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John Lally,1–3 Fiona Gaughran,1,3 Philip Timms,4,5 Sarah R Curran5–7 1Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK; 2Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland; 3National Psychosis Service, 4START Team, South London and Maudsley NHS Foundation Trust, 5King’s College London, 6South West London and St George’s Mental Health NHS Foundation Trust, 7St George’s University of London, London, UK Abstract: Up to 30% of people with schizophrenia do not respond to two (or more) trials of dopaminergic antipsychotics. They are said to have treatment-resistant schizophrenia (TRS). Clozapine is still the only effective treatment for TRS, although it is underused in clinical practice. Initial use is delayed, it can be hard for patients to tolerate, and clinicians can be uncertain as to when to use it. What if, at the start of treatment, we could identify those patients likely to respond to clozapine – and those likely to suffer adverse effects? It is likely that clinicians would feel less inhibited about using it, allowing clozapine to be used earlier and more appropriately. Genetic testing holds out the tantalizing possibility of being able to do just this, and hence the vital importance of pharmacogenomic studies. These can potentially identify genetic markers for both tolerance of and vulnerability to clozapine. We aim to summarize progress so far, possible clinical applications, limitations to the evidence, and problems in applying these findings to the management of TRS. Pharmacogenomic studies of clozapine response and tolerability have produced conflicting results. These are due, at least in part, to significant differences in the patient groups studied. The use of clinical pharmacogenomic testing – to personalize clozapine treatment and identify patients at high risk of treatment failure or of adverse events – has moved closer over the last 20 years. However, to develop such testing that could be used clinically will require larger, multicenter, prospective studies. Keywords: personalized medicine, pharmacogenetics, treatment resistant psychosis, clozapine, pharmacokinetic, pharmacodynamic

With the increasing sophistication of online survey tools and the necessity of distanced research during the COVID-19 pandemic, the use of online questionnaires for research purposes has proliferated. Still, many researchers undertake online survey research without knowledge of the prevalence and likelihood of experiencing survey questionnaire fraud nor familiarity with measures used to identify fraud once it has occurred. This research note is based on the experience of researchers across four sites who implemented an online survey of families' experiences with COVID-19 in the U.S. that was subject to substantial fraud. By the end of data collection, over 70% of responses were flagged as fraudulent with duplicate IP addresses and concurrent start/end times representing the most common indicators of fraud observed. We offer lessons learned to illustrate the sophisticated nature of fraud in online research and the importance of multi-pronged strategies to detect and limit online survey questionnaire fraud.

Population projections provide predictions of future population sizes for an area. Historically, most population projections have been produced using deterministic or scenario-based approaches and have not assessed uncertainty about future population change. Starting in 2015, however, the United Nations (UN) has produced probabilistic population projections for all countries using a Bayesian approach. There is also considerable interest in subnational probabilistic population projections, but the UN's national approach cannot be used directly for this purpose, because within-country correlations in fertility and mortality are generally larger than between-country ones, migration is not constrained in the same way, and there is a need to account for college and other special populations, particularly at the county level. We propose a Bayesian method for producing subnational population projections, including migration and accounting for college populations, by building on but modifying the UN approach. We illustrate our approach by applying it to the counties of Washington State and comparing the results with extant deterministic projections produced by Washington State demographers. Out-of-sample experiments show that our method gives accurate and well-calibrated forecasts and forecast intervals. In most cases, our intervals were narrower than the growth-based intervals issued by the state, particularly for shorter time horizons., (Copyright © 2023 The Authors.)

Objective: Certain copy number variants (CNVs) greatly increase the risk of autism. The authors conducted a genetics-first study to investigate whether heterogeneity in the clinical presentation of autism is underpinned by specific genotype-phenotype relationships., Methods: This international study included 547 individuals (mean age, 12.3 years [SD=4.2], 54% male) who were ascertained on the basis of having a genetic diagnosis of a rare CNV associated with high risk of autism (82 16p11.2 deletion carriers, 50 16p11.2 duplication carriers, 370 22q11.2 deletion carriers, and 45 22q11.2 duplication carriers), as well as 2,027 individuals (mean age, 9.1 years [SD=4.9], 86% male) with autism of heterogeneous etiology. Assessments included the Autism Diagnostic Interview-Revised and IQ testing., Results: The four genetic variant groups differed in autism symptom severity, autism subdomain profile, and IQ profile. However, substantial variability was observed in phenotypic outcome in individual genetic variant groups (74%-97% of the variance, depending on the trait), whereas variability between groups was low (1%-21%, depending on the trait). CNV carriers who met autism criteria were compared with individuals with heterogeneous autism, and a range of profile differences were identified. When clinical cutoff scores were applied, 54% of individuals with one of the four CNVs who did not meet full autism diagnostic criteria had elevated levels of autistic traits., Conclusions: Many CNV carriers do not meet full diagnostic criteria for autism but nevertheless meet clinical cutoffs for autistic traits. Although profile differences between variants were observed, there is considerable variability in clinical symptoms in the same variant.

This study examines processes of class construction within a transnational community of professionals and managers who are emigrants, returnees, and non-migrants. Building on Bourdieu's class analysis and literature on transnational migration, we examine how class statuses are supported by moral claims based on varying transnational mobility strategies. We draw our results from qualitative interviews with 45 Hong Kong respondents in Hong Kong and Canada. We find that despite Hong Kong emigrants' loss of economic capital due to de-professionalization, their cultural and symbolic claims frame an alternative set of norms about their life successes. Returnees claim to have the best of both worlds having amassed economic capital, while making social distinctions from stayers in terms of their globalized cosmopolitan imaginaries. Stayers appear envious of emigrants' and returnees' flexibility and seek to accumulate economic capital for future retirement migration or to send their children abroad. Respondents' moralizing discourses reveal a social field defining within class distinctions apart from hyper concerns of upward mobility through material gains. Nuanced class distinctions articulate values around freedom of space, time, and expression not readily accessible to residents remaining in Hong Kong.

Environmental determinists predict that people move away from places experiencing frequent weather hazards, yet some of these areas have rapidly growing populations. This analysis examines the relationship between weather events and population change in all U.S. counties that experienced hurricanes and tropical storms between 1980 and 2012. Our database allows for more generalizable conclusions by accounting for heterogeneity in current and past hurricane events and losses and past population trends. We find that hurricanes and tropical storms affect future population growth only in counties with growing, high-density populations, which are only 2 percent of all counties. In those counties, current year hurricane events and related losses suppress future population growth, although cumulative hurricane-related losses actually elevate population growth. Low-density counties and counties with stable or declining populations experience no effect of these weather events. Our analysis provides a methodologically informed explanation for contradictory findings in prior studies.

Classic migration theory predicts that individual and household migration decisions are partially responsive to economic pushes from origin communities and pulls from destinations. Recent theorizing argues that this basic relationship is fundamentally influenced by the experiences accumulated within migrant streams, connecting potential migrants with future migrants between origin and destination. Drawing upon a 16-year study of migrant departures and returns from 22 villages in northeastern Thailand, we extend current knowledge about these fundamental relationships before, during, and after Thailand's economic crisis of 1997. We answer the following questions: How are migrant departures from the origin affected by the crisis, how are migrant returns to origin communities affected by the crisis, and how do migrants' accumulated experiences connecting origin and destination moderate these relationships? We examine effects separately for men and women since village and destination economies are sufficiently sex differentiated. We find that migrant selectivity partially explains year effects: that is, earlier periods are more highly selective. Migrant cumulative experiences facilitate migration throughout the time period and modestly influence the migration decisions during economic downturns, but these effects are far more important for women than for men. For return migration, year effects emerge only for the post 1997-98 period and only after controlling for migrant social capital and occupational sector. Origin-based migrant social capital slightly, but significantly, reduces the odds of return migration throughout the period of observation. However, migrant social capital does amplify the likelihood of return migration after the Asian Financial Crisis. Construction workers are the most likely to return to their origin villages after the Asian Financial Crisis, while manufacturing, service, and agricultural workers show little change in behavior.

Importance: Most evidence to date highlights the importance of genetic influences on the liability to autism and related traits. However, most of these findings are derived from clinically ascertained samples, possibly missing individuals with subtler manifestations, and obtained estimates may not be representative of the population., Objectives: To establish the relative contributions of genetic and environmental factors in liability to autism spectrum disorder (ASD) and a broader autism phenotype in a large population-based twin sample and to ascertain the genetic/environmental relationship between dimensional trait measures and categorical diagnostic constructs of ASD., Design, Setting, and Participants: We used data from the population-based cohort Twins Early Development Study, which included all twin pairs born in England and Wales from January 1, 1994, through December 31, 1996. We performed joint continuous-ordinal liability threshold model fitting using the full information maximum likelihood method to estimate genetic and environmental parameters of covariance. Twin pairs underwent the following assessments: the Childhood Autism Spectrum Test (CAST) (6423 pairs; mean age, 7.9 years), the Development and Well-being Assessment (DAWBA) (359 pairs; mean age, 10.3 years), the Autism Diagnostic Observation Schedule (ADOS) (203 pairs; mean age, 13.2 years), the Autism Diagnostic Interview-Revised (ADI-R) (205 pairs; mean age, 13.2 years), and a best-estimate diagnosis (207 pairs)., Main Outcomes and Measures: Participants underwent screening using a population-based measure of autistic traits (CAST assessment), structured diagnostic assessments (DAWBA, ADI-R, and ADOS), and a best-estimate diagnosis., Results: On all ASD measures, correlations among monozygotic twins (range, 0.77-0.99) were significantly higher than those for dizygotic twins (range, 0.22-0.65), giving heritability estimates of 56% to 95%. The covariance of CAST and ASD diagnostic status (DAWBA, ADOS and best-estimate diagnosis) was largely explained by additive genetic factors (76%-95%). For the ADI-R only, shared environmental influences were significant (30% [95% CI, 8%-47%]) but smaller than genetic influences (56% [95% CI, 37%-82%])., Conclusions and Relevance: The liability to ASD and a more broadly defined high-level autism trait phenotype in this large population-based twin sample derives primarily from additive genetic and, to a lesser extent, nonshared environmental effects. The largely consistent results across different diagnostic tools suggest that the results are generalizable across multiple measures and assessment methods. Genetic factors underpinning individual differences in autismlike traits show considerable overlap with genetic influences on diagnosed ASD.

The genetic architecture of autism spectrum disorder involves the interplay of common and rare variants and their impact on hundreds of genes. Using exome sequencing, here we show that analysis of rare coding variation in 3,871 autism cases and 9,937 ancestry-matched or parental controls implicates 22 autosomal genes at a false discovery rate (FDR) < 0.05, plus a set of 107 autosomal genes strongly enriched for those likely to affect risk (FDR < 0.30). These 107 genes, which show unusual evolutionary constraint against mutations, incur de novo loss-of-function mutations in over 5% of autistic subjects. Many of the genes implicated encode proteins for synaptic formation, transcriptional regulation and chromatin-remodelling pathways. These include voltage-gated ion channels regulating the propagation of action potentials, pacemaking and excitability-transcription coupling, as well as histone-modifying enzymes and chromatin remodellers-most prominently those that mediate post-translational lysine methylation/demethylation modifications of histones.

Scholars point to climate change, often in the form of more frequent and severe drought, as a potential driver of migration in the developing world, particularly for places where populations rely on agriculture for their livelihoods. To date, however, there have been few large-scale, longitudinal studies that explore the relationship between climate change and migration. This study significantly extends current scholarship by evaluating distinctive effects of climatic variation and models these effects on men's and women's responsiveness to drought and rainfall. Our study also investigates how land ownership moderates these effects. We find small, but significant, increases in migration above existing migratory levels during periods of prolonged climatic stress, and that these patterns differ both by gender and land tenure.

Background: Autism spectrum disorder (ASD) is well recognized to be genetically heterogeneous. It is assumed that the genetic risk factors give rise to a broad spectrum of indistinguishable behavioral presentations., Methods: We tested this assumption by analyzing the Autism Diagnostic Interview-Revised (ADI-R) symptom profiles in samples comprising six genetic disorders that carry an increased risk for ASD (22q11.2 deletion, Down's syndrome, Prader-Willi, supernumerary marker chromosome 15, tuberous sclerosis complex and Klinefelter syndrome; total n = 322 cases, groups ranging in sample sizes from 21 to 90 cases). We mined the data to test the existence and specificity of ADI-R profiles using a multiclass extension of support vector machine (SVM) learning. We subsequently applied the SVM genetic disorder algorithm on idiopathic ASD profiles from the Autism Genetics Resource Exchange (AGRE)., Results: Genetic disorders were associated with behavioral specificity, indicated by the accuracy and certainty of SVM predictions; one-by-one genetic disorder stratifications were highly accurate leading to 63% accuracy of correct genotype prediction when all six genetic disorder groups were analyzed simultaneously. Application of the SVM algorithm to AGRE cases indicated that the algorithm could detect similarity of genetic behavioral signatures in idiopathic ASD subjects. Also, affected sib pairs in the AGRE were behaviorally more similar when they had been allocated to the same genetic disorder group., Conclusions: Our findings provide evidence for genotype-phenotype correlations in relation to autistic symptomatology. SVM algorithms may be used to stratify idiopathic cases of ASD according to behavioral signature patterns associated with genetic disorders. Together, the results suggest a new approach for disentangling the heterogeneity of ASD.

Clozapine is a uniquely efficacious antipsychotic drug in treatment-resistant schizophrenia. Its use is restricted due to adverse effects including a rare but dangerous reduction in neutrophils (agranulocytosis) and the mandatory hematological monitoring this entails in many countries. We review the statistical, ethical and legal issues arising from a hypothetical pharmacogenetic test for clozapine, using the UK as an exemplary case for consideration. Our key findings include: a consideration of the probabilistic results that a pharmacogenetic test may return; the impact on drug licensing; and the potential for pharmacogenetic tests for clozapine being used without consent under the UK's legal framework. We make recommendations regarding regulatory changes applicable to the special case of pharmacogenetic testing in clozapine treatment.

Background: Oral fluid provides a noninvasive method of sample collection. The aim of this study was to obtain oral fluid, plasma, and whole blood from patients prescribed amisulpride, aripiprazole, clozapine, quetiapine, risperidone, or sulpiride and to measure plasma:whole blood and plasma:oral fluid analyte distribution., Methods: Matched oral fluid, plasma and whole-blood samples were analyzed by liquid chromatography-tandem mass spectrometry., Results: There were 101 sets of samples from 90 (56 male, 34 female) patients (nine prescribed 2 antipsychotics, and one 3). There were ≤ 5 samples for aripiprazole, amisulpride, and sulpiride. There was a good relationship between the plasma and hemolyzed whole-blood concentrations (R > 0.95), with plasma:whole-blood ratios varying between 0.7 (amisulpride) and 1.8 (aripiprazole). Amisulpride plasma and oral fluid concentrations were similar, whereas aripiprazole and dehydroaripiprazole oral fluid concentrations were approximately 8% of those in the plasma, reflecting the weak and strong plasma protein binding of these compounds, respectively. For the other analytes, plasma concentrations were 2-4 times higher than oral fluid concentrations. In general, there was a poor relationship (R = 0.3-0.7) between the plasma and oral fluid concentrations, possibly due to intrapatient saliva pH variation during sample collection., Conclusions: This work shows that hemolyzed whole-blood samples can be used for therapeutic drug monitoring purposes for the analytes of interest, provided that the plasma:whole-blood ratio is taken into account when interpreting results. For aripiprazole and dehydroaripiprazole, measurements in oral fluid will probably not be feasible. However, the relationship between plasma and oral fluid concentration for amisulpride, clozapine (and norclozapine), quetiapine (and possibly quetiapine metabolites), and risperidone/9-hydroxyrisperidone shows potential for oral fluid analysis.

We argue that important, overlooked differences in what we call the 'cultural armature' of Portland, Maine, and Danbury, Connecticut help explain the variation in how each city received new immigrants in recent years. Portland has a long history of contact with the outside world and used its cosmopolitan character to promote urban redevelopment and welcome immigrants from a range of countries of origin. Danbury's small-town, insular outlook, and the fact that most of its newcomers came from a single country of origin - some without legal documents - made immigrants' welcome more fragmented. While leaders in both cities speak of multiculturalism and tolerance, the 'cultural armature' of each led city leaders to put that talk into action differently. We describe how we see this 'cultural armature' at work and argue that it - in combination with demographic realities - led immigrants to be more warmly welcomed in Portland than in Danbury.

Tracing the Thai cassava ( Manihot esculenta ) trade network, between 1960 and 2000, offers a compelling example of global complexity at work. The emergence of Thailand's dominance of world export markets caught the world by surprise. The opening up of a European market for cassava was supposed to be met by Brazilian and Indonesian producers. Instead, Thailand took over the market by 1975. Several factors facilitated this emergence including: entrepreneurial diasporic networks of Thai-Chinese traders, local political economy conditions in both Europe and Thailand, and ecological conditions in Thailand. These same factors also shaped the subsequent timing of the closing of the European market, the emergence of a new industry association, the creation of new cassava products, and the expansion to other markets. Furthermore, the dynamic nature of cassava market yielded equivocal outcomes for both Europe and Thai farmers.

The inexorable link between migration and development is paradoxically both taken for granted and a challenging puzzle. Describing interdependent dynamic processes, the study of both offers opportunities to theorize and observe social change. The body of knowledge that has come to include studies of both migration and development has enriched the individual fields of migration and development. In the development field, concerned with the processes that underlie economic growth or contribute to improved livelihoods, adding a migration focus has broadened observations about development to include those about vulnerability and security, for example. A migration lens on the development process also reveals the presence of social networks and the selectivity of behaviors and events. In both cases, such observations have enriched our understanding of development processes. The same epistemological process is at work when migration scholars consider development in relation to migration. A development lens means attention to the institutions that regulate the production of goods and services and the related distributional processes. The migration of populations and experiences of migrants elucidate both the potentialities and vulnerabilities that accompany development and globalization, while simultaneously introducing a new conceptualization of class.

A review of the sociological research about gender and migration shows the substantial ways in which gender fundamentally organizes the social relations and structures influencing the causes and consequences of migration. Yet, although a significant sociological research has emerged on gender and migration in the last three decades, studies are not evenly distributed across the discipline. In this article, we map the recent intellectual history of gender and migration in the field of sociology and then systematically assess the extent to which studies on engendering migration have appeared in four widely read journals of sociology (American Journal of Sociology, American Sociological Review, Demography, and Social Forces ). We follow with a discussion of these studies, and in our conclusions, we consider how future gender and migration scholarship in sociology might evolve more equitably.

Background: Studies of chromosome 15 abnormality have implicated over-expression of paternally imprinted genes in the 15q11-13 region in the aetiology of autism. To test this hypothesis we compared individuals with Prader-Willi syndrome (PWS) due to uniparental disomy (UPD--where paternally imprinted genes are over-expressed) to individuals with the 15q11-13 deletion form of the syndrome (where paternally imprinted genes are not over-expressed). We also tested reports that PWS cases due to the larger type I (TI) form of deletion show differences to cases with the smaller type II (TII) deletion., Method: Ninety-six individuals with PWS were recruited from genetic centres and the PWS association. Forty-nine individuals were confirmed as having maternal UPD of chromosome 15 and were age and sex matched to 47 individuals with a deletion involving 15q11-13 (32 had the shorter (T II) deletion, and 14 had the longer (TI) deletion). Behavioural assessments were carried out blind to genetic status, using the Autism Diagnostic Observation Schedule (ADOS), the Autism Diagnostic Interview (ADI), the Autism Screening Questionnaire (ASQ), the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), the Vineland Adaptive Behaviour Scales (VABS), and measurements of intellectual ability, including the Wechsler and Mullen Scales and Raven's Matrices., Results: UPD cases exhibited significantly more autistic-like impairments in reciprocal social interaction on questionnaire, interview and standardised observational measures. Comparison of TI and TII deletion cases revealed few differences, but ability levels tended to be lower in the TI deletion cases., Conclusions: Findings from a large study comparing deletion and UPD forms of Prader-Willi syndrome were consistent with other evidence in indicating that paternally imprinted genes in the 15q11-13 region constitute a genetic risk factor for aspects of autistic symptomatology. These genes may therefore play a role in the aetiology of autism. By contrast with another report, there was no clear-cut relationship between the size of the deletion and the form of cognitive and behavioural phenotype.

Employing longitudinal data from Thailand to replicate studies of cumulative causation, we extend current knowledge by measuring frequency of trips, duration of time away, level of network aggregation (village or household), and sex composition of migrant networks to estimate a model of prospective migration among men and women in Thailand. We find that trips and duration of time away have distinct influences upon migration; that household level migrant networks are more influential than village level migrant networks; that female migrant networks and male migrant networks have different influences upon migration outcomes; and, that migrant social capital influences men and women's migration differently. Our elaboration provides significant quantitative evidence as to how gender and family variously imbue migration dynamics.

Recent literature on migration and the environment has identified key mediating variables such as how migrants extract resources from the environment for their livelihoods, the rate and efficiency of extraction, and the social and economic context within which their extraction occurs. This paper investigates these variables in a new ecological setting using data from coastal fishing villages in North Sulawesi, Indonesia. We do not find as many differences between migrant and non-migrant families regarding destructive fishing behavior, technology, and investment as might have been expected from earlier theories. Instead, the context and timing of migrant assimilation seems to be more important in explaining apparent associations of migration and environmental impacts than simply migrants themselves. This finding fits well with recent literature in the field of international migration and immigrant incorporation.

This study addresses the debate over whether higher-order marriages will help offset the expected loss of social support from kin due to divorce for future generations of the elderly. We use data from the first wave of the National Survey of Families and Households (NSFH1, 1987-1988) to examine the effects of marriage, marital disruption, and remarriage on perceptions of overall support and support from kin. To measure perceptions of overall support, we look at whether respondents say that they have someone to: (1) turn to in an emergency, (2) borrow money from, and (3) talk to when they are depressed. To measure perceived support from kin, we look at whether respondents name kin as a source of support. We find that marriage and remarriage increase perceptions of support from kin, whereas divorce reduces perceptions of support. We also find that men benefit more from marriage and lose more from divorce than women. Taken together our findings suggest growing inequality in social support among the future elderly population.

This article compares the impact of family migrant and destination-specific networks on international and internal migration. We find that migrant networks are more important for international moves than for internal moves and that female networks are more important than male networks for moves within Mexico. For moves to the United States, male migrant networks are more important for prospective male migrants than for female migrants, and female migrant networks lower the odds of male migration, but significantly increase female migration. We suggest that distinguishing the gender composition and destination content of migrant networks deepens our understanding of how cumulative causation affects patterns of Mexican migration.

Within individual countries, the paths towards increasing educational attainment are not always linear and individuals are not equally affected. Differences between boys' and girls' educational attainments are a common expression of this inequality as boys are more often favored for continued schooling. We examine the importance of birth cohort, sibship size, migration, and school accessibility for explaining both the gender gap and its narrowing in secondary schooling in one district in Northeast Thailand between 1984-1994. Birth cohort is a significant explanation for the narrowing of the gender gap. Migration, sibship size, and remote village location are important explanations for limited secondary education opportunities, especially for girls.

Our synthesis focuses on how markets influence the population and environment relationship within coastal ecosystems by considering the differential valuing of environmental resources and ecosystem services through 3 perspectives: livelihood, globalization, and public goods and externalities. These are not new perspectives when considering how markets shape demographic and environmental outcomes. However, we suggest that the insight offered by viewing coastal and marine health through these combined lenses brings into focus with renewed urgency the perils facing these vital ecosystems.

Common property systems are a critical institution mediating the relationship between population change and environmental outcomes, especially in coastal and marine ecosystems. Evidence from El Salvador; Goa, India; and the Solomon Islands demonstrates how the social structures and institutions stemming from patterns of human migration variably influence environmental out-comes through their effects on common property resource institutions. In each of the case studies, the demographic phenomenon is not population growth or a change in numbers, but an underlying process that affects population size and growth rates: i.e. migration and associated social relations that result from or cause more migration. The following 3 cases studies provide the respective historical and cultural context to show that there is a nonlinear link between population and environment, which when explored reveals the importance of understanding how individuals and communities are embedded in sets of social relations that must be considered when evaluating environmental policies or when determining the causes of environmental degradation.

How does family planning accessibility affect contraceptive choice? In this paper we use techniques of spatial analysis to develop measures of family planning accessibility, and evaluate the effects of these geographically derived measures in a multilevel statistical model of temporary method choice in Nang Rong, Thailand. In our analyses we combine spatial data obtained from maps and Global Positioning System (GPS) readings with sociodemographic data from surveys and administrative records. The new measures reveal (1) important travel time effects even when family planning outlets are close by; (2) independent effects of road composition; (3) the relevance of alternative sources of family planning supply; and (4) the importance of the local history of program placement.

This paper blends quantitative with qualitative data in an investigation of community and contraceptive choice in Nang Rong, Thailand. Specifically, it develops an explanation of 1) method dominance within villages, coupled with 2) marked differences between villages in the popularity of particular methods. The quantitative analysis demonstrates the importance of village location and placement of family planning services for patterns of contraceptive choice. The qualitative data provide a complementary perspective, emphasizing the importance of social as well as physical space and giving particular attention to the structure of conversational networks.