Are Rural and Urban Newly Licensed Nurses Different? A Longitudinal Study of a Nurse Residency Programme

Aim This 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. Background Nurse 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. Method A 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 6 months and the end of the programme. Results At 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. Conclusions Differences in these outcomes may be result from unique characteristics of rural vs. urban nursing practice that need further exploration. Implications for nursing management Providing a nurse residency programme in rural and urban hospitals can be a useful recruitment and retention strategy

Influence of Motivation on the Efficacy of Natural Family Planning

Purpose: Mutual motivation is recognized as essential for effective behavioral methods of family planning. Few studies have studied this factor in family planning efficacy. The purpose of this study was to determine the influence of mutual motivation on unintended pregnancy rates of couples who used natural family planning (NFP) methods to avoid pregnancy. Study Design and Methods: Using an online taught NFP method, 358women and ( their male partners) indicated “how much” and “how hard” they wished to avoid pregnancy on a scale of 0-10 before each menstrual cycle charted over 12 month of use. This motivation scale is used in the National Survey of Family Growth as a measure of motivation. All pregnancies were verified with an online pregnancy evaluation and urine based pregnancy test. A combined motivation score was used in analysis. Results: There were 28 pregnancies among the low motivation participants (N=60) and 16 among the high motivation participants (N=298). At 12 months of use, there were 75 pregnancies per 100 users for the low motivation group and only 8 for the high motivation group. There was an 80% greater likelihood of a pregnancy with the low motivation group (χ2 = 25.5, p \u3c .001) OR = 1.80; 95% CI = 1.61-1.90). Clinical Implications: High motivation to avoid pregnancy by both the female user of a behavioral method of family planning and her male partner is required for high efficacy. Assessing motivation of both the woman and her male partner before prescribing NFP methods is recommended

Intra- and inter-examiner Reliability of Direct Facial Soft Tissue Measurements Using Digital Calipers

Background: The objective of this study is to determine if facial soft tissue measurements using digital calipers can be reliably taken by the same examiner and by a large group of examiners. Materials and Methods: Ten examiners performed a set of 18 in-clinic measurements on 10 female and 10 male dental students using a digital caliper twice over a 3-week period. The intra-class correlation coefficient and the Shrout-Fleiss method were used for the statistical analysis. Results: Anthropometric intra-examiner reliability was high for all measurements (none fell below R = 0.934). However, inter-examiner reliability exhibited a wide range of values, some reliable (nasal width at widest nostrils [R = 0.922] and subnasale to upper lip [R = 0.926]), and others unreliable [base of nose (R = 0.590), mouth height (R = 0.585), and soft tissue B point to gnathion (R = 0.623)]. Conclusions: Soft tissue measurements of clearly identifiable points measured by the same examiner produced highly consistent, accurate and reliable measurements. Soft tissue points with poor definition resulted in average-to-poor reliabilities measurements

Investigation of Force Decay in Aesthetic, Fibre-Reinforced Composite Orthodontic Archwires

Background/Objectives: Because 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. Materials/Methods: Quasi 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. Results: Significant (P \u3c 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. Conclusions: The 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. Limitations: Clinical efficacy of the aesthetic, fibre-reinforced composite orthodontic archwires remains to be observed

Randomized Comparison of Two Internet-Supported Fertility Awareness Based Methods of Family Planning

Background: The aim was to compare the efficacy and acceptability of two Internet-supported fertility-awareness-based methods of family planning. Study design: Six 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. Results: The 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 (pb.01) in survival functions. Mean acceptability for both groups increased significantly over time (pb.0001). Continuation rates at 12 months were 40.6% for the monitor group and 36.6% for the mucus group. Conclusion: In 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

The Effect of Water Storage on the Bending Properties of Esthetic, Fiber-Reinforced Composite Orthodontic Archwires

Objective: To 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. Materials and Methods: Align 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. Results: In terms of stiffness and force delivery during activation, in general: beta-titanium was \u3e TorQ B \u3e TorQ A \u3e 0.019 × 0.025-inch NiTi and 0.016-inch SS \u3e Align C \u3e 0.018-inch NiTi \u3e Align B \u3e 0.016-inch NiTi \u3e Align A \u3e 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\u3e .05) affected by water storage. Overall, the alloy wires possessed more consistent force values compared to the composite wires

Dimensional Changes of Upper Airway after Rapid Maxillary Expansion: A Prospective Cone-beam Computed Tomography Study

Introduction: The 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. Methods: Fourteen 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 conebeam 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. Results: After rapid maxillary expansion, significant and equal amounts of 4.8 mm of expansion were observed at the first molar (P 5 0.0000) and the first premolar (P 5 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%) (P 5 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 mm2 (59.6%) after rapid maxillary expansion (P 5 0.0004). Conclusions: These 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

Motor planning brings human primary somatosensory cortex into action-specific preparatory states

Motor planning plays a critical role in producing fast and accurate movement. Yet, the neural processes that occur in human primary motor and somatosensory cortex during planning, and how they relate to those during movement execution, remain poorly understood. Here, we used 7T functional magnetic resonance imaging and a delayed movement paradigm to study single finger movement planning and execution. The inclusion of no-go trials and variable delays allowed us to separate what are typically overlapping planning and execution brain responses. Although our univariate results show widespread deactivation during finger planning, multivariate pattern analysis revealed finger-specific activity patterns in contralateral primary somatosensory cortex (S1), which predicted the planned finger action. Surprisingly, these activity patterns were as informative as those found in contralateral primary motor cortex (M1). Control analyses ruled out the possibility that the detected information was an artifact of subthreshold movements during the preparatory delay. Furthermore, we observed that finger-specific activity patterns during planning were highly correlated to those during execution. These findings reveal that motor planning activates the specific S1 and M1 circuits that are engaged during the execution of a finger press, while activity in both regions is overall suppressed. We propose that preparatory states in S1 may improve movement control through changes in sensory processing or via direct influence of spinal motor neurons

Spinal stretch reflexes support efficient hand control

© 2019, The Author(s), under exclusive licence to Springer Nature America, Inc. Motor behaviour is most efficiently controlled by correcting only disturbances that influence task success. It is currently thought that such control is computed within a transcortical feedback pathway. Here we show that, for postural hand control, even the fastest spinal feedback pathway can produce efficient corrective responses, forcing a re-evaluation of how the nervous system derives the control laws that support motor behavior