The Role of Relationship and Other Factors Associated with Condom Use Intention Among Young American Indian Men Ages 18 to 24 Years Old

The purpose of this study was to investigate the heterosexual relationship factors that were associated with condom use intention for STI prevention in a purposive sample of American Indian men. The sample was drawn from the Fort Peck Reservations in northeastern Montana. The sample size included 122 American Indian men ages 18 to 24. The theory of planned behavior and interdependence theory provided the theoretical basis for the study. Seventy- seven percent of the young men reported being in a steady relationship with 60.3% agreeing that they were committed to maintaining their relationship with their current partner. Relationship duration and type and control of condom use was significantly associated with condom use intention for STI prevention. In addition control of condom use and relationship commitment was significantly associated with condom use communication. Regression results suggest that relationship duration, moderate or high participation in condom use decision making and female control of condom use are positively associated with moderately or extremely likely use of condoms in the future. The results from this study suggest that American Indian men are in need of culturally relevant sexual risk prevention efforts that address relationship factors to help reduce STIs in this population

Sexual Health and Sexually Transmitted Infections in the North American Arctic

STI rates reported for the Arctic are much higher than those reported for their southern counterparts

Envisioning an ecological systems theoretical approach to sexual and reproductive health programs in Greenland

People in Greenland experience disparate sexual and reproductive health (SRH) outcomes relative to populations in other circumpolar countries and Denmark. SRH in Greenland is intrinsically linked to multiple levels of an individual’s life, including family, partner relationship, healthcare access, and unique sociocultural factors. In this article we advocate for the use of ecological systems theory to design SRH programs in Greenland that incorporate the many interrelated systems that affect individual health outcomes. We introduce key concepts and strengths of ecological systems models for SRH programs, and we elucidate specific constructs of ecological systems theory that complement the existing Greenlandic health environment. We suggest that ecological systems theory is culturally congruent with how people in Greenland understand the interconnectedness of individuals, families, communities, and the natural and built environment. Incorporating ecological systems theory in SRH program design may promote interorganizational collaboration of SRH services, and integrate SRH education across family, school, and healthcare settings

Comparison of Intraoperative and Early Postoperative Outcomes of Caudal Versus Dorsal Penile Nerve Blocks for Outpatient Penile Surgeries

Objective To compare intraoperative and 1-hour postoperative outcomes in caudal versus dorsal penile nerve block (DPNB) patients undergoing penile surgeries. Material and Methods We performed a retrospective cohort study of males 3. Secondary outcomes were intraoperative/post-anesthesia care unit (PACU) narcotics, pre-incision anesthesia time, adjusted operating room charges and complications. We performed bivariate and multivariable analyses controlling for demographic/procedure characteristics and clustering by surgeon. Results Of 738 patients, (mean age 2.1 years) 74.1% had a caudal. DPNB patients were more likely to have a maximum pain score >3 (19.5% vs. 8.1%, p 3 (95% CI 1.7- 4.4, p<0.0001) and 5.2 times the odds of intraoperative/PACU narcotic administration (95% CI 3.3-8.1, p<0.0001). In multivariable analyses, caudal patients had longer pre-incision anesthesia time (27.9 ± 7.4 vs. 19.5 ± 6.6 minutes, p<0.0001) and higher adjusted operating room charges ($12,760 ± 4077 vs.$9,402 ± 3741, p=0.01). Conclusion Caudal blocks may offer a small advantage in the immediate postoperative period although cost-effectiveness is unproven

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

An ecological analysis of adolescent females' perseptions of sex : implications for onset of sexual intercourse

This study explores the intrapersonal and interpersonal ecological factors that influence adolescent females' perceptions of sex and the extent to which their perceptions of sex impact onset of sexual intercourse as they mature. Particular attention is given to how depression influences individual, personal and social factors in an adolescent female's life, to shape her attitudes towards sex, and determine her engagement in sex as she reaches young adulthood. Ecological Systems Theory is used to examine the extent to which individual, family, and social factors impact adolescent females' perceptions of sex and onset of sexual intercourse. Data are from the National Longitudinal Study of Adolescent Health. Multinomial logistic regression reveals that the factors associated with less positive perceptions of sex are age, self-esteem, sexual intercourse, religiosity and connection to mother and peers, as well as, depression in combination with religiosity and connection to one's peers. More positive perceptions of sex are linked with depression, connection to one's school, as well as, depression in conjunction with aging and sexual intercourse. Results from the logistic regression analysis determines that less positive perceptions of sex delay onset of sexual intercourse among adolescent females; however, adolescent females' attitudes towards sex vary greatly in determining onset of sexual intercourse as they mature. Furthermore, there is no association between depression and adolescent females' perceptions of sex in predicting onset of sexual intercourse as they progress into young adulthood. The findings from this study suggest that programs focused on shaping attitudes toward sex should assist young women in forming a definite opinion about their decision to have sexual intercourse or abstain from engagement in sexual intercourse. A female's age, sense of self-worth, emotional state, and religiosity as well as the strength of her relationships with parents, peers and school must be considered when addressing her sexual health. This investigation supports the use of Ecological Systems Theory as a useful theoretical framework for examining the factors that influence adolescent females' perceptions of sex and engagement in sexual intercourse. A more cognitive investigation of the relationship between depression and the factors in an adolescent female's life that influence her attitudes towards sex and how depression affects an adolescent female's perception of sex and her decision to engage in sexual intercourse is warranted as this study finds only minor support for the use of Ecological Systems Theory when exploring the association between depression and adolescent female sexual health