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Widespread uptake of COVID-19 vaccination is vital to curtailing the pandemic, yet rates remain suboptimal in the U.S. Vaccine mandates have previously been successful, but are controversial. An April 2021 survey of a nationally representative sample (N = 1208) examined vaccine uptake, attitudes, and sociodemographic characteristics. Sixty-seven percent were vaccine acceptors, 14% wait-and-see, and 19% non-acceptors. Compared to wait-and-see and non-acceptors, acceptors were more likely to have a household member over age 65, have received a flu shot, have positive COVID-19 vaccine attitudes, and view COVID-19 vaccination as beneficial. Mandate support was higher among respondents who were vaccine acceptors, had positive views about COVID-19 vaccines, believed in COVID-19 preventive strategies, perceived COVID-19 as severe, were liberal, resided in the Northeast, were non-White, and had incomes < $75,000. Public health campaigns should target attitudes that appear to drive hesitancy and prepare for varying mandate support based on demographics, COVID-19 vaccine attitudes, and the scope of the mandate., Author(s): Julen N. Harris [sup.1] [sup.2] , Christine Mauro [sup.3] , Jane A. Andresen [sup.1] , Gregory D. Zimet [sup.4] , Susan L. Rosenthal [sup.1] [sup.5] Author Affiliations: (1) grid.239585.0, [...]

The World Health Organization has designated vaccine hesitancy and vaccine confidence among the most pressing issues in global health. The COVID-19 pandemic has made vaccine hesitancy and vaccine confidence particularly salient and urgent. The purpose of this special issue is to highlight a broad range of perspectives on these critical issues. We have included a total of 30 papers that address issues related to vaccine hesitancy and vaccine confidence across multiple levels of the Socio-Ecological Model. We have organized the empirical papers into the following sections: individual-level beliefs, minority health and health disparities, social media and conspiracy beliefs, and interventions. In addition to the empirical papers, three commentaries are included in this special issue., Author(s): Austin S. Baldwin [sup.1] , Jasmin A. Tiro [sup.2] , Gregory D. Zimet [sup.3] Author Affiliations: (1) grid.263864.d, 0000 0004 1936 7929, Department of Psychology, Southern Methodist University, , [...]

Introduction The impact on research findings that use pregnancy data from surveys with underreported abortions is not well-established. We estimate the percent of all pregnancies missing from women's self-reported pregnancy histories because of abortion underreporting. Methods We obtained abortion and fetal loss data from the 2006-2015 National Survey of Family Growth (NSFG), annual counts of births from US vital statistics, and external abortion counts from the Guttmacher Institute. We estimated the completeness of abortion reporting in the NSFG as compared to the external counts, the proportion of pregnancies resolving in abortion, and the proportion of pregnancies missing in the NSFG due to missing abortions. Each measure was examined overall and by age, race/ethnicity, union status, and survey period. Results Fewer than half of abortions (40%, 95% CI 36-44) that occurred in the five calendar years preceding respondents' interviews were reported in the NSFG. In 2006-2015, 18% of pregnancies resolved in abortion, with significant variation across demographic groups. Nearly 11% of pregnancies (95% CI 10-11) were missing from the 2006-2015 NSFG due to abortion underreporting. The extent of missing pregnancies varied across demographic groups and was highest among Black women and unmarried women (18% each); differences reflect both the patterns of abortion underreporting and the share of pregnancies ending in abortion. Discussion Incomplete reporting of pregnancy remains a fundamental shortcoming to the study of US fertility-related experiences. Efforts to improve abortion reporting are needed to strengthen the quality of pregnancy data to support maternal, child, and reproductive health research., Author(s): Sheila Desai [sup.1] , Laura D. Lindberg [sup.1] , Isaac Maddow-Zimet [sup.1] , Kathryn Kost [sup.1] Author Affiliations: (1) grid.417837.e, 0000 0001 1019 058X, Guttmacher Institute, , 125 Maiden [...]

CONTEXT: Menstrual regulation (MR) has been part of the Bangladesh family planning program since 1979. However, clandestine abortion remains a serious health problem in Bangladesh, and anecdotal reports indicate that [...]

Better understanding of the impact of unintended childbearing on infant and early childhood health is needed for public health practice and policy. Data from the 2004-2008 Oklahoma Pregnancy Risk Assessment Monitoring System survey and The Oklahoma Toddler Survey 2006-2010 were used to examine associations between a four category measure of pregnancy intentions (intended, mistimed, Author(s): Laura Lindberg[sup.1] , Isaac Maddow-Zimet[sup.1] , Kathryn Kost[sup.1] , Alicia Lincoln[sup.2] Author Affiliations: (1) Guttmacher Institute, New York, NY, USA (2) Maternal and Child Health Service, Oklahoma Department of [...]

CONTEXT: Although Colombia partially liberalized its abortion law in 2006, many abortions continue to occur outside the law and result in complications. Assessing the costs to the health care system [...]

Despite recommendations in the U.S. for routine HPV vaccination of adolescent girls since 2006, rates of vaccination continue to be low. This study reports vaccination uptake, factors associated with vaccine uptake and reasons for non-vaccination within a national sample of adolescent females during 2010. Using a computer administered survey of a national sample of 501 mothers of daughters 14-17 years old we assessed maternal reports of HPV vaccination as well as socio-demographical factors, maternal HPV exposures and reasons chosen for nonvaccination. Reported HPV vaccination rates were slightly over 50% (51.1%), with 38.3% reporting completion of all 3 doses. Socioeconomic and demographic factors were not associated with vaccination initiation; however, Blacks and Hispanics were less likely to complete vaccination. The most common reasons for non-vaccination were concerns about vaccine safety, danger to daughter, and provider non-recommendation. Relatively poor HPV vaccine initiation and only modest 3-dose completion continues to be a major public health concern that requires continued efforts to address identified predictors and reasons for non-vaccination. Keywords HPV * Vaccination rates * Adolescent health behaviors * Sexually transmitted infections, Introduction Human papillomavirus (HPV) vaccination can lead to substantial reductions in the incidence of HPV infection and HPV-related diseases, including anogenital cancers and genital warts [1]. The introduction and licensing [...]

CONTEXT: Bangladesh is unique in including menstrual regulation (MR) services as part of the government family planning program, despite having a highly restrictive abortion law. The only national estimates of [...]

Currently in clinical trials, microbicides have historically been promoted as a woman-controlled (although more recently woman initiated) method of sexually transmitted infection (STI) prevention. The contradicition that exists in this rationale is that women's bodies, specifically the genitals, have been constructed as a negotiated space within sexual interactions. This study qualitatively explored the factors influencing 40 young women's use of a vaginal moisturizer (VM), utilized as a microbicide surrogate. The results indicated that use of the VM was dependent upon product characteristics (i.e., the lubricating qualities affect on sexual pleasure, timing of insertion), individual factors (i.e., reproductive health goals, experiences with side effects of existing contraceptive methods), and contextual factors (i.e., social norms). An understanding of these bodily and social issues may be beneficial in designing targeted educational campaigns and effective instructional materials as well as in facilitating positive dialogue around women's bodies and their sexuality., The desire for a woman-initiated disease prevention method has increased the attention on vaginal microbicides as a method for the prevention of sexually transmitted infections (STIs), including human immunodeficiency virus [...]

OBJECTIVES. Prophylactic vaccines against human papillomavirus (HPV) are expected to be available for public use by 2007 and likely will be targeted to preadolescent children. Parental acceptance of these vaccines will be critical for their success. The objectives of this study were (1) to determine the overall acceptance of HPV vaccines for preadolescent children by parents, (2) to evaluate the influence of written educational information about HPV on parental acceptability of HPV vaccines, and (3) to identify independent predictors associated with HPV vaccine acceptability by parents. METHODS. A randomized intervention study within a cross-sectional survey was conducted. Parental HPV vaccine acceptability was measured under 3 different hypothetical scenarios. A self-administered survey on the knowledge, attitudes, and beliefs about HPV and HPV vaccines was sent to 1600 parents of 8- to 12-year-old children. In addition to a baseline paragraph about HPV that was received by all study participants, a random half of the study participants received a detailed "HPV Information Sheet" outlining the epidemiology and potential clinical sequelae of HPV infection. Independent predictors of parental HPV vaccine acceptability were determined using multivariate linear regression models. RESULTS. Parents who received the HPV information sheet had higher mean scores on the HPV knowledge assessment tool than the control group. However, despite this apparent improvement in knowledge, there was not a statistically significant difference in HPV vaccine acceptability between the 2 groups. CONCLUSIONS. Providing parents with an HPV information sheet did seem to improve knowledge about HPV, but this increased knowledge had little effect on the acceptability of these vaccines by parents for their children. Instead, attitudes and life experiences seemed to be more important factors influencing HPV vaccine acceptability among parents. Key Words human papillomavirus, vaccines, sexually transmitted disease, Abbreviations HPV--human papillomavirus STI--sexually transmitted infection CI--confidence interval HUMAN PAPILLOMAVIRUS (HPV) infection is believed to be the most common sexually transmitted infection both in the United States and worldwide. (1,2) [...]

A study of the intellectual competence of 300 children who were referred to day and inpatient psychiatric treatment showed that the intellectual ability of children undergoing inpatient treatment is similar to that of children in day treatment. WISC-R scores, scatter indices and factor structure of emotionally disordered children did not differ significantly from those for earlier standardization samples. Cluster analysis of the group also revealed three distinct cognitive profiles of children with serious disorders.

Study of the intellectual performance of children with psychiatric disorders is in partial accord with the observations of Hodges and Plow. Conduct-disordered children possess a relative deficit in verbal abilities. Children with anxiety disorders possess lower IQ. The WISC-R summary scores do not exhibit differences.

Several vaccines for sexually transmitted infections (STI) are presently in development and the eventual availability of such vaccines is expected to result in the prevention of a significant number of burdensome conditions. Young adolescents are presumed to be likely targets for these vaccines since adolescents' risk for STI increases as they age and become sexually active. It is unclear, however, to what extent parents will agree to having adolescents receive STI vaccines. Inasmuch as acceptance is the foundation for effective immunization programs, an understanding of parental perspectives about this issue is required to inform future STI vaccine program strategies. This paper presents findings from a qualitative study that used in-depth interviews to elicit attitudes from 34 parents about accepting vaccines for genital herpes, human immunodeficiency virus, human papillomavirus and gonorrhea for their children (aged 8-17). Data were collected from parents bringing their children for care at an urban clinic and a suburban private office. Content analysis of the responses revealed that most parents (>70%) approved the administration of all four of the STI vaccines proposed. Parents' reasons for acceptance included wanting to protect their children, being concerned about specific disease characteristics, and previous experience with the infections. Parents who declined the vaccines did so primarily because they perceived their children to be at low risk for the infections or they had low concern about features of the diseases. Most parents thought they should be the decisionmaker regarding children receiving an STI vaccine. Results from this study will be used to plan subsequent investigations of the determinants of STI vaccine acceptance by parents. Keywords: Sexually Transmitted Infections; Health beliefs; Immunization Vaccination Adolescents; Parents: USA

The consistency of childhood sexual abuse (CSA) reporting was explored in this study. Two-hundred seventeen adolescents and young adults (ages 14-24) enrolled in urban health care clinics completed self-report questionnaires assessing CSA and other problem behaviors at enrollment and at 7 months. Results indicated that the stability of CSA self-report at two time points was poor (58% consistent nonreporters of CSA, 20% consistent reporters, 22% inconsistent reporters). Consistent and inconsistent reporters were differentiated on risk measures. Adolescents who endorsed more items from the CSA scale were five times more likely to be consistent reporters. In sum, adolescent CSA reporting was quite inconsistent over time. Using multi-item scales and assessing CSA at two time points enhances accuracy of reporting., Surveys of adolescent behavior often rely upon single-item, self-report measures. When this method is used, it is quite possible to misclassify experiences, particularly when assessing sensitive subjects such as adolescent [...]

Objective. To examine the role of self-esteem in predicting coitus initiation in a population of early adolescents. Methods. Questionnaires assessing coital status, self-esteem, and pubertal maturation were collected from 188 participants who had not engaged in coitus by enrollment. Data were collected longitudinally while the participants were in the seventh and ninth grade. Ages ranged from 12 to 14 (mean: 12.50; standard deviation: 0.57) at Time 1 and from 14 to 16 (mean: 14.30; standard deviation: 0.49) at Time 2. Results. Boys with higher self-esteem ratings at Time 1 were more likely to initiate intercourse by Time 2. Girls with higher self-esteem at Time 1 were more likely to remain virgins than girls with lower self-esteem. Pubertal status was unrelated to initiation of coitus in this sample. Conclusions. Self-esteem, regardless of pubertal status, predicted coitus transition differentially in boys and girls. Results from this longitudinal study seem to fit within traditional problem behavior theory. Pediatrics 2002;109:581-584; coitus initiation, adolescents, self-esteem, longitudinal. ABBREVIATIONS. RSES, Rosenberg Self-Esteem Scale; SD, standard deviation., The relationship of self-esteem to initiation of intercourse in early adolescents has been discussed often but has received relatively little attention in the research literature. The few studies that have [...]

Studies of condom use must rely upon self-report data which may not be reliable and valid. This investigation examined how 192 undergraduates (17-48 years) interpret response categories (never, rarely, sometimes, most of the time, always) used in some surveys to assess frequency of condom use. Subjects completed a questionnaire that described a scenario of a couple who had engaged in sexual intercourse 20 times during the past 3 months. As part of the survey, there were 21 statements in which the stated number of times condoms were used varied from 0 to 20 (e.g., condoms were used 18 out of the 20 episodes of sexual intercourse). For each statement, subjects were instructed to circle the category they believed best matched the frequency with which condoms had been used: 31% indicated that using condoms 1 out of 20 times was an example of never using condoms; similarly, 23% indicated that using condoms 2 times out of the 20 encounters was an example of never using condoms, 40% indicated that condom use for 19 out of 20 encounters was always using condoms, whereas 23% applied the always label to condom use for 18 out of 20 encounters. These results generally support the validity of this type of condom use measurement, but suggest that caution is needed in interpretation. Implications of these findings are discussed with respect to health messages and research methodology. KEY WORDS: self-report; verbal meaning; condoms; measurement.

Many homeless and runaway adolescents may be at a high risk for HIV infection. Ideas about the severity of AIDS, possible modes of transmission, and the integrity of those who provide information about HIV/AIDS come into play as youths make safer sex decisions. Information on youths' ideas about these issues can be used to improve the effectiveness of HIV/AIDS education programs that target them. We interviewed 98 adolescents at two youth shelters in Cleveland, Ohio over a one-year span in 1992-93. When asked directly, two-fifths of the youths said that HIV/AIDS information is being held back from us; one-fifth reported that their beliefs differed from those of the experts. However, analysis of interview discourse suggested that the number of doubters actually may be much greater, and that doubting the experts may be a logical reaction to discrepancies in the HIV/AIDS information received as well as to historical and contemporary social and political factors. Interview responses also suggested that youths' generally high HIV/AIDS knowledge scores may reflect rote memorization rather than comprehension; the new information may be internalized in ways that fit with preexisting AIDS understandings. Key words: adolescents, HIV/AIDS, conspiracy, sex behavior, runaways; US, Ohio, Cleveland

Byline: H. Artucio (1), J. Hurtado (1), L. Zimet (1), J. de Paula (1), M. Beron (1) Keywords: Key words Tricuspid regurgitation; Adult Respiratory Distress Syndrome; Acute lung injury; PEEP; Pulmonary hypertension; Right ventricular afterload Abstract: : To determine the presence of tricuspid regurgitation (TR) in patients affected by acute lung injury (ALI) and the adult respiratory distress syndrome (ARDS) during mechanical ventilation with positive end-expiratory pressure (PEEP). Design: A prospective clinical study. Setting: 10-bed general intensive care unit in a University Hospital. Patients: 7 consecutive patients an age 44.7 +- 8.6 years with a diagnosis of ALI or ARDS were studied. All were on mechanical ventilation with PEEP. Interventions: PEEP was increased in steps of 5 cm [H.sub.2]O until the appearance of TR or up to a limit of 20 cm [H.sub.2]O. Measurements and results: Right atrial pressure, pulmonary artery pressure, and wedge pressure were measured and cardiac output was determined by thermodilution. TR was graded from 0 to 3. Standard 2D echocardiographic and pulsed-wave images were obtained at each level of PEEP. PEEP was increased from 4 +- 3 to 17 +- 2 cm [H.sub.2]O. Mean PAP increased from 27.7 +- 2.9 to 36.7 +- 3.5 mm Hg (p &lt 0.02) when PEEP was increased. Five patients had competent valves and two had mild TR at baseline. In six out of the seven, TR either developed or increased when PEEP was increased. Conclusions: Our study demonstrated the development of TR after the use of PEEP in patients with ALI and ARDS as a consequence of pulmonary hypertension and right ventricular overloading. Since TR may randomly affect cardiac output values and derived parameters, the assessment of cardiac performance by some techniques such as thermodilution should be used with caution. Author Affiliation: (1) Intensive Care Department, Hospital de Clinicas (University Hospital), Universidad de la Republica, Montevideo, Uruguay, UY Article note: Received: 3 December 1996 Acepted: 5 May 1997