Group-based memory rehabilitation for people with multiple sclerosis: subgroup analysis of the ReMiND trial

Background/Aim: Memory problems are frequently reported in people with multiple sclerosis (MS). These can be debilitating and affect individuals and their families. This sub-group analysis focused on the effectiveness of memory rehabilitation in patients with MS. Methods: Data were extracted from a single blind randomised controlled trial, the ReMiND trial, which also included participants with traumatic brain injury and stroke. Participants were randomly allocated to compensation or restitution treatment programmes, or a self-help control. The programmes were manual-based and comprised two individual and ten group sessions. Outcome measures included assessments of memory, mood and activities of daily living. A total of 39 patients with MS participated in this study (ten males (26%), 29 females (74%); mean±SD age: 48.3±10.8 years). Results: Comparison of groups showed no significant effect of treatment on memory, but there were significant differences between compensation and restitution on self-report symptoms of emotional distress at both 5- (p=0.04) and 7-month (p=0.05) follow-up sessions. The compensation group showed less distress than the restitution group. Conclusions: Individuals with MS who received compensation memory rehabilitation reported significantly less emotional distress than those who received restitution. Further research is needed to explore why self-reported memory problems did not differ between groups

Prevalence and correlates of perpetration of violence among young people: a population-based survey from Goa, India.

The aim of this study was to describe the prevalence and factors associated with perpetration of violence in young people in India. It was a cross-sectional survey of 3663 individuals (16-24 years old). Data on sociodemographics, sexual/physical violence, common mental disorders, and substance abuse were collected by face-to-face structured interviews. Logistic regression was used to estimate odds ratios for association of violence with various factors. Prevalence of physical violence in the past year was 10.2%. In both genders, younger age, urbanicity, being a victim of sexual abuse, common mental disorders, and tobacco use were associated with increased risk of physical violence. Being a victim of forced sexual intercourse and alcohol use was associated with violence in males; and not living with parents was associated with violence in females. Future research should be designed to tease out the pathways that underlie the associations, identified in the study, to derive potential preventive strategies

Associations of morbidity in the underweight

Background: There is little research on the demographic characteristics and morbidity of people categorised as ‘underweight’ from their Body Mass Index (BMI) although they have often been shown to have greater mortality. This uncertainty makes it difficult to determine whether to include or exclude these individuals when estimating the health and mortality impacts of BMI. This project compares the demographic characteristics and morbidity patterns of the underweight with those of acceptable weight and the overweight. Methods: Data on 10 243 community-living residents from the Health Survey for England (2003) were used. Logistic regression models were constructed to compare demographic, biochemical and anthropometric factors in the underweight (BMI<18.5) with those classified as acceptable weight (BMI 18.5-24.9) or overweight (BMI 25.0-29.9). Results: Univariate analyses found, when compared with other BMI categories, underweight individuals were significantly younger, more likely to smoke, alcohol abstainers, inactive, poorer, and were less likely to be ethnically white (all p<0.001). U-shaped relationships between BMI and activities of daily living, respiratory disease, physical activity and mental health variables were seen. In multivariate analysis the fewest number of significant differences in demographic and morbidity factors were between the underweight and those of acceptable weight. Conclusion: We recognise that these are cross-sectional data and exclude individuals in institutional settings, but these findings are important. Overall we could not conclude that the underweight were less healthy than individuals in the other BMI categories. We cannot therefore recommend that the underweight should be excluded from analyses that examine the effects of obesity on mortality

Opportunities for treating sexually transmitted infections and reducing HIV risk in rural South Africa.

Title. Opportunities for treating sexually transmitted infections and reducing HIV risk in rural South Africa Aim. This paper is a report of a study to determine the aetiological distribution of sexually transmitted infections and prevalence of human immunodeficiency virus infection in selected primary health care clinic attendees. Background. South Africa has a high prevalence of human immunodeficiency virus and other sexually transmitted infections. Sexually transmitted infections are managed syndromically in the public sector as part of the essential nurse-driven primary care services provided at no cost to the client. Method. This cross-sectional study was conducted in a rural community in South Africa between September and November 2002. A total of 277 consenting women were recruited. Vulvo-vaginal swabs were collected for screening for Neisseriae gonorrheae, Chlamydia trachomatis and Trichomonas vaginalis using DNA amplification methods and Gram stain with Nugent’s score for the diagnosis of bacterial vaginosis. Seroprevalence of syphilis and human immunodeficiency virus infection were determined. Findings. The overall prevalence of human immunodeficiency virus in the study was 43.7% (95% confidence interval 37.6–50.0) with the prevalence in family planning clinic attendees 45.5% (95% confidence interval 38.9–52.3) and antenatal clinic attendees 33.3% (95% confidence interval 19.6–50.3). The prevalence of sexually transmitted infections amongst both the antenatal clinic and family planning attendees accounted for at least 70% of cases. Fifty per cent of women had one recognized sexually transmitted infection with 17.9% of the family planning and 14.5% of the antenatal clinic attendees having infections from two recognized pathogens. All infections were asymptomatic. Conclusion. Nurse-driven antenatal and family planning services provide a useful opportunity for integrating reproductive health services, human immunodeficiency virus voluntary counselling and testing and treatment of sexually transmitted infections