•Vaccine uptake was significantly higher in foreign-born individuals.•Increased educational attainment was associated with higher vaccine uptake.•There was a difference in vaccine uptake between ...White and Black individuals.•Insurance status did not influence vaccine uptake.
To identify discrepancies in influenza, Tdap, and COVID-19 vaccine uptake and offer rates among pregnant individuals across various social determinants of health including race, ethnicity, foreign-born status, education level, and health insurance coverage, highlighting potential interventions to improve vaccine uptake in pregnancy.
An IRB-approved cross-sectional survey was conducted on the postpartum floor of a large urban hospital in South Florida. Between July to September 2021, 359 participants consented and answered questions on their demographics, social background, and influenza, Tdap, and COVID-19 vaccine history.
Most participants identified as White (67.7 %), Hispanic (67.4 %), and foreign-born (68.5 %) with an average age of 29.7 ± 6 years. There was a significant difference in mean vaccine between White (1.3) and Black individuals (0.9, p = 0.002). Mean uptake was significantly higher in foreign-born individuals (1.3) compared to US-born (0.9, p < 0.001). Mean uptake was significantly higher for those with graduate (1.7) and college (1.4) degrees compared to those with a high school degree (1.0) or less than high school (1.0, p < 0.0001).
Significant differences in the uptake and offer rates of influenza, Tdap, and COVID-19 vaccines were observed across a variety of social determinants including educational attainment, employment, insurance, and median income of the zip code of primary residence.
Synopsis
The rate of COVID‐19 vaccine uptake in pregnant individuals approximately doubled following the release of a US Practice Advisory recommending COVID‐19 immunization in pregnancy.
Tucatinib is a tyrosine kinase inhibitor currently used in salvage therapy for human epidermal growth factor receptor 2 (HER2)-positive breast and colorectal cancer. The use of tucatinib alone or in ...combination with ado-trastuzumab emtansine (T-DM1) in the treatment of advanced HER2-positive cancers is rapidly expanding.
We report the case of a 66-year-old female who presented to the dermatology clinic with a one-year history of widespread telangiectasias that began after initiation of combination chemotherapy with tucatinib and T-DM1 for metastatic HER2-positive invasive ductal carcinoma.
The patient's lesions regressed upon cessation of combination therapy and reappeared in the setting of tucatinib re-initiation, with gradual improvement over the following four months following electrocautery to the affected regions.
We postulate that telangiectasias may be a previously unreported dermatologic side effect of combination treatment with tucatinib and T-DM1. Electrocautery is a safe and effective procedure to reduce the appearance of telangiectasias and improve patient satisfaction during chemotherapy.
Objective
To assess provider attitudes and practices regarding vaccination in pregnancy to discern strategies to increase vaccination rates in pregnancy, given that in the USA, various healthcare ...organizations recommend that pregnant individuals be vaccinated against influenza, pertussis, and SARS‐CoV‐2, but vaccination rates among gravidas remain suboptimal across these vaccines.
Methods
An Institutional Review Board‐approved survey was disseminated to obstetric healthcare providers by email from June through October 2021. Questions assessed provider demographics, attitudes, and practices surrounding vaccination in pregnancy. A total of 192 providers consented, 179 initiated the survey, and 153 completed it entirely. Statistical software (SAS) was used to perform descriptive statistics.
Results
All providers strongly agreed/agreed that all pregnant individuals should receive vaccines in pregnancy. Following patient vaccination consent, 13% reported needing to refer patients to alternative sites for vaccine administration. Following patient vaccination decline, 13% did not determine reasons for refusal, 30% did not re‐counsel at subsequent visits, and 92% did not ask another staff member to counsel the patient.
Conclusion
Despite provider support for maternal immunization, uptake of vaccines in gravidas remains suboptimal, demonstrating a gap between provider recommendations and patient uptake. These data highlight opportunities for intervention regarding counseling and vaccine availability to increase vaccine uptake in pregnancy.
Synopsis
US obstetrics providers strongly support vaccination in pregnancy, yet opportunities exist for improvement in counseling, documentation, and administration of vaccines to improve uptake among gravidas.
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More than half of GYO PDs are female (50.8%).
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Female PDs are younger than male PDs (46.4 years vs 51.9 years, p = 0.0014).
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The average number of publications is higher in male PDs than in ...female PDs (97.3 vs 45.8, p = 0.0008).
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While research productivity may be reflective of age, gender-based equity in research time should be further explored.
Our objective was to examine the educational, research, and leadership trends among gynecologic oncology (GYO) fellowship program directors (PD) and how these vary by gender.
PDs were identified using the Society of Gynecologic Oncology Fellowship Directory. Surveys were sent to PDs’ emails to obtain information about demographics, education, and research background. Publicly available data and institutional biographies were used to supplement primary survey data for incomplete responses or survey non-responders. Scopus was used to determine the h-index and number of publications and citations for each PD. Parametric data were compared using unpaired two-tailed t-tests. Chi-square and Fisher’s exact tests were performed for categorical data. The significance level was p < 0.05.
Approximately one-half of PDs were female (50.8%). Female PDs had a younger mean age than male PDs (46.4 years vs 51.9 years, p = 0.0014). The average overall h-index was 22 (SD = 14.5) and the average number of publications was 71.2 (SD = 63.3). The average h-index was higher in male PDs than females (27.8 vs 16.3, p = 0.0012), as were the number of publications (97.3 vs 45.8, p = 0.0008).
Differences exist among GYO PDs by gender. While research productivity may be reflective of age, gender-based equity in research time should be further explored.
Developing effective design solutions requires successful idea generation, development and selection. Studies have demonstrated that engineering students face challenges in these idea phases and may ...struggle to implement recommended practices, hindering the potential for an innovative outcome. The first part of the study investigated student practices in idea generation, development and selection through think-aloud experimental sessions and post-session interviews. Data analysis from mechanical engineering students’ sessions, with think-aloud and interview data, revealed that students focused on existing ideas, assumed requirements that constrained their divergence, limited their development of ideas and did not engage much in idea selection. Then, in the second phase of the study, we implemented a learning intervention that leveraged research-based education practices to examine student adoption of recommended practices. After engaging with the learning blocks, students generated unconventional ideas, abstained from requirement assumptions early in ideation, generated a larger quantity of ideas, developed ideas intentionally and used more rigorous idea selection methods. These outcomes demonstrated that a relatively short and targeted intervention can support students in leveraging recommended approaches to idea generation, development and selection.
Abstract Objective: To determine the occurrence of dental anomalies in patients with special needs from Barranquilla, Colombia. Material and Methods: An observational, cross-sectional descriptive ...study with a sample of 59 patients chosen at convenience for 6 months during the course of 2017. With prior approval by experts, an instrument that identified dental anomalies was applied, followed by an institutional clinical history, intraoral clinical examination and final evaluation of the study variables, with descriptive statistics. Results: With regards to age ranges, 25% of subjects were between 14 to 17 years, and 19% between 22 to 25 years. The average age was 14 (± 7.9). No cases were found in the age range of 26 to 29 years. In terms of gender, males predominated with 78%. The anomaly that predominated was fluorosis (50.8%), followed by agenesis (23.7%). The syndrome and / or disorder with the highest frequency of dental anomalies was mental retardation with 39%, followed by behavioral disorders (22%) Conclusion: The frequency of dental anomalies in patients with special needs was evidenced, showing higher prevalence of dental fluorosis in patients with mental retardation, and a higher incidence in males; in the patients with syndromes and / or disorders who were observed, there were a few oral findings unrelated to dental anomalies.
Humans share sensory systems with a common anatomical blueprint, but individual sensory experience nevertheless varies. In olfaction, it is not known to what degree sensory perception, particularly ...the perception of odor pleasantness, is founded on universal principles,1–5 dictated by culture,6–13 or merely a matter of personal taste.6,8–10,12,14 To address this, we asked 225 individuals from 9 diverse nonwestern cultures—hunter-gatherer to urban dwelling—to rank the monomolecular odorants from most to least pleasant. Contrary to expectations, culture explained only 6% of the variance in pleasantness rankings, whereas individual variability or personal taste explained 54%. Importantly, there was substantial global consistency, with molecular identity explaining 41% of the variance in odor pleasantness rankings. Critically, these universal rankings were predicted by the physicochemical properties of out-of-sample molecules and out-of-sample pleasantness ratings given by a tenth group of western urban participants. Taken together, this shows human olfactory perception is strongly constrained by universal principles.
•Culture plays a minimal role in the perception of odor pleasantness•Individuals within cultures vary as to which odors they find pleasant•Odor pleasantness can be predicted by the physicochemical properties of molecules•Human olfactory perception is strongly constrained by universal principles
Arshamian et al. compare 10 diverse cultures, including hunter-gatherers and horticulturalists, for their perception of odor pleasantness. Contrary to expectations, they find that culture is not a major predictor of odor pleasantness. Instead, there is substantial global consistency, which can be predicted by the physicochemical properties of molecules.
INTRODUCTION:
Immunization plays an essential role in protecting the mother and child dyad from serious illnesses. Despite current recommendations from the American College of Obstetricians and ...Gynecologist, Advisory Committee on Immunization Practices, and Centers for Disease Control and Prevention, vaccination rates in the U.S. are significantly below 100%. The aim of this study is to assess uptake of influenza, Tdap, and COVID-19 vaccination in pregnancy among a culturally diverse population in South Florida.
METHODS:
An institutional review board‒approved cross-sectional survey was administered among inpatient postpartum persons between July and September 2021. The 359 enrolled participants completed a survey assessing basic demographics and vaccination history. Chi-square tests, set at a significance level of
P
<.05, compared uptake of each vaccine by ethnicity and U.S.-born status.
RESULTS:
Of the 359 participants, 67.7% self-identified as White, 67.4% reported Hispanic ethnicity, and 68.5% were non-U.S.-born. Compared to the 2019–2020 national average, Tdap vaccine uptake in this cohort was higher (74.7% versus 56.6%) and influenza vaccine uptake was lower (45.1% versus 61.2%). COVID-19 vaccine uptake during the study period mirrored the national average (18.1% versus 18.9%). Generally, there was higher vaccination uptake among Hispanics and non-U.S.-born individuals. However, a significant difference was only observed for uptake in influenza vaccine between U.S.-born and non-U.S.-born persons (chi-square=11.54,
P
=.0007).
CONCLUSION:
The suboptimal rates of influenza, Tdap, and COVID-19 vaccination seen in this cohort demonstrate the necessity for interventions to improve education about the safety and effectiveness of vaccination in pregnancy. Furthermore, increased efforts to maximize availability and access to vaccines during prenatal care are also needed. Together, these strategies may increase vaccine uptake in pregnancy, especially across diverse populations.
INTRODUCTION:
Immunization against SARS-COV-2 protects pregnant persons from severe COVID-19 illness. Pregnant individuals are less likely (19.2%) to be vaccinated against COVID-19 than their ...non-gravidas counterparts (69.6%). This disparity may be attributed to a lack of knowledge regarding the risks of SARS-COV-2 infection in pregnancy and the benefits and safety of vaccination. This study aims to determine the impact of patients’ self-reported COVID-19 knowledge on COVID-19 vaccination rates during pregnancy.
METHODS:
A total of 359 postpartum patients consented to participate in an institutional review board‒approved cross-sectional survey at an urban academic medical center in Miami, Florida between July and September 2021. Participants self-reported their COVID-19 vaccination status and answered questions to assess their general knowledge regarding COVID-19 infection and its impact on pregnancy, as well as knowledge of current guidelines for vaccination in pregnancy and safety of vaccination in pregnancy and breastfeeding. Correct responses to each item earned 1 point, while incorrect responses detracted 1 point, yielding knowledge scores ranging from –5 to +5.
RESULTS:
The mean knowledge score across participants was 1.7±1.77. Controlling for age and education, a 1-point increase in knowledge score was associated with a 1.6-times increase in the odds of vaccination. There was a monotonic increase in vaccination rates as knowledge score rose (
P
<.001).
CONCLUSION:
The strongly positive correlation between knowledge scores and vaccination emphasizes the vital role that knowledge plays in the decision to be vaccinated for gravida individuals. This elucidates the importance of empowering pregnant persons with reputable and accurate information to increase the likelihood of vaccination in this at-risk population.
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