Demographic Influences on Adult HPV Vaccination: Results from a Cross-Sectional Survey in Tennessee.

HPV is the most prevalent sexually transmitted infection in the U.S., with more than 80% of all Americans contracting it by age 45. Effective vaccines for HPV exist and were recently approved for adults aged 27-45 years, though uptake remains low in all age groups, particularly in Tennessee where 1089 cancers were attributed to HPV in 2020. Between 29 June and 17 August 2023, we conducted a cross-sectional survey to gain insights about the barriers and facilitators of HPV in 2011 adults aged 18 to 45 years in Tennessee. We developed our survey based on previous instruments to understand predictors of HPV vaccination in adults. Using descriptive statistics and bivariate and logistic regression analyses, we found higher vaccination rates in females, participants aged 18-38 years, participants with a high school education or higher, Hispanic or Latine individuals, and participants identifying as moderate or liberal. These insights highlight the need for public health interventions that consider demographic differences to successfully increase vaccination rates and reduce HPV-associated cancer risk.

Radiographic lung congestion scores in dogs with acute congestive heart failure caused by myxomatous mitral valve disease.

BACKGROUND: In humans, lung congestion scores are predictive of recurrence of acute congestive heart failure (CHF) and are superior to cardiac biomarkers in predicting survival. OBJECTIVES: The primary aim of this retrospective study was to determine if a modified lung congestion score (LCS) in dogs diagnosed with acute CHF because of myxomatous mitral valve disease was associated with time until recurrence or death. ANIMALS: Complete medical records were available for a total of 94 dogs between 2010 and 2019, but only 35 dogs fulfilled the criteria for inclusion. METHODS: This retrospective study used descriptive statistics to describe the cumulative and corrected LCS. Correlations were used to examine the association of the corrected LCS and time until recurrence or death, selected echocardiographic variables, and timing of furosemide administration. RESULTS: The mean LCS was 8.4 (SD 3.3) and corrected LCS was 0.48 (SD 0.19). The pattern was predominantly symmetric (40% of dogs) and focal (caudal) but more commonly right-sided when asymmetric (40% vs 20%). The median number of days after initial diagnosis of acute CHF to readmission and death was 150 days (range 4-572), and 266 days (range 5-965), respectively. No significant association between the dog's corrected LCS and number of days until readmission (r = .173, P = .42) nor survival (r = .109, P = .56) was found. There was a negative significant correlation (r = -.71, P < .001) between the time interval of furosemide administration and corrected LCS.

A Descriptive Methodology for Studying the Ontogeny of Object Play and Breed Differences in Dogs (Canis lupus familiaris).

Play behavior is a prominent aspect of juvenile behavior for many animals, yet early development, especially play with objects, has received little attention. Our previous study on object play introduced our general methods, focusing on litter differences in the developmental trajectory of object play and toy preferences. Here, we present a detailed ethogram of more than 30 observed object play behaviors. We focus on breed differences in the development of play in the three following breeds: Welsh Terriers, Vizslas, and standard Poodles. Puppies were video recorded from 3 to 7 weeks of age at half-week intervals upon the introduction of a standard set of five toys into their home environments. Ten minutes of video from each session for each puppy were analyzed using the Noldus Observer XT program. Aside from analyzing individual behaviors, they were also grouped into three behavioral categories. These were behaviors that occurred only in a solitary context, only in a social context, or in both contexts. Solitary object play developed first, and social object play developed later across breeds. There was a significant three-way interaction between breed, developmental age, and the context in which play occurred. Pairwise comparisons within each breed, age, and context are discussed, but a prominent result is that the onset of many behaviors occurred later in Welsh Terriers compared to the other breeds.

Nurses' Short-Term Sickness Absences Before and After the Implementation of a Brief Napping Opportunity During Night Shifts.

BACKGROUND: Nurses who work at night have used naps to alleviate their sleepiness and fatigue. Research has shown night shifts, sleepiness, and fatigue predict nurses' missed workdays. Thus, nighttime napping may have a beneficial consequence of reducing nurses' sickness absences. The purpose of this brief report was to describe the difference in rates of short-term sickness absence before and after implementation of a 30-min nap opportunity in one U.S. hospital for 12-hr shift nurses. METHODS: The study was a retrospective pre-post evaluation design. Eight units provided nap opportunities for the nurses. Full-time nurses were classified into night and rotating shifts based on their 2 years of scheduling patterns. Absence data were extracted from the hospital's timekeeping system and annual absence rates were computed. A single linear mixed model with rank transformed data was conducted for each group. Median estimates, minimum and maximum, and p-values were reported. FINDINGS: The median absence rates for night shift nurses were 4.3% and 4.0% for the pre-napping and post-napping implementation periods, respectively; however, this difference was not statistically significant (p = .241). The median absence rates for rotating shift nurses were 2.0% and 3.9% for the pre-napping and post-napping implementation periods, respectively; and the difference increase was statistically significant (p < .001). CONCLUSION/APPLICATION TO PRACTICE: A nap policy which provides nurses with the opportunity to take nighttime naps did not benefit their sickness absence rates. Future research needs to examine the actual napping process on sickness absences, as well as explore other sickness management avenues.

Evaluation of a pet-separating automatic feeder and high-frequency meal feeding for weight loss in multi-cat households.

OBJECTIVES: The objectives of this study were two-fold: (1) to determine if a feeder system providing individualized food access and automatic dispensing of meals makes weight-loss programs in multi-cat homes easier for cat owners; and (2) to assess if feeding six meals daily reduces food-seeking behavior and increases calorie requirements vs two meals per day. METHODS: Adult cats with body condition scores (BCSs) of 7/9 or greater underwent a weight-loss plan for up to 6 months using a traditional feeding bowl with two meals per day (B2) or an automatic feeder with two meals (A2) or six meals (A6) per day. Cats were weighed at weeks 0, 2, 4, 6, 10, 14, 18, 22 and 26 and food intake was adjusted to maintain weight-loss rates between 0.5% and 1.5% body weight per week. Owner questionnaires were completed at each study visit. RESULTS: Twenty-three cats were included in the study. Cats fed from the automatic feeders were more likely to reach ideal body condition (P = 0.006), with 83.2% of cats in A6, 40% of cats in A2 and no cats in B2 achieving a BCS of ⩽6/9. Owners of cats fed from automatic feeders reported the weight-loss plan was easier vs owners of cats fed from bowls (P = 0.01). Owners using the automatic feeders also reported fewer incidences of certain food-seeking behaviors. Neither percent body weight lost per week nor calorie intake per kg differed between groups. CONCLUSIONS AND RELEVANCE: Feeding six instead of two meals daily did not result in faster rates of weight loss or the need to increase calorie intake to maintain appropriate rates of weight loss. However, use of an automatic feeder that provided separated, portioned meal feeding made the weight-loss program easier, reduced food-seeking behaviors and improved the overall success of the weight-loss plan.

Abdominal ultrasound and clinicopathologic findings in 22 cats with exocrine pancreatic insufficiency.

BACKGROUND: Awareness of exocrine pancreatic insufficiency (EPI) in cats has increased since the development of an assay for feline trypsin-like immunoreactivity (fTLI). Ultrasound findings in cats with EPI have only been reported rarely and described as nonspecific. HYPOTHESIS/OBJECTIVES: To describe the ultrasonographic findings, clinical signs, and concurrent diseases in cats with EPI. ANIMALS: Twenty-two client-owned cats with EPI. METHODS: Multicenter retrospective descriptive study including cats with serum fTLI concentration ≤8 µg/L and an abdominal ultrasound examination performed within 6 weeks of fTLI measurement. Sonographic measurements of maximal pancreatic thickness and maximal pancreatic duct diameter as well as ratios of pancreatic duct diameter to pancreatic thickness were obtained. Additional sonographic findings, concurrent conditions, and clinical signs were recorded. RESULTS: The most common clinical sign was weight loss (15/22 cats). Chronic enteropathy was the most common concurrent disease (13/22 cats). In 39% of cats, the pancreas had minimal or no sonographic alterations. Pancreatic duct dilatation (>2.5 mm), pancreatic duct tortuosity with variable diameter, or both were seen in 6/13 cats. The pancreatic parenchyma was subjectively thin in 6 cats. A significant relationship was found between subjectively thin pancreatic parenchyma and increased pancreatic duct size : pancreatic thickness ratio (P = .004). Diffuse gastrointestinal dilatation with echogenic content was observed in 8/22 cats. CONCLUSION: Exocrine pancreatic insufficiency often causes minimal to no sonographic pancreatic changes. Nonetheless, the findings of thin pancreatic parenchyma, pancreatic duct dilatation, or diffuse small intestinal dilatation with echogenic contents in cats with unexplained weight loss or unformed feces should raise clinical suspicion for EPI.

Magnetic Resonance Imaging Features of Extradural Spinal Neoplasia in 60 Dogs and Seven Cats.

This retrospective study describes the MRI features of extradural spinal neoplasia in 60 dogs and seven cats to identify potential distinguishing features between tumor classes and individual tumor types within each class. In dogs, mesenchymal tumors were most common (48%), with undifferentiated sarcomas being the predominant tumor type. Round cell neoplasms were second most common (35%), with lymphoma and multiple myeloma/plasma cell tumor comprising the majority of cases. Only two benign tumors were identified. In cats, lymphoma was most common (5/7), with one case of mesenchymal neoplasia and one case of metastatic carcinoma. Despite some overlap, certain imaging features were able to help prioritize differential diagnoses. The combined features that predicted round cell neoplasia (84%) included the preservation of vertebral shape, homogeneous contrast enhancement, and lesion centering on bone. The combined features that predicted mesenchymal neoplasia (73%) included altered vertebral shape, heterogeneous contrast enhancement, and lesion centering on paraspinal soft tissues. Round cell neoplasms were more likely to have cortical sparing, preservation of overall shape, lesion centering on bone, small soft tissue tumor size, and homogeneous contrast enhancement. Both epithelial and mesenchymal neoplasms were more likely to have cortical lysis, a cavitary component to the soft tissue mass and medium to large soft tissue mass size. The findings of this study can aid in prioritizing differential diagnoses in cases of extradural spinal neoplasia in cats and dogs, which can impact case management, but tissue sampling remains the gold standard for definitive diagnosis.

Readiness to Perform Aerobic Activity in Adults With Obesity: A Thematic Analysis of Online Surveys.

Flexible nonlinear periodization (FNLP) was designed to optimize sport-specific resistance training by matching bout demand to pre-exercise mental and physical states ("readiness to train"). Before applying this participant-responsive framework to aerobic prescriptions for inactive adults, operational definitions of readiness are needed. Purpose: To identify themes underlying readiness to perform aerobic bouts considered to be low-demand bouts (LDB) and high-demand bouts (HDB) in adults with obesity. Method: Using Qualtrics, 1,059 respondents initiated the online survey. Quality responses from adults with obesity (N = 112) were analyzed. Respondents described physical and mental states necessary to complete an LDB (10-min slow stroll) and an HDB (60-min jog). Data were assessed using content and thematic analyses. Results: Respondents (57% female) could be classified with class II obesity (35 ± 5 kg/m2) and were 48 ± 12 years old. One theme, body integrity (no pain//illness) emerged for both the LDB and HDB. Regarding affect/arousal, both bouts required the need to feel rested and in a positive mood, but the HDB required higher states of arousal ("pumped up"). Specific to the LDB, a recurring theme suggested that it could be completed under normal or worse (hungry, sick) circumstances. Specific to the HDB were themes relating to physical fitness, proper fueling ("hydrated," "not hungry but not too full"), and enhanced motivation ("determination," "focus," "confidence"). Conclusions: These uncovered themes provide empirical evidence to guide the construction of a readiness checklist that can be further validated and applied in adults with obesity undergoing an FNLP-based aerobic exercise prescription.

Administration of certain sedative drugs is associated with variation in sonographic and radiographic splenic size in healthy cats.

Ultrasonography and radiography are standard diagnostic tests for cats with suspected splenic disease, however published information on outside sources of variation are currently lacking. The purpose of this prospective, randomized, crossover group study was to evaluate effects of common sedative drugs on the sonographic and radiographic characteristics of the spleen in healthy cats. Fifteen healthy adult research cats were randomly assigned into one of three groups corresponding to different sequences of administration of five sedative drugs/drug combinations (acepromazine; butorphanol; dexmedetomidine; midazolam and butorphanol (MB); and dexmedetomidine, butorphanol, and ketamine (DBK)), administered at 1-week intervals. At each visit, three-view abdominal radiographic and ultrasonographic examinations were performed prior to sedation and repeated 15-30 min and 2-3 h post sedation. Two board-certified radiologists (one ACVR and one ACVR/ECVDI) evaluated the anonymized and randomized images. Acepromazine resulted in significantly increased sonographic and radiographic splenic measurements from baseline, which remained significantly increased 2-3 h post sedation. The mean magnitude of this change ranged from 0.9 mm (tail height, SD 1.4 mm) to 1.8 mm (body height, SD 1.7 mm) for ultrasound, and was 2.2 mm (ventrodorsal width, SD 2.3 mm) for radiographs. With butorphanol, there was no significant change in splenic size. For dexmedetomidine, MB, and DBK, there was a trend toward increased splenic size from baseline to the first post-sedation timepoint, which was statistically significant for radiographic measurements, although not for ultrasound. Findings indicated that acepromazine should be avoided prior to imaging while butorphanol may be used when sedation is needed in cats presenting for potential splenic disease.

Development and Validation of a PACER Prediction Equation for VO2peak in 10- to 15-Year-Old Youth.

Previous progressive aerobic cardiovascular endurance run (PACER) equations were developed to estimate peak oxygen consumption (VO2peak) from data collected during treadmill running. No equation has been developed using VO2peak assessed during the PACER. Purpose: To develop and validate a prediction equation to estimate VO2peak from the PACER in 10- to 15-year-olds. Methods: A sample of 163 youth were recruited to develop (n = 101) and validate (n = 62) a prediction equation. VO2peak was measured using a portable metabolic unit. Regression analysis yielded a prediction equation that included laps, body mass index, and interaction between sex and age. Correlations and repeated-measures analysis of variances were used to compare the measured and estimated VO2peak from the new Scott et al equation and 2 commonly used FitnessGram™ (Mahar et al 2011 and Mahar et al 2018) equations, and the impact of sex on predicted VO2peak. Results: Predicted VO2peak from the Mahar et al 2011 and 2018 equations was significantly lower compared with measured values, and the Scott et al prediction was not different. The Mahar et al 2018 equation tended to overestimate VO2peak in males but worked well for females. The Mahar et al 2011 and Scott et al equations revealed no sex differences. Conclusions: The Scott et al equation resulted in a more accurate estimate of VO2peak, performing equally well for both sexes.

Video-Recorded Validation of Wearable Step Counters under Free-living Conditions.

PURPOSE: The purpose of this study was to determine the accuracy of 14-step counting methods under free-living conditions. METHODS: Twelve adults (mean ± SD age, 35 ± 13 yr) wore a chest harness that held a GoPro camera pointed down at the feet during all waking hours for 1 d. The GoPro continuously recorded video of all steps taken throughout the day. Simultaneously, participants wore two StepWatch (SW) devices on each ankle (all programmed with different settings), one activPAL on each thigh, four devices at the waist (Fitbit Zip, Yamax Digi-Walker SW-200, New Lifestyles NL-2000, and ActiGraph GT9X (AG)), and two devices on the dominant and nondominant wrists (Fitbit Charge and AG). The GoPro videos were downloaded to a computer and researchers counted steps using a hand tally device, which served as the criterion method. RESULTS: The SW devices recorded between 95.3% and 102.8% of actual steps taken throughout the day (P > 0.05). Eleven step counting methods estimated less than 100% of actual steps; Fitbit Zip, Yamax Digi-Walker SW-200, and AG with the moving average vector magnitude algorithm on both wrists recorded 71% to 91% of steps (P > 0.05), whereas the activPAL, New Lifestyles NL-2000, and AG (without low-frequency extension (no-LFE), moving average vector magnitude) worn on the hip, and Fitbit Charge recorded 69% to 84% of steps (P < 0.05). Five methods estimated more than 100% of actual steps; AG (no-LFE) on both wrists recorded 109% to 122% of steps (P > 0.05), whereas the AG (LFE) on both wrists and the hip recorded 128% to 220% of steps (P < 0.05). CONCLUSIONS: Across all waking hours of 1 d, step counts differ between devices. The SW, regardless of settings, was the most accurate method of counting steps.

Use of Videoconferencing for Lactation Consultation: An Online Cross-Sectional Survey of Mothers' Acceptance in the United States.

BACKGROUND: Suboptimal breastfeeding duration and exclusivity rates are a public health concern. Therefore, there is a need for identifying effective tools for use in interventions targeting specific barriers to optimal breastfeeding outcomes. Research aim: This study aimed to assess the relationship between acceptance of remote lactation consultation using videoconferencing and (a) maternal demographic factors, (b) technology acceptance subscales, (c) maternal learning style preferences, and (d) other potentially explanatory maternal factors. METHODS: This was a cross-sectional, online study. English-speaking mothers of at least 18 years of age, with an infant age 4 months or younger, and who reported initiating breastfeeding were eligible to participate. Mothers were recruited from 27 randomly selected states. One hundred one mothers completed the survey, resulting in a response rate of 71%. The main outcome was acceptance of videoconferencing use for lactation consultation. RESULTS: No significant differences were found in acceptance by maternal demographic factors or learning style preferences. Acceptance was significantly related to perceived ease of use ( r = .680, p < .001), perceived usefulness/extrinsic motivation ( r = .774, p < .001), intrinsic motivation ( r = .689, p < .001), desire for control of privacy ( r = -.293, p < .01), and mother's perception of the infant father's/maternal partner's acceptance of videoconferencing for lactation consultation ( r = .432, p < .001). Only perceived usefulness/extrinsic motivation and maternal age remained in the final regression model ( R2 = .616, p < .001). Although perceived usefulness/extrinsic motivation was positively associated with acceptance, maternal age was inversely related. CONCLUSION: This sample of mothers indicated general acceptance of videoconferencing for lactation consultation, with younger mothers and those perceiving it to be more useful demonstrating greater acceptance.

StepWatch accuracy during walking, running, and intermittent activities.

INTRODUCTION: The purpose of this study was two-fold: 1) to investigate effects of cadence and sensitivity settings for the StepWatch (SW3) on step count accuracy over a wide range of ambulatory speeds, and 2) to compare the preprogrammed "quick start" settings to modified settings during intermittent lifestyle activities. METHODS: Part 1: Fifteen participants (18-57 years of age) performed two trials of treadmill walking and running at ten speeds ranging from 26.8 to 268mmin-1 while wearing four SW3 devices. During the first trial, the cadence setting was maintained while sensitivity was varied; in the second trial sensitivity was maintained while the cadence setting was varied. Part 2: Fifteen participants performed four intermittent activities and drove an automobile while wearing two SW3 devices, one with preprogrammed settings and the other with the modified settings determined in Part 1. RESULTS: Part 1: The modified settings (cadence setting of 70% of default and sensitivity of 16) provided the greatest step counting accuracy across a wide range of speeds reporting 96.0-104% of actual steps between 53.6 and 268mmin-1. Part 2: The preprogrammed settings tended to have higher accuracy for light household tasks (recording 88% to 94% of actual steps) than the modified settings (recording 82% to 86% of actual steps) which showed a trend towards higher accuracy for tennis (recording 93% vs. 89% of actual steps) (p<0.05). CONCLUSION: The preprogrammed "quick start" StepWatch settings should be used with individuals who do not engage in running and vigorous sports. However, for individuals who engage in running and tennis, use of modified settings may result in improved step counting accuracy.