Cigarette smoking and drug use among a nationally representative sample of HIV-positive individuals

Background and Objectives: Among HIV-positive populations, the prevalence of cigarette smoking remains disproportionately high and is associated with significant morbidity and mortality. Little is known about this topic among HIV-positive persons in the general population. Methods: Data came from the 2005 to 2011 National Survey on Drug Use and Health (NSDUH) public use data files. Unadjusted and adjusted multinomial logistic regression analyses explored the associations between socio-demographic, drug and alcohol use, and drug and/or alcohol treatment characteristics with smoking status among HIV-positive individuals (n = 349). Results: More than 40% of the sample was current smokers. In adjusted analyses, females (aRRR = .11, 95% CI = .03–.41) and participants who had never been married (aRRR = .19, 95% CI = .05–.58), were more likely to be former smokers than never smokers. Females (aRRR = .37, 95% CI = .14–.96) and individuals older than age 35 (aRRR = .37, 95% CI = .16–.89) were less likely to be current smokers than never smokers. Conversely, previously married persons (aRRR = 5.72, 95% CI = 1.40–23.31), participants reporting binge drinking (aRRR = 5.96, 95% CI = 2.27–15.64), and lifetime drug or alcohol treatment (aRRR = 5.12, 95% CI = 2.09–12.55) were more likely to be current smokers than never smokers. Conclusions: Findings help confirm the high prevalence of smoking among HIV-positive persons suggesting the need for integrated substance use and smoking cessation treatment among HIV-positives. Scientific Significance: The present findings have implications for the development and implementation of targeted smoking cessation programs for HIV-positive smokers

Changing the malaria treatment protocol policy in Timor-Leste: an examination of context, process, and actors’ involvement

In 2007 Timor-Leste, a malaria endemic country, changed its Malaria Treatment Protocol for uncomplicated falciparum malaria from sulphadoxine-pyrimethamine to artemether-lumefantrine. The change in treatment policy was based on the rise in morbidity due to malaria and perception of increasing drug resistance. Despite a lack of nationally available evidence on drug resistance, the Ministry of Health decided to change the protocol. The policy process leading to this change was examined through a qualitative study on how the country developed its revised treatment protocol for malaria. This process involved many actors and was led by the Timor-Leste Ministry of Health and the WHO country office. This paper examines the challenges and opportunities identified during this period of treatment protocol change

Electron-radiation interaction in a Penning trap: beyond the dipole approximation

We investigate the physics of a single trapped electron interacting with a radiation field without the dipole approximation. This gives new physical insights in the so-called geonium theory.Comment: 12 pages, RevTeX, 6 figures, Approved for publication in Phys. Rev.

Patterns of youth tobacco and polytobacco usage: The shift to alternative tobacco products

Background: Despite significant declines in youth cigarette smoking, overall tobacco usage remains over 20% as non-cigarette tobacco product usage is increasingly common and polytobacco use (using 1+ tobacco product) remains steady. Objectives: The present study was designed to identify patterns of youth tobacco use and examine associations with sociodemographic characteristics and tobacco dependence. Methods: The current analysis uses Latent Class Analysis (LCA) to examine the 6,958 tobacco users (n = 2,738 female) in the National Youth Tobacco Survey (2012 and 2013). We used as indicators past month use of tobacco products (cigarettes, cigars, smokeless tobacco, e-cigarettes, hookah, snus, pipes, bidis, and kreteks) and regressed resulting classes on sociodemographic characteristics and tobacco dependence. Results: Nine classes emerged: cigarette smokers (33.4% of sample, also included small probabilities for use of cigars and e-cigarettes), cigar smokers (16.8%, nearly exclusive), smokeless tobacco users (12.3%, also included small probabilities for cigarettes, cigars, snus), hookah smokers (11.8%), tobacco smokers/chewers (10.7%, variety of primarily traditional tobacco products), tobacco/hookah smokers (7.2%), tobacco/snus/e-cig users (3.3%), e-cigarette users (2.9%,), and polytobacco users (1.7%, high probabilities for all products). Compared to cigarette smokers, tobacco/hookah smokers and hookah smokers were more likely to report Hispanic ethnicity. Polytobacco users were more likely to report dependence (AOR:2.77, 95% CI:[1.49–5.18]), whereas e-cigarette users were less likely (AOR:0.49, 95% CI:[0.24–0.97]).Conclusion: Findings are consistent with other research demonstrating shifts in adolescent tobacco product usage towards non-cigarette tobacco products. Continuous monitoring of these patterns is needed to help predict if this shift will ultimately result in improved public health

Random array of drifting acoustic receivers (RADAR'07)

Rep 04/07 - SiPLAB 15/December/2007This report describes the complete set of data acquired during the RADAR’07 sea trial, that took place aboard the NRP D. Carlos from July 9 - 15, 2007, off the west coast of Portugal, in the Set´ubal area

Development and Validation of a Predictive Model of Acute Glucose Response to Exercise in Individuals With Type 2 Diabetes

Background: Our purpose was to develop and test a predictive model of the acute glucose response to exercise in individuals with type 2 diabetes. Design and methods: Data from three previous exercise studies (56 subjects, 488 exercise sessions) were combined and used as a development dataset. A mixed-effects Least Absolute Shrinkage Selection Operator (LASSO) was used to select predictors among 12 potential predictors. Tests of the relative importance of each predictor were conducted using the Lindemann Merenda and Gold (LMG) algorithm. Model structure was tested using likelihood ratio tests. Model accuracy in the development dataset was assessed by leave-one-out cross-validation. Prospectively captured data (47 individuals, 436 sessions) was used as a test dataset. Model accuracy was calculated as the percentage of predictions within measurement error. Overall model utility was assessed as the number of subjects with ≤ 1 model error after the third exercise session. Model accuracy across individuals was assessed graphically. In a post-hoc analysis, a mixed-effects logistic regression tested the association of individuals\u27 attributes with model error. Results: Minutes since eating, a non-linear transformation of minutes since eating, post-prandial state, hemoglobin A1c, sulfonylurea status, age, and exercise session number were identified as novel predictors. Minutes since eating, its transformations, and hemoglobin A1c combined to account for 19.6% of the variance in glucose response. Sulfonylurea status, age, and exercise session each accounted for \u3c1.0% of the variance. In the development dataset, a model with random slopes for pre-exercise glucose improved fit over a model with random intercepts only (likelihood ratio 34.5, p \u3c 0.001). Cross-validated model accuracy was 83.3%. In the test dataset, overall accuracy was 80.2%. The model was more accurate in pre-prandial than postprandial exercise (83.6% vs. 74.5% accuracy respectively). 31/47 subjects had ≤1 model error after the third exercise session. Model error varied across individuals and was weakly associated with within-subject variability in pre-exercise glucose (Odds ratio 1.49, 95% Confidence interval 1.23-1.75). Conclusions: The preliminary development and test of a predictive model of acute glucose response to exercise is presented. Further work to improve this model is discussed

Personality characteristics are independently associated with prospective memory in the laboratory, and in daily life, among older adults

Prospective memory (PM) can deteriorate with age and adversely influence health behaviours. Research suggests that personality is related to PM in healthy young adults, but we know little about the role of personality in the PM amongst older adults. Community-dwelling older adults (N=152) completed the NEO Five-Factor Inventory-3 and PM measures. After adjusting for demographics and general cognition, higher neuroticism and lower levels of openness were independently associated with lower objectively-measured time- and event-based PM. Lower conscientiousness was the only personality predictor of self-reported everyday PM failures. Findings indicate that personality plays a role in PM functioning in the laboratory and daily life

Modes of rf capacitive discharge in low-pressure sulfur hexafluoride

This paper presents the results of an experimental study of rf capacitive discharge in low-pressure SF6. The rf discharge in SF6 is shown to exist not only in weak-current (α-) and strong-current (γ -) modes but also in a dissociative δ-mode. This δ-mode is characterized by a high degree of SF6 dissociation, high plasma density, electron temperature and active discharge current, and it is intermediate between α- and γ -modes. The δ-mode appears due to a sharp increase in the dissociation rate of SF6 molecules via electron impact starting after a certain threshold value of rf voltage. At the same time the threshold ionization energy of SFx (x = 1–5) radicals formed is below the ionization potential of SF6 molecules. The double layer existing in the anode phase of the near-electrode sheath is shown to play an important role in sustaining the α- mode as well as the δ-mode but it is not a cause of the rf discharge transition from α- to δ-mode

An Insightful Model to Study Innate Immunity and Stress Response in Deep‐Sea Vent Animals: Profiling the Mussel Bathymodiolus azoricus

Deep‐sea environments are, in some cases, largely unexplored ecosystems, where life thrives driven by the geochemical features of each location. Among these environments, chemosynthesis‐based ecosystems, in the Mid Atlantic Ridge, have an exclusive combination of high depth, high sulfur, and high methane concentrations. This is believed to modulate the biological composition of vent communities and influence the overall vent animal transcriptional activity of genes involved in adaptation processes to extreme environments. This opens, thus, the possibility of finding gene expression signatures specific to a given hydrothermal vent field. Regardless of the extreme physicochemical conditions that characterize deep‐sea hydrothermal vents, the animals dwelling around the vent sites exhibit high productivity and thus must cope with toxic nature of vent surrounding, seemingly deleterious to the animals, while developing surprisingly successful strategies to withstand adverse environmental conditions, including environmental microbes and mechanical stress whether ensuing from animal predation or venting activity. The deep‐sea vent mussel Bathymodiolus azoricus has adapted well to deep‐sea extreme environments and represents the dominating faunal community from hydrothermal vent sites in the Mid‐Atlantic Ridge, owing its successful adaptation and high biomasses to specialized exploitation of methane and sulfide sources from venting activity. Its extraordinary capabilities of adapting and thriving in chemosynthesis‐based environments, largely devoid of photosynthetic primary production and characterized by rapid geochemical regime changes are due to symbiotic associations with chemosynthetic bacteria within its large gills. In an attempt to understand physiological reactions in animals normally set to endure extreme deep‐sea environments, our laboratory has undertaken, for the last few years, a series of investigations, aimed at characterizing molecular indicators of adaptation processes of which components of the host defense system has received most attention. This study reviews recent advances on the characterization of molecules and genes participating in immune reactions, using in vivo and ex vivo models, to elucidate cellular and humoral defense mechanisms in vent mussels and the strategies they have adopted to survive under extreme environments

Determinants of health care utilisation: The case of Timor-Leste

© The Author(s) 2018. Background: Health financing and delivery reforms designed to achieve universal health coverage (UHC) need to be informed by an understanding of factors that both promote access to health care and undermine it. This study examines the level of health care utilisation in Timor-Leste and the factors that drive it. Methods: Data from a nationally representative cross-sectional survey of health care utilisation in 1712 households were used to develop multilevel models exploring how need and predisposing and enabling factors explain health care utilisation at both primary and secondary care facilities. Results: Need was found to be the key driver in seeking both primary care and hospital services. Rural households were less likely to go to hospital (odds ratio 0.7) than urban households. The poorest quintile was also less likely to use more expensive hospital services than other socio-economic groups. Conclusions: Understanding the determinants of seeking health care in Timor-Leste is of considerable policy significance, because health care is free at the point of use. Our findings indicate that the public resources for health care are subsidising the rich more than the poor. Health care reforms in Timor-Leste need to reduce the 'other' costs of health care, such as distance barriers, to address these inequities