Methods used in cross-culturalcomparisons of vasomotor symptoms and their determinants

Methodological differences among studies of vasomotor symptoms limit rigorous comparison or systematic review. Vasomotor symptoms generally include hot flushes and night sweats although other associated symptoms exist. Prevalence rates vary between and within populations, but different studies collect data on frequency, bothersomeness, and/or severity using different outcome measures and scales, making comparisons difficult. We reviewed only cross-cultural studies of menopausal symptoms that explicitly examined symptoms in general populations of women in different countries or different ethnic groups in the same country. This resulted in the inclusion of nine studies: Australian/Japanese Midlife Women's Health Study (AJMWHS), Decisions At Menopause Study (DAMeS), Four Major Ethnic Groups (FMEG), Hilo Women's Health Survey (HWHS), Mid-Aged Health in Women from the Indian Subcontinent (MAHWIS), Penn Ovarian Aging Study (POAS), Study of Women's Health Across the Nation (SWAN), Women's Health in Midlife National Study (WHiMNS), and Women's International Study of Health and Sexuality (WISHeS). These studies highlight the methodological challenges involved in conducting multi-population studies, particularly when languages differ, but also highlight the importance of performing multivariate and factor analyses. Significant cultural differences in one or more vasomotor symptoms were observed in 8 of 9 studies, and symptoms were influenced by the following determinants: menopausal status, hormones (and variance), age (or actually, the square of age, age2), BMI, depression, anxiety, poor physical health, perceived stress, lifestyle factors (hormone therapy use, smoking and exposure to passive smoke), and acculturation (in immigrant populations). Recommendations are made to improve methodological rigor and facilitate comparisons in future cross-cultural menopause studies

Overview of methods used in cross-culturalcomparisons of menopausal symptoms and their determinants: Guidelines for Strengthening the Reporting of Menopause and Aging (STROMA) studies

This paper reviews the methods used in cross-cultural studies of menopausal symptoms with the goal of formulating recommendations to facilitate comparisons of menopausal symptoms across cultures. It provides an overview of existing approaches and serves to introduce four separate reviews of vasomotor, psychological, somatic, and sexual symptoms at midlife. Building on an earlier review of cross-cultural studies of menopause covering time periods until 2004, these reviews are based on searches of Medline, PsycINFO, CINAHL and Google Scholar for English-language articles published from 2004 to 2010 using the terms “cross cultural comparison” and “menopause.” Two major criteria were used: a study had to include more than one culture, country, or ethnic group and to have asked about actual menopausal symptom experience. We found considerable variation across studies in age ranges, symptom lists, reference period for symptom recall, variables included in multivariate analyses, and the measurement of factors (e.g., menopausal status and hormonal factors, demographic, anthropometric, mental/physical health, and lifestyle measures) that influence vasomotor, psychological, somatic and sexual symptoms. Based on these reviews, we make recommendations for future research regarding age range, symptom lists, reference/recall periods, and measurement of menopausal status. Recommendations specific to the cross-cultural study of vasomotor, psychological, somatic, and sexual symptoms are found in the four reviews that follow this introduction

Left Behind: Intersectional Stigma Experiences of African American College Women With ADHD

African American college women with attention deficit hyperactivity disorder (ADHD) can experience intersectional stigmas based on race, gender, and learning disability. Intersectional stigmas affect African American college women in self-esteem, social acceptance, and academic progress. The scholarly community has not published literature regarding intersectional stigma experienced by African American college women with ADHD. The purpose of this study was to explore the lived experiences of African American college women who had encountered intersectional stigma based on race, gender, and ADHD. Goffman’s social stigma theory and Crenshaw’s intersectional stigma theory served as the theoretical and conceptual frameworks to explore how African American college women with ADHD described their experiences of intersectional stigma. A qualitative descriptive phenomenological approach was used to develop an interview instrument to collect data from 13 participants through semi-structured telephone interviews. Analysis of the interview transcripts was conducted to determine common themes. Findings indicated that ADHD symptoms, lack of college preparation, and overwhelming emotions were a concern; reluctance to reveal diagnosis to professors and fellow students for fear of stigmatization and discrimination; ADHD accommodations, coping skills, and teaching in multiple intelligences was beneficial; and early diagnosis and treatment of ADHD is essential. Results may contribute to positive social change by providing college administrators with a better understanding of African American women’s needs and challenges with ADHD and providing data to help develop support and services that will assist in this population’s academic success

Left Behind: Intersectional Stigma Experiences of African American College Women With ADHD

African American college women with attention deficit hyperactivity disorder (ADHD) can experience intersectional stigmas based on race, gender, and learning disability. Intersectional stigmas affect African American college women in self-esteem, social acceptance, and academic progress. The scholarly community has not published literature regarding intersectional stigma experienced by African American college women with ADHD. The purpose of this study was to explore the lived experiences of African American college women who had encountered intersectional stigma based on race, gender, and ADHD. Goffman’s social stigma theory and Crenshaw’s intersectional stigma theory served as the theoretical and conceptual frameworks to explore how African American college women with ADHD described their experiences of intersectional stigma. A qualitative descriptive phenomenological approach was used to develop an interview instrument to collect data from 13 participants through semi-structured telephone interviews. Analysis of the interview transcripts was conducted to determine common themes. Findings indicated that ADHD symptoms, lack of college preparation, and overwhelming emotions were a concern; reluctance to reveal diagnosis to professors and fellow students for fear of stigmatization and discrimination; ADHD accommodations, coping skills, and teaching in multiple intelligences was beneficial; and early diagnosis and treatment of ADHD is essential. Results may contribute to positive social change by providing college administrators with a better understanding of African American women’s needs and challenges with ADHD and providing data to help develop support and services that will assist in this population’s academic success

Higher Education Student\u27s Use of Technologies for Assessment Within Personal Learning Environments (PLEs)

Higher education students\u27 use of technologies has been documented over the years but their specific use of technologies for assessment-related tasks has yet to be fully investigated. Researchers at two higher education institutions recently conducted a study which sought to discover the technologies most commonly used by students within their Personal Learning Environments (PLEs). A specific aim of the study was to determine which of these technologies the students used when they complete and submit assessment tasks such as assignments and examinations. Results from questionnaires, focus groups and mapping exercises are reported and the implications of the findings for developing institutional infrastructure to engage students and support their learning are highlighted

Skunk River Review September 1990, vol 2

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Vitamin C and asthma in children: modification of the effect by age, exposure to dampness and the severity of asthma

Retraction: Clinical and Translational Allergy 2012, 2:6BACKGROUND: We previously found a significant benefit of vitamin C supplementation in asthmatic children. PURPOSE: To test whether the effect of vitamin C on asthma is heterogeneous over the participant population. METHODS: Egyptian asthmatic children between 7 and 10 years of age (n = 60) were included in the cross-over trial. They were administered 0.2 grams per day of vitamin C and placebo for separate 6-week periods. The variation in the vitamin C effect on two clinically relevant outcomes was analyzed: the childhood asthma control test (C-ACT), which measures the severity of asthma symptoms (the scale ranges from 0 to 27 points, < 20 points indicating unsatisfactory asthma control), and FEV1. We used linear modeling to examine the variation of the vitamin C effect in the subgroups. RESULTS: The effect of vitamin C on the C-ACT was significantly modified by age and baseline C-ACT levels. In the children aged 7.0-8.2 years with a baseline C-ACT of 18 to 19 points, vitamin C increased the C-ACT score by 4.2 points (95% CI: 3.3-5.3); whereas in the children aged 8.3-10 years who had a baseline C-ACT of 14 to 15 points, vitamin C increased the C-ACT score by only 1.3 points (95% CI: 0.1-2.5). The effect of vitamin C on the FEV1 levels was significantly modified by age and exposure to dampness. In the children aged 7.0-8.2 years with no exposure to dampness, vitamin C increased the FEV1 level by 37% (95% CI: 34-40%), whereas in the children aged 8.3-10 years with exposure to dampness or mold in their bedroom more than one year prior to the study, vitamin C increased the FEV1 level by only 21% (95% CI: 18-25%). CONCLUSIONS: We found strong evidence that the effect of vitamin C on asthmatic children is heterogeneous. Further research is needed to confirm our findings and identify the groups of children who would receive the greatest benefit from vitamin C supplementation.Peer reviewe

Molecular characterization of hepatitis B virus in people living with HIV in rural and peri-urban communities in Botswana

This article belongs to the Special Issue titled "Pathogenesis, Diagnosis, and Therapeutics of Infectious Diseases (2nd Edition))".DATA AVAILABITY STATEMENT: The data generated in this study are available upon request from the corresponding author. The sequences are not publicly available, as they are currently being analyzed for other objectives.BACKGROUND : Hepatitis B virus (HBV) sequencing data are important for monitoring HBV evolution. We aimed to molecularly characterize HBV sequences from participants with HBV surface antigen-positive (HBsAg+) serology and occult hepatitis B infection (OBI+). METHODS : We utilized archived plasma samples from people living with human immunodeficiency virus (PLWH) in Botswana. HBV DNA was sequenced, genotyped and analyzed for mutations. We compared mutations from study sequences to those from previously generated HBV sequences in Botswana. The impact of OBI-associated mutations on protein function was assessed using the Protein Variation Effect Analyzer. RESULTS : Sequencing success was higher in HBsAg+ than in OBI+ samples [86/128 (67.2%) vs. 21/71 (29.2%)]. Overall, 93.5% (100/107) of sequences were genotype A1, 2.8% (3/107) were D3 and 3.7% (4/107) were E. We identified 13 escape mutations in 18/90 (20%) sequences with HBsAg coverage, with K122R having the highest frequency. The mutational profile of current sequences differed from previous Botswana HBV sequences, suggesting possible mutational changes over time. Mutations deemed to have an impact on protein function were tpQ6H, surfaceV194A and preCW28L. CONCLUSIONS : We characterized HBV sequences from PLWH in Botswana. Escape mutations were prevalent and were not associated with OBI. Longitudinal HBV studies are needed to investigate HBV natural evolution.The Wellcome Trust; the Fogarty International Center at the US National Institutes of Health; Institutes of Health (NIH) Common Fund and the United States President’s Emergency Plan for AIDS Relief (PEPFAR).https://www.mdpi.com/journal/biomedicinesSchool of Health Systems and Public Health (SHSPH)SDG-03:Good heatlh and well-bein

Persistence and risk factors of occult hepatitis B virus infections among antiretroviral therapy-naïve people living with HIV in Botswana

AimThis study aimed to determine the kinetics of occult hepatitis B virus infections (OBI) among people with HIV (PWH).MethodsThe study used archived plasma samples from longitudinal HIV natural history studies. We identified new OBI cases and assessed risk factors for OBI using Cox proportional hazards regression analysis.ResultsAt baseline, 8 of 382 [(2.1%) (95% CI: 1.06–4.1)] samples tested positive for hepatitis B surface antigen (HBsAg+). Of the 374 HBsAg-negative samples, 76 had sufficient sample volume for HBV DNA screening. OBI positivity (OBI+) at baseline was reported in 11 of 76 [14.7 95% CI (8.3–24.1)] HBsAg-negative (HBsAg−) participants. Baseline HBsAg-negative samples with sufficient follow-up samples (n = 90) were used for analysis of newly identified OBI cases. Participants contributed 129.74 person-years to the study and were followed for a median of 1.02 years (IQR: 1.00–2.00). Cumulatively, there were 34 newly identified OBI cases from the 90 participants, at the rate of 26.2/100 person-years (95% CI: 18.7–36.7). Newly identified OBI cases were more common among men than women (61.1% vs. 31.9%) and among participants with CD4+ T-cell counts ≤450 cells/mL (p-value = 0.02). Most of the newly identified OBI cases [55.9% (19/34)] were possible reactivations as they were previously HBV core antibody positive.ConclusionThere was a high rate of newly identified OBI among young PWH in Botswana, especially in men and in participants with lower CD4+ T-cell counts. OBI screening in PWH should be considered because of the risk of transmission, possible reactivation, and risk factors for the development of chronic liver disease, including hepatocellular carcinoma