What Works for Adolescent Reproductive Health: Lessons from Experimental Evaluations of Programs and Interventions

This Child Trends fact sheet reviews evaluated programs that focus on adolescent reproductive health. Among the findings: Many different types of programs have been shown to positively affect reproductive health outcomes. Not only school- and community-based sex education programs, but also clinic-based programs, youth development programs, service-learning programs, early childhood programs, and programs for young mothers have been found to be effective. Comprehensive sex education can improve adolescent reproductive health. Of the 21 comprehensive sex education programs that have been experimentally evaluated, 11 had a significant positive impact on the behavior of the youth studied or important subgroups of the sample. No abstinence-only interventions have yet been shown to positively affect any behavioral outcomes. Six abstinence-only interventions have had their impacts on behavioral outcomes experimentally evaluated. None has had an impact on initiation of sexual intercourse, frequency of sexual activity, number of sexual partners, use of condoms, use of contraceptives, pregnancies, births, or STD contraction. None of these six abstinence-only interventions have been shown to negatively affect any behavioral outcomes, either. In particular, in spite of their exclusive focus on abstinence, none have served to significantly decrease condom or contraceptive use. The fact sheet includes a table that shows whether the evaluated programs were found to work, not proven to work, or had mixed findings

A Micro-Computed Tomographic Assessment of Dentin Removal Following Ultrasonically Activated Irrigation Comparing Stainless Steel and Nickel-Titanium Tips

Introduction: Ultrasonic irrigation is performed to disinfect and debride the canal space, yet little is known about the influence of ultrasonic tip selection and its impact on the surrounding structural components. The aim of this study was to quantitatively evaluate the amount of dentin removed following ultrasonic irrigation using the EndoUltra™ ultrasonic device. We compared this to a Satelec® Aceton® P5 Newtron® XS LED ultrasonic unit, commonly used in our postgraduate clinic at the Medical University of South Carolina. Methods: Thirty mandibular premolars were standardized in length and instrumented to a size 35/04 taper. The teeth were then randomly divided into two groups (n = 15). Group A: 20/02 NSK Varios SS U files; Group B: 15/02 EndoUltra™ NiTi tips. Teeth were scanned following instrumentation using a micro-computed tomographic (micro-CT) device at an isotropic resolution of 16 μm. Ultrasonic irrigation was completed for both Groups using 6% sodium hypochlorite (NaOCl), 17% EDTA and 2% CHX, with 0.9% saline rinse following each irrigating solution. After final irrigation, the teeth were scanned a second time. Three-dimensional models were created to determine volumetric changes in dentin from pre- and post-irrigation scan comparisons. Statistical analysis of data was performed with a Wilcoxon signed-rank test, with significance set at P \u3c.05. Results: Removal of dentin was observed within both Groups. A statistically significant difference (P \u3c.01) in the amount of dentin removed between Group A (Satelec® using a 20/02 SS U file) and Group B (EndoUltra™ 15/02 NiTi tip) following ultrasonic irrigation was observed. Conclusions: Both groups exhibited dentin removal following ultrasonic activation. The EndoUltra™ manufacturer’s claim that their activator tips do not engage or remove tooth structure was disproved

Why do women of low socioeconomic status have poorer dietary behaviours than women of higher socioeconomic status? A qualitative exploration

In developed countries, persons of low socioeconomic status (SES) are generally less likely to consume diets consistent with dietary guidelines. Little is known about the mechanisms that underlie SES differences in eating behaviours. Since women are often responsible for dietary choices within households, this qualitative study investigated factors that may contribute to socioeconomic inequalities in dietary behaviour among women. Semi-structured interviews were conducted with 19 high-, 19 mid- and 18 low- SES women, recruited from Melbourne, Australia, using an area-level indicator of SES. An ecological framework, in which individual, social and environmental level influences on diet were considered, was used to guide the development of interview questions and interpretation of the data. Thematic analysis was undertaken to identify the main themes emerging from the data. Several key influences varied by SES. These included food-related values such as health consciousness, and a lack of time due to family commitments (more salient among higher SES women), as well as perceived high cost of healthy eating and lack of time due to work commitments (more important for low SES women). Reported availability of and access to good quality healthy foods did not differ strikingly across SES groups. Public health strategies aimed at reducing SES inequalities in diet might focus on promoting healthy diets that are low cost, as well as promoting time-efficient food preparation strategies for all women.<br /

THE VALIDATION OF A SWIMMING TURN WALL-CONTACT-TIME MEASUREMENT SYSTEM

The effectiveness of the swimming turn is highly influential to overall performance in competitive swimming. The push-off or wall contact, within the turn phase, is directly involved in determining the speed the swimmer leaves the wall. Therefore, it is paramount to develop reliable methods to measure the wall-contact-time during the turn phase for training and research purposes. The aim of this study was to determine the reliability and concurrent validity of the Pool Pad system to measure wall-contact-time during the turn. Despite measurement differences, the results analyses demonstrated that the Pool Pad is suitable for measuring wall-contact-time within a training environment

Validation of ICD-9-CM diagnosis codes for surgical site infection and noninfectious wound complications after mastectomy

BACKGROUNDFew studies have validated ICD-9-CM diagnosis codes for surgical site infection (SSI), and none have validated coding for noninfectious wound complications after mastectomy.OBJECTIVESTo determine the accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes in health insurer claims data to identify SSI and noninfectious wound complications, including hematoma, seroma, fat and tissue necrosis, and dehiscence, after mastectomy.METHODSWe reviewed medical records for 275 randomly selected women who were coded in the claims data for mastectomy with or without immediate breast reconstruction and had an ICD-9-CM diagnosis code for a wound complication within 180 days after surgery. We calculated the positive predictive value (PPV) to evaluate the accuracy of diagnosis codes in identifying specific wound complications and the PPV to determine the accuracy of coding for the breast surgical procedure.RESULTSThe PPV for SSI was 57.5%, or 68.9% if cellulitis-alone was considered an SSI, while the PPV for cellulitis was 82.2%. The PPVs of individual noninfectious wound complications ranged from 47.8% for fat necrosis to 94.9% for seroma and 96.6% for hematoma. The PPVs for mastectomy, implant, and autologous flap reconstruction were uniformly high (97.5%–99.2%).CONCLUSIONSOur results suggest that claims data can be used to compare rates of infectious and noninfectious wound complications after mastectomy across facilities, even though PPVs vary by specific type of postoperative complication. The accuracy of coding was highest for cellulitis, hematoma, and seroma, and a composite group of noninfectious complications (fat necrosis, tissue necrosis, or dehiscence).Infect Control Hosp Epidemiol 2017;38:334–339</jats:sec

Female identity and the British female ensemble drama 1995-1998

This thesis focuses upon a distinctive form of 'feminine-gendered' fiction, that of the British female ensemble drama, that has proliferated across televisual schedules since the late 1970s and which has received little academic attention. Although not a discrete genre, the female ensemble drama is nevertheless identifiable as a distinctive form of 'feminine-gendered' fiction that is largely written and/or produced by women, which diegetically focuses on particular communities of female characters and which is predominantly aimed at female audiences. The purpose of this text-based analysis of the female ensemble drama is to engage with a central concern of feminist television criticism, that of the gendered identity of this particular media form and the constructions of gender within it given its association with women at these three sites of production, text and audience. While I provide a historical overview of the development of this form of drama in relation to its textual precedents I isolate a particular moment in the history of this form of drama, that of the late 1990s, for closer analysis. Firstly I isolate the late 1990s to provide knowledge and understanding of the way in which the 'feminine' identity of this form of drama has contributed to its academic neglect within this socio-cultural period. Secondly I provide a close textual analysis of the constructions of 'women' within three female ensemble dramas in order to engage with and explore the textual negotiations they embody surrounding discourses of feminism and post feminism, de- and re-traditionalization in this particular period. While these themes have begun to be addressed in feminist television criticism they have largely been explored in relation to constructions of femininity in American dramas. This analysis then, allows for an exploration of these discourses in relation to a regional form of British drama. It is through investigating the academic neglect of this form of drama; providing a historical, thematic and aesthetic overview of the female ensemble drama as well as a detailed analysis of three of the female ensemble dramas of the 1990s that I contribute knowledge and understanding of this particular regional form of 'feminine-gendered' fiction to the field of Feminist Television Studies.sub_mcpaunpub92_ethesesunpu

A central line care maintenance bundle for the prevention of central line–associated bloodstream infection in non–intensive care unit settings

OBJECTIVE: To evaluate a central line care maintenance bundle to reduce central line-associated bloodstream infection (CLABSI) in non-ICU settings. DESIGN: Before-after trial with 12 month follow-up period. SETTING: 1250-bed teaching hospital. PARTICIPANTS: Patients with central lines on eight general medicine wards. Four wards received the intervention and four served as controls. INTERVENTION: A multifaceted catheter care maintenance bundle consisting of educational programs for nurses, update of hospital policies, visual aids, a competency assessment, process monitoring, regular progress reports, and consolidation of supplies necessary for catheter maintenance. RESULTS: Data were collected for 25,542 catheter-days including 43 CLABSI (rate = 1.68 per 1,000 CL-days) and 4,012 catheter dressing observations. Following the intervention, a 2.5% monthly decrease in the CLABSI incidence density was observed on intervention floors, but this was not statistically significant (95% confidence interval (CI); −5.3 – 0.4). On control floors, there was a smaller, but marginally significant decrease in CLABSI incidence during the study (change in monthly rate = −1.1%; 95% CI, −2.1 - −0.1). Implementation of the bundle was associated with improvement in catheter dressing compliance on intervention wards (78.8% compliance pre-intervention vs. 87.9% during intervention/follow-up; p<0.001) but improvement was also observed on control wards (84.9% compliance pre-intervention vs. 90.9% during intervention/follow-up; P = .001). CONCLUSIONS: A multi-faceted program to improve catheter care was associated with improvement in catheter dressing care, but no change in CLABSI rates. Additional study is needed to determine strategies to prevent CLABSI in non-ICU patients

ShopSmart 4 Health - protocol of a skills-based randomised controlled trial promoting fruit and vegetable consumption among socioeconomically disadvantaged women

BackgroundThere is a need for evidence on the most effective and cost-effective approaches for promoting healthy eating among groups that do not meet dietary recommendations for good health, such as those with low incomes or experiencing socioeconomic disadvantage. This paper describes the ShopSmart 4 Health study, a randomised controlled trial conducted by Deakin University, Coles Supermarkets and the Heart Foundation, to investigate the effectiveness and cost-effectiveness of a skill-building intervention for promoting increased purchasing and consumption of fruits and vegetables amongst women of low socioeconomic position (SEP).Methods/designShopSmart 4 Health employed a randomised controlled trial design. Women aged 18&ndash;60 years, holding a Coles store loyalty card, who shopped at Coles stores within socioeconomically disadvantaged neighbourhoods and met low-income eligibility criteria were invited to participate. Consenting women completed a baseline survey assessing food shopping and eating habits and food-related behaviours and attitudes. On receipt of their completed survey, women were randomised to either a skill-building intervention or a wait-list control condition. Intervention effects will be evaluated via self-completion surveys and using supermarket transaction sales data, collected at pre- and post-intervention and 6-month follow-up. An economic evaluation from a societal perspective using a cost-consequences approach will compare the costs and outcomes between intervention and control groups. Process evaluation will be undertaken to identify perceived value and effects of intervention components.DiscussionThis study will provide data to address the currently limited evidence base regarding the effectiveness and cost-effectiveness of skill-building intervention strategies aimed at increasing fruit and vegetable consumption among socioeconomically disadvantaged women, a target group at high risk of poor diets.<br /