Going beyond the individual: How state-level characteristics relate to HPV vaccine rates in the United States

Abstract Background The human papillomavirus (HPV) vaccine is an underutilized cancer control practice in the United States. Although individual contextual factors are known to impact HPV vaccine coverage rates, the impact of macro-level elements are still unclear. The aim of this analysis was to use HPV vaccination rates to explore the underuse of an evidence-based cancer control intervention and explore broader-level correlates influencing completion rates. Methods A comprehensive database was developed using individual-level date from the National Immunization Survey (NIS)-Teen (2016) and state-level data collected from publically available sources to analyze HPV vaccine completion. Multi-level logistic models were fit to identify significant correlates. Level-1 (individual) and level-2 (state) correlates were fitted to a random intercept model. Deviance and AIC assessed model fit and sampling weights were applied. Results The analysis included 20,495 adolescents from 50 U.S. states and the District of Columbia. Teen age, gender, race/ethnicity, and maternal education were significant individual predictors of HPV completion rates. Significant state-level predictors included sex education policy, religiosity, and HPV vaccine mandate. States with the lowest HPV coverage rates were found to be conservative and highly religious. Little variation in vaccine exemptions and enacted sex and abstinence education polices were observed between states with high and low HPV vaccine coverage suggesting various contextual and situational factors impact HPV vaccine completion rates. Conclusions Given that gender, religiosity, political ideology, and education policies are predictors of HPV vaccine completion, the interaction and underlying mechanism of these factors can be used to address the underutilization of the HPV vaccine

Attachment Relationships and Adolescent Psychological Health: The Influence of Romantic Relationships

Research demonstrates that attachment relationships play important roles in adolescent psychological health. The influence of romantic relationships on adjustment is less clear. Using a cross-sectional sample of 515 adolescents, the current study examines whether romantic relationships replace the influence of other attachment relationships on adolescent psychological health. Regression analyses revealed that romantic relationships did not significantly impact on the influence of other attachment relationships when predicting depression but did significantly decrease the influence of peer attachment for self-esteem. It is concluded that romantic relationships during adolescence do not have major direct effects on adjustment and have only a minor influence on existing attachment relationships in predicting psychological health. Findings are discussed in the light of the continuity model of interpersonal relationships

Poverty in Buffalo: Causes, Impacts, Solutions

This policy report examines the scope of poverty and inequality in Buffalo-Niagara, the causes of poverty, and its impacts across health, homelessness, education, and more. It features the insights of testifiers and commissioners from the Buffalo Truth Commission on Poverty, convened on January 25, 2018 by the Coalition for Economic Justice, the WNY Poor People\u27s Campaign, and the New York State Truth Commission on Poverty. The report concludes with solutions from the local to the federal level

Sexting and Mental Health: A School-based Longitudinal Study Among Youth in Texas

Background: Sexting has emerged as a common socio-cultural problem in our society today. Few studies have estimated the prevalence of sexting among younger middle school youth and even fewer have assessed the relationship between sexting and mental health outcomes like anxiety and depression symptoms among middle school youth. Objectives: To estimate the prevalence of sexting among sixth and seventh-grade middle school students in a large urban school district in Southeast Texas and to assess its relationship with mental health outcomes (both anxiety and depression) among these youth. Methods: A retrospective analysis of an existing three-year randomized, two-arm, nested longitudinal study was conducted. Associations between sexting and depression symptoms; and sexting and anxiety symptoms were assessed via univariate and multivariate logistic analysis. Results: The prevalence of sexting among sixth graders was found to be 12%. Compared to youth who were not engaged in sexting, engagement in sexting was associated with significantly increased odds of depression and anxiety symptoms. Conclusion: Sexting is common among youth and is associated with poorer mental health outcomes such as anxiety and depression among these youth, but further validation of these findings is needed

Characteristics of temporal fluctuations in the hyperpolarized state of the cortical slow oscillation

We present evidence for the hypothesis that transitions between the low- and high-firing states of the cortical slow oscillation correspond to neuronal phase transitions. By analyzing intracellular recordings of the membrane potential during the cortical slow oscillation in rats, we quantify the temporal fluctuations in power and the frequency centroid of the power spectrum in the period of time before “down” to “up” transitions. By taking appropriate averages over such events, we present these statistics as a function of time before transition. The results demonstrate an increase in fluctuation power and time scale broadly consistent with the slowing of systems close to phase transitions. The analysis is complicated and limited by the difficulty in identifying when transitions begin, and removing dc trends in membrane potential

Sexual health education for behavior change: How much is enough?

Purpose: Successful implementation of sexual health curricula in school settings is often compromised by competing academic priorities. This study explores the association between exposure to sexual health lessons (time-on-task in hours and lesson content topics) and delayed sexual initiation of middle school students at long term follow-up. Methods: Post hoc data analysis was conducted from a RCT (n=15 middle schools) in the south-central U.S. in which grade 7 students demonstrated delayed sexual initiation (adjusted odds ratio [AOR]: 1.54, 95% CI: 1.20 to 1.99) by grade 9 follow-up after using It’s Your Game (IYG), a 24 lesson sexual health curriculum. Logistic regression was conducted on a sub-sample of 314 grade 7 and 8 students who received IYG and who were sexually inexperienced at baseline, adjusting for covariates of age, gender, and race/ethnicity to address the impact of lesson exposure variables (time-on-task in hours and type of sexual health content) on initiation of any sex by grade 9. Results: The greatest impact of exposure on delayed sexual initiation was a duration of 13 or more lesson hours (OR = 8.40; p\u3c0.05) and exposure to lesson content on HIV/STI and pregnancy consequences (OR = 4.93; p\u3c0.05). Conclusions: Results support previous exposure studies and provide guidance on how effective sexual health curricula can meet the challenges of delivery in a reduced and competitive academic environment