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Objective: Colleges are potential hotspots for transmission of SARS-CoV-2 due to lower immunization rates and possible close contacts among young adults. Some universities have implemented policies mandating COVID-19 vaccination; however, their effects remain uncertain. We estimated COVID-19 vaccination rates with and without university-mandated vaccination policies. Participants: A university-wide survey was conducted among 2,011 students. Methods: Students completed an online questionnaire on sociodemographics, COVID-19 vaccine status, and vaccine intention. Results: Without university vaccine mandates, 76% of students would receive a COVID-19 vaccination, and with vaccine mandates, more than 82% of students would receive vaccination. Despite this improvement, we observed fewer changes in vaccine coverage for certain subgroups of students, indicating these policies could exacerbate ongoing disparities in COVID-19 vaccination rates. Conclusions: COVID-19 vaccine mandates on campuses are likely to increase vaccination rates modestly. However, interventions will likely be required to supplement vaccine mandates. [ABSTRACT FROM AUTHOR]

Background: Nonpharmaceutical interventions, including face mask-wearing, physical distancing, and avoidance of crowds and poorly ventilated spaces, have been widely recommended to limit the spread of SARS-CoV-2. To date, there is little data available on engagement in nonpharmaceutical interventions and COVID-19 in college students. Using a large sample of college students, we estimate the prevalence of engagement in mask-wearing, physical distancing, and avoidance of crowds/poorly ventilated spaces and their associations with COVID-19. Methods: A cross-sectional study was conducted (February–March 2021) using a college-wide online survey among students (n = 2,132) in California. Multiple modified poisson regression models assessed associations between mask-wearing indoors, physical distancing (both indoors or public settings/outdoors), avoidance of crowds/poorly ventilated spaces and COVID-19, controlling for potential confounders. Results: Fourteen percent (14.4%) reported a previous COVID-19 illness. Most students reported wearing masks consistently indoors (58%), and 78% avoided crowds/poorly ventilated spaces. About half (50%) reported consistent physical distancing in public settings/outdoor and 45% indoors. Wearing a mask indoors was associated with 26% lower risk of COVID-19 disease (RR = 0.74; 95% CI: 0.60,0.92). Physical distancing indoors and in public settings/outdoors was associated with a 30% (RR = 0.70; 95% CI: 0.56,0.88) and 28% (RR = 0.72; 95% CI: 0.58,0.90) decrease risk of COVID-19, respectively. No association was observed with avoidance of crowds/poorly ventilated spaces. The risk of COVID-19 declined as the number of preventive behaviors a student engaged in increased. Compared to those who did not engage in any preventive behaviors (consistently), students who consistently engaged in one behavior had a 25% lower risk (RR = 0.75; 95% CI: 0.53,1.06), those who engaged in two behaviors had 26% lower risk (RR = 0.74; 95% CI: 0.53,1.03), those who engaged in three behaviors had 51% lower risk (RR = 0.49; 95% CI: 0.33,0.74), and those who consistently engaged in all four behaviors had 45% lower risk of COVID-19 (RR = 0.55; 95% CI: 0.40,0.78). Conclusions: Wearing face masks and physical distancing were both associated with a lower risk of COVID-19. Students who engaged in more nonpharmaceutical interventions were less likely to report COVID-19. Our findings support guidelines promoting mask-wearing and physical distancing to limit the spread of COVID-19 on campuses and the surrounding communities. [ABSTRACT FROM AUTHOR]

Vaccine hesitancy is an urgent public health threat. While tools have been developed to monitor vaccine hesitancy among parents and the general adult population, no such tool exists for adolescents. We modified an existing adult Vaccine Hesitancy Scale to create a teen COVID-19 Vaccine Hesitancy Scale (tVHS-COVID) for adolescents and their parents. To validate our scale, we conducted a nationally representative survey of 764 parent-teen dyads. We performed exploratory factor analysis (EFA) to determine the factor structure followed by confirmatory factor analysis (CFA) to test the factor structure validity using two random subsets. We evaluated internal consistency by Cronbach alpha values and construct validity by comparing tVHS-COVID scores to intention to receive future COVID-19 doses. EFA suggested a three-factor structure with 13-items. CFA indicated good fit for adolescents (CFI = 1.00; RMSEA = 0.023; SRMR = 0.062; NNFI-TLI = 0.998) and for parents (CFI = 1.00, RMSEA = 0.031; SRMR = 0.028; NNFI-TLI = 1.00). Internal consistency exceeded 0.79 for adolescents and 0.78 for parents. As tVHS-COVID scores increased, the percent of adolescent and parent respondents who reported they were willing to receive a COVID-19 vaccine decreased. The tVHS-COVID offers a unique tool that can be used to monitor COVID-19 vaccine hesitancy among adolescents and their parents. As adolescents take on more proactive roles in medical decision-making, monitoring vaccine hesitancy among this population becomes increasingly important. [ABSTRACT FROM AUTHOR]

Being threatened or injured with a weapon is a serious form of physical bullying. Little is known about the effects of being threatened or injured with a weapon on substance use and mental health among adolescents. A secondary analysis of 2017 Youth Risk Behavior Survey data assessed the associations between having been threatened or injured with a weapon and substance use (binge drinking, marijuana, tobacco use, prescription medication misuse) and mental health (feeling sad or hopeless, considering suicide). Multiple logistic regression models with complex survey weights were used, controlling for potential confounders. Approximately 6.0% of students reported having been threatened/injured with a weapon. After adjusting for covariates, having been threatened/injured with a weapon was associated with binge drinking (AOR = 2.5; 95% CI: 1.9–3.4), marijuana (AOR = 2.1; 95% CI: 1.6–2.7), tobacco use (AOR = 2.6; 95% CI: 2.0–3.5), and misuse of prescription medication (AOR = 2.2; 95% CI: 1.6–3.0) compared with students who have not been threatened/injured. Having been threatened/injured with a weapon was associated with 1.6 times the odds (95% CI: 1.2–2.2) of feeling sad/hopeless and 1.7 times the odds (95% CI: 1.3–2.3) of considering suicide. Having been threatened or injured with a weapon is an important public health issue associated with negative mental health and substance use. [ABSTRACT FROM AUTHOR]

Background and Purpose: The influence of chronic treatment by antiplatelet drug (APD) at stroke onset on the outcomes of patients with acute ischemic stroke (AIS) treated with combined intravenous thrombolysis (IVT) and endovascular therapy (EVT) is unclear. We investigated whether prior APD use influences the risk of symptomatic intracranial hemorrhage (sICH) and functional outcome in AIS patients treated with combined reperfusion therapy. Methods: A single‐center retrospective analysis of AIS patients with proximal intracranial occlusion who underwent IVT and EVT between January 2015 and May 2017. The main outcomes were the incidence of sICH using the Heidelberg Bleeding Classification and patients' functional status at 90 days, as defined by the modified Rankin scale (mRS). Outcomes were evaluated according to daily exposure to APD, and associations were assessed using multivariate logistic regression analysis. Results: This study included 204 patients: 71 (34.8%) were taking APD before AIS. Patients with chronic treatment by APD at stroke onset had a higher rate of sICH (26.7% vs. 3.7%; p<.001) and worse functional outcome (mRS >2) at 90 days (69% vs. 36.8%; p <.001). Prior APD use was associated with an increased likelihood of sICH (OR 9.8; 95%CI [3.6–31.3], p <.05) and of functional dependence at 90 days (OR 5.72; 95%CI [2.09–1.72], p <.001), independent of confounders on multivariate analysis. Conclusions: Chronic treatment by APD at stroke onset in AIS patients with proximal intracranial occlusion treated using IVT and EVT increases the risk of sICH and worsens the functional prognosis. Further investigation to refine acute revascularization strategies in this population might be required. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Heavy drinking is prevalent among undergraduate students and is linked with drinking to cope with depression motives for drinking. Drinking to cope with depression remains poorly understood given that alcohol has been shown to have adverse effects on mood when consumed at high doses. Using semi-structured qualitative interviews, the present study examined the perceived effects of alcohol on depressive symptoms as reported by undergraduate students who endorse high levels of drinking to cope with depression.Design and Methods: Sixteen undergraduate coping-with-depression-motivated (CWDM) drinkers (nine women, seven men), identified using the Modified Drinking Motives Questionnaire-Revised [1], reported on their experiences of drinking to cope with depression. Thematic analysis was conducted to identify themes and subthemes in the data.Results: Undergraduate students reported several effects of alcohol on affective, cognitive and behavioural depressive symptoms. While most of the perceived alcohol effects they described involved relief from depressive symptoms, some perceived effects involved worsening depressive symptoms.Discussion and Conclusions: The study generated several hypotheses to explain drinking to cope with depression, some of which might be testable in future experimental work. Overall, findings suggest the mood-altering effects of alcohol do not fully explain why depression and alcohol use are frequently co-morbid. Indeed, effects of alcohol on cognitive and behavioural depressive symptoms might be particularly reinforcing for CWDM drinkers. Interventions that target co-morbid depression and alcohol use might be improved by teaching CWDM drinkers skills to reduce depressive cognitions and to improve interpersonal interactions outside of drinking contexts. [ABSTRACT FROM AUTHOR]

Female entertainment and sex workers (FESW) are vulnerable to violence, which impedes safer sex behaviors and increases risk of HIV. FESW are also disproportionately affected by co-occurring psychosocial health conditions, including substance use, depression, and economic insecurity, which increased risk of exposure to violence. We used a syndemic framework to examine the effects of co-occurring psychosocial conditions on the risk of client-perpetrated physical and sexual violence against FESW. Data were collected among 1198 Cambodian FESW on recent client–perpetrated physical and sexual violence, and psychosocial conditions (psychological distress, alcohol consumption, amphetamine-type stimulant (ATS) use, debts, housing, and food insecurity). Bivariate and multivariate logistic regressions were conducted. Prevalence of physical and sexual violence from clients was 4.8% and 6.9%, respectively. Client-perpetrated physical violence was associated with housing insecurity, ATS use, and psychological distress. All psychosocial conditions, except ATS, were associated with exposure to sexual violence. In multivariable models, odds of client-perpetrated physical violence were twice higher among women with ≥ 4 compared to ≤ 3 psychosocial conditions. Risk of sexual violence increased with the number of psychosocial conditions. Compared to those with ≤ 1 condition, FESW with two psychosocial conditions had twice the odds (AOR = 2.08; 95% CI 1.00–4.31) and women with 5–6 psychosocial conditions had eightfold higher odds (AOR = 8.10; 95% CI 3.4–19.31) of sexual violence from clients. Our findings support a syndemic model of co-occurring psychosocial conditions among FESW that are associated with increased risk of violence. Violence prevention interventions targeting FESW should adopt comprehensive approaches that address co-occurring psychosocial conditions. [ABSTRACT FROM AUTHOR]

Background: One objective of massage therapy applied to hypertrophic scar (HSc), is to improve the structural properties so skin possesses the strength and elasticity required for normal mobility. However, research supporting this effect is lacking. The objective of this study was to characterize the changes in scar elasticity, erythema, melanin, and thickness immediately after a massage therapy session and after a 12-week course of treatment compared to intra-individual matched control scars.Methods: We conducted a prospective, randomized, single-blinded, pragmatic, controlled, clinical trial evaluating the impact of a 12-week course of massage therapy. Seventy burn survivors consented to participate and 60 completed the study. Two homogeneous, intra-individual scars were randomized to usual care control or massage therapy plus usual care. Massage, occupational or physical therapists provided massage treatment 3x/week for 12 weeks. Scar site characteristics were evaluated weekly immediately before and after massage treatment including elasticity (Cutometer), erythema and melanin (Mexameter), and thickness (high-frequency ultrasound). Analysis of covariance (ANCOVAs) were performed to test for immediate and long-term treatment effects. A mixed-model approach was used to account for the intra-individual scars.Results: Scar evaluation immediately before and after massage therapy at each time point revealed changes for all scar characteristics, but the group differences were predominantly present during the early weeks of treatment. The within group long-term analysis revealed a significant increase in elasticity, and a reduction in thickness, during the 12-week treatment period for both the control scar (CS) and massage scar (MS). The increase in elasticity reached significance at week 8 for the MS and week 10 for the CS and the reduction in thickness at week 5 for the CS and week 7 for the MS. There was no significant within group long-term differences for either erythema or melanin. There were group differences in erythema at week 8 and 11 where the CS was less erythematous than the MS.Conclusions: The immediate impact of forces applied during massage therapy may lead patients and therapists to believe that there are long-term changes in elasticity, erythema, and pigmentation, however, once baseline measures, the control scar, and time were incorporated in the analysis there was no evidence of long-term benefit. Massage therapy applied with the objective of increasing scar elasticity or reducing erythema or thickness over the long-term should be reconsidered. [ABSTRACT FROM AUTHOR]

Introduction: Burns of the face and mouth region have a profound impact on function. Currently the outcome measure that is most commonly used in the burn care literature is horizontal and vertical opening. Impairment-based outcomes such as this do not capture the functional implications of these injuries in spite of the devastating impact they can have on burn survivor's lives.Purpose Of the Study: To generate an assessment that evaluates the impairments, activity limitations, and participation restrictions associated with mouth injuries and prospectively collect data to examine the clinimetric properties.Methods: A multistep assessment development process was undertaken including a comprehensive literature search and review, burn care expert and burn survivor interviews, generation of a preliminary version and field-testing, modifications based on field testing and updated literature review, and further field testing with data collection of 23 burn survivors. Clinimetric properties were examined by evaluating: whether there was a ceiling or floor effect, the internal consistency, construct validity, and responsiveness.Results: The mouth impairment and disability assessment (MIDA) has a 28 item self-report portion, divided into four subscales, completed by the patient and an impairment-based section completed by the burn therapist. Two items demonstrated a ceiling effect, one was removed the other retained. There was strong and statistically significant (p<0.0001) correlation of the symptoms subscale as well as vertical opening with the functional activities subscale of the MIDA. The functional activities subscale demonstrated good internal consistency and the symptoms subscale was adequate. Re-evaluation approximately seven and a half months after the baseline evaluation demonstrated a statistically significant change with time and treatment.Conclusions: The MIDA now offers clinicians the ability to assess mouth impairment and disability of burn survivors who have sustained burn injuries to their face and mouth region. [ABSTRACT FROM AUTHOR]

Background: In Cambodia, most of the female sex workers (FSW) work in venues where unhealthy alcohol use is ubiquitous and potentially contributing to the HIV epidemic. However, no accurate data exists. We compare self-reported unhealthy alcohol consumption to a biomarker of alcohol intake in Cambodian FSW and male clients, and determine factors associated with unhealthy alcohol use.Methods: A cross-sectional study was conducted among FSW (n=100) and male clients (n=100) in entertainment and sex work venues in Cambodia. Self-reported unhealthy alcohol use (AUDIT-C) was compared to phosphatidylethanol (PEth) positive (≥50ng/ml), a biomarker of alcohol intake. Sociodemographics data was collected. Correlates of self-reported unhealthy alcohol use and PEth positive were determined.Results: The prevalence of PEth positive in FSW was 60.0%. Self-reported unhealthy alcohol consumption was reported by 85.0% of the women. Almost all women (95.0%) testing PEth positive also reported unhealthy alcohol use. Prevalence of unhealthy alcohol consumption (self-report and PEth positive) was higher in FSW working in entertainment establishments compared to other sex work venues (p<0.01). Among male clients, 47.0% reported unhealthy alcohol consumption and 42.0% had a PEth positive. However, only 57.1% of male clients with PEth positive reported unhealthy alcohol use.Conclusions: Unhealthy alcohol consumption is prevalent in Cambodian sex work settings. Self-reported unhealthy alcohol use is well reported by FSW, but less by male clients. These findings highlight the urgency of using accurate measures of unhealthy alcohol consumption and integrating this health issue into HIV prevention interventions. [ABSTRACT FROM AUTHOR]

Background: Accurate measurement of unprotected sex is essential in HIV prevention research. Since 2001, the 100% Condom Use Program targeting female sex workers (FSWs) has been a central element of the Cambodian National HIV/AIDS Strategy. We sought to assess the validity of self-reported condom use using the rapid prostate-specific antigen (PSA) test among Cambodian FSWs. Methods: From 2009 to 2010, we enrolled 183 FSWs in Phnom Penh in a prospective study of HIV risk behavior. Prostate-specific antigen test results from the OneStep ABAcard were compared with self-reported condom use in the past 48 hours at quarterly follow-up visits. Results: Among women positive for seminal fluid at the first follow-up visit, 42% reported only protected sex or no sex in the detection period. Discordant results were more likely among brothel and street-based FSW versus entertainment (56% vs. 17%), recent (last 3 months) amphetamine-type stimulant (ATS) users (53% vs. 20%), and those with 5 or more partners in the past month (58% vs. 13%). In multivari-able regression models, positive PSA results were associated with recent ATS use (adjusted risk ratio [ARR], 1.5; 95% confidence interval [CI], 1.1-2.2), having a nonpaying last sex partner (ARR, 1.7; CI, 1.2-2.5), and sex work venue (ARR, 3.0; CI, 1.4-6.5). Correspondingly, women with a nonpaying last sex partner were more likely to report unprotected sex (ARR, 1.5; CI, 1.1-2.2), but no associations were found with sex work venue or ATS use. Conclusions: Results confirm the questionable validity of self-reported condom use among FSW. The PSA biomarker assay is an important monitoring tool in HIV/sexually transmitted infection research including prevention trials. [ABSTRACT FROM AUTHOR]

Abstract: Background: Amphetamine-type stimulant (ATS) use has increased in Cambodia and emerged as a significant problem among female sex workers (FSWs), potentially contributing to increased risk of HIV. We examined the prevalence of ATS use and its effect on sexual risk behaviors, and sexually transmitted infections (STI) among FSWs in Phnom Penh, Cambodia. Methods: A one-year prospective study among young women engaged in sex work in brothels, entertainment establishments and on a freelance basis. Socio-demographics, sexual risks, and recent ATS use were assessed by self-report. Blood and urine samples were collected to detect HIV, Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC). Bivariate and multivariate longitudinal analyses were conducted to assess the effects of ATS use on number of sex partners, inconsistent condom use with paying partners and incident STI. Results: ATS use was higher among women working freelance (35.6%) and in brothels (34.8%) compared to women working in entertainment establishments (17.7%) or in multiple venues (14.8%). ATS users reported more sex partners and days drunk in the previous month. In multivariate longitudinal analysis, ATS use was associated with having a higher number of sex partners (adjusted relative ratio 1.49; 95% CI: 1.00–2.21) and incident STI (adjusted odds ratio 5.41; 95% CI: 1.15–25.48), but not inconsistent condom use with paying partner. Conclusion: ATS users had more sex partners, high level of alcohol use, and were at increased risk of STI. Our findings underscore ATS use as an important emerging risk exposure that should be integrated into HIV prevention interventions targeting this population. [Copyright &y& Elsevier]

Background: Although cervical cancer is the leading cancer in Cambodia, most women receive no routine screening for cervical cancer and few treatment options exist. Moreover, nothing is known regarding the prevalence of cervical HPV or the genotypes present among women in the country. Young sexually active women, especially those with multiple sex partners are at highest risk of HPV infection. We examine the prevalence and genotypes of cervical HPV, as well as the associated risk factors among young women engaged in sex work in Phnom Penh, Cambodia. Methods: We conducted a cross-sectional study among 220 young women (15-29 years) engaged in sex work in different venues including brothels or entertainment establishments, and on a freelance basis in streets, parks and private apartments. Cervical specimens were collected using standard cytobrush technique. HPV DNA was tested for by polymerase chain reaction (PCR) and genotyping using type-specific probes for 29 individual HPV types, as well as for a mixture of 10 less common HPV types. All participants were also screened for HIV status using blood samples. Multivariate logistic regression analyses were conducted to assess risk factors for any or multiple HPV infection. Results: The prevalence of cervical HPV 41.1%. HPV 51 and 70 were the most common (5.0%), followed by 16 (4.6%), 71 (4.1%) and 81 (3.7%). Thirty-six women (16.4%) were infected with multiple genotypes and 23.3% were infected with at least one oncogenic HPV type. In multivariate analyses, having HIV infection and a higher number of sexual partners were associated with cervical HPV infection. Risk factors for infection with multiple genotypes included working as freelance female sex workers (FSW) or in brothels, recent binge use of drugs, high number of sexual partners, and HIV infection. Conclusions: This is the first Cambodian study on cervical HPV prevalence and genotypes. We found that HPV infection was common among young FSW, especially among women infected with HIV. These results underscore the urgent need for accessible cervical cancer screening and treatment, as well as for a prophylactic vaccine that covers the HPV subtypes present in Cambodia. [ABSTRACT FROM AUTHOR]

The article presents a study on the prevalence of HIV and sexually transmitted infections (STI) in women sex workers (SWs) in Phnom Penh, Cambodia. The study assessed women SWs who were below 29 years of age through self-report in a prospective study, and they were examined for HIV and STI by using specimens gathered from their blood and urine. Results show that the risk of infection for HIV and STI were highest among the freelancers who worked as SWs.

The article reports on a study examining the relationship between the human immunodeficiency virus (HIV ) risk behaviors and intimate partner violence (IPV) among men in Haiti. The study shows that men perpetrating IPV engage in sexual behaviors that increase the risk of sexually transmitted infections (STI) and HIV for intimate partners. The study suggests that societal norms concerning violence against women should be taken into consideration while organizing intervention programs in Haiti.

A cross-sectional survey was conducted to examine factors influencing intention of condom use among 378 clients of female sex workers (FSWs) visiting commercial sex sites in St-Marc and Gonaives, Haiti. Mean age of the study participants was 24 years. A structured questionnaire was used to collect data on socio-demographic characteristics, behaviors, and the theory of planned behavior (TPB) constructs. Seventy-four percentage of clients reported having used condoms with a FSW the last time they had had sexual intercourse. The majority (81.7%) firmly intended to use condoms during the next sexual encounter with a FSW. Multivariate logistic models revealed that subjective norms (odds ratio (OR)=1.75; 95% confidence interval (CI): 1.06-2.88), perceived behavioral control (OR=1.34; 95% CI: 1.09-1.63) and attitudes (OR=1.23; 95% CI: 1.04-1.44) were predictors of intention to use condoms, with norms being more important. Clients having used condoms the last time they had a sexual intercourse with a FSW, were more likely to have the intention to use them in the future (OR=3.17; 95% CI: 1.65-6.10), indicating an adopted behavior. Lastly, having had a previous sexually transmitted infection was associated with intention, suggesting that a negative experience can influence a future behavior. In conclusion, intention to use condoms among the clients of Haitian FSWs was well predicted by TPB constructs. Our findings provide evidence for designing interventions targeted at reducing risky sex behaviors in this population. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To examine the equity of screening for breast and cervical cancer among women aged 50 and over living in Mexico City according to the Andersen behavioural model. Methods: Logistic regressions were used to analyze the associations of predisposing factors, enabling resources and health needs with mammography and Pap testing among 1323 women aged 50 and over living in Mexico City. The data were taken from SABE, a survey conducted in Latin American and Caribbean cities in 1999–2000. Results: Referring to the previous two years, use of mammography was less frequent (14.8%) than Pap testing (53.7%). Higher education and having private health insurance were associated with receiving both procedures. Being married was associated with receipt of Pap testing, while being unmarried was associated with mammography. Younger women were more likely to receive a Pap test. Other cancer prevention behaviours were strong predictors of mammography and Pap test use. Conclusions: There are inequities in access to cancer screening services among women aged 50 and over in Mexico. Cancer prevention programs need to implement strategies that guarantee free and accessible services independently of social conditions or type of health insurance. The observed clustering of screening services suggests that packaging screening programs for gynaecological cancer could be used to increase coverage. [Copyright &y& Elsevier]

The article focuses on the sociodemographic characteristics, risk behaviors and the spread of sexually transmitted infection (STI) among clients of female sex workers in Haiti. A cross-sectional survey is conducted among clients. Dried blood spot samples were used in determining the spread of HIV, herpes simplex virus 2 (HSV-2), and syphilis. Results suggest that STI prevalence was high among the clients of female sex workers for they had many sex partners and different condom use that depends on the category of partner.

Objectives: To examine the influence of life course socioeconomic disadvantages (SED) on cognitive function in later life. Method: Data originate from a survey of people 60 and older living in seven Latin American and Caribbean cities. Cognitive function was measured with a modified Mini-Mental State Examination and the Pfeffer Scale of Functional Capacity. Homogeneity tests were used to pool data. Associations between cognitive function and SED were evaluated, fitting logistic regressions. Results: Cognitive impairment (CI) prevalence ranged from 0.3% to 6.5% in men and 1.2% to 10.1% in women. Childhood rural living, poor childhood health, illiteracy, housewife or farmer occupation, and insufficient income were associated with CI in all seven cities. The odds of CI increase with cumulative exposure to disadvantages along life course. Conclusions: Life course SED is related to cognitive function later in life. Difficulty in properly distinguishing cognitive function from test performance remains an issue. [ABSTRACT FROM AUTHOR]

Retinoids are vitamin A derivatives, which cause growth inhibition, differentiation and/or apoptosis in various cell types, including some breast cancer cells. In general, estrogen receptor (ER)-positive cells are retinoic acid (RA) sensitive, whereas ER-negative cells are resistant. In this report, we show that ER-negative MDA-MB-231 cells are strongly growth inhibited by retinoids in combination with a PKC inhibitor. While neither RA nor GF109203X (GF) has a significant growth inhibitory effect in these cells, RA+GF potently suppress proliferation. We found that RA+GF induce apoptosis, as shown by an increase in fragmented DNA, Annexin-V-positive cells and caspase-3 activation. Apoptosis was also induced by GF in combination with two synthetic retinoids. Expression of phosphorylated as well as total PKC was decreased by GF and this was potentiated by RA. In addition, treatment with GF caused a strong and sustained activation of ERK1/2 and p38-MAPK, as well as a weaker activation of JNK. Importantly, inhibition of ERK but not p38 or JNK suppressed apoptosis induced by RA+GF, indicating that activation of ERK is specifically required. In support of this novel finding, the ability of other PKC inhibitors to cause apoptosis in combination with RA correlates with ability to cause sustained activation of ERK.Oncogene (2004) 23, 7053-7066. doi:10.1038/sj.onc.1207956 Published online 26 July 2004 [ABSTRACT FROM AUTHOR]

Acceptance of recommended vaccines is lower among pregnant people compared to non-pregnant adults, yet no tool has specifically measured prenatal vaccine hesitancy. We evaluated the performance of an existing adult Vaccine Hesitancy Scale (aVHS) in measuring vaccine hesitancy toward routinely recommended prenatal vaccines. Between December 2021 and April 2022, we conducted a cross-sectional national online survey with 917 US postpartum adults 18–49 years old who had given birth in the past six months. Vaccine hesitancy was measured using the aVHS, a 10-item scale previously validated among the adult general population. Scores range from 10 to 50, with higher scores indicating greater vaccine hesitancy. Structural equation modeling (SEM) with weighted least squares means and variances adjusted (WLSMV) estimator was used to assess the fit of the aVHS structure. Construct validity was assessed by examining the correlation between the aVHS score and the self-reported receipt of recommended prenatal vaccines. SEM indicated acceptable fit (RMSEA: 0.098; CFI: 0.983; TLI: 0.978; SRMR: 0.040) of the data to the two-factor model: (1) lack of vaccine confidence, and (2) perceived vaccine risks. For the paths from the two factors to the vaccine acceptance, lack of vaccine confidence was significantly correlated with influenza vaccine acceptance (β = −0.41, p < 0.001) and COVID-19 vaccine acceptance (β = −0.64, p < 0.001), while perceived vaccine risk was significantly linked with Tdap vaccine acceptance (β = −0.57, p < 0.001) and influenza vaccine acceptance (β = −0.25, p < 0.001). Additionally, pregnant people with higher aVHS scores were less likely to receive recommended prenatal vaccines. Although the aVHS offered acceptable measurement of prenatal vaccine hesitancy, a scale that measures pregnancy-specific concerns may offer more tailored measurement for this unique population. [ABSTRACT FROM AUTHOR]

Background: Fear of victimization has been associated with poorer physical and mental health, yet is understudied in public health. Few studies have examined sex differences in the effects of fear of victimization on substance use. We examined associations between fear of victimization and hazardous alcohol drinking, tobacco, and marijuana use among female and male university students.Methods: A cross-sectional study was conducted among university students in an urban location (n = 1415). Socio-demographics, substance use, and fear related to various crimes were measured using online surveys. All fear types were summed into a total fear score and categorized into quartiles: no/little fear, moderate fear, high fear, and very high fear. Chi-square tests and multiple logistic regression models were used to examine associations between fear of victimization, hazardous alcohol drinking, tobacco and marijuana use, by sex.Results: Females were more likely to report high and very high fear of victimization (26.6% and 33.1%) than male students (19.8% and 16.3%; p < 0.001). In multiple logistic regression models, associations differed by sex: moderate, high, and very high fear were all independently associated with hazardous drinking among females but not males. Female students with very high fear of victimization were more likely to report tobacco use. High and very high fear was also independently associated with marijuana use among female only.Conclusions: Higher fear of victimization was associated with substance use among females but not male students. Public health and health care professionals should acknowledge fear of victimization as a potential risk factor for substance use, particularly among women. [ABSTRACT FROM AUTHOR]

Introduction and Aims: This study tested the measurement invariance of the Drinking Motives Questionnaire-Revised Short Form (DMQ-R-SF) in undergraduates across 10 countries. We expected the four-factor structure to hold across countries, and for social motives to emerge as the most commonly endorsed motive, followed by enhancement, coping and conformity motives. We also compared individualistic and collectivistic countries to examine potential differences in the endorsement of drinking motives when countries were divided according to this broad cultural value.Design and Methods: A sample of 8478 undergraduate drinkers from collectivistic (Portugal, Mexico, Brazil, Spain; n = 1567) and individualistic (Switzerland, Hungary, Canada, the Netherlands, the UK and Ireland, and the USA; n = 6911) countries completed the DMQ-R-SF. Countries were classified as individualistic or collectivistic based on world-wide norms.Results: Using multigroup confirmatory factor analysis, the 4-factor model of the DMQ-R-SF showed configural and metric invariance across all 10 countries. As predicted, the rank order of undergraduates' drinking motive endorsement was identical across countries (social > enhancement > coping > conformity), although a mixed model analysis of variance revealed a significant interaction where undergraduates from individualistic countries more strongly endorsed social and enhancement motives relative to undergraduates from collectivistic countries.Discussion and Conclusions: There was broad cross-cultural consistency in the factor structure and mean patterns of drinking motives. Undergraduate students appear to drink mainly for positive reinforcement (i.e. for social and enhancement reasons), although this tendency is particularly pronounced among those from more individualistic countries. [Mackinnon SP, Couture M-E, Cooper ML, Kuntsche E, O'Connor RM, Stewart SH, and the DRINC Team. Cross-cultural comparisons of drinking motives in 10 countries: Data from the DRINC project. [ABSTRACT FROM AUTHOR]

The objective of this paper is to determine the prevalence of fear of bullying among college students, examine socio-demographic predictors of fear of bullying, and assess associations between fear of bullying and depression and anxiety. A cross-sectional study was conducted among college students. Data on socio-demographics; fear of bullying on campus, off campus, and electronically; depression; and anxiety were collected. Multiple logistic regression models were used to assess predictors of fear and the association between fear of bullying and mental health. After controlling for covariates, the odds of fear of bullying on campus, off-campus, and electronic bullying were higher among transgender/gender nonconforming and lesbian/gay/bisexual students. Non-citizens had higher odds of all three types of fear. Fear of bullying on campus, off campus, and electronic bullying were all associated with anxiety and depression. Disparities in fear of bullying exist in college students and should be considered when designing mental health interventions. [ABSTRACT FROM AUTHOR]

Background: Social anxiety (SA) is highly comorbid with alcohol use disorder (AUD). Alcohol may be negatively reinforcing for SA individuals by dampening post-event rumination (i.e., negative rumination following social interactions). Prior research has supported this hypothesis with negative rumination. Depression, commonly comorbid with SA and AUD, also features rumination. Method: Through secondary analyses, we examined the effects of alcohol consumption before an in-lab social interaction and depressive symptoms on both negative and positive post-event rumination about the interaction. Ninety-four high SA undergraduates were randomized to consume alcohol or no alcohol before the interaction; depressive symptoms were measured. Post-event rumination was measured three days later. Results: Those higher (vs lower) in depressive symptoms reported more negative rumination. Those randomized to the alcohol (vs no alcohol) condition reported more positive rumination after the interaction. Conclusions: Individuals with SA may find alcohol positively reinforcing by increasing positive post-event rumination, independent of negative reinforcement effects. Clinical implications are discussed. [ABSTRACT FROM AUTHOR]

Fear is associated with several adverse health behaviors and outcomes. Fear of crime is associated with less exercise and outdoor activity, worse self-rated health status, and increased BMI. Fear of crime is also associated with more anxiety, depression, and psychological distress. Yet little is known about the predictors of fear of specific types of crime. The objectives of this study are to (1) determine the prevalence of fear of violent victimization and fear of property crime among university students, (2) assess the association between sociodemographic predictors and (a) fear of violent victimization and (b) property crimes. A cross-sectional study was conducted among university students (n = 1415). Data on sociodemographics, fear of a variety of types of violent crime (physical assault, sexual assault, robbery/burglary, murder, and verbal threats), and property crime (arson, theft, and vandalism) were collected using online surveys. Summary variables for fear of violent crime and fear of property crime were created. Wilcoxen rank-sum and Kruskal–Wallis tests, and multivariate negative binomial regression models were used to assess relationships between sociodemographic predictors and fear variables. Native Hawaiian/Pacific Islander students had the highest mean fear scores of physical assault, robbery/burglary, arson, and theft, while fear of verbal threats and vandalism were highest among Middle Eastern students. Muslim students reported the highest fear of verbal threats, arson, and vandalism. In multivariate models, fear of violent crime was significantly higher among Black (ME: 5.59), Hispanic (ME: 5.16), Asian (ME: 3.07), female (ME: 8.19), transgender/gender non-conforming (ME: 9.82), gay (ME: 12.16), and bisexual (ME: 3.74) students while fear of property crime was significantly higher among Black (ME: 2.81), Hispanic (ME: 2.10), Asian (ME: 1.84), female (ME: 2.49), and gay (ME: 3.11) students. Minority students have higher levels of fear than their peers. Universities must consider the issue of fear among minority students in an effort to prevent this public health issue. [ABSTRACT FROM AUTHOR]

The present study examined relations among attachment, aggression, and anxiety sensitivity (AS) in a sample of male and female undergraduates. Given that some individuals may use aggression to modulate negative emotional states, it was predicted that AS dimensions would mediate relations between attachment anxiety (vs. attachment avoidance) and certain forms of aggression, particularly impulsive aggression. Moreover, it was hypothesized that the relations among attachment, aggression, and AS would be moderated by gender. Participants (N = 1,042) completed measures of attachment (Experiences in Close Relationships–Revised [ECR-R]), aggression (Aggression Questionnaire [AQ]; Impulsive/Premeditated Aggression Scales [IPAS]), and AS (AS Index–3 [ASI-3]). Results indicated that AS mediated relations between attachment dimensions (both anxiety and avoidance) and most forms of aggression, with each of the AS dimensions playing a unique role differentially by gender. Cognitive concerns emerged as a significant mediator, particularly for men; physical and social concerns played more of a mediating role for women. Interestingly, none of the AS dimensions played a significant mediating role between attachment (either anxiety or avoidance) and physical aggression for men. Results are discussed in terms of their clinical implications and directions for future research. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has challenged existing health communication strategies as more people turn to social media as a primary health information source. Although many studies have explored how young people use social media, this study examined how sociodemographic factors and political ideology are associated with use and trust in social media as a source for COVID-19 information among young adults, and how use and trust in social media as a COVID-19 information source are associated with their beliefs about COVID-19. In Spring 2021, an online survey was conducted among 2,105 18–29-year-old students at an urban university in California. Our findings show that younger, female, non-binary, Asian, and Black/African American students are most likely to obtain and trust COVID-19 information on social media. Results also suggest that liberal students are more likely to turn to social media as a source for COVID-19 information compared to conservatives. However, conservative students who use social media as a source for information were more likely to believe false health information about prevention measures and the vaccine and to have lower perceived effectiveness of COVID-19 prevention behaviors and vaccination compared to liberals. [ABSTRACT FROM AUTHOR]

Borderline personality disorder (BPD) is characterized by dysregulated emotion, interpersonal relationships, and impulsivity, and is putatively linked to a known transdiagnostic risk factor, anxiety sensitivity (AS). AS is a dispositional fear of the physical, cognitive, and/or social consequences of arousal-related somatic sensations. Gratz et al. (2008) demonstrated significantly higher AS in outpatients with BPD and a predictive value of AS over and above emotion dysregulation and impulsivity. The present study sought to extend these findings with a larger sample of outpatients with BPD by investigating predictive value of AS dimensions; relations between AS and attachment style; and impact of BPD treatment on AS. Participants completed measures at three time points: pretreatment and 6 and 12 months posttreatment. AS social was the best predictor; attachment anxiety correlated positively with AS global and AS physical. AS levels significantly decreased from pretreatment to 6 months posttreatment. Clinical implications discussed include targeting AS in BPD treatment. [ABSTRACT FROM AUTHOR]

Transcriptional cross-talk exists between the estrogen receptor (ERα) and retinoic acid receptor (RAR) pathways in human breast cancer cells. We have previously shown that re-expression of ERα in ER-negative cells stimulates the transcriptional and growth inhibitory effects of all-trans-retinoic acid (tRA) by a mechanism that is independent of the ER ligands estradiol and tamoxifen. In this study, we generated cell lines stably expressing ERα-deletion mutants to elucidate the mechanism whereby ERα modulates RAR transcriptional activity. Using RT-PCR and RNAse protection assays, we observed that expression of ERα suppresses basal expression of the RA-responsive gene RARβ2, while allowing it to be strongly induced by tRA. Repression of basal RARβ2 transcription was confirmed by transient expression of the reporter plasmid βRE-tk-CAT, containing the RARβ2 promoter. In the ERα-negative cells, on the other hand, transcription was only weakly induced by RA. We further determined that this effect of ERα on RARβ induction required the N-terminal AF-1-containing region, including the DNA-binding domain, but was independent of the C-terminal ligand-binding domain. Consistent with these results, the ER agonist estradiol and the AF-2 antagonist 4-hydroxytamoxifen had no significant effect on βRARE activity. Conversely, the full ER antagonist ICI 182,780, which blocks ERα AF-1 activity, was able to completely relieve repression of basal βRARE activity. The effect of ERα is specific for RAR-mediated transcription and does not occur on promoters containing typical response elements for the Vitamin D or thyroid hormone receptors. Moreover, the cross-talk between ERα and RAR does not seem to be mediated by sequestration of a number of common co-regulators, suggesting a novel mechanism whereby the N-terminal region of ERα modulates the transcriptional activity of RAR. [Copyright &y& Elsevier]

Background: Objective measurement of alcohol consumption is important for clinical care and research. Adjusting for self‐reported alcohol use, we conducted an individual participant data (IPD) meta‐analysis to examine factors associated with the sensitivity of phosphatidylethanol (PEth), an alcohol metabolite, among persons self‐reporting unhealthy alcohol consumption. Methods: We identified 21 eligible studies and obtained 4073 observations from 3085 participants with Alcohol Use Disorders Identification Test—Consumption (AUDIT‐C) positive scores (≥3 for women and ≥4 for men) and PEth measurements. We conducted 1‐step IPD meta‐analysis using mixed effects models with random intercepts for study site. We examined the associations between demographic (sex, race/ethnicity, and age) and biologic (body mass index—BMI, hemoglobin, HIV status, liver fibrosis, and venous versus finger‐prick blood collection) variables with PEth sensitivity (PEth≥8 ng/ml), adjusting for the level of self‐reported alcohol use using the AUDIT‐C score. Results: One third (31%) of participants were women, 32% were African, 28% African American, 28% White, and 12% other race/ethnicity. PEth sensitivity (i.e., ≥8 ng/ml) was 81.8%. After adjusting for AUDIT‐C, we found no associations of sex, age, race/ethnicity, or method of blood collection with PEth sensitivity. In models that additionally included biologic variables, those with higher hemoglobin and indeterminate and advanced liver fibrosis had significantly higher odds of PEth sensitivity; those with higher BMI and those living with HIV had significantly lower odds of PEth sensitivity. African Americans and Africans had higher odds of PEth sensitivity than whites in models that included biologic variables. Conclusions: Among people reporting unhealthy alcohol use, several biological factors (hemoglobin, BMI, liver fibrosis, and HIV status) were associated with PEth sensitivity. Race/ethnicity was associated with PEth sensitivity in some models but age, sex, and method of blood collection were not. Clinicians should be aware of these factors, and researchers should consider adjusting analyses for these characteristics where possible. [ABSTRACT FROM AUTHOR]

Background: Violence, substance use, and HIV disproportionately impact female entertainment and sex workers (FESW), but causal pathways remain unclear.Methods: We examined data from an observational cohort of FESW age 15-29 in Phnom Penh, Cambodia for associations between violence exposure and sexual risk and drug use. Validated measures of physical and sexual violence were assessed at baseline. Self-reported outcomes measured quarterly over the next 12-months included past month sexual partners, consistent condom use by partner type, sex while high, and amphetamine type stimulant (ATS) use. Biomarkers measured quarterly included prostate specific antigen (PSA) and urine toxicology. Generalized estimating equations were fit adjusting for age, education, marital status and sex work venue.Results: Of 220 women, 48% reported physical or sexual violence in the preceding 12-months. Physical violence was associated with increased number of sex partners (adjusted incidence rate ratio [aIRR] 1.33; 95% CI: 1.04-1.71), greater odds of sex while high (adjusted odds ratio [aOR] 2.42; 95% CI: 1.10-5.33), increased days of ATS use (aIRR 2.74; 95% CI: 1.29-5.84) and increased odds of an ATS+ urine screen (aOR 2.80, 95%CI: 1.38-5.66). Sexual violence predicted decreased odds of consistent condom use with non-paying partners (aOR 0.24; 95% CI: 0.10-0.59) and greater odds of a PSA+ vaginal swab (aOR 1.83; 95% CI: 1.13-2.93).Conclusions: Physical and sexual violence are prevalent among Cambodian FESW and associated with subsequent sexual risk and drug use behaviors. Clinical research examining interventions targeting structural and interpersonal factors impacting violence is needed to optimize HIV/AIDS prevention among FESW. [ABSTRACT FROM AUTHOR]

Cambodia's 100% Condom Use Programme is credited with an increase in consistent condom use in commercial sexual interactions and a decrease in HIV prevalence among female sex workers (FSWs). There has been little improvement in condom use between FSWs and non-commercial partners, prompting calls for more innovative approaches to increasing condom use in these relationships. To understand why condoms are used or not used in sexual interactions involving FSWs, we examined condom negotiation across different types of relationships. We conducted 33 in-depth interviews with young (15 to 29 years) women engaged in sex work in Phnom Penh. There was an important interplay between the meanings of condom use and the meanings of women's relationships. Commercial relationships were characterised as inherently risky and necessitated condom use. Despite a similar lack of sexual fidelity, sweetheart relationships were rarely construed as risky and typically did not involve condom use. Husbands and wives constructed their sexual interactions with each other differently, making agreement on condom use difficult. The lack of improvement in condom use in FSWs' non-commercial sexual relationships needs to be understood in relation to both sex work and the broader Cambodian sexual culture within which these relationships are embedded. [ABSTRACT FROM AUTHOR]

Objectives: To estimate prevalence and incidence of HIV and sexually transmitted infections (STI) and associated risk factors among young women working as sex workers (SWs) in Phnom Penh, Cambodia.Methods: A prospective study of young (<29 years) women working as SWs in brothels, entertainment establishments, and freelance. Sociodemographics, sexual risk, and use of amphetamine-type stimulants (ATS) ("yama" and "crystal") were assessed by self-report. HIV and STI (Chlamydia trachomatis and Neisseria gonorrhoeae) testing were conducted on blood and urine specimens, respectively.Results: Baseline prevalences of HIV, C. trachomatis, and N. gonorrhoeae were 23%, 11.5%, and 7.8%, respectively. HIV incidence was 3.6 per 100 person-years (95% confidence interval [CI], 1.2%-11.1%); STI incidence was 21.2 per 100 person-years (95% CI, 12.6%-35.8%). At baseline, 26.5% reported recent ATS use. HIV infection was associated with freelance SW (adjusted odds ratio, 5.85; 95% CI, 1.59-21.58) and younger age of first sex (≤15 years; adjusted odds ratio, 3.06; 95% CI, 1.01-8.46). Incident STI was associated with duration (per year) of SW (adjusted hazard ratio, 1.1; 95% CI, 1.1-1.2) and recent yama use (adjusted hazard ratio, 3.9; 95% CI, 1.5-10.3).Conclusions: HIV and STI infection rates were high among SWs working in various settings; freelancers had highest risk. ATS use was associated with incident STI. Venue of sex work and drug prevention should be considered in prevention programs. [ABSTRACT FROM AUTHOR]

The steroid and xenobiotic receptor SXR (human pregnane X receptor) is a nuclear receptor that plays a key role in the body's detoxification response by regulating genes involved in drug metabolism and transport. SXR ligands include a wide range of compounds, which induce transcription of SXR target genes via activation of a heterodimeric transcription factor consisting of SXR and the related nuclear receptor retinoid X receptor (10(R). We investigated the effect of RXR-selective ligands, rexinoids, on SXR/RXR activity. In agreement with previous reports, we found that rexinoids are weak activators of SXR, but we also found that they can antagonize SXR activation by the potent SXR agonist rifampicin. This antagonism included suppression of rifampicin-induced expression of SXR target genes, as well as reduced binding of SXR/RXR to SXR response elements both in vivo and in vitro. Interestingly, two rexinoids, bexarotene (LGD1069/Targretin®) and LG100268, caused a rapid and sustained decrease in the protein levels of both SXR and RXR. The decrease in SXR level was due to an enhanced rate of protein degradation and was dependent on calpain activity, as opposed to rexinoid-induced RXR degradation, which is mediated via the proteasome. Thus, we have demonstrated a novel, rexinoid-modulated mechanism regulating SXR protein stability, which may explain why rexinoids are only weak activators of SXR/RXR-mediated transcription, despite reports that they bind to SXR with high affinity. We suggest that the ability of rexinoids to induce degradation of both SXR and RXR, in combination with competition for binding to SXR, can also explain why rexinoids antagonize the activation of SXR by drugs like rifampicin. [ABSTRACT FROM AUTHOR]