Caregivers\u27 Comprehension of the Terms Decay and Cavities: A Qualitative Analysis

Purpose: Tooth decay and cavities are the most common oral health consequences for young children that may result from inadequate oral health literacy (OHL) or understanding of their caregivers. The purpose of this study was to describe the understanding of terms related to decay and cavities among caregivers of preschool-aged children. Methods: English-speaking caregivers with children aged(OH-LIP). Responses were recorded, transcribed, coded, and assigned to domains and categories. Results: Responses from 111 participants were included in the analysis. About one fifth of the participants (19.8%, n=22) indicated that they did not know what decay was or provided an incorrect response. The majority (71.2%, n=79) made the association that decay was something bad that happens to the teeth. However only a minority of the participants (9%, n=10) correctly identified decay as destruction of the tooth surface because of bacterial action. When asked to define the word cavities, more than half (68.5%) indicated that cavities were something harmful to teeth, while only about one quarter (27%, n=30) correctly identified cavities as resulting from the decay process. Conclusion: Knowledge disparities related to the terms decay and cavities among caregivers suggest that more education is needed regarding the tooth decay process and factors causing dental caries to ensure timely preventive services are received. Gaps in oral health literacy should be addressed by health care professionals. Dental hygienists are in an ideal position to educate caregivers as well as non-dental health care professionals who provide services to caregivers and children

The influence of cultural-linguistic background on family and SLP perceptions of pragmatic communication skills following right-hemisphere stroke

Pragmatic communication abilities are frequently impaired in persons who have had a right-hemisphere stroke. Speech-language pathologists (SLPs) often supplement their own pragmatic communication assessment ratings with ratings from the patients’ family members. These ratings, by both SLPs and family members, are likely to be biased by their respective cultural-linguistic backgrounds. The pragmatic communication ratings of Caucasian SLPs were compared with Caucasian and African-American families’ ratings for patients following right-hemisphere stroke. SLPs’ ratings agreed more closely with Caucasian families, but not to a degree that reached statistical significance. The nature of this agreement regarding specific pragmatic communication behaviors, as well as clinical implications, are discussed

Perceptions of Mailed HPV Self-testing Among Women at Higher Risk for Cervical Cancer

Whether human papillomavirus (HPV) self-testing can expand access to cervical cancer screening will depend on making the test accessible and acceptable to higher-risk women. To evaluate a novel delivery mode, we mailed HPV self-test kits to low-income, under-screened women and assessed their perceptions of self-testing and cervical cancer prevention

The Mental Health of War?damaged Populations

Summaries This article draws upon the psychiatric, psycho?analytic and anthropological literature to show that we know very little about the psychological consequences of war and upheaval in the non?Western world. The small amount we do know suggests that while suffering is often intense, many of the therapeutic responses on offer are inappropriate as they are informed by psychiatric and psycho?analytic thought and practice which have little relevance to the majority of people living in the non?Western world

Implementation of a provider-focused intervention for maximizing human papillomavirus (HPV) vaccine uptake in young cancer survivors receiving follow-up care in pediatric oncology practices: Protocol for a cluster-randomized trial of the HPV PROTECT intervention

BACKGROUND: Childhood cancer survivors are at high risk for developing new cancers (such as cervical and anal cancer) caused by persistent infection with the human papillomavirus (HPV). HPV vaccination is effective in preventing the infections that lead to these cancers, but HPV vaccine uptake is low among young cancer survivors. Lack of a healthcare provider recommendation is the most common reason that cancer survivors fail to initiate the HPV vaccine. Strategies that are most successful in increasing HPV vaccine uptake in the general population focus on enhancing healthcare provider skills to effectively recommend the vaccine, and reducing barriers faced by the young people and their parents in receiving the vaccine. This study will evaluate the effectiveness and implementation of an evidence-based healthcare provider-focused intervention (HPV PROTECT) adapted for use in pediatric oncology clinics, to increase HPV vaccine uptake among cancer survivors 9 to 17 years of age. METHODS: This study uses a hybrid type 1 effectiveness-implementation approach. We will test the effectiveness of the HPV PROTECT intervention using a stepped-wedge cluster-randomized trial across a multi-state sample of pediatric oncology clinics. We will evaluate implementation (provider perspectives regarding intervention feasibility, acceptability and appropriateness in the pediatric oncology setting, provider fidelity to intervention components and change in provider HPV vaccine-related knowledge and practices [e.g., providing vaccine recommendations, identifying and reducing barriers to vaccination]) using a mixed methods approach. DISCUSSION: This multisite trial will address important gaps in knowledge relevant to the prevention of HPV-related malignancies in young cancer survivors by testing the effectiveness of an evidence-based provider-directed intervention, adapted for the pediatric oncology setting, to increase HPV vaccine initiation in young cancer survivors receiving care in pediatric oncology clinics, and by procuring information regarding intervention delivery to inform future implementation efforts. If proven effective, HPV PROTECT will be readily disseminable for testing in the larger pediatric oncology community to increase HPV vaccine uptake in cancer survivors, facilitating protection against HPV-related morbidities for this vulnerable population. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04469569, prospectively registered on July 14, 2020

Type I Interferon: Potential Therapeutic Target for Psoriasis?

Background: Psoriasis is an immune-mediated disease characterized by aberrant epidermal differentiation, surface scale formation, and marked cutaneous inflammation. To better understand the pathogenesis of this disease and identify potential mediators, we used whole genome array analysis to profile paired lesional and nonlesional psoriatic skin and skin from healthy donors. Methodology/Principal Findings: We observed robust overexpression of type I interferon (IFN)–inducible genes and genomic signatures that indicate T cell and dendritic cell infiltration in lesional skin. Up-regulation of mRNAs for IFN-a subtypes was observed in lesional skin compared with nonlesional skin. Enrichment of mature dendritic cells and 2 type I IFN–inducible proteins, STAT1 and ISG15, were observed in the majority of lesional skin biopsies. Concordant overexpression of IFN-c and TNF-a–inducible gene signatures occurred at the same disease sites. Conclusions/Significance: Up-regulation of TNF-a and elevation of the TNF-a–inducible gene signature in lesional skin underscore the importance of this cytokine in psoriasis; these data describe a molecular basis for the therapeutic activity of anti–TNF-a agents. Furthermore, these findings implicate type I IFNs in the pathogenesis of psoriasis. Consistent and significant up-regulation of type I IFNs and their associated gene signatures in psoriatic skin suggest that type I IFNs may b

Limited Neutralizing Antibody Specificities Drive Neutralization Escape in Early HIV-1 Subtype C Infection

We previously showed that HIV-1 subtype C viruses elicit potent but highly type-specific neutralizing antibodies (nAb) within the first year of infection. In order to determine the specificity and evolution of these autologous nAbs, we examined neutralization escape in four individuals whose responses against the earliest envelope differed in magnitude and potency. Neutralization escape occurred in all participants, with later viruses showing decreased sensitivity to contemporaneous sera, although they retained sensitivity to new nAb responses. Early nAb responses were very restricted, occurring sequentially and targeting only two regions of the envelope. In V1V2, limited amino acid changes often involving indels or glycans, mediated partial or complete escape, with nAbs targeting the V1V2 region directly in 2 cases. The alpha-2 helix of C3 was also a nAb target, with neutralization escape associated with changes to positively charged residues. In one individual, relatively high titers of anti-C3 nAbs were required to drive genetic escape, taking up to 7 weeks for the resistant variant to predominate. Thereafter titers waned but were still measurable. Development of this single anti-C3 nAb specificity was associated with a 7-fold drop in HIV-1 viral load and a 4-fold rebound as the escape mutation emerged. Overall, our data suggest the development of a very limited number of neutralizing antibody specificities during the early stages of HIV-1 subtype C infection, with temporal fluctuations in specificities as escape occurs. While the mechanism of neutralization escape appears to vary between individuals, the involvement of limited regions suggests there might be common vulnerabilities in the HIV-1 subtype C transmitted envelope

MUSiC : a model-unspecific search for new physics in proton-proton collisions at root s=13TeV

Results of the Model Unspecific Search in CMS (MUSiC), using proton-proton collision data recorded at the LHC at a centre-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 35.9 fb(-1), are presented. The MUSiC analysis searches for anomalies that could be signatures of physics beyond the standard model. The analysis is based on the comparison of observed data with the standard model prediction, as determined from simulation, in several hundred final states and multiple kinematic distributions. Events containing at least one electron or muon are classified based on their final state topology, and an automated search algorithm surveys the observed data for deviations from the prediction. The sensitivity of the search is validated using multiple methods. No significant deviations from the predictions have been observed. For a wide range of final state topologies, agreement is found between the data and the standard model simulation. This analysis complements dedicated search analyses by significantly expanding the range of final states covered using a model independent approach with the largest data set to date to probe phase space regions beyond the reach of previous general searches.Peer reviewe