Articles

<b>Background:</b> Sexual and gender minority (SGM) youth are at elevated risk for adverse mental health and substance use outcomes. Stressors such as family conflict, discrimination, and trauma have been suggested as possible mediators of these disparities. <b>Aims:</b> This study examined whether family conflict, discrimination, and trauma mediate the associations between SGM identity and adverse outcomes, including suicide attempt, major depressive disorder (MDD), nicotine use, and marijuana use. <b>Methods:</b> Participants were children from the Adolescent Brain Cognitive Development (ABCD) study. SGM identity was reported at baseline, while outcomes included past MDD and suicide attempts as well as future nicotine and marijuana use. Structural equation modeling (SEM) was used to test both direct and indirect pathways linking SGM identity to mental health and behavioral outcomes. <b>Results:</b> No significant mediation was found through family conflict, discrimination, or trauma. Instead, effects of SGM identity were primarily direct: SGM youth had higher odds of past suicide attempts and MDD, as well as future marijuana use, but not future nicotine use. Stressor variables, however, were independently associated with outcomes. Discrimination predicted all outcomes; trauma was positively associated with suicide, nicotine, and marijuana use but not MDD; and family conflict predicted all outcomes except MDD. <b>Conclusion:</b> Family conflict, discrimination, and trauma did not mediate SGM disparities in mental health and substance use, but each emerged as an independent predictor of risk. These findings highlight the complexity of mechanisms underlying SGM-related disparities and suggest the need for future research to explore additional pathways and contextual influences.

<b>Background</b><b>:</b> Socioeconomic status (SES) is a well-established determinant of health, often associated with lower risk of cardiometabolic diseases (CMD). However, the extent to which SES influences CMD may vary by gender due to differences in social roles, health behaviors, and biological susceptibilities. This study examined the relationship between SES, measured by the poverty-to-income ratio (PIR), and CMD indicators—including obesity, diabetes, and cardiovascular disease (CVD)—among men and women using data from the National Health and Nutrition Examination Survey (NHANES). <b>Methods</b><b>:</b> This cross-sectional study utilized NHANES data (1999-2018), adjusting for race/ethnicity and age. SES was operationalized using PIR, with CMD outcomes (obesity, diabetes, and CVD) as dependent variables. Generalized linear models (GLM) were employed to evaluate the main effects of SES on CMD, with gender included as a moderator. <b>Results</b><b>:</b> Higher SES was associated with lower overall CMD risk. However, the protective effects of SES were more pronounced in women than in men for all outcomes. These findings suggest that gender-specific pathways may mediate the relationship between SES and CMD. Women may derive greater health benefits from higher SES due to factors such as reduced stress exposure, healthier behaviors, and increased healthcare utilization. Conversely, the weaker association observed in men may reflect differences in social hierarchy sensitivity, responses to unemployment, or other contextual factors. <b>Conclusion</b><b>:</b> The findings highlight the importance of gender-specific considerations when addressing SES-related disparities in CMD outcomes. Policies and interventions aimed at reducing CMD burden should account for these gender differences to promote equitable improvements in cardiometabolic health. Further research is needed to unravel the mechanisms driving these differences and to inform targeted strategies.

<b>Background: </b>Socioeconomic status (SES) is a well-established predictor of cognitive function in children, but the neurobiological pathways through which SES influences cognitive outcomes remain underexplored. This study examines the role of the cingulate gyrus (region of the brain that is involved in emotion regulation, decision-making, error detection, and cognitive control) in mediating the relationship between SES and cognitive performance, with a focus on whether these effects vary by sex. <b>Objective: </b>To investigate the role of the cingulate gyrus in mediating the association between social gradients (family SES) and cognitive function in children and assess potential sex differences in these pathways. <b>Methods:</b> Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study. Cognitive function was assessed using a composite measure of executive function and general cognitive ability. Structural MRI data were used to measure the volume of the cingulate gyrus. Path analysis was conducted to examine the mediating role of the cingulate gyrus in the association between SES and cognitive function. Interaction terms were included to test for sex differences. <b>Results:</b> Higher SES was significantly associated with a larger cingulate gyrus volume and better cognitive function. The volume of the left cingulate gyrus partially mediated the relationship between family and neighborhood SES and cognitive function, explaining a portion of the social gradient in cognitive outcomes. No significant sex differences were found in these mediating effects. <b>Conclusions:</b> The cingulate gyrus partially mediates the link between SES and cognitive function in children. These findings suggest that social disparities in cognitive function may operate, in part, through neurobiological changes such as those in the cingulate gyrus, without significant variation by sex.

<b>Objective: </b>This study investigates the pathways linking socioeconomic status (SES), trauma, early puberty, and tobacco use, with a focus on how these relationships differ by sex. Using data from the Adolescent Brain Cognitive Development (ABCD) study, we explore how SES and race contribute to trauma exposure, which in turn may influence early puberty and tobacco use. The study also examines potential mediating effects of trauma and early puberty on the association between SES and tobacco use, while comparing these pathways for males and females.<b> </b><b>Methods: </b>Data were drawn from the ABCD study, and structural equation modeling (SEM) was employed to test direct and indirect pathways between SES, trauma, early puberty, and tobacco use. The sample was stratified by sex to assess differences in these relationships for males and females. Key predictors included SES, race, and age, while outcomes were trauma, early puberty, and tobacco use. The model assessed mediating effects of trauma and early puberty on tobacco use.<b> </b><b>Results: </b>Trauma was a significant predictor of early puberty for females (B = 0.032, SE = 0.015, p = 0.039) but not males. Early puberty was significantly linked to tobacco use for females (B = 0.048, SE = 0.015, p = 0.001) but not for males. Additionally, trauma had an effect on tobacco use among females (B = 0.048, SE = 0.014, p < 0.001) but not males.<b> </b>Lower SES was significantly associated with higher trauma exposure for both males (B = -0.109, SE = 0.014, p < 0.001) and females (B = -0.110, SE = 0.015, p < 0.001). <b>Conclusions: </b>The findings suggest that trauma and early puberty play more significant roles in the pathways from SES to tobacco use for females than for males. While trauma and early puberty are crucial mediators for females, these factors are less predictive for males. These results highlight the importance of sex-specific interventions targeting trauma and early puberty as pathways to early tobacco use.

This study investigated the use of digital design as a tool for assessing attitudes among male sex offenders by exploring how artistic expression can reveal complex emotional landscapes related to their crimes. The study utilized digital paintings, a type of digital design that involves creating artwork using digital tools and software. Digital painting tools allowed the researcher to simulate traditional painting techniques, while benefiting from the flexibility and versatility of digital media. It is essential to comprehend and address offenders’ attitudes towards sexual crimes to create prevention and rehabilitation plans that work. The effectiveness of digital paintings that illustrate the consequences of sexual crimes on offender, victim and the offender’s family was examined in this study. The study examined whether exposure to these visual representations could result in a quantifiable decrease in supporting attitudes toward sexual crimes by comparing participants' pre-test and post-test attitudes using the Crime Pics II tool. There is little research on how visual cues can change offenders' attitudes and perceptions, despite the urgent need for creative evaluation techniques in this delicate field. This study adds to the continuing conversation on crime prevention and offender rehabilitation by demonstrating how well digital design can change perceptions of sexual crimes. A total of 61 male convicts of defilement and rape were purposively sampled for the study. The study utilized an art exhibition and Rapid Serial Visual Presentation format to repeatedly display digital paintings to participants aged 18-45. The artwork produced in both monochrome and polychrome schemes and in realist and surrealist styles was designed to elicit immediate emotional and cognitive responses. Qualitative and quantitative analyses of the participants' responses and reflections provided important insights into their attitudes, including sentiments of regret and guilt as well as a sophisticated awareness of the wider effects of their behaviour. Monochrome paintings tended to portray darker emotions, whereas polychrome paintings showed a wider range of emotions, including hope and recognition of the harm done. The findings demonstrate that digital design can effectively support offenders' emotional processing and self-reflection, demonstrating its potential as a helpful tool in rehabilitative and assessment contexts.

Background:</b> Early life socioeconomic conditions and race/ethnicity are critical determinants of long-term health and behavioral outcomes. Epigenetic changes, particularly those measured by the GrimAge biomarker, may mediate the impact of these early adversities on later life outcomes. This study investigates the relationships between race/ethnicity, poverty at birth, epigenetic aging at age 15, and subsequent self-rated health, school discipline, depression, and school dropout at age 22. We explored sex differences in these paths. <b>Methods:</b> Data were drawn from the Fragile Families and Child Wellbeing Study (FFCWS), which included 733 youth with comprehensive follow-up data up to age 22. Structural Equation Modeling (SEM) was employed to assess the pathways from race/ethnicity and poverty at birth to epigenetic aging (GrimAge) at age 15, and subsequently to self-rated health and school discipline at age 22. The model controlled for potential confounders including sex, family structure, and parental education. <b>Results:</b> Race/ethnicity and poverty at birth were significantly associated with higher GrimAge scores at age 15 (p < 0.05). Higher GrimAge scores were predictive of poorer self-rated health (β = -0.08, p < 0.05) and increased instances of school discipline (β = 0.13, p < 0.01) at age 22. The indirect effects of race/ethnicity and poverty at birth on self-rated health and school discipline through GrimAge were also significant (p < 0.05), suggesting that epigenetic aging partially mediates these relationships. Sex differences were also observed. Poverty at birth predicted faster epigenetic aging at age 15 for males not females. We also observed that faster epigenetic aging at age 15 was predictive of school discipline of male not female participants at age 22. In contrast, faster epigenetic aging at age 15 was predictive of self-rated health (SRH) of female not male participants at age 22. <b>Conclusions:</b> This study provides evidence that with some sex differences, race/ethnicity and poverty at birth contribute to accelerated epigenetic aging (GrimAge) by age 15, which in turn predicts poorer self-rated health and increased school discipline issues by age 22. These findings emphasize the importance of early interventions targeting social determinants to mitigate long-term health and behavioral disparities. Addressing these early life conditions is crucial for improving health equity and outcomes in young adulthood.

This study aimed to explore the relationship between teacher training and challenges in delivering effective sex education in the Sagnarigu district in the Northern region of Ghana. The Social-cultural theory underpins the study. A descriptive survey research design was adopted for the study. The population of this study comprises teachers, head teachers and a School Improvement Support Officer (SiSo) in basic schools in the Gumani/Nyanshegu circuit in the Sagnarigu district of the Northern Region. This study adopted multi-sampling methods to select respondents. Random and purposive sampling techniques were used to select the study's 10 basic schools and 83 respondents. The main tools used for the data collection were the questionnaire and interview. The data was analysed using Statistical Package for Social Scientists (SPSS) software version 23 tools. Descriptive Statistical tools such as frequencies were used to gauge the number of occurrences of the studied variables. The qualitative data was also further analysed in line with the research questions to establish patterns of similarities and variations. These were then validated with the quantitative data for any possible contradictions in the findings. The study concludes that people's socio-cultural and religious beliefs and practices affect the teaching of sex education in school. It was observed that sex education could be misconstrued as an encouragement to young people to engage in early sexual promiscuity. Finally, the study concludes that there cannot be effective sex education without the appropriate logistics such as T.L.M.s, syllabus and time allocation for the subject. The study also acknowledges that the availability of these materials must go along with appropriate capacity building for teachers to be well-positioned to teach the subject. It is recommended that Sexuality education should be included in the curricular and academic calendar of basic schools, along with the provision of adequate T.L.M.s and the proper collaboration with appropriate agencies for the effective teaching of the subject. Sex education needs to be given maximum attention, just as any of the life skills subjects, with adequate investment and motivation to both teachers and pupils to ensure a meaningful impact. There should be regular monitoring, supervision, and assessment of the training of teachers and its influence on the teaching of the subject, as well as ensuring that ethical considerations regarding cultural and religious sensitivities and individual privacy issues are upheld.

This article assesses the realities of sexual harassment (SH) in selected tertiary educational institutions in Ghana. Using multiple data collection techniques, three areas that are related to SH were assessed. These are knowledge of what constitutes SH, the nature and incidence of SH, and strategies/procedures for handling issues of SH in tertiary educational institutions. The findings from the perspective of teaching and non-teaching staff strongly suggest that knowledge of SH was high among teaching staff but low among non-teaching staff. Staff could not relate very well to the reporting systems and procedures of SH in their institutions. Issues of SH were left in the hands of only a few staff while newly recruited staff showed little understanding of the reporting systems and procedures. From the perspective of students, knowledge of what constitutes SH was high. Students were able to indicate the various SH reporting systems/procedures in the tertiary educational institutions and further indicated that the institutions have provided a safe environment and appointed designated people to handle sexual harassment complaints. Surprisingly, the incidence of sexual harassment was low, and this affected sexual harassment reporting.

Intersectionality has significantly enhanced our understanding of how overlapping social identities—such as race, ethnicity, gender, sex, class, and sexual orientation—interact to shape individual experiences. However, despite its theoretical importance, much of the existing literature has relied on qualitative approaches to define and study intersectionality, limiting its application in predictive modeling, comparative analysis, and policy development. This paper introduces the concept of Quantitative Intersectionality Scoring System (QISS), a novel approach that assigns numerical scores to intersecting identities, thereby enabling a more systematic and data-driven analysis of intersectional effects. We argue that QISS can substantially enhance the utility and predictive validity of quantitative models by capturing the complexities of multiple, overlapping social determinants. By presenting concrete examples, such as the varying impacts of socioeconomic mobility on life expectancy among different intersectional groups, we demonstrate how QISS can yield more precise and reliable forecasts. Such a shift would allow policymakers and service providers to dynamically assess economic and health needs, as well as the uncertainties around them, as individuals move through different social and economic contexts. QISS-based models could be more responsive to the complexities of intersecting identities, allowing for a more quantified and nuanced evaluation of policy interventions. We conclude by discussing the challenges of implementing QISS and emphasizing the need for further research to validate these quantifications using robust quantitative methods. Ultimately, adopting QISS has the potential to improve the accuracy of predictive models and the effectiveness of policies aimed at promoting social justice and health equity.

This study is aimed at examining the prevalence of premarital sex among adolescents between 13-19 years within Chorkor, Korle Gonno and Mamprobi communities in the Accra Metropolis. The study with a sample size of 268 used a descriptive approach and a combination of convenient and quota sampling methods. The study recommends the establishment of a school guidance and counselling unit to sensitize and advise students and parental monitoring of adolescent lives and the use of social media on mobile devices.

<b>Objective: </b>Previous research has underscored the link between allostatic load—a comprehensive indicator of the cumulative physiological burden of chronic stress—and depression. However, there remains a significant gap in understanding how this relationship may differ across race and sex intersectional groups. This study aimed to investigate variations in the association between elevated allostatic load (AL>4) and depression among different race-sex intersectional groups within the general population. <b>Methods: </b>This cross-sectional secondary analysis utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 2005-2018. The analysis included variables such as race, sex, age, socioeconomic status, depression (measured via the Patient Health Questionnaire - PHQ), and allostatic load. Linear regression analyses were conducted to examine the interactions between race and sex with allostatic load, focusing on the likelihood of high depression as the outcome. <b>Results: </b>Across the pooled sample, an allostatic load greater than 4 was significantly associated with increased depression. Notably, an interaction effect was observed between race and AL>4 on depression among women, indicating that non-Hispanic Black women with a high allostatic load exhibited more pronounced depressive symptoms (Beta: 1.09, CI: 0.02-2.61). Conversely, among men, allostatic load greater than 4 neither correlated with nor interacted with race to influence depression levels. <b>Conclusion: </b>The study highlights the critical need to consider allostatic load as a key target for interventions that aim to reduce depression among Black women. These findings underscore the necessity for customized intervention strategies that address the nuanced race-sex disparities in the impact of allostatic load on mental health across populations.

This study investigated adolescent students‟ knowledge of sexually transmitted infections (STIs) in eastern region schools for the deaf in Ghana. A descriptive survey design was used for the study. The researchers used HIV- The knowledge Questionnaire to assess the knowledge of respondents on STIs. Stratified sampling and simple random sampling techniques were employed. Proportional representation was used to select a sample of ninety-five (95) adolescent students with deafness from JHS2 and JHS3 between the ages of 13 and 24 years. Data were analyzed descriptively into frequencies and percentages. The results of the study indicated that the students knew of some of the types of STIs such as Gonorrhea, Syphilis, and HIV/AIDS. They, however, had inadequate knowledge of STIs such as Hepatitis B and Chlamydia.

<b>Background:</b> Sexuality is considered to be one of the most significant markers of quality of life. This is due to the fact that sexuality is linked to ideas, feelings, behaviors, social integration, and therefore, a person's physical and mental health and well-being but with patients who have gynecologic cancers, there are significant challenges when it comes to matters of sexuality and intimacy. <b>Aim:</b> To find out how gynecological cancer affects women's sexual experiences and how they express sexuality in the context of their sickness <b>Design:</b> A qualitative synthesis, thematic approach <b>Result:</b> Nineteen (19) eligible studies centered with gynecologic cancers on sexual functioning were included with two (2) main themes emerged: (1) Issues with Sexual Experiences and (2) Physical and Emotional Burden. Many individuals were found to have one or more sexual dysfunctions, which commonly caused distress. <b>Conclusion:</b> Changes in the women’s quality of life in the sexual aspect due to their disease takes a toll not just on the physical but in other facets as well. Better knowledge and patient-centered approaches would improve gynecologic cancer patients' capacity to cope in terms of sexual functioning. <b>Implications:</b> Healthcare professionals such as oncology nurses and doctors should better understand ways to address the sexual problems of their patients following the myriad of events following their diagnosis and treatment of their gynecologic cancers.

Addressing adolescent and sexual reproductive healthcare is essential to providing young patients with the resources they need to navigate and empower themselves with. However, there is limited data about how often this occurs. Several studies have previously indicated that there is a large gap in accessing this gap in low-income neighborhoods. Our study aims to identify the establishment of gynecologic care among adolescent cisgender women and elucidate potential reasons for seeking or not seeking out care. We approached women in the pediatric emergency room that matched the inclusion criteria set out. Qualitative surveys were conducted until thematic saturation was reached and a cross-section study design was employed. Interviews were analyzed through modified ground theory. The study was conducted at the pediatric emergency department at University Hospital located in Newark, NJ. In 2018 estimates, the Newark population consists of 47.0% Black and 39.2% Hispanic or Latinos. Semi-structured interviews were conducted with 27 cisgendered, English-speaking females between ages 18 to 25 presenting to the pediatric emergency room who may or may not have previously established primary care with a gynecologist. Transcriptions were analyzed using modified grounded theory and themes were identified using inductive coding of patient interviews.

Alpha emitters in internal contamination are the main cause of homosexuality. There is a pattern that can be identified and described precisely as a hormone cloning process, after initial loss from alpha emitters of testosterone, and development of a painkilling effect through steroid accumulation with sodomy feeding development of steroidogenic cells. This altogether explains how homosexuality becomes a self-refeeding bubble. A treatment method is proposed at the end to break the cycle and help the subject return into heterosexuality.

The purpose of this study was to assess the influence of sex education on the sexual behaviour of adolescents in Senior and Junior High Schools in the New Juaben Municipality. A cross-sectional research design was adopted for the study. The population of the study are adolescents in Junior and Senior High Schools in New Juaben Municipality. A random sampling technique was used to select two-hundred and fifty (250) respondents from two Junior High Schools and two Senior High Schools in New Juaben Municipality. The main instrument used for data collection was a questionnaire. Both inferential and descriptive statistics were used to analyse the data. The study indicated that sex education (in terms of HIV/AIDS education) has had a significant influence (impact) on sexual behaviours. The positive sexual behaviours of adolescent in Junior and Senior High Schools is evident in their attitude toward premarital sex. The study also revealed that adolescents exhibited a positive attitude toward premarital sex and abstaining from sex that will make them sick or look odd in society, neither would it give them problems during intercourse when they finally marry. It is recommended that Parents should ensure that their children receive more sex education to offset the negative influences of the media. It is also recommended that Government may also consider replicating the popular nationwide Science and Mathematics quiz in the area of adolescent sexual behaviour and reproductive health in SHS and JHS to increase the awareness of students about appropriate adolescents’ sexual behaviours and reproductive health issues.

<b>Background:</b> Psoriasis is extensively studied among middle-aged adults, but not many have studied psoriasis in older adults(geriatrics). OBJECTIVES: To analyze epidemiological, clinical, comorbidities and therapeutic profile of geriatric psoriasis(GP). METHODS: All consenting clinically diagnosed psoriatic patients ≥60 years were divided into two groups: Elderly psoriatic(EP)(60-75 years) and Ultra elderly psoriatic(UP)(>75 years). The dermatologist filled their clinical characteristics’ standardised questionnaire to determine comorbidities, drug interactions profile and compared with age-matched controls using Chi square test. RESULTS: Prevalence of GP is 14.5%(Average age:68 years; Sex ratio=2.5:1)among geriatrics attending dermatology OPD. Most common(49.9%) as well as initial site affected(39.3%) were Palms±Soles. Nummular plaque (90.2%) was most common type. Superficial fungal infection(26.9%) and pruritus(90.8%) were commonly associated cutaneous disease and symptom(p<0.05) respectively. Hypertension(49.7%),Diabetes Mellitus(22.8%), dyslipidemia(25.8%) and Metabolic syndrome(MS)(17.8%) were associated systemic comorbidities. Dyslipidemia and MS(p<0.0001) were more common among GP(163) than controls(963). Drug aggravated psoriasis could not be linked to polypharmacy. Although, topicals were mainstay, oral Methotrexate was most efficacious systemically. CONCLUSION: Our findings suggest a trimodal age of psoriasis onset at 68 years. As age advances, psoriasis severity decreases, unstable guttate lesions decrease; palms±soles commonly involved; infrequent familial occurrence with Polypharmacy not aggravating psoriasis. Active screening for cardiovascular comorbidities in all geriatric psoriasis patients is highly recommended.