Graduating into Lower Risk: Chlamydia and Trichomonas Prevalance among Community College Students and Graduates

Background: Community colleges enable youth from economically disadvantaged and minority populations to access college and may enable social mobility including improved health outcomes. However, educational health disparities studies rarely assess the health outcomes for community college graduates. Methods: Chlamydia and trichomonas prevalence were assessed with nucleic acid based tests in a nationally representative sample of 6233 high school graduates (ages 18–25) from five educational levels: young adults without post-secondary credentials who were not enrolled in college, community college students, 4-year college students, associate’s degree, and bachelor’s degree. To reduce confounding between educational attainment and STI status, we used full matching to balance on 22 measures of demographics, socioeconomic status, educational factors, and sexual risk-taking. Estimates of associations between educational attainment and STI status were obtained from multivariate regression in the full (n=6233) and matched (n=1655) samples. Results:Four-year college students (adjusted incidence rate ratio (IRR) = 0.41, 95% CI [0.27, 0.61], p Conclusions: Community college students come from populations with greater health risks than 4-year college students, but community college graduation may reduce the likelihood of chlamydia infection. STI interventions can meet the needs of young adults who access college through community college by partnering with community college health clinics to encourage continued STI prevention, testing, and treatment after the intervention ends. Public health studies that use inclusive educational attainment measures that incorporate sub-baccalaureate credentials will better capture health disparities

Comparing Dutch Case management care models for people with dementia and their caregivers: The design of the COMPAS study

<p>Abstract</p> <p>Background</p> <p>Dementia care in the Netherlands is shifting from fragmented, ad hoc care to more coordinated and personalised care. Case management contributes to this shift. The linkage model and a combination of intensive case management and joint agency care models were selected based on their emerging prominence in the Netherlands. It is unclear if these different forms of case management are more effective than usual care in improving or preserving the functioning and well-being at the patient and caregiver level and at the societal cost. The objective of this article is to describe the design of a study comparing these two case management care models against usual care. Clinical and cost outcomes are investigated while care processes and the facilitators and barriers for implementation of these models are considered.</p> <p>Design</p> <p>Mixed methods include a prospective, observational, controlled, cohort study among persons with dementia and their primary informal caregiver in regions of the Netherlands with and without case management including a qualitative process evaluation. Inclusion criteria for the cohort study are: community-dwelling individuals with a dementia diagnosis who are not terminally-ill or anticipate admission to a nursing home within 6 months and with an informal caregiver who speaks fluent Dutch. Person with dementia-informal caregiver dyads are followed for two years. The primary outcome measure is the Neuropsychiatric Inventory for the people with dementia and the General Health Questionnaire for their caregivers. Secondary outcomes include: quality of life and needs assessment in both persons with dementia and caregivers, activity of daily living, competence of care, and number of crises. Costs are measured from a societal perspective using cost diaries. Process indicators measure the quality of care from the participant’s perspective. The qualitative study uses purposive sampling methods to ensure a wide variation of respondents. Semi-structured interviews with stakeholders based on the theoretical model of adaptive implementation are planned.</p> <p>Discussion</p> <p>This study provides relevant insights into care processes, description of two case management models along with clinical and economic data from persons with dementia and caregivers to clarify important differences in two case management care models compared to usual care.</p

Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans

Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in 25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16 regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP, while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium (LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region. Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the refined data for existing association signals, we estimate that these loci now explain ∼38.9% of the familial relative risk of PrCa, an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent signals within the same regio

Reborn a Virgin: Adolescents’ Retracting of Virginity Pledges and Sexual Histories

Objectives. We examined retractions of virginity pledges and of sexual histories among adolescents taking part in waves 1 and 2 of the National Longitudinal Study of Adolescent Health. Methods. Logistic regression analyses were used to compare respondents’ reports of virginity pledges and sexual histories at waves 1 and 2. Results. Among wave 1 virginity pledgers, 53% denied having made a pledge at wave 2; after control for confounders, pledgers who subsequently initiated sexual activity were 3 times as likely to deny having made a pledge as those who did not initiate sexual activity (odds ratio [OR] = 3.21; 95% confidence interval [CI] = 2.04, 5.04). Among wave 1 nonvirgins who subsequently took virginity pledges, 28% retracted their sexual histories at wave 2; respondents who took virginity pledges were almost 4 times as likely as those who did not to retract reports of sexual experience (OR=3.88; 95% CI=1.87, 8.07). Conclusions. Adolescents who initiate sexual activity are likely to recant virginity pledges, whereas those who take pledges are likely to recant their sexual histories. Thus, evaluations of sexual abstinence programs are vulnerable to unreliable data. In addition, virginity pledgers may incorrectly assess the sexually transmitted disease risks associated with their prepledge sexual behavior

Confidence Disparities: Pre-course Coding Confidence Predicts Greater Statistics Intentions and Perceived Achievement in a Project-Based Introductory Statistics Course

AbstractSelf-efficacy is associated with a range of educational outcomes, including science and math degree attainment. Project-based statistics courses have the potential to increase students’ math self-efficacy because projects may represent a mastery experience, but students enter courses with preexisting math self-efficacy. This study explored associations between pre-course math confidence and coding confidence with post-course statistical intentions and perceived achievement among students in a project-based statistics course at 28 private and public colleges and universities between fall 2018 and winter 2020 (n = 801) using multilevel mixed-effects multivariate linear regression within multiply imputed data with a cross-validation approach (testing n = 508 at 20 colleges/universities). We found that pre-course coding confidence was associated with, respectively, 9 points greater post-course statistical intentions and 10 points greater perceived achievement on a scale 0–100 (0.09, 95% confidence interval (0.02, 0.17), p = 0.02; 0.10, 95% CI (0.01, 0.19), p = 0.04), and that minoritized students have greater post-course statistical intentions than nonminoritized students. These results concur with past research showing the potential effectiveness of the project-based approach for increasing the interest of minoritized students in statistics. Pre-course interventions to increase coding confidence such as pre-college coding experiences may improve students’ post-course motivations and perceived achievement in a project-based course. Supplementary materials for this article are available online

Additional file 1 of Blood pressure in children with sickle cell disease is higher than in the general pediatric population

Additional file 1: Supplementary table 1. Systolic and diastolic blood pressures for males and females ages 5-17 with and without Sickle Cell Disease