Jessica E. Pruszynski

Influenza Vaccine Effectiveness Against 2009 Pandemic Influenza A(H1N1) Virus Differed by Vaccine Type During 2013–2014 in the United States

BACKGROUNDnThe predominant strain during the 2013-2014 influenza season was 2009 pandemic influenza A(H1N1) virus (A[H1N1]pdm09). This vaccine-component has remained unchanged from 2009.nnnMETHODSnThe US Flu Vaccine Effectiveness Network enrolled subjects aged ≥6 months with medically attended acute respiratory illness (MAARI), including cough, with illness onset ≤7 days before enrollment. Influenza was confirmed by reverse-transcription polymerase chain reaction (RT-PCR). We determined the effectiveness of trivalent or quadrivalent inactivated influenza vaccine (IIV) among subjects ages ≥6 months and the effectiveness of quadrivalent live attenuated influenza vaccine (LAIV4) among children aged 2-17 years, using a test-negative design. The effect of prior receipt of any A(H1N1)pdm09-containing vaccine since 2009 on the effectiveness of current-season vaccine was assessed.nnnRESULTSnWe enrolled 5999 subjects; 5637 (94%) were analyzed; 18% had RT-PCR-confirmed A(H1N1)pdm09-related MAARI. Overall, the effectiveness of vaccine against A(H1N1)pdm09-related MAARI was 54% (95% confidence interval [CI], 46%-61%). Among fully vaccinated children aged 2-17 years, the effectiveness of LAIV4 was 17% (95% CI, -39% to 51%) and the effectiveness of IIV was 60% (95% CI, 36%-74%). Subjects aged ≥9 years showed significant residual protection of any prior A(H1N1)pdm09-containing vaccine dose(s) received since 2009, as did children <9 years old considered fully vaccinated by prior season.nnnCONCLUSIONSnDuring 2013-2014, IIV was significantly effective against A(H1N1)pdm09. Lack of LAIV4 effectiveness in children highlights the importance of continued annual monitoring of effectiveness of influenza vaccines in the United States.

Dimensional changes of upper airway after rapid maxillary expansion: A prospective cone-beam computed tomography study

INTRODUCTIONnThe aim of this prospective study was to use cone-beam computed tomography to assess the dimensional changes of the upper airway in orthodontic patients with maxillary constriction treated by rapid maxillary expansion.nnnMETHODSnFourteen orthodontic patients (mean age, 12.9 years; range, 9.7-16 years) were recruited. The patients with posterior crossbite and constricted maxilla were treated with rapid maxillary expansion as the initial part of their comprehensive orthodontic treatments. Before and after rapid maxillary expansion cone-beam computed tomography scans were taken to measure the retropalatal and retroglossal airway changes in terms of volume, and sagittal and cross-sectional areas. The transverse expansions by rapid maxillary expansion were assessed between the midlingual alveolar bone plates at the maxillary first molar and first premolar levels. The measurements of the before and after rapid maxillary expansion scans were compared by using paired t tests with the Bonferroni adjustment for multiple comparisons.nnnRESULTSnAfter rapid maxillary expansion, significant and equal amounts of 4.8 mm of expansion were observed at the first molar (Pxa0= 0.0000) and the first premolar (Pxa0= 0.0000) levels. The width increase at the first premolar level (20.0%) was significantly greater than that at the first molar level (15.0%) (Pxa0= 0.035). As the primary outcome variable, the cross-sectional airway measured from the posterior nasal spine to basion level was the only parameter showing a significant increase of 99.4 mm(2) (59.6%) after rapid maxillary expansion (Pxa0= 0.0004).nnnCONCLUSIONSnThese results confirm the findings of previous studies of the effect of rapid maxillary expansion on the maxilla. Additionally, we found that only the cross-sectional area of the upper airway at the posterior nasal spine to basion level significantly gains a moderate increase after rapid maxillary expansion.

Religiosity and Sexual Risk Behaviors Among Latina Adolescents: Trends from 1995 to 2008

PURPOSEnThe purpose of this study was to determine trends in the influence of religiosity on sexual activity of Latina adolescents in the United States from 1995 to 2008 and to determine if differences existed between the Mexican American and other Latina groups.nnnMETHODSnThe sample comprised the subset of unmarried, 15-21-year-old (mean 17 years) Latina female respondents in the 1995 (n=267), 2002 (n=306), and 2006-2008 (n=400) National Survey of Family Growth (NSFG) datasets. Associations between religiosity (importance of religion and service attendance) and history of ever having sex, number of sex partners, and age of sexual debut were investigated.nnnRESULTSnLess than one half of Latinas in 1995 (44%) and in 2006-2008 (44%) reported that religion was very important to them, whereas in 2002, 50% reported it was important. Only in 1995 did Latinas who viewed religion as very important have a significantly lower level of sexual initiation. In 1995 and in 2006-2008, Latinas who held religion as very important had significantly fewer partners. In all three cohorts, the higher religious importance group had higher virgin survival rates. Across cohorts, approximately one third of respondents reported frequent religious attendance. In all cohorts, frequent attenders were less likely to have had sex, had fewer partners, and had older age at sexual debut. The survival rate as virgins for Mexican origin Latinas was higher in 1995 and 2002 compared to non-Mexican Latinas but was almost the same in 2006-2008.nnnCONCLUSIONSnReligiosity had a protective association with sexual activity among Latina adolescents. The association of importance of religion with sexual activity has diminished from 1995 to 2008, however, whereas the importance of service attendance has remained stable. The influence of religion was more apparent among the Latinas of Mexican origin, but this greater influence also diminished by 2006-2008.

Randomized comparison of two Internet-supported fertility-awareness-based methods of family planning.

BACKGROUNDnThe aim was to compare the efficacy and acceptability of two Internet-supported fertility-awareness-based methods of family planning.nnnSTUDY DESIGNnSix hundred and sixty-seven women and their male partners were randomized into either an electronic hormonal fertility monitor (EHFM) group or a cervical mucus monitoring (CMM) group. Both groups utilized a Web site with instructions, charts and support. Acceptability was assessed online at 1, 3 and 6 months. Pregnancy rates were determined by survival analysis.nnnRESULTSnThe EHFM participants (N=197) had a total pregnancy rate of 7 per 100 users over 12 months of use compared with 18.5 for the CMM group (N=164). The log rank survival test showed a significant difference (p<.01) in survival functions. Mean acceptability for both groups increased significantly over time (p<.0001). Continuation rates at 12 months were 40.6% for the monitor group and 36.6% for the mucus group.nnnCONCLUSIONnIn comparison with the CMM, the EHFM method of family planning was more effective. All users had an increase in acceptability over time. Results are tempered by the high dropout rate.

Are rural and urban newly licensed nurses different? A longitudinal study of a nurse residency programme

AIMnThis study aimed to compare rural and urban nurse residency programme participants personal and job characteristics and perceptions of decision-making, job satisfaction, job stress, nursing performance and organisational commitment over time.nnnBACKGROUNDnNurse residency programmes are an evolving strategy to foster transition to practice for new nurses. However, there are limited data available for programme outcomes particularly for rural nurses.nnnMETHODnA longitudinal design sampled 382 urban and 86 rural newly licensed hospital nurses during a 12-month nurse residency programme. Data were collected at the start of the programme, at 6xa0months and the end of the programme.nnnRESULTSnAt the end of the programme, rural nurses had significantly higher job satisfaction and lower job stress compared with urban nurses. Across all time-periods rural nurses had significantly lower levels of stress caused by the physical work environment and at the end of the programme had less stress related to staffing compared with urban nurses. Perceptions of their organisational commitment and competency to make decisions and perform role elements were similar.nnnCONCLUSIONSnDifferences in these outcomes may be result from unique characteristics of rural vs. urban nursing practice that need further exploration.nnnIMPLICATIONS FOR NURSING MANAGEMENTnProviding a nurse residency programme in rural and urban hospitals can be a useful recruitment and retention strategy.

A theater intervention to prevent teen dating violence for Mexican-American middle school students.

PURPOSEnTo test a theater intervention designed to raise awareness of the dynamics and consequences of teen dating violence (TDV) and to facilitate creation of nonviolent responses to TDV among Latino and Latina adolescents. The intervention was based on Theater of the Oppressed, which advocates the use of theater methods to explore social issues and to allow audiences to experiment with problem-solving, thereby promoting change.nnnMETHODSnThis study used a pretest-posttest, no control group, mixed-measures design to study 66 Mexican-American adolescents (mean age, 13.4 ± 5 years). Two plays containing subtle and overt signs of control and abuse were written and performed. Scripts were based on data from prior studies of TDV among Latino and Latina adolescents. At baseline, we measured sociodemographics, personal safety, and ethnic identity. Pre-post instruments measured acceptance of TDV, confidence to resolve conflicts nonviolently, and intentions to use nonviolent strategies to resolve conflict. We collected qualitative data via essay.nnnRESULTSnAt posttest, participants had less acceptance of TDV (t = -2.08; p < .05), increased confidence to resolve conflicts nonviolently (t = 3.82; p < .001), and higher intentions to use nonviolent strategies (t = 3.35; p = .001). We analyzed 20 essays. Qualitative results provided context for understanding participants changes in attitude, confidence, and nonviolent behavioral intentions.nnnCONCLUSIONSnThis adaptation of Theater of the Oppressed was an effective way to interact with Latino adolescents. In a safe setting, participants vicariously experienced TDV, which facilitated self-reflection and cognitive rehearsal strategies to respond nonviolently to TDV.

An investigation into the mechanical and aesthetic properties of new generation coated nickel-titanium wires in the as-received state and after clinical use.

BACKGROUND/OBJECTIVESnThe purpose of this study was to compare the mechanical, structural, and aesthetic properties of two types of aesthetic coated nickel-titanium (NiTi) wires compared with comparable regular NiTi wires in the as-received state and after clinical use.nnnMATERIALS/METHODSnSixty one subjects were randomly assigned to four groups (N = 61), two groups of coated wires and two groups of comparable, non-coated controls (n = 15/group). The period in the mouth ranged from 4 to 12 weeks after insertion. In total, 121 wires (61 retrieved and 60 as-received) were used in the study. The percentages of coating retention and loss were extrapolated from scans. A brief survey of five questions with three choices was given to all patients. Differential scanning calorimetry (DSC) and three-point bending tests were done on as-received and used wires.nnnRESULTSnThe surface characterization by the percentage of resin remaining indicated that most wires in both test groups lost a significant amount of coating. A patient survey indicated that this was a noticeable feature for patients. DSC analysis of the wires indicated that the metallurgical properties of the coated wires were not similar to the uncoated wires in the as-received condition. Three-point bending results indicate a wide variation in test results with large standard deviations among all the groups.nnnLIMITATIONSnThe extent of coating loss requires investigating, as do the biological properties of the detached coating.nnnCONCLUSIONSnBoth wires lost a significant amount of aesthetic coating after varying periods in the mouth. The metallurgical testing of these findings may indicate that these wires perform differently in the mouth.

The effect of water storage on the bending properties of esthetic, fiber-reinforced composite orthodontic archwires

OBJECTIVEnTo study the effect of water storage on the bending properties of fiber-reinforced composite archwires and compare it to nickel-titanium (NiTi), stainless steel (SS), and beta-titanium archwires.nnnMATERIALS AND METHODSnAlign A, B, and C and TorQ A and B composite wires from BioMers Products, 0.014-, 0.016, and 0.018-inch, and 0.019×0.025-inch NiTi, 0.016-inch SS, and 0.019×0.025-inch beta-titanium archwires were tested (n=10/type/size/condition). A 20-mm segment was cut from each end of the archwire; one end was then stored in water at 37°C for 30 days, while the other was stored dry. The segments were tested using three-point bending to a maximum deflection of 3.1 mm with force monitored during loading (activation) and unloading (deactivation). Statistical analysis was completed via two-way analysis of variance with wire and condition (dry and water-stored) as factors.nnnRESULTSnIn terms of stiffness and force delivery during activation, in general: beta-titanium was >TorQ B>TorQ A>0.019×0.025-inch NiTi and 0.016-inch SS>Align C>0.018-inch NiTi>Align B>0.016-inch NiTi>Align A>0.014-inch NiTi. Water exposure was detrimental to the larger translucent wires (Align B and C, TorQ A and B) because they were more likely to craze during bending, resulting in decreased forces applied at a given deflection. Align A and the alloy wires were not significantly (P>.05) affected by water storage. Overall, the alloy wires possessed more consistent force values compared to the composite wires.nnnCONCLUSIONnEnvironmental conditions are more likely to affect fiber-reinforced composite archwires compared to alloy wires.

Investigation of force decay in aesthetic, fibre-reinforced composite orthodontic archwires.

BACKGROUND/OBJECTIVESnBecause polymer-based materials typically exhibit viscoelastic properties, the objective was to determine if commercially available, aesthetic, fibre-reinforced composite archwires maintain continuous forces without undergoing force decay when deflected continuously.nnnMATERIALS/METHODSnQuasi force decay was evaluated by comparing three-point bending profiles of nickel-titanium (NiTi) and fibre-reinforced composite archwires (BioMers) prior to and after 30 days of continuous deflection of either 1 or 2mm. Paired t-tests or non-parametric signed rank tests were used to statistically compare pre- and post-deflection bending forces. A control group consisting of wires not subject to the 30-day constant deflection was tested to check whether the initial testing altered the second three-point bend test.nnnRESULTSnSignificant (P < 0.01) differences in the pre- and post-deflection deactivation force delivery were most evident in the composite 2mm deflection group and all of the NiTi groups. The composite 2mm deflection group failed to deliver consistent forces as the majority of the wires experienced crazing during the 30-day deflection period. The decrease in force delivery in the NiTi groups may be attributed to the small standard deviations.nnnCONCLUSIONSnThe composite 1mm deflection group demonstrated that fibre-reinforced composite archwires are able to deliver a consistent force after 30 days of deflection. However, the clinical applicability of these fibre-reinforced composite archwires may be limited as they are unable to sustain deflections of 2mm without experiencing crazing and loss of force delivery.nnnLIMITATIONSnClinical efficacy of the aesthetic, fibre-reinforced composite orthodontic archwires remains to be observed.

What can parents do to reduce youth obesity? An initial study with a diverse sample.

The body mass index (BMI) of diverse, low-income fifth grade students (n = 36) was regressed on physical activity (Child Adolescent Activity Log), percentage dietary fat (Food Habits Questionnaire), and the Food/Activity Parenting Practices Questionnaire. The model explained 50% of the variance in student BMI, adjusted R(2) = .50, F (4, 19) = 6.84, p = .001. Students accurately perceived their weight status. Students perception of parenting strategies, along with dietary fat, was significantly associated with their BMI. Parents (n = 14) BMI, not the childs, was associated with the strategies they used. Three parents tested an online authoritative parenting program. Further research is needed.