81 research outputs found
Changes in Sexual Behavior Among HIV-Infected Women After Initiation of HAART
Objectives: We assessed the association between initiation of highly active antiretroviral treatment (HAART) regimens and sexual risk behaviors among HIVinfected women.
Methods: We analyzed data from 724 women who initiated HAART between January 1996 and January 2001 and who had pre-HAART viral loads at or above 400 copies per milliliter.
Results: Sexually active women were less likely (odds ratio [OR] = 0.79) to report 2 or more partners during a 6-month period after HAART initiation than before HAART initiation. However, the risk for unprotected sex was higher after HAART initiation than before HAART initiation among all sexually active women (both those who reported 2 or more partners [OR = 1.84] and those who reported 1 partner [OR = 1.22]).
Conclusions: Sexual risk behaviors are associated with receipt of therapy but not with therapeutic response, indicating a risk for transmission among female HAART recipients.VoRSUNY DownstateCommunity Health SciencesN/
HIV Infection and Women's Sexual Functioning
Objective: To compare sexual problems among HIV-positive and HIV-negative women and describe clinical and psychosocial factors associated with these problems.
Design: Data were collected during a study visit of the Women's Interagency HIV Study (WIHS). The WIHS studies the natural and treated history of HIV among women in the United States.
Methods: Between October 01, 2006, and March 30, 2007, 1805 women (1279 HIV positive and 526 HIV negative) completed a study visit that included administration of the Female Sexual Function Index. In addition, the visit included completion of standardized interviewer-administered surveys, physical and gynecological examinations, and blood sample collection.
Results: Women with HIV reported greater sexual problems than did those without HIV. Women also reported lower sexual function if they were classified as menopausal, had symptoms indicative of depression, or if they reported not being in a relationship. CD4 cell count was associated with Female Sexual Function Index scores, such that those with CD4 <or=199 cells per microliter reported lower functioning as compared with those whose cell count was 200 or higher.
Conclusions: Given research documenting relationships between self-reported sexual problems and both clinical diagnoses of sexual dysfunction and women's quality of life, greater attention to this issue as a potential component of women's overall HIV care is warranted.VoRSUNY DownstateCommunity Health SciencesN/
Late cardiac events after childhood cancer: Methodological aspects of the pan-european study pancaresurfup
Background and Aim Childhood cancer survivors are at high risk of long-Termadverse effects of cancer and its treatment, including cardiac events. The pan-European PanCareSurFup study determined the incidence and risk factors for cardiac events among childhood cancer survivors. The aim of this article is to describe the methodology of the cardiac cohort and nested case-control study within PanCareSurFup. Methods Eight data providers in Europe participating in PanCareSurFup identified and validated symptomatic cardiac events in their cohorts of childhood cancer survivors. Data onsymptomatic heart failure, ischemia, pericarditis, valvular disease and arrhythmia were collected and graded according to the Criteria for Adverse Events. Detailed treatment data, data on potential confounders, lifestyle related risk factors and general health problems were collected. Results The PanCareSurFup cardiac cohort consisted of 59,915 5-year childhood cancer survivors with malignancies diagnosed between 1940 and 2009 and classified according to the International Classification of Childhood Cancer 3. Different strategies were used to identify cardiac events such as record linkage to population/ hospital or regional based databases, and patient-And general practitioner-based questionnaires. Conclusion The cardiac study of the European collaborative research project PanCareSurFup will provide the largest cohort of 5-year childhood cancer survivors with systematically ascertained and validated data on symptomatic cardiac events. The result of this study can provide information to minimize the burden of cardiac events in childhood cancer survivors by tailoring the follow-up of childhood cancer survivors at high risk of cardiac adverse events, transferring this knowledge into evidence-based clinical practice guidelines and providing a platformfor future research studies in childhood cancer patients. © 2016 Feijen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Review of the Evidence Base for Peer Network Interventions for Students With Intellectual and Developmental Disabilities
A systematic literature review was conducted to examine the evidence for peer network interventions for students with intellectual and developmental disabilities (IDD). Fifteen studies were identified and evaluated for methodological rigor using the quality indicators published by the Council for Exceptional Children (CEC) and by examining the risk of bias. Relying only on the guidelines from the CEC, peer network interventions are an evidence-based practice for increasing the communication and interaction of students with IDD with their peers without disabilities. However, risk of bias assessment revealed several methodological issues, outcome measurement was generally restricted to being context-bound rather than generalized, and there is a need for further research at the middle school level, with students with intellectual disability who do not have an autism diagnosis, and with students who use augmentative and alternative communication (AAC). Implications are provided about training and supporting school personnel to implement peer network interventions. </jats:p
sj-pdf-1-rse-10.1177_07419325221075013 – Supplemental material for Review of the Evidence Base for Peer Network Interventions for Students With Intellectual and Developmental Disabilities
Supplemental material, sj-pdf-1-rse-10.1177_07419325221075013 for Review of the Evidence Base for Peer Network Interventions for Students With Intellectual and Developmental Disabilities by Elizabeth E. Biggs and Sarah E. Robison in Remedial and Special Education</p
Reward Network Immediate Early Gene Expression in Mood Disorders
Over the past three decades, it has become clear that aberrant function of the network of interconnected brain regions responsible for reward processing and motivated behavior underlies a variety of mood disorders, including depression and anxiety. It is also clear that stress-induced changes in reward network activity underlying both normal and pathological behavior also cause changes in gene expression. Here, we attempt to define the reward circuitry and explore the known and potential contributions of activity-dependent changes in gene expression within this circuitry to stress-induced changes in behavior related to mood disorders, and contrast some of these effects with those induced by exposure to drugs of abuse. We focus on a series of immediate early genes regulated by stress within this circuitry and their connections, both well-explored and relatively novel, to circuit function and subsequent reward-related behaviors. We conclude that IEGs play a crucial role in stress-dependent remodeling of reward circuitry, and that they may serve as inroads to the molecular, cellular, and circuit-level mechanisms of mood disorder etiology and treatment
Connecting People and Place Prosperity: Workforce Development and Urban Planning in Scholarship and Practice
In recent years, the field of workforce development has emerged as a distinct area of policy and practice. While planning scholars have begun to engage with the workforce development field, its relevance and points of connection to planning scholarship remain underexplored. This article attempts to define the workforce development field by articulating its core concerns as well as its domains of practice and scholarship outside the planning field. The article locates workforce development within three stands of planning scholarship, concluding that workforce development represents an important bridge for planners between “place” and “people” prosperity within communities
Readmissions and perioperative outcomes for same-day versus next-day discharge after prolapse surgery
Epigenetic Regulation of Hippocampal<i>Fosb</i>Expression Controls Behavioral Responses to Cocaine
Drug addiction results in part from maladaptive learning, including the formation of strong associations between the drug and the circumstances of consumption. However, drug-induced changes in gene expression underlying the saliency of these associations remain understudied. Consolidation of explicit memories occurs within the hippocampus, and we have shown that spatial learning induces expression of the transcription factor ΔFosB in hippocampus and that this induction is critical for learning. Drugs of abuse also upregulate ΔFosB in hippocampus, but the mechanism of its induction by cocaine and its role in hippocampus-dependent cocaine responses is unknown. We investigated differences in mouse dorsal and ventral hippocampal ΔFosB expression in response to chronic cocaine, because these regions appear to regulate distinct cocaine-related behaviors. We found that cocaine-mediated induction of ΔFosB was subregion-specific, and that ΔFosB transcriptional activity in both the dorsal and ventral hippocampus is necessary for cocaine conditioned place preference. Further, we characterize changes in histone modifications at theFosBpromoter in hippocampus in response to chronic cocaine and found that locus-specific epigenetic modification is essential forFosBinduction and multiple hippocampus-dependent behaviors, including cocaine place preference. Collectively, these findings suggest that exposure to cocaine induces histone modification at the hippocampalFosBgene promoter to cause ΔFosB induction critical for cocaine-related learning.SIGNIFICANCE STATEMENTAlthough cocaine addiction is driven in part by the formation of indelible associations between the drug and the environment, paraphernalia, and circumstances of use, and although this type of associative learning is dependent upon changes in gene expression in a brain region called the hippocampus, the mechanisms by which cocaine alters hippocampal gene expression to drive formation of these associations is poorly understood. Here, we demonstrate that chronic cocaine engages locus-specific changes in the epigenetic profile of theFosBgene in the hippocampus, and that these alterations are required for cocaine-dependent gene expression and cocaine–environment associations. This work provides novel insight into addiction etiology and potential inroads for therapeutic intervention in cocaine addiction.</jats:p
Multiple Biomarker Algorithms to Predict Epithelial Ovarian Cancer in Women with a Pelvic Mass: Can Additional Makers Improve Performance?
Introduction Management of a woman with a pelvic mass is complicated by difficulty in discriminating malignant from benign disease. Many serum biomarkers have been examined to determine their sensitivity for detecting malignancy. This study was designed to evaluate if the addition of biomarkers to HE4 and CA125, as used in the Risk of Malignancy Algorithm (ROMA), can improve the detection of EOC. Methods This was an IRB approved, prospective clinical trial examining serum obtained from women diagnosed with a pelvic mass who subsequently underwent surgery. Serum biomarker levels for CA125, HE4, YKL-40, transthyretin, ApoA1, Beta-2-microglobulin, transferrin, and LPA were measured. Logistic regression analysis was performed for various marker combinations, ROC curves were generated, and the area under the curves (AUCs) were determined. Results A total of 184 patients met inclusion criteria with a median age of 56 years (Range 20–91). Final pathology revealed there were 103 (56.0%) benign tumors, 4 (2.2%) LMP tumors, 61 EOC (33.1%), 2 (1.1%) non-EOC ovarian cancers, 6 (3.3%) gynecologic cancers with metastasis to the ovary and 8 (4.3%) non-gynecologic cancers with metastasis to the ovary. The combination of HE4 and CA125 (i.e. ROMA) achieved an AUC of 91.2% (95% CI: 86.0–96.4) for the detection of EOC vs benign disease. The combination of CA125, HE4, YKL-40, transthyretin, ApoA1, Beta 2 microglobulin, transferrin, LPA and menopausal status achieved the highest AUC of 94.6% (95% CI: 90.1–99.2) but this combination was not significantly better than the HE4 and CA125 combination alone (p = 0.078). Conclusions The addition of select further serum biomarkers to HE4 and CA125 does not add to the performance of the dual marker combination for the detection of ovarian cancer
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