While many clinicians encounter parents or adolescents who refuse HPV vaccine, little is known about the prevalence of hesitancy for HPV vaccine nationally or its association with vaccination.
In ...April 2019, we surveyed families with adolescents 11–17 years using a national online panel (Knowledge Panel®) as the sampling frame. We assessed the prevalence of HPV vaccine hesitancy with the validated 9-item Vaccine Hesitancy Scale (VHS). We used multivariate analyses to assess demographic factors associated with HPV vaccine hesitancy. We also assessed practical barriers to receipt of HPV vaccine and the relationship between barriers and hesitancy. Finally, we evaluated the association between both HPV vaccine hesitancy and practical barriers on HPV vaccine receipt or refusal.
2,177 parents out of 4,185 sampled (52%) completed the survey, 2,020 qualified (lived with adolescent). Using a VHS cut-off score > 3 out of 5 points, 23% of US parents were hesitant about HPV vaccine. Hesitancy was lower among those with Hispanic ethnicity. At least one out of five parents disagreed that the HPV vaccine is beneficial for their adolescent, that the vaccine is effective, protects against HPV-related cancers, or that they followed their adolescent’s health-care provider’s recommendation about the vaccine. Many were concerned about vaccine side effects and the novelty of the vaccine. Adolescents living with vaccine-hesitant parents were less than one-third as likely to have received the vaccine (RR = 0.29, 95% CI 0.24, 0.35) or completed the vaccine series (RR = 0.29, 95% CI 0.23, 0.36), and were 6-fold more likely to have refused the vaccine because of parental vaccine-related concerns (RR = 6.09, 95% CI = 5.26, 7.04). Most practical barriers were independently associated with vaccine receipt but not with vaccine refusal.
HPV vaccine hesitancy is common nationally and strongly related to both under-vaccination and vaccine refusal.
AbstractA laboratory modeling program has been conducted to evaluate the hydraulic conditions required for backward erosion piping (BEP) to initiate and progress in sandy soils. The first stage of ...BEP consists of loosening the soil near the unprotected seepage exit face from which the piping initiates. As the differential head on the system increases, the loosened zone increases in size to reach equilibrium with the increasing hydraulic gradient near the seepage exit. Laboratory models were performed on sandy soils to model the development of BEP and measure the hydraulic regime surrounding the developing loosened zones. Inverse analyses were performed using three-dimensional finite-element (FE) seepage analyses to assess the critical gradients needed to initiate soil loosening and create or expand the loosened zone. By analyzing the observed behavior and data of piping development with the inverse-analysis procedure, exponential and linear fit equations were developed to define the relationship between effective stress and the critical gradient at the boundary of the loosened zone. The exponential relationship was shown to have a moderately better fit of the data than the linear relationship, indicating that internal friction resistance in addition to overburden weight contributes to the resistance to soil loosening.
AbstractA laboratory modeling program has been conducted to assess the mechanics of initiating the piping erosion process in sandy soils. The models were performed on several soils, differing in ...gradation, grain size, grain shape, and specific gravity. Observations and monitoring of pore pressures within the samples during the modeling identified four stages in the development of piping initiation: initial movement, progressive heave, boil formation, and total heave. By linking the observed behavior with the measured pore-pressure regime in the sample, a model for the mechanics of piping development has been developed. Finite-element seepage analyses were performed to model the progression of piping development in the laboratory models and corroborate the developed model of mechanics. The findings of the study identified a new model for the initiation of piping development that can be applied to the assessment of piping in the field.
A substantial body of evidence points to the heritability of dietary preferences. While vegetarianism has been practiced for millennia in various societies, its practitioners remain a small minority ...of people worldwide, and the role of genetics in choosing a vegetarian diet is not well understood. Dietary choices involve an interplay between the physiologic effects of dietary items, their metabolism, and taste perception, all of which are strongly influenced by genetics. In this study, we used a genome-wide association study (GWAS) to identify loci associated with strict vegetarianism in UK Biobank participants. Comparing 5,324 strict vegetarians to 329,455 controls, we identified one SNP on chromosome 18 that is associated with vegetarianism at the genome-wide significant level (rs72884519, beta = -0.11, P = 4.997 x 10.sup.-8 ), and an additional 201 suggestively significant variants. Four genes are associated with rs72884519: TMEM241, RIOK3, NPC1, and RMC1. Using the Functional Mapping and Annotation (FUMA) platform and the Multi-marker Analysis of GenoMic Annotation (MAGMA) tool, we identified 34 genes with a possible role in vegetarianism, 3 of which are GWAS-significant based on gene-level analysis: RIOK3, RMC1, and NPC1. Several of the genes associated with vegetarianism, including TMEM241, NPC1, and RMC1, have important functions in lipid metabolism and brain function, raising the possibility that differences in lipid metabolism and their effects on the brain may underlie the ability to subsist on a vegetarian diet. These results support a role for genetics in choosing a vegetarian diet and open the door to future studies aimed at further elucidating the physiologic pathways involved in vegetarianism.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background and aims
Liver transplantation (LT) in alcohol‐associated hepatitis (AH) remains controversial, in part because spontaneous recovery (SR) can occur. There is a paucity of data on SR in ...patients with severe AH who undergo LT evaluation. The purpose of this study was to determine factors associated with SR and survival in patients with severe AH who undergo LT evaluation.
Approach and results
This is a retrospective study of ALD patients with Model for End‐Stage Liver Disease (MELD) >25 and <90 days abstinence who underwent LT evaluation at a single center between 2012 and 2018. One hundred forty‐four patients (median age, 45.5 years; 68.1% male) were included. Forty‐nine (34%) underwent LT and 95 (66%) patients did not undergo LT, and of those, 34 (23.6%) experienced SR. Factors associated with recovery were younger age (OR, 0.92; p = 0.004), lower index international normalized ratio (INR; 0.31; p = 0.03), and lower peak MELD (OR, 0.83; p = 0.02). Only 7 patients (20.6%) achieved a compensated state with a MELD <15 and absence of therapy for ascites or HE. Survival was improved in patients who underwent early LT when compared to SR. Survival was impaired in SR following relapse to alcohol use when compared to SR patients who abstained and LT recipients. Among all 6‐month survivors of AH, alcohol use trended toward an association with mortality (HR, 2.05; p = 0.17), but only LT was associated with decreased mortality risk (HR, 0.20; p = 0.005).
Conclusions
SR from AH after LT evaluation is associated with age, index INR, and lower peak MELD. Most recovered patients continue to experience end‐stage complications. LT is the only factor associated with lower mortality.
The Marxian Law of Value is here presented as a useful lens with which to interpret the present educational crisis. Capital needs labour-power more than any other element, and in exponentially ...increasing amounts, as it alone is the foundation of capitalist profit. To deal with this challenge, it has moved the costs of education - the process of creation of labour-power - on to the consumer and pressured the state to privatise the field. The resultant foregrounding of STEM and neglect of the humanities is leading to the destruction of the 100-year-old basis of the original universities, thus constituting a new key phase in their historical evolution. To effect these changes, the corporatised university and VET sector have supressed many academic liberties and liberal discussion, as these challenge much of the required restructuring. The implications for scholar activists are immediate and urgent: for example, who continues to teach the humanities, and in what civil society context? The Law of Value can thus provide a useful array of conceptual tools and insights that allow scholar-activists to perspicaciously grasp systemic causes, and hence assists us in developing an effective metalanguage of analysis and strategising as campaigners for a fully human form of education. Author abstract
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Solar Photovoltaic (PV) electricity systems are part of Australia's energy supply matrix. In the case of New South Wales (NSW), the state government has had to deal with a complex policy problem. In ...order to play its role in the federal Small-scale Renewable Energy Scheme, the NSW government initiated the 7 year Solar Bonus Scheme in 2010. However, in attempting to maximise community investment in small-scale solar PV systems, it relied on faulty financial modelling that applied a generous Feed-in Tariff (FiT) and underestimated the level of investor participation and installed capacity. Consequently, the scheme has resulted in very high public costs that will require policy changes that bring investors and energy retailers into conflict, and unpopular electricity retail price adjustments. This paper uses a structured case and stakeholder analysis to critically analyse the FiT policy, while also highlighting important lessons for policymakers engaging in FiT design.
•Describes the design of a feed-in tariff policy for solar PV electricity exports.•Exposes a A$1 billion payment overrun and weaknesses in policy controls.•Identifies policy design flaws and opportunities to improve future tariff designs.•Discusses the importance of developing nationally integrated feed-in tariff policies.
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