Implementation of a Risk Assessment Tool to Increase Screening for Extragenital Gonorrhea and Chlamydia in Men Who Have Sex with Men

INTRODUCTION: Gonorrhea and chlamydia account for the majority of sexually transmitted infections (STIs) in the United States and are often thought to infect only the urogenital tract. Infections can also be harbored at extragenital sites (rectum and oropharynx), and these infections can increase susceptibility to HIV. Extragenital screening recommendations exist for populations deemed high risk, including men who have sex with men (MSM); yet, routine screening is not consistently completed. PURPOSE: To improve screening rates for extragenital gonorrhea and chlamydia in MSM within a primary care setting by using an STI risk assessment tool. METHODS: Clinicians completed a baseline knowledge survey. Clinicians were then provided education on extragenital STI infections and how to use the risk assessment tool. The risk assessment tool was given to eligible patients during preventative and STI screening office visits. Clinicians completed a follow-up questionnaire seven weeks after the risk assessment tool was implemented. RESULTS: Clinicians reported improved knowledge base with extragenital STIs and felt more comfortable screening patients when appropriate. Clinicians reported being more likely to offer extragenital screenings using the risk assessment tool. LIMITATIONS: Limitations included the number of clinicians participating as well as a narrow population focus. This limited the ability to evaluate the risk assessment tool for effectiveness. IMPLICATIONS FOR PRACTICE: Clinicians are better equipped to consistently offer extragenital STI screening to patients when appropriate. On a larger scale, this process may reduce susceptibility to HIV and create opportunities to discuss and offer HIV prevention options such as pre-exposure prophylaxis (PrEP)

The Effects of the Norepinephrine Agonist, Guanfacine, on Scopolamine-Induced Memory Impairments in the Rat

Cognitive deficits associated with Alzheimer\u27s disease are known to result from decreases in acetylcholine within the cholinergic system ofthe medial septal area, which projects to the hippocampus. Recent studies have proposed that increasing levels ofthe neurotransmitter norepinephrine may help to decrease the cognitive impairments associated with Alzheimer\u27s disease and aging. The present study measured the effects that Guanfacine, an alpha-2 noradrenergic agonist, has on memory deficits produced by the acetylcholine antagonist, Scopolamine. Memory ability was assessed using an object recognition task and a socially transmitted food preference task. Following administration of Scopolamine, memory ability was significantly impaired from baseline levels on both memory tasks. Pretraining injection of Scopolamine followed by post-training injection of Guanfacine resulted in memory performance that was equivalent to baseline memory performance on both tasks. Guanfacine administration alone did not improve memory performance, but rather had a trend toward impairing performance. Results from this study indicate that Guanfacine may be effective at improving memory impairments caused by decreased acetylcholine function as seen in Alzheimer\u27s disease

Raising rivals’ fixed costs

This article demonstrates that raising fixed costs can serve as a credible mechanism for a well placed firm to exclude its rivals. We identify a number of credible avenues, such as increased regulation, vexatious litigation and increased prices for essential inputs, through which such a firm can raise fixed costs. We show that for a wide range of oligopoly models this may be a profitable strategy, even if the firm’s own fixed costs are affected as much (or even more) than its rivals and even if it is less efficient. The resulting reduction in the number of firms in the market is detrimental to consumer welfare and hence worthy of scrutiny by competition and regulatory authorities

Perinatal Exposure to Environmentally Relevant Levels of Bisphenol A Decreases Fertility and Fecundity in CD-1 Mice

Bac k g r o u n d: Perinatal exposure to low-doses of bisphenol A (BPA) results in alterations in the ovary, uterus, and mammary glands and in a sexually dimorphic region of the brain known to be important for estrous cyclicity. Objectives: We aimed to determine whether perinatal exposure to environmentally relevant doses of BPA alters reproductive capacity. Met h o d s: Female CD-1 mice that were exposed to BPA at 0, 25 ng, 250 ng, or 25 µg/kg body weight (BW)/day or diethylstilbestrol (DES) at 10 ng/kg BW/day (positive control) from gestational day 8 through day 16 of lactation were continuously housed with proven breeder males for 32 weeks starting at 2 months of age. At each delivery, pups born to these mating pairs were removed. The cumulative number of pups, number of deliveries, and litter size were recorded. The purity of the BPA used in this and our previous studies was assessed using HPLC, mass spectrometry, and nuclear magnetic resonance. Res u l t s: The forced breeding experiment revealed a decrease in the cumulative number of pups, observed as a nonmonotonic dose–response effect, and a decline in fertility and fecundity over time in female mice exposed perinatally to BPA. The BPA was 97 % pure, with no evidence of contaminatio

Bisphenol A alters the development of the rhesus monkey mammary gland

The xenoestrogen bisphenol A (BPA) used in the manufacturing of various plastics and resins for food packaging and consumer products has been shown to produce numerous endocrine and developmental effects in rodents. Exposure to low doses of BPA during fetal mammary gland development resulted in significant alterations in the gland’s morphology that varied from subtle ones observed during the exposure period to precancerous and cancerous lesions manifested in adulthood. This study assessed the effects of BPA on fetal mammary gland development in nonhuman primates. Pregnant rhesus monkeys were fed 400 μg of BPA per kg of body weight daily from gestational day 100 to term, which resulted in 0.68 ± 0.312 ng of unconjugated BPA per mL of maternal serum, a level comparable to that found in humans. At birth, the mammary glands of female offspring were removed for morphological analysis. Morphological parameters similar to those shown to be affected in rodents exposed prenatally to BPA were measured in whole-mounted glands; estrogen receptor (ER) α and β expression were assessed in paraffin sections. Student's t tests for equality of means were used to assess differences between exposed and unexposed groups. The density of mammary buds was significantly increased in BPA-exposed monkeys, and the overall development of their mammary gland was more advanced compared with unexposed monkeys. No significant differences were observed in ER expression. Altogether, gestational exposure to the estrogen-mimic BPA altered the developing mammary glands of female nonhuman primates in a comparable manner to that observed in rodents

Twelve weeks of soccer-specific training: effects on mucosal immunity, salivary alpha-amylase and body composition in male African youths

Purpose: The primary aim of this study was to determine the levels of salivary secretory IgA (sIgA) and salivary alpha-amylase (sAA) in young, black male soccer players, before and after 12 weeks of soccer-specific training. Methods: Thirty-four children (11–13 years) who were part of a youth soccer development training academy, participated in the study. The participants underwent 12 weeks of soccer-specific training. Resting saliva samples were collected 48 h before the commencement, and 48 h after the completion, of the training program. Samples were taken between 07:30 and 08:30, 90 min after waking. Body fat percentage (BF %), lean body mass (LBM) and cardiorespiratory fitness (CRF) were also measured. Results: Significant differences were found between pre- and post-training for body mass index (BMI) (P &lt; 0.05), waist-to-hip ratio (P &lt; 0.05), height (P &lt; 0.0001), BF % (P &lt; 0.0001) and LBM (P &lt; 0.0001). sIgA secretion rate increased significantly from pre- to post-training (P &lt; 0.05) however, no significant differences were found in sAA concentration (P &gt; 0.05), sAA secretion rate (P &gt; 0.05) or sIgA concentration (P &gt; 0.05). The magnitude of differences from pre- to post-training applying Cohen’s d effect sizes (ES) were moderate (&gt;0.5) for estimated VO 2max , sAA, sAA secretion rate, sIgA and sIgA secretion rate. Conclusion: These findings suggest that, 12 weeks of soccer-specific training enhances mucosal immunity and body composition and may have an effect on the sympathetic nervous system in black, male youths. </p