1,316 research outputs found

    State statutes and regulations related to human papillomavirus vaccination

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    A cross-sectional analysis of human papillomavirus (HPV) vaccine statutes and regulations from states and the District of Columbia in the United States (U.S.) was conducted from September-November 2018 to advance analyses of policy impact on HPV vaccination uptake. A search was conducted using WestlawNext, a legal research database. Statutes and regulations relevant to the study were analyzed and coded based on their legal attributes into ten broad coding questions and several sub-questions. Of the 212 laws identified by the initial search string, 93 (43.9%) reference HPV vaccination in statute or regulation. An additional three laws were added following subsequent review. There was a total of 52 statutes and 44 regulations from 34 states and the District of Columbia. Most laws were related to developing and distributing HPV vaccination materials for parents, and mechanisms to fund and reimburse for the vaccination. This study can be used by policymakers in jurisdictions that are considering establishing HPV vaccination promotion interventions in state law and highlighting the limited statutory and regulatory efforts that have been implemented to promote HPV vaccination. Importantly, this study can also be used to conduct evaluations of the efficacy of statutory and regulatory strategies in increasing HPV vaccination rates

    High dimensional decision dilemmas in climate models

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    An important source of uncertainty in climate models is linked to the calibration of model parameters. Interest in systematic and automated parameter optimization procedures stems from the desire to improve the model climatology and to quantify the average sensitivity associated with potential changes in the climate system. Building upon on the smoothness of the response of an atmospheric circulation model (AGCM) to changes of four adjustable parameters, Neelin et al. (2010) used a quadratic metamodel to objectively calibrate the AGCM. The metamodel accurately estimates global spatial averages of common fields of climatic interest, from precipitation, to low and high level winds, from temperature at various levels to sea level pressure and geopotential height, while providing a computationally cheap strategy to explore the influence of parameter settings. Here, guided by the metamodel, the ambiguities or dilemmas related to the decision making process in relation to model sensitivity and optimization are examined. Simulations of current climate are subject to considerable regional-scale biases. Those biases may vary substantially depending on the climate variable considered, and/or on the performance metric adopted. Common dilemmas are associated with model revisions yielding improvement in one field or regional pattern or season, but degradation in another, or improvement in the model climatology but degradation in the interannual variability representation. Challenges are posed to the modeler by the high dimensionality of the model output fields and by the large number of adjustable parameters. The use of the metamodel in the optimization strategy helps visualize trade-offs at a regional level, e.g., how mismatches between sensitivity and error spatial fields yield regional errors under minimization of global objective functions

    A 700 year record of Southern Hemisphere extratropical climate variability

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    Annually dated ice cores from West and East Antarctica provide proxies for past changes in atmospheric circulation over Antarctica and portions of the Southern Ocean, temperature in coastal West and East Antarctica, and the frequency of South Polar penetration of El Niño events. During the period AD 1700–1850, atmospheric circulation over the Antarctic and at least portions of the Southern Hemisphere underwent a mode switch departing from the out-of-phase alternation of multi-decadal long phases of EOF1 and EOF2 modes of the 850 hPa field over the Southern Hemisphere (as defined in the recent record by Thompson and Wallace, 2000; Thompson and Solomon, 2002) that characterizes the remainder of the 700 year long record. From AD 1700 to 1850, lower-tropospheric circulation was replaced by in-phase behavior of the Amundsen Sea Low component of EOF2 and the East Antarctic High component of EOF1. During the first phase of the mode switch, both West and East Antarctic temperatures declined, potentially in response to the increased extent of sea ice surrounding both regions. At the end of the mode switch, West Antarctic coastal temperatures rose and East Antarctic coastal temperatures fell, respectively, to their second highest and lowest of the record. Polar penetration of El Niño events increased during the mode switch. The onset of the AD 1700–1850 mode switch coincides with the extreme state of the Maunder Minimum in solar variability. Late 20th-century West Antarctic coastal temperatures are the highest in the record period, and East Antarctic coastal temperatures close to the lowest. Since AD 1700, extratropical regions of the Southern Hemisphere have experienced significant climate variability coincident with changes in both solar variability and greenhouse gase

    Trust and reputation policy-based mechanisms for self-protection in autonomic communications

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    Currently, there is an increasing tendency to migrate the management of communications and information systems onto the Web. This is making many traditional service support models obsolete. In addition, current security mechanisms are not sufficiently robust to protect each management system and/or subsystem from web-based intrusions, malware, and hacking attacks. This paper presents research challenges in autonomic management to provide self-protection mechanisms and tools by using trust and reputation concepts based on policy-based management to decentralize management decisions. This work also uses user-based reputation mechanisms to help enforce trust management in pervasive and communications services. The scope of this research is founded in social models, where the application of trust and reputation applied in communication systems helps detect potential users as well as hackers attempting to corrupt management operations and services. These so-called “cheating services” act as “attacks”, altering the performance and the security in communication systems by consumption of computing or network resources unnecessarily

    Increasing Efforts to Reduce Cervical Cancer through State-Level Comprehensive Cancer Control Planning

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    Reducing cervical cancer disparities in the U.S. requires intentional focus on structural barriers such as systems and policy which impact access to human papillomavirus (HPV) vaccination, cervical cancer screening and treatment. Such changes are difficult and often politicized. State comprehensive cancer control (CCC) plans are vehicles that, if designed well, can help build collective focus on structural changes. Study objectives were to identify the prioritization of cervical cancer in state CCC plans, the conceptualization of HPV within these plans, and the focus of plans on structural changes to reduce cervical cancer disparities. Data were gathered by systematic content analysis of CCC plans from 50 states and the District of Columbia from February-June 2014 for evidence of cervical cancer prioritization, conceptualization of HPV, and focus on structural barriers to cervical cancer vaccination, screening or treatment. Findings indicate that prioritization of cervical cancer within state CCC plans may not be a strong indicator of state efforts to reduce screening and treatment disparities. While a majority of plans reflected scientific evidence that HPV causes cervical and other cancers, they did not focus on structural elements impacting access to evidence-based interventions. Opportunities exist to improve state CCC plans by increasing their focus on structural interventions that impact cervical cancer prevention, detection, and treatmentparticularly for the 41% of plans ending in 2015 and the 31% ending between 2016-2020. Future studies should focus on the use of policy tools in state CCC plans and their application to cervical cancer prevention and treatment

    Barriers to health service access among female migrant Ugandan sex workers in Guangzhou, China.

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    BACKGROUND: Increased trade between China and Uganda has fueled trafficking of female Ugandans into China. These women may face challenges accessing health services. This study focused on examining barriers to health care access among female Ugandan sex workers in China. METHODS: In 2014, we undertook in-depth interviews with 19 female Ugandan sex workers in Guangzhou, China. Interviews focused on barriers to health service access and were analyzed using an a priori coding framework followed by open-coding to capture emergent themes. RESULTS: Out of 19 women, 12 women reported a history of being trafficked into China. None of the women had a valid Chinese visa. Fear of being arrested for lack of documentation discouraged women in this sample from accessing hospital services. Low pay, housing exploitation, and remittances contributed to participants' lack of financial resources, which further inhibited their ability to access health services. Participants expressed feeling social isolation from the local community and reported mistrust of local individuals and organizations, including hospitals. CONCLUSION: Ugandan sex workers in China faced substantial structural barriers that limited health service access. Policy changes and the development of new programs are urgently needed to ensure these women have improved access to health services

    Trust and Reciprocity: Are Effort and Money Equivalent?

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    Trust and reciprocity facilitate cooperation and are relevant to virtually all human interactions. They are typically studied using trust games: one subject gives (entrusts) money to another subject, which may return some of the proceeds (reciprocate). Currently, however, it is unclear whether trust and reciprocity in monetary transactions are similar in other settings, such as physical effort. Trust and reciprocity of physical effort are important as many everyday decisions imply an exchange of physical effort, and such exchange is central to labor relations. Here we studied a trust game based on physical effort and compared the results with those of a computationally equivalent monetary trust game. We found no significant difference between effort and money conditions in both the amount trusted and the quantity reciprocated. Moreover, there is a high positive correlation in subjects' behavior across conditions. This suggests that trust and reciprocity may be character traits: subjects that are trustful/trustworthy in monetary settings behave similarly during exchanges of physical effort. Our results validate the use of trust games to study exchanges in physical effort and to characterize inter-subject differences in trust and reciprocity, and also suggest a new behavioral paradigm to study these differences
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