to the UK. While this mosquito-borne infection is rarely fatal, it can cause severe joint and muscle pain, headaches, sensitivity to light and skin rashes.” said Dr Philip Veal, a consultant at the UK Health Security Agency.

Graphite is a key structural component in some of the world’s oldest nuclear reactors and many of the next-generation designs being built today. But it also condenses and swells in response to radiation — and the mechanism behind those changes has proven difficult to study.

Now, MIT researchers and collaborators have uncovered a link between properties of graphite and how the material behaves in response to radiation. The findings could lead to more accurate, less destructive ways of predicting the lifespan of graphite materials used in reactors around the world.

“We did some basic science to understand what leads to swelling and, eventually, failure in graphite structures,” says MIT Research Scientist Boris Khaykovich, senior author of the new study. “More research will be needed to put this into practice, but the paper proposes an attractive idea for industry: that you might not need to break hundreds of irradiated samples to understand their failure point.”

Specifically, the study shows a connection between the size of the pores within graphite and the way the material swells and shrinks in volume, leading to degradation.

“The lifetime of nuclear graphite is limited by irradiation-induced swelling,” says co-author and MIT Research Scientist Lance Snead. “Porosity is a controlling factor in this swelling, and while graphite has been extensively studied for nuclear applications since the Manhattan Project, we still do not have a clear understanding of the porosity in both mechanical properties and swelling. This work addresses that.”

The open-access paper appears this week in Interdisciplinary Materials. It is co-authored by Khaykovich, Snead, MIT Research Scientist Sean Fayfar, former MIT research fellow Durgesh Rai, Stony Brook University Assistant Professor David Sprouster, Oak Ridge National Laboratory Staff Scientist Anne Campbell, and Argonne National Laboratory Physicist Jan Ilavsky.

A long-studied, complex material

Ever since 1942, when physicists and engineers built the world’s first nuclear reactor on a converted squash court at the University of Chicago, graphite has played a central role in the generation of nuclear energy. That first reactor, dubbed the Chicago Pile, was constructed from about 40,000 graphite blocks, many of which contained nuggets of uranium.

Today graphite is a vital component of many operating nuclear reactors and is expected to play a central role in next-generation reactor designs like molten-salt and high-temperature gas reactors. That’s because graphite is a good neutron moderator, slowing down the neutrons released by nuclear fission so they are more likely to create fissions themselves and sustain a chain reaction.

“The simplicity of graphite makes it valuable,” Khaykovich explains. “It’s made of carbon, and it’s relatively well-known how to make it cleanly. Graphite is a very mature technology. It’s simple, stable, and we know it works.”

But graphite also has its complexities.

“We call graphite a composite even though it’s made up of only carbon atoms,” Khaykovich says. “It includes ‘filler particles’ that are more crystalline, then there is a matrix called a ‘binder’ that is less crystalline, then there are pores that span in length from nanometers to many microns.”

Each graphite grade has its own composite structure, but they all contain fractals, or shapes that look the same at different scales.

Those complexities have made it hard to predict how graphite will respond to radiation in microscopic detail, although it’s been known for decades that when graphite is irradiated, it first densifies, reducing its volume by up to 10 percent, before swelling and cracking. The volume fluctuation is caused by changes to graphite’s porosity and lattice stress.

“Graphite deteriorates under radiation, as any material does,” Khaykovich says. “So, on the one hand we have a material that’s extremely well-known, and on the other hand, we have a material that is immensely complicated, with a behavior that’s impossible to predict through computer simulations.”

For the study, the researchers received irradiated graphite samples from Oak Ridge National Laboratory. Co-authors Campbell and Snead were involved in irradiating the samples some 20 years ago. The samples are a grade of graphite known as G347A.

The research team used an analysis technique known as X-ray scattering, which uses the scattered intensity of an X-ray beam to analyze the properties of material. Specifically, they looked at the distribution of sizes and surface areas of the sample’s pores, or what are known as the material’s fractal dimensions.

“When you look at the scattering intensity, you see a large range of porosity,” Fayfar says. “Graphite has porosity over such large scales, and you have this fractal self-similarity: The pores in very small sizes look similar to pores spanning microns, so we used fractal models to relate different morphologies across length scales.”

Fractal models had been used on graphite samples before, but not on irradiated samples to see how the material’s pore structures changed. The researchers found that when graphite is first exposed to radiation, its pores get filled as the material degrades.

“But what was quite surprising to us is the [size distribution of the pores] turned back around,” Fayfar says. “We had this recovery process that matched our overall volume plots, which was quite odd. It seems like after graphite is irradiated for so long, it starts recovering. It’s sort of an annealing process where you create some new pores, then the pores smooth out and get slightly bigger. That was a big surprise.”

The researchers found that the size distribution of the pores closely follows the volume change caused by radiation damage.

“Finding a strong correlation between the [size distribution of pores] and the graphite’s volume changes is a new finding, and it helps connect to the failure of the material under irradiation,” Khaykovich says. “It’s important for people to know how graphite parts will fail when they are under stress and how failure probability changes under irradiation.”

From research to reactors

The researchers plan to study other graphite grades and explore further how pore sizes in irradiated graphite correlate with the probability of failure. They speculate that a statistical technique known as the Weibull Distribution could be used to predict graphite’s time until failure. The Weibull Distribution is already used to describe the probability of failure in ceramics and other porous materials like metal alloys.

Khaykovich also speculated that the findings could contribute to our understanding of why materials densify and swell under irradiation.

“There’s no quantitative model of densification that takes into account what’s happening at these tiny scales in graphite,” Khaykovich says. “Graphite irradiation densification reminds me of sand or sugar, where when you crush big pieces into smaller grains, they densify. For nuclear graphite, the crushing force is the energy that neutrons bring in, causing large pores to get filled with smaller, crushed pieces. But more energy and agitation create still more pores, and so graphite swells again. It’s not a perfect analogy, but I believe analogies bring progress for understanding these materials.”

The researchers describe the paper as an important step toward informing graphite production and use in nuclear reactors of the future.

“Graphite has been studied for a very long time, and we’ve developed a lot of strong intuitions about how it will respond in different environments, but when you’re building a nuclear reactor, details matter,” Khaykovich says. “People want numbers. They need to know how much thermal conductivity will change, how much cracking and volume change will happen. If components are changing volume, at some point you need to take that into account.”

This work was supported, in part, by the U.S. Department of Energy.