Towards condom skills: a cross-sectional study of the association between condom proficiency, condom problems and STI risk amongst MSM

<p>Abstract</p> <p>Background</p> <p>Condom use problems are common amongst Scotland’s men who have sex with men (MSM). To date condom errors have been associated with the likelihood of sexually transmitted infections in heterosexual sexually transmitted infection (STI) clinic attendees but not in MSM and direct evidence of a link between condom problems and STI acquisition in MSM have been lacking. This study investigated the possibility of an independent association between condom proficiency, condom problems and STI acquisition in MSM in Scotland.</p> <p>Methods</p> <p>An exploratory observational design employed cross-sectional surveys in both STI clinic and community settings. Respondents completed self-report measures of socio-demographic variables, scales of condom proficiency and condom problems and numbers of different partners with whom men have had unprotected anal intercourse (UAI partners) in the preceding year. Self-report data was corroborated with clinical STI diagnosis where possible. Analysis included chi-squared and Mann–Whitney tests and multiple logistic regression.</p> <p>Results</p> <p>792 respondents provided data with an overall response rate of 70% (n = 459 clinic sample, n = 333 community sample). Number of UAI partners was the strongest predictor of self-reported STI acquisition over the previous 12 months (p < 0.001 in both clinic and community samples). Demographic characteristics were not associated with self-reported STI diagnosis. However, condom proficiency score was associated with self-reported STI acquisition (p < 0.05 in both samples). Condom problem score was also associated with self-reported STI diagnosis in the clinic (p = 0.001) but not the community sample. Condom problem score remained associated with self-reported STI diagnosis in the clinic sample after adjusting for number of UAI partners with logistic regression.</p> <p>Conclusions</p> <p>This exploratory study highlights the potential importance of targeted condom use skills interventions amongst MSM. It demands further research examining the utility of condom problem measures in wider populations, across prospective and experimental research designs, and a programme of research exploring their feasibility as a tool determining candidacy for brief interventions.</p

Deep Theorizing in International Relations

This paper starts from the observation that, at a time when the popularity of grand theory is in decline among IR scholars, they do not agree on what they mean by theory. In fact, the celebration of theoretical pluralism is accompanied by the relative absence of a serious conversation about what ‘theory’ is, could, or should be. Taking the view that we need such a conversation, this puts forward the notion of ‘deep theorizing’. Countering both the shallow theorizing of modern scholarship that conflates theory with scientific method, and the postmodern view that abstract narratives must be deconstructed and rejected, it offers a reading of the parameters along which substantial theorizing proceeds. Specifically, it suggests that ‘deep theorizing’ is the conceptual effort of explaining (inter)action by developing a reading of drives/basic motivations and the ontology of its carrier through an account of the human condition, that is, a particular account of how the subject (the political actor) is positioned in social space and time. The paper illustrates the plausibility of this meta-theoretical angle in a discussion of realist, liberal and postcolonial schools of thought

The axial age and the problems of the twentieth century: Du Bois, Jaspers, and universal history

The axial age debate has put big questions of social and cultural change back on the agenda of sociology. This paper takes this development as an occasion to reflect on how social thought works with (and against) nineteenth-century intellectual traditions in its efforts to understand history on a macro scale. Karl Jaspers, who initially formulated the axial age thesis in The Origin and Goal of History, revised the Hegelian account of world history by broadening the scope of the narrative to encompass all civilizations participating in the events of the first millennium BCE that saw the rise of major philosophical and religious traditions. However, his account, like the earlier philosophical accounts he seeks to improve upon, privileges cognitive developments over material practices and social interactions, and as such offers little to those seeking to make sense of how cultural patterns interact with others and spread. Here another social theorist engaging with Hegel, W. E. B. Du Bois, provides a helpful contrast. His account of the development of double-consciousness in "Of Our Spiritual Strivings," the opening chapter of The Souls of Black Folk, helps us to understand experiences of encounter and the perduring historical effects they may have. Du Bois’ relational theory reminds us of the importance of unpacking abstractions and understanding processes in terms of social interactions

Effectiveness of angiotensin-converting enzyme inhibitors in pediatric patients with mid to severe aortic valve regurgitation

The long-term benefit of angiotensin-converting enzyme inhibitors in pediatric patients with aortic valve regurgitation is under consideration. Eighteen patients with mid to severe aortic valve regurgitation were retrospectively evaluated. Echocardiographic parameters (left ventricular end-diastolic diameter, shortening fraction, left ventricular posterior wall thickness, and grade of aortic valve regurgitation) were analyzed before and during therapy with angiotensin-converting enzyme inhibitors. Data are given as standard deviation scores (Z-scores) derived from body surface-adjusted normal values. Median (interquartile range) age at start of therapy was 8.4 (5.4 to 10.0) years, and total follow-up 2.3 (0.9 to 5.4) years. Left ventricular end-diastolic diameter increased from 3.6 (2.3 to 4.5) to 3.7 (2.4 to 4.8), and left ventricular posterior wall diameter decreased from 1.9 (1.1 to 3.0) to 1.1 (0.5 to 2.3). Grade of aortic valve regurgitation increased from 3.5 (2.3 to 4.0) to 4.0 (2.0 to 4.0), and shortening fraction decreased from 39% (34% to 43%) to 37% (34% to 42%). No significant effect of angiotensin-converting enzyme inhibitors on left ventricular dimensions or function was found in our population of patients with mid to severe aortic valve regurgitation. Angiotensin-converting enzyme inhibitors may not alter left ventricular overload in pediatric patients with aortic valve regurgitation