A theory-based approach to understanding condom errors and problems reported by men attending an STI clinic

The official published version can be accessed from the link below - Copyright @ 2008 Springer VerlagWe employed the information–motivation–behavioral skills (IMB) model to guide an investigation of correlates for correct condom use among 278 adult (18–35 years old) male clients attending a sexually transmitted infection (STI) clinic. An anonymous questionnaire aided by a CD-recording of the questions was administered. Linear Structural Relations Program was used to conduct path analyses of the hypothesized IMB model. Parameter estimates showed that while information did not directly affect behavioral skills, it did have a direct (negative) effect on condom use errors. Motivation had a significant direct (positive) effect on behavioral skills and a significant indirect (positive) effect on condom use errors through behavioral skills. Behavioral skills had a direct (negative) effect on condom use errors. Among men attending a public STI clinic, these findings suggest brief, clinic-based, safer sex programs for men who have sex with women should incorporate activities to convey correct condom use information, instill motivation to use condoms correctly, and directly enhance men’s behavioral skills for correct use of condoms

Condoms are more effective when applied by males: a study of young black males in the United States

PurposeTo determine, among a sample of young black male (YBM), whether female application of male condoms for penile–vaginal intercourse would be associated with higher or lower rates of breakage or slippage. A secondary aim was to investigate if higher rates of breakage or slippage were associated with increased odds of acquiring chlamydia and/or gonorrhea.MethodsA cross-sectional study of 412 YBM, aged 15 to 23 years, was conducted in three US cities located in the Southern United States.ResultsAmong YBM reporting frequent female application of condoms, 43.5% reported one or more instance of breakage or slippage, compared with those reporting less frequent female application (27.2%, P = .003). Among YBM reporting one or more event of breakage or slippage, 25.4% tested positive for chlamydia and/or gonorrhea. In contrast, among those not reporting breakage or slippage, 17.2% tested positive (P = .047).ConclusionsFindings suggest that educational and behavioral interventions should seek to improve young women's skills relative to condom application and use. Further studies could also investigate whether intervention efforts should encourage some YBM to be responsible for their own condom application

Research Mentoring and Scientist Identity: Insights from Undergraduates and their Mentors

Background Mentored research apprenticeships are a common feature of academic outreach programs that aim to promote diversity in science fields. The current study tests for links between three forms of mentoring (instrumental, socioemotional, and negative) and the degree to which undergraduates psychologically identify with science. Participants were 66 undergraduate-mentor dyads who worked together in a research apprenticeship. The undergraduate sample was predominantly composed of women, first-generation college students, and members of ethnic groups that are historically underrepresented in science. Results Findings illustrated that undergraduates who reported receiving more instrumental and socioemotional mentoring were higher in scientist identity. Further, mentors who reported engaging in higher levels of negative mentoring had undergraduates with lower scientist identity. Qualitative data from undergraduates’ mentors provided deeper insight into their motivation to become mentors and how they reason about conflict in their mentoring relationships. Conclusions Discussion highlights theoretical implications and details several methodological recommendations

Outcomes of a residential respite service for homeless people with tuberculosis in London, UK: a cross-sectional study

Background: Many countries are seeking to eliminate tuberculosis (TB), but incidence remains high in socially excluded groups such as people experiencing homelessness. There is limited research into the effectiveness of residential respite services (RRS), which provide accomodation and social and clinical support for homeless people with active TB. // Methods: We used a register of all cases of TB diagnosed in London between 1 January 2010 and 3 October 2019 to compare characteristics and outcomes of patients treated in an RRS with patients receiving standard care. The primary outcome was successful treatment completion. We used logistic regression to compare likelihood of completing treatment, and simulation to estimate the absolute change in treatment completion resulting from this service. // Results: A total of 78 homeless patients finished an episode of TB treatment at the RRS. Patients treated in the RRS were more likely than patients treated in standard care to have clinical and social risk factors including drug resistance, history of homelessness, drug or alcohol use, and need for directly observed therapy. After adjusting for these factors, patients treated in the RRS had 2.97 times the odds of completing treatment (95% CI = 1.44–6.96). Treatment ended in failure for 8/78 patients treated in the RRS (10%, 95% CI = 5%–20%). We estimated that in the absence of the RRS, treatment would have ended in failure for 17/78 patients (95% CI = 11–25). // Conclusion: The residential respite service for homeless TB patients with complex social needs was associated with better treatment outcomes

Condom-Associated Erection Problems: A Study of High-Risk Young Black Males Residing in the Southern United States

Previous research indicates that young men may experience condom-associated erection loss and that these problems may lead to inconsistent or incomplete condom use. The primary aim of this study was to assess, using a retrospective recall period of 2 months, correlates of condom-associated erection problems among young Black men attending sexually transmitted infection (STI) clinics. Data were collected in clinics treating patients with STIs in three southern U.S. cities. Males 15 to 23 years of age who identified as Black/African American and reported recent (past 2 months) condom use were eligible. A total of 494 men participated. Nineteen percent reported that condom-associated erection problems during condom application occurred at least once, and 17.8% indicated erection difficulties occurred during sexual intercourse at least once in the past 2 months. Multivariate analyses identified that condom-associated erection problems were associated with reports of sex with more than one partner during the recall period, reported problems with condom fit and feel, lower motivation to use condoms, and attempts at condom application before having a full erection. Findings suggest that clinic interventions should address possible condom-associated erection problems among young Black men who are at risk of STIs. Encouraging men who may be vulnerable to erection loss when condoms are used to allow sufficient time for sexual arousal to build may be an effective strategy

Older female children experience poorer quality of life when levels of perceived racial bias are high

Background: Individuals with sickle cell disease (SCD) experience significant health problems that result in unpredictable pain episodes and frequent healthcare utilization. Disparities in clinical care and emergency room visits in which medical providers mistrust the severity of reported pain symptoms may contribute to health-related stigma. In addition to stigma related to seeking care for acute pain, racism is a source of stigma with associated systemic inequities for this majority Black population. There is currently limited research into the effects of health-related stigma and racial bias on the underserved SCD population; however, the small body of research has found barriers to healthcare utilization, greater pain burden, and increased emotional distress. There is little known about the influence of health-related stigma and racial bias on quality of life (QOL) of children with SCD. The present study assessed these relationships, and additionally, we sought to understand whether there were differences in this relationship with regards to demographic factors (e.g., age, gender). / Methods: Data was collected from African-American children with SCD aged 8 - 16 years (57% male, 63% HbSS) who received care at a medical center in the United States. Sixty-three percent of children were receiving chronic transfusion therapy or pheresis and 37% were receiving hydroxyurea therapy. Children completed the Childhood Stigma Scale (adapted for SCD), the Child Perceptions of Racism in Children and Youth scale (PRaCY), and the Pediatric Quality of Life Inventory for SCD (PedsQL). Caregivers provided demographic information. / Results: We first assessed whether age, gender, and health-related stigma predicted QOL and demonstrated a significant overall model, F(7, 22) = 4.59, p = .003, r = .46. Health-related stigma (p = .007) predicted QOL, but neither age or gender were significant predictors. The next model assessed whether age, gender, and racial bias predicted QOL and demonstrated a significant overall model, F(7, 22) = 4.59, p < .001, r = .52. Specifically, age (p = .03), but neither gender or racial bias were significant predictors. Of interest, there was a significant interaction between age, gender, and racial bias (p = .02), which indicated that males generally had higher QOL that did not differ as a function of racial bias or age. Similarly, females who reported low levels of racial bias had higher QOL that did not differ as a function of age. In contrast, females who reported high levels of racial bias had QOL that differed as a function of age. Specifically, older female children who reported high levels of perceived racial bias had poorer QOL (see Figure 1)

Evidence for equilibrium iron isotope fractionation by nitrate-reducing iron(II)-oxidizing bacteria

Iron isotope fractionations produced during chemical and biological Fe(II) oxidation are sensitive to the proportions and nature of dissolved and solid-phase Fe species present, as well as the extent of isotopic exchange between precipitates and aqueous Fe. Iron isotopes therefore potentially constrain the mechanisms and pathways of Fe redox transformations in modern and ancient environments. In the present study, we followed in batch experiments Fe isotope fractionations between Fe(II)_(aq) and Fe(III) oxide/hydroxide precipitates produced by the Fe(III) mineral encrusting, nitrate-reducing, Fe(II)-oxidizing Acidovorax sp. strain BoFeN1. Isotopic fractionation in ^(56)Fe/^(54)Fe approached that expected for equilibrium conditions, assuming an equilibrium Δ^(56)Fe_(Fe(OH)3–Fe(II)aq) fractionation factor of +3.0‰. Previous studies have shown that Fe(II) oxidation by this Acidovorax strain occurs in the periplasm, and we propose that Fe isotope equilibrium is maintained through redox cycling via coupled electron and atom exchange between Fe(II)_(aq) and Fe(III) precipitates in the contained environment of the periplasm. In addition to the apparent equilibrium isotopic fractionation, these experiments also record the kinetic effects of initial rapid oxidation, and possible phase transformations of the Fe(III) precipitates. Attainment of Fe isotope equilibrium between Fe(III) oxide/hydroxide precipitates and Fe(II)_(aq) by neutrophilic, Fe(II)-oxidizing bacteria or through abiologic Fe(II)_(aq) oxidation is generally not expected or observed, because the poor solubility of their metabolic product, i.e. Fe(III), usually leads to rapid precipitation of Fe(III) minerals, and hence expression of a kinetic fractionation upon precipitation; in the absence of redox cycling between Fe(II)_(aq) and precipitate, kinetic isotope fractionations are likely to be retained. These results highlight the distinct Fe isotope fractionations that are produced by different pathways of biological and abiological Fe(II) oxidation

Factors influencing the time to ethics and governance approvals for clinical trials: a retrospective cross-sectional survey

Background: The findings from multi-centre trials are central to the practice of evidence-based medicine, enabling the development and implementation of new treatments. The time it takes to commence clinical trials at sites can be long, and ethics and governance approvals are key steps on the pathway to site activation. The goal of this study was to explore factors influencing the times to ethics approval, governance approval and site activation for multi-centre clinical trials. Methods: This paper assessed the associations of trial characteristics (disease area and trial phase), site characteristics (government or private ownership, country) and characteristics of the ethics and governance processes (scope guidelines, mutual acceptance requirements and triage of projects by risk) with times to approvals and activation. Median times were compared between site initiations that were and were not exposed to each characteristic using non-parametric tests in univariable and multivariable regressions. Results: There were data from 150 site activations done across 91 sites, 16 trials and 5 countries from November 2013 to November 2021. The overall median time to activation was 234 days (range 74 to 657), with ethics approval taking a median of 48 days (0 to 369) and governance approval a median of 34 days (0 to 489). Both the univariable and multivariable analyses identified associations of disease area, particularly oncology (p univariable = 0.012, p multivariable = 0.044), use of scope guidelines (p 0.054). The only factors associated with reduced overall time to site activation in both univariable and multivariable analyses were the early trial phase (p < 0.001, p = 0.013) and mutual acceptance of ethics approvals (p = 0.031, p = 0.030). Interpretation: Times to ethics and governance approvals were only one third of total trial start-up time. Factors influencing times to approval and activation were somewhat inconsistent across analyses, but it seems likely that the introduction of selected governance and ethics processes can reduce approval times

Perceptions of a self-management intervention for adolescents with sickle cell disease

Objective: Individuals with sickle cell disease (SCD) are at increased risk for complications from their disease during their adolescent and young adult (AYA) years. The risk of morbidity in AYAs with SCD can be decreased with improved self-management. Existing self-management interventions typically focus on one aspect of self-management (e.g., adherence) and do not address factors that activate patients (knowledge, motivation, self-efficacy, and social support) to self-manage. Sickle Cell Thrive (SCThrive) is a mixed in-person/online, technology-enhanced (use of a mobile app), group self-management intervention that targets patient activation. To determine the most clinically significant intervention components, a qualitative study was conducted. Method: Participants were 19 AYAs (Mage = 17.05) with SCD who participated in individual semistructured phone interviews after completing SCThrive. Interview content was coded using a grounded-theory approach to generate themes related to SCThrive’s feasibility, acceptability, and motivation for and impact on self-management. Results: SCThrive was reported to be highly feasible due to the mixed in-person/online format and acceptable because they learned skills to manage SCD in a group of AYAs with SCD. Action planning and pain/mood tracking appeared to be key factors in motivating AYAs for self-management. Participants reported continuing to use self-management skills post-SCThrive (self-efficacy) including applying them to other domains of their lives (e.g., educational/vocational). Conclusions: Study results provide data that can be leveraged to enhance the feasibility, acceptability, and impact of SCThrive and other self-management interventions. Findings can also inform clinical and mobile health interventions to increase self-management in this population

Original Article

本研究の目的は,健康な小児ががんや白血病といった病名からどのようなイメージを抱くのか,自分が大きな病気になったとしたら,病名や治療などについて教えて欲しいと思っているのかを明らかにすることである。千葉県内の小中高校に通っている小学校5年生から高校3年生までの児童生徒1964名から得られたアンケートの回答を,統計ソフトSPSSにて分析を行い以下の結果を得た。1.健康な小児が抱くがんのイメージは,「死ぬ・治らない」「重い・危険・苦しい」といった悲観的なのものが多く,全体の約65%を占めていた。「聞いたことがない・わからない」と答えたものもおり全体の約15%であり,どの学年でも同様の傾向であった。2.健康な小児が抱く白血病のイメージは「病態や特徴について」「原因や治療について」といったものが,全体の約38%を占めていた。「聞いたことがない・わからない」と答えたものは全体の約33%を占め,小学生では半数以上が「聞いたことがない・わからない」と答えていた。3.自分が病気になったときにされる説明については小学生の80%,中学生の85%,高校生の91%が真実を伝えられることを求めていた。その理由として自分の知る権利,治療に前向きに取り組めるといった姿勢の向上,知らないことが不安になる,残された命を有意義に悔いのないように過ごしたいといったものがあげられていた。The purposes of this study were to identify the images of healthy children on cancer and leukemia, and the way of thinking of truth telling with disease. The number of subjects were 1964. They belonged to between the fifth grade of primary school and the third year in high school. They answered someitem-questionnaire, and the answers were analyzed using SPSS. The results were as follows: 1. Sixty-five percent of the images of cancer were pessimistic, like death or incurable and serious or painful . About fifteen percent were having no images. 2. Thirty-eight percent of the images of leukemia were the feature and the cause or the treatment . About thirty-three percent were having no images. 3. Truth telling was desired by eighty percent of students of primary schools, eighty-five percent of junior high schools and ninety-one percent of a high school. The reasons were the rights to know , to be patient with treatments , to become more anxious without truth telling , and to live the remaining days without regrets