Determinants of influenza vaccine uptake among pregnant women: Demographics and medical care access.

OBJECTIVE: To investigate how sociodemographic and medical care access variables are associated with influenza vaccine uptake among pregnant women in the USA. METHODS: This is an observational study using 2015-2019 data from the US Behavioral Risk Factor Surveillance System. Pregnant women aged 18-49 years were included. Weighted χ2 tests and weighted logistic regression models were performed using the software SAS. RESULTS: A total of 9149 pregnant women were included, of whom 39.9% received the influenza vaccine. Age, income, education and race/ethnicity were significantly associated with influenza vaccination. The following medical access factors were associated with a higher likelihood of receiving the influenza vaccine: having insurance (odds ratio [OR] 1.43, 95% confidence interval [CI] 1.04-1.97), having had a checkup in the past year (OR 1.69, 95% CI 1.40-2.03), and having a primary care provider (OR 1.45, 95% CI 1.18-1.78). In subgroup analysis by race/ethnicity, non-Hispanic black women had the least difference in influenza vaccine uptake between those with medical care access and those without. CONCLUSION: Our findings suggest that the influenza vaccine uptake level was far from optimal among pregnant women. Influenza vaccine uptake was associated with social demographics and medical care access among pregnant women.

Enhancing community engagement in Patient-Centered Outcomes Research: Equipping learners to thrive in translational efforts.

Community engagement is a critical component of translational research. Innovative educational approaches to support meaningful involvement of stakeholders in clinical research allows for bidirectional learning and greater engagement in translational efforts. Our Penn State Community-Engaged Research Core (CeRC) team has developed an innovative research curriculum for a variety of stakeholders, including patient partners, organizational representatives, and Community Health Workers (CHWs). This brief report will outline unique curricular approaches, guided by adult learning principles, to enhance stakeholder education and engagement in activities. Initial evidence of impact on learning is also reported.

The androgen receptor in bone marrow progenitor cells negatively regulates fat mass.

It is well established that testosterone negatively regulates fat mass in humans and mice; however, the mechanism by which testosterone exerts these effects is poorly understood. We and others have shown that deletion of the androgen receptor (AR) in male mice results in a phenotype that mimics the three key clinical aspects of hypogonadism in human males; increased fat mass and decreased bone and muscle mass. We now show that replacement of the Ar gene specifically in mesenchymal progenitor cells (PCs) residing in the bone marrow of Global-ARKO mice, in the absence of the AR in all other tissues (PC-AR Gene Replacements), completely attenuates their increased fat accumulation. Inguinal subcutaneous white adipose tissue and intra-abdominal retroperitoneal visceral adipose tissue depots in PC-AR Gene Replacement mice were 50-80% lower than wild-type (WT) and 75-90% lower than Global-ARKO controls at 12 weeks of age. The marked decrease in subcutaneous and visceral fat mass in PC-AR Gene Replacements was associated with an increase in the number of small adipocytes and a healthier metabolic profile compared to WT controls, characterised by normal serum leptin and elevated serum adiponectin levels. Euglycaemic/hyperinsulinaemic clamp studies reveal that the PC-AR Gene Replacement mice have improved whole-body insulin sensitivity with higher glucose infusion rates compared to WT mice and increased glucose uptake into subcutaneous and intra-abdominal fat. In conclusion, these data provide the first evidence for an action of androgens via the AR in mesenchymal bone marrow PCs to negatively regulate fat mass and improve metabolic function.