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Biomedical subjects

A Raj

Publications and source records attributed to A Raj.

34 records · Page 2Linked to original sources
PubMed1998

Community empowerment paradigm drift and the primary prevention of HIV/AIDS.

Long discussed in the public health arena, the concept of empowerment has only recently entered the discourse on the primary prevention of HIV/AIDS in the United States. Despite its broad appeal, empowerment has not been systematically incorporated into theory-based interventions, which may reflect a lack of consensus on the meaning of empowerment, how to measure it, and the intervention strategies it implies. The purpose of this paper is to consider the relevance of empowerment to community interventions for persons at risk for HIV, particularly women. The origins of empowerment are reviewed; community empowerment as an intervention framework is described and its core assumptions defined. There is some evidence of the growing influence of empowerment and related concepts in recent HIV-related policy, research, and programs funded through the Centers for Disease Control and Prevention. However, adoption of an empowerment framework for HIV prevention will require further theory and measurement development, as well as changes in how public health researchers and practitioners work with the communities they serve.

Community Medicine↗
PubMed1998

Gender and suicide in India: a multiperspective approach.

The gap between male and female suicide rates in India is relatively small. However, society's views on female and male motives are quite different. In order to investigate the perceptions of male and female suicide, we interviewed a focus group of university professors as well as police inspectors, crime reporters, and hospital nurses in Bangalore. We also obtained four narratives of suicide. Women tended to be blamed for their own or their husband's suicide, although they were also viewed more often as victims of life adversities than men. A historical review illustrates that both men and women have been associated with culturally sanctioned suicides. One known form is sati, and we discuss the recent case of sati-murder of Roop Kanwar in 1987. The social sciences and the media also pay a lot of attention to the typical female suicides, symbolizing their role as martyrs of society, which seems to compensate for attribution of blame.

Attitude↗
PubMed1997

Sequence variations in EBNA-1 may dictate restriction of tissue distribution of Epstein-Barr virus in normal and tumour cells.

In seropositive individuals Epstein-Barr virus (EBV) establishes a virus reservoir in peripheral blood lymphocytes (PBLs). Transmission from one individual to another occurs via saliva due to a lytic (virion productive) phase of infection in the oropharynx. EBNA-1 is responsible for maintaining viral episomes in the host cell and could, therefore, also affect the persistence of the virus in different cell lineages. Based on sequence analysis of EBNA-1 we now demonstrate that (i) in addition to the prototype EBNA-1 (identical to the B95.8 virus EBNA-1), EBV in normal individuals encompasses multiple EBNA-1 subtypes, both in PBLs and in oral secretions; (ii) although EBV with prototype EBNA-1 is the predominant virus in normal individuals, it is very rarely associated with either nasopharyngeal carcinoma (NPC) or Burkitt's lymphoma (BL); (iii) EBV with an EBNA-1 subtype (V-val) frequently associated with NPC is also selectively detected in oral secretions and not in PBLs; (iv) EBV with the EBNA-1 subtype V-pro is restricted to PBLs, while a mutated version of this subtype is present in BL, but not in NPC. These findings suggest that the variations in EBNA-1 may be relevant to the ability of EBV to persist in different cell types, and hence relevant to its oncogenic potential.

Amino Acid Sequence↗
PubMed1996

Variation in the sequence of Epstein Barr virus nuclear antigen 1 in normal peripheral blood lymphocytes and in Burkitt's lymphomas.

We have examined sequence variations in the EBNA-1 protein of EBV in normal peripheral blood lymphocytes (PBL) and Burkitt's lymphomas (BL). We find two EBNA-1 strains P (prototype) and V (variant) which differ by 15 amino acids. Each strain has two subtypes defined by the amino acid at position 487 (P-ala, P-thr, V-pro and V-leu). In PBLs from 32 normal individuals, up to three of these subtypes were found in each sample, but the V strain did not occur in the absence of P strain viruses, nor was the V-leu subtype ever observed in normal PBL. In BLs only a single subtype was observed in each tumor. The P-thr and V-leu subtypes were more frequently seen than the P-ala and V-pro subtypes, which occurred in only two and one of the 36 tumor samples respectively. The P-thr was the most commonly observed subtype in peripheral blood of both American and African lymphocytes as well as in African tumors. However, in 11 of 12 American tumors, the EBNA-1 subtype was V-leu. These data indicate that some EBNA-1 subtypes are more likely to lead to oncogenesis, and one subtype, V-leu, appears only to occur in tumors.

Amino Acid Sequence↗
PubMed1996

Identification of social cognitive variables as predictors of safer sex behavior and intent in heterosexual college students.

The purpose of this study was to identify social cognitive factors significantly associated with consistent condom use and safer sex intentions for heterosexual college students. No or new relationship involvement, positive attitudes toward condoms, higher HIV risk perceptions, being male, and being younger were associated with more consistent condom use. Higher HIV risk perceptions, positive attitudes toward condoms, safer sex negotiation, no or newer relationship involvement, lower classification, and higher safer sex perceptions of self-efficacy were associated with increased intent to engage in safer sex. HIV knowledge was not associated with safer sex intent or condom use. HIV intervention must go beyond presenting information. Intervention must incorporate social cognitive factors associated with safer sex intent and practice into their design, targeting groups and building safer sex skills.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Factors predicting high-risk sexual behavior in heterosexual college females.

The purpose of this study was to determine which factors based in social cognitive theory are associated with risky sexual behavior in heterosexual college females. Results showed that negative attitudes toward condoms and toward involvement in a relationship were associated with less consistent condom use; frequent alcohol use preceding intercourse and low sexual satisfaction were associated with less consistent contraceptive use. Sex education on the college campus currently provides protection information only; these strategies have not proved successful. We encourage the development of more comprehensive educational strategies, which include discussion of the social cognitive factors shown here to be associated with risky sexual behavior.

Adult↗
PubMed1993

Vestibular and balance rehabilitation therapy.

A prospective observational study of the performance of patients enrolled in an individually customized program of habituation and balance rehabilitation physical therapy was conducted from January 1988 to January 1990. Patients ranged in age from 20 to 89 years, with a wide variety of diagnoses. Two global outcome measures--posttherapy symptom response score and pretherapy and posttherapy disability score--were developed and used to judge overall patient performance. In addition, two specific indicators--one for balance performance (dynamic posturography) and one for sensitivity to rapid head movements (motion sensitivity quotient)--were used to measure performance in these two areas. Results indicate statistically significant changes before versus after therapy for both specific measures, and 80% to 85% of the patients showed a reduction in symptoms and disability score following therapy. Analysis of variance and multiple regression analysis indicate that nature of symptoms, pretherapy disability level, history of head injury, and results on dynamic posturography were the variables most predictive of therapy outcome, while age and duration of symptoms made no difference. Other variables, such as medications and site of lesion, were found to affect the length of therapy but not the outcome.

Disability Evaluation↗
PubMed1990

Mitral valve prolapse and panic disorder.

The literature and clinical experience suggest a higher-than-normal incidence of mitral valve prolapse in patients with panic disorder, although the relationship between these two conditions is currently a matter of speculation. Patients with panic disorder are likely to first consult their family practitioner or internist, who may then refer them to a psychiatrist. Hence psychiatrists should be familiar with the signs, symptoms, and management of mitral valve prolapse. The authors describe mitral valve prolapse, panic disorder, and their association, then suggest a strategy for evaluation and treatment of these conditions.

Anxiety Disorders↗
PubMed1987

Medical evaluation of panic attacks.

Panic disorder with or without agoraphobia is dominated by the occurrence of panic attacks. However, panic attacks are also reported to occur as part of the clinical picture in several medical conditions, notably thyroid disease, hypoglycemia, and pheochromocytoma. The authors examine these conditions, review the relevant literature, and offer an evaluation strategy. Routine screening is not recommended. Panic disorder is also associated with mitral-valve prolapse and temporal lobe seizures. The authors explore the possible consequences of this association and outline an evaluation strategy. Again, routine screening is not recommended.

Adrenal Gland Neoplasms↗
PubMed1986

Detection of neural tube defects with alpha-fetoprotein measurement in amniotic fluid. A protocol for managing elevated values.

The clinical efficacy of rocket immunoelectrophoresis (RIE) and radioimmunoassay (RIA) methods for the measurement of amniotic fluid alpha-fetoprotein (AFP) were compared in separate series of over 1,000 pregnancies each. Using a mean +3 SD limit, 21 of 1,414 pregnancies monitored with RIE and 21 of 1,006 monitored with RIA were interpreted as having borderline elevated values. Five of the elevated AFP values in each series represented abnormal fetuses. No neural tube defects went undetected, although one was recognized only with ultrasound. Only two of seven abnormal fetuses had a family history of neural tube defects, indicating that maternal serum AFP measurement is an important preventive measure in pregnancies that are not recognized as at high risk. The data support the use of commercially available RIA kits for amniotic fluid AFP measurement and suggest a protocol for management of elevated values.

Amniotic Fluid↗
PubMed1985

The phenotypic and cytogenetic spectrum of partial trisomy 9.

A new patient with trisomy for the chromosome segment 9pter----q22 is compared to 19 previously reported cases of partial trisomy 9. Manifestations such as microcephaly, prominent nasal root, bulbous nose, and down-turned corners of the mouth are common to patients with trisomic segments extending from 9p21 to 9q13, while intra-uterine growth retardation, cleft lip/palate, skeletal anomalies, and heart defects are more common with trisomic segments extending through 9q22-9q32. A graphic method illustrates this progression in the partial trisomy 9 malformation spectrum as the triplicated chromosome region extends from bands 9p21 to 9q32. More severe and random defects are observed with complete trisomy 9 or tetrasomy 9p, suggesting an extreme excess of material greatly increases developmental variability.

Abnormalities, Multiple↗
PubMed1984

Bicarbonate hemodialysis: influence on plasma refilling and hemodynamic stability.

The present study compares the effect of sodium bicarbonate (LoNaHCO3, Na = 134, HCO3 = 33 mEq/l) and sodium acetate (LoNaAc, Na = 134, acetate 33 mEq/1)dialysate on the extravascular fluid mobilization (VFM) and hemodynamic changes in 6 patients during 3 h of hemodialysis with equivalent fluid ultrafiltration of about 600 ml/h. The cumulative decrease in plasma volume after 1, 2 and 3 h of dialysis was significantly less during LoNaHCO3 dialysis than during LoNaAc dialysis, with plasma volume almost completely refilled by VFM during the first 2 h of LoNaHCO3 dialysis. High sodium acetate dialysate (HiNaAc, Na = 144, acetate = 33 mEq/1) with equivalent fluid ultrafiltration also resulted in less net decrease in plasma volume and greater VFM than LoNaAc, although the temporal pattern of refilling was somewhat different from that during LoNaHCO3: rapid and complete refilling during the early portion of LoNaHCO3, slower and more progressive refilling during HiNaAc, with similar cumulative refilling for LoNaHCO3 and HiNaAc by 3 h. Mean arterial pressure (MAP) tended to decrease during LoNaAc dialysis, whereas MAP remained stable during LoNaHCO3 and increased slightly during HiNaAc. This study, therefore, suggests that improved hemodynamic stability utilizing bicarbonate dialysate may be due, in part, to greater plasma refilling and better preservation of plasma volume.

Acetates↗
PubMedDate not supplied

Racial/ethnic disparities in the HIV and substance abuse epidemics: communities responding to the need.

In 1998, community leaders prompted members of the Black and Hispanic Congressional Caucuses to urge President Clinton to declare HIV/AIDS a crisis in the African American and Latino communities; their advocacy resulted in the formation of the Minority AIDS Initiative. As part of this initiative, the Center for Substance Abuse Prevention (CSAP) of the Substance Abuse and Mental Health Services Agency funded the Substance Abuse and HIV Prevention Youth and Women of Color Initiative (CSAP Initiative). The CSAP Initiative is the first major federal effort to develop community-based integrated HIV and substance abuse prevention approaches targeting racial/ethnic populations that have been disproportionately impacted by HIV/AIDS. This article describes the current state of HIV prevention research involving racial/ethnic minority populations and the current status of the CSAP Initiative. The data collected through the CSAP Initiative, implemented by 47 community organizations, will help to fill the existing knowledge gap about how to best prevent HIV in these communities. This data collection effort is an unparalleled opportunity to learn about risk and protective factors, including contextual factors, that are critical to the prevention of HIV/AIDS in African American, Latino, and other racial/ethnic minority communities but that are often not investigated.

Adolescent↗
PubMedDate not supplied

Is a general women's health promotion program as effective as an HIV-intensive prevention program in reducing HIV risk among Hispanic women?

OBJECTIVE: This study aimed to assess whether participants in an HIV-intensive prevention program and participants in a general women's health promotion program reported greater HIV risk-reduction than participants in a wait-list control group immediately following program participation and at three-month follow-up. METHODS: The authors studied 162 Hispanic women ages 18 to 35 years, most of them immigrants. Three-fourths of the sample (74%) reported earning less than $800 a month, 29% did not have a high school degree, and 90% had children. Data were gathered through surveys at baseline, at intervention completion, and at three-month follow-up. Information was collected on sociodemographics, HIV risk factors, and risk behaviors. Crude and adjusted (for demographics and dose) logistic regression analyses were used to assess program effects on participants' risk reduction. RESULTS: Crude logistic regression analyses reveal that both programs resulted in increased condom use at post-test and follow-up. Only participants in the HIV-intensive prevention program reported increased safer sex negotiation at post-test and follow-up, however, and only participants in the women's health promotion program reported increased HIV testing at post-test. CONCLUSION: Both interventions increased condom use. The HIV-intensive prevention program appeared to be more effective in promoting safer sex negotiation, and the women's health promotion program appeared more effective in promoting HIV testing. The findings suggest that both approaches may be viable ways to package HIV prevention for short-term behavior change in this population.

AIDS Serodiagnosis↗