Socioecological and message framing factors influencing maternal influenza immunization among minority women

Objective

A suboptimal level of seasonal influenza vaccination among pregnant minority women is an intractable public health problem, requiring effective message resonance with this population. We evaluated the effects of randomized exposure to messages which emphasize positive outcomes of vaccination (“gain-frame”), or messages which emphasize negative outcomes of forgoing vaccination (“loss-frame”). We also assessed multilevel social and community factors that influence maternal immunization among racially and ethnically diverse populations.

Study design

Minority pregnant women in metropolitan Atlanta were enrolled in the longitudinal study and randomized to receive intervention or control messages. A postpartum questionnaire administered 30 days postpartum evaluated immunization outcomes following baseline message exposure among the study population. We evaluated key outcomes using bivariate and multivariate analyses.

Results

Neither gain- [OR = 0.5176, (95% CI: 0.203,1.322)] nor loss-framed [OR = 0.5000, 95% CI: (0.192,1.304)] messages were significantly associated with increased likelihood of immunization during pregnancy. Significant correlates of seasonal influenza immunization during pregnancy included healthcare provider recommendation [OR = 3.934, 95% CI: (1.331,11.627)], use of hospital-based practices as primary source of prenatal care [OR = 2.584, 95% CI: (1.091,6.122)], and perceived interpersonal support for influenza immunization [OR = 3.405, 95% CI: (1.412,8.212)].

Conclusion

Dissemination of vaccine education messages via healthcare providers, and cultivating support from social networks, will improve seasonal influenza immunization among pregnant minority women.     

Pre-clinical development of the anti-tumour agent CB 7646, BIS N-(hydroxymethyl) trimethylmelamine,a stable analogue of trimelamol

Formulation difficulties prevented the otherwise promising clinical development of the anti-tumour agent trimelamol (TM; tris-[hydroxymethyl]trimethylmelamine). A synthetic analogue programme resulted in the identification of CB 7646 (bis N-[hydroxymethyl]trimethylmelamine) as a compound with improved stability and favourable formulation characteristics. The in vitro and in vivo activity of CB 7646 was shown to be very similar to that of TM. In addition, curative activities were shown in the PXN/65 human ovarian cancer xenograft and the MX-1 and T-61 human breast cancer xenograft models. The effectiveness of the N-(hydroxymethyl)melamines against platinum-refractory disease was noted in the phase I clinical trial of TM. In line with this finding, the present study confirmed the effective activity of both TM and CB 7646 against various forms of platinum resistance in in vitro models. Curative activity for TM and CB 7646 was seen in the HX110P human ovarian cancer xenograft with acquired carboplatin resistance. Animal studies indicated less neurotoxicity for CB 7646 than for TM. The pharmacokinetic profile of CB 7646 indicated a decreased plasma elimination, indicative of slower in vivo degradation than for TM. CB 7646, therefore, represents a promising candidate for clinical development, designed to supersede TM. © 1996 Wiley-Liss, Inc.     

Assessment of a conceptually informed measure of emotion dysregulation: Evidence of construct validity vis a vis impulsivity and internalizing symptoms in adolescents with ADHD

ObjectivesDespite advances in understanding associations among attention‐deficit hyperactivity disorder (ADHD), emotion dysregulation (ED), and related outcomes, there is incongruity between ADHD‐relevant conceptualizations of ED and available measures of ED. To assess the psychometric properties of a parent‐report questionnaire of ED conceptualized as deficits in the ability to modulate the (a) speed/degree of emotion escalation; (b) expression intensity; and (c) speed/degree of de‐escalation.MethodsParticipants were 209 adolescents with ADHD (78% male; 13.5–17.8 years old [M = 15.2 SD = 0.91]). Questionnaire items were selected from parent‐report scales of ED and oppositional defiant disorder and subjected to exploratory factor analysis (EFA) and validity analyses.ResultsThe EFA revealed two factors, with speed/degree of escalation combined with intensity as factor one, and speed/degree of de‐escalation as factor two. Factor one scores were related to ADHD impulsivity symptoms but not to anxiety and depression symptoms and they remained predictors of impulsivity even in the presence of self‐report ED, evincing convergent, discriminant, and incremental validity. Factor two scores were related to anxiety and depression but not impulsivity, evincing convergent and discriminant validity.ConclusionThese results inform our understanding of ADHD‐relevant ED in adolescence and offer avenues for future research in measurement development, as well as for understanding ED and ADHD‐related impairment.     

Rare genetic diseases affecting skeletal development and oral health disparities among children and adolescents: a pathway analysis

Background: To examine the relationships of rare genetic diseases affecting skeletal development, socio-demographic characteristics, and oral health-related behaviours with dental clinical measures in children and adolescents. Methods: A cross-sectional study paired by age, gender and social class included 61 children and adolescents with osteogenesis imperfecta (n = 40) or mucopolysaccharidoses (n = 21) and those without genetic rare diseases (n = 60). Participants were selected at two referral hospitals for rare genetic diseases in the city of Belo Horizonte, Brazil. Caregivers completed a questionnaire to obtain age, gender, caregiver’s schooling, social class, patterns of dental attendance and duration of breastfeeding. Oral hygiene, dental caries, dental anomalies and malocclusion were assessed through dental examinations. The relationships between variables were estimated through Pathway analysis using the maximum likelihood method. Results: Rare genetic diseases affecting skeletal development were directly associated with dental caries (β = 0.22), dental anomalies (β = 0.36) and malocclusion (β = 0.29). They were also inversely linked to a preventive pattern of dental attendance (β = –0.25). Rare genetic diseases affecting skeletal development were associated with poor oral hygiene (β = 0.28) and shorter breastfeeding duration (β = –0.21). Rare genetic diseases affecting skeletal development were linked indirectly with dental caries, a reduced pattern of dental attendance and poor oral hygiene (β = 0.43). Patterns of dental attendance mediated the link between rare genetic diseases affecting skeletal development and malocclusion (β = –0.05). Conclusion: Rare genetic diseases affecting skeletal development were associated with poor oral health. Patterns of dental attendance and poor oral hygiene mediated the link between rare genetic diseases affecting skeletal development and dental clinical measures.Key words: Dental care for disabled, disabled children, rare diseases, oral health, osteogenesis imperfecta, mucopolysaccharidosis     

18F-labeled FECNT: a selective radioligand for PET imaging of brain dopamine transporters

Fluorine-18 labeled 2beta-carbomethoxy-3beta-(4-chlorophenyl)-8-(2-fluoroethyl)nort ropane (FECNT) was synthesized in the development of a dopamine transporter (DAT) imaging ligand for positron emission tomography (PET). The methods of radiolabeling and ligand synthesis of FECNT, and the results of the in vitro characterization and in vivo tissue distribution in rats and in vivo PET imaging in rhesus monkeys of [18F]FECNT are described. Fluorine-18 was introduced into 2beta-carbomethoxy-3beta-(4-chlorophenyl)-8-(2-fluoroethyl)nort ropane (4) by preparation of 1-[18F]fluoro-2-tosyloxyethane (2) followed by alkylation of 2beta-carbomethoxy-3beta-(4-chlorophenyl)nortropane (3) in 21% radiochemical yield (decay corrected to end of bombardment [EOB]). Competition binding in cells stably expressing the transfected human DAT serotonin transporter (SERT) and norepinephrine transporter (NET) labeled by [3H]WIN 35428, [3H]citalopram, and [3H]nisoxetine, respectively, indicated the following order of DAT affinity: GBR 12909 > CIT > 2beta-carbomethoxy-3beta-(4-chlorophenyl)-8-(3-fluoropropyl) nortropane (FPCT) > FECNT. The affinity of FECNT for SERT and NET was 25- and 156-fold lower, respectively, than for DAT. Blocking studies were performed in rats with a series of transporter-specific agents and demonstrated that the brain uptake of [18F]FECNT was selective and specific for DAT-rich regions. PET brain imaging studies in monkeys demonstrated high [18F]FECNT uptake in the caudate and putamen that resulted in caudate-to-cerebellum and putamen-to-cerebellum ratios of 10.5 at 60 min. [18F]FECNT uptake in the caudate/putamen peaked in less than 75 min and exhibited higher caudate- and putamen-to-cerebellum ratios at transient equilibrium than reported for 11C-WIN 35,428, [11C]CIT/RTI-55, or [18F]beta-CIT-FP. Analysis of monkey arterial plasma samples using high performance liquid chromatography determined that there was no detectable formation of lipophilic radiolabeled metabolites capable of entering the brain. In equilibrium displacement experiments with CIT in rhesus monkeys, radioactivity in the putamen was displaced with an average half-time of 10.2 min. These results indicate that [18F]FECNT is a radioligand that is superior to 11C-WIN 35,428, [11C]CIT/RTI-55, [18F]beta-CIT-FP, and [18F]FPCT for mapping brain DAT in humans using PET.     

Complementary Public Service Announcements as a Strategy for Enhancing the Impact of Health-Promoting Messages in Fictional Television Programs

Research suggests that health-promoting storylines in developed nations’ fictional television programs can have a beneficial impact on viewers’ beliefs, attitudes, intentions, or behaviors. The sizes of the effects are generally modest; however, the audience reach is substantial. Given that many fictional programs may hold the prolonged attention of millions of viewers, it is of value to examine potential strategies for enhancing the persuasive impact of their health-promoting storylines. Complementary public service announcements may be a promising strategy. This randomized experimental study (N = 310) examined the effects of viewing a complementary public service announcement after an organ donation story in an episode of Grey’s Anatomy. Results indicated that the public service announcement enhanced the beneficial impact of the story on viewers’ discussion behavior (about one’s organ donor wishes), discussion intention, and perceived learning. This experimental study is the first to examine the effects of viewing a non-character public service announcement after a health-related storyline in a developed nation’s fictional program compared to viewing the same episode of the program on its own. It is important for future research to examine whether these findings replicate for different health issues and with a nationally representative sample.