HPV Vaccination Knowledge, Attitudes, and Uptake in College Nursing Students

Background: The human papillomavirus (HPV) is a preventable, sexually transmitted infection. The vaccines for HPV are safe and effective, but previous research demonstrated that nursing students have low knowledge levels and vaccine uptake. Low knowledge and attitude levels in nurses and nurse practitioners can influence parental and patient decision making for HPV vaccination. Purpose: The purpose of this scholarly project was to evaluate HPV knowledge and attitudes and their association with vaccination uptake in college nursing students. There is limited research in the United States on HPV knowledge, attitudes, and uptake of the vaccine among nursing students. Methods: This project was a replication study utilizing an anonymous, cross-sectional, online survey methodology to measure the HPV knowledge, attitudes, and uptake of the vaccine in nursing students. The survey was given to a convenience sample of undergraduate and graduate nursing students (n = 447) at a private, liberal arts university. Results: Nursing students had high knowledge and attitude scores. While there were no significant differences between knowledge between genders (p = .59), there were differences in knowledge between undergraduate and graduate students (p \u3c .001). There were no differences in attitude between genders and student classification. Knowledge was not associated with uptake (p = .63), but there was an association between attitudes and uptake (p Conclusion:This study supported that nursing students have high knowledge and attitude levels towards HPV and HPV vaccination, which may lead to improved vaccination uptake in the future

“Doctors are in the best position to know…”: The perceived medicalization of contraceptive method choice in Ibadan and Kaduna, Nigeria

Objectives The medicalization and clinic-based distribution of contraceptive methods have been criticized as barriers to increasing levels of contraceptive use in Nigeria and other settings; however, our understanding of how clients themselves perceive the contraceptive method decision-making process is very limited. Methods Focus group discussions among men and women in Ibadan and Kaduna, Nigeria, were used to examine attitudes and norms surrounding contraceptive method decision-making in September and October of 2010. Results Choosing a family planning method was presented as a medical decision: best done by a doctor who conducts clinical tests on the client to determine the best, side effect free, contraceptive method for each client. An absolute trust in health professionals, hospitals, and governments to provide safe contraception was evident. Conclusion The level of medicalization placed on contraceptive method choice by urban Nigerians is problematic, especially since a test that can determine what contraceptive methods will cause side effects in an individual does not exist, and side effects often do occur with contraceptive method use. Practice implications Provider and client education approaches would help to improve client involvement in contraceptive decision-making and method choice

Joanna C. Colcord Correspondence

Entries include a typed letter of book gift presentation on personal stationery, a printed biography, an article from Yachting about sea terms with a glossary, typed letters on Charity Organization Department of the Russell Sage Foundation stationery, a handwritten letter on illustrated stationery, and a typed letter from her brother Lincoln on Penobscot Marine Museum stationery

Directly Measured Denitrification Reveals Oyster Aquaculture and Restored Oyster Reefs Remove Nitrogen at Comparable High Rates

Coastal systems are increasingly impacted by over-enrichment of nutrients, which has cascading effects for ecosystem functioning. Oyster restoration and aquaculture are both hypothesized to mitigate excessive nitrogen (N) loads via benthic denitrification. The degree to which these management activities perform similar functions for removing N, however, has not been extensively examined in New England, a place where nutrient runoff is high and increasing oyster (Crassostrea virginica) restoration and aquaculture activity is taking place. Here, we use a novel in situ methodology to directly measure net N2 and O2 fluxes across the sediment-water interface in a shallow (~1 m) coastal pond in southern Rhode Island. We collected data seasonally during 2013 and 2014 at restored oyster reefs, oyster aquaculture, oyster cultch (shell), and bare sediment. Restored oyster reefs and aquaculture had the highest mean (±SE) denitrification rates, 581.9 (±164.2) and 346 (±168.6) μmol N2−N m−2 h−1, respectively, and are among the highest recorded for oyster-dominated environments. Denitrification rates at sites with oyster cultch were 60.9 (±44.3) μmol N2−N m−2 h−1, which is substantially less than the sites with active oysters but still more than 50% higher than denitrification rates measured in bare sediment (24.4 ± 10.1 μmol N2–N m−2 h−1). The increase in denitrification rates at treatments, however, varied by season and the greatest rates for restored reefs were in the fall. Overall, the greatest aggregate denitrification rates occurred in the fall. Sediment oxygen demand (SOD) followed similar patterns but with greater overall rates in the summer, and displayed a strong linear relationship with denitrification (R2 = 0.93). Our results demonstrate that habitats associated with live oysters have higher net denitrification rates and that oyster reef restoration and oyster aquaculture may provide similar benefits to the ecosystem in terms of N removal. However, gas fluxes may also be affected where three-dimensional structure is introduced via oyster shell cultch and this appears to be seasonally-dependent. These data will be important for managers as they incorporate oysters into nutrient reduction strategies and consider system-level trade-offs in services provided by oyster reef restoration and aquaculture activities

Directly Measured Denitrification Reveals Oyster Aquaculture and Restored Oyster Reefs Remove Nitrogen at Comparable High Rates

Coastal systems are increasingly impacted by over-enrichment of nutrients, which has cascading effects for ecosystem functioning. Oyster restoration and aquaculture are both hypothesized to mitigate excessive nitrogen (N) loads via benthic denitrification. The degree to which these management activities perform similar functions for removing N, however, has not been extensively examined in New England, a place where nutrient runoff is high and increasing oyster (Crassostrea virginica) restoration and aquaculture activity is taking place. Here, we use a novel in situ methodology to directly measure net N2 and O2 fluxes across the sediment-water interface in a shallow (~1 m) coastal pond in southern Rhode Island. We collected data seasonally during 2013 and 2014 at restored oyster reefs, oyster aquaculture, oyster cultch (shell), and bare sediment. Restored oyster reefs and aquaculture had the highest mean (±SE) denitrification rates, 581.9 (±164.2) and 346 (±168.6) μmol N2−N m−2 h−1, respectively, and are among the highest recorded for oyster-dominated environments. Denitrification rates at sites with oyster cultch were 60.9 (±44.3) μmol N2−N m−2 h−1, which is substantially less than the sites with active oysters but still more than 50% higher than denitrification rates measured in bare sediment (24.4 ± 10.1 μmol N2–N m−2 h−1). The increase in denitrification rates at treatments, however, varied by season and the greatest rates for restored reefs were in the fall. Overall, the greatest aggregate denitrification rates occurred in the fall. Sediment oxygen demand (SOD) followed similar patterns but with greater overall rates in the summer, and displayed a strong linear relationship with denitrification (R2 = 0.93). Our results demonstrate that habitats associated with live oysters have higher net denitrification rates and that oyster reef restoration and oyster aquaculture may provide similar benefits to the ecosystem in terms of N removal. However, gas fluxes may also be affected where three-dimensional structure is introduced via oyster shell cultch and this appears to be seasonally-dependent. These data will be important for managers as they incorporate oysters into nutrient reduction strategies and consider system-level trade-offs in services provided by oyster reef restoration and aquaculture activities

Inadequate Birth Spacing is Perceived as Riskier than All Family Planning Methods, Except Sterilization and Abortion, in a Qualitative Study among Urban Nigerians

Background Fertility is high in Nigeria and contraceptive use is low. Little is known about how urban Nigerians perceive the risk of contraceptive use in relation to pregnancy and birth. This study examines and compares the risk perception of family planning methods and pregnancy related scenarios among urban Nigerians. Methods A total of 26 focus group discussions with 243 participants were conducted in September and October 2010 in Ibadan and Kaduna. The groups were stratified by sex, age, family planning use, and city. Study participants were asked to identify the risk associated with six different family planning methods and four pregnancy related risks. The data were coded in ATLAS.ti 6 and analyzed using the thematic content analysis approach. Results The ten family planning and pregnancy related items ranked as follows from most to least risky: sterilization, abortion, getting pregnant soon after having a baby (no birth spacing), pill, IUD, injectable, having a birth under 18 years of age (teenage motherhood), condom use, having six children, and fertility awareness methods. Risk of family planning methods was often categorized in terms of side effects and complications. Positive perceptions of teenage motherhood and having many children influenced the low ranking of these items. Conclusion Inadequate birth spacing was rated as more risky than all contraceptive methods and pregnancy related events except for sterilization and abortion. Some of the participants’ risk perceptions of contraceptives and pregnancy related scenarios does not correspond to actual risk of methods and practices. Instead, the items’ perceived riskiness largely correspond with prevailing social norms. However, there was a high level of understanding of the risks of inadequate birth spacing. Trial registration Number: This study is not a randomized control trial so the study has not been registered as such

How different data sources and definitions of neighbourhood influence the association between food outlet availability and body mass index: a cross-sectional study.

Inconsistencies in methodologies continue to inhibit understanding of the impact of the environment on body mass index (BMI). To estimate the effect of these differences, we assessed the impact of using different definitions of neighbourhood and data sets on associations between food outlet availability within the environment and BMI. Previous research has not extended this to show any differences in the strength of associations between food outlet availability and BMI across both different definitions of neighbourhood and data sets. Descriptive statistics showed differences in the number of food outlets, particularly other food retail outlets between different data sets and definitions of neighbourhood. Despite these differences, our key finding was that across both different definitions of neighbourhood and data sets, there was very little difference in size of associations between food outlets and BMI. Researchers should consider and transparently report the impact of methodological choices such as the definition of neighbourhood and acknowledge any differences in associations between the food environment and BMI

Genomic risk scores for juvenile idiopathic arthritis and its subtypes

Objectives: Juvenile idiopathic arthritis (JIA) is an autoimmune disease and a common cause of chronic disability in children. Diagnosis of JIA is based purely on clinical symptoms, which can be variable, leading to diagnosis and treatment delays. Despite JIA having substantial heritability, the construction of genomic risk scores (GRSs) to aid or expedite diagnosis has not been assessed. Here, we generate GRSs for JIA and its subtypes and evaluate their performance. Methods: We examined three case/control cohorts (UK, US-based and Australia) with genome-wide single nucleotide polymorphism (SNP) genotypes. We trained GRSs for JIA and its subtypes using lasso-penalised linear models in cross-validation on the UK cohort, and externally tested it in the other cohorts. Results: The JIA GRS alone achieved cross-validated area under the receiver operating characteristic curve (AUC)=0.670 in the UK cohort and externally-validated AUCs of 0.657 and 0.671 in the US-based and Australian cohorts, respectively. In logistic regression of case/control status, the corresponding odds ratios (ORs) per standard deviation (SD) of GRS were 1.831 (1.685 to 1.991) and 2.008 (1.731 to 2.345), and were unattenuated by adjustment for sex or the top 10 genetic principal components. Extending our analysis to JIA subtypes revealed that the enthesitis-related JIA had both the longest time-to-referral and the subtype GRS with the strongest predictive capacity overall across data sets: AUCs 0.82 in UK; 0.84 in Australian; and 0.70 in US-based. The particularly common oligoarthritis JIA also had a GRS that outperformed those for JIA overall, with AUCs of 0.72, 0.74 and 0.77, respectively. Conclusions: A GRS for JIA has potential to augment clinical JIA diagnosis protocols, prioritising higher-risk individuals for follow-up and treatment. Consistent with JIA heterogeneity, subtype-specific GRSs showed particularly high performance for enthesitis-related and oligoarthritis JIA

Epigenetic dysregulation of naive CD4+ T-cell activation genes in childhood food allergy

Food allergy poses a significant clinical and public health burden affecting 2–10% of infants. Using integrated DNA methylation and transcriptomic profiling, we found that polyclonal activation of naive CD4+ T cells through the T cell receptor results in poorer lymphoproliferative responses in children with immunoglobulin E (IgE)-mediated food allergy. Reduced expression of cell cycle-related targets of the E2F and MYC transcription factor networks, and remodeling of DNA methylation at metabolic (RPTOR, PIK3D, MAPK1, FOXO1) and inflammatory genes (IL1R, IL18RAP, CD82) underpins this suboptimal response. Infants who fail to resolve food allergy in later childhood exhibit cumulative increases in epigenetic disruption at T cell activation genes and poorer lymphoproliferative responses compared to children who resolved food allergy. Our data indicate epigenetic dysregulation in the early stages of signal transduction through the T cell receptor complex, and likely reflects pathways modified by gene–environment interactions in food allergy