OBJECTIVE To examine the impact of sexuality education practices on adolescent birthrates while controlling for demographic characteristics and religious/political factors at a state level. DESIGN Prospective cohort study. SETTING Twenty-four states, from 1997 through 2005. PARTICIPANTS Girls aged 15 to 17 years. MAIN EXPOSURE The state sexuality education practices (ie, sexually transmitted disease prevention, pregnancy prevention, condom efficacy) for 1996 through 2004 from the Centers for Disease Control and Prevention School Health Profiles Survey. MAIN OUTCOME MEASURES State birthrates for girls aged 15 to 17 years for 1997 through 2005 from the Centers for Disease Control and Prevention. RESULTS In a longitudinal, unadjusted model, our findings provide evidence that increased sexuality education within school curricula is associated with lower adolescent birthrates (average sexuality education topics β = -0.61; P = .001). However, the effect of sexuality education disappeared when taking into consideration the demographic characteristics, religiosity, and abortion policies of the state (average sexuality education topics β = -0.12; P = .26). States with higher religiosity rankings and greater political conservatism had higher adolescent birthrates. CONCLUSIONS The effects of sexuality education were constrained by state characteristics and do not independently explain the considerable variations in adolescent birthrates found across states. Our findings underscore the strong influence of state characteristics on adolescent birthrates above and beyond sexuality education, which must be considered when evaluating the efficacy of sexuality education programs.
OBJECTIVE To evaluate the effectiveness of Sprinkles alongside infant and young child feeding (IYCF) education compared with IYCF education alone on anemia, deficiencies in iron, vitamin A, and zinc, and growth in Cambodian infants. DESIGN Cluster-randomized effectiveness study. SETTING Cambodian rural health district. PARTICIPANTS Among 3112 infants aged 6 months, a random subsample (n = 1350) was surveyed at baseline and 6-month intervals to age 24 months. INTERVENTION Daily micronutrient Sprinkles alongside IYCF education vs IYCF education alone for 6 months from ages 6 to 11 months. MAIN OUTCOME MEASURES Prevalence of anemia; iron, vitamin A, and zinc deficiencies; and growth via biomarkers and anthropometry. RESULTS Anemia prevalence (hemoglobin level <11.0 g/dL [to convert to grams per liter, multiply by 10.0]) was reduced in the intervention arm compared with the control arm by 20.6% at 12 months (95% CI, 9.4-30.2; P = .001), and the prevalence of moderate anemia (hemoglobin level <10.0 g/dL) was reduced by 27.1% (95% CI, 21.0-31.8; P < .001). At 12 and 18 months, iron deficiency prevalence was reduced by 23.5% (95% CI, 15.6-29.1; P < .001) and 11.6% (95% CI, 2.6-17.9; P = .02), respectively. The mean serum zinc concentration was increased at 12 months (2.88 μg/dL [to convert to micromoles per liter, multiply by 0.153]; 95% CI, 0.26-5.42; P = .03). There was no statistically significant difference in the prevalence of zinc and vitamin A deficiencies or in growth at any time. CONCLUSIONS Sprinkles reduced anemia and iron deficiency and increased the mean serum zinc concentration in Cambodian infants. Anemia and zinc effects did not persist beyond the intervention period. TRIAL REGISTRATION anzctr.org.au Identifier: ACTRN12608000069358.
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Two creole languages are compared in this paper with respect to the possible reference of fully bare nominals (FBNs) in them. One is a Portuguese-related Creole, Kriyol spoken in Guinea-Bissau and Casamance, the other is a French-related Creole, Haitian. Both languages are similar in allowing for FBNs, i.e. uninflected nouns not in the scope of a determiner or a quantifier, in all syntactic positions and grammatical functions. The main difference between them is that Haitian avails itself of a definite determiner in addition to a specific indefinite determiner, whereas Kriyol only has the latter. Given such empirical data, which are examined at length and in detail, the paper aims to show that the referential possibilities of FBNs in both languages can be analysed as emergent properties from the constructions the FBNs are inserted into, without recourse to functional categories.
This paper argues that, in order to understand the language use of Basque immigrants to southern California, it is essential to consider how language ideologies intersect with gender. First, although traditional Basque culture privileges men, the culture has changed in the American context in ways that may make it more welcoming to women. Second, speaking Basque has different social meanings for men and women when it comes to “performing” gender identities. For men, speaking Basque is appropriate for presenting oneself as a man and as a Basque. For women, speaking Basque is often incompatible with presenting oneself as a fashionable woman. Third, men are more likely to speak Basque in the public domain even in America, because of their greater access to employment and social networks composed of Basque speakers. At the same time, some women have increased their use of Basque after emigration, in part because the American context provides a less negative semantic space when it comes to women speaking Basque. The implications of these findings for Fishman’s theory on Reversing Language Shift are discussed.
In this paper we present a unified analysis of generic and weak interpretations of definite (DEF) and demonstrative (DEM) descriptions. In such contexts, the DEF only denotes the kind, whereas the DEM cannot denote the maximal node of a taxonomy. We claim that this contrast can be explained if we transpose Wolter’s (2006) semantics to the domain of kinds, a domain of taxonomies. The paper presents this proposal, which is also an argument against the direct referential treatment of demonstratives. This paper shows that, in Brazilian Portuguese (BrP), the generic and the weak uses of demonstrative phrases (DEM) contrast with generic and weak definite descriptions (DEF): in both contexts, DEF denotes the kind (never the sub-kind), and DEM denotes the sub-kind (never the kind). Our contribution is an explanation for this phenomenon. The paper focuses on the contrast between the singular DEF and the singular DEM: ‘o cachorro’ (the dog) versus ‘esse/este cachorro’ (this dog), respectively. In contemporary BrP, ‘esse’ and ‘este’ are variants that contrast with ‘aquele’: ‘esse/este’ (this) is near the speaker and ‘aquele’ (that) is far. * We are very grateful for the feedback given by the audience at the Workshop on Referentiality in Curitiba, 2012. The final version of our paper owes to the comments of the two JoPL reviewers. The second author is also grateful to CNPq for the research grant (Process Nr. 313011/2013) 1 The translations are rough approximations. There are important differences between English and BrP demonstrative systems, but they are well beyond the aims of this paper. Bowdle & Ward (1995) make similar considerations for English demonstratives, although in a different perspective.’ Journal of Portuguese Linguistics, 13-2 (2014) / 14-1 (2015), 45-62 ISSN 1645-4537 46 Renato Miguel Basso & Roberta Pires de Oliveira We will not address this issue in this paper, and concentrate on ‘esse/este’ (this). Moreover, we will not deal with plurality, which would certainly pose many other issues. Our aim is to understand the differences between the Definite Singular (DEF) and the Singular Demonstrative (DEM) in generic and weak contexts. The examples below illustrate the contrast in the generic context. Suppose a scenario in which these sentences are uttered while the speaker is pointing to a Labrador: (1) a. O cachorro é amigável. (individual or kind interpretation) ‘The dog is friendly.’ b. O cachorro está em extinção. (kind interpretation) ‘The dog is on the verge of extinction.’ (2) a. Esse cachorro é amigável. (individual or sub-kind interpretation) ‘This dog is friendly.’ b. Esse cachorro está em extinção. (sub-kind interpretation) ‘This dog is on the verge of extinction.’ In generic contexts, DEFs are interpreted as about the kind, whereas the generic DEM is about the sub-kind. This is the contrast we aim to explain. According to Wolter (2006), DEM and DEF phrases are translated by the iota operator – thus, both are definite because they carry a presupposition of uniqueness. The difference between them is that DEM phrases carry a presupposition of non-default situation (a non-maximal situation), whereas the DEF requires a maximal situation. We transpose this idea to the kind domain, which is structured as taxonomies, by re-interpreting the role of situation in this domain. Our analysis proposes that generic descriptions, as well as weak interpretations, are explained by sorting the ontology into a domain of object-level individuals (Krifka et al., 1995), which is structured via sums, and the domain of intensional entitites, concepts, which are structured as taxonomies. Thus, the DEF denotes the highest node in the hierarchy, i.e. the maximal individual, whereas DEM must denote a nonmaximal node. In our proposal the iota operator also carries a presupposition of familiarity (Heim, 1982), which will help us understand why DEM cannot be rendered as a covert classifier phrase, as ‘tipo de’ (type of). The kind interpretation of DEMs depends on the existence of a presupposed taxonomy. This explains why these constructions are restricted. If DEMs are covert classifier phrases, one cannot explain this restriction. Section 1, “Generic deixis”, shows that there is a contrast between generic interpretations of definite and of demonstrative descriptions in deictic contexts: the definite generic only denotes the kind, whereas the demonstrative must denote the sub-kind. Section 2, “Weak contexts”, supports the claim that there are weak demonstratives, as proposed by Basso & Vogt (2013), and Basso (2014), and show that they contrast with weak Generic and Weak Demonstratives 47 definites in the same way as in the generic context: the demonstrative only denotes the sub-kind; the definite, the kind. The third section presents our theoretical account of this contrast. It extends Wolter’s (2006) theory of demonstrative descriptions to generic and weak uses, by combining it with the Aguilar-Guevara & Zwarts (2010, 2013) proposal that weak definites denote a kind. In the conclusion, we suggest that our proposal is an argument against direct referential treatments of demonstratives, and discuss briefly some loose ends.
OBJECTIVES:To measure the effect of rotavirus vaccine (RVV) on acute gastroenteritis (AGE) managed by primary care physicians in the first 2 rotatvirus seasons following the introduction of RVV. DESIGN:Retrospective cohort study. SETTING:Practice-based network composed of 33 ambulatory pediatric practices in Philadelphia, Pennsylvania. PARTICIPANTS:All children born from February 22, 2006 (date of RVV licensure), through February 29, 2008, and who received care at any network site. MAIN EXPOSURE:Receipt of RVV. OUTCOME MEASURES:The primary outcomes were AGE-related office visits, telephone calls, and episodes (composite outcome consisting of all visits and calls within a 10-day period). RESULTS:Rates of AGE visits in the 2 rotavirus seasons following the introduction of RVV steadily decreased from 3.0 AGE visits per 100 total office visits in the 2005 season to 1.8 in the 2008 season. In 2007, vaccinations were administered to 9351 of 13 951 vaccine-eligible children (67.0%), and in 2008, they were administered to 9958 of 10 728 (92.8%). Among RVV-immunized children in 2007, AGE calls and episodes were significantly reduced with vaccine effectiveness of 53% and 46%, respectively. No significant difference was seen between RVV-immunized and RVV-nonimmunized children for any outcome in 2008. CONCLUSIONS:Rotavirus vaccine was associated with a significant reduction in outpatient AGE calls and episodes among immunized children in our network in 2007. Despite a reduction in winter AGE rates in the network, no difference was detected between RVV-immunized and RVV-nonimmunized children for any outcome in 2008. Further study is needed to understand the lack of vaccine effect in 2008.
OBJECTIVE:To determine whether hospital discharges for intussusception in children younger than 1 year have changed since the reintroduction of rotavirus vaccine in the United States.DESIGN:Serial cross-sectional analysis.SETTING:US hospitals.PARTICIPANTS:Children younger than 1 year with a discharge diagnosis of intussusception identified in the Kids' Inpatient Database, a series of nationally representative data sets of pediatric hospital discharges in the United States with 4 available years prior to vaccine reintroduction (1997, 2000, 2003, and 2006) and 1 year after (2009).MAIN EXPOSURES:Hospital discharge before vs after rotavirus vaccine reintroduction.OUTCOME MEASURES:Total number and rate of hospital discharges for infants younger than 1 year with a diagnosis of intussusception (International Classification of Diseases, Ninth Revision, Clinical Modification code 560.0).RESULTS:From 1997 to 2006, there was no change in the total number of hospital discharges for intussusception, with a small decrease in the rate of intussusception discharges (41.6 [95% CI, 36.7-46.5] to 36.5 [95% CI, 31.7-41.2] per 100,000 infants). Based on the trend, the predicted rate of discharges for intussusception in 2009 was 36.0 (95% CI, 30.2-41.8) per 100,000 infants. The measured rate of hospital discharges for intussusception in 2009 was 33.3 (95% CI, 29.0-37.6) per 100,000 infants.CONCLUSION:The reintroduction of rotavirus vaccine since 2006 has not resulted in a detectable increase in the number of hospital discharges for intussusception among US infants.
OBJECTIVE:To assess the safety of the quadrivalent human papillomavirus vaccine (HPV4) in females following routine administration.DESIGN:In a cohort of vaccinated females, we compared the risk of emergency department visits and hospitalizations during the interval soon after vaccination with risk during a comparison interval more remote from vaccination.SETTING:Kaiser Permanente in California.PARTICIPANTS:All females who received the HPV4 vaccine.MAIN EXPOSURE:One or more doses of HPV4 between August 2006 and March 2008.MAIN OUTCOME MEASURES:Outcomes were emergency department visits and hospitalizations, grouped into predefined diagnostic categories. Within diagnostic groups, we used odds ratios (ORs) to estimate whether each subject had any outcome in postvaccination risk intervals (days 1-60, days 1-14, and day 0), compared with a control interval distant in time from vaccination.RESULTS:One hundred eighty-nine thousand six hundred twenty-nine females received at least 1 dose and 44 001 received 3 HPV4 doses. Fifty categories had significantly elevated ORs during at least 1 risk interval. Medical record review revealed that most diagnoses were present before vaccination or diagnostic workups were initiated at the vaccine visit. Only skin infections during days 1 to 14 (OR, 1.8; 95% CI, 1.3-2.4) and syncope on day of vaccination (OR, 6.0; 95% CI, 3.9-9.2) were noted by an independent Safety Review Committee as likely associations with HPV4.CONCLUSIONS:The quadrivalent human papillomavirus vaccine was associated with same-day syncope and skin infections in the 2 weeks after vaccination. This study did not detect evidence of new safety concerns among females 9 to 26 years of age secondary to vaccination with HPV4.
Kendrin R. Sonneville, ScD, RD; Catherine M. Gordon, MD, MSc; Mininder S. Kocher, MD, MPH; Laura M. Pierce, BA; Arun Ramappa, MD; Alison E. Field, ScD
