Trends in Sexual Risk Behavioral Responses among High School Students between Mississippi and the United States: 2001 to 2019 YRBSS.

BACKGROUND: Early sexual reproductive health (SRH) education is linked to a reduction in risky sexual behaviors. Sexually transmitted infections (STIs) are rising at alarming rates. Risky sexual behaviors, including initiation of sex before age 13, having more than four sexual partners, and lack of use of condoms, increase the chance of infection and cancer. Informing students about the link between risky behaviors and cancer is vital to reduce morbidity and mortality. METHODS: A trend analysis of the Youth Risk Behavior Surveillance System (YRBSS) data between 2001 and 2019 was conducted. Results from four survey responses related to sexual risk behaviors among 9th to 12th grade in Mississippi students are compared with their US peers. RESULTS: Between 2001 and 2019, favorable declines in 3 out of 4 sexual risk behaviors were observed. Declining prevalence was reported for "ever had sexual intercourse," "age of sexual initiation at age 13 or younger," and "having 4 or more sexual partners in their lifetime" are promising. However, fewer students report using condoms. The adjusted prevalence rates for Mississippi students in all 4 measures were higher than the national responses. CONCLUSIONS: Our analysis supports the need for early skill-based sex education to promote health. States with increased behavioral risk among students should consider trends in data to improve education and policy.

Exploring Parents' Intentions to Monitor and Mediate Adolescent Social Media Use and Implications for School Nurses.

Social media may promote health and social connectedness, but its misuse and frequency of use may pose risks. Social media use during adolescence requires parental monitoring and mediation to mitigate potentially harmful effects such as depression, anxiety, and risk-taking behaviors. While parents and health care professionals convey concern surrounding exposure to inappropriate content, prolonged screen time, and cyberbullying, appropriate social media monitoring remains challenging. The purpose of this study was to explore parental monitoring and mediation of social media use in adolescents. Online recruitment yielded a nationwide sample (n = 836) of parents of adolescents. The results of the online survey indicated that parents are concerned about adolescent social media use and endorse positive attitudes toward monitoring. Yet parents perceived little control over monitoring. Findings from this study support the school nurse in promoting healthy social media use, media literacy among parents and adolescents, and the use of screening tools.

Potential Influencers of COVID-19 Vaccine Acceptance Among Adults Living in the United States Who Have Accepted or Plan to Accept the Vaccine: An Online Survey.

PURPOSE: The purpose of this study was to 1) determine the demographic differences between adults who have accepted, or plan to accept, the COVID-19 vaccine and those who will not accept the COVID-19 vaccine and 2) describe the potential influencers in deciding to accept the COVID-19 vaccine among adults living in the United States who have accepted or plan to accept the vaccine. DESIGN: A cross-sectional design utilizing an online survey was deployed using social media and a crowdsourcing platform. SETTING: United States. SUBJECTS: One thousand three hundred ninety-five (1395) adults completed the survey. The majority were white, male, between the ages of 25 and 45, and with representation from 50 states and Puerto Rico. MEASURES: A two-branched survey was used to assess demographic information, vaccination intention, and 19 potential influencers of COVID-19 vaccine acceptance. ANALYSIS: Analysis included descriptive statistics and Chi-square tests to determine differences between groups. RESULTS: A higher proportion of male (P < .001), married (P < .001), and college-educated (P < .001) participants reported acceptance of the vaccine. The factors with the highest mean score of reported level of influence were duty to protect the vulnerable and contribution to move society back to a sense of normalcy. CONCLUSION: Understanding the potential influencers of vaccine acceptance may provide insight into strategies that could increase vaccination uptake.

Health assessment validation: Challenging tradition.

BACKGROUND: Undergraduate health assessment courses aim to prepare nursing students to conduct systematic physical assessment of patients. Competency in the undergraduate health assessment course is traditionally validated by student demonstration of a memorized, comprehensive physical examination. PROBLEM: Often, this validation requires performance of an exhaustive list of physical examination skills rather than the typical physical assessment performed by the generalist nurse in the hospital setting. This precedent to "do it all" does not align with competency-based education and may cause students to be ill-prepared for clinical practice. APPROACH: Faculty in a 12-month second-degree accelerated BSN program adapted the comprehensive physical assessment validation to better reflect a clinically relevant bedside assessment. The process, results, challenges, and recommendations are described. Here, the redefined comprehensive physical assessment included evaluation of the patient's general appearance, activity, vital sign measurements, pain, and key assessment of the neurologic, respiratory, cardiovascular, integumentary, gastrointestinal, and genitourinary systems. In alignment with the AACN recommendations, students were also validated on focused assessments. CONCLUSION: This change improved the students transition to clinical practice. We challenge faculty to prepare students for real-world nursing assessment by adapting validations to closely mirror bedside practice.

Implementation of a Pediatric Early Warning Scoring System at an Academic Medical Center.

Despite the addition of family-activated rapid response to the rapid response team algorithm, a children's hospital did not see an increase in utilization of the pediatric rapid response team. A Pediatric Early Warning Score in non-ICU pediatric inpatient units was implemented to increase the number of rapid response team activations. A retrospective review of the 130-bed facility, over a 12-month period, revealed an increase in pediatric rapid response calls, with a subsequent decrease in code team activations. The authors outline implementation strategies and discuss barriers encountered throughout the process, along with implications for nurse leaders.

Toward development of artificial viruses for gene therapy: a comparative evaluation of viral and non-viral transfection.

Problems related to the safety and efficacy of gene therapies have checked the enthusiasm once surrounding this field, though it remains a promising approach for the treatment of numerous diseases. Despite the high transfection efficiencies attainable using viral vectors, manufacturing difficulties, safety concerns, and limitations related to targeting and plasmid size have prompted considerable research into the development of non-viral vectors. Non-viral vectors demonstrate low toxicity, low immunogenicity, and ease of manufacture. However, they have not yet achieved the transfection efficiencies displayed by viruses. The inability to explain or predict transfection efficiencies results, in part, from insufficient understanding of the intracellular processes involved in gene delivery. Increasingly, research has been undertaken to probe the processes involved in overcoming the major obstacles to vector-mediated transfection: (1) internalization, (2) intracellular trafficking, (3) escape to the cytosol, (4) nuclear translocation, and (5) gene transcription/expression. This paper reviews and compares the pathways and techniques involved in successful viral and non-viral transfection. In addition, this review provides evidence that non-viral vector development has been pursued successfully thus far, producing systems capable of evading almost all major obstacles to transfection. Evaluating the abilities of non-viral and viral vectors to overcome specific cellular barriers reveals that the greatest advantage of viral vectors may be related to viral DNA, which is transcribed considerably more efficiently than plasmid DNA. Further study in this area should enable the development of non-viral vectors that transfect as efficiently as viral vectors.

Cell line-dependent internalization pathways and intracellular trafficking determine transfection efficiency of nanoparticle vectors.

It has been suggested that cell physiology may affect the internalization pathways of non-viral vectors, leading to cell line-dependent transfection efficiency. To verify this hypothesis, fluorescently labeled alginate-chitosan nanoparticle complexes were used as non-viral vectors to transfect 293T, COS7, and CHO cells and to observe the cellular interactions and internalization mechanisms of the complexes in each cell line. 293T cells, which demonstrate the highest transfection efficiency, internalize complexes primarily through clathrin-mediated processes. COS7 cells also demonstrate some internalization of complexes through the clathrin-dependent pathway, explaining the moderate transfection exhibited. In contrast, CHO cells internalize complexes predominantly through caveolin-mediated pathways and are not transfected. Results suggest that following clathrin-mediated endocytosis, complexes are trafficked to the endo-lysosomal pathway, where the proton-sponge effect leads to their release into the cytosol. Contrarily, the absence of trafficking to this pathway following caveolin-mediated endocytosis results in vesicle-entrapped complexes that become transfection-incompetent. These results demonstrate that cell physiology is a critical factor in efficient transfection, and that trafficking to the endo-lysosomal pathway through specific internalization mechanisms is essential for transfection with alginate-chitosan nanoparticle complexes.

Effects of alginate inclusion on the vector properties of chitosan-based nanoparticles.

Chitosan nanoparticles have shown considerable promise as gene vectors but do not mediate transfection with satisfactory efficiency. To improve upon the transfection efficiency of chitosan, we approached the development of alginate-chitosan nanoparticles with the goals of maintaining low toxicity and biocompatibility. Through ionic gelation, particles were formed with a mean Z-average diameter of 157 nm and a zeta potential of +32 mV. Competition binding assays indicated that the presence of alginate reduces the strength of interaction between chitosan and DNA, contributing to improved transfection. Cell viability assays indicated that nanoparticles exhibit the same low toxicity as chitosan, and significantly reduced toxicity compared to a commercial liposome formulation. As well, complexation with nanoparticles maintained DNA integrity and protected it from nuclease degradation better than chitosan alone. Alginate-chitosan nanoparticles were able to mediate transfection of 293T cells four times that achieved by chitosan nanoparticles; at 48 h, the transfection efficiency was as high as with Lipofectamine, with significantly reduced cytotoxicity. Overall, alginate inclusion improved the vector properties of chitosan-based nanoparticles, demonstrating superior transfection ability while maintaining biocompatibility and low toxicity.

Effect of experimental parameters on the formation of alginate-chitosan nanoparticles and evaluation of their potential application as DNA carrier.

This study introduces a new procedure to prepare alginate-chitosan nanoparticles and examines several experimental parameters in relation to their formation and characteristics. Using DLS and TEM analysis, nanoparticle formation was shown to be predominantly affected by the ratio of alginate to chitosan, the molecular weight of the biopolymers and the solution pH. We report a method that results in spherical particles with mean diameters ranging from 323 nm to 1.6 microm, depending on the preparation conditions. The smallest particles were formed using lower molecular weight polymers with pH between 5.0 and 5.6 and having an alginate/chitosan weight ratio of 1:1.5. We have shown that DNA can be loaded with 60% association efficiency. Our system demonstrates suitable size, loading and release characteristics for application in drug- and gene-delivery systems.