37 research outputs found
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The relationship between abortion and depression : evidence from the National Longitudinal Study of Adolescent Health
A majority of states require parental consent or notification before a minor may have an abortion. Parental involvement laws are based in part on the assumption that abortion poses a risk to the psychological health of adolescents. Previous research has catalogued the risks to adolescent mothers and their children posed by early childbearing, the alternative to abortion. The health risks of delaying abortion also have been documented. Few studies, however, have attempted to quantify the risks of abortion to adolescents' mental health. Research suggests that associations between abortion and depression demonstrated in some studies of adult women may be spurious and reflect unmeasured covariates, such as intendedness of the pregnancy. This study used secondary data from the National Longitudinal Study of Adolescent
Health (Add Health) to test whether having an abortion put adolescent women at risk for developing depression in the short term and over time. Respondents were interviewed three times, in 1994-1995 (Wave I), 1996 (Wave II), and in 2001 (Wave III). Logistic regression was used to test whether adolescents who had an abortion between Waves I and II had an increased risk for developing depression. Adolescents who had an abortion were compared with adolescents who also became pregnant but did not have an abortion and with the larger sample of female adolescents. Abortion was not associated with developing depression, either in the short term or over time. Unintended pregnancy between Waves I and II also was not significant in predicting depression. Prior pregnancy (before Wave I), however, did predict depression five years later. Thus, this study found no evidence to support legal restrictions on abortion for minors on the basis of increased risk of depression. However, findings do suggest that pregnancy in early adolescence may be a risk factor for developing depression in young adulthood. The relationship between adolescent pregnancy and later depression underscores the need for effective pregnancy prevention programs in early adolescence
One Love: Explicit Monogamy Agreements among Heterosexual Young Adult Couples at Increased Risk of Sexually Transmitted Infections
HIV prevention strategies among couples include condom use, mutual monogamy, and HIV testing. Research suggests that condom use is more likely with new or casual partners, and tends to decline as relationships become steady over time. Little is known, however, about explicit mutual monogamy agreements and HIV testing within heterosexual couples. This study used data from 434 young heterosexual couples at increased risk of HIV and sexually transmitted infections (STIs) to assess (a) couple concordance on perceptions of a monogamy agreement, sustained monogamy, and HIV testing; and (b) the associations of relationship and demographic factors with monogamy agreement, sustained monogamy, and HIV testing. Results indicated only slight to fair agreement within couples on measures of monogamy agreement and sustained monogamy. Overall, 227 couples (52%) concurred that they had an explicit agreement to be monogamous; of those, 162 (71%) had sustained the agreement. Couples with greater health protective communication and commitment were more likely to have a monogamy agreement. Couples of Latino and Hispanic ethnicity and those with children were less likely to have a monogamy agreement. Only commitment was related to sustained monogamy. Having children, greater health protective communication, and perceived vulnerability to HIV and STIs were associated with HIV testing within the couple
Whose Intentions Predict? Power over Condom Use within Heterosexual Dyads
According to major theories of behavioral prediction, the most proximal psychological predictor of an individual’s behavior is that individual’s intention. With respect to interdependent behaviors such as condom use, however, relationship dynamics influence individuals’ power to make decisions and to act. Objective: The current study examines how relationship dynamics impact 3 condom use relevant outcomes: (a) the individual forming his or her own intention to use condoms, (b) the couple forming their joint intention to use condoms, and (c) actual condom use behavior. Method: We conducted a 2-wave longitudinal study of young heterosexual adult couples at high risk for HIV infection involving the collection of both individual- and couple-derived data. Results: Results demonstrate the importance of both person (e.g., biological sex and dispositional dominance) and relational (e.g., relational power and amount of interest in the relationship, operationalized as commitment and perceived alternatives to the relationship) factors in predicting condom use intentions and behavior. Individuals who are lower in dispositional dominance are likely to incorporate their partner’s intentions into their own individual intentions; the intentions of individuals who have less interest in the relationship are more highly predictive of the couple’s joint intention; and the intentions of men and individuals higher in relationship power are more likely to exert a direct influence on condom use. Conclusions: These findings have implications for improving the health of high-risk individuals, including suggesting situations in which individuals are highly influenced by their partners’ intentions
Can Young Adults Accurately Report Sexual Partnership Dates? Factors Associated With Interpartner and Dyad Agreement
Sexual partnership dates are critical to STI/HIV research and control programs, though validity is limited by inaccurate recall and reporting
Association of perceived partner non-monogamy with prevalent and incident sexual concurrency
Concurrency is suggested as an important factor in sexually transmitted infection transmission and acquisition, though little is known regarding factors that may predict concurrency initiation. We examined the association between perception of a partner’s non-monogamy (PPNM) and simultaneous or subsequent concurrency among at-risk heterosexual young adults in the Los Angeles area
Concurrent Sexual Partnerships Among Young Heterosexual Adults at Increased HIV Risk: Types and Characteristics
The impact of concurrency on STI transmission depends upon coital frequency, condom use, duration of relationship overlap, and number of partners. Previous research has identified distinct concurrency types; however, little is known about their risk characteristics
Desire and Dread from the Nucleus Accumbens: Cortical Glutamate and Subcortical GABA Differentially Generate Motivation and Hedonic Impact in the Rat
Background: GABAergic signals to the nucleus accumbens (NAc) shell arise from predominantly subcortical sources whereas glutamatergic signals arise mainly from cortical-related sources. Here we contrasted GABAergic and glutamatergic generation of hedonics versus motivation processes, as a proxy for comparing subcortical and cortical controls of emotion. Local disruptions of either signals in medial shell of NAc generate intense motivated behaviors corresponding to desire and/or dread, along a rostrocaudal gradient. GABA or glutamate disruptions in rostral shell generate appetitive motivation whereas disruptions in caudal shell elicit fearful motivation. However, GABA and glutamate signals in NAc differ in important ways, despite the similarity of their rostrocaudal motivation gradients. Methodology/Principal Findings: Microinjections of a GABAA agonist (muscimol), or of a glutamate AMPA antagonist (DNQX) in medial shell of rats were assessed for generation of hedonic ‘‘liking’ ’ or ‘‘disliking’ ’ by measuring orofacial affective reactions to sucrose-quinine taste. Motivation generation was independently assessed measuring effects on eating versus natural defensive behaviors. For GABAergic microinjections, we found that the desire-dread motivation gradient was mirrored by an equivalent hedonic gradient that amplified affective taste ‘‘liking’ ’ (at rostral sites) versus ‘‘disliking’ ’ (at caudal sites). However, manipulation of glutamatergic signals completely failed to alter pleasure-displeasure reactions to sensory hedonic impact, despite producing a strong rostrocaudal gradient of motivation
The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance
INTRODUCTION
Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic.
RATIONALE
We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs).
RESULTS
Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants.
CONCLUSION
Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century
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Medical Mistrust, Perceived Discrimination, and Satisfaction With Health Care Among Young-Adult Rural Latinos
PURPOSE:
Little research has analyzed mistrust and discrimination influencing receipt of health care services among Latinos, particularly those living in rural areas. The present study examined the associations between medical mistrust, perceived discrimination, and satisfaction with health care among young-adult rural Latinos.
RESEARCH DESIGN:
This cross-sectional study analyzed data from 387 young-adult Latinos (ages 18-25) living in rural Oregon. The Behavioral Model of Vulnerable Populations was utilized as the theoretical framework. Correlations were run to assess bivariate associations among variables included in the study. Ordered logistic regression models evaluated the associations between medical mistrust, perceived discrimination, and satisfaction with health care.
RESULTS:
On average, participants used health services 4 times in the past year. Almost half of the participants had health insurance (46%). The majority reported that they were moderately (32%) or very satisfied (41%) with health care services used in the previous year. In multivariable models, medical mistrust and perceived discrimination were significantly associated with satisfaction with health care.
CONCLUSIONS:
Medical mistrust and perceived discrimination were significant contributors to lower satisfaction with health care among young-adult Latinos living in rural Oregon. Health care reform implementation, currently under way, provides a unique opportunity for developing evaluation systems and interventions toward monitoring and reducing rural Latino health care disparities.Keywords: Satisfaction with health care, Rural Latinos, Medical mistrust, Perceived discriminatio