Risk Factors For Sexually Transmitted Bacterial and Viral Diseases: Analysis of 2007-2010 NHANES Data

Abstract Background : This study examines factors that are more associated with risk of sexually transmitted bacterial and viral diseases in a representative sample of American adults. Methods : This is a cross sectional study using secondary data from the 2007-2010 National Health and Nutritional Examination Survey (NHANES) data. Statistical Package for the Social Sciences (SPSS) is the software used in analysis of descriptive data and logistic regression models. Univariate logistic regression analyses were performed to determine associations between risk factors and sexually transmitted diseases. Multivariate logistic regression analyses were performed to determine associations between risk factors and sexually transmitted diseases while controlling for confounders. A forward stepwise logistic regression analysis was to determine the best predictors of each type of sexually transmitted diseases. Results : The sample size for the study population is n=9,216. There were four observed risk factors that were significantly associated with both bacterial sexually transmitted diseases as well as viral sexually transmitted diseases at the 0.05 level of probability. Lack of health insurance was associated with 1.66 increased odds of sexually transmitted viral disease compared to 1.55 increased odds seen in sexually transmitted bacterial disease. History of birth control was associated with 2.61 and 1.66 increased odds in sexually transmitted bacterial disease and sexually transmitted viral disease, respectively. Having first sexual encounter in adulthood was associated with 3.01 increased odds in sexually transmitted bacterial disease and 1.72 times increased odds in sexually transmitted viral diseases. Multiple sexual partners was associated with decreased odds in both sexually transmitted bacterial and viral sexually transmitted diseases. Conclusions : The results of this study indicating differences in factors that are associated with sexually transmitted bacteria diseases and sexually transmitted viral diseases provide evidence for developing public health intervention that is based on type of infection. Public health intervention programs that address sex education, effect of IV drug use, the importance of health insurance, the use of birth control, circumcision, and smoking cessation may help to curb the prevalence of both sexually transmitted bacterial and viral infections in at-risk groups

Molding Minds for Peace: A Curriculum for Early Childhood Educators to Teach Peacebuilding Concepts and Skills

The United States is amidst a period of substantial growth in diversity. This diversification along with feelings of anti-immigrant sentiment has also led to an increase in tension and violence. Molding Minds for Peace: A Curriculum for Early Childhood Educators To Teach Peacebuilding Concepts is a project designed to teach early childhood students the skills that they need to peacefully navigate conflict and difference. After exploring literature about early childhood education/development, multicultural education, and peace education, this project provides early childhood educators with six complete lesson plans that are fully ready for implementation. These lessons have been developed in such a way that the outcomes revolve around peace building skills including cultural awareness and understanding, identifying and managing emotions, empathy, conflict resolution, and cooperation. The project also offers limitations and recommendations for implementation

Effects of Systematic Sleep Fragmentation on Tolerance and Threshold in a Pressure Pain Task: Associations with Sustained Attention

Purpose: Pain is amplified following partial sleep deprivation. Pain has not been evaluated after sleep interruption, when total sleep time is preserved. Sleep interruption, also called sleep fragmentation, is ecologically relevant because it is caused by common sleep disorders such as Obstructive Sleep Apnea [OSA], Upper Airway Resistance Syndrome [UARS] and Periodic Limb Movements Disorder [PLMD]. The Sleep Continuity Hypothesis posits that the restorative effects of sleep are related to sleep quality in addition to quantity. With this study, my goal was to evaluate whether sleep fragmentation affected pain threshold and/or tolerance by systematically fragmenting the sleep of otherwise healthy adults.;Methods: Twelve adult female participants without chronic pain or evidence of a sleep disorder underwent a 14-day protocol. Sleep was monitored using actigraphy throughout the study. Participants completed daily morning and evening reaction time tasks to evaluate changes in attention. To measure changes in pain threshold (when a stimulus becomes painful) and tolerance (when a stimulus is no longer tolerable), a pressure-pain task was administered in-lab by a researcher. This test occurred a total of eight times, morning and evening. Participants spent the eighth, ninth and 13th nights in-lab. Night eight was for acclimatization to the research facility [BASE]. To compare pain after experimental sleep fragmentation (every five minutes; [FRAG]) with pain after sham [SHAM], these conditions were assigned pseudo-randomly to nights nine and 13. Three nights of recovery sleep outside the lab occurred between SHAM and FRAG nights.;Results: Sleep interruptions were induced at a rate of 5.2 times per hour, on average, without changing participants\u27 total sleep time. Stage two sleep proportion was higher on fragmentation night. Lapses in vigilance were lower after BASE than other nights. The slowest 10% of reaction times were slower after SHAM than BASE. Overall, reaction time did not reliably differ as a result of fragmentation. Neither pain threshold nor pain tolerance differed as a function of experimental condition.;Conclusions: Systematic sleep fragmentation, particularly of stage two sleep, did not affect reaction time (a measure of sustained attention) or pressure pain (threshold or tolerance). Reaction time was not related to individual-level changes in fragmentation or pain. Future work should aim to establish the minimal fragmentation that engenders a clinical effect (without concomitant hypoxemia) to inform clinical definitions of fragmentation severity

Real-time analysis and display of quantitative measures to track and improve clinical workflow

PURPOSE: Radiotherapy treatment planning is a complex process with multiple, dependent steps involving an interdisciplinary patient care team. Effective communication and real-time tracking of resources and care path activities are key for clinical efficiency and patient safety. MATERIALS AND METHODS: We designed and implemented a secure, interactive web-based dashboard for patient care path, clinical workflow, and resource utilization management. The dashboard enables visualization of resource utilization and tracks progress in a patient\u27s care path from the time of acquisition of the planning CT to the time of treatment in real-time. It integrates with the departmental electronic medical records (EMR) system without the creation and maintenance of a separate database or duplication of work by clinical staff. Performance measures of workflow were calculated. RESULTS: The dashboard implements a standardized clinical workflow and dynamically consolidates real-time information queried from multiple tables in the EMR database over the following views: (1) CT Sims summarizes patient appointment information on the CT simulator and patient load; (2) Linac Sims summarizes patient appointment times, setup history, and notes, and patient load; (3) Task Status lists the clinical tasks associated with a treatment plan, their due date, status and ownership, and patient appointment details; (4) Documents provides the status of all documents in the patients\u27 charts; and (5) Diagnoses and Interventions summarizes prescription information, imaging instructions and whether the plan was approved for treatment. Real-time assessment and quantification of progress and delays in a patient\u27s treatment start were achieved. CONCLUSIONS: This study indicates it is feasible to develop and implement a dashboard, tailored to the needs of an interdisciplinary team, which derives and integrates information from the EMR database for real-time analysis and display of resource utilization and clinical workflow in radiation oncology. The framework developed facilitates informed, data-driven decisions on clinical workflow management as we seek to optimize clinical efficiency and patient safety

Recombinant Simian Varicella Virus-Simian Immunodeficiency Virus Vaccine Induces T and B Cell Functions and Provides Partial Protection against Repeated Mucosal SIV Challenges in Rhesus Macaques

HIV vaccine mediated efficacy, using an expanded live attenuated recombinant varicella virus-vectored SIV rSVV-SIVgag/env vaccine prime with adjuvanted SIV-Env and SIV-Gag protein boosts, was evaluated in a female rhesus macaques (RM) model against repeated intravaginal SIV challenges. Vaccination induced anti-SIV IgG responses and neutralizing antibodies were found in all vaccinated RMs. Three of the eight vaccinated RM remained uninfected (vaccinated and protected, VP) after 13 repeated challenges with the pathogenic SIVmac251-CX-1. The remaining five vaccinated and infected (VI) macaques had significantly reduced plasma viral loads compared with the infected controls (IC). A significant increase in systemic central memory CD4+ T cells and mucosal CD8+ effector memory T-cell responses was detected in vaccinated RMs compared to controls. Variability in lymph node SIV-Gag and Env specific CD4+ and CD8+ T cell cytokine responses were detected in the VI RMs while all three VP RMs had more durable cytokine responses following vaccination and prior to challenge. VI RMs demonstrated predominately SIV-specific monofunctional cytokine responses while the VP RMs generated polyfunctional cytokine responses. This study demonstrates that varicella virus-vectored SIV vaccination with protein boosts induces a 37.5% efficacy rate against pathogenic SIV challenge by generating mucosal memory, virus specific neutralizing antibodies, binding antibodies, and polyfunctional T-cell responses

Predicting reliability through structured expert elicitation with the repliCATS (Collaborative Assessments for Trustworthy Science) process

As replications of individual studies are resource intensive, techniques for predicting the replicability are required. We introduce the repliCATS (Collaborative Assessments for Trustworthy Science) process, a new method for eliciting expert predictions about the replicability of research. This process is a structured expert elicitation approach based on a modified Delphi technique applied to the evaluation of research claims in social and behavioural sciences. The utility of processes to predict replicability is their capacity to test scientific claims without the costs of full replication. Experimental data supports the validity of this process, with a validation study producing a classification accuracy of 84% and an Area Under the Curve of 0.94, meeting or exceeding the accuracy of other techniques used to predict replicability. The repliCATS process provides other benefits. It is highly scalable, able to be deployed for both rapid assessment of small numbers of claims, and assessment of high volumes of claims over an extended period through an online elicitation platform, having been used to assess 3000 research claims over an 18 month period. It is available to be implemented in a range of ways and we describe one such implementation. An important advantage of the repliCATS process is that it collects qualitative data that has the potential to provide insight in understanding the limits of generalizability of scientific claims. The primary limitation of the repliCATS process is its reliance on human-derived predictions with consequent costs in terms of participant fatigue although careful design can minimise these costs. The repliCATS process has potential applications in alternative peer review and in the allocation of effort for replication studies