Lactation Advice through Texting Can Help: An Analysis of Intensity of Engagement via Two-Way Text Messaging.

Rates of breastfeeding initiation and duration among women who attend the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are dramatically lower than nonparticipants. Innovative solutions are needed to improve breastfeeding rates in this population. The Lactation Advice through Texting Can Help (LATCH) study was one such approach, designed to augment and reinforce the WIC breastfeeding peer counseling process. The purpose of the present study was to examine engagement via two-way text messaging in a sample of women attending the WIC breastfeeding peer counseling program and enrolled in LATCH. The objectives were to: (1) describe text message engagement in the context of LATCH; and (2) assess the association between engagement variables and exclusive breastfeeding status. Text messaging data were first coded qualitatively by two independent researchers and engagement variables created. An analysis of engagement was conducted using descriptive statistics for normally distributed data and binary logistic regression. In the multivariable model, intensity of engagement during the first 2 weeks post partum was the single strongest predictor of exclusive breastfeeding status. LATCH is an innovative intervention designed to enhance the capacity of breastfeeding peer counselors and holds much potential for improving exclusive breastfeeding rates in this population.

An assessment of the social cognitive predictors of exclusive breastfeeding behavior using the Health Action Process Approach.

RATIONALE: In the United States rates of exclusive breastfeeding duration remain exceedingly low. Exclusive breastfeeding is a complex learned behavior that is influenced by social cognitive, interpersonal, and structural factors. Interventions are needed that address factors at multiple levels of the social-ecological model. This study was designed to examine the social cognitive predictors of exclusive breastfeeding behavior in a sample of low-income women attending the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) breastfeeding peer counseling program and enrolled in the Lactation Advice Through Texting Can Help (LATCH) study. OBJECTIVES: The objectives were to examine whether: (1) the theoretical model, the Health Action Process Approach (HAPA), fit the data well; (2) planning mediated the effect of intentions and maintenance self-efficacy on exclusive breastfeeding; and (3) recovery self-efficacy mediated the association between maintenance self-efficacy and exclusive breastfeeding behavior. METHODS: Outcome expectancies, action self-efficacy and intentions were assessed prenatally at baseline in N = 119 participants. Maintenance self-efficacy, planning, recovery self-efficacy and breastfeeding behavior were measured at two weeks post partum. Structural equation modeling with mean and variance adjusted Weighted Least Squares estimation was used to examine the applicability of the HAPA model to the data. RESULTS: Phase specific self-efficacy and planning significantly predicted exclusive breastfeeding status. Planning and recovery self-efficacy mediated the association between maintenance self-efficacy and exclusive breastfeeding. Planning did not emerge as a mediator between intentions and behavior. CONCLUSION: These results demonstrate the utility of the HAPA model in predicting exclusive breastfeeding behavior among low-income women attending WIC. LATCH is a theoretically sound text messaging intervention that can be used to augment and reinforce the WIC breastfeeding peer counseling process.

Cinco anos de implantes com cobertura de hidroxiapatita utilizados para apoio de sobredentaduras inferiores / Five years of HA-coated implants used to support mandibular overdentures

O objetivo deste estudo retrospectivo foi apresentar a taxa de manutenção dos 158 implantes com cobertura de hidroxiapatita instalados em 43 mandíbulas edêntulas para suporte de sobredentaduras, num período de cinco anos. Deste material, seis implantes foram perdidos, levando a uma taxa de sobrevida de 96,2 por cento, demonstrando que implantes com cobertura de hidroxiapatita podem ser mantidos com excelentes resultados longitudinais na situação clínica específica

Clinical evaluation of hydroxyapatite-coated single-tooth implants: a 5-year retrospective study.

The use of implants to replace missing single teeth has become a valuable treatment option. This study presents a 5-year retrospective clinical analysis of single teeth replaced with hydroxyapatite-coated implants. Of the 271 cylinder and screw implants placed over this period, 12 were lost (survival rate = 95.57%). In addition to aesthetic compromise, the most frequent complication was loosening of the abutment screw. These results corroborate findings from the literature and suggest that the described procedure can be safely performed in daily restorative procedures.

Vasopressinergic innervation of the mouse suprachiasmatic nucleus: an immuno-electron microscopic analysis.

Attempts are being made to unravel the local circuitry of the suprachiasmatic nucleus, with a view toward eventually correlating specific neuronal systems with circadian events. Hence, the vasopressinergic innervation of this nucleus in the laboratory mouse has been analyzed immunocytochemically at the light and electron microscopical levels. Monoclonal antineurophysin and polyclonal antivasopressin were used on aldehyde-fixed brains. Serial vibratome sections of the appropriate forebrain region were prepared for pre-embedding immunoperoxidase staining and/or postembedding immunogold labeling. Immunoreactive somata, processes, varicosities, and synaptic terminals were found throughout the suprachiasmatic nucleus, their ratio and density varying at different locations. The predominant type of vasopressinergic soma was ovoid to rounded (7-10 microns), containing secretory granules (85-120 nm), a large proportion of which were immunoreactive. Axon terminals, both nonimmunoreactive and immunoreactive, impinged upon vasopressinergic somata and processes, often displaying synaptic specializations. Vasopressinergic terminals, containing secretory granules and microvesicles, were found throughout the nucleus, particularly within the dorsomedial neuropil. These labeled terminals varied in size (0.4-3.4 microns 2) and shape, ranging from compact boutons to pleomorphic profiles, some deeply indented by postsynaptic spines, either dendritic or somatic. Approximately 65% of the vasopressin-containing terminals were axodendritic and 30% axosomatic; about 5% appeared to be axoaxonic. At least a quarter of all vasopressinergic synaptic terminals were axospinous. Other forms of interneuronal contact involving vasopressinergic elements (somata, dendrites) included extensive membrane to membrane appositional sites, and multiple puncta adhaerentia. The versatility of interconnections between vasopressin-containing neurons in the mouse suprachiasmatic nucleus suggests a highly active and coordinated network, which contributes substantially to local intranuclear circuitry. In addition, a dense efferent vasopressinergic output is directed dorsally towards the periventricular hypothalamus, where direct associations may be established with diverse hypothalamic neuroendocrine systems.

Albumin indirectly modulates fibrin and protofibrin ultrastructure.

Albumin modulation of fibrin and protofibrin coagulation parameters was studied. Cation-depleted, fatty acid free, human and bovine albumins decrease fibrin clot turbidity in a concentration-dependent manner. Albumin also inhibits the formation of protofibrin gels, induced by addition of 25 microM Zn(II) to protofibrils, though it does not bind to (proto)fibrin. In order to verify that competition for cations underlies the influence of albumin, fibrinogen was dialyzed against cation-depleted albumin. Elemental analysis indicates a redistribution of Zn(II) from the fibrinogen to the albumin compartment, and the resultant fibrin clots are less turbid. Apparently, cation-depleted albumin acts as a competitor for divalent cations. The ability of albumin to compete for available Zn(II) was also expressed in gels formed by pH-jump experiments, in which fibrin monomer, maintained soluble at pH 4.9, is induced to change phase by addition of NaOH to pH 7.4. While turbidimetric evidence indicates that individual fibrin fibers simply become thinner with albumin, scanning electron micrographs (SEM) reveal a more complex effect on ultrastructure. Though albumin does not bind to the gels, fibrin gels produced with albumin show major changes in fiber ultrastructure, particularly evident in gels formed in the presence of Zn(II). These structural modifications are discussed within the context of the "excluded volume" effect, in which "crowding" by albumin alters (proto)fibrin reactivity and ultrastructure.