Text4Health: impact of text message reminder-recalls for pediatric and adolescent immunizations.

OBJECTIVES: We conducted 2 studies to determine the impact of text message immunization reminder-recalls in an urban, low-income population. METHODS: In 1 study, text message immunization reminders were sent to a random sample of parents (n = 195) whose children aged 11 to 18 years needed either or both meningococcal (MCV4) and tetanus-diphtheria-acellular pertussis (Tdap) immunizations. We compared receipt of MCV4 or Tdap at 4, 12, and 24 weeks with age- and gender-matched controls. In the other study, we compared attendance at a postshortage Haemophilus influenzae B (Hib) immunization recall session between parents who received text message and paper-mailed reminders (n = 87) and those who only received paper-mailed reminders (n = 87). RESULTS: Significantly more adolescents with intervention parents received either or both MCV4 and Tdap at weeks 4 (15.4% vs 4.2%; P < .001), 12 (26.7% vs 13.9%; P < .005), and 24 (36.4% vs 18.1%; P < .001). Significantly more parents who received both Hib reminders attended a recall session compared with parents who only received a mailed reminder (21.8% vs 9.2%; P < .05). After controlling for age, gender, race/ethnicity, insurance status, and language, text messaging was still significantly associated with both studies' outcomes. CONCLUSIONS: Text messaging for reminder-recalls improved immunization coverage in a low-income, urban population.

Exploring pregnant women's views on influenza vaccination and educational text messages.

BACKGROUND: The influenza vaccine has the potential to reduce morbidity among pregnant women and newborns but immunization coverage remains low. Effective interventions are needed to promote vaccine uptake in this population. PURPOSE: The goal of this study was to explore attitudes toward influenza vaccination and interest in targeted educational text messages among urban pregnant women. METHODS: English and Spanish language focus groups were conducted with pregnant women in New York City in April 2010. Transcripts were independently coded using content analysis. RESULTS: The 40 participants ranged in age from 19-35 years (mean=26, SD=5). Their gestational age ranged from 8-40 weeks (mean=27, SD=8). Most were Latina (85%), had other children (70%), and were publicly insured (78%). Nearly half had received the seasonal influenza or influenza A (H1N1) 2009 monovalent vaccine. Barriers to vaccination included concerns regarding vaccine safety and efficacy, misperceptions regarding risks for influenza, and lack of provider recommendation. Pregnant women expressed interest in receiving educational text messages regarding influenza. Even women who had refused the influenza vaccine thought the text messages would encourage vaccine-related discussions during prenatal visits. CONCLUSION: Among urban pregnant women, educational text messages regarding influenza would be well received and may effectively address current barriers to vaccination.

Penetrating cardiac trauma: analysis of 240 cases from a hospital in Bogota, Colombia.

BACKGROUND: Trauma characteristics and its management is influenced by socioeconomic context. Cardiac trauma constitutes a challenge for surgeons, and outcomes depend on multiple factors including initial care, characteristics of the wounds, and surgical management. METHODS: This is a retrospective cross-sectional case series of patients with penetrating cardiac injuries (PCI) from January 1999 to October 2009 who underwent surgery in a trauma referral center in Bogotá, Colombia. Demographic variables, trauma characteristics, treatment, and outcomes were analyzed. RESULTS: The study included 240 cases: 96.2% males, mean age of 27.8 years. Overall mortality was 14.6%: 11.7% from stab wounds and 41.2% from gunshot wounds. Upon admission, 44% had a normal hemodynamic status and 67% had cardiac tamponade. About 32% had Grade II injuries and 29% Grade IV injuries. In 85% of the cases, there were ventricular compromise and 55% of patients had associated lesions. In 150 cases, a pericardial window was performed. Highest mortality occurred in wounds to the right atrium. In tamponade patients, mortality was 20% being higher for gunshot wounds (54.5%) than for stab wounds (18%) (p = 0.0120). CONCLUSIONS: The study evidenced predominance of stab wounds. Based on characteristics of the trauma, patients, and survival rate, there is most likely a high pre-hospitalization mortality rate. The difference in mortality due to stab wounds and those produced by gunshots was more related to technical difficulties of the surgical repair than with the type of injury established by the Injury Grading Scale. Mortality was higher in patients with cardiac tamponade. Surgical management was satisfactory using pericardial window as the diagnostic method and sternotomy as the surgical approach.

Effect of daily text messages on oral contraceptive continuation: a randomized controlled trial.

OBJECTIVE: To estimate whether daily educational text messages affect oral contraceptive pill (OCP) continuation at 6 months. METHODS: We randomized young women electing OCPs at an urban family planning health center to either routine care or routine care plus 180 days of daily educational text messages. Investigators masked to treatment allocation randomized participants who were not masked to treatment. The primary outcome measure was self-reported OCP continuation through a telephone call at 6 months (contacts between 5 and 8 months). RESULTS: We enrolled 962 participants (480 intervention and 482 routine care) and obtained continuation data on 683 (346 and 337, respectively). At the follow-up, 64% of participants randomized to the intervention were still OCP users compared with 54% of the routine care group (P=.005). Continuation was highest in the intervention group if the interview took place while the intervention was ongoing (75% compared with 54%, P=.003); the effect of the intervention on continuation was less after the intervention ended (60% compared with 54%, P=.16). Participants receiving the intervention were more likely to continue oral contraception than control participants at 6 months (odds ratio 1.44, 95% confidence interval 1.03-2.00) in analyses adjusted for age, race or ethnicity, age at coitarche, pregnancy history, and OCP experience. CONCLUSION: The use of daily educational text messages improves OCP continuation at 6 months over routine care alone. Ten women would need to receive this simple intervention to improve continuation in one. This effect is strongest in the women whose follow-up took place while the text intervention was ongoing. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.ClinicalTrials.gov, NCT00677703.

Text message reminders to promote human papillomavirus vaccination.

OBJECTIVE: To implement and evaluate text message reminders for the second (HPV2) and third (HPV3) vaccine doses. DESIGN: Site-based intervention. SETTING: Nine pediatric sites (5 academic and 4 private) located in New York City. PARTICIPANTS: Parents of adolescents 9-20 years who received HPV1 or HPV2 during the intervention period, January-June 2009. INTERVENTION: Parents who enrolled received up to three weekly text message reminders that their daughter was due for her next vaccine dose. OUTCOME MEASURE: On-time receipt of the next vaccine dose, within one month of its due date. RESULTS: During the intervention period, of 765 eligible HPV vaccine events, 434 enrollment instructions were distributed to parents (56.7% of doses). Parents of 124 adolescent girls (28.6% of those handed instructions) activated text message reminders. Comparing children of parents who enrolled versus those who did not, on-time receipt of next HPV vaccine dose occurred among 51.6% (95% CI 42.8-60.4%) versus 35.0% (95% CI 29.6-40.2%) of adolescents (p=.001). Similarly, among a historical cohort of adolescents, receiving HPV1 or HPV2 in the six months prior to the intervention period, on-time receipt of next vaccine dose was noted for 38.1% (95% CI 35.2-41.0%) (p=.003). Increases in receipt of next vaccine dose among intervention subjects were sustained at 4 months following the vaccine due date. Using a logistic regression model, after controlling for insurance and site of care, intervention subjects were significantly more likely than either control population to receive their next HPV vaccine dose on-time. CONCLUSION: Among those choosing to enroll, text message reminders were an effective intervention to increase on-time receipt of HPV2 or HPV3.

Jovens urbanos: ações estético-culturais e novas práticas políticas / Jóvenes urbanos: acciones estético-culturales y nuevas prácticas políticas / Urban youth: aesthetic, cultural activities and new political practices

O artigo consiste da apresentação de resultados parciais (anos 60 e 70) de pesquisa desenvolvida no Brasil, como parte de investigação latino-americana vinculada à CLACSO. A reflexão se rganiza ao redor de quatro eixos teórico-metodológicos: campo teórico (marcos da produção acadêmica sobre juventude); políticas públicas (marcos de produção de uma legislação para a juventude); acontecimentos estético- ulturais; consumo e culturas juvenis.

El artículo presenta los resultados parciales (años 60 y 70) de la investigación desarrollada en Brasil y articulada a la investigación de Clacso sobre juventud y nuevas prácticas políticas en América Latina. La reflexión se compone de cuatro ejes teóricos y metodológicos: campo teórico (marcos de la producción académica sobre juventud); políticas públicas (marcos de la producción de una legislación para la juventud); acontecimientos estéticos y culturales y por último consumo y culturas juveniles.

The article focuses on partial researcher’s results (60´s and 70´s) of an academic investigation developed in Brazil, related to a Latin- American research, on CLACSO´s working group’s field. These results are articulated on four theoretical and methodological aspects: theoretical framework; public policies; esthetical and cultural events; consume and youth cultures.

Avaliação in vitro da adaptação marginal de restaurações indiretas de resinas compostas e cerâmica feldspática / In vitro evaluation of marginal adaptation of indirected restorations of composite resin and feldspathic ceramics

Objetivo: Avaliar a adaptação marginal de restaurações indiretas inlay de resinas compostas e cerâmica feldspática. Métodos: Foi utilizado um troquel metálico com preparo cavitário oclusoproximal, que foi moldadocom silicona de adição e o molde, vazado com gessopedra tipo IV. Dez restaurações em resinas compostasVita Zeta, Dialog II e Solidex foram confeccionadas pela técnica incremental, com três ciclos de ativaçãode 180s utilizando uma unidade de luz UniXS. Vinte restaurações de cerâmica feldspática Noritake EX-3 foram confeccionadas, sendo dez pela técnica convencional e dez pela técnica de pressão positiva de presa do revestimento refratário. Para verificação da adaptação marginal, as restaurações foram inseridas no troquelmetálico com um peso de 1,0 Kg e realizadas dez leituras na parede gengival da caixa proximal por meiode microscópio comparador MitutoyoTM, sendo os dados submetidos à análise estatística (Anova) para avaliação da adaptação marginal entre as marcas de resina composta e t-student para avaliação da variação técnicas de obtenção do modelo refratário. Resultados e conclusão: Não houve diferença estatisticamente significativana adaptação marginal entre as restaurações de resinas compostas e a cerâmica feldspática (p = 0,279), nem entre a técnica convencional e de pressão positiva de presa do revestimento refratário ( p = 0,385)

Aprender de los demás: a propósito de una investigación intercultural / To learn from others: with regard to a cross-cultural investigation

La inmigración plantea a los profesionales de la salud el reto de cuidar a personas con hábitos y prácticas de autocuidados muy diferentes a las nuestras. Es por tanto necesario conocer cómo son estas prácticas. En una investigación previa realizada no logramos obtener información fiable sobre dichas prácticas en un grupo concreto de inmigrantes. En este trabajo se pretende compartir el aprendizaje realizado a través de un grupo comunicativo de reflexión con los investigadores, para comprender los elementos que interfieren en el diálogo sobre prácticas de autocuidado con personas de otras culturas. Se han identificado factores como la falta de horizontalidad y los modos de actuación inadecuados del entrevistador como factores que condicionan en la falta de comunicación. También se han identificado estrategias que permiten el acercamiento y la comunicación con personas con prácticas de cuidado diferentes

Immigration challenges healthcare professionals with having to care for people with self-care habits and practices that are quite different to ours. Hence, it is necessary to study these practices to find out what they are like. In a previous investigation, we were unable to obtain reliable information regarding such practices in aspecific group of immigrants. This paper attempts to share the knowledge acquired by means of a communicative reflexion group with the investigators in order to gain some insight into the elements that intervene in the dialogue on self-care practices with people from other cultures. Factors such as a lack of horizontality and inadequate interviewing skills on the part of the interviewer as factors that limit the lack of communication have been identified. Other strategies that allow the approximation and communication between people through different care practices have also been implemented