Complexity of childhood sexual abuse: predictors of current post-traumatic stress disorder, mood disorders, substance use, and sexual risk behavior among adult men who have sex with men

Men who have sex with men (MSM) are the group most at risk for HIV and represent the majority of new infections in the United States. Rates of childhood sexual abuse (CSA) among MSM have been estimated as high as 46 %. CSA is associated with increased risk of HIV and greater likelihood of HIV sexual risk behavior. The purpose of this study was to identify the relationships between CSA complexity indicators and mental health, substance use, sexually transmitted infections, and HIV sexual risk among MSM. MSM with CSA histories (n = 162) who were screened for an HIV prevention efficacy trial completed comprehensive psychosocial assessments. Five indicators of complex CSA experiences were created: CSA by family member, CSA with penetration, CSA with physical injury, CSA with intense fear, and first CSA in adolescence. Adjusted regression models were used to identify relationships between CSA complexity and outcomes. Participants reporting CSA by family member were at 2.6 odds of current alcohol use disorder (OR 2.64: CI 1.24–5.63), two times higher odds of substance use disorder (OR 2.1: CI 1.02–2.36), and 2.7 times higher odds of reporting an STI in the past year (OR 2.7: CI 1.04–7.1). CSA with penetration was associated with increased likelihood of current PTSD (OR 3.17: CI 1.56–6.43), recent HIV sexual risk behavior (OR 2.7: CI 1.16–6.36), and a greater number of casual sexual partners (p = 0.02). Both CSA with Physical Injury (OR 4.05: CI 1.9–8.7) and CSA with Intense Fear (OR 5.16: CI 2.5–10.7) were related to increased odds for current PTSD. First CSA in adolescence was related to increased odds of major depressive disorder. These findings suggest that CSA, with one or more complexities, creates patterns of vulnerabilities for MSM, including post-traumatic stress disorder, substance use, and sexual risk taking, and suggests the need for detailed assessment of CSA and the development of integrated HIV prevention programs that address mental health and substance use comorbidities.This study was supported by a Grant from the NIMH (R01 MH095624) PI: O'Cleirigh; Author time (Safren) was supported, in part, by Grant 5K24MH094214. (R01 MH095624 - NIMH; 5K24MH094214)Accepted manuscrip

The interview as narrative ethnography : seeking and shaping connections in qualitative research.

Acts of counter-subjectification in qualitative research are always present but are often submerged in accounts that seek to locate the power of subjectification entirely with the researcher. This is particularly so when talking to people about sensitive issues. Based on an interview-based study of infertility and reproductive disruption among British Pakistanis in Northeast England, we explore how we, as researchers, sought and were drawn into various kinds of connections with the study participants; connections that were actively and performatively constructed through time. The three of us that conducted interviews are all female academics with Ph.Ds in anthropology, but thereafter our backgrounds, life stories and experiences diverge in ways that intersected with those of our informants in complex and shifting ways. We describe how these processes shaped the production of narrative accounts and consider some of the associated analytical and ethical implications

Testing T Invariance in the Interaction of Slow Neutrons with Aligned Nuclei

The study of five-fold (P even, T odd) correlation in the interaction of slow polarized neutrons with aligned nuclei is a possible way of testing the time reversal invariance due to the expected enhancement of T violating effects in compound resonances. Possible nuclear targets are discussed which can be aligned both dynamically as well as by the "brute force" method at low temperature. A statistical estimation is performed of the five-fold correlation for low lying p wave compound resonances of the $^{121}$Sb, $^{123}$Sb and $^{127}$I nuclei. It is shown that a significant improvement can be achieved for the bound on the intensity of the fundamental parity conserving time violating (PCTV) interaction.Comment: 22 pages, 5 figures, published versio

Molecular and morphometric variation in European populations of the articulate brachiopod <i>Terebeatulina retusa</i>

Molecular and morphometric variation within and between population samples of the articulate brachiopod &lt;i&gt;Terebratulina&lt;/i&gt; spp., collected in 1985-1987 from a Norwegian fjord, sea lochs and costal sites in western Scotland, the southern English Channel (Brittany) and the western Mediterranean, were measured by the analysis of variation in the lengths of mitochondrial DNA (mtDNA) fragments produced by digestion with nine restriction endonucleases and by multivariate statistical analysis of six selected morphometric parameters. Nucleotide difference within each population sample was high. Nucleotide difference between population samples from the Scottish sites, both those that are tidally contiguous and those that appear to be geographically isolated, were not significantly different from zero. Nucleotide differences between the populations samples from Norway, Brittany, Scotland and the western Mediterranean were also very low. Morphometric analysis confirmed the absence of substantial differentiation

Accuracy and utility of three-dimensional contrast-enhanced magnetic resonance angiography in planning carotid stenting

BackgroundContrast-enhanced magnetic resonance angiography (CE-MRA) is a proven diagnostic tool for the evaluation of carotid stenosis; however, its utility in planning carotid artery stenting (CAS) has not been addressed. This study assessed the accuracy of three-dimensional CE-MRA as a noninvasive screening tool, compared with digital subtraction angiography (DSA), for evaluating carotid and arch morphology before CAS.MethodsIn a series of 96 CAS procedures during a 2-year period, CE-MRAs and DSAs with complete visualization from the aortic arch to the intracranial circulation were obtained before CAS in 60 patients. Four additional patients, initially considered potential candidates for CAS, were also evaluated with CE-MRA and DSA. The two-by-two table method, receiver operating characteristic curve, and Bland-Altman analyses were used to characterize the ability of CE-MRA to discriminate carotid and arch anatomy, suitability for CAS, and degree of carotid stenosis.ResultsThe sensitivity and specificity of CE-MRA were, respectively, 100% and 100% to determine CAS suitability, 87% and 100% to define aortic arch type, 93% and 100% to determine severe carotid tortuosity, and 75% and 98% to detect ulcerated plaques. CE-MRA had 87% sensitivity and 100% specificity for the detection of carotid stenosis ≥80%. The accuracy of CE MRA to determine optimal imaging angles and stent and embolic protection device sizes was >90%. The operative technique for CAS was altered because of the findings of preoperative CE-MRA in 22 procedures (38%). The most frequent change in the operative plan was the use of the telescoping technique in 11 cases (18%). CAS was aborted in four patients (5%) due to unfavorable anatomy identified on CE-MRA, including prohibitive internal carotid artery tortuosity (n = 1), long string sign of the internal carotid artery (n = 2), and concomitant intracranial disease (n = 1). Among patients considered suitable for CAS by CE-MRA, technical success was 100%, and the 30-day stroke/death rate was 1.6%.ConclusionsContrast-enhanced magnetic resonance angiography of the arch and carotid arteries is accurate in determining suitability for CAS and may alter the operative technique. Certain anatomic contraindications for CAS may be detected without DSA. Although CE-MRA is less accurate to estimate the degree of stenosis, it can accurately predict imaging angles, and stent and embolic protection device size, which may facilitate safe and expeditious CAS

Microrheology with optical tweezers: data analysis

We present a data analysis procedure that provides the solution to a long-standing issue in microrheology studies, i.e. the evaluation of the fluids' linear viscoelastic properties from the analysis of a finite set of experimental data, describing (for instance) the time-dependent mean-square displacement of suspended probe particles experiencing Brownian fluctuations. We report, for the first time in the literature, the linear viscoelastic response of an optically trapped bead suspended in a Newtonian fluid, over the entire range of experimentally accessible frequencies. The general validity of the proposed method makes it transferable to the majority of microrheology and rheology techniques

Unified analysis of terminal-time control in classical and quantum systems

Many phenomena in physics, chemistry, and biology involve seeking an optimal control to maximize an objective for a classical or quantum system which is open and interacting with its environment. The complexity of finding an optimal control for maximizing an objective is strongly affected by the possible existence of sub-optimal maxima. Within a unified framework under specified conditions, control objectives for maximizing at a terminal time physical observables of open classical and quantum systems are shown to be inherently free of sub-optimal maxima. This attractive feature is of central importance for enabling the discovery of controls in a seamless fashion in a wide range of phenomena transcending the quantum and classical regimes.Comment: 10 page

Defining the type of surgeon volume that influences the outcomes for open abdominal aortic aneurysm repair

ObjectivePrior studies have reported improved clinical outcomes with higher surgeon volume, which is assumed to be a product of the surgeon's experience with the index operation. We hypothesized that composite surgeon volume is an important determinant of outcome. We tested this hypothesis by comparing the impact of operation-specific surgeon volume versus composite surgeon volume on surgical outcomes, using open abdominal aortic aneurysm (AAA) repair as the index operation.MethodsThe Nationwide Inpatient Sample was analyzed to identify patients undergoing open AAA repairs for 2000 to 2008. Surgeons were stratified into deciles based on annual volume of open AAA repairs (“operation-specific volume”) and overall volume of open vascular operations (“composite volume”). Composite volume was defined by the sum of several open vascular operations: carotid endarterectomy, aortobifemoral bypass, femoral-popliteal bypass, and femoral-tibial bypass. Multiple logistic regression analyses were used to examine the relationship between surgeon volume and in-hospital mortality for open AAA repair, adjusting for both patient and hospital characteristics.ResultsBetween 2000 and 2008, an estimated 111,533 (95% confidence interval [CI], 102,296-121,232) elective open AAA repairs were performed nationwide by 6,857 surgeons. The crude in-hospital mortality rate over the study period was 6.1% (95% CI, 5.6%-6.5%). The mean number of open AAA repairs performed annually was 2.4 operations per surgeon. The mean composite volume was 5.3 operations annually. As expected, in-hospital mortality for open AAA repair decreased with increasing volume of open AAA repairs performed by a surgeon. Mortality rates for the lowest and highest deciles of surgeon volume were 10.2% and 4.5%, respectively (P < .0001). A similar pattern was observed for composite surgeon volume, as the mortality rates for the lowest and highest deciles of composite volume were 9.8% and 4.8%, respectively (P < .0001). After adjusting for patient and hospital characteristics, increasing composite surgeon volume remained a significant predictor of lower in-hospital mortality for open AAA repair (odds ratio, 0.994; 95% CI, .992-.996; P < .0001), whereas increasing volume of AAA repairs per surgeon did not predict in-hospital deaths.ConclusionsThe current study suggests that composite surgeon volume—not operation-specific volume—is a key determinant of in-hospital mortality for open AAA repair. This finding needs to be considered for future credentialing of surgeons

Attitudes towards the ‘stranger’: negotiating encounters with difference in the UK and Poland

Due to recent intensification in international mobility in Europe, its citizens are exposed to a much wider range of lifestyles and competing attitudes towards difference. Individuals are, therefore, increasingly likely to encounter ‘strangers’ and are, therefore, required to negotiate discontinuities and contradictions between the values that are transmitted through different sites. In response, the article explores the concept of the ‘stranger’ through original data collected in the UK and Poland. The article highlights that the construction of who is a stranger depends on national historical contexts, core values and related visions of the society. The UK and Poland have very different histories and experiences with social diversity, impacting on the ways in which individuals negotiate strange encounters. In both countries, the ‘stranger’ is often seen in a negative way and in relation to the minority groups that are perceived to be visibly different, distinct or ‘unknown’ in contemporary times. In Poland, this is now largely articulated through sexual prejudice (homophobia), whilst in the UK, attitudes towards the ‘stranger’ are largely conveyed through religious prejudice (Islamophobia). As such, the article offers a means of understanding how encounters with difference ‘produce’ strangers in different contexts