Background

Relapse may occur suddenly, following a short period of craving, or after extended consideration. The time to relapse may reveal underlying mechanisms of relapse and have important implications for treatment.

Objective

The Time to Relapse Questionnaire (TRQ), a self-administered questionnaire, was designed to assess the time from the initial thought of drug use to actual use.

Methods

Psychometric properties of the TRQ were evaluated in two distinct populations (n = 183 and 194) with DSM-IV primary substance use disorders.

Results

Factor analysis and item refine-ment led to a 9-item TRQ with a three-factor solution accounting for 63% of the total variance. Three discrete types of relapse style were identified: Sudden Relapse, Short Delay Relapse, and Long Delay Relapse. The TRQ demonstrated good construct validity and adequate internal consistency for the total (α= .61) and individual factor (α= .64–.75) scores. Measures to assess convergent validity of the TRQ suggest that Sudden Relapse may not reflect more generalized deficits of inhibitory control.

Conclusions and Significance

The TRQ may provide a useful self-report measure to discriminate between addicted patients who relapse without forewarning compared to those with a period of delay. Clinical interventions may be targeted towards different relapse styles.

Previous observational studies using differing methodologies have yielded inconsistent results regarding the association between glycemic control and outcomes in diabetic patients receiving maintenance hemodialysis (MHD). We examined mortality predictability of A1C and random serum glucose over time in a contemporary cohort of 54,757 diabetic MHD patients (age 63 ± 13 years, 51% men, 30% African Americans, 19% Hispanics). Adjusted all-cause death hazard ratio (HR) for baseline A1C increments of 8.0–8.9, 9.0–9.9, and ≥10%, compared with 7.0–7.9% (reference), was 1.06 (95% CI 1.01–1.12), 1.05 (0.99–1.12), and 1.19 (1.12–1.28), respectively, and for time-averaged A1C was 1.11 (1.05–1.16), 1.36 (1.27–1.45), and 1.59 (1.46–1.72). A symmetric increase in mortality also occurred with time-averaged A1C levels in the low range (6.0–6.9%, HR 1.05 [95% CI 1.01–1.08]; 5.0–5.9%, 1.08 [1.04–1.11], and ≤5%, 1.35 [1.29–1.42]) compared with 7.0–7.9% in fully adjusted models. Adjusted all-cause death HR for time-averaged blood glucose 175–199, 200–249, 250–299, and ≥300 mg/dL, compared with 150–175 mg/dL (reference), was 1.03 (95% CI 0.99–1.07), 1.14 (1.10–1.19), 1.30 (1.23–1.37), and 1.66 (1.56–1.76), respectively. Hence, poor glycemic control (A1C ≥8% or serum glucose ≥200 mg/dL) appears to be associated with high all-cause and cardiovascular death in MHD patients. Very low glycemic levels are also associated with high mortality risk.

Background

Clinically important medication errors are common after hospital discharge. They include preventable or ameliorable adverse drug events as well as medication discrepancies or non-adherence with high potential for future harm (potential adverse drug events).

Objective

The Pharmacist Intervention for Low Literacy in Cardiovascular Disease (PILL-CVD) study sought to determine the effect of a tailored intervention on the occurrence of clinically important medication errors after hospital discharge.

Design

Randomized controlled trial with concealed allocation and blinded outcome assessors.

Setting

Two tertiary care academic hospitals.

Patients

Adults hospitalized with acute coronary syndromes or acute decompensated heart failure.

Intervention

Pharmacist-assisted medication reconciliation, inpatient pharmacist counseling, low-literacy adherence aids, and individualized telephone follow-up after discharge.

Measurements

The primary outcome was the number of clinically important medication errors per patient during the first 30 days after hospital discharge. Secondary outcomes included preventable or ameliorable adverse drug events, as well as potential adverse drug events.

Results

Among 851 participants, 432 (50.8%) experienced 1 or more clinically important medication errors; 23% of such errors were judged to be serious, and 2% life-threatening. Adverse drug events occurred in 258 patients (30.3%) and potential adverse drug events in 253 (29.7%). The intervention did not significantly alter the per-patient number of clinically important medication errors (IRR=0.92; 95% CI, 0.77 to 1.10) or adverse drug events (IRR=1.09; CI, 0.86 to 1.39). Intervention patients tended to have fewer potential adverse drug events (IRR=0.80; CI, 0.61 to 1.04).

Limitations

The characteristics of the study hospitals and participants may limit generalizability.

Conclusions

Clinically important medication errors were present among half of patients after hospital discharge and were not significantly reduced by a health-literacy sensitive, pharmacist-delivered intervention.

HMGB proteins are members of a class of small proteins that are ubiquitous in eukaryotic cells and non-specifically bind to DNA, inducing large-angle DNA bends, enhancing the flexibility of DNA, and likely facilitating numerous important biological interactions. To determine the nature of this behavior for different HMGB proteins, we used atomic force microscopy (AFM) to quantitatively characterize the bend angle distributions of DNA complexes with human HMGB2(Box A), yeast Nhp6A, and two chimeric mutants of these proteins. While all of the HMGB proteins bend DNA to preferred angles, Nhp6A promoted the formation of higher-order oligomer structures and induced a significantly broader distribution of angles, suggesting that the mechanism of Nhp6A is more like a flexible hinge than that of HMGB2(Box A). To determine the structural origins of this behavior, we used portions of the cationic N-terminus of Nhp6A to replace corresponding HMGB2(Box A) sequences. We found that the oligomerization and broader angle distribution correlated directly with the length of the N-terminus incorporated into the HMGB2(Box A) construct. Therefore, the basic N-terminus of Nhp6A is responsible for its ability to act as a flexible hinge and form high order structures.

The present study investigated whether emotional conflict and emotional conflict adaptation could be triggered by unconscious emotional information as assessed in a backward-masked affective priming task. Participants were instructed to identify the valence of a face (e.g., happy or sad) preceded by a masked happy or sad face. The results of two experiments revealed the emotional conflict effect but no emotional conflict adaptation effect. This demonstrates that emotional conflict can be triggered by unconsciously presented emotional information, but participants may not adjust their subsequent performance trial-by trial to reduce this conflict.

Hemianopia patients have lost vision from the contralateral hemifield, but make behavioural adjustments to compensate for this field loss. As a result, their visual performance and behaviour contrast with those of hemineglect patients who fail to attend to objects contralateral to their lesion. These conditions differ in their ocular fixations and perceptual judgments. During visual search, hemianopic patients make more fixations in contralesional space while hemineglect patients make fewer. During line bisection, hemianopic patients fixate the contralesional line segment more and make a small contralesional bisection error, while hemineglect patients make few contralesional fixations and a larger ipsilesional bisection error. Hence, there is an attentional failure for contralesional space in hemineglect but a compensatory adaptation to attend more to the blind side in hemianopia. A challenge for models of visual attentional processes is to show how compensation is achieved in hemianopia, and why such processes are hindered or inaccessible in hemineglect. We used a neurophysiology-derived computational model to examine possible cortical compensatory processes in simulated hemianopia from a V1 lesion and compared results with those obtained with the same processes under conditions of simulated hemineglect from a parietal lesion. A spatial compensatory bias to increase attention contralesionally replicated hemianopic scanning patterns during visual search but not during line bisection. To reproduce the latter required a second process, an extrastriate lateral connectivity facilitating form completion into the blind field: this allowed accurate placement of fixations on contralesional stimuli and reproduced fixation patterns and the contralesional bisection error of hemianopia. Neither of these two cortical compensatory processes was effective in ameliorating the ipsilesional bias in the hemineglect model. Our results replicate normal and pathological patterns of visual scanning, line bisection, and differences between hemianopia and hemineglect, and may explain why compensatory processes that counter the effects of hemianopia are ineffective in hemineglect.

Brain regions in the intraparietal and the premotor cortices selectively process visual and multisensory events near the hands (peri-hand space). Visual information from the hand itself modulates this processing potentially because it is used to estimate the location of one’s own body and the surrounding space. In humans specific occipitotemporal areas process visual information of specific body parts such as hands. Here we used an fMRI block-design to investigate if anterior intraparietal and ventral premotor ‘peri-hand areas’ exhibit selective responses to viewing images of hands and viewing specific hand orientations. Furthermore, we investigated if the occipitotemporal ‘hand area’ is sensitive to viewed hand orientation. Our findings demonstrate increased BOLD responses in the left anterior intraparietal area when participants viewed hands and feet as compared to faces and objects. Anterior intraparietal and also occipitotemporal areas in the left hemisphere exhibited response preferences for viewing right hands with orientations commonly viewed for one’s own hand as compared to uncommon own hand orientations. Our results indicate that both anterior intraparietal and occipitotemporal areas encode visual limb-specific shape and orientation information.

In total hip arthroplasty, determining the impingement free range of motion requirement is a complex task. This is because in the native hip, motion is restricted by both impingement as well as soft tissue restraint. The aim of this study is to determine a range of motion benchmark which can identify motions which are at risk from impingement and those which are constrained due to soft tissue. Two experimental methodologies were used to determine motions which were limited by impingement and those motions which were limited by both impingement and soft tissue restraint. By comparing these two experimental results, motions which were limited by impingement were able to be separated from those motions which were limited by soft tissue restraint. The results show motions in extension as well as flexion combined with adduction are limited by soft tissue restraint. Motions in flexion, flexion combined with abduction and adduction are at risk from osseous impingement. Consequently, these motions represent where the maximum likely damage will occur in femoroacetabular impingement or at most risk of prosthetic impingement in total hip arthroplasty.

Electronic supplementary material

The online version of this article (doi:10.1007/s11517-012-1016-3) contains supplementary material, which is available to authorized users.

Others’ gaze and emotional facial expression are important cues for the process of attention orienting. Here, we investigated with magnetoencephalography (MEG) whether the combination of averted gaze and fearful expression may elicit a selectively early effect of attention orienting on the brain responses to targets. We used the direction of gaze of centrally presented fearful and happy faces as the spatial attention orienting cue in a Posner-like paradigm where the subjects had to detect a target checkerboard presented at gazed-at (valid trials) or non gazed-at (invalid trials) locations of the screen. We showed that the combination of averted gaze and fearful expression resulted in a very early attention orienting effect in the form of additional parietal activity between 55 and 70 ms for the valid versus invalid targets following fearful gaze cues. No such effect was obtained for the targets following happy gaze cues. This early cue-target validity effect selective of fearful gaze cues involved the left superior parietal region and the left lateral middle occipital region. These findings provide the first evidence for an effect of attention orienting induced by fearful gaze in the time range of C1. In doing so, they demonstrate the selective impact of combined gaze and fearful expression cues in the process of attention orienting.

This study aimed to assess the potential association between age-related prefrontal brain changes and slot machine gambling, an activity that has become increasingly popular among older adults. Functional magnetic resonance imaging was used to assess healthy older and younger adults whilst playing a slot machine. Results revealed that the older group over-recruited several bilateral and contralateral brain structures relative to the younger group. Specifically, older adults exhibited increased neural activation in the superior prefrontal cortex and left orbitofrontal cortex, indicating greater reliance on these structures. These results suggest a compensatory mechanism, by which older adults recruit a greater number of neural networks from both hemispheres to complete the same gambling task as their younger peers. The broader implications of these findings are discussed in relation to theories of neurocognitive and degenerative change that occurs in late adulthood.

Background

Rheumatoid Arthritis (RA) commonly affects the hands and wrists with inflammation, deformity, pain, weakness and restricted mobility leading to reduced function. The effectiveness of exercise for RA hands is uncertain, although evidence from small scale studies is promising. The Strengthening And Stretching for Rheumatoid Arthritis of the Hand (SARAH) trial is a pragmatic, multi-centre randomised controlled trial evaluating the clinical and cost effectiveness of adding an optimised exercise programme for hands and upper limbs to best practice usual care for patients with RA.

Methods/design

480 participants with problematic RA hands will be recruited through 17 NHS trusts. Treatments will be provided by physiotherapists and occupational therapists. Participants will be individually randomised to receive either best practice usual care (joint protection advice, general exercise advice, functional splinting and assistive devices) or best practice usual care supplemented with an individualised exercise programme of strengthening and stretching exercises. The study assessors will be blinded to treatment allocation and will follow participants up at four and 12 months. The primary outcome measure is the Hand function subscale of the Michigan Hand Outcome Questionnaire, and secondary outcomes include hand and wrist impairment measures, quality of life, and resource use. Economic and qualitative studies will also be carried out in parallel.

Discussion

This paper describes the design and development of a trial protocol of a complex intervention study based in therapy out-patient departments. The findings will provide evidence to support or refute the use of an optimised exercise programme for RA of the hand in addition to best practice usual care.

Trial registration

Current Controlled Trials ISRCTN89936343

ChEBI (http://www.ebi.ac.uk/chebi) is a database and ontology of chemical entities of biological interest. Over the past few years, ChEBI has continued to grow steadily in content, and has added several new features. In addition to incorporating all user-requested compounds, our annotation efforts have emphasized immunology, natural products and metabolites in many species. All database entries are now ‘is_a’ classified within the ontology, meaning that all of the chemicals are available to semantic reasoning tools that harness the classification hierarchy. We have completely aligned the ontology with the Open Biomedical Ontologies (OBO) Foundry-recommended upper level Basic Formal Ontology. Furthermore, we have aligned our chemical classification with the classification of chemical-involving processes in the Gene Ontology (GO), and as a result of this effort, the majority of chemical-involving processes in GO are now defined in terms of the ChEBI entities that participate in them. This effort necessitated incorporating many additional biologically relevant compounds. We have incorporated additional data types including reference citations, and the species and component for metabolites. Finally, our website and web services have had several enhancements, most notably the provision of a dynamic new interactive graph-based ontology visualization.

Objectives

To describe geographical and dispersion patterns of men who have sex with men (MSM)-related venues in a large East African city and their associations with times, participants and venue type.

Methods

Mapping of MSM sites in Dar es Salaam was carried out by community research workers who catalogued, observed and reported data on venue sites, formality, times of operation, type of participant, police or vigilante activity, length of operation and the degree to which it is known both in and outside the MSM and gay communities.

Results

There is a large and widely disseminated MSM/gay satellite cultures of at least 98 sites, which has some formal sites, but is largely informal and operates within mixed entertainment environments and at particular times (including some weekend-only locales) across the city. There is a mix of places for sexual contact, largely social venues and sex on location sites. Cruising appears to be limited to open spaces and parks, with no vehicular component and almost no internet component. They are widely disseminated across all suburbs and there is no central location for MSM activities. MSM sex workers (SWs) operate at a third of these sites.

Conclusions

There is a large number of ‘local’ MSM contact, social and sex sites and any work with MSM will have to include these less-formal and less-known sites. The widely disseminated nature of the MSM sites, however, also suggests that sexual networks may not be closely linked between sites. The climate of stigma, abuse and potential violence appear to be limiting the development of more formal sites. This pattern is probably typical of other large urban areas in East Africa and perhaps across sub-Saharan Africa (SSA).

Eukaryotic High-Mobility Group B (HMGB) proteins alter DNA elasticity while facilitating transcription, replication and DNA repair. We developed a new single-molecule method to probe non-specific DNA interactions for two HMGB homologs: the human HMGB2 box A domain and yeast Nhp6Ap, along with chimeric mutants replacing neutral N-terminal residues of the HMGB2 protein with cationic sequences from Nhp6Ap. Surprisingly, HMGB proteins constrain DNA winding, and this torsional constraint is released over short timescales. These measurements reveal the microscopic dissociation rates of HMGB from DNA. Separate microscopic and macroscopic (or local and non-local) unbinding rates have been previously proposed, but never independently observed. Microscopic dissociation rates for the chimeric mutants (∼10 s−1) are higher than those observed for wild-type proteins (∼0.1–1.0 s−1), reflecting their reduced ability to bend DNA through short-range interactions, despite their increased DNA-binding affinity. Therefore, transient local HMGB–DNA contacts dominate the DNA-bending mechanism used by these important architectural proteins to increase DNA flexibility.

Over the past century, the total material wealth of humanity has been enhanced. However, in the twenty-first century, we face scarcity in critical resources, the degradation of ecosystem services, and the erosion of the planet’s capability to absorb our wastes. Equity issues remain stubbornly difficult to solve. This situation is novel in its speed, its global scale and its threat to the resilience of the Earth System. The advent of the Anthropence, the time interval in which human activities now rival global geophysical processes, suggests that we need to fundamentally alter our relationship with the planet we inhabit. Many approaches could be adopted, ranging from geo-engineering solutions that purposefully manipulate parts of the Earth System to becoming active stewards of our own life support system. The Anthropocene is a reminder that the Holocene, during which complex human societies have developed, has been a stable, accommodating environment and is the only state of the Earth System that we know for sure can support contemporary society. The need to achieve effective planetary stewardship is urgent. As we go further into the Anthropocene, we risk driving the Earth System onto a trajectory toward more hostile states from which we cannot easily return.

MetaboLights (http://www.ebi.ac.uk/metabolights) is the first general-purpose, open-access repository for metabolomics studies, their raw experimental data and associated metadata, maintained by one of the major open-access data providers in molecular biology. Metabolomic profiling is an important tool for research into biological functioning and into the systemic perturbations caused by diseases, diet and the environment. The effectiveness of such methods depends on the availability of public open data across a broad range of experimental methods and conditions. The MetaboLights repository, powered by the open source ISA framework, is cross-species and cross-technique. It will cover metabolite structures and their reference spectra as well as their biological roles, locations, concentrations and raw data from metabolic experiments. Studies automatically receive a stable unique accession number that can be used as a publication reference (e.g. MTBLS1). At present, the repository includes 15 submitted studies, encompassing 93 protocols for 714 assays, and span over 8 different species including human, Caenorhabditis elegans, Mus musculus and Arabidopsis thaliana. Eight hundred twenty-seven of the metabolites identified in these studies have been mapped to ChEBI. These studies cover a variety of techniques, including NMR spectroscopy and mass spectrometry.

Missing in metastasis (MIM) is a member of newly emerged inverse BAR-domain protein family and a putative metastasis suppressor. Although reduced MIM expression has been associated with bladder, breast, gastric cancers, evidence for the role of MIM in tumor progression remains scarce and controversial. Herein we characterized a MIM knockout mouse strain and observed that MIM deficient mice often developed enlarged spleens. Autopsy and histological analysis revealed that nearly 78% of MIM(−/−) mice developed tumors with features similar to diffuse large B lymphoma during a period from one to two years. MIM(−/−) mice also exhibited abnormal distribution of B cells in lymphoid organs with decrease in the spleen but increase in the bone marrow and the peripheral blood. Furthermore, the bone marrow of MIM(−/−) mice contained a higher percentage of pre-B2 cells but fewer immature B-cells than wild type mice. In response to CXCL13, a B-cell chemokine released from splenic stromal cells, MIM deficient B-cells did not undergo chemotaxis or morphologic changes in response to the chemokine and also did not internalize CXCR5, the receptor of CXCL13. Microarray analyses demonstrated that MIM is the only member of the I-BAR domain family that was highly expressed in human B cells. However, low or absent MIM expression was common in either primary B-cell malignancies or established B-cell acute lymphocytic leukemia or lymphomas. Thus, our data demonstrate for the first time an important role for MIM in B-cell development and suggests that predisposition of MIM null mice to lymphomagenesis may involve aberrant interactions between B lineage cells and the lymphoid microenvironment.

Introduction

Increasing evidence indicates that gender equity has a significant influence on women’s health; yet few culturally specific indicators of gender relations exist which are applicable to health. This study explores dimensions of gender relations perceived by female undergraduate students in southern Vietnamese culture, and qualitatively examines how this perceived gender inequity may influence females’ sexual or reproductive health.

Methods

Sixty-two female undergraduate students from two universities participated in eight focus group discussions to talk about their perspectives regarding national and local gender equity issues.

Results

Although overall gender gaps in the Mekong Delta were perceived to have decreased in comparison to previous times, several specific dimensions of gender relations were emergent in students’ discussions. Perceived dimensions of gender relations were comparable to theoretical structures of the Theory of Gender and Power, and to findings from several reports describing the actual inferiority of women. Allocation of housework and social paid work represented salient dimensions of labor. The most salient dimension of power related to women in positions of authority. Salient dimensions of cathexis related to son preference, women’s vulnerability to blame or criticism, and double standards or expectations. Findings also suggested that gender inequity potentially influenced women’s sexual and reproductive health as regards to health information seeking, gynecological care access, contraceptive use responsibility, and child bearing.

Conclusion

Further investigations of the associations between gender relations and different women’s sexual and reproductive health outcomes in this region are needed. It may be important to address gender relations as a distal determinant in health interventions in order to promote gender-based equity in sexual and reproductive health.

Abstract

Aims

Down Syndrome (DS), a genetic disease caused by a triplication of chromosome 21, is characterized by increased markers of oxidative stress. In addition to cognitive defects, patients with DS also display hematologic disorders and increased incidence of infections and leukemia. Using the Ts65Dn mouse model of DS, the goal of this study was to examine hematopoietic stem and lymphoid progenitor cell function in DS.

Results

Analysis of hematopoietic progenitor populations showed that Ts65Dn mice possessed fewer functional hematopoietic stem cells and a significantly decreased percentage of bone marrow lymphoid progenitors. Increased reactive oxygen species and markers of oxidative stress were detected in hematopoietic stem cell populations and were associated with a loss of quiescence. Bone marrow progenitor populations expressed diminished levels of the IL-7Rα chain, which was associated with decreased proliferation and increased apoptosis. Modulating oxidative stress in vitro suggested that oxidative stress selectively leads to decreased IL-7Rα expression, and inhibits the survival of IL-7Rα-expressing hematopoietic progenitors, potentially linking increased reactive oxygen species and immunopathology.

Innovation

The study results identify a link between oxidative stress and diminished IL-7Rα expression and function. Further, the data suggest that this decrease in IL-7Rα is associated with defective hematopoietic development in Down Syndrome.

Conclusion

The data suggest that hematopoietic stem and lymphoid progenitor cell defects underlie immune dysfunction in DS and that increased oxidative stress and reduced cytokine signaling may alter hematologic development in Ts65Dn mice. Antioxid. Redox Signal. 15, 2083–2094.

Interviews were conducted with 203 male and 95 female heroin injectors aged 17 to 25 in Dar es Salaam, Tanzania. Nearly one-quarter of participants reported injecting with needles used by someone else. Few reported cleaning needles with bleach. Multiple sexual partnerships, unprotected sex, and trading sex for money were especially present among women, the majority (55%) of whom was HIV seropositive. Self reports suggest the presence of heroin dependence among users. While most participants expressed a desire to quit their use, only 14 (5%) had been in treatment. There appears to be a large unmet need for heroin use treatment. These findings need to be considered in light of a potential forthcoming wave of heroin injection in sub-Saharan Africa.

Background

We physically interact with external stimuli when they occur within a limited space immediately surrounding the body, i.e., Peripersonal Space (PPS). In the primate brain, specific fronto-parietal areas are responsible for the multisensory representation of PPS, by integrating tactile, visual and auditory information occurring on and near the body. Dynamic stimuli are particularly relevant for PPS representation, as they might refer to potential harms approaching the body. However, behavioural tasks for studying PPS representation with moving stimuli are lacking. Here we propose a new dynamic audio-tactile interaction task in order to assess the extension of PPS in a more functionally and ecologically valid condition.

Methodology/Principal Findings

Participants vocally responded to a tactile stimulus administered at the hand at different delays from the onset of task-irrelevant dynamic sounds which gave the impression of a sound source either approaching or receding from the subject’s hand. Results showed that a moving auditory stimulus speeded up the processing of a tactile stimulus at the hand as long as it was perceived at a limited distance from the hand, that is within the boundaries of PPS representation. The audio-tactile interaction effect was stronger when sounds were approaching compared to when sounds were receding.

Conclusion/Significance

This study provides a new method to dynamically assess PPS representation: The function describing the relationship between tactile processing and the position of sounds in space can be used to estimate the location of PPS boundaries, along a spatial continuum between far and near space, in a valuable and ecologically significant way.

Exciting funding initiatives are emerging in Europe and the US for metabolomics data production, storage, dissemination and analysis. This is based on a rich ecosystem of resources around the world, which has been build during the past ten years, including but not limited to resources such as MassBank in Japan and the Human Metabolome Database in Canada. Now, the European Bioinformatics Institute has launched MetaboLights, a database for metabolomics experiments and the associated metadata (http://www.ebi.ac.uk/metabolights). It is the first comprehensive, cross-species, cross-platform metabolomics database maintained by one of the major open access data providers in molecular biology. In October, the European COSMOS consortium will start its work on Metabolomics data standardization, publication and dissemination workflows. The NIH in the US is establishing 6–8 metabolomics services cores as well as a national metabolomics repository. This communication reports about MetaboLights as a new resource for Metabolomics research, summarises the related developments and outlines how they may consolidate the knowledge management in this third large omics field next to proteomics and genomics.

Background

Worldwide, the literature on sexual behaviour has documented associations between gender-based relationship inequality and sexual communication ability and the actual use of condoms or other contraceptives among young women. This study aimed to examine these associations among undergraduate female students in the Mekong Delta of Vietnam.

Methods

A cross-sectional survey of 1181 female third-year students from two universities in the Mekong Delta was conducted. Latent variable modelling and logistic regression were employed to examine the hypothesised associations.

Results

Among the 72.4% of students who had ever had boyfriends, 44.8% indicated that their boyfriends had asked for sex, 13% had had penile–vaginal sex and 10.3% had had oral sex. For those who had had penile–vaginal sex, 33% did not use any contraceptive method, including condoms, during their first sexual intercourse. The greater a student’s perception that women were subordinate to men, the lower her self-efficacy for sexual communication and the lower her actual frequency of discussing safer sex matters and asking her partner to use a condom. Sexual communication self-efficacy was associated with actual contraceptive use (P = 0.039) but only marginally with condom use (P = 0.092) at first sexual intercourse.

Conclusion

Sexual health promotion strategies should address the influence of gender relations on young women’s sexual communication self-efficacy and the subsequent impact on actual contraceptive and condom use.

Abstract

Background

The 2010 Cochrane Collaboration Review reported laser acupuncture as being effective in depression. The treatment was on LR 8, LR 14, CV 14, and HT 7 over 12 sessions within a 2-month period.

Objective

The aim of this study was to investigate the biological plausibility of low-intensity laser acupuncture as an antidepressant treatment.

Design

Randomized stimulation with a fiber-optic infrared laser on these acupoints and KI 3 acupoint. We used a blocked design, alternating laser and placebo laser/rest blocks, while the blood oxygenation level-dependent (BOLD) fMRI response was recorded from the whole brain on a 3T MRI scanner.

Setting

This study took place at the research institute.

Subjects

Ten subjects were studied, as confirmed by the Hamilton Depression Rating Scale (HAM-D17).

Intervention

Low-intensity laser acupuncture.

Main outcome measures

Significant brain patterns for each acupoint greater than the other acupoints and placebo.

Results

Each acupoint laser stimulation condition resulted in a different activation size and pattern of neural activity. Regions with significantly increased activation and deactivation compared to placebo included fronto-limbic-striatal brain regions. There was no significant activation or deactivation with KI 3. Blinding was afforded with the block design and the infrared laser.

Conclusions

There is positive biological evidence to support the empirical evidence for laser acupuncture in the treatment of depression. With its minimal adverse effect profile and ease of application, laser acupuncture should be included in depression management strategies.