Prevalence of cervical disease at age 20 after immunisation with bivalent HPV vaccine at age 12-13 in Scotland: retrospective population study

The manuscript was reviewed by Jo’s Trust, which supports the conclusions. It made the following statement: We think (it has) massive implications for the screening programme, vaccine and also impact on diagnoses in the future. It gives weight for activity to increase vaccine uptake, has implications on screening intervals. The clinically relevant herd protection is very interesting too. It also feeds into our policy calls for a new IT infrastructure (for the screening programme in England) to record and enable invitations based on whether someone has at the vaccine if intervals can be extended. Funding: This study has been undertaken as part of the programme of surveillance of immunisation against human papillomavirus in Scotland, included within the routine work of Health Protection Scotland, a part of the Scottish National Health Service. No funding has been received from industry.Peer reviewedPublisher PD

La prévention des problèmes de comportement à l’adolescence : le Adolescent Transition Program

The Adolescent Transition Program (ATP) is a multi-component preventive intervention designed to reduce escalation in problem behaviors among high-risk young adolescents. A previous evaluation of this program showed that aggregating high-risk youths for intervention purposes led to an escalation in delinquency and smoking. The results of this study also suggested that an intervention targeting parenting practices was more beneficial. These findings led to the development of a new intervention program aimed at the modification of parenting practices. This school-based program proposes a multiple gating approach to parent intervention with each level of intervention building on the previous one to reduce the overall prevalence of risk. A pilot study designed to evaluate the implementation of this intervention program suggested that schools seem to be an appropriate setting for reaching parents of high-risk adolescents and delivering intervention services

Ethical dilemmas in sport and exercise psychology practice

As Sport and Exercise Psychologists we often are presented with many ethical issues. This article is derived from candidates currently undertaking SEPAR as part of a peer supervision group, with the purpose of sharing experiences. The reflections below are provided by professionals working in the field and highlight some pertinent experiences for us as practitioners to reflect upon

Reflections in Systemic Family Psychotherapy and Adult Mental Health Services in the South East of Ireland; and beyond.

Systemic Family Psychotherapy (SFP) has been involved in the Carlow Kilkenny South Tipperary Adult Mental Services since 1994: in the main this involved meeting with service users, their families, couples and friends. However, from 2012 to 2019 five SFPs retired. This occurred when decisions were made by some Mental Health Management not to replace those SFPs that retired: thereby reducing the number of SFPs in the Southeast Adult Mental Health Services (AMHS); presumably due to funding difficulties at that time. However, as the months and years went by it became oblivious that two AMHSs were not going to employ SPTs. It was obvious that the AMHS in Waterford had never employed any SFT, and Wexford AMHS has only employed a half-time SFT for four Community Mental Teams. Consequently, this had an impact on the availability of SFPs in AMHSs in the south east AMHSs. However, on the other hand, the Carlow Kilkenny AMHS continues to be supported from Management and colleagues; SFTs since 1997. This is obvious as all Community Mental Health Teams refer service users attends the AMHSs in Carlow and Kilkenny, as well as their families/partners/friends for SFP. This article will try to ascertain how this came about, and what can be done to influences AMHS managers’ and concerning supporting SFPs. Key words: Family Therapy; Families; Mental Health Services; Family Meetings; Context in family therapy

Droplet digital PCR quantification suggests that higher viral load correlates with improved survival in HPV-positive oropharyngeal tumours

Background: Although HPV-positive oropharyngeal cancer (OPC) patients have improved prognosis compared to HPV negative patients; there remains an HPV-positive group who have poor outcomes. Biomarkers to stratify discrete patient outcomes are thus desirable. Our objective was to analyse viral load (VL) by droplet digital PCR (ddPCR), in HPV-positive patients with OPC on whom clinical outcome data were available. Methods: In a cohort of patients that had previously tested HPV positive via conventional PCR, VL was determined using ddPCR assays for HPV16 L1 and E6 genes. VL was classed as “medium/high” if more than 5.57 copies or 8.68 copies of the HPV 16 L1 or E6 gene were detected respectively. Effect of VL on overall survival and hazard of death & disease progression was performed with adjustments made for sex, age, deprivation, smoking, alcohol consumption and stage. Results: L1 VL ranged from 0.0014–304 gene copies per cell with a mean of 30.9; comparatively E6 VL ranged from 0.0012–356 copies per cell with a mean of 37.9. Univariate analysis showed those with a medium/high VL had a lower hazard of death; this was significant for L1 (p = 0.02) but not for E6 (p = 0.67). The ratio of E6 to L1 deviated from n = 1 in most samples but had no influence on clinical outcomes. Conclusions: HPV viral load may be informative for the further stratification of clinical outcomes in HPV positive OPC patient

Continued reduction in HPV prevalence and early evidence of herd immunity following the human papillomavirus vaccination programme in Scotland

In 2008, a national human papillomavirus (HPV) immunization program using a bivalent vaccine against HPV types 16 and 18 was implemented in Scotland along with a national surveillance program designed to determine the longitudinal effects of vaccination on HPV infection at the population level. Each year during 2009–2013, the surveillance program conducted HPV testing on a proportion of liquid-based cytology samples from women undergoing their first cervical screening test for precancerous cervical disease. By linking vaccination, cervical screening, and HPV testing data, over the study period we found a decline in HPV types 16 and 18, significant decreases in HPV types 31, 33, and 45 (suggesting cross-protection), and a nonsignificant increase in HPV 51. In addition, among nonvaccinated women, HPV types 16 and 18 infections were significantly lower in 2013 than in 2009. Our results preliminarily indicate herd immunity and sustained effectiveness of the bivalent vaccine on virologic outcomes at the population level